Background:Critical care services are essential for the subset of obstetric patients suffering from severe maternal morbidity. Studies on obstetric critical care are important for benchmarking the issues which need to be addressed while managing critically ill obstetric patients. Although there are several published studies on obstetric critical care from India and abroad, studies from Eastern India are limited. The present study was conducted to fill in this lacuna and to audit the obstetric critical care admissions over a 5 years’ period.Settings and Design:Retrospective cohort study conducted in the general critical care unit (CCU) of a government teaching hospital.Materials and Methods:The records of all obstetric patients managed in the CCU over a span of 5 years (January 2011-December 2015) were analyzed.Results:During the study, 205 obstetric patients were admitted with a CCU admission rate of 2.1 per 1000 deliveries. Obstetric hemorrhage (34.64%) was the most common primary diagnosis among them followed by pregnancy-induced hypertension (26.83%). Severe hemorrhage leading to organ failure (40.48%) was the main direct indication of admission. Invasive ventilation was needed in 75.61% patients, and overall obstetric mortality rate was 33.66%. The median duration (in days) of invasive ventilation was 2 (interquartile range [IQR] 1-7), and the median length of CCU stay (in days) was 5 (IQR 3-9).Conclusions:Adequate number of critical care beds, a dedicated obstetric high dependency unit, and effective coordination between critical care and maternity services may prove helpful in high volume obstetric centers.

Moistening misoprostol tablets with 5% acetic acid before vaginal application creates no difference in outcomes when compared with those after the vaginal application of dry tablets for the termination of second-trimester pregnancy.

Problems related to performances of the construction projects appear through different directions. Most of the projects fail either in time performance or in cost performance or both. So, the factors assessment in contemporary condition is most. This research was designed to conduct study of ten numbers of underconstruction projects funded by German government-owned development bank, KfW (Kreditanstalt für Wiederaufbau) via TDF. Questionnaire surveys were conducted and examination of records from concerned representatives of the client, consultants and contractors within the research area has been carried out. The factors affecting the overall project performance were ranked using 'five-point' scale ranged from 1 (not important) to 5 (extremely important) and transformed to Relative Importance Index (RII). All projects under study have been granted extension of time based on the Public Procurement Act (PPA) 2063 and Public Procurement Regulation (PPR) 2064.This study shows material related factors as the most important factors among 8 numbers of groups for time overrun in projects. The potential effect of the time overrun in project is cost overrun followed by arbitration, Litigation, Dispute arousal and Total abandonment. The major factors that affect the performance of the project according to the ranking based on RII value for the perceived view of the client, consultants and the contractors on factors affecting the performance are Design related issues, shortage of materials, Quality related issues, slow decision making, construction methodology, labour supply, payment related issues, site management ,discrepancies in contract documents, flaws in organisational structure, interfaces, productivity, change orders, unforeseen site condition, weather conditions and regulatory changes that affect the overall project performance. The major factors identified needs to be addressed to minimize the project time overrun and hence its effects on the Project.

DOI: http://dx.doi.org/10.3126/njog.v5i2.5070 NJOG 2010 Nov-Dec; 5(2): 8-13

No abstract

No abstract

Background: Women in India constitute a neglected part of the society and their sufferings are least highlighted. Ovarian cancer is a fatal disease that affects them silently. Its incidence is rising with progressively enlarging elderly population. Early diagnosis is challenging, since majority of the cases of ovarian carcinomas are detected in advanced stage with nonspecific symptoms. Neo-adjuvant chemotherapy, a useful therapeutic modality, is limited by toxicity and resistance. Hence, targeted therapy is now being proposed to overcome these hurdles. Objectives: 1. To study the histopathological spectrum of epithelial ovarian tumors. 2. To study the expression of HER2/neu among carcinomas on immunohistochemistry. Materials and Methods: It was an observational, descriptive, cross-sectional study carried out among 68 patients admitted in the hospital, who were newly diagnosed as having primary epithelial ovarian tumor. Postoperatively, the surgical specimens were processed accordingly. Histopathological sections were examined under Hematoxylin and Eosin stain. Histopathologically confirmed carcinomas were analyzed for HER2/neu expression status on immunohistochemistry. Statistical analysis was carried out using SPSS software, version 20. Results: Of the total cancer cases, 64.71% were benign, 5.88% borderline, 29.41% malignant. Serous type constituted majority for both benign and malignant variants (59.09% and 70% respectively). Overall, serous type constituted 58.82% of total population studied. Risk of malignancy index score was >200 for 95% of carcinomas in sharp contrast to benign tumors (15.91%). Grade 3+ HER2/neu expression was found in 35% of malignant cases, of which 85.71% were at advanced stage (FIGO III and IV). Conclusion: Serous type was the most common type of epithelial ovarian tumor. Risk of malignancy index score had strongly correlated with the malignant nature of tumor (p < 0.001). Grade 3+ HER2/neu expression was associated with advanced stage carcinomas.

No abstract