Vaginal hysterectomy a safe option in non-descent uterus as compared to abdominal hysterectomy

Background: The objective of present study was to compare the advantage of vaginal hysterectomy over abdominal hysterectomy in non-descent uterus.Methods: A non-randomized controlled trial was carried out in the Bundelkhand Medical College, Sagar and associated hospital from October 2015 to September 2017. A total of 150 cases were included in the study. Out on 150, 75 underwent vaginal hysterectomy for non-descent uterus and other 75 underwent abdominal hysterectomy for similar indications.Results: Among total 150 cases, 75 were underwent non-descent vaginal hysterectomy and similar number of cases underwent abdominal hysterectomy. Common age group was 35-54 years. Commonest indication was DUB (48.7%). Postoperatively, complications were more common in those who underwent abdominal hysterectomy such as ambulation (18 hours), incidence of nausea, vomiting, abdominal discomfort, bladder injury and wound infection were less in vaginal hysterectomy compared to abdominal hysterectomy. It was also observed that blood transfusion requirement, operative timing and hospital stay (3 days) were less in vaginal hysterectomy group.Conclusions: Vaginal hysterectomy for benign gynecological disorders is a safe, effective, least invasive and is associated with lesser complications as compare to abdominal hysterectomy. Today in the era where patient is more cosmetically concern, vaginal hysterectomy for non-descent uterine disorder needs to be considered as good and safe option

Effects of interpregnancy interval and outcome of preceding pregnancy on present pregnancy outcome

Background: The objective of the present study was to estimate the effects of interpregnancy interval and outcome of preceding pregnancy on present pregnancy outcome.Methods: This study was undertaken as observational study. 1000 women were included in this study then interpregnancy interval categorized in 4 groups. Outcome of preceding pregnancy were included in term of induce abortion, miscarriage, still birth and live birth.Results: For each group the highest rate of IA occur for woman whose previous pregnancy ended with an IA. For pregnancy after an IA the rate of subsequent IA is 16.6%, 11.6%, 5% for IPI of <6 month, 6-14 months and 27-50 months respectively. Overall lowest rate of IA found for IPI of 27-50 months following live birth i.e. 1.25% and for group III 2% only. Rate of miscarriage was higher for IPI of <26 months began with a miscarriage 15.6% and 13.6% for following live birth.Conclusions: Outcome of present pregnancy not only depend upon interpregnancy interval but also depend upon outcome of preceding pregnancy. So, outcome of previous pregnancy will also determine outcome of present pregnancy.

Maternal mortality at a tertiary health care: a retrospective study

Background: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of pregnancy from any cause related to or aggravated by the pregnancy, but not from accidental or incidental causes. The aim of this study is to find out the causes of maternal mortality and the complications leading to maternal death.Methods: A retrospective study was conducted by reviewing the hospital records to study the maternal deaths and complication leading to maternal death over the period of one year from July 2016 June 2017 in the Department of Obstetrics and Gynecology, Bundelkhand Medical College, and associated hospital Sagar, Madhya Pradesh. All the maternal deaths were scrutinized for various aspects likely to be related to death such as age, locality of residence, antenatal care, admission death interval and the cause of death.Results: The maternal mortality ratio in the present study is 292.33/100,000 live births. There were 28 maternal deaths out of 9578 live birth during the study period. The majority of deaths occurred in the 20-30 age group. hemorrhage (32.14%) and hypertensive disorders (14.28%) are two most common direct cause of maternal deaths. 42.85% of maternal deaths occurred within the first twenty-four hours of admission. Post-operative and post abortal sepsis, amniotic fluid embolism and pulmonary embolism are other direct causes. Indirect causes of maternal deaths account for 21.42%. Severe anemia was the leading indirect causes of maternal deaths.Conclusions: Hemorrhage, hypertensive disorders, and anaemia remain the major cause of maternal deaths. Delay in decision making, provision of treatment and referral to tertiary centre contributed higher maternal mortality. This requires more efforts to recognize the direct and indirect causes of maternal deaths

Review on unmanned aerial vehicle assisted sensor node localization in wireless networks: soft computing approaches

Node positioning or localization is a critical requisite for numerous position-based applications of wireless sensor network (WSN). Localization using the unmanned aerial vehicle (UAV) is preferred over localization using fixed terrestrial anchor node (FTAN) because of low implementation complexity and high accuracy. The conventional multilateration technique estimates the position of the unknown node (UN) based on the distance from the anchor node (AN) to UN that is obtained from the received signal strength (RSS) measurement. However, distortions in the propagation medium may yield incorrect distance measurement and as a result, the accuracy of RSS-multilateration is limited. Though the optimization based localization schemes are considered to be a better alternative, the performance of these schemes is not satisfactory if the distortions are non-linear. In such situations, the neural network (NN) architecture such as extreme learning machine (ELM) can be a better choice as it is a highly non-linear classifier. The ELM is even superior over its counterpart NN classifiers like multilayer perceptron (MLP) and radial basis function (RBF) due to its fast and strong learning ability. Thus, this paper provides a comparative review of various soft computing based localization techniques using both FTAN and aerial ANs for better acceptability

Spectroscopy of odd-mass cobalt isotopes toward the N=40 subshell closure and shell-model description of spherical and deformed states

The neutron-rich cobalt isotopes up to A = 67 have been studied through multinucleon transfer reactions by bombarding a 238U target with a 460-MeV 70Zn beam. Unambiguous identification of prompt γ rays belonging to each nucleus has been achieved using coincidence relationships with the ions detected in a high-acceptance magnetic spectrometer. The new data are discussed in terms of the systematics of the cobalt isotopes and interpreted with large-scale shell-model calculations in the fpgd model space. In particular, very different shapes can be described in 67Co, at the edge of the island of inversion at N = 40, where a low-lying highly deformed band coexists with a spherical structureThis work was partially supported by the European Community FP6, Structuring the ERA Integrated Infrastructure Initiative Contract No. EURONS RII3-CT-2004-506065, by MICINN, Spain (Contract No. FPA2011-29854), by IN2P3, France (Contract No. AIC-D-2011-648), by Comunidad de Madrid, Spain (Contract No. HEPHACOS S2009-ESP-1473), and by Generalitat Valenciana, Spain (Contract No. PROMETEO/ 2010/101). A. Gadea and E. Farnea acknowledge the support of MICINN, Spain, and INFN, Italy, through the AIC-D-2011-0746 bilateral actio

Fasting and surgery timing (FaST) audit

Background & aimsInternational guidance advocates the avoidance of prolonged preoperative fasting due to its negative impact on perioperative hydration. This study aimed to assess the adherence to these guidelines for fasting in patients undergoing elective and emergency surgery in the East Midlands region of the UK.MethodsThis prospective audit was performed over a two-month period at five National Health Service (NHS) Trusts across the East Midlands region of the UK. Demographic data, admission and operative details, and length of preoperative fasting were collected on adult patients listed for emergency and elective surgery.ResultsOf the 343 surgical patients included within the study, 50% (n = 172) were male, 78% (n = 266) had elective surgery and 22% (n = 77) underwent emergency surgery. Overall median fasting times (Q1, Q3) were 16.1 (13.0, 19.4) hours for food and 5.8 (3.5, 10.7) hours for clear fluids. Prolonged fasting >12 h was documented in 73% (n = 250) for food, and 21% (n = 71) for clear fluids. Median fasting times from clear fluids and food were longer in the those undergoing emergency surgery when compared with those undergoing elective surgery: 13.0 (6.4, 22.6) vs. 4.9 (3.3, 7.8) hours, and 22.0 (14.0, 37.4) vs. 15.6 (12.9, 17.8) hours respectively, p < 0.0001.ConclusionsDespite international consensus on the duration of preoperative fasting, patients continue to fast from clear fluids and food for prolonged lengths of time. Patients admitted for emergency surgery were more likely to fast for longer than those having elective surgery

Adapting Agriculture to Climate Change: A Synopsis of Coordinated National Crop Wild Relative Seed Collecting Programs across Five Continents

The Adapting Agriculture to Climate Change Project set out to improve the diversity, quantity, and accessibility of germplasm collections of crop wild relatives (CWR). Between 2013 and 2018, partners in 25 countries, heirs to the globetrotting legacy of Nikolai Vavilov, undertook seed collecting expeditions targeting CWR of 28 crops of global significance for agriculture. Here, we describe the implementation of the 25 national collecting programs and present the key results. A total of 4587 unique seed samples from at least 355 CWR taxa were collected, conserved ex situ, safety duplicated in national and international genebanks, and made available through the Multilateral System (MLS) of the International Treaty on Plant Genetic Resources for Food and Agriculture (Plant Treaty). Collections of CWR were made for all 28 targeted crops. Potato and eggplant were the most collected genepools, although the greatest number of primary genepool collections were made for rice. Overall, alfalfa, Bambara groundnut, grass pea and wheat were the genepools for which targets were best achieved. Several of the newly collected samples have already been used in pre-breeding programs to adapt crops to future challenges.info:eu-repo/semantics/publishedVersio

Phylogeographical analysis of the dominant multidrug-resistant H58 clade of Salmonella Typhi identifies inter- and intracontinental transmission events.

The emergence of multidrug-resistant (MDR) typhoid is a major global health threat affecting many countries where the disease is endemic. Here whole-genome sequence analysis of 1,832 Salmonella enterica serovar Typhi (S. Typhi) identifies a single dominant MDR lineage, H58, that has emerged and spread throughout Asia and Africa over the last 30 years. Our analysis identifies numerous transmissions of H58, including multiple transfers from Asia to Africa and an ongoing, unrecognized MDR epidemic within Africa itself. Notably, our analysis indicates that H58 lineages are displacing antibiotic-sensitive isolates, transforming the global population structure of this pathogen. H58 isolates can harbor a complex MDR element residing either on transmissible IncHI1 plasmids or within multiple chromosomal integration sites. We also identify new mutations that define the H58 lineage. This phylogeographical analysis provides a framework to facilitate global management of MDR typhoid and is applicable to similar MDR lineages emerging in other bacterial species

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe