Post caesarean section complication and its management in Dhaka medical college hospital

Background: The increase in the rate of caesarian sections globally is intimately related to the development of the women access to this procedure when required. But it is still related to the indiscriminate use without medical indication. This has fulminated in the recent efforts to reduce these rates while incorporating the obstetric preferences of women. Objective of the current study was to find out the predisposing factors for caesarian complications and to observe its management pattern. Methods: This was a cross sectional observational and descriptive study performed in the department of obstetrics and gynecology, Dhaka medical college hospital, Dhaka from January2019 to June 2019. All mothers admitted for elective and emergency cesarean section were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 100 patients were finalized. A pre-tested, observation based, peer-reviewed data collection sheet was prepared before study. Data regarding clinical, biochemical and surgical profile were recorded. Results: The mean age of the respondents was 25.96±4.43 (age range: 17-39) years. Among 100 mothers, 59% underwent elective and 41% underwent emergency cesarean section. 67% had uneventful outcome after LSCS. Rest 33% had post cesarean section complications. Among them 33% mother who had complications, 19 (57.57%), 12 (36.36%), 10 (30.30%) and 8(24.24%) had wound gap, UTI, GIT complications and haemorrhage respectively. 3 (9.09%) each suffered from thromboembolic complications and septic thrombophlebitis. Only one (3.03%) experienced DIC. Out of 33 complicated cases; 27 (81.81%) required treatment with injection oxytocin, blood transfusion, condom catheterization and 10 (30.30%) required secondary closure. Among them 4 (12.12%) underwent mass closure and received antithrombotic drug. One (3.03%) each underwent excision sinus tract and re-laparotomy. Conclusions: Caesarean section complications can result in death or morbidity. Despite advances in technology and expertise, wound infection or wound gap remains the most common post-c-section complication. It is critical to successfully manage complications after cesarean section in order to reduce morbidity and mortality among mothers

Clinical study on the relationship of scar tenderness with scar integrity at repeat caesarean section

Background: Caesarean section is an operative process whereby the fetuses after the end of 28th weeks are delivered through an incision on the abdominal and uterine wall. This excludes delivery through an abdominal incision where the fetus lying free in the abdominal cavity following uterine rupture or in secondary abdominal pregnancy. The first operation carried out on a patient is referred to as an primary caesarean section. When the operation is carried out in subsequent pregnancies, it is referred to as repeat caesarean section. Caesarean section is used in cases where vaginal delivery is not either feasible or would impose undue risks on mother or baby. The aim of the study to assess the Relationship of Scar Tenderness with Scar Integrity at repeat caesarean section. Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh. The duration of the period from April 2017 to October 2017. Results: This study shows that the according to age of 50 Patients aged 20 to 35 years. Here out of 50 mothers the highest 23(46%) mothers belonged to 21-25 years age group. Subsequently, 15(30%), 9(18%), 2(4%) and 1(2%) belonged to 26-30 years, ≤20 years, 31-35 years and >35 years respectively. The mean age of the respondents was 23.16±5.79 (age range: 17-38) years. Conclusions: The scar complications are highly associated with the intensity of scar tenderness. Henceforth, it can be concluded here that scar tenderness is a vital factor responsible for scar complications.

Risk factors and complications in pregnancies associated with placenta previa among admitted cases in FMCH

Background: Placenta previa is a leading cause of antepartum haemorrhage. Placenta previa present a significant clinical problem and patients are at risk for significant haemorrhage, needing blood transfusion. The risks are increased in women with previous placenta previa, endometrial damage caused by DE and C, caesarean delivery, myomectomy, multiparity, alcohol cocaine use during pregnancy, smoking during pregnancy. Methods: Admitted patients were selected with convenience sampling type of non-probability sampling type of non-probability sampling technique. The primary end point was to determine the risk factors of placenta previa and its complications. The secondary end point was to determine maternal morbidity and mortality of placenta previa. Results: Incidence of placenta previa was 2.03% out of 2459 patients, 70% were associated with risk factors. Among them 42% had history of caesarean section, 14% had history of abortion, 10% had history of manual removal, 48% patients were more than 25% years old, 36% were more than 30 years. Placenta previa occurred in gravida 3rd or more. Forty two percent patients belonged to lower socioeconomics group. Only 12% patients had regular antenatal checkup. Malpresentations were present in 24% cases. In this study 50% patients were associated with central placenta previa. Eighty percent patients were in shock, only 2% patients were asymptomatic. Regarding management 76.34% patients were managed actively, 12% patients had expectant management. Only 2% patients delivered vaginally, 82% patients delivered by caesarean section. Maternal mortality rate was 02%. Regarding fetal outcome, 76% babies were alive and there were 20% perinatal deaths. Conclusions: Although etiology of placenta previa largely remain obscure and speculative. There is a strong association between advanced maternal age, multiparity, history of caesarean section and abortion with subsequent development of placenta previa. Women aged >30 years, grand multipara, previa and must be monitored carefully. Hence the study advocates proper antenatal care early referral to hospital and prompt management of patients after proper selection can reduce maternal morbidity and mortality

FLY ASH AS A POTENTIAL SOURCE OF SOIL AMENDMENT IN AGRICULTURE AND A COMPONENT OF INTEGRATED PLANT NUTRIENT SUPPLY SYSTEM

ABSTRACT The present study investigates the effect of fly ash amended soil on the growth and photosynthetic pigment content of Capsicum annuum. A pot culture experiment comprising four treatments such as 5%, 10%, 15% and 20% were carried out with a control pot. The different photosynthetic pigments like chlorophyll a, chlorophyll b, total chlorophyll, carotenoid and physical parameters like total length of plant, root length and shoot length were studied on different experimental days, i.e. 10 th day, 20 th day, 30 th day, 40 th day, 50 th day and 60 th day. The different physico-chemical characteristics of soil before and after the experiment were analyzed. Photosynthetic pigments like chlorophyll a, chlorophyll b, total chlorophyll and carotenoid were found to be highest in 5% fly ash amended soil on 40 th days of growth followed by a decline trend. One way ANOVA test for those pigments between different days of growth and also within different fly ash amendment soils showed a significant difference (P < 0.05). Further, the physical parameters like root length, shoot length and total length of the plant were studied on each experimental days. One way ANOVA test for those parameters between different days of growth and also within different fly ash amendment soils were not found to be significant. The change in soil physico-chemical parameter such as pH, conductivity (µs/cm), moisture content (%), OC (g%), OM (g%), N (mg/kg), P (mg/kg), Cu (mg/kg), Zn (mg/kg), Fe (mg/kg), Cr (mg/kg) were also analyzed from each culture pot after the end of the experiment. It was observed that except N, P, K all other parameter have increased with increase in fly ash amendment

A case of an 81-year-old with cough and dyspnea

It is uncommon to diagnose usual interstitial pneumonitis as a unilateral presentation. We present a case of an 81-year-old current smoker who presented with exertional dyspnea and dry cough. The patient had right sided UIP pattern in the CT chest along with hiatus hernia. The etiology for the unilateral lung involvement was postulated to be due to the hiatus hernia leading to gastro-esophageal reflux disease (GERD) which caused micro aspirations leading to lung injury and fibroblast activation. Whether this can be prevented by anti-reflux medications needs further research. Our patient was managed with pirfenidone, metered dose inhalers containing tiotropium and proton-pump inhibitors Thus, a high index of suspicion for underlying gastro-esophageal reflux must be kept in such patients to arrive at an early diagnosis and start treatment

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe