Characteristics Symptoms of Imminent Eclampsia: A case Referent Study from a Tertiary Hospital in Tanzania

\ud \ud Maternal mortality in developing coun- tries is unacceptably high with eclampsia being con- sistently among the top causes. As yet, primary pre- vention of this complication is not possible since causes of pre-eclampsia are largely unknown and bio- chemical, hematological and radiological markers have proved unsuitable for routine prediction of eclamptic fits. Although headache, visual disturbance, abdominal pain, nausea, and vomiting are routinely elicited when managing pre-eclampsia and have been reported to predict eclamptic fits, the literature at- tempting to characterize them is scanty. We sought to establish characteristics of the prodromal symptoms of eclampsia and compare them with similar symp- toms as experienced by normotensive pregnant women at Muhimbili National Hospital (MNH) in Tanzania. Methods: This study was conducted at MNH in 2010 by enrolling 123 eclamptic and 123 normotensive women. Women in the two groups were interviewed about their experiences and characteristics of head-ache, visual disturbances, abdominal pain, nausea and vomiting using a semi structured questionnaire. The severity, nature and other characteristics of the symptoms were assessed using standard scale/meth- ods and data compared among the two groups. Re- sults: Prodromal symptoms of eclampsia were pre- sent in 90% of eclamptic women. Headache was more frequent among eclamptic women (88%) than the normotensive (43%), p < 0.001). The symptom was also more perceived as severe among eclamptic (46.3%) than the normotensive (5.7%), p < 0.001. The most frequent location for headache was frontal in 65.7% of eclamptic women compared to frontal (41.5%) or generalized (39.6%) for the normotensive. Likewise, visual problems were significantly more frequent among eclamptic women (39%) compared to the normotensive (3%), p < 0.001. Upper abdominal pain was significantly more reported by eclamptic (36%) than normotensive women (0.9%), p = 0.001. The general occurrence of abdominal pain, nausea and vomiting was not significantly different in the two groups. The time lag from development of a sym- ptom to eclamptic fit was up to seven days for most symptoms except visual disturbances of which 98% developed fits within 12 hours. Conclusion: Whereas the prodromal symptoms of eclampsia and similar symptoms in normotensive women were common, the characteristics of headache and visual disturbance differ significantly in the two groups. The knowledge of these differences could be utilized to improve the quality of management of pre-eclamptic women in order to prevent eclampsia.\u

Bolted connections between open section beams and box columns

This thesis reports on the full scale testing of jOints comprised of open section beams, bolted to square closed formed columns (SHS) using the novel Flowdrill blind bolting connector. Twenty-six joints were constructed using Flowdrill connectors. In addition six stand alone tests were conducted on endplates. Three joint tests were also conducted using a rival Hollo-bolt connector, in which the joint geometry was nominally identical to those of the Flowdrill joints. Thus a total of thirty-five cantilevered joint tests of member configurations typically found in building frames were conducted. Only welded end plates were examined in the programme of joint tests which included partial depth (flexible), flush and extended endplate details. These particular details enabled the full range of both connection stiffness and strength in typical simple and rigid construction to be examined. The aim of the project was to investigate the joint's semi-rigid behaviour, and the acceptability of the flowdrill connector as a method to site bolt the beam to the column rather than using the welded solution commonly associated with closed formed columns. From the experimental moment-rotation data collected during the tests, a proposed joint model for both the flush and extended end plate details was developed to predict its full non linear behaviour. The model provides guidance on the joint's rotation limit and ultimate design capacity. It assumes that the endplate of the joint is rigid and provides only a limited contribution to the joints overall rotation for its effect to be ignored in the model; the principal failure of all the joints being severe column face deformation. Although the capacity of the connector was not in the original aim of the investigation, an assessment on the published capacities has been conducted for completeness. As well as providing design guidance for these type of joints, the thesis also presents the results of a parametric study into sub-frame behaviour using the actual joint responses from the test data. The findings suggest that the restraint afforded by the connection on stocky columns in sub-frame arrangements do not outweigh the disadvantages of the moment transfer. A further study on the economics of using tubular columns has also been included. This shows only a marginal increase in cost to that using equivalent open sections, when the advantages of reduced fire protection are included in the pricing