Near-infrared spectrometry in pregnancy: progress and perspectives, a review of literature

Near-infrared spectroscopy (NIRS) allows continuous noninvasive monitoring of in vivo oxygenation in selected tissues. It has been used primarily as a research tool for several years, but it is seeing wider application in the clinical arena all over the world. It was recently used to monitor brain circulation in cardiac surgery, carotid endarteriectomy, neurosurgery and robotic surgery. According to the few studies used NIRS in pregnancy, it may be helpful to assess the impact of severe forms of preeclampsia on brain circulation, to evaluate the  efficacy of different treatments. It may also be used during cesarean section to detect earlier sudden  complications. The evaluation of placental function via abdominal maternal approach to detect fetal growth restriction is a new field of application of NIRS.Key words: Near-Infrared Spectrometry, pregnancy, preeclamsia, cesarean sectio

Réhabilitation précoce post césarienne: enquête de pratique auprès des maternités de la région de Sfax en Tunisie

Introduction: Bien que la plupart des principes de réhabilitation précoce post césarienne paraissent applicable dans nos structures de soins, il semble que la mise en oeuvre reste limitée. Méthodes: Il s'agit d'une enquête structurée par courrier électronique auprès des médecins anesthésistes de la région de Sfax décrivant leurs pratiques habituelles dans les maternités étatiques et privées de la région de Sfax. Nous avons utilisé un questionnaire dans le cadre de prise en charge de la césarienne programmée. Résultats: Le taux de réponse des médecins était de 68% (30/44). L'analgésie orale a été débutée au cours des 24 premières heures par 13% des anesthésistes. La perfusion post opératoire a été arrêtée avant 24h dans 27% des cas. Le Retrait de la sonde < H6, la reprise des boissons < H6, la reprise de l'alimentation < H12 ont été observé respectivement dans 57%, 63% et 30% des cas. L'emploi d'ocytocine limité à H6 est la conduite de 60% des médecins interrogés. La carbétocine est encore non utilisée. Conclusion: Les différents composants de la réhabilitation précoce post césarienne sont encore insuffisamment mis en oeuvre.Pan African Medical Journal 2016; 2

The analgesic effect of clonidine as an adjuvant in dorsal penile nerve block

Introduction: Dorsal penile nerve block (DPNB) is a commonly performed regional anesthetic technique for male circumcision. The aim of this study was to assess the analgesic effect of the adjunction of clonidine to bupivacaine 0.5% in this block. Methods: It was a prospective randomized double-blind clinical trial including 40 ASA1 boys aged from 1 to 4 years undergoing elective circumcision. Dorsal penile nerve block was performed under general Anesthesia. Patients were randomized in two groups: Group 1 (G1) : received 0.1 ml/Kg of bupivacaine 0.5 %with 1μg/kg of clonidine in each side. Group 2 (G2): received 0.1 ml/kg of bupivacaine 0.5 % with placebo in each side. The failure of the DNPB was defined by the increase of heart rate by more than 25% comparing to baseline and in his case an intravenous injection of 20 μg/kg of alfentanyl was given. Post-operative pain was assessed by CHEOPS score. Results: A total of 40 patients were enrolled. Demographic parameters were similar in both groups. We noted no case of DNPB failure in this study. The supply for additional analgesia was seen in 12 patients in group 2 versus 3 cases in group 1. CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) was significantly lower in group 1 from 2nd post operative hour until the 24th hour. Conclusion: Clonidine can be used in dorsal penile nerve block to improve and to prolong its analgesic effects after male circumcision.Pan African Medical Journal 2016; 2

Golden hour for fibrinogen concentrate infusion to improve post partum hemorrhage

ON APPEAL FROM THE FOURTH CIRCUIT COURT, UTAH COUNTY, OREM DEPARTMENT HONORABLE ROBERT J. SUMSION Circuit Judg

Effect of Thermal Radiation and Variable Viscosity on Bioconvective and Thermal Stability of Non-Newtonian Nanofluids under Bidirectional Porous Oscillating Regime

The bioconvective flow of a Jeffrey fluid conveying tiny particles under the effect of an oscillating stretched bidirectional surface is considered in this paper. The effects of thermal radiation and a porous medium are also investigated. The Cattaneo–Christov diffusion theories are used to analyze the heat and mass transfer phenomena. The activation energy effects are included in the concentration equation. The solved dimensionless equations system is established, based on non-dimensional variables. The analytical findings are evaluated using the homotopic analysis technique. The convergence of solutions is ensured. The results are validated by already available published findings and a good concordance is encountered. The fundamental physical aspect of flow parameters is graphically evaluated. The main results reveal that the velocity is reduced by increasing the permeability of the porous medium. An increase in the temperature occurs when the viscosity of the fluid is varied. The obtained results can be useful in thermal systems, energy production, heat transfer devices, solar systems, biofuels, fertilizers, etc

Postoperative analgesia in children when using clonidine in addition to fentanyl with bupivacaine given caudally

The aim of the study was to evaluate the efficacy of clonidine in association with fentanyl as an additive to bupivacaine 0.25% given via single shot caudal epidural in pediatric patients for postoperative pain relief. In the present prospective randomized double blind study, 40 children of ASA-I-II aged 1-5 years scheduled for infraumblical surgical procedures were randomly allocated to two groups to receive either bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg and clonidine 1μg/kg (group I) or bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg (group II). Caudal block was performed after the induction of general anesthesia. Postoperatively patients were observed for analgesia, sedation, hemodynamic parameters, and side effects or complications.Both the groups were similar with respect to patient and various block characteristics. Heart rate and blood pressure were not different in 2 groups. Significantly prolonged duration of post-operative analgesia was observed in group I (P<0.05). Side effects such as respiratory depression, vomiting and bradycardia were similar in both groups. The adjunction of clonidine to fentanyl as additives to bupivacaine in single shot caudal epidural in children may provide better and longer analgesia after infraumblical surgical procedures. The Pan African Medical Journal 2016;2

Prediction of Solar Energy Yield Based on Artificial Intelligence Techniques for the Ha’il Region, Saudi Arabia

In order to satisfy increasing energy demand and mitigate global warming worldwide, the implementation of photovoltaic (PV) clean energy installations needs to become common practice. However, solar energy is known to be dependent on several random factors, including climatic and geographic conditions. Prior to promoting PV systems, an assessment study of the potential of the considered location in terms of power yield should be conducted carefully. Manual assessment tools are unable to handle high amounts of data. In order to overcome this difficulty, this study aims to investigate various artificial intelligence (AI) models—with respect to various intuitive prediction benchmark models from the literature—for predicting solar energy yield in the Ha’il region of Saudi Arabia. Based on the daily data, seven seasonal models, namely, naïve (N), simple average (SA), simple moving average (SMA), nonlinear auto-regressive (NAR), support vector machine (SVM), Gaussian process regression (GPR) and neural network (NN), were investigated and compared based on the root mean square error (RMSE) and mean absolute percentage error (MAPE) performance metrics. The obtained results showed that all the models provided good forecasts over three years (2019, 2020, and 2021), with the naïve and simple moving average models showing small superiority. The results of this study can be used by decision-makers and solar energy specialists to analyze the power yield of solar systems and estimate the payback and efficiency of PV projects

Numerical Study of 3D MHD Mixed Convection and Entropy Generation in Trapezoidal Porous Enclosure Filled with a Hybrid Nanofluid: Effect of Zigzag Wall and Spinning Inner Cylinder

A numerical study was performed to analyze the impact of the combination of several factors on heat transfer rate, flow behavior, and entropy generation in a hybrid nanofluid occupying a porous trapezoid enclosure containing a rotating inner tube. The governing equations were discretized and solved using the Finite Element Method using Comsol multiphysics. The effects of the Darcy and Hartman number, nanoparticle volume fraction (from 0 to 6%), the utilization of various zigzag patterns of the hot wall, and the rotation speed of the inner tube (Ω = 100. 250 and 500) are illustrated and discussed in this work. The outputs reveal that flow intensity has an inverse relationship with Hartman number and a direct relationship with the Darcy number and the velocity of the inner tube, especially at high numbers of undulations of the zigzag hot wall (N = 4); also, intensification of heat transfer occurs with increasing nanoparticle volume fraction, Darcy number and velocity of the inner tube. In addition, entropy generation is strongly affected by the mentioned factors, where increasing the nanoparticle concentration augments the thermal entropy generation and reduces the friction entropy generation; furthermore, the same influence can be obtained by increasing the Hartman number or decreasing the Darcy number. However, the lowest entropy generation was found for the case of Ø = 0, Ha = 0 and Da = 0.01

Three-Dimensional Unsteady Mixed Convection Flow of Non-Newtonian Nanofluid with Consideration of Retardation Time Effects

The advances in nanotechnology led to the development of new kinds of engineered fluids called nanofluids. Nanofluids have several industrial and engineering applications, such as solar energy systems, heat conduction processes, nuclear systems, chemical processes, etc. The motivation of the present work is to analyze and explore the thermal and dynamic behaviors of a non-Newtonian fluid flow under time retardation effects. The flow is unsteady and caused by a bidirectional, periodically moving surface. In addition to the convective heat transfer and fluid flow, the radiation and chemical reactions have also been considered. The governing equations are established based on the modified Cattaneo–Christov heat flux formulation. It was found that the bidirectional velocities oscillate periodically, and that the magnitude of the oscillation increases with the retardation time. Higher temperatures occur when the porosity parameter is increased, and lower concentrations are encountered for higher values of the concentration relaxation parameter. The current results can be applied in thermal systems, heat transfer enhancement, chemical synthesis, solar systems, power generation, medical applications, the automotive industry, process industries, refrigeration, etc