Clinical outcome of post placental IUD CuT380 insertion in terms of expulsion

Background: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the World Health Organization (WHO), as one of the safe and effective methods of temporary contraception. In the immediate post delivery period the women are highly motivated and need an effective method for contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. However, immediate post-partum IUD insertion may have disadvantages as well. The risk of spontaneous expulsion may be unacceptably high.Methods: After taking approval from hospital ethical committee, all women planning vaginal delivery desiring IUD, admitted through OPD and emergency were evaluated in detailed on design Performa Performa include patient’s identity, age, parity, gestational age, no of alive children, outcome and timings of insertion. Informed consent was obtained. With aseptic precautions IUD was inserted with kellys forceps in the uterine cavity up to the fundus, then cervix was examined for thread (that should not be visible at cervix if proper insertion done). The procedure was performed by myself. Patients were followed at 6week by examining the threat of IUD. All the information was recorded by myself. Follow up was done by taking patients contact number.Results: In our study, out of 300 cases, 63.67% (n=191) were between 18-30 years of age while 36.33% (n=109) were between 31-40 years of age, mean+sd was calculated as 29.49+4.62 years, mean gestational age was calculated as 38.53+0.94 weeks, mean parity was calculated as 3.49+1.06 paras. Frequency of expulsion in post placental intra uterine device cuT 380 insertions reveals in 8.67% (n=26).Conclusions: We concluded that the frequency of expulsion in post placental intra uterine device cuT 380 insertions is not significantly higher and appears to be safe and effective method of contraception.

Determine the frequency of peripartum hystrectomy in placenta previa

Background: Peripartum hysterectomy is one of the life saving procedure performed after vaginal delivery or caesarean birth or in the immediate postpartum period in cases of intractable haemorrhage due to uterine atony, rupture uterus and placental disorders and it is usually reserved for the situations where conservative measures fail to control the haemorrhage. The objective of the study was to determine the frequency of peripartum hysterectomy in placenta praevia.Methods: The study was cross-sectional. It was conducted at the Department of Obstetrics and Gynaecology, Punjab Medical College and affiliated Hospital, Faisalabad. Study was carried out over a period of six months from October 2010 to March 2011. Total 130 cases of placenta praevia undergone caesarean section were included in this study. In cases of primary postpartum haemorrhage conservative management was done first in the form of intramuscular syntometrine (Oxytocin 5 IU/ergometrine 0.5 mg). Intravenous infusion syntocinon (40 IU in 500ml 0.9% saline over 4-6 hours).Results: Mean age of the patients was found to be 30.9±6.7 years. Distribution of cases by gestational age shows, 52 (40.0%) patients had gestation of 28-36 weeks and 78 (60.0%) patients had gestation of 37-41. Mean gestational age was observed 37.5±3.4 weeks. Parity distribution was as follows: 76 (58.5%) patients had parity 0-3, 34 (26.1%) patients had parity 4-6 and 20 (15.4%) patients had parity > 6 with mean parity of 3.2±1.9. Conservative management was done in 129 patients (99.3%). Peripartum hysterectomy was found to be in 1 patient (0.7%).Conclusions: Placental pathology is the leading cause of postpartum hemorrhage and the main indications of peripartum hysterectomy. Timely operation minimizes the morbidity and mortality

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Clinical Variables Associated With Hydration Status In Acute Ischemic Stroke Patients With Dysphagia

Acute stroke patients with dysphagia are at increased risk for poor hydration. Dysphagia management practices may directly impact hydration status. This study examined clinical factors that might impact hydration status in acute ischemic stroke patients with dysphagia. A retrospective chart review was completed on 67 ischemic stroke patients who participated in a prior study of nutrition and hydration status during acute care. Prior results indicated that patients with dysphagia demonstrated elevated BUN/Cr compared to non-dysphagia cases during acute care and that BUN/Cr increased selectively in dysphagic patients. This chart review evaluated clinical variables potentially impacting hydration status: diuretics, parenteral fluids, tube feeding, oral diet, and nonoral (NPO) status. Exposure to any variable and number of days of exposure to each variable were examined. Dysphagia cases demonstrated significantly more NPO days, tube fed days, and parenteral fluid days, but not oral fed days, or days on diuretics. BUN/Cr values at discharge were not associated with NPO days, parenteral fluid days, oral fed days, or days on diuretics. Patients on modified solid diets had significantly higher mean BUN/Cr values at discharge (27.12 vs. 17.23) as did tube fed patients (28.94 vs. 18.66). No difference was noted between these subgroups at baseline (regular diet vs. modified solids diets). Any modification of solid diets (31.11 vs. 17.23) or thickened liquids (28.50 vs. 17.81) resulted in significantly elevated BUN/Cr values at discharge. Liquid or diet modifications prescribed for acute stroke patients with dysphagia may impair hydration status in these patients

Short and Long-Run Causal Effects of CO2 Emissions, Energy Use, GDP and Population Growth: Evidence from India Using the ARDL and VECM Approaches

This paper investigates the nexus between CO2 emissions (CO2E), GDP, energy use (ENU), and population growth (PG) in India from 1980–2018 by comparing the “vector error correction” model (VECM) and “auto regressive distributed lag” (ARDL). We applied the unit root test, Johansen multi-variate cointegration, and performed a Variance decomposition analysis using the Cholesky approach. The VECM and ARDL-bound testing approaches to cointegration suggest a long-term equilibrium nexus between GDP, energy use, population growth and CO2E. The empirical outcomes show the existence of a long-term equilibrium nexus between the variables. The Granger causality results show that short-term bi-directional causality exists between GDP and ENU, while a uni-directional causality between CO2E and GDP, CO2E and ENU, CO2E and PG, and PG and ENU. Evidence from variance decomposition indicates that 58.4% of the future fluctuations in CO2E are due to changes in ENU, 2.8% of the future fluctuations are due to changes in GDP, and 0.43% of the future fluctuations are due to changes in PG. Finally, the ARDL test results indicate that a 1% increase in PG will lead to a 1.4% increase in CO2E. Our paper addresses some important policy implications

Numerical Assessment of Dipole Interaction with the Single-Phase Nanofluid Flow in an Enclosure: A Pseudo-Transient Approach

Nanofluids substantially enhance the physical and thermal characteristics of the base or conducting fluids specifically when interacting with the magnetic field. Several engineering processes like geothermal energy extraction, metal casting, nuclear reactor coolers, nuclear fusion, magnetohydrodynamics flow meters, petrochemicals, and pumps incorporate magnetic field interaction with the nanofluids. On the other hand, an enhancement in heat transfer due to nanofluids is essentially required in various thermal systems. The goal of this study is to figure out that how much a magnetic field affects nanofluid flow in an enclosure because of a dipole. The nanofluid is characterized using a single-phase model, and the governing partial differential equations are computed numerically. A Pseudo time based numerical algorithm is developed to numerically solve the problem. It can be deduced that the Reynolds number and the magnetic parameter have a low effect on the Nusselt number and skin friction. The Nusselt number rises near the dipole location because of an increase in the magnetic parameter Mn and the Reynolds number Re. The imposed magnetic field alters the region of high temperature nearby the dipole, while newly generated vortices rotate in alternate directions. Furthermore, nanoparticle volume fraction causes a slight change in the skin friction while it marginally reduces the Nusselt number

Short and Long-Run Causal Effects of CO₂ Emissions, Energy Use, GDP and Population Growth: Evidence from India Using the ARDL and VECM Approaches

This paper investigates the nexus between CO2 emissions (CO2E), GDP, energy use (ENU), and population growth (PG) in India from 1980–2018 by comparing the “vector error correction” model (VECM) and “auto regressive distributed lag” (ARDL). We applied the unit root test, Johansen multi-variate cointegration, and performed a Variance decomposition analysis using the Cholesky approach. The VECM and ARDL-bound testing approaches to cointegration suggest a long-term equilibrium nexus between GDP, energy use, population growth and CO2E. The empirical outcomes show the existence of a long-term equilibrium nexus between the variables. The Granger causality results show that short-term bi-directional causality exists between GDP and ENU, while a uni-directional causality between CO2E and GDP, CO2E and ENU, CO2E and PG, and PG and ENU. Evidence from variance decomposition indicates that 58.4% of the future fluctuations in CO2E are due to changes in ENU, 2.8% of the future fluctuations are due to changes in GDP, and 0.43% of the future fluctuations are due to changes in PG. Finally, the ARDL test results indicate that a 1% increase in PG will lead to a 1.4% increase in CO2E. Our paper addresses some important policy implications

CRITICAL ANALYSIS OF MEDIA EMPLOYEE PERFORMANCE AFTER COVID- 19 SCENARIO

COVID-19 has a detrimental impact on the employee's work performance and raised the likelihood of mistake. It's about determining whether a correlation between employee support and business success can be established on a wide scale. Let us examine the distinctions between job fairness and workplace justice. A convenience survey of 222 media workers was defined and chosen for this analysis. To elicit answers, the questionnaires were left open-ended. It was used to evaluate a subset of the responses through a Pseudo-Differential Templating Method. Employee morale increases through periods of increased cash flow, since COVID-19 sees this as supplying workers with more resources rather than providing a foundation for their jobs. Both concepts are not mutually exclusive; indeed, they must be followed together, since corporate fairness is critical in explaining the relationship between perceived operational assistance and employee performance. Managers must provide their employees with the opportunities necessary to excel if they want their employees to perform well. When workers perceive management's motivation and honesty as something of personal worth, they become inspired and perform at their highest. Employee commitment to an organization's overall success is much more important. The thesis examined the relationship between non-reported assistance and employees' levels of job success in the sense of COVID-19 and discovered a nonlinear relationship between expectations of assistance and performance. The public continues to face extra financial assistance from companies in the modern era

Role of localized magnetic field in vortex generation in tri-hybrid nanofluid flow: A numerical approach

Tri-hybrid nanofluid (THNF) can achieve a higher heat transfer rate than conventional hybrid nanofluid by combining three different nanoparticles with synergistic effects. It can have more diverse physical and thermal properties by choosing different combinations of nanoparticles. That is why it has more potential applications in various fields such as solar thermal, biomedical, and industrial processes. On the other hand, vortices are circular motions of liquid or gas that occur when there is a velocity difference. They are important for understanding how fluids mix and transport mass. They can be found in nature, such as in tornadoes and hurricanes. The aim of the current study is to mainly investigate the complex interaction of Lorentz force with the tri-hybrid nanoparticles inside a lid-driven square cavity. It can be seen that the magnetic field has caused the evolution of new vortices (which are very important while analyzing any flow model due to their importance in interpreting fluid mixing and mass transport phenomena) in the flow field, thus adding much more significance to our work. Most of the scientific literature is enriched with investigations dealing with the problems assuming a uniform magnetic field occupying the flow field, but in this research, a vertical strip of magnetism within the flow field will be introduced. It may be the first effort to interpret the role of the applied magnetic field in the formation of the new vortices in the flow field. A single-phase model is utilized to describe THNF whereas a numerical solution to the governing differential equations has been obtained by employing an algorithm based on the central difference discretization and the alternating direction implicit method. The analysis reveals that the magnetic field intensity may result in up to 13 and 119% increase in the skin friction and Nusselt number, respectively. Similarly, a remarkable change in the Nusselt number and the skin friction is also observed by raising the Reynolds number Re. Moreover, the localization or confinement of the magnetic field does not always increase or decrease the Nusselt number. Thus, it is concluded that there will be a certain width of the magnetic corridor for which the Nusselt number would be optimal. Further, the THNF containing Al2O3, Ag, and TiO2 outperforms in terms of enhancing the average Nusselt number, compared to the simple nanofluid containing the abovementioned particles