Obstetric admissions to intensive care units in Australia and New Zealand: a registry-based cohort study.

OBJECTIVE: Describe the epidemiology of obstetric patients admitted to an Intensive Care Unit (ICU). DESIGN: Registry-based cohort study. SETTING: One hundred and eighty-three ICUs in Australia and New Zealand. POPULATION: Women aged 15-49 years, admitted to ICU between 2008 and 2017, classified as pregnant, postpartum or with an obstetric-related diagnosis. METHODS: Data were extracted from the Australia and New Zealand Intensive Care Society (ANZICS) Adult Patient Database and national agencies. MAIN OUTCOME MEASURES: Incidence of ICU admission, cohort characteristics, maternal outcomes and changes over time. RESULTS: The cohort comprised 16 063 patients. The annual number of obstetric ICU admissions increased, whereas their proportion of total ICU admissions (1.3%) did not change (odds ratio 1.02, 95% CI 0.99-1.04, P = 0.14). There were 10 518 (65%) with an obstetric-related ICU diagnosis, and 5545 (35%) with a non-obstetric ICU diagnosis. Mean (SD) age was 31 (6.4) years, 1463 (9.1%) were Indigenous, 2305 (14%) were transferred from another hospital, and 3008 (19%) received mechanical ventilation. Median [IQR] length of stay in hospital was 5.2 [3.1-7.9] days, which included 1.1 [0.7-1.8] days in ICU. There were 108 (0.7%) maternal deaths, most (n = 97, 90%) having a non-obstetric diagnosis. There was no change in risk-adjusted length of stay or mortality over time. CONCLUSIONS: Obstetric patients account for a stable proportion of ICU admissions in Australia and New Zealand. These patients typically have a short length of ICU stay and low hospital mortality. TWEETABLE ABSTRACT: Obstetric patients in Australia/New Zealand ICUs have a short length of ICU stay and low mortality.

Assessment of knowledge and attitude about basic life support among dental interns and postgraduate students in Bangalore city, India / 世界急诊医学杂志（英文）

@#BACKGROUND: Life-threatening emergencies can occur at anytime, at anywhere and in anyone. Effective management of an emergency situation in the dental office is ultimately the dentist's responsibility. The lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legal complications. Therefore, health professionals including dentists must be well prepared to deal with medical emergencies. This study was undertaken to assess the knowledge about and attitude towards basic life support (BLS) among dental interns and postgraduate students in Bangalore city, India. METHODS: A cross sectional survey was conducted among dental interns and postgraduate students from May 2014 to June 2014 since few studies have been conducted in Bangalore city. A questionnaire with 17 questions regarding the knowledge about and attitude towards BLS was distributed to 202 study participants. RESULTS: The data analyzed using the Chi-square test showed that dental interns and postgraduate students had average knowledge about BLS. In the 201 participants, 121 (59.9％) had a positive attitude and 81 (40.1％) had a negative attitude towards BLS. CONCLUSIONS: Cardiopulmonary resuscitation should be considered as part of the dental curriculum. Workshops on a regular basis should be focused on skills of cardiopulmonary resuscitation for dental students.

Congenital myotonic dystrophy with asymptomatic mother.

Myotonic dystrophy is an autosomal dominant neuromuscular disorder characterised by extreme pleiotropism and variability in disease expression. A congenital form is rare and is observed in infants born to symptomatic mothers with multisystem involvement. We report a case of a neonate with congenital myotonic dystrophy born to an asymptomatic mother.

Torsade de pointes in a patient with acute prolonged QT syndrome and poorly controlled diabetes during sevoflurane anaesthesia.

We report a case of torsade de pointes secondary to acute QT interval prolongation in a patient with poorly controlled diabetes mellitus towards the end of a laparoscopic nephrectomy under sevoflurane anaesthesia. The patient was successfully resuscitated and made a complete recovery. Our case suggests that acute QT interval prolongation should be considered in any patient with poor glycaemic control during prolonged procedures.

Widespread infestation of the exotic mealybug species, Phenacoccus solenopsis (Tinsley) (Hemiptera: Pseudococcidae), on cotton in India.

A survey was conducted in 47 locations in nine cotton-growing states of India to identify the composition of mealybug species occurring on cotton. Results of the taxonomic study showed that two mealybug species, the solenopsis mealybug, Phenacoccus solenopsis (Tinsley), and the pink hibiscus mealybug, Maconellicoccus hirsutus (Green), were found to infest cotton plants from all nine cotton growing states of the country. However, P. solenopsis was found to be the predominant mealybug species, comprising 95% of the samples examined. P. solenopsis, which was hitherto not reported to occur in India, now appears to be widespread on cotton in almost all cotton-growing states of the country. P. solenopsis is an exotic species originated from the USA and was reported to damage cotton and crops of 14 families. This report discusses the implications of the introduction of this exotic polyphagous pest species and the necessary steps to mitigate its potential threat to agriculture in India.

Seasonal variations in compostability and production of vermiprotein by Eisenia fetida.

The potential of E. fetida to degrade wastes into vermicompost and to produce vermiprotein in the form of worm-biomass during different seasons was evaluated. Results revealed that the environmental factors prevailing during different seasons did influence directly the life activities of the worm and indirectly the compostability of the wastes. Feeding activities of E. fetida reduced the time of production of an efficient organic pool with energy reserves as vermicompost. Further, the amount of vermicompost produced by the worm activity depended primarily on the environmental factors and secondarily on the nature of organic wastes.

Influence of animal manures on the biology of temperate earthworm, Eisenia fetida in tropical semiarid climate.

For understanding the potential utility in field scale production of vermicompost and vermiprotein economically, Eisenia fetida was cultured to establish the influence of (i) prevailing tropical semiarid (North-East region of Karnataka, India) environmental factors and (ii) different animal manures (cattle, horse and 1:1 mixture of cattle and horse) (on its growth, reproduction and life span. In three forms of diet, growth (mg/d/g live weight of worm) was almost similar, but the biomass in cattle manure (565.7 +/- 15.3) was significantly more than horse manure (494.9 +/- 22.8) and 1:1 mixture (470.3 +/- 22.0). Mean cocoon production (per worm/week) in horse manure (0.16) was significantly (P<0.001) lower than that in cattle manure (1.6) and in 1:1 mixed manure (1.4). Cattle favoured biomass, growth and cocoon production. Horse manure inhibited cocoon production and the conserved energy in this process might have been added to the body weight almost equal to that in cattle manure. In 1:1 mixed manure, the biomass was less due to moderate cocoon production (presumably due to the stimulatory influence of 50% cattle manure) under semifavorable nutrients and environmental conditions. Fecundity of the worms declined with aging, despite favourable nutrients and environmental conditions. Worms survived up to 92, 68 and 66 weeks in cattle manure, 1:1 mixed manure and horse manure respectively.

Effect of temperature on growth and reproduction of the epigeic earthworm, Eudrilus Eugeniae (Kinberg).

Influence of temperature on growth and reproduction of Eudrilus eugeniae has been investigated by laboratory culturing at regulated 25.0 degrees C, 30.0 degrees C, 37.5 degrees C and 40.0 degrees C and in fluctuating (22.7-27.3 degrees C) room temperature of prevailing (winter) season over 16 weeks. All worms died during first and tenth week at 40.0 degrees C and 37.5 degrees C respectively. Weight (biomass) and growth of worms cultured at different temperature varied significantly (P<0.01). The mean growth (mg/g live weight/day) at 25.0 degrees C., 30.0 degrees C, 35.0 degrees C, 37.5 degrees C and in fluctuating temperatures was 1,074.04 +/- 6.07, 1,554.01 degrees 192.37, 148.1 +/- 15.28, 192.83 +/- 25.8 and 1450.4 +/- 162.1 respectively. Growth declined after maturity drastically with coccon production. At 25.0 degrees C though worms are sexually mature, they failed to produce cocoons within 16 weeks whereas, at 35.0 degrees C and 37.5 degrees C they did not sexually mature. Worms attained sexual maturity at a mean weight of about 1000 mg/worm. The mean per cent maturity was higher and earlier in fluctuating temperatures and at 30.0 degrees C than at 25.0 degrees C. Cocoon production was observed only at 30.0 degrees C and in fluctuating temperatures with a mean of 0.9 and 1.5 cocoons/ wom/week and the cumulative cocoon number of 10.8 and 14.7/worm over 16th week respectively. The fluctuating temperature of uncontrolled room environment and 30.0 degrees C were favorable for various life activities of the worms. Eudrilus eugeniae appears to have range of temperature optima more than 25.0 degrees C and less than 28 degrees C. The climatic conditions prevailing in whole of the peninsular India during winter season are favourable for employing this worm in intensive field scale vermiculturing practices.