bluuebunny/crossref_metadata_2025 huggingface dataset:
CFD Simulation and Validation of Flow in Small Arteries to Enable Further Drug Delivery Studies
Authors: Mercado-Montoya Marcela , Cruz-Jiménez Juan Carlos , Hernandez Alher Mauricio
Published: January 2020

Treatments based on nanocarriers such as nanoparticles have emerged as alternatives to overcome common limitations and side effects caused by traditional treatments against cancer and neurological diseases. The main attribute of nanoparticles stems from the fact that they can transport pharmacological agents in a guided manner. This allows drugs to selectively target diseased rather than healthy tissues. This work was aimed at modeling and simulating fluid flow inside small arteries and experimentally validating the model through quantitative measurements of pressure and flow rates. The validity of the model was evaluated in the light of different indexes of percentage agreement between simulated and measured values. The model was previously verified via mesh convergence analysis and qualitative observations of velocity profile. Our findings provide a robust basis for studying nanoparticle transport in arteries as the developed platform enables their releasing and remote manipulation both in silico and in vitro.
A model for collection of Waste Electrical and Electronical Equipment in Metropolitan Area of Bucaramanga
Authors: Arias-Osorio Javier , Ríos-Mercado Ruben Darío , Tamayo-Morantes Ingrid Dayanna
Published: January 2020

In this paper, a model for the collection of waste electrical and electronic equipment is designed based on a problem of location and vehicle routing. Two main phases are carried out: The localization phase, in which the WEEE collection points are defined from a series of potential points, involving the novelty about the assignment of different types of devices to each of those points. And, the routing phase in which the collection routes are designed to minimize the associated costs. A case study is analyzed for the collection of WEEE in communes 6, 7 and 8 of Bucaramanga. For the localization phase, a mixed integer linear programming model is developed, which is solved with the GAMS software. The capacitated vehicle routing problem CVRP is addressed with the objective of minimizing the costs associated with the distance traveled by the vehicle for each of the assigned collection points, and a GRASP metaheuristic with local search operators is proposed as a solution technique to solve this second phase. The algorithm was programmed in MATLAB Software and validated with instances of the literature, showing good results for the defined case study.
Characterization of the urban heat island at Bucaramanga, Colombia, using real-time temperature monitoring
Authors: Villamil-Almeida Hildreth Jadira , Blanco-Mantilla Kevin Andrés , Salah-García Oscar Yazit , García Sánchez Carlos Eduardo
Published: January 2020

One of the meteorological effects in cities is the increase in local temperature, which is known as urban heat island (UHI). The objective of this study was to detect and quantify the possible UHI in the city of Bucaramanga, Colombia. For this purpose, a real-time temperature measurement network was installed, composed of seven nodes, used to obtain temperature values every minute. Six of the nodes were located in different positions in the city, and the remaining one was used to give the reference measurement. The data collected were processed for elimination of outliers, management of missing data and noise filtering. Analysis of the data allowed detecting differences in the diurnal and nocturnal UHI intensity trends. It was concluded that the UHI intensity during the day varies depending on the Local Climate Zone that represents the location, while the UHI intensity value at night is quite uniform across the city, with a mean value of 1.0 °C. It was also possible to conclude that the magnitude of the daytime UHI is lower in the dry season.
SLANG AS A METALANGUAGE VARIABLE IN THE HISTORICAL AND COMPARATIVE ASPECTS
Authors: Borys D.P.
Published: January 2020

The article examines the term slang in the light of its polysemantic nature in English, Ukrainian, Polish, Hungarian, French, Italian, and Spanish language studies. Approaches to defining slang in English are specified and systematized. Interlingual semantic equivalents utilized to name English slang counterparts in the other six analyzed national language terminological systems are established.
Effectiveness and Safety of Nitrous Oxide as a Sedative Agent at 60% and 70% Compared to 50% Concentration in Pediatric Dentistry Setting
Authors: Kharouba Johny , Somri Mostafa , Hadjittofi Christopher , Hasan Jomana , Blumer Sigalit
Published: January 2020

Objective: Sedation using 50% nitrous oxide (N2O) concentration is common in pediatric dentistry.

The aim to assess sedation and cooperation levels following sedation with 60% and 70% N2O concentrations in children whose dental treatment failed using 50% N2O concentration.

Study design: Children (n=51) aged 5–10 years were included. Sedation started with N2O concentration of 50%; when appropriate cooperation and sedation were not achieved, N2O concentration was increased to 60%, and subsequently to 70% during the same session. Sedation and cooperation levels were the primary outcomes. Adverse events were defined as secondary outcomes.

Results: At 50% N2O concentration, five children reached adequate sedation and cooperation and completed their dental treatment, where 32 children completed the treatment at 60% N2O concentration. Fourteen children required a concentration of 70% to complete treatment. For ten of the latter, treatment was successfully completed, while for four, treatment failed, despite the achievement of adequate sedation. Adverse events were observed in 9%, 22%, of the children who received 60%, 70% N2O concentrations, respectively. Conclusions: When sedation with 50% N2O concentration does not achieve satisfactory cooperation to complete pediatric dental treatment, 60% N2O concentration appears to be more effective than 50% and safer than 70%.
The study of hydrogen sulfide in cord blood to predict the functioning of the ductus arteriosus in preterm infants
Authors: Kharlamova Natalya V. , Fisuk Julia A. , Sitnikova Olga G. , Gorozhanina Tatiana Z. , Nazarov Sergey B.
Published: January 2020

The hemodynamically significant functioning ductus arteriosus in premature infants can cause many complications and worsen the prognosis for life and health. Therefore, the determination of a high risk of the functioning of the ductus arteriosus is an urgent problem of the early neonatal period. Characteristic echocardiographic manifestations of a functioning ductus arteriosus is a lower stroke volume, higher pressure in the pulmonary artery and aorta. Inthe framework of this study, the frequency of the functioning ductus arteriosus in deeply premature infants was revealed. It was found that the concentration of hydrogen sulfide in umbilical cord blood in lower preterm infants with a functioning arterial duct is lower than in newborns without a functioning arterial duct. It is shown that the concentration of hydrogen sulfide in cord blood can be used for early detection of this condition. A method for predicting the functioning of the arterial duct has been developed, which consists in calculating the prognostic indexDtaking into account the gestational age, weight and height of the newborn, as well as the concentration of hydrogen sulfide in cord blood.
Diagnosis and treatment of upper gastrointestinal bleeding in patients with acute cerebrovascular accident
Authors: Korolev Mikhail P. , Spesivtsev Yuriy A. , Fedotov Leonid E. , Klimov Aleksey V. , Terekhov Igor S. , Kondratyev Anatoliy N. , Daliev Bahodir B. , Doniyarov Shokhrukh Kh.
Published: January 2020

Bleeding from the uppergastrointestinal tract is one of the most dangerous complications in patients with acute CVA (ischemic and/or hemorrhagic type). The combination of these conditions requires special attention in the diagnosis and choice of treatment methods. Central Nervous System pathology makes diagnosis, choosing methods oftreatment and the use of drug more complicated to surgeons in the postoperative period. With onset of hemorrhage, antithrombotic treatment should be canceled, that can negatively affect the results of treatment of patients with ischemic type of cerebral vascular accident. The use of anti-ulcer drugs, namely proton pump inhibitors, may increase the risk of hospital-acquired pneumonia,Clostridium difficileinfections, and cardiovascular diseases. These factors force us to consider issues related to diagnosis and treatment plans in this group of patients. The most promising direction in the treatment of patients with ischemic or hemorrhagic stroke in combination with gastroduodenal bleeding is the identification of risk factors for upper gastrointestinal bleeding, early endoscopic diagnosis and treatment, performing preventive treatment. The article presents a brief review of domestic and foreign literature, some issues of etiology and pathogenesis of gastroduodenal bleeding in patients with cancer, the results of our own research, capabilities of modern endoscopy in the diagnosis and treatment of gastrointestinal bleeding in this group of patients. The algorithm of management of patients with a combination of bleeding from the upper gastrointestinal tract and CNS pathologies.
Predictors of the development of cardiac arrhythmias in women after induction of superovulation in vitro fertilization
Authors: Vakareva Victoria V. , Avdeeva Marina V. , Scheglova Larisa V. , Bondarev Sergey A. , Voronkov Pavel B.
Published: January 2020

The article presents the results of a clinical and instrumental examination of 80 healthy women (average age 32,313,57 years) in order to assess the heart rhythm disturbances after induction of superovulation duringin vitrofertilization. All women were examined twice before and after induction of superovulation during extracorporeal fertilization. Clinical and instrumental examination included: electrocardiography at rest; echocardiography; 24-hour ECG monitoring with heart rate variability analysis; 24-hour blood pressure monitoring. Induction of superovulation is associated with a significant increase in mean daily HR max (р0,01), and consequently with an increase in myocardial oxygen demand. It has been established that induction of superovulation contributes to the development of supraventricular arrhythmias (р0,01) and an increase in episodes of apnea/hypnea (р0,01). Regression analysis revealed predictors of supraventricular arrhythmias after induction of superovulation, including adverse circadian heart rate profile, adverse circadian blood pressure profile, impaired autonomic regulation of heart activity (р0,01). It was shown that the appearance of rhythm disturbances is associated with both the initial functional state of the cardiovascular system and its response to the induction of superovulation. It was established a correlation between the estradiol concentration and the increase of daily average heart rate after induction of superovulation (r=0,30,р0,05), apnea/hypnea index after induction of superovulation (r=0,34,р0,05). Conclusion. Superovulation induction may exacerbate existing chronic cardiovascular diseases. Due to the adverse effect of superovulation induction on the daily heart rate profile, women need to evaluate the functional state of the cardiovascular system duringinvitrofertilization planning. This will prepare the woman for the upcoming procedure and avoid adverse reactions from the cardiovascular system in response to stimulation of superovulationin vitrofertilization.
Alcoholic lung injury
Authors: Davydova Zlata V. , Yagmurov Oraz D.
Published: January 2020

The article presents modern data on pathomorphological changesin lung tissue formed under the influence of acute and chronic intoxication with ethanol and its metabolites. At autopsy of the persons abusing alcohol, along with defeat ofabrain, heart, a liver note considerable changes in lungs. It was found that ethanol is excreted by the lungs and kidneys unchanged. The lungs are actively involved in the conversion of ethanol into carbon dioxide. The toxic effect ofethanol and its metabolites increases the permeability of the vascular wall, which leads to the accumulation of protein in the lung tissue with the development of pronounced dystrophic and destructive changes with the formation ofsubsequent pneumosclerosis. Alcohol negatively affects the function of alveolar macrophages, which have an important role inprotecting the lungs. Under the influence of ethanol in macrophages, biochemical processes are slowed down, expressed in a sharp decrease in their phagocytic activity and ability to move. In turn, it is necessary to note the studies that reflect the data on the influence of alcohol on the lung surfactant, which stabilizes the surface tension in the alveoli and counteracts the transudation of fluid into the alveoli. Alcohol adversely affects the phospholipids included in the surfactant and disrupts the process of its formation. Alcohol intoxication is the cause of 60% of comatose States, and obturation-aspiration complications are the leading form of respiratory disorders. Alcohol-induced disorders of the mucociliary apparatus contribute to the ingress of foreign particles into the respiratory tract. The defeat of these protective mechanisms in combination with a decrease in the overall immune reactivity of the body cause the development of anumber of pathological changes in the lungs. Thus, the study of morphological features of lung injuries in acute ethanol poisoning is of fundamental importance in elucidating the links of pathogenesis ofterminal States, their justified therapy.
A Brief Introduction to Seismic Instrumentation: Where Does My Data Come From?
Authors: Ringler Adam T. , Bastien Patrick
Published: January 2020

Modern seismology has been able to take advantage of several technological advances. These include feedback loops in the seismometer, specialized digitizers with absolute timing, and compression formats for storing data. While all of these advances have helped improve the field, they can also leave newcomers a bit confused. Our goal here is to give a brief overview of how recordings of seismic ground motion originate. We discuss the chain of events that are required to obtain digital data plus how these steps can be reversed to recover units of ground motion such as acceleration, velocity, or displacement. Finally, we show a few examples of data that have become compromised because of various non-ground-motion signals. We hope this brief overview provides a quick practical introduction to allow the reader to become familiar with the various jargon used in observational seismology.
Data Retrieval System of JMA Analog Seismograms in the Headquarters for Earthquake Research Promotion of the Japanese Government
Authors: Furumura Mitsuko , Iwasa Koji , Suzuki Yasunori , Demachi Tomotsugu , Ishibe Takeo , Matsu’ura Ritsuko S.
Published: January 2020

To archive precious analog seismograms of major earthquakes that occurred in and around Japan, we have scanned selected analog seismograms from 113 stations deployed by the Japan Meteorological Agency (JMA) and are constructing a database of the scanned digital images accessible through the website of the Headquarters for Earthquake Research Promotion (HERP) of the Japanese government. This project started in 2006 and was conducted by the Association for the Development of Earthquake Prediction. The database of HERP now contains more than 185,000 digital images of seismograms recorded during the period from 1884 to 1995. It includes seismograms of earthquakes that occurred in and around Japan and of some major teleseismic earthquakes. The oldest analog seismogram was recorded on 2 January 1884 at a station in Tokyo. The seismograms are the intellectual property of mankind, and the database of these digital images will be an important material for studies of past destructive earthquakes. Technological progress such as artificial intelligence image recognition technology will help to further explore the data.
Matematik Öğretmen Adaylarının Tek Değişkenli Fonksiyonların Limit Kavramına Yönelik İşlemsel Bilgilerinin İncelenmesi
Authors: YILDIZ Birgül , İNCEOĞLU Gonca
Published: January 2020

Bu araştırmanın amacı öğretmen adaylarının tek değişkenli fonksiyonların limiti kavramına yönelik işlemsel bilgilerinin incelenmesidir. Bu araştırmada öğretmen adaylarının limit kavramı ile ilgili sadece işlemsel bilgisi ele alınmıştır. Araştırmanın modeli temel nitel araştırma olup veri toplama aracı açık uçlu sorulardan oluşmaktadır. Bu çalışmada, elde edilen bulguların yorumlanmasında içerik analizi tekniği benimsenmiştir. Bu araştırmanın katılımcıları 2017-2018 eğitim öğretim yılı güz döneminde Türkiye' de bir devlet üniversitesinde İlköğretim Matematik Öğretmenliği Programında kayıtlı olan Analiz I dersini alan 30 öğretmen adayından oluşmuştur. Araştırmadan elde edilen veriler incelendiğinde öğretmen adaylarının genellikle fonksiyonun bir noktadaki limitini bulurken istenen noktayı fonksiyonda yerine yazdıkları, eşleniği ile çarparak ve cebirsel işlemler yaparak sonuca ulaşmayı tercih ettikleri görülmüştür. Öğretmen adayların tek değişkenli fonksiyonların sol, sağ limitini almada ve tanım değerini limit değerine eşitlemekte başarılı oldukları gözlenmiştir. Adaylar en çok tam değer fonksiyonunun limitini bulmada zorlanmışlardır. Bu durum; adayların tam değer fonksiyonu ile ilgili kavramsal bilgi eksikliğine sahip olmaları ile ilgilidir. Limit, fonksiyonun limiti alınan noktadaki değeri ile ilişkilendirilirse ezbere çözümler elde edilir. Bir fonksiyonun bir noktadaki limiti, fonksiyonun limiti alınan noktanın komşuluğundaki davranışı ile ilişkilendirilmelidir. Limit öğretiminde kavramsal ve işlemsel bilgi arasında denge kurulmalı ve ezbere yöntemlerden kaçınarak matematiksel düşünmenin gelişimini sağlayacak kavramsal öğrenmeyi destekleyen öğretim yöntemleri kullanılmalıdır.
Science Education for Citizenship: A Case Study
Authors: ÖZDEN Muhammet
Published: January 2020

The aim of this study is to discover the topics/contexts covered in the science course with respect to citizenship education. This study was carried out using a case study design, a qualitative research approach. Since this study was designed as a case study, the primary data collection technique was the participant observation technique. Critical case sampling was used to collect qualitative data during the observations. The observational data were obtained from two classes in 2009 during the fall semester. Also, several semi-structured interviews were conducted with the teachers in 2010 during the spring semester to support observation data and increase the credibility of the study. Criterion sampling was used to determine the teachers to enroll in the study, and a total of 24 teachers participated in the interviews. The study data were analyzed through content analysis. In the content analysis, a conceptual framework was formed in light of the literature on the relationship between citizenship education and citizenship education within a science course. The coding stage in this study was based on this conceptual framework. The results showed that, as a part of citizenship education, science course could deal with the topics of Science-Technology-Society-Environment, Scientific Literacy, Socio-Scientific Issues, Rights and Duties.
Intercultural elements in the DaF- textbook series “Begegnungen-Erkundungen A1-C2” and Turkish as a Foreign Language “Yedi İklim Türkçe A1-C2”
Authors: ÜNAL Bilge
Published: January 2020

Learning languages is a necessity today. Teaching programs, methods and materials, teacher potentials together with motivational reasons are decisive for the success of the teacher. But learning a language alone is not enough; the learner should also be able to empathize with the culture of the language in order to avoid certain interference errors. This is based on intercultural elements of serious relevance. Inspired by the literature methodology, comparative statistics, the textbooks “Begegnungen/Erkundungen” German as a foreign language and “Yedi İklim Türkçe” Turkish as a foreign language with the corresponding Working books and CDs qualitatively are explored from Level A1 to C2 based on patrimonial-intercultural elements and compared these discussed cultural aspects to interculturality. The aim is to examine the cultural elements in the teaching and learning texts and to evaluate them qualitatively as well as quantitatively. The result is intended to show to what extent foreign understanding is addressed in language, literature and culture and is processed in the textbooks.
¿Emergency ambulances potential source of infections? An assessment of cleaning and disinfection procedures
Authors: Alvarez-Aldana Adalucy , Henao-Benavidez Mónica Juliana , Laverde-Hurtado Sebastián Camilo , Muñoz Diana María , López-Villegas María Elena , Soto-De León Sara Cecilia , Henao Trujillo Olga Maria
Published: January 2020

Objective: evaluate the cleaning and disinfection procedures (CDP) in six ambulances from three different entities in Pereira (Risaralda-Colombia).

Methods: cross-sectional descriptive study frequencies of presence/absence were calculated from data obtained in the bacterial growth results before and after CDP, taking samples in three different places on the ambulances, being: back door, stretcher and wall next to the patient, before and after said processes. Additionally, surveys were carried out at the domicile of companies providing pre-hospital transport service.

Results: 77.8% of the samples were positive. The most frequent morphology in the study was gram-positive cocci, which remained in a greater proportion after disinfection. At the microbiologic level, most of these suggested being Staphylococcus aureus-type. By implementing CDP, microbiological isolates were eliminated in 33.3%, being the door the ambulance area, which showed the greatest decrease (50.0%).

Conclusions: A high prevalence of potentially pathogenic microorganisms exists in non-critical points of emergency ambulances. With CDPs, a decrease in microorganisms is achieved, but not their elimination, leaving in evidence that different factors must be considered in order to improve these CDP.
Type D personality in patients with coronary heart disease underwent coronary stenting: a prospective study
Authors: Pushkarev G. S. , Kuznetsov V. A. , Fisher Ya. A.
Published: January 2020

Aim. To evaluate the type D personality relation with clinical and instrumental parameters in patients with coronary heart disease (CHD) underwent coronary stenting (CS) and to determine the influence of the personality type D on the prognosis in these patients within one year after CS. Material and methods. Into prospective study we included 977 patients (740 men and 237 women) aged 33 to 86 years (mean age 58.7±9.4) who underwent CS. The Cox proportional hazard regression model was used to estimate the relative risk (RR) with a 95% confidence interval (CI) of the end point. The end points included death from all causes, death from cardiovas- cular disease (CVD), myocardial infarction (fatal + non-fatal) (MI), non-fatal myocardial infarction (non-fatal MI), unstable angina (UA), and stroke. Results. Type D personality was found in 31.8% patients. These did not differ from the others in terms of age, gender, main cardiovascular risk factors. Patients of D-type had tendency to the increase of diabetes diagnosed – 25.1% vs 20.3% (p=0.09). At the same time D-type patients had more prevalent ≥2 myocardial infarction in anamnesis – 9.0% vs 4.5% (p=0,006) among those with post infarction cardiosclerosis. There was no difference between the groups according to echocardiography and the short-term outcomes of CS. During the prospective study period (12±1.8 months) 24 patients (2.4%) died from all causes, 21 patients (2.1%) died from CVD. MI developed in 47 patients (4.8%) of whom, 23 patients (2.4%) underwent non-fatal MI. In 50 patients (5.1%) ischemic heart disease in a prospective period complicated UA. In 8 patients (0.8%) developed a stroke. There was no effect of personality type D on the prognosis in patients with CHD who underwent CS for 1 year after surgery. Conclusion. Among CHD patients underwent CS, type D personality was found in 31.8%. There is no link for type D personality and severity of CHD clinically as well as the short-term and long-term outcomes of CS.
Risk assessment of acute kidney injury in patients with acute cardiovascular disease without invasive intervention
Authors: Avdoshina S. V. , Efremovtseva M. A. , Villevalde S. V. , Kobalava Zh. D.
Published: January 2020

Objective. To evaluate the prevalence, predictors, prognostic value of cardiorenal interrelations in patients with acute cardiovascular disease (CVD), and to develop an algorithm for stratification these patients at risk of acute kidney injury (AKI). Materials and methods. 566 patients (pts) were examined: 278 with acute decompensated heart failure (ADHF) and 288 with non-ST-elevation acute coronary syndrome (NSTE-ACS). The levels of electrolytes, glucose, urea, creatinine were evaluated, glomerular filtration rate (GFR) was determined according to the formula CKD-EPI. Chest x-ray, electrocardiography at admission and in dynamics, echocardiography at admission with assessment of systolic and diastolic myocardial functions were performed. Chronic kidney disease (CKD), AKI, ADHF, NSTE-ACS were diagnosed according to Russian and international Guidelines. Mann-Whitney test and multivariate logistic regression analysis were considered significant if p<0.05. Results. Different variants of cardiorenal interrelations were revealed in 366 (64.7%) pts. CKD was diagnosed in 259 (45.8%), with more than half of the cases (61%) diagnosed for the first time at this hospitalization, 62 (11%) pts had signs of kidney damage of unknown duration (which did not allow to diagnose CKD). AKI occurred in 228 (40,3%) pts, more frequently in patients with ADHF vs with NSTE-ACS (43.5 and 37.2%). In all groups stage 1 of AKI was prevalent. In-hospital mortality was significantly higher in pts with AKI vs without AKI (14.9 vs 3.6%, p<0.001). The risk of AKI was determined by kidney function and blood pressure levels at admission, and comorbidities. Conclusion. Prevalence of cardiorenal interactions in patients with acute CVD (ADHF and NSTE-ACS) was 64.7%. Development of AKI was associated with poor prognosis in both groups. Renal function and blood pressure levels on admission are the main predictors of AKI.
Difficulties in diagnosis of heart failure with preserved ejection fraction in clinical practice: dissonance between echocardiography, NTproBNP and H2HFPEF score
Authors: Mareev Yu. V. , Garganeeva A. A. , Tukish O. V. , Rebrova T. Yu. , Anikina D. V. , Mareev V. Yu.
Published: January 2020

This pilot study was aimed to assess the percentage of patients admitted to a Russian hospital and diagnosed with heart failure with preserved ejection fraction (HFpEF) maintaining this diagnosis when evaluated against the ESC 2016 and Russian 2017 heart failure guidelines. In addition, we reviewed the probability of an HFpEF diagnosis when patients were assessed against the H2FPEF score. Forty-two patients (mean age 68 ±7,5) diagnosed with HFpEF on their discharge record, admitted between March 2018 and May 2018, were included. Twenty percent of patients did not meet Russian guideline criteria for HFpEF due to either the absence of symptoms and/or echocardiographic evidence of structural/functional abnormalities. Using the ESC 2016 guidelines (which required an elevation in NT Pro BNP) the diagnosis was confirmed in only 37% of patients, mostly due to the normal level of NTproBNP in 54.8% of those investigated. The probability of HFpEF by H2FPEF score in patients with dyspnea and HFpEF by ESC 2016 criteria was 93% and without HFpEF by ESC 2016 criteria 68% (p = 0.054). In contrast, the probability of HFpEF by H2FPEF score in patients with dyspnea and HFpEF by Russian criteria was 84.4%.
Thyroid disorders in pregnancy: prevalence and its fetomaternal outcome in a tertiary hospital of Delhi, India
Authors: Bansal Neha , . Divya
Published: January 2020

Background: This study was conducted to determine the feto maternal outcome in pregnant women with thyroid disorders. The prevalence of thyroid disorders in present study was 15.75%.Methods: This was a prospective observational study carried out in all pregnant women irrespective of their parity, who attended ANC clinic in department of obstetrics and gynaecology in a tertiary care hospital over a period of 2 years. After registering, the patients were followed up with routine antenatal visits up to delivery and records were reviewed for development of abortion, PIH, preterm delivery, GDM, anemia, placental abruption, still birth, anomalies, fetal distress, meconium stained liquor, low birth weight and neonatal outcome by neonate Apgar score and TSH value.Results: Mean age group in our study was 27.61±3.14. Family history was present in 8% of study group versus 0% in control group which was statistically significant (p=0.028). Eighteen percent of preeclampsia was diagnosed in study group as compared to 4% in control group which was statistically significant (p-value= 0.005). Fourteen percent patients had preterm labour in study group as compared to 6.7% in control group which was statistically significant (p value= 0.047). Increased neonatal TSH was found in study group (61.3%) as compared to control group (32%), this difference was statistically significant (p-value <0.001). There was increased importance of measuring TSH in first trimester as it was statistically significant in study group (p-value <0.001).Conclusions: All pregnant women should be screened for hypothyroidism as early as possible or before conception to prevent any fetomaternal complications.
Epidural analgesia during labour: its influences on pain relief, progress of labour, mode of delivery, maternal and foetal
Authors: Suneetha M. , Saritha A.
Published: January 2020

Background: Today, the availability of regional anaesthesia for labour is considered a reflection of standard obstetric care. This study is to be conducted in a tertiary care centre with all facilities available for proposed end of proving that epidural analgesia is a safe and effective method for both parturient and the foetus in abolishing pain during labour.Methods: A total of 60 parturients were studied. they were randomly divided into two groups Group 1 includes 30 parturients. In this group parturient received epidural analgesia. The loading dose consisted of 10 ml of Bupivacaine 0.1% and Fentanyl 0.0002% (20 mcg). The top up doses were 10 ml of 0.1% Bupivacaine and Fentanyl 0.0002%, administered whenever the parturient complained of pain. When parturients enters into second stage a further 12-15 ml was injected with parturient in sitting position or semi-sitting position. Group 2 - (control group) Includes 30 parturients. In this group parturient was monitored without any analgesia.Results: This prospective study was done to assess the effect of epidural analgesia on the progress of labour and its outcome, to evaluate its efficacy as an analgesic technique and to study the maternal and fetal outcome. The total number of 60 parturients were selected and randomly categorized into two groups. CASE-Those who received epidural analgesia, CONTROL-Those who did not receive any analgesia.Conclusions: Epidural analgesia provides a versatile method of administering effective and satisfactory pain relief to parturient women. The technique should not be considered as a single entity, because the type and the dose of epidural medication can be altered as needed.
Extraperitoneal versus transperitoneal cesarean section: a retrospective analysis
Authors: Vaswani Babita P. , Trivedi Aditi , Gopal Sriram
Published: January 2020

Background: Cesarean section is becoming a more common delivery type worldwide. The objective of this study was to compare surgical morbidity in extraperitoneal versus transperitoneal techniques of cesarean section.Methods: A total of 60 patients was included in this study out of which 30 underwent extraperitoneal cesarean section(ECS) and 30 patients underwent transperitoneal cesarean section (TCS) and compared both the techniques with respect to nausea or vomiting intra-operatively, pain score (as measured by visual analogue scale) post operatively, return of bowel function and blood loss.Results: Intra-operative nausea and vomiting was noted in 33.34% of patients in TCS group while none of the patients in ECS group had any such complaints. No difference was noted in average blood loss between the 2 groups. Post-operative pain in ECS was 4.13 as compared to 6.86 in TCS. Return of bowel sounds in ECS group was much earlier (5.46 hours) as compared to TCS group (11.33 hours).Conclusions: We conclude that extraperitoneal technique is advantageous over transperitoneal approach. Decreased nausea and vomiting, early return of bowel function in the post-operative period, decreased post-operative pain allowing early feeding and mobilization are definite benefits of this technique. This further helps in making a relatively smoother post-operative recovery.
Demographic profile in women undergoing second stage caesarean section
Authors: . Isha , Lal Prabha , Dutta Vikram , Kaushal Aayushi
Published: January 2020

Background: Incidence of caesarean section is rapidly rising over the last two decades and 25% is contributed by second stage caesarean section. Demographic factors influencing fetomaternal outcome in second stage caesarean section include BMI, socioeconomic status, booking/ unbooking status, gravidity and maternal height.Methods: The present study was prospective observational study conducted in the department of obstetrics and gynaecology at Lady Hardanger Medical College New Delhi from December 2015 to March 2017. 80 women were enrolled in the study. A detailed history and examination of each patient was carried out. Women were observed during lab our till second stage caesarean section.Results: Mean age of population was 25.26±3.75 ranging from 19-40 year. 76.25% included in study were booked and 11.25% were unbooked, 42.5% belonged to lower middle class and 31.25% belonged to upper middle class. 47% women had height of <150 cm and 70% had a BMI between (25-29.9) kg/m. 43% women had gestational age between 39-40 weeks.Conclusions: Second stage caesarean section was more common in young age group and primigravidae. Higher BMI was not only operative but obstetrical risk as well.
Study on fetomaternal outcome in short interpregnancy interval: case control study
Authors: Lewis Preeti , Mor Shreya
Published: January 2020

Background: This study was carried out at a tertiary health centre with the aim of studying the effect of short interpregnancy interval on fetomaternal outcome. The maternal complications and fetal complications of short interpregnancy interval were analysed in comparison to normal interpregnancy interval.Methods: This is a case control study. 125 women with short interpregnancy interval seeking healthcare at tertiary health care centre were matched with 125 women with normal interpregnancy interval on the basis of demographic characteristics like age, height, weight and socio-economic status. These were included in the case control study.Results: Short interpregnancy interval is associated with increased risk of anemia, premature rupture of membranes (PROM), scar dehiscence and low birth weight whereas normal interpregnancy interval is associated with increased risk of PIH as compared to short interpregnancy interval.Conclusions: Short interpregnancy interval is associated with increased risk of anemia, PROM, scar dehiscence and low birth weight whereas normal interpregnancy interval is associated with increased risk of PIH.
Role of trans vaginal sonography with hysteroscopy in detection of uterine causes of abortions
Authors: Vishwakarma Shubhi , Khari Sonia , Verma Pooja
Published: January 2020

Background: Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the aetiology is often unknown and there are only few evidence-based diagnostic and treatment strategies. Objective of this study was to compare the role of trans vaginal sonography with hysteroscopy in detection of uterine causes of abortions.Methods: This prospective cohort study was conducted in the department of obstetrics and gynaecology, Kasturba Hospital, Daryaganj, Delhi. The study was conducted from January 2016 to December 2016.Results: On transvaginal sonography majority of women i.e. 39(78%) patients had normal ultra-sonographic findings. 11(22%) showed various abnormal findings. Most commonly diagnosed abnormal finding on TVS was polyp, seen in 5(10%) patients. It was seen as a well-defined, uniformly hyperechoic mass within the endometrial cavity. normal hysteroscopic findings were seen in 27(54%) patients. Rest 23(46%) patients had abnormal uterine factors as diagnosed by hysteroscopy.Synechiae was detected in 9(18%) patients. It was the most common abnormality detected on hysteroscopy. Out of 9 patients who had synechiae, 2 had severe dense adhesions. In 6 patients, the adhesions were mild and flimsy. While minimal adhesions were noted in 1 patient, seen near the cornua.Conclusions: hysteroscopy is still the gold standard for diagnosis and most definitive procedure of choice if any kind of operative intervention is required.
Outcome of pregnancy in gestational diabetes as compared to overt diabetes
Authors: Banker Chirag R. , Mehta Latika R.
Published: January 2020

Background: Diabetes mellitus is a chronic metabolic disorder characterised by polyuria, polyphagia, polydipsia and glycosuria. Diabetes in pregnancy can be defined as pregestational (pre-existing) diabetes or gestational diabetes have type 1 (T1DM) or type 2 (T2DM) diabetes mellitus. Present study was carried to compare the maternal and perinatal outcome of overt diabetes mellitus as compared to gestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM).Methods: An observational study was conducted at obstetrics and gynaecology department of a tertiary care center from July 2010 to October 2012 among 23 diabetic women. Seven of them were cases of overt diabetes while 16 were diagnosed during pregnancy. Maternal and fetal outcome were studied. All patients were followed from time of admission to discharge from hospital.Results: mean age of the participants were 26.71±4.89 in overt diabetes as compared to 27.56±4.41 among gestational diabetes. Illiteracy, low socio-economic status, rural residence, family history of diabetes was also high in overt diabetes mellitus as compared to GDM but none of them was statistically significant (P < 0.05). Intrauterine fetal death was more among GDM (37.5%) as compared to overt diabetes (28.57%). Prematurity and LBW were also high in overt diabetes as compared to GDM but none of them were statistically significant. Oligohydramnios, polyhydramnios and premature rupture of membrane were higher in gestational diabetes mellitus as compared to overt diabetes among women. Rate of LSCS were higher in gestational diabetes.Conclusions: Diabetes whether over or gestational is responsible for the poor outcome of the pregnancy so tight control is needed.
Study and clinical evaluation of 25 cases of primary amenorrhea
Authors: Bhatu Jaydeep J. , Bhadaraka Govind B.
Published: January 2020

Background: Primary amenorrhea is absence of menstruation and secondary sexual characters by age of 14 years primary amenorrhea is < 1%. Development of female genital organs takes place from mullerian DUCT (paramesonephric duct). The objective of this study was to note the various causes, complete clinical picture and the management in 25 such cases of primary amenorrhea.Methods: This is a prospective study done in 25 cases. They were investigated, managed and patients were called up for follow up for their response to treatment.Results: Out of 25 cases studied, maximum cases presented at 14-16 years of age, with chief complaint of primary amenorrhea, out of which 8% were married, 44% cases were of MRKH syndrome which was the most common cause of primary amenorrhea.Conclusions: Amenorrhea has got multi factorial etiology. For patients with amenorrhea physical examination should focus on pubertal development and possible genital out flow obstruction.
A prospective study of role of doppler in pregnancy and the perinatal outcome
Authors: M. Chaithra , S. Anitha G. , Suresh Sukanya , C. Savitha
Published: January 2020

Background: The development of doppler ultrasonographic technology has provided an opportunity to obtain a qualitative and quantitative assessment of maternal and foetal circulation using a non-invasive method. It has been proved by many studies that doppler has a very important role in screening of high-risk pregnancies. Objective of this study was to evaluate the role of colour doppler study in normal and high-risk pregnancy in relation to perinatal outcome.Methods: A prospective study was done including 75 women with high risk pregnancy and 75 normal pregnant women during the period October 2018 to September 2019 in hospitals attached to Bangalore Medical College and Research Institute. Doppler examination was done after recording patients’ history, clinical examination and ultrasound. Results were analysed and conclusions were made.Results: Out of the 22 patients with PIH, 20 patients had abnormal umbilical artery S/D ratio and all 22 had abnormal MCA PI. Out of 12 patients with diabetes, 10 had abnormal umbilical artery S/D ratio. All the patients with IUGR had abnormal umbilical artery S/D ratio and abnormal MCA PI.Conclusions: Colour doppler flow velocimetry done repeatedly can predict adverse foetal events with a great degree of accuracy.
Cerebro-umbilical doppler ratio as a predictor of adverse perinatal outcome
Authors: Kamalarani A. Esther , Victor Sheba Rosette
Published: January 2020

Background: Intrauterine growth restriction (IUGR) is defined as a subnormal bodyweight or mass in utero. Fetal Doppler studies have been identified as one of the reliable and non-invasive methods of antepartum fetal surveillance in growth-restricted fetuses to detect hypoxemia and to plan timely delivery to precede acidemia. The aim of this study is to evaluate the screening efficacy of the pulsatility indices (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and the ratio of these two indices in predicting the adverse perinatal outcome in pregnancies complicated by IUGR.Methods: In this study patients were included after diagnosed to have fetal growth restriction clinically by a disparity of four weeks or more between symphysis-fundal height and gestational age and on the serial measurement of symphysis-fundal height after 30 weeks of gestation.Results: Out of 100 patients who fulfilled the criteria for the study, only 85 patients delivered. Out of them, only 16 women (18.8%) had a ratio of <1.08 which was considered abnormal and the rest of the women (81.2%) had a ratio >1.08 which was considered normal. The specificity for the Cerebro-umbilical ratio (<1.08) to predict adverse perinatal outcome was 96% whereas that for PI of umbilical A (>1.12) was 83% and that for the PI of middle cerebral A (<1.2) was 84%. However, the sensitivities for these indices were very low.Conclusions: The ratio of the pulsatility indices of the umbilical artery and middle cerebral artery is useful to predict the adverse perinatal outcome.
Evaluation of endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal women with abnormal uterine bleeding at tertiary rural centre
Authors: Singh Priyanka , Kumari Kalpana , Seth Shikha , Verma Vandana , Singh Vikram
Published: January 2020

Background: Abnormal uterine bleeding is one of the commonest clinical presentation ac-counts for 33% gynaecological consultations and this proportion rises to 70% in perimenopausal and postmenopausal age group in any gynaecology clinic. The most probable etiology of abnormal uterine bleeding relates to the patients reproductive age. Various diagnostic techniques have been evolved over the periods to determine the etiology of abnormal uterine bleeding in perimenopausal women, but their accuracy has not been compared properly. The aim of study is to evaluate the endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal patients with abnormal uterine bleeding.Methods: Total 96 patients in perimenopausal age group, admitted with chief complaints of ab-normal uterine bleeding were included. All patients underwent transvaginal ultrasonography and hysteroscopy, followed by hysteroscopy guided biopsy and histopathological examination. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated for both methods and compared, considering histopathological diagnosis as gold standard.Results: Mean age of patients was 44.05±3.29. Hysteroscopy has high accuracy, sensitivity, specificity, positive predictive value and negative predictive value than Transvaginal sonography for diagnosis of all endometrial and intrauterine pathologies.Conclusions: Hysteroscopy results are more consistent with the results of histopathology. Hysteroscopy and hysteroscopy guided biopsy has been proven as gold standard for endometrial evaluation of patients with abnormal uterine bleeding. TVS can be used as most cost effective first step investigation in cases of perimenopausal bleeding.
Correlation of serum homocysteine levels in pregnancy related hypertensive disorders versus normotensive pregnancies
Authors: Hymavathi Kalki , Shukla Neha , Madhuri P.V. Sreeleena
Published: January 2020

Background: Homocysteine concentrations decrease during normal pregnancy, but this does not occur in pre-eclampsia. In pre-eclampsia, homocysteine levels further increase with severity of pre-eclampsia. Elevated homocysteine levels can be due to genetic or multifactorial deficit or a combination of both.Methods: The present study is conducted at department of obstetrics and gynaecology, Narayana Medical College and Hospital, Nellore. 200 pregnant (100 women with pregnancy related hypertensive disorders and 100 normotensive pregnants) recruited. Maternal serum Homocysteine levels were analyzed among women with pregnancy related hypertensive disorders and compared with normotensive pregnant. Chemiluminescence immunoassay was used for determining the Homocysteine levels.Results: The study revealed significant elevation in the levels of homocysteine in pre-eclamptic women (17.54±5.34) compared to normotensive women (7.59±1.91). The study showed a strong association between serum homocysteine levels and severity of pre-eclampsia. The mean homocysteine levels in women with severe Pre-eclampsia (20.59±4.3) were significantly higher than those with mild pre-eclampsia (15.17±1.9). A positive correlation is found between homocysteine levels with serum uric acid and LDH demonstrating the harmful action of hyperhomocysteinemia upon the endothelium. A negative correlation is found between homocysteine levels with hemoglobin and hematocrit even though in anemic patients the hematological levels are found to be little high due to hemoconcentration. The perinatal outcome in women with raised levels of homocysteine was poor with an increased incidence of IUGR (41%), SGA (9%), still births (3%) and IUD (4%) among women with pregnancy related hypertensive disorders when compared to normotensive pregnant women.Conclusions: Elevated levels of homocysteine can be reduced by administering vitamins which help by increasing the metabolism of homocysteine. The internationally accepted treatment for hyperhomocystenemia is using a combination of folic acid 400 µg, vitamin B12 500 µg and pyridoxine 10mg initiating from pre-conceptional period can be used.