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Raghavan S.,Gynuity Health Projects | Geller S.,University of Illinois at Chicago | Miller S.,University of California at San Francisco | Goudar S.S.,Jawaharlal Nehru University | And 9 more authors.
BJOG: An International Journal of Obstetrics and Gynaecology | Year: 2016

Objective To assess whether secondary prevention, which preemptively treats women with above-average postpartum bleeding, is non-inferior to universal prophylaxis. Design A cluster-randomised non-inferiority community trial. Setting Health sub-centres and home deliveries in the Bijapur district of Karnataka, India. Population Women with low-risk pregnancies who were eligible for delivery with an Auxiliary Nurse Midwife at home or sub-centre and who consented to be part of the study. Methods Auxiliary Nurse Midwifes were randomised to secondary prevention using 800 mcg sublingual misoprostol administered to women with postpartum blood loss ≥350 ml or to universal prophylaxis using 600 mcg oral misoprostol administered to all women during the third stage of labour. Main outcome measures Postpartum haemoglobin ≤7.8 g/dl, mean postpartum blood loss and postpartum haemoglobin, postpartum haemorrhage rate, transfer to higher-level facilities, acceptability and feasibility of the intervention. Results Misoprostol was administered to 99.7% of women as primary prevention. In secondary prevention, 92 (4.7%) women had postpartum bleeding ≥350 ml, of which 90 (97.8%) received misoprostol. The proportion of women with postpartum haemoglobin ≤7.8 g/dl was 5.9 and 8.8% in secondary and primary prevention clusters, respectively [difference -2.9%, one-sided 95% confidence interval (CI) <1.3%]. Postpartum transfer and haemorrhage rates were low (<1%) in both groups. Shivering was more common in primary prevention clusters (P = 0.013). Conclusion Secondary prevention of postpartum haemorrhage with misoprostol is non-inferior to universal prophylaxis based on the primary outcome of postpartum haemoglobin. Secondary prevention could be a good alternative to universal prophylaxis as it medicates fewer women and is an acceptable and feasible strategy at the community level. Tweetable abstract Secondary prevention of postpartum haemorrhage with misoprostol is non-inferior to universal prophylaxis. Tweetable abstract Secondary prevention of postpartum haemorrhage with misoprostol is non-inferior to universal prophylaxis. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists. Source


Patil S.G.,Blde University Sri til Medical College | Mullur L.M.,Blde University Sri til Medical College | Khodnapur J.P.,Blde University Sri til Medical College | Dhanakshirur G.B.,Blde University Sri til Medical College | Aithala M.R.,Blde University Sri til Medical College
Indian Journal of Physiology and Pharmacology | Year: 2013

Subjunior athletes experience mental stress due to pressure from the coach, teachers and parents for better performance. Stress, if remains for longer period and not managed appropriately can leads to negative physical, mental and cognitive impact on children. The present study was aimed to evaluate the effect of integrated yoga module on heart rate variability (HRV) measure as a stress index in subjunior cyclists. Fast furrier transform technique of frequency domain method was used for the analysis of HRV. We have found a significant increase in high frequency (HF) component by 14.64% (P<0.05) and decrease in the low frequency component (LF) of HRV spectrum by 5.52% (P<0.05) and a decrease in LF/ HF ratio by 19.63% (P<0.01) in yoga group. In the control group, there was decrease in the HF component and, no significant difference in the LF component of HRV spectrum and LF/HF ratio. The results show that yoga practice decreases sympathetic activity and causes a shift in the autonomic balance towards parasympathetic dominance indicating a reduction in stress. In conclusion, yoga practice helps to reduce stress by optimizing the autonomic functions. So, it is suggested to incorporate yoga module as a regular feature to keep subjunior athletes both mentally and physically fit. Source

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