Trygfonden, Lundbeckfonden, and the Danish National Research Foundation.

No abstract

Introduction: Through forensic auditing a new way to monitor medical data was opened. Forensic auditing uses Benford's law, which explains the frequency distribution in naturally occurring data sets. We applied this law on data for Maternal Mortality. This is an extremely important number in policy-making for sustainable project implementation. Methodology: The law states that the probability of a leading occurring number Chi-square was higher than the cut off value, which leads to the rejection the null hypothesis. The rejection of the null hypothesis means that the numbers observed in the publication are not following Benford's law. Explanations can reach from errors, operational discrepancies and psychological challenges to manipulations in the struggle for international funding. Conclusion: Knowledge on this mathematical relation is not used widely in medicine, despite being a very valuable and quick tool to identify datasets in need of close scrutiny.

Background: Postoperative nausea and vomiting are common complications of anaesthesia and surgery. Known risk factors include motion sickness, migraine, gender and types of surgery. Other possible risk factors for postoperative nausea and vomiting are ethnicity and genetics surgery. Objective: The main objective of the study was to describe factors associated with postoperative nausea and vomiting among adult Malawians. Methods: This was a prospective observational study. 138 adult patients were recruited into the study. Data were collected using a predesigned questionnaire. Patients were followed up to 18 hours postoperatively and any episodes of postoperative nausea and vomiting were noted. Results: A total of 138 patients were enrolled in the study. 78 were female (56.5%) and 60 were males (43.5%). The ages ranged from 18 to 87 years. The mean age was 36.9 years. The overall incidence of postoperative nausea and vomiting was 29.6%. It was higher among women than men. Patients with motion sickness had the highest incidence of postoperative nausea and vomiting (78.6%) followed by those with migraine (73.3%). Patients whose intraoperative systolic blood pressure fell <80 mmHg had an incidence of 71.4% and those who received postoperative opioids had an incidence of 37.7%. Conclusions: Patients with a history of migraine, motion sickness, whose intraoperative blood pressures fall below a systolic of 80 mmHg and who receive postoperative opioids are at an increased risk for postoperative nausea and vomiting.

In 2011 we published a study on how to detect the threshold for malnutrition in children, simply using their own hands and without any technical tool. The fight against malnutrition can only be reached when its measurements involve every single child, almost continuously, in the affected villages. In this paper we try to show that, thanks to our method, it is possible to use mid-upper-arm-circumference as a measurement for malnutrition in children, discriminating between severe and moderate malnutrition and providing the basis for the decision on whether to admit a child to a nutritional rehabilitation unit or not. We trained 63 participants in four groups (Group 1: doctors and clinical officers; Group 2: nurses and students; as Group 3 we defined the 20 best participants and Group 4 consisted of 10 more intensely trained participants) to measure the circumference of 9 different artificial arms (between 9 and 13 cm) using their own fingers and hands. The training was short and consisted of an introduction of 5 min, a first training phase of 10-15 min, a test, the critical discussion of the results, a second training phase of 5 min and a final test. We found that 95.3% of participants in the general group and 97.9% in the intensely trained group have identified the severely malnourished child; 87.3% in the general group and 91.9% in the intensely trained group have additionally identified the moderately malnourished child. Both groups haven’t admitted the well nourished child to a therapeutic feeding program retaining their resources. The third group reached without any additional training the results in the above categories. A subsequent discussion with the participants on the influence of procurement, maintenance and pricing of our tool, found our method much less vulnerable than others. We conclude that this method should be considered as a future training in the villages to detect the trend towards malnutrition early enough.