Evaluation of maternal and perinatal morbidity and mortality in eclampsia by early termination of pregnancy

 Background: Eclampsia is one of the leading causes of maternal mortality in India.Methods: A prospective observational study was done on 200 pregnant women admitted with antepartum eclampsia in Malda Medical College from 1 April 2017 to 30 October 2019. Group A included patients who delivered through vaginal route within 10 to 12 hrs of eclampsia by stabilisation of patients while Group B included subjects who underwent early caesarean section for uncontrolled convulsions or poor Bishop score. Maternal and perinatal outcomes were compared between the groups. Data was recorded in a pretested performa and was analyzed using appropriate statistical methods with SPSS.Results: Caesarean section (group B) was done in 130 cases (65%) while vaginal delivery (group A) was done in 65 cases (37.5%). Group A had higher maternal mortality (10.7%) in comparison to group B (4.6%) which was statistically not significant (p=0.1075). There were 32 neonatal deaths (24.6%) and 11 still births (8.46%) in group A while there were 12 neonatal deaths (18.46%) and 3 still births (4.61%) in group B. There was a statistically significant difference (p<0.0001) between the groups with respect to total perinatal deaths.Conclusions: Antenatal and intranatal eclampsia should be managed by early termination of pregnancy preferably with Caesarean section. Early presentation and timely decision to terminate pregnancy will improve the maternal and perinatal outcome

Earliest use of initial prophylactic dose of magnesium sulphate (MgSO4) in severe pre-eclampsia to improve maternal and perinatal outcome, in a rural medical college, WB, India

Background: Eclampsia is one of the high risk obstetric complication throughout the world. Till today, eclampsia is one of the important cause of maternal mortality in our country. However the administration of magnesium sulphate (MgSO4) has changed the scenario significantly.  Methods: The study includes 100 patients with severe pre-eclampsia admitted Malda medical college hospital, from 1st June 2013 to 30th April 2014. This study compares the maternal fatal outcome between two groups of patients with severe pre-eclampsia (BP ≥160/110 mm. proteinuria 2 gm/24 hours. or ≥2 + dipstick.). The first group of patients were admitted in this institution after being referred from primary and secondary health care facilities, after getting initial prophylactic dose of magnesium sulphate (MgSO4) (Group A). The second group (Group B) includes those patients who were admitted without getting any prophylactic dose of magnesium sulphate (MgSO4) from outside.Results: Patients were included, in group A, eclampsia and maternal mortality were nil. Where as in group B eight (8) patients (16%) had eclampsia and 4 patents (8%) expired.Conclusions: Initial dose prophylactic magnesium sulphate (MgSO4) the earliest, can prevent both maternal perinatal maternal mortality. So, prophylactic magnesium sulphate (MgSO4) must be started at the first point of contact by trained health providers

Sonographic assessment of lower uterine segment at term with previous caesarean section

Background: The present study is an attempt to evaluate the efficacy of trans abdominal sonography to measure the thickness of scarred lower uterine segment at term and to detect anatomical defect if there is any to predict the risk of scar rupture.Methods: This study assessed the usefulness of sonographic measurement of lower uterine segment thickness in 100 patients with previous Caesarean patients. Lower uterine segment thickness was compared by antenatal sonography caliper measurements and observations during caesarean section.Results: Lower uterine segment thickness measured by ultrasonography correlated well with the thickness measured by vernier calipers at Caesarean section. Sensitivity of 92.86%, specificity of 77.27%, positive predictive value of 83.87% and negative predictive value of 89.47% suggested that if the thickness of lower uterine segment was 2.6 mm or more, chances of vaginal delivery following trial of labour was high.Conclusions: Antenatal ultrasonographic assessment of lower uterine segment thickness can result a successful trial of labour in women with previous caesarean section

SLURRY FLOW MODELLING BY CFD

An attempt has been made in the present study to develop a generalized slurry flow model using CFD and utilize the model to predict concentration profile. The purpose of the CFD model is to gain better insight into the solid liquid slur¬ry flow in pipelines. Initially a three-dimensional model problem was developed to understand the influence of the particle drag coefficient on the solid concen¬tration profile. The preliminary simulations highlighted the need for correct mo¬delling of the inter phase drag force. The various drag correlations available in the literature were incorporated into a two-fluid model (Euler-Euler) along with the standard k- turbulence model with mixture properties to simulate the tur¬bulent solid-liquid flow in a pipeline. The computational model was mapped on to a commercial CFD solver FLUENT6.2 (of Fluent Inc., USA). To push the en¬velope of applicability of the simulation, recent data from Kaushal (2005) (with solid concentration up to 50%) was selected to validate the three dimensional simulations. The experimental data consisted of water-glass bead slurry at 125 and 440-micron particle with different flow velocity (from 1 to 5 m/s) and overall concentration up to 10 to 50% by volume. The predicted pressure drop and concentration profile were validated by experimental data and showed excel-lent agreement. Interesting findings came out from the parametric study of ve-locity and concentration profiles. The computational model and results discus¬sed in this work would be useful for extending the applications of CFD models for simulating large slurry pipelines

On (n,m)(n,m)-chromatic numbers of graphs having bounded sparsity parameters

An $(n,m)$-graph is characterised by having $n$ types of arcs and $m$ types of edges. A homomorphism of an $(n,m)$-graph $G$ to an $(n,m)$-graph $H$, is a vertex mapping that preserves adjacency, direction, and type. The $(n,m)$-chromatic number of $G$, denoted by $\chi_{n,m}(G)$, is the minimum value of $|V(H)|$ such that there exists a homomorphism of $G$ to $H$. The theory of homomorphisms of $(n,m)$-graphs have connections with graph theoretic concepts like harmonious coloring, nowhere-zero flows; with other mathematical topics like binary predicate logic, Coxeter groups; and has application to the Query Evaluation Problem (QEP) in graph database. In this article, we show that the arboricity of $G$ is bounded by a function of $\chi_{n,m}(G)$ but not the other way around. Additionally, we show that the acyclic chromatic number of $G$ is bounded by a function of $\chi_{n,m}(G)$, a result already known in the reverse direction. Furthermore, we prove that the $(n,m)$-chromatic number for the family of graphs with a maximum average degree less than $2+ \frac{2}{4(2n+m)-1}$, including the subfamily of planar graphs with girth at least $8(2n+m)$, equals $2(2n+m)+1$. This improves upon previous findings, which proved the $(n,m)$-chromatic number for planar graphs with girth at least $10(2n+m)-4$ is $2(2n+m)+1$. It is established that the $(n,m)$-chromatic number for the family $\mathcal{T}_2$ of partial $2$-trees is both bounded below and above by quadratic functions of $(2n+m)$, with the lower bound being tight when $(2n+m)=2$. We prove $14 \leq \chi_{(0,3)}(\mathcal{T}_2) \leq 15$ and $14 \leq \chi_{(1,1)}(\mathcal{T}_2) \leq 21$ which improves both known lower bounds and the former upper bound. Moreover, for the latter upper bound, to the best of our knowledge we provide the first theoretical proof.Comment: 18 page

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Reduce Distillation Column Cost by Hybrid Particle Swarm and Ant Colony Optimization Technique

A novel method for optimum design of plate type distillation column integrating the equilibrium, hydraulic and economic calculations is presented in the present paper. The present study explores the use of non-traditional optimization technique: called hybrid Particle swarm optimization (PSO) and Ant colony optimization (ACO), for design optimization of plate type distillation column from economic point of view. The optimization procedure involves the selection of the major plate geometric parameters such as hole diameters, ratio of downcomer area to tower area, weir height, fractional hole area in tray, tray spacing, tower diameter etc. and minimization of total annual cost is considered as design target subjected to operational constraints like flooding, weeping entrainment, quality specifications etc. The solution space of such type of problem is very complex due to presence of various nonlinear constraints and multiple minima. Hybrid Particle swarm optimization and Ant colony optimization (PSACO) technique is applied to deal with such complexity. The particle swarm optimization applies for global optimization and ant colony approach is employed to update positions of particles to attain rapidly the feasible solution space. Ant colony optimization works as a local search, wherein, ants apply pheromone-guided mechanism to update the positions found by the particles in the earlier stage. The presented hybrid Particle swarm optimization and Ant colony optimization (PSACO) technique is simple in concept, few in parameters and easy for implementations. Furthermore, the PSACO algorithm explores the good quality solutions quickly, giving the designer more degrees of freedom in the final choice with respect to traditional methods. One case study is presented to demonstrate the effectiveness and accuracy of proposed algorithm. The PSACO approach is able to reduce the total cost of distillation column as compare to cost obtained by commercial simulator