Conditions in Indian sterilization clinics are under renewed scrutiny after a doctor was removed from his job for using a bicycle pump to inflate women’s abdomens during the procedure. Health officials in Odisha state have launched an investigation after reports that bicycle pumps were used on 56 women undergoing sterilization surgery at a government-run community health center in Banarpal, Angul district, Friday.

The physician was identified as Dr. Mahesh Chandra Rout, a retired surgeon who carried out work when required for the clinic, said Odisha Health Secretary Arti Ahuja. She said he would no longer be called on to work for the clinic, and could face charges as a result of the inquiry. Ahuja said the medical equipment that should have been used in the procedure — a carbon dioxode insufflator had been provided to the clinic, and investigators would try to determine why it was not used.

But Sachin Ramachandra, a health official in the district where the procedures took place, said inquiries revealed the insufflator was missing, which is why the bicycle pump had been used instead. A health official who did not wish to be named told CNN that the use of bicycle pumps in sterilization surgery was widespread. In the wake of the incident, state health officials issued a directive that all sterilizations must be carried out according to correct protocols.

In sterilization surgery, the patient’s abdomen needs to be inflated to allow room to move surgical instruments. Dr. Naresh Trehan, the chief medical officer at the Medanta medical institute in New Delhi, told CNN that using a carbon dioxide insufflator allows a doctor to measure and calibrate the amount of pressure placed on the abdomen. Using a bicycle pump a method Trehan said he was alarmed to hear about, is highly dangerous. “If you use a bicycle pump, you don’t know how much air you’re pumping in and you might burst the abdomen,” he said. Dr. Vidhyadhar Sahu, the chief medical officer for Angul district, said none of the 56 women who underwent surgery on Friday reported any problems.

a comprehensive study of genetic diversity in Sub-Saharan Africa, the BBC has reported. The African Genome Variation Project analysed the DNA of 1,800 people living across the continent.

The data is helping scientists to understand how susceptibility to disease varies across the region and has provided more insight into how populations have moved within Africa.

The research is published in the journal Nature.

Until now, most studies examining genetic risk factors for disease have focused on Europe. Little has been known about Africa, the most genetically diverse region in the world.

Dr Manj Sandhu, from the Wellcome Trust Sanger Institute and the University of Cambridge, said: “We originally set out to look at chronic diseases in Africa, and one strategy to understand the causes of those diseases is to look at the underlying genetic susceptibility.

“But to do that, you need a pretty good grasp of the variation in genomes across the region, but we realised that information wasn’t available.”

To find out more, a team of African, UK and US researchers collected genetic material from 1,800 people in Sub-Saharan Africa, including 320 whole genome sequences. The researchers found that there were some key regional differences.

For example, people from South Africa are less likely to carry a genetic mutation that offers protection against malaria than those from other parts Africa.

And globally, Africans are more likely to have a greater risk of high blood pressure than Europeans.

However, the researchers also found that there were more genetic similarities across Africa than they had thought.

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