Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Episiotomy and perineal trauma prevalence and obstetric risk factors in Port Harcourt, Nigeria

No Abstract.Nigerian Journal of Medicine Vol. 16 (3) 2007: pp. 242-24

Not Available

Not AvailableRice (Oryza sativa L.) is consumed by more than half of the world's population for whom it is the main source of nutrients and carbohydrates. Rice starch is hydrolyzed by enzymes in the digestive tract and converted into glucose which is the main energy source for metabolic functions. After meeting the energy requirement of the body, the extra calories from starch are stored as glycogen or fats for later use. Therefore, overeating rice with sedentary lifestyle potentially leads to some health problems, such as obesity, type-II diabetes, and colon diseases in long terms especially in Asian countries. Starch hydrolysis begins in the mouth with the action of salivary a-amylase and continues in the small intestine with involvement of other enzymes. However, the resistant starch (RS) which normally comprises < 3% of cooked rice escapes digestion and therefore, its calories are unavailable for use by cells. RSs are categorized into five types based on their mechanism of resistance to enzymatic digestion. Rice contains type 5 RS, wherein amylose forms complex with lipids making it more thermostable. The more the RS, the slower the digestion of rice and the lower is the glycemic index (GI), which is indicative of the ability of food to raise the blood sugar level. The GI of rice is known to be relatively high compared to other starchy foods. It was revealed that increased RS content in rice grain is mediated by soluble starch synthase (SSIIIa), which requires high level expression of granule bound starch synthase (gbssI). In this study, biochemical analysis was done to determine the GI, RS and amylose content (AC) in rice genotypes from different ecologies. Large variation in the value of GI (60.07-70.36), RS (0.35-2.57%) and AC (03.79 -23.32%) was observed. Among the genotypes studied, Mahsuri showed lowest GI (60.07) and highest RS (2.57%). The highest value for GI (70.36) was found in Abhishek with relatively low RS (0.83%). O. brachyantha had the lowest RS content (0.35%) with relatively high GI (68.84). A significant negative correlation (R= -0.688) was also observed between GI and RS. Expression analysis of gbssI was carried out in developing grains of three rice genotypes (Mahsuri, Abhishek and Vandana) differing widely in GI, RS and AC. There was dramatic increase in the expression levels of the gene in the middle stage of grain development in all the three genotypes. Maximum expression of the gene was observed in Mahsuri at middle stage showing a positive correlation between RS content and gbssI expression in the rice cultivars studied. These findings emphasize upon the need to identify and develop rice genotypes with high RS, amylose and low GI which may be suitable for consumption by people suffering from diabetes, obesity and colon diseases.Not Availabl

Haematological and anti-oxidant changes associated with chloroquine resistance reversal by leaf extract of Moringa oleifera Lam

Anti-oxidant and heamatological indices in mice passaged with quinine resistant Plasmodium berghei treated with chloroquine co-administered with flavonoid rich anti-plasmodial fraction of Moringa oleifera leaves were determined in this study. Using Rane’s test, 60 male albino mice were randomized into 10 groups of six mice each. Nine groups were inoculated with quinine resistant strains of Plasmodium berghei and treated with tween 80, 10 mg/kg chloroquine (CQ) co-administered with graded concentrations of fractions of Moringa oleifera leaves, and standard artemisinin combination therapy (ACT) drug, Artemether lumefantrin at a dose of 1.14/6.85 mg/kg, while the uninfected Tenth Group was treated with tween 80. In addition to the parasitaemia suppression, malondialdehyde (MDA), enzymic anti-oxidant activities, non enzymic anti-oxidants concentrations and heamatological indices were determined from blood collected by ocular puncture using standard methods. Phytochemical profiling of fraction was done using standard methods. The extract co-administration with 10 mg/kg CQ significantly (p&lt;0.05) dose and time dependently suppressed parasitaemia in the treated groups with total parasite clearance observed in the ACT and CQ-fraction treated-groups by day 9. Meanplasma MDA concentration were significantly (p&lt;0.05) decreased in the CQ-fraction treatments when compared with the ACT treatment. Mean packed cell volume and white blood cell counts were decreased but not significantly (p&gt;0.05) in the CQ-fraction treated groups when compared to the ACT treated-group. The finding of this study has demonstrated the CQ resistance reversal of extract of M. oleifera leaves with amelioration of malarial-induced haematological and oxidative stress.Keywords: resistance reversal, Moringa oleifera, co-administration, anti-oxidant

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was coprioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low-middle-income countries. Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of 'single-use' consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low-middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion: This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high- and low-middle-income countries