Mohammed El-Shahat

OBJECTIVES: The study documented facility-based obstetric practices for normal labor in Egypt for the first time, to determine their relationship to evidence-based medicine. This paper describes the labor augmentation pattern observed.

METHODS: 176 cases of normal labor were observed by medically-trained observers using a checklist. Ward activities were also documented. Observed women were interviewed postpartum and all findings were shared with the providers for their feedback.

RESULTS: Labor was augmented in 91% (165) of the labors observed; this was inappropriate for 93% or 154 women. Reasons for inappropriateness were: oxytocin ordered at the first vaginal exam (41%); in spite of intact membranes (36%), at the time of membrane rupture (42%), in spite of good progress (24%), or a combination of these. The monitoring of oxytocin-receiving women and their babies was inadequate.

CONCLUSIONS: Labor augmentation and monitoring deviated from evidence-based guidelines. Obstacles to implementing protocols need to be explored.

In the present work a detailed study has been performed on the effect of the matrix on the limit of detection (LOD) and the plasma parameters of the laser induced breakdown spectroscopy (LIBS) technique. The LOD of magnesium, silicon, manganese and copper as minor elements was evaluated in aluminium standard sample alloys compared to the values of the LOD of the same elements in standard steel alloys. The effect of changing the matrix on the laser induced plasma plume parameters, namely the plasma temperature Te and the electron density Ne, has been also studied. Calibrations were achieved for the four elements with linear regression coefficients between 98-99% on average. According to the obtained results Mn and Cu have the lowest LOD in the steel alloy matrix, while Mg has much lower LOD in the aluminium alloy matrix. These results may be interpreted in view of the compatibility of the physical properties of the elements existing in the same matrix. Approximately similar electronic structure and values of melting point, density, atomic weight, etc., may facilitate better conditions for energy transfer within the matrix. From the application view point, it is possible for LIBS in the on-line industrial process control to follow up only a single element (that with the lowest LOD in such matrix) as a marker for the correct alloying in metals and mixing in pharmaceuticals. © The Royal Society of Chemistry 2004.