bluuebunny/crossref_metadata_2025 huggingface dataset:
Atrial fibrillation in old age: risk management and features of the use of direct oral anticoagulants
Authors: Kanorskii S. G.
Published: July 2021

Senile patients with atrial fibrillation (AF) are at a higher risk of thromboembolism and hemorrhage than younger patients. Three direct oral anticoagulants (DOAC), apixaban, dabigatran, and rivaroxaban, are registered in the Russian Federation and are extensively used for prevention of stroke in patients with AF. The DOAC treatment of older patients requires considering peculiarities of these patients, clinical situation and properties of individual drugs to achieve the balance of efficiency and safety and a comprehensive protection. According to studies of real clinical practice DOAC may have advantages over warfarin (reduced risk of fractures, diabetes mellitus, and dementia). Compliance with and constancy of the DOAC treatment are important for its efficiency, particularly in senile age. Results of clinical trials and real clinical practice studies have confirmed that rivaroxaban may provide a comprehensive protection for a senile patient with AF due to favorable indexes of efficiency and safety, beneficial effect on the risk of coronary events and impairment оf renal function, whereas once a day dosing of rivaroxaban improves the compliance with this treatment and its constancy.
Results of Register in Patients with Acute Coronary Syndrome and Atrial Fibrillation Receiving Rivaroxaban
Authors: Baturina O. А. , Andreev D. A. , Sychev D.i A. , Mesitskaya D. F. , Andranovich S. V. , Babakova N. A. , Suvorov A. Yu.
Published: July 2021

Aim      To evaluate outcomes in patients with acute coronary syndrome and atrial fibrillation who receive rivaroxaban and the patients’ compliance with the antithrombotic therapy.

Material and methods  The study was performed from October 2017 through December 2019 and included 129 patients. Events between the discharge from the hospital and 12 months of follow-up were recorded. The primary endpoint was development of major, minor or requiring medical attention bleeding according to the TIMI scale. The secondary endpoint was a combination of recurrent myocardial infarction, nonfatal acute ischemic cerebrovascular disease, nonfatal systemic embolism, stent thrombosis, and cardiovascular mortality.

Results 32 (24.8%) patients early terminated the antiplatelet treatment and 22 (17.1%) patients terminated the rivaroxaban treatment. 26 (20.2 %) patients had hemorrhagic complications. The highest incidence of hemorrhage was observed within the first 2 months after the discharge. None of the bleedings was fatal. Composite endpoint events were observed in 24 (18.6 %) patients, including 14 (10.9 %) who died from cardiovascular causes.

Conclusion      The compliance with the antiplatelet therapy was insufficient. The incidence of hemorrhagic complications was relatively high; minor and requiring medical attention hemorrhages mostly contributed to the structure of these complications. The observed incidence of recurrent ischemic events associated with a high mortality presents a more serious problem compared to hemorrhagic complications of the combination antiplatelet therapy and warrants a more aggressive tactics of the antiplatelet treatment in high-risk patients.
The ability of modern therapy to improve the prognosis of patients with HF: role of angiotensin neprilysin inhibitors and sodium-glucose cotransporter inhibitors
Authors: Mareev Yu. V. , Mareev V. Yu.
Published: July 2021

Major principles for treatment of chronic heart failure with reduced left ventricular ejection fraction <40% (HFrEF) include a “triple neurohormonal blockade” as a main approach. However, in recent 6 years, two new classes of drugs for the treatment of HFrEF have appeared, which beneficially influence the prognosis. These drugs are angiotensin receptor neprilysin inhibitors (ARNI) and type 2 sodium-glucose cotransporter 2 (SGLT2) inhibitors.Aim    To compare the net effect of simultaneous treatment with ARNI and SGLT2 inhibitors with the triple neurohormonal blockade in stable or decompensated patients with CHF based on Russian data.Material and methods    We analyzed the risk of death per 100 patient-years in patients with HFrEF. Stable patients were followed up at the A.L. Myasnikov Institute of Cardiology (presently, A.L. Myasnikov Research Institute of Clinical Cardiology of the National Medical Research Center of Cardiology) from 2006 through 2007; data from the EPOCH-Decompensation-CHF study were used for decompensated patients (12.2 % and 36.8 %, respectively).Results    When patients with stable HFrEF were successively switched from renin-angiotensin-aldosterone system (RAAS) inhibitors to ARNI (–16 %) and subsequently supplemented with SGLT2 (–13 %) the risk of death per 100 patient-years decreased from 12.2 % to 8.9 % (total risk decreased by 27 %; to save one patient the ARNI+ SGLT2 combination has to be prescribed to 30 patients). The estimated risk of death upon discharge from the hospital for the patients with decompensated CHF switched from RAAS inhibitors to ARNI (–16 %) and subsequently supplemented with SGLT2 (–13 %) was 26.9 deaths per 100 patient-years, whereas the number of patients to be treated for saving one life was only 10. Based on available data that demonstrate a greater effect of ARNI+ SGLT2 in patients immediately after CHF aggravation, the risk of death was recalculated. According to this analysis, the death rate per 1000 patient-years decreased from 36.8 to 19.9 % (relative risk decrease, 46 %), and to save one life only 6 patients had to be treated after they have achieved compensation of HFrEF.Conclusions    This analysis shows the importance of early initiation of the ARNI+ SGLT2 therapy in patients with both decompensated and with stable HFrEF.
The Effect of Programming Classes with Tangible Scratch Blocks on the Programming Interest of 6th Grade Elementary School Students
Authors:   Seoul National University of Education, Republic of Korea, Chun Seok-Ju , Jo Yunju , Lee Seungmee
Published: July 2021

In this paper, we introduce an original, classroom-based approach for teaching Scratch programming to 6th grade elementary school students. Scratch is a programming language that involves assembling icon-based command blocks. It was designed to avoid the complex syntax errors seen in other programming languages, making it especially accessible for younger learners. While Scratch does provide a visual programming environment in which potentially just about anyone can learn to read and write programming code, there can still be a reduced overall interest in learning programming, because younger learners in particular can find it difficult to intuitively understand or be stimulated by abstract concepts of programming such as sequences, conditions, and repetition, which are present in Scratch. Our research involves the development of a tangible, electronic block system that allows students to manipulate physical objects with their hands to perform programming tasks. The system consists of a Scratch simulator and physical, Scratch electronic blocks embodying Scratch user interface shapes. We devised and delivered a programming course to 6th grade Korean elementary school students using our block system. The results are encouraging.
The post-lunch effect of regular and decaffeinated coffee on psychomotor performance: a randomized double-blind cross-over study
Authors: Ramachandran Suganthi S. , Kumar Vijay L. , Dwivedi S. N. , Singh Vishwajeet , Gupta Pooja
Published: July 2021

Background: This study aimed to compare the effect of regular coffee and decaffeinated coffee on psychomotor performance in healthy volunteers during post-lunch period.Methods: In this randomized double-blind cross-over study, adult healthy volunteers were given hot coffee (3 g each of regular or decaffeinated coffee) during post-lunch period. Psychomotor functions (critical flicker-fusion frequency (CFF), choice reaction time (CRT) and error count in hand-steadiness test (HST)), blood pressure and heart rate were measured pre-lunch, pre-coffee (1-hour post-lunch) and 1-hour post-coffee consumption. Subjective ratings of sleepiness and mood were also assessed during post-lunch sessions.Results: The mean age of the participants (n=16) was 27.4±2.7 years with a male: female ratio of 7:9. There was no significant deterioration in psychomotor performance post-lunch when compared to pre-lunch on both the days. The mean CFF, CRT, errors committed in HST and cardiovascular parameters did not differ significantly between regular coffee and decaffeinated groups during post-lunch sessions. There was no significant difference in values of cardiovascular parameters as well as subjective ratings of sleep and mood between two groups.Conclusions: In healthy adult individuals’ consumption of both regular coffee and decaffeinated coffee during the post-lunch period did not affect psychomotor performance.
Effect of remedial teaching on academic performance of poorly performing students in pharmacology: a quasi experimental study
Authors: Modi Sophia B. , R. Bindulatha Nair , K. Libu G.
Published: July 2021

Background: Significant learning difficulties requiring remediation has been observed to be experienced by many medical trainees. Research with regard to individualized remedial teaching based on pedagogical diagnosis is a strong need of the time. The objectives of this study were to assess the effect of remedial teaching in improving academic performance among poorly performing students in pharmacology and to assess factors that could affect academic performance.Methods: The study was conducted in 2019. Academically poor performing students (<50 % marks in pharmacology first sessional exam) were selected after getting informed consent. After obtaining baseline information and study skills self-assessment inventory information from all students, academically poor performing students (53 students) were identified and they were randomized into two groups. One group (26 students) received academic support alone. The second group (27 students) received academic support, sessions on study skills, stress-coping strategies and counselling regarding their academic and non-academic problems.Results: The improvement in test scores among all participants of remedial sessions was statistically significant. Mean pre-test mark was 5.27±3.6, post-test was 14.63±1.24 and the difference is statistically significant. Though apparently high 10.02±3.25 versus 8.59±3.55, the post intervention gain in scores is not statistically significant between academic support+special package group versus academic support alone group (p value 0.16).Conclusions: Tailored or individualized remediation measures can greatly enhance the academic performance of undergraduate medical students and help them make satisfactory progress on the course.
Knowledge, attitudes, and practices towards COVID-19 among residents of Gujarat, India
Authors: Domadia Dharmesh , Patadiya Jigisha , Bhabhor Prakash
Published: July 2021

Background: India, having diverse demographic profile, any single measure to curtain COVID-19 spread will become ineffective by default. Hence, determining knowledge and behaviours of population regarding COVID-19 is must to extract and decide on an effective approach to reduce the spread of COVID-19. For the same, we conducted KAP study.Methods: It was a KAP study of adult residents of various districts of Gujarat, India; consisting questions with multiple responses pertaining to knowledge, attitude, and practices towards COVID-19. Responses were analysed and represented by their percentage. Knowledge related questions’ responses were statistically analysed based upon responder’s age, gender, education level.Results: Knowledge scores of male and female participants were 7.03 and 6.96. Mean knowledge score of age group of 18-30 years, differed significantly to that of age group of >60 years. Study participants’ scores didn’t differ statistically according their education levels. 91.3% participants felt that COVID-19 can be more effectively managed if person has been diagnosed or tested earlier in the disease. 69.8% participants felt that patients of COVID-19 infection can be safely treated at home. 74.4% of participant were in favour of lockdown if need arises. 77% participants were willing to take COVID-19 vaccine.Conclusions: Knowledge level didn’t differ for any gender or education level. Knowledge scores of populations above age of 60 years were statistically less as compared to the scores of participants aged between 18 to 30 years. TV news channels and newspapers were most sought way of getting information for current study population.
A perspective review of deadly viral diseases: An era of viruses
Authors: Sharma Abhishek , Bhyan Sarita J. , Malik Abdul
Published: July 2021

This review article overviewed briefly about the era of deadly viruses. Humans have been combating viruses since before our species had even evolved into its recent form. In some cases of viral infections, vaccines and antiviral drugs have allowed us to treat infections from spreading broadly, and have facilitated to patient recover. But it is far from over to fight the viruses. In recent decades, a number of viruses have sprung from animals to humans and have caused massive outbreaks, claiming thousands of lives such as the virus that led to the 2014-2016 Ebola outbreak in West Africa kills up to 90% of the population, making it the deadliest member of the Ebola family. But there are some viruses that are equally deadly, and some are even more deadly. Some viruses, including the novel coronavirus currently undergoing global outbreaks, have a low mortality rate but still pose a serious health risk as we have no means of access to the health facilities and scarcity of resources and infrastructure. Here we are reporting such type of ten deadly viruses. those have infected humans within last 50 years.
Evaluation of reproductive profile in male albino rats following varied duration of administration with Revive capsule
Authors: Ibama Onengiyeofori , Green Kinikanwo I. , Nwachuku Edna O. , Ben-Chioma Adline Erinma
Published: July 2021

Background: Revive capsule is a polyherbal formulation commonly used to treat erectile dysfunction or enhance libido in men. Some of the individual herbs used in the formulation of this drug have been known scientifically to affect various biochemical components of the human body; hence this study was aimed at evaluating the reproductive profile in male albino rats following varied duration of administration with Revive capsule.  Methods: A total of 42 male albino rats were used for the study, and were divided into six (6) groups of seven (7) rats each. They were allowed to acclimatize for two (2) weeks by maintaining 12-hour light and dark cycles daily, with access to standard feed and water ad libitum. Group A (negative control) rats were administered with distilled water once daily, while groups B, C, D, E and F were administered once daily with 72 mg/kg of Revive capsule for 1 week, 2 weeks, 3 weeks, 4 weeks and 6 weeks respectively. The rat dose administered was extrapolated from the human dose using the formula by Paget and Barnes. At the end of each treatment week, the rats were allowed to fast overnight, followed by their anaesthetization using chloroform, and blood sample collection via jugular vein puncture. Also, the testes were excised; the epididymis were also excised from the testes and used immediately for semen analysis, while the epididymis-free testes were examined histologically. Rat-specific test kits with ELISA method were used to analyze serum LH, FSH and testosterone.Results: The results showed a significant increase (p<0.05) in serum LH, FSH and testosterone levels, and a significant increase in sperm count and sperm quality parameters in the treatment groups compared to the negative control, with the maximum levels attained after 6 weeks of treatment (group F). Also, photomicrographs of histologically examined testes of the treatment groups appeared indifferent from those of the negative control.Conclusions: These findings may suggest that in using a rat model, treatment with Revive capsule at the appropriate dosage for 6 weeks is safe, and that, besides its acclaimed use in enhancing libido or treating erectile dysfunction, it may also be effective in promoting male fertility.
Relationship of lunar phases and sex of the foetus: a retrospective study
Authors: Raj Aman Deep , Abichandani Roshni , Sethi Harish
Published: July 2021

Background: The relation of lunar phases at the time of conception to the sex of the child at birth has been touted as a method of sex selection by various birth calendars with controversial results. It is made to believe that indeed there is a relation of lunar phase at the time of conception/intercourse which results in birth of a particular gender. The purpose of this study was to examine the influence of the lunar phase on the possible relationship between lunar position at EDD/LMP and the gender of the child.Methods: One thousand and five deliveries were retrospectively analysed from 1 January 2016 to 31 December 2018 at the department of obstetrics and gynaecology of military hospital, Gwalior (latitude and longitude coordinates: 26.218287, 78.182831). Females having regular menstrual periods history around conception and in general their periods have been normal and regular were included in the study. Females having irregular menstrual periods history or having oligomenorrhoea/polymenorrhoea, ART/IVF conceptions were excluded from the study. Exact lunar phases were determined at the time of EDD and not with their LMP since that would automatically corelate well with LMP because of regularity of their periods. The actual date of birth was not considered while corelating with moon phase because of obvious reason of unexpected timing of labour.Results: The analysis revealed no significant correlation of gender of the child to lunar phases at EDD. This would indirectly corelate well with the LMP since the inclusion criterion had females having normal and regular menstrual periods.Conclusions: There is no predictable influence of the lunar phase on the gender of the baby. As expected, and in agreement with some recent studies this pervasive myth is not evidence based.
The effect of clonidine with bupivacaine on perioperative hemodynamics and post-operative analgesia in cesarean section cases
Authors: Kumar Priti , Arya Sangeeta , Singh Sushil Kr. , Kumar Sunil
Published: July 2021

Background: Cesarean section is the commonest procedure in Obstetric practice and postoperative pain can be a major factor for wound healing as well as mother and baby bonding. Spinal anesthesia is considered to be safest and easiest modality for cesarean section cases. Bupivacaine is the commonest drug given in spinal anesthesia, but many additive drugs have been introduced to cover post-operative analgesia. Clonidine is an alpha 2 agonist which can be used as an adjunct to heavy bupivacaine to extend analgesic effects.Methods: A randomized double-blind study was performed in 100 women undergoing elective cesarean section under spinal anaesthesia. After proper informed written consent patient undergoing cesarean section were divided by computerized method into group A (Given 10.0 mg 0.5% hyperbaric Bupivacaine) and Group B (Given 9.0 mg 0.5% hyperbaric bupivacaine and 30 μg clonidine).Results: Intraoperative hypotension is the most worrisome factor but it is transient and can be managed by ephedrine effectively. Intraoperative nausea and vomiting are slightly higher with clonidine as occurrence of hypotension is more. VAS scoring in post-operative period was better and need of first analgesic dose was much delayed in women been given clonidine with bupivacaine.Conclusions: Clonidine can be considered as adjunct in spinal anesthesia to extend post-op analgesic cover.
Analysis of outcome of pregnant women affected with COVID-19 in a tertiary care hospital
Authors: S. Prasannalakshmi , Gayathri S. S. , Swathisree K. M.
Published: July 2021

Background: Corona virus is a single stranded RNA virus with a diameter of 80 to 120 nm. It causes respiratory illness ranging from mild nasal stuffiness to severe respiratory infection which may lead to death. The aim of the study was to evaluate the effect of COVID-19 on maternal and perinatal outcome.Methods: This retrospective study was conducted in the department of obstetrics and gynaecology, Government Sivagangai Medical College from June 2020 to November 2020. Totally 406 mothers were included in this study and the maternal and perinatal outcome analysed.Results: Majority of the patients were less than 30 years (85.95%) and only 14.03% were more than 30 years. Out of 406 patients 208 (51.23%) were multigravida. Out of 406 patients 148 patients had medical disorders like gestational hypertension, hypothyroidism, gestational diabetes mellitus, heart disease, anemia and bronchial asthma. Anemia being the most common followed by gestational hypertension. Among 406 patients, 100 (24.64%) patients were asymptomatic, 89 patients (21.92%) had fever, 50 patients (12.31%) had cough, 22 patients (5.4%) had difficulty in breathing, 62 patients (15.2%) had nasal congestion, 28 patients (6.8%) had headache, 55 patients (13.54%) had anosmia.72 (17.7%) patients had minimal ground glass opacity, 21 patients (5.17%) had ground glass opacity with consolidation, 15 patients (3.69%) had pneumonia with pleural effusion. Remedisivir IV was administered as per protocol to symptomatic patients and patients with CT findings. None of the mothers needed ventilator support or high flow oxygen (>12 l) and there was no maternal death. Among 207 babies (1 twin) delivered, about 91 babies weighed more than 3 kg, 77 babies weighed 2.6 to 3 kg, 31 babies weighed 2.1 to 2.5 kg, 8 babies weighed less than 2 kg. 38 babies had low birth weight. Five babies were found to be COVID-19 positive at birth and all five of them weighed more than 3 kg.Conclusions: Appropriate timely management is the key for safe motherhood and healthy offspring during this pandemic.
A retrospective study on causes of unsafe abortions in referred patients, at a tertiary care centre in western Uttar Pradesh
Authors: Kulshrestha Kalpna , Gupta Barkha , Verma Kalpana , Tarun Mandvi
Published: July 2021

Background: Unsafe abortions occur when pregnancy is terminated by unqualified person or in an environment that do not conform to minimal medical standards or both. The aim of this study was to analyse the causes in referred patients of unsafe abortions, methods used and complications with which patients were admitted.Methods: A retrospective observational study conducted in the department of Obstetrics and Gynaecology, SIMS Hapur Uttar Pradesh, India from 1stJune 2019 to 29thFebruary 2020. Data was collected from previous hospital records. Total 150 women aged between 18-40 years, admitted with complications of unsafe abortions and who had taken advice for termination outside our institute, were included. The demographic profile, detailed history, first contact person for abortion advice, abortion service provider, method of termination and prior ultrasound were noted. Exclusion criteria was period of gestation more than 20 weeks and spontaneous abortions.Results: The study showed 92% contacted unqualified person, out of which 22.5%were uncertified doctors, 30.4% ANM’s, 16.7% Nurses, 12.3% consulted quacks and 10.9% Chemists. Among the abortion service providers 23.6% were uncertified doctors, 45.7% Chemists, 15% Nurses, 5.7% Quacks, 3.6% ANM’s and 6.4% had taken self-medication. Prior ultrasound was done in 28% cases. Method of termination was medical in 78.7% and surgical in 21.3% cases. Period of gestation was <8 weeks in 69.3%, 8-12 weeks in 27.3%, 12-16 weeks in 2%. 37.3% had parity 2 and 55.3% were Hindus.Conclusions: Despite availability of safe abortion services, unsafe abortion practices are still prevalent. Approved MTP centres, skilled and certified abortion providers must be easily accessible to women even in rural areas to safeguard their health.
Maternal and neonatal outcome of twin pregnancies with single fetal demise
Authors: Rai Gunjan , Mansingh Sudhir , Bhardwaj Bikram
Published: July 2021

Background: In current study we managed twin pregnancies having single fetal demise with a successful outcome. Generally monochorionic and monoamniotic pregnancies are having high probability of complications, so we have to be more watchful in these pregnancies. Termination of pregnancy is not the only option as we can manage and prolong pregnancies with a good outcome by strict monitoring of patients. Aim of our study was to look for fetomaternal outcome in twin pregnancies with single fetal demise.Methods: This is a retrospective study done between July 2017 to June 2020 at Command hospital, Panchkula, Haryana. Total 3249 deliveries have been conducted during above said period. Out of which 47 deliveries were having twin pregnancy. We had six twin pregnancies who reported with one fetal demise. These cases were managed with regular monitoring of coagulation profile and strict fetal surveillance for surviving twin. The cases were studied for antenatal, postnatal and any neonatal complication.Results: No antenatal, postnatal maternal or any neonatal complication observed in this study. During study period we delivered total 3249 patients, out of which 47 were twin pregnancy. Out of these 47 (1.44%) twins’ pregnancies 33 (70.31%) were DADC and 14 (29.69%) DAMC. We studied six twin pregnancies who had single fetal demise. Conclusions: Even with single fetal demise pregnancies can be continued till term with strict monitoring for maternal and fetal complications. Termination is not the only answer in twin pregnancies with single fetal demise. Although our study was small, it indicates that in case of twin pregnancy with single fetal death and under good surveillance, the live fetus can be salvaged.
Comparison of conventional Papanicolaou smear and liquid‑based cytology: a study of cervical cancer screening at a tertiary care center in Bengaluru
Authors: Krishna Chaitra , Chandraiah Savitha , Krishna Chandana
Published: July 2021

Background: Cervical cancer is the fourth commonest cancer affecting women worldwide and the second most common cancer in women aged 15-44 years. The Papanicolaou (Pap) smear has been the cornerstone of screening for cervical neoplasm for the last 50 years. Liquid-based cytology (LBC) was introduced in mid-1990s as an alternative technique to process cervical samples has many benefits over Pap. A new second generation technique, Liquiprep was introduced after a decade has the advantage of a much lower cost. However, the information available on second generation liquid based cytology is limited. The objective was to look for the efficacy of LBC and to compare it to that of conventional cytology.Methods: This hospital based comparative study was undertaken 100 women who attended gynaecology OPD during 2017 at a tertiary care hospital in Bengaluru. Two cervical smears were simultaneously prepared from each subject, one for Pap smear and another for LBC followed by colposcopy and biopsy.Results: Among the study subjects, 89% of Pap smear analysis and 100% of smears in LBC showed satisfactory smear. Cytological abnormality was detected in 11% and 21% in pap and LBC, respectively. The present study showed higher sensitivity and specificity of 100% and 75% by LBC when compared to Pap smear (55% and 100% respectively).Conclusions: The present study showed that liquid based cytology is better in detecting cervical lesions when compared to conventional smear.
Awareness of cervical cancer and its screening methods in Indian women
Authors: Singh Khushboo , Goel Alka , Attri Manisha
Published: July 2021

Background: In spite of effective screening methods, cervical cancer continues to be a major public health problem in India. Therefore, the present study was carried out to assess the knowledge of cervical cancer and its screening among women, it also focuses on the reasons for not undergoing regular screening and the effect of counseling for the same.Method: 400 women were randomly enrolled from the women attending/visiting/working at a tertiary hospital. They were asked questions related to cervical cancer. All answers were obtained verbally and recorded in the questionnaire by the same investigator.Results: Out of 400 women, only 103 were aware of cervical cancer as well as its screening, and only 10 of them were undergoing regular screening. Among those who were aware of cervical cancer, majority (95.14%) were health care workers and most of them got this knowledge form their textbooks. After counseling, all except 6 women were willing for regular screening. The reason for refusal for the same was either they believed they were not at risk or they found pelvic examination uncomfortable.Conclusions: The study found that women had poor knowledge about cervical cancer and its screening. Awareness was higher among the women who had received higher education or were healthcare workers. However, cervical cancer screening rate was low even in these women. Government and health care professionals need to actively promote awareness of the risk factors of cervical cancer and encourage women to undergo regular Pap smear as a cervical cancer screening method.
Conception rate with or without hCG trigger in clomiphene induced cycles
Authors: Verma Aruna , Gupta Abhilasha , Kashyap Monika , Meraj Juveriya
Published: July 2021

Background: Clomiphene citrate (CC) is still the most common drug for ovulation induction. Most physicians use hCG trigger routinely for follicle rupture. Ideally hCG is recommended only where there is no spontaneous LH surge. Hence this study was conducted to see the role of hCG for follicle rupture in CC induced cycle. Aims and objectives of the study were to compare the ovulation rate in CC induced cycle with or without hCG trigger and finally the conception rate.Methods: Study was conducted in the department of OBG, LLRM medical college Meerut on women with anovulatory infertility. All women were given 50-100 mg CC. Follicular study from D-9 was done till follicle rupture. Women in group A were observed without any trigger and women in group B were given inj. hCG trigger 10,000 IU when follicle size reached 20-22 mm.Results: Conception rates were 25% Vs 31% in group A and group B. Follicle rupture was seen in 84% cases in group A and 71% in group B. Results were comparable in both the groups.Conclusions: By adding inj. hCG for ovulation trigger does not increase the conception rate. LH surge is already there in CC induced cycles. It is having role only in cases where no LH surge is there.
Clinicopathological profile of patients with brain secondaries from Ca cervix: a case series of five patients from tertiary cancer centre in North India
Authors: Sharma Jyoti , Upadhyay Mrinalini , Gupta Manish , Fotedar Vikas
Published: July 2021

Ca cervix is a common gynaecological cancer in daily practice but secondaries in brain after ca cervix as primary is a rare occurrence. As the survival of ca cervix patients has improved, we are able to encounter secondaries in unusual sites like brain. Prognosis is usually dismal due to presence of extra cranial mets along with brain secondaries which limits the use of new radiotherapy techniques like Stereotactic radiosurgery. We present a case series of five patients who presented to us post radical treatment of cancer cervix and treated with whole brain radiation therapy and best supportive care.
A rare case of utero-vaginal prolapse seen at third trimester: case report and review of literature
Authors: Awoniyi Adebayo , Ugwu Aloy Okechukwu , Garba Sunusi Rimi , Aniugwu Nneoma Kwemtochukwu , Egba Augustine , Olanrewaju Olabisi , Familusi Oluwaseun Emmanuel , Olumakinwa Olayemi Emmanuel , Okunade Kehinde
Published: July 2021

Pelvic organ prolapse (POP) is an infrequent cause of morbidity in pregnancy. We presented a case of stage three uterovaginal prolapse that was first noticed in the third trimester. Management of POP is individualized and its determined by the severity of the symptoms, stage of the prolapse, gestational age, patient’s desire and expertise of the gynaecologist. Different options of management have been proposed ranging from conservative to laparoscopy, hysterectomy in women with no desire for further child bearing. Vaginal delivery is an option; however, most obstetricians opt for elective caesarean section at term.
Recurrent cornual pregnancy: a case report
Authors: Saikia Neelotparna , Halder Sukalyan , Jain Punam
Published: July 2021

Cornual ectopic pregnancy accounts for 2-4% of all the ectopic pregnancies with a mortality rate 6-7 times higher than that of the ectopics in general. It is a diagnostic and therapeutic challenge to the clinician with a significant risk of rupturing and bleeding. As of yet, the incidence of recurrent cornual ectopic pregnancies is unknown. This report described the case of a patient who developed two cornual ectopic pregnancies within a span of 3 years with an intervening full term normal vaginal delivery. The 1st cornual ectopic was successfully managed by laparoscopic resection, which was followed by an uneventful postoperative course. The following contralateral cornual ectopic was managed by laparotomy since the patient presented with large hemoperitoneum.
Dysgerminoma presenting at fifty, consequence to undiagnosed Swyer syndrome
Authors: Amin Sapna Vinit , Kumaran Aswathy
Published: July 2021

Swyer syndrome or XY complete gonadal dysgenesis (CGD) is a rare disorder of sex development (DSD) characterized by presence of dysgenetic gonads in a phenotypically female patient with a male karyotype. Usually Swyer syndrome is diagnosed following appropriate evaluation for amenorrhea in adolescence and prophylactic gonadectomy is done as these patients have high risk of developing malignancy in their dysgenetic gonads.  Here we presented patient who presented later in life with ovarian malignancy which turned out to be a consequence of undiagnosed Swyer syndrome. Her case exemplifies that fact that improper evaluation of primary amenorrhea in adolescence and omission to do prophylactic bilateral gonadectomy led to her presenting with malignancy at this advanced age. Therefore, be aware to not let Swyer syndrome go undiagnosed and mismanaged.
OS USOS DO PASSADO NOS ANOS DE CHUMBO: UMA ANÁLISE ICONOGRÁFICA E ICONOLÓGICA DE UM ATLAS DE EDUCAÇÃO MORAL E CÍVICA (1971)
Authors: Matos Marlos Vinícius Gama de
Published: July 2021

Resumo: Este artigo se interessa pela cultura escolar, mais especificamente pela produção e circulação de livros didáticos e paradidáticos. Ele se insere na área da História da Educação, assim também como no campo do Ensino de História. O objetivo deste artigo é estudar a representação do passado na produção imagética deste Atlas que foi escrito e comercializado no ano de 1971. Utilizamos o método iconográfico-iconológico proposto por Peter Burke para a análise de imagens, bem como os postulados de Circe Bittencourt e Kazumi Munakata sobre produção e circulação de materiais didáticos. Os resultados alcançados apontam que a representação visual de agentes históricos foi utilizada com a intenção de criar um cidadão brasileiro a partir de três baluartes: religião, pátria e família. Por outro lado, a ausência de determinados sujeitos históricos como negros, mulheres e indígenas revelou uma noção branca, masculina, europeia e católica da formação do Brasil contemporâneo.Palavras-chave: EMC, Livro didático, História, Brasil.Abstract: The theme of this research is interested in school culture, more specifically in the concern with the production and circulation of textbooks and accompanying materials. This theme is inserted in the History of Education, as well as in the field of History Teaching. The objective of this article aims to study the representation of the past in the imagery production in a Modern Atlas of MCE, which was written and marketed in 1971. As a research procedure, we used the iconographic-iconological method proposed by Peter Burke for image analysis, as well as Circe Bittencourt and Kazumi Munakata’s studies on the production and circulation of textbooks. The expected results indicate to us that the visual representation of historical agents was used with the intention of creating a Brazilian citizen from three bulwarks: religion, homeland, and family. On the other hand, the absence of certain historical subjects such as blacks, women and indigenous people revealed a white, European, male, and catholic notion of contemporary Brazil's formation.Keywords: MCE, Textbook, History, Brazil.
AGOSTINHO JOSÉ DE OLIVEIRA MACHADO, UM BACHAREL NEGRO NO SÉCULO XIX
Authors: Cavassin Alves Alessandro
Published: July 2021

O presente texto tem por objetivo recuperar a biografia de um brasileiro negro no século XIX, Agostinho José de Oliveira Machado, advogado, professor, escritor e membro atuante do partido liberal. Nascido em Santos, conseguiu o título acadêmico de bacharel em Ciências Sociais e Jurídicas pela faculdade de São Paulo, em 1843, o que lhe proporcionou autonomia profissional e intensa participação política. Seria mais um exemplo da referência do fenômeno da “ascensão do bacharel e do mulato” no Brasil do século XIX que Gilberto Freyre discute no seu clássico livro Sobrados e Mucambos. Tanto as biografias discutidas por Freyre, somada a de Agostinho, perpassam enfrentamentos aos preconceitos raciais, confirmando a necessidade de se forjar um novo país.
NOS ENREDOS DE VIVÊNCIAS DE ADEMAR VIDAL: CONSTRUÇÕES DE AFETIVIDADES E INTELECTUALIDADE
Authors: Marques Maria Joedna Rodrigues
Published: July 2021

Este artigo faz parte de uma pesquisa desenvolvida em torno da obra e vida do intelectual paraibano Ademar Vidal (1897-1986). Para este texto, optamos por destacar a apresentação de alguns traços biográficos e do lugar social de Vidal, na intenção de compreender seu processo de erudição. Partimos da problematização do sujeito descrito por Alice Vidal no livro Ademar Vidal: para não esquecer (2010), destacamos o sujeito narrado e memorizado. Seguindo neste caminho, nos direcionamos para aspectos da sua formação intelectual, sua atuação em instituições, grupos sociais, trocas epistolares e encontros com outros intelectuais. Essas vivências e espaços influenciaram Ademar Vidal e sua produção no campo cultural, com ênfase nos estudos folclóricos da década de 1940 e consequentemente a formulação de uma identidade cultural para Paraíba. Dialogamos com Sérgio Vilas Boas (2008), Jean-François Sirinelli (2003) e  Aleida Assmann (2011).
A CULTURA VISUAL NO CAMPO POLÍTICO: UM ESTUDO DE CASO NA LITERTURA DE CORDEL
Authors: Rodrigues Filho José
Published: July 2021

Este artigo realiza uma discussão em torno das imagens da literatura de cordel atreladas à política, para tanto a pesquisa faz uso de um conjunto de imagens relacionadas a um personagem em específico: Tancredo Neves. No trabalho se buscou compreender a visualidade enquanto constituidora de narrativas culturais imersas em um poder que objetiva enfatizar memórias visuais. Para isso, utiliza-se enquanto fonte imagens de capas de folhetos de cordéis e jornais. Confrontando e problematizando os dois suportes é possível observar como cada espaço teceu narrativas verbais e visuais sobre o contexto relacionado a campanha, vitória e morte de Tancredo Neves. O artigo adota o recorte que compreende os anos de 1984-1985. Teoricamente se utiliza as reflexões propostas por Ana Maria Mauad, Paulo Knauss e Ulpiano Bezerra de Meneses, além de dialogar com Carlo Ginzburg, Aby Warburg, e bibliografia complementar.
ENTRE MALDITOS E MARGINAIS: UM DEBATE SOBRE MOVIMENTOS ARTÍSTICOS BRASILEIROS (1960-1970)
Authors: De Paiva Faria Luis Gustavo
Published: July 2021

O trabalho tem como objetivo distinguir o modo pelo qual as categorias de “maldito” e de “marginal” são abordadas pela produção acadêmica que enfoca músicos e a música popular brasileira das décadas de 1960 e 1970, ponderando a perspectiva dos atores e das instituições sociais, bem como as relações de grupos artísticos com a política, a indústria cultural e a crítica de arte atuantes no mundo artístico-intelectual brasileiro do período. A pesquisa propõe-se a fazer uma revisão sistemática da produção acadêmica sobre o tema e período aqui estudados. Esboça-se a hipótese de que as categorias de “maldito” e “marginal” não são sinônimas, nem tanto por seu caráter semântico, mas por sua dimensão sociológica: a primeira é assumida pelos próprios artistas como categoria de identidade, enquanto a segunda surge de uma imposição externa de rotulação operada pela indústria fonográfica, pelo Estado autoritário e/ou pela crítica de arte.
Immunomodulatory phytochemicals for chemoprevention
Authors: Agrawal Surendra , O. Patil Pravin
Published: July 2021

Chemoprevention and chemotherapeutics with traditional and complimentary system has gained importance with increase in the relapse cases treated with modern system of medicine. The increased mortality rate due to severe toxicity is another concern. The role of phytochemicals from different class viz-dietary polyphenols and saponins in chemoprevention along with different mechanistic pathways has created remarkable progress as the toxicity issues are of lesser concern. Phytochemicals can prevent the carcinogenesis process via antioxidant or anti-inflammatory action by modulating the proteins involved in different pathways like NF-kB, Nrf-2, AP-1, MAPK, and COX-2. In this review, we have focused on the potential molecular targets and signalling pathways that provoke the tumorigenesis process and the various phytochemicals that are targeted towards these signalling pathways by chemoprevention.
A review on stability improvement of sugarcane juice by using natural preservatives
Authors: Chopade Vitthal , Mankuskar Kamlesh
Published: July 2021

Sugarcane juice is liquid extract as a drinking beverage in India, possesses therapeutic value. Stability or shelf life is very less due to spoilage or degradation of sugarcane juice because of presence of simple sugar in sugarcane juice. Microorganisms like bacteria prone to degradation of sugarcane juice. Which convert sucrose into dextran as deteriorating agent. Shelf life or stability can be improved by using natural preservatives also chemical preservatives; having a therapeutic value. In this article improvement of stability of sugarcane juice by using natural preservatives such as lemon extract, ginger extract, also may be moringa extract over the chemical preservatives. Citric acid in lemon extract acts as antimicrobial agent while ascorbic acid in ginger extract both improves stability of sugarcane juice. Stabilization of sugarcane juice improved by using naturally obtained preservatives up to several days with good quality.
Study of incidence of heart failure in COPD exacerbation- A study in north India
Authors: Oli Ritamvara , Mishra J K , Srivastava G N , Mishra Saurabh , Brighten M
Published: July 2021

Progression of chronic obstructive pulmonary disease has a considerable effect on heart function including pulmonary hypertension, cor-pulmonale, Right and Left sided heart dysfunction. As COPD and heart failure (HF) share a common clinical feature, delay in diagnosis is associated with increased mortality. We aimed to study the incidence of heart failure in patients with COPD exacerbation.

142 patients were enrolled for study. It is a cross-sectional comparative study. We categorized exacerbation into two groups: respiratory failure and non-failure group. Patients were staged by spirometry after stabilization. Echocardigraphic evaluation and BNP levels were measured along with routine investigations.

The mean age of the study group was 63.53±9.021. The overall incidence of heart failure in exacerbation of COPD patients in our study group was 33.09%(n=47). Incidence of HF was 50.6%(n=41) patients in the respiratory failure group and 9.8%(n=6) in non-respiratory failure group respectively. Right sided heart failure was recorded in 82.92% of case in group one whereas in group two 66.66% had left ventricular dysfunction.

Our study concludes that overall incidence of heart failure in COPD exacerbation is 33.09%. Respiratory failure complicates heart failure and hence the incidence increases. Severe stages of disease are associated with Right sided heart failure more frequently.
HISPANISMO Y PATRIMONIO ARQUEOLÓGICO IBÉRICO
Authors: Aranegui Gascó Carmen
Published: July 2021

Este artículo apoya la existencia de arqueólogos hispanistas entre el siglo XIX y la primera mitad del XX. Destacan los profesionales franceses que reconocieron y divulgaron la singularidad de España desde sus orígenes, alentados por la sensibilidad romántica de la época. El itinerario de la Dama de Elche hasta su exposición en el Museo del Louvre es el mejor testimonio de este fenómeno.
EL HISPANISMO FRANCÉS Y LA HISTORIA MODERNA DE LA MONARQUÍA HISPÁNICA
Authors: Vincent Bernard
Published: July 2021

La aportación del hispanismo francés a la historia moderna no ha dejado de ser importante durante las dos últimas décadas. Gracias a su buena implantación en todo el tejido académico francés, ha tenido una producción abundante de monografías y libros colectivos que abarcan todas las ramas de la historia. Sin embargo, se caracteriza por dos rasgos esenciales: el interés muy marcado por la historia política y sociopolítica, y su ambición por explicar la complejidad de la construcción de la Monarquía hispánica en el conjunto de sus territorios.
HISPANISM AND THE HISTORIOGRAPHY OF COLONIAL LATIN AMERICA: NORTH AMERICAN TRENDS
Authors: Lane Kris
Published: July 2021

El hispanismo o la fascinación por todo lo “español” tienen una larga tradición en los Estados Unidos. El fenómeno ha tenido tanto manifestaciones populares como académicas, y por lo tanto debe tratarse de una manera amplia cuando se tiene en cuenta la historiografía de la América Latina colonial producida por académicos anglófonos, tanto dentro como fuera de los EE. UU. Los apologistas, críticos y todos los demás han tenido que lidiar con el legado hispano en las Américas, tanto en lo cultural como en lo religioso, económico, ambiental y de otro tipo. Este ensayo rastrea las principales preocupaciones o preguntas “hispanas” que generaron subcampos académicos y escuelas durante el último cuarto de siglo más o menos entre los anglófonos que investigan sobre América Latina colonial. La pregunta sigue siendo: ¿En qué medida el hispanismo o la preocupación por los múltiples legados coloniales de España han impulsado estas tendencias historiográficas? ¿Se ha desvanecido el hispanismo o simplemente ha tomado nuevas formas?
UNA CARTOGRAFÍA PARA LOS ONCE CONDADOS DE LA DIÓCESIS DE LUGO: HACIA UNA NUEVA APROXIMACIÓN AL "PARROCHIALE SUEVUM"
Authors: Bermúdez Beloso Mariña , Ibáñez Beltrán Luis Miguel
Published: July 2021

Se considera que el texto conocido como Parrochiale Suevum fue originariamente escrito en el siglo VI, pero la relevancia de su contenido lo convirtió en objeto de varias copias interpoladas en las centurias sucesivas. En todas las versiones alteradas del documento que se han conservado el obispado de Lugo está organizado en once comitatus. En este artículo analizaremos un documento que presenta una detallada descripción de estos condados, en un grado de precisión que permite la reconstrucción cartográfica de cada uno de ellos. Aunque la fecha proporcionada en el texto es el 572, la evidencia histórica sitúa su redacción a finales del siglo XI, dentro de un contexto más amplio y agitado en las diócesis ibéricas occidentales. Este artículo propone un análisis detallado del documento que describe los comitatus, combinando las herramientas proporcionadas por las Humanidades Digitales, los SIG en particular, con una metodología histórica más tradicional. El mapa resultante proporciona el punto de partida para una mejor comprensión de las ambiciones del obispo de Lugo sobre el territorio y del contexto político y religioso del siglo XI, así como del propio Parrochiale Suevum.