Mifepristone alone versus mifepristone-misoprostol combination regimen for management of intrauterine fetal death

Background: Early pregnancy failure is a common complication of pregnancy. If women do not abort spontaneously, they will undergo medical or surgical treatment in order to remove the products of conception from the uterus. Curettage, although highly effective, is associated with a risk of complications; medical treatment with misoprostol is a safe and less expensive alternative. Unfortunately, after 1 week of expectant management in case of EPF, medical treatment with misoprostol has a complete evacuation rate of approximately 50%. Misoprostol treatment results may be improved by pre-treatment with mifepristone; its effectiveness has already been proven for other indications of pregnancy termination. The study objective was to compare the outcome of Mifepristone alone with the Mifepristone- Misoprostol combination regimen for the management of IUFD.Methods: This was a Prospective clinical trial at the department of obstetrics and gynecology, Chittagong Medical College Hospital, Chittagong. From March 2016 (Actual patient enrolment started after obtaining ethical clearance i.e. March 2018) to September 2018.Results: A subjects delivered earlier than group B and the mean induction delivery interval in Group A is significantly less in comparison to Group B (p=<0.001). Out of 50 women, 2(4%) and 10(20%) women in Groups A and B required oxytocin infusion to establish good contractions, and completion of termination who regarded as a failure. In the mifepristone alone group, the success rate is significantly higher than in the combination group.Conclusions: The efficacy of mifepristone alone was found superior to that of the mifepristone misoprostol combination regimen in the present study.

Efficacy of the Swede score in prediction of high-grade lesions of cervix

Background: Cervical cancer is a preventable lesion that can be identified by stepwise screening methods. Visual inspection of the cervix with acetic acid, Lugol’s iodine, pap smear, and HPV are the primary screening methods. This study aims to evaluate the efficacy of the Swede score in predicting high-grade lesions of the cervix among patients attending a colposcopy clinic. Methods: This observational cross-sectional study was performed in a colposcopy clinic under the department of obstetrics and gynaecology at CMCH. All referral patients to the colposcopy clinic were the study population. Women aged between 25-65 years was the study subject. Results: Majority (47.5%) of the patient’s Swede score was 4 and 20.1of % of patients had scores of 5-6 and only 1.3% of patients had scores ≥7%. 63 (79%) patients had low grade/normal/ cervical intraepithelial lesion (CIN) 1, 16 (20%) patients had high grade/non-invasive cancer/CIN 2 and only 1 patient had high grade/suspected invasive cancer/CIN 3. A score of 6 had a specificity of 100% for CIN 2 with a sensitivity of 30% positive and negative predictive value (PPV=100%; NPV=90.9%). Lowering the score to 5 for predicting CIN 2 improved the sensitivity at the expense of specificity (sensitivity=60%; specificity=90%; PPV= 94%; NPV=46.2%).Conclusions: Swede scoring system is consistent and reproducible, has a simple structure, and thus contributes to preventing cervical cancer. Swede score of 6 or more has 100% specificity; this scoring method is a preferred method for the treatment of high-grade CIN.

Dielectron and heavy-quark production in inelastic and high-multiplicity proton–proton collisions at √s = 13 TeV

The measurement of dielectron production is presented as a function of invariant mass and transverse momentum (pT) at midrapidity (|ye| < 0.8) in proton–proton (pp) collisions at a centre-of-mass energy of √s = 13 TeV. The contributions from light-hadron decays are calculated from their measured cross sections in pp collisions at √s = 7 TeV or 13 TeV. The remaining continuum stems from correlated semileptonic decays of heavy-flavour hadrons. Fitting the data with templates from two different MC event generators, PYTHIA and POWHEG, the charm and beauty cross sections at midrapidity are extracted for the first time at this collision energy: dσcc¯/dy|y=0 = 974 ± 138 (stat.) ± 140 (syst.) ± 214(BR) μb and dσbb¯ /dy|y=0 = 79 ± 14 (stat.) ± 11 (syst.) ± 5(BR) μb using PYTHIA simulations and dσcc¯/dy|y=0 = 1417 ± 184 (stat.) ± 204 (syst.) ± 312(BR) μb and dσbb¯ /dy|y=0 = 48 ± 14 (stat.) ± 7 (syst.) ± 3(BR) μb for POWHEG. These values, whose uncertainties are fully correlated between the two generators, are consistent with extrapolations from lower energies. The different results obtained with POWHEG and PYTHIA imply different kinematic correlations of the heavy-quark pairs in these two generators. Furthermore, comparisons of dielectron spectra in inelastic events and in events collected with a trigger on high charged-particle multiplicities are presented in various pT intervals. The differences are consistent with the already measured scaling of light-hadron and open-charm production at high charged-particle multiplicity as a function of pT. Upper limits for the contribution of virtual direct photons are extracted at 90% confidence level and found to be in agreement with pQCD calculations

J/ψ production as a function of charged-particle multiplicity in p–Pb collisions at √sNN = 8.16 TeV

Inclusive J/ψ yields and average transverse momenta in p-Pb collisions at a center-of-mass energy per nucleon pair sNN−−−√ = 8.16 TeV are measured as a function of the charged-particle pseudorapidity density with ALICE. The J/ψ mesons are reconstructed at forward (2.03<ycms<3.53) and backward (−4.46<ycms<−2.96) center-of-mass rapidity in their dimuon decay channel while the charged-particle pseudorapidity density is measured around midrapidity. The J/ψ yields at forward and backward rapidity normalized to their respective average values increase with the normalized charged-particle pseudorapidity density, the former showing a weaker increase than the latter. The normalized average transverse momenta at forward and backward rapidity manifest a steady increase from low to high charged-particle pseudorapidity density with a saturation beyond the average value

Higher harmonic non-linear flow modes of charged hadrons in Pb-Pb collisions at sNN\sqrt{s_{\rm{NN}}} = 5.02 TeV

International audienceAnisotropic flow coefficients, v$_{n}$, non-linear flow mode coefficients, χ$_{n,mk}$, and correlations among different symmetry planes, ρ$_{n,mk}$ are measured in Pb-Pb collisions at $\sqrt{s_{\mathrm{NN}}}$ = 5.02 TeV. Results obtained with multi-particle correlations are reported for the transverse momentum interval 0.2 < p$_{T}$< 5.0 GeV/c within the pseudorapidity interval 0.4 < |η| < 0.8 as a function of collision centrality. The v$_{n}$ coefficients and χ$_{n,mk}$ and ρ$_{n,mk}$ are presented up to the ninth and seventh harmonic order, respectively. Calculations suggest that the correlations measured in different symmetry planes and the non-linear flow mode coefficients are dependent on the shear and bulk viscosity to entropy ratios of the medium created in heavy-ion collisions. The comparison between these measurements and those at lower energies and calculations from hydrodynamic models places strong constraints on the initial conditions and transport properties of the system.[graphic not available: see fulltext

Soft-dielectron excess in proton-proton collisions at s\sqrt{s} = 13 TeV

A measurement of dielectron production in proton-proton (pp) collisions at $\sqrt{s} = 13$ TeV, recorded with the ALICE detector at the CERN LHC, is presented in this Letter. The data set was recorded with a reduced magnetic solenoid field. This enables the investigation of a kinematic domain at low dielectron invariant mass $m_{\rm ee}$ and pair transverse momentum $p_{\rm T,ee}$ that was previously inaccessible at the LHC. The cross section for dielectron production is studied as a function of $m_{\rm ee}$, $p_{\rm T,ee}$, and event multiplicity ${\rm d} N_{\rm ch}/{\rm d} \eta$. The expected dielectron rate from hadron decays, called hadronic cocktail, utilizes a parametrization of the measured $\eta/\pi^0$ ratio in pp and proton-nucleus (p-A) collisions, assuming that this ratio shows no strong dependence on collision energy at low transverse momentum. Comparison of the measured dielectron yield to the hadronic cocktail at $0.15<m_{\rm ee}<0.6$ GeV/$c^2$ and for $p_{\rm T,ee} < 0.4$ GeV/$c$ indicates an enhancement of soft dielectrons, reminiscent of the 'anomalous' soft-photon and -dilepton excess in hadron-hadron collisions reported by several experiments under different experimental conditions. The enhancement factor over the hadronic cocktail amounts to $1.61\pm 0.13\,(\rm{stat.})\pm 0.17\,(\rm{syst., data}) \pm 0.34\,(\rm{syst., cocktail})$ in the ALICE acceptance. Acceptance-corrected excess spectra in $m_{\rm ee}$ and $p_{\rm T,ee}$ are extracted and compared with calculations of dielectron production from hadronic bremsstrahlung and thermal radiation within a hadronic many-body approach