Prevalence and predictors of surgical-site infection after caesarean section at a rural district hospital in Rwanda.

BACKGROUND: There are few prospective studies of outcomes following surgery in rural district hospitals in sub-Saharan Africa. This study aimed to estimate the prevalence and predictors of surgical-site infection (SSI) following caesarean section at Kirehe District Hospital in rural Rwanda. METHODS: Adult women who underwent caesarean section between March and October 2017 were given a voucher to return to the hospital on postoperative day (POD) 10 (±3 days). At the visit, a physician evaluated the patient for an SSI. A multivariable logistic regression model was used to identify risk factors for SSI, built using backward stepwise selection. RESULTS: Of 729 women who had a caesarean section, 620 were eligible for follow-up, of whom 550 (88·7 per cent) returned for assessment. The prevalence of SSI on POD 10 was 10·9 per cent (60 women). In the multivariable analysis, the following factors were significantly associated with SSI: bodyweight more than 75 kg (odds ratio (OR) 5·98, 1·56 to 22·96; P = 0·009); spending more than €1·1 on travel to the health centre (OR 2·42, 1·31 to 4·49; P = 0·005); being a housewife compared with a farmer (OR 2·93, 1·08 to 7·97; P = 0·035); and skin preparation with a single antiseptic compared with a combination of two antiseptics (OR 4·42, 1·05 to 18·57; P = 0·043). Receiving either preoperative or postoperative antibiotics was not associated with SSI. CONCLUSION: The prevalence of SSI after caesarean section is consistent with rates reported at tertiary facilities in sub-Saharan Africa. Combining antiseptic solutions for skin preparation could reduce the risk of SSI.

Comparison of dentine-resin interface in total-etch and self-etching adhesives using electron microscopy.

The important condition for the adhesive bond between dentine and composite filling is the change of dentine property from hydrophilic to hydrophobic. Substances able to accomplish this change, dentinal adhesives, have undergone complex development. Recently, the so-called self-etching adhesives have been formulated. The aim of the present paper was to compare the structural pattern of dentin/resin interface after the application of dentinal adhesives used in total- and self-etching technique. Dentinal adhesives Single bond, Prime bond, Prompt-L-pop Adper, and Xeno III were used. The former two belong to the total etch technique, the latter two to the self-etching technique. The dentin/resin interface was studied in transmission (TEM) and scanning (SEM) electron microscope. In TEM sixteen teeth were investigated, each adhesive was applied in four teeth. Under SEM forty teeth were studied, each adhesive was applied in ten teeth. The obtained results demonstrated that all the dentine adhesives studied were able to penetrate into dentinal tubules and to form a hybrid layer with the demineralized intertubular and peritubular dentine. There was no substantial difference in morphology of the dentine/resin interface between the techniques studied. Our results suggest that the hybrid layer function of all four adhesives might be of the same quality.

Captopril como droga monoterapica de la hipertensión diastolica / Captopril as drug monotherapy of diatolic hypertension

La efectividad e inocuidad del captopril, como droga monoterápica, fue evaluada en 35 pacientes con hipertensión diastólica crónica de etiología desconocida, en un estudio abierto de 8 días de duración. Fueron administrados 75 mg diarios de la droga, en forma de comprimidos por vía oral. La efectividad hipotensora fue del 82 por ciento. El 31,4 de los pacientes presentaron efectos adversos, ocurriendo la respuesta a primera dosis en el 11,2 por ciento no siendo necesaria la suspensión de la medicación en ningún caso