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2013년 12월 2일 월요일

About 'indian accounting standard'|...of betraying those, the Indians, whom he considered his...retrospectively judging literary work by the standards of another millennium may yet cut both ...







About 'indian accounting standard'|...of betraying those, the Indians, whom he considered his...retrospectively judging literary work by the standards of another millennium may yet cut both ...








The               drug               misoprostol,               condemned               as               dangerous               when               used               "off               label"               for               purposes               such               as               inducing               labor               or               as               an               adjunctive               drug               during               elective               abortions               has               been               proven               to               be               a               safe,               convenient,               and               inexpensive               means               to               prevent               postpartum               hemorrhage,               a               major               killer               of               women               in               developing               countries.

In               developed               countries,               where               the               majority               of               births               occur               in               hospitals               and               emergency               care               is               available,               deaths               from               postpartum               hemorrhage               are               rare.

However,               the               condition               can               be               life-threatening               in               countries               where               most               births               occur               at               home               and               emergency               care               is               not               always               available.
               In               rural               ,               where               the               study               took               place,               50               %               of               births               occur               at               home               or               in               facilities               without               a               physician               in               attendance               and               estimated               maternal               death               rate               in               that               country               is               407               women               for               every               100,000               births.

The               study               also               cited               estimates               that,               worldwide,               about               500,000               maternal               deaths               occur               during               childbirth               each               year,               with               postpartum               hemorrhage               accounting               for               about               30               percent               of               those               deaths.

The               comparable               rate               in               the               is               about               10               maternal               deaths               per               100,000               births,               with               postpartum               hemorrhage               accounting               for               about               17               percent               of               these               deaths.
               The               study,               which               was               conducted               by               researchers               from               the               University               of               Missouri,               India's               Jawaharlal               Nehru               Medical               College,               and               the               National               Institutes               of               Health,               appears               in               the               October               7,               2006               issue               of               Lancet               and               was               funded               by               the               Global               Network               for               Women's               and               Children's               Health               Research,               a               public-private               partnership               between               the               National               Institute               of               Child               Health               and               Human               Development               (part               of               the               National               Institutes               of               Health)               and               the               Bill               and               Melinda               Gates               Foundation.
               The               study,               conducted               between               September,               2002,               and               December,               2005,               was               a               placebo-controlled               trial               involving               1,620               women               in               rural               who               received               either               oral               misoprostol               or               a               placebo               after               delivery.

25               auxiliary               nurse               midwives               undertook               the               deliveries,               administered               the               study               drug,               and               measured               blood               loss.
               At               the               conclusion               of               the               study               it               was               found               that               only               6.4               %               of               the               women               that               received               misoprostol               were               likely               to               have               experienced               acute               postpartum               hemorrhage               (defined               as               the               loss               of               from               500               milliliters               [ml]               to               just               under               1000               ml               of               blood               or               slightly               more               than               a               pint               to               slightly               more               than               a               quart.)               compared               with               12               %               in               the               placebo               group.

The               misoprostol               group               also               had               fewer               occurrences               of               acute               severe               postpartum               hemorrhage               -               the               loss               of               1000               ml               or               more               of               blood.

Overall,               the               researchers               reported               that               one               case               of               postpartum               hemorrhage               was               prevented               for               every               18               women               treated.
               In               developed               countries,               oxytocin               is               the               standard               drug               used               to               prevent               postpartum               hemorrhage               and               stops               bleeding               in               the               uterus               by               causing               the               uterus               to               contract.

However,               oxytocin               must               be               kept               cold               and               must               be               given               by               trained               medical               personnel               -               conditions               that               make               it               unsuitable               for               use               in               parts               of               the               world               where               most               births               are               at               home               and               refrigeration               and               skilled               medical               personnel               are               in               short               supply.
               Misoprostol,               which               also               stops               uterine               bleeding               by               causing               the               uterus               to               contract,               does               not               require               refrigeration,               can               be               given               once               after               delivery               as               3               oral               tablets               costing               as               little               as               $.14               each,               and               does               not               require               highly               trained               personnel               and               it               can               be               given               by               semi-skilled               birth               attendants.
               According               to               the               summary               appearing               with               the               Lancet               report               "Oral               misoprostol               was               associated               with               significant               decreases               in               the               rate               of               acute               postpartum               hemorrhage               and               mean               blood               loss.

The               drug's               low               cost,               ease               of               administration,               stability,               and               a               positive               safety               profile               make               it               a               good               option               in               resource-poor               settings."
               Disclaimer
               The               information               presented               in               this               article               and               its               included               links               is               of               an               informational               nature               only               and               is               not               intended               as               a               recommendation               of               any               changes               in               the               reader's               health               care               program.

Before               making               any               changes               in               diet,               medications,               or               other               treatments               the               reader               is               strongly               advised               to               consult               with               their               health               care               provider.






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