The impact of tubal ectopic pregnancy in Papua New Guinea - a retrospective case review

BACKGROUND: Ectopic pregnancy (EP) is an important cause of morbidity and mortality amongst women of reproductive age. Tubal EP is well described in industrialised countries, but less is known about its impact in low-resource countries, in particular in the South Pacific Region. METHODS: We undertook a retrospective review of women with tubal EP treated at a provincial referral hospital in coastal Papua New Guinea over a period of 56 months. Demographic and clinical variables were obtained from patients’ medical records and analysed. The institutional rate of tubal EP was calculated, and diagnosis and management reviewed. Potential risk factors for tubal EP were identified, and delays contributing to increased morbidity described. RESULTS: A total of 73 women had tubal EP. The institutional rate of tubal EP over the study period was 6.3 per 1,000 deliveries. There were no maternal deaths due to EP. The mean age of women was 31.5+/−5.7 years, 85% were parous, 67% were rural dwellers and 62% had a history of sub-fertility. The most commonly used diagnostic aid was culdocentesis. One third of women had clinical evidence of shock on arrival. All women with tubal EP were managed by open salpingectomy. Tubal rupture was confirmed for 48% of patients and was more common amongst rural dwellers. Forty-three percent of women had macroscopic evidence of pelvic infection. Two-thirds of patients received blood transfusions, and post-operative recovery lasted six days on average. Late presentation, lack of clinical suspicion, and delays with receiving appropriate treatments were observed. CONCLUSIONS: Tubal EP is a common gynaecological emergency in a referral hospital in coastal PNG, and causes significant morbidity, in particular amongst women residing in rural areas. Sexually transmitted infections are likely to represent the most important risk factor for tubal EP in PNG. Interventions to reduce the morbidity due to tubal EP include the prevention, detection and treatment of sexually transmitted infections, identification and reduction of barriers to prompt presentation, increasing health workers’ awareness of ectopic pregnancy, providing pregnancy test kits to rural health centres, and strengthening hospital blood transfusion services, including facilities for autotransfusion

Well-posedness of 2-D and 3-D swimming models in incompressible fluids governed by Navier-Stokes equations

We introduce and investigate the wellposedness of two models describing the self-propelled motion of a "small bio-mimetic swimmer" in the 2-D and 3-D incompressible fluids modeled by the Navier-Stokes equations. It is assumed that the swimmer's body consists of finitely many subsequently connected parts, identified with the fluid they occupy, linked by the rotational and elastic forces. The swimmer employs the change of its shape, inflicted by respective explicit internal forces, as the means for self-propulsion in a surrounding medium. Similar models were previously investigated in [15-19] where the fluid was modeled by the liner nonstationary Stokes equations. Such models are of interest in biological and engineering applications dealing with the study and design of propulsion systems in fluids and air

Una nuova dedica a Ercole da un manoscritto di Bonifacius Amerbach

The manuscript C VI a 77, once belonged to the XVIth century humanist Bonifacius Amerbach and now preserved in the Universitätsbibliothek Basel, is not a high quality epigraphic manuscript, but includes at least a couple of Roman inscriptions elsewhere unknown. One of them, already published in the previous years, is a dedication to Iuppiter Optimus Maximus set by an eques singularis; the other one is a dedication to Hercules Invictus – here published for the first time - set, when he was an urban praetor, by L. Turranius Venustus Gratianus, member of a well known senatorial family of the III/IV century AD