This study examined 131 stillbirths that occurred over 10 months at a tertiary hospital in India. The researchers found that illiteracy, rural residence, lack of antenatal care, and low socioeconomic status were commonly associated with stillbirths. The most common medical causes of stillbirth were pregnancy-induced hypertension, antepartum hemorrhage, preterm labor, and cord accidents. Most stillborn babies were low birth weight and premature. The researchers concluded that improving access to antenatal care, monitoring for high-risk conditions, and timely medical intervention could help reduce stillbirth rates in this population.
O documento fornece a programação detalhada de uma conferência sobre o mercado imobiliário brasileiro com painéis sobre macroeconomia, setores corporativo, residencial e industrial. O evento contará com apresentações, debates e interação com participantes ao longo de dois dias.
Hospital based study on perinatal mortality in RIMS,Manipuriosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document discusses maternal morbidity and near-misses, which are defined as life-threatening complications during pregnancy, childbirth, or postpartum that are survived due to medical intervention. It notes that while maternal mortality has declined, morbidity remains high. The document then presents statistics on near-misses from a private and rural hospital in India, finding higher rates in the rural hospital. The most common causes of near-misses were pre-eclampsia/HELLP syndrome and hemorrhage. Improved management of severe complications, emergency protocols, training, and access to care are needed to further reduce maternal mortality and morbidity.
This document discusses severe maternal morbidity, also known as near-misses, which are life-threatening complications during pregnancy, childbirth, or postpartum that women survive only through medical intervention. It notes that over 50 million women experience maternal health issues annually. The document then provides definitions of near-miss cases and discusses risk factors. It presents statistics on near-miss cases from a private hospital in India compared to a rural hospital, finding higher rates in the rural hospital. The leading causes of near-misses are identified as pre-eclampsia/eclampsia and hemorrhage. The conclusion emphasizes the need for improved management of near-miss cases to reduce maternal mortality.
IOSRPHR(www.iosrphr.org) IOSR Journal of Pharmacyiosrphr_editor
The document summarizes a study on the efficacy and safety of vaginal misoprostol for second trimester medical termination of pregnancy. 148 women between 13-20 weeks gestation were given initial doses of 400 micrograms of misoprostol followed by 200 micrograms every 4 hours. The overall success rate was 92% with an average induction-abortion interval of 14 hours. Common side effects like cramping, nausea and diarrhea were reported but were managed with symptomatic treatment. The study concluded that misoprostol was found to be safe and effective for second trimester medical termination of pregnancy.
A Clinical Study on Maternal and Fetal Outcome in Multiple Pregnancies in Wom...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
This study examines heart disease complicating pregnancy in 35 cases seen at a rural hospital in India. The incidence of heart disease in pregnancy was 1.3%. Most patients were from low socioeconomic backgrounds and rural areas. Rheumatic heart disease accounted for 77% of cases. Mitral stenosis was the most common lesion. Most deliveries were spontaneous and vaginal, with few complications. The perinatal mortality rate was 40 per 1000 live births. Early diagnosis, management, and institutional delivery can help reduce mortality and morbidity from heart disease in pregnancy.
Vital registration maternal mortality. Case of JamaicaPAHO_RHO
This document summarizes findings from a study examining underreporting of maternal deaths in Jamaica in 2008. The study found that only 19% of actual maternal deaths were reflected in vital registration data. Through extensive data collection from multiple sources, 54 actual maternal deaths were identified for 2008. However, only 10 of these deaths were correctly registered and coded as maternal within 3 months. Underreporting was associated with delays in death registration, poor certification practices, and coding errors. The maternal mortality ratio estimated from complete registration and coding data was nearly 4 times lower than estimated from surveillance data. The study highlights ongoing challenges with the timely registration and accurate certification and coding of maternal deaths in Jamaica.
O documento fornece a programação detalhada de uma conferência sobre o mercado imobiliário brasileiro com painéis sobre macroeconomia, setores corporativo, residencial e industrial. O evento contará com apresentações, debates e interação com participantes ao longo de dois dias.
Hospital based study on perinatal mortality in RIMS,Manipuriosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document discusses maternal morbidity and near-misses, which are defined as life-threatening complications during pregnancy, childbirth, or postpartum that are survived due to medical intervention. It notes that while maternal mortality has declined, morbidity remains high. The document then presents statistics on near-misses from a private and rural hospital in India, finding higher rates in the rural hospital. The most common causes of near-misses were pre-eclampsia/HELLP syndrome and hemorrhage. Improved management of severe complications, emergency protocols, training, and access to care are needed to further reduce maternal mortality and morbidity.
This document discusses severe maternal morbidity, also known as near-misses, which are life-threatening complications during pregnancy, childbirth, or postpartum that women survive only through medical intervention. It notes that over 50 million women experience maternal health issues annually. The document then provides definitions of near-miss cases and discusses risk factors. It presents statistics on near-miss cases from a private hospital in India compared to a rural hospital, finding higher rates in the rural hospital. The leading causes of near-misses are identified as pre-eclampsia/eclampsia and hemorrhage. The conclusion emphasizes the need for improved management of near-miss cases to reduce maternal mortality.
IOSRPHR(www.iosrphr.org) IOSR Journal of Pharmacyiosrphr_editor
The document summarizes a study on the efficacy and safety of vaginal misoprostol for second trimester medical termination of pregnancy. 148 women between 13-20 weeks gestation were given initial doses of 400 micrograms of misoprostol followed by 200 micrograms every 4 hours. The overall success rate was 92% with an average induction-abortion interval of 14 hours. Common side effects like cramping, nausea and diarrhea were reported but were managed with symptomatic treatment. The study concluded that misoprostol was found to be safe and effective for second trimester medical termination of pregnancy.
A Clinical Study on Maternal and Fetal Outcome in Multiple Pregnancies in Wom...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
This study examines heart disease complicating pregnancy in 35 cases seen at a rural hospital in India. The incidence of heart disease in pregnancy was 1.3%. Most patients were from low socioeconomic backgrounds and rural areas. Rheumatic heart disease accounted for 77% of cases. Mitral stenosis was the most common lesion. Most deliveries were spontaneous and vaginal, with few complications. The perinatal mortality rate was 40 per 1000 live births. Early diagnosis, management, and institutional delivery can help reduce mortality and morbidity from heart disease in pregnancy.
Vital registration maternal mortality. Case of JamaicaPAHO_RHO
This document summarizes findings from a study examining underreporting of maternal deaths in Jamaica in 2008. The study found that only 19% of actual maternal deaths were reflected in vital registration data. Through extensive data collection from multiple sources, 54 actual maternal deaths were identified for 2008. However, only 10 of these deaths were correctly registered and coded as maternal within 3 months. Underreporting was associated with delays in death registration, poor certification practices, and coding errors. The maternal mortality ratio estimated from complete registration and coding data was nearly 4 times lower than estimated from surveillance data. The study highlights ongoing challenges with the timely registration and accurate certification and coding of maternal deaths in Jamaica.
An Extension of Calderón Transfer Principle and its Application to Ergodic Ma...BRNSS Publication Hub
We first prove that the well-known transfer principle of Calderón can be extended to the vector-valued setting, and then, we apply this extension to vector-valued inequalities for the Hardy–Littlewood maximal function to prove the vector-valued strong type Lp norm inequalities for 1< p < α and the vector-valued weak type (1,1) inequality for ergodic maximal function.
This study examined the bio-socio-demographic characteristics of 70 individuals with pterygium. The mean age was 37.23 years, with most cases between 26-50 years old. Pterygium was slightly more common in females (55.71%) than males. The majority of cases were housewives (52.86%) or labourers (14.29%) with high sun exposure (80%). The average pterygium size was 2.616 mm. Keratometry found average astigmatism of 1.35D while Scheimpflug imaging found 1.22D, indicating pterygium induces corneal astigmatism.
This document discusses fitting probability distributions to maternal mortality rate (MMR) data in Nigeria. Four distributions were fitted to the MMR data: gamma, lognormal, Weibull, and exponential. The Akaike information criterion (AIC) and Bayesian information criterion (BIC) were used to select the best fitting distribution. The exponential distribution had the lowest AIC and BIC values, indicating it was the best fitting distribution. The estimated rate parameter for the exponential distribution was 0.5853659, with this model providing the best fit for analyzing MMR in Nigeria.
This Journal Club presentation provides a summary and discussion of the following free access article published in UOG:
Prospective risk of late stillbirth in monochorionic twins: A regional cohort study
Southwest Thames Obstetric Research Collaborative (STORK)
Volume 39, Issue 5, Date: May 2012, pages 500-504
This can be accessed here:
http://onlinelibrary.wiley.com/doi/10.1002/uog.11110/abstract
Safety issues in assisted reproduction technology Safety issues in assisted...MedicineAndHealth14
The document discusses safety issues related to assisted reproduction technologies (ARTs) such as in vitro fertilization (IVF). It finds that both multiple pregnancies and singleton pregnancies resulting from ARTs are associated with increased health risks for children compared to naturally conceived pregnancies. Multiple pregnancies face risks such as prematurity, growth restriction, and low birth weight. Singleton pregnancies from ARTs also show increased risks of cerebral palsy, preterm birth, and low birth weight compared to singletons conceived without ARTs. The causes of safety issues in both multiple and singleton pregnancies resulting from ARTs require further study. Medical guidelines recommend aiming to minimize health risks by promoting singleton pregnancies through practices like elective single embryo transfer
Skin cancer exposed - Background informationXplore Health
This document provides background information on skin cancer and melanoma. It discusses the state of research on melanoma, including epidemiology, causes, diagnosis, prognosis, treatment options and molecular pathways. Ethical, legal and social aspects related to prevention, screening, treatment and research are also reviewed. The document is intended to help educators prepare lessons using multimedia resources on a skin cancer module.
This study analyzed perinatal mortality trends at Kathmandu Medical College Teaching Hospital from 2002-2007. It found that the perinatal mortality rate decreased from 30.7 in 2002-2003 to 19.1 in 2003-2005 but slightly increased to 25.5 in 2007. The main causes of perinatal deaths were prematurity (33.3%), intrapartum asphyxia (25%), and congenital anomalies (8.3%). Improving antenatal care, preventing preterm births, better monitoring during delivery, and intensive care for low birth weight infants could help reduce the perinatal mortality rate further.
Breastfeeding And The Risk Of Postneonatal Death In The United StatesBiblioteca Virtual
This study examined the association between breastfeeding and postneonatal mortality in the United States using data from the 1988 National Maternal and Infant Health Survey. The study found that children who were ever breastfed had a 21% lower risk of postneonatal death compared to children who were never breastfed. Longer durations of breastfeeding were associated with even lower risk. The protective effect of breastfeeding was seen across different causes of postneonatal death, including infections, injuries, and sudden infant death syndrome.
The 2011 census of St. Maarten's population shows an aging trend. Key findings include:
- The population is aging, with decreases in those under 40 and increases in those over 40. The largest growth is people aged 55-59.
- The country of birth has shifted, with the top 5 being St. Maarten, Dominican Republic, Haiti, Jamaica, and Saint Martin.
- Nearly two-thirds of the population has Dutch nationality, with the second largest being Haitian.
- There are more women (52.91%) than men (47.06%).
- High blood pressure remains the most common illness, more than doubling since 2001, along with increases
"Internal podalic version- revival of a disappearing art"Charu Mittal
I presented this paper at Kolkata AICOG with data related to the IPV procedure ..it is now truly a disappearing art and postgraduates need dedicated teachers to develop the skills for proper selection and execution
Prevalence of Congenital Malformations in Newborns Delivered in a Rural Medic...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document summarizes research on mother to child transmission of HIV, with a focus on transmission during the third trimester of pregnancy and interventions to prevent it. Key findings include:
- Studies from the 1990s showed that antiretroviral therapy (ART) like zidovudine given to the mother during late pregnancy and delivery and to the newborn infant can reduce transmission rates by 50-70%.
- Subsequent randomized clinical trials found that combination ART regimens starting in the second or third trimester were more effective at preventing transmission than monotherapy or short course regimens.
- Studies also explored the impact of mode of delivery, finding that elective caesarean section before
This document provides an overview of maternal and newborn health in the Philippines. It shows that 1 in 10 Filipino mothers die from pregnancy or childbirth complications each day. 61% of births occur at home and are attended by traditional birth attendants. Perinatal and infant mortality rates are higher for young, older, lower income mothers and those with closer birth intervals or more children. Integrating maternal and newborn care can help address the social, economic, cultural and environmental factors contributing to deaths.
Prenatal diagnosis involves identifying fetal abnormalities through tests such as ultrasound scans and blood tests. Fetal therapy aims to improve the fetal environment through procedures like blood transfusions. First trimester screening for Down syndrome includes assessing the mother's age, measuring the fetal nuchal translucency, and testing maternal serum markers. Combining these factors provides a 79-87% detection rate. Additional markers like absent nasal bone and abnormal ductus venosus or tricuspid valve Doppler flows may further refine risk assessment. Genetic counseling is an important part of the screening and diagnostic process to help expectant families understand risks and make informed decisions.
This document summarizes several studies on birth defects in children conceived through assisted reproductive technologies like IVF and ICSI:
- Meta-analyses found that ICSI and IVF are associated with a 40-70% increased risk of major birth defects compared to spontaneously conceived children. The risk was higher for singleton births and boys.
- A Danish study found infertility itself may be an independent risk factor for birth defects, as children conceived naturally after infertility also had a higher risk than spontaneously conceived controls.
- A prospective study of over 1,000 ICSI and IMSI births found IMSI was associated with a significantly lower rate of major malformations, especially in male children. IMSI may help select sperm with normal
This study examined the rate of "practically perfect" births, defined as spontaneous labor without intervention resulting in spontaneous vaginal delivery of a healthy baby and intact perineum, among first-time mothers. The study reviewed data from over 18,000 deliveries at a Dublin hospital over 2 years. After applying several exclusion criteria, the study found that less than 1% (58) of the initial group of over 8,000 first-time mothers had a practically perfect birth without any interventions, emergency procedures, or adverse maternal or neonatal outcomes.
This document discusses the investigation and assessment of stillbirths. It defines stillbirth as fetal loss after 20 weeks of gestation or a birth weight over 500g. Stillbirths can be antepartum (before labor) or intrapartum (during labor). The prevalence of stillbirth globally is discussed, with rates being much higher in developing countries. Common risk factors for stillbirth include maternal age, obesity, medical conditions like diabetes and hypertension, thrombophilias, infection, and multiple pregnancies. An algorithm is presented for the etiologic investigation of stillborn infants, beginning with maternal and family history, physical examination of the stillborn infant, examination of the umbilical cord, and examination of the placent
This document summarizes the key points from a debate on whether all patients undergoing invasive prenatal testing should have chromosomal microarray analysis (CMA). One speaker argued in favor, stating that CMA has higher resolution than karyotyping and can find clinically relevant microdeletions and duplications in 6-10% of cases. It provides direct mapping and faster results. The other speaker argued against, saying that karyotyping has been the standard for 40 years and can detect structural abnormalities, while CMA finds variants of uncertain significance. Both sides acknowledged pros and cons, with the debate centering on whether improved detection outweighs uncertainty.
Role of MRIversus US in placental abnormalities and diseasesSoha Hamed
This study evaluated the role of MRI versus ultrasound in assessing placental abnormalities and diseases. It found that MRI may be more accurate than ultrasound for diagnosing invasive placental processes like placenta accreta. The study examined 50 pregnant females, finding placental location abnormalities in 40 cases, gestational trophoblastic disease in 8 cases, and placental hematoma/abruption in 2 cases. MRI was more sensitive than ultrasound at identifying features suggestive of invasive placentation. The study concludes that MRI used along with ultrasound provides more accurate diagnosis of placental abnormalities, especially invasive conditions.
The Perinatal Periods of Risk (PPOR) approach is a comprehensive 6-step method used in Massachusetts to address racial and ethnic disparities in feto-infant mortality rates. PPOR involves analyzing fetal and infant death data by birth weight and age at death over four risk periods to identify gaps between racial groups. Phase I maps and analyzes this data, while Phase II further investigates causes of death in high-risk groups and periods. An application of PPOR in Worcester, MA from 2008-2012 found Black and Latino feto-infant mortality rates around 1.5-2 times higher than whites, with the largest gaps existing for deaths occurring in the Maternal Health and Prematurity period.
Congenital Agenesis Of The Corpus Callosum With Intracerebral Lipoma And Fron...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
“Hemodynamic and recovery profile with Dexmedetomidine and Fentanyl in intrac...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
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Similar to IOSRPHR(www.iosrphr.org) IOSR Journal of Pharmacy
An Extension of Calderón Transfer Principle and its Application to Ergodic Ma...BRNSS Publication Hub
We first prove that the well-known transfer principle of Calderón can be extended to the vector-valued setting, and then, we apply this extension to vector-valued inequalities for the Hardy–Littlewood maximal function to prove the vector-valued strong type Lp norm inequalities for 1< p < α and the vector-valued weak type (1,1) inequality for ergodic maximal function.
This study examined the bio-socio-demographic characteristics of 70 individuals with pterygium. The mean age was 37.23 years, with most cases between 26-50 years old. Pterygium was slightly more common in females (55.71%) than males. The majority of cases were housewives (52.86%) or labourers (14.29%) with high sun exposure (80%). The average pterygium size was 2.616 mm. Keratometry found average astigmatism of 1.35D while Scheimpflug imaging found 1.22D, indicating pterygium induces corneal astigmatism.
This document discusses fitting probability distributions to maternal mortality rate (MMR) data in Nigeria. Four distributions were fitted to the MMR data: gamma, lognormal, Weibull, and exponential. The Akaike information criterion (AIC) and Bayesian information criterion (BIC) were used to select the best fitting distribution. The exponential distribution had the lowest AIC and BIC values, indicating it was the best fitting distribution. The estimated rate parameter for the exponential distribution was 0.5853659, with this model providing the best fit for analyzing MMR in Nigeria.
This Journal Club presentation provides a summary and discussion of the following free access article published in UOG:
Prospective risk of late stillbirth in monochorionic twins: A regional cohort study
Southwest Thames Obstetric Research Collaborative (STORK)
Volume 39, Issue 5, Date: May 2012, pages 500-504
This can be accessed here:
http://onlinelibrary.wiley.com/doi/10.1002/uog.11110/abstract
Safety issues in assisted reproduction technology Safety issues in assisted...MedicineAndHealth14
The document discusses safety issues related to assisted reproduction technologies (ARTs) such as in vitro fertilization (IVF). It finds that both multiple pregnancies and singleton pregnancies resulting from ARTs are associated with increased health risks for children compared to naturally conceived pregnancies. Multiple pregnancies face risks such as prematurity, growth restriction, and low birth weight. Singleton pregnancies from ARTs also show increased risks of cerebral palsy, preterm birth, and low birth weight compared to singletons conceived without ARTs. The causes of safety issues in both multiple and singleton pregnancies resulting from ARTs require further study. Medical guidelines recommend aiming to minimize health risks by promoting singleton pregnancies through practices like elective single embryo transfer
Skin cancer exposed - Background informationXplore Health
This document provides background information on skin cancer and melanoma. It discusses the state of research on melanoma, including epidemiology, causes, diagnosis, prognosis, treatment options and molecular pathways. Ethical, legal and social aspects related to prevention, screening, treatment and research are also reviewed. The document is intended to help educators prepare lessons using multimedia resources on a skin cancer module.
This study analyzed perinatal mortality trends at Kathmandu Medical College Teaching Hospital from 2002-2007. It found that the perinatal mortality rate decreased from 30.7 in 2002-2003 to 19.1 in 2003-2005 but slightly increased to 25.5 in 2007. The main causes of perinatal deaths were prematurity (33.3%), intrapartum asphyxia (25%), and congenital anomalies (8.3%). Improving antenatal care, preventing preterm births, better monitoring during delivery, and intensive care for low birth weight infants could help reduce the perinatal mortality rate further.
Breastfeeding And The Risk Of Postneonatal Death In The United StatesBiblioteca Virtual
This study examined the association between breastfeeding and postneonatal mortality in the United States using data from the 1988 National Maternal and Infant Health Survey. The study found that children who were ever breastfed had a 21% lower risk of postneonatal death compared to children who were never breastfed. Longer durations of breastfeeding were associated with even lower risk. The protective effect of breastfeeding was seen across different causes of postneonatal death, including infections, injuries, and sudden infant death syndrome.
The 2011 census of St. Maarten's population shows an aging trend. Key findings include:
- The population is aging, with decreases in those under 40 and increases in those over 40. The largest growth is people aged 55-59.
- The country of birth has shifted, with the top 5 being St. Maarten, Dominican Republic, Haiti, Jamaica, and Saint Martin.
- Nearly two-thirds of the population has Dutch nationality, with the second largest being Haitian.
- There are more women (52.91%) than men (47.06%).
- High blood pressure remains the most common illness, more than doubling since 2001, along with increases
"Internal podalic version- revival of a disappearing art"Charu Mittal
I presented this paper at Kolkata AICOG with data related to the IPV procedure ..it is now truly a disappearing art and postgraduates need dedicated teachers to develop the skills for proper selection and execution
Prevalence of Congenital Malformations in Newborns Delivered in a Rural Medic...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document summarizes research on mother to child transmission of HIV, with a focus on transmission during the third trimester of pregnancy and interventions to prevent it. Key findings include:
- Studies from the 1990s showed that antiretroviral therapy (ART) like zidovudine given to the mother during late pregnancy and delivery and to the newborn infant can reduce transmission rates by 50-70%.
- Subsequent randomized clinical trials found that combination ART regimens starting in the second or third trimester were more effective at preventing transmission than monotherapy or short course regimens.
- Studies also explored the impact of mode of delivery, finding that elective caesarean section before
This document provides an overview of maternal and newborn health in the Philippines. It shows that 1 in 10 Filipino mothers die from pregnancy or childbirth complications each day. 61% of births occur at home and are attended by traditional birth attendants. Perinatal and infant mortality rates are higher for young, older, lower income mothers and those with closer birth intervals or more children. Integrating maternal and newborn care can help address the social, economic, cultural and environmental factors contributing to deaths.
Prenatal diagnosis involves identifying fetal abnormalities through tests such as ultrasound scans and blood tests. Fetal therapy aims to improve the fetal environment through procedures like blood transfusions. First trimester screening for Down syndrome includes assessing the mother's age, measuring the fetal nuchal translucency, and testing maternal serum markers. Combining these factors provides a 79-87% detection rate. Additional markers like absent nasal bone and abnormal ductus venosus or tricuspid valve Doppler flows may further refine risk assessment. Genetic counseling is an important part of the screening and diagnostic process to help expectant families understand risks and make informed decisions.
This document summarizes several studies on birth defects in children conceived through assisted reproductive technologies like IVF and ICSI:
- Meta-analyses found that ICSI and IVF are associated with a 40-70% increased risk of major birth defects compared to spontaneously conceived children. The risk was higher for singleton births and boys.
- A Danish study found infertility itself may be an independent risk factor for birth defects, as children conceived naturally after infertility also had a higher risk than spontaneously conceived controls.
- A prospective study of over 1,000 ICSI and IMSI births found IMSI was associated with a significantly lower rate of major malformations, especially in male children. IMSI may help select sperm with normal
This study examined the rate of "practically perfect" births, defined as spontaneous labor without intervention resulting in spontaneous vaginal delivery of a healthy baby and intact perineum, among first-time mothers. The study reviewed data from over 18,000 deliveries at a Dublin hospital over 2 years. After applying several exclusion criteria, the study found that less than 1% (58) of the initial group of over 8,000 first-time mothers had a practically perfect birth without any interventions, emergency procedures, or adverse maternal or neonatal outcomes.
This document discusses the investigation and assessment of stillbirths. It defines stillbirth as fetal loss after 20 weeks of gestation or a birth weight over 500g. Stillbirths can be antepartum (before labor) or intrapartum (during labor). The prevalence of stillbirth globally is discussed, with rates being much higher in developing countries. Common risk factors for stillbirth include maternal age, obesity, medical conditions like diabetes and hypertension, thrombophilias, infection, and multiple pregnancies. An algorithm is presented for the etiologic investigation of stillborn infants, beginning with maternal and family history, physical examination of the stillborn infant, examination of the umbilical cord, and examination of the placent
This document summarizes the key points from a debate on whether all patients undergoing invasive prenatal testing should have chromosomal microarray analysis (CMA). One speaker argued in favor, stating that CMA has higher resolution than karyotyping and can find clinically relevant microdeletions and duplications in 6-10% of cases. It provides direct mapping and faster results. The other speaker argued against, saying that karyotyping has been the standard for 40 years and can detect structural abnormalities, while CMA finds variants of uncertain significance. Both sides acknowledged pros and cons, with the debate centering on whether improved detection outweighs uncertainty.
Role of MRIversus US in placental abnormalities and diseasesSoha Hamed
This study evaluated the role of MRI versus ultrasound in assessing placental abnormalities and diseases. It found that MRI may be more accurate than ultrasound for diagnosing invasive placental processes like placenta accreta. The study examined 50 pregnant females, finding placental location abnormalities in 40 cases, gestational trophoblastic disease in 8 cases, and placental hematoma/abruption in 2 cases. MRI was more sensitive than ultrasound at identifying features suggestive of invasive placentation. The study concludes that MRI used along with ultrasound provides more accurate diagnosis of placental abnormalities, especially invasive conditions.
The Perinatal Periods of Risk (PPOR) approach is a comprehensive 6-step method used in Massachusetts to address racial and ethnic disparities in feto-infant mortality rates. PPOR involves analyzing fetal and infant death data by birth weight and age at death over four risk periods to identify gaps between racial groups. Phase I maps and analyzes this data, while Phase II further investigates causes of death in high-risk groups and periods. An application of PPOR in Worcester, MA from 2008-2012 found Black and Latino feto-infant mortality rates around 1.5-2 times higher than whites, with the largest gaps existing for deaths occurring in the Maternal Health and Prematurity period.
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Congenital Agenesis Of The Corpus Callosum With Intracerebral Lipoma And Fron...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
“Hemodynamic and recovery profile with Dexmedetomidine and Fentanyl in intrac...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Correlation of Estrogen and Progesterone Receptor expression in Breast Canceriosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Analytical Study of Urine Samples for Epidemiology of Urinary Tract Infection...iosrphr_editor
The current study was carried out in District Abbottabad aimed to determine the common urinary
tract infections in local community to determine the epidemiology of significant diseases in asymptomatic patients
of renal disorder. In this study a total of 1000 urine samples were examined during 3rd February to 1st April 2015
from patients attending Ayub Teaching Hospital Abbottabad by using dipstick and microscopic analysis of urine.
There were 638 females and 362 males patients examined during this period. The range of age groups is between
1.5 years to 80 years. Results of this study was reported as Pyuria 11%, Proteinuria 21.1%, Hematuria 10.4%,
Epithelial Cells 8.2%, pH 7.8 %, Granular casts 7.3%, Triple phosphate 6.6%, Calcium oxalate 6.4%, Glycosuria
6.3%, Bacteria 6.2% and mucous 4.1%. This study concludes that routing urinalysis should be performed for all
individuals to diagnose the asymptomatic diseases that will help in simple therapeutic measurements as urinalysis
is a simple step to determine the root of Urinary tract disorders.
Chest sonography images in neonatal r.d.s. And proposed gradingiosrphr_editor
BACKGROUND : Lung sonography has been used to monitor the patients of R.D.S. in
N.I.C.U. in recent times.
AIMS : To Describe and Grade the changes of R.D.S. by lung sonography.
SETTING & DESIGN : Tertiary care institutional set up in a rural medical college.
STUDY DURATION : September 2014 to May 2015. Follow-up variable, upto 2 weeks.
PROSPECTIVE, ANALYTICAL STUDY.
MATERIALS AND METHODS -This was a single institute study approved by the institutional ethics
committee. Prior informed consent was obtained from the parents. 100 consecutive patients admitted in
N.I.C.U. WITH gestational age < 36 weeks with respiratory complaints were enrolled. Chest x-ray was
obtained within few hours of admission and lung sonography was performed within 24 hours. Follow – up
sonography was performed as and when necessary. Sonography image was graded and correlated with chest
xray and clinical picture
The Comprehensive Review on Fat Soluble Vitaminsiosrphr_editor
This review article deals with brief description of fat soluble vitamins with figures and tables
showing statistical analytical data duly quoting the references wherever necessary. The word “soluble” actually
means “able to be dissolved.” Whether a vitamin is classified as 'fat-soluble' or 'water-soluble' has to do with
how the vitamin is absorbed, stored and removed from the body. Vitamins are tiny organic compounds with a
huge impact on the health and well-being of the body. The body needs a small amount of fat soluble vitamins in
order to stay in optimal health. Fat soluble vitamins play an important role in keeping the body healthy and
functioning from immune system and muscle and heart function, easy flow and clotting of blood as well as eye
health. They are critical to health and wellness–particularly reproductive health and wellness. Low-fat, no-fat
and vegan diets are woefully lacking in fat soluble vitamins. However a diet based on traditional foods can
naturally provide these vitamins. Science is still learning about many of the functions of vitamins. "Too much
vitamin A, D, or K can lead to increased levels that are unhealthy and can cause serious health consequences.
Diseased conditions leading to decreased fat absorption leads to decreased absorption of vitamins. The fatsoluble
vitamins work most safely and effectively when obtained them from natural foods within the context of a
diet rich in all their synergistic partners. If fat soluble vitamins are stored for lengthy time they generate threat
for toxicity than water soluble vitamins and such situation even aggravated, provided they are consumed in
excess. Vitamin products, above the legal limits are not considered food supplements and must be registered as
prescription or non-prescription (over-the-counter drugs) due to their potential side effects. Vitamin A and E
supplements do not provide health benefits for healthy individuals, instead they may enhance mortality, and it is
held proved that beta-carotene supplements can be harmful to smokers
Sulphasalazine Induced Toxic Epidermal Necrolysis A Case Reportiosrphr_editor
The document describes a case study of an 18-year-old female patient who developed toxic epidermal necrolysis as a severe adverse reaction to the drug sulfasalazine, which she had been taking for ankylosing spondylitis. She was admitted to the intensive care unit and treated with high dose corticosteroids, fluid replacement, and supportive care. She improved with treatment and was discharged with only post-inflammatory hypopigmentation.
Evaluation the efficacy of IVIgG in treatment of Hemolytic Disease of Newborniosrphr_editor
Hemolytic disease of newborn (HDN) is an important cause of hyperbilirubinemia in the
neonatal period,and delayed diagnosis and treatment may lead to permanent brain damage. Traditional
neonatal treatment of HDN is intensive phototherapy and exchange transfusion.Intravenous
immunoglobulin(IVIgG) has been introduced as an alternative therapy to exchange transfusion. This study was
conducted to assess the effect of IVIG in HDN .
FIBROLIPOMATOUS HAMARTOMA OF ULNAR NERVE: A RARE CASE REPORT.iosrphr_editor
Nervous fibrolipomatous hamartoma is said to be a rare tumor-like condition involving the peripheral
nerves,in which the epineurium and perineurium are enlarged and distorted by excess of fatty and fibrous tissue
s that infiltrate between and around nerve boundaries. The median nerve is more likely to develop a hamartoma
than other nerves with a predilection for the carpal tunnel.
A fibrolipomatous hamartoma – is a rare, benign, congenital lesion most commonly found in the median nerve,
usually at the level of the wrist or hand.
We report a case of this rare condition in ulnar nerve.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
This study examined self-medication practices for oral health problems among dental patients in Bangalore, India. The study found that 100% of the 175 dental patients surveyed practiced self-medication. Toothache was the most common triggering factor reported. Analgesics and herbal remedies were commonly used for self-treatment. Most participants consulted pharmacists for advice on self-medication and would see a dentist only if problems persisted after self-medicating. The high prevalence of self-medication indicates a need for education programs to increase awareness of risks.
Clinico-haematological Profile of Falciparum Malaria in a Rural Hospital of T...iosrphr_editor
Aim: To study the clinico-haematological profile malaria in a rural hospital of Tripura.
Material and methods: A cross-sectional hospital-based study was done from at Kulai District
Hospital,Tripura. This hospital based cross sectional study was done on 60 confirmed cases of falciparum
malaria (either by peripheral smear or rapid diagnostic test) admitted in Kulai District Hospital. A case sheet
proforma was prepared and data (demographic profile,clinical feature, investigation, treatment, and
complication) from all indoor patients was collected and analyzed.
Result: Out of 60 patients, 40(66.6%) were males and 20 (33.4%) were females. Most of the patients were
between the age group 21-40 years with the highest prevalence between the age group of 21-30. Fever was the
most common symptom. Anemia was present in 42(70%) patients, out of which 6(10%) patients had severe
anemia. Thrombocytopenia was present in 36(60%) patients.Abnormal liver function tests were observed in
26(43.3%) subjects while abnormal kidney function tests were observed in16(26.6%) patients. All the 60
patients received Artemisinin based antimalarial drugs.
Conclusion: Early detection, prompt management, and adequate supportive therapy may reduce mortality due
to falciparum cerebral malaria.
Indonesian Wild Ginger (Zingiber sp) Extract: Antibacterial Activity against ...iosrphr_editor
The document summarizes a study that tested the antibacterial activity of extracts from three species of wild ginger plants from Indonesia (Zingiber zerumbet, Zingiber amaricans, and Zingiber aromaticum) against Mycoplasma gallisepticum, a pathogen that causes respiratory disease in chickens. Phytochemical analysis revealed the presence of alkaloids, flavonoids, tannins, and terpenoids in the plant extracts. Disc diffusion and minimum inhibitory concentration assays showed that ethanol extracts of dried rhizomes had the strongest inhibitory effects against the pathogen, with minimum inhibitory concentrations ranging from 7.8 to 31.2 mg/ml. The results suggest that extracts from these wild ginger plants
A case of allergy and food sensitivity: the nasunin, natural color of eggplantiosrphr_editor
Abstract: Allergies and food sensitivities can both be considered as "adverse reactions individualistic" to food.
Are pathological and individual forms because they affect a few individuals in way rather serious; immediate
or delayed reactions occur instead with simple effects histamine, or, in severe cases with respiratory and
anaphylactic shock
The eggplant (Solanum melongena L.) is known to cause food allergies in some Asian countries, but detailed
studies on allergies caused by eggplant are lacking, however, it was highlighted the presence of allergens in
edible parts of eggplant with preponderance in the peel .
The purpose of this study was to propose an extraction method rapid, efficient and cost of natural dye from
waste products from the food industry, such as the peels of eggplant, from which it was extracted, isolated and
purified the nasunin,a colored molecule in red-fuchsia.
Nasusin was tested on 58 patients to evaluate the potential sensitizing effect on the skin. The results demonstrate
that allergenic effects are negligible and therefore the nasunin can be used as a colorant in various industrial
sectors with a certain safety margin
Complete NMR Assignment of MogrosidesII A2, II E andIII A1Isolated from Luo H...iosrphr_editor
NMR analysis allowed complete assignments of three known mogrol glycosides, Mogroside IIA2 (1),
II E (2)and IIIA1 (3), isolated from the extracts of Luo Han Guo. Herein, complete 1H and 13C NMR
assignmentsof all threemogrosidesare described based on NMR experiments (1H NMR, 13C NMR, COSY,
HSQC-DEPT, HMBC, NOESY and 1DTOCSY) and mass spectral data.
Nanoemulsion and Nanoemulgel as a Topical Formulationiosrphr_editor
: Nanoemulsion is referred type of emulsion with uniform and extremely small droplet size in the range
of 20-200 nm. Nanoemulsion provides numerous advantages over other carrier such as polymeric nanoparticle
and liposomes, including low cost preparation procedure, high hydrophilic and lipophilic drug loading system
to enhance the longer shelf live upon preserving the therapeutic agents. Incorporating the preparation of
nanoemulsion with hydrogel matrix to produce nanoemulgel exhibited by the two separate systems that forming
it. Nanoemulgel possesses the properties of thixotropic, non-greasy, effortlessly spreadable, easily be removed,
emollient, not staining, soluble in water, longer shelf life, bio-friendly, translucent and agreeable appearance.
Pharmacokinetics of High-Dose Methotrexate in Egyptian Children with Acute Ly...iosrphr_editor
Aim:Since several factors have been shown to influence the clearance of methotrexate, the purpose of this study
was to identify potential relationships between patient covariates and the methotrexate clearance estimates and
deduce a pharmacokinetic model for the estimation of methotrexate clearance in Egyptian pediatric ALL
patients that may help dosage adjustment and achieve target steady-state plasma concentrations in a similar
sittings.
Patients and methods: A total of 94 pediatric patients with B-cell ALL, of whom 70 were the studied population
and 24 were the test population, were treated with four courses of HDMTX doses 2.5 gm/m2
(low-risk arm) or 5
gm/m2
(standard-/high-risk arm) given every other week by intermittent intravenous infusions over 24 hours as
a part of their treatment protocol. Patients were monitored for the 24 hour MTX concentration and the systemic
methotrexate clearance was calculated for each methotrexate dose
Epidemiology of Tuberculosis (TB) in Albania 1998-2009iosrphr_editor
Abstract : In Albania, many people erroneously think that tuberculosis (TB) is a disease of the past-an illness
that no longer constitutes a public health threat. Surveillance is an integral part of tuberculosis (TB) control.
Albania has a highTB notification rate and there are doubts about underreporting. The evolution of the
incidence of tuberculosis is presented, together with more detailed figures over the period 1998-2009. These
figures were obtained by the monthly forms (called 14/Sh) compared with the individual notification data.
Objective: To examine the distribution and sources of increased tuberculosis (TB) morbidity and reporting
system deficiencies in the Albania from 1998 through 2009. Metodology: The study is descriptive one conductet
during the period 1998-2009. The statistical analysis is based on data reported from regional level (regional
epidemiological departments) to the central level (Public Health Institute). Results: The main findings were:
discordance between the collected data (individual form) and reported data (monthly form); tuberculosis
incidence rate shows little oscillations which ranges from 6.67 to 9.2 cases/100.000 population; 50% of the
regions show a lack of information on the confirmation of diagnosis and laboratory examination type used for
confirmation. Conclusion: TB disease in high-risk populations where it is difficult to detect, diagnose, and treat;
limitations of current control measures and the need for new tests and treatments, including an effective
vaccine; improving information system, regulation of individual form and personnel training.
Total Phenol and Antioxidant from Seed and Peel of Ripe and Unripe of Indones...iosrphr_editor
Study on total phenol and antioxidantactivity ofsugar apple fruits of various solvent, part of fruits, and level of ripening. Solvent extraction used were 80% (v/v) methanol, 50% (v/v) acetone, boiling water, and 50% (v/v) ethanol. Part of fruits thatbeen used for samples were seed and peel which are normally by products of sugar apple processing, level of ripening were unripe, and ripe sugar apple fruits. Total phenol was determined by Folin-ciocalteau method. Total antioxidant was quantified by 1,1-diphenyl-2-picrylhydrazyl(DPPH) method.Therewas a difference in type of solvent, part of fruits, and level of ripeningon total phenol and antioxidant concentration of sugar apple fruits. Seeds have higher total phenol concentration than peels of this fruits. Unripe sugar apple fruits have higher total phenol and antioxidant than ripe fruit. The best solvent for phenol extraction was ethanol 50%butthe best solvent for antioxidant extraction was acetone 50%.
A Review on Step-by-Step Analytical Method Validationiosrphr_editor
When analytical method is utilized to generate results about the characteristics of drug related samples it is essential that the results are trustworthy. They may be utilized as the basis for decisions relating to administering the drug to patients. Analytical method validation required during drug development and manufacturing and these analytical methods are fit for their intended purpose. To comply with the requirements of GMP pharmaceutical industries should have an overall validation policy which documents how validation will be performed. The purpose of this validation is to show that processes involved in the development and manufacture of drug, production and analytical testing can be performed in an effective and reproducible manner. This review article provides guidance on how to perform validation characteristics for the analytical method which are utilized in pharmaceutical analysis.
A Cross Sectional Study of Ethnic Differences in Occurrence and Severity of A...iosrphr_editor
Non-steroidal anti-inflammatory drugs are the most widely used "over the counter" medication all over the world despite their complications in different major organs. Present studies envisaged for knowing the occurrence and severity of adverse drug reactions from NSAIDs in different ethnic communities of Sikkim. A cross sectional study was undertaken in the medicine outpatients department of a secondary and tertiary care hospital. The patients belonging to Nepalese, Bhutias, Lepchas ethnic communities and others community (settlers from other parts of India) were included to analyzed the data based on the age and gender, ethnicity and ADRs, drugs and ADRs. Severity assessment was done using Hartwing and Siegel scale and causality assessment by Naranjo scale. Total 109 cases of ADRs, predominating in female were detected. Nepalese were the most affected and Gastrointestinal tract (GIT) being the most affected organ in them. Diclofenac showed maximum number of ADRs in all the communities. Maximum number of cases occurred on single day use (40.36%) of drugs. All the cases were belonging to the "possible category" and the maximum being the mild (72.48%) in nature. It is advisable to consider the ethnic/racial differences equally with other factors, to improve the safety and efficacy of a drug.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
1. IOSR Journal of Pharmacy
Vol. 2, Issue 3, May-June, 2012, pp.475-478
REVIEW OF SOCIO DEMOGRAPHIC FACTORS AND
OBSTETRIC CAUSES OF STILLBIRTHS AT
TERTIARY CARE HOSPITAL
Bangal Vidyadhar B, Chandaliya Rajiv M, Pandit Hrishikesh A
Department of Obstetrics and Gynecology, Rural Medical college, Loni, Ahmednagar, MS
ABSTRACT
Background: - Occurrence of stillbirth pose difficult situation for the obstetrician and cause great psychological and
emotional trauma to the couple and the family. It reflects the suboptimum quality of maternal and child health services.
Stillbirth rates are unacceptably high in developing countries .Study was carried out to find out the causes of stillbirths and
the socio demographic profile of women ,who had stillbirth. Material and Methods: - A clinical observational study was
undertaken at tertiary care teaching hospital over a period of 10 months from January 2011 to October 2011. Results:-
Illiteracy, rural residence, lack of antenatal care ,low socioeconomic status were commonly associated with stillbirths.
Pregnancy induced hypertension, ante partum hemorrhage ,cord related accidents and preterm labour were mainly
responsible for stillbirths .Low birth weight and extreme prematurity were directly related to stillbirths. Conclusion:- High
rate of ante partum stillbirths due to hypertension ,ante partum hemorrhage and preterm labour can be reduced by early
recognition of the problem ,regular antenatal check ,color Doppler study to diagnose fetal growth restriction, and timely
obstetric intervention .Ultrasonograpy to diagnose cord abnormalities ,use of intrapartum electronic fetal monitoring,
partograph and prevention of prolongation of second stage of labour will help in reduction of stillbirths.
Keywords:- Perinatal mortality ,Perinatal deaths , Stillbirths
1. INTRODUCTION
Occurrence of stillbirth is a tragic event faced by the obstetrician .It has many implications for the couple, family
and the health care provider. It reflects a failure or lapse in implementation of maternal and child health care programme .It is
estimated that approximately 3.2 million stillbirths occur in the world every year. Majority of them take place in
underdeveloped and developing countries [1].Stillbirths contribute to more than half of the perinatal deaths .More than two
third of the stillbirths take place during pregnancy and remaining during course of labour.[2,3]Suboptimum care during
pregnancy and labour results in macerated stillbirths and fresh stillbirths respectively.[4,5]Stillbirths during pregnancy are
usually due to lack of adequate nutrition ,hypertensive disorders ante partum hemorrhage, genetic abnormalities in fetus,
maternal infections and exposure to some toxic agents .[6]Intrapartum deaths are usually related to prolong and neglected
labour ,malpresentations and cord related complications .Present study was carried out to find out the socio economic profile
of women who had stillbirths after institutional delivery and different medical and obstetric causes related to these
stillbirths. Preventive measures are suggested in the end to reduce the perinatal mortality as a result of stillbirths.
2. MATERIAL AND METHODS
The present study was a hospital based retrospective observational study carried out at Pravara rural hospital,
which is a tertiary care teaching hospital in Ahmednagar district of Maharashtra .All pregnant women who after admission,
delivered a stillborn baby during a period of one year from January 2011 to December 2011 were included for analysis in the
study .The data regarding socio demographic profile and antenatal investigations to find out cause of stillbirths was collected
from the indoor case sheet .The information regarding intrapartum events was collected from labour record and partograph of
every case .The data related to total deliveries and stillbirths was collected from medical record section of Pravara Rural
Hospital. Relevant data was entered on a structured performa and then transferred to master chart .The statistical analysis was
performed using Z test. Variations of P<0.05 were considered to be statistically significant.
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2. IOSR Journal of Pharmacy
Vol. 2, Issue 3, May-June, 2012, pp.475-478
3. RESULTS
During the study period, the total number of deliveries were 3997 and there were 131 stillbirths .The stillbirth rate
was 33.30 per thousand births (Table 1).Sixty one percent stillbirths occurred during antepartum period and remaining 39
percent during intrapartum period .Perinatal mortality rate was 51 per thousand births .Out of 131 stillbirths,14 percent were
among teenage primigravidas and 3 percent were among elderly primigravidas .Majority of women were in their third decade
of life .Women from rural residential area and from lower socio economic class had more stillbirths as compared to their
counterparts .Primigravida women delivered more stillborn babies than multigravidas(Table 2) .It was observed that
pregnancy induced hypertension and preterm labour resulting in birth of preterm babies were the common obstetric problems
related to causation of stillbirths .Other causes being cord related accidents like cord prolapse ,true knot formation of cord
entanglement ,either nuchal or around fetal body parts. Malpresentations, prolonged and obstructed labour and labour
abnormalities resulted in many fresh stillbirths. Antepartum hemorrhage,especially accidental hemorrhage resulted in acute
placental insufficiency and fetal deaths. Fetal congenital abnormalties and postdated pregnancy was responcible for many
macerated stillbirths.(Table 3) It was observed that eighty eight percent of stillborn babies were low birth weight ,of which
sixty six percent were very low birth weight .Seventy eight percent of stillborn babies were premature of which seventy five
percent had gestational age of below 34 weeks.
Table no. 1 perinatal outcome
Sr. Indicator Number
No
1 Total births 3997
2 Total live births 3794
3 Perinatal deaths 203
- Stillbirths 131
- Neonatal deaths 072
4 Perinatal mortality rate 50.78/1000 births
5 Stillbirth rate 33.30/1000 births
Table .2 Socio demographic profile of women with stillbirths
Sr. Socio demographic parameter No. of cases Percentag
No (n= 131 ) e
1 Age distribution
-Below 20 years 18 14
-20-30 years 109 83
-Above 30 years 04 03
2 Parity distribution
-Primigravida 73 56
-Multigravida 58 44
3 Socio economic class
-(I) 03 2.29
-(II) 05 3.81
-(III) 37 28.24
-(IV) 52 39.69
-(V) 34 25.95
4 Unbooked/Booked 102/29 78/22
5 Area of residence-Urban/Rural 10/121 08/92
6 Marital status 0/131 -0/100
(unmarried/married)
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3. IOSR Journal of Pharmacy
Vol. 2, Issue 3, May-June, 2012, pp.475-478
Table. 3 Distribution of stillbirths as per the etiology
Sr. Etiology of Stillbirth No. of cases Percentage
No (n= 131 )
1 Pregnancy induced hypertension 33 25.19
2 Prematurity 31 23.66
3 Antepartum haemorrhage 16 12.21
4 Cord accidents 09 07.63
5 Fetal malformations 06 06.87
6 Postdatism O8 06.10
7 Malpresentations 06 04.58
8 Labour abnormalities 05 03.81
9 Medical disorders 05 03.81
(Anemia,Heart disease,Liver
disease)
10 Idiopathic 08 06.10
4. DISCUSSION
Stillbirths contribute to majority of perinatal deaths .Sometimes they occur suddenly and unexpectedly and at times
they are anticipated by the obstetrician. Irrespective of type ,time of occurrence and cause ,they cause lots of psychological
trauma to the patient and relatives .With the news of the stillbirth ,the dream of fulfillment of motherhood disappears and is
gets replaced by state of shock .the severity of this problem is much more with sudden intrapartum deaths due to birth
asphyxia due to various reasons .In the present study ,the rate of stillbirths(33.30 per 1000 births) was comparable to the rates
reported by other authors.[7,8,9,10,11] and was much less than reported by few authors.[12,13]The stillbirths were common
during antepartum period (61%) than during intrapartum period( 39% ).Common causes of antepartum stillbirths were
placental insufficiency secondary to hypertension an antepartum hemorrhage.Similar observations were reported by
Ravikumar,Nayak and Dalal and Uchil.[11,7,14]Congenital malformation of fetus were responsible for 7 percent of
stillbirths.Ravikumar et al and korde et al reported slightly higher rates of malformations causing stillbirths.[11,8]Among all
the socio demographic factors studied, lack of antenatal care,lower socio economic class and illiteracy were found to be
significantly associated with higher still birth rates.(p value less than 0.05) Kameshwaran and Ravikumar et al and
Chitrakumari have reported similar observations in their studies.[9,11,13] Prematurity and low birth weight due to various
medical or obstetrical causes were associated with more than eighty percent of stillbirths. Maternal under nutrition,
anaemia,cervico vaginal infections ,heavy strenuous work during pregnancy contribute to the onset of preterm labour and still
birth of premature and low birth weight babies.
Many of the stillbirths can be avoided by proper diet, adequate rest, regular antenatal check up.Early detection of
high risk factors and their prompt management can save many antepartum deaths due to placental insufficiency. Modern
gadgets like color Doppler, non stress tests can detect the fetal jeopardy before occurrence of stillbirth . Carefully performed
obstetric ultrasonography can detect nuchal cord position and cord entanglement around body parts. Sonologist must alert the
obstetrician of such occurrence, so that necessary care is taken during labour .Use of partograph and intrapartum fetal
monitoring can detect fetal distress before major damage takes place. Avoidance of prolongation of labour ,especially the
second stage ,careful selection of cases for instrumental deliveries and availability of neonatologist for resuscitation of
asphyxiated newborn can reduce the rate of stillbirths.
5 .CONCLUSION
Large numbers of stillbirth are preventable by regular antenatal check up and institutional delivery. High rate of ante
partum stillbirths due to hypertension, antepartum hemorrhage and preterm labour can be reduced by early recognition of
the problem, color Doppler study to diagnose fetal growth restriction, and timely obstetric intervention .Ultrasonograpy to
diagnose cord abnormalities ,use of electronic fetal monitoring ,partograph and prevention of prolongation of second stage of
labour will help in reduction of intrapartum stillbirths. Improvement in female literacy ,health education to paramedical
workers in identifying high risk pregnancies and their timely referral to tertiary care center and periodic departmental audits
of all stillbirths can help in reduction of stillbirths
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4. IOSR Journal of Pharmacy
Vol. 2, Issue 3, May-June, 2012, pp.475-478
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New York, NY: The McGraw-Hill Professional Publishing; 2005.
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epidemiology and overview of the evidence review. BMC Pregnancy and Childbirth 2009, 9
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rates to measures of obstetric care in developed and developing countries. Acta Obstet Gynecol Scand
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7. Nayak AH, Dalal AR ,A review of stillbirth.J Obstet Gynecol India.1993;43:225-229
8. Korde-Nayak VN,Gaikwad PR,Causes of Stillbirth.J.Obstet Gynecol India2008;58(4):314-318
9. Kameshwaran C,Bhatia BD, Bhat BV et al, Perinatal mortality;A hospital based study.Indian
Paediatrics.1993;30:997-1001
10. Githa k ,Yamuna,Gopal et al,Perinatal outcome in Pregnancy induced hypertension in a referral
maternity hospital.J Obstet Gynecol India.1992;42:607-610
11. Ravikumar M,Devi A,Bhat V, et al.Analysis of stillbirths in a referral hospital.J Obstet Gynecol
India.1996;46:791-796
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