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Biomedical subjects

P Barss

Publications and source records attributed to P Barss.

At least 19 recordsLinked to original sources
PubMed1990

Endemic placenta accreta in a population of remote villagers in Papua New Guinea.

Using a combination of prospective registration of definite cases (n = 47) and retrospective identification of probable cases (n = 22) over a 6.5-year period, we have estimated that the rate of placenta accreta in the Milne Bay Province of Papua New Guinea is at least 1.6 per 1000 births, and probably in excess of 2.3 per 1000. This is substantially higher than other reported estimates of the frequency of this condition, which causes significant maternal morbidity. The study population of 130,000 consisted mainly of subsistence cultivators who live in remote hamlets, and included about 27,600 women between the ages of 15 and 49 years. A number of factors seem likely to be important in the aetiology of the condition in Milne Bay Province, including infection associated with previous childbirth and abortion. Over three-quarters of the cases would have been prevented if all women of para greater than or equal to 4 or with a history of retained placenta had used effective contraception. Better obstetric care, including early treatment of postpartum sepsis and incomplete abortion, may also help to reduce the frequency of placenta accreta in this population.

Female↗
PubMed1990

Injuries and illnesses aboard research vessels of the University National Oceanographic Laboratory System.

The University National Oceanographic System operates a fleet of vessels to carry out its scientific projects. Illnesses and injuries at sea are handled by first responders aboard the vessels in consultation with land-based physicians at a telecommunications response center in the United States. During the period 1985 to 1987, 122 cases among regular and scientific crew required medical consultation by telecommunications. Of these, 31% were injuries, 34% were medical cases (infected), 12% were sexually transmitted diseases, and 23% were medical cases (noninfected). Evacuation from the vessel, vessel diversion, or repatriation of the patient was required for 20% of all cases; of these, 48% were for injuries, 36% for noninfected medical illnesses, and 16% for infected medical cases. Rates of illness and injury were calculated using the crew days at sea as a denominator.

Adult↗
PubMed1985

Ward design and neonatal jaundice in the tropics: report of an epidemic.

Architectural modifications to an existing tropical obstetric ward involved extension of the roof overhangs to a width of several metres. These extensions excluded most of the daylight from the ward. An alarming increase in the incidence of jaundice (bilirubin concentration greater than or equal to 240 mumol/l (greater than or equal to 14 mg/100 ml] from 0.5% to 17% in newborn infants occurred after the modifications. Tropical obstetric wards and nurseries should continue to be built with windows facing north-south for coolness. They should, however, have as many windows as possible and the roof overhangs should be limited to about 1 m to allow adequate indirect sunlight to enter, giving a high intensity of illumination, and help prevent neonatal jaundice.

Disease Outbreaks↗
PubMed1985

Grand multiparity: benefits of a referral program for hospital delivery and postpartum tubal ligation.

The maternal death rate is high in grand multiparas giving birth in remote villages in Milne Bay Province, Papua New Guinea. Such women are often reluctant to go to hospital for delivery. However, many of them have accepted the idea of going to hospital to await delivery and postpartum tubal ligation. We discuss the results and benefits of this program. 43% of grand multiparas suffered one or more complications during their hospitalization; 77% were sterilized. Considerable morbidity and mortality can be prevented by an active program for hospital management of grand multiparas. Costs of such early referral are at least partially offset by decreasing costs for late emergency transfer of obstetric disasters. 47% of emergency air charters for obstetric complications were for grand multiparas. Numbers of such emergency transfers have decreased as increasing numbers of grand multiparas have been referred early for delivery and tubal ligation.

Emergencies↗
PubMed1985

Training appropriate laboratory workers for rural health centres in Papua New Guinea.

Many rural health centres in developing countries continue to treat patients without the help of any laboratory tests. The result is often inaccurate diagnosis, wasteful use of multiple drugs, and increasing drug resistance of pathogens. It is unlikely that there will ever be sufficient funds to employ a full-time laboratory worker at each of the many small remote health centres in Papua New Guinea. It is also doubtful whether staff and health extension officers who run such centres have the appropriate knowledge to adequately utilize full-time laboratory personnel. It is feasible, however, to train selected health workers in courses of three to four months' duration to perform a few simple laboratory tests part-time, in addition to their clinical duties. Suitable tests are those where the result does not require skilled interpretation. For most such tests, the result is the diagnosis. After the clinical staff have received the laboratory diagnosis, they are free to decide whether it fits the clinical picture. If so, they can then find the appropriate treatment to prescribe in standard treatment books. The present paper describes the experience in setting up and operating laboratory training for health centre staff in Milne Bay Province, Papua New Guinea. Costs and initial results of the program are discussed.

Allied Health Personnel↗
PubMed1985

Fractured hips in rural Melanesians: a nonepidemic.

Fractured hips are increasingly common in elderly citizens of many developed countries. Such fractures seem to be rare in less affluent people of some developing countries, even amongst the elderly. A four year review was done of all trauma patients admitted to a provincial hospital in hospital in Papua New Guinea which serves 135.000 people living mainly in remote hamlets. Only three fractures of the proximal femur were noted. One of these was in a bedridden plantation owner. Not a single fracture of the femoral neck was noted in the Melanesian population. Colles fractures of the distal radius were also rarely seen. Other fractures were common. Elderly Melanesian villagers are physically active, and it appears that this is an important factor in preventing bone weakness and associated fractures of the hip and distal radius. Modern cities and urban lifestyles need radical change to keep elderly people more physically active.

Age Factors↗