Trends of maternal mortality in a tertiary care hospital: a five year retrospective study

Background: Maternal mortality is a measure of quality of health care in community. Maternal mortality ratio is a very sensitive index that reflect the quality of reproductive care provided to the pregnant women. The aims and objectives were to study the institutional maternal mortality, the causes of maternal death and the impact of COVID-19 on MMR.Methods: A retrospective hospital-based study of 38 maternal death was done over a period of 5 years from June 2016 to May 2021 in obstetrics and gynaecology department, RIMS Imphal. Details of all the mortalities were collected from individual case sheets, facility based maternal death review forms and MDR case summary.Results: A total of 38 deaths were analysed. MMR in the study period was 86 per 1 lakh live births. Maximum maternal deaths were reported in the age group of 30-34 years. Majority of maternal death were reported in multipara (57.9%) as compared to primipara (34.2%). Most of them were un-booked (63.2%) and belonged to rural areas (60.5%). The commonest cause was obstetrics haemorrhage (42.1%) followed by hypertensive disorders (23.6%). Acute respiratory distress syndrome associated with SARS-CoV-2 is one of the most important causes of increasing mortality rate (10.5%).Conclusions: Early identification of high-risk pregnancy, regular antenatal check-up and proper training of health personnel along with timely referral to tertiary care centre can help to reduce the mortality. There is an increase in MMR during the current pandemic 2020-2021

Acute kidney injury in obstetrics: a five-year study in a tertiary centre

Background: Pregnancy Related Acute Kidney Injury (PRAKI) is a major cause of maternal and foetal morbidity and mortality in developing countries. The incidence has declined due to improvements in reproductive health but it is still associated with significant perinatal mortality and maternal morbidity. It may be due to decrease in renal perfusion or ischemic tubular necrosis from a variety of conditions encountered during pregnancy. Our study aims at determining the predisposing factors and causes of AKI during pregnancy and its impact on maternal and foetal outcome.Methods: A retrospective cohort study over a period of 5 years was conducted on pregnant women with AKI as per inclusion and exclusion criteria. The detailed history, events, mode of delivery, cause leading to AKI, management, hospital stay, maternal and foetal outcome were studied in detail and evaluated. These patients were classified according to RIFLE criteria and were followed up for hospital stay and residual morbidities.Results: The incidence of PRAKI in the study was 0.07% (36 out of 50,735 deliveries) and among obstetric ICU patients, it was 6.8%. Most of the majority of the cases were unbooked (66.7%) and multipara (61.1%). Maternal morbidity was seen in 66.7% and mortality was 27.8%. Poor foetal outcome was seen in 44.4%.Conclusions: Haemorrhage is the most common cause of PRAKI, followed by toxaemia of pregnancy and sepsis. Early detection and meticulous management of haemorrhage, hypertension and sepsis reduce the incidence of PRAKI and associated maternal mortality

Association of maternal serum triglycerides at term and macrosomia in gestational diabetes mellitus

Background: Aim of the study was to determine association of maternal serum triglycerides (TG) at term and macrosomia in gestational diabetes mellitus (GDM). Methods: A cross sectional study was carried out in the department of obstetrics and gynaecology, RIMS, Manipur. The study was conducted for 2 years duration from September 2019 to August 2021 and 85 singleton term pregnant women with GDM were included. All the patients were subjected to check fasting serum TG, FBS, PPBS. Descriptive statistics like mean, standard deviation and Inferential statistics like Chi-square test was used for comparing study variables between large for gestational age (LGA) and non LGA group. T-test was used to compare the mean values of age, pre-pregnancy BMI, pregnancy weight gain, OGTT, FBS, PPBS, fasting serum TG between LGA and non LGA group. Results: The observed mean TG values in LGA and non LGA group in our study was 262.35±26.08 and 158.18±13.24 mg/dL respectively. The serum TG values in the LGA group mothers was significantly higher when compared to the non LGA group. The mean weight gain in pregnancy 15.17±1.82 and 9.60±1.47 in LGA and non LGA respectively. The mean BMI comparison among LGA and non LGA are 27.7±1.74 and 22.94±1.6 respectively. Conclusions: It is observed that maternal fasting serum TG may be a strong predictor of foetal size irrespective of the glycemic status. Our study clearly pointed out the usefulness of measuring serum TG in GDM pregnancy. In addition to maternal hypertriglyceridemia, pre-pregnancy BMI, excessive weight gain in pregnancy significantly associated with foetal macrosomia in GDM mothers

'Investigating the appropriate Renewable Energy Technologies in the Mauritian context'

With limited indigenous conventional energy resources, Mauritius imports over 80% of its energy supply from foreign countries, mostly from the Middle East. Developing independent renewable energy resources is thus of priority concern for the Mauritian government. A tropical island surrounded by the Indian Ocean, Mauritius has enormous potential to develop various renewable energies, such as solar energy, biomass energy, wind power, geothermal energy, hydropower, etc. However, owing to the importance of conventional fossil energy in generating remarkably cheap electricity, renewable energy has not yet fully developed in Mauritius, resulting from a lack of market competition. So, in order to reduce the external dependency of fuel, and also to cut down the expenses involved in the imported fuels, the Mauritius Government introduced attractive policies and invited investors of the homeland and abroad to invest in renewable energy technologies. Consequently, numerous promotional and subsidy programs have recently been proclaimed by the Mauritian government, focused on the development of various renewable energies. Thus, the Government of Mauritius has a long-term vision of transforming Mauritius into a sustainable Island. One important element towards the achievement of this vision is to increase the country’s renewable energy usage and thereby reducing dependence on fossil fuels. Democratisation of energy production is determined to be the way forward. A step in this direction is to transfer citizens the ability and motivation to produce electricity via small-scale distributed generation (SSDG), i.e. wind, photovoltaic, Hydropower. As a stepping stone the Government and the Central Electricity Board, with the help of the UNDP, established a grid code in May 2009 which encompasses tariffs and incentive schemes that have in many countries proved essential in order to achieve any substantial development in renewable electricity production based on SSDG.   In line with the government’s vision on renewable energy, the University of Mauritius is working as a partner with DIREKT team to promote renewable energy infrastructure locally. The DIREKT (Small Developing Island Renewable Energy Knowledge and Technology Transfer Network) is a teamwork scheme that involves the participation and collaboration of various universities from Germany, Fiji, Mauritius, Barbados and Trinidad & Tobago.  The aim of the DIREKT project is to reinforce the science and technology competency in the domain of renewable energy through technology transfer, information exchange and networking, targeting ACP (Africa, Caribbean, Pacific) Small Island developing states. This study was therefore initiated to investigate the main renewable energy technologies that stakeholders, institutions as well as businesses and organizations would like to invest in Mauritius based in the attracting incentive schemes provided by the Government.   From the study it was found that the majority of the Organizations, Institutions, Businesses and stakeholders are ready to accept and invest in the solar photovoltaic technology. Moreover, the economic evaluation for the implementation of the photovoltaic technology revealed that within a period of 4.3 years (payback period), the total capital invested can be recovered and after that, the capital generated from the excess electricity produced will contribute to the profit of the organization, Business or Institution

'Investigating the appropriate Renewable Energy Technologies in the Mauritian context'

With limited indigenous conventional energy resources, Mauritius imports over 80% of its energy supply from foreign countries, mostly from the Middle East. Developing independent renewable energy resources is thus of priority concern for the Mauritian government. A tropical island surrounded by the Indian Ocean, Mauritius has enormous potential to develop various renewable energies, such as solar energy, biomass energy, wind power, geothermal energy, hydropower, etc. However, owing to the importance of conventional fossil energy in generating remarkably cheap electricity, renewable energy has not yet fully developed in Mauritius, resulting from a lack of market competition. So, in order to reduce the external dependency of fuel, and also to cut down the expenses involved in the imported fuels, the Mauritius Government introduced attractive policies and invited investors of the homeland and abroad to invest in renewable energy technologies. Consequently, numerous promotional and subsidy programs have recently been proclaimed by the Mauritian government, focused on the development of various renewable energies. Thus, the Government of Mauritius has a long-term vision of transforming Mauritius into a sustainable Island. One important element towards the achievement of this vision is to increase the country’s renewable energy usage and thereby reducing dependence on fossil fuels. Democratisation of energy production is determined to be the way forward. A step in this direction is to transfer citizens the ability and motivation to produce electricity via small-scale distributed generation (SSDG), i.e. wind, photovoltaic, Hydropower. As a stepping stone the Government and the Central Electricity Board, with the help of the UNDP, established a grid code in May 2009 which encompasses tariffs and incentive schemes that have in many countries proved essential in order to achieve any substantial development in renewable electricity production based on SSDG.   In line with the government’s vision on renewable energy, the University of Mauritius is working as a partner with DIREKT team to promote renewable energy infrastructure locally. The DIREKT (Small Developing Island Renewable Energy Knowledge and Technology Transfer Network) is a teamwork scheme that involves the participation and collaboration of various universities from Germany, Fiji, Mauritius, Barbados and Trinidad & Tobago.  The aim of the DIREKT project is to reinforce the science and technology competency in the domain of renewable energy through technology transfer, information exchange and networking, targeting ACP (Africa, Caribbean, Pacific) Small Island developing states. This study was therefore initiated to investigate the main renewable energy technologies that stakeholders, institutions as well as businesses and organizations would like to invest in Mauritius based in the attracting incentive schemes provided by the Government.   From the study it was found that the majority of the Organizations, Institutions, Businesses and stakeholders are ready to accept and invest in the solar photovoltaic technology. Moreover, the economic evaluation for the implementation of the photovoltaic technology revealed that within a period of 4.3 years (payback period), the total capital invested can be recovered and after that, the capital generated from the excess electricity produced will contribute to the profit of the organization, Business or Institution

'Investigating the appropriate Renewable Energy Technologies in the Mauritian context'

With limited indigenous conventional energy resources, Mauritius imports over 80% of its energy supply from foreign countries, mostly from the Middle East. Developing independent renewable energy resources is thus of priority concern for the Mauritian government. A tropical island surrounded by the Indian Ocean, Mauritius has enormous potential to develop various renewable energies, such as solar energy, biomass energy, wind power, geothermal energy, hydropower, etc. However, owing to the importance of conventional fossil energy in generating remarkably cheap electricity, renewable energy has not yet fully developed in Mauritius, resulting from a lack of market competition. So, in order to reduce the external dependency of fuel, and also to cut down the expenses involved in the imported fuels, the Mauritius Government introduced attractive policies and invited investors of the homeland and abroad to invest in renewable energy technologies. Consequently, numerous promotional and subsidy programs have recently been proclaimed by the Mauritian government, focused on the development of various renewable energies. Thus, the Government of Mauritius has a long-term vision of transforming Mauritius into a sustainable Island. One important element towards the achievement of this vision is to increase the country’s renewable energy usage and thereby reducing dependence on fossil fuels. Democratisation of energy production is determined to be the way forward. A step in this direction is to transfer citizens the ability and motivation to produce electricity via small-scale distributed generation (SSDG), i.e. wind, photovoltaic, Hydropower. As a stepping stone the Government and the Central Electricity Board, with the help of the UNDP, established a grid code in May 2009 which encompasses tariffs and incentive schemes that have in many countries proved essential in order to achieve any substantial development in renewable electricity production based on SSDG.   In line with the government’s vision on renewable energy, the University of Mauritius is working as a partner with DIREKT team to promote renewable energy infrastructure locally. The DIREKT (Small Developing Island Renewable Energy Knowledge and Technology Transfer Network) is a teamwork scheme that involves the participation and collaboration of various universities from Germany, Fiji, Mauritius, Barbados and Trinidad & Tobago.  The aim of the DIREKT project is to reinforce the science and technology competency in the domain of renewable energy through technology transfer, information exchange and networking, targeting ACP (Africa, Caribbean, Pacific) Small Island developing states. This study was therefore initiated to investigate the main renewable energy technologies that stakeholders, institutions as well as businesses and organizations would like to invest in Mauritius based in the attracting incentive schemes provided by the Government.   From the study it was found that the majority of the Organizations, Institutions, Businesses and stakeholders are ready to accept and invest in the solar photovoltaic technology. Moreover, the economic evaluation for the implementation of the photovoltaic technology revealed that within a period of 4.3 years (payback period), the total capital invested can be recovered and after that, the capital generated from the excess electricity produced will contribute to the profit of the organization, Business or Institution

Live-birth after transplantation of cryopreserved ovarian tissue

This article does not have an abstract

A multicentric randomized clinical trial of homoeopathic medicines in fifty millesimal potencies vis-à -vis centesimal potencies on symptomatic uterine fibroids

Objective: The primary objective was to evaluate the effects of homoeopathic medicines in fifty millesimal (LM) potencies vis-à -vis centesimal (CH) potencies on symptomatic uterine fibroids. Materials and Methods: A multicentric randomized clinical trial was conducted at six centers under the Central Council for Research in Homoeopathy. Patients were screened for symptomatic uterine fibroids with the preset inclusion and exclusion criteria. A consultant specialized in obstetrics and gynecology was engaged at each center to screen and follow-up the enrolled patients. Homoeopathic physicians engaged in the study were responsible for prescription and follow up for 12 months. The primary outcome was changes in symptoms of uterine fibroid on a visual analog scale (VAS) of 0–10 and findings through ultrasonography (USG) between LM and CH potencies. The secondary outcome was to assess the changes in uterine fibroid symptom quality of life questionnaire (UFSQOL). Data analysis was done as per intention to treat (ITT) analysis. Results: Of 216 patients enrolled in the study (LM: 108 and CH: 108), 209 patients were analyzed under modified ITT (LM: 106, CH: 103). Both LM and CH potencies were equally effective in reducing the symptoms (percentage change) due to uterine fibroid on VAS scale after 1 year of treatment (P > 0.05). The health-related quality of life (HRQOL) and subdomains of UFSQOL also showed equal effectiveness in both the groups (P = 0.05). However, no difference was observed in all the USG findings except for uterine volume (P = 0.03). There was overall difference before and after homoeopathic treatment irrespective of assigned groups, i.e., LM or CH (P < 0.05) in all the above parameters. The medicines frequently prescribed were: Pulsatilla, Sulphur, Lycopodium, Sepia, Phosphorus, Calcarea carbonica, and Natrum muriaticum. Conclusion: LM and CH potencies are equally effective in giving symptomatic relief to patients suffering from symptomatic uterine fibroids

Synthesis, structures, antioxidant, and antifungal activities of organotin(IV) complexes derived from 1-(3′-carboxyphenylhydrazono)naphthalene-2-one

In this study, the hydrazone ligand 1-(3′-carboxyphenylhydrazono)naphthalene-2-one (H2L) was employed to generate three new organotin(IV) compounds with the general formula of [RxSnIV(HL)y] (where R = Me, x = y = 2 (1); R = n-Bu, x = 3, y = 1 (2), and R = Ph, x = 3, y = 1 (3)). The single-crystal structures of 1 and 3 were examined to establish the coordination environment about Sn(IV). Compound 1 possesses a hepta-coordinate homo-polymer with a chromophoric coordination environment of Me2SnIVO5. Compound 3, on the other hand, has monomeric distorted tetrahedral geometry with Ph3SnO chromophoric unit. The 119Sn-NMR signals in the spectra of 1–3 are found to be at 145.5, 120.1, and −104.4 ppm, respectively, indicating that they are isostructural and adopt four-coordinate tetrahedral geometry in solution. The bioactivities of 1 and 3 among the three are distinct. The antioxidant activity of 1 in ethanol is the highest, with a 45.64% DPPH-scavenging efficiency, whereas 3 shows excellent antifungal efficacy against Penicilium chrysogenum, with a 21 mm inhibited zone at 750 μg/mL, which is significantly higher than that of standard drug amphotericin-B. Thus, the compounds could be treated as potential antioxidant and antifungal agents.</p