A Comparative study between who modified Partogram and paperless partogram in the Effective management of labour

BACKGROUND: The partogram was designed with the aim to provide at a glance a pictorial representation of labour, in order to sensitise obstetric care providers to deviations in the normal process and course of labour. AIMS AND OBJECTIVES: To compare WHO modified Partograph and Paperless Partogram in the effective management of labour on the basis of 1. Labour crossing the Alert Line/ Alert ETD, 2. Labour crossing the Action Line/ Action ETD, 3. Rate of caesarean section, 4. Perinatal outcome, 5. Maternal complications. MATERIALS AND METHODS: This is an observational study which was conducted among 200 singleton pregnant women delivering at Institute of Social Obstetrics Kasturba Gandhi Hospital and Institute of Obstetrics and Gynaecology, Egmore. INCLUSION CRITERIA: • Any parturient irrespective of age and parity in established labour (1 contraction in 10 min or more frequently) with cephalic presentation, irrespective of whether the membranes are intact or ruptured. • Onset of labour has to be spontaneous (not induced) • The parturient must be atleast 4cm or more dilated at the point of inclusion. • Gestational maturity should be 37 completed weeks or more. EXCLUSION CRITERIA: • Induced labour, • Previous caesarean, • Multiple pregnancy, • Pregnancy Induced Hypertension, • Antepartum hemorrhage, • Presence of any severe complications. RESULTS: • Mean age is 24.09±3.85 and 25.23±3.82 respectively. • 64% primis and 57% primis were included in WHO and paperless partographs respectively. 36% multis in WHO and 43% multis in paperless group were included. • Mean gestational age in WHO and paperless was 38.13±1.02 and 37.87±1.07 respectively. All parameters were comparable in both the study groups. • Most of the subjects 61%and57% entered the study at 4cm dilatation in WHO and paperless respectively. • Alert ETD was crossed in 10% WHO group and 8% in paperless group. Action ETD was crossed in 3% WHO and 1% in paperless group. • In WHO partograph 66 women required more than 2 pervaginal examinations, and 4 of them even required 6PVs. In paperless partograph 87 required only 2 pervaginal examinations,none of them required more than 3PVs. • Oxytocin was used for augmentation in 39% of cases in WHO group, but only 16% cases required oxytocin in paperless group. Inspite of increased usage of oxytocin mean duration of active phase (234.87vs 215.79) was comparable in both the study groups. • 65% of subjects in paperless partograph had spontaneous vaginal delivery, where as in WHO partograph only 45% had spontaneous vaginal delivery, but the difference in the rate of instrumental delivery (3% and 4%) and csection (29% and 22%) were not statististically significant in both the study groups. • Admissions to NICU in both groups (28% and 24%) were similar in both groups

Evaluation of safety, efficacy, acceptance and expulsion of post placental intrauterine contraceptive device in a tertiary care centre

Background: Postpartum intrauterine device provides an effective temporary method of contraception for the woman who needs birth spacing rather than birth limitation and also a quasi-permanent family planning method. The aim of this study was to study the efficacy, acceptance, safety and complication of PPIUCD insertion.Method: This a retrospective analytical study done in a tertiary care teaching institute, Institute of Obstetrics and Gynaecology Egmore for a six-year period from January 2010 to December 2015 with a sample size of 81204. Outcomes measured were safety, efficacy, acceptance (patients and professionals) and complications.Results: For the study period of six years the total number of women delivered were 81204. A steady increase was noted in the insertion of PPIUCD from 2010 (1.98%) to 2015 (58%). 50.5% had insertion following caesarean section and 49.5% following vaginal delivery. Primipara had a higher rate of acceptance amounting to 74.74%. Most common complication reported was missing strings 9.25% and a greater part of the patients (83%) did not have any complaints.Conclusions: Enthusiasm and conviction on the part of the health care provider goes a long way in improving the acceptance rate of PPIUCD. It is an indispensable contraceptive tool for our country since our women most often do not return for postnatal contraceptive options

(R1984) Analysis of M^[X1], M^[X2]/G1, G_2^(a,b)/1 Queue with Priority Services, Server Breakdown, Repair, Modified Bernoulli Vacation, Immediate Feedback

In this investigation, the steady state analysis of two individualistic batch arrival queues with immediate feedback, modified Bernoulli vacation and server breakdown are introduced. Two different categories of customers like priority and ordinary are to be considered. This model propose nonpreemptive priority discipline. Ordinary and priority customers arrive as per Poisson processes. The server consistently afford single service for priority customers and the general bulk service for the ordinary customers and the service follows general distribution. The ordinary customers to be served only if the batch size should be greater than or equal to a , else the server should not start service until a customers have accumulated. Meanwhile priority queue is empty; the server becomes idle or go for vacation. If server gets breakdown while the priority customers are being served, they may wait in the head of the queue and get fresh service after repair completion, but in case of ordinary customers they may leave the system. After completion of each priority service, customer may rejoin the system as a feedback customer for receiving regular service because of inappropriate quality of service. Supplementary variable technique and probability generating function are generally used to solve the Laplace transforms of time-dependent probabilities of system states. Finally, some performance measures are evaluated and express the numerical results

Design of Static Segment Adder for Approximating Computing Applications

The digital VLSI design needs to attain high performance with desired reliability range. The high performance involves low power, area efficiency and high speed. This paper proposes a design of High speed energy efficient static segment adder (SSA) to enhance the overall performance based on approximation technique. Static segmentation includes both accurate and inaccurate part. The normal full adder performs accurate part and the carry select adder is used for inaccurate part. By using static segmentation the approximate computation is done. Approximate computing is a computation which generates “good enough” result rather than totally accurate result. Image processing is accomplished using SSA design. In this process 99.4% whole computational accuracy for 16 bit addition and also for 8 bit addition can be achieved

Correlation between first trimester uric acid level and subsequent development of gestational diabetes mellitus

Background: The aim of the study was to correlate between first trimester uric acid level and its association with subsequent development of gestational diabetes mellitus.Methods: This is a prospective study conducted at Govt. Raja Mirasudar Hospital attached to Thanjavur Medical College, Thanjavur over a period of one year from September 2015. A total of one hundred and eighty seven ante natal women less than 14 weeks of gestational age who attended the outpatient antenatal department were included in this study. Serum uric acid estimation was done in women with 3.6 mg/dl and 2 with serum uric acid <3.6 mg/dl developed GDM. This shows development of GDM increases with increase in uric acid concentration.Conclusions: Though our study results suggest that serum uric acid level estimation in first trimester can be used as a marker to predict GDM in pregnant women, large scale studies are required before it can be recommended as a routine first trimester screening test for prediction of gestational diabetes mellitus

Artificial Intelligence in Human Resource Management: Advancements, Implications and Future Prospects

The present condition, challenges, and potential applications of artificial intelligence (AI) in human resource management (HRM) are all explored in this survey article. As an innovation, artificial intelligence (AI) has the potential to completely revolutionize several facets of human resource management (HRM). Examining the usage of AI-powered tools and systems in different HR processes, the present situation with AI in HRM is examined. These encompass learning and development, performance management, employee engagement, and recruiting. The use of AI algorithms and machine learning approaches to automate regular HR operations, analyze vast amounts of employee data, and provide insightful data to aid decision-making is addressed in this article. However, integrating AI into HRM also poses a number of difficulties that must be resolved. Bias, privacy issues, and transparency are just a few of the ethical and legal ramifications of using AI in decision-making processes that are discussed in this survey. The study emphasizes how accountability and fairness must be maintained in AI systems by responsible design, oversight, and periodic evaluation. With an emphasis on job displacement and workforce reorganization, the possible influence of AI on the human workforce is also explored. To effectively traverse this change, strategies including work role redefinition, employee up skilling, and establishing a collaborative atmosphere between humans and AI are suggested. The possible advantages and breakthroughs that AI might bring to HRM practices are highlighted as the future perspectives of AI in HRM are examined. As new applications for AI in HRM, sentiment analysis, predictive analytics, intelligent decision support, and personalized employee experiences are all highlighted. In order to fully realize the promise of AI in HRM, the study underlines the significance of data infrastructure, data governance frameworks, and a data-driven culture. Overall, this survey study offers an in-depth review of the existing situation, difficulties, and prospects for AI in HRM. It aggregates current information, identifies research gaps, and gives practitioners and scholars new perspectives on how AI will fundamentally alter the way HRM activities are carried out in the future

Comparative analysis of the remineralization potential of CPP?ACP with Fluoride, Tri-Calcium Phosphate and Nano Hydroxyapatite using SEM/EDX ? An in vitro study

In recent years, the non-invasive management of non cavitated caries lesions using remineralization systems to repair the enamel have received more attention from the scientific community. Aim: To quantitatively evaluate the remineralization potential of Casein phosphopeptide-amorphous calcium phosphate-fluoride(CPP-ACPF), Tri-calcium phosphate(TCP) & Nano-hydroxyapatite(nHAP) using Scanning Electron Microscopy(SEM) and Energy dispersive X-ray Analysis(EDX). 40 enamel specimens were prepared, and immersed in demineralising solution at a pH of 4.4 for 96 hours at 37°C, to induce artificial carious lesions. Remineralization was carried out for a period of 30 days using CPP-ACPF, TCP, nHAP. The specimens were evaluated for calcium and phosphorus content using SEM-EDX. The Ca/P mass % after remineralization was significantly higher with CPP-ACP-F and TCP-F followed by nHAP. CPP-ACP-F and TCP can promote significant remineralization of incipient carious lesions. These are excellent delivery vehicles available in a slow release amorphous form to localize calcium, phosphate and fluoride at the tooth surface