Fes

Researchers are evaluating the effects of norepinephrine versus phenylephrine infusions to maintain blood pressure during spinal anesthesia in women undergoing elective cesarean delivery. This randomized, double-blind controlled trial aims to compare neonatal outcomes measured by umbilical artery pH and maternal hemodynamics, hypothesizing that norepinephrine provides similar neonatal safety with more stable blood pressure and fewer heart rate drops. Participants receive either phenylephrine or norepinephrine as a continuous infusion started simultaneously with spinal anesthesia. The infusion rates are manually adjusted based on maternal systolic blood pressure measured every minute to keep values near baseline. Spinal anesthesia involves injecting hyperbaric bupivacaine with fentanyl, followed by rapid intravenous fluid expansion. The study drug concentrations and infusion protocols are standardized to ensure comparable dosing between groups. Throughout the cesarean procedure, maternal blood pressure and heart rate are closely monitored, with adjustments made to infusion rates as needed to manage hypotension, hypertension, and bradycardia. Umbilical arterial blood is sampled immediately after delivery to assess blood gases. Additional measures include recording newborn APGAR scores and any adverse maternal or neonatal events. The studys main outcome is umbilical artery pH, with various secondary outcomes tracked to evaluate safety and efficacy.

Researchers are evaluating health behaviors and school policies among adolescents aged 13 to 17 in secondary cities of four low- and middle-income countries. The study aims to use health information collected through school surveys to empower students, teachers, and local authorities to improve health policies and programs. This cluster randomized trial includes 30 schools, with half randomly assigned to receive the intervention and half serving as control schools. The intervention includes interactive workshops facilitated by WHO and trained local personnel. These workshops use the Global Accelerated Action for the Health of Adolescents Global AA-HA approach to identify health needs, assess existing policies, and prioritize actions to improve health. Behavioral and school-level interventions will be developed based on baseline data and implemented over two years in 15 schools, while the other 15 schools continue without intervention. Participants will complete baseline and follow-up surveys after two years using the Global School-based Student Health Survey GSHS and Global School Health Policies and Practices Study G-SHPPS. The study will measure changes in behaviors such as alcohol and tobacco use, diet, drug use, physical activity, mental health, sexual behavior, hygiene, protective factors, and violence. Monitoring and evaluation will assess the effectiveness of the implemented actions during the study period ending in 2027.