Indications and trends of caesarean birth delivery in the current practice scenario

Background: Objective of current study was to analyze incidence, indications and trends of cesarean birth delivery in our environment.Methods: A prospective study of the cesarean sections performed at V.S. general teaching hospital in Ahmedabad from January 2008 to December 2013Results: Out of 28,411 total deliveries, 11629 women underwent CS. Each year the CS rate, above 40%, was relatively constant. 72.46% patients were within 20-29 years of age group. 39% patients were from middle to higher socio-economic class. CS in emergency patient was consistently more than 50% and in registered patient around 40%. Maternal indications for CS were twice common to fetal indications. Previous CS and fetal distress were the commonest among maternal and fetal indications respectively. Overall maternal morbidity in CS ranged from 8-10%, commonest being blood transfusion and wound infection. Neonatal morbidity was less than half and neonatal mortality was almost one third in comparison to normal delivery. Rising CS trend was noted in patients with previous CS, fetal distress, oligohydramnios and failed induction. Gradual but constant decline in CS rate was noted among emergency patients, patient with CPD, obstructed labor and PROM.Conclusions: Although to some extent higher CS rate is justifiable due to remarkable reduction in neonatal mortality and morbidity in high risk patients; the CS rate in our environment is still three times higher than WHO recommendation. In controlled environment with experienced staff, careful selection of patients for normal delivery among patients with previous CS, breech presentation and scientific induction of labor may satisfy our concern for mother and newborn safety while keeping the CS rate low

Role of doppler in fetal growth restriction

Background: Fetal growth restriction is an important and particularly challenging problem for modern obstetricians and paediatricians. The present study is to correlate the importance of Doppler velocimetry and perinatal outcome in cases of growth restricted foetuses by comparing perinatal outcome of control & study groups with normal and abnormal Doppler waveforms.Methods: A study and a control group comprising of 50 pregnant women having growth restricted foetuses in each group was matched for all other confounding factors except for Doppler changes. These patients were followed up and the perinatal outcomes of FGR foetuses having Doppler changes was compared with those having normal Doppler studies.Results: In our study, alteration in both MCA and UmbA Doppler was associated with perinatal morbidity and NICU admissions in 64% and mortality in 28%. Doppler changes showing altered CPR less than 1 had adverse outcome with NICU admission in 61% and mortality in 34%. Alteration in DV Doppler was associated with perinatal morbidity and NICU admissions in 17% cases and mortality in 83% cases, with no pregnancies having a healthy outcome. Among high-risk pregnancies with suspected IUGR, the use of Doppler assessment significantly decreases the likelihood of labor induction, caesarean delivery, and perinatal deaths.Conclusions: Abnormal Doppler waveform changes indicate adverse perinatal outcome of pregnancies with FGR. Doppler study helps to reduce perinatal mortality and morbidity by timely and appropriate interventions

A STUDY ON CLINICAL PROFILE, RISK FACTORS AND MORTALITY IN HYPERTENSIVE INTRACEREBRAL HEMORRHAGE IN A TERTIARY CARE HOSPITAL IN SURAT CITY

Background: Hypertensive intracerebral hemorrhage remains a serious disease despite attempts at improving outcome by medical and neurosurgical treatment. This prompted us to conduct a study on the clinical presentation, risk factors and to assess the prognosis and mortality in hypertensive intracerebral hemorrhage. Methodology: The present study was conducted on the 50 cases of ICH coming to the tertiary care centre of Surat. The clinical profile and risk factors of the enrolled cases were studied. The outcome (30 day mortality) of ICH patients were noted by follow-up or telephonic interview. Results: Hypertensive intracerebral hemorrhage was most common in males, constituting 80% of the cases. The age range of the cases varied from 35 to 74 years of age. Maximum numbers of cases were in the age group between 44-74 years. A strong diurnal tendency for occurrence of intracerebral hemorrhage was noted with 94% of cases presenting during morning and early afternoon hours. Altered sensorium followed by weakness of limb/limbs constituted the most frequent presenting symptoms. History of smoking was present among 48% of cases. 34% of the cases had a history of alcohol consumption. 60% of the cases had history of tobacco chewing. Conclusion: It was concluded that the most common presentation of cases of hypertensive ICH was altered sensorium (60%). Diurnal variation in the occurrence of hypertensive ICH was present with 94% of the cases during either morning hours or early afternoon hours. Alcohol abuse and tobacco abuse was significantly associated with 30 days mortality

QoS Enabled IoT Based Low Cost Air Quality Monitoring System with Power Consumption Optimization

Air pollution has emerged as a major concern of the current century. In recent times, fellow researchers have conducted numerous researches in the area ofair quality monitoring. Still, air quality monitoring remains an open research area due to various challenges such as sophisticated topology design, privacy and security, power backup, large memory requirements and deployment of such systems at resource-constrained sites. The proposed research work is an attempt to address the issues of communication topology design, assessment of the Quality of Service(QoS) levels against accuracy, sensing through put and power consumption optimization. In the undertaken work, the proposed IoT based Air Quality Monitoring system has been deployed at indoor and outdoor sites to measure air quality parameters such as PM10, PM2.5, carbon monoxide, temperature and humidity. The proposed system is also tested at variety of quality of service levels at the indoor and outdoor sites. The conducted experiments have also recorded accuracy in terms ofreliable delivery of the messages under employed protocol.

QoS Enabled IoT Based Low Cost Air Quality Monitoring System with Power Consumption Optimization

Air pollution has emerged as a major concern of the current century. In recent times, fellow researchers have conducted numerous researches in the area ofair quality monitoring. Still, air quality monitoring remains an open research area due to various challenges such as sophisticated topology design, privacy and security, power backup, large memory requirements and deployment of such systems at resource-constrained sites. The proposed research work is an attempt to address the issues of communication topology design, assessment of the Quality of Service(QoS) levels against accuracy, sensing through put and power consumption optimization. In the undertaken work, the proposed IoT based Air Quality Monitoring system has been deployed at indoor and outdoor sites to measure air quality parameters such as PM10, PM2.5, carbon monoxide, temperature and humidity. The proposed system is also tested at variety of quality of service levels at the indoor and outdoor sites. The conducted experiments have also recorded accuracy in terms ofreliable delivery of the messages under employed protocol.