SECOND TRIMESTER UTERINE RUPTURE WITH PLACENTA PERCRETA IN PREVIOUS LOWER SEGMENT CESAREAN SCAR

Rupture of a pregnant uterus is a serious threat to the mother’s life and her unborn child. Most of the reported cases of uterine rupture in scarred uterus are due to dehiscence of previous cesarean scar or a rupture of myomectomy scar and usually occur in the third trimester. Spontaneous uterine rupture in first or second trimester is very rare. Here we report a case of second-trimester spontaneous uterine rupture with a particular emphasis on the etiological factors, discuss the course of events and difficulties in the diagnosis. The lesson learned from this case is that, although uterine rupture is very rare in the second trimester of pregnancy, it should be taken into consideration in the differential diagnosis of acute abdomen, especially if there is a predisposing factor such as previous lower segment caesarean section and fluid in the abdomen

E-Leadership or “How to Be Boss in Instant Messaging?” The Role of Nonverbal Communication

Doing leadership in the virtual realm has now become a routine part of many leaders’ daily work, yet our understanding of how leadership is enacted in mediated contexts—especially in text-only channels—is very limited. By applying micro-level analysis to naturally occurring instant message conversations, this article exposes the strategies leaders employ to achieve a range of complex communication goals: to get the work done while fostering informality and collegiality and creating the sense of a real—and not virtual—collaboration between team members. The findings further our understanding in two domains: They provide empirical grounding for e-leadership theories by exposing practices from real-life interactions, and they contribute to discursive leadership literature by addressing nonverbal communication practices. The findings of the article could form the basis for management and leadership training by drawing attention to the linguistic and semiotic resources digital leaders have at their disposal in virtual work environments

Exploring capability maturity models and relevant practices as solutions addressing information technology service offshoring project issues

This research investigated Capability Maturity Models (CMM) / Capability Maturity Model Integration (CMMI) best practices and their effects on managing and mitigating critical issues associated with offshore development. Using a web-based survey, data was collected from 451 Information Technology and software development firms in the US. The results of the analysis show that IT companies applying CMM/CMMI models have fewer issues associated with IT offshoring. When US IT companies utilizing and incorporating different practices from TSP and People-CMM into CMMI-DEV/SVC and CMMI-ACQ, they have fewer offshoring issues related to language barriers and cultural differences

Efficacy and safety of nelarabine in patients with relapsed or refractory T-cell acute lymphoblastic leukemia: a systematic review and meta-analysis

Nelarabine is approved for the treatment of relapsed/refractory (R/R) T-cell acute lymphoblastic leukemia (T-ALL) patients who relapse following at least two different chemotherapy regimens. Previous studies have evaluated the efficacy and safety of nelarabine with chemotherapy in the treatment of R/R T-ALL. However, the results are inconsistent. This review aimed to summarize findings on efficacy and safety data in R/R T-ALL patients administered with the drug nelarabine. The present review conducted a comprehensive search of MEDLINE (via PubMed), WHO Clinical Trial Registry, Clinical Trials.gov, and Cochrane Central Register of Controlled Trials until 15 January 2022. Thirteen studies fulfilled the eligibility criteria with a total of 2508 patients. The efficacy of nelarabine was studied in terms of complete remission (CR) and partial remission (PR). Included studies reported overall random-effects pooled prevalence of CR and PR were 37.2 (95% CI: 22.8, 51.5) and 10.2 (95% CI: 4.9, 15.5), respectively. Most common adverse events associated with nelarabine were neutropenia, thrombocytopenia, fatigue, infections, and reversible peripheral neuropathy. Nelarabine is being used as salvage therapy as a bridge to hematopoietic stem cell transplantation and the findings of this meta-analysis indicate that it is an effective and safe treatment to be used in addition to the first-line treatment for R/R T-ALL