11 research outputs found
Case Report HAEMORRHAGIC CORPUS LUTEUM MIMIC APPENDICITIS
No full textHaemoperitoneum secondary to ruptured corpus luteum is a rare complication for women of reproductive life. The differential diagnosis of hemoperitoneum includes various types of acute abdomen that usually associated with acute lower abdominal pain and swelling lower abdomen. The differential diagnosis includes ruptured ectopic pregnancy, ruptured chocolate cyst, twisted ovarian tumor, pelvic inflammatory disease and pelvic peritonitis. Ruptured hemorrhagic corpus luteum is an uncommon cause of acute abdomem. Its occurrence is unknown but is likely quite frequent and without symptoms. Most cases are self limiting; enquire only observation with abdominal pain relieved with analgesics. Some need laparoscopy or laparotomy to achieve homeostasis if the patient is haemodynamically unstable
Potential effect of COVID-19 pandemic on pregnancy outcome: a prospective observational study
No full textBackground: The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide, particularly impacting vulnerable populations such as pregnant women. Physiological changes during pregnancy may increase susceptibility to severe outcomes from COVID-19, necessitating a deeper understanding of its effects on maternal and fetal health. This study aimed to observe the outcomes of pregnant patients diagnosed with COVID-19, focusing on maternal morbidity, fetal outcomes, and the impact on healthcare resources.
Methods: A multicenter, non-randomized, quasi-experimental prospective observational study was conducted at Rajshahi Medical College Hospital, Bangladesh, from July 2020 to June 2021. A total of 81 pregnant women with confirmed COVID-19 were included in the study. Data were collected using a pre-prepared data collection sheet and analyzed using SPSS version 26.
Results: The majority of patients were in the third trimester (49.1%) and between 35-40 weeks gestation (83%). Common symptoms included severe cough (26%) and fever (14%). Six patients (7.4%) experienced multiorgan failure, while 3 (3.7%) required mechanical ventilation. There were 3 spontaneous abortions, 52 deliveries (64.2%), and 2 neonates were COVID-positive. Maternal hospital stays averaged 13.1 days (SD±6.37), with a mean breastfeeding interval of 13.3 days (SD±6.44).
Conclusions: COVID-19 had a detrimental impact on both maternal and fetal health, emphasizing the need for improved treatment strategies and resource allocation. This study highlights the importance of further research to better understand and mitigate the effects of COVID-19 on pregnant women
Effectiveness of an integrated approach to reduce perinatal mortality: recent experiences from Matlab, Bangladesh
No full textAbstract Background Improving perinatal health is the key to achieving the Millennium Development Goal for child survival. Recently, several reviews suggest that scaling up available effective perinatal interventions in an integrated approach can substantially reduce the stillbirth and neonatal death rates worldwide. We evaluated the effect of packaged interventions given in pregnancy, delivery and post-partum periods through integration of community- and facility-based services on perinatal mortality. Methods This study took advantage of an ongoing health and demographic surveillance system (HDSS) and a new Maternal, Neonatal and Child Health (MNCH) Project initiated in 2007 in Matlab, Bangladesh in half (intervention area) of the HDSS area. In the other half, women received usual care through the government health system (comparison area). The MNCH Project strengthened ongoing maternal and child health services as well as added new services. The intervention followed a continuum of care model for pregnancy, intrapartum, and post-natal periods by improving established links between community- and facility-based services. With a separate pre-post samples design, we compared the perinatal mortality rates between two periods--before (2005-2006) and after (2008-2009) implementation of MNCH interventions. We also evaluated the difference-of-differences in perinatal mortality between intervention and comparison areas. Results Antenatal coverage, facility delivery and cesarean section rates were significantly higher in the post- intervention period in comparison with the period before intervention. In the intervention area, the odds of perinatal mortality decreased by 36% between the pre-intervention and post-intervention periods (odds ratio: 0.64; 95% confidence intervals: 0.52-0.78). The reduction in the intervention area was also significant relative to the reduction in the comparison area (OR 0.73, 95% CI: 0.56-0.95; P = 0.018). Conclusion The continuum of care approach provided through the integration of service delivery modes decreased the perinatal mortality rate within a short period of time. Further testing of this model is warranted within the government health system in Bangladesh and other low-income countries.</p
Thermo-Mechanical Analysis of Temporary Bonding Systems for Flexible Microelectronics Fabrication Applications
No full textabstract: Temporary bonding-debonding of flexible plastic substrates to rigid carriers may facilitate effective substrate handling by automated tools for manufacture of flexible microelectronics. The primary challenges in implementing practical temporary bond-debond technology originate from the stress that is developed during high temperature processing predominately through thermal-mechanical property mismatches between carrier, adhesive and substrate. These stresses are relaxed through bowing of the bonded system (substrate-adhesive-carrier), which causes wafer handling problems, or through delamination of substrate from rigid carrier. Another challenge inherent to flexible plastic substrates and linked to stress is their dimensional instability, which may manifest itself in irreversible deformation upon heating and cooling cycles. Dimensional stability is critical to ensure precise registration of different layers during photolithography. The global objective of this work is to determine comprehensive experimental characterization and develop underlying fundamental engineering concept that could enable widespread adoption and scale-up of temporary bonding processing protocols for flexible microelectronics manufacturing. A series of carriers with different coefficient of thermal expansion (CTE), modulus and thickness were investigated to correlate the thermo-mechanical properties of carrier with deformation behavior of bonded systems. The observed magnitude of system bow scaled with properties of carriers according to well-established Stoney's equation. In addition, rheology of adhesive impacted the deformation of bonded system. In particular, distortion-bowing behavior correlated directly with the relative loss factor of adhesive and flexible plastic substrate. Higher loss factor of adhesive compared to that of substrate allowed the stress to be relaxed with less bow, but led to significantly greater dimensional distortion. Conversely, lower loss factor of adhesive allowed less distortion but led to larger wafer bow. A finite element model using ANSYS was developed to predict the trend in bow-distortion of bonded systems as a function of the viscoelastic properties of adhesive. Inclusion of the viscoelasticity of flexible plastic substrate itself was critical to achieving good agreement between simulation and experiment. Simulation results showed that there is a limited range within which tuning the rheology of adhesive can control the stress-distortion. Therefore, this model can aid in design of new adhesive formulations compatible with different processing requirements of various flexible microelectronics applications.Dissertation/ThesisPh.D. Chemical Engineering 201
Author Correction: Prediction of gestational age using urinary metabolites in term and preterm pregnancies
No full textAuthor Correction to "Prediction of gestational age using urinary metabolites in term and preterm pregnancies
Association of antenatal care with facility delivery and perinatal survival – a population-based study in Bangladesh
No full textAbstract Background Antenatal Care (ANC) during pregnancy can play an important role in the uptake of evidence-based services vital to the health of women and their infants. Studies report positive effects of ANC on use of facility-based delivery and perinatal mortality. However, most existing studies are limited to cross-sectional surveys with long recall periods, and generally do not include population-based samples. Methods This study was conducted within the Health and Demographic Surveillance System (HDSS) of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in Matlab, Bangladesh. The HDSS area is divided into an icddr,b service area (SA) where women and children receive care from icddr,b health facilities, and a government SA where people receive care from government facilities. In 2007, a new Maternal, Neonatal, and Child Health (MNCH) program was initiated in the icddr,b SA that strengthened the ongoing maternal and child health services including ANC. We estimated the association of ANC with facility delivery and perinatal mortality using prospectively collected data from 2005 to 2009. Using a before-after study design, we also determined the role of ANC services on reduction of perinatal mortality between the periods before (2005 – 2006) and after (2008–2009) implementation of the MNCH program. Results Antenatal care visits were associated with increased facility-based delivery in the icddr,b and government SAs. In the icddr,b SA, the adjusted odds of perinatal mortality was about 2-times higher (odds ratio (OR) 1.91; 95% confidence intervals (CI): 1.50, 2.42) among women who received ≤1 ANC compared to women who received ≥3 ANC visits. No such association was observed in the government SA. Controlling for ANC visits substantially reduced the observed effect of the intervention on perinatal mortality (OR 0.64; 95% CI: 0.52, 0.78) to non-significance (OR 0.81; 95% CI: 0.65, 1.01), when comparing cohorts before and after the MNCH program initiation (Sobel test of mediation P Conclusions ANC visits are associated with increased uptake of facility-based delivery and improved perinatal survival in the icddr,b SA. Further testing of the icddr,b approach to simultaneously improving quality of ANC and facility delivery care is needed in the existing health system in Bangladesh and in other low-income countries to maximize health benefits to mothers and newborns.</p
Association of maternal prenatal copper concentration with gestational duration and preterm birth: a multicountry meta-analysis Author links open overlay panel.
No full textBackground: Copper (Cu), an essential trace mineral regulating multiple actions of inflammation and oxidative stress, has been implicated in risk for preterm birth (PTB).
Objectives: This study aimed to determine the association of maternal Cu concentration during pregnancy with PTB risk and gestational duration in a large multicohort study including diverse populations.
Methods: Maternal plasma or serum samples of 10,449 singleton live births were obtained from 18 geographically diverse study cohorts. Maternal Cu concentrations were determined using inductively coupled plasma mass spectrometry. The associations of maternal Cu with PTB and gestational duration were analyzed using logistic and linear regressions for each cohort. The estimates were then combined using meta-analysis. Associations between maternal Cu and acute-phase reactants (APRs) and infection status were analyzed in 1239 samples from the Malawi cohort.
Results: The maternal prenatal Cu concentration in our study samples followed normal distribution with mean of 1.92 μg/mL and standard deviation of 0.43 μg/mL, and Cu concentrations increased with gestational age up to 20 wk. The random-effect meta-analysis across 18 cohorts revealed that 1 μg/mL increase in maternal Cu concentration was associated with higher risk of PTB with odds ratio of 1.30 (95% confidence interval [CI]: 1.08, 1.57) and shorter gestational duration of 1.64 d (95% CI: 0.56, 2.73). In the Malawi cohort, higher maternal Cu concentration, concentrations of multiple APRs, and infections (malaria and HIV) were correlated and associated with greater risk of PTB and shorter gestational duration.
Conclusions: Our study supports robust negative association between maternal Cu and gestational duration and positive association with risk for PTB. Cu concentration was strongly correlated with APRs and infection status suggesting its potential role in inflammation, a pathway implicated in the mechanisms of PTB. Therefore, maternal Cu could be used as potential marker of integrated inflammatory pathways during pregnancy and risk for PTB
Vibrio gazogenes Inhibits Aflatoxin Production Through Downregulation of Aflatoxin Biosynthetic Genes in Aspergillus flavus
No full textAspergillus flavus is an opportunistic pathogen of oilseed crops such as maize, peanut, cottonseed, and tree nuts and produces carcinogenic secondary metabolites known as aflatoxins during seed colonization. Aflatoxin contamination not only reduces the value of the produce but is also a health hazard to humans and animals. Previously, we observed inhibition of A. flavus aflatoxin biosynthesis on exposure to the marine bacterium Vibrio gazogenes (Vg). In this study, we used RNA sequencing to examine the transcriptional profiles of A. flavus treated with both live and heat-inactivated dead Vg and control samples. Fungal biomass, total accumulated aflatoxins, and expression profiles of genes constituting secondary metabolite biosynthetic gene clusters were determined at 24, 30, and 40 h after treatment. Statistically significant reductions in total aflatoxins were detected in Vg-treated samples as compared with control samples at 40 h. However, no statistical difference in fungal biomass was observed on these treatments. The Vg treatments were most effective on aflatoxin biosynthesis, as was reflected in significant downregulation of most genes in the aflatoxin gene cluster, including the aflatoxin pathway regulator gene, aflR. Along with aflatoxin genes, we also observed significant downregulation in some other secondary metabolite gene clusters, including cyclopiazonic acid and aflavarin, suggesting that the treatment could inhibit other secondary metabolites as well. Finally, a weighted gene correlation network analysis identified an upregulation of 10 genes that were most strongly associated with Vg-dependent aflatoxin inhibition and provide a novel starting point in understanding the mechanisms that result in this phenomenon. [Figure: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2022
Author Correction: Prediction of gestational age using urinary metabolites in term and preterm pregnancies
No full textAssessment of gestational age (GA) is key to provide optimal care during pregnancy. However, its accurate determination remains challenging in low- and middle-income countries, where access to obstetric ultrasound is limited. Hence, there is an urgent need to develop clinical approaches that allow accurate and inexpensive estimations of GA. We investigated the ability of urinary metabolites to predict GA at time of collection in a diverse multi-site cohort of healthy and pathological pregnancies (n = 99) using a broad-spectrum liquid chromatography coupled with mass spectrometry (LC-MS) platform. Our approach detected a myriad of steroid hormones and their derivatives including estrogens, progesterones, corticosteroids, and androgens which were associated with pregnancy progression. We developed a restricted model that predicted GA with high accuracy using three metabolites (rho = 0.87, RMSE = 1.58 weeks) that was validated in an independent cohort (n = 20). The predictions were more robust in pregnancies that went to term in comparison to pregnancies that ended prematurely. Overall, we demonstrated the feasibility of implementing urine metabolomics analysis in large-scale multi-site studies and report a predictive model of GA with a potential clinical value
