A comparative study of perineal morbidity in vaginal delivery with and without episiotomy

Background: The objective was to determine the occurrence of perineal morbidity in women who delivered vaginally with an episiotomy versus those who delivered without.Methods: Primigravid women were enrolled into the study on documentation of full dilatation of the cervix and randomized into either the study group (delivered without an episiotomy) or Control Group (delivered with an episiotomy). All labours were carefully monitored with intermittent auscultation of foetal heart rate and partograph was plotted for everyone. Labour was augmented with oxytocin infusion if required. Good perineal and para urethral support at the time of crowning of the head and during delivery of the baby was given for patients of both the groups. Right mediolateral episiotomy was given for the control group. Perineum was then examined and if any lacerations were noted it was sutured, if necessary, as per standard protocol (vicryl rapide was used). Episiotomy was sutured in 3 layers with vicryl rapide.Results: The total number of patients studied was 300 – equally distributed in both the groups. The age group of the patients and birth weight of the babies were comparable. In the study group, 22.0% patients had no lacerations in the perineum. Inspite of an episiotomy, 15.34% had anterior and posterior perineal lacerations and in that 4.67% patients had anal sphincter tear. 9 patients had more than 50% of EAS torn but none of them complained of incontinence during their follow-up. 68.37% patients in the control group had persistent perineal pain for more than one week versus 19.42% in the study group. 4.27% patients in the control group had persistent pain whereas no patients in the study group had pain more than 2 months.Conclusions: Short term perineal morbidity is significantly lower in parturients who delivered without an episiotomy and that episiotomy did not offer protection against sustaining severe perineal lacerations

Barriers to the use of a diagnostic oral microbiology laboratory by general dental practitioners

OBJECTIVE: To identify barriers on the use of diagnostic microbiology facilities in general dental practice. DESIGN: A cross-sectional survey using a postal questionnaire. SETTING: Primary/secondary care interface between the diagnostic oral microbiology laboratory, University of Glasgow Dental Hospital and School, Glasgow and dental practitioners within the surrounding health boards, 1998. SUBJECTS: All GDPs (797) within Argyll and Clyde, Ayrshire and Arran, Lanarkshire and Greater Glasgow Health Boards. MAIN OUTCOME MEASURES: The responses were expressed as both absolute and relative frequencies. RESULTS: Responses were received from 430 (55%). The most frequent reason for failure to use the service was lack of information, with more than half of the respondents claiming to be unaware of the facility. Lack of request forms and sampling equipment were also viewed as barriers to using the service. CONCLUSIONS: The laboratory is failing to successfully communicate its role in addressing the growing burden of antibiotic resistance in the community and must be more proactive in encouraging appropriate use and increasing accessibility of the service to GDPs

Broadening of Spectral Lines due to Dynamic Multiple Scattering and the Tully-Fisher Relation

The frequency shift of spectral lines is most often explained by the Doppler Effect in terms of relative motion, whereas the Doppler broadening of a particular line mainly depends on the absolute temperature. The Wolf effect on the other hand deals with the correlation induced spectral change and explains both the broadening and shift of the spectral lines. In this framework a relation between the width of the spectral line is related to the redshift z for the line and hence with the distance. For smaller values of z a relation similar to the Tully-Fisher relation can be obtained and for larger values of z a more general relation can be constructed. The derivation of this kind of relation based on dynamic multiple scattering theory may play a significant role in explaining the overall spectra of quasi stellar objects. We emphasize that this mechanism is not applicable for nearby galaxies, $z \leq 1$.Comment: 18 pages, 5 figures, revised Version has been submitted to Physical Review A. (2nd author's affiliation corrected

Singular Short Range Potentials in the J-Matrix Approach

We use the tools of the J-matrix method to evaluate the S-matrix and then deduce the bound and resonance states energies for singular screened Coulomb potentials, both analytic and piecewise differentiable. The J-matrix approach allows us to absorb the 1/r singularity of the potential in the reference Hamiltonian, which is then handled analytically. The calculation is performed using an infinite square integrable basis that supports a tridiagonal matrix representation for the reference Hamiltonian. The remaining part of the potential, which is bound and regular everywhere, is treated by an efficient numerical scheme in a suitable basis using Gauss quadrature approximation. To exhibit the power of our approach we have considered the most delicate region close to the bound-unbound transition and compared our results favorably with available numerical data.Comment: 14 pages, 5 tables, 2 figure

Comparison of trends in butterfly populations between monitoring schemes

Butterflies are an important indicator of the impacts of environmental change. Butterfly monitoring schemes (BMS) have provided national and Europe-wide trends in their abundance and been widely used for research. Most schemes sample sites that are self-selected by contributors and therefore tend to cover locations that are rich in butterflies. To provide a more representative assessment of butterfly populations, the wider countryside butterfly survey (WCBS) was developed with a stratified-random sample of survey sites across the UK. We compare butterfly trends from the WCBS locations against those measured from traditional butterfly transects which are typically located in areas of good quality semi-natural habitats. Across the 26 species analysed, there was a significant positive relationship between trends measured from the two schemes between 2009 and 2013, the period when both schemes were operating fully. There was a tendency (17 out of 26 species analysed) for these changes to be greater within WCBS compared to traditional BMS transects, although this effect was not consistent across comparisons between pairs of consecutive years. When assessing these individual year-to-year changes, there was however a significant correlation between the two schemes in all cases. Over relatively short time periods, weather patterns are likely to dominate butterfly population fluctuations and lead to comparable trends across monitoring schemes. Over longer time periods, differences in land management may affect habitat condition differently for protected areas versus the wider countryside and it is therefore important to maintain comprehensive butterfly monitoring programmes to detect and interpret such effects