bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19: Hospital pharmacological treatment according to geographic region in Colombia v1
Authors: Machado Alba Jorge
Published: November 2021

Introduction: The impact of COVID-19 prompted a race to find a treatment that would reduce its mortality. Most studies have not shown favorable results for many of these drugs, but they are still used. Objective: To determine the differences and similarities in the hospital pharmacological management of patients with COVID-19 according to sex, age group, and geographical region of Colombia, 2020-2021. Materials and methods: Descriptive cross-sectional study. We identified the prescription patterns of the medications given to patients diagnosed with COVID-19 treated in eight clinics in Colombia between March 6, 2020 and May 31, 2021. We performed a descriptive analysis of the sociodemographic, clinical, and pharmacological variables of the patients. Results: A total of 8596 patients from 170 cities were identified, with a median age of 53.0 years and 53.3% of them men. A total of 24.3% required care in the intensive care unit, and 18.7% required invasive mechanical ventilation. The most commonly used drugs for the treatment of COVID-19 were systemic corticosteroids (63.6%), followed by colchicine (12.8%), azithromycin (8.9%), and ivermectin (6.4%). Corticosteroids, anticoagulants, colchicine, azithromycin, ivermectin, and hydroxychloroquine were prescribed more frequently in men, and their overall use increased with age. There were differences in prescriptions between geographic regions. Conclusions: The majority of patients were managed with medications included in the management guidelines. There were differences between sexes, age groups, and geographical regions.
Genital tumors in newborn girls
Authors: Cutusheva G. F. , Nemilova T. K. , Karavaeva S. A.
Published: November 2021

The analysis of 23 clinical cases of tumors in newborn girls - a rare gynecological pathology of this period of life is performed. The ovarian neoplasm in newborn were mostly a retention cysts. We noted the increase in congenital ovarian cysts diagnostics for the recent years. The tactics for treatment of newborn girls with ovarian tumors is determined.
Natural micronized progesterone for hormonal replacement therapy in reproductive medicine
Authors: Repina M. A. , Kornilov N. V.
Published: November 2021

A total of 64 artificial cycles with natural micronized progesterone replacement therapy were studied. Progesterone zoos used from day 4-5 before embryo transfer till gestational week 8-11 in different programmes (ovum/embryo donation, surrogacy, thawed embryos transfer after previous IVF/ICSI failures). Pregnancy rate was 43.5%. The HRT by natural micronized progesterone in artificial cycles could be stopped on gestational week 9 without any risk.
Hormone replacement therapy and malignant tumors
Authors: Urmancheeva A. F. , Burnina M. M.
Published: November 2021

The review on malignant tumors morbidity and its risk during hormone replacement therapy (HRT) is shown. The questions on possibilities of HRT in oncologic patients and the results of successful HRT management in rehabilitation of cervical cancer patients after surgical and and combined treatment are discussed.
Vocational guidance and assistance system for the employment of persons with disabilities and persons with disabilities within the framework of the international movement “Abilimpix”
Authors: Ananyeva Tatyana N. , Ilyukhina Galina I. , Sazonova Yulia V.
Published: November 2021

Human health and well-being largely depend on a sufficient standard of living, educational opportunities and participation in social and social life, and successful professional activities. It should be recognized that in the surrounding society it is in these areas of life that people with disabilities and disabilities are especially disadvantaged, but not neglected by society and the state.

Currently, in the Russian Federation, the State programme Accessible Environment is being implemented to support and assist persons with disabilities and disabilities, with the aim of creating legal, economic and institutional conditions conducive to the integration of persons with disabilities into society and improving their quality of life. The programme contains three subprogrammes that are effectively implemented in modern society, namely: (1) Ensuring the accessibility of priority facilities and services in priority areas of life of persons with disabilities and other mobile populations; (2) Improvement of the system of comprehensive rehabilitation and habilitation of persons with disabilities; (3) Improvement of the state system of medical and social expertise.

The organizers of the Abilimpix social movement were able to demonstrate to people with disabilities their individual capabilities and prospects for accessibility to all types, forms and means of obtaining knowledge and professional skills, their effective application in practice.
Strategic paths for development of contemporary cultural policies and their educational implications
Authors: Żardecki Wiesław Andrzej
Published: November 2021

Active, value-based cultural policy leads to development of culture and forms of cultural expression of individuals, groups or societies; also, it has direct influence on activities of creative industries combining artistic activity and entrepreneurship, operating in the free market and growing globalisation conditions.
Modern Trends in Personnel Management in the Civil Service: An Overview of Innovative Practices and Features of Administrative and Legal Regulation
Authors: Balashov Іvan , Evsyukova Oksana , Obushna Nataliia , Selivanov Serhii , Teplov Serhii
Published: November 2021

The COVID-19 pandemic has significantly affected all spheres of social-political life of the world community. As a result, there have been serious changes in the labour market, including the civil service. The labour market for civil servants is becoming increasingly complex, and new flexible technological solutions necessitate civil servants’ constant readiness for changes and lifelong learning. After all, the attribute of the new time is the quick-speed changes (we live in the mode “from slow to fast and faster”), both in terms of the amount of changes and in terms of the speed of their appearance. In such conditions, the civil service needs highly professional managers who are able to work to achieve expected results, apply European standards of public administration and develop effective public policy. Therefore, the purpose of the article is to substantiate the theoretical and methodological and applied aspects of personnel management in the civil service, taking into account the progressive innovative world human resources practices and features of administrative and legal regulation in this area. The authors proved the feasibility and identified the features of the formation of the talent management system as a leading modern trend in the field of personnel management in the civil service, examined the development of a talent management system in the civil service with an applied innovative tool such as e-learning in the conditions of modern challenges, and reviewed the positive international practice of talent management in the civil service (on the example of the USA, Germany, France, Great Britain, Singapore and Japan). On this basis, the main trends in the formation of the talent management system in the civil service of Ukraine are identified and the specifics of its administrative and legal regulation are analyzed.
Forensics as a Science and Practice
Authors: Kasprzak Jerzy , Kasprzak Magdalena
Published: November 2021

Modern forensics is a science that has been dynamically developing in recent years, which is related both to the general development of science and technology and to the needs of the judiciary and law enforcement agencies. The main feature of forensics is its interdisciplinarity. All the facts presented cause that the identity of modern forensics is changing. It is, in a way, a natural process. However, it poses a great danger of disintegrating this science. The article presents a discussion on the constantly changing paradigm of forensics, its goals and tasks. Such important theoretical issues have a large impact on forensic practice, primarily on expert opinions, teaching forensics and knowledge of forensics by lawyers.
Dopuszczalność orzeczenia przez sąd odwoławczy wyrokiem łącznym kary łącznej po raz pierwszy albo orzeczenia jej w zakresie innym niż orzekł sąd pierwszej instancji. Glosa do uchwały składu 7 sędziów Sądu Najwyższego z dnia 28 czerwca 2018 r. (I KZP 3/18, OSNKW 2018, nr 8, poz. 55)
Authors: Marko Dawid
Published: November 2021

The commentary raises the problem of the admissibility of the issuing cumulative penalty in cumulative judgement by appeal court for the first time or issuing that penalty within the different scope of punishment, from the perspective of the power to alter decisions of a court of the first instance, the principle of two-instance court proceedings, access to court and the right of defence. By discussing the essence of the constitutional and convention provisions, the author attempts to answer the question what the scope of the appeal court’s power is to alter cumulative judgement issued in the first instance, by concluding that neither Article 176 (1) of the Polish Constitution, nor Article 6 of the European Convention on Human Rights (ECHR) and Article 2 of Protocol no. 7 to the ECHR supplementing its content, as well as Article 14 (5) of the International Covenant on Civil and Political Rights in principle stand in the way of such an approach, which should be reflected in the process of interpretation of Article 437 (2) of the Code of Criminal Procedure. However, in the author’s opinion, doubts arise, from the perspective discussed above, if the appellate court were to take into account, when imposing the cumulative penalty, a unit judgement unknown, for various reasons, to the court of first instance, to which a special part of the considerations and critical remarks is devoted.
Economic Consequences of the Overuse of Short-Acting ß-Adrenergic Agonists in the Treatment of Asthma in Spain
Authors: Valero A , Molina J , Nuevo J , Simon S , Capel M , Sicras-Mainar A , Sicras-Navarro A , Plaza V
Published: November 2021

Objective: To determine the relationship between short-acting ß-adrenergic agonist (SABA) overuse and health care resource use and costs in asthma patients in routine clinical practice. Methods: A longitudinal retrospective study was conducted in Spanish primary and specialized care centers using the BIG-PAC medical records database. The study population comprised asthma patients ≥12 years of age who attended ≥2 consultations during 2017 and had 1-year follow-up data available. The main outcomes were demographics, comorbidities, medication, and clinical and health care resource use and costs. The relationship between SABA overuse and health care costs and between asthma severity and health care costs was determined. Results: The SABA use IN Asthma (SABINA) study included 39 555 patients, with a mean (SD) age of 49.8 (20.7) years (64.2% female). The Charlson comorbidity index was 0.7 (1.0). SABA overuse (≥3 canisters/y) was 28.7% (95%CI, 27.7-29.7), with a mean of 3.3 (3.6) canisters/y. Overall, 5.1% of patients were prescribed ≥12 canisters/y. SABA overuse was correlated with health care costs (ρ=0.621; P<.001). The adjusted mean annual cost/patient according to the Global Initiative for Asthma (GINA 2019) classification of asthma severity was €2231, €2345, €2735, €3473, and €4243 for steps 1-5, respectively (P<.001). Regardless of asthma severity, SABA overuse yielded a significant increase in health care costs per patient and year (€5702 vs €1917, P<.001) compared with recommended use (<2 canisters/y).Conclusion: SABA overuse yields high costs for the Spanish National Health System. Costs increased with severity of asthma.
The Effect of Corporate Governance Mechanism on Intellectual Capital Disclosure of High IC-Intensive Companies in Indonesia and Malaysia
Authors: Rahmawati Evi , Fadlurrahman Naufal , Azzahra Firda Shofia
Published: November 2021

Research aims: This study examines the effect of corporate governance mechanisms, such as board size, CEO duality, number of the audit committee, board gender, and family ownership, on intellectual capital disclosures.Design/Methodology/Approach: The sample study was high intellectual capital (IC)-intensive companies listed on the Indonesia Stock Exchange and Malaysia Stock during 2017-2018.Research findings: For Indonesia, the results revealed that the number of the audit committee and board size had a positive and significant effect on intellectual capital disclosures. Meanwhile, in Malaysia, the results showed that audit committees had a positive and significant effect on intellectual capital disclosures.Theoretical contribution/Originality: This study adds literature on the effect of corporate governance mechanisms on intellectual capital disclosure of high IC-intensive companies in the development of the country context.
Mahkamah Konstitusi Indonesia di Era Digital: Upaya Menegakan Konstitusi, Keadilan Substantif dan Budaya Sadar Berkonstitusi
Authors: Adhani Hani
Published: November 2021

Penelitian ini dilakukan untuk mengakji upaya Mahkamah Konstitusi sebagai lembaga peradilan baru yang bertugas menjaga konstitusi dan demokrasi serta melindungi hak asasi manusia agar dapat dengan mudah dikenali oleh masyarakat Indonesia melalui alat bantu teknologi digital sehingga masyarakat Indonesia bukan hanya dapat dengan mudah mengetahui Mahkamah Konstitusi namun juga dapat dengan mudah mengajukan permohonan atau gugatan ke Mahkamah Konstitusi apabila mengalami kerugian konstitusional. Dalam penelitian ini menggunakan data sekunder, yakni data yang diperoleh dari studi kepustakaan mulai UUD 1945, risalah amandemen UUD 1945, UU MK dan peraturan lainnya tentang MK, laporan tahunan MK, artikel, buku dan juga berbagai berita. Hasil dari penelitian ini dapat disimpulkan bahwa Mahkamah Konstitusi telah berhasil menjadi pengadilan konstitusi yang bukan hanya di percaya oleh masyarakat, namun juga menjadi benchmark dalam hal penggunaan teknologi E-Court yang memudahkan masyarakat untuk mengajukan gugatan ke Mahkanmah Konstitusi
Urgensi Penegakan Hukum Pidana pada Penerima Pinjaman Kegiatan Peer To Peer Lending Fintech Ilegal dan Perlindungan Data Pribadi
Authors: Hanifawati Saida Dita
Published: November 2021

Kegiatan peer to peer lending di Indonesia sangat pesat ketika covid 19, hampir segala kegiatan di alihkan menjadi serba online atau digital, yang mana tidak menutup kemungkinan seperti meminjam uang secara online/dalam jaringan. Hal tersebut, memungkinkan adanya tindak kejahatan baru seperti membuat platform P2P lending tanpa izin Otoritas Jasa Keuangan (OJK)/pihak berwenang atau dapat juga disebut ilegal. Banyak masyarakat yang menjadi korban P2P lending ilegal ini dan terlilit hutang dengan bunga yang sangat besar. Penegakan hukum terhadap pembasmian tindak pidana ini masih sangat minim atau belum terlaksana dengan maksimal. Walaupun banyak pasal yang sudah mengakomodir kejahatan itu, tetapi faktanya baru terdapat 2 putusan pidana terkait penyelesaian kasus ini. Penelitian hukm ini bersifat normatif dengan mengumpulkan data serta studi dokumen atau literatur dalam jaringan. Terdapat hasil penelitian yang mana platform P2P lending ilegal setiap tahun meningkat di Indonesia, yang mana tidak secara resmi terdaftar dalam OJK. Penegakan hukum yang digunakan adalah dengan menekankan pada ancaman kekerasan atau menakut-nakuti yang ditujukan secara pribadi / pasal 45 (4) jo pasal 27 (4) UU RI No. 19 2016 tentang perubahan atas UU No 11 Tahun 2008 tentang ITE, sedangkan perlindungan data pribadi belum menjadi hal yang di lindungi oleh UU/Negara.
Influencing factors of unmet needs for child spacing among selected countries experiencing high maternal-mortality in sub-Saharan Africa
Authors: Olarinmoye Abayomi T. , Eniade Olanrewaju D. , Kayode Olariike O. , Abiola Abimbola A. , Onifade Modupe O. , Odewale Sarafa O. , Kayode Bode
Published: November 2021

Background: Maternal complication and death has been implicated in unintended pregnancy. The indicator for measuring the risk of unintended pregnancy is unmet need for family planning (FP). It is necessary to explore the current situation of unmet need for child spacing (UNCS) as well as its influencing factors among countries that are experiencing high maternal mortality ratio. We aimed to unveil the prevalence of UNCS and its associated factors in Nigeria, Liberia and Sierra Leone.Methods: We analysed the data from DHS phase VII survey, a cross- sectional study conducted from year 2017 to 2018 across several countries. Total records of 25,539, 5,553, and 10,050 were extracted for Nigeria, Liberia and Sierra Leone respectively. Explored variables were UNCS, demographic characteristics and husband’s partners profile. Data was analysed using SPSS version 25. Descriptive statistics, test of association (chi-square) and binary logistic regression were used during the data analysis (α0.05).Results: UNCS was high in Nigeria (15.9%), Liberia (22.5%) and Sierra Leone (21.9%). In Nigeria, Liberia and Sierra Leone, 40%, 37% and 49.1% were uneducated respectively. The proportion of married women were 89% in Nigeria, 32% in Liberia and 70.2% in Sierra Leone. Also, female headship of household (OR: 1.29, 95%CI: 1.09-1.54) was associated with UNCS relative to male headship of household.Conclusions: UNCS was high in the three countries. Factors like educational status of women, age, as well as women as head of the households should be given much attention in the efforts to reduce UNCS as identified in this study.
Analysis of the relationship between premature rupture of membranes with delivery method and newborn asphyxia
Authors: Nurdin Azizah , Nurdin Haizah , . Rahmayanti , Sari Mutmainnah
Published: November 2021

Background: As many as 20% of maternal deaths are caused by premature rupture of membranes (PROM). The high rate of PROM is believed to affect newborn asphyxia. In addition, the high rate of cesarean section is one of the reasons or most frequent indications of PROM. Therefore, researchers were interested in knowing how the relationship between PROM and delivery method and newborn asphyxia was.Methods: This study was an analytical study conducted with a cross-sectional approach by taking secondary data from patients through medical records of pregnant women who experienced PROM in January 2020 to July 2021.Results: This study found that the incidence of PROM was more dominant in multiparous women 55.4%, in term pregnancy 79.2%, duration of PROM ≥12 hours 55.4%, have normal leukocyte levels 76.2%, the incidence of asphyxia (mild asphyxia) 90.1% and the rate of cesarean section as much as 24%. The bivariate analysis found a significant relationship between the length of PROM and the method of delivery (p value 0.049) and the duration of PROM with newborn asphyxia (p value 0.040) and there was no significant relationship between maternal leukocyte count and newborn asphyxia (p value 0.444).Conclusions: The longer the duration of PROM with delivery, the greater the chance of infection for the mother and fetus. The length or duration of PROM will have an impact on the method of delivery and increase the likelihood of asphyxia in newborns.
Is there any role of antibiotic as a post procedure prophylaxis in dilatation and curettage? A comparative single centre study at tertiary care centre
Authors: Thiyagarajan Kamalpriya , Chaudhary Vaishali , Patil Yogini , Gawali Vijaykumar
Published: November 2021

Background: Dilatation and curettage (D and C) is one of commonest procedure in the gynaecology. There are still two schools of thoughts pertaining to whether to administer antibiotic as a pre and post procedure prophylaxis or not to administer and hence study planned to evaluate the incidence of infection in patients after dilation and curettage with and without prophylactic antibiotics.Methods: Adults (>18 years) (n=100) who underwent dilatation and curettage procedure for any indication were included and patients with prior history of infection were excluded from the study. Patients were divided into 2 groups; group 1 (n=50) received prophylactic antibiotics and group 2 (n=50) received no prophylactic antibiotics as per the discretion of treating doctor.Results: Infection in both the groups was 2% and there is no statistically significant difference between the groups (p>0.349).Conclusions: Appropriate use of antibiotics can be a cost-effective strategy which can minimize the chances of development of antibiotic resistance and other side effects. Antibiotic are not necessary for pre and post procedure prophylaxis in D and C.
Correlation of cervical pap smears with histopathological diagnosis in cervical lesions
Authors: Farooq Ruksana , Quraishi Azhar-un-Nisa , Mohammad Shahida
Published: November 2021

Background: Cervical cancer is the most common genital cancer in India. In India alone,almost,130000 new cases occur with the death toll of 70000 everywhere. Objective of current study was correlation of pap smear with histopathological diagnosis.Methods: A retrospective study was conducted in tertiary care hospital in 130 sexually active women. Pap smears were taken and histopathological diagnosis was performed in all such patientsResults: From pap smear findings, out of 130 patients, maximum number of cases, 74 (56.9%) were categorized as. Out of epithelial cell abnormality, ASCUS was seen in 25 patients (10.2%), LSIL in 17 patients (13.1%), HSIL in 11 patients (8.5%). SCC was seen in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). From cervical biopsy reports, 51 cases(39.2%) were diagnosed as chronic cervicitis, 34 cases (26.2%) were diagnosed as chronic cervicitis with squamous metaplasia, CIN I in 31 patients (23.8%), CIN II in 8 patients (6.2%) and CIN III in 3 patients (2.3%), squamous cell carcinoma in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear test was 91.1%, 82.4%,73.2%, 94.6% and 85.4%, respectively.Conclusions: Pap smear has excellent correlation with histopathological diagnosis. Therefore it should be encouraged as effective tool for cervical cancer screening program to reduce incidence and mortality caused by cervical cancer.
Efficacy of ultrasonography for structural categorisation of abnormal uterine bleeding
Authors: Rathi Jyoti , Wagh Girija
Published: November 2021

Background: Abnormal uterine bleeding (AUB) is defined as bleeding from the uterine corpus endometrium to be precise, the bleeding is abnormal in regularity, volume, frequency, or duration. The international federation of gynecology and obstetrics (FIGO) categorized AUB based on structured medical history, laboratory tests, ultrasound, and or hysteroscopy-based techniques.The classification is based on the phrase "PALM- COEIN", (pronounced “pahm-koin”) of which "PALM" represents polyp, adenomyosis, leiomyoma, malignancy (and hyperplasia) and defines structural pathologies that can be assessed visually. Transvaginal ultrasound (TVS) is the first-line imaging test for the evaluation of abnormal uterine bleeding in both premenopausal and postmenopausal women. The purpose of this study was to estimate the diagnostic effectiveness of two-dimensional ultrasound (TAS and TVS) in assessing the structural causes of AUB and to compare the histopathological and intraoperative findings with ultrasound.Methods: It was a prospective observational study. A total of 200 women presenting with abnormal uterine bleeding between the age group of 18-55 years were included in study. All patients were subjected to routine investigations for AUB and ultrasonography (USG). Wherever appropriate the findings of USG were compared with intra-operative and histopathology findings.Results: Diagnostic accuracy of USG was 78.1% with sensitivity and specificity of 88.5% and 60%. Positive predictive value (PPV) and negative predictive value (NPV) was 79.4% and 75%. USG is a simple, safe, fast, efficient and tolerable procedure. In diagnosing structural uterine pathology responsible for abnormal uterine bleeding, it has outstanding diagnostic accuracy and should be followed in all such cases.Conclusions: We cannot be definitive in our approaches always, USG act as a wonderful modality to help us not only in identifying the structural causes but also the functional causes. However, the gold standard of identifying endometrial pathology is histopathology and it can’t be replaced by anything.
A case report on placental chorioangioma
Authors: Barde Kalyani P. , Aher Gautam S. , Gavali Urmila G.
Published: November 2021

Chorioangioma is the term used to describe an abnormal proliferation of vessels arising from chorionic tissue, which is most commonly observed in the third, and less frequently in the second trimester of pregnancy as a solitary nodule or, less commonly, as multiple nodules. We here report a case of placental chorioangioma which presented as a case of preterm labour. 21 year old primigravida presented to us at 26 weeks of gestation with history of PV leak and pain in abdomen. Ultrasound showed a single live foetus corresponding to 24-26 weeks of gestation with amniotic fluid index (AFI): 5 cm (oligohydramnios) there was evidence of 58×42 mm heterogeneously hypoechoic lesion noted over placenta likely s/o chorioangioma. Patient went into spontaneous preterm labour on day 5 and delivered vaginally. Placenta weighted 700 gm. A globular mass of size 6×7 cm was attached to foetal surface of placenta with a pedicle with confirmed the finding of ultrasonography. Placental chorioangioma is associated with high rates of perinatal complications. Most complications may appear early and delivery is problematic due to prematurity. Thus better prenatal investigations and regular follow up is required for early diagnosis and treatment.
Puerperal Group A Streptococcal sepsis: a case report
Authors: J. Nithya , G. Sathyamurthy , R. Balavinoth
Published: November 2021

Group A Streptococcal (GAS) sepsis in puerperium is one of the recognised causes of maternal mortality. Though the onset is often insidious, it can progress rapidly to a life-threatening invasive infection, toxin-mediated shock, and end-organ failure, even before clinical signs become apparent. We report a case of puerperal GAS sepsis that was successfully managed. 24-years-old para 1 was readmitted to the intensive care unit requiring non-invasive ventilation on postnatal day 6 with clinical and biochemical features of sepsis. Blood culture, episiotomy wound swab, and high vaginal swab grew GAS. Broad-spectrum antibiotics initiated. She developed ascites that progressively increased and needed therapeutic paracentesis. She was discharged after four weeks of hospitalization. Early identification and prompt treatment are the keys to prevent severe morbidity and maternal mortality.
Misplaced intrauterine contraceptive devices: a case report
Authors: Thakkar Nidhi D. , Hindocha Jaydeep D.
Published: November 2021

Contraception is a new topic gaining attention in country like India and a new proposed area of research. Intrauterine contraceptive devices (IUCDs) are one contraceptive method requiring less efforts and having more efficacy. ‘Misplaced IUCD’ is one of the rare and the most dreadful complication of IUCD insertion. Clinically, it can present as having pain, bleeding, recurrent pregnancy loss or can be asymptomatic. This is a case report of a 40 year old P4A1L4 female who presented to us with suspicion of misplaced IUCD without clinical symptoms. Clinical examination and radiological investigations made a diagnosis of misplaced IUCD and laparoscopy confirmed it. Laparoscopically misplaced IUCD was removed.
Satisfaction with life among MBBS students and resident doctors of a tertiary hospital in South Delhi
Authors: Singh Abhay , Singh Neetu , Dixit Shivam , Kaur Samarjeet , Chellaiyan Vinoth Gnana , Alfred Jerry
Published: November 2021

Background: When doctors are not satisfied with their lives, their dissatisfaction may reflect on their performance at their workplace. The objective was to determine subjective well-being and level of satisfaction among MBBS students and resident doctors.Methods: A cross sectional study was carried out using stratified random sampling among1st professional year MBBS students and resident doctors of a tertiary care teaching hospital, New Delhi. Satisfaction with life scale (SWLS) was used to evaluate the level of satisfaction with life in the study population. Data was analyzed with SPSS version 21.Results: It was seen that 76% of1st prof. MBBS Students and 68% of resident doctors were satisfied with their life. The major determining factors of satisfaction with life among 1st prof. MBBS students were ‘choosing MBBS course (72%) and hostel accommodation and food (69%). The major determining factors among the resident doctors were ‘choosing medical profession’(67%), working in a reputed institute (82%) and satisfaction with income (78%).Conclusions: Though a majority of Students and Doctors were found to be satisfied with their lives around one fourth of students (24%) and one third of doctors (32%) were found not to be. It is important to address the predictors of satisfaction to improve the overall quality of life of doctors and MBBS students.
Prospective observational study on prescribing pattern of infertility treatment options and their success rates in women with polycystic ovary syndrome at tertiary care teaching hospital
Authors: Abbagoni Rishitha Sanjana , Mushan Madhuri , Kosika Pooja , Vemula Prathyusha , Pattepura Manognya
Published: November 2021

Background: Polycystic ovary syndrome or in shortcut PCOS previously called as Stein-Leventhal syndrome is a primary and major cause of anovulatory infertility in women of child bearing ages. 3 in every 5 women with PCOS have trouble getting pregnant. Various therapeutic options are available in managing several PCOS symptoms and in increasing chances of pregnancy. The aim of the study was to observe the prescribing pattern of infertility treatment options and their individual success rates.Methods: The study was conducted in out-patient department of obstetrics and gynaecology, tertiary care teaching hospital, Telangana, India. The study included women aged between 18-37 years who were seeking treatment for infertility due to PCOS. Patients were divided into two categories based on their age and treatment they received which was further grouped accordingly.Results: The frequency of infertility was found to be significantly higher among PCOS women of age group between 23-27 when compared to other age groups. Among infertility treatment options, ovulation induction drugs were mostly prescribed and among supplements folic acid and myo-inositol were widely prescribed as supplements as well as an adjuvant. Patients who received treatment with ovulation inducing drugs showed high success rate.Conclusions: Lifestyle modifications were chosen as primary therapeutic option. Ovulation induction drugs among infertility treatment options, folic acid and myo-inositol among supplements were the mostly prescribed medicines to treat or improve infertility in PCOS women. Ovulation inducing drugs showed high success rate.
Investigation of hesitancy to donate plasma among COVID-19 survivors in Goa: an online survey
Authors: Dhupdale Nitin Y. , Sawant Vedang , Fernandes Bolivia Crocete Aloysia , Cacodcar Jagadish , Barretto Steffi
Published: November 2021

Background: The ongoing COVID-19 pandemic led to surge in mortality. In the absence of definitive treatment, convalescent plasma therapy was accepted as a modality to treat COVID-19 patients. There exists hesitancy with regards to COVID-19 convalescent plasma donation. To find the deterrents to CCP donation.Methods: An online survey was conducted by snowball technique. The study participants were COVID-19 survivors. They were asked to express their willingness to donate CCP. The reasons for not donating CCP were recorded. The data was analyzed using R-program. The adjusted and unadjusted Odds ratios were calculated to find the predictors of willingness to donate CCP.Results: 110 study participants responded to the survey. 49.1% of the responders were willing to donate plasma. The top three deterrents of CCP donation were ill health (27.6%; 95% CI, 18.28%-39.27%), ineligibility (10.5%; 95% CI, 4.98%-20.21%), not recovered completely (6.58%; 95% CI, 2.45%-15.34%). The female gender, older age, being symptomatic, unaware of government incentives, tested by RAT, and unaware of CPT were associated with lower odds of donating CCP.Conclusions: Ill health, ineligibility, and perceived incomplete recovery were the major deterrents of CCP donation. Being female, older age, being symptomatic, unaware of government incentives, tested by RAT, and unaware of CPT were associated with lower willingness to donate CCP. There is a need to develop interventions to target these factors to improve CCP donation whenever it is indicated.
Septic arthritis of multiple native joints following tooth extraction
Authors: Siddegowda Chidambar , Nanjundappa Nalina , Japatti Sharanbasappa , Subramanian Akshaya
Published: November 2021

Infection of the distant parts of the body especially the joints after a tooth extraction is uncommon, but when it occurs due to the virulence of the organism or due to the risk factors, it may cause severe joint infection with abscess formation and may limit the movements. We report a case of arthritis of the knee joint along with involvement of other joints following mandibular third molar teeth extraction one week postoperatively. The patient had swelling and limited range of motion of the involved joints, pain over other multiple joints. The patient had two episodes of postoperative septic arthritis following each mandibular third molar extraction. He was diagnosed of having septic arthritis and treated with antibiotics, analgesics, and steroids, that resolved after 3 weeks. 
A comparative study of efficacy, safety and compliance of intravenous ferric carboxymaltose versus iron sucrose in the treatment of iron deficiency anaemia of pregnancy
Authors: Kamath Vathsala , Reddy Naimisha , Shettian Nishita
Published: November 2021

Iron deficiency is the most common cause of anaemia worldwide and is associated with significant maternal and fetal morbidity. Current options for treatment include oral iron supplementation which can be ineffective and poorly tolerated, intravenous iron which can be used in patients who are intolerant to or unresponsive to oral iron and red blood cell transfusions which carry an inherent risk because of which it should be avoided. Intravenous iron therapy may reduce the requirement for allogenic blood transfusion. Ferric carboxymaltose is a new intravenous iron formulation promising to be more effective and as safe as iron sucrose. It may even have a better compliance as it offers the administration of a much higher iron dosage at a time.

The study was designed to compare the efficacy and safety of IV ferric carboxymaltose versus iron sucrose in the treatment of iron deficiency anaemia of pregnant women with moderate anaemia in the second and third trimester.

A hospital based randomized prospective study was done from July 2013 to June 2015 in the department of Obstetrics and Gynaecology, A.J. Institute of Medical Sciences, Mangalore. Baseline haemoglobin, peripheral smear and serum ferritin levels were measured to diagnose iron deficiency anaemia. 60 pregnant women who met the inclusion criteria and who formed the study subjects were randomly allocated into two groups comprising of 30 in Group C (Received ferric carboxymaltose) and 30 in Group S (Received iron sucrose). Outcome was assessed by measuring haemoglobin 3 weeks after treatment and a comparison of the safety and efficacy between the two groups was made.

In the present study the commonest age group was 21 to 30 years: 80% in group C and 73.3% in group S and mean age of the study population in group C and S was comparable (25.2±3.54 vs 24.8±4.58 years). The socio demographic characteristics, obstetric history, vitals and pretreatment haemoglobin were comparable in both the groups (p>0.050). The post treatment haemoglobin levels in 63.3% of the women in group C compared to 46.7% in group S were found to be 11 or more and mean post treatment haemoglobin levels were comparable in group C and group S (11.016±0.789 vs 10.73±0.821 gm%; p=0.174). In the present study, post treatment mean increase in haemoglobin levels was noted between 2.0 to 2.5 gm% in 43.3% of the women in group C compared to 50.0% in group S.

Ferric carboxymaltose administration in pregnant women in the second and third trimesters is well tolerated and is not associated with any clinical safety concerns. Both ferric carboxymaltose and iron sucrose have a comparable safety profile even when ferric carboxymaltose was administered in a much higher dosage compared to iron sucrose. Ferric carboxymaltose should be considered as the drug of choice, if i.v. iron treatment becomes necessary in the second or third trimester of pregnancy.
A comparative study of induction of labour with intravaginal misoprostol and intracervical dinoprostone gel and its fetomaternal outcome in a tertiary care hospital
Authors: Valvi Sheryl S , Airao Bhavesh B
Published: November 2021

The objective of the present study was to compare the two most commonly used agents for induction of labor-vaginal misoprostol and intracervical dinoprostone gel in terms of the incidence of cardiotocography (CTG) abnormalities and its correlation with fetal distress and fetomaternal outcome.

This is prospective case-control study conducted in department of obstetrics and gynecology, C. U. Shah Medical College and Hospital, Surendranagar over a period of 15 months. 112 women requiring induction were randomly assigned to two groups of 56 each, Group M received vaginal misoprostol and Group D received intracervical dinoprostone E2 gel. 56 women with spontaneous labor served as control group. Groups were compared in terms of the incidence of suspicious or pathological CTG tracings, fetal distress, induction to vaginal delivery time, vaginal delivery rates, dose requirements, rate of emergency cesarean.

Misoprostol was associated with shorter induction to delivery time (9.54 hours) than dinoprostone gel (13.54 hours), higher vaginal delivery rates (80.35% versus 62.5%), higher delivery rates (73.9%) with single dose itself unlike Group D, where 47.22% required more than one dose. Incidence of suspicious CTG was higher in group M (15.68%) versus 10.25% in Group D. Incidence of pathological CTG was also highest in Group M (7.8%) followed by Group D (2.56%) and Group C (7.8%). Dinoprostone gel lead to failed induction in 25% women, and hence higher caesarean rates.

While misoprostol is a better agent for induction when compared with dinoprostone E2 gel in terms of induction-delivery time, higher vaginal delivery rates, less dose requirement, it is associated with greater incidence of non-reassuring/pathological CTG. There was justified improvement in perinatal outcome due to preparedness beforehand with use of CTG.
Role of physiotherapy in preventing tears rolling down the legs in an eight year old girl: A case report
Authors: Esha R Shetty , Titiksha T Pol , Kirti J Jadhav
Published: November 2021

Urinary incontinence in children is an underdiagnosed symptom in India with a prevalence of 7%. An appropriate diagnosis and early intervention can help prevent the progression of the disorder. Here we present a case reportof an 8-year-old girl referred for physiotherapy with the chief complaint of urinary incontinence. She had a wide bladder neck along with leaking urine and a small bladder capacity. She was managed conservatively with medications and comprehensive physiotherapeutic assessment and management that included a combination of electrotherapy, pelvic floor training, balance and postural exercises and other interventions that gave a positive outcome in terms of eliminating the dribbling episodes and improvement in her quality of life.
Rehabilitation of hypotonus pelvic floor muscles with a telerehab approach- Case report
Authors: Borkar Sudini S Sinai , Dave Binal
Published: November 2021

Pelvic floor muscle is a group of muscles which acts as a Sling to Support, Assist and Aid the functions of Bladder, Bowel and Sexual activities. Hypotonus Pelvic floor muscle Dysfunction is a common condition suffered by Postmenopausal women where the strength of the Pelvic muscles reduces. Mostly reported is the incidence of Urinary incontinence and Pelvic organ prolapse. There are Various Proven Exercises, Equipments and Interventions which can be administered for the Hypotonus rehabilitation however due to the Covid- 19 Pandemic lockdown and with Social distancing there was a dearth felt by the Pelvic floor therapist for the rehabilitation of the Pelvic floor concern. This case report discusses the Telerehab approach and Progression Intervention for the Hypotonic Pelvic floor rehabilitation by Improving the Strength and the Quality of life of the women during such times when reaching the Pelvic floor therapist is difficult.
Catastrophe at menarche
Authors: Dasari Paapa , Garg Sonal
Published: November 2021

Menarche, the beginning of menstrual function occurs as a result of complex interaction between the hypothalamus, pituitary and ovarian hormones and is an important event in any girl’s life as it signifies the beginning of fertility. Rarely some diseases like migraine, epilepsy, inherited bleeding disorders can manifest at menarche and cause significant anxiety to the parents and the adolescent girl. A 13-year-old girl presented with convulsions following 8 days of excessive bleeding at the time of menarche. She had altered sensorium, severe anaemia with Respiratory alkalosis and needed ICU Care. She needed multiple transfusions of blood and blood products. She showed features of sepsis on haemogram at admission later manifested respiratory findings. Her bleeding per vaginum did not respond to antifibrinolytics and progesterones and stopped only after evacuation of contents on day 5 under GA. No organism could be isolated and she recovered on Day 6 of higher broad spectrum antibiotics. Her parents were counselled to watch for occurrence of seizures in later life as this catastrophe may signify onset of epilepsy in later life.
Guillain barre syndrome in pregnancy – Successful management with IVIG- A case report
Authors: Raman Srimathy , Rao Lavanya , Prakruthi KP  , Venkataram Padmalatha
Published: November 2021

Guillain Barre Syndrome is a rare immune mediated acute demyelinating polyradiculopathy, uncommon in pregnancy, but with increased mortality and morbidity. It poses a great diagnostic challenge. Good outcomes can be achieved in these patients with multidisciplinary team involvement. We would like to highlight the need for obstetricians to keep this rare cause in mind by describing the case report of a pregnant lady who presented to our hospital with muscle weakness and how timely diagnosis by appropriate investigations-nerve conduction studies and timely treatment with IVIG prevented complications.

1. Delay in diagnosis is common in pregnancy due to initial nonspecific symptoms which mimic changes in pregnancy. 2. GBS should be considered in pregnant patients presenting with weakness, tingling and numbness. 3. Early diagnosis by involving multidisciplinary team, appropriate investigations (NCS) and prompt initiation of immunomodulatory treatment improves outcomes. 4. Management in pregnancy is like that in the non-pregnant population.
Clinicopathological study of lesions of nasal cavity and paranasal sinuses- A two year study
Authors: Chaudhari Ankita Sunil , Birare Shivaji Dadarao
Published: November 2021

Sinonasal masses are common in the ENT Outpatient Department. The incidence being 1-4% of population. The symptoms and signs frequently overlap, hence, a diagnostic dilemma exists. The aim of this study was to study the occurrence of various lesions, the age, site and sex wise distribution in a tertiary care hospital of Maharashtra over the period of two years.

The study aims to examine the occurrence of various lesions in nasal cavity and paranasal sinuses, to determine the age, sex and site wise incidence of different benign and malignant lesions of nasal cavity and paranasal sinuses and to correlate the clinical and histopathological findings.

Descriptive Study

A descriptive study was carried out in the Department of Pathology at Tertiary Health Care among patients with clinically diagnosed nasal and paranasal sinus lesions attending the OPD of ENT during a period of 2 years. The specimens were grossly examined; fixed and routine microscopic staining was done. Interpretation was done using colour of the nuclei and the specimens were classified as neoplastic and non-neoplastic lesions. The data was statistical analysed.

Mean, Median, Mode

The most common clinical presentation was nasal obstruction 97 (93.26%), rhinorrhoea 73 (70.19%) and facial pain 24 (23%). 1: Mean age for the lesions to occur was years with the range 21-30 years (20.92%); 2: Non-neoplastic lesions 82 (79.6%) were more common than neoplastic lesions; 3: Simple nasal polyp 74 (90.23%), hemangiomas (50%) and squamous cell carcinoma (50%) were most common.

The study concludes that complete clinical, radiological and histopathological correlation helps us to categorize these sino-nasal lesions into various non-neoplastic and neoplastic types. But final histopathological examination provides a confirmatory diagnosis, as a significant number of cases may be missed on clinical evaluation alone.

The clinical features of non-neoplastic and neoplastic nasal and paranasal sinuses lesions may be indistinguishable from each other leading to delay in proper diagnosis and treatment. Histopathological examination is a reliable, cost effective diagnostic tool for accurate diagnosis and management of such lesions, as a significant number of cases may be missed on clinical evaluation alone.
Plasmacytoma of the mandible: A diagnostic conundrum
Authors: Pol Jaydeep N , Patil Dipti B , Desai Sharad S , Calcuttawala Adnan B
Published: November 2021

Plasma cell dyscrasias are neoplastic proliferation of monoclonal plasma cells that encompass a wide range of entities. Plasmacytoma may present as one of two distinct clinical entities: Multiple myeloma and solitary plasmacytoma. The incidence of solitary plasmacytoma is 2-5% among all plasma cell neoplasms and it commonly involves long bones and vertebrae. Its occurrence in the jaw is extremely rare and only 4.4% are seen in mandible. Clinically, plasmacytoma of mandible presents as pain, tooth migration, hard and soft tissue swelling or pathological fracture. Radiologically, it presents as unilocular or multilocular lesion mimicking odontogenic tumour creating a diagnostic dilemma.

We report a series of 3 cases of plasmacytoma of the mandible with comprehensive details of clinico-radiological, histological, immunohistochemistry findings and treatment with a review of the literature.

These three cases were clinically mistaken for Ameloblastoma, Odontogenic tumour and Oral cancer respectively. There was one case of Solitary Plasmacytoma and two cases on further workup proved to be multiple myeloma. All these cases were confirmed by immunohistochemistry.

Plasmacytoma of mandible is very rare. It is usually mistaken for other common mandibular lesions and oral cancers. Every attempt must be made to diagnose them precisely as management is quite specific. To best of our knowledge, this is the first series of plasmacytoma of the mandible in the Indian literature.