Incomplete Expulsion Research Articles

Research on Origin and Development of Postpartum Diarrhea

This paper provides an in-depth study of the origins of postpartum diarrhea, discussing the history, etiology and treatment of the condition. Through combing ancient literature, it was found that postpartum diarrhea was closely related to the weakness of the woman's qi and blood, incomplete expulsion of postpartum lochia, and physical factors. Medical practitioners of all generations have emphasised the importance of regulating the spleen and stomach, resolving blood stasis and generating new blood, and tonifying the kidneys to consolidate the fundamentals in treatment. This article aims to provide useful references for clinicians for guiding clinical practice.

Comparison of mifepristone plus misoprostol with misoprostol alone for first trimester medical abortion: A systematic review and meta-analysis.

To compare mifepristone plus a misoprostol-combined regimen with misoprostol alone in the medical abortion of first trimester pregnancy. An internet-based search of available literature was performed using text words contained in titles and abstracts. PubMed/Medline, Cochrane CENTRAL, EMBASE, and Google scholar were used to locate English-based articles published until December 2021. Studies fulfilling the inclusion criteria were selected, appraised, and assessed for methodological quality. The included studies were pooled for meta-analysis, and the results were presented in risk ratio at a 95% confidence interval. Nine studies comprising 2,052 participants (1,035 intervention and 1,017 controls) were considered. Primary endpoints were complete expulsion, incomplete expulsion, missed abortion, and ongoing pregnancy. The intervention was found to more likely induce complete expulsion irrespective of gestational age (RR: 1.19; 95% CI: 1.14-1.25). The administration of misoprostol 800 mcg after 24 h of mifepristone pre-treatment in the intervention group more likely induced complete expulsion (RR: 1.23; 95% CI: 1.17-1.30) than after 48 h. The intervention group was also more likely to experience complete expulsion when misoprostol was used either vaginally (RR: 1.16; 95% CI: 1.09-1.17) or buccally (RR: 1.23; 95% CI: 1.16-1.30). The intervention was more effective in the subgroup with a negative foetal heartbeat at reducing incomplete abortion (RR: 0.45; 95% CI: 0.26-0.78) compared with the control group. The intervention more likely reduced both missed abortion (RR: 0.21; 95% CI: 0.08-0.91) and ongoing pregnancy (RR: 0.12; 95% CI: 0.05-0.26). Fever was less likely to be reported (RR: 0.78; 95% CI: 0.12-0.89), whereas the subjective experience of bleeding was more likely to be encountered (RR: 1.31; 95% CI: 1.13-1.53) by the intervention group. The review strengthened the theory that a combined mifepristone and misoprostol regimen can be an effective medical management for inducing abortions during first trimester pregnancy in all contexts. Specifically, there is a high-level certainty of evidence on complete expulsion during the early stage and its ability to reduce both missed and ongoing pregnancies. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019134213, identifier CRD42019134213.

Safety and Efficacy of Misoprostol for the Management of Early Pregnancy Loss: A Non-Randomized Clinical Trial

Background: Management of early pregnancy loss is very crucial for the safety of women.
 Objective: The purpose of the present study was to see the safety and efficacy of misoprostol for the management of early pregnancy loss.
 Methodology: This non-randomized clinical trial was conducted in the Department of Obstetrics and Gynaecology in Shaheed Ziaur Rahman Medical College Hospital, Bogra, Bangladesh from January 2007 to December 2007 for a period of 12 months. Women with early pregnancy loss who were fulfilling the selection criteria were selected as the study population during the study period. On admission all women were received a vaginal administration of 800 μg misoprostol by digital insertion into the posterior fornix through a speculum (4 tablets of 200 μg misoprostol). The interval between administration of misoprostol and expulsion of product of conception was recorded. After 7 days (8th day) they were instructed to come to the hospital to see the completeness of expulsion of product of conception by ultrasonography. If sonography shows incomplete expulsion then surgical evacuation was done. Every woman were advised to come for follow-up on 15th day. Results: A total of 200 women with first-trimester pregnancy loss were non-randomly assigned to give treatment with misoprostol. The mean with the SD of the study population was 24.95±4.17 years. In most cases expulsion occurred within 24 hours of application of misoprostol, 142(71.0%) cases completed expulsion within 48 hours, 168(84.0%) cases within 7 days, 170(85.0%) cases out of 200 cases completed expulsion occurred. Complete evacuation after the first dose was in 142(71.0%) cases and remained incomplete was 58(29.0%) cases. After administration of the second dose (85.0%) complete evacuation occurred and 30(15.0%) cases remained complete that needed surgical evacuation. Analysis was reveled statistically significant (P<0.05). Vaginal misoprostol treatment appeared to be well tolerated. Only few percent shows mild side effects. About 190(95.0%) cases required no blood transfusion. Conclusion: In conclusion the efficacy of misoprostol for the management of early pregnancy loss gives a good results with minimum adverse events.
 Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):152-156

Study on notch tensile properties of Magnetically Impelled Arc Butt (MIAB) welded carbon steel tubes

Magnetically Impelled Arc Butt (MIAB) welding is a pressure welding process that uses the circumferential rotating arc to cause uniform heating of the faying surfaces. In this work, notched tensile testing of MIAB welded Carbon steel was carried out to determine the notch sensitivity of Thermo-Mechanically Affected Zones (TMAZ) and to compare the notch tensile property of these zones with the base metal property. In MIAB welding, after sufficient melting of the faying surface, a short pulse of high current is applied to expel the molten metal and impurities from the interface before welding. Insufficient expulsion and formation of Light Band (LB) zone at weld interface resulted in lower Notch Tensile Strength (NTS). Incomplete expulsion with lower upset current at the weld interface contributes to lower Normalized Notch Strength Ratio. Instead higher upset current contributed to higher NTS due to complete expulsion and stronger acicular ferrite formation. Other TMAZs away from the weld interface showed higher notch tensile strength with Notch Strength Ratio (NSR) and Normalized Notch Tensile Strength Ratio (NTSN) greater than unity.

Direct evidence of microstructure dependence of magnetic flux trapping in niobium

Elemental type-II superconducting niobium is the material of choice for superconducting radiofrequency cavities used in modern particle accelerators, light sources, detectors, sensors, and quantum computing architecture. An essential challenge to increasing energy efficiency in rf applications is the power dissipation due to residual magnetic field that is trapped during the cool down process due to incomplete magnetic field expulsion. New SRF cavity processing recipes that use surface doping techniques have significantly increased their cryogenic efficiency. However, the performance of SRF Nb accelerators still shows vulnerability to a trapped magnetic field. In this manuscript, we report the observation of a direct link between flux trapping and incomplete flux expulsion with spatial variations in microstructure within the niobium. Fine-grain recrystallized microstructure with an average grain size of 10–50 µm leads to flux trapping even with a lack of dislocation structures in grain interiors. Larger grain sizes beyond 100–400 µm do not lead to preferential flux trapping, as observed directly by magneto-optical imaging. While local magnetic flux variations imaged by magneto-optics provide clarity on a microstructure level, bulk variations are also indicated by variations in pinning force curves with sequential heat treatment studies. The key results indicate that complete control of the niobium microstructure will help produce higher performance superconducting resonators with reduced rf losses1 related to the magnetic flux trapping.

Misoprostol treatment for early pregnancy loss: an international survey

Research questionWhat is the global variability in misoprostol treatment for the management of early pregnancy loss (EPL)? DesignAn international web-based survey of fertility specialists and obstetrics and gynaecology clinicians was conducted between August and November 2020. The survey consisted of 16 questions addressing several aspects of misoprostol treatment for EPL. ResultsOverall, 309 clinicians from 80 countries participated in the survey, of whom 67.3% were fertility specialists. Nearly one-half (47.9%) of the respondents let the patient choose the first line of treatment (expectant management, misoprostol treatment or surgical aspiration) according to her own preference. The 248 respondents who administer misoprostol in their daily practice were asked further questions; 59.7% of them advise patients to take the medication at home. The most common dose and route of administration is 800 µg administered vaginally. Only 28.6% of participants use mifepristone pretreatment. Variation in the timing of the first follow-up visit after misoprostol administration was wide, ranging from 24 h to 1 week in most clinics. In case of incomplete expulsion, only 42.3% of the respondents routinely administer a second dose. The timing of the final visit and the definition of successful treatment also differed greatly among respondents. ConclusionsThere is large variability in the use of misoprostol for the management of EPL. High-quality research is necessary to examine several aspects of the treatment. Particularly, the timing and effectiveness of a second dose administration and the criteria to decide on treatment failure or success deserve more research in the future.

Misoprostol only or in combination with intra cervical Foley’s catheter for termination of the second trimester demise pregnancy in patient with previous caesarean sections

Objective: Termination of second trimester pregnancy is unique obstetric contest due to its difficulty and risky especially if the condition is associated with prior Caesarean deliveries. Aim of the work: To compare the safety and efficacy of two regimens for termination of the second trimester pregnancy in ladies with scarred uterus by prior Caesarean deliveries either by using sublingual and vaginal misoprostol or sublingual misoprostol in a combination with intra cervical Foley’s catheter. Patients and methods: 163 pregnant ladies with second trimester demise pregnancy at14-24 gestational weeks in scarred uterus (≥ one cesarean sections) participated in this prospective randomized comparative study which was performed in obstetric emergency unit in Zagazig University Hospitals, Egypt from June 2019 to May 2020. 140 patients only far-reached the trial through termination of the pregnancy via induction of abortion by sublingual and vaginal misoprostol Group 1 (GI) or Foley’s catheter with vaginal misoprostol Group 2 G (II). Whichever of those methods sustained for 48 hours else the fetus expulsed formerly .Outcomes was determined by comprehensive expulsion of fetus and placenta, Induction Abortion interval, Incidence of side effects, requirement for surgical intervention and complications" rate. Results: The demographic criteria of both groups revealed no significant difference (P-value>0.05). The mean (SD) of Induction to abortion interval (hours) in GI was significant longer than in G II (51.07±23.84, 45.20±31.28) respectively with (P- value 0.021). Total dose (μg) of misoprostol used in GI (1100.72±23.54) was higher than G II (645.35± 322) with p value 0.001. Admission-termination hospitalization (days) was significant longer in G I (4.11±1.02) than in G II (2.371±1.98) with P value 0.004. No significant difference as regard occurrence of adverse effects between both groups except the incidence of fever (17.1%) in G I and (5.7%) in G II with P value 0.01. Success rate in GI and G II were (80%, 95%) respectively with P-value 0.01. Incomplete expulsion was higher in GI (14.3%) in comparison with G II (4.2%) with P value 0.04. Incidence of haemorrhage was significant higher in G II than in GI P value 0.03. No significant differences between both groups as regard incidence of rupture uterus or occurrence of infection. Conclusion: Practice of inserting Foley’s catheter through cervix with misoprostol sublingually for termination of mid-trimester pregnancy in preceding uterine scar(s) is efficient, inexpensive and safe procedure.

MEDICAL MANAGEMENT OF THE COMPLICATIONS OF EARLY PREGNANCY WITH MISOPROSTOL

OBJECTIVE: The study’s goal was to ascertain if misoprostol is beneficial for people who have early pregnancycomplications. And to prevent these individuals from undergoing surgical evacuation.METHODOLOGY: Between 2015 and 2017, an experimental investigation was carried out at the MardanMedical Complex Hospital in Mardan at the Department of Obstetrics and Gynecology, Unit A. For misoprostoltherapy, 200 women with early pregnancy problems were included. Patients with early pregnancy problems who werehemodynamically stable and had a gestational age of fewer than 15 weeks met the inclusion criteria. Patients having ahistory of ectopic pregnancy, gestational trophoblastic illness, hemodynamic instability, uterine rupture, hypersensitivityto prostaglandin, and hemoglobin levels below 9 g were excluded. The ability to successfully resolve miscarriages withoutthe need for surgery was the primary outcome measure. Incidence of discomfort, vaginal bleeding, infection, pyrexia,and adverse gastrointestinal symptoms were secondary outcomes. The research included 200 women in total. They wereprimigravida to grand multigravida, ranging in age from 16 to 45. Thirty (15%) had an embryonic pregnancy, 88(44%) had an incomplete abortion, and 82 (41%) had an early fetal death. When misoprostol was the only medicationused for therapy, 140 (or 70%) women entirely expelled the conceptual products; nevertheless, 60 (30%) patients neededsurgery since their conceptual products had not been fully expelled and they were bleeding excessively. The average timebetween induction and expulsion was 16 hours. The most common adverse effects reported were diarrhea, vomiting,pyrexia, discomfort, and nausea. In 14 individuals, more than one side event was reported. For individuals with earlypregnancy difficulties, misoprostol is an appropriate and effective treatment for early pregnancy loss. It may be kept atroom temperature and is inexpensive and heat stable.RESULTS: The study concerned a diverse institution of women, starting from primigravida to grand multigravida,and spanning a while sixteen to 45. The distribution of pregnancy headaches covered 15% with embryonic pregnancy,44% with incomplete abortion, and 41% with early fetal demise. Out of the 2 hundred girls, one hundred forty (70%)effectively expelled the conceptual products solely through misoprostol therapy. However, 30% of sufferers requiredsurgical operation because of incomplete expulsion and excessive bleeding. The common time between misoprostolinduction and complete expulsion changed into reported as sixteen hours.The look at additionally referred to notunusual adverse consequences, such as diarrhea, vomiting, pyrexia, pain, and nausea. In some instances, a couple ofside impact became reported, affecting 14 people.CONCLUSION: The observe contributes treasured insights into the scientific management of early pregnancycomplications using misoprostol. It emphasizes the effectiveness of misoprostol in resolving miscarriages without theneed for surgery in a significant proportion of instances. The documented negative consequences, while present, shouldbe weighed towards the blessings of averting surgical processes.KEYWORDS: Misoprostol, medical treatment, miscarriage.

Assessment of the Antithrombogenicity of a Poly-2-Methoxyethylacrylate-Coated Central Venous Port-Catheter System.

The purpose of this study was to evaluate the antithrombogenic effects of poly-2-methoxyethylacrylate (PMEA) coating applied to the internal surfaces of the port-catheter system to prevent thrombotic occlusion. PMEA coating was applied to the inner surfaces of the entire system, including the chamber, catheter, and connecting stem. PMEA-coated and uncoated port-catheter systems were each filled with fresh human blood for 1 or 3h and then flushed with saline. Volumes of residual thrombi in the system and protein in the catheter were then compared. Saline flushing of the PMEA-coated port-catheter system expelled all visually recognizable thrombi, leaving no unremovable adhesions. In contrast, the uncoated port showed thrombi adherent to the inner surfaces and incomplete expulsion with flushing. Mean (± standard deviation) residual thrombus mass was significantly lower in PMEA-coated port-catheter systems (20.5 ± 6.2mg) than in uncoated systems (230.3 ± 92.5mg; p < 0.01). Mean residual protein was likewise significantly lower in PMEA-coated systems (20.5 ± 6.2mg) than in uncoated systems (230.3 ± 92.5mg; p < 0.01). PMEA coating on a central venous port-catheter system decreased accumulation and facilitated flushing of thrombi from the system by flushing, as compared with the uncoated system. PMEA-coated central venous port-catheter systems appear relatively antithrombotic compared to uncoated systems.

Reproductive and Obstetric Outcomes After Hysteroscopic Removal of Retained Products of Conception

To evaluate the reproductive outcomes in women treated for retained products of conception (RPOC) by hysteroscopy (morcellation vs loop resection). Cohort study. A teaching and university hospital. Patients included in a previous randomized controlled trial on hysteroscopic removal of RPOC comparing morcellation (n = 46) with loop resection (n = 40). Hysteroscopic morcellation versus loop resection. The primary outcome measures were live birth and pregnancy complications (including abnormal placentation [placenta accreta/increta/percreta], placenta previa, vasa previa, retained placenta after delivery or incomplete expulsion with the need for manual removal or curettage, and RPOC), uterine rupture, and other complications (blood loss, preterm labor, preterm premature rupture of membranes, hypertensive disorders of pregnancy, and intrauterine growth restriction). The live birth rate was 88.9% in the morcellation group and 68.2% in the loop resection group (p = .09). Uterine rupture occurred in 1 patient in the morcellation group (4.2%) (p = 1.00). Placental complications were found in 20.8% and 22.2% of the hysteroscopic morcellation and loop resection groups, respectively (p = .33), and other pregnancy complications were seen in 33.3% and 16.6% of the 2 groups (p = .33). The secondary outcome was time to pregnancy. The median time to pregnancy was 14 weeks (interquartile range [IQR], 5-33 weeks) in the morcellation group and 15 weeks (IQR, 6-37 weeks) in the loop resection group (p = .96). Hysteroscopic removal of RPOC seems to have no detrimental effect on reproductive outcome and no significant effect on pregnancy rate.

Canaanite Genocide and Palestinian Nakba in Conversation: A Postcolonial Exercise in Bi-directional Hermeneutics

David Ben-Gurion's attempt to forge a collective Israeli identity rooted in the biblical conquest myth adopted a bi-directional hermeneutic: biblical text and modern reality were mutually illuminating. While Ben-Gurion read Scripture ‘from above’, with the eyes of the IDF, Edward Said called for readings ‘from below’, with the eyes of the Canaanites. Following Said, this paper reads the Conquest narrative and the Nakba bi-directionally, tracing four themes: (1) Depopulation and dispossession, (2) Traitors and Tricksters, (3) Spoils of War, (4) Incomplete expulsion. The exercise cautions those who see both narratives as zero-sum games only one side of which merits moral consideration.

Oral Versus Vaginal Misoprostol in the Management of Missed Abortion

Missed abortions are common and represent a significant gynaecological emergency workload. The search for a non invasive method with high success rate has led to the use of misoprostol. Most research into the use of misoprostol for the medical evacuation of missed abortion has concentrated on its effect after oral administration. Recent evidence suggested an improved efficacy of uterine evacuation and a reduced incidence of side-effects if misoprostol was administered vaginally. The present study has been designed to compare the safety and efficacy of oral versus vaginal misoprostol for medical management of missed abortion. The present study was experimental and randomized. A total of 100 women with pregnancies of &lt; 12 weeks from last menses (verified by ultrasound) were recruited for the study. Eligible women were allocated randomly to the two treatment groups by means of lottery. The primary outcome was measured by complete expulsion rate. The secondary outcome measure was patient’s side effects and satisfaction. The following variables were compared: complete or incomplete expulsion of the conceptus in 24 hours, induction expulsion interval time, side effects; dilatation of cervical canal in those patients who required surgical intervention, number of doses required, women’s perception and duration of hospital stay. The present study demonstrated that early expulsion of the product following induction, complete expulsion of the product after 24 hours, were significantly higher in the vaginal misoprostol group than those in the oral misoprostol group. The dose of misoprostol was also much lower in the vaginal group compared to the oral group. The need for surgical evacuation was markedly decreased in the vaginal group than that in the oral group. So, treatment of missed abortion by misoprostol through vaginal route should be explored for introduction into health care delivery system nation wide.TAJ 2011; 24(2): 106-110

Experimental and finite element analysis of ultrasonic vibration−assisted continuous-wave laser surface drilling

ABSTRACTIn pulsed laser drilling with co-axial assisted gas, material removal mechanism (surface vaporization and melt expulsion) determines the machining/drilling rate and quality of the drilled holes. Incomplete melt expulsion is one of the major causes of laser drilling defects. To improve the drilling efficiency and quality of holes, a novel ultrasonic vibration−assisted continuous-wave laser drilling (UVLD) approach is proposed. The application of ultrasonic vibrations (of frequency of 20 kHz and vibration displacement of 23 µm) during laser surface melting facilitates the melt expulsion in the form of sideways melt flow and droplet ejection from the drilling front. A systematic experimental study on the ultrasonic vibration-assisted laser drilling of AISI 316 stainless steel is performed to investigate the effect of working distance on the geometric features and surface quality of the holes. The experimental results based on high-speed photography indicate that the melt expulsion under the influence of ultrasonic vibrations initiates after the laser melted pool reaches a critical size/volume. Based on this underlying mechanism, a simplified finite element analysis is performed for the UVLD process to predict the hole volumes for the investigated working distances.

Comparative study to evaluate the success rate of manual vaccum aspiration and Medical abortion in termination the first trimester pregnancy

Objectives: This study was undertaken to evaluate the success rate of manual vaccume aspiration in termination the first trimester pregnancy, study the merits and demerits of the method and compare it with other method i.e. medical abortion by misoprostol and mifepristone in first trimester MTP. Methodology: In a prospective randomized controlled study, participants were divided in two groups: Study group of 30 patients of 6-12 weeks gestational age subjected to MTP by manual vacuum aspiration. Another group consisted of 30 patients of 6-8- weeks gestational age who were subjected to MTP by medical method using mifepristone and misoprostol. Result: Present study consist of 30 cases of medical termination of pregnancy in Ist trimester carried out by (manual vaccum aspiration) MVA. A comparison of observation and results was made with another group of 30 patients who had undergone pregnancy termination in Ist trimester using mifepristone and misoprostol. In 6-8 weeks pregnancies incidence of complete abortion was 100% In 10 weeks complete termination was done in 8 patient’s only 1 patient had incomplete termination. In medical abortion also results show that in up to 6 week pregnancy 3(12%) patient had incomplete expulsion, in up to 8 week 11(20%) patient had incomplete expulsion In present study over all success rate with MVA was 93.33% whereas with medical abortion success rate is found to be 86.67%. Conclusion: It is concluded from present study that Manual Vaccum Aspiration is safe, simple and easy procedure with minimal need of anesthesia and analgesia. It is very good option in low resource settings.

Quantitative measurement of transmitters in individual vesicles in the cytoplasm of single cells with nanotip electrodes.

The quantification of vesicular transmitter content is important for studying the mechanisms of neurotransmission and malfunction in disease, and yet it is incredibly difficult to measure the tiny amounts of neurotransmitters in the attoliter volume of a single vesicle, especially in the cell environment. We introduce a novel method, intracellular vesicle electrochemical cytometry. A nanotip conical carbon-fiber microelectrode was used to electrochemically measure the total content of electroactive neurotransmitters in individual nanoscale vesicles in single PC12 cells as these vesicles lysed on the electrode inside the living cell. The results demonstrate that only a fraction of the quantal neurotransmitter content is released during exocytosis. These data support the intriguing hypothesis that the vesicle does not open all the way during the normal exocytosis process, thus resulting in incomplete expulsion of the vesicular contents.

Quantitative Measurement of Transmitters in Individual Vesicles in the Cytoplasm of Single Cells with Nanotip Electrodes

AbstractThe quantification of vesicular transmitter content is important for studying the mechanisms of neurotransmission and malfunction in disease, and yet it is incredibly difficult to measure the tiny amounts of neurotransmitters in the attoliter volume of a single vesicle, especially in the cell environment. We introduce a novel method, intracellular vesicle electrochemical cytometry. A nanotip conical carbon‐fiber microelectrode was used to electrochemically measure the total content of electroactive neurotransmitters in individual nanoscale vesicles in single PC12 cells as these vesicles lysed on the electrode inside the living cell. The results demonstrate that only a fraction of the quantal neurotransmitter content is released during exocytosis. These data support the intriguing hypothesis that the vesicle does not open all the way during the normal exocytosis process, thus resulting in incomplete expulsion of the vesicular contents.

English

&nbsp; The objective of the study was to evaluate the efficacy of misoprostol in patients with complication of first trimester pregnancy loss. After the departmental approval, a total of 102 women with first trimester pregnancy failure were recruited for treatment with misoprostol. The inclusion criteria were gestational age of less than 12 weeks and hemodynamically stable. The exclusion criteria were patients with history of hypersensitivity to prostaglandin, bronchial asthma and hemoglobin less than 9 g. Main outcome measures were the successful resolution of miscarriages without surgical intervention; secondary outcomes were incidence of pain, vaginal bleeding, infection, pyrexia and gastrointestinal side effects. A total of 102 women were included in the study. Age ranged from 16 to 40 years and parity ranged from 0 to grand multipara. Women were not selected according to parity but parity was a random occurrence. No relationship was found between parity and response to treatment with misoprostol. Incomplete abortion was found in 82 (80.39%), an embryonic pregnancy in 7 (6.86%) and early fetal demise in 13 (12.74%). 62.74% women completely expelled the conceptual products on treatment with misoprostol alone, while 38 (37.25%) patients required surgical evacuation due to incomplete expulsion of conceptual products. Mean induction to expulsion interval was 15.66 h. Main side effects noted were pain, pyrexia, nausea, vomiting and diarrhea. More than one side effect was noted in 7 (22.54%) patients. Treatment of early pregnancy loss with misoprostol is efficient, acceptable and cost effective for patients with complications of first trimester pregnancy loss. &nbsp; &nbsp; Key words: Misoprostol, medical treatment, miscarriage.

Effect of Upset Current in Magnetically Impelled Arc Butt (MIAB) Welding of Carbon Steel Tubes

Magnetically Impelled Arc Butt (MIAB) welding is an unique forge welding process in which an arc is drawn in the gap between the two tubes to be welded in order to raise them to a high temperature to allow forging to form a solid state weld. This paper presents the investigations carried out on MIAB welding trials of carbon steel tubes with varying upset current. Upset current is the short pulse of high current applied prior to upset. It plays a significant role in expulsion of molten metal and impurity from weld interface. This study aims at studying the effect of upset current on weld properties. Carbon steel tubes of SA-210 Grade A have been chosen with outside diameter of 44 mm and thickness of 4.5 mm. Mechanical and microstructural characterization of MIAB weldments was carried out. Good correlation exists between the mechanical properties/microstructure and upset current. Lower upset current has detrimental effect on weld tensile strength due to incomplete expulsion of decarburized zone.

Spinal Cord Injury‐Induced Neurogenic Bladder

Spinal cord injury (SCI) is one of the most debilitating and devastating injuries to humans. Lower urinary tract dysfunction is of most concern in the management of SCI patients. Proper management depends on understanding the mechanisms underlying the development of neurogenic bladder. Suprasacral SCI induces detrusor areflexia and urine retention initially. The recovery of lower urinary tract function occurs several weeks later, but the voiding function deteriorates and manifests by hyperreflexia and incomplete voiding secondary to the simultaneous contraction of the detrusor and external urethral sphincter (detrusor–sphincter dyssynergia) during voiding. Electrophysiological and pharmacological studies of animals reveal that the recovery of lower urinary tract function relies on the plasticity of bladder afferent pathways. The Aδ afferents convey proprioception and initiate micturition reflex in intact cats and rats. Chronic SCI animals exhibit hyperreflexia during storage and incomplete expulsion during voiding. The Aδ afferent pathway is replaced by capsaicin‐sensitive C‐fiber afferents in chronic SCI cats. In chronic SCI rats, voiding is still mediated thru Aδ afferents. However, C‐fiber afferents modify bladder function and induce bladder hyperreflexia and detrusor–sphincter dyssynergia in chronic SCI rats. Thus, multiple factors have been implicated in the development of neurogenic bladder induced by SCI.

Gynäkologische Notfälle

Any primary care doctor should be prepared to encounter and to handle gynaecological emergencies in patients, even those in critically ill states. We want to present a concentrated review on some of the "hard" gynaecological emergencies like extrauterine pregnancy, abortion, and malignancy associated hemorrhage. Moreover, there is another group of patients with "soft" gynaecological emergencies, as for instance the distressing symptoms caused by a vulvovaginal infection. Despite most advanced strategies for early detection, emergency situations caused by ectopic pregnancies still happen. Ectopic pregnancies are most frequently located in the fallopian tubes. Tubal abortion and tubal rupture are very demanding situations in the course of a tubal pregnancy that need immediate assessment and treatment, and maybe emergency life support. Of all the different types of abortion, incomplete abortion is most likely to provoke life-threatening situations. Incomplete expulsion of the products of conception may lead to severe bleeding from the uterus. Immediate uterine curettage is required in this case. Advanced stages of cervical cancer may cause life-threatening hemorrhages as a result of vascular arrosion. Ovarian torsion is a gynaecological emergency characterised by acute abdominal pain.