bluuebunny/crossref_metadata_2025 huggingface dataset:
Conocimientos y prácticas de las mujeres gestantes con relación a las zoonosis por animales de compañía
Authors: Garaycochea Alejandra , León Daphne , Falcón Néstor
Published: February 2020

El objetivo del estudio fue determinar conocimientos y prácticas relacionadas a zoonosis transmitidas por animales de compañía entre mujeres gestantes que se atendían en el Instituto Nacional Materno Perinatal de Lima, Perú. Se utilizó una encuesta que incluyó información demográfica de la persona encuestada, tenencia y manejo de animales de compañía, y conocimientos y prácticas potencialmente asociados a transmisión de zoonosis. Se recabaron 250 encuestas. El 87.2 y 46.8% de las gestantes mencionó tener canes y gatos, respectivamente, y el 93.6 y 94.9% los utilizaban como animales de compañía, respectivamente. El 91.6% de las encuestadas manifestaron no conocer o haber escuchado la palabra zoonosis; sin embargo, el 82.8% manifestaron saber que existen enfermedades que se transmiten de los animales a las personas. El 57.2% de las encuestadas indicó que los animales de compañía pueden ocasionar problemas de salud durante el embarazo y el 44% consideró a los pelos como elemento de trasmisión de enfermedad. Las costumbres con los animales de compañía variaron entre las encuestadas, antes y después de estar gestando. El conocimiento de las principales enfermedades zoonóticas potencialmente transmisibles a mujeres gestantes y su forma de transmisión fue baja, a excepción de la rabia.
Habilidades sociales en Grupos de Estudio en la Facultad de Ciencias Veterinarias de la Universidad Nacional del Litoral (Esperanza, Santa Fe, Argentina)
Authors: Báez María Ludmila , Cadoche Lilian
Published: February 2020

Para acceder a una buena oferta laboral se debe estar capacitado para ello y la Universidad es uno de los pilares principales para cumplir este requisito, aunque su currículo debe ser complementada con otros aspectos como son el desarrollo de habilidades sociales. Un grupo de estudio debe poseer habilidades sociales básicas tales como trabajo en equipo, empatía, comunicación y liderazgo, entre otras. Los objetivos de esta investigación fueron: socializar entre los integrantes de cada Grupo de Estudio Dirigido de la Facultad de Ciencias Veterinarias las condiciones que identifican un equipo, describir desde la propia percepción de los integrantes de cada grupo sus habilidades sociales para integrar el grupo y las dificultades para que el mismo se constituya en equipo y realizar encuestas para conocer sus opiniones y poder ser evaluadas. Se puede concluir que hay una mayor valorización de la propia percepción del trabajo en equipo en los grupos funcionales. Se hace evidente la necesidad de diseñar por parte de las instituciones educativas un programa especial donde se comprometan con la tarea de implementar instancias de trabajo en equipo y espacios de interacción para mejorar la comunicación para generar, no solo profesionales exitosos en lo científico-técnico, sino también en lo social y afectivo, lo que redundará en un profesional capaz de relacionarse eficazmente con la comunidad.
Lithuanian Statistics in the Context of Celebrating the World Statistics Day
Authors: Markelevičius Jonas , Lapėnienė Vilija
Published: February 2020

On the 3rd of July, the United Nations General Assembly, taking into consideration the decision of the Statistical Commission, has adopted a Resolution wherein it was decided to designate 20 October 2010 as the World Statistics Day. Aiming to focus on the core values of statistics, such as quality services, in­tegrity and professionalism, the main topic of the celebration will be “Celebrating the many contribu­tions and achievements of official statistics”.

The official Lithuanian statistics meets the World Statistics Day not only by declaring but also by actually implementing the principles of statistics of a democratic state, complying with the standards of European statistics and satisfying the needs of na­tional and foreign users of statistics.

The article gives a brief overview of the path­ways of national statistics stretching 90 years back­wards, the development of statistical thought, statis­tical integration processes in democratic society, as well as discusses the significance of statistical capacity in preparing reliable and timely statistical information necessary to arrive at legitimate political decisions and to inform society, demonstrates the achievements of Lithuanian statistics over 20 years of independence, and mentions key statistical works to be implemented in the nearest future.
Statistical Survey on Household Consumption in the Context of Economic Growth and Decline
Authors: Molienė Ona , Misiūnas Algimantas
Published: February 2020

The article presents an in-depth analysis of household consumption expenditure in Lithuania in 2005−2008 through the use of not only traditional indicators and methods but also those proposed by the authors of the article. The results of the calcula­tions might be useful in the analysis of the efficiency of the poverty and social inequality reduction policy. The purpose of the article is to reflect the socioeco­nomic stratification of society and its changes across the country, in urban and rural areas. In the survey, different – identification, secondary grouping, sum­mary indicators, and index – methods were used. Tra­ditional and elementary statistical indicators – an arithmetic mean, a mode, and a median – were used for the assessment of the asymmetry of the distribu­tion of expenditure. In summarising structural differ­ences in consumption expenditure, it is proposed to use the Gateva integral coefficient of structural differ­ences; movement in this coefficient helps to reveal shifts in consumption patterns in household groups.

The analysis carried out confirmed the assump­tion that the outbreak of the economic crisis in 2008 had a negative impact on the level and structure of household consumption expenditure, which was stronger in case of urban than rural households.
Multidimensional Scaling in Market Research: Advantages and Disadvantages
Authors: Kėdaitienė Angelė , Kėdaitis Vytautas
Published: February 2020

Multidimensional scaling was developed by psychometricians, namely R. N. Shepard (1962) and J. B. Kruskal (1964). Its purpose is to deduce indirectly the dimensions a respondent uses to evaluate alterna­tives. The reason for using the indirect approach is that, in many cases, the attributes may be unknown and respondents may be unable or unwilling to repre­sent their reasons accurately. As already mentioned, multidimensional scaling requires an object-by-object similarity matrix as an input.

Initially popularized, however, multidimen­sional scaling relies on judged similarity. That is, re­spondents indicate how similar pairs of objects are directly rated (e.g. on a 1–10 scale). This can be a bur­densome task since for p objects p(p-1)/2judgments are needed. Still, the use of similarity judgments is relatively easy for respondents, especially when they cannot or do not want to reveal the basis for their opinion.

The results of multidimensional scaling depend on (a) the sample chosen to judge similarity and (b) the objects whose similarity is judged and the quality of input data. Multidimensional scaling derives dimen­sions that appear to be used by those rating a par­ticular set of objects.

The basic type of multidimensional scaling in­volves deducing graphical models of alternatives (e.g. brands) alone (simple space) from similarity data.

Some early applications of multidimensional scaling accepted apparent dimensions as “truth” without question or validation, which often proved to be disastrous. It is advisable to use multidimensional scaling as a generator of hypotheses rather than as a final model of the market. Any important result should be confirmed on a separate sample with a separate method, such as direct questioning, before the results are given too much credence.

Multidimensional scaling generates a configu­ration in which the relative positions of the brands are unique. The picture can be changed by several opera­tions without changing the relationship among the interpoint distance in some of the algorithms (as­suming the Euclidean distance is used, which it almost always is).

A major problem in data collection is the bur­den on respondents as the number of alternatives increases (e.g. 20 alternatives require 190 pairs). However, if respondents are “homogeneous”, it is possible to have different subjects rate a different pair.
Changes of Real Estate Sector in Context of Economy Lithuania
Authors: Misiūnas Algimantas
Published: February 2020

The paper analyses macroeconomic and financial ratios of Lithuanian enterprises (real estate enterprises) in the periodfrom 1998 to 2010. During the period in question, which was selected consciously and purposefully, Lithuanian economyexperienced two recessions: the first one took place after the Russian crisis 1998, the second one started in 2008, together with theglobal financial crisis. In the period between the two crises, a rapid economic development was observed.The efficiency is assessed using various financial ratios, reflecting various aspects of performance of an economic entity: itscapability to secure income, to perform profitably, to properly manage liabilities, to make proper use of available potential, to avoidjeopardising its further performance. Since no common methodology for the assessment of economic efficiency has been developedyet, it is offered to form an integral aggregate ratio to make possible the intercomparison of economic sectors and to determine thelevel of efficiency based on a set of financial ratios, not on each of them separately.
Lithuanian Consumers Expectations and Their Assessment
Authors: Misiūnas Algimantas , Jazukevičiūtė Rūta
Published: February 2020

In the first part of the paper the historical development of consumer expectations, the evolution and estimation of themain expectations theories, the impact of economical expectations various economic processes are reviewed through the analysis ofliterature. The second part of the paper presents consumers surveys that provide a possibility to evaluate and track consumerexpectations.After the analysis of literature the author carried out a study to model alternative methods that could reflect consumer’sexpectations. The results of consumer surveys in Lithuania were the main information source for the research. In the researchprocess, the author analyzed the fluctuations and compositions of consumer confidence indicators.The conclusions and recommendations summarize the main concepts of the analysis literature and the main results of theresearch performed. The results of the study could be useful to economic policy-makers, business representatives, analysts and otherpersons concerned.
Kernel Density Estimators for Gaussian Mixture Models
Authors: Ruzgas Tomas , Drulytė Indrė
Published: February 2020

The problem of nonparametric estimation of probability density function is considered. The performance of kernel estimators based on various common kernels and a new kernel K (see (14)) with both fixed and adaptive smoothing bandwidth is compared in terms of the symmetric mean absolute percentage error using the Monte Carlo method. The kernel K is everywhere positive but has lighter tails than the Gaussian density. Gaussian mixture models from a collection introduced by Marron and Wand (1992) are taken for Monte Carlo simulations. The adaptive kernel method outperforms the smoothing with a fixed bandwidth in the majority of models. The kernel K shows better performance for Gaussian mixtures with considerably overlapping components and multiple peaks (double claw distribution).
Prediction of Baltic Sectorial Share Price Indices
Authors: Rudzkis Rimantas , Valkavičienė Roma , Kvedaras Virmantas
Published: February 2020

Extending the research started in [31], the paper uses econometric methods for the short-term forecasting of quarterly values of sector indexes of stock prices from the OMX Baltic stock exchange. The ARMA models and modelling methodology that was used to build the statistical models in the previous paper are now augmented with the algorithms of time series aggregation and identification of special features of the series. Here, the search for informative factors relies on the study of related literature. The specification of models is further tailored using the traditional significance (p-value) analysis of regressors and a cross-validation analysis. The latter is implemented in this paper using the Jack-knife approach. The data period analysed covers the years 2000–2013. The results of the analysis indicate that the inclusion not only of recent autoregressive terms but also of some aggregated characteristics (as certain special features of indexes) improves the precision of forecasting substantially. The calculations were performed using the statistical analysis software SAS.
Poverty Dynamics in Lithuania: Persistence, Transitions, Triggers
Authors: Navickė Jekaterina
Published: February 2020

While Lithuania is among the countries with the highest at-risk-of-poverty rates in the European Union, povertyresearch has so far been dominated by cross-sectional poverty analysis. This paper is aimed at contributing to better understandingof poverty as a dynamic process in Lithuania by examining poverty risk persistence, transitions and triggers. Theanalysis is based on the longitudinal component of the Survey on Income and Living Conditions. The longitudinal at-risk-ofpovertyrate within the four-year panels is estimated to be at around a third of the Lithuanian population within a period of2005–2012. Poverty risk in Lithuania proved to be both widely spread and persistent. The major role of income events forpoverty risk entries and exits highlights the importance of activation into work, especially as concerns secondary householdearners and better income protection in Lithuania. While no robust evidence of poverty penalty was found for poverty exits,the incidence of poverty re-entries within the initial three-year period after poverty exit substantially exceeds poverty entryrates in the general population.
Evaluation of the Shadow Economy and Informal Employment Trends in Lithuania
Authors: Pocius Arūnas
Published: February 2020

The author analyses the state of the shadow economy, informal employment and their trends based on differentstatistical calculation methodologies and survey data. The evaluation of the situation in Lithuania is based on the data of StatisticsLithuania, State Social Insurance Fund Board (SODRA), special surveys and results of statistical calculations. According to researchexperience, the methodological issues of evaluation of informal employment are discussed. Assiduous attention is paid to theevaluation and the scope of the shadow economy and the comparative analysis of informal employment issues in the EU. Whileassessing the trends in the shadow economy, the indicators from the research of different authors or institutions are compared usingdifferent calculation methods – to determine relative trends in the shadow economy.
Sensitivity Analysis of the TOPSIS Method in Respect of Initial Data Distributions
Authors: Simanavičienė Rūta , Petraitytė Vaida
Published: February 2020

The present article investigates the sensitivity of the multiple criteria decision-making method TOPSIS in respectof attribute probability distributions. To carry out research, initial data – attribute values – were generated according to anormal, log-normal, uniform, and beta distributions. Decision matrixes were constructed from the generated data. Byapplying the TOPSIS method to the matrixes generated, result samples were received. A statistical analysis was conductedfor the results obtained, which revealed that the distributions of the initial data comply with the distributions of the resultsreceived by the TOPSIS method. According to the most common alternative rank value, it was ascertained that the TOPSISmethod is the most sensitive for data distribution according to beta distribution, and the least sensitive for data distributionaccording to lognormal distribution.
Estimation of Parameters and Verification of Statistical Hypotheses for Gaussian Models of Stock Price
Authors: Marushkevych Dmytro , Munchak Yevheniia
Published: February 2020

We construct models of asset prices on the Ukrainian stock market and analyse their applicability by checkingappropriate statistical hypotheses using actual observed data. We also analyse the presence of jumps in the dynamics ofdifferent assets and estimate the Hurst coefficient for the logarithm of the price of the asset by two different methods.
Nelson-Siegel Model Approach to the Euro Area Yield Curves
Authors: Mazanauskaitė Akvilė
Published: February 2020

In this paper Nelson-Siegel model has been examined. The main purpose of this paper is to fit the best Nelson-Siegel model to the Euro Area yield curves and to compare with Lithuanian yields in order to draw conclusions about readiness of Lithuania to join the Euro Area. In order to succeed in achieving the goal, Euro Area zero coupon bonds have been examined and various static Nelson-Siegel models were developed. Also, the mean of absolute errorof the Lithuanian government treasury bills was calculated using the best-fitting Nelson-Siegel model of the Euro Areayields. The results have shown that if the static model is calculated for each year, the yield are described precisely in the model.
A JANGAR-CHAPTER CHANTED BY THE BAARIN KHUURCH RINCHIN
Authors: Chaogetu  , Sarina  , Birtalan Ágnes
Published: February 2020

In the present paper, one chapter of theJangarepic, chanted by the famous storyteller,khuurchRinchin of Inner-Mongolian Baarin origin, is discussed from two main points of view: (1) the spread ofJangaramong Mongols not belonging to Oirats and Kalmyks, and (2) how contemporary social circumstances transform the traditional heroic epic into another folkloric genre, i.e. the so-calledkhuuriin ülger. The chapter ‘Minggan, the Beauty of the World’ told bykhuurchRinchin—discussed here—is well known from otherJangarpublications like the ‘Mingyan the Beauty of the World’ (published in the Thirteen ChaptersJangar/Jinggar:Takil ǰula qaγan-u üledel Tangsuγ bumba qaγan-u ači Üǰüng aldar qaγan-u köbegün üye-in önöčin Jingγar-un tuγuǰi arban γurban bölög). The life story of Rinchin and his creative innovation in traditional folklore genres are typical phenomena of the contemporary transitional period in preserving and sustaining folklore genres and performance.
A drum, deferred
Authors: Gazit Ofer
Published: February 2020

During the 1960s, West African musicians rattled the New York jazz scene, bringing new sounds to late-night jam sessions, recording studios, and jazz festivals. Jazz scholars have interpreted musical imaginations of Africa by American jazz musicians as a sign of pan-African solidarity and cultural affinity among musicians of African and Afrodiasporic ancestry. While these studies have been important in identifying the political implications of such collaborations for African American musicians, they underplay the complex positioning of West African immigrants in these contexts and the social and musical gaps that separate African immigrants from their American counterparts. Drawing on my work with composer and percussionist Solomon Ilori, one of the leading Yoruba musicians in New York and amongst the last living exponents of the African jazz scene of the 1960s, I use the notion of décalage to explore how linguistic, social and historical gaps are articulated in musical recordings and public concerts in the 1960s African jazz scene in New York. Originally coined by Léopold Senghor to describe a sense of discrepancy between Africans and African Americans, décalage allows me to show how different perceptions of time, as well as choice of repertoire, instrumentation, rhythmic patterns and melodic material complicate a notion of musical pan-Africanism. Moreover, it explicates the unique ways in which African immigrants reacted socially and musically to the boundaries they face in the US and its particular formations of national, racial and musical identity.
Recoged la cosecha
Authors: Balabarca Cárdenas Yvan Martín
Published: February 2020

El autor exhorta a todos los que están comprometidos en la Misión de Evangelizar el mundo a no tener miedo por los números. Sin embargo, considera que la única manera de alcazaar los altos blancos será a través de  hombres y mujeres consagrados enteramente a Dios y que le permitan al Espíritu Santo trabajar a través de ellos. Luego, insiste que el éxito evangelístico demanda mucha energía y trabajo.
Empatía y creencias irracionales en internos por delito contra la libertad sexual de un instituto penitenciario de Lima Este
Authors: Quinteros Zúñiga Dámaris , Jara Cueto Rudy Mijael , Casariego More Lisseth Brigitte
Published: February 2020

La presente investigación consiste en analizar la relación entre las variables “empatía” y “creencias irracionales.” Su diseño es no-experimental, de corte transversal y alcance correlacional. La muestra estuvo compuesta por 127 internos de un centro penitenciario de Lima Este, cuya edad supera los 18 años y se encuentran recluidos por delitos contra la libertad sexual. Los instrumentos utilizados para la recolección de datos fueron la Escala de Reactividad Interpersonal de Davis (1980) y el Registro de Opiniones de Davis, McKay y Eshelman (1987). Los resultados pusieron en evidencia que la relación significativa inversa entre empatía y creencias irracionales de competencia absoluta y continuidad de efectos (p<0.05). No obstante, no se halló relación significativa entre empatía y las creencias irracionales de afecto y aprobación, relatividad de los actos, expectativas sociales y control externo (p>0.05). En consecuencia, se afirma que la empatía está vinculada de manera inversa a la autosuficiencia generada por la creencia de ser absolutamente competente y el inadecuado afrontamiento de experiencias del pasado.
Relación entre el dominio de la comprensión de lectura y la resolución de problemas matemáticos en estudiantes del sexto grado de primaria de la IE Mariscal Ramón Castilla, UGEL 06 de Vitarte
Authors: Rodriguez Cieza Liliana
Published: February 2020

La presente investigación intenta relacionar los conceptos de comprensión de lectura y la resolución de problemas matemáticos en los alumnos del sexto grado de educación primaria de la Institución Educativa Mariscal Ramón Castilla, de Ñaña (Lima), durante el año 2017. La población se compuso de 120 estudiantes del mencionado centro educativo, a los cuales se les aplicó la CLP (Prueba de complejidad lingüística progresiva) – forma A, con el objetivo de medir el nivel de comprensión lectora de los alumnos. Asimismo, se les aplicó una prueba de resolución de problemas matemáticos (de María Bastiand) de la UNMSM. A fin de relacionar los resultados de la comprensión lectora con la resolución de problemas matemáticos, se utilizó el software estadístico SPSS v24 y el Currículo Nacional de Educación Básica. Se resolvió que la relación entre la comprensión inferencial y la resolución de problemas matemáticos, según el coeficiente de correlación de Spearman es igual a 0.266; esto indica una relación positiva y directa, donde el p valor es igual a 0.038 (p<0.05). Asimismo, en el nivel literal de comprensión se reveló que no existe relación condicionante con la resolución de problemas matemáticos, pues el valor del estadístico es igual a 0.092, y el valor p es igual a 3.20 (p>0.05). Este resultado indica que la relación no es significativa.
New Research on Housing and Territorial Stigma: Introduction to the Thematic Issue
Authors: Smets Peer , Kusenbach Margarethe
Published: February 2020

This introduction to the thematic issue on housing and territorial stigma provides concise overviews of the concepts of stigma, housing stigma, and territorial (or neighborhood) stigma, while tracing back current research on these topics to the pioneering work of Erving Goffman and Loic Wacquant. In doing this, we place particular attention on social responses to, and coping strategies with, stigma, especially various forms of stigma resistance. Finally, in brief summaries of all articles in the thematic issue, we emphasize their shared themes and concerns.
Teen Food Insecurity: Finding Solutions through the Voices of Teens
Authors: Burris Mecca , Bradley Sarah , Rykiel Kayla , Himmelgreen David
Published: February 2020

Teens are vulnerable to food insecurity for both biological and social reasons. This study aimed to better understand the factors that underpin teen food insecurity and the coping strategies teens employ when faced with limited food access and hunger. A sociodemographic survey including the USDA's Self-Administered Food Security Survey Module for Children Ages 12 Years and Older, focus groups, and photovoice were used to collect data on the demographics, food insecurity prevalence, and experiences of food insecurity among thirty-eight teens from five different communities in Tampa Bay, Florida. Results showed that approximately 44 percent of teens were food insecure. Factors that associated with food insecurity included: (1) negative perceptions of food quality, food options, school administration, food waste, and food assistance utilization; (2) school and programming issues including the timing of meals, portion sizes, and regulations associated with food and access; (3) stigma and bullying; and (4) socioeconomics. Teens relied on their communities (e.g., friends, churches), illegal activities (e.g., stealing), cheap and unhealthy foods, jobs, or their teachers to cope with food insecurity. The findings highlight significant opportunities for food security interventions that target the unique nutritional needs and social experiences of adolescents. The study was funded by the county Juvenile Welfare Board.
Attainment of menstrual hygiene by girls in boarding secondary schools in a state in Sub-Saharan Africa
Authors: Inyang Etoh Emmanuel C. , Ekanem Uwemedimbuk S. , Umoiyoho Aniefiok J.
Published: February 2020

Background: Menarche is the most dramatic manifestation of puberty in girls; unlike the biometric developmental changes that occur at puberty, menarche requires the personal adjustment and response of an affected girl in order to attain good menstrual hygiene. This study was designed to evaluate how boarding secondary school girls manage their menstruation in school, away from the guidance of their parents.Methods: A cross sectional survey was performed in four public boarding secondary schools in the study area with the aid of structured questionnaires to evaluate how such girls manage their menstruation while in school.Results: The study population was 975 girls whose survey revealed the mean age at menarche of 12.5±1.4 years.  Seven hundred and two (72.0%) respondents had received sexuality education before onset of menarche. Respondents who attained good menstrual hygiene were 775(79.5%). Such respondents were those who had received sexuality education (p<0.001) and those who had access to synthetic sanitary pad (p=0.005). Duration of the menstrual period and the volume of menstrual blood loss did not affect (p=0.219) the ability of respondents to attain good menstrual hygiene. Respondents who received sexuality education had about 605 chances of attaining good menstrual hygiene than those who did not receive such education.Conclusions: A vast majority of the respondents had received sexuality education before onset of menarche and a larger proportion attained good menstrual hygiene. Major factors that positively influenced the girls’ capacity to attained good menstrual hygiene were prior sexuality education and access to synthetic sanitary pad.
Effectiveness of ursodeoxycholic acid therapy in intrahepatic cholestatsis of pregnancy
Authors: Pitale Devdatt I. , Jadhav Sujata N.
Published: February 2020

Background: Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy specific disorder and commonly presents with maternal pruritus, abnormal liver function tests and adverse maternal -foetal outcomes. ICP lacks protocol-based therapy as etiology is multifactorial and is based on symptomatic treatment. The overall incidence of ICP is variable from 0.1 to 15.6% worldwide. The aim of this study is to assess the effectiveness of UDCA in ICP with regards to reduction in pruritus, normalizing LFTs and maternal-foetal outcomes.Methods: This multicentric prospective study was performed from June 2017 to December 2019 in pregnant women with ICP attending the Antenatal clinic at INHS Patanjali, MH Dehradun, INHS Asvini, INHS Sandhani. In this study, 50 women with ICP. who satisfied the inclusion and exclusion criteria were started on UDCA therapy. The effectiveness of therapy was evaluated on the basis of normalization of LFT levels, reduction in pruritus, safe confinement, maternal-foetal outcomes and adverse effects if anyResults: The pregnant women with ICP on UDCA therapy showed marked improvement in pruritus, near normal LFT levels. After the UDCA therapy the frequency and intensity of pruritus was reduced in 50 (100%) of women. Safe confinement was achieved, with normal delivery in 45 (90%) women with no any major adverse effects and adverse maternal-foetal outcomes.Conclusions: This study shows the effectiveness of URCA therapy in reducing the ICP associated pruritus, normalizing LFTs and safe confinement without any major adverse effects. UDCA therapy is an effective and safe option in ICP.
Polycystic ovarian syndrome among adolescent and young women: a hospital based observational study in a tertiary care teaching Hospital
Authors: Jain Arpita , Garg Swati , Sharma Urvashi
Published: February 2020

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorder among women of fertile age. The incidence of PCOS as claimed by various observer ranges from 2.2% to as high as 26%. India is considered as an emerging epidemic area for PCOS and limited studies are done. Hence aim of this study is to find the prevalence of PCOS and determine the associated determining factors in adolescent girls.Methods: All the girls aged 15-24 years were approached and after undergoing detailed history, examination and investigations were further diagnosed as PCOS. The study subjects were then classified into two group: the PCOS and non-PCOS group and compared to determine significant differences as per the Rotterdam criteria.Results: The prevalence of PCOS was 7.5%, 18.68% and 11.18% as per NIH, Rotterdam and AES criteria respectively. BMI more than 30, waist circumference > 80 cm, hyperandrogenic manifestations, menstrual irregularity (oligomenorrhea) and family history of PCOS and DM showed statistically significant association with PCOS. Serum LH, LH/FSH ratio, S. Testosterones, serum insulin and HOMA-IR had significant association with PCOS. No significant association of Fasting blood sugar levels and deranged lipid profile was found with PCOS.Conclusions: PCOS is an emerging disorder during adolescents and hence awareness creation, early screening in order to inculcate early life style modifications and prevent metabolic and reproductive complications of this disease.
Antenatal service utilization among women in South India: a community based cross sectional study
Authors: K. Chethana , Anil Manjula , Nelliyanil Maria
Published: February 2020

Background: Antenatal period is important for identifying pregnancy related threats and antenatal care (ANC) is one of the most effective health interventions during this period. It provides a unique opportunity for screening and diagnosis, health promotion and disease prevention. This study assessed the antenatal service utilization pattern and its determinants among women.Methods: A community based cross sectional study was conducted in the field practice area of a teaching hospital in Mangalore. Study included 142 women who had delivered in the last one year in the study area, selected using snowball sampling method. A pretested semi-structured validated questionnaire was used to collect the data. Predictors of full ANC were identified using univariate analysis and explanatory variables were entered into multivariate regression model to obtain the adjusted odds ratios to find the association between full ANC coverage and its determinants.Results: Among the participants, 99.3% registered their pregnancy and 78.9% had early registration. Majority, 91.5% had minimum antenatal visits, 83.1% consumed iron and folic acid supplements for more than three months and tetanus toxoid (TT) coverage was 98.6%. Full ANC coverage was found to be 81% and unadjusted analysis showed higher odds of full ANC coverage among housewives, primiparous, women in joint family and among literates. However, multi variable analysis revealed literacy as the major determinant of full ANC.Conclusions: In the present study, majority of the women had adequate antenatal care utilization. Full antenatal coverage was found to be statistically significant among literate women.
Study on knowledge, attitude and practice of ante-natal care among pregnant women attending antenatal tertiary care institution
Authors: Sitalakshmi Vuppu , Bavyasri Pothu , Talapala Rajyalakshmi , Kopperla Manjula
Published: February 2020

Background: The primary aim of antenatal care is to achieve a healthy mother and baby. Antenatal care helps to identify the complications and to remove anxiety and dread associated with delivery. Current study designed to assess knowledge, attitude and ante natal care practice among pregnant women attending to antenatal tertiary care hospital.Methods: A cross-sectional study was conducted on 500 pregnant women attending antenatal care centre at department of obstetrics and genecology, Narayana Medical College and Hospital, Nellore during June 2017 to June 2019 under Narayana Mathru Seva Pathakam. Face to face interview was conducted to assess their knowledge, attitude and practice using a structured questionnaire.Results: A total 86% belongs to 20-29 years age group and 71.4% belongs to multiverdia. 20.6% women responded that they had completed 3 antenatal visits, 26.6% are those who thought that at least more than 5 ANC checkup should be done during pregnancy. 96.1% pregnant responded that registration for antennal care and visits is essential. 87.2% responds to take iron and folate during pregnancy and 11% responds does not taken the same. 92% pregnant responded that tetanus toxoid (TT) should be given during pregnancy but 3.2% told don’t know. When they asked about resting period, 24.2% responded 5-6 hours, 35.4% responded 7-8 hours, 35.6% responded > 8 hours per day to rest they are taking. 55.8% pregnant responded that they had taken decision to give birth the baby in the hospital. 71.2% pregnant females reported that they knew about the danger signs during pregnancy. The reasons for not attending antenatal check-up were financial reasons, illiterate (15.4%), transport and unaware about ANC.Conclusions: Information, education and communication activities should be increased on ANC through community campaign and mass media to motivate women to utilize maternal care services.
Frequency and management of gestational diabetes mellitus according to the new diabetes in pregnancy study group of India guidelines among Sikkimese women attending tertiary teaching hospital of East Sikkim
Authors: Singh Kirti , Rahman Hafizur
Published: February 2020

Background: The screening of GDM is important as various pregnancy related complications are associated to it. With early screening and diagnosis, the complications associated with GDM can be reduced. Studies have shown various ethnic groups are at increasing risk of developing GDM with prevalence differing in different ethnicity. No data is available about frequency of GDM in different ethnic women of Sikkim. This study was performed to determine the frequency of GDM and its variation according to different demographic profiles of Sikkimese women.Methods: Pregnant women between 16-34 weeks of gestation, attending antenatal OPD were included for this study. All the patients were subjected to DIPSI recommended 75 gm oral glucose tolerance test. Diagnosis of impaired glucose tolerance was made when plasma glucose of ≥120-140 mg/dl and diagnosis of GDM was made when the plasma glucose of >140 mg/dl as per DIPSI guidelines.Results: A total of 202 consenting pregnant women during 16-34 weeks of pregnancy were evaluated with DIPSI recommended 75 g oral glucose tolerance test. Overall frequency of GDM was 11.9% among the Sikkimese women while 10.9% had impaired results in OGTT.Conclusions: Frequency of GDM was high (12%) in pregnant women attending tertiary hospital of Sikkim. This implies Sikkimese women should be universally screened for GDM. There was also high occurrence of GDM among Lepcha and Bhutia women which need further study to find out the contributing factors in these women.
Comparison of safety and efficacy of Ormeloxifene and Norethisterone acetate in the treatment of heavy menstrual bleeding
Authors: Juneja Sunil Kumar , Tandon Pooja , Kaur Gagandeep
Published: February 2020

Background: Menorrhagia (menstrual blood loss more than 80% per cycle) affects 10-33% of women at some stage of their lives. Medical management is the first line of therapy for menorrhagia (heavy menstrual bleeding: HMB). Progestins have been found to be very effective in the management of heavy menstrual bleeding especially during acute episodes, norethisterone acetate being widely used for the same. Ormeloxifene is a new drug with promising results in managing HMB. The study was undertaken to compare the efficacy, safety and acceptability of Ormeloxifene /Norethisterone acetate in the medical management of heavy menstrual bleeding.Methods: This was a retrospective study conducted from January 2016 till December 2018 in which 98 women of reproductive age group presented with abnormal uterine bleeding without any organic, systematic and iatrogenic causes. The patients were divided into 2 groups. Those wanting contraception along with control of HMB were assigned to Group O and given Ormeloxifene and others were given norethisterone (Group N). The primary outcomes measured were menstrual blood loss assessed subjectively by patients and ultrasonography for endometrial thickness. The secondary outcomes measured were acceptability and side effects of Ormeloxifene and norethisterone.Results: There is a significant reduction in menstrual blood loss as evidenced by the history of patients recorded on follow up and there was a significant reduction in the endometrial thickness as evidenced on follow up scan at the end of 3-4 months. no major side effects were observed with both the drugs.Conclusions: Ormeloxifene in comparison to norethisterone acetate with its effectiveness, significant results, convenient dosages schedule and no major side effects is an effective and safe alternative medical management of HMB.
Successful conservative surgical management of ovarian mucinous cystadenoma with silent torsion in pregnancy: a case report
Authors: De Arpita , Tripathi Reva
Published: February 2020

To report the successful conservative surgical management of Ovarian mucinous cystadenoma with silent torsion in a 24 years old pregnant woman in a tertiary care center in Delhi. An antenatal woman came for a routine visit to the OPD of the hospital at 13 weeks gestation. She had a vague, mild pain in lower abdomen since the last four weeks. A cystic mass was discovered during an abdominal examination. Further on sonography, a multisepatated cystic mass was seen, likely to be mucinous cystadenoma. Routine tumor markers came out to be negative. A laparotomy was planned at 15 weeks. On laparotomy a 20 × 15 cm multiloculated cyst with one and half turns of torsion was found. Detorsion, cystectomy of the intact cyst followed by ovarian reconstruction was done after due consent. On histopathological examination the cyst was found to be Benign mucinous cystadenoma. The pregnancy continued without any adverse effects. The woman delivered vaginally at 38 weeks without any feto-maternal complications. She was able to conceive again spontaneously at 18 months post-delivery. After 16 weeks of gestation in the second pregnancy she went to her home town and no further follow-up was possible. This case emphasizes the importance of a thorough examination in all pregnant woman to rule out any adnexal mass separate from the gravid uterus. Big ovarian masses in pregnancy, if not diagnosed can cause growth retardation, preterm deliveries, acute abdomen due to infection, rupture or torsion. Sonography, MRI and tumor markers can facilitate diagnosis before surgery. Torsion and rupture of mucinous cystadenoma need prompt surgery. Wherever possible conservative surgery (detorsion and cystectomy) should be done especially in young women.
Chronic non puerperal uterine inversion due to submucosal fibroid: a rare case report
Authors: Dulewad Shirish , Haritha Chitikala
Published: February 2020

Chronic uterine inversion is a very rare and often difficult to distinguish between uterovaginal prolapse, submucous fibroid and cervical fibroid. Its diagnosis is based on high index of suspicion. A 50-year-old Para-3Live-3 tubectomised postmenopausal women with k/c/o psychiatric illness, resident R/0 Jambhrun, Mudhkhed came to our hospital with a complaint of irreducible mass protruding per vaginum since 2-3 months duration Subsequently vaginal hysterectomy has been done. The certainty of diagnosis of inverted uterus reached intraoperatively. Gross examination of cut uterus showed fundally located sub-mucous fibroid and specimen sent for histo-pathological report. Non puerperal chronic inversion of uterus is rare condition occurring in approximately 17% of all uterine inversions and most uterine inversions are acute and puerperal. Its incidence is 1/30,000 deliveries and is considered a serious complication of child birth. Most common factor causing inversion -> prolapse and extrusion of fibroids1 especially submucous myoma of fundus (80-85%). Its diagnosis should be considered at any age in post-menopausal period. Superinfection of the infected part should be suspected and treated with appropriate broad-spectrum antibiotics before the surgery.
A rare case of caesarean scar ectopic pregnancy: a case report
Authors: B. Hiremath P. , Anandabaskar Vinothini , Arthi Nivedhana , E. Rohini , R. Indu N.
Published: February 2020

Scar ectopic pregnancy is a condition where the gestational sac implants into the previous caesarean scar site. Although it is a rare entity, its incidence is increasing due to rising rates of caesarean deliveries. Here authors report a case of caesarean scar ectopic pregnancy managed by laparotomy with caesarean scar ectopic excision following failed medical management. The patient recovered without any intraoperative or postoperative complications. An early diagnosis and management are vital in preventing maternal morbidity and mortality.
A prospective hospital based study of relation between carotid artery intimal medial thickness in patients with type 1 diabetes
Authors: Noor Huma , Khan Imran , Bashir Iftikhar , Shaheen Feroze , Gul Sabeeha
Published: February 2020

Background: The aim of this study was to found association between Type 1 Diabetes Mellitus and Carotid Arterial Intimal Thickness (CIMT).Methods: Study design: It was a prospective case control hospital-based study. One hundred type 1 diabetes patient between the age group 3-36 years were taken. The association between type 1 diabetes with CIMT was studied. All the measurements were standardized. 50 age and sex matched controls were taken for comparison.Results: There is positive correlation between type 1 diabetes and CIMT (p<0.0001). The correlation further extends between duration of diabetes, glycemic control, age of onset, frequency and severity of diabetic related complication with CIMT.Conclusions: Carotid atherosclerosis as measured by CIMT has definite association with type 1 diabetes.
Management and outcome of post-traumatic cerebrospinal fluid rhinorrhea
Authors: Ismail Nasiru Jinjiri , Lasseini Ali , Koko Aliyu Muhammad , Shehu Bello Bala
Published: February 2020

Background: Post-traumatic cerebrospinal fluid (CSF) rhinorrhea are relatively uncommon neurosurgical condition that is associated with serious morbidity and life-threatening complications like meningitis. As such, it requires prompt and thorough evaluation and treatment. Is of note that, only few studies discussed CSF rhinorrhea in literature especially in sub-Saharan Africa. This study was designed to report outcomes of management of post-traumatic CSF rhinorrhea seen in our institution.Methods: Relevant data of all patients with post-traumatic CSF rhinorrhea managed from July 2015 to June 2019 were retrospectively reviewed.Results: Out of the total 1942 cases of head injury managed over the study period 20 cases (1%) were diagnosed with CSF rhinorrhea. The mean age of presentation was 30.5 years. All patients were male and road traffic accidents was the only aetiological factor noted. Majority of patients developed rhinorrhea after 48 hours of injury (12/20). Pneumocephalus was the commonest computerised tomographic scan finding and about 2/3rd of the patients required operative treatment by transcranial anterior cranial fossa repair (13/20). The remaining patients were managed non-operatively with acetazolamide, antihistamines, stool softeners and antibiotics. The outcome was generally good with no recurrence noted. The rate of mortality was 10% (2/20) and resulted from meningitis.Conclusions: Posttraumatic CSF rhinorrhea was seen in 1% of cases of head injury in our environment and affects males predominantly. Although, the outcome of treatments was good, 10% mortality caused by meningitis was recorded.
The study of association of fetal and maternal factors in the occurrence of hyperbilirubinemia in early neonatal period
Authors: Goyal Megha , Srivastava Anshuman
Published: February 2020

Background: Hyperbilirubinemia in neonates is considered to be one of the common phenomena which generally occurs during the first week of life and usually leads to NICU admission in both term and preterm new-born babies. It is also regarded as one of the most common causes which leads to neonatal morbidity and mortality.Methods: A total of 100 neonates along with their mothers were enrolled in the study from time period between 2018 to March 2019. Newborns were assessed daily for the jaundice and serum bilirubin levels were done. Various fetal-maternal factors included in proforma were. analysed to find out the association of feto-maternal factors in the occurrence of significant neonatal hyperbilirubinemia. Two groups, group A <15.7 mg/dl and group B>=15.7 mg/dl were taken. For data analysis chi square test is applied and p-value is calculated.Results: Statistically significant association between total serum bilirubin with neonatal factors like birth weight (p<0.014), maturity (p<0.011), period of gestation (p<0.003), and heart rate abnormality (p<0.005) and maternal factors like age in years (p<0.05), oral contraceptive pills use (p<0.005),  and anti-epileptics use (p<0.034) were found to be linked to neonatal hyperbilirubinemia.Conclusions: Neonatal jaundice should be considered as the main policy in all health care settings of the country. Therefore, identification of factors affecting the incidence of jaundice can be effective in preventing susceptible predisposing factors in new-borns and high-risk mothers.