A retrospective study of maternal mortality in a tertiary care hospital in Western Maharashtra, India

Background: Maternal mortality is a vital index of the effectiveness of obstetric services prevailing in a country. The key to progress of a country lies in reducing its maternal morbidity and mortality, hence to give a better assessment of the problem a retrospective study on maternal mortality was carried out. An objective of the study was to find the cause and epidemiological factors for maternal mortality in a tertiary care hospital in western Maharashtra from January 2018 to August 2019.Methods: A retrospective, descriptive study done at tertiary care hospital in western Maharashtra from January 2018 to august 2019. Data was collected from medical records department and the study was conducted by reviewing the records of maternal death and scrutinizing for various aspects likely to be related to maternal death such as age, locality of residence, antenatal care, admission death time interval and cause of death.Results: during the study period 63 maternal deaths occurred and 75302 live births, Maternal Mortality Ratio were 83.66 per 1 lakh live birth. 46% of maternal deaths were in age group of 21-25 years, 87% of patients belonged to rural area, 74% belonged to lower socioeconomic status. 43%  were unregistered patients, 43% had vaginal delivery, 73% had no free transportation, 68% were referred patients, 60% were referred from private hospitals, 48% of maternal death occurred <24 hours, 73% of maternal death were due to direct cause, 28% of maternal deaths were due to pre-eclampsia and its complications, 15.8% due to sepsis and 12.6% due to Postpartum hemorrhage.Conclusions: Being a tertiary care hospital, where patients are referred from periphery maternal mortality was found to be on higher side. Proper implementation of government policies with community participation along with strengthening of First Referral Unit (FRU) and Primary Health Centres can help to reduce maternal mortality

Vortex dynamics in a compact Kardar-Parisi-Zhang system

We study the dynamics of vortices in a two-dimensional, non-equilibrium system, described by the compact Kardar-Parisi-Zhang equation, after a sudden quench across the critical region. Our exact numerical solution of the phase-ordering kinetics shows that the unique interplay between non-equilibrium and the variable degree of spatial anisotropy leads to different critical regimes. We provide an analytical expression for the vortex evolution, based on scaling arguments, which is in agreement with the numerical results, and confirms the form of the interaction potential between vortices in this system.Comment: 5 pages, 3 figures and Supplementary Materia

The contribution of short-term memory for sound features to speech-in-noise perception and cognition

\ua9 2024 The Author(s)Speech-in-noise (SIN) perception is a fundamental ability that declines with aging, as does general cognition. We assess whether auditory cognitive ability, in particular short-term memory for sound features, contributes to both. We examined how auditory memory for fundamental sound features, the carrier frequency and amplitude modulation rate of modulated white noise, contributes to SIN perception. We assessed SIN in 153 healthy participants with varying degrees of hearing loss using measures that require single-digit perception (the Digits-in-Noise, DIN) and sentence perception (Speech-in-Babble, SIB). Independent variables were auditory memory and a range of other factors including the Pure Tone Audiogram (PTA), a measure of dichotic pitch-in-noise perception (Huggins pitch), and demographic variables including age and sex. Multiple linear regression models were compared using Bayesian Model Comparison. The best predictor model for DIN included PTA and Huggins pitch (r2 = 0.32, p &lt; 0.001), whereas the model for SIB included the addition of auditory memory for sound features (r2 = 0.24, p &lt; 0.001). Further analysis demonstrated that auditory memory also explained a significant portion of the variance (28 %) in scores for a screening cognitive test for dementia. Auditory memory for non-speech sounds may therefore provide an important predictor of both SIN and cognitive ability

Speech-in-noise detection is related to auditory working memory precision for frequency

Speech-in-noise (SiN) perception is a critical aspect of natural listening, deficits in which are a major contributor to the hearing handicap in cochlear hearing loss. Studies suggest that SiN perception correlates with cognitive skills, particularly phonological working memory: the ability to hold and manipulate phonemes or words in mind. We consider here the idea that SiN perception is linked to a more general ability to hold sound objects in mind, auditory working memory, irrespective of whether the objects are speech sounds. This process might help combine foreground elements, like speech, over seconds to aid their separation from the background of an auditory scene. We investigated the relationship between auditory working memory precision and SiN thresholds in listeners with normal hearing. We used a novel paradigm that tests auditory working memory for non-speech sounds that vary in frequency and amplitude modulation (AM) rate. The paradigm yields measures of precision in frequency and AM domains, based on the distribution of participants’ estimates of the target. Across participants, frequency precision correlated significantly with SiN thresholds. Frequency precision also correlated with the number of years of musical training. Measures of phonological working memory did not correlate with SiN detection ability. Our results demonstrate a specific relationship between working memory for frequency and SiN. We suggest that working memory for frequency facilitates the identification and tracking of foreground objects like speech during natural listening. Working memory performance for frequency also correlated with years of musical instrument experience suggesting that the former is potentially modifiable

A specific relationship between musical sophistication and auditory working memory

Previous studies have found conflicting results between individual measures related to music and fundamental aspects of auditory perception and cognition. The results have been difficult to compare because of different musical measures being used and lack of uniformity in the auditory perceptual and cognitive measures. In this study we used a general construct of musicianship, musical sophistication, that can be applied to populations with widely different backgrounds. We investigated the relationship between musical sophistication and measures of perception and working memory for sound by using a task suitable to measure both. We related scores from the Goldsmiths Musical Sophistication Index to performance on tests of perception and working memory for two acoustic features-frequency and amplitude modulation. The data show that musical sophistication scores are best related to working memory for frequency in an analysis that accounts for age and non-verbal intelligence. Musical sophistication was not significantly associated with working memory for amplitude modulation rate or with the perception of either acoustic feature. The work supports a specific association between musical sophistication and working memory for sound frequency

Study of maternal mortality at a tertiary care centre

Background: Pregnancy is not a disease and so pregnancy related death is almost always preventable. High rates of maternal deaths still exist in places, particularly in underdeveloped communities. The objective was to identify the maternal mortality ratio in our tertiary care centre and to discuss about the causes for maternal deaths.Methods: The present study is a prospective observational study on maternal mortality conducted in the department of Obstetrics and Gynecology, VDGMC, Latur, Maharashtra, India during the period of  18 months from January 2019 to June 2020.Results are expressed in frequencies and percentages.Results: Maternal mortality ratio (MMR) in our present study is 335.85 per 1,00,000 live birth. Among direct obstetric causes of maternal deaths, there were 58% hypertensive disorder cases,25% APH cases,25% puerperal sepsis cases, 8% embolism cases. Among indirect causes of maternal deaths, there were 61% anemic cases,39% liver disease cases,33% DIC cases, 11% heart disease.Conclusions: Maternal mortality is widely accepted as a key indicator of health and socioeconomic development. Each stage should be a positive experience, ensuring women and their babies reach their full potential for health and well-being

The hearing hippocampus

The hippocampus has a well-established role in spatial and episodic memory but a broader function has been proposed including aspects of perception and relational processing. Neural bases of sound analysis have been described in the pathway to auditory cortex, but wider networks supporting auditory cognition are still being established. We review what is known about the role of the hippocampus in processing auditory information, and how the hippocampus itself is shaped by sound. In examining imaging, recording, and lesion studies in species from rodents to humans, we uncover a hierarchy of hippocampal responses to sound including during passive exposure, active listening, and the learning of associations between sounds and other stimuli. We describe how the hippocampus' connectivity and computational architecture allow it to track and manipulate auditory information – whether in the form of speech, music, or environmental, emotional, or phantom sounds. Functional and structural correlates of auditory experience are also identified. The extent of auditory-hippocampal interactions is consistent with the view that the hippocampus makes broad contributions to perception and cognition, beyond spatial and episodic memory. More deeply understanding these interactions may unlock applications including entraining hippocampal rhythms to support cognition, and intervening in links between hearing loss and dementia

Product quality driven auto-prognostics: Low-cost digital solution for SMEs

Setting out existing prognostics solutions in small and medium enterprises (SMEs) is accompanied by challenges. These include employing expensive sensors, acquisition systems; and attending geometric limitations. Additionally, these solutions call for a specialist to take on feature engineering, machine learning algorithm selection, etc. Presented in this paper is a low-cost digital solution (intelligently integrate cost-cutting off-the-shelf technologies) for SMEs via product quality driven auto-prognostics. First, we develop upon existing solutions by addressing their drawbacks viz. cost, geometric limitations via a new product quality-centered condition monitoring strategy. Every SME must investigate the quality of their products, and therefore the authors believe this to be a low-cost solution. Next, the proposed solution integrates automated machine learning via Auto-WEKA, an off-the-shelf open-source technology. Lastly, the practical advantages of the proposed solution over the existing sensor-based solution were investigated via a case study. Results depict that this low-cost prognostics solution is vital for maintenance planning in SMEs.Royal Academy of Engineering London, UK (IAPP 18-19/31)