BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the effic...BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.展开更多
Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial con...Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial concern that contributes to heightened morbidity and mortality. This study is designed to evaluate the frequency and key determining factors associated with surgical site infections following cesarean section procedures in a tertiary care hospital in Bangladesh. Materials and Methods: This observational cross-sectional study, conducted at the Gynecology Department of Dhaka Medical College Hospital, involved 100 patients aged 15 - 45 who had cesarean deliveries. Data was collected during hospitalization and post-discharge and analyzed to determine the prevalence and relationship between socio-demographic characteristics and surgical site infection. Results: Among the study participants, 14% developed surgical site infections following cesarean operations. More than half of these patients were under the age of 25, with a mean age of 24.45 ± 4.44 years. Surgical site infections were more prevalent in individuals over 30 years old (P-value Conclusion: Post-cesarean surgical site infections are notably prevalent among the participants in this study. Several risk factors have been identified, including age, body mass index (BMI), socioeconomic status, anemia, preterm delivery, personal hygiene practices, regular menstrual cycles, and adherence to antenatal check-ups. The implementation of an effective awareness program, coupled with updated antibiotic protocols, is crucial for significantly reducing the incidence of these infections.展开更多
Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who requ...Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who required an emergency cesarean section,posing a significant challenge to the anesthesiologist.The patient had developed Type 1 respiratory failure and needed supplemental oxygen with high-flow nasal oxygen.Due to contraindications for neuraxial anesthesia,the cesarean section was performed under general anesthesia.After induction of anesthesia,the patient’s hypoxemia worsened.Eventually,after treatment with fluid restriction,diuretics,and albumin,oxygenation improved gradually,and the procedure was performed successfully.Both the patient and the newborn had a good prognosis.展开更多
The direct and dissociative ionizations of oxygen molecule are investigated experimen-tally by electron collision with energies from 350 eV to 8000 eV.The absolute ionization cross sections for the product ions(O_(2)^...The direct and dissociative ionizations of oxygen molecule are investigated experimen-tally by electron collision with energies from 350 eV to 8000 eV.The absolute ionization cross sections for the product ions(O_(2)^(2+),O_(2)^(2+)O^(+),O^(2+),and their total)and two Coulomb explosion channels(O^(+)+O^(+)and O^(2+)+O^(+))are obtained by putting the data of O^(2+)on the scale of Ar+from O_(2)and Ar gases mixed with a fixed relative flow ratio of 1:1.The experimental errors are assessed by taking uncertainties of various factors into account.The present absolute cross sections are well consistent with the previous data in the overlapped energy range below 1000 eV.展开更多
Although a 3rd-order difference formula has often been employed to investigate the odd-even staggering(OES)in experimental cross sections,other formulas can also be very useful.In this work,three formulas,the 2nd,4th,...Although a 3rd-order difference formula has often been employed to investigate the odd-even staggering(OES)in experimental cross sections,other formulas can also be very useful.In this work,three formulas,the 2nd,4th,and 5th-order difference formulas,are proposed for systematic OES studies.These new difference formulas with different orders are applied to extract the OES magnitudes in extensive accurate cross sections measured in different fragmentation and spallation reaction systems over a broad energy range.According to comparisons of these(2nd,4th,and 5th-order)OES magnitudes derived from different reaction systems,they almost do not rely on the projectile-target combinations or the projectile energy.A similar universality was observed for the 3rd-order OES magnitudes obtained from various reaction systems in our previous studies of the 3rd-order OES.The weighted average values of the 2nd,4th,and 5th-order OES magnitudes extracted from different experimental datasets are recommended as the 2nd,4th,and 5th-order OES evaluations,respectively.Finally,comparisons of these(new)2nd,4th,5th,and previous 3rd-order OES evaluations support that these OES evaluations with different orders are consistent and that all the difference formulas with different orders are applicable to OES studies.展开更多
Inelastic collisions are the dominant cause of energy loss in radiotherapy.In the energy range around the Bragg peak,single ionization(SI)and single-electron capture(SC)are the primary inelastic collisions that lead t...Inelastic collisions are the dominant cause of energy loss in radiotherapy.In the energy range around the Bragg peak,single ionization(SI)and single-electron capture(SC)are the primary inelastic collisions that lead to energy loss.This study employs the classical trajectory Monte Carlo method to study the SI and SC processes of H_(2)O molecules using He^(2+) and C^(6+) projectiles in the energy range of 10 keV/u to 10 MeV/u.The total cross sections,single differential cross sections,impact parameter dependence of SI and SC,and fragmentation cross sections were investigated.Results illustrate that the cross section for SI is the highest when the projectile energy is close to the Bragg peak energy.When the projectile energy is below the Bragg peak energy,the ionized electrons in the forward direction dominate,and the removal of electrons can be associated with large impact parameters.As the projectile energy increases,the emission angle of the electrons gradually transitions from small angles(60°~120°)to large angles(60°~120°),and the removal of electrons is associated with small impact parameters.The energy distributions of the ionized electron are similar when the projectile energy is equal to,below or above the Bragg peak energy.The fragmentation cross sections after SI and SC in the energy range around the Bragg peak were also estimated.展开更多
Dear Editor,I am writing in response to the article“Assessment of nurses’workplace silence behavior motives:A cross-sectional study”by Alhojairi et al.published in the September 2024 issue of the International Jour...Dear Editor,I am writing in response to the article“Assessment of nurses’workplace silence behavior motives:A cross-sectional study”by Alhojairi et al.published in the September 2024 issue of the International Journal of Nursing Sciences[1].This is a letter written by a nurse with 10 years of clinical work experience and a personal interest in team dynamics.I appreciate the authors'recommendations on mitigating workplace silence among nurses to enhance clinical work development,and I believe their proposals could be expanded further.展开更多
The radioisotope actinium-225(^(225)Ac)has been successfully used for targeted alpha therapy in preclinical and clinical applications because of its excellent nuclear characteristics.Medium-and high-energy proton-spal...The radioisotope actinium-225(^(225)Ac)has been successfully used for targeted alpha therapy in preclinical and clinical applications because of its excellent nuclear characteristics.Medium-and high-energy proton-spallation reactions on thorium are the most important methods for producing^(225)Ac.This study examines the possibility of producing^(225)Ac by irradiating thorium oxide with medium-energy protons.Thorium-oxide sheets were irradiated with 40-,50-,60-,70-,and 80-Me V protons on the Associated Proton-beam Experiment Platform(APEP)of the China Spallation Neutron Source(CSNS).The cross sections for the formation of^(225)Ac were measured using the activation method and offline gamma-ray spectrometric technique.The experimental results were compared with the existing data from EXFOR as well as the theoretical data from the TALYS-based evaluated nuclear-data library.Based on the experimental cross section and theoretical calculations,the production yield of^(225)Ac in the irradiated thorium targets was examined.The results showed that APEP can produce sufficient quantities of^(225)Ac for purification and clinical therapy.This work is the first measurement of proton-induced nuclearreaction cross sections at the CSNS APEP.展开更多
BACKGROUND Following cesarean section,a significant number of women encounter moderate to severe pain.Inadequate management of acute pain post-cesarean section can have far-reaching implications,adversely impacting ma...BACKGROUND Following cesarean section,a significant number of women encounter moderate to severe pain.Inadequate management of acute pain post-cesarean section can have far-reaching implications,adversely impacting maternal emotional wellbeing,daily activities,breastfeeding,and neonatal care.It may also impede maternal organ function recovery,leading to escalated opioid usage,heightened risk of postpartum depression,and the development of chronic postoperative pain.Both the Chinese Enhanced Recovery After Surgery(ERAS)guidelines and the American ERAS Society guidelines consistently advocate for the adoption of multimodal analgesia protocols in post-cesarean section pain management.Esketamine,functioning as an antagonist of the N-Methyl-D-Aspartate receptor,has been validated for pain management in surgical patients and has exhibited effectiveness in depression treatment.Research has suggested that incorporating esketamine into postoperative pain management via pain pumps can lead to improvements in short-term depression and pain outcomes.This study aims to assess the efficacy and safety of administering a single dose of esketamine during cesarean section.AIM To investigate the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.METHODS A total of 315 women undergoing elective cesarean section under combined spinal-epidural anesthesia were randomized into three groups:low-dose esketamine(0.15 mg/kg),high-dose esketamine(0.25 mg/kg),and control(saline).Postoperative Visual Analog Scale(VAS)scores were recorded at 6 hours,12 hours,24 hours,and 48 hours.Edinburgh Postnatal Depression Scale(EPDS)scores were noted on 2 days,7 days and 42 days.Ramsay sedation scores were assessed at specified intervals post-injection.Postoperative adverse reactions were also recorded.RESULTS Low-dose group and high-dose group compared to control group,had significantly lower postoperative VAS pain scores at 6 hours 12 hours,and 24 hours(P<0.05),with reduced analgesic usage(P<0.05).EPDS scores and postpartum depression rates were significantly lower on 2 days and 7 days(P<0.05).No significant differences in first exhaust and defecation times were observed(P>0.05),but ambulation times were shorter(P<0.05).Ramsay scores were higher at 5 minutes,15 minutes,and upon room exit(P<0.05).Low-dose group and high-dose group had higher incidences of hallucination,lethargy,and diplopia within 2 hours(P<0.05),and with low-dose group had lower incidences of hallucination,lethargy,and diplopia than high-dose group(P<0.05).CONCLUSION Esketamine enhances analgesia and postpartum recovery;a 0.15 mg/kg dose is optimal for cesarean sections,balancing efficacy with minimized adverse effects.展开更多
BACKGROUND Cesarean hemorrhage is one of the serious complications,and short-term massive blood transfusion can easily cause postoperative infection and physical stress response.However,predictive nursing intervention...BACKGROUND Cesarean hemorrhage is one of the serious complications,and short-term massive blood transfusion can easily cause postoperative infection and physical stress response.However,predictive nursing intervention has important clinical significance for it.AIM To explore the effect of predictive nursing intervention on the stress response and complications of women undergoing short-term mass blood transfusion during cesarean section(CS).METHODS A clinical medical record of 100 pregnant women undergoing rapid mass blood transfusion during sections from June 2019 to June 2021.According to the different nursing methods,patients divided into control group(n=50)and observation group(n=50).Among them,the control group implemented routine nursing,and the observation group implemented predictive nursing intervention based on the control group.Moreover,compared the differences in stress res-ponse,complications,and pain scores before and after the nursing of pregnant women undergoing rapid mass blood transfusion during CS.RESULTS The anxiety and depression scores of pregnant women in the two groups were significantly improved after nursing,and the psychological stress response of the observation group was significantly lower than that of the control group(P<0.05).The heart rate and mean arterial pressure(MAP)of the observation group during delivery were lower than those of the control group,and the MAP at the end of delivery was lower than that of the control group(P<0.05).Moreover,different pain scores improved significantly in both groups,with the observation group considerably less than the control group(P<0.05).After nursing,complications such as skin rash,urinary retention,chills,diarrhea,and anaphylactic shock in the observation group were 18%,which significantly higher than in the control group(4%)(P<0.05).CONCLUSION Predictive nursing intervention can effectively relieve the pain,reduce the incidence of complications,improve mood and stress response,and serve as a reference value for the nursing of women undergoing rapid mass transfusion during CS.展开更多
The neutron-induced total cross sections of natural lead have been measured in a wide energy range(0.3 eV-20 MeV)on the back-streaming white neutron beamline(Back-n)at the China Spallation Neutron Source.Neutron energ...The neutron-induced total cross sections of natural lead have been measured in a wide energy range(0.3 eV-20 MeV)on the back-streaming white neutron beamline(Back-n)at the China Spallation Neutron Source.Neutron energy was determined by the neutron total cross-section spectrometer using the time-of-flight technique.A fast multi-cell fission chamber was used as the neutron detector,and a 10-mm-thick high-purity natural lead sample was employed for the neutron transmission measurements.The on-beam background was determined using Co,In,Ag,and Cd filters.The excitation function of ^(nat)Pb(n,tot)reaction below 20 MeV was calculated using the TALYS-1.96 nuclear-reaction modeling program.The present results were compared with previous results,the evaluated data available in the five major evaluated nuclear data libraries(i.e.,ENDF/B-VIII.0,JEFF-3.3,JENDL-5,CENDL-3.2,and BROND-3.1),and the theoretical calculation curve.Good agreement was found between the new results and those of previous experiments and with the theoretical curves in the corresponding region.This measurement obtained the neutron total cross section of natural lead with good accuracy over a wide energy range and added experimental data in the resonance energy range.This provides more reliable experimental data for nuclear engineering design and nuclear data evaluation of lead.展开更多
Displacement control algorithms commonly used to evaluate axial force-bending moment(PM)diagrams may lead to incorrect interpretations of the strength envelopes for asymmetric sections.This paper aims to offer valuabl...Displacement control algorithms commonly used to evaluate axial force-bending moment(PM)diagrams may lead to incorrect interpretations of the strength envelopes for asymmetric sections.This paper aims to offer valuable insights by comparing existing displacement control algorithms with a newly proposed force control algorithm.The main focus is on the PM diagrams of three example sections that exhibit varying degrees of asymmetry.The comparative study indicates that conventional displacement control algorithms inevitably introduce non-zero out-of-plane bending moments.The reported PM diagram in such cases erroneously neglects the out-of-plane moment and fails to represent the strength envelope accurately.This oversight results in significant and unconservative errors when verifying the strength of asymmetric sections.展开更多
Permafrost degradation in the embankment–bridge transition section(EBTS)along the Qinghai–Tibet Railway has led to extensive damage to bridge structures,posing a serious threat to railway safety.With the ongoing glo...Permafrost degradation in the embankment–bridge transition section(EBTS)along the Qinghai–Tibet Railway has led to extensive damage to bridge structures,posing a serious threat to railway safety.With the ongoing global warming,reinforcing the affected EBTS to ensure long-term stability remains a pressing challenge.To address this issue,this study proposes a targeted cooling thermosyphon array(TCTA)approach utilising variable inclination evaporator(VIE)thermosyphons.The effectiveness of the VIE thermosyphon was evaluated through an in-situ test.Meanwhile,a three-dimensional numerical model was employed to analyse the overall cooling effect,long-term performance and thermal enhancement provided by the TCTA approach.The findings indicated that the VIE thermosyphon exhibited excellent cooling performance and maintained uniform wall temperature,with the lowest wall temperature reaching−15℃.Within one year of implementation,a cold core of−2℃ formed at the centre of the foundation,and the permafrost table was uplifted by approximately 3 m,showcasing its potential to rapidly enhance the thermal stability of in-service EBTS in permafrost.With prolonged operation,the cold accumulative effect of this approach gradually becomes apparent,and the range of the low-temperature cores expands.This method effectively reinforces the thermal stability of in-service EBTS and is well-suited for future railway construction in warm permafrost amidst the challenges of climate change.展开更多
Aluminum is the primary structural material in nuclear engineering,and its cross section induced by 14-MeV neutrons is of great significance.To address the issue of insufficient accuracy for the^(27)Al(n,2n)^(26)Al re...Aluminum is the primary structural material in nuclear engineering,and its cross section induced by 14-MeV neutrons is of great significance.To address the issue of insufficient accuracy for the^(27)Al(n,2n)^(26)Al reaction cross section,the activation method and accelerator mass spectrometry(AMS)technique were used to determine the^(27)Al(n,2n)^(26)Al cross section,which could be used as a D-T plasma ion temperature monitor in fusion reactors.At the China Academy of Engineering Physics,neutron activation was performed using a K-400 neutron generator produced by the T(d,n)4He reaction.The^(26)Al∕^(27)Al isotope ratios were measured using the newly installed GYIG 1 MV AMS at the Institute of Geochemistry,Chinese Academy of Sciences.The neutron flux was monitored by measuring the activity of 92mNb produced by the 93Nb(n,2n)92mNb reaction.The measured results were compared with available data in the experimental nuclear reaction database,and the measured values showed a reasonable degree of consistency with partially available literature data.The newly acquired cross-sectional data at 12 neutron energy points through systematic measurements clarified the divergence,which has two different growth trends from the existing experimental values.The obtained results are also compared with the corresponding evaluated database,and the newly calculated excitation functions with TALYS−1.95 and EMPIRE−3.2 codes,the agreement with CENDL−3.2,TENDL-2021 and EMPIRE−3.2 results are generally acceptable.A substantial improvement in the knowledge of the^(27)Al(n,2n)^(26)Al reaction excitation function was obtained in the present work,which will lay the foundation for the diagnosis of the fusion ion temperature,testing of the nuclear physics model,evaluation of nuclear data,etc.展开更多
Nitrates,thiocyanates,and perchlorates are ubiquitous in the environment and can be introduced to the public through various dietary and environmental sources.Nitrates,thiocyanates,and perchlorates mainly affect healt...Nitrates,thiocyanates,and perchlorates are ubiquitous in the environment and can be introduced to the public through various dietary and environmental sources.Nitrates,thiocyanates,and perchlorates mainly affect health via the same mechanism.These toxins may act as endocrine disrupters and can result in decreased levels of thyroid hormones^([1]).展开更多
We present the angular distribution of the ejected electron for single ionization of He by fast proton impact.A fourbody formalism of the three-Coulomb wave is applied to calculate the triple differential cross sectio...We present the angular distribution of the ejected electron for single ionization of He by fast proton impact.A fourbody formalism of the three-Coulomb wave is applied to calculate the triple differential cross sections at several impact energies in the scattering,perpendicular and azimuthal planes.Moreover,the three-body formalism of three-Coulomb,two-Coulomb and first Born approximation models has also been used to study the many-body effect on electron emission and the validity of the models.In the three-Coulomb wave model,the final state wave function incorporates distortion due to the three-body mutual Coulombic interaction.In this formalism,we use an uncorrelated and correlated Born initial state,which consists of a plane wave for the incoming projectile times a two-electron bound state wavefunction of the helium atom representing the 1s^(2)(1S)state.But,in the case of the three-body formalism,the initial state wavefunction consists of a long-range Coulomb distortion for the incoming projectile and one active electron of the He atom described by the Roothaan–Hartree–Fock wavefunction.The structure with a single or two peaks with unequal intensity is observed in the angular distributions of the triple differential cross sections for the different kinematic conditions.In addition,the influence of static electron correlations is investigated using different bound state wavefunctions for the ground state of the He target.In the four-body formalism,the present computations are very fast by reducing a nine-dimensional integral to a two-dimensional real integral.Despite the simplicity and speed of the proposed quadrature,the comparison shows that the obtained results are in reasonable agreement with the experiment and are compatible with those of other theories.展开更多
This article examines the soft soil roadbed reinforcement technology for widened sections of highways in a specific project.It provides an overview of the project,the principles of soft soil roadbed reinforcement tech...This article examines the soft soil roadbed reinforcement technology for widened sections of highways in a specific project.It provides an overview of the project,the principles of soft soil roadbed reinforcement technology for wide sections,and its practical application.The analysis aims to offer guidance on applying soft soil roadbed wide section reinforcement technology and enhancing the overall quality of similar projects.展开更多
BACKGROUND: Pain management following caesarean section still remains a challenge in our environment. Most potent analgesics are either not readily available or expensive. Diclofenac suppository is an NSAID that can b...BACKGROUND: Pain management following caesarean section still remains a challenge in our environment. Most potent analgesics are either not readily available or expensive. Diclofenac suppository is an NSAID that can be used for postoperative analgesia. It is available and affordable. OBJECTIVE: To compare the efficacy and safety of combined rectal diclofenac and intramuscular pentazocine with intramuscular pentazocine alone for post operative pain control following lower segment caesarean section. METHODOLOGY: A total of 120 women who met the selection criteria scheduled for caesarean section under spinal anaesthesia with bupivacaine were randomized into two equal groups to receive either 75 mg diclofenac suppository 12 hourly for 24 hours or one anusol suppository (the placebo) 12 hourly for 24 hours. Both groups received pentazocine as primary analgesia. RESULT: The primary outcome measure is the proportion of patients with severe pain at 24 hours using the visual analogue rating scale. Secondary outcome measures are the time from surgery to ambulation, Passage of flatus, maternal satisfaction and presence of complications. Statistical analysis was done using spss version 22 and graph pad statistical package. Student T-test was used for continuous variables whereas chi square was used for categorical variables P CONCLUSION: Adjuvant rectal diclofenac is superior to pentazocine alone in the management of pain after caesarean section. Less number of patients had moderate to severe pain at 24 hours post operation. Maternal satisfaction in relation to pain management is better with diclofenac suppository. The levels of complications were comparable in both groups.展开更多
Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and ...Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and morbidity from pregnancy and labour-related causes can be eliminated by a timely caesarean section. The acceptance of the life-saving procedure remains unsatisfactory in most sub-Saharan nations. The study aimed to assess the acceptability of caesarean section and associated factors among pregnant women seeking antenatal care at Women and Newborn Hospital-University Teaching Hospitals in Lusaka Zambia. The study utilised a quantitative cross-sectional analytical study design involving 420 pregnant women selected using systematic random sampling at Women and Newborn Hospital-University Teaching Hospitals Lusaka Zambia. Data was obtained using an Interview schedule and analysed using R software version 4.3.2. Chi-square, Fisher’s exact test, Wilcoxon rank sum test and binary logistic regression for statistical analysis at a 5% level of significance. The study found that the acceptability of Caesarean section as a mode of delivery was low (29%) among respondents at Women and Newborn Hospital-University Teaching Hospitals. This was influenced by marital status (P = 0.002), socioeconomic status (P = 0.050), parity (P = 0.004), gestation age (P = 0.008), previous history of caesarean section (P = 0.003), knowledge (P < 0.001), attitude (P < 0.001), and sociocultural beliefs (P = 0.045). Low acceptability of Caesarean section delivery is common among women at Women and Newborn Hospital-University Teaching Hospitals, despite its potential benefits for maternal and neonatal health. Socio-demographic and maternal characteristics, knowledge, attitude, perception, and socio-cultural beliefs play a major role in determining acceptability. Therefore, efforts to enhance acceptability should focus on improving knowledge, enhancing positive perceptions and attitudes, and allaying negative socio-cultural beliefs towards caesarean section.展开更多
Utero-cutaneous fistula following cesarean section is a rare occurrence. We present the case of a 34-year-old woman who presented to our department four years after her second cesarean section with a history of pain a...Utero-cutaneous fistula following cesarean section is a rare occurrence. We present the case of a 34-year-old woman who presented to our department four years after her second cesarean section with a history of pain and blood discharge from a previous Pfannenstiel incision, during menstruation, with an absence of vaginal menstrual flow. Despite a prior surgical repair operation, her symptoms persisted. A pelvic MRI was done to confirm the diagnosis of utero-cutaneous fistula, and surgical management was pursued. This case report aims to contribute to the existing literature on utero-cutaneous fistula and provide insights into the diagnostic considerations and management strategies for this rare complication.展开更多
文摘BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.
文摘Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial concern that contributes to heightened morbidity and mortality. This study is designed to evaluate the frequency and key determining factors associated with surgical site infections following cesarean section procedures in a tertiary care hospital in Bangladesh. Materials and Methods: This observational cross-sectional study, conducted at the Gynecology Department of Dhaka Medical College Hospital, involved 100 patients aged 15 - 45 who had cesarean deliveries. Data was collected during hospitalization and post-discharge and analyzed to determine the prevalence and relationship between socio-demographic characteristics and surgical site infection. Results: Among the study participants, 14% developed surgical site infections following cesarean operations. More than half of these patients were under the age of 25, with a mean age of 24.45 ± 4.44 years. Surgical site infections were more prevalent in individuals over 30 years old (P-value Conclusion: Post-cesarean surgical site infections are notably prevalent among the participants in this study. Several risk factors have been identified, including age, body mass index (BMI), socioeconomic status, anemia, preterm delivery, personal hygiene practices, regular menstrual cycles, and adherence to antenatal check-ups. The implementation of an effective awareness program, coupled with updated antibiotic protocols, is crucial for significantly reducing the incidence of these infections.
文摘Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who required an emergency cesarean section,posing a significant challenge to the anesthesiologist.The patient had developed Type 1 respiratory failure and needed supplemental oxygen with high-flow nasal oxygen.Due to contraindications for neuraxial anesthesia,the cesarean section was performed under general anesthesia.After induction of anesthesia,the patient’s hypoxemia worsened.Eventually,after treatment with fluid restriction,diuretics,and albumin,oxygenation improved gradually,and the procedure was performed successfully.Both the patient and the newborn had a good prognosis.
基金supported by the National Key Research and Development Program of China(No.2022YFA1602502)the National Natural Science Foundation of China(No.12127804).
文摘The direct and dissociative ionizations of oxygen molecule are investigated experimen-tally by electron collision with energies from 350 eV to 8000 eV.The absolute ionization cross sections for the product ions(O_(2)^(2+),O_(2)^(2+)O^(+),O^(2+),and their total)and two Coulomb explosion channels(O^(+)+O^(+)and O^(2+)+O^(+))are obtained by putting the data of O^(2+)on the scale of Ar+from O_(2)and Ar gases mixed with a fixed relative flow ratio of 1:1.The experimental errors are assessed by taking uncertainties of various factors into account.The present absolute cross sections are well consistent with the previous data in the overlapped energy range below 1000 eV.
基金Supported by the National Natural Science Foundation of China(12005314)the SYSU 100 Top Talents Program,and the Major Project of Basic and Applied Basic Research of Guangdong Province,China(2021B0301030006)。
文摘Although a 3rd-order difference formula has often been employed to investigate the odd-even staggering(OES)in experimental cross sections,other formulas can also be very useful.In this work,three formulas,the 2nd,4th,and 5th-order difference formulas,are proposed for systematic OES studies.These new difference formulas with different orders are applied to extract the OES magnitudes in extensive accurate cross sections measured in different fragmentation and spallation reaction systems over a broad energy range.According to comparisons of these(2nd,4th,and 5th-order)OES magnitudes derived from different reaction systems,they almost do not rely on the projectile-target combinations or the projectile energy.A similar universality was observed for the 3rd-order OES magnitudes obtained from various reaction systems in our previous studies of the 3rd-order OES.The weighted average values of the 2nd,4th,and 5th-order OES magnitudes extracted from different experimental datasets are recommended as the 2nd,4th,and 5th-order OES evaluations,respectively.Finally,comparisons of these(new)2nd,4th,5th,and previous 3rd-order OES evaluations support that these OES evaluations with different orders are consistent and that all the difference formulas with different orders are applicable to OES studies.
基金supported in part by the National Natural Science Foundation of China(Nos.12105327 and 11775108)the Hunan Provincial Innovation Foundation For Postgraduate(No.QL20220210)the Advanced Energy Science and Technology Guangdong Laboratory.
文摘Inelastic collisions are the dominant cause of energy loss in radiotherapy.In the energy range around the Bragg peak,single ionization(SI)and single-electron capture(SC)are the primary inelastic collisions that lead to energy loss.This study employs the classical trajectory Monte Carlo method to study the SI and SC processes of H_(2)O molecules using He^(2+) and C^(6+) projectiles in the energy range of 10 keV/u to 10 MeV/u.The total cross sections,single differential cross sections,impact parameter dependence of SI and SC,and fragmentation cross sections were investigated.Results illustrate that the cross section for SI is the highest when the projectile energy is close to the Bragg peak energy.When the projectile energy is below the Bragg peak energy,the ionized electrons in the forward direction dominate,and the removal of electrons can be associated with large impact parameters.As the projectile energy increases,the emission angle of the electrons gradually transitions from small angles(60°~120°)to large angles(60°~120°),and the removal of electrons is associated with small impact parameters.The energy distributions of the ionized electron are similar when the projectile energy is equal to,below or above the Bragg peak energy.The fragmentation cross sections after SI and SC in the energy range around the Bragg peak were also estimated.
文摘Dear Editor,I am writing in response to the article“Assessment of nurses’workplace silence behavior motives:A cross-sectional study”by Alhojairi et al.published in the September 2024 issue of the International Journal of Nursing Sciences[1].This is a letter written by a nurse with 10 years of clinical work experience and a personal interest in team dynamics.I appreciate the authors'recommendations on mitigating workplace silence among nurses to enhance clinical work development,and I believe their proposals could be expanded further.
基金supported by the National Natural Science Foundation of China(No.12075135)the National Natural Science Foundation of China(No.12375127)。
文摘The radioisotope actinium-225(^(225)Ac)has been successfully used for targeted alpha therapy in preclinical and clinical applications because of its excellent nuclear characteristics.Medium-and high-energy proton-spallation reactions on thorium are the most important methods for producing^(225)Ac.This study examines the possibility of producing^(225)Ac by irradiating thorium oxide with medium-energy protons.Thorium-oxide sheets were irradiated with 40-,50-,60-,70-,and 80-Me V protons on the Associated Proton-beam Experiment Platform(APEP)of the China Spallation Neutron Source(CSNS).The cross sections for the formation of^(225)Ac were measured using the activation method and offline gamma-ray spectrometric technique.The experimental results were compared with the existing data from EXFOR as well as the theoretical data from the TALYS-based evaluated nuclear-data library.Based on the experimental cross section and theoretical calculations,the production yield of^(225)Ac in the irradiated thorium targets was examined.The results showed that APEP can produce sufficient quantities of^(225)Ac for purification and clinical therapy.This work is the first measurement of proton-induced nuclearreaction cross sections at the CSNS APEP.
基金the Project of Science and Technology Bureau of Shijiazhuang,Hebei Province,No.201460823.
文摘BACKGROUND Following cesarean section,a significant number of women encounter moderate to severe pain.Inadequate management of acute pain post-cesarean section can have far-reaching implications,adversely impacting maternal emotional wellbeing,daily activities,breastfeeding,and neonatal care.It may also impede maternal organ function recovery,leading to escalated opioid usage,heightened risk of postpartum depression,and the development of chronic postoperative pain.Both the Chinese Enhanced Recovery After Surgery(ERAS)guidelines and the American ERAS Society guidelines consistently advocate for the adoption of multimodal analgesia protocols in post-cesarean section pain management.Esketamine,functioning as an antagonist of the N-Methyl-D-Aspartate receptor,has been validated for pain management in surgical patients and has exhibited effectiveness in depression treatment.Research has suggested that incorporating esketamine into postoperative pain management via pain pumps can lead to improvements in short-term depression and pain outcomes.This study aims to assess the efficacy and safety of administering a single dose of esketamine during cesarean section.AIM To investigate the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.METHODS A total of 315 women undergoing elective cesarean section under combined spinal-epidural anesthesia were randomized into three groups:low-dose esketamine(0.15 mg/kg),high-dose esketamine(0.25 mg/kg),and control(saline).Postoperative Visual Analog Scale(VAS)scores were recorded at 6 hours,12 hours,24 hours,and 48 hours.Edinburgh Postnatal Depression Scale(EPDS)scores were noted on 2 days,7 days and 42 days.Ramsay sedation scores were assessed at specified intervals post-injection.Postoperative adverse reactions were also recorded.RESULTS Low-dose group and high-dose group compared to control group,had significantly lower postoperative VAS pain scores at 6 hours 12 hours,and 24 hours(P<0.05),with reduced analgesic usage(P<0.05).EPDS scores and postpartum depression rates were significantly lower on 2 days and 7 days(P<0.05).No significant differences in first exhaust and defecation times were observed(P>0.05),but ambulation times were shorter(P<0.05).Ramsay scores were higher at 5 minutes,15 minutes,and upon room exit(P<0.05).Low-dose group and high-dose group had higher incidences of hallucination,lethargy,and diplopia within 2 hours(P<0.05),and with low-dose group had lower incidences of hallucination,lethargy,and diplopia than high-dose group(P<0.05).CONCLUSION Esketamine enhances analgesia and postpartum recovery;a 0.15 mg/kg dose is optimal for cesarean sections,balancing efficacy with minimized adverse effects.
文摘BACKGROUND Cesarean hemorrhage is one of the serious complications,and short-term massive blood transfusion can easily cause postoperative infection and physical stress response.However,predictive nursing intervention has important clinical significance for it.AIM To explore the effect of predictive nursing intervention on the stress response and complications of women undergoing short-term mass blood transfusion during cesarean section(CS).METHODS A clinical medical record of 100 pregnant women undergoing rapid mass blood transfusion during sections from June 2019 to June 2021.According to the different nursing methods,patients divided into control group(n=50)and observation group(n=50).Among them,the control group implemented routine nursing,and the observation group implemented predictive nursing intervention based on the control group.Moreover,compared the differences in stress res-ponse,complications,and pain scores before and after the nursing of pregnant women undergoing rapid mass blood transfusion during CS.RESULTS The anxiety and depression scores of pregnant women in the two groups were significantly improved after nursing,and the psychological stress response of the observation group was significantly lower than that of the control group(P<0.05).The heart rate and mean arterial pressure(MAP)of the observation group during delivery were lower than those of the control group,and the MAP at the end of delivery was lower than that of the control group(P<0.05).Moreover,different pain scores improved significantly in both groups,with the observation group considerably less than the control group(P<0.05).After nursing,complications such as skin rash,urinary retention,chills,diarrhea,and anaphylactic shock in the observation group were 18%,which significantly higher than in the control group(4%)(P<0.05).CONCLUSION Predictive nursing intervention can effectively relieve the pain,reduce the incidence of complications,improve mood and stress response,and serve as a reference value for the nursing of women undergoing rapid mass transfusion during CS.
基金This work is supported by the National Natural Science Foundation of China(No.12375296)the Key Laboratory of Nuclear Data Foundation(No.JCKY2022201C153)+2 种基金the Natural Science Foundation of Hunan Province of China(Nos.2021JJ40444,2020RC3054)the Youth Innovation Promotion Association CAS(No.2023014)the National Key Research and Development Plan(No.2022YFA1603303).
文摘The neutron-induced total cross sections of natural lead have been measured in a wide energy range(0.3 eV-20 MeV)on the back-streaming white neutron beamline(Back-n)at the China Spallation Neutron Source.Neutron energy was determined by the neutron total cross-section spectrometer using the time-of-flight technique.A fast multi-cell fission chamber was used as the neutron detector,and a 10-mm-thick high-purity natural lead sample was employed for the neutron transmission measurements.The on-beam background was determined using Co,In,Ag,and Cd filters.The excitation function of ^(nat)Pb(n,tot)reaction below 20 MeV was calculated using the TALYS-1.96 nuclear-reaction modeling program.The present results were compared with previous results,the evaluated data available in the five major evaluated nuclear data libraries(i.e.,ENDF/B-VIII.0,JEFF-3.3,JENDL-5,CENDL-3.2,and BROND-3.1),and the theoretical calculation curve.Good agreement was found between the new results and those of previous experiments and with the theoretical curves in the corresponding region.This measurement obtained the neutron total cross section of natural lead with good accuracy over a wide energy range and added experimental data in the resonance energy range.This provides more reliable experimental data for nuclear engineering design and nuclear data evaluation of lead.
基金supported by the Natural Science Foundation of China(52122811).
文摘Displacement control algorithms commonly used to evaluate axial force-bending moment(PM)diagrams may lead to incorrect interpretations of the strength envelopes for asymmetric sections.This paper aims to offer valuable insights by comparing existing displacement control algorithms with a newly proposed force control algorithm.The main focus is on the PM diagrams of three example sections that exhibit varying degrees of asymmetry.The comparative study indicates that conventional displacement control algorithms inevitably introduce non-zero out-of-plane bending moments.The reported PM diagram in such cases erroneously neglects the out-of-plane moment and fails to represent the strength envelope accurately.This oversight results in significant and unconservative errors when verifying the strength of asymmetric sections.
基金supported by the National Natural Science Foundation of China(42071095)the Second Tibetan Plateau Scientific Expedition and Research(STEP)Program(2019QZKK0905)+2 种基金the Science and Technology Program of Gansu Province(23ZDFA017)the Natural Science Foundation of Gansu Province(22JR5RA086)the Science and Technology Research and Development Program of the Qinghai‒Tibet Group Corporation(QZ2022-G02).
文摘Permafrost degradation in the embankment–bridge transition section(EBTS)along the Qinghai–Tibet Railway has led to extensive damage to bridge structures,posing a serious threat to railway safety.With the ongoing global warming,reinforcing the affected EBTS to ensure long-term stability remains a pressing challenge.To address this issue,this study proposes a targeted cooling thermosyphon array(TCTA)approach utilising variable inclination evaporator(VIE)thermosyphons.The effectiveness of the VIE thermosyphon was evaluated through an in-situ test.Meanwhile,a three-dimensional numerical model was employed to analyse the overall cooling effect,long-term performance and thermal enhancement provided by the TCTA approach.The findings indicated that the VIE thermosyphon exhibited excellent cooling performance and maintained uniform wall temperature,with the lowest wall temperature reaching−15℃.Within one year of implementation,a cold core of−2℃ formed at the centre of the foundation,and the permafrost table was uplifted by approximately 3 m,showcasing its potential to rapidly enhance the thermal stability of in-service EBTS in permafrost.With prolonged operation,the cold accumulative effect of this approach gradually becomes apparent,and the range of the low-temperature cores expands.This method effectively reinforces the thermal stability of in-service EBTS and is well-suited for future railway construction in warm permafrost amidst the challenges of climate change.
基金the Open Project of Guangxi Key Laboratory of Nuclear Physics and Nuclear Technology(NLK 2022-04)the Central Government Guidance Funds for Local Scientific and Technological Development,China(No.Guike,ZY22096024)+1 种基金the National Natural Science Foundation of China(12065003)Guangxi Key R&D Project(2023AB07029).
文摘Aluminum is the primary structural material in nuclear engineering,and its cross section induced by 14-MeV neutrons is of great significance.To address the issue of insufficient accuracy for the^(27)Al(n,2n)^(26)Al reaction cross section,the activation method and accelerator mass spectrometry(AMS)technique were used to determine the^(27)Al(n,2n)^(26)Al cross section,which could be used as a D-T plasma ion temperature monitor in fusion reactors.At the China Academy of Engineering Physics,neutron activation was performed using a K-400 neutron generator produced by the T(d,n)4He reaction.The^(26)Al∕^(27)Al isotope ratios were measured using the newly installed GYIG 1 MV AMS at the Institute of Geochemistry,Chinese Academy of Sciences.The neutron flux was monitored by measuring the activity of 92mNb produced by the 93Nb(n,2n)92mNb reaction.The measured results were compared with available data in the experimental nuclear reaction database,and the measured values showed a reasonable degree of consistency with partially available literature data.The newly acquired cross-sectional data at 12 neutron energy points through systematic measurements clarified the divergence,which has two different growth trends from the existing experimental values.The obtained results are also compared with the corresponding evaluated database,and the newly calculated excitation functions with TALYS−1.95 and EMPIRE−3.2 codes,the agreement with CENDL−3.2,TENDL-2021 and EMPIRE−3.2 results are generally acceptable.A substantial improvement in the knowledge of the^(27)Al(n,2n)^(26)Al reaction excitation function was obtained in the present work,which will lay the foundation for the diagnosis of the fusion ion temperature,testing of the nuclear physics model,evaluation of nuclear data,etc.
文摘Nitrates,thiocyanates,and perchlorates are ubiquitous in the environment and can be introduced to the public through various dietary and environmental sources.Nitrates,thiocyanates,and perchlorates mainly affect health via the same mechanism.These toxins may act as endocrine disrupters and can result in decreased levels of thyroid hormones^([1]).
基金Project supported by the Science and Engineering Research Board(SERB),New Delhi,India(Grant No.CRG/2022/001668).
文摘We present the angular distribution of the ejected electron for single ionization of He by fast proton impact.A fourbody formalism of the three-Coulomb wave is applied to calculate the triple differential cross sections at several impact energies in the scattering,perpendicular and azimuthal planes.Moreover,the three-body formalism of three-Coulomb,two-Coulomb and first Born approximation models has also been used to study the many-body effect on electron emission and the validity of the models.In the three-Coulomb wave model,the final state wave function incorporates distortion due to the three-body mutual Coulombic interaction.In this formalism,we use an uncorrelated and correlated Born initial state,which consists of a plane wave for the incoming projectile times a two-electron bound state wavefunction of the helium atom representing the 1s^(2)(1S)state.But,in the case of the three-body formalism,the initial state wavefunction consists of a long-range Coulomb distortion for the incoming projectile and one active electron of the He atom described by the Roothaan–Hartree–Fock wavefunction.The structure with a single or two peaks with unequal intensity is observed in the angular distributions of the triple differential cross sections for the different kinematic conditions.In addition,the influence of static electron correlations is investigated using different bound state wavefunctions for the ground state of the He target.In the four-body formalism,the present computations are very fast by reducing a nine-dimensional integral to a two-dimensional real integral.Despite the simplicity and speed of the proposed quadrature,the comparison shows that the obtained results are in reasonable agreement with the experiment and are compatible with those of other theories.
文摘This article examines the soft soil roadbed reinforcement technology for widened sections of highways in a specific project.It provides an overview of the project,the principles of soft soil roadbed reinforcement technology for wide sections,and its practical application.The analysis aims to offer guidance on applying soft soil roadbed wide section reinforcement technology and enhancing the overall quality of similar projects.
文摘BACKGROUND: Pain management following caesarean section still remains a challenge in our environment. Most potent analgesics are either not readily available or expensive. Diclofenac suppository is an NSAID that can be used for postoperative analgesia. It is available and affordable. OBJECTIVE: To compare the efficacy and safety of combined rectal diclofenac and intramuscular pentazocine with intramuscular pentazocine alone for post operative pain control following lower segment caesarean section. METHODOLOGY: A total of 120 women who met the selection criteria scheduled for caesarean section under spinal anaesthesia with bupivacaine were randomized into two equal groups to receive either 75 mg diclofenac suppository 12 hourly for 24 hours or one anusol suppository (the placebo) 12 hourly for 24 hours. Both groups received pentazocine as primary analgesia. RESULT: The primary outcome measure is the proportion of patients with severe pain at 24 hours using the visual analogue rating scale. Secondary outcome measures are the time from surgery to ambulation, Passage of flatus, maternal satisfaction and presence of complications. Statistical analysis was done using spss version 22 and graph pad statistical package. Student T-test was used for continuous variables whereas chi square was used for categorical variables P CONCLUSION: Adjuvant rectal diclofenac is superior to pentazocine alone in the management of pain after caesarean section. Less number of patients had moderate to severe pain at 24 hours post operation. Maternal satisfaction in relation to pain management is better with diclofenac suppository. The levels of complications were comparable in both groups.
文摘Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and morbidity from pregnancy and labour-related causes can be eliminated by a timely caesarean section. The acceptance of the life-saving procedure remains unsatisfactory in most sub-Saharan nations. The study aimed to assess the acceptability of caesarean section and associated factors among pregnant women seeking antenatal care at Women and Newborn Hospital-University Teaching Hospitals in Lusaka Zambia. The study utilised a quantitative cross-sectional analytical study design involving 420 pregnant women selected using systematic random sampling at Women and Newborn Hospital-University Teaching Hospitals Lusaka Zambia. Data was obtained using an Interview schedule and analysed using R software version 4.3.2. Chi-square, Fisher’s exact test, Wilcoxon rank sum test and binary logistic regression for statistical analysis at a 5% level of significance. The study found that the acceptability of Caesarean section as a mode of delivery was low (29%) among respondents at Women and Newborn Hospital-University Teaching Hospitals. This was influenced by marital status (P = 0.002), socioeconomic status (P = 0.050), parity (P = 0.004), gestation age (P = 0.008), previous history of caesarean section (P = 0.003), knowledge (P < 0.001), attitude (P < 0.001), and sociocultural beliefs (P = 0.045). Low acceptability of Caesarean section delivery is common among women at Women and Newborn Hospital-University Teaching Hospitals, despite its potential benefits for maternal and neonatal health. Socio-demographic and maternal characteristics, knowledge, attitude, perception, and socio-cultural beliefs play a major role in determining acceptability. Therefore, efforts to enhance acceptability should focus on improving knowledge, enhancing positive perceptions and attitudes, and allaying negative socio-cultural beliefs towards caesarean section.
文摘Utero-cutaneous fistula following cesarean section is a rare occurrence. We present the case of a 34-year-old woman who presented to our department four years after her second cesarean section with a history of pain and blood discharge from a previous Pfannenstiel incision, during menstruation, with an absence of vaginal menstrual flow. Despite a prior surgical repair operation, her symptoms persisted. A pelvic MRI was done to confirm the diagnosis of utero-cutaneous fistula, and surgical management was pursued. This case report aims to contribute to the existing literature on utero-cutaneous fistula and provide insights into the diagnostic considerations and management strategies for this rare complication.
