Role of methylergometrine versus oxytocin in the active management of third stage of labour: a randomised control trial

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal death globally. The routine practice of active management of third stage of labour has been shown to reduce haemorrhage by up to 60%. The present study evaluated the role of methylergometrine versus oxytocin in active management of third stage of labour in reducing the risk of PPH.Methods: This study was conducted on a total of 400 women admitted in the labour ward of PESIMSR hospital, by using simple randomized design. The first study group included women who received intramuscular oxytocin (n=200) and, the second group included women who received intravenous Methylergometrine (n=200) within, one minute of delivery of the baby.Results: The mean blood loss among study first and the second study group were 172.8 ml and 148.9 ml respectively (p<0.05) and, the mean duration of third stage of labour were 5.9 and 5.1 minutes respectively (p<0.05). The mean pre-and post-delivery haemoglobin values among the first and second group were 11.76 mg/dl, 10.46 mg/dl and, 11.76 mg/dl, 10.6 mg/dl respectively (p<0.05). There was an increase in the blood pressure in the ergometrine group and, slight decrease of blood pressure in oxytocin group.Conclusions: The use of methyl ergometrine as part of active management of third stage of labour was associated with a significant reduction in mean blood loss value, duration of third stage of labour, and the additional need of oxytocic though, methylergometrine has significant side effects like nausea, vomiting and rise in blood pressure

Comprehensive User Engagement Sites (CUES) in Philadelphia: A Constructive Proposal

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage

High energy X-γ ray spectrometer on the Chandrayaan-1 mission to the Moon

The Chandrayaan-1 mission to the Moon scheduled for launch in late 2007 will include a high energy X-ray spectrometer (HEX) for detection of naturally occurring emissions from the lunar surface due to radioactive decay of the 238U and 232Th series nuclides in the energy region 20-250 keV. The primary science objective is to study the transport of volatiles on the lunar surface by detection of the 46.5 keV line from radioactive 210Pb, a decay product of the gaseous 222Rn, both of which are members of the 238U decay series. Mapping of U and Th concentration over the lunar surface, particularly in the polar and U-Th rich regions will also be attempted through detection of prominent lines from the U and Th decay series in the above energy range. The low signal strengths of these emissions require a detector with high sensitivity and good energy resolution. Pixelated Cadmium-Zinc-Telluride (CZT) array detectors having these characteristics will be used in this experiment. Here we describe the science considerations that led to this experiment, anticipated flux and background (lunar continuum), the choice of detectors, the proposed payload configuration and plans for its realizatio

Describing the profile of diagnostic features in autistic adults using an abbreviated version of the Diagnostic Interview for Social and Communication Disorders (DISCO-Abbreviated)

The rate of diagnosis of autism in adults has increased over recent years; however, the profile of behaviours in these individuals is less understood than the profile seen in those diagnosed in childhood. Better understanding of this profile will be essential to identify and remove potential barriers to diagnosis. Using an abbreviated form of the Diagnostic Interview for Social and Communication Disorders, comparisons were drawn between the profile of a sample of able adults diagnosed in adulthood and the profile of a sample of able children. Results revealed both similarities and differences. A relative strength in non-verbal communication highlighted a potential barrier to diagnosis according to DSM-5 criteria for the adult sample, which may also have prevented them from being diagnosed as children

Reduced cortical thickness in patients with acute-on-chronic liver failure due to non-alcoholic etiology

Background: Acute-on-chronic liver failure (ACLF) is a form of liver disease with high short-term mortality. ACLF offers considerable potential to affect the cortical areas by significant tissue injury due to loss of neurons and other supporting cells. We measured changes in cortical thickness and metabolites profile in ACLF patients following treatment, and compared it with those of age matched healthy volunteers. Methods: For the cortical thickness analysis we performed whole brain high resolution T1-weighted magnetic resonance imaging (MRI) on 15 ACLF and 10 healthy volunteers at 3T clinical MR scanner. Proton MR Spectroscopy (1H MRS) was also performed to measure level of altered metabolites. Out of 15 ACLF patients 10 survived and underwent follow-up study after clinical recovery at 3 weeks. FreeSurfer program was used to quantify cortical thickness and LC- Model software was used to quantify absolute metabolites concentrations. Neuropsychological (NP) test was performed to assess the cognitive performance in follow-up ACLF patients compared to controls. Results: Significantly reduced cortical thicknesses in multiple brain sites, and significantly decreased N-acetyl aspartate (NAA), myo-inositol (mI) and significantly increased glutamate/glutamine (glx) metabolites were observed in ACLF compared to those of controls at baseline study. Follow-up patients showed significant recovery in cortical thickness and Glx level, while NAA and mI were partially recovered compared to baseline study. When compared to controls, follow-up patients still showed reduced cortical thickness and altered metabolites level. Follow-up patients had abnormal neuropsychological (NP) scores compared to controls. Conclusions: Neuronal loss as suggested by the reduced NAA, decreased cellular density due to increased cerebral hyperammonemia as supported by the increased glx level, and increased proinflammatory cytokines and free radicals may account for the reduced cortical thickness in ACLF patients. Presence of reduced cortical thickness, altered metabolites and abnormal NP test scores in post recovery subjects as compared to those of controls is associated with incomplete clinical recovery. The current imaging protocol can be easily implemented in clinical settings to evaluate and monitor brain tissue changes in patients with ACLF during the course of treatment

Out on a limb: Arboreal camera traps as an emerging methodology for inventorying elusive rainforest mammals

Traditionally, arboreal rainforest mammals have been inventoried using ground-based survey techniques. However, given the success of camera traps in detecting secretive terrestrial rainforest mammals, camera trapping could also be a valuable tool for inventorying arboreal species. Here we assess, for the first time, the effectiveness of arboreal camera traps for inventorying arboreal rainforest mammals and compare the results with those from other methodologies. We do so in one of the world’s most biodiverse conservation areas, the Manu Biosphere Reserve, Peru. We accumulated 1201 records of 24 arboreal mammal species. Eighteen species were detected by arboreal cameras, seven by diurnal line transects, six by nocturnal transects and eighteen through incidental observations. Six species were only detected using arboreal camera traps. Comparing arboreal camera traps with traditional ground-based techniques suggests camera traps are an effective tool for inventorying arboreal rainforest mammal communities. They also detected more cryptic species compared with other methodologies. Daily detection frequency patterns were found to differ between ground-based techniques and arboreal cameras. A cost-effort analysis indicated that despite greater upfront costs in equipment and training for arboreal camera trapping, when accounting for the additional survey hours required to provide similar numbers of records using ground-based methods, overall costs were similar. Our work demonstrates that arboreal camera trapping is likely to be a powerful technique for inventorying canopy mammals. The method has considerable potential for the study of charismatic and threatened arboreal mammal species that may otherwise remain largely unknown and could quietly disappear from the world’s tropical forests. © 2016, Mongaby.com e-journal. All rights reserved

Effects of GnRH vaccination in wild and captive African Elephant bulls (Loxodonta africana) on reproductive organs and semen quality

OBJECTIVES: Although the African elephant (Loxodonta africana) is classified as endangered by the International Union for Conservation of Nature (IUCN), in some isolated habitats in southern Africa, contraception is of major interest due to local overpopulation. GnRH vaccination has been promoted as a non-invasive contraceptive measure for population management of overabundant wildlife. We tested the efficacy of this treatment for fertility control in elephant bulls. METHODS: In total, 17 male African elephants that were treated with a GnRH vaccine were examined in two groups. In the prospective study group 1 (n = 11 bulls, ages: 8±36 years), semen quality, the testes, seminal vesicles, ampullae and prostate, which were all measured by means of transrectal ultrasound, and faecal androgen metabolite concentrations were monitored over a three-year period. Each bull in the prospective study received 5 ml of Improvac® (1000 μg GnRH conjugate) intramuscularly after the first examination, followed by a booster six weeks later and thereafter every 5±7 months. In a retrospective study group (group 2, n = 6, ages: 19±33 years), one examination was performed on bulls which had been treated with GnRH vaccine for 5±11 years. RESULTS: In all bulls of group 1, testicular and accessory sex gland sizes decreased significantly after the third vaccination. In six males examined prior to vaccination and again after more than five vaccinations, the testis size was reduced by 57.5%. Mean testicular height and length decreased from 13.3 ± 2.6 cm x 15.2 ± 2.8 cm at the beginning to 7.6 ± 2.1 cm x 10.2 ± 1.8 cm at the end of the study. Post pubertal bulls (>9 years, n = 6) examined prior to vaccination produced ejaculates with viable spermatozoa (volume: 8±175 ml, sperm concentration: 410-4000x106/ml, total motility: 0±90%), while after 5±8 injections, only 50% of these bulls produced ejaculates with a small number of immotile spermatozoa. The ejaculates of group 2 bulls (vaccinated >8 times) were devoid of spermatozoa. Faecal androgen metabolite concentrations measured in captive males decreased significantly after the fourth vaccination. None of the males entered musth during the treatment period. CONCLUSIONS: Our results showed a marked decrease in semen quality, testicle and secondary sex gland sizes following repeated GnRH vaccinations. After 2±4 years of continuous treatment every 5±7 months, the effects were similar to surgical castration.ISIScopu