bluuebunny/crossref_metadata_2025 huggingface dataset:
Forest product harvesting in the Eastern Cape, South Africa: Impacts on habitat structure
Authors: Leaver Jessica , Cherry Michael I.
Published: September 2020

The Eastern Cape Province harbours 46% of South Africa’s remaining indigenous forest cover, and is one of the country’s poorest and least developed provinces. Forest resources thus represent a vital component of rural livelihoods in this region. Consequently, forest management policies aim to balance the needs of resource users with the ecological integrity of forest ecosystems. In a recent study, forest bird ranges were shown to have declined in the Eastern Cape over the past 20 years, despite increases in forest cover over the same time period, indicating that habitat degradation may be driving forest bird losses. Given that harvesting of forest products represents the primary human disturbance in forests in the Eastern Cape today, insight is needed regarding the link between resource use and habitat modification. We report on effects of harvesting of three key forest products – poles, timber and medicinal bark – on habitat structure at the ground, understorey and canopy layers in indigenous forests in the province. Harvest activities had considerable impacts on habitat structure, depending on the nature and extent of harvesting. Bark and timber harvesting resulted in canopy gaps, whereas pole harvesting reduced tree density, resulting in understorey gaps. Overall, harvest activities increased the frequency of canopy disturbance, and density of understorey layer foliage. Unsustainable bark harvesting practices increased the mortality rate of canopy trees, thereby increasing dead wood availability. By providing insight into human-mediated habitat modification in forests of the Eastern Cape, this study contributes to the development of ecologically informed sustainable resource management policies.
Significance:

Unregulated harvesting of forest products in state-managed indigenous forests of the Eastern Cape results in habitat modification.
The nature and extent of habitat modification is dependent on the type and intensity of resource use, indicating that resource use may be sustainably managed.
Timber and medicinal bark harvesting activities result in canopy disturbances, thereby altering natural canopy gap dynamics, with concomitant impacts on understorey habitat structure.
Changes in forest habitat structure associated with high levels of resource use are likely to have ramifying effects on forest biodiversity.
A portfolio perspective of rural livelihoods in Bushbuckridge, South Africa
Authors: Ragie Fatima H. , Olivier David W. , Hunter Lori M. , Erasmus Barend F.N. , Vogel Coleen , Collinson Mark , Twine Wayne
Published: September 2020

Land-based income streams, which include the consumption and selling of crops, livestock and environmental products, are inherent in rural households’ livelihoods. However, the off-farm cash income stream – primarily composed of migrant labour remittances, social grants, and savings and loans – is increasing in importance in many regions. This case study of 590 households from Bushbuckridge, South Africa, analyses the economic value of each of these income streams at three points: what enters the household, what is used and what is sold. Two important findings emerge. First, dependence on offfarm cash incomes is far higher than previously suggested by case studies in the area and the benefits of employment accrue to those already better educated and wealthier. This suggests that shifts in offfarm opportunities will exacerbate already deep inequalities. Second, while environmental products and crops are important for direct use, they generate insignificant cash incomes from sales. This suggests a weakening of the direct links between the local ecosystem and this society, challenging traditional notions of African rurality being intrinsically land based.
Significance:

Off-farm incomes such as wage labour, remittances and social grants are almost the sole source of cash for households in the study area. Even when including non-monetary incomes such as harvested produce, foraged goods and livestock products, off-farm incomes still represent the overwhelmingly largest proportion of overall household income value. This highlights the fact that South African rural economies are not consistently or primarily land based, and indicates the necessity of rural development strategies that facilitate participation in local cash economies. Otherwise, such efforts will be unable to yield broad benefits and will, instead, simply enrich those who are already better off.
Statistical classification of South African seasonal divisions on the basis of daily temperature data
Authors: Van der Walt Adriaan J. , Fitchett Jennifer M.
Published: September 2020

Across South Africa, a wide range of activities is influenced by differences in seasonality. In a South African context, there is little consensus on the timing of seasonal boundaries. Inconsistency exists through the use of ad-hoc approaches to define seasonal boundaries across South Africa. In this paper, we present one of the very first uniform statistical classifications of South African seasonal divisions on the basis of daily temperature data. Daily maximum and minimum temperature data were obtained from 35 selected South African Weather Service meteorological stations that had sufficiently complete data sets and homogeneous time series, spanning the period 1980–2015. An Euclidean cluster analysis was performed using Ward’s D method. We found that the majority of the stations can be classified into four distinct seasons, with the remaining 12 stations’ data best classified into three seasons, using Tavg as the classifier. The statistically classified seasonal brackets include summer (October/November/December/ January/February/March), early autumn (April) and late autumn (May), winter (June/July/August), and spring (September). Exploring the boundaries of seasons, the start of summer and end of winter months follow a southwest to northeastwards spatial pattern across the country. Summers start later and winters end later in the southwestern parts of the country, whereas in the northeast, summers start earlier and winters end earlier.
Significance:

The findings contribute to the common knowledge of seasonality in South Africa.
New seasonal divisions in South Africa are proposed.
Structure of the sunflower plant breeders’ rights landscape in South Africa
Authors: Nhemachena Charity R. , Muchara Binganidzo
Published: September 2020

Varietal innovations and protection of plant breeders’ rights (PBRs) contribute to the development of any crop’s ability to produce higher yields relatively consistently. Producing yields under adverse weather conditions and the overall characteristic of drought tolerance, make the sunflower an attractive crop for producers in dryland production regions. The main objective of this study was to give an overview of the structure of the South African sunflower breeding programme, focusing on the construction of PBRs and the leading players in sunflower breeding and seed production in South Africa. We compiled a detailed database of sunflower varietal innovations in South Africa from 1979 to 2019 using various sources such as the South African Grain Laboratory, the Department of Agriculture’s Plant Variety Journals and the Crop Estimation Committee. This data set was then analysed using descriptive statistics and trend analysis to determine the main trends in ownership of PBRs and sunflower varieties. We looked at the inclusion of new sunflower varieties on the national variety list for sunflower varietal improvements in South Africa over this period. A total of 76 PBR sunflower varietal applications were lodged for the period – an average of 1.9 applications per year. The principal applicants for varietal inclusions on the national variety list were Pannar with 102 varieties (23.8%), Pioneer seeds with 51 varieties (11%), Saffola seed with 42 varieties (9.8%) and Agricultural Research Council with 10 varieties (2.3%). In order for breeders to benefit from their investment in research and avoid exploitation of their work, they need to be protected and receive returns on their investments. Innovation can be stimulated by proper collaboration between the private and public sectors, aided by broader variety sector legislation that encourages all players to invest.
Significance:

The study addresses the absence of empirical proof on the patterns and trends of sunflower varietal improvements in South Africa.
The study provides evidence on the evolution of varietal rights, the extent of varietal rights granted, and which sunflower varieties were included on the national variety list and the breeders and owners of the varieties.
Grade 9 learners’ algebra performance: Comparisons across quintiles, insights from errors and curriculum implications
Authors: Pournara Craig
Published: September 2020

It is well known that learners’ performance in mathematics in under-resourced secondary schools in South Africa is poor. However, little is known about the performance of learners in top-performing well-resourcedsecondary schools apart from their good results in Grade 12. In this study, the performance of Grade 9 learners in top-performing quintile 5 (i.e. well-resourced) schools was compared with that of learners in quintile 1–3 (i.e. poorly resourced) schools using a 45-item test. While the quintile 5 learners obtained higher test scores, the performance pattern across the test items was very similar for both quintile groupings. A detailed error analysis of 89 quintile 5 learners’ responses to equation items revealed difficulties in applying the standard equation-solving procedure, and in operating with negatives and subtraction, particularly on like terms. These problems may be related to a poorly conceived curriculum in the areas of integers and equations. It is recommended that Grade 8 and 9 teachers pay regular attention to all four arithmetic operations on integers. Furthermore, the teaching of equations should give greater attention to the cognitive shifts required in solving equations with letters on both sides of the equal sign.
Significance:

Learner performance patterns on a test were similar for learners from top-performing quintile 5 schools and learners from lower quintile schools, although the quintile 5 learners obtained higher test scores.
Quintile 5 learners’ ability to solve linear equations correctly is substantially impacted by their difficulties in simplifying two algebraic terms to a single term, particularly when negatives and/or subtraction are involved.
Particular aspects of the curriculum may partly be responsible for the difficulties learners experience with integers and equations.
Newly identified hominin trackways from the Cape south coast of South Africa
Authors: Helm Charles W. , Lockley Martin G. , Cawthra Hayley C. , De Vynck Jan C. , Dixon Mark G. , Helm Carina J.Z. , Thesen Guy H.H.
Published: September 2020

Three new Pleistocene hominin tracksites have been identified on the Cape south coast of South Africa, one in the Garden Route National Park and two in the Goukamma Nature Reserve, probably dating to Marine Isotope Stage 5. As a result, southern Africa now boasts six hominin tracksites, which are collectively the oldest sites in the world that are attributed to Homo sapiens. The tracks were registered on dune surfaces, now preserved in aeolianites. Tracks of varying size were present at two sites, indicating the presence of more than one trackmaker, and raising the possibility of family groups. A total of 18 and 32 tracks were recorded at these two sites, respectively. Ammoglyphs were present at one site. Although track quality was not optimal, and large aeolianite surface exposures are rare in the region, these sites prove the capacity of coastal aeolianites to yield such discoveries, and they contribute to what remains a sparse global hominin track record. It is evident that hominin tracks are more common in southern Africa than was previously supposed.
Significance:

Three new Pleistocene hominin trackways have been identified on the Cape south coast, bringing thenumber of known fossil hominin tracksites in southern Africa to six.
The tracks were all registered on dune surfaces, now preserved as aeolianites.
These are the six oldest tracksites in the world that are attributed to Homo sapiens.
Hominin tracks are more common in southern Africa than was previously supposed.
'Pollute the bay and poison the people': A short history of the Green Point marine sewage outfall, 1882–1992
Authors: Overy Neil
Published: September 2020

The City of Cape Town in South Africa pumps 40 million litres of untreated sewage into the Atlantic Ocean from the Green Point outfall pipeline every day. This results in microbial and chemical pollution of the sea (including persistent organic pollutants), marine organisms and recreational beaches, breaching the City’s constitutional commitment to ‘prevent pollution and ecological degradation’ and, in doing so, it fails to uphold the constitutional right to an environment for citizens that is not harmful to ‘health or well-being’. This article explores how the decision to build this marine outfall was reached in 1895. It illustrates how narrow economic interests from the 1880s until today have driven the City’s commitment to the Green Point outfall despite a long history of opposition from citizens and scientists and repeated instances of pollution and ill-health. The findings reveal how, rather than being the cost-saving option that the City has always claimed it to be, its maintenance has cost enormous sums of money. The story of the Green Point outfall is one in which unimaginative, short-term monetary thinking has thwarted the search for an ecologically and hydrologically sustainable alternative means of sewage disposal – a legacy the City’s residents and the oceans that surround it live with today.
Significance:

The findings show that the disposal of untreated sewage into the sea at Green Point has always been controversial (scientifically, politically and socially), and has resulted in episodes of illness among Cape Town citizens. It has never been the most economic option as repeatedly asserted by the City Council. The findings also illustrate that the City Council has consistently rejected ecologically and hydrologically sustainable alternative disposal options, and has denied problems associated with the outfall, despite overwhelming evidence to the contrary, a pattern which persists. These findings are important for civic governance, desalination, water quality, environmental humanities, health (human and marine), sanitation and urban planning.
Relación entre el principio de reciprocidad y el compromiso del consumidor
Authors: Mejía-Giraldo Juan F.
Published: September 2020

El enfoque relacional del marketing ha ganado mucha relevancia incluso en medio de una transición hacia una digitalización cada vez más significativa. El objetivo del presente artículo es identificar la relación entre el principio de reciprocidad y comportamientos de compromiso del consumidor, con el fin de plantear las características que debería tener un marketing en que se privilegien los vínculos recíprocos entre organizaciones con fines lucrativos con sus clientes. Para esto, se realizó una revisión bibliográfica de 32 artículos, publicados en revistas académicas, que abordan el tema del compromiso del consumidor con marcas y de 30 que referencian estudios relacionados con manifestaciones solidarias y altruistas en seres humanos, las cuales se vinculan con el principio de reciprocidad. A partir de esta revisión, se puede indicar que las marcas con características humanas y hedónicas son mucho más proclives a incentivar comportamientos de compromiso en sus clientes, a pesar de esto parece extremadamente ambicioso lograr establecer una relación como la que se da entre seres humanos, por lo que muchas empresas usan incentivos para estrechar los vínculos con sus compradores. En este sentido, se considera que una estrategia basada en el principio de reciprocidad sería mucho más sostenible para tal fin, logrando que los clientes se vinculen con las organizaciones a partir de un propósito compartido, que aporte al bien común y que sea retribuido en términos de comportamientos de compromiso.
La transparencia publicitaria en los influencers de las redes sociales
Authors: Guiñez-Cabrera Nataly , Mansilla-Obando Katherine , Jeldes-Delgado Fabiola
Published: September 2020

Las redes sociales han contribuido a una nueva estrategia de marketing donde las marcas forjan alianzas con los influencers de las redes sociales para generar contenido publicitario. Esta estrategia conocida como marketing de influencer se encuentra en crecimiento y ganando un interés sustancial en la literatura. Sin embargo, la comprensión actual de la percepción de los influencers de las redes sociales frente a la transparencia del contenido que publicitan sigue siendo limitada, donde prácticamente todos los estudios se centran en la percepción del seguidor y en países desarrollados donde existe mayor regulación frente a la transparencia publicitaria. Para abordar esta problemática, la presente investigación utilizó la teoría de credibilidad de la fuente y la teoría institucional con el objetivo de explorar las percepciones de los influencers de las redes sociales frente a la transparencia del contenido que publicitan. Sobre la base de un estudio cualitativo que incorporó entrevistas semiestructuradas con ocho influencers de las redes sociales en Chile. Los resultados de este estudio muestran que los influencers de las redes sociales consideran relevante en su credibilidad de la transparencia publicitaria; la confiabilidad, la experiencia, la auto-presentación en línea y los aspectos normativos. Estos hallazgos contribuyen a la literatura de marketing de influencer y también tiene importantes implicancias prácticas para el amplio y creciente campo de la publicidad como son los profesionales de marketing, las marcas y los agentes reguladores encargados de proteger al consumidor.
Uso de las prácticas de comercialización de las PYME de la Ciudad de México y su relación con la competitividad
Authors: Saavedra-García María Luisa , Demuner-Flores María del Rosario , Choy-Zevallos Elsa Esther
Published: September 2020

El objetivo de esta investigación consiste en conocer las prácticas de comercialización que utilizan las PYME de la Ciudad de México y determinar si existe relación entre estas y la competitividad interna, considerando el tamaño y el sector en que se desempeñan. El método de investigación es empírico con un alcance descriptivo y correlacional, se trabajó con una muestra de 400 PYME recolectando datos a través de un trabajo de campo, se aplicó el mapa de competitividad del BID adaptado por Saavedra (2014b), que mide la competitividad interna de las empresas considerando 8 áreas, para este trabajo sólo se analizó el área de comercialización que incluye las prácticas: Plan de mercado, estrategias comerciales, conocimiento de competidores, determinación de precios, productos nuevos, marketing, servicio al cliente, fuerza de ventas y sistemas de distribución. Los resultados muestran un bajo nivel de aplicación de las prácticas de Comercialización, determinado por el uso de prácticas básicas y una relación significativa entre las prácticas de comercialización y la competitividad, lo cual implica la importancia del uso de prácticas de comercialización para impulsar la competitividad de las PYME.
Revisión sistemática de literatura sobre factores clave en la identificación de oportunidades de negocio
Authors: Gamero Harold , Ostos Jhony
Published: September 2020

La identificación de oportunidades de negocio es una tarea determinante dentro de la dinámica del emprendimiento. Por ello, diferentes investigaciones han buscado relaciones entre los factores individuales y los resultados exitosos de este primer paso emprendedor. Aunque numerosos factores han sido analizados existe todavía una extensión considerable de definiciones que varían entre ellos. Atendiendo a esta necesidad, este artículo desarrolla una revisión sistemática de la literatura, consolidando aquellos factores que han sido incluidos en investigaciones de este campo durante los últimos diez años. Esta revisión se llevó a cabo siguiendo la metodología trietápica de Jennifer Platt, la cual ha sido ampliamente utilizada en artículos similares. Partiendo de un total de 3119 artículos, se hizo una depuración sistemática teniendo como resultado final un análisis de 30 artículos. Los resultados de este estudio indican que existen alrededor de 22 factores propuestos, siendo cinco los factores más importantes que facilitan la identificación de oportunidades de negocio: el conocimiento previo, el estado de alerta emprendedor, la autoeficacia, la creatividad, y las redes de contacto. Otros factores encontrados en el análisis son: la experiencia en emprendimiento, la experiencia laboral, la educación, las capacidades cognitivas, las intenciones de emprendimiento y la búsqueda activa de oportunidades en el mercado. Este trabajo contribuye a la literatura resumiendo los factores incluidos en múltiples investigaciones y ofreciendo líneas futuras de investigación para académicos interesados en el área.
Knowledge and practice of menstrual hygiene management among women living in a low-income neighbourhood, Karachi, Pakistan
Authors: Usman Ghazala , Abbas Kiran , Arshad Rimsha , Muneer Amna , Syed Hiba S. , Iqbal Anoosha , Dar Farea N. , Anum Urfa , Ahmed Moiz , Tehreem Khudija , Zulfi Muhammad Hassan , Khan Javeria
Published: September 2020

Background: The aim of the study was to determine the degree of awareness and practice of proper menstrual hygiene management among women living in low-income neighbourhood in Karachi, Pakistan.Methods: A cross-sectional study was conducted at the Bizerta Lines, Karachi between January and June 2019. All women of reproductive age were included in the study. Amenorrheic, menopausal, or women on birth control were excluded from the study. Degree of awareness and current practices pertaining to menstrual hygiene management were assessed through pro-forma. The study tool collected the participant’s knowledge, awareness, and misconceptions about menstruation. The factors affecting the quality of life during menstruation of women living in poor socio-economic conditions were also observed. Statistical Package for Social Sciences (SPSS v.23) was used to analyze the collected data.Results: Of the 338 participants, 82.5% had no knowledge of menstruation prior to their first menstrual period. Only a minority of the women knew that the source of menstrual blood was the uterus while 41.4% of the women incorrectly claimed that the menstrual blood and urine were expelled from the same orifice. More than half of the participants used disposable sanitary napkins (55.5%). 65% of the participants changed the absorbent at least 1 to 3 times a day.Conclusions: Most of the participants used disposable sanitary napkins. However, the basic knowledge of female anatomy and physiology behind menstruation was poor among women.
Clinical study of role of ultrasound in first trimester vaginal bleeding
Authors: K. Sandyashree P. , C. V. Swathi Nayak
Published: September 2020

Background: Vaginal bleeding is a serious cause which needs an emergency consultation. Major causes are abortion, ectopic pregnancy and molar pregnancy others like cervical erosion, polyp and carcinoma. The objective is to identify cause, assess the prognosis and institute appropriate management.Methods: Prospective study in MMC and RI, OBG, Mysore from November 2015 to September 2017. General physical and pelvic examination done for provisional clinical diagnosis and subjected to Ultrasound. Clinical diagnosis and ultrasound diagnosis were correlated.Results: 100 cases of first trimester bleeding evaluated by Ultrasonography with an incidence 2.37%. Most common cause was abortion (81.6%) then molar (10%) and ectopic pregnancy (9%). Out of 100 cases, 72 cases confirmed, 28 cases proved by ultrasound which was misdiagnosed on clinical examination with disparity of 72 between clinical and ultrasound diagnosis. 13 cases viable pregnancy by ultrasonography with sensitivity, specificity, NPV and PPV of 100% and 69 cases nonviable pregnancies with sensitivity, specificity and NPV of 100%. 9 cases ectopic pregnancy were diagnosed on ultrasound with sensitivity 100%, specificity 98.9%, PPV 99% and accuracy 99%. Clinical diagnosis in diagnosing viable pregnancies has sensitivity 76.92%, specificity 64.36% and PPV 24.39%. In diagnosis nonviable pregnancies, clinical diagnosis, poor statistical correlation with sensitivity 77.58, specificity 83.33%, PPV 86.53% and NPV 72.91%. Ultrasonographic diagnosis proved as very accurate on statistical correlation.Conclusions: Ultrasound is sensitive, cost effective and non-invasive diagnostic tool in first trimester bleeding. In this study, it helped in correct diagnosis of clinically misdiagnosed cases apart from confirming the diagnosis in others.
Meconium stained liquor in labour and mode of delivery: a time for reappraisal
Authors: Patra Sharda , S. Shruthi S. , Puri Manju , Nangia Sushma , Trivedi S. S.
Published: September 2020

Background: The objective of this study was to determine the significance of meconium staining of the amniotic fluid and find out an appropriate mode of delivery in women with MSL.Methods: A retrospective study was carried out in Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, a tertiary government hospital, New Delhi over a time period of 1 year between 2009 to 2010 on 1425 consecutive women of which 142 women were diagnosed as having meconium staining of the amniotic fluid during labour.  All cases were critically analysed and maternal and fetal outcomes were studied in these women.Results: The incidence of MSL was 10% (142/1425), 45% had thin MSL and 55% had thick MSL. In women with thick MSL, 85% had early thick MSL and 15% had late thick MSL. In women who had early thick MSL (n=66), 55 (83.3%) delivered by LSCS and 11 (16.7%) delivered vaginally. On correlating the perinatal outcome with mode of delivery irrespective of fetal heart rate abnormality in early thick MSL, it was seen that the perinatal outcome was significantly affected by mode of delivery. The rates of respiratory distress and MAS was significantly higher in babies who delivered vaginally compared to those by LSCS (18% & 100% vs 9% & 40%, p=0.012, RR- 5.2 [95% CI: 1.8-3.42]. There were no perinatal mortality in early thick MSL.Conclusions: In distinguishing between thick and thin meconium, it was noted that finding of thick meconium in the latent phase of labour (i.e. early thick MSL) is ominous and demands an urgent caesarean delivery.
Intrauterine fetal death associated socio-demographic factors and obstetric causes: a retrospective study
Authors: Mufti Asma Hassan , Mufti Samiya , Wani Nasir Jeelani
Published: September 2020

Background: The death of a fetus is emotionally traumatic for the parents. It is also distressing for the treating obstetrician. Besides being emotionally challenging, fetal demise raises a lot of questions and increases an obstetrician’s medicolegal risk. The aim of this study was to identify various maternal conditions and socio-demographic factors associated with fetal death and to find the preventable causes of fetal death.Methods: A retrospective observational study was undertaken at Lalla Ded Hospital, Srinagar, Kashmir - a tertiary care centre. The cases of singleton intrauterine fetal deaths (IUFD) with either ultrasound reports proving IUFD or diagnosed on clinical examination by absence of fetal heart sound with gestational age >28 weeks were included. Exclusion criteria includes molar pregnancy and multiple pregnancy.Results: Still birth rate in our study was 19.6 per 1000. Most of the patients with stillbirth belonged to age group of 21-30 years accounting for 67.1% of all cases. Unbooked cases comprised of 58.9%. Most of the study patients i.e. 74.7% belonged to lower middle class. In our study 39% of stillbirth cases were in the range of 28-32 gestational weeks followed by 33.6% cases in 33-37 gestational weeks. Maternal hypertensive disorders had a strong association with IUFD 33.6% (pre-eclampsia 27.4%, eclampsia 6.2%). This was followed by placental abruption comprising 11.7%. Gestational diabetes and severe anaemia accounted for 6.2% and 3.4% respectively. Gross congenital anomalies and fetal infections contributed 2.7% and 2% respectively.Conclusions: Routine antenatal checkups with identification of high risk pregnancies, better access to emergency obstetric care especially during labor, emphasis on institutional deliveries community birth attendant training should help in reducing stillbirth rates in developing countries. Optimal evaluation for future pregnancy is necessary. Counseling and support group should be involved.
Female sterilization failure, consequences and further contraception: a review of cases over ten years
Authors: Rani Reena , Sharma Rachna , Kohli Charu
Published: September 2020

Objective: To study the socio-demographic profile and etiological factors responsible for failure of tubal ligation. Their outcome and further adopted methods of contraception.Methods: This was a retrospective observational study done in a tertiary care centre from January 2009 to December 2018. All cases who came with sterilization failure were reviewed including their demographic patterns, previous methods used and the contraception choices adopted after procedural failure.Results: Over a period of ten years, out of a total of 157 cases of sterilization failure 43.33% (n=68) were laparoscopic interval ligation, 42.60% (n=67) were laparoscopic ligation with termination of pregnancy, 10.20% (n=16) were sterilization done along with lower segment cesarean section and 1.9% (n=3) were mini-laparotomy (minilap) done in postpartum period. Only 63.05% (n=99) got repeat sterilization procedure done despite previous failure. Out of 157 cases, in 50.9% (n=80) recanalization was found, tuboperitoneal fistula was responsible in 5.7% (n=9) women, slipped fallope ring was found in 5.7% (n=9) women, wrong application of fallope ring was seen in 1.9% (n=3) and 35.6% (n=56) did not opted for religation.Conclusion: Failures of sterilization procedures do exist especially in laparoscopic ligation. Counseling prior to adoption of this method, risk of failure and other noninvasive options of contraception must be discussed.
Review of ectopic pregnancy at tertiary care center: 2 years analysis
Authors: Sharma Suman S. , Gokhale Ashish V. , Agarwal Shonali , Modi Dimpi , Gedia Kajal
Published: September 2020

Background: Ectopic pregnancy is defined as any intra or extra-uterine pregnancy in which the fertilized ovum implants at an aberrant site which is inconducive to its growth and development. It is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergencies affecting approximately 2% of all pregnancies. The purpose of this study is to review cases of ectopic pregnancy and determine: incidence, high risk factors, types of clinical presentation, diagnostic methods, management, morbidity and mortality.Methods: The present study, conducted over a period of 2-year, total number of deliveries was 16,144 and total number of ectopic pregnancies was 116. More than half of the cases (56.04%) had one or the other identifiable risk factor. Results: Amongst the various risk factors studied, history of previous pelvic surgery (15.43%), history of Pelvic inflammatory disease (PID) (12.9%), use of Intrauterine contraceptive device (IUCD) (10.3%) and either spontaneous or induced abortion (7.76%) has been found. History of self-administered medical termination of pregnancy (MTP) pill was present in 3.45%. Repeat ectopic pregnancies were seen in 1.72%. There was no identifiable risk factor in 49.63% of cases.Conclusion: Ectopic pregnancy is a major challenge in obstetrical practice because of its varied clinical presentation. It can be diagnosed early by keeping a high index of suspicion. Undue delay in referral reduces significant morbidity and improves the chances of preserving future fertility. Mass education regarding safe abortion practices and post abortal care should be promoted. Unsupervised usage of MTP pill intake should be condemned.
Sexual satisfaction and associated individual factors among midlife and older people in Ile-Ife, Southwest Nigeria: implications for sexual and reproductive health
Authors: Omotosho Rhoda Oluwatofunmi , Solanke Bola Lukman
Published: September 2020

Background: Studies in Nigeria have rarely documented the prevalence and associated factors of sexual satisfaction among the midlife and older persons as a special group of underserved population in the country. This study investigates the prevalence and individual associated factors of sexual satisfaction among the midlife and older people in Ile-Ife, Southwest Nigeria.Methods: A sample size of 404 was analysed in the study. The outcome variable was sexual satisfaction. The explanatory variables are sets of individual and relational characteristics. Data were analysed using Stata 14. Bivariable and multivariable binary logistic regression models were estimated.Results: Findings reveal 42.0% level of sexual satisfaction. Higher educational attainment (AOR=0.864, p<0.01; 95% CI: 0.841-0.886), longer length of marriage (AOR=0.931, p<0.01; 95% CI: 0.912-0.950), remarriage (AOR=0.536, p<0.01; 95% CI: 0.387-0.742), economic inactivity (AOR=0.456, p<0.01; 95% CI: 0.322-0.646) reduces the odds of sexual satisfaction while absence of serious health challenges (AOR=2.742, p<0.01; 95% CI: 1.594-4.716) and spousal high wealth level (AOR=1.038, p<0.01; 95% CI: 1.017-1.059) increase the odds of sexual satisfaction.Conclusions: Individual characteristics of midlife and older men and women are significantly associated with their sexual satisfaction. These characteristics should be targeted in a special programme focusing on midlife and older persons in Nigeria.
Role of cancer antigen-125 in diagnosing malignant adnexal masses: a prospective observational study
Authors: Khan Shazia Ashraf , Rahi Shaista , Khan Nahida
Published: September 2020

Background: Adnexal masses present a diagnostic and therapeutic dilemma across age-groups. This study aimed to evaluate the performance of cancer antigen-125 (CA-125) in distinguishing between benign and malignant adnexal masses.Methods: This was a prospective, observational, single tertiary-care center study, done in North India from January, 2011 till December, 2012. Serum CA-125 levels was obtained preoperatively in consecutive patients presenting with ultrasonography confirmed adnexal masses. The cut-off value between benign and malignant was taken as 35 IU/ml. Histopathological diagnosis was obtained in all patients.Results: A total of 126 patients presented with adnexal masses, of which 100 were enrolled (mean age: 37.5±14.4 years, range: 18-80 years). Most of the masses were benign 81% (malignant=19%). Dermoid cyst (25.9%) and endometriomas (21%) were the most common benign masses. Serous (21%) and mucinous cystadeno-carcinoma (15.8%) were the most common malignant masses, more often seen in elderly, married, parous and post-menopausal patients. Mean CA-125 levels were significantly higher in malignant masses (257.30 [105.68-408.92] versus 19.26 [16.53-22.00], p<0.001). Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CA-125 for diagnosing malignant adnexal mass was 94.7%, 87.65%, 64.28%, 98.6%, and 88.91% respectively. The same was 100%, 85.1%, 54.5%, 100%, 87.3% in premenopausal and 85.7%, 100%, 100%, 93.3%, 95.2% in postmenopausal women respectively.Conclusion: Benign masses form the bulk of the adnexal masses in all age groups. CA-125 levels has high sensitivity and negative predictive value in premenopausal patients while as high specificity and positive predictive value in postmenopausal patients.
Cesarean scar defect and its association with clinical symptoms, uterine position and the number of cesarean sections
Authors: B. Madhangi V. , C. Ramany
Published: September 2020

Background: Caesarean scar defect (CSD), also called isthmocele or niche is a long-term complication, which can be asymptomatic or can give rise to chronic pelvic pain, dyspareunia and postmenstrual spotting. The objective of this study was to assess the association of CSD with clinical symptoms, position of the uterus and the number of caesarean sections.Methods: This was a prospective observational study done at a tertiary care teaching hospital from January 2019 to December 2019. The study included women with history of previous one or more caesarean sections with demonstrable CSD on transvaginal ultrasound. Various scar dimensions noted were width and depth of the scar. A deficiency ratio was calculated as a ratio of residual myometrium at the scar to the adjacent myometrium.Univariate analysis was done to assess the relationship of clinical symptoms with the defect parameters and number of previous caesarean sections. Multiple logistic regression analysis was done to find out the association between symptoms and number of previous caesarean sections with the scar defect dimensions.Results: The width, depth and deficiency ratio of the CSD were significantly higher in study subjects with a greater number of caesarean sections. Retroflexed uteri had larger CSD. There was no association of clinical features with the defect dimensions and the position of the uterus.Conclusions: CSD dimensions and deficiency ratio correlate with the number of previous caesarean sections and the position of the uterus. There was no association of clinical symptoms with the defect parameters.
Poor management of menstrual hygiene: a leading cause of school absenteeism among adolescent girls in the urban slum of Madhya Pradesh
Authors: Bali Surya , Sembiah Sembagamuthu , Yadav Kriti , Burman Jayeeta
Published: September 2020

Background: Despite the strides made in the field of adolescent and women health, menstrual problems remain a stigma. Unsatisfactory menstrual hygiene practices have a profound influence on the adolescent girl’s health and academic performance. Therefore, the present study aimed to assess the relationship between school absenteeism and poor MHM and its impacts on school girl’s day to day lives.Methods: This is a cross-sectional study conducted among 384 adolescent girls enrolled in anganwadi centres of the urban slum of Madhya Pradesh from January to June 2018. A pre-designed and pretested questionnaire used to collect the data regarding menstrual hygiene practices and school absenteeism. Data were analyzed using the SPSS software (version 16.0. Chicago, SPSS Inc.).Results: The study found that around two-thirds (64.3%) and nearly one third (30%) of the participants were using a simple cloth and sanitary pads. About half (50.6%) of the respondents miss their school during the menstruation. Majority of them perceived that menstruation interferes with their school performance. The main reason for missing the schools was fear/ shame of leakage. In multivariable regression lack of sanitary facilities and painful menstruation remained significant predictors of school absenteeism.Conclusions: There is a dire need to fortify efforts directed towards increasing awareness on menstrual hygiene, to revamp the existing measures for improving menstrual health of the adolescent girls. Focused attention is warranted by policymakers to improve the quality of life of this vulnerable group.
Cerebro-placental ratio as a prognostic factor of fetal outcome in women with hypertensive disorders complicating pregnancy during third trimester
Authors: K. Sahana , B. Suma K. , R. Nischay
Published: September 2020

Background: CPR is emerging as an important predictor of adverse pregnancy outcome and helps in management of high risk pregnancy. Therefore we undertook the study to find the correlation of CPR with perinatal outcomes in women with hypertensive disorder complicating during third trimester.Methods: 128 patients with hypertensive disorder of pregnancy, ≥32 weeks of singleton gestation, were randomly selected during their hospital visit. They were subjected to USG Doppler study to calculate MCA/UA pulsatility index-CPR. The CPR<1 was considered abnormal and >1 as normal. These results were compared with the perinatal outcome and adverse fetal outcome.Results: The present study revealed that the incidence of adverse outcomes like Apgar score <7 (36.5%), still birth (15.9%), NICU admission (69.8%) and LBW i.e. <2500 gm (68.3%) were significantly higher in abnormal CPR than normal CPR.Conclusions: Abnormal CPR is valuable in predicting the outcome of hypertensive disorders in pregnancy. CPR is an easy procedure which can be included in the routine antenatal sonographic evaluation to predict poor perinatal outcome and to detect or recognize those fetuses at risk.
Study of relationship between umbilical cord blood hemoglobin percentage and perinatal asphyxia
Authors: . Sambedna , Kumar Amit , Chakore Rita
Published: September 2020

Background: Perinatal asphyxia may be caused by perinatal anemia. The pathophysiology and neurodevelopment effects are theoretically different from other causes of fetal asphyxia. Severe asphyxia can occur in infants around the time of birth by various reasons. The aim of this study to find the relationship between cord blood hemoglobin and perinatal asphyxia.Methods: This was a retrospective comparative study in department of OBG In tertiary care health centre. Umbilical cord blood samples were collected from 100 newborns with asphyxia at birth as study group and 100 newborns with non asphyxia as control group. Hemoglobin was measured colorimetrically.Results: This study finds that maximum number of patients in both the control and study group had hemoglobin in the range of 16.3-17.3 gm/dl. The difference was not statistically significant. P value>0.05.Conclusions: Hematological changes observed early after delivery can determine the duration of hypoxemia (acute versus chronic) Perinatal anemia causing moderate to severe perinatal asphyxia is associated with a higher risk for neonatal mortality. All survivors with perinatal anemia, however, showed no abnormalities in neurodevelopment in contrast to children who were born asphyxiated due to various another causes. The underlying pathophysiological mechanism for the favorable NDO in the perinatal anemia group needs further elucidation.
A study on risk factors of abortion in a tertiary care hospital in Thrissur District, Kerala
Authors: Sunil Vivek , Valsan Sruthi Mankara
Published: September 2020

Background: Abortion is the spontaneous termination of pregnancy before 22 weeks or if the foetus weighs less than 500 gm. Spontaneous abortions may occur as a result of genetic factors, infectious agents, uterine abnormalities and other maternal factors. The present study was undertaken to study risk factors of abortion in a tertiary care hospital in Thrissur district.Methods: A hospital based case control study was done during a five month period. The sample size was calculated using the formulae [(Zα + Zβ)2 × 2 × PQ]/d2. Total 40 mothers admitted with abortion were taken as cases and 40 mothers admitted with conditions other than abortion of the same trimester were taken as controls. Data was collected with the help of an interviewer administered semi structured questionnaire.Results: Out of total 80 mothers, 46.2% of them belongs to 21-25 age group and more than half, 66.2% of the mothers were primi gravida. There was a statistically significant association between mother’s occupation and occurrence of abortion. The abortion rates were higher among overweight mothers, but this difference was not statistically significant. Among obstetric determinants, previous history of abortion, primi gravida mothers, and history of travel had higher risk for abortion with odds ratio 3.5, 2.8, and 2.72 respectively.Conclusions: Previous history of abortion and history of travel contributes to higher risk of abortion. Interventions could be targeted more on women with prevalent risk factors to increase health profits.
Correlation between ultrasonographic and histopathological findings of hysterectomy specimen in patients with abnormal uterine bleeding
Authors: Mahajan Kaushik , Devi R. K. Praneshwari , Singh Ajitkumar , Lairenjam Dipenty , Singh Leimapokpam Roshan , . Nungsangtemjen , Roy Madhumita , Jeevana C.
Published: September 2020

Background: AUB is a common and debilitating condition and it is one of the main gynaecological reasons for hysterectomy. Ultrasonography can be as good as histopathology (HPE) in the diagnosis of abnormal uterine bleeding. Hence, our study was conducted to validate the ultrasonographic findings with HPE findings in diagnosis of AUB.Methods: A hospital based cross-sectional analytical study was conducted among 86 patients with abnormal uterine bleeding in the department of Obstetrics and Gynaecology in collaboration with department of Pathology, RIMS, Imphal from September 2017 to March 2019. The clinical history and socio demographic profile were collected using a pre-designed proforma. General physical examination, pelvic examination and ultrasonagraphy was carried out and the hysterectomy specimens were subjected to histopathological examination.Results: Fibromyoma was diagnosed by ultrasound in 62.8% of the patients and it was the common diagnosis in this study. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing leiomyoma was 92.9%, 93.3%, 96.3%, 87.5% and 84.9% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing adenomyosis was 53.8%, 98.6%, 87.5%, 92.3% and 62.3% respectively.Conclusions: The study provides an evidence that ultrasonography has good diagnostic accuracy as histopathology in the diagnosis of fibroid in patients with abnormal uterine bleeding. However, as with all the diagnostic procedures, the utility of ultrasound in the diagnosis of adenomyosis is questionable, since it has a low sensitivity amidst good specificity.
Role of uterine artery doppler at 18-22 weeks in the prediction of pre-eclampsia: a prospective study
Authors: M. Lakshmi Manjeera , Pereira Patricia Malini
Published: September 2020

Background: Pre-eclampsia is the most common pregnancy complication associated with serious maternal and fetal morbidity. Uterine artery Doppler reflects the impaired trophoblastic invasion of the uterine spiral arteries, which is involved in the aetiology of preeclampsia. Thus, uterine artery Doppler was proposed as a screening test for pre-eclampsia.Methods: A prospective cohort study of 100 singleton pregnancies was conducted in a tertiary centre and the study population were subjected to uterine artery Doppler study at 18-22 weeks gestation. Uterine artery Doppler indices of pulsatility index (PI), resistance index (RI) and persistence of diastolic notch was obtained and the outcome of pre-eclampsia was studied.Results: Out of 100 women, 14 women developed pre-eclampsia in which the resistance index showed a sensitivity of 21.4%, specificity of 91.8%, positive predictive value of 30% and negative predictive value of 87.7% and pulsatility index showed sensitivity of 35.7%, specificity of 90.6%, positive predictive value of 38.4% and negative predictive value of 89.6%. Diastolic notch had a sensitivity of 35.7%, specificity of 98.8%, positive predictive value of 83.3% and a negative predictive value of 90.4%.Conclusions: The high negative predictive values, indicated that women with normal Doppler velocimetry were unlikely to develop preeclampsia. Uterine artery Doppler, being non-invasive can be included during routine sonography to identify patients at risk of developing pre-eclampsia. Early, screening for pre-eclampsia will help in individualized antenatal surveillance and initiation of prophylactic therapy, early to reduce the adverse maternal and foetal complications of preeclampsia.