Prevalence of perceived heavy postpartum hemorrhage and its associated factors among married mothers in squatter settlements of Karachi

Objectives; To estimate the prevalence of postpartum hemorrhage (PPH) and identify its associated factors among the married women of 15-49 years, residingin the Karachi, Pakistan. Methodology: This cross-sectional survey was carried out in five squatter settlements of Karachi during 2000-2001. Information was collected regarding age, gravida, education, antenatal, natal and postnatal care, with perceived puerperal morbidities from 525 mothers, who were in their 42nd to 56th post delivery day. Univariate and multivariate analyses were computed using multiple logistic regression method. Results: The estimated prevalence for perceived PPH was 7.24%. Three hundred and ninety six (75.4 %) women received ante-natal care with 273 (52%) consulting skilled health professionals and 268 (51%) gave birth to their babies at a health facility. Eighty nine (16.9%) women who delivered at a health facility were advised for the post partum routine care and only 127 (24.2%) women followed the instructions. Two hundred and seventy eight (53%) mothers reported at least one perceived puerperal morbidity and among them 38 (7.24%) women perceived PPH. On multivariate analysis, the factors associated with PPH were older age (aOR=1.10, 95% CI:1.04-1.1), longer duration of labor (aOR=1.08,95% CI :1.02-1.2) and restricted fluid intake (aOR=2.1, 95% CI :1.05-4.0).Conclusion: Older age group, longer duration of labor and restricted fluid in take were found to be the common factors associated with PPH. Women need to be educated regarding family planning program, safe and timely delivery by skilled medical personnel and intake of extra fluid during post partum period

Comparison of keorolac with morphine for intraoperative analgesia in patients undergoing total abdominal hysterectomy

Direct laryngoscopy and endotracheal intubation during anaesthesia and cutting, stretching and tissue manipulation during surgery is the most painful time for a patient undergoing surgery. The elicited pain during a surgical procedure is associated with significant hemodynamic changes including rise in blood pressure, heart rate, sweating, pupillary dilatation etc. These hemodynamic changes are not desirable and may produce deleterious effects in patients with hypertension, ischemic heart disease and cerebro-vascular disease and impose a great challenge for anaesthesiologist to maintain physiologic homeostasis during these periods of stress. Opioids are considered to be the corner stone in the management of intraoperative and postoperative pain, morphine being the gold standard . Use of Opioids to provide intraoperative analgesia is associated with some untoward effects i.e., somnolence, respiratory depression and nausea and vomiting, which are well known causes of delay in discharge from the post anaesthesia care unit (PACU) and unplanned hospital admission or delay in discharge to home-1

Associations of controlling behavior, physical and sexual violence with health symptoms

Controlling behavior is often manifested as monitoring, coercing or threatening the partner. Globally, it has been experienced by the women (in range of 5.2% to 56.6%) and often results in their physical and mental ill health. To the best of our knowledge there is no published research on controlling behaviors. Therefore, a cross sectional study was conducted to measure the magnitude of the controlling behaviors and its association to some physical stress symptoms of women. The study was conducted in urban settings of Karachi, Pakistan, using simple random sampling technique. The data was collected by trained midwifes from the 759 married women of aged 25 to 60 years. The data was entered in Epi Info version 6 and analyzed on SPSS version 11. The study showed that the prevalence of pastyear physical and sexual violence is 68% while controlling behavior was experienced by 51.6% of the women. Among the different types of controlling behavior, refusal of the husband to give money for the household chores was the most common. The results of the bi-variate analysis showed that there was a significant association between women who had past-year physical or sexual violence experience with shoulder and neck pain, feeling worthlessness and suicidal thoughts. This study identified that most women in middle and lower socioeconomic groups are exposed to physical, sexual and psychological violence. Furthermore, we found that in addition to exposure to violence, women face controlling behaviors from their partner which restrict their decisions making toward their health

“Anything that makes life’s journey better.” Exploring the use of digital technology by people living with motor neurone disease

Our aim was to explore the attitudes of those living with motor neuron disease towards digital technology. Postal and online questionnaires surveyed 83 people with MND (pwMND) and 54 friends and family members (fMND). Five pwMND and five fMND underwent semi-structured interviews. 82% of pwMND and 87% of fMND use technology every day with iPads and laptops being the devices most commonly used. pwMND used technology to help them continue to participate in everyday activities such as socialising, entertainment and accessing the internet. The internet provided peer support and information about MND but information could be distressing or unreliable. Participants preferred information from professionals and official organisations. Participants were generally supportive of using of technology to access medical care. Barriers to technology, such as lack of digital literacy skills and upper limb dysfunction, and potential solutions were identified. More challenging barriers included language and cognitive difficulties, and the fear of becoming dependent on technology. Addressing the barriers identified in this research could help pwMND access technology. However, as healthcare delivery becomes more reliant on digital technology, care should be taken to ensure that those who are unable or unwilling to use technology continue to have their needs met in alternative ways

miRNAs: Small but deadly

microRNAs (miRNAs) are unique class of global gene regulators identified both in plants and animals. They can reduce protein levels of their target genes with a minor impact on the target genes mRNA. Levels of some miRNAs are found altered in cancers, so we might expect these regulatory molecules to be involved in the development of different carcinomas. The differential expression of certain miRNAs in various tumors might become a powerful tool to aid in the diagnosis and treatment of cancers. The precise biological roles of most miRNAs are still poorly understood and therefore, this review is an attempt to highlight the role and connections of human miRNA with different aspects of cancers.Key words: microRNA, cancer, tumour, metastasis, upregulation, miRNA

Regulation of Antimycin Biosynthesis Is Controlled by the ClpXP Protease

The survival of any microbe relies on its ability to respond to environmental change. Use of extracytoplasmic function (ECF) RNA polymerase sigma (σ) factors is a major strategy enabling dynamic responses to extracellular signals. Streptomyces species harbor a large number of ECF σ factors, nearly all of which are uncharacterized, but those that have been characterized generally regulate genes required for morphological differentiation and/or response to environmental stress, except for σAntA, which regulates starter-unit biosynthesis in the production of antimycin, an anticancer compound. Unlike a canonical ECF σ factor, whose activity is regulated by a cognate anti-σ factor, σAntA is an orphan, raising intriguing questions about how its activity may be controlled. Here, we reconstituted in vitro ClpXP proteolysis of σAntA but not of a variant lacking a C-terminal di-alanine motif. Furthermore, we show that the abundance of σAntA in vivo was enhanced by removal of the ClpXP recognition sequence and that levels of the protein rose when cellular ClpXP protease activity was abolished. These data establish direct proteolysis as an alternative and, thus far, unique control strategy for an ECF RNA polymerase σ factor and expands the paradigmatic understanding of microbial signal transduction regulation

1-(Benz­yloxy)naphthalene

In the title compound, C17H14O, the dihedral angle between the naphthyl ring system and the benzyl group is 83.22 (4)°. Both of these moieties are planar, with mean deviations from their least-squares planes, defined by the naphthyl ring C atoms and the O atom, and the phenyl ring C atoms and the benzyl α-C atom, of 0.0176 (1) and 0.0024 (13) Å, respectively. The crystal structure is stabilized by C—H⋯π and π–π inter­actions [centroid–centroid distance = 3.7817 (10) Å]