bluuebunny/crossref_metadata_2025 huggingface dataset:
Samsun, Amasya, Tokat ve Eskişehir İlleri Memeli Faunası ve Türlerin Koruma Statüleri
Authors: SELÇUK Ahmet Yesari , KEFELİOĞLU Haluk
Published: December 2019

Bu çalışmada Samsun, Amasya,
Tokat ve Eskişehir illerinin memeli faunası araştırılmış ve belirlenen memeli
türlerinin koruma statüleri belirtilmiştir. Samsun, Amasya, Tokat ve Eskişehir illerinde 2014-2016 yılları arasında arazi çalışması
gerçekleştirilmiştir. Arazi çalışmaları sırasında, canlı hayvan yakalama
kapanları, çukur tuzaklar, fotokapan, yuva alanları, hayvan dışkı ve izleri ve pelet
içeriklerindeki (baykuş kusmukları) memeli hayvan kalıntılarından (kafatası ve
çene kemikleri) faydalanılmıştır. Bu çalışmalar sonucunda Böcekçil (Eulipotyphla), Kemirgen (Rodentia),
Tavşanımsı (Lagomorpha), Etçil (Carnivora), Çift Toynaklı (Artiodactyla) memeli
takımları içerisinde sınıflandırılan Samsun ili için 47, Amasya ili için 32, Tokat
ili için 49 ve Eskişehir ili için 34 memeli hayvan türü tespit edilmiştir.
An Econometric Analysis of Factors Affecting Fish Consumption: The Case of Tekirdag, Turkey
Authors: ABDİKOĞLU Derya İlkay , AZABAĞAOĞLU Mecit Ömer , UNAKITAN Gökhan
Published: December 2019

The
aim of this study was to determine the factors affecting the fish consumption
in Tekirdag province. The
data were obtained from 270 consumers selected by using random sampling method
from 48000 households living in Tekirdag province. Consumers' demographic
characteristics were analyzed and responses for preferences about fish
consumption habits were discussed. In this study, Factor Analysis was performed
to analyze the purchasing behavior of consumers about fish consumption. Factor
groups were named as “attitude towards processed and canned products”,
“conscious purchasing”, “opinion about aquaculture”, “health benefits”, “impact
on consumption amount”. Factors affecting the amount of fish consumption per
capita were explained with Tobit model. Consumer’s income, education level and
factor groups derived from factor analysis were used as explanatory variables
in the model. According to the results conscious purchasing factor, health
benefits factor, consumer income and education level have positive effect on
fish consumption. As a result of the study, it was observed that the increases
in income level and conscious level would increase fish consumption. Based on
the result of the Tobit model, in order to increase fish consumption, consumers
should be informed about the health benefits of fish.
Book Review - Science and Engineering for Grades 6-12: Investigation and Design at the Center, 2019. National Academies of Sciences, Engineering, and Medicine (US)
Authors: Benz Richard
Published: December 2019

No abstract available.
Does folic acid reduce congenital anomalies and adverse pregnancy outcomes in women received long-term low dose Methotrexate?
Authors: Farag Ahmed M. , Ibrahim Safaa A.
Published: December 2019

Background: Methotrexate (MTX) which is folic acid antagonist is used to treat many diseases, including rheumatic, inflammatory, autoimmune disorders or malignancies; it is also used for the medical treatment of ectopic pregnancy and termination of pregnancy. The objective of this study was to assess the impact of folic acid in preventing congenital anomalies (CAs) in the fetus of pregnant that take long-term low dose methotrexate.Methods: The study included 1569 with history of low dose methotrexate therapy <25 mg/week that stopped one month before pregnancy, they were divided into 3 groups; Group 1 comprised 272 pregnant women, Group 2 comprised 367 pregnant women both groups take folic acid 4-5 weeks preconception and for the first 12-13 weeks gestation, the dose in the 1st group was 0.4 mg/day while in 2nd Group 4 mg/day, Group 3 comprised of 930 pregnant disease-matched with no folic acid. Group 4 comprised of 1015 pregnant no underlying autoimmune and no folic acid intake.Results: The overall rate of CAs and cardiovascular CAs were higher in fetuses of Group 3 (OR: 1.7; 95% CI: 1.1-2.7) and (OR: 2.7; 95% CI: 1.4-5.2) respectively compared to the overall rate of CAs and cardiovascular CAs in other groups. Other adverse outcomes as abortion, preterm delivery, preeclampsia, placenta abruption, PROM, low birth weight, admission to NICU, IUGR and IUFD were higher in Group 3 and 4 than in Group 1 and 2. There were no significant differences in umbilical arterial PH. The Apgar scores <7 at 1, 5 min and gestational age at delivery were higher in Group 1 and 2 than Group 3 and 4.Conclusions: There was a certain reduction in methotrexate teratogenic effect on the fetuses with folic acid intake during pregnancy, these pregnancies might benefit from taking of folic acid in high doses before conception and during the first trimester of pregnancy and improvement in fetal and maternal outcomes but the explanation of this effect requires further study.
Study of fetomaternal outcome in cases of premature rupture of membrane at tertiary care rural institute of Western Uttar Pradesh
Authors: Singh Jigyasa , Kanti Vaibhav , Verma Vandana
Published: December 2019

Background: Premature rupture of membranes (PROM) is the rupture of the fetal membranes before the onset of labor. Preterm PROM complicates approximately 3 percent of pregnancies and leads to one third of preterm births. It increases the risk of prematurity and leads to a number of other perinatal and neonatal complications.Methods: This was a prospective study carried out at the department of obstetrics and gynaecology, UPUMS, Saifai from April 2018 to September 2018 (6 months study). Patients with Spontaneous rupture of membranes any time beyond 28th week of pregnancy, but before the onset of labour. Patients with following conditions were excluded from the study- meconium stain liquor, cord prolapse, antepartum haemorrhage, active infection at other sites, active liver disease.Results: A total of 103 cases of premature rupture of membrane (PROM) were recorded from April 2018 to September 2019 among 1523 admitted pregnant patients. Most of the patients 56 (54.36%) were delivered by caesarean section (C/S). Previous C/S, oligohydramnios, fetal distress, chorioamnionitis were the common indications for doing C/S. Forty-seven (45.63%) patients were delivered vaginally.Conclusions: Most of the affected women belongs to 20-24 years of age (53.39%). Term PROM was more in comparison to PPROM and most of them were multigravidae. Cesarean section rate was high. Most common complication was of subclinical urogenital infection (51.02%).
A study of evaluation of unhealthy cervix by various diagnostic modalities
Authors: Gohil Ami M. , Ponde Sanjay , Agrawal Poorvi , Bal Himadri
Published: December 2019

Background: This study was carried out to evaluate cases of unhealthy cervix by using Pap (Papanicolaou) smear, colposcopy and cervical biopsy and to arrive at a definitive diagnosis. It correlated the findings of Pap smear, colposcopy and histopathology. It is important to strictly implement the screening program and spread awareness of the disease symptoms and its management to reduce the overall incidence of morbidity and mortality reported due to cervical cancer.Methods: A total 120 patients satisfying the inclusion/exclusion criteria were recruited for the study and informed consent was taken from all the participants. Pap smear was taken for all the cases. Then cases were subjected to colposcopy followed by biopsy. All the findings were correlated and analyzed. The findings of Pap smear and colposcopy were correlated with the gold standard of histopathology.Results: The sensitivity and specificity of Pap smear and colposcopy with respect to cervical biopsy were 53.1% and 98.7%, 87.87% and 72.72% respectively. Colposcopy had higher sensitivity and lower specificity than Pap smear for screening of cancer cervix.Conclusions: Cervical cancer is one of the preventable and highly curable conditions when diagnosed in the precancerous stage. The incidence of deaths resulting from cervical cancer can be brought down with adequate cervical cancer screening. Colposcopy and colposcopy directed biopsy should be done along with Pap smear in screening for early detection of cervical cancer since the accuracy of detection of cervical abnormalities is higher when these two methods are used complementarily.
Effect of first trimester maternal serum pregnancy associated plasma protein: a level on fetomaternal outcome
Authors: Singh Shilpi , Singh Pushpa
Published: December 2019

Background: Serum pregnancy-associated plasma protein-A (PAPP-A) levels fluctuate in continuation with the pregnancy and thus become an important standalone marker in monitoring the adverse outcomes that may occur in pregnancy.Methods: A prospective observational study was conducted in the department of obstetrics and gynaecology. A total of 240 pregnant women in their first trimester were included in the study. Serum PAPP-A levels were measured at 11-13+6week of gestation and were evaluated with respect to the feto-maternal outcome. The data was entered in MS excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0.Results: The mean age of the study population was 27 years. Among the maternal pregnancy parameters, PIH, pre-term labor and Emergency LSCS were significantly associated with low (<0.5 MoM) Serum PAPP-A levels, P<0.05. All the fetal outcome measures: IUGR, IUD, low birth weight, SGA babies, prematurity and NICU admissions, were significantly associated with low (<0.5 MoM) Serum PAPP-A levels, p <0.05.Conclusions: Serum PAPP-A in the early pregnancy showed significant correlation with feto-maternal outcome. Thus, it has the potential to be used as a prognostic factor and in the management of adverse outcomes by increasing surveillance for pregnant women with high-risk factors.
Incidence of maternal near-miss events in a tertiary care hospital of Gujarat, India
Authors: Kansara Vijay , Vaja Disha , Desai Ajesh
Published: December 2019

Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases. Because maternal mortality is a rare event, it is important to study maternal near-miss as a complement to evaluate and improve the quality of obstetric care. Thus, the study was conducted with the aim of assessing the incidence and causes of maternal near-miss.Methods: A facility-based cross-sectional study was conducted in the department of obstetrics and gynecology in GMERS medical college and hospital, Sola, Ahmedabad from January 1, 2019 to August 31, 2019. All maternal near-miss cases admitted to the hospital during the study period were recruited. World Health Organization criteria were used to identify maternal near-miss cases. The number of maternal near-miss cases over one year per 1000 live births occurring during the same year was calculated to determine the incidence of maternal near-miss. Underlying and contributing causes of maternal near-miss were documented from each participant’s record.Results: During the period of study, 3235 deliveries were done at the institution while 16 cases of near-miss were identified. The prevalence of near-miss case in this study was 0.5%. Near-miss per 1000 delivery was 5%. Maternal death to near miss ratio was 1:2.67. The leading causes of maternal near miss were hypertensive disorders (62%) and haemorrhage (32%) The morbidity was high in un-booked cases.Conclusions: Maternal near miss is good alternative indicator of health care system. Efforts made toward improvement in the management of life-threatening obstetric complications could reduce the occurrence of maternal near-miss problems that occur during hospitalization.
Uterine rupture: a preventable obstetric catastrophe
Authors: Raval Bina M. , Patil Apoorva G. , Shah Parav D.
Published: December 2019

Background: Maternal health has long been acknowledged to be the cornerstone in public health. The objective of this study was to determine the incidence, etiology, risk factors, complications, treatment strategies, maternal and fetal outcome associated with uterine rupture and to determine how to decrease the maternal morbidity and mortality pertaining to it, as it is indeed a preventable obstetric catastrophe!Methods: This is a retrospective study which was carried out in our institute. Analysis of 45 cases of uterine rupture including scar dehiscence, registered/emergency, rupture occurring in the antepartum or intrapartum period, irrespective of previous vaginal or cesarean delivery was done between July 2017 to June 2019 out of 16,330 deliveries. None of the cases were excluded. Statistical analysis was done comparing the mortality in general population and study population and it was determined that it contributes to the maternal mortality significantly hence making it essential to promptly diagnose and treat the cases.Results: The incidence of rupture of uterus is average 0.27% (1 in 362). Out of 45 cases 9 (20%) were registered, and 36 (80%) were referred patients. The 20-30 years age group is the most vulnerable. Scarred uterus undergoing rupture were 34 (75.55%) as compared to rupture in intact uterus which were 11 (24.44%). The commonest modality of treatment used is suturing of tear which was done in 34 (75.55%) followed by total hysterectomy. There were 2 maternal deaths giving maternal mortality rate of 4.44% and perinatal mortality occurred in 18 (40%) cases.Conclusions: Uterine rupture is a dire emergency with a high incidence of maternal and fetal morbidity and mortality. Skilled attendance with accessible obstetric care, focused antenatal care, strict intrapartum monitoring and good surgical approach are key elements for the prevention and management of uterine rupture.
The burden of caesarean section and its determinants from a tertiary care hospital, Thrissur, Kerala, India
Authors: Baby Merin , V. Sruthi M.
Published: December 2019

Background: Caesarean section is a surgical procedure done when vaginal delivery is contraindicated. The prevalence of caesarean section in Kerala showing an increasing trend. Even though the caesarean section is an emergency lifesaving procedure, various other factors like socio-demographic determinants, economic factors and patient’s or clinician’s preferences also influence this increasing trend. The present study was undertaken to compare the various determinants of caesarean section with normal delivery from a tertiary care hospital in Thrissur district.Methods: A hospital-based case control study was done taking mothers who had undergone caesarean section as cases and mothers who had undergone normal delivery as controls during two-month period. The sample size was calculated using the formulae: (Zα + Zβ)2x2xPQ/d2, and the calculated sample size was 88. The various determinants used were socio-demographic, obstetrics and cultural determinants.Results: In this study, it was found that the most common indications for C-section were previous C-section, PPROM and foetal distress. There was a statistically significant association between obstetrics determinants like complications during pregnancy, number of USG taken, period of gestation with mode of delivery. The present study also shows that mothers with educational status up to graduate/PG have lesser incidence of caesarean section. There was a statistically significant association between delivery date close to holidays/festival days and C-section.Conclusions: It is necessary to have health awareness sessions to pregnant mothers about the complication of pregnancy, benefits of normal delivery and complications of C-sections in-order to reduce the patients’ preference for C-section.
Analysis of transfusion of blood and blood products and their utilization pattern at department of obstetrics of tertiary care hospital
Authors: Vasava Dipti C. , Thaker Rajal V. , Tyagi Aditi A. , Patel Foram P.
Published: December 2019

Background: In developing countries, nutritional anaemia and obstetric complications are leading causes of transfusion of blood and blood products. The study was aimed to analyse utilization pattern and to identify the indications of transfusion of blood and blood products in obstetrics and to study outcome and management of pregnancy in patients who required blood and/or blood products.Methods: This retrospective study was carried out at department of obstetrics of tertiary care teaching hospital from September 2018 to November 2018 and data was collected from all patients who had received transfusion of blood and/or blood products for any obstetric cause.Results: A total of 164(6.8%) patients received blood and blood products transfusion. Department of obstetrics utilized maximum units of blood and FFP whereas PRC utilization was second highest. There were 62(37.8%) of patients who had not taken any antenatal care, whereas 64(39.0%) patients had less than 4 antenatal visits. Three most common indications for transfusion of blood and blood products were 63.4% in nutritional anaemia, 17.1% in obstetric haemorrhage and 11.6% in first trimester complications.Conclusions: Three most common indications for transfusion were nutritional anaemia, obstetric haemorrhage and first trimester complications. Majority of patients had inadequate or no antenatal care. Early and regular antenatal care, early diagnosis and management of high-risk pregnancies and obstetric complications, institutional delivery can reduce the rate of transfusion of blood and blood products.
Study of maternal serum lipid profile and apolipoprotein a levels and its correlation with fetal growth restriction
Authors: Devi Akoijam Tamphasana , Yadav Reena , Yadav Amita , Singh Yanglem Ajitkumar
Published: December 2019

Background: This study was aimed to estimate maternal serum lipid profile and apolipoprotein A levels in pregnancies complicated with FGR and to compare the levels with the levels in normal pregnancies.Methods: A prospective observational study was conducted in Lady Hardinge Medical College, New Delhi, in a study group consisting of 30 pregnant women at gestation 32-34 weeks with ultrasound diagnosed FGR and control group consisting of 30 age and gestation matched uncomplicated pregnant women. Maternal serum lipid profile and apolipoprotein A levels were measured and compared between the two groups.Results: Total serum cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and Apolipoprotein A were significantly lower in FGR group compared to normal controls. Mean±SD of total cholesterol was found to be 199.17±49.06 mg/dl in cases and 244.10±53.17 mg/dl in controls. Mean±SD of triglyceride was 200.53±60.25 mg/dl in cases compared to 304.13±69.12 mg/dl in controls. Mean±SD of LDL-Cholesterol was 98.19±37.91 mg/dl in cases and 127.07±47.84 mg/dl in controls. Mean±SD of VLDL-cholesterol was 40.11±12.05 mg/dl in cases and 60.83±13.82 mg/dl in controls. Mean±SD of Apolipoprotein A was 147.71±16.40 mg/dl in cases compared to 163.30±16.07 mg/dl in controls. HDL-cholesterol did not change significantly as its mean±SD was 60.87±15.18 mg/dl in FGR group and 56.20±16.07 mg/dl in control group.Conclusions: The decreased levels of total cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and apolipoprotein A levels may be used as biochemical marker for detection of FGR.
Diagnostic accuracy of ultrasonography with laparoscopy for assessment of benign adnexal masses
Authors: Sarbhai Vinita , Yadav Medha
Published: December 2019

Background: Adnexal masses are one of the most common pathologies among women of all age groups. Objective of this study was to assess efficacy of ultrasonography in diagnosing adnexal pathology, rule out malignancy and its comparison with laparoscopy and pathology results.Methods: A total 32 women with benign adnexal mass were evaluated by clinical examination, ultrasonography and laparoscopy. Findings of ultrasound were compared with laparoscopy and histopathology reports and diagnostic accuracy was calculated.Results: Sensitivity of USG in diagnosing simple ovarian cyst is 20% and specificity is 88.9% while laparoscopy has sensitivity of 100% and specificity of 94.4%. USG versus laparoscopy has sensitivity of 50% versus 100% and specificity of 94.1% versus 100% in diagnosing endometrioma. Sensitivity of USG in diagnosing dermoid cyst is 66.7% and specificity is 95% while laparoscopy has both sensitivity and specificity of 100%. USG and laparoscopy, both have 100% sensitivity and specificity in diagnosing ectopic pregnancy, para-ovarian cyst and TO abscess. Benign serous cystadenoma is a histopathological diagnosis and is missed by both laparoscopy and ultrasonography.Conclusions: Ultrasonography should be the primary imaging modality used to identify and characterize adnexal masses, as it is readily available, and noninvasive.
Trends of caesarean section: an analytical overview of indications
Authors: Gavhane Shruti A. , Chaudhari Shilpa N.
Published: December 2019

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.
Complications and pregnancy outcome in women with preeclampsia and eclampsia
Authors: Thiripurasundari G. , Christe D. M. , Shobha S. , Sangeetha V. , Sevugaperumal Suganya
Published: December 2019

Background: One of the complications of pregnancy which till today challenges the obstetrician is preeclampsia and its severe form of eclampsia. Objective of this study was to find out the complications and outcome of pregnant women with preeclampsia and eclampsia admitted in a tertiary referral center.Methods: Case records, in labor room, were scrutinized to find out the number and the outcome of pregnancy, in women admitted with preeclampsia or eclampsia in the year 2018.Results: Pregnant women admitted with preeclampsia or eclampsia numbered 2511 and, 109 women developed complications. Maternal complications, were more often seen in mothers, (62.4%) of female babies. Only 37.6% of mothers of male babies developed complications. Complications seen were Renal complications in 34.8%, Hematological complications in 33%, Neurological complications in 25.6%, Pulmonary complications in 16.5%, ophthalmological complications in 11% and Sepsis in 6.4% and MODS in 10%. Of total maternal deaths, 34% was caused by complications of preeclampsia or eclampsia. Major cause of maternal death was MODS and Pulmonary complications. Nearly, 62.3% of babies born had birth weight of 1.8 kg and nearly one-third of babies (26.6%) were dead born.Conclusions: The incidence of preeclampsia and eclampsia in our referral center for the year 2018 was 15%, and 4.3% of women developed complications, and 6% died, making preeclampsia and eclampsia the causative factor for 34% of total maternal deaths. Major maternal complications were Renal, Hematological, Neurological, Pulmonary and MODS. Complications of preeclampsia were more often present in 62.4% mothers of female babies in contrast to 37.6% of mothers of male babies. Nearly one-third of babies (26.6%) were dead born.
A prospective study on maternal near miss cases at a tertiary care hospital
Authors: Das Karuna Kanta , Das Sasindra Kumar , Das Dhritimala
Published: December 2019

Background: Pregnant women’s health status is not only reflected by mortality indicators alone hence the concept of Severe Acute Maternal Morbidity (SAMM) is appropriate for present health providing system. It helps to evaluate the quality of obstetric care in a particular institute. The main objectives of the study were to find a) Incidence of MNMM; b) Disorders underlying MNMM; c) Socio-demographic variables among MNMM; d) Facilities and skills needed to handle these near miss situations.Methods: A prospective hospital-based study was conducted in the department of obstetrics and gynaecology, Gauhati Medical College and Hospital, Guwahati during the period 1st June 2018 to 31st May 2019. Cases were identified based on maternal near miss operational guidelines December 2014.Results: Out of 16222 live births, 241 near miss cases were identified during the study. The maternal near miss incidence ratio is 14.86 per 1000 live births. The maternal near miss to maternal mortality ratio is 2.025. Most common cause of MNMM is hemorrhage (48.54%) followed by hypertension (19.5%), anemia (13.28%), sepsis (10.37%), cardiac dysfunction (6.2%), liver dysfunction (0.83%), renal dysfunction (0.83%) and respiratory dysfunction (0.41%).Conclusions: The large magnitude of MNM cases may be attributed to improper management of obstetric emergencies at the referring hospitals, poor referral practices, inefficient transport system, limited availability of blood products and poor utilization of health care services at the peripheral hospitals. In our tertiary center, with the help of multidisciplinary action to all the near miss cases we can reduce maternal mortality to a great extent.
A study on feto-maternal outcome of intra hepatic cholestasis of pregnancy
Authors: Mitra Binay , Maji Debkalyan , Borse D. S.
Published: December 2019

Background: Intrahepatic cholestasis of pregnancy is one kind of the hepatic disorder which is unique to pregnancy. It is associated with many adverse pregnancy outcomes if doesn’t intervened at right time. It requires adequate clinico-biochemical correlation during management.Methods: A prospective observational study was conducted at multispecialty government zonal hospital. Total 137 IHCP patients were managed during the study period from 01 Jan 2017 to 30 Jun 2019. Incidence and pregnancy outcome in form of several maternal and fetal factors were analysed by appropriate statistical test using spps software version 20.0.Results: During the study period total 4872 patients were undergoing delivery and 137 patients were diagnosed with IHCP. The incidence of IHCP was 2.81%. Majority of cases 75 out 137 (54.74%) were nulligravida. Total 29.92% (41/137) cases were underwent LSCS delivery and of this 21.17% (29/137) were primary caesarean delivery. There were three still birth noted in IHCP study population. Total 28 cases (20.44%) of IHCP were presented with preterm labour. And NICU admissions of the study population were 32 new born babies (23.36%). 2.18% case of still birth was noted among study population.Conclusions: IHCP causes significant maternal and neonatal morbidity and is major contributor of preterm delivery, caesarean delivery, meconium stained liquor and NICU admission.
Healthcare workers’ knowledge and attitude towards prompt referral of women with postpartum haemorrhage in Nigeria: a community-based study
Authors: Olowokere Adekemi Eunice , Olajubu Aanuoluwapo Omobolanle , Ayeni Ifeoluwa Eunice , Aremu Olayinka Olaitan
Published: December 2019

Background: Postpartum Haemorrhage (PPH) is a major contributor to maternal mortality in developing countries most especially in the rural areas where Emergency Obstetric Care (EmOC) are not available. Delay in referring women from rural health facilities to settings where EmOC services are available have been reported. This study assessed community-based healthcare workers’ (CHWs) knowledge and attitude towards the prevention, early recognition and prompt referral of women with Post-Partum Haemorrhage (PPH) for Emergency Obstetric Care (EmOC).Methods: Descriptive cross-sectional design was used. Structured questionnaire was used to collect data from 200 CHWs recruited from community-based healthcare. Data analysis was done in SPSS version 20 at significance level of 0.05.Results: Findings show that 86.5% (n=173) of the respondents had good knowledge while 12% (n=24) and 1.5% (n=3) had moderate and poor knowledge respectively. Negative attitude towards prompt referral of women affected with PPH was found among 51% (n=102) of the respondents. Unavailability of blood drapes to estimate blood loss [χ2 (1, n=200) = 4.51, p=0.03], lack of ambulance [χ2 (1, n=200) = 4.46, p=0.03], and poor state of the roads [χ2 (1, n=200) = 4.44, p=0.03] were factors linked to poor attitude of CHWs towards prompt referral of affected women.Conclusions: The study concluded that there is a need for intervention that can help improve community healthcare workers’ attitude towards prompt referral of women affected with postpartum haemorrhage. There is also a need for general overhaul of community-based facilities to effectively support prompt referral.
Study of choices of contraception in postpartum women in a tertiary care institute in Mumbai, Maharashtra, India
Authors: Farogh Aliya , Palve Tushar
Published: December 2019

Background: This modern era talks about women strength and empowerment where they are working either equally or one step ahead of men. However, a fall back in making decisions for contraception use and family planning can still be observed. It is most frequently seen among women belonging to some village as they are exposed to a minimal health care. Keeping this in mind, this crucial period was considered as opportunity to test the issue regarding the various choices of contraception available. Objective of this study was to find out the criteria and methods of contraception selected by women in the postpartum period.Methods: A cross-sectional study in the department of obstetrics and gynaecology was conducted over a period of 11/2 years in which a total of 150 postpartum women were interrogated and counselled regarding various methods of contraception.Results: The contraceptive methods most commonly selected in postpartum period are PPIUCD, Barrier, tubal ligation and injectable contraception of which condom is the most common method adopted. The important factors responsible for the choice of contraception include parity, breast- feeding, education and socio-economic status of the women.Conclusions: Postpartum period is particularly important for initiating contraception as the largest proportion with unmet need of contraception is found among those in their first year after child birth. In order to space birth in a healthy manner postpartum contraception should be emphasized upon.
Manfort, a blend from plant extracts used for infertility treatment and improvement of testicular histology
Authors: Hussein Mahmoud Elnahas
Published: December 2019

Background: Flavonoids and polyphenols are groups of natural substances have variable phenolic configurations, many benefits as anti-inflammatory and anti-oxidants, and have many protective roles against male reproductive system disorders. Objective of this study was to study the safety as well as the efficacy of a blend from some plants extracts with precise ratios and rich with flavonoids and polyphenols named in this study as “Manfort” on the safety, fertility, and testicular histology in the male mice.Methods: Firstly, some mice were used to evaluate the safety of Manfort and the levels of the testosterone in the serum of the treated animals with Manfort using biochemical analysis. Also, the efficacy of the Manfort on the histological architectures of the treated testis was evaluated using histological techniques.Results: The mice treated with Manfort did not show any signs of mortality, toxicities and blood contents changes. Furthermore, testosterone levels in the serum elevated after administration with Manfort twice a day for 21 days compared with the non-treated mice. Additionally, the histological structures of the testis improved in the mice treated with Manfort compared with that in the non-treated animals.Conclusions: In general flavonoids and polyphenols, which were found in the Manfort diet in a large amount, have important role in as antioxidant, anti-inflammatory and improve the fertility in the male mice. In the future these data might be very important to manufacture a drug composed from safe natural products for infertility and intractable diseases treatment.
An empirical study on maternal and perinatal outcome of placenta previa-risk factors, morbidity and mortality in JNIMS, Imphal, India
Authors: Sanglakpam Haripriya Devi , Ng. Indrakumar Singh
Published: December 2019

Background: The observational study to analyse the maternal and perinatal outcome in pregnancies complicated with placental previa evaluating the potential risk factor, associated with morbidity and mortality.Methods: The study was a prospective longitudinal comprising of all the pregnant women after 28 week of gestation irrespective of gravid and parity that attended or admitted in the department of obstetrics and gynaecology, JNIMS, diagnosed as having placental previa by transabdominal ultrasonography and conducted for the period of 20 months i.e. from October 2017 to June 2019 analyzing 54 cases of placenta previa.Results: During this period there were total of 9967 deliveries with incidence of placenta previa being 0.54% in JNIMS, Porompat. The estimated risk factors out of total 54 cases were 20-30 (52%) years by age group, 25 (46%) gravida, 18 (32%) parity, 36 low lying placenta and 11 cases (20%) preterm.Conclusions: Highest levels of placenta previa are associated with poor maternal and perinatal outcome.
First and second trimester bleeding and pregnancy outcome: a prospective study in a tertiary government hospital
Authors: M. Chaithra , S. Anitha G. , Suresh Sukanya , C. Savitha
Published: December 2019

Background: Bleeding in first and second trimester of pregnancy is one of the common complications of pregnancy. there is evidence from various prospective and retrospective studies that first and second trimester vaginal bleeding which continue with pregnancy is associated with adverse pregnancy outcome, including preterm delivery, low birth weight babies, perinatal death and congenital anomalies. Objective of this study was to know the outcome of pregnancies who have bleeding in first and second trimester of pregnancy.Methods: This study was prospective study done in the department of obstetrics and gynaecology, Vanivilas Hospital, Bangalore from September 2018 to August 2019.Results: This study concludes that I trimester vaginal bleeding are at increased risk of abortion than in II trimester vaginal bleeding. Risk of placenta previa was more in II trimester vaginal bleeding than in I trimester vaginal bleeding.Conclusions: This study concludes that I trimester vaginal bleeding are at increased risk of abortion than in II trimester vaginal bleeding. Risk of placenta previa was more in II trimester vaginal bleeding than in I trimester vaginal bleeding. Bleeding in I trimester and II trimester call for special attention in view of increased risk of preterm birth and perinatal death. Recognition of these association will be useful for detection and follow up of pregnancies being at high risk.
Parturient satisfaction with labour epidural and factors affecting satisfaction scores: experiences from a tertiary centre in Southern India
Authors: George Leah Raju , Mani Thenmozhi , Rai Ekta
Published: December 2019

Background: Labour analgesia though widely practised is still not routinely administered to all parturients in India. We conducted this historical observational cross-sectional study to assess parturient knowledge and factors affecting satisfaction in those who received epidural labour analgesia; aiming at improving the services.Methods: All parturients requesting epidural labour analgesia have the catheter sited and the drug administered as per institutional protocols. A feedback form is given to these parturients, postnatally. The form consists of questions regarding her knowledge of and experience with labour analgesia, including her satisfaction score on a scale of 0 to 10. Author collected these forms and analyzed them along with information from the labour epidural register and the discharge summary.Results: The mean satisfaction score was 7.1 (SD- 2.28). 46 parturients (31.08%) had ‘low satisfaction’ (<7 score) and 102 parturients (68.9%) had ‘high satisfaction’ (≥7 score). The timing of initiation of epidural analgesia within the parturients expectations and adequate analgesia were two factors that were found to affect satisfaction scores, with statistically significant values (p=0.002 and p=0.006 respectively). Those with a very short or very long duration of labour analgesia, were more likely to give less satisfaction scores (p=0.023 and p=0.002). Only 30% of parturients had heard of labour analgesia in the past.Conclusions: In this setting good analgesia and receiving it on time are of utmost importance in those receiving epidural labor analgesia, emphasising the need for adequate analgesia and prompt initiation of the same.
Prevalence and characteristics of accidental perineal tears during childbirth in a communal medical center in Guinea-Conakry: a cross-sectional study
Authors: Bah Oumou Hawa , Diallo Boubacar Alpha , Soumah Aboubacar Fode Momo , Diallo Boubacar Siddi
Published: December 2019

Background: Prevalence studies are still rare in sub-Saharan Africa on perineal tears. We conducted this cross-sectional study in a communal hospital in Guinea-Conakry, with the objective of this study was to determining the prevalence and characteristics of post-obstetric perineal lesions.Methods: All deliveries between March 1st and August 31st, 2014 were reviewed. We included in the analysis all the single deliveries with perineal tears. The Anglo-Saxon classification of perineal tears was used.Results: The prevalence of perineal tears was 5.7% with 5.4% benign lesions and 0.3% severe lesions. We did not register 4th degree lesions. The average age of parturient was 22 years. The majority (96.6%) of parturient had a history of genital mutilation and perineal scarring (60.3%).Conclusions: This prevalence appear low compared to those reported in other studies in Africa and point to the need for more sophisticated studies to have a better estimate of the prevalence of perineal tears in Guinea-Conakry.
A study of clinical characteristics and outcome of obstetric patients in intensive care and high dependency unit of a tertiary centre of Jharkhand, India
Authors: Kamal Samarina , Singh Vandita , Singh Shashibala
Published: December 2019

Background: Few women during their pregnancy, labour and postnatal period require critical care related to the pregnancy itself, aggravation of a pre-existing illness and complications of the delivery. Pregnant patients account for a small number of ICU admission - 2-10% two main indications for admission are hypertensive disorders (17.2%-46%) and massive haemorrhage (10%-32.8%). The primary objective of the present study was to review the characteristics of the obstetric patients admitted to our ICU over a 2-year period.Methods: It was a prospective study conducted over 50 patients in high dependency and intensive care unit at Alam hospital over a period of 2 years (October 2014 to October 2016).Results: During the study period a total of 50 obstetric patients were transferred to the intensive care unit (ICU). Antenatal care played significant role in the obstetric outcome. 84% of patients transferred to the ICU during the study period had inadequate or no antenatal care, while 8% were booked in their pregnancy and had adequate antenatal care. ICU interventions included mechanical ventilation used in 20(40%) patients, blood and blood product transfusion in 35(70%) patients’ inotropes in 20 patients (40%) antihypertensive therapy in 20 patients (40%), arterial embolization in 2(4%) patients. Maternal mortality was seen in 10 patients (20%).Conclusions: There is a need for training in emergency obstetrics so that the complication can be managed right at the time of occurrence.
Suture granuloma masquerading as primary ovarian malignancy: a case report
Authors: Palo Seetu , N. Kanchana P. V.
Published: December 2019

Suture granuloma is an uncommon surgical complication comprising of foreign body granulomatous tissue reaction against the suture material. We present a case of ovarian suture granulomas in a 28-year-old female who was clinico-radiologically misdiagnosed as ovarian carcinoma. She presented with intermittent pelvic pain, on and off low-grade fever and menstrual irregularities for 6 months and had undergone laparoscopic tubectomy two years back. Ultrasonographic findings were suspicious of left ovarian malignancy. CA-125 levels were elevated (115 U/mL). Left oophoro-salpingectomy was performed and histopathological examination revealed multiple suture-related granulomas.
Successful outcome in a perplexing case of Roberts uterus: a rare uterine anomaly! A rare case report with review of literature
Authors: Singh Swati , Malik Renuka , Gupta Pooja , Ara Anjum
Published: December 2019

Robert uterus is a rare Mullerian development anomaly with very few cases reports available. It presents with triad of morphologic features of - Blind hemi cavity with or without unilateral hematometra, contralateral unicornuate uterine cavity and normal uterine fundus with or without small external indentation. The major difficulty lies in making the diagnosis of Robert’s uterus. All the reported cases of Robert’s uterus have been managed differently according to patient’s complaints. A 25-year-old married female, resident of Agra presented to gynecology OPD of Dr RML Hospital and associated PGIMER in June 2013, with primary infertility and cyclical left sided dysmenorrhoea since menarche. Patient was consulting at her hometown Agra for 2 years and had an USG and MRI pelvis report of Feb. 2013 with her showing unicornuate uterus with rudimentary horn. Infertility investigations were done in our hospital. HSG report was of localized spill on right with left tubal block. Patient was posted for diagnostic hystero-laproscopy which was further followed by laprotomy, after which we could reach to a diagnosis of Robert uterus with non-communicating left cavity and with severe endometriosis. Patient needed a second hysteroscopy for lysis of septum and subsequently conceived with IVF. She delivered a healthy male baby of 2.65 kg by elective LSCS at 37 weeks with associated breech presentation with gestational hypertension with severe IHCP on 20 June 2019. Paediatric surgeons and gynecologists should be aware of this rare atypical obstructive Mullerian malformation and its management to avoid inappropriate management delays in these patients. A timely diagnosis and definite treatment have a great impact on future reproductive and endocrine function.
A rare case of fetus papyraceous presenting in monozygotic biamniotic twins
Authors: S. Lakshmi , K. Rajkumar
Published: December 2019

Fetus papyraceous or compresses is characteristic of compressed mummified, parchment like remains of dead twin retained in utero after intrauterine death in the second trimester. It is an uncommon finding and we report in a G2P1L1 with 22 weeks with Monozygoticbiamniotic twins with fetus papyraceous stuck to left upper segment followed up to 36 weeks. The mother was advised regular antenatal visits and frequent feto-maternal monitoring was done. Patient delivered a single live baby and a placenta with mummified fetus within it. The incidence of fetus papyraceous is about 1 in 17000 to 1 in 20000 pregnancies. Early diagnosis of this condition helps in monitoring the surviving fetus.
Laparoscopic sleeve gastrectomy versus laparoscopic mini-gastric bypass and early metabolic outcome in super-obese patients
Authors: Shaker Nassar Mohammed Nazeeh , Eldin Abdallah Abdallah Salah , Anwar Hasan Hesham Wefky , Mohammed Ibrahim Aboulfotoh
Published: December 2019

Background: Bariatric surgery became the most popular choice in the management of obesity. Laparoscopic sleeve gastrostomy (LSG) and laparoscopic mini-gastric bypass (LMGB) has taken place in weight-loss and improvement in comorbidities.Methods: This was a retrospective cohort study with equal allocation included 112 super-obese patients with body mass index ≥50 kg/m2, which carried out in General Surgery department of Al-Azhar University Hospitals, between January 2016 and December 2018. 56 patients underwent LSG (Group A), and 56 patients underwent LMGB (Group B). Metabolic effect and weight loss outcomes were evaluated over one year.Results: Operative time was shorter in LSG than LMGB (64.3±33.32 min versus 70±37.24 min). There was a highly significant more weight loss in LSG than in LMGB at 6 and 12 months following the surgery. Also, improvement of type 2 diabetes mellitus, hypertension, hyperlipidemia, and quality of life occurred after 1 year in both surgeries.Conclusions: LSG and LMGB were better optimal procedures for super-obese patients with a comparable percent excess weight loss and improvement of associated comorbidities.
Study of evaluation of Alvarado scoring system in acute appendicitis
Authors: Puttaraju Shashidhara , D. Y. Deva Keerthana
Published: December 2019

Background: Acute appendicitis is one of the most common surgically correctable acute abdomen presenting at emergency department worldwide. Inspite of all advances in diagnostic modalities and surgical techniques, diagnosis remains difficult sometimes as a challenge and delayed decision making complicates this surgical disease. Alvarado scoring system is one of available scoring system for diagnosis of acute appendicitis, based on history, clinical examination, lab investigations and easy to apply, helps in clinical decision regarding planning surgery and avoid negative laparotomies. The aim of the study was to evaluate diagnostic accuracy of Alvarado scoring system in preoperative diagnosis of acute appendicitis and correlating with postoperative findings.Methods: This study was conducted in 100 cases of suspected appendicitis admitted in surgery department of Rajiv Gandhi Speciality Hospital, Agatti Island, Lakshadweep, Union territory of India, from July 2015 to June 2017 adopting Alvarado scoring system. Results were analyzed.Results: Out of 100 patients admitted with suspected acute appendicitis, number of cases operated suspecting acute appendicitis were 83 of which 80 were found to have acutely inflamed appendix. Results of Alvarado score of operated patients are as follows: 80 patients had score 7-10, and 3 patients had score 5-6, patients with Alvarado score <5 (17 pts) were managed conservatively.Conclusions: The Alvarado scoring system is a simple and useful diagnostic tool for diagnosis of acute appendicitis with acceptable sensitivity and specificity and can be used with high degree of accuracy. Our findings suggest that patients presenting with abdominal pain and Alvarado scores greater than 7 are more likely to have appendicitis.