A study of the socio demographic and obstetric factors in pregnant women with COVID-19 infection at a tertiary care hospital, Kollam, Kerala, India

Background: The first wave of the COVID-19 pandemic took the world to task. Pregnant women needed care without actually knowing if the treatment schedules outside of pregnancy could be extrapolated to the pregnant state. Obstetric protocols were adhered to as far as was feasible, yet world over there was an increase in cesarean section rates. The so-called alpha variant that we saw at the time appeared to infect pregnant women too with equal frequency but they fared well. The issues regarding infectivity and the use of personal protective equipment (PPE) assumed mammoth dimensions. The objectives of this paper were to explore the demographic data and the epidemiological risk factors and study the symptomatology, severity and course of COVID-19 in pregnancy.Methods: This was an observational study conducted on all the COVID-19 positive pregnant women admitted to the department of obstetrics and gynecology at the designated COVID hospital for the district - Government Medical College Kollam - for a period of 6 months from October 2020 to March 2021. These women were studied with respect to their socio demographic details and their Obstetric risk factors and performance. Data was collected and analyzed using statistical package for the social sciences (SPSS) software.Results: 377 antenatal COVID-19 positive women were admitted and analyzed during the study period. Nulliparous women (48.5%%) in the age group 20 to 30 years (74.28%) formed the major group. Third trimester and near date admissions were the majority (48.80%). Most women (79.31%) were asymptomatic. Most common symptoms were fever in 35% and flu like upper respiratory symptoms (20%). Breathlessness and lung involvement was seen in 2.91%. Contact tracing revealed a travel history or contact with infected persons at 15.64%. However, 84.8% had no contact history. All antenatal women were tested at admission and reverse transcriptase-polymerase chain reaction (RTPCR) was done in 73.21%. Rapid antigen and nucleic acid amplification test (NAAT) detected the rest. 46% had some co morbidity gestational diabetes mellitus (GDM), gestational hypertension, thyroid disease and anemia were the common co morbidities detected. The presence of GDM in 24.14% of the study population is noteworthy.Conclusions: Pregnancy being an immune compromised state, unpredictable outcomes are possible with COVID-19 infection. Asymptomatic patients too can experience complications. Frequent hospital and lab visits could be a source of infection. The growing incidence of GDM in the midst of the COVID-19 pandemic is a point for concern

Review of emergency obstetric hysterectomies at a tertiary care hospital

Background: Emergency obstetric hysterectomy refers to surgical removal of pregnant or recently pregnant uterus with the pregnancy in utero or due to complications of delivery. This surgery is usually done as a last resort in life threatening obstetric hemorrhage. Objective of present study was to determine the incidence, sociodemographic and obstetric factors and indications associated with emergency obstetric hysterectomies. Methods: A retrospective, analytical study was conducted over a period of five years in the department of obstetrics and Gynecology of Government Medical college Thiruvananthapuram. Kerala. All cases of obstetric hysterectomy done during the study period in this hospital were analysed after getting approval from the institutional ethical committee. Results: During the study period there were total number of 78613 deliveries in SATH. Emergency obstetric hysterectomy was done for 86 cases. Obstetric hysterectomy rate in SATH during the study period was 0.109% or 1.09/1000 deliveries. Atonic postpartum hemorrhage (55%) was the most common indication followed by placenta praevia (27%). Majority were referred cases. Conclusions: Emergency obstetric hysterectomy can be a lifesaving procedure when other medical and surgical methods fail to control obstetric hemorrhage. This study highlights the unpredictable need of this procedure, need for identifying the at-risk cases and early referral to higher center

Bayes estimation of Lorenz curve and Gini-index for power function distribution

In this article, we estimate the shape parameter, Lorenz curve and Gini-index for 3power function distributions using a Bayesian method. Bayes estimators have been developed under squared error loss function as well as under weighted squared error loss function. We demonstrate the use of the proposed estimation procedure with the U. S. average income data for the period 1913-2010. Our proposed Bayesian estimators are compared using a Monte Carlo simulation study with the ML estimators proposed by Belzunce, Candel and Ruiz (1998)

Neurotrophins, cytokines, oxidative parameters and funcionality in Progressive Muscular Dystrophies

We investigated the levels of brain derived-neurotrophic factor (BDNF), cytokines and oxidative parameters in serum and tried to correlate them with the age and functionality of patients with Progressive Muscle Dystrophies (PMD). The patients were separated into six groups (case and controls pared by age and gender), as follows: Duchenne Muscular Dystrophy (DMD); Steinert Myotonic Dystrophy (SMD); and Limb-girdle Muscular Dystrophy type-2A (LGMD2A). DMD patients (±17.9 years old) had a decrease of functionality, an increase in the IL-1β and TNF-α levels and a decrease of IL-10 levels and superoxide dismutase activity in serum. SMD patients (±25.8 years old) had a decrease of BDNF and IL-10 levels and superoxide dismutase activity and an increase of IL-1β levels in serum. LGMD2A patients (±27.7 years old) had an decrease only in serum levels of IL-10. This research showed the first evidence of BDNF involvement in the SMD patients and a possible unbalance between pro-inflammatory and anti-inflammatory cytokine levels, along with decreased superoxide dismutase activity in serum of DMD and SMD patients

Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Introduction. Switchingfrom polluting (e.g. wood, crop waste, coal)to clean (e.g. gas, electricity) cooking fuels can reduce household air pollution exposures and climate-forcing emissions.While studies have evaluated specific interventions and assessed fuel-switching in repeated cross-sectional surveys, the role of different multilevel factors in household fuel switching, outside of interventions and across diverse community settings, is not well understood. Methods.We examined longitudinal survey data from 24 172 households in 177 rural communities across nine countries within the Prospective Urban and Rural Epidemiology study.We assessed household-level primary cooking fuel switching during a median of 10 years offollow up (∼2005–2015).We used hierarchical logistic regression models to examine the relative importance of household, community, sub-national and national-level factors contributing to primary fuel switching. Results. One-half of study households(12 369)reported changing their primary cookingfuels between baseline andfollow up surveys. Of these, 61% (7582) switchedfrom polluting (wood, dung, agricultural waste, charcoal, coal, kerosene)to clean (gas, electricity)fuels, 26% (3109)switched between different polluting fuels, 10% (1164)switched from clean to polluting fuels and 3% (522)switched between different clean fuels

Evaluation and prediction of fused fabric composites properties – A review

Garment parts are fused with an interlining for achieving a specific handle, form and fall. Fusing helps in ease of construction of garment parts enabling pucker-free and clean look in finished products. The properties of the fused components are considered essential for enhancing garment aesthetics and functionality. The main objective of this review is to elaborate the factors affecting the properties of fused fabric composites, the methods to evaluate the same and explore the models that aid in better selection of interlinings for a specific hand and functionality. Interlinings are available in a variety of fibre content, base fabric structure, weight, finish, resin type and resin content. These attributes influence the characteristics of fused fabric composites. They are essential criteria in interlining selection for a given application. Mechanical properties used to evaluate and predict the fused fabric behaviour objectively are discussed. The most important mechanical properties that describe the characteristics of fused fabric composites are bending rigidity, shear rigidity, tensile properties, drape and dimensional stability of the component fabrics. Objective and subjective methods used to evaluate these properties are elaborated. The methods employed in determining the optimum fusing conditions and fused composite quality include theoretical, statistical, numerical, and computational modelling. A better understanding of the properties of fused fabric composites leads to optimisation in the interlining selection and fusing process for a given hand feel and application. </jats:p

A study of the socio demographic and obstetric factors in pregnant women with COVID-19 infection at a tertiary care hospital, Kollam, Kerala, India

Background: The first wave of the COVID-19 pandemic took the world to task. Pregnant women needed care without actually knowing if the treatment schedules outside of pregnancy could be extrapolated to the pregnant state. Obstetric protocols were adhered to as far as was feasible, yet world over there was an increase in cesarean section rates. The so-called alpha variant that we saw at the time appeared to infect pregnant women too with equal frequency but they fared well. The issues regarding infectivity and the use of personal protective equipment (PPE) assumed mammoth dimensions. The objectives of this paper were to explore the demographic data and the epidemiological risk factors and study the symptomatology, severity and course of COVID-19 in pregnancy.Methods: This was an observational study conducted on all the COVID-19 positive pregnant women admitted to the department of obstetrics and gynecology at the designated COVID hospital for the district - Government Medical College Kollam - for a period of 6 months from October 2020 to March 2021. These women were studied with respect to their socio demographic details and their Obstetric risk factors and performance. Data was collected and analyzed using statistical package for the social sciences (SPSS) software.Results: 377 antenatal COVID-19 positive women were admitted and analyzed during the study period. Nulliparous women (48.5%%) in the age group 20 to 30 years (74.28%) formed the major group. Third trimester and near date admissions were the majority (48.80%). Most women (79.31%) were asymptomatic. Most common symptoms were fever in 35% and flu like upper respiratory symptoms (20%). Breathlessness and lung involvement was seen in 2.91%. Contact tracing revealed a travel history or contact with infected persons at 15.64%. However, 84.8% had no contact history. All antenatal women were tested at admission and reverse transcriptase-polymerase chain reaction (RTPCR) was done in 73.21%. Rapid antigen and nucleic acid amplification test (NAAT) detected the rest. 46% had some co morbidity gestational diabetes mellitus (GDM), gestational hypertension, thyroid disease and anemia were the common co morbidities detected. The presence of GDM in 24.14% of the study population is noteworthy.Conclusions: Pregnancy being an immune compromised state, unpredictable outcomes are possible with COVID-19 infection. Asymptomatic patients too can experience complications. Frequent hospital and lab visits could be a source of infection. The growing incidence of GDM in the midst of the COVID-19 pandemic is a point for concern.</jats:p