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S C Hodges

Publications and source records attributed to S C Hodges.

8 recordsLinked to original sources

Anaesthesia services in developing countries: defining the problems.

We describe the use of a questionnaire to define the difficulties in providing anaesthesia in Uganda. The results show that 23% of anaesthetists have the facilities to deliver safe anaesthesia to an adult, 13% to deliver safe anaesthesia to a child and 6% to deliver safe anaesthesia for a Caesarean section. The questionnaire identified shortages of personnel, drugs, equipment and training that have not been quantified or accurately described before. The method used provides an easy and effective way to gain essential data for any country or national anaesthesia society wishing to investigate anaesthesia services in its hospitals. Solutions require improvements in local management, finance and logistics, and action to ensure that the importance of anaesthesia within acute sector healthcare is fully recognised. Major investment in terms of personnel and equipment is required to modernise and improve the safety of anaesthesia for patients in Uganda.

Adult↗

Nitrogen Loss Estimation Worksheet (NLEW): an agricultural nitrogen loading reduction tracking tool.

The Neuse River Basin in North Carolina was regulated in 1998, requiring that all pollution sources (point and nonpoint) reduce nitrogen (N) loading into the Neuse Estuary by 30%. Point source N reductions have already been reduced by approximately 35%. The diffuse nature of nonpoint source pollution, and its spatial and temporal variability, makes it a more difficult problem to treat. Agriculture is believed to contribute over 50% of the total N load to the river. In order to reduce these N inputs, best management practices (BMPs) are necessary to control the delivery of N from agricultural activities to water resources and to prevent impacts to the physical and biological integrity of surface and ground water. To provide greater flexibility to the agricultural community beyond standard BMPs (nutrient management, riparian buffers, and water-control structures), an agricultural N accounting tool, called Nitrogen Loss Estimation Worksheet (NLEW), was developed to track N reductions due to BMP implementation. NLEW uses a modified N-balance equation that accounts for some N inputs as well as N reductions from nutrient management and other BMPs. It works at both the field- and county-level scales. The tool has been used by counties to determine different N reduction strategies to achieve the 30% targeted reduction.

Agriculture↗

A protocol for safe anasthesia for cleft lip and palate surgery in developing countries.

A project to perform surgical correction of cleft lips and palates was carried out in Uganda in 1998. Twenty centres were visited and 336 cleft lips and 41 cleft palates were repaired. The age of the patients ranged from 2 weeks to 60 years. Many of the centres visited were remote and lacked even the most basic equipment. Patients were anasthetised using ketamine, ether or halothane according to a protocol that we developed. There was no anasthetic mortality and only one case of significant morbidity. We report our experience and discuss recommendations regarding the provision of anasthesia in remote circumstances based on our outcome. An additional benefit of the project was that we provided training to local medical personnel in anasthesia and surgery for cleft lips and palates.

Adolescent↗

A rural cleft project in Uganda.

Over an 8-month period a cleft project was organised across Uganda. The aim of the project was to travel to as many districts as possible in the available time and repair all the cleft patients who could be mobilised. Local surgeons were trained and the results of the project were assessed. This was a prospective study which assessed immediate patient outcome, feedback from participating hospitals and cost. The team visited 20 hospitals, many in remote rural areas. All equipment necessary for surgery was transported to the hospitals. 336 cleft lip repairs and 41 cleft palate repairs were performed on 343 patients. There was no anaesthetic morbidity or mortality and no immediate perioperative morbidity. Two cleft lip repairs developed partial wound dehiscence and there was one palatal fistula. Five local surgeons underwent cleft training. All centres participating in this project requested further visits. The total cost for each cleft repair was 27 pounds sterling. Visiting remote centres with a mobile team is an efficient, safe and cost-effective method to treat the large numbers of unrepaired clefts in developing countries.

Adolescent↗

Effect of heat and sodium dodecyl sulfate on solubilization of proteins before two-dimensional polyacrylamide gel electrophoresis.

To solubilize biological samples, sodium dodecyl sulfate (SDS) frequently is added and the mixture heated at 70-100 degrees C. However, two-dimensional polyacrylamide gel electrophoresis of a single protein after SDS treatment has not been reported. When rabbit-muscle creatine kinase was so run, we saw considerable difference in the gel staining pattern for the heated and nonheated enzyme dissolved in the SDS solution. After heating for 10 min at 95 degrees C the number of silver-stained spots apparent increased, and staining of several spots intensified. After 60 min, most of the discrete spots disappeared. Evidently the peptide backbone had been hydrolyzed. When the enzyme was simply left at room temperature for four days, the effects were similar. Appearance of new spots and loss of spots apparently are caused by heating alone but are intensified by SDS. Experiments with human serum albumin yielded similar results.

Creatine Kinase↗

Effect of fluoroscopic tube placement on basal gastric secretion collections.

To determine whether fluoroscopic positioning of nasogastric tubes is useful in the measurement of basal gastric acid output, four subjects were studied six times each and two subjects ten times each. Fluoroscopic positioning was used or not used according to random sequences. No more gastric juice was obtained in the collections after fluoroscopic positioning of the nasogastric tube than after blind placement. The results suggest no routine need to use fluoroscopic tube placement in the absence of prior gastric surgery.

Adolescent↗