In trichorionic pregnancies, fetal reduction from three to two lowers the risk of severe preterm delivery, but provides no advantage in survival. Similar data for dichorionic triamniotic (DCTA) triplets is not readily available. To... more
In trichorionic pregnancies, fetal reduction from three to two lowers the risk of severe preterm delivery, but provides no advantage in survival. Similar data for dichorionic triamniotic (DCTA) triplets is not readily available. To document the natural history of DCTA triplets and the effect of reduction on the risk of miscarriage and severe preterm delivery, compared with expectant management. Systematic search on MEDLINE, EMBASE, and the Cochrane Library. DCTA triplets with three live fetuses at 8-14 weeks of gestation, outcome data with expectant management and/or reduction, miscarriage before 24 weeks of gestation and/or severe preterm delivery before 32-33 weeks of gestation. Five studies were included. Data from these were combined with data from three centres. There were 331 DCTA triplets. The miscarriage rate was 8.9% (95% CI 5.8-13.3%) and the severe preterm delivery rate was 33.3% (95% CI 27.5-39.7%), with expectant management. The miscarriage rate was 14.5% (95% CI 7.6-26...
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Abstract In this paper, we study the resource allocation problem in orthogonal frequency division multiple access (OFDMA) systems. An analytical approach based on an optimization problem formulation for the time-frequency spectrum... more
Abstract In this paper, we study the resource allocation problem in orthogonal frequency division multiple access (OFDMA) systems. An analytical approach based on an optimization problem formulation for the time-frequency spectrum allocation matter is ...
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Anemia in hemodialysis patients is a complex syndrome. The impetus of this study was to assess the safety and efficacy of iron saccharate complex (ISC) and sodium ferric gluconate complex (SFGC) in treating anemia in hemodialysis... more
Anemia in hemodialysis patients is a complex syndrome. The impetus of this study was to assess the safety and efficacy of iron saccharate complex (ISC) and sodium ferric gluconate complex (SFGC) in treating anemia in hemodialysis patients. Forty-eight adult anemic patients of both genders (33 males and 15 females) who had an adequate level of both hemodialysis and nutrition status and received neither EPO nor parenteral iron therapy during the preceding 6 months were randomized to 2 groups. The first group comprised 22 patients who were treated with parenteral ISC, 100 mg twice weekly for 2 months and once weekly thereafter. The second group included 26 patients who received SFGC, 62.5 mg twice weekly for 2 months and once weekly thereafter. The patients were followed up for 6 months. This head-to-head study showed that iron stores were adequately repleted by the use of both drugs. Repletion of iron stores was associated with a significant rise in both hemoglobin and hematocrit in both groups at the end of the follow-up period in comparison to their initial values at the start of the study (p < 0.001). Both parenteral iron therapy preparations were tolerated without a statistical difference between both groups. This head-to-head study confirmed that both parenteral iron preparations are effective for adequate repletion of iron stores and constituted a step forward in the management of anemic hemodialysis patients without noticeable adverse effects related to the administration of both iron preparations.
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The results of living non-related renal transplants from India involving unethical exploitation of the donor are inferior. We followed-up 12 patients from our unit who went to a center in Bombay for renal transplantation and compared the... more
The results of living non-related renal transplants from India involving unethical exploitation of the donor are inferior. We followed-up 12 patients from our unit who went to a center in Bombay for renal transplantation and compared the results with our local new renal transplant programme. Two-year graft survival was 70% compared to 88% with our new renal transplant program. Also, we emphasised the human side of the problem. We addressed the problem of shortages of organ donation locally because failure to obtain consent from relatives and the need for intensive public education is required to overcome this problem. Finally, Islamic principles and rules that are related to organ transplantation have been discussed in detail, and the main purpose is to enlighten the Western reader.
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The aim of this study was to determine the association between biometry discordance at the time of the anomaly scan and adverse perinatal outcomes in twin pregnancies. Retrospective cohort study. Nine hospitals in the Southwest Thames... more
The aim of this study was to determine the association between biometry discordance at the time of the anomaly scan and adverse perinatal outcomes in twin pregnancies. Retrospective cohort study. Nine hospitals in the Southwest Thames Region of London Obstetric Research Collaborative (STORK). Population multicentre retrospective study of all twin pregnancies booked for antenatal care in nine hospitals over a period of 10 years. Methods Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the association between abdominal circumference (AC) and estimated fetal weight (EFW) discordance, recorded between 20 and 22 weeks of gestation, and adverse pregnancy outcomes. Stillbirth, neonatal mortality, preterm birth (PTB) at <34 weeks of gestation, and birthweight (BW) discordance ≥25%. A total of 2399 twin pregnancies [457 monochorionic (MC) and 1942 dichorionic (DC)] were included in the study. The predictive accuracy of the EFW discordance was poor for fetal loss after 22 weeks of gestation (area under the curve, AUC 0.54, 95% CI 0.46-0.64), fetal loss beyond 28 weeks of gestation (AUC 0.42, 95% CI 0.31-0.52), perinatal loss (AUC 0.51, 95% CI 0.44-0.57), BW discordance (AUC 0.63, 95% CI 0.56-0.65), and PTB before 34 weeks of gestation (AUC 0.52, 95% CI 0.49-0.55). There was no significant difference in the prediction of these outcomes when using EFW discordance or AC discordance. Once structural malformations, chromosomal abnormalities, and twin-to-twin transfusion syndrome have been excluded, second-trimester EFW and AC discordance have poor predictive value for adverse perinatal outcomes in twin pregnancy.
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Artery Research, Volume 5, Issue 4, Pages 168, December 2011, Authors:A. Khalil; R. Akolekar; A. Syngelaki; M. ElKhaouly; K. Nicolaides.
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ABSTRACT: In a multi-hop mobile ad hoc network (MANET) mobile nodes communicate with each other forming a cooperative radio network. Security remains a major challenge for these networks due to their features of open medium, dynamically... more
ABSTRACT: In a multi-hop mobile ad hoc network (MANET) mobile nodes communicate with each other forming a cooperative radio network. Security remains a major challenge for these networks due to their features of open medium, dynamically changing topologies, ...