RESUMO
Objective: The aim of the article is to assess the impact of retrograde intrarenal surgery under central neuraxial blockade in comparison to general anesthesia (GA). Material and Methodology: This systematic review was conducted following the guidelines set out by the preferred reporting items for systematic reviews and meta-analyses. We conducted a comprehensive search across major electronic databases, including various types of studies such as descriptive studies and full-text literature, all of which were incorporated into the current review from 2018 to 2023. We involved those studies, which included the comparative study of spinal anesthesia (SA), epidural anesthesia (EA), and combined spinal epidural anesthesia with GA. Result: In our meta-analysis of 12 studies, it was found that anesthesia technique significantly affected operation time, with neuraxial anesthesia (NA) showing a mean difference of -2.28 (95% confidence interval (CI): -3.5 to -1.04, P = 0.003) compared to GA. However, there were no significant differences in rates of stone clearance, 24-h pain scores and length of hospital stay among patients administered with NA or GA for retrograde intrarenal surgery (RIRS). Conclusion: On the basis of the outcomes of study, NA can serve as a viable alternative to GA for RIRS. Our analysis reveals no significant differences in rates of stone clearance, operation duration, 24-h pain scores, complication rates, and length of hospital stay between NA in addition to GA in the context of RIRS. This suggests that given the potential economic advantages, NA might be a preferable choice over GA, contingent on patient preferences, baseline characteristics, and stone burden.
RESUMO
Introduction: As per WHO guidelines, it is important to have quality among mortality audit documents to improve outcome in health services. Objective: To assess quality of facility-based neonatal mortality audits implementation. Methodology: Mixed-method descriptive analysis was conducted. Totally, 96 death review documents were reviewed. The 25 healthcare workers were interviewed in depth. Observation analysis done for audit meetings using WHO modified checklist for quality in audit toolkit. Results: The observation of audit meetings highlighted that almost half of the members were not communicated regarding vision of audit and framework of audit and review meetings. In quantitative analysis, it was found that secondary care hospitals were not having accuracy and consistency in audit documentation. Conclusion: The quality of neonatal death audit was poor due to challenges faced by the hospitals in creating an enabling atmosphere, which can be overcome by sharing the vision of audit with the whole staff of the hospital. A standard operating procedure for audit committee to be adopted to implement action plans. Commitment, investment, and intentional leadership from everyone, including all healthcare workers, can make these ambitious goals attainable.
RESUMO
The Indian Ocean (IO) continental shelf characterized by unique oceanographic and meteorological features and extreme habitat is a biodiversity hotspot region. Marine biodiversity provides valuable resources and services, in terms of economy, cultural, science, and education. Unsustainable exploitation and habitat degradation represent the greatest threat to biodiversity. Understanding how these services will change in the future requires knowledge of marine biodiversity. Although macrofaunal biodiversity is critical for the functioning of shelf systems, it has received much less attention, particularly in the IO, mainly due to logistics reasons precluding our ability to predict future changes. Here, we discuss the state of knowledge of macrofaunal ecology, to identify the knowledge gaps, which will allow for setting research priorities. The new framework in research synthesis, research weaving, that combines systematic mapping with bibliometric analysis was applied. The research weaving approach helps illustrate the evolution of research over time and identifies areas of current research interests and the performance of institutions and collaboration patterns. Data retrieved from the Web of Science were analyzed in the R and VOS Viewer software. The results highlight how macrofaunal research in IO is constrained by spatial and temporal scales, with the majority of studies focused on structural patterns. Moreover, most studies were conducted in a few countries (India, Australia, Saudi Arabia, Iran, and South Africa) using different sampling techniques hindering comparison within the IO habitats. Future studies investigating the macrofaunal community using a multidisciplinary approach and scientific collaboration (regional and international) can advance our efforts to close the marine biodiversity knowledge gaps.
