bluuebunny/crossref_metadata_2025 huggingface dataset:
Fundament władzy i prawa w kościelnej wspólnocie
Authors: Żurowski Marian
Published: February 2019

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Problem „sytuacji granicznych” w ujęciu Karla Jaspersa
Authors: Piszkalski Henryk
Published: February 2019

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Ḥesed a ḥāsîd w świetle Psałterza
Authors: Łach Józef
Published: February 2019

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Chrystus w obliczu kenozy. O właściwy przekład Flp 2, 6ᵇ
Authors: Jankowski Augustyn
Published: February 2019

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Widzialny aspekt Chrystusowego Kościoła według Ambrozjastra
Authors: Staniek Edward
Published: February 2019

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Geneza pojęcia Kościół-Sakrament w Konstytucji Dogmatycznej o Kościele
Authors: Kubiś Adam
Published: February 2019

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Gdzie i kiedy powstał obraz Madonny Ostrobramskiej
Authors: Tomkiewicz Władysław
Published: February 2019

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Potrydencki system rekrutacji duchowieństwa w diecezji krakowskiej XVI–XVIII wieku
Authors: Kracik Jan
Published: February 2019

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Die neutestamentliche Exegese in Polen (1945–1977)
Authors: Chmiel Jerzy
Published: February 2019

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Obsada biskupstwa krakowskiego w latach 1790–1914
Authors: Kumor Bolesław
Published: February 2019

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Ideowe problemy w twórczości braci Eycków. Adoracja Baranka
Authors: Przybyszewski Bolesław
Published: February 2019

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Les théologiens polonais en Congrès
Authors: Kubiś Adam
Published: February 2019

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Katedra Historii Sztuki Kościelnej na Wydziale Teologicznym Uniwersytetu Jagiellońskiego
Authors: Kuś Jan
Published: February 2019

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Jan van Eyck jako malarz religijny i portrecista
Authors: Przybyszewski Bolesław
Published: February 2019

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Obsada metropolii lwowskiej obrządku łacińskiego w latach 1772–1918
Authors: Kumor Bolesław
Published: February 2019

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Zmiany postawy religijnej na przełomie XIX i XX wieku
Authors: Michalski Konstanty
Published: February 2019

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Nieznany list Jana Długosza
Authors: Pieradzka Krystyna
Published: February 2019

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Vaticanum II – wydarzenie i dzieło
Authors: Kubiś Adam
Published: February 2019

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Antropologia i etyka nadziei
Authors: Schaeffler Richard
Published: February 2019

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The Origins of the Stalingrad Victory: Psychological Aspect
Authors: Strizoe Aleksandr
Published: February 2019

Introduction. The article points out the need for a special study of psychological aspects of the reasons for the victory of the Red Army at Stalingrad, which for a long time remained undervalued due to the traditional attention of researchers paid to the role of ideological factors. These aspects are revealed in the process of radical change in the moods of soldiers and commanders of the Red Army in the period between the issuance of Order No. 227 in July 1942 and the formation of new urban combat tactics in the winter of 1942-1943. The author notes the need to evaluate measures of command and practices of soldiers’ and commanders’ behaviour in war, taking into account the achievements of modern psychology.

Methods. The author presents a methodological scheme for analysing the process of changing moods, the transition from confusion and panic to the formation of readiness for active defence and attack. Its elements include studying adaptation to the everyday difficulties of war, interpersonal trust and rational organization of various aspects of life in war as prerequisites for a psychological break in the moods of soldiers and commanders.

Analysis and results. The article emphasizes the role of formation of self-organization and liberation of personal initiative of soldiers as one of the manifestations of positive psychological changes. These changes are conceptualized in a new understanding of courage. Along with the ‘courage of self-sacrifice’ characteristic of archaic culture and traditional society, the ‘courage of self-affirmation’, which is rooted in the values of the Renaissance and the early modern period and focused on success in military confrontation and preservation of the lives of soldiers and commanders, arises and spreads. The emergence and spread of new psychological attitudes and orientations during the Stalingrad battle can be assessed as the beginning of moral and psychological break in the Red Army, the beginning of the formation of the ‘psychology of victory’ as a powerful mobilizing factor.
On the Political Impact of the Ingour Battle of November 6, 1855
Authors: Plotnikov Dmitriy
Published: February 2019

Introduction. The article analyzes the battle on the Ingour river on November 6, 1855 from the political perspective in order to establish its role in the Caucasian campaign of 1855 of the Crimean war (1853-1856).

Methods. Using the approach created by Carl von Clausewitz and developed by Alexander Svechin, the author views war as the continuation of politics and explores the political impact of the Ingour battle regarding its connection with the development of guerilla war in Mingrelia against the Turkish army under Omer-pasha (Ömer Lütfi Paşa).

Analysis. Tactical analysis of the battle demonstrates that its organization and conduct on Russian side included considerable flaws. However, political analysis allows understanding that the impact of the Ingour battle went beyond its immediate tactical outcome. Political instability in Mingrelia demanded imperatively that major-general I.K. Bagration-Mukhranskiy, who commanded Russian Gurian force, would confront Omer-pasha at Mingrelian border in order to confirm the political credibility of Russian authorities among the local population.

Discussion. Russian readiness to fight for Mingrelia influenced the political situation positively and contributed to the development of guerilla war against Omer-pasha. It was especially beneficial in the difficult conditions of Batum operational area and made a significant contribution to the outcome of the campaign. Thus, it is established in the article that one should view the Ingour battle not as a woeful defeat, but as the sensible tactical sacrifice for political ends that yielded considerable results and influenced the outcome of the 1855 Caucasian campaign in an important way.
French Arms Export Policy: Features and Prospects
Authors: Chikhachev Aleksey
Published: February 2019

Introduction. As part of French foreign policy, arms trade is currently considered to be a specific way to promote national influence in the world and support defense industry at home. This approach has been already exercised for several decades, but the last presidency was an entirely new and interesting point in this respect because in 2015 and 2016 French arms trade attained the highest income rates.

Methods. The key notion of this article is French ‘strategic autonomy’ which remains a pivotal point of any diplomatic activity of France since Charles de Gaulle’s presidency. Arms export perfectly corresponds to this point because it helps to maintain French autonomy in economic and political ways. To prove it, several methods were provided such as functional method, comparative analysis and SWOT-analysis.

Analysis. This article aims to identify the specifics of contemporary French arms export policy. In this regard, the text is divided in three parts. The first one defines military export as a part of ‘strategic autonomy’ concept. To explain the recent growth, the second part explores a new governmental approach to arms trade. The third part brings together the issues and prospects of French military export expected for Emmanuel Macron’s term.

Results. The main conclusion is that the new president seems to conduct the same policy as his predecessor. The government has reaffirmed its main principles in the field and renewed a political support for arms contracts. Military cooperation with foreign countries still officially depends on the idea of ‘strategic autonomy’ of France and its defense industry.
Uma outra Ameaça Fantasma: a relação entre autor, conteúdos e públicos em The Prequels Strike Back
Authors: Moura Pedro
Published: February 2019

As prequelas de Star Wars (1999-2005) são, ainda hoje, obras controversas entre os fãs desta narrativa transmediática. O documentário The Prequels Strike Back (2016) procurou compreender a insatisfação dos públicos descontentes, mas também a recepção daqueles que, tendo apreciado a segunda trilogia da saga, se viram inseridos numa cultura de antagonismo aos filmes. Neste artigo apresenta-se uma análise deste documentário, centrando-se no modo como a recepção das prequelas foi retractada. O modelo de cooperação textual de Umberto Eco e os conceitos de cultura de convergência e narrativas transmediáticas de Henry Jenkins são as principais referências. Conclui-se que apesar do documentário abordar pertinentemente os diferentes elementos constitutivos da proposta do autor italiano, ignorou uma dimensão crucial para a compreensão da recepção dos públicos de Star Wars: a natureza transmediática de uma saga que não esteve suspensa entre o final da trilogia original e o lançamento das prequelas.
A denúncia política na origem do new journalism: o caso pioneiro de Rodolfo Walsh
Authors: Figueira João
Published: February 2019

Quinze anos antes da obra seminal de Tom Wolfe caraterizar o new journalism e com uma década de avanço sobre “A sangue frio”, de Truman Capote, o jornalista e escritor argentino Rodolfo Walsh publicou “Operação massacre”, a primeira de três investigações jornalísticas, que verdadeiramente marca o nascimento do novo jornalismo. Partindo de uma releitura crítica sobre o new journalism, mostramos como esta corrente nasceu fora nos Estados Unidos e como só a hegemonia da língua inglesa explica que o fenómeno seja, geralmente, focado na realidade norte-americana, ignorando outras experiências anteriores. O presente artigo deixa ainda evidente a dimensão política do trabalho jornalístico de Walsh, que constitui uma marca diferenciadora face à maioria dos autores norte-americanos do new journalism.
Briefing: Ciria guide C760: guidance on embedded retaining wall design
Authors: Kelly Lee , Tully Kieran , Gaba Asim , Hardy Stuart , Selemetas Dimitrios , Doughty Lauren , Powrie William
Published: February 2019

This paper details key aspects of the update of the Construction Industry Research and Information Association’s good practice on embedded retaining walls (C760). The authors of C760 provide an overview of the new guidance on the selection and design of vertical embedded retaining walls that satisfy the requirements of Eurocodes. The guidance also covers temporary and permanent cantilevers, and anchored, single-propped and multi-propped retaining walls that are supported by embedment in soft soils, stiff clays and other competent soils and soft rocks. C760 addresses the technical and construction issues relating to the selection of appropriate wall types and construction sequence to achieve a satisfactory design. It clarifies areas of ambiguity and common misunderstandings when applying the Eurocodes to the design of embedded retaining walls and presents a clear, unambiguous method for the application of the observational method.
Sample preparation for single nuclei sequencing of brain v1
Authors: Martinez Casals Anna , Mitsios Nicholas
Published: February 2019

Sample preparation for single nuclei sequencing using fresh frozen tissue from human postmortem brain. The protocol is a combination of an already existing and published protocol in Nature protocols Using single nuclei for RNA-seq to capture the transcriptome of postmortem neurons and the 10x Genomics handbook Sample preparation, isolation of nuclei for single nuclei RNA sequencing.
Thawing and Seeding Frozen Cells v1
Authors: Schackart Kenneth
Published: February 2019

How to thaw cells from the liquid nitrogen storage and seed into a tissue culture flask
Quo vadis, dear EU? (The evolution of european security strategies approaches in the changing European Union)
Authors: Vdovychenko Victoria
Published: February 2019

Nowadays European Union is facing challenges of immigration, the threat of radicalization, downturns in the fiscal and monetary policies, as well as the discussions on how to build bridges with the UK after Brexit. Such concerns are crucial for understanding the EU’s political and economic landscape, shaping global security issues as well.

The article attempts to analyze the circumstances favoring the implementation of the EU’s Global Strategy that served to be strategic reality-checks upon how to bring stability and security to Europe. It shapes the period from the origins of the European security strategies till the new era of the EU presented by EU Global Strategy in 2016.
The article questions weather the political will is deeply essential for the EU to remain solid tackling economic and political challenges. Therefore, the article is divided in two parts, namely: 1) the evolution of the EU security strategies; 2) the hybrid challenges for Europe shaped by EU Global Strategy.

It is concluded that the EU should perceive the concept of the adaptability as pivotal in order to find credible and fit-for-purpose solutions and create the full-fledged EU Global Strategy. The latter still needs to be adapted to the civilian and integrated capabilities in order to become a real global strategy.
LEGAL NATURE OF DERIVATIVES AND DERIVATIVE SECURITIES AS FINANCIAL MARKETS INSTRUMENTS
Authors: Vygovskyy O.
Published: February 2019

The article reveals the issues of legal nature of derivative securities and derivatives as financial instruments, their characteristic features in comparison with ordinary securities, explores theoretical background for their differentiation and distinct qualification of these two different legal categories. The author of the article analyzes broad and narrow interpretation of the concept of a derivative security in doctrinal and practical dimensions, specific features of derivatives as standardized financial contracts and outlines their key attributes which allows to distinguish them from similar instruments. This article also deals with an important theoretical issue concerning the possibility of qualification of depositary receipts as derivative securities, taking into consideration the distinctive features of legal relationship arising in the area of issue and trading in depositary receipts.
LEGAL FRAMEWORK OF GOOD MANUFACTURING PRACTICE (GMP) FOR VETERINARY MEDICINAL PRODUCTS IN THE EU: EXPERIENCE FOR UKRAINE
Authors: Berezovska I.
Published: February 2019

The article comprehensively analyzes current legislation of the European Union on Good Manufacturing Practice (GMP) for veterinary medicinal products in particular the provisions of Directives No. 91/412 and No. 2001/82, and describes GMP main elements. It is noted that as a result of EU-Ukraine Association Agreement signing a new stage in the development of Ukrainian legislation regarding the turnover of veterinary medicinal products has begun, which is characterized by the increased impact of EU law on the legal regulation of this industry. The state of the appropriate national legislation reforming was analyzed. It was proved that today the main directions of such reforming are related to the integrated introduction of Good Manufacturing Practice and to the restoration of the production of veterinary medicinal products licensing. The importance of prompt and effective completion of these reforms which will have significant consequences not only for the national pharmaceutical industry, but also for the protection of the health of animals and people in general, was underscored. It was emphasized that the scale of the obligations undertaken by Ukraine to harmonize the legislation on the circulation of veterinary medicinal products requires prompt and qualified organizational work by the Ukrainian competent authorities.
Neonatal meconium aspiration: risk factors and adaptation by the newborns
Authors: Bogomazova I. M. , Strizhakov A. N. , Ignatko I. V. , Belousova V. S. , Timokhina E. V. , Pitskhelauri E. G. , Kardanova M. A. , Spiridonova N. V.
Published: February 2019

Aim: to identify the risk factors of meconium aspiration and study its impact on neonatal adaptation.Materials and methods. Medical records of 44 women and their infants were studied.Results. In 85 % of cases, the diagnosis of complicated pregnancy was made, in 100 % cases – there was a complicated delivery; 100 % of newborns were put on mechanical ventilation, 95 % of them were diagnosed with cerebral depression syndrome, and 72.5 % – with aspiration pneumonia. Conclusion. A differentiated approach to the management of pregnancy and labor will reduce perinatal morbidity.
The relationships between pregnancy-associated protein A levels, placental localization and fetal birth weight
Authors: Güler A. E. , Atasever M. , Fidan U. , Artürk E. , Kinci M. F. , Bodur S.
Published: February 2019

Aim. This study was designed to determine the relationship between pregnancy-associated protein A (PAPP-A), placenta localization and fetal birth weight (FBW).Materials and methods. First trimester PAPP-A levels, second trimester placental localization and birth weights of 1145 infants were obtained through a retrospective review of the patient follow up charts in Koru Hospital. Serum PAPP-A levels were recorded as the multiple of median (MоM) values, the FBW values of infants were recorded in grams, and the placental localization was recorded under seven different pre-defined categories: 1. placenta anterior; 2. placenta posterior; 3. placenta fundal; 4. placenta fundal-anterior; 5. placenta fundal-posterior; 6. placenta lateral-right; 7. placenta lateral-left. The data were analyzed using the Statistical Package for Social Sciences (SPSS) program (SPSS Inc., Chicago, IL, USA).Results.There was no significant difference between the FBW and PAPP-A levels. The comparison of seven placental localizations shows that the anterior and posterior localizations have an impact on FBW of the infants.Conclusion. The FBW was highest in the cases where the placenta was located in the corpus uteri. We believe this finding is consistent with the fact that the corpus uteri receives the largest blood supply.
Analysis of obstetric «near miss» cases in the Ryazan region
Authors: Мamontova I. K. , Shevlyakovа T. V. , Petrova E. I.
Published: February 2019

Although maternal mortality cases in Russia have become rare, the problem of their prevention remains relevant. To enforce the preventive measures, an analysis of critical conditions and «near miss» cases in obstetrics is commonly used. As a result, the quality of medical care in obstetric institutions improves. Aim: to assess the character and incidence of critical situations in obstetrics practice over the Ryazan region in 2015-2017 and to analyze the failures in medical care that led to such situations. Materials and methods. We analyzed 46 «near miss» cases and 1 case of maternal death recorded in the Ryazan region in 2015-2017. Results. The leading cause of critical conditions in obstetrics found in the Ryazan region was hemorrhage following an emergency caesarean section delivery. In most cases, bleeding was caused by pregnancy complications, although extragenital conditions also contributed to the development of the «near miss» situations. The main indication for emergency delivery was the premature detachment of a normally located placenta; in the normal term delivery, it was an inconsistent uterine scar after cesarean section and the accompanying pathology, such as placenta accreta. Conclusion. Considering the «near miss» cases as a separate group of obstetrics conditions contributes to the prevention of maternal mortality and improves the healthcare standards in obstetric institutions.
Preterm birth: from understanding of pathogenesis to pregnancy management
Authors: Belousova V. S. , Strizhakov A. N. , Timokhina E. V. , Svitich O. A. , Bogomazova I. M. , Pitskhelauri E. G.
Published: February 2019

Preterm birth is an important issue in the current obstetrics as it is associated with perinatal morbidity and mortality. Today, most studies are aimed at understanding of the pathogenesis of preterm delivery. The known data on cytokine gene polymorphism indicate that in women with preterm birth, the presence of pro-inflammatory dominant alleles is typical. This may lead to increased production of pro-inflammatory cytokines in the utero-placental complex and may also initiate preterm delivery. At present, studies are under way to identify genes that determine the duration of the gestation period. A better understanding of the preterm birth pathogenesis is expected to help prevent this unfortunate outcome and decrease perinatal morbidity and mortality.
Hepatoprotective Role of Phlogacanthus thyrsiflorus Nees as a Potential Iron Chelating Drug
Authors: Saikia Queen , Das Manas , Saikia Archana
Published: February 2019

Exceeding iron levels in the body get accumulated in the liver and other vital organs that induce oxidative stress in the affected areas , which is clinically diagnosed as “iron overload”. Present study was undertaken to investigate the role of Phlogacanthus thyrsiflorus Nees, an endemic species of North-east India, in ameliorating such diseased conditions. Our results indicate that the methanolic leaf extract of Phlogacanthus thyrsiflorus (PTME) exhibits excellent iron chelation and antioxidant activities in dose dependent manner in vitro. To understand the in vivo conditions, thirty six mice were divided into six groups which were treated with differing doses of PTME. Levels of serum markers ALT and AST significantly elevates during diseased conditions but PTME treated mice have shown a marked decrease in the group (S200) by 39.24 and 17.24%. On the contrary lowering levels of liver antioxidant enzymes (GST, GSH, SOD and CAT) indicates stress. But 200mg/kg b.w of PTME treated groups restored the enzyme to optimum levels. Morphological changes were observed through histopathological analysis of liver tissues and we found significant differences in them . PTME was found to be completely nontoxic in the in vivo treatment, suggesting its feasibility as a safe oral drug. The above study suggests that PTME contributed to its free radical scavenging and iron chelation activity; however, further studies are required for the assessment of the phytoconstituents and the pathways through which it act to treat iron-overload diseases.
Role of chromohysteroscopy in detection of endometrial pathology in abnormal uterine bleeding
Authors: Haider Aleena , Bano Imam , Sabzposh Noor Afshan , Arif Sayeedul Hasan
Published: February 2019

Background: Abnormal uterine bleeding is one of the most common clinical problems encountered in gynaecological practice. Chromohysteroscopy is thought to improve the diagnostic accuracy of hysteroscopy and reach the final diagnosis in AUB and is the subject matter of this study.Methods: A prospective cross-sectional study was performed on 35 women with AUB, who presented to the Dept. of Obstetrics and Gynecology, JNMCH, Aligarh, over a period of 2 years (2014-2016). After transvaginal sonography, all cases underwent hysteroscopy followed by chromohysteroscopy using 5% methylene blue dye. Differentially stained pattern of the uterine cavity was observed and hysteroscopic guided biopsy was taken from stained and unstained areas, followed by endometrial aspiration biopsy. All three samples were sent for histopathological examination. Results were analyzed and compared.Results: Out of 35 cases studied, 13 cases showed diffuse light staining, while 22 cases had focal dark staining. Histopathology results from diffuse light stained group showed 9 (69.2%) had normal endometrium. Out of 22 cases with focal dark staining, 20 (90.0%) cases had abnormal histopathology. It was found that focal dark staining to detect endometrial pathology had a sensitivity of 83.3%, specificity of 81.8%, positive predictive value of 90.9 %, negative predictive value of 69.2% and accuracy 82.8%. The difference in the diagnostic ability of stained tissue biopsy was highly significant (p< 0.001) when compared to blind endometrial aspiration biopsy.Conclusions: Chromohysteroscopy is an efficacious simple tool for detecting endometrial pathology in cases of AUB.
Total laparoscopic hysterectomy: why surgeon teachers must learn and train residents
Authors: Valecha Shalini Mahana , . Pandeeswari , Bashani Dolly , Syed Saman
Published: February 2019

Background: The purpose of the present study is to demonstrate the feasibility of laparoscopic surgery for hysterectomy and elaborate our experience.Methods: Between September 2017 and April 2018, 15 patients who were counselled for and opted for total laparoscopic hysterectomy our hospital enrolled in this study. Surgeons used a four-port system with, one 10mm and three 5-mm trocars. All surgical procedures were performed with 30°, 10-mm laparoscope and conventional laparoscopic instruments including monopolar and bipolar cautery system and the LigaSure system.  Patient’s history, clinical findings and surgical outcomes were prospectively tabulated, evaluated and analyzed.Results: Out of 15 patients under the study with age range of 40-55years, only 2 patients had hypertension and diabetes mellitus and 2 had anaemia. All 15 patients underwent conventional laparoscopic surgery. Operative time was in a range of 6O–240 min.  There were no intra operative complications in 6 patients (40%) and no post op complications in 11 women (73%).Conclusions: The results from our 15 women show that, in experienced hands, laparoscopic hysterectomy is not associated with any increase in major complication rates.
Role of Mifepristone in treatment of uterine fibroid: an experience from tertiary care centre in South India
Authors: Nachiketha S. V. , Hadi Veena
Published: February 2019

Background: Uterine fibroid are the most common benign tumour of the uterus and is seen in 20% of women in their reproductive age group. The aim of the study was to evaluate effect of Mifepristone on uterine fibroid with reference to reduction in size of fibroid and change in symptomatic profile.Methods: It is a hospital based interventional study conducted at KIMS Hubli hospital. 98 patients with symptomatic fibroid uterus were given 50mg of Mifepristone on alternate day for 3 months.Results: Mifepristone treatment significantly reduced mean PBAC score from baseline score of 212.61 to 20.39 at the end of 3rd month of therapy. Mean fibroid volume also reduced significantly from baseline value of 237.95cm3 to 30.45cm3 after 3 months of treatment. At the end of therapy hemoglobin was raised from 9.57g/dl at baseline to 10.42g/dl after 3 months of treatment. No major side effects were observed, and 7% patients had hysterectomy.Conclusions: Mifepristone is very useful option in perimenopausal women with symptomatic fibroid. It reduces fibroid size and its symptoms without any major side effects. However, future long term RCTs are needed to assess the safety and efficacy of Mifepristone.
Preventable gynecological surgeries in hysterectomized women : a review of causes and measures of prevention
Authors: Anant Monika
Published: February 2019

Background: Hysterectomy, the most common gynaecologic surgery performed around the world. however, repeat gynaecologic intervention / surgery may be required for some conditions, adding cost and morbidity for patients and posing a burden on healthcare systems. The objective of the present study was to find out the incidence of  and types of surgical intervention required post hysterectomy.Methods: A retrospective analysis of hospital records was done for gynecologic operative procedures done in post hysterectomy patients 2014-2016.Results: Out of a total of 1028 in the year 2014-2016 in our centre, 75 (7.3%) surgeries were performed for benign conditions in hysterectomized women.  Hydrosalpinx(29%) was most common condition for surgery, followed by endometriosis(24%) with   31-40 years age group women   undergoing  the maximum surgeries. Vault prolapse(16%) in elderly and vaginal vault  granulation(16%)  in younger women  also underwent a repeat gynecological procedure post hysterectomy.Conclusions: Some measures can be taken during the primary surgery(hysterectomy) to prevent a repeat gynaecological surgery in these women. Concurrent salpingectomy can prevent  benign and malignant fallopian tube lesions and ovarian cancer . Endometriosis surgery should be precise to prevent any remnant ovarian or endometriotic foci. McCall’s culdoplasty  in primary hysterectomy is proven to prevent vaginal vault prolapse. Most  genitourinary  fistulas can be prevented by detailed  knowledge  of pelvic anatomy, preoperative risk stratification of patients at higher risk of ureteric and urinary bladder injuries,  meticulous surgical technique and judicious use of electrosurgical energy. Prevention is always  better than a repeat surgery.
Evaluation of pain relief and satisfaction in women using epidural analgesia in labour
Authors: Shembekar Manisha C. , Shembekar Chaitanya A. , Shembekar Shantanu C. , Upadhye Jayshree J.
Published: February 2019

Background: Pain during childbirth is the most severe pain women may experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour.Methods: This retrospective study was carried out at Omega Hospital, Nagpur in 50 women in labour who demanded epidural analgesia for pain relief. It was carried out to determine extent of pain relief and overall satisfaction in women using epidural analgesia.Results: In present study, out of 50, 28 (56%) patients delivered by normal vaginal delivery, 14 (28%) patients delivered by cesarean section, 8 (16%) patients had vacuum delivery while in no patient forceps were applied. In first stage,36 (72%) patients had zero score (no pain), 13 (26%) patients had 1-3 score (mild pain) while 1 (2%) patient had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had very good effect in first stage in terms of pain scoring. In second stage, 13 (26%) patients had zero score (no pain), 31 (62%) had 1-3 score (mild pain) while 6 (12%) had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had good effect in second stage in terms of pain scoring. In terms of satisfaction, 11 (22%) patients said it was excellent, 27 (54%) patients said it was good, 8 (16%) patients said it was average while 4 (8%) said it was poor. Apgar score for all babies at 1 min and 5 min was very good. It was ≥7 in all 50 (100%) of newborn babies.Conclusions: Epidural labor analgesia gives significantly less pain scores and has better maternal satisfaction. It is not associated with increased rate of instrumental vaginal delivery or cesarean delivery. Patients had excellent neonatal outcome.
Perceptions and practices of rural Indian women in contraception, abortion, and sexual health: a cross sectional study
Authors: Davis Amenda Ann
Published: February 2019

Background: Maternal mortality is an important target of health care policies, especially in India. While numerical indicators of maternal health improve, this can only be sustained with change in the knowledge, attitudes, and practices of women. Gender empowerment is a neglected aspect of health care policy, and there is a need to assess the perceptions of Indian women, the true torch-bearers of change.Methods: This was a hospital based cross sectional quasi-quantitative study in a sub-district hospital in the town of Ballabgarh, Haryana, India. Married women attending the outpatient clinic, antenatal clinic, labor ward, and primary health centres in the age group of 20 to 40 years were interviewed using a semi-structured questionnaire with both closed and open-ended questions. Health concerns were concurrently addressed.Results: Author interviewed 956 women. No form of modern contraception had ever been used by 58.36% of the women. Intra-uterine contraceptive devices were discontinued by 76.12% of the women who had used them. Emergency contraception was a concept known to 49.89% of the women, but fraught with misconceptions. Induced abortions was being used as a form of family planning, with nearly 90% of the women having taken over-the-counter abortifacients. Women were receptive to contraception, and many expressed an interest in long acting contraceptives other than IUCDs.Conclusions: This study provides insight into the thinking of Indian women regarding family planning. This may help guide family planning policies.
Effect of hypovitaminosis D and its related factors in pregnant women and their newborns
Authors: Sandhu Amrita , Nautiyal Ruchira , Mehrotra Vinit , Wasim Sanober
Published: February 2019

Background: Maternal and fetal vitamin D deficiency has nowadays emerged as a frequent morbidity. Adequate vitamin D concentrations during pregnancy are necessary to maintain neonatal calcium homeostasis, bone maturation and mineralization. Objectives of this study were to evaluate serum vitamin D concentration in mothers and its correlation with neonatal cord blood vitamin D at the time of delivery and to study the impact of hypovitaminosis on neonatal anthropometry. Effect of related factors like calcium (Ca), alkaline phosphatase (ALP) and parathyroid hormone (PTH) on maternal vitamin D levels were to be evaluated.Methods: Cross sectional study was done on a total of 220 healthy uncomplicated antenatal females with singleton pregnancy attending labor room at the time of delivery. Maternal and neonatal cord blood samples were drawn in the delivery room and analyzed. Neonatal anthropometry was recorded. Correlations among various maternal and neonatal factors were studied.Results: Widespread vitamin D deficiency was observed in expectant subjects and neonates with 70.91% having deficient levels which were also reflected in newborns (71.82%). Maternal ALP (r= -0.5503, p=0.000) bears a weak negative correlation (p<0.05), maternal serum Ca positive correlation (r = 0.7486, p=0.000) and plasma PTH levels a negative correlation (r = -2.084, p=0.000) with hypovitaminosis. No significant correlation was observed between neonatal anthropometry and vitamin D levels.Conclusions: High prevalence of hypovitaminosis was observed among pregnant women and their neonates in this study. A positive linear relationship was seen between maternal and cord blood vitamin D (r 0.974, p 0.0001).
Prevalence of metabolic syndrome in women with polycystic ovary syndrome attending a tertiary care hospital in West Delhi, India
Authors: Laul Poonam , Miglani Urvashi , Laul Anish , Saxena Pinkee , Malhotra Megha , Kadam V. K.
Published: February 2019

Background: The aim of the present study was to evaluate the prevalence of metabolic syndrome in women with polycystic ovary syndrome (PCOS).Methods: All the women attending the gynae out-patient department of our hospital were screened for polycystic ovary syndrome as diagnosed by the Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group, 2004. Two hundred women with PCOS underwent screening for metabolic syndrome as defined by the national cholesterol education program adult treatment panel III (ATPIII) (2001) definition and the prevalence of metabolic syndrome was compared with two hundred age and BMI matched healthy control subjects. A multivariate logistic regression analysis was applied, and significant predictors identified for the prediction of metabolic syndrome.Results: The prevalence of metabolic syndrome among PCOS patients was 42 % in present study group as compared to 14 % in control group (p=0.01). The prevalence of metabolic syndrome was even higher in obese PCOS Vs non obese PCOS (52 % Vs 28.6 %). But even non-obese PCOS had higher prevalence of metabolic syndrome as compared to controls (28.6 % Vs 14 %).Conclusions: The study suggests a high prevalence of metabolic syndrome in patients with PCOS & thus it is important to screen all PCOS patients for manifestations of metabolic syndrome & its cardiovascular sequelae.
Vaginal hysterectomy a safe option in non-descent uterus as compared to abdominal hysterectomy
Authors: Singh Sona , Gajbhiye Vishal
Published: February 2019

Background: The objective of present study was to compare the advantage of vaginal hysterectomy over abdominal hysterectomy in non-descent uterus.Methods: A non-randomized controlled trial was carried out in the Bundelkhand Medical College, Sagar and associated hospital from October 2015 to September 2017. A total of 150 cases were included in the study. Out on 150, 75 underwent vaginal hysterectomy for non-descent uterus and other 75 underwent abdominal hysterectomy for similar indications.Results: Among total 150 cases, 75 were underwent non-descent vaginal hysterectomy and similar number of cases underwent abdominal hysterectomy. Common age group was 35-54 years. Commonest indication was DUB (48.7%). Postoperatively, complications were more common in those who underwent abdominal hysterectomy such as ambulation (18 hours), incidence of nausea, vomiting, abdominal discomfort, bladder injury and wound infection were less in vaginal hysterectomy compared to abdominal hysterectomy. It was also observed that blood transfusion requirement, operative timing and hospital stay (3 days) were less in vaginal hysterectomy group.Conclusions: Vaginal hysterectomy for benign gynecological disorders is a safe, effective, least invasive and is associated with lesser complications as compare to abdominal hysterectomy. Today in the era where patient is more cosmetically concern, vaginal hysterectomy for non-descent uterine disorder needs to be considered as good and safe option.
A comparative study of maternal and fetal outcome in trial of labour after caesarean delivery and elective repeat caesarean delivery
Authors: Neravi Asha , Kulkarni Namrata , Brindhini M. Usha , Udayashree V.
Published: February 2019

Background: Globally, high rates of caesarean section (CS) are an issue of public health concern. For women who have had a previous caesarean, choices for mode of birth in their next pregnancy are either a trial of vaginal birth after caesarean (TOLAC) or an elective repeat caesarean delivery (ERCD). Both ERCD and TOLAC have benefits and risks associated.Methods: A prospective comparative study was conducted in the Department of Obstetrics and Gynecology at SDM college of medical science and hospital, Dharwad, Karnataka, India. The study included 80 women with one previous lower segment caesarean section over a period of 1 year. A 40 women underwent TOLAC and 40 women had a repeat caesarean section. The maternal and fetal outcomes in trial of labour after caesarean delivery and repeat caesarean delivery were compared.Results: In this study maternal morbidity was more common in ERCD group than in the TOLAC group. Neonatal outcome was the same in both the study groups. Conclusions: In our study the TOLAC success rate was 70-80%, pregnant woman with one previous lower segment Caesarean section should be given the option of TOLAC, unless contraindicated.
A study of fetomaternal outcome of hepatic disorders in pregnancy
Authors: Jain Mahima , Thaker Himani
Published: February 2019

Background: Liver is a vital organ to maintain physiology of the body and supports every organ of the body. Its proper functioning during pregnancy is essential for a good maternal and fetal outcome. The study analyses the causes and fetomaternal outcome in pregnancies with jaundice and suggests measures to reduce morbidity and mortality.Methods: This is a one-year prospective study in a tertiary care institute during which 7165 deliveries are conducted. Total 55 cases of Jaundice with pregnancy are identified and studied for clinical, biochemical profile, etiology and maternal and fetal outcome. 8 maternal deaths are reported amongst this study group.Results: In this study 55 cases of hepatic disorders in pregnancy are studied. The age group reported is 21-29 years. Majority 72% cases belong to rural areas and 85% in lower socioeconomic class. 96.3% patients were in the third trimester of pregnancy. Most common etiology of hepatic disorders in pregnancy is acute viral hepatitis followed by intrahepatic cholestasis of  pregnancy and preeclampsia and HELLP syndrome. In acute viral hepatitis 81% patients were hepatitis E positive. Most common complication are DIC followed by hemorrhagic shock and subsequently AKI and septicemia. 77.7% babies were born alive and 30.9% NICU admission due to severe birth asphyxia and prematurity. Of these 16.6% died in neonatal period. Maternal mortality in 14.5% patients due to viral hepatits, HELLP and septicemia.Conclusions: Jaundice in pregnancy is a rare medical disorder and deadly combination affecting maternal and fetal outcome. Earl detection and timely intervention with multidisciplinary approach including obstetrician, neonatologist, intensivist and skilled nursing care can help to reduce maternal mortality and morbidity.
Comparative study of causative organism in erosive cervicitis, cervical intra epithelial neoplasia and carcinoma cervix using Pap smear
Authors: Bindal Jyoti , Paldiya Deepak
Published: February 2019

Background: Cervical cancer is the third largest cause of cancer mortality in India after cancers of the mouth and oropharynx, and oesophagus, accounting for nearly 10% of all cancer related deaths in the country.Methods: The present study carried out 300 patients in Gajra Raja Medical College in the Department of Obstetrics and Gynaecology, OPD and indoor admitted patients from July 2016 to December. 2016. The selected patients were examined with care to note any cervical lesion, appearance of cervix, nature of any cervical/ vaginal discharge. Then a cervical scrape was taken with an Ayre’s spatula and slide stained and then examined.Results: The maximum cases of HPV were seen in CIN, LSIL and HSIL. Maximum incidence of all cases was seen in the age group of 30-50 yrs. The women married before 18 years had the highest incidence of CIN and HPV infection. Majority of the cases of cervicitis were co-infected with H-Vaginalis and Trichomonas. Most women opted for a sterilization procedure rather than any other method of contraception. Use of no contraception puts these women at a high risk of acquiring HPV infection from infected partners.Conclusions: Occurrence of HPV infection declines with increasing grades. Most of the patients with HPV infection had presented with non-specific symptoms of discharge P/V or lower abdominal pain.
Pre-operative diagnosis of ovarian ectopic pregnancy: a challenge to practicing clinician
Authors: Valecha Shalini Mahana , Bashani Dolly , Gedam Jaya , . Pandeeswari
Published: February 2019

The first case of primary ovarian ectopic pregnancy was reported by St. Maurice in 1689. Primary ovarian ectopic pregnancy is rare entity, with incidence of around 3% of all ectopic pregnancies. The aim of present case report is to study the role of different modalities like clinical findings, biochemistry, sonography, surgery and histopathology in diagnosis of primary ovarian ectopic pregnancy. Authors present a case of a 24 years old female with history of 2 months amenorrhoea, per vaginal spotting and mild intermittent abdominal pain in RIF. Examination was unremarkable and serum βHCG was 2007.5IU/ml. An ultrasound scan showed an ectopic mass in the right adnexa suggestive of a tubal ectopic pregnancy and she underwent surgical management at our institute.  At laparoscopy, both fallopian tubes were noted to be normal with an ectopic mass attached to the right ovary with a pedicle. With these unusual laparoscopic findings, possibilities of tubal miscarriage, ovarian pregnancy, or abdominal pregnancy were suspected. Ectopic mass was coagulated and cut through the pedicle with bipolar cautery and specimen was sent for HPE. Our patient made an uneventful recovery and no further medical management was indicated. The diagnosis of right ovarian ectopic pregnancy was finally confirmed by histopathological evidence of the presence of chorionic villi in a background of ovarian stromal tissue, in consideration with Spigelberg’s criteria. Present case highlights the importance of considering non-tubal ectopic pregnancies when making a diagnosis based on ultrasound scan. Pre-operative diagnosis of ovarian ectopic pregnancy still remains a challenge in spite of current medical advances. Despite the benefits and reliability of ultrasound scanning, there will still be situations where the definitive diagnosis can only be made at surgery. However, histopathological examination is confirmatory and always mandatory.
Coexistence of both Brenner tumor and cystadenofibroma of ovary in a postmenopausal woman: a rare case
Authors: Kalpana B. , Panda Soumya Ranjan
Published: February 2019

Brenner tumor, and cystadeno fibroma of ovary are rare varieties of ovarian tumor, characterized by presence of solid components. There are very rare instances where both Brenner tumor and cystadenofibroma coexist in a single patient. A 48-year P1L1, postmenopusal woman presented at Guru hospital, Madurai, with chief complaints of on and off postmenopausal bleeding for 6 months. On ultrasonography there were two simple cysts of ovary measuring 6x 6 cm on left side and 4x4 cm on right side. She was managed with total laparoscopic hysterectomy and bilateral salpingoophorectomy.  Intraoperatively there was a right ovarian mass of 6x6 cm size and a left ovarian mass of 4x4 cm size. Left ovarian mass reported as benign cystadenofibroma while the right ovarian mass was reported to be brenners tumor on histopathology. As the preoperative imaging are not completely relied for diagnosing these tumors, awareness of the surgeons of these entities is particularly important. The prognosis of both of these tumors is excellent with suitable treatment. They have a very low recurrence risk on compete removal through surgery.
A rare case of hydrocele in a female
Authors: Patil Prachi Prabhakar , Satia Meena , Badhwar V.
Published: February 2019

Vulval swellings have always been a case of a difficult and a puzzling situation and more so when they are huge in size. Vulvar swellings are of various types such as Bartholin cyst, sebaceous cyst, cyst of canal of nuck, inguino-labial hernia and vulval varicosities. Most common vulvar cysts are epidermal inclusion cysts. Usual location is beneath the epidermis. An alternative histogenesis is embryonic remnants or occlusion of pilosebaceous ducts of sweat glands. Cutaneous cysts which are lined by ciliated epithelium are very rare, and authors present a rare case of a cyst arising from a left labium majus resembling a hydrocele seen in males with histopathology suggestive of ciliated cyst of the vulva.
Isolated twisted hematosalphinx misleading with ovarian cyst torsion
Authors: Khairnar Vaibhav , Valecha Shalini Mahana , . Pandeeswari
Published: February 2019

Normal or chronically inflamed fallopian tube can undergo torsion and present as acute abdomen, simulating clinically as ectopic gestation. Torsion of the fallopian tube is less frequent but significant cause of lower abdominal pain in reproductive age women that is difficult to recognize preoperatively. Authors present a rare case of hematosalpinx with torsion at its pedicle with hemoperitonium who presented as 28 years old female with acute abdomen that was successfully treated. In cases presenting with hemoperitoneum diagnosis of ruptured ectopic pregnancy should be made unless proved otherwise during reproductive age. Rarely ruptured ovarian cyst may also be a cause. Unfortunately, hematosalpinx sometimes can undergo torsion due to circulatory imbalance and can present as hemoperitoneum and circulatory collapse due to rupture. There have been no specific symptoms, clinical findings, imaging or laboratory characteristics identified for this condition. Imaging findings are non-specific in the preoperative diagnosis of torsed fallopian tubes. Therefore, most of cases with isolated fallopian tubal torsion had a delayed diagnosis and a subsequent delay of timely intervention that may result in failure to save tubal function. Torsion of tube can lead to hematosalpinx, hemoperitonium and necrosis of tube which necessitates urgent surgical management. This case report describes a twisted hematosalpinx presentation without any predisposing high-risk factors. A tubal torsion should be suspected in females with acute pelvic pain, of any age group. An early diagnosis and treatment are required to prevent complications. This rare case may highlight a new insight into pathogenesis of tubal torsion associated with hematosalpinx.