Características del uso de tratamiento alternativo y complementario en dismenorrea en mujeres en edad fértil

Objetive: To describe the characteristics of the use of alternative and complementary treatment in dysmenorrhea in women of childbearing age in a city in northern Peru. The study: Cross-sectional analytical study in women of childbearing age in Mórrope, Lambayeque. Prior training on dysmenorrhea and main variables. 336 women were interviewed in their homes after accepting informed consent. Findings: The age group of 15 to 35 years prevailed in the studied population with 83.92% (n=282), with secondary education 57.14% (n=192), more than 90% had lower/marginal socioeconomic status. Regarding dysmenorrhea, more than 30% were found to have severe/unbearable pain, whose main treatment was MAC with 82.1% (n=220). Plants were the main MAC, only finding an association of MAC use with the religion variable (p=0.023). Conclusions: Women of childbearing age notoriously use CAM, such as phytotherapy, as a treatment for dysmenorrhea despite not finding reliefObjetivo: Describir las características del uso de tratamiento alternativo y complementario en dismenorrea en mujeres en edad fértil de una ciudad del norte de Perú. El estudio: Estudio trasversal analítico en mujeres en edad fértil en Mórrope, Lambayeque. Previa capacitación sobre dismenorrea y principales variables. Se entrevistó a 336 mujeres en sus domicilios previa aceptación de consentimiento informado. Hallazgos: Predominó en población estudiada el grupo etario de 15 a 35 años con 83,92% (n=282), con educación secundaria el 57,14% (n=192), más del 90% tenían estrato socioeconómico inferior/marginal. Referente a la dismenorrea, se encontró más del 30% con dolor severo/insoportable, cuyo tratamiento principal fue la MAC con 82,1%(n=220). Las plantas fueron la principal MAC, hallando solamente asociación de uso de MAC con la variable religión (p=0,023). Conclusiones: Las mujeres en edad fértil emplean notoriamente la MAC, como la fitoterapia, como tratamiento de dismenorrea a pesar de no encuentran alivio

Efecto repelente y tiempo de protección de aceites esenciales frente al estadio adulto de Aedes aegypti

The aim of this was to evaluate the repellent effect and protection time of essential oils against the adult Aedes aegypti mosquito. A completely randomized design was used with a factorial arrangement that included 10 essential oils (Minthostachys mollis, Schinus molle, Ruta graveolens, Piper aduncun, Myrica pubescens, Lippia alba, Mentha piperita, Lantana glutinosa, Cymbopogon citratus, Eucalyptus globulus and the DEET control. 10%) and four concentrations of the oils (125, 250, 500 and 1000 mg/ml). Each experimental group consisted of 50 adult female A. aegypti mosquitoes raised in the laboratory and the repellent effect and protection time were evaluated using a sedated animal bait (Rattus rattus) with applications of 0.1 ml of the oils on the legs, tail and face. The rats and mosquitoes were found in two communicating cages of 25x25x40 cm. The oils with the greatest repellent effect and protection time, respectively, were C. citratus (97.4%; 165 minutes), E. globulus (95.8%; 165 minutes), L. glutinosa (93.8%; 180 minutes) and M. piperite (93.5%; 180 minutes) in its highest concentration (1000 mg/l); with differences between oils and between concentrations (p<0.001). Likewise, DEET 10% obtained a repellency of 95.3% and a protection time of 173 minutes. It is concluded that the essential oils of C. citratus, E. globulus, L. glutinosa and M. piperita can be considered as having natural repellent potential for A. aegypti.El estudio tuvo como objetivo evaluar el efecto repelente y tiempo de protección de aceites esenciales frente al mosquito adulto de Aedes aegypti. Se trabajó con un diseño completamente al azar con arreglo factorial que incluyó 10 aceites esenciales (Minthostachys mollis, Schinus molle, Ruta graveolens, Piper aduncun, Myrica pubescens, Lippia alba, Mentha piperita, Lantana glutinosa, Cymbopogon citratus, Eucalyptus globulus y el control DEET 10%) y cuatro concentraciones de los aceites (125, 250, 500 y 1000 mg/ml). Cada grupo experimental se constituyó por 50 mosquitos hembra adultos de A. aegypti criados en laboratorio y el efecto repelente y tiempo de protección se evaluaron usando un cebo animal sedado (Rattus rattus) con aplicaciones de 0.1 ml de los aceites en patas, cola y cara. Las ratas y los mosquitos se encontraron en dos jaulas comunicadas de 25x25x40 cm. Los aceites con mayor efecto repelente y tiempo de protección, respectivamente, fueron: C. citratus (97.4%; 165 minutos), E. globulus (95.8%; 165 minutos), L. glutinosa (93.8%; 180 minutos) y M. piperita (93.5%; 180 minutos) en su concentración mayor concentración (1000 mg/l); con diferencias entre aceites y entre concentraciones (p<0.001). Asimismo, el DEET 10% obtuvo una repelencia de 95.3 % y tiempo de protección de 173 minutos. Se concluye que los aceites esenciales de C. citratus, E. globulus, L. glutinosa y M. piperita pueden considerarse con potencial repelente natural para A. aegypti

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030