Objectives. (1) To determine the frequency of maternal near miss, maternal near miss incidence ratio (MNMR), maternal near miss to mortality ratio and mortality index. (2) To compare the nature of near miss events with that of maternal mortality. (3) To see the trend of near miss events. Design. Audit. Setting. Kasturba Hospital, Manipal University, Manipal, India. Population. Near miss cases & maternal deaths. Methods. Cases were defined based on WHO criteria 2009. Main Outcome Measures. Severe acute maternal morbidity and maternal deaths. Results. There were 7390 deliveries and 131 “near miss” cases during the study period. The Maternal near miss incidence ratio was 17.8/1000 live births, maternal near miss to mortality ratio was 5.6 : 1, and mortality index was 14.9%. A total of 126 cases were referred, while 5 cases were booked at our hospital. Hemorrhage was the leading cause (44.2%), followed by hypertensive disorders (23.6%) and sepsis (16.3%). Maternal mortality ratio (MMR) was 313/100000 live births. Conclusion. Hemorrhage and hypertensive disorders are the leading causes of near miss events. New-onset viral infections have emerged as the leading cause of maternal mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.
In the present work, we examine normal and malignant stage IIIB cervical tissue by laser induced fluorescence, with 2 different objectives. (i) Development of the fluorescence spectroscopy technique as a standard optical method for discrimination of normal and malignant tissue samples and, (ii) Optimization of the technique by the method of matching of a sample spectrum with calibration sets of spectra of pathologically certified samples. Laserinduced fluorescence spectra were measured using samples from 62 subjects at different excitation wavelengths. Principal component analysis (PCA) of spectra and intensity ratios of curveresolved fluorescence peaks were tested for discrimination. It was found that PCA of total fluorescence at 325 nm excitation gives specificity and sensitivity over 95%. Use of calibration sets of spectra of histo-pathologically certified samples combined with PCA for matching and pass/fail classification of test samples is shown to have high sensitivity/specificity for routine diagnostic purposes as well as for possible staging of the disease. Further, the multi-component origin of the fluorescence spectra is illustrated by curve resolution and fluorescence spectra of separated proteins of tissue homogenates. ' 2006 Wiley-Liss, Inc.
Key words: laser induced fluorescence; optical diagnosis; principal component analysisCervical Cancer is the second leading cancer in females all over the world, standing first in many of the developing countries.1,2 Most patients are diagnosed with cervical cancer through symptoms such as abnormal vaginal bleeding and vaginal discharge. Investigation by Pap smear/colposcopy followed by histopathology confirms the diagnosis. Pap smear is reported to have high false negative (15-40%) rates. 3,4 The extraordinary monotony of the work, large volume of smears in screening applications, inadequate sampling and comparatively smaller cellular changes being overlooked because of fatigue are all reasons ascribed to the high rate of false-negative results. At present, liquid based cytological screening technique ''Thin prep'' aided by Pap Net, an automated computer based visualization technique, seems to have increased the sensitivity of cytological screening. However, the efficiency of thin prep and Pap net are still under scrutiny. 5,6
Background: DOC2B promoter hypermethylation is an early and frequent event in cervical cancer. Results: DOC2B hypermethylation induces transcriptional repression, reactivated by demethylation; ectopic expression increases Ca 2ϩ flux and inhibits key characteristics of tumorigenesis including proliferation, motility, and invasion. Conclusion: DOC2B gene is epigenetically regulated and inhibits cervical cancer growth. Significance: DNA methylation regulates DOC2B gene expression in cervical cancer.
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