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Phospholipid Transport in Silicon Hydrogel Contact LensesZhao, Yibei 20 September 2011 (has links) (PDF)
Dry eye syndrome has been associated with the lack of phospholipids in the tear film, leading to disruption of the tear film and subsequent irritation. Characterization of the transport and release of phospholipids from a silicone hydrogel contact lens is required to assess the possible use of these lenses for phospholipid delivery to increase patient comfort. This thesis examines the use of silicone hydrogel contact lenses as phospholipid delivery devices. Contact lenses of silicone hydrogel composition were loaded with varying amounts of radiolabeled 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) from a solution of n-propanol. These lenses were eluted at 35°C into artificial tear fluid (ATF) or ATFcontaining varying amounts of DMPC. The amount of DMPC loaded into a lens is a linear function of the time of exposure to the DMPC/propanol solution. The initial rate of elution into ATF appears to be diffusion controlled for at least 10 hrs and is proportional to the amount of DMPC loaded. The ease of loading and the controllable release of DMPC from silicone hydrogels present the possibility of using such lenses to counter eye discomfort caused by inherently low levels of phospholipid in tears. To reduce manufacturing steps and concern for residual n-propanol in the lens, it is beneficial to incorporate the DMPC into the monomer formulation and then photopolymerize the lens. Results showed that using this process, DMPC can be placed in the lens and then eluted at faster rates than when it was loaded from n-propanol.
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Review of Earlier Thesis work at BTH Related to Packaging and Packaging FieldAhmad, Abu ul Hasnat January 2021 (has links)
This work aims at giving a systematic review of the numerical approaches and obtained results published in recent years. Focus is set on both the recent trends and achievements as well as challenges and open questions. Thesis critically reviews work done in previous thesis related to food packaging material and design, at Blekinge Institute of Technology with the collaboration of Tetra Pak liquid food packaging company. Here, 27 numbers of master’s thesis are critical review all the while using 4 PHD works for referencing. Focus of these thesis works relates to the mechanics and its sub-branch fracture mechanics. Due to this all the theory related to mechanics and fracture mechanics, which is compulsory to know for understanding is defined initially. Main material which are under consideration throughout the work are PP, LDPE, PET-LDPE, and aluminum foil. As three materials are used in the liquid food packaging which are PE, paper board and aluminum. Uses of this material and there required physical properties are measured. Testing methods which are used to check whether the material meets the required parameters are tensile testing, tear testing, peel testing and shear test. Also, some methods are used along with these tests to perform the test more precisely, to evaluate and compare result i.e., Nakajima test, Digital image correlation. DIC testing technique is used to compare the results obtained from simulation. It is also understood that DIC method provided the user with increased quality of obtained results. Most of the topics of discussions have been reviewed for corresponding thesis, displaying the used ideas, theory, applied experimentation and realized conclusions. Using these above it was able to derive a conclusion based on the developed research questions and hypothesis. Defined problems in previous work are studied also solution as a future work is suggested to overcome these problems. Mainly the slippage issue while holding PE in clamps. Furthermore, various development is discussed which is done to introduce new material which is more possible being used in the future.
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Novel guar crosslinkers for improved ophthalmic solutionsMafi, Roozbeh 06 1900 (has links)
In-situ chain extension of polymers used in the formulation of artificial tears and mild gelation are techniques to increase the residence time of eye drops on cornea. In-situ chain extension also helps to control the stability of ophthalmic emulsions both in the bottle and in the tear film. In this work, the interaction of hydrophobically modified guar and tear proteins as a method of polymer chain extension and mild gelation has been evaluated. Guar and its derivatives have been found to be very effective for ophthalmic applications. The ideal guar gelation agent is the one that turns on the gelation upon introduction onto the eye and that gelation chemistry is biocompatible and biodegradable. Controllable gelation is desirable to have relatively low viscosity eye drops for easy application and the drops form weak gels in the eye.
One recent strategy to cure dry eye disease is to include emulsions in lubricant eye drops. The idea is to supplement the natural lipid layer on the exterior surface of the tear film. Formulating artificial tear emulsions is relatively complicated and must satisfy conflicting criteria. Emulsion droplets should be stable over the period of their shelf life without creaming or aggregate formation. On the other hand, in the tear film the emulsion droplets must cream fast enough and deposit onto the water/lipid film interface on the exterior surface of the tear film. Thus, the emulsion must be stable but not too stable. Initially, science-based design rules were proposed for the development of future generations of lubricant eye drops. The effect of guar molecular weight and concentration on emulsion stability was evaluated. According to the concentration-molecular weight plot, polymer solutions can be divided into stable and unstable regions. They are defined based on the critical flocculation concentration (CFC) and critical viscosity concentration (C*). Inverted QCM-D has been proposed as a simple and fast method to define the stability of oil in water emulsion systems. This technique is a promising alternative for time consuming conventional creaming experiments.
Low molecular weight guar can be optimized to out-perform high molecular weight guars without the complications of formulating eye drops with high molecular weight polymers. Hydroxypropyl guar samples were oxidized and modified with linear alkyl amines to give a series of hydrophobically modified guars (MGuars). Lysozyme and human serum albumin (HSA), natural tear proteins, are able to extend the effective chain length of MGuar through polymer/protein complex formation. Hydrophobic modifications on guar enable efficient interaction with proteins, through their mutual hydrophobic characteristics. The interaction of proteins with various alkyl chain lengths, degrees of substitution and a range of molecular weights were examined. Binding and rheological measurements were employed to evaluate the interactions efficiency. Our results suggest that higher degrees of substitution and longer alkyl chain length give higher viscosity values. Lowering molecular weight allows for higher concentration, while keeping the initial viscosity constant. Higher viscosity was achieved as the chain extension occurred. The influence of hydrophobic modification and molecular weight variation on lubrication behavior of MGuars has also been determined. Hydrophobic modification enhanced the lubrication between hydrophobic surfaces. However, saturation of hydrophobes with protein abolished the lubricity. / Thesis / Doctor of Philosophy (PhD)
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DEVELOPMENT OF SMART CONTACT LENS TO MONITOR EYE CONDITIONSSeul Ah Lee (17591811) 11 December 2023 (has links)
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<p>In this study, we present advancements in smart contact lenses, highlighting their potential as minimally or non-invasive diagnostic and drug delivery platforms. The eyes, rich in physiological and diagnostic data, make contact lens sensors an effective tool for disease diagnosis. These sensors, particularly smart contact lenses, can measure various biomolecules like glucose, urea, ascorbate, and electrolytes (Na+, K+, Cl-, HCO3-) in ocular fluids, along with physical biomarkers such as movement of the eye, intraocular pressure (IOP) and ocular surface temperature (OST).</p>
<p>The study explores the use of continuous, non-invasive contact lens sensors in clinical or point-of-care settings. Although promising, their practical application is hindered by the developmental stage of the field. This thesis addresses these challenges by examining the integration of contact lens sensors, covering their working principle, fabrication, sensitivity, and readout mechanisms, with a focus on monitoring glaucoma and eye health conditions like dry eye syndrome and inflammation.</p>
<p>Our design adapts these sensors to fit various corneal curvatures and thicknesses. The lenses can visually indicate IOP through microfluidic channels' mechanical deformation under ambulatory conditions. We also introduce a colorimetric hydrogel tear fluid sensor that detects pH, electrolytes, and ocular surface temperature, indicating conditions like dry eye disease and inflammation.</p>
<p>The evaluation of these contact lens sensors includes in vivo/vitro biocompatibility, ex vivo functionality studies, and in vivo safety assessments. Our comprehensive analysis aims to enhance the practicality and effectiveness of smart contact lenses in ophthalmic diagnostics and therapeutics.</p>
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Visuell bedömning av standardiserade armlyft efter rotatorkuffrupturoperation : En utvärdering av inter- och intrabedömarreliabilitet / Visual assessment of standardized arm lifts after rotator cuff rupture surgery : An evaluation of inter- and intra-rater reliabilitySöderlund, Emelie, Peterson, Sofia January 2023 (has links)
Bakgrund: Rehabiliteringen efter en rotatorkuffrupturoperation är oftast lång och följer olika faser med hänsyn till senans inläkning. Behandlingsresultatet är multifaktoriellt och det rekommenderas att rehabiliteringen individanpassas. För att följa och utvärdera rehabiliteringsprocessen behövs funktionella axeltester. I dagsläget saknas reliabla och validerade funktionella axeltester under rehabiliteringens tidigare faser. Syfte: Syftet med denna studie är att undersöka reliabiliteten hos två standardiserade armlyft, Aktivt armlyft i flexion och Aktivt armlyft i skapulaplanet, med statiskt kvarhåll i 90° under 30 sekunder, för vuxna individer som genomgått enrotatorkuffrupturoperation för cirka tre månader sedan. Metod: Datainsamlingen utfördes i tre steg, först utfördes en videoinspelning av de standardiserade armlyften av två fysioterapeuter. Därefter utfördes två bedömningstillfällen av två andra fysioterapeuter. Videoinspelningarna, armlyften och bedömningarna utfördes enligt standardiserade protokoll. Inter- och intrareliabilitetsbedömningarna baserades på videoinspelningarna där de två bedömarna graderade patienternas förmåga att utföra de två standardiserade armlyften utifrån utfallsmåtten ”Klarar” eller ”Klarar ej”. Överensstämmelsen analyserades i IBM SPSS med Cohens Kappa. Resultat: Åtta manliga studiedeltagare i åldrarna 49–71 år (medelålder 59,4 år) deltog. Videoinspelningarna utfördes i genomsnitt 15,25 (±3,9) veckor efter operation. Den andra bedömningen genomfördes i genomsnitt 9 (±3,1) dagar efterförsta bedömningen. Resultatet visade att interbedömarreliabiliteten var ”God”(k=0,71) till ”Utmärkt” (k=1,00) och intrabedömareliabiliteten var ”Utmärkt”(k=1,00). Slutsats: Denna studie fann att inter- och intrabedömarreliabilitet var ”God” till”Utmärkt” gällande de två standardiserade armlyften. Resultatet bör tolkas med försiktighet på grund av det begränsade deltagarantalet och ingen säker slutsats kandras. Ytterligare forskning behövs för att fastställa klinisk betydelse. / Background: Rehabilitation after rotator cuff tear surgery is often long and follows different phases with consideration for tendon healing. The treatment result is multifactorial, and the rehabilitation is recommended to be individualized.vFunctional shoulder tests are of value and evaluate the rehabilitation process. Currently, reliable and validated functional shoulder tests are lacking during the earlier phases of rehabilitation. Purpose: The purpose of this study is to investigate the reliability of two standardized arm lifts, Active shoulder flexion and Active shoulder scaption, with astatic hold at 90° for 30 seconds, three months post-surgery. Method: Data collection was conducted in three steps. Starting with videorecordings of the standardized arm lifts by two physiotherapists. Followed by two assessment sessions with approximately one week apart, by two other physiotherapists. The video recordings, arm lifts, and assessments were performed according to standardized protocols. Inter- and intrarater reliability assessments were based on the video recordings. The examiners graded the patient’s ability to perform the two functional shoulder tests based on the outcomes "Approved" or "Non-approved". The agreement was calculated with IBM SPSS using Cohen's Kappa. Results: Eight men were included, 49-71 years (mean age 59,4 years). The videorecordings and the first evaluation were performed in mean 15,3 (±3,9) weeks postsurgery. The second evaluation was performed in mean 9,4 (±3,1) days after the first evaluation. The results showed that the interrater-reliability was “Good” (k=0,71) to“Excellent” (k=1,00), and the intrarater-reliability was “Excellent” (k=1,00). Conclusion: This study found that the inter- and intrarater reliability for the two standardized arm lifts were good to excellent. The limited number of participants requires caution with the interpretation of the results and no definitive conclusion can be drawn. Further research is needed to establish any clinical significance.
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Tear Film Dynamics Associated with Contact Lens WearMcClure, Kate Alexandra 14 August 2018 (has links)
No description available.
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以五力分析為基探討Value Analysis Tear-Down 對光電產業競爭優勢之影響-以Z公司為例 / A Study on the Impacts of Competitive Advantages using Value Analysis Tear-Down Method – A Case Study on Company Z賴威光, Lai,William Unknown Date (has links)
Even though TFT-LCD is a high-tech industry, it is a highly competitive business and the average selling price has been dropping year over year. The high technology no longer guarantees high profit margin due to intensive direct competitions among overflowing TFT-LCD makers. Every TFT-LCD maker is aggressively migrating to next generation fabrication and working rapidly to vertically integrate component suppliers to lower the cost. It is believed that in the manufacturing industry such as TFT-LCD is facing the toughest competition ever and all TFT-LCD companies are thinking of possible ways enhance their competitiveness regardless of their scales.
To analyze the current industry situation and provide suggestions to current players in the field, this research proceeds with the approach of case study. Using Porter’s Five Forces Model as competitive advantage measuring factors, we apply Value Analysis Tear-down method to see how it can influence each force.
Based on the case analysis, the author has reached the following findings:
1.Creating sustainable competitive advantages is very difficult by using cost reduction strategy only
2.Top management’s involvement of a new method or strategy can expedite the execution process and stimulate more innovative ideas
3.Future improvements derived from Value Analysis Tear-Down process must be constantly monitored and implemented to create sustainable advantages
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Modélisation par la Méthode des Eléments Discrets de la Déchirure du Complexe Musculo-Tendineux / Modelling of the tear of a Muscle-Tendon Complex with Discrete Element MethodRoux, Anthony 30 June 2016 (has links)
La déchirure musculaire est la première cause de blessure chez les athlètes. De nombreuses études décrivent ce traumatisme musculaire sans parvenir à en identifier clairement la chronologie et ses circonstances. L’objectif de la thèse est de décrire le phénomène de déchirure musculaire avec la méthode des éléments discrets, en s’appuyant sur des essais expérimentaux pour valider les modèles numériques. Dans une première partie, une revue de littérature permet d’acquérir les propriétés mécaniques des différents éléments constituant le complexe musculo-tendineux afin de pouvoir en réaliser un modèle macroscopique. Dans une deuxième partie, la modélisation du complexe musculo-tendineux est réalisée. La validation du comportement mécanique en traction passive du modèle proposé est réalisée en comparaison des travaux de L-L. Gras sur le muscle sternocléidomastoïdien humain. L’influence des paramètres morphologiques sur le comportement mécanique global est ensuite étudiée. La rupture fait l’objet de la troisième partie. Une modélisation de l’ensemble {tendon d’Achille/triceps sural} est réalisée et soumise à un test de traction passif jusqu’à rupture. La validation des résultats est faite vis-à-vis des essais expérimentaux réalisés sur cet ensemble musculaire provenant de pièces anatomiques humaines. L’étape suivante s’attache à modéliser la contraction musculaire, implémentée au niveau des fibres musculaires. Une validation du comportement actif du complexe musculo-tendineux est réalisée. Cette dernière étape, combinée à la traction destructive permet d’étudier la faisabilité de modéliser la déchirure par la méthode des éléments discrets, mais également d’étudier les structures endommagées et les mécanismes de rupture. Cela ouvre des possibilités d’utilisation cliniques de ce modèle pour comprendre et prévenir des blessures par déchirure musculaire. / Tearing of the muscle-tendon complex is a common sport-related injury for athletes. Many studies reported description of this traumatism but mechanisms leading to such an injury are still unclear as are the site of mechanical failure and involved structures. The aim of the thesis is to describe the phenomenon of the muscle-tendon-complex’s tear using the discrete element method and validating the numerical model with experimental data. In the first part, a literature review explains the different properties of the muscle-tendon complex main components’ in order to model it at the macroscopic scale. In the second part, the muscle-tendon complex is modeled. Validation of the mechanical behavior in passive tensile test is proposed by comparison with experimental data from L.-L. Gras on human sternocleidomastodeus muscle. Then, the different influences of morphometric parameters on the mechanical behavior of the complex are investigated. The third part focuses on the rupture. A model of the complex set of {Achilles tendon/surae triceps} is built and a tensile test until rupture is applied. Model validity is assessed by comparison with in vitro experiments from human cadavers. The fourth part focuses on the muscular activation, implemented inside fibers’ behavior. Validity of its active behavior is investigated. This fifth and last presents the enrichment with destructive tensile test. This added test allows first to study the feasibility to model the tear with the discrete element method; and second to focus on damaged structures and rupture’s mechanisms. This offers possibilities for clinical applications of this model to understand and prevent injuries caused by a tear of the muscle-tendon complex
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Análise das alterações do piscar, do filme lacrimal e da superfície ocular induzidas pelo uso de monitor de computador / Analysis of alterations in blinking, lacrimal tear film and ocular surface induced by the use of video terminal displaySchaefer, Tania Mara Cunha 26 March 2010 (has links)
A relação trabalho e visão é tão remota que determinou a adaptação da espécie humana ao meio em que está inserida. Demonstrou-se que trabalhar em um ambiente confortável, sem doenças ocular, favorece o desempenho visual e aumenta a produtividade. Conhecer os efeitos do monitor de computador (VDT) sobre o sistema visual significa planejar melhor o ambiente de trabalho e a atividade laboral para se obter máximo conforto e produtividade. Este estudo teve como objetivo geral analisar as alterações do piscar, do filme lacrimal e da superfície ocular induzidas pelo uso de monitor de computador (VDT). Para sua realização efetivou-se um estudo transversal, descritivo, observacional, analítico, realizado na Volkswagen do Brasil, São José dos Pinhais (PR), tendo como amostra, a população de funcionários do setor administrativo que utiliza VDT, com idade acima de 18 anos, sem doenças da superfície ocular, sistema palpebral e lacrimal. O ambiente de trabalho foi caracterizado pela temperatura, grau de umidade, velocidade do ar e iluminamento. Preencheram os critérios de inclusão 108 funcionários (idade média 34,1±7,88 anos e tempo mínimo de utilização do VDT 6 horas/dia). Foram avaliados as sintomatologias, filmagem da face para mensuração do tempo entre piscadas na situação de conversação, exame do olho externo e biomicroscopia das pálpebras, conjuntiva e córnea, filmagem videoceratoscópica para determinar tempo de ruptura do filme lacrimal, avaliação da quantidade de lágrima do lago lacrimal pelo Zone-Quick Phenol Red Thread tear test, avaliação do epitélio corneano pelo teste da lissamina verde, filmagem da face dos sujeitos para mensuração do tempo entre piscadas em leitura de VDT. Ao final da jornada de trabalho, foram feitas a reavaliação do tempo de ruptura do filme lacrimal da quantidade de lágrima e a avaliação do epitélio corneano. Compararamse o tempo entre as piscadas em conversação e em uso de VDT e o tempo de ruptura do filme lacrimal, antes e ao final da jornada de trabalho. A comparação desses tempos classificou os sujeitos como expostos, com tempo médio de ruptura do filme lacrimal menor que o tempo médio entre piscadas e não expostos com tempo médio de ruptura do filme lacrimal maior que o tempo médio entre piscadas. Nas condições do estudo, em jornada de trabalho com tempo mínimo de 6 horas de uso de VDT, houve aumento da exposição da superfície ocular causada pelo aumento do tempo entre piscadas. O aumento da exposição da superfície ocular foi causado pela diminuição do tempo de ruptura do filme lacrimal constatado ao final da jornada de trabalho. O tempo entre piscadas na situação de leitura em VDT que foi significantemente maior que na situação de conversação. O tempo de ruptura do filme lacrimal, ao final da jornada de trabalho, foi significativamente menor que em seu início. A exposição ocular observada durante a jornada de trabalho com usuários de VDT, nas condições deste estudo, não causou alteração epitelial detectável ao teste da lissamina verde. Não houve alteração do volume lacrimal em olhos com exposição, antes da jornada de trabalho com VDT, nem houve alteração do volume lacrimal em olhos com exposição ocular, após a jornada de trabalho com VDT. / The relationship between work and vision is so remote that has determined the adaptation of human beings to the environment in which they are inserted. It has been demonstrated that working in a pleasant environment, without any ocular disease, has favored visual performance and increased productivity. Knowing the effects of video terminal display (VDT) on the visual system helps plan labor environments and labor activities more effectively so that optimal comfort and productivity are obtained. This transversal study, performed at Volkswagen do Brasil, São José dos Pinhais, PR, has the objective to investigate the influence of VDT labor activities on blinking, tear film and ocular surface, ocular exposure and amount of tear in the lacrimal lake. The population sample comprised VDT administrative department employees older than 18, without diseases on the ocular surface, tear film and blinking system. The evaluation of the working environment included measurements of temperature, humidity, air speed and lighting. One hundred and eight employees met the study criteria (mean age 34.1±7.88 and minimal VDT use time of 6 hours/day). Several evaluations were performed: the ocular surface symptomatology; the measurement of the blink time in conversation situations; the examination of the ocular surface and lacrimal film; a videokeratoscopy to establish the tear film break-up time; evaluation of the amount of tears of the lacrimal lake by means of the Zone-Quick Phenol Red Thread tear test; evaluation of the corneal epithelium by means of the lissamine green test; and determination of the blink time in VDT reading situations. At the end of the working period, the amount of tears and the corneal epithelium structure were re-evaluated. Comparisons between the blink time in conversation and VDT reading situations were performed before and at the end of the working day. The comparison data obtained classifies the subjects into two categories: exposed, with a tear film break-up time shorter than the mean time between blinks; and non-exposed, with tear film break-up time longer than the mean time between blinks. The findings obtained reveal that there was an increase in the ocular surface exposure caused by the increase in the time between blinks during the working period and increase of the ocular surface exposure caused by the decrease in the tear film break-up time determined at the end of the working day. The time between blinks at VDT reading situations was significantly longer than at conversation situations. The tear film break-up time at the end of the working day was significantly shorter than at the beginning. The ocular exposure during the VDT use has not caused epithelium alterations detectable at the lissamine green test. There were no alterations in the amount of tears in the eyes which underwent ocular exposure after VDT use situations.
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Impacto nas taxas de lacerações obstétricas do esfíncter anal com o uso restrito da episiotomia em um hospital escolaSchneider, Samanta January 2017 (has links)
Introdução: A laceração obstétrica do esfíncter anal (LOEA) está associado com incontinência anal. A episiotomia foi proposta como uma forma de proteção do esfíncter anal no parto, especialmente a episiotomia mediolateral; entretanto, diversos estudos mostraram que o uso de rotina da episiotomia não reduz o risco de LOEA. Objetivo: Este estudo tem por objetivo analisar se a redução na taxa de episiotomia em hospital escola no Brasil foi associada a um aumento na incidência de lacerações obstétricas do esfíncter anal, além de fatores associados a elas. Métodos: Estudo observacional, transversal e retrospectivo, realizado no Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brasil. Foram incluídos todos os partos vaginais de gestações únicas, apresentação cefálica, a partir de 34 semanas de idade gestacional, realizados em 2011-2012 (uso liberal da episiotomia) e 2015-2016 (uso restrito da episiotomia), e comparados em relação a taxa de episiotomia mediolateral e de LOEA. Resultados: foram analisados 4268 partos (2043 no período de 2011-2012, 2225 de 2015-2016), foram analisados 2043 partos. A taxa de episiotomia reduziu de 59.4% para 44.2% (p≤0.0001). No período 2011-2012, ocorreram 10 lacerações obstétricas do esfíncter anal em 2043 partos (0.48%), enquanto que no período 2015-2016, ocorreram 31 lacerações em 2225 partos (1.39%). Houve interação quando comparado os dois períodos em relação a realização de episiotomia e a ocorrência de LOEA (p≤0.0001). A episiotomia foi fortemente associada a não ocorrência de LOEA em 2011-2012 (59.5%), enquanto que não ter episiotomia foi associado ao grupo com (67.7%) e sem LOEA (55.7%) em 2015-2016. Fatores associados a LOEA foram indução do parto e distócia de ombro. Conclusão: Houve um aumento na taxa de lacerações do esfíncter anal com a diminuição da taxa de episiotomia. A episiotomia de rotina foi prote / Introduction: Obstetric anal sphincter tear (OAST) is associated with anal incontinence. Episiotomy was proposed as a form of protection of the anal sphincter at delivery, especially mediolateral episiotomy; however, several studies have shown that routine use of episiotomy does not reduce the risk of OAST. Objective: This study aims to analyse whether the reduction in the rate of episiotomy in a school hospital in Brazil was associated with an increase in the incidence of obstetric lacerations of the anal sphincter, in addition to associated factors. Methods: Observational, cross-sectional and retrospective study, conducted at Hospital de Clínicas, Porto Alegre, Rio Grande do Sul, Brazil. We included all vaginal deliveries of single pregnancies, cephalic presentation, from 34 weeks of gestational age, performed in 2011-2012 (liberal episiotomy) and 2015- 2016 (restricted episiotomy), and compared in relation to the rate of mediolateral episiotomy and OAST. Results: 4268 births were analysed (2043 in 2011-2012 and 2225 in 2015-2016). The episiotomy rate decreased from 59.4% to 44.2% (p≤0.0001). In 2011-2012, there were 10 obstetric anal sphincter lacerations in 2043 births (0.48%), while in the period 2015-2016 there were 31 lacerations in 2225 births (1.39%). There was interaction when comparing the two periods in relation to the episiotomy and the occurrence of OAST (p≤0.0001). Episiotomy was strongly related to 2011-2012 group with no OAST (59.5%), while not having an episiotomy was related to both OAST (67.7%) and no OAST (55.7%) group in 2015-2016. Factors associated with OAST were labor induction and shoulder dystocia. Conclusion: There was an increase in the rate of lacerations of the anal sphincter with a decrease in the rate of episiotomy. Routine episiotomy was protective.
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