Oxytocin and oral misoprostol for labor induction in prelabor rupture of membranes

Background: Prelabor rupture of membrane is one of the most common complications of pregnancy, and the best management option for women with this condition is debatable. This study aims to compare intravenous oxytocin with that of oral misoprostol for labor induction in women with prelabor rupture of membrane.Methods: One hundred and forty women at Central Referral Hospital, Gangtok, India were randomized to receive either misoprostol 50 µg orally every 4 hours or intravenous oxytocin. The primary outcome measure was time from induction to vaginal delivery.Results: The mean time±standard deviation to vaginal birth with oral misoprostol was 5.0±2.58 hours compared with 4.33±2.3 h with oxytocin which was just statistically significant (P = 0.048). There were no difference in the maternal secondary outcome, including cesarean birth (ten and twelve respectively) and gastrointestinal side effects. Neonatal outcomes including Apgar scores and admission to ICU (NICU) were not different.Conclusions: Although oxytocin resulted in shorter induction to delivery interval, oral misoprostol is still an effective option for PROM, as delivery and neonatal outcomes were similar

Life cycle assessment of soybean biodiesel production in South Africa : a preliminary assessment

Abstract: South Africa has limited oil reserves and its transportation sector mostly depends on imported petroleum products. Renewable fuels, such as biodiesel, have potential to extend and diversify South African energy supply, and help the nation to cope with energy security and emissions issues. The renewability and environmental benefits of biodiesel have been illustrated in several life cycle assessment (LCA) studies. South Africa is in initial phase of establishing large scale commercial biodiesel industries and it is sensible to measure biodiesel’s life cycle performance. This study uses secondary data from literatures to develop a life cycle inventory on farming, crushing and conversion capacity of soybean and then conduct LCA of soybean biodiesel production in South Africa. The LCA results indicate that soybean biodiesel is renewable, environmentally sustainable and economically viable. Soybean biodiesel yields 125% more useful energy than the energy requires to make it, saves 31.5% GHG emissions compared to fossil diesel, and on average returns 1.39 times the cost of the energy input

Development of life cycle inventory (LCI) for sugarcane ethanol production in South Africa

Abstract: The Biofuels Industrial Strategy established by the government of South Africa in 2007 has emphasised the need to understand the potential benefits and consequences of developing biofuels in the country. Life cycle assessment (LCA) is a preferred tool to measure energy and environmental performances of biofuel production; however, LCA relies heavily on data and developing a life cycle inventory (LCI) plays a crucial role in any LCA studies. The lack of availability and difficulty in obtaining data from reliable sources can provide a great challenge during the process of developing biofuels LCI. This study develops a LCI database for the production of ethanol using sugarcane molasses in South Africa. The inventory includes all the input and output data associated with various sub-system of ethanol production. Relevant data are collected through national statistics and various literatures. The LCI has been developed as a first step towards the LCA studies which can assist in measuring the performance of South African ethanol development in the future

Multi-objective preemptive optimization of residential load scheduling problem under price and CO2 signals

Abstract: This paper addresses the residential load scheduling problem with the objective of investigating the influence of price and CO2 signals in (i) the electricity bill, (ii) the consumer inconvenience, (iii) the electric peak load, and (iv) the CO2 emissions. These objectives were considered widely in the literature; however, they were not considered simultaneously in one model before. Furthermore, CO2 emissions targets constraint was not considered in the previous literature. This paper contributes by twofold. First, the CO2 signal is drawn up based on the proposed generation-mix plan in South Africa and an hourly CO2 emissions limit is guaranteed. Second, a multi-objective mixed integer programming model is proposed, and a preemptive multi-objective optimization approach is applied. The model is tested with and without considering the hourly CO2 emissions limit. Furthermore, the model is solved at four scenarios to explore the effect of the price and CO2 signals and the order of optimization. Results showed that the price and CO2 signals and the order of optimization have remarkable effect on the appliance schedule and on the four objectives

Thyroid disorder in antenatal women in sub-himalayan region: a need for universal screening

Background: Thyroid dysfunction constitutes the second most common endocrine disorder of pregnancy, associated with adverse maternal and fetal outcome and is often overlooked in pregnancy due to their nonspecific symptoms and the hypermetabolic pregnant state. Objective of present study was to establish the prevalence of thyroid dysfunction, study the effects in pregnancy in sub-himalayan population and whether universal screening for thyroid dysfunction is required.Methods: The study was conducted on 200 patients in the age group of 20 to 35 years with a singleton pregnancy and gestational age between 6 to 24 weeks.Results: In the 200 women screened, the prevalence of thyroid dysfunction was found to be 14% with 8% having subclinical hypothyroidism while an equal percentage of 2% having clinical hypothyroidism, subclinical hyperthyroidism and clinical hyperthyroidism. The mean age of patients with subclinical hypothyroidism was 28.6 ± 4.9 years, with thyroid disorder in pregnancy being significantly more common in primigravida. Statistically significant association was found between patients with thyroid dysfunction and abortions, preeclampsia, preterm labor, small for gestational age, low birth weight, and admission to NICU.Conclusions: Prevalence of thyroid dysfunction was found to be high in our study, particularly subclinical hypothyroidism and was associated with adverse pregnancy outcomes; hence, more research is required in the Sub-Himalayan goitre belt to assess the magnitude of the problem and formulate universal screening protocols in this particular subset of the Indian population accordingly

Ergodic Risk-Sensitive Control for Regime-Switching Diffusions

In this article, we study the ergodic risk-sensitive control problem for controlled regime-switching diffusions. Under a blanket stability hypothesis, we solve the associated nonlinear eigenvalue problem for weakly coupled systems and characterize the optimal stationary Markov controls via a suitable verification theorem. We also consider the near-monotone case and obtain the existence of principal eigenfunction and optimal stationary Markov controls

Opportunities and challenges of embracing smart factory in South Africa

Abstract: The fourth industrial revolution combines cyberphysical systems with manufacturing processes, enabling industries to automate and maintain their production in real time. Smart technologies open new global markets and increase global economy, however there are some challenges associated with the implementation such as lack of skilled manpower, social inequality, potential disruption in labor market, cyber-risks, etc. This paper investigates the opportunities and challenges associated with the adoption and implementation of smart factory in South Africa using extensive review of available literatures, which is triangulated using a single case study. It was observed that the current adoption of smart technologies is low. South African manufacturing industry and existing workforce will require upgrades to match skills required for smart factory. Smart factory may displace specific labor force with automation, however it will also create new types of jobs. Some industries are already using flexible production and producing customerspecific goods, which indicates that these industries will easily transform to mass customization. Cyber-risks and privacy issues of digital revolution provides a platform for existing ICT professionals to engage in R&D, as well as create new jobs related to development of security systems and software. Industries and people are showing certain level of acceptance, however they are yet to fully engage in smart factory

Laparoscopic evaluation and prevalence of endometriosis among infertile women: a prospective study

Background: Endometriosis can be defined as presence of endometrial mucosa outside the uterine cavity. There are no specific signs and symptoms of endometriosis and the presentation may vary depending upon the site of involvement. It is one of the common causes of subfertility and infertility in young women. The Management of endometriosis may include medical as well as surgical intervention. Laparoscopic interventions have found to have encouraging results in terms of increasing chances of fertility in young women with endometriosis.Methods: This was a prospective study in which women who had infertility and subsequently diagnosed to be having endometriosis were included. A detailed history was taken with particular emphasis on duration of symptoms, presence of additional co-morbidities and duration of infertility was recorded. Diagnostic laparoscopy was done in all the cases. Depending upon location and severity of endometriosis adhesiolysis, excision and ablation of endometrial lesions was done. Patients were followed up and successful pregnancies (spontaneous as well as secondary to assisted reproductive techniques) were recorded.Results: Out of 200 studied cases endometriosis was seen in 23 (11.5%) patients. the most common affected age group was between 26-30 years (47.83%). 18 patients (78.26%) had primary infertility whereas remaining 5 patients (21.74%) were found to have secondary infertility. The most common site was found to be ovaries which was found to be involved in all the cases. cystectomy (30.43%), endometrioma drainage and fulguration (13.04%) or adhesiolysis (34.78%) were the commonly done surgical interventions in cases. out of 18 patients who had successful ovulation following laparoscopic intervention 12 (66.66%) patients completed their pregnancies successfully.Conclusions: Laparoscopic interventions in patients with infertility have diagnostic as well as therapeutic value and are found to have good outcome in terms of successful pregnancy