Clinicopathological evaluation of abnormal uterine bleeding in perimenopausal women

Background: Abnormal uterine bleeding is considered as one of the most common and challenging problem presenting to the gynecologist. It is responsible for as many as one third of all outpatient gynaecological visits. This study was carried out in the department of Obstetrics and Gynaecology, Assam Medical College and Hospital, Dibrugarh to evaluate clinically gynaecological causes and the endometrial pattern of abnormal uterine bleeding in perimenopausal women.Methods: This is a retrospective study of 148 perimenopausal women with complain of abnormal uterine bleeding in the age group ranging from 40-50 years for a period of one year from 01 November 2014 to 30 November 2015. The age, parity, menstrual complaints were noted and clinical diagnosis with ultrasound report and histopathological reports (of endometrial tissue) were analyzed. Finally the histopathological report of the hysterectomy specimen was correlated.Results: Menorrhagia was the commonest complaint. AUB was seen more in multiparous women (64.8%). Fibroid uterus was the commonest cause which is 52.7% followed by DUB 41.2%, adenomyosis 4.7%, and uterine malignancy 1.3%.Conclusions: Clinicopathological evaluation of AUB showed that fibroid uterus followed by DUB is the most common cause in perimenopausal women. Occurrences of endometrial hyperplasia increases in perimenopause which is of great value as it is a forerunner of carcinoma

Intraoperative surgical difficulties encountered during repeat caesarean section in a tertiary care centre in Northeast India

Background: Caesarean section is the commonest obstetric operative procedure worldwide. The potential perioperative problems in repeat caesarean section include adhesions, increased blood loss, prolonged operative time, injuries to adjacent structures, hysterectomy etc. These increase with increase in caesarean section number.Methods: Hospital based observational study, conducted at Dept. of Obstetrics and Gynaecology, Assam Medical College, from July 2019 to June 2020 with the aim to study intraoperative difficulties encountered during repeat caesarean section. Cases were grouped into two main groups based on number of prior caesarean sections. A detailed history, clinical and intraoperative findings of all pregnant women undergoing repeat caesarean section were noted. Results were tabulated and analysed.Results: Out of 400 women with prior caesarean section who underwent repeat caesarean. 321 had 1 prior caesarean and rest had 2. Among the cases cephalopelvic disproportion was the commonest (43.25%) indication and obstructed labour was the least common (0.25%). Common complications were adhesions (38.25%), thinned lower uterine segment (27%), advance bladder (19.50%), uterine dehiscence (14.75%), excess blood loss (12.75%), extension of uterine incision (8.25%), uterine rupture (1%), placenta accrete (0.75%), and bladder injury (0.5%). Intraoperative complications like adhesions, uterine dehiscence, delivery and operating time were significantly higher in women with 2 prior caesarean section compared to 1 prior caesarean section (p<0.001).Conclusions: Women with caesarean scar are at high risk in subsequent pregnancies particularly in a country like India where antenatal care is often neglected. Best technique to reduce multiple potential complications of repeat caesarean section is to reduce the rates of primary and repeat caesarean sections whenever possible

An assessment of the perception of secondary school students towards Vocational Education and Training in Arumeru district in Tanzania.

The study's main objective was to assess the perception of secondary school students towards vocational education and training in Arumeru District in Tanzania. In addition, the study was guided by the following specific objectives; to determine the perception of secondary school students towards vocational education and training in Arumeru district, to identify the channels through which secondary school students access information about vocational education and training in Arumeru district and to determine the challenges facing students to join VET after secondary school education in the Arumeru district. A descriptive research design was adopted. The researcher adopted simple random sampling techniques. The sample size was 120 respondents, which included; 21 respondents from Bishop Danning Secondary, 2 from Ilboru PC Centre, 25 from Mshikamano PC centre, 23 from Sinoni PC Centre, 21 respondents from Enaboishu secondary school, 5 Secondary Schools Heads and 4 VET Colleges Principals. Research questionnaires were used as the primary data collection instruments. Data collected were analyzed using SPSS version 20. The findings indicate that most of the respondents strongly agreed that they received information about vocational education from; their churches, newspapers, friends, and social media. The study concluded that there is a need for more career information to be provided to the VET learners as attitude change takes quite some time. The study recommended that there is a need for the government and the relevant stakeholders to come up with a policy framework that clearly shows how a student can transition from the path of VET to further education. Keywords: Secondary School Students, Education, Perception, Vocational Education and Training

The gender-responsive church: Models of religious community in realising alignment for women

This research investigates the persistent disparity in evaluation, treatment, and access to opportunities across gender lines that pervades everyday life. Gender-based inequities, biases, and exploitation are entrenched within structural and cultural spheres. Within this framework, the church as a faith-based institution is called upon ecclesiologically to effectuate a ministry attuned to gender sensitivities. Employing qualitative methodologies, this study focuses on female congregants of the Nazarene Church in the Java-Bali district. Data collection was facilitated via Forum Group Discussions (FGDs) across five women’s groups in the said district. The objective of this research is to elucidate a paradigm for church ministry that aligns more closely with gender-responsive principles. Through this examination, the study delineates four innovative ministry models in pursuit of gender egalitarianism: facilitative, participatory, assistive, and advocative

Hepatitis B Vaccine Administration Prior to Discharge

https://scholarlycommons.baptisthealth.net/se-2022-smh-bpf/1013/thumbnail.jp

Vitamin D deficiency and length of pediatric intensive care unit stay: a prospective observational study

BACKGROUND: Due to the limited data available in the pediatric population and lack of interventional studies to show that administration of vitamin D indeed improves clinical outcomes, opinion is still divided as to whether it is just an innocent bystander or a marker of severe disease. Our objective was therefore to estimate the prevalence of vitamin D deficiency in children admitted to intensive care unit (ICU) and to examine its association with duration of ICU stay and other key clinical outcomes. METHODS: We prospectively enrolled children aged 1 month–17 years admitted to the ICU over a period of 8 months (n = 101). The primary objectives were to estimate the prevalence of vitamin D deficiency (serum 25 (OH) <20 ng/mL) at ‘admission’ and to examine its association with length of ICU stay. RESULTS: The prevalence of vitamin D deficiency was 74 % (95 % CI: 65–88). The median (IQR) duration of ICU stay was significantly longer in ‘vitamin D deficient’ children (7 days; 2–12) than in those with ‘no vitamin D deficiency’ (3 days; 2–5; p = 0.006). On multivariable analysis, the association between length of ICU stay and vitamin D deficiency remained significant, even after adjusting for key baseline variables, diagnosis, illness severity (PIM-2), PELOD, and need for fluid boluses, ventilation, inotropes and mortality [adjusted mean difference (95 % CI): 3.5 days (0.50–6.53); p = 0.024]. CONCLUSIONS: We observed a high prevalence of vitamin D deficiency in critically ill children in our study population. Vitamin D deficient children had a longer duration of ICU stay as compared to others. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13613-015-0102-8) contains supplementary material, which is available to authorized users

Efficient Removal of Congo Red Dye Using Activated Carbon Derived from Mixed Fish Scales Waste: Isotherm, Kinetics and Thermodynamics Studies

The discharge of large quantities of organic dyes into the environment causes significant harm to humans and the environment. Thus, there is an urgent need to develop cost-effective adsorbents for removing these dyes. In the present study, the synthesis of activated carbon (AC) derived from mixed fish scale waste using KOH activation was investigated for Congo red (CR) dye removal. The finding shows that the obtained biocarbon has a fixed carbon of 42.9% with a crystallinity index of 15.01%. N2 adsorption-desorption isotherm was found to be type IV, signifying mesoporous structure with a surface area and total pore volume of 150.049 m2 g-1 and 0.119 cm3.g-1. Batch adsorption was carried out by various adsorbent doses, initial concentration, contact time, and pH to comprehend the effect of operating parameters on its removal efficacy. The isotherm studies fitted well for Freundlich with an R2 of 0.99%. Adsorption kinetics was best fitted by the pseudo-second-order model and thermodynamic studies revealed the adsorption process to be exothermic and spontaneous. The efficiency of AC was also studied by an amount of sorption and desorption cycles which showed its potential for reusability up to the sixth cycle. Thus, the findings suggest that activated carbon derived from mixed fish scale waste is a promising adsorbent for removing Congo red dye from aqueous solutions