4 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
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
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
