A new class of colloidal insulating transformer oil is formulated by dispersing CNT nanomaterials with mineral oil in purpose to enhance the breakdown strength performanc existing transformer oil. This paper represents the experimental studied dealing with the influence of CNT nanomaterials mix with transformer mineral oil in term of AC breakdown voltage at various gap distances. The concentrations of CNT nanomaterials were measured in range 0.01g/L to 0.2g/L. The impact of three gap distances (1.5mm, 2.5mm and 3.5mm) for mushroom-mushroom electrode configuration is studied in order to observe and trend between conventional mineral oil and CNT nanofluids. To employ CNTs as effective reinforcement in mineral oil, proper dispersion methods need to be applied.

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Background Placenta accreta spectrum (PAS) disorders have become a significant life-threatening issue due to its increased incidence, morbidity and mortality. Several studies have tried to identify the risk factors for PAS disorders. The ideal management for PAS disorders is a matter of debate. The study objectives were to evaluate the incidence and risk factors of PAS disorders and to compare different management strategies at a tertiary referral hospital, Minia, Egypt. Methods This prospective study included 102 women diagnosed with PAS disorders admitted to Minia Maternity university hospital, Egypt between January 2017 to August 2018. These cases were categorized into three groups according to the used approach for management: Group (A) , ( n = 38) underwent cesarean hysterectomy, group (B) , ( n = 48) underwent cesarean section (CS) with cervical inversion and ligation of both uterine arteries and group (C) , ( n = 16): the placenta was left in place. Results The incidence of PAS disorders during the study period was 9 / 1000 maternities (0.91%). The mean age of cases was 32.4 ± 4.2 years, 60% of them had a parity ≥3 and 82% of them had ≥2 previous CSs. Also, 1/3 of them had previous history of placenta previa. Estimated blood loss (EBL) and blood transfusion in group A were significantly higher than other groups. Group (C) had higher mean hospital stay duration. Group A was associated with significantly higher complication rate. Conclusions The incidence of PAS disorders was 0.91%. Maternal age > 32 years, previous C.S. (≥ 2), multiparity (≥ 3) and previous history of placenta previa were risk factors. The management of PAS disorders should be individualized. Women with PAS disorders who completed their family should be offered cesarean hysterectomy. Using the cervix as a tamponade combined with bilateral uterine artery ligation appears to be a safe alternative to hysterectomy in patients with focal placenta accreta and low parity desiring future fertility. Patients with diffuse placenta accreta keen to preserve the uterus could be offered the option of leaving the placenta aiming at conservative management after proper counseling. Trial registration Registered 28th October 2015, ClinicalTrials.gov NCT02590484 .

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