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- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
- Ray, Sumit Kumar, et al.
(författare)
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Modern analogue to past coseismic ground uplift in North Andaman, India
- 2021
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Ingår i: Catena (Cremlingen. Print). - : Elsevier. - 0341-8162 .- 1872-6887. ; 205
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Tidskriftsartikel (refereegranskat)abstract
- Dynamics of surface geological processes, triggered by coseismic ground uplift following the 2004 Sumatra-Andaman earthquake (M-w > 9.2), provide a modern analogue for assessing the paleoseismic significance of an enigmatic subsurface peat occurrence within beach sands in the western coast of North Andaman Island. The megathrust earthquake uplifted vast stretches of coastal intertidal zones to supratidal levels. As a result, intertidal flora, including mangroves, desiccated and perished. Mass mortality of the flora continued even three years after the earthquake and generated a large volume of forest debris. Coastal waves pushed the debris to the high tide line where the accumulated debris would be gradually buried, and would subsequently transform into linear peat bodies keeping a record of the seismic event in 2004. Accordingly, we have interpreted a linear strand-parallel peat occurrence in beach sand as a record of earlier mass mortality of plants likely associated with a coseismic ground uplift. Stable isotope studies indicate that local intertidal flora is the source of the peat organic matter. Moreover, the 1817 CE calibrated mean AMS radiocarbon age of the peat suggests recurrence of a megathrust earthquake in the Andaman subduction zone about 200 years ago.
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