Peripartum hysterectomy for cesarean section with morbidly adherent placenta: case series of 25 patients

Background: The current paper reports the outcome of case series of patients presented with placenta accreta confirmed histopathologicaly after management by peripartum hysterectomy.Methods: The study was set in Women’s Health Hospital, Assiut University, Egypt. This was a case series of 25 women presented with placenta accreta between May 2017 and April 2018. We included all pregnant women with placenta previa as diagnosed by ultrasound with suspicion of abnormal placentation by Doppler, confirmed intra-operatively undergoing either emergent or elective CS. All cases were performed by an expert team of obstetricians and anesthetists. Cesarean delivery was done under general anesthesia through pfannensteil incision. The primary outcome was the estimated intra-operative blood loss through assessment of amount of blood in the suction by ml, difference between the weight of surgical drapes and towels before and after operation.Results: Pre-operative Hb was 10.64±1.01 gm/dL and there was significant decline in the postoperative Hb reaching 8.36±1.21 gm/dL (p<0.001). The mean drop in Hb was 2.28±1.43gm/dL. Estimated intra-operative blood loss was 974.4±398.05 ml in the towels and 847.6±362.56 ml in the suction apparatus. The total blood loss was 1822±653.73 ml. The mean number of units of whole blood transfused was 2160.0±825.6 ml and fresh frozen plasma was 1010.0±349.7 ml. Regarding intra-operative complications, bladder injury was the most common one in 14 cases (56%), followed by ureteric injury in two cases (8%). Postoperative ICU admission was in 6 cases (24%) and the mean duration of hospital stay 12.44 ± 4.07 days. No cases of maternal mortality.Conclusions: In conclusion, peripartum hysterectomy is considered life-saving surgery in patients with placenta accreta

Synthesis and Biological activity of 1,3-Thiazolylidenehydrazinylidene ethylpyridiniumbromide monohydrate, 1,3-Thiazolylidenehydraziniumbromide and 1,3-Thiazolylidenehydrazine derivatives

1,3-Thiazolylidenehydrazinylidene ethylpyridinium bromide monohydrate, 1,3-thiazolylidenehydrazinium bromide and 1,3-thiazolylidenehydrazine derivatives were synthesized by heterocyclization of 2-(1-substituted ethylidene) hydrazinecarbothioamides, characterized and screened for their anti-bacterial activities. The structures of synthesized compounds were established by spectroscopic (IR, 1H, 13C-NMR, Mass) and X-ray analyses

Heating rate and electrode charging measurements in a scalable, microfabricated, surface-electrode ion trap

We characterise the performance of a surface-electrode ion "chip" trap fabricated using established semiconductor integrated circuit and micro-electro-mechanical-system (MEMS) microfabrication processes which are in principle scalable to much larger ion trap arrays, as proposed for implementing ion trap quantum information processing. We measure rf ion micromotion parallel and perpendicular to the plane of the trap electrodes, and find that on-package capacitors reduce this to <~ 10 nm in amplitude. We also measure ion trapping lifetime, charging effects due to laser light incident on the trap electrodes, and the heating rate for a single trapped ion. The performance of this trap is found to be comparable with others of the same size scale.Comment: 6 pages, 10 figure

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Impact of perceived social media marketing activities on brand and value consciousness: Roles of usage, materialism and conspicuous consumption

Copyright © 2018 Inderscience Enterprises Ltd. This research investigates the impact of perceived social media marketing activities on brand- and value consciousness. It further examines the effect of social media usage on materialism, brand consciousness and conspicuous consumption, as examining materialism-centric behaviour is becoming important in a consumption-based economy. A self-administered questionnaire was developed and administered to a sample of 346 undergraduate students. Two different research models are tested and confirmed. The findings of this research indicated that perceived social media marketing activities have a significant effect on brand loyalty; brand consciousness and value consciousness mediate the relationship between perceived social media marketing activities and brand loyalty. Moreover, evidence supports the idea that the greater the use of social media, the greater the tendency towards materialism and conspicuous consumption. This study confirms the growing importance of perceived social media marketing activities in envisioning brand loyalty and provides insights on impact of social media on materialism and conspicuous consumption

Using Netnography Research Method to Reveal the Underlying Dimensions of the Customer/Tourist Experience

Purpose – The interest in customer experience has increased at a phenomenal rate. However,research to capture the true meaning of the concept is limited. Therefore, this study aims to address thequestion of what are the underlying dimensions that constitute the construct of customer experience.Design/methodology/approach – The netnography method is utilized to validate a priori conceptsthat have been identified in the literature within the tourist industry in Egypt.Findings – The results identified eight dimensions; comfort, educational, hedonic, novelty,recognition, relational, safety and beauty, which are consistent with major studies on experience.Research limitations/implications – The focus of the study was on customer reviews thatwere written in English and posted online. Therefore, care should be taken when interpreting thesefindings.Practical implications – This study attempted to gain a meaningful degree of understanding ofcustomer experience construct. The results suggest a number of implications for service, marketingand brand managers. The knowledge of customer experience and the challenge of creating greatcustomer experience are of utmost importance. Many marketers acknowledge the importance ofcustomer experience, but they have very little knowledge of what the components are of customerexperience.Originality/value – Netnography has not been widely used as a marketing research technique

DFT, ADMET and Molecular Docking Investigations for the Antimicrobial Activity of 6,6&prime;-Diamino-1,1&prime;,3,3&prime;-tetramethyl-5,5&prime;-(4-chlorobenzylidene)bis[pyrimidine-2,4(1H,3H)-dione]

Heterocyclic compounds, including pyrimidine derivatives, exhibit a broad variety of biological and pharmacological activities. In this paper, a previously synthesized novel pyrimidine molecule is proposed, and its pharmaceutical properties are investigated. Computational techniques such as the density functional theory, ADMET evaluation, and molecular docking were applied to elucidate the chemical nature, drug likeness and antibacterial function of molecule. The viewpoint of quantum chemical computations revealed that the molecule was relatively stable and has a high electrophilic nature. The contour maps of HOMO-LUMO and molecular electrostatic potential were analyzed to illustrate the charge density distributions that could be associated with the biological activity. Natural bond orbital (NBO) analysis revealed details about the interaction between donor and acceptor within the bond. Drug likeness and ADMET analysis showed that the molecule possesses the agents of safety and the effective combination therapy as pharmaceutical drug. The antimicrobial activity was investigated using molecular docking. The investigated molecule demonstrated a high affinity for binding within the active sites of antibacterial and antimalarial proteins. The high affinity of the antibacterial protein was proved by its low binding energy (&minus;7.97 kcal/mol) and a low inhibition constant value (1.43 &micro;M). The formation of four conventional hydrogen bonds in ligand&ndash;protein interactions confirmed the high stability of the resulting complexes. When compared to known standard drugs, the studied molecule displayed a remarkable antimalarial activity, as indicated by higher binding affinity (B.E. &minus;5.86 kcal/mol &amp; Ki = 50.23 M). The pre-selected molecule could be presented as a promising drug candidate for the development of novel antimicrobial agents