Effectiveness, Safety, and Side Effect of Depo Progestin and Depo Vigestron Contraception

Introduction: Trends in contraceptive injections increased in the last two decades. Hormonal contraceptive injection is available in single or combination dose. However, the products are available more than 1 ml (more than recommendation of WHO). This study aims to determine the effectiveness, safety and side effects of the contraceptive injection Depo Progestin® 3 ml, Depo Vigestron® 3 ml and Depo Vigestron® 1 ml. Method: This study used randomized controlled clinical trial and open label. The research subject were 900 people in two center, Surabaya and Palembang. The samples were divided into 3 (three) groups, group Depo Progestin® vial 3 ml, group Depo Vigestron® vial 3 ml, and group Depo Vigestron® vial 1 ml. Each of consist 300 women using the "random permutation block". Analysis was performed 5 times, when an initial injection and a schedule of repeated injections in the 3rd, 6th, 9th and 12th month. The data analyzed include weight, blood pressure, menstrual pattern, and the complaints of the patients. Results: From the 900 only 862 valid samples. The results showed no signi fi cant difference between groups Depo Progestin® 3ml, Depo Vigestron® 3 ml and Depo Vigestron® 1 ml. The majority of respondents experienced an increase in weight, but still within normal limits, did not have increased blood pressure, increased menstrual blood volume, Pregnancy didn\u27t occured to all respondents and found no abnormalities in cervical cytology. Conclusion: Contraceptive injection of Depo Progestin® 3 ml, Depo Vigestron® 3 ml dan Depo Vigestron® 1 ml, have used during 12 months can be concluded that those tree kind of contraception were efective, safe and had no side effect

Implementation of a flexible and modular multiphase framework for the analysis of surface-tension-driven flows based on a LS-VOF approach

The mathematical modelling and numerical simulation of multi-phase flows are both a demanding and highly complex exercise. In typical problems with industrial relevance, the fluids are often in non-isothermal conditions and interfacial phenomena are a relevant part of the problem. A number of effects due to the presence of temperature differences must be adequately taken into account to make the results of numerical simulations consistent and realistic. Moreover, in general, gradients of surface tension at the interface separating two liquids are a source of numerical issues that can delay (and even prevent completely in some circumstances) the convergence of the solution algorithm. Here, we propose a fundamental and concerted approach for the simulation of the typical dynamics resulting from the presence of a dispersed phase in an external matrix in nonisothermal conditions based on the modular computer-aided design, modelling, and simulations capabilities of the OpenFOAM environment. The resulting framework is tested against the migration of a droplet induced by thermocapillary effects in the absence of gravity. The simulations are fully three-dimensional and based on an adaptive mesh refinement (AMR) strategy. We describe in detail the countermeasures taken to circumvent the problematic issues associated with the simulation of this kind of flows

Global Perspectives on Task Shifting and Task Sharing in Neurosurgery.

BACKGROUND: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. METHODS: The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018-January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. RESULTS: Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). CONCLUSIONS: Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Isorhapontigenin, a resveratrol analogue selectively inhibits ADP-stimulated platelet activation

Isorhapontigenin is a polyphenolic compound found in Chinese herbs and grapes. It is a methoxylated analogue of a stilbenoid, resveratrol, which is well-known for its various beneficial effects including anti-platelet activity. Isorhapontigenin possesses greater oral bioavailability than resveratrol and has also been identified to possess anti-cancer and anti-inflammatory properties. However, its effects on platelet function have not been reported previously. In this study, we report the effects of isorhapontigenin on the modulation of platelet function. Isorhapontigenin was found to selectively inhibit ADP-induced platelet aggregation with an IC50 of 1.85µM although it displayed marginal inhibition on platelet aggregation induced by other platelet agonists at 100µM. However, resveratrol exhibited weaker inhibition on ADP-induced platelet aggregation (IC50>100µM) but inhibited collagen induced platelet aggregation at 50µM and 100µM. Isorhapontigenin also inhibited integrin αIIbβ3 mediated inside-out and outside-in signalling and dense granule secretion in ADP-induced platelet activation but interestingly, no effect was observed on α-granule secretion. Isorhapontigenin did not exert any cytotoxicity on platelets at the concentrations of up to 100µM. Furthermore, it did not affect haemostasis in mice at the IC50 concentration (1.85µM). In addition, the mechanistic studies demonstrated that isorhapontigenin increased cAMP levels and VASP phosphorylation at Ser157 and decreased Akt phosphorylation. This suggests that isorhapontigenin may interfere with cAMP and PI3K signalling pathways that are associated with the P2Y12 receptor. Molecular docking studies emphasised that isorhapontigenin has greater binding affinity to P2Y12 receptor than resveratrol. Our results demonstrate that isorhapontigenin has selective inhibitory effects on ADP-stimulated platelet activation possibly via P2Y12 receptor

Trace inequalities for matrices

Trace inequalities for sums and products of matrices are pre- sented. Relations between the given inequalities and earlier results are dis- cussed. Among other inequalities it is shown that if A and B are positive semideÂ…nite matrices, then tr (AB)k min kAkk trBk; kBkk trAk for any positive intger k. DOI: 10.1017/S000497271200062