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Comparison of Vaginal Microbiota in Women With Spontaneous Preterm Labour Versus Those With Term Labour

Thesis Info

Author

Gulavi, Edgar

Department

Obstetrics and Gynaecology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2019

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728041938

Similar


Background: Preterm birth presents a challenge on a global scale with a disease burden that is on the rise. It is a leading cause of perinatal morbidity and mortality worldwide with approximately 15 million preterm births every year. Kenya has a 12% preterm birth rate with about 190,000 babies born preterm every year. The female lower genital tract bacterial community plays a vital role in maternal and neonatal health. An association between altered vaginal microbial composition and preterm birth has been demonstrated in previous studies. However, findings in terms of composition and diversity of these bacteria across the few studies available have differed. With the progress and increased availability of using gene sequencing based techniques, the contribution of these vaginal microbial community changes to preterm birth have emerged as an area for research focus. Study Objective: The study objective was to compare the vaginal microbiota of women who presented with spontaneous preterm labour with those with term labour using 16S ribosomal RNA gene sequence-based techniques. Methodology: The study was a case control study set in AKUH Nairobi labour ward. Vaginal swabs were collected from mothers who presented between 26 weeks to 36 weeks of gestational age with diagnosis of preterm labour as well as controls matched for age and parity who presented in labour past 37 weeks of gestation. The vaginal microbiota of women who were in preterm labour was compared to those in term labour using 16S ribosomal RNA (rRNA) gene sequences. Results: In total, 100 participants were recruited for the study with 50 cases of preterm labour and 50 matched controls. Vaginal gene sequencing was done for 46 cases and 19 control with high quality reads achieved from 52 samples. The vaginal microbiota in both study groups was rich in the Lactobacillus genus of organisms. Fourty seven samples (90.4%) had a microbiota rich in different Lactobacillus species including unclassified Lactobacillus (n=35), Lactobacillus. iners (n=23), Lactobacillus. helviticus (n=18), Lactobacillus. vaginalis (n=17), Lactobacillu.mucosae (n=2), Lactobacillus. zeae (n=1) and Lactobacillus. coleohominis (n=1) existing with several overlaps. There was high diversity of the vaginal microbiota although it did not fall into any assigned community state type. Conclusions: This study demonstrates a spectrum of diversity in the vaginal microbiota without clear evidence of any specific microbiota patterns that have a correlation with preterm labour.
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۔مولوی فیروز الدین ڈسکوِی کی ادبی خدمات

مولوی فیروز الدین ڈسکوِی کی ادبی  خدمات

ڈاکٹر نصیر احمد اسد

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الإعلام البديل ودوره في تشكيل الرأي العام الوطني: موريتانيا أنموذجا

انطلقت هذه الدراسة أساسا من محاولة وضع تعريف جامع مانع لمفهوم الإعلام البديل وكذا الدور الكبير الذي يلعبه في التشكلات الأولية للرأي العام الموريتاني. واستخدم الباحث في دراسة هذا الموضوع المنهج الوصفي التحليل. وقد توصلت الدراسة إلى أن الإعلام البديل يساهم بشكل كبير في تشكل وصناعة الرأي العام بمختلف تجلياته سواء تعلق الأمر بالرأي العام المنقاد أو المستنير. كما تبين من خلال التحليل عبر مباحث المقال أن الإعلام البديل له دور كبير في صناعة القرار السياسي، فقد بات واضحا أن العديد من القرارات التي تتخذها الحكومات تبنى على رغبات الرأي العام ومواقفه من قضايا تم نقاشها عبر مواقع التواصل الاجتماعي وهذا ما جعل بعض الباحثين يطلق مفهوم السلطة الرابعة على الإعلام.

New Methods for Null Steering in the Field of Adaptive Beamforming

In this dissertation two categories of adaptive beamforming algorithms have been studied. In first category the adaptive beamforming has been applied for null steering whereas in second category it has been applied for direction of arrival mismatch problem to avoid performance degradation of the beamformers. New algorithms have been contributed in both categories. In case of first category a specific structure has been proposed which provides independent steering of all the available nulls present in the radiation pattern of an array antenna. The idea is based on decoupling of the complex weights employed with each antenna element to provide adaptively by controlling their values. This results in a proposed specific structure. The proposed structure is further improved by incorporating sidelobe suppression capability. Second Order Cone Programming has been used to get the appropriate set of weights to be utilized in the proposed structure. Similarly, the method for improving beam symmetry around the desired signal direction is also incorporated. These additional features are included over the cost of number of steerable nulls. A tailored Genetic Algorithm is proposed to compute the weight vector required to incorporate the proposed structure for beam symmetry. The second part of dissertation is meant for the second category of adaptive beamformers applied for direction of arrival mismatch problem. Performance of these beamformers degrades severely whenever there is a mismatch between the presumed and actual direction of desired signal impinging on an antenna array. A Robust Generalized Sidelobe Canceller has been proposed in this domain as remedial measure to restore the performance. The major advantage of proposed algorithm is that it provides improved results without broadening the main beam. This feature is an added advantage in comparison with the previously existing techniques. For this purpose the blocking matrix present in GSC has been modified without disturbing the quiescent weight vector. This results in robustness against signal look direction error without broadening the main beam. The simulation results confirm the improved performance of the beamformer. Another approach in this domain is based on diagonal loading of signal and data covariance matrices, involved in subsequent computations. The amount of this diagonal loading level is very critical which must not exceed a specific level to ensure the positive definite behavior of signal covariance matrix. This is a standard requirement for the convergence of existing general rank algorithms. Currently, there exists no reliable criterion for deciding the amount of diagonal loading level. In this context a new algorithm has been contributed to decide the amount of diagonal loading. Proposed algorithm is iterative in nature and uses the beam symmetry around the presumed signal direction to decide the level.