bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of osteoprotegerin and soluble ligand of receptor of kappa-B transcription factor activator in the calcification of aortic valve
Authors: Voronkina I.V. , Irtyuga O.B. , Smagina L.V. , Adamova P.E. , Zhiduleva E.V. , Malashicheva A.B. , Sibagatullina Y.S. , Kruk L.P. , Gordeev M.L. , Moiseeva O.M.
Published: February 2019

The mechanism of valve calcification that is the main cause of aortic stenosis formation and progression is not yet clear. In recent years, the role of the OPG/RANKL/RANK system is considered as one of possible variants of pathogenesis of valve calcification. In presented work the differences in OPG and sRANKL levels involved in the calcification processes in tissues of patients with severe aortic stenosis have been examined. The study was performed using three groups of patients: group 1 – patients with aortic stenosis, group 2 – patients with aortic aneurysm, and group 3 – patients with aortic stenosis and aortic dilatation. In patients with aortic stenosis, the level of RANKL was significantly higher, and the level of RANKL was higher in valve than in tissue. The negative correlation between aortic dilatation and RANKL level indicated the lack of RANKL influence on pathogenesis of aortic dilatation. The obtained data confirm the increased expression of RANKL in patients with aortic valve calcification. The results of this study confirm importance of the OPG/RANKL/RANK system in calcification in patients with aortic stenosis. Athough patients of all groups had comparable values of OPG (including patients with aortic dilatation), the RANKL level increased only in patients with aortic stenosis. This suggest involvement of some additional mechanisms influencing the increase of RANKL expression.
Maternal body mass index and feto-maternal outcome: a comparative study
Authors: Hemalatha N. , . Shanthini
Published: February 2019

Background: Increasing BMI in women poses multiple threat of illness especially in the reproductive age group impacting pregnancy. Pregnant women with overweight and obesity are at a higher risk of developing complications at all stages of the physiological pregnancy. A focus on the methods to prevent this trend of increasing weight gain in adolescence is essential curb the complications due to obesity.Methods: This prospective study was conducted in the Department of Obstetrics and Gynecology, Madras Medical College, Chennai. Written informed consent was obtained and pregnant women visiting the antenatal OP were registered. Detailed history taking and examination was carried out with the measurement of body mass index as weight in kg/height in meter square. The women were followed up for the antepartum, intrapartum, post-partum variables and neonatal outcome.Results: Two hundred pregnant women with high BMI >25 kg/m2 and two hundred pregnant women with normal BMI were selected and were followed prospectively.  Present study showed an increased incidence of pre-eclampsia in patients with high BMI (28% as compared to 8% of the normal BMI) and a higher incidence of Gestational diabetes mellitus among women with high BMI with a value of 27.5 % compared to a value of 7.5% in women with normal BMI. Caesarean delivery was found in 54.5% of the high BMI mothers compared to 31.5% in normal BMI mothers. Postoperatively, wound gaping was found with an incidence of 4.5% in high BMI mothers. IUGR was found in 10% of babies of women with high BMI and still birth occurred in 2.5% of deliveries of high BMI mothers compared to 0.5% in mothers of normal BMI group.Conclusions: The obstetrician needs to be well versed with dietary advice and life style pattern advice to the women of the reproductive age group in order to prevent the complications of high Body mass index in pregnancy. Its imperative to counsel these women about the pre-pregnancy loss of weight, healthy food and exercise, and healthy life style pattern during pregnancy in order to have a healthy outcome.
ICSI outcome in surgically retrieved sperm compared with ejaculated sperm control
Authors: S. Vishwekar Pallavi , Lad Nikita , Shivtare Mamta , Shetty Pradnya
Published: February 2019

Background: Globally, the prevalence of infertility is around 10% of the total population. 30% of these have male factor infertility. Azoospermia is found in 1% of men, in 20% of which, the etiology is a bilateral obstruction of the male genital tract while others have non obstructive azoospermia. In azoospermic men sperms are microsurgically retrieved from epididymis and testes by TESA and PESA respectively. The aim of this study was to evaluate the outcomes of intracytoplasmic sperm injection ICSI using surgically retrieved sperm of azoospermic men either obstructive or nonobstructive and to compare it with ejaculated sperms in men having severe oligospermia.Methods: This was retrospective cohort study conducted based on the data collected from our reproductive endocrinology and infertility unit, 126 ICSI cycles performed during the period of 5 years were taken and divided into two groups, one with patients having ejaculated sperms with oligospermia and other group with patients who had surgically retrieved normal sperms due to azoospermia. Outcome of these ICSI cycles included fertilization, cleavage, biochemical and clinical pregnancy was assessed.Results: In present study it was found that ICSI outcome was comparable in both the groups with ejaculated sperm and surgically retrieved sperm as fertilization rate (72% vs 65%), Implantation Rate (58 vs 51%), clinical pregnancy rate (CPR) (51% vs 44.82%) observed with ejaculated or retrieved sperm group respectively showed no statistical difference.Conclusions: Present study shows that minimally invasive techniques of PESA and TESA can be successfully performed to retrieve sperm for ICSI in the treatment of azoospermic men which gives them the chance to father their biological child. The result of this study indicates that treatment outcomes of PESA/TESA-ICSI cycles compare favourably with that of ICSI using ejaculated sperm.
Pelvic pain and early IUD discontinuation: a prospective cohort study
Authors: Gerber Sharon R. , Natell Noah , Doty Nora , Liu Xiaoyu , Overbey Jessica R. , Masch Rachel
Published: February 2019

Background: The aim of the study is to assess if pelvic pain is a risk factor for intrauterine device (IUD) discontinuation within one year of placement.Methods: This is a prospective cohort study of women who had IUDs inserted at a family planning office for the primary intent of contraception. Baseline pelvic pain characteristics were assessed using a validated pelvic pain questionnaire.  Women were contacted at 1 year to assess IUD continuation.Results: From February 1, 2014 to August 11, 2015 authors enrolled a sample of 179 women.  Of the 179 enrolled,163 participants completed the questionnaire, 98 reported a history of baseline pelvic pain and 65 reported no history of baseline pelvic pain. 20 participants were lost to follow-up. 86 women in the pelvic pain and 57 in the no pelvic pain group were included in the final analysis. Discontinuation rates at one year follow up were 25.6% (22) and 35.1% (20) respectively. There was no significant difference in those with and without pelvic pain discontinuing IUDs at one year (p = 0.22).Conclusions: Baseline generalized pelvic pain may not be a risk factor for IUD discontinuation within one year of placement.
A prospective study of indications and maternal outcome in case of emergency obstetric hysterectomy in a tertiary care hospital of Gujarat, India
Authors: Jain Mahima , Dave Devanshi
Published: February 2019

Background: Obstetric hysterectomy was developed as a heroic operation arising out of necessity to control post-partum haemorrhage thereby reducing maternal mortality. The objectives of this study are to examine the incidence, indications, outcomes and complications of obstetric hysterectomy in a tertiary care hospital. It also aims to study the changing trends in incidence and indications in present day obstetric practice.Methods: This is a one-year study including 31 cases of obstetric hysterectomy performed in the Department of Obstetrics and Gynecology in a tertiary care hospital of Gujarat. Each case is analyzed, computed and tabulated as per standard proforma including clinical assessment, questionnaire, examination and investigations.Results: In present study 68% cases were in 21-30 years which is peak reproductive age. 55% patients were from rural areas and 52% cases were having three or more parity. The incidence of obstetric hysterectomy is 0.432% in both vaginal and cesarean deliveries i.e. 1 in 231 deliveries. Major indication for obstetric hysterectomy is morbidly adherent placenta 32% followed by atonic PPH 25.8% and ante partum hemorrhage in 22.58% due to increase in rate of cesarean sections. Most common complication is DIC and maternal mortality in around 16.12%.Conclusions: Obstetric hysterectomy is still a lifesaving surgery in modern day obstetrics. Quick decision for obstetric hysterectomy reduces maternal morbidity and mortality. Most of the morbidity is attributable to its indication and underlying disorder rather than the procedure itself.
Prophylactic antenatal corticosteroid before elective cesarean delivery at or near term: a retrospective study
Authors: Sharfuddin Sana , Pradhan Anup , Imam Md Nazar
Published: February 2019

Background: While the role of antenatal steroids administration to mother is proved in reducing neonatal morbidity and mortality in preterm gestation secondary to respiratory distress and hyaline membrane disease its role in patients undergoing elective cesarean deliveries at or near term appears to be controversial.Methods: This was a retrospective observational study in which women who have undergone elective cesarean delivery between 34-37 weeks of gestation were included. Those women who received two intramuscular injections of 12 mg betamethasone 24 h apart were included in group S whereas the women who didn’t receive such injections were included in group B. Outcome measures were incidence of transient tachypnea of the newborn, hyaline membrane disease and NICU admissions due to respiratory distress.Results: Neonates in the treatment group had a statistically significant lower overall incidence of transient tachypnea of newborn, respiratory distress syndrome and NICU admissions. The incidence of transient tachypnea of newborn and respiratory distress in Group S was 5% and 8.33% respectively where as TTN and respiratory distress was seen in 18.33% and 28.33% neonates in the group N. The over NICU admission rates, due to respiratory distress in group S and Group N were found to be 8.33% and 28.33% respectively.Conclusions: Antenatal administration of corticosteroids to women at or near term (34-37 weeks) is found to have a beneficial effect in reducing neonatal morbidity and NICU admissions secondary to respiratory distress in women undergoing elective CS.
Study of maternal and fetal outcome in eclampsia at Government Medical college, Aurangabad, Maharashtra, India
Authors: Mahale Rahulkumar S. , Gadappa Srinivas N.
Published: February 2019

Background: Eclampsia is an obstetric enigma. Eclampsia as a clinical entity has been known from times immemorial. Even today it is one of the dreaded complications. Today also eclampsia is a life-threatening emergency that continues to be a major cause of serious maternal and perinatal morbidity and it’s still the leading cause of maternal mortality in our country.Methods: Method analysis of case records of all eclampsia cases from study period of October 2013 to September 2015, a observational study.Results: The incidence of eclampsia was found to be 1.06% in GMC, Aurangabad. The number of maternal deaths of eclampsia patients was 7 out of 335 eclampsia cases. Maternal mortality in eclampsia patients was 2.08% in 2-year study, however maternal mortality in hospital was 0.23% in 2 years study and the perinatal mortality rate in eclampsia was 361 per 1000 total births. while it is 84 per 1000 total birth for total deliveries in GMC Aurangabad during study. Majority of patients i.e. 87.75% were in the age group of 16-25 years, 55.82% of total eclampsia were primigravida 57% eclampsia cases were referred from government or private hospitals, 11% booked in GMC and 32% patients were self.  Antepartum eclampsia was the commonest type 82.11%. 80% patients of eclampsia were delivered vaginally and 18% underwent caesarean section ,2% instrumental deliveries. 12% of babies had birth weight 1000gm. 41% babies delivered with weight 2001 gm. Out of 264 live births 92 babies required NICU admission and 45 babies died in early neonatal period.Conclusions: With good antenatal, intranatal and postnatal care with judicious use of anti-hypertensive, anti-convulsant and battery of investigations and judicious obstetric intervention, maternal and perinatal mortality can be reduced.
Evaluation of postoperative outcome of different techniques of lower segment caesarean section
Authors: Rajoria Lata , Kala Manisha , Hooja Nupur , Bhargava Smriti , Dadhich Brijesh
Published: February 2019

Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared.Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav  technique.Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.
A study of factors affecting regression of βhCG in gestational trophoblastic disorders
Authors: Devasia Neena , Philip Tinu
Published: February 2019

Background: Gestational trophoblastic disorders are among the rare human tumors that can be cured even in the presence of widespread dissemination. Authors can anticipate the development of persistent trophoblastic disease by identifying high risk factors affecting βhCG regression in vesicular mole. The study of this aim was to determine the incidence of gestational trophoblastic disorders and persistent trophoblastic disease in our institution. Factors affecting regression of βhCG and thereby leading to persistent disease are assessed.Methods: The study was conducted for a period of 2 years at a tertiary care centre in central Kerala. The factors affecting progression to persistent disease are assessed by a case control study. Those developing persistent trophoblastic disease were taken as cases and those with normal regression of βhCG were taken as controls. Variables studied were age, sociodemographic factors, obstetric history, histopathological report, βhCG value, post evacuation USG and clinical features.Results: The incidence of gestational trophoblastic diseases was 1 in 178 births and of persistent trophoblastic disease was 18.6%. Fourteen cases with persistent trophoblastic disease were studied and 61 controls were recruited. Incidence increased in older age group (>30) and low socio-economic group. Pre-evacuation βhCG> 40000 and presence of theca lutein cyst are important factors affecting βhCG regression.  Strong association with uterine size >poa, post evacuation uterine subinvolution and presence of hyperthyroidism was found.Conclusions: Progression to persistent trophoblastic disease was associated with low socioeconomic status, high   pre-evacuation βhCG values, uterine size>poa and presence of theca lutein cysts. Identification of these risk factors helps in proper counseling and meticulous follow up of patients.
Managing gestational diabetes: the role of patient counselling
Authors: S. Ammulu , O. M. Fasalu Rahiman , K. P. Muhammed Rasheeq
Published: February 2019

Background: Unmanaged gestational diabetes mellitus (GDM) increases the risk of neonatal and fetal complications and the risk of congenital malformations. Apart from the medications used, non-pharmacological agents such as diet modification, exercise, and patient education can improve the quality of life in GDM patients. The present study was aimed to evaluate the role of patient counselling in the management of GDM in patents.Methods: Unmanaged gestational diabetes mellitus (GDM) increases the risk of neonatal and fetal complications and the risk of congenital malformations. Apart from the medications used, non-pharmacological agents such as diet modification, exercise, and patient education can improve the quality of life in GDM patients. The present study was aimed to evaluate the role of patient counseling in the management of GDM in patents.Results: The result showed that there is a slight increase in the QOL of test population with GDM. i.e., there is no significant progression in the disease condition. The result showed that each domain, physical, psychological, social and environmental conditions were improved a lot when compared with the control group.Conclusions: Results suggests a positive impact of patient counseling on the management of GDM in patients.
Is first trimester body mass index of antenatal mothers associated with selected feto-maternal outcomes?
Authors: Arora Chanchal , Thadathil Smitha , R. Rejani , Sharma Punita A.
Published: February 2019

Background: Mothers are the creators and sustainers of progeny. The health and wellbeing of children is intimately linked with the health, nutrition, education and well-being of their mothers because she is both the seed as well as the soil where in the baby is nurtured for 9 months. Hence the present study was conducted to determine the association between first trimester body mass index (BMI) of antenatal mothers with the mode of delivery, birth weight and APGAR scores of new born babies at birth in a tertiary care hospital.Methods: A cross-sectional study was conducted amongst 115 antenatal mothers who reported to the Labor room in a tertiary care hospital of Pune during the period of Nov. 2017 to Feb. 2018, to determine the association between first trimester body mass index (BMI) of antenatal mothers with the mode of delivery, birth weight and APGAR scores of new born babies.Results: The findings were suggestive of increased odds of APGAR of <7 at 1 min of birth among new born babies born to the study participants of low BMI group as compared to the new born babies born to the high BMI group; Increased odds of birth weight of  >3.5 kg and gestational weight gain of >14 kg and greater odds of complications among new born babies born to the study participants of high BMI group than the new born babies born to the low BMI group.Conclusions: The study concluded that birth weight of the new born babies shows a clinically significant increasing trend in association with the increasing first trimester BMI of their mothers.
Perinatal outcomes in abruptio placenta
Authors: Tambawaala Zenab , Kale Deepali
Published: February 2019

Background: Abruptio placentae is an obstetric emergency where placenta completely or partially separates before delivery of the baby. It occurs approximately in one in 120 deliveries. It is an important cause of perinatal morbidity and mortality.Methods: This was a prospective hospital-based study design conducted over a period of 2 years, in the Department of Obstetrics and Gynecology at a tertiary care hospital in Mumbai comprising of 60 cases.Results: The incidence of abruption placentae in Present study is 0.51%. Authors had perinatal mortality in 6.6% of the cases. Out of 60 cases, 2 deaths occurred in utero. Out of the remaining 58 cases, 24 babies needed NICU care, out of them, 22 went home alive and 2 had neonatal deaths. Perinatal morbidity in the form of hyperbilirubinemia, CNS depression, septicemia, neonatal anemia and neonatal DIC were noted.Conclusions: High incidence of perinatal mortality in abruptio placentae is because of increased number of still births. In our studies, the perinatal mortality is 6.6% as compared to all other studies. This decline in perinatal mortality is due to improved obstetric care and excellent NICU facilities which are required for a majority of the cases.
Outcomes of induction in trial of labor after cesarean delivery
Authors: Varshney Anubha , Mohsin Zehra
Published: February 2019

Background: The objective of this study is to evaluate the outcomes of induction of labor in women attempting trial of labor after cesarean delivery and to compare maternal and neonatal morbidity and mortality in women who were induced to those delivering spontaneously.Methods: The prospective study was carried out in the Department of Obstetrics and Gynecology in collaboration with the Neonatal Section, Department of Pediatrics at J.N. Medical College and Hospital, AMU Aligarh. The sample included 280 women with one previous cesarean section, of whom 130 women underwent induction of labor (study group) and 150 were admitted with spontaneous onset of labor. Prostaglandin gel and intracervical Foley’s were used for cervical ripening in the study group. Indication of cesarean section, mode of delivery, maternal and neonatal outcome were studied in between groups.Results: Overall rate of vaginal delivery after cesarean section was 45.3% and 56% in both study and control group respectively. The rate of cesarean section were higher in women who were induced and having unfavorable cervix. Maternal and neonatal morbidity were not significantly higher as compared in both groups, however one case of scar rupture was found in study group.Conclusions: Induction of labor in women with previous cesarean section had higher rates of cesarean section however it does not adversely affect neonatal and maternal morbidity. Overall vaginal birth is safe and effective in women with previous cesarean section by prostaglandin gel or intracervical Foley’s. Authors cautiously suggest, induction of labor should be considered in preselected patient with strict monitoring.
Study of prevalence of bacterial vaginosis in preterm and term labour patients
Authors: Shree Tamanna , Kaur Amrit Pal , Dhillon S. P. S. , Oberoi Loveena
Published: February 2019

Background: Bacterial vaginosis (BV) is a clinical condition caused by replacement of the normal hydrogen peroxide producing Lactobacillus species with high concentrations of aerobic and anaerobic bacteria. Studies have shown that spontaneous abortion, preterm labour (PTL), premature birth, preterm premature rupture of membranes, amniotic fluid infection, and postpartum endometritis are increased because of infection with BV. In India, not many studies have been done to estimate the prevalence and association of BV with preterm labour, hence this study is being taken up to know the prevalence of BV in preterm and term labour patients and its relationship with preterm delivery, low birth weight of baby and puerperal sepsis.The objective of the present study was to observe the prevalence of bacterial vaginosis in women presenting with preterm and term labour, its impact on preterm and term delivery and to analyze the maternal and fetal complications associated with BV.Methods: An observational study involving 100 patients with preterm and term labour (50 patients in each group) was conducted at a BNMCCC, Government Medical College, Amritsar. Women fulfilling the Amsel’s criteria and/or a score of 7 or more on gram staining of vaginal smears (Nugent’s score) was considered to have bacterial vaginosis.Results: The proportion of patients, who fulfilled Amsel’s criteria and/or a Nugent’s score of 7 or more for the diagnosis of BV, was more in PTL group versus term labour group, and the difference was statistically significant. Prevalence of BV in preterm labour and term labour patients was 18(36%) versus 4(8%) respectively. In PTL group, 27.8% of low birth weight neonates were born to BV positive mothers versus 3.1% were born to BV negative mothers. Maternal postpartum complications observed were 33.3% with BV versus 6.25% without BV in PTL group.Conclusions: BV is major risk factor for PTL. Therefore, the testing and prompt treatment of BV may reduce the risk of PTL. This will also go a long way in the prevention of maternal morbidity and neonatal complications due to prematurity.
Hypertensive disorders of pregnancy: a clinical study in a rural tertiary care centre of western Uttar Pradesh, India
Authors: Swaroop Neelam , Singh Mamta , Kumari Kalpana , Verma Vandana
Published: February 2019

Background: The aim of study was to find out the frequency and clinical outcome in hypertensive disorder of pregnancy (HDP) in a rural tertiary care centre. Hypertensive disorder of pregnancy is a commonest medical disorder which constitutes about 12-22% of all pregnancies and it is a major cause of maternal morbidity as well as mortality world wide.Methods: It is a retrospective hospital-based study to find out the clinical outcome in different hypertensive disorder of pregnancy in a rural tertiary care centre of western Uttar Pradesh.Results: Present study showed the prevalence of HDP was 4.01% among the study population. Most of the patients were primipara ,unbooked and less than 25 years of age. The most common HDP was mild preeclampsia  and HELLP was its commonest  complication.Conclusions: Hypertensive disorder of pregnancy (HDP) is still a major cause of maternal mortality and morbidity. Authors intend to aware the pregnant women regarding high risk factors of pregnancy and motivate them for regular antenatal care so that  complications of  hypertensive disorders can be  managed timely.
Study of maternal and fetal outcomes in patients with gestational diabetes mellitus
Authors: Gedam Smruti , Ponde Sanjay
Published: February 2019

Background: Diabetes mellitus is the commonest medical problem complicating pregnancy, with possibility of grave consequences. With the present study, incidence, management and perinatal outcomes in the cases of GDM were studied.Methods: All the pregnant patients attending antenatal clinic at the study centre during study period of three years were studied. Those with positive history were screened for GDM as early as possible and rest screened at 24-28 weeks gestation. Carpenter and Coustan criteria were used for the diagnosis of gestational diabetes mellitus. All the diagnosed cases of gestational diabetes mellitus were followed up throughout the course of gestation and complications, if any, recorded.Results: A total of 39 patients were diagnosed as GDM. Majority were multigravida (69.3%, 27) and weighed over 75 kg (56%, 22). Patients were mostly diagnosed at the gestational age of 31-35 weeks (n-15) and 21-25 weeks (n-11). Fifteen patients (38.4%) had HbA1c values between 6-7%, 14 patients (35.8%) between 7-8% and 3 patients had HBA1c levels more than 10%. Twenty-three percent (9) patients had PIH, 13% (5) polyhydramnios and 7.6% (3) had PROM. Three mothers had babies suffering from IUGR. Sixteen (41%) had full term normal delivery while 2 (5.1%) patients had preterm labor and delivered normally. Twenty-one mothers (53.84%) had LSCS, out of which 3 had preterm LSCS.Conclusions: Diabetes during pregnancy is associated with risk factors as well as high maternal and foetal morbidity. GDM has good maternal and foetal outcomes depending upon how well the blood sugar levels are controlled.
Evaluation of postpartum intrauterine contraceptive devices (IUCD) insertion: 5 years study
Authors: Antaratani Ramalingappa C. , D. Vinay Raju , K. Sanjana
Published: February 2019

Background: The intrauterine contraceptive device (IUD) primarily in the form of copper T is used by more than 150 million women around the world making it the most widely used reversible method of contraception with a remarkably low failure rate of less than 1 per 100 women in the first year of use for cu T 380 A. It is more suitable for a country like India which is in urgent need of population control methods.Methods: A Prospective observational study was under taken where in a series of women who delivered either vaginally or through caesarean section during the period of November 2013 to October 2017 in the Department of Obstetrics and Gynecology, Karnataka Institute of Medical Sciences, Hubli counseled for PPIUCD insertion were included in the study. Mothers who were suffered from Chorioamnionitis, Puerperal sepsis, Postpartum haemmorrhage, PROM more than 18 hours, extensive genital trauma, uterine abnormalities, Multiple sexual partners and obstructed labour were excluded from the study. Since it was a time bound study, a total of 16009 cases were enrolled in the study after counseling them.Results: A total of 16009 women were counseled to undergo PPIUCD, out which 5144 women accepted for PPIUD amounting to a total acceptance rate of 32.1%.Out of the 10865 women who did not accept device, the reason for non-acceptance preference another contraception 60%, family opposition was reason in 21% of women, while 08% of women had side effects from their previous use. 11% of women said that they were not desire to use contraception.Conclusions: Family planning and mother and child health services are supplied to the people free of cost in India. Use of an intrauterine device is simpler , less expensive, and immediately reversible.
A comparative study on placebo and trenaxamic acid for the prophylaxis is of post-partum hemorrhage: a randomised double-blind control study
Authors: Parveen S. , Chandra G. Kesava , Reddy K. Ravindra , Kavya Sree A. V. , Varalakshmi M. , Gayathri R. , Chandra V. Bhuvana , Ramana P. Venkata
Published: February 2019

Background: Obstetric haemorrhage accounts for 20-25% of maternal mortality and morbidity. Anti-fibrinolytics are being widely used in field of surgery. It is also used to reduce heavy menstrual blood loss. The aim of this study was to analyse the effectiveness of TXA in reducing blood loss during normal vaginal delivery.Methods: The randomized double-blind control study was done in the Labour ward. It was conducted on 100 women undergoing Normal vaginal delivery. They were allocated to either Study or Control group by randomization. TXA was given during the Third stage of delivery in study group in addition to the routine care whereas the control group had routine care alone. Blood loss was measured in both groups by bag method.Results: The significant of reduction in blood loss calculated from placental delivery to 2hrs. 141.9 ml in study group versus 270.4 ml in control group. Among primi patients, the control group average blood loss was 325ml, the study group avg blood loss was 169ml. Among G2 patients, the control group average blood loss was 248.5ml. The study group average blood loss was 128.25ml. Among G3 patients, the control group average blood loss was 203ml, the study group average blood loss was 115ml.Conclusions: TXA significantly reduced the amount of blood loss during normal vaginal delivery. Thus, TXA can be used safely and effectively in subjects undergoing normal vaginal delivery.
Perinatal outcomes and intrahepatic cholestasis of pregnancy: a prospective study
Authors: Parihar Sangeeta , Singh Swatantar
Published: February 2019

Background: Women with intrahepatic cholestasis of pregnancy (ICP) have an increased risk for postpartum haemorrhage, dyslipidaemia, preterm labour and operative interference. Fetus in ICP has been associated with an increased incidence of preterm labour, preterm prelabour rupture of membrane, fetal distress, abnormal CTG, meconium staining, spontaneous intrauterine death. The present study was done to evaluate the perinatal outcomes – maternal outcomes and fetal outcomes of ICP.Methods: This was a prospective observational study carried out in a tertiary care teaching hospital. Total 1100 pregnant women were screened during the study period. Patients with ICP were identified in maternity care units after eliciting history about itching. Pregnancies with pregnancy induced hypertension and other liver diseases in pregnancy were excluded.Results: 62 pregnant women with prevalence rate of 5.64% have been found to be suffering from ICP. The most frequently affected (22, 35.48%) age-group with ICP were belong to age > 35 years. A majority of pregnant women with intrahepatic cholestasis of pregnancy was of multipara. ICP was highly significantly associated with small for gestational age (SGA, p-value: 0.0003); abnormal cardiotocography (CTG, p-value: 0.0002); and meconium stained liquor (p-value: 0.0001). Caesarean section as mode of delivery found significantly associated (p-value: 0.0033) with ICP. Insomnia (p-value: 0.0045); dyslipidemia (p-value: 0.0011); and postpartum haemorrhage (p-value: 0.0122) were also found significantly with ICP.Conclusions: ICP can adversely affect fetal as well as maternal pregnancy outcomes. Maternal outcomes have good prognosis, but fetal outcomes can be improved by timely and effective intervention.
Successful management of a patient with severe brady-arrhythmia in peripartum period
Authors: Tandon Aditi , Satia Meena , Badhwar Vijaya
Published: February 2019

Pregnancy is a normal physiological state with hyperdynamic circulation that is characterised by important physiological changes, many of which take place in the cardiovascular system. Few patients with physiological bradycardia may, in the second trimester, feel symptomatic as their blood pressure drops due to a reduction in systemic vascular resistance however, treatment is rarely required. Pathological bradycardia in pregnant women is rare and usually secondary to either Congenital heart block, Myocarditis, or Severe Hypocalcaemia with an incidence as low as 1:20 000 women. Authors present a rare case of severe bradycardia during peripartum period who required LSCS in view of IUGR with Anhydroamnios. On admission her general condition was good her pulse was 42 beats per mins and BP was 170/100 mm of Hg with 1+ protinuria.  A clinical impression of preeclampsia was made. ECG showed sinus bradycardia with no irregularity. 2 DEcho showed no structural lesion in the heart and normal functional capacity so dilated peripartum cardiomyopathy was ruled out. Her serum electrolytes were normal and serum calcium and magnesium was markedly reduced which was corrected. Post operatively on day 4 pulse was mor than 60 and she was transferred out of ICU. The ECG performed on day 6 was normal.
Clinicopathological and immunofluorescence study of vesiculobullous disorders
Authors: Gopalakrishnan Geetha K. , Bindu V. , Riyaz Najeeba
Published: February 2019

Background: Vesiculobullous diseases are mostly immune mediated and diagnosed based on the clinical features, histology and Immunofluorescence. The aim of the study was to identify the immunofluorescence pattern in auto immune vesiculobullous diseases and correlate it with the clinical profile and histology.

Methods: Patients attending the dermatology outpatient department in a tertiary hospital with vesiculobullous diseases, suggestive of auto immune aetiology were evaluated clinically. Histopathology and direct immuno-fluorescence were done in all patients.

Results: During the one year period from June 2008 to July 2009, 40 patients with vesiculobullous disorders clinically suggestive of auto immune aetiology attended the outpatient department. Out of the 40 patients, 22 (55%) patients were diagnosed to have intraepidermal with female preponderance and 18 patients (45%) sub epidermal blistering diseases. Bullous pemphigoid was the commonest sub epidermal disease, seen in 8 patients.

Conclusions: In all cases diagnosed clinically as pemphigus a histological diagnosis of pemphigus was made (100%). The clinical variants of pemphigus could also be diagnosed in all cases histologically (100%). The positive and negative predictive value was 100% in pemphigus group cases. Histology of all patients showed subepidermal bulla (100%). A specific diagnosis could be made in 18 patients with sub epidermal disease (100%). DIF was found to be an invaluable tool in diagnosing different diseases belonging to the sub epidermal group, but it was not of much help in sub classifying variants of pemphigus.

 
Estado do Conhecimento sobre Comunidades Virtuais de Prática em Dissertações e Teses Brasileiras
Authors: Mendes Vieira da Silva Daniela , Da Conceição Esquincalha Agnaldo , Giraldo Victor Augusto
Published: February 2019

O presente artigo apresenta um estado do conhecimento sobre comunidades virtuais de prática em dissertações e teses brasileiras publicadas até agosto de 2018. Este trabalho apresenta brevemente a metodologia de pesquisa do tipo estado do conhecimento, destacando suas principais características e delimitando seu escopo de busca. As contribuições dos oito trabalhos selecionados foram organizadas em categorias relacionadas e discutidas com base em seus autores, como preconiza a literatura. Como conclusão, destacamos a importância das comunidades virtuais, que agregam profissionais com interesses em comum e que, segundo os autores pesquisados, facilitam e promovem o compartilhamento de ideias, promoção de novos conhecimentos de maneira coletiva e integrada, com indícios de desenvolvimento profissional.
Palavras-chave: Comunidades virtuais de prática. Estado do conhecimento. Desenvolvimento profissional.
Investigação etiológica nas situações de deficiência intelectual ou atraso global do desenvolvimento
Authors: Melo Débora Gusmão , Pilotto Rui Fernando , Rodrigues Stephania Araújo , De Avó Lucimar Retto da Silva , Germano Carla Maria Ramos
Published: February 2019

Objetivos: Examinar estudos sobre diagnóstico etiológico nas situações de deficiência intelectual ou atraso global do desenvolvimento, racionalizando o processo de investigação causal em um fluxograma aplicável na prática clínica. Método: Revisão não sistemática da literatura nas bases de dados PubMed e SciELO, sem restrições de tempo ou idioma, com seleção de artigos relevantes, análise crítica e síntese dos resultados. Resultados: Causas ambientais de deficiência devem ser consideradas na história clínica, identificando-se fatores de risco pré, peri e pós-natais. A história familiar e os exames físico, dismorfológico e neurológico podem sugerir a etiologia e orientar a investigação. Para investigar causas genéticas, a análise cromossômica por microarray é indicada como teste de primeira linha, associada à pesquisa de erros inatos do metabolismo e à testagem para síndrome do X-frágil. Exames de neuroimagem são importantes em pacientes selecionados, assim como a investigação de outros genes localizados no cromossomo X. Há uma discussão emergente sobre o papel do sequenciamento completo do exoma nessa investigação. Conclusões: A frequência de definição etiológica tem aumentado com a incorporação de novas tecnologias genéticas na investigação da deficiência intelectual. Afora a investigação etiológica, a abordagem clínica deve considerar diferentes demandas e permitir a construção de um plano terapêutico individualizado.
Ações de educação alimentar e nutricional em pré-escolares: um relato de experiência.
Authors: Backes Vanessa , França Franciny Santos , Dos Santos Jordana Silva , Marques Juliana Flesch , Ramos da Silva Maria Carolina , Gresele Fernanda Cardonetti
Published: February 2019

É durante a infância que ocorre a formação do hábito alimentar, e, por isso, destaca-se a necessidade de ações que estimulem a alimentação adequada e saudável, incentivando a autonomia alimentar. O objetivo deste trabalho foi desenvolver autonomia alimentar nos pré-escolares de 5 a 6 anos de uma escola privada de Educação Infantil de Sapucaia do Sul, a partir de ações educativas em alimentação e nutrição. Foram propostas para a turma de pré-escolares quatro intervenções: a primeira delas foi através do conto “Tia Zilá e suas amigas frutas”; na segunda foi abordada a trajetória dos alimentos, a necessidade da mastigação e medidas caseiras; na terceira, a roda dos alimentos; e, na quarta, autonomia alimentar. Após quinze dias da última intervenção, foi realizada a observação dos resultados. Os alunos demonstraram conhecer os alimentos, ter coordenação motora suficiente para servirem e se alimentarem individualmente, além de ter interesse pelas atividades propostas, bem como participar delas. Contudo, para que estas ações tenham continuidade, faz-se necessária a participação e o engajamento daqueles que acompanham diariamente as crianças.
Percepção dos pais em relação ao estado nutricional dos seus filhos
Authors: Gomes Elen Ramos , Backes Vanessa
Published: February 2019

Introdução: A difícil percepção dos pais em relação ao estado nutricional de seus filhos prejudica a promoção da saúde e prevenção de doenças. Objetivo: Identificar a percepção dos pais em relação ao estado nutricional dos seus filhos. Materiais e métodos: Estudo transversal com aferição de dados antropométricos de pré-escolares do município de Gravataí – Rio Grande do Sul (RS) e aplicação de questionário com os pais para identificação da imagem corporal através da escala de silhuetas de Tiggemann e estado nutricional com o propósito de confrontar as informações fornecidas pelos responsáveis com o real diagnóstico nutricional das crianças. Resultados: Dentre os pré-escolares avaliados, 36% eram eutróficos e 64% apresentavam risco nutricional. 100% dos pais classificaram como sendo normal o estado nutricional dos seus filhos. De acordo com a imagem corporal assinalada, 35,7% dos pais marcaram a mesma imagem para definir o estado nutricional dos filhos. Quanto à comparação entre a percepção dos pais e o real diagnóstico dos filhos, 62,5% das crianças com sobrepeso foram subestimadas pelos pais. Conclusão: Todos os responsáveis identificaram seus filhos como normais em relação ao estado nutricional. Contudo, a percepção dos pais a respeito do peso corporal tende a ser distorcida principalmente entre crianças com sobrepeso.
Perfil Motor de Lactentes Nascidos no Município de Coari/AM
Authors: Mendonça Ayrles Silva Gonçalves Barbosa , Gonçalves Eric Brasil , Furtado Michelle Alexandrina dos Santos , Santos Christian Caldeira
Published: February 2019

Introdução: No primeiro ano de vida infantil, as etapas do desenvolvimento motor (DM) progridem de movimentos simples e desorganizados para movimentos mais complexos e voluntários, estando as crianças suscetíveis aos riscos biológicos e ambientais, o que pode alterar o DM infantil. Objetivo: Avaliar o DM de lactentes cadastrados em uma Unidade Básica de Saúde (UBS) de Coari, Amazonas, e apresentar os possíveis fatores de risco para o DM atípico. Método: Estudo descritivo observacional transversal, com amostragem intencional e não probabilística, em que lactentes cadastrados em uma UBS foram avaliados utilizando questionários de variáveis clínicas, socioeconômicas, ambientais e aplicação da Escala Motora Infantil de Alberta (AIMS). Resultados: Foram avaliados 42 lactentes, dos quais 92,9% apresentaram desempenho motor normal. A baixa renda familiar e reduzida escolaridade dos pais foram achados predominantes, porém sem interferências no DM. As doenças pregressas mais frequentes foram: pneumonia, infecção urinária, diarreia, malária, catapora, infecção intestinal e coqueluche. Nenhuma criança frequentava creches no período da avaliação. Conclusão: A maioria dos lactentes, pertencentes da UBS, do bairro Pêra, em Coari/AM, possuíram o DM adequado, segundo avaliação da AIMS, mesmo eles apresentando alguns fatores de risco para o DM, como prematuridade e baixos níveis de renda e escolaridade dos seus pais.
Klaas van Berkel, Universiteit van het Noorden. Vier eeuwen academisch leven in Groningen. Deel 1: De oude universiteit, 1614-1876
Authors: De Ridder-Symoens Hilde
Published: February 2019

Klaas van Berkel, Universiteit van het Noorden. Vier eeuwen academisch leven in Groningen. Deel 1: De oude universiteit, 1614-1876 (Hilversum: Verloren, 2014, 912 pp., isbn 978 90 87 04466 4).
Kees-Jan van Klaveren, Het onafhankelijkheidssyndroom. Een cultuurgeschiedenis van het naoorlogse Nederlandse zorgstelsel
Authors: Vandendriessche Joris
Published: February 2019

Kees-Jan van Klaveren, Het onafhankelijkheidssyndroom. Een cultuurgeschiedenis van het naoorlogse Nederlandse zorgstelsel (Amsterdam: Wereldbibliotheek, 2016, 288 pp., isbn 978 90 28 42550 7).
Carla van Boxtel, Maria Grever and Stephan Klein (eds.), Sensitive Pasts. Questioning Heritage in Education
Authors: Tyssens Jeffrey
Published: February 2019

Charlottesville (Virginia), 12 augustus 2017. Diverse rechts-extremistische, racistische groepjes houden een optocht in de doorgaans rustige universiteitsstad. Medestander James Fields rijdt met zijn wagen progressieve tegenbetogers overhoop. Bilans: een dode en ettelijke gewonden. Motief van de optocht? De plannen om een standbeeld weg te halen van Robert E. Lee, de bekende generaal van de Confederatie tijdens de Amerikaanse burgeroorlog. Meteen lokt het incident in tal van andere landen – onder meer in België – vurige debatten uit of ook daar de ‘foute’ monumenten, straatnaambordjes en dergelijke uit de publieke ruimte moeten worden verwijderd.
Effects of the polyhistidine tag on kinetics and other properties of trehalose synthase from Deinococcus geothermalis.
Authors: Panek Anna , Pietrow Olga , Filipkowski Paweł , Synowiecki Józef
Published: February 2019

Two recombinant trehalose synthases from Deinococcus geothermalis (DSMZ 11300) were compared. A significant influence of the artificial polyhistidine tag was observed in protein constitution. The recombinant trehalose synthase from D. geothermalis with His₆-tag has a higher Km value of 254 mM, in comparison with the wild-type trehalose synthase (Km 170 mM), and displayed a lower activity of maltose conversion when compared to the wild type. Moreover, differences in properties like temperature, pH, thermal- and pH-stability were observed. Presence of the histidine tag caused a decrease of thermal resistance in case of trehalose synthase with His₆-tag. These data confirmed a suggestion that the introduction of the histidine domain produces in some seldom cases undesirable changes in the protein.
Low-glucose medium induces ORP150 expression and exerts inhibitory effect on apoptosis and senescence of human breast MCF7 cells.
Authors: Krętowski Rafał , Stypułkowska Anna , Cechowska-Pasko Marzanna
Published: February 2019

Glucose deprivation is a factor evoking endoplasmic reticulum (ER) stress and induction of expression of an oxygen-regulated protein of 150 kDa (ORP150). We studied the effect of inducible overexpression of ORP150 on senescence and apoptosis of human breast carcinoma cells (MCF7) and human skin fibroblasts. We found an inhibitory effect of ORP150 on apoptosis and senescence of MCF7 cells, but not fibroblasts in ER stress conditions. An increased expression of senescence-associated β-galactosidase and acid β-galactosidase activity (biomarkers of cellular senescence) was observed. We suggest that ORP150 induction in cancer cells can promote tumour progression and may be a major cause of their resistance to chemotherapeutics.