Study Design: An analysis of 14 cases of ruptured uterus was done during January 2003 to December 2003 in Obstetrics & Gynae Department of Lahore General Hospital, Lahore. Objective: The purpose of this Audit was to analyse the different management options, maternal and fetal outcome in uterine rupture. Material and Methods: Total no of births in 2003 was 4840. Total number of ruptured uterus found to be 14 (2.9%/1000) deliveries. Among these incomplete rupture were 3 (21.4%) and complete rupture were 11 (78.4%). Regarding the common sites of uterine rupture lower uterine segment interior surface = 11 (78.4%). Lower uterine segment posterior surface = 2 (14.2%) and upper uterine segment rupture was = 1 (7.14%). The most common cause of uterine rupture was found to be multiparity and injudicious use of oxytocin by TBA in 5 cases. (35.7%) and previous uterine surgery in 5 cases (35.7%). 2 cases (14.21) were due to cephalopelvic disproportion due to hydrocephalus and 2 (14.2%) cases were of malpresentation (transverse lie) mostly handled at home by TBAs. Hysterectomy, total or sub total was done in 7 cases (50%). Repair of uterus was done in 5 cases (35.7%), in 2-cases (14.2%). Bladder repair alongwith uterine repair was done. In two cases (14.2%) of scar dehiscence, repeat cesarean section was done. The maternal mortality was found to be zero, while intrauterine death were 10(71.4%) and alive babies were 4 (28.5%) high perinatal mortality of 71% were found. Conclusion: Ruptured uterus is avoidable catastrophe by proper education, training of patients and TBA`s and by providing effective family planning services, transportation, diagnostic facilities and by reducing the unnecessary caesarean section.
<abstract><p>In this article, we make mathematical and practical contributions to the Bell-X family of absolutely continuous distributions. As a main member of this family, a special distribution extending the modeling perspectives of the famous Burr XII (BXII) distribution is discussed in detail. It is called the Bell-Burr XII (BBXII) distribution. It stands apart from the other extended BXII distributions because of its flexibility in terms of functional shapes. On the theoretical side, a linear representation of the probability density function and the ordinary and incomplete moments are among the key properties studied in depth. Some commonly used entropy measures, namely Rényi, Havrda and Charvat, Arimoto, and Tsallis entropy, are derived. On the practical (inferential) side, the associated parameters are estimated using seven different frequentist estimation methods, namely the methods of maximum likelihood estimation, percentile estimation, least squares estimation, weighted least squares estimation, Cramér von-Mises estimation, Anderson-Darling estimation, and right-tail Anderson-Darling estimation. A simulation study utilizing all these methods is offered to highlight their effectiveness. Subsequently, the BBXII model is successfully used in comparisons with other comparable models to analyze data on patients with acute bone cancer and arthritis pain. A group acceptance sampling plan for truncated life tests is also proposed when an item's lifetime follows a BBXII distribution. Convincing results are obtained.</p></abstract>
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