Trimester 1

A generalized approach is introduced for getting minimal trim in one- dimensional cutting stock problem (1D-CSP) which occurs extensively while manufacturing of different engineering objects. Our study is especially focused on transmission tower manufacturing industry. The concept of computing total trim by using the idea of pre-defined sustainable trim has been explored in previous work of authors. Given m stock lengths  ,  , … ,  , the cutting plan consists of cutting of at most two order lengths at a time out of the demanded set of n order lengths ,  , … ,  . Considering the given data, the total trim has been computed corresponding to two different sustainable trims of order one (viz. ) and order two (viz.  ). Introducing various values of sustainable trims as knots between and  , the total trim has been computed corresponding to each knot, the linear approximation has been constructed which predict the total trim loss at any arbitrary point lying between and  .

ASKEP KEHAMILAN FISIOLOGIS  Definisi dari masa kehamilan dimulai dari konsepsi sampai lahirnya janin. Lamanya hamil normal adalah 280 hari (40 minggu atau 9 bulan 7 hari) di hitung dari hari pertama haid terakhir.  Pembagian kehamilan dibagi dalam 3 trimester, yaitu : Trimester pertama dimulai dari konsepsi sampai 3 bulan (0-12 minggu); Trimester kedua dari bulan keempat sampai 6 bulan (13-28 minggu); Trimester ketiga dari bulan ketujuh sampai 9 bulan (29-42 minggu). Tanda Kehamilan 1. Mendeteksi Tanda Pasti Kehamilan Indikator pasti hamil adalah dengan pemeriksaan melalui USG yaitu Ultrasonografi yang akan menggambarkan adanya janin. 2. Mendeteksi Tanda Kemungkinan Hamil Indikator kemungkinan hamil adalah karakteristik fisik yang bisa dilihat atau diukur oleh pemeriksa dan lebih spesifik dalam hal psikologis yang disebabkan oleh kehamilan.  Reaksi kehamilan positif : dasar dari tes kehamilan adalah pemeriksaan hormon Choriorlik gonadotropin sub unit beta (beta heg) dalam urine.  Uterus membesar , mengalami perubahan bentuk, besar dan konsistensi rahim.  Tanda Hegar yaitu segmen bawah rahim melunak. Ditemukannya serviks dan isthmus uteri yang melunak usia kehamilan 4 sampai 6 minggu dan menjadi nyata pada minggu ke 7-8.  Tanda Chadwick. Biasanya muncul pada minggu kedelapan dan terlihat lebih jelas pada wanita yang hamil berulang. Tanda ini merupakan perubahan warna menjadi merah kebiruan yang terlihat pada portio, vagina, dan labia. Tanda ini terjadi karena adanya pelebaran vena akibat peningkatan kadar esterogen

The uterine artery Doppler velocimetry (UADV) are described by authors in 108 women with history of hypertensive disorder of pregnancy (HDP) between the 10th and 13th week of pregnancy to identify those at higher risk for recurrent preeclampsia and to evaluate the efficacy of prophylactic pharmacological treatment in this subgroup of patients. Patients with abnormal flow values (RI > 0.58 and any notching) were immediately started on aspirin 100 mg/daily, replaced by daily subcutaneous injection of low molecular weight heparin from the 24th week till delivery. Concerning the maternal morbidity (expressed by abnormal both mean blood pressure and 24-hour proteinuria throughout pregnancy), the Authors found that the average pregnancy course in 20 (18.5%) prophylactic treated patients with altered 1st trimester UADV (group A) was better than in their previous pregnancies, however regarding the above parameters no significant difference (P > 0.05) was found between the patients treated and another cohort of patients (n =20), also extrapolated from the same pool of patients at risk for HDP, but with normal I trimester UADV studies (group B) who were not prophylactic treated. Both groups of patients were followed up from the time of Doppler studies till 6 weeks post partum. The study suggests that UADV in the late first trimester of pregnancy is useful in reducing the risk of preeclampsia in patients with history of HDP, allowing the prompt institution of prophylactic treatment in selected patients. Index Terms—About four key words or phrases in alphabetical order, separated by commas.

Background: Low back pain (LBP) is a common disorder involving the muscles, nerves, and bones of the back. Pain can vary from a dull constant ache to a sudden sharp feeling. This can be due to a combination of mechanical, hormonal, and psychosocial factors. These have a negative impact on their quality of life. Treatment options are often poor, as the cause of back pain is not always fully understood. Furthermore, treatments that are available usually have a low success rate and consist mainly of lifestyle adjustments and bed rest. Material and Methods: Two hundred and ten women were selected from the OPD of genecology and obstetrics department of Jinnah hospital Lahore for interview, a structured questionnaire was used for information, data entered in computer software SPSS version 22.0. A cross sectional survey was done. Participants of the study are 15 to 45 years old having established diagnosis of low back pain. Duration of the study was 3 months. Result: Among 210 females, 22.22% noted ongoing back pain at the time they became pregnant. 54% were multigravidas and 41% were grand multigravidas. In the latter group, 19% patients had backache before pregnancy and 81% had during pregnancy. No treatment was taken in 61% patients, rest in 19%, analgesic in 12% and light exercise by 9% patients. The present study revealed that backache is more prevalent in multigravidas, grand multigravidas and associated factors like weightlifting, heavy work, bending, standing posture etc. are main causes of backache. Analgesics are effective in relieving backache in pregnancy. The appropriate treatment aims to reduce the discomfort and the impact on the pregnant woman's quality of life. Conclusion: Back pain is a common problem in pregnant women and many factors contribute to it. About half of the patients are taking rest to treat LBP. It is advised that the patient should be given special advice regarding posture and exercise, training of health care provider, education of the pregnant during antenatal sessions, about proper nutrition, weight control, and family planning.

Introduction: Brucellosis is a highly contagious zoonotic disease caused by ingestion of unpasteurized milk or undercooked meat from infected animals or close contact with their secretions. Subject and Methods: Sero-prevalence of brucellosis in pregnant women was conducted for the first time in Kathmandu, Nepal. A total of 80 sera samples were collected from the pregnant women visiting Kathmandu Model Hospital. The patients were categorized on the basis of age, trimester and ethnic groups. The sera samples were tested by ELISA method. Results: The sero-prevalence of brucellosis among pregnant women was found to be 11.25%. Madhesi ethnic group showed the highest (16.66%) seropositivity rates followed by Janajati (11.53%) and the lowest was in Brahmin (8.33%) ethnic group. Similarly, the age group 31-35 years showed highest prevalence (29.41%) followed by the age group 26-30 years (13.33%). There is absence of seropositivity among the age group 16-20 years and 21-25 years. The highest sero-prevalence rate (12.76%) was found in the third trimester followed by first trimester (10%) and the lowest was in second trimester (8.69%). About 3% of them consume raw milk directly from milking animals which is one of the risk factor of brucellosis in pregnant women. Conclusion: The prevalence was found to be high in pregnant women and ELISA was a sensitive and specific test for the detection of IgG antibodies against Brucella.