Laparoscopic management of uterine perforation: report of three cases

We present three cases of uterine perforation which were managed laparoscopically at the Aga Khan University Hospital Nairobi, between January and December 2008. Our objective was to determine the outcomes of uterine perforations and to create awareness on the availability of the laparoscopic management at such complications and to recommend the procedure as a suitable option to laparotomy

Mobile agent location management in global networks

Mobility management is a necessity in highly dynamic and large-scale Mobile Agents (MAs) networks, especially in a multi-region environment in order to control and communicate with agents after launching. Existing mechanisms for locating MAs are not efficient as these do not consider the effect of location updates on migration time and produce network overload. This paper presents a hierarchical model for location management of MAs in global networks. Three protocols are developed, namely search, update and search-update. The location management technique uses one combination of search, update and search-update protocols throughout execution. Three cases are considered for Update and Search-Update Protocols. Thus, nine combinations of location management protocols are generated, from which an agent can dynamically select one as per requirement, to communicate with other agents on the global network. We have implemented these protocols on the system developed at IIT Roorkee, to evaluate the performance. Results indicate that overhead generated by these protocols does not affect the actual agent response and migration time[1].  

Day care laparoscopic surgery in gynaecology at a dedicated unit in Nairobi, Kenya

Objective: To evaluate and audit the outcomes of Gynaecological Day care Laparoscopic Surgery inNairobi,KenyaDesign: Retrospective case analysisSetting: The International Centre for Minimal Access Surgery, NairobiSubjects: one thousand three hundred and seventy nine patients undergoing Laparoscopic SurgeryResults: Between January 2011 to December 2015 a total of 1,379 Laparoscopic procedures were undertaken during the reporting period of which 1,121 ( 88.5 % ) were done as day procedures. In total 137 patients ( 9.9 % ) spent one night at ICMAS, 21 ( 1.5 % ) were transferred to a Major Hospital and 41 patients (2.9 %) underwent conversion to Laparotomy. There were two Hospital re-admissions (0.14 % ) and one complication ( 0.07% ), a bladder injury was encountered.Conclusions: Daycare surgery is a continually evolving speciality being competently performed by several units by various disciplines world over , including Kenya. In recent years the complexity of the procedures has increased with a wider range of patients being considered for challenging surgeries including those presenting with acute conditions. Our experiences have been favourable

EECDA: Energy Efficient Clustering and Data Aggregation Protocol for Heterogeneous Wireless Sensor Networks

In recent years, energy efficiency and data gathering is a major concern in many applications of Wireless Sensor Networks (WSNs). One of the important issues in WSNs is how to save the energy consumption for prolonging the network lifetime. For this purpose, many novel innovative techniques are required to improve the energy efficiency and lifetime of the network. In this paper, we propose a novel Energy Efficient Clustering and Data Aggregation (EECDA) protocol for the heterogeneous WSNs which combines the ideas of energy efficient cluster based routing and data aggregation to achieve a better performance in terms of lifetime and stability. EECDA protocol includes a novel cluster head election technique and a path would be selected with maximum sum of energy residues for data transmission instead of the path with minimum energy consumption. Simulation results show that EECDA balances the energy consumption and prolongs the network lifetime by a factor of 51%, 35% and 10% when compared with Low-Energy Adaptive Clustering Hierarchy (LEACH), Energy Efficient Hierarchical Clustering Algorithm (EEHCA) and Effective Data Gathering Algorithm (EDGA), respectively

District level baseline survey of family planning program in Uttar Pradesh: Jaunpur

Uttar Pradesh (UP) is the most populous state in India, with a population of 139 million, as of the 1991 census. The socioeconomic profile is characterized by relatively low levels of per capita income and literacy. Further, assessment of the family planning program and the demographic status as measured by Couple Protection Rate (CPR) and Mortality/Fertility rates mark UP as one of the country’s more demographically disadvantaged states. UP has a relatively higher Infant Mortality Rate, crude death rate, birth rate, and total fertility rate than the country as a whole, whereas CPR is much too low. The district of Jaunpur falls in the Eastern Region of the state, which on the whole is more disadvantaged than the Western Region. As noted in this report, no systematic surveys have ever been done to provide district-level estimates of fertility and mortality or CPR except in a few districts. The present survey is designed to provide valid estimates of vital rates and CPR at the district level and to fill gaps in the available information on several aspects related to the demographic situation and family planning program

District level baseline survey of family planning program in Uttar Pradesh: Ghaziabad

Uttar Pradesh is the most populous state in India with 139 million individuals, per the 1991 census. The Sample Registration System in 1992 indicated a high population growth rate of 2.3 percent and a very high birth rate of 36.2 per 1,000. Several measures have been taken to contain the growth and bring a rapid decline in the fertility rate. The Government of India and USAID began the Innovations in Family Planning Services Project under the management of the State Innovations in Family Planning Services Agency. The goal was to reduce the fertility rate in Uttar Pradesh by expanding and improving family planning (FP) services. Since there has been differential impact of FP services over the years in the state’s different districts, it was considered desirable to take up the district as a unit and develop an adequate data base for generating suitable intervention programs. Baseline surveys were conducted in 14 districts in different regions of the state. The Centre for Development Research and Training, Madras, conducted the surveys in Ghaziabad and Tehri Garhwal. This preliminary report contains the details of the survey conducted in Ghaziabad district

District level baseline survey of family planning program in Uttar Pradesh: Gorakhpur

The state of Uttar Pradesh (UP) in India had a population of 139 million, as of the 1991 census. The socioeconomic profile is characterized by relatively low levels of per capita income and literacy. Further, assessment of the family planning program and the demographic status as measured by Couple Protection Rate (CPR) and Mortality/Fertility rates marks UP as one of the country’s more demographically disadvantaged states. UP has a relatively higher infant mortality rate, crude death rate, birth rate, and total fertility rate than the country as a whole, whereas CPR is much too low. The district of Gorakhpur falls in the Eastern Region of the state, which on the whole is more disadvantaged than the Western Region. As noted in this report, no systematic surveys have ever been done to provide district-level estimates of fertility and mortality or CPR except in a few districts. The present survey is designed to provide valid estimates of vital rates and CPR at the district level and to fill gaps in the available information on several aspects related to the demographic situation and family planning program

District level baseline survey of family planning program in Uttar Pradesh: Sitapur

The Government of India and the United States Agency for International Development began the Innovations in Family Planning Services Projects (IFPS) in Uttar Pradesh under the management of the State Innovations in Family Planning Services Agency (SIFPSA). IFPS’s objectives are to increase access to family planning (FP) services, improve the quality of health care services, and promote contraceptive use. While achieving these goals, the IFPS project will support service innovations in the public and nongovernmental sectors, and contraceptive social marketing mechanisms. Baseline information being sought includes desired family size and sex preference among mothers, utilization of health services and immunization of mothers and children, maternal and child health care and delivery practices, contraceptive information and services and satisfaction with health providers, contraceptive use and unmet need, and media exposure and the role of the media in promoting small-family norm. The Operations Research Group, at the request of SIFPSA, has carried out the present baseline survey in the district of Sitapur. The baseline information will be used as the reference for the measurement of improvements in contraceptive use

District level baseline survey of family planning program in Uttar Pradesh: Jaunpur

Uttar Pradesh (UP) is the most populous state in India, with a population of 139 million, as of the 1991 census. The socioeconomic profile is characterized by relatively low levels of per capita income and literacy. Further, assessment of the family planning program and the demographic status as measured by Couple Protection Rate (CPR) and Mortality/Fertility rates mark UP as one of the country’s more demographically disadvantaged states. UP has a relatively higher Infant Mortality Rate, crude death rate, birth rate, and total fertility rate than the country as a whole, whereas CPR is much too low. The district of Jaunpur falls in the Eastern Region of the state, which on the whole is more disadvantaged than the Western Region. As noted in this report, no systematic surveys have ever been done to provide district-level estimates of fertility and mortality or CPR except in a few districts. The present survey is designed to provide valid estimates of vital rates and CPR at the district level and to fill gaps in the available information on several aspects related to the demographic situation and family planning program