Evaluation of Surgical Site Infection among Post Cesarean Patients in Mymensingh Medical College Hospital.

Surgical site infection (SSI) in postnatal period is a noteworthy misery for the mother as well as the family increasing both hospital stay and hospital expenses. SSI in post cesarean patients has not been well documented in study area despite considerable number of cesarean section performed and the relatively common occurrence of SSI. Hence this cross sectional observational study was intended in the department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital, Mymensingh (MMCH), Bangladesh among 100 patients to assess the risk factors of incisional SSI after cesarean section from March 2012 to February 2013. The patients diagnosed as SSI were enrolled purposively. Age, status of antenatal checkup, indication of operation, duration of operation, thickness of subcutaneous fat, character and bacteriological study of wound discharge, post operative day of detection of wound infection, status of hemoglobin were considered as major variables. Among the patients 96% underwent emergency cesarean section which were done 40% due to obstructed labour, 35% had prolonged labour and 26% had PROM more than 24 hours. Most of the infections (50%) were detected on 5th post operative day. Duration of operation was more than one hour in 35% cases, 65% patient's subcutaneous fat thickness was more than 2cm. Regarding wound discharge, 65% were serosanguinous. Organisms from wound swab were detected in 55% cases. Among those 85% infection occurred by Staphylococcus and 15% by E. coli. Moderate to severe anaemia was diagnosed in 75% patients. Maximum (80%) patients were not under regular antenatal check up. Finally it was revealed that emergency CS, obstructed labour, prolonged ruptured membrane, prolong duration of operation, anaemia, irregular antenatal check up are possible considerable risk factors for surgical site infection. Obstetrician should meticulously follow surgical safety checklist and ensure the essential safety steps into their normal operative workflow specially during handling the patients with risk factors. Encourage for regular ANC & improvement of host factor also should consider as remedial measures.

Complex effective index in graphene-silicon waveguides.

We report for the first time and characterize experimentally the complex optical conductivity of graphene on silicon photonic waveguides. This permits us to predict accurately the behavior of photonic integrated devices encompassing graphene layers. Exploiting a Si microring add/drop resonator, we show the effect of electrical gating of graphene on the complex effective index of the waveguide by measuring both the wavelength shift of the resonance and the change in the drop peak transmission. Due to electro-refractive effect of graphene a giant (>10-3) change in the effective index is demonstrated for the first time on Si photonics waveguides and this large effect will crucially impact performances and consumption of Si photonics devices. We confirmed the results by two independent experiments involving two different gating schemes: Si gating through the ridge waveguide, and polymer-electrolyte gating. Both the experiments demonstrate a very large phase effect in good agreement with numerical calculations. The reported results validate the Kubo model for the case of graphene-Si photonics interfaces and for propagation in this type of waveguide. This is fundamental for the next design and fabrication of future graphene-silicon photonics devices.