Peripartum Hysterectomy among Patients Admitted to the Department of Obstetrics and Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Emergency peripartum hysterectomy is a life-saving procedure performed as an emergency procedure to control torrential bleeding and it is associated with significant maternal morbidity and mortality. There are only a few studies regarding this topic so this study guides us to monitor the trend and start appropriate policies to reduce unnecessary caesarean deliveries. The aim of this study was to find out the prevalence of peripartum hysterectomy among patients admitted to the Department of Obstetrics and Gynaecology in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of the tertiary care centre. Data from 1 January 2015 to 31 December 2022 were collected between 25 January 2023 and 28 February 2023 from the hospital records. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 2301241700). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 54,045 deliveries, peripartum hysterectomy was seen in 40 (0.074%) (0.05-0.10, 95% Confidence Interval). The major indication of emergency peripartum hysterectomy was abnormal placentation (placenta accreta spectrum) which was 25 (62.50%) followed by uterine atony in 13 (32.50%) of patients and uterine rupture in 2 (5%). Conclusions: The prevalence of peripartum hysterectomy was lower than in other studies done in similar settings. The indication for Emergency peripartum hysterectomy has changed in recent years from uterine atonicity to the morbidly adherent placenta which is due to a rise in the caesarean section rate. Keywords: caesarean section; hysterectomy; placenta accreta.

Primary Immune Response Provides Protective Efficacy against SARS-CoV-2 Reinfection.

While there is absolutely no evidence to ensure recovered patients are either likely or unlikely to get reinfected. But studies in non-human primates indicate that reinfection of recovered patients is highly unlikely. It is also clear that primary immune responses or induced immunity to severe acute respiratory syndrome coronavirus 2 remain in circulation for several months and at least temporarily confer immunity to protect from reinfection. In addition, negative virus culture analysis of re-positive suggests that positive reverse transcriptase-polymerase chain reactions in recovered patients are more likely to be false-positive, or detection of genetic remnants of virus discharged from lesions of lungs or better sampling at the time of repeat analysis. However, emerging severe acute respiratory syndrome coronavirus 2 variants are likely to be causing the infections observed in some of the recovered patients.

Prevalence of vitamin D deficiency in pregnant women and their babies in Bhaktapur, Nepal.

BACKGROUND: Vitamin D deficiency has been observed worldwide in pregnant women and their newborns. Maternal vitamin D deficiency can lead to deficiency in their newborn baby and has been linked with various complications during pregnancy and delivery. There is risk of premature delivery and it is associated with high neonatal mortality. METHODS: Seventy-nine pregnant women who were admitted to the Siddhi Memorial Hospital for delivery and their newborn babies were enrolled in the study. Maternal blood samples were taken before delivery while umbilical cord blood samples of their babies were taken after delivery. Serum vitamin D level and calcium level were assessed by fluorescence immunoassay using Ichromax vitamin D kit and endpoint method, respectively in the Siddhi Memorial Hospital laboratory. RESULTS: Mean +/- SD serum vitamin D and calcium levels in pregnant mother before delivery were 14.6 +/- 8.5 ng/ml and 8.0 +/- 0.5 mg/dl, respectively, and in the cord blood were 25.7 +/- 11.2 ng/ml and 8.6 +/- 0.9 mg/dl, respectively. Eighty-one percent of the mothers and 35.8% of their babies were found to have vitamin D deficiency. Although 97.5% of the pregnant women were taking calcium supplementation, serum calcium was found lower than the normal reference value in 67% of the pregnant women and 64.2% of their babies. There were a linear relationship between the maternal and baby's serum vitamin D (P < 0.001) and calcium (P < 0.001) levels. CONCLUSION: There is high prevalence of vitamin D and calcium deficiency in pregnant mothers and newborn babies in Bhaktapur, Nepal. Pregnant women need to be supplemented with adequate amounts of these nutrients.

Electrically induced displacement transport of immiscible oil in saline sediments.

Electrically assisted mitigation of coastal sediment oil pollution was simulated in floor-scale laboratory experiments using light crude oil and saline water at approximately 1/10 oil/water (O/W) mass ratio in pore fluid. The mass transport of the immiscible liquid phases was induced under constant direct current density of 2A/m(2), without water flooding. The transient pore water pressures (PWP) and the voltage differences (V) at and in between consecutive ports lined along the test specimen cell were measured over 90days. The oil phase transport occurred towards the anode half of the test specimen where the O/W volume ratio increased by 50% over its initial value within that half-length of the specimen. In contrast, the O/W ratio decreased within the cathode side half of the specimen. During this time, the PWP decreased systematically at the anode side with oil bank accumulation. PWP increased at the cathode side of the specimen, signaling increased concentration of water there as it replaced oil in the pore space. Electrically induced transport of the non-polar, non-conductive oil was accomplished in the opposing direction of flow by displacement in absence of viscous coupling of oil-water phases.

Effect of ultrasound on removal of persistent organic pollutants (POPs) from different types of soils.

A new and promising technology is utilization of sonochemistry on decontamination of polluted soil. The feasibility of this technology on treatment of contaminated soils (synthetic clay, natural farm clay, and kaolin) was studied by using two target persistent organic pollutants (POPs): hexachlorobenzene (HCB) and phenanthrene (PHE). The soils were highly contaminated in 500 mg/kg. The laboratory experiments were conducted with various conditions (moisture, power, and time duration). The effects of these parameters on ultrasonication (as well as the removal of contaminants) were examined. The reasonable moisture ratio of the slurry could be in range of 2:1-3:1. The process did not change pH values of soils. Experimental results showed that ultrasonication has a potential to reduce the high concentrations of these POPs.

Removal of hexachlorobenzene from soil by electrokinetically enhanced chemical oxidation.

This study investigates the feasibility of enhanced electrokinetic Fenton process for the remediation of hexachlorobenzene (HCB) in low permeable soil. Laboratory scale experiments were carried out in two different type of experimental setup to evaluate the influence of electrode positions in the system. Kaolin was artificially contaminated with HCB and treated by electrokinetic Fenton process. beta-Cyclodextrin was used to enhance the solubility of HCB in pore fluid. Results show that the position of electrodes in the system and the way in which Fenton's reagent was added to the system has a significant influence on the treatment efficiency.

Remediation of hexachlorobenzene in soil by enhanced electrokinetic Fenton process.

The feasibility of enhanced electrokinetic Fenton process for the remediation of Hexachlorobenzene (HCB) in low permeability soil was investigated. Kaolin was artificially contaminated with HCB and treated by electrokinetic and electrokinetic Fenton processes. beta -Cyclodextrin was used to enhance the solubility of HCB in pore fluid. Three tests were carried out, of which two were electrokinetic experiments to observe the suitability of beta -cyclodextrin as a flushing solution for these processes. The third experiment was the electrokinetic Fenton test using beta -cyclodextrin as an enhancing agent. Results show that the removal efficiency depends on the choice of a suitable flushing solution and physical parameters like pH, electric current and electro-osmotic flow.

Effects of Mn(II) and Fe(II) on microbial removal of arsenic (III).

GOAL, SCOPE, AND BACKGROUND: Arsenic contamination in groundwater creates severe health problems in the world. There are many physiochemical and biological methods available for remediation of arsenic from groundwater. Among them, microbial remediation could be taken as one of the least expensive methods, though it takes longer treatment time. The main objective of this research was to study the improvement on remediation by addition of some essential ion salts such as Mn and Fe. MATERIALS AND METHODS: Staphylococcus aureus, Bacillus subtilis, Klebsiella oxytoca, and Escherichia coli were taken as model microbes from Dhulikhel, 30 km east from Kathmandu, Nepal. RESULTS AND DISCUSSION: Microbes used in this study showed different abilities in their removal of As(III) with and without addition of Mn and Fe salts. The trend of remediation increased with time. S. aureus was found to be the best among the microbes used. It showed almost 100% removal after 48-h culture, both with and without Fe and Mn salts. Rate of removal of As increased with addition of Fe and Mn for all microbes. Removal efficiency was found to increase by about 32% on average after addition of salts in 24-h cultures of S. aureus.