Study of feto-maternal outcome in referred obstetric cases in tertiary care center in Rajasthan: a cross sectional study

Background: Pregnant women are at high risk for life threatening complications throughout the pregnancy and during delivery as well. Most of these complications are unpredictable with routine clinical examination. Skilled medical interventions such as blood transfusion, caesarean delivery, expert surgical team, medicines etc. are required to prevent these complications. Emergency obstetric referral should be carried out to avoid maternal and fetal morbidity and mortality. Aims and objectives of current study were to investigate the pattern of referral in tertiary care center and fetomaternal outcome in referred cases.Methods: This is a observational study conducted in the department of obstetrics and gynaecology, at a tertiary care hospital. Patients are referred from nearby PHCs, CHCs, SDHs and private hospitals. All referred antenatal and intra-natal patients to our center of >24 weeks of gestational age were studied.Results: Majority of them 43% women were of 21-25 year of age, 35% women were of 26-30 year of age group. Out of 76 delivered women, 55% underwent caesarean section and 36.84% were delivered normally. PPH seen in 6.66% patients, maternal deaths reported 2.5%, septicaemia 1.6%, wound gaping in 3.33%, puerperal pyrexia in 5% of patients. 77% neonates were shifted to mother-side, whereas 18% were admitted to NICU.Conclusions: Referral system is an important part of health care system. By providing good antenatal care, availability of blood products, well organized referral center, timely identification and referral of high-risk patients, skilled birth attendants at time of child birth all will help in reducing feto-maternal morbidity and mortality and will help in achieving goal of ideal MMR and NMR.

A study of dengue fever in pregnancy and its maternal and fetal prognosis

Background: Dengue is a vector borne viral disease. Female Anopheles mosquito is the vector for the disease. Recently, there is an increase in the incidence of dengue fever in adult population in South Asian countries. With increasing rate of adult dengue fever victims, the number of infected pregnant women has also been increased. Dengue, during pregnancy may be associated with various complications, including abortions, preterm delivery, maternal mortality, low birth weight, neonatal admissions and fetal anomalies. Timely intervention can improve the maternal as well as fetal outcome. This study was aimed to assess the clinical profile, maternal and fetal outcome of dengue fever during pregnancy.Methods: The study was carried out on 25 pregnant females diagnosed and serologically confirmed to have dengue fever and were admitted in Umaid hospital, associated to Dr. S. N. Medical College Jodhpur, Rajasthan, India. Patients were included irrespective of the period of gestation of contracting the disease. Serological testing for dengue virus specific antigen and antibody was done for the diagnosis of dengue fever. The World Health Organization (WHO) classification and case definitions 2009 were used to categorize the dengue patients. A predesigned proforma was used to collect data related to maternal and fetal consequences both during pregnancy and at birth, as well as the effect on the newborn. Informed and written consent was taken from all those who participated in the study.Results: Thrombocytopenia (platelet count <1.5lakh/mm3) was found in 22 (88%) patients out of which 6 (24%) of them had platelet count below 20,000 cells/mm3 and 3(12%) patients required platelet transfusion. Other complications observed were spontaneous abortions (4%); preterm birth (16%), oligohydramnios (8%) and antepartum hemorrhage (4%). One patient was admitted to Intensive Care Unit. Fetal distress and meconium stained amniotic fluid was observed in 16% and 12% patients respectively. Adverse fetal outcome was observed in form of low birth weight, prematurity. 8% of the babies required NICU admission and 4% were Intra Uterine Fetal Death (IUFD).Conclusions: Maternal infection with the dengue virus during antenatal period represents a real risk of premature birth. Early onset or late onset in pregnancy appeared to have a bad prognosis.  A high index of clinical suspicion is essential in any pregnant woman with fever during the epidemic. The treatment of dengue in pregnancy is mainly conservative as in non-pregnant adults. In case of high risk cases early referral to well-equipped health centres where technical, transfusion and intensive care facilities are available may prove lifesaving

A prospective analytical study of intrauterine fetal death cases and associated maternal condition at a tertiary centre

Background: Intrauterine fetal death (IUFD) is a cataclysmic event for the parents and a lamentable event for the caregiver. Intrauterine fetal death is an important indicator of maternal and perinatal health of a given population. This study was undertaken to study the maternal and fetal factors associated with intrauterine fetal death. In this traumatic time, it is important to ensure that the emotional needs of the family are met. The objective of the study was to evaluate and understand the prevalence, socio-epidemiological and etiological factors of IUFD.Methods: This was a prospective analytical study carried out at Umaid Hospital associated to Dr. S. N. Medical College, Jodhpur, Rajasthan from August 2015 to Jan 2016 for a duration of 6 months. Informed consent was taken from all the participants. A predesigned proforma was used to collect relevant information from all those who gave consent to participate in the study. The details of complaints at admission, obstetrical history, menstrual history, examination findings, per vaginal examination findings, mode and method of delivery, and fetal outcome and investigation reports were recorded.Results: A total of 435 intrauterine fetal deaths were reported amongst 11615 deliveries conducted during the study period in our hospital. The incidence of IUFD was 37/1000 live births. 327 (75.17%) deliveries were unbooked and unsupervised and had no antenatal check-up. 306(70.74%) patients were from rural areas and 243 (50.11%) were preterm and 430(98.85%) were singleton delivery. Amongst the identifiable causes, hypertensive disorders (22.75%) and very severe anaemia (13.10%) were the most common ones followed by placental causes (9.97%). Congenital malformations were responsible for 11.03% cases of IUFD and in rest 10.57% cases no obvious cause could be identified. Induction was done in 195 patients, 174 patients had spontaneous onset of labour and caesarean section was done in 66 patients.Conclusions: The incidence of intrauterine fetal deaths in our population is higher than that reported from the developed countries. The present study is an effort to compile a profile of maternal, fetal and placental causes culminating in IUFD at our centre. This emphasizes the importance of proper antenatal care and identification of risk factors and its treatment. Institutional deliveries should be promoted to prevent IUFD. Decrease in the incidence of IUFD would significantly reduce the perinatal mortality. Majority of fetal wastage can be prevented with universal and improved antenatal care

Multi-dependency and time based resource scheduling algorithm for scientific applications in cloud computing

Workflow scheduling is one of the significant issues for scientific applications among virtual machine migration, database management, security, performance, fault tolerance, server consolidation, etc. In this paper, existing time-based scheduling algorithms, such as first come first serve (FCFS), min–min, max–min, and minimum completion time (MCT), along with dependency-based scheduling algorithm MaxChild have been considered. These time-based scheduling algorithms only compare the burst time of tasks. Based on the burst time, these schedulers, schedule the sub-tasks of the application on suitable virtual machines according to the scheduling criteria. During this process, not much attention was given to the proper utilization of the resources. A novel dependency and time-based scheduling algorithm is proposed that considers the parent to child (P2C) node dependencies, child to parent node dependencies, and the time of different tasks in the workflows. The proposed P2C algorithm emphasizes proper utilization of the resources and overcomes the limitations of these time-based schedulers. The scientific applications, such as CyberShake, Montage, Epigenomics, Inspiral, and SIPHT, are represented in terms of the workflow. The tasks can be represented as the nodes, and relationships between the tasks can be represented as the dependencies in the workflows. All the results have been validated by using the simulation-based environment created with the help of the WorkflowSim simulator for the cloud environment. It has been observed that the proposed approach outperforms the mentioned time and dependency-based scheduling algorithms in terms of the total execution time by efficiently utilizing the resources.peer-reviewe

Image based Seen Detection in Real Time Video Interpretation for Surveillance Systems using Support Vectors Machine

People that&nbsp;are perpetually hunting for knowledge will benefit from data acquisition. The early phase in video data acquisition is splitting the video into images. Many images are tiny and don't reveal a lot about the picture's information. Scene boundary identification,&nbsp;or video segmentation into action sequences, enables a more complete comprehension of the image sequence by classifying images based on comparable visual content. The purpose of this article is to discuss video scene recognition, particularly video structure extraction for pattern comparison with significant properties. The article designed and developed a methodology that would include stages for image collection, detecting commonalities among&nbsp;frames, selecting important frames, and detecting the time at where the&nbsp;relevant frame is identified. The pictures are generated by Python's OpenCV and scene classification metrics are used to assess the method. As assessed by numerous parameters, the findings shows that scene identification and accuracy are considerable. Furthermore, we investigated and researched contemporary identification and assessment techniques. Moreover, we have tested extensively our research framework on a variety of publicly available event video databases, and these outperformed several futuristic techniques. The outcomes of this research can be utilized to generate real-time definitional video assessments

Detection and comparison of fetal malnutrition by CANSCORE and other methods

Background: Objective of current study was clinical assessment of nutritional status of neonate using CANSCORE and comparison with other methods of determining fetal malnutrition. Design: Cross sectional study. Setting: Tertiary care hospital. Study subjects: 384 live born singleton neonates with known gestational age and no major congenital malformation.Methods: Birth weight, length, midarm circumference and head circumference recorded in new-borns. Ponderal index and mid arm to head circumference ratio was calculated. Clinical assessment of nutritional status was done on the basis of CANSCORE and compared with other methods.Results: CANSCORE <25 separated 67.71% of the babies as well-nourished and 32.29% as malnourished. Weight for age and MAC/HC classified nearly 70% of babies as well-nourished and 30% as malnourished. Also Ponderal index classified 75.52% the babies as well-nourished and 24.48% as malnourished.Conclusion: CANSCORE may be a simple clinical index for identifying fetal malnutrition and for prediction of neonatal morbidity associated with it, without the aid of any sophisticated equipments.

Influence of Soret and Dufour effect on MHD flow over an exponential stretching sheet: A numerical study

The present paper analyzes the effect of chemical reaction on free convection MHD motion of steady, laminar, incompressible liquid under the influence of heat source/sink. The motion is considered over an exponential radiative extending surface with a magnetic field. An appropriate similar transformation is employed to convert the nonlinear system of partial differential equations (PDEs) to a set of ordinary differential equations (ODEs). Due to the high nonlinearity, the analytical approach for these coupled nonlinear equations does not hold good. Therefore, these transformed ODEs are solved by using numerical techniques adopting Runge-Kutta fourth-order method accompanied by shooting technique. The behavior of different physical parameters on the motion phenomena is shown via diagrams. However, as a concluding remark, the major outcomes of the present investigation are described as: the buoyant forces overshoot the velocity profile significantly whereas the fluid temperature retards with an increasing Soret number. Finally, the chemical reaction parameter favors retard the concentration profiles resulted in reducing the thickness of the solutal boundary layer

Influence of Soret and Dufour effect on MHD flow over an exponential stretching sheet: A numerical study

558-568The present paper analyzes the effect of chemical reaction on free convection MHD motion of steady, laminar, incompressible liquid under the influence of heat source/sink. The motion is considered over an exponential radiative extending surface with a magnetic field. An appropriate similar transformation is employed to convert the nonlinear system of partial differential equations (PDEs) to a set of ordinary differential equations (ODEs). Due to the high nonlinearity, the analytical approach for these coupled nonlinear equations does not hold good. Therefore, these transformed ODEs are solved by using numerical techniques adopting Runge-Kutta fourth-order method accompanied by shooting technique. The behavior of different physical parameters on the motion phenomena is shown via diagrams. However, as a concluding remark, the major outcomes of the present investigation are described as: the buoyant forces overshoot the velocity profile significantly whereas the fluid temperature retards with an increasing Soret number. Finally, the chemical reaction parameter favors retard the concentration profiles resulted in reducing the thickness of the solutal boundary layer

Adoption of cloud services in central banks : hindering factors and the recommendations for way forward

Current research on cloud computing often focuses on the technology itself and the benefits that one company can use and choose from cloud services. Most of the research has focused on mainstream enterprises and limited regard to Central Banks' (CBs') Cloud Computing Adoption (CCA). CBs are continually exploring opportunities to enhance IT efficacy while minimizing expenditures and ensuring data protection and network security. This paper investigates the factors affecting the CBs' CCA by surveying 40 CBs representing approximately 25% of total CBs worldwide. The main participants were senior IT managers who are responsible for any IT decisions in CBs. The findings are also significant for other organizations or businesses where data privacy is crucial. The study results indicate that CBs are still reluctant to migrate to the public cloud. Influential factors preventing CCA are data protection, privacy, and risks.peer-reviewe

Effective cloud resource utilisation in cloud ERP decision-making process for industry 4.0 in the United States

Cloud enterprise resource planning (C-ERP) represents an evolution of traditional ERP, which also offers the advantages of cloud computing (CC) such as ease of use and resource elasticity. This article presents the opportunities and challenges of the C-ERP adoption for industry 4.0 in the United States as well as the factors that boost or hinder such a decision. The quantitative research method is used to gather the predictor factors and correlation amongst them. An online survey questionnaire received 109 responses, mainly decision-makers and professionals from the US consumer goods industry. Statistical analysis has been carried out to rank the different levels of influence in the C-ERP adoption decision. The predictor’s complexity and regulatory compliance positively influence C-ERP private service deployment, whereas technology readiness is a good predictor of community service deployment. This paper also proposes a decision support system (DSS), tailored to industry 4.0, and aimed at assisting decision-makers in adopting C-ERP as an effective resource for decision-making. The DSS is built upon the predictors using the analytic hierarchy process (AHP) and it supports decision-makers in the selection of services and deployment models for C-ERP as a resource.peer-reviewe