bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender Perceptions: Employer Branding Through Attractiveness, Job Characteristics and Organizational Attributes
Authors: Aslam Summer , Mason Cordelia , Zakria Asma , Farid Mohd
Published: March 2020

The novelty of employer branding is undeniable in HR practices. However, the pair studies are also found in employer branding with the perception of gender. A gender difference is said to occur when male and female react differently in perceptions. In Pakistan, human capital is an inadequacy in bank jobs and female less appearance in the sector creates more shortage of skilled employees. However, the results reported have given an insignificant difference between male and female in the perception of employer branding. Moreover, the gender disparity has no borders, so re-justification is an admirable in another region. Hence, a significant relationship exists between employer branding and intention to apply. Intention to apply is a central dealing with recruitment as appears with the wish for of submitting a job application. Furthermore, the wider applicant pool can achieve with employer branding. Employers can persuade to potential employees through attractiveness, unique organizational attributes and job characteristics. Concluded, banks in Pakistan can increase a wider applicant pool with the implementation of employer branding. Data Analysis was done by using SPSS and smart PLS. Future recommendations and implications are at the end.
Economic Sanctions: Astute Policy or Just another Barrier to Free Trade?
Authors: Rarick Charles A.
Published: March 2020

When mentioning free trade the topic of economic sanctions is seldom mentioned. However, governments of the developed world, especially the United States, have used economic sanctions as a foreign policy tool to compel other countries to change their behavior. The increasing use of economic sanctions as a form of foreign policy is not without cost, however, and that cost is borne by citizens of sanctioned countries and businesses who find international markets closed to them, either entirely or in part. In addition, consumers pay a price through less choice and higher prices. Economic sanctions are barriers to free trade and interfere with the free flow of goods and services. This case examines the current state of economic sanctions imposed by the United States and explores sanctions imposed on Cuba, Myanmar and Iran; three heavily sanctioned countries which recently have experienced a change in U.S. foreign policy action, yet still suffer from trade restrictions.
The Effects of Risk Management System on Financial Performance of Commercial Banks in Rwanda: A Case of Cogebanque Ltd.
Authors: Hitimana Mireille , Kule Julius Warren , Mbabazize Peter Mbabazi
Published: March 2020

This research study entitled an Assessment of the Effect of Risk Management System on Financial Performance of Commercial Banks in Rwanda aimed at assessing risk factors that performance of commercial banks like credit risk, embezzlement, theft and among others. Three specific objectives were formulated namely; to analyze the effect of directive control system on Financial Performance of Cogebanque Ltd; to establish the effect of preventive control system on Financial Performance of Cogebanque Ltd; to examine the effect of detective control system on Financial Performance of Cogebanque Ltd. The study examined risk management system and financial performances in Cogebanque Ltd located in Kigali City for a period of four years from 2011-2014. The study used descriptive design. A sample size of 40 staff of Cogebanque Ltd, participated in the study. SPSS software (version 22) was used to process the data and analysis were made by use of frequency/percentages, mean and standard deviation. The relationship between the variables was established by use of Pearsons correlation.  The study established that different risk management systems which consist of directive control system, preventive control system and detective control system. The study revealed that risk management system has improved Cogebanque bank’s return on investment, profitability, liquidity, return asset and return on equity and loan returns by 72.7%.
Marketing Efficiency and Value Chain Analysis: The Case of Garlic Crop in Bangladesh
Authors: Hasan Md. Kamrul , Khalequzzaman K. M.
Published: March 2020

Garlic is a highly profitable crop and is largely used both in medicinal and culinary purposes. The study was undertaken to determine marketing system, marketing cost, marketing margin, marketing efficiencies and to examine the value chain of garlic aiming to determine the value addition in different steps of garlic marketing. A purposive and simple randomized sampling procedure was used in selecting primary data. Marketing margin, profit, efficiency ratio, value addition etc. were calculated by different relevant equations and formulas. Four major marketing channels were identified for domestic produced garlic marketing. Channel-3 was the most important supply chain through which 40% domestic produced garlic reaches to consumers. Marketing margin and profit were the highest in retailer than those of other intermediaries. Out of four marketing channel, Channel-2 was more efficient than those of other channels. Six actors like; farmer, local trader, trader, commission agent, wholesaler, retailer and consumer are identified who are involved in the garlic value chain activities. Retailer added highest amount of value per unit of garlic and that of the lowest in wholesaler. Eleven marketing problem were identified, among them price fluctuation, high transport cost and lack of loan facilities were the major problem. It is therefore, recommended that Government intervention is urgent necessary to stabilize the price of garlic, loan facilities should be provided to the intermediaries and transportation cost should be kept reasonable.
Managerial Accounting and Society: Emerging Factors for ‘Decision Making’ of Accountants in the Modern Era
Authors: Masoom Muhammad Rehan , Zaman Fareen
Published: March 2020

The managerial accounting offers a universal set of tools to manage the administration and acts as patterned entities for producing a return for the organization. In doing so, the chief problem faced by a professional and academic discipline like accounting is that it has to deal with two distinct planes: one is the theoretical stage, and the other is on the practical height. Since the influence of accounting affects areas beyond mere corporate and business entities to the day-to-day social role of accounting, the discipline must pay proper discretion in addressing both the aspects.  This paper address three complicates issues that the modern day accounting is facing. First, it attempts to shed lights on the sociological concepts applicable in accounting to comprehend the implicative insinuations. Second, the civil discourse and the decision-making edifice of the management have taken under consideration. Third, it intends an approach to reconstruct the behavioral accounting.
Should American Antitrust Laws Protect Only American Consumers?
Authors: Phan Thanh
Published: March 2020

The United States adopted its first antitrust statute in 1890. Despite their long history of development, American antitrust laws do not specify any objectives. The primary objective of the American antitrust laws centers a long-standing debate among many scholars. This paper firstly argues that the American antitrust laws were designed to promote consumer welfare. However, exemptions for export cartels confine the concept of “consumers” protected by the Sherman Act to those in the U.S territory. This paper secondly proposes that exemptions for export cartels should be abolished for two reasons. First, the exemptions make American antitrust policy inconsistent because they do not reflect the objective that promotes consumer welfare. Second, from an international perspective, exemptions for export cartels are inconsistent with the efforts of the American Government to apply the Sherman Act extraterritorially—a measure that aims to protect consumers from international cartels.
Impact of Digital Marketing as a Tool of Marketing Communication: A Behavioral Perspective on Consumers of Bangladesh
Authors: Yamin Ahmad Bin
Published: March 2020

This study shows the impact of digital marketing on behavioral prospect of consumers of Bangladesh. For conducting this study a sample of Bangladeshi consumers are surveyed to attain their behavioral pattern on digital marketing. Modern day marketing has been going through a radical change. Fast moving marketing trends based on the growth and innovation of new technologies as well as portable communication devices influencing the customer behavior significantly. A well designed marketing plan with specific digital marketing tools is the demand in the integrated marketing communication plan for this tech friendly environment. High speed internet connectivity brings massive number of young crowd in social media indicating marketer should be more focused and concentrated in digital marketing tools for effective and efficient targeting of market as well as to achieve other organizational goals.
Management of the Development and Implementation of New Generation Technologies
Authors: Komkov N. I. , Sutyagin V. V.
Published: March 2020

Purpose: to justification of the need to develop new-generation domestic technologies that ensure the competitiveness and stability of the Russian economy to external challenges. Using the laws of accelerated development of various systems, objects and processes of the material world will allow us to construct a mechanism for analysis, decision-making and management of the justification, development and implementation of new generation technologies.

Methods: the research method is based on the generalization of forecasting the accelerated development of various processes under the conditions of growth restrictions, methods for constructing targeted information-logic models, decision-making methods for justifying the costs of upgrading one-generation technology options and analyzing domestic and foreign technology development experience new generation.

Results: within the space of creation and development of new generation technologies, in accordance with the well-known concept of the full life cycle, the process of development and implementation of new generation technologies in the form of a logistic curve has been specified. The solution to the problem of managing the creation of new generation technologies is presented as the fastest possible implementation of projects to search for innovative solutions that meet the requirements of competitiveness. Mathematical models of the formulated problem are considered. Examples of practical tasks for managing the development and development of new generation technologies are given.

Conclusions and Relevance: the dynamics of development and the economic conditions for the transition to technology modernization are determined by the need for further development of new generation technologies in the interests of full use of the innovative potential of this generation. Information-logical and mathematical models have been developed for making decisions on managing the justification of the necessary resources for the implementation of projects in the full cycle during the transition from innovative solutions to new technologies and innovative products.
Association of menopausal sexual dysfunction with demographic and obstetric factors in postmenopausal women in Hamadan, Iran
Authors: Alavipour Narges , Masoumi Seyedeh Zahra , Kazemi Farideh , Parsa Parisa
Published: March 2020

Background: Sexual dysfunction is a common menopausal problem that may be affected by demographic factors. The present study aimed to determine demographic and obstetric factors affecting sexual dysfunction in menopause.Methods: The present cross-sectional descriptive-analytical study was conducted on 315 postmenopausal women in Hamadan. The research instruments included demographic questionnaire, and female sexual function index (FSFI). Univariate and multivariate linear regressions were used to investigate the association of different factors and sexual function at a significance level of less than 0.05.Results: The participants' mean age was 54.15±4.24 years. Their mean sexual function score was 18.92±4.25 indicating poor sexual function. The multivariate analysis indicated that increasing the number of spouse marriage, sexual function score decreased by 2.45 (p=0.006). Furthermore, the sexual function score in those, who were not satisfied with their marriage, was 5.58 points lower than those who were satisfied with their marriage status (p <0.001).Conclusions: Given the relationship between number of spouse marriage and marital satisfaction with sexual function in postmenopausal women, it is necessary to design and implement training sessions for them.
A prospective interventional study of intra-caesarean copper intrauterine contraceptive devices insertion in a teaching hospital in a rural medical college in Telangana, India
Authors: Vijayalakshmi Gillella , Kothapally Kavitha , Bhashyakarla Uma , Kavati Vasantha
Published: March 2020

Background: Providing quality contraceptive services to women is essential for achieving maternal and child health. Objective of this study was to evaluate the efficacy of intra-caesarean insertion of copper IUCDs as postpartum contraception. To study the side effects of intra caesarean copper device. To study the continuation rates of intra-caesarean copper IUCDs. To study the acceptability of intra-caesarean copper IUCD as immediate postpartum contraceptive.Methods: The prospective study was undertaken at Bhaskar medical college and general hospital, Yenkepally, Moinabad, Telangana, between January 2016 and March 2018 after ethical committee clearance. About 60 pregnant women were enrolled into the study after an informed written consent regarding the procedure, benefits and complications and the need for follow up for at least one year. Copper T 380A/multiload copper 375 was inserted into the uterine cavity after delivery of the placenta and membranes during caesarean section. Patients were followed up at 6 weeks, 6 months and one-year intervals for any complaints, visibility of threads and for ultrasound examination for position of copper IUCDs in the uterus. Data analysis was done using Microsoft excel 2016.Results: Nearly 48.33% continued intra-caesarean copper IUCDs for more than 1 year. 70% did not have any complaints. 86.67% came for more than one follow-up visit. 47% had copper IUD threads visible by one year. No case of perforation either during insertion or during continuation was noted. None conceived with copper IUCD in situ. Removal of copper IUCD was also easy and none required hysteroscopic removal.Conclusions: Intra-caesarean copper IUCD insertion is a safe and effective long acting reversible contraceptive method in the postpartum period.
Will women’s choice of position in first stage of labor affect labor process?
Authors: Rao Shubha , Sridharan Shylabhirami , Vasudeva Akhila , S. Roopa P.
Published: March 2020

Background: Controlling the process of childbirth has disabled the parturient to embrace the most spontaneous position of delivery but constricting her to assume a recumbent position. Objective of this study was to study if alternating comfortable maternal positioning i.e., recumbent and alternative position have any influence in the process of labor, type of delivery, neonatal well-being.Methods: Study conducted an observation study on term pregnant women. Study inclusion criteria included all term pregnant women. Exclusion criteria included multiple pregnancies, preterm patient, severe pre-eclampsia, and eclampsia, preterm premature rupture of membranes, sever intrauterine growth restricted fetus. The measured date were maternal general characteristics, duration of labor process, type of delivery and neonatal outcome. Patients were divided into two groups. Group A - if they spent more than 50% in a recumbent position and Group B - any other alternating position.Results: A total 250 women were equally included in this study. The demographic characteristics were matched in both groups and found no significant difference. In the process of labor, Group B had a difference of 1 hours as compared to Group A and the rate of cervical dilation was also faster in Group B. Both of these variables were found to be statistically significant. However, there were no significant difference in the terms of type of delivery and neonatal outcome.Conclusions: The ancient practice of recumbent position during labor is to be discarded as alternating maternal position during the process of labor may a positive influence on the total duration labor. However even though it may or may not have an influence on the other outcome such as route of delivery and neonatal outcome, it is best to encourage women to move and deliver in the most comfortable position.
Study of cases of post-partum hemorrhage after spontaneous vaginal delivery in labour room of obstetrics and gynecology department of tertiary care center, Ranchi, Jharkhand, India
Authors: Moitra Bratati , Oraon Bulllu Priya
Published: March 2020

Background: Postpartum haemorrhage is one of the common causes of maternal death worldwide. Whenever the amount of blood loss from or into genital tract is 500 ml or more after delivery of baby or any amount of bleeding that makes patients haemodynamically unstable is post-partum haemorrhage.Methods: In this study amount of blood loss after spontaneous vaginal delivery was measured in 100 cases by calibrated blood drape. Patients having high risk criteria for PPH were excluded.Results: In this study 55% patients were from 20-30 years age group. 82% cases were nontribal. 94% belonged to lower middle class. 67% patients were primigravida. 89% patients had atonic PPH and 11% had traumatic PPH. 85% patients had mild PPH. 60% of atonic PPH was managed by oxytocin only. 10% required oxytocin + Methergin, 6% required oxytocin + Methergin + Misoprostol. 6% required Oxytocin + Methergin + Misoprostol + Carboprost. In this study surgical intervention was required in 18% cases. Blood transfusion was required in 74% cases. 75% cases were from non-tribal ethnicity.Conclusions: PPH is a life-threatening condition. If it can be diagnosed early and managed properly then many maternal lives can be saved. In this study there was no maternal death.
The efficiency and efficacy of tranexamic acid in prevention of blood loss during or after caesarean delivery: a comparative study
Authors: Raina Supriya , Suguna V. , Prabraju Padmaja
Published: March 2020

Background: The practice of caesarean section is increasing day by day. Delivery by caesarean section can cause more complications than normal vaginal delivery and one of the most common complications is primary or secondary postpartum hemorrhage. The aim of present study was to study the efficacy and safety of tranexamic acid in reducing blood loss during and after caesarean section.Methods: This study was conducted at Deccan College of Medical Sciences, Hyderabad. It was a prospective randomized double blind placebo controlled study. This study includes 60 pregnant women divided in to two groups. Just before the induction of anesthesia 1 gm of tranexamic acid in 20 ml of normal saline was given over 10 minutes in test group and 20 ml of normal saline was infused in control group.Results: The demographic characters of patients in two groups were comparable. There was no statistically significant difference in the heart rates, respiratory rates and blood pressures in the two groups. There was statistically significant difference in the quantity of the blood loss from during the operation and 2 hours postpartum (p=0.003). Total mean blood loss in control group was 718.80±233.1 ml and in study group was 554.28±207.8 ml. The drop in hemoglobin after caesarean section in study group was not significant where as in control group was significant. There was no significant difference in the prothrombin time and partial thromboplastin time in the groups, pre and post operatively. In this study the use of tranexamic acid reduced the dose of other uterotonics like syntocin in study group.Conclusions: Tranexamic acid significantly reduced the amount of blood loss during the caesarean section and also reduced the use of other uterotonics. Thus, tranexamic acid can be used safely and effectively in subjects undergoing caesarean section.
Interventions to reduce caesarean section rates at government medical college and hospital Aurangabad, India
Authors: Gadappa Shrinivas , Gemavat Honey , Deshpande Sonali , Shah Ankita
Published: March 2020

Background: Caesarean sections are effective in saving maternal and infant lives, but only when they are performed for medically indicated reasons, The Objective of this study was to reduce caesarean Section rate at GMCH, Aurangabad and to improve overall birthing experience with respectful maternity care.Methods: The caesarean sections done at GMCH Aurangabad were audited using Robson`s Ten Group classification system to identify the major contributors to the overall CS rate. The following clinical and non-clinical interventions were applied dynamically to control the caesarean section rates. Clinical Interventions were changes in protocols regarding induction of labour, Intermittent auscultation as opposed to continuous electronic foetal monitoring in low risk cases, use of a partogram, encouragement of different birthing positions, promoting TOLAC to reduce the secondary CS rate. Nonclinical interventions include encouragement of DOULA (birth companion), ante-natal counselling of the expectant mothers, training of healthcare staff for respectful maternity care and use of evidence based clinical practice guidelines with mandatory second opinion for every non recurrent indication of CS. Auditing of caesarean section using Robson classification.Results: In this study there has been steady decline in LSCS rates from 33% to 26.9%. On analysis with Robson classification, group 5 (previous LSCS) made largest contribution of 36.9% followed by Group 1, 2, 10 each contributed 18.01%,13.2% and 11.2% respectively. Group 6 to 10 account for 23%. Various birthing positions lowered use of oxytocics from 33 % to 19% as well lowered episiotomy rates with greater success in vaginal delivery.Conclusions: Modification of induction protocols have reduced the primary LSCS rates and successful VBAC using FLAMM score was helpful in reducing the repeat caesarean Sections. Various birthing positions, DOULA gave greater success in vaginal delivery. LSCS rates in mothers with breech, multiple or oblique/transverse lies were largely unmodifiable. Limiting the CS rate in low-risk pregnancies by individualizing every labour and not to set a time limit as long as mother and baby are closely monitored.
A prospective clinical trial to evaluate the role of very low dose mifepristone 10 mg in medical management of uterine leiomyoma in tertiary care hospital from North West India
Authors: Kochar Swati , Suthar Neha , Chaudhary Shweta , Chandad Shahnaj
Published: March 2020

Background: Uterine leiomyomas are the most common benign tumours of the uterus and also the most common benign solid tumor in female. It arises from the uterine smooth muscles (myometrium) but contain varying amount of fibrous connective tissue. Aim of study was to evaluate the efficacy of very low dose Mifepristone (10 mg) on leiomyoma volume and its related symptoms.Methods: This was a prospective clinical study. 30 women met with the inclusion criteria and giving informed consent for the study.Results: Mean myoma volume was 60.32±51.89 at initial visit and 36.13±48.54 at 3 months follow up visit with 40.1% reduction which was statistically significant difference (p < 0.001). Mean PBAC score in Group I was 155.53±21.70 at initial visit and 0.97±2.97 at 3 months follow up visit with 99.3% reduction which was statistically significant (p < 0.001).Conclusions: Mifepristone 10 mg is efficacious in term of control of bleeding, alleviation of pain related symptoms with few side effects. So low dose mifepristone can be used as a suitable option for women with symptomatic fibroids in perimenopausal periods or patients not willing or fit for surgery.
Hamman’s syndrome: a case report of spontaneous pneumomediastinum after vaginal delivery
Authors: Gentile Marco , Zinna Mariaconcetta , Costanza Antonio , Remo Andrea , Sala Giuseppe , Catapano Pietro
Published: March 2020

Spontaneous pneumediastinum (Hamman’s syndrome) is a rare pathology defined as the presence of free air in the mediastinum with subcutaneous emphysema without trauma or medical problem. It is also a rare complication of labour and delivery and it usually occurs in the second stage of labour. A twenty-six-year-old primigravida presented to our hospital at 39 weeks and 6 days in spontaneous labour. Two hours following the delivery the patient developed neck tightness and chest tenderness with palpation. Chest X-ray and CT scan revealed pneumomediastinum extending into the soft tissue of the neck. A conservative management was performed. Spontaneous pneumomediastinum is a rare condition with a reported incidence of less than 1:44000 and in the setting of pregnancy or labor 1:100000. Regarding pregnancy, the valsalva maneuvers produced in the second stage of labor has been implicated in the development of spontaneous pneumomediastinum. Chest X-ray (posteroanterior and lateral view) is the most important test to confirm the diagnosis. The Hamman’s syndrome has usually a benign course and the management in often conservative. A timely diagnosis of Hamman’s syndrome is necessary for patient safety and correct management, but most cases have a self-limiting course.
Uterine torsion of 90 degrees: case report
Authors: Tanouti S. , Chakri M. , Taheri H. , Saadi H. , Mimouni A.
Published: March 2020

Uterine torsion is defined as a rotation of uterus more than 45 degrees along its long axis. However, a pathologic rotation of the uterus beyond 45 degrees-torsion of the entire uterus-is rarely seen in obstetrical practice, authors report a case of torsion of the uterus by 90 degrees. The patient, a 30-year-old gravida 3 para 2 at 37 weeks’ gestation with a singleton pregnancy, her prior obstetrical history included two uncomplicated term vaginal deliveries, and the current pregnancy had been uncomplicated until the date of presentation was admitted to the obstetrical unit  with  labour at 37 weeks 5 days ,on obstetric examination the patient was in labour with transversal presentation of the fetus so an emergency caesarean section (CS) was carried out for. At the time of CS, the diagnosis of uterine torsion of 90 degrees was made. After the delivery of the baby, uterus returned to anatomical position and the torsion corrected spontaneously. The patient recovered and was discharged home with her baby on the third postoperative day. Uterine torsion is an infrequently reported and potentially dangerous complication of pregnancy that occurs mainly in the third trimester.
A rare case presentation of large mucinous ovarian cystadenocarcinoma in a young female
Authors: Singh Akansha , Dadhwal Ankita , Verma Ashok , Agarwal Swati
Published: March 2020

Here authors report a case of large ovarian mucinous cystadenocarcinoma in a young female complicating young pregnancy. Ovarian mucinous adenocarcinoma is a rare ovarian tumour that arises from the surface epithelium of the ovary. A 25-year young female, 9 days post-partum presented to the hospital with complain of abdominal distension. USG finding suggesting large solid cystic mass 36 × 14 cm arising from pelvis extending up to epigastrium. MRI pelvis evident of heterogenous hyperintense solid cystic mass lesion giving bunch of grapes appearance with size 24.5 × 25 × 11.5 cms seen in intra peritoneal space extending cranially up to epigastrium and caudally into pelvis giving anterior displacement of uterus.  And posterior displacement of bowel loops. A large part of lesion is cystic with solid component with multiple internal echoes.
A rare case report of recurrent ectopic pregnancy
Authors: Prabhudev Prema , S. Sapna I. , Mudegoud Soujanya M.
Published: March 2020

This case presenting a 30-year-old lady, a case of G4A1E2 who presented with history of 1 month of amenorrhoea, followed by bleeding per vaginum 1 week back for 3 days. Presented to hospital with spotting PV and pain abdomen for 2 days. UPT done at home was positive. USG revealed right ovarian complex haemorrhagic cyst and left adnexal ectopic pregnancy near left ovarian fimbriae. Conservative management by Methotrexate and Folinic acid regimen was tried but as there were no signs of resolution on serial ultrasonography reports and serial human chorionic gonadotropin (hCG) levels did not fall as expected, hence decision of laparoscopy/laparotomy was made and salpingectomy was done. Later patient was followed up with serial hCG levels.
Degenerated fibroid: a diagnostic dilemma
Authors: Gaur Nayanika , Jha Manish
Published: March 2020

Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.
Surgical management of caesarean scar pregnancy: a case report
Authors: Gautam Savita Singh , Kaur Manmeet
Published: March 2020

Caesarean scar ectopic is one of the rarest of all ectopic pregnancies. The incidence of caesarean scar pregnancy (CSP), which was extremely rare till recent times, has been rising steadily. Case have more of such cases being published in medical literature now. It is defined as when a blastocyst implants on a previous caesarean scar. The incidence of caesarean scar ectopic has increased due to increase in number of caesarean deliveries. Early diagnosis of this can be done by using ultrasound. It is very important because a delay can lead to increased maternal morbidity and mortality. Early diagnosis leads to prompt management and improves the outcome by allowing preservation of future fertility. Magnetic resonance imaging (MRI) has important role when sonography is equivocal or inconclusive before therapy or intervention. Case are reporting a rare case of G2P1l1 with previous one caesarean delivery, diagnosed as caesarean scar ectopic pregnancy with the help of sonography. Patient underwent laparotomy and on histopathological examination caesarean scar pregnancy was confirmed. Due to the rarity of this condition, there are no specific guidelines available for its management.
A prospective study on the predictors of mechanical ventilation in organophosphate poisoning
Authors: Datla Aravind Varma , Duddu Rosaiah , Maske Pravin Gulab Rao
Published: March 2020

Background: Organophosphorus poisoning is one of the most common poisonings often requiring ICU care and ventilatory support. The objective and aim of this study are to identify the factors which predict the need for ventilation in these patients.Methods: 50 patients who were diagnosed to have consumed organophosphorus compound poison admitted in Konaseema Institute of Medical Sciences and Research Foundation who presented within 24 hours of consumption are included in the study. Patients with double poisonings, concomitant illnesses, chronic lung diseases and those treated outside are excluded from the study.Results: A total number of 50 patients were studied. 18(36%) patients required ventilation. Generalized fasciculations was a discernible feature in 66% of cases in this study. 69.2% of patients with a fasciculation score of ≥4 required ventilation. Ventilation was needed by 55% of patients who had a Glasgow Coma Scale score of ≤10.Conclusions: Patients who presented with higher fasciculation scores and/or lower GCS scores were more likely to require ventilation. Using GCS scores as a predictor for the requirement of ventilatory support in organophosphate poisoning, a GCS score ten or less was significantly associated with an increased need for ventilatory support.
Pattern of congenital heart diseases in Western Rajasthan: an echocardiographic study
Authors: Baroopal Anil , Mathur Rohit , Sanghvi Sanjeev , Soni J. P.
Published: March 2020

Background: Congenital heart disease (CHD) accounts for nearly one third of all major congenital anomalies. Globally the prevalence of CHD is 1.01 to 17.5 per 1000 live births. In India it is 1.3 to 26.4 per 1000 study population. CHD is an important cause of mortality and morbidity representing a global health burden. Early diagnosis and treatment may lead to improved prognosis in patients suffering from CHD. The aim of this study was to assess the pattern of CHD in Western Rajasthan, India by echocardiography.Methods: This was a retrospective study carried out at Dr. S. N. Medical College and attached group of hospitals in Jodhpur, Rajasthan, India. The study period was from July 2014 to June 2017. Records of all patients undergoing transthoracic echocardiography from newborn to 25 years of age were analyzed for age, sex and CHD findings.Results: In the study period, a total of 24,914 patients underwent echocardiography, of which 877 patients were identified as having CHD. Prevalence of CHD was 35.20 per 1000 study population. Amongst the total diagnosed CHD cases, 489 (55.76%) patients were male, with male to female ratio of 1.2:1. CHDs were diagnosed more commonly between 1 month and 1 year of age (41.28%). The commonest type of acyanotic CHD in the present study was ventricular septal defect (21.44%) and cyanotic CHD was tetralogy of Fallot (18.24%).Conclusions: Prevalence of CHD in Western Rajasthan, India was 35.20 per 1000 study population. Profile of CHDs in the present study was similar to that in published literature.
Safety and efficacy of glued intraocular lens implantation in eyes with inadequate capsular support
Authors: Gonde Payal P. , Aghadate Sagar
Published: March 2020

Background: Aim of the study was to analyze the postoperative visual outcomes, complication rate of fibrin glue-assisted, suture-less posterior chamber (PC) intraocular lens (IOL) implantation technique in eyes with inadequate capsule support at a tertiary eye care hospital.Methods: This is a retrospective, nonrandomized case series. This study analyzes 50 eyes which underwent PC-IOL implantation by fibrin glue-assisted, suture-less technique. All patients who had IOL implants by the fibrin glue-assisted PC-IOL technique from 2017 to 2019 were included in the study. Intra- and post-operative complications were analyzed. The postoperative best corrected visual acuity (BCVA) was evaluated and recorded at the end of 6 months.Results: Mean age of distribution are 42.94 years in glued IOL implantation. Among 50 cases 30 are males and 20 are females. There is significant difference in BCVA between preoperatively and postoperatively, p value for pre-operative to post-operative vision in glued intraocular lens group is <0.0001 i.e. there is definite improvement in vision  in glued intraocular group. BCVA ≥6/24 was 18 (48%) in Glued IOL subjects.Conclusions: Glued IOL implantation is a feasible option in rehabilitating patients with aphakia without adequate capsular support.
Knowledge, attitude and practices regarding smoking amongst young females
Authors: Singh Isha , Sharma Manjushri , Sharma Isha , Sharma Pooja , Garg Kranti , . Deepali
Published: March 2020

Background: Smoking amongst women is increasing in the developing countries like India. There is paucity of data on the knowledge, attitude and practices of smoking amongst females in India. Hence a study was planned to assess the same.Methods: It was a qualitative research using descriptive questionnaire, prepared using the basic protocols available as per WHO Global Adult Tobacco Survey, conducted by self-reporting, from February to March, 2018 in the University Institute of Applied Management Sciences, Panjab University, Chandigarh. It was administered to 111 females aged 18 to 35 years, residing in Chandigarh.Results: Total22.5% of the female respondents were current smokers. Majority of them belonged to the age group of 26-35years; were either employed or were studying and felt that females resorted to smoking for gaining pleasure and relieving stress. Most of them were aware of passive smoking. Majority felt that people who smoke should quit for their own health and for their families and street plays, public awareness camps, television and cinema halls are important mediums for helping to quit. Will power be found to be most important to help smokers quit. Some quoted the role of nicotine replacement therapy, exercise, individual counseling etc also. Majority of the females started smoking early, at an age of 16-25years, consuming 1-10cigarettes per day and had been smoking since more than a year when interviewed. Smoking was primarily introduced by peers. All the smokers were aware of different types of smoking hazards, most commonly reported as cancer and asthma. 16/25 smokers wanted to quit and 14/16 had tried in the past but were unsuccessful.Conclusions: This study gives an indication of rising smoking trend in females. Smoking cessation measures need to be made more gender-sensitive, targeting females in their early ages.
Evaluation of hormonal profile and some stress biomarkers in infertile couples in Abuja, Nigeria
Authors: Abriba Simon P. , Osadolor Humphrey B.
Published: March 2020

Background: Infertility is a growing gynaecological problem in couples of childbearing age having difficulties bearing children. Couples with infertility are known to present with high levels of stress and psychopathology A cross sectional case control study aimed at evaluating the hormonal profile, some stress biomarkers, sperm analysis in infertile couples was carried out to ascertain their contributions to infertility in couples of child bearing age.Methods: Serum Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Prolactin, Progesterone, Estrogen (E2), Testosterone, Salivary Cortisol and Salivary Alpha Amylase were evaluated using both competitive and non-competitive Enzyme Linked Immunosorbent Assay (ELISA) techniques; while sperm cells analysis were evaluated using conventional methods, in 164 infertile couples (study) and 100 fertile couples (control) attending fertility clinic in General Hospitals in Abuja, Nigeria.Results: The mean serum Prolactin and Salivary (S) Cortisol in the female were significantly higher (p<0.05) in the study group relative to the control group, while Salivary Alpha Amylase and LH show no significant difference (p>0.05) between the two groups. FSH, Progesterone and E2 in the female were significantly lower in the study group (p<0.05) compared with control group. Testosterone, FSH, Sperm cells count and Sperm activity (%) were significantly lower (p<0.05) in the male study group relative to the control group; while prolactin, S. cortisol and S. amylase were significantly higher (p<0.05) in the male study group relative to the control group. Conclusions: Abnormal hormones values and abnormal sperm quality and quantity are associated with elevated stress biomarkers in couples presenting with infertility. Strong positive correlations exist between hormones and stress biomarker in infertility conditions.
A study of health seeking behavior about sexually transmitted infection in women with high risk behavior in an urban slum
Authors: Parve Sneha , Acharya Shrikala , Chide Pratik
Published: March 2020

Background: Health care seeking for sexually transmitted infection is frequently inadequate, particularly among female sex workers because of the low levels of awareness regarding sexual health. Correct diagnosis and treatment with health information are essential components of sexually transmitted infection (STI) services. Objective was to study demographic profile and to assess their health seeking behavior for STI and prevention services.Methods: Study was done in urban slum in Mumbai. It was cross sectional study conducted from May 2018 to December 2018.Results: The median age of women was 26 years. Majority belong to lower socio economic class, 39.4% women admitted that they took alcohol on occasions while 22% had sex with alcohol intake, 41% women were using condom during sexual activity. Only 14.5% women completed treatment who had past history of STI.Conclusions: Ensuring timely complete treatment of STI/RTI among women with high risk behavior is priority to prevent spread among general population.
Medical students’ perception of their educational environment during foundation course
Authors: Maharjan Shreekrishna , Shakya Tripti
Published: March 2020

Background: Learning environment is how students perceive the climate of an institution. The strength and weakness of learning environment should be identified to help change, adjust and manage training programs with objectives for improving learning quality. Dundee Ready Education Environment Measure (DREEM) is a validated tool designed to measure educational environment specifically for medical schools and other health profession institutions. This tool has been used in 20 countries, including Nepal. The aim of this study was to determine the perception of medical students of Foundation Course toward their learning environment using this tool.Methods: The study was conducted among the medical students attending Foundation Course in School of Medicine at Patan Academy of Health Sciences in Nepal using the DREEM tool.Results: Total mean of DREEM score was 150.51 and that of subscales for Students' Perception of Learning (SPL), Students' Perception of Teachers (SPT), Students' Academic Self-Perception (SASP), Students' Perception of Atmosphere (SPOA) and Students' Social Self-Perception (SSSP) were 36.96/48, 34.01/44, 23.96/32, 36.03/48 and 19.55/28 respectively. In item scores, students scored more than 3 for 29 items, between 2 and 3 for 20 items and only 1 item received less than 2 score indicating an issue requiring attention on overemphasis of factual learning during the course.Conclusions: Students have a positive perception about their educational environment. Their perception is a valuable resource for institutional curriculum planners to make appropriate changes to enhance student learning. It is important to get feedbacks from students on how they are experiencing their learning environment.
Hair tourniquet syndrome of labia minora in 14 year teen: a rare case report
Authors: Nutan Kumari , Jain Ajay Kumar
Published: March 2020

Hair tourniquet syndrome (HTS) is rare clinical phenomenon in which body appendage is circumferentially entangled by string of hair leading to ischemia and necrosis or even autoamputation of the appendage. HTS commonly affects toes, finger or genitalia. Early diagnosis and prompt intervention lead to good outcome.  This article presents a case of hair tourniquet syndrome of labia minora, a rare presentation in 14 year child.
Ovarian fibrothecoma with minor sex cord elements: a case report
Authors: Mahendran Revathy , Kanchana Madurai Padmanaban
Published: March 2020

Ovarian fibroma is the most common sex cord stromal tumour of ovary accounting to 1-5% of all ovarian tumours. Minor sex cord elements in ovarian fibroma are a rare entity occupying less than 10% of tumour area. To the best of our knowledge only 20 cases has been reported till date. This case is presented because of its rarity. Authors reported a case of fibrothecoma with minor sex cord elements in a 70yr old postmenopausal women who presented with postmenopausal bleeding with abdominal mass.
Clinical, hematological and cytogenetic profile in fibroblast growth factor receptor 1 rearranged hematoloymphoid malignancies
Authors: Shetty Dhanlaxmi , Talker Elizabeth , Mohanty Purvi , Jain Hemani , Yadav Anil Kumar , Jain Hasmukh , Nayak Lingaraj , Tembare Prashant , Patkar Nikhil , Subramanian P. G. , Kumar Amit
Published: March 2020

FGFR1 belongs to a family of four, high-affinity receptor tyrosine kinase and is a legitimate oncogene associated with uterine, cervical, prostate, bladder, colorectal and lung cancers. It is rarely concomitant in myeloid and lymphoid neoplasms but has an aggressive clinical course with a high mortality rate when present. Cytogenetic abnormalities involving the FGFR1 gene is most frequently observed in AML, MPN with eosinophilia, T-ALL and T-LBL with ZMYM2 gene being the most common fusion partner. Methods of this study was to authors report a series of 4 cases with FGFR1 rearrangements. Results is three patients presented as T-cell Lymphoblastic lymphoma (T-LBL) and one as mixed phenotype acute leukemia (MPAL). The T-LBL cases harbored the FGFR1/ ZMYM2 fusion and the MPAL case harbored the CNTRL/FGFR1 fusion as identified by conventional cytogenetics and confirmed by molecular studies. Conclusion is authors herewith describe the clinical, biochemical, molecular and cytogenetic features observed in these cases.
Surgical management of Dupuytren contracture of the ring finger: a case report
Authors: Nugraha Gede Ketut Alit Satria , Karna Made Bramantya , Andika Gde Dedy , Sunaria Made
Published: March 2020

Dupuytren’s disease, also called Dupuytren’s contracture or palmar fibromatosis, is a condition in which the connective tissue under the skin of the palm contracts and toughens over time. The gold standard treatment for Dupuytren’s contracture is surgery. We present a case of Dupuytren’s contracture treated with Bruner incision which resulted in good functional outcome. A 79 year old male presented to our Orthopaedic Clinic RSUP Sanglah Denpasar with the complaints of pain and stiffness on his left ring finger since 5 years ago. Patient had same history with his right hand and had operation 20 years ago. The patient underwent release of contracture using Bruner incision and had no complaint in 6 month follow-up. Extension deficit was <5°, reduction of contracture was >50%, the Patient and Observer Scar Assessment Scale (POSAS) gave overall opinion of the scar being minimal. The Dupuytren's disease etiology remains uncertain, with genetics perceived as most probable factor. Despite short-term success, there is a high rate of recurrent contracture with additional comorbidities such as wound-healing complications and neurovascular injury. In this case, the patient was treated using fasciotomy with Bruner incision and had satisfying outcome. Fasciotomy is known to have less complication in terms of recurrence. Dupuytren disease is characterized by abnormal thickening of the palmar fascia beneath the skin and the gold standard of treatment is surgery. This case presented surgical treatment using Bruner incision which had satisfying outcome in 6 month follow-up.