bluuebunny/crossref_metadata_2025 huggingface dataset:
Comportamento sedentário associado ao tempo de tela em acadêmicos de Educação Física
Authors: Martins Jéssica Dos Santos , Torres Michele Gonçalves Romcy , Alves de Oliveira Rayane
Published: July 2017

Introdução: Atualmente o tempo de tela é importante indicador de atividades sedentárias. A explosão nos últimos anos de acesso à internet e o avanço da tecnologia vem contribuindo significativamente para o comportamento sedentário. A premissa é que quanto maior for o tempo de tela, menor será a prática de atividade física. Objetivo: Investigar o comportamento sedentário associado ao tempo de tela em acadêmicos de Educação Física. Métodos: Estudo de delineamento transversal e natureza quantitativa realizado nas Instituições de Ensino Superior reconhecidas pelo Ministério de Educação (MEC) e com sede própria na capital de Fortaleza e Região Metropolitana do Ceará. Para investigação do nível de atividade física e comportamento sedentário foi utilizado o Questionário Internacional de Atividade Física (IPAQ - versão curta) e para investigação do tempo de tela, questionário semiestruturado com perguntas relacionadas ao tempo despendido na utilização de televisão, videogame, computador (tablets; ipad e outros tipos de computador portátil) e celular. Resultados: Participaram do estudo 887 acadêmicos de Educação Física, sendo 600 (67,6%) do sexo masculino.  A maior parte da amostra foi de acadêmicos com idades entre 19 e 23 anos, do turno da noite e que trabalhavam. A prevalência de comportamento sedentário nos acadêmicos que apresentavam tempo sentado superior a ≥ 6 horas semanais foi de 94,6% e sua associação foi positiva quando relacionado ao tempo de tela. Conclusões: O comportamento sedentário esteve diretamente associado ao tempo de tela. Desta forma, estudos que associem diversos fatores e indicadores de tempo de tela tornam-se importantes para direcionamentos futuros de políticas públicas voltadas à saúde e combate ao comportamento sedentário.
Vascular dementia and the cholinergic pathways
Authors: Engelhardt Eliasz , Moreira Denise Madeira , Laks Jerson
Published: July 2017

Abstract Vascular cognitive impairment/vascular dementia have been the subject of a large number of studies, due to their high prevalence and broad preventive and compensatory therapeutic potential. The knowledge of the cerebral anatomy correlated to the vascular territories of irrigation enables understanding of clinical manifestations, as well as classification into the several types of syndromic presentations. The central cholinergic system exercises important neuromodulatory functions on cerebral circuits related to cognitive and behavioral integration, as well as on vasomotor control related to cerebral blood flow adjustments. The acquisition of data on the anatomy of the cholinergic pathways, including the localization of the nuclei of the basal prosencephalon and the routes of their projections, established an important milestone. The knowledge of the vascular distribution and of the trajectories of the cholinergic pathways allows identification of the strategic points where a vascular lesion can cause interruption. The ensuing denervation leads to cholinergic hypofunction in the involved territories. This information proves important to better evaluate the sites of vascular lesions, emphasizing their strategic localizations in relation to the cholinergic pathways, and offering more robust foundations for treatment aiming at enhancing cholinergic activity.
Brief cognitive battery in the diagnosis of mild Alzheimer's disease in subjects with medium and high levels of education
Authors: Nitrini Ricardo , Caramelli Paulo , Porto Claudia Sellitto , Charchat-Fichman Helenice , Formigoni Ana Paula , Carthery-Goulart Maria Teresa , Otero Carla , Prandini João Carlos
Published: July 2017

Abstract There has been an increasing trend to utilize short cognitive batteries for the diagnosis of dementia. Most of these batteries have been designed in countries with high standards of education and are less suitable for populations with low levels of education. We developed a battery that has been previously shown to be highly accurate in the diagnosis of dementia in individuals with low levels of education. The accuracy of this battery for patients with higher levels of education is unknown. Objectives: To evaluate the accuracy of a brief cognitive battery in the diagnosis of Alzheimer's disease (AD) in subjects with medium and high levels of schooling, and to develop a mathematical model that includes the most discriminative tests. Methods: Seventy-three mildly demented patients with probable AD and 94 control subjects were evaluated. Sixty patients and 60 controls were randomly selected to generate a mathematical model including the most discriminative tests of the battery using logistic regression. The model was back-tested for the remaining sample of patients and controls. Results: Delayed recall, learning and category fluency tests were included in a mathematical model that obtained an area of 0.917 in the ROC curve in the back-testing. Inter-rater reliabilities of these tests were high (kappa>0.8). Conclusions: This model showed a high accuracy for the diagnosis of mild AD in patients with medium and high educational levels. Future studies with more heterogeneously educated individuals are necessary to investigate whether the educational level (number of years at school) should also be included in the model.
The influence of schooling on cognitive screening test in the elderly
Authors: Christofoletti Gustavo , Oliani Merlyn Mércia , Stella Florindo , Gobbi Sebastião , Gobbi Lílian Teresa Bucken
Published: July 2017

Abstract Introduction: Tests for screening cognitive functions are gaining importance with the increasing incidence and prevalence of demential syndromes. For our elderly population, the challenge is to develop neuropsychological tests independent from the influence of educational level. Objective: To compare the influence of education on the elderly with or without cognitive decline, on the Brief Cognitive Screening Battery (BCSB). Methods: We studied 176 elderly people: 60 with cognitive decline (aged 73.6±9.3 years and with 5.7±0.7 years of education) and 116 without cognitive impairments (aged 73.4±0.6 years and with 5.6±0.5 years of education). The BCSB was applied in all subjects. The data were submitted to descriptive statistics and analyzed by Independent Student test with 95% confidence intervals. Results: The data showed that the BCSB is an appropriate battery for identifying cognitive status in normal elderly individuals, as well as cognitive decline in our elderly sample. The BCSB items were not significantly influenced by schooling years, making this test favorable for different groups characterized by illiterate individuals, as well as by those with low or high levels of formal education. Conclusion: The BCSB proved to be a useful cognitive screening test for old people with or without cognitive decline independent of their educational level.
Diagnosis and rehabilitation attempt of a patient with acquired dyslexia
Authors: Carthery-Goulart Maria Teresa , Senaha Mirna Lie Hosogi
Published: July 2017

Abstract Although dyslexia is a common consequence of brain damage there are few studies about the rehabilitation of this disorder. Cognitive Neuropsychology models of reading have been used to describe several syndromes of acquired dyslexia. Phonological dyslexia is a reading disorder characterized by a dysfunctional grapheme-to-phoneme conversion procedure, which affects the ability to read low frequency words and nonwords. Lexical reading is preserved and patients can read frequent words (regular and irregular). Objective: Verify the application of the cognitive model in the characterization of the reading disorder of a patient with acquired dyslexia and in the devising and implementation of a rehabilitation plan. Methods: This study presents OCS, a 57-year-old patient who suffered from acquired phonological dyslexia after a left temporo-parietooccipital ischemic stroke. A rehabilitation program based on the principles of Cognitive Neuropsychology was devised non-words and low frequency words with controlled lengths were used and the patient was stimulated to read them aloud in a 22-session treatment. Results: The post-test evaluation showed quantitative and qualitative improvements Significant improvements were verified in the total number of correct responses including self-correction attempts (p<0.01) and in the reading of trisyllabic and polysyllabic non-words of simple syllabic structure (p=0.0007 and p=0.02 respectively). Conclusions: The use of the cognitive model to devise a rehabilitation program was successful and we observed significant improvement of reading skills in a short period of treatment. The achievements over this period provided the patient with functional reading performance.
Hepatocyte Nuclear Factor-1β Controls Mitochondrial Respiration in Renal Tubular Cells
Authors: Casemayou Audrey , Fournel Audren , Bagattin Alessia , Schanstra Joost , Belliere Julie , Decramer Stéphane , Marsal Dimitri , Gillet Marion , Chassaing Nicolas , Huart Antoine , Pontoglio Marco , Knauf Claude , Bascands Jean-Loup , Chauveau Dominique , Faguer Stanislas
Published: July 2017

AKI is a frequent condition that involves renal microcirculation impairment, infiltration of inflammatory cells with local production of proinflammatory cytokines, and subsequent epithelial disorders and mitochondrial dysfunction. Peroxisome proliferator-activated receptor γ coactivator 1-α (PPARGC1A), a coactivator of the transcription factor PPAR-γ that controls mitochondrial biogenesis and function, has a pivotal role in the early dysfunction of the proximal tubule and the subsequent renal repair. Here, we evaluated the potential role of hepatocyte nuclear factor–1β (HNF-1β) in regulating PPARGC1A expression in AKI. In mice, endotoxin injection to induce AKI also induced early and transient inflammation and PPARGC1A inhibition, which overlapped with downregulation of the HNF-1β transcriptional network. In vitro, exposure of proximal tubule cells to the inflammatory cytokines IFN-γ and TNF-α led to inhibition of HNF-1β transcriptional activity. Moreover, inhibition of HNF-1β significantly reduced PPARGC1A expression and altered mitochondrial morphology and respiration in proximal tubule cells. Chromatin immunoprecipitation assays and PCR analysis confirmed HNF-1β binding to the Ppargc1a promoter in mouse kidneys. We also demonstrated downregulation of renal PPARGC1A expression in a patient with an HNF1B germinal mutation. Thus, we propose that HNF-1β links extracellular inflammatory signals to mitochondrial dysfunction during AKI partly via PPARGC1A signaling. Our findings further strengthen the view of HNF1B-related nephropathy as a mitochondrial disorder in adulthood.
From superstition to folk medicine
Authors: Comelles Josep M.
Published: July 2017

n/a
Ecologies of evidence in a mysterious epidemic
Authors: Briggs Charles L.
Published: July 2017

An epidemic in a Venezuelan rainforest in 2007-2008 killed 38 children and young adults, puzzling clinicians, epidemiologists, and healers alike for over a year. This essay traces the way each contribution to knowledge production formed part of a larger ecology of evidence. Focusing on how the parents' knowledge was exploited and denigrated by clinicians, epidemiologists, and healers alike points to the health/communicative inequities—grossly unequal distributions of access to the production and circulation of evidence—that structured ecologies of evidence in ways that thwarted diagnosis. Recruiting a nurse, a healer, a physician, and an anthropologist, two indigenous leaders launched an investigation that juxtaposed parents' narratives, vernacular healing, epidemiology, and clinical medicine, resulting in a clinical diagnosis of bat-transmitted rabies. This case suggests that perspectives in global health will fail to become fully critical unless they attend to health/communicative inequities, how they structure ecologies of evidence, and strategies for transforming them.
The work of evidence in critical global health
Authors: Adams Vincanne , Biehl João
Published: July 2017

This special section critically examines the paradigms and values that undergird the ever-expanding field of global health. The richly textured ethnographic think pieces presented here tackle problems of evidence and efficacy as complex forms of ethical and theoretical engagement in contexts of neoliberalism, war, technological innovation, inequality, and structural violence. These works seek to contribute to a people-centered and politically relevant social theory for the twenty-first century.
Images of hospices on social media
Authors: Borgstrom Erica
Published: July 2017

n/a
Am I fine?
Authors: Offersen Sara Marie Hebsgaard , Risør Mette Bech , Vedsted Peter , Andersen Rikke Sand
Published: July 2017

Woven into the fabric of human existence is the possibility of death and suffering from disease. This essential vulnerability calls forth processes of meaning making, of grappling with uncertainty and morality. In this article we explore the uncertainty and ambiguity that exists in the space between bodily sensations and symptoms of illness. Bodily sensations have the potential to become symptoms of disease or to be absorbed into ordinariness, prompting the question: how do we ascribe meaning to sensations? In the context of middle-class everyday life in Denmark, we show how different potentialities of ambiguous sensations are weighed against each other on a culturally and morally contingent continuum between normal and not normal, uncovering the complex interplay between the body, everyday life, and pervasive biomedical discourses focusing on health promotion, symptom awareness, and care seeking.
Regimes of freshness
Authors: Friedrich Alexander , Höhne Stefan
Published: July 2017

Today, it seems that nearly every aspect of life is affected by cryogenic techniques: we cool our food, environments, drugs, organs, eggs, milk, semen, tissue, blood and much more. Our central argument is that these developments lead to the formation of a new form of life, which in many ways is the antipode of what Agamben calls bare life. In analyzing the emergence of cryogenic culture from a biopower point of view, this study offers a new perspective on how populations are fostered and governed through regimes of freshness. While the history of chilled and frozen food slowly gains increasing attention in historical and cultural studies, the historical dynamics of the cryopolitical economy in the network society still need to be explored. Biotechnology, encompassing food production as well as assisted reproductive technology (ART), currently emerges as a most important apparatus (dispositif) of governing populations. It should be understood as a means of ‘biopower’ because it not only contributes to reproducing life but also helps to improve and preserve it. Highly dependent on refrigeration, modern biopower invents a new type of life, which is technologically self-sustained: this is the cryogenic culture. In our paper, we trace the emergence and dissemination of what we call cryogenic life – meaning the ways of producing, distributing, maintaining and dispositioning organic matter via cooling, chilling and freezing. With the introduction of artificial coldness in the late nineteenth century and the expansion of the cold chain, these techniques have become a constitutive element of modern biopower.
Constructing landscapes
Authors: Winchester Margaret , King Brian
Published: July 2017

The concept of therapeutic landscapes has been adopted from geography by anthropologists with a similar commitment to addressing the intersections between the construction of place and the multifaceted and symbolic dimensions of health. Drawing from health geography and medical anthropology, we take up the challenge from these fields to approach health broadly in order to understand how health decision making is connected to intersecting political, economic, social, and cultural processes that shape what options are available to people. This article presents findings from an ongoing study of the political ecology of health in northeastern South Africa. We consider how therapeutic landscapes are produced by physical infrastructure, social dynamics, and the use of natural resources for livelihoods and health management. While each of these dimensions is critical in shaping human health, we argue that it is through their interaction that therapeutic landscapes are produced. Landscapes of care are thus complicated and shifting, with rural households making strategic decisions to leverage government support, social support, and resources for health management. We conclude by emphasizing the need for further integration of anthropological and geographic frameworks in studying human health.
Is there a pathological way of ageing?
Authors: Cloos Patrick
Published: July 2017

This think piece discusses ‘Alzheimer’s disease’ from a critical anthropological perspective. I aim to challenge the taken-for-granted biomedical framing in four steps. First, a brief genealogical account shows that Alzheimer’s disease as a biomedical category has only recently become a public and global health preoccupation. Second, the concept of medicalization is mobilized to illustrate the construction of and the uncertainty around this new medical object. Third, I build a case for analysing this medical category within a sociocultural context. Finally, a brief account of the relevance of social intervention is given.
Traces of the future
Authors: Abi-Rached Joelle M.
Published: July 2017

n/a
A reflection on medical anthropology and epidemiology
Authors: Janes Craig R.
Published: July 2017

n/a
Sobre la Paz Pública
Authors: Pinzón Cerbeleón
Published: July 2017

En su célebre viaje a las mansiones celestes, encontró Mahoma en el sétimo cielo “compuesto todo de clarísima luz, un ánjel de setenta mil cabezas; cada cabeza tenía otras tantas bocas, cada boca setenta mil lenguas, i cada lengua hablaba setenta mil idiomas con que alababa las glorias del Señor.” ¿Por qué no existe en el Mundo de Colon un políglota semejante que dia i noche pregone las alabanzas i las glorias de la paz? Podrá observárseme que este vocero celestial seria innecesario, no habiendo hoi en el Nuevo Mundo quien no conozca la necesidad i las ventajas de la paz. Tal observacion careceria desde luego de fuerza. Que el ánjel de la paz pudiera en nuestras Repúblicas predicar en un desierto, se concibe; pero que su voz no fuese necesaria en ellas, puede al ménos ponerse en duda. Los hispano-americanos, en teoría todos somos partidarios de la paz; pero en la práctica, es lo cierto que la paz desaparece frecuentemen te, sin saberse cómo, de entre las manos de sus amigos entusiastas.
Mathematical simulation of the Vertical solar still (VSS) production with the external reflector
Authors: Mohammed Ahmed
Published: July 2017

In this work, a vertical solar still was constructed in Basra city in Iraq. Anexperimental achievement was carried out on two solar stills under the same conditions.Also, each still has one evaporative side. The still contains a basin with the total area of(0.125 m2). The still basin covers with a piece of black cotton cloth wet with brackishwater. In addition, one of the still was provided with an external reflector, in order toreflect the direct sunlight to the absorber surface. The solar still was prepared fromavailable local materials. We found in this experimental study that the efficiency withoutany improvement vertical solar still is (17.6 %) and increases to (38.2 %) by usingvertical solar still with external reflector of the day 17 July 2012.
The Approximate Solutions of Helmholtz and Coupled Helmholtz Equations on Cantor Sets within Local Fractional Operator
Authors: Jassim Hassan
Published: July 2017

In this paper, we proposed local fractional Laplace decomposition method to solve the

Helmholtz and coupled Helmholtz equations on Cantor sets within local fractional

operator. The approximate solutions are obtained by using the local fractional Laplace

decomposition method, which is the coupling method of local fractional Laplace

transform and Adomian decomposition method. Illustrative examples are included to

demonstrate the high accuracy and fast convergence of this new method.
A Novel Hybrid Technique for Exchange Rate Forecasting
Authors: Salah Abbas , Rashid Tarik , Shareef Shareef
Published: July 2017

Exchange rate prices play a significant role in economic and financial systems. Theprecise forecasting of the exchange rate will aid to predict the situations of otheraspects in the future. This offers useful information for economist traders to fulfill vitalactions to eliminate risks that might lead to financial losses. One vital and commonapproach for forecasting is a quantitative technique. The quantitative technique is splitinto two approaches; fundamental and technical analysis. Both approaches have onedifferent, which is the economic factor. The fundamental analysis uses economicfactors while the other not, but both of them have drawbacks. In fundamentaltechnique, the forecasters cannot understand the economic factors totally, the valuesand quantity of the factors unstable, while the technical analysis neglects the factorstotally. This paper suggests a new technique which is appeared to be as a hybridized ofthe both techniques for forecasting exchange rate prices to overcome the issuesmentioned above. The proposed technique makes new factors that have real values andhave a real impact on the accurate result. It also derives the inputs and factors in theprediction models by a feature extraction technique which produces very accurateresults.
Forming of an innovative design of industry clusters as basis of preventive crisis regional management
Authors: MERZLIKINA G. S. , PSHENICHNIKOV I. V.
Published: July 2017

Significant institutional weaknesses of the formation of the management structure of an industry cluster are revealed, the possibility of engineering new structures of governance based on the principles of innovative management is identified. Feature of industrial clusters is the need and necessity of innovation that permeates all structures of the cluster management and all the processes of cluster management and, in turn, creates the preconditions for the formation of business entities the ability to successfully overcome a crisis situation. The purpose of the work is to develop the improved construction of innovational sectorial clustering with the use of effective centralized system of management of cluster business processes, based on diffusion of innovational technologies and their production embodiment. A typical structure of sectorial cluster management does not allow determining goals, tasks, tools, and mechanisms of innovational development of sectorial cluster’s enterprises. Drawbacks of the typical structure of sectorial cluster management are as follows: lack of representation of the scheme of cooperation between cluster members and external environment, format of development of interrelations between cluster’s elements in the sphere of information exchange, movement of material flows and financial resources, lack of formed areas of responsibility and matrices of competences of cluster members in various scenarios of development of external environment.

The “structural imbalance” in the system of management of sectorial cluster is determined, which consists in elaboration of production and functional structure and “fuzziness” of responsibility for cluster activities efficiency. The use of the improved innovational construction of sectorial cluster management will eliminate structural imbalance in the process of management of sectorial clusters and increase effectiveness of their activities under the conditions of turbulent development of external environment.
Modern information technologies as an imperative of effective anti-crisis management
Authors: SOLDATENKOV V. YU.
Published: July 2017

There are shown actual issues of applying modern information technologies to provide effective anti-crisis management. There has been analyzed aspects of using Internet resources to assess the counterparty’s (debtor’s) insolvency (bankruptcy) risk.
“Promoting Cities as Places of Promise”: Remarks at the Annual Meeting of the Coalition of Urban and Metropolitan Universities Washington, D.C., October 23, 2016
Authors: Ruble Blair A.
Published: July 2017

What does it mean for a city to be a place of promise?
Student Success for All: Support for Low-Income Students at an Urban Public University
Authors: Potter Mark
Published: July 2017

Although federal financial aid has increased in recent years, the costs of college tuition and living expenses have increased even more, leaving larger numbers of students with unmet need. Restructuring of financial aid, however, is insufficient to address the problem of diverging attainment gaps between low-income students and their more advantaged peers. Low-income students share patterns and traits that put them at greater risk of dropping out of college. In response, the Lumina Foundation published the report Beyond Financial Aid, which identifies six strategies for supporting low-income students, offers examples of how those strategies may be implemented, and provides an institutional self-assessment tool. At Metropolitan State University of Denver, a cross-functional team of faculty and staff at MSU Denver gained considerable insight by using and discussing the Beyond Financial Aid assessment tool. The action plan that emerged from the team’s work consists of five goals: Take advantage of easy wins; use data to know our low-income students; increase broad-based support for low-income students; foster culture change; and enhance financial literacy. Additionally, MSU Denver has leveraged partnerships to strengthen support for its low-income students as a natural extension of the University’s regional stewardship mission.
Undergraduate Student Research Opportunities and Economic Revitalization through Urban Agriculture Initiatives
Authors: Schläppi Michael R.
Published: July 2017

Through interactions with the recently formed Cooperative of the Institute of Urban Agriculture and Nutrition (CIUAN), a catalyst initiative co-governed by community organizations and academia to engage in mutually beneficial research and teaching projects, Marquette University in Milwaukee, Wisconsin, is supporting community efforts to bring healthy food to urban environments. This paper will discuss an innovative model, Sustainable Research and Economic Developmenet model, to involve undergraduate students in interdisciplinary community-based research exploring pathways for urban agriculture and urban farmers markets to turn blighted properties into gardens, or rice paddies, as part of a larger metropolitan community economic development effort.
Conceptualizing Community Engagement: Starting a Campus-Wide Dialogue
Authors: Starke Anthony M. , Shenouda Keristiena , Smith-Howell Deborah
Published: July 2017

Institutions of higher education are increasingly compelled to produce evidence that illustrates their contribution to society. In this age of demonstrating value added, self-assessment is critical for urban and metropolitan universities. This study will explore the design and implementation of a landscape analysis – phase one of an in-depth self-assessment – at the University of Nebraska at Omaha (UNO). This process is intended to help universities gain a better understanding of how community engagement is conceptualized and institutionalized on their campus. A thorough understanding of the meaning of, and linguistics associated with, community engagement is imperative for the creation of community engagement measurement and assessment mechanisms. The authors will share the methodology and key findings, which include the discovery of domains of community engagement and acknowledgement of a spectrum of engagement.
Charting Ahead: Navigating Threats and Challenges to the Urban-Serving Research University Mission
Authors: Zerquera Desiree D. , Doran Erin E.
Published: July 2017

The higher education context that our CUMU institutions must navigate is complex and begets challenges resulting from the distinct mission our institutions seek to uphold. The implications of these challenges give rise to impacts on everyone within the institution and consequently our constituents within the cities we seek to serve. Bringing together literature, emerging research, and points from discussions at the 2016 CUMU conference, this paper analyzes challenges and their implications and highlights the strategies being employed to navigate them. We consider the tensions inherent in the urban-serving university identity, the cost of serving urban regions, and the state structures that provide funding. All of these tensions have implications for commitment to mission, access for historically marginalized students, and the experiences of faculty within the institution. We also discuss strategic initiatives and efforts that reflect collaboration, strategic alignment, and innovation. This work is of value for those working within urban-serving universities, those who work to uphold their mission in higher education, and policy makers that shape the context of these institutions’ work.
Charting the Future of Metropolitan Universities: The 2016 CUMU Annual Conference
Authors: Villarreal Mary Ann
Published: July 2017

Charting the Future of Metropolitan Universities: The 2016 CUMU Annual Conference
Extraperitoneal versus transperitoneal cesarean section in surgical morbidity in a tertiary care centre
Authors: S. Bebincy D. , J. Chitra
Published: July 2017

Background: To test the advantages of extraperitoneal cesarean section over transperitoneal cesarean section.Methods: It is a single blinded prospective study. Women who were planned for emergency LSCS in the department of OG, Kanyakumari Government Medical College, Asaripallam were randomly allocated into extraperitoneal cesarean section (ECS) (n=80) or transperitoneal cesarean section (TCS) (n=80) from November 2015 to January 2017 and evaluated.Results: Even though the time taken to deliver the baby was more in ECS group (Average 4:57 minutes) than TCS group (Average 2:05 minutes, there is no change in Apgar score at 1 minute. The postoperative pain measured by VAS was lesser (4.28) in ECS than TCS (7.06). Bowel function returned early in ECS (8.687 hours) than in TCS (16.487 hours) group. None of the cases in ECS group had peroperative vomiting or post-operative wound infection.Conclusions: So, we can conclude that ECS is a better method in experienced hands than the TCS in selected cases.
A study of glycemic control with diet in women with gestational diabetes mellitus
Authors: Kanani Medha , Leuva Bakul
Published: July 2017

Background: Gestational diabetes (GDM) represents carbohydrate intolerance first discovered in pregnancy, occurs in 3.8-21% of pregnancies. Postpartum glucose intolerance returns to normal in majority. However, there is high risk of developing impaired glucose tolerance or overt diabetes mellitus later in life. Balanced diet at proper time can help achieving glycemic control. It also helps women with GDM to avoid need for insulin reducing costs of treatment.Methods: Study was done in Dhiraj Hospital in Obstetrics and Gynecology department. Study duration was 1.5 years. It was a prospective study comprising of patients who came with raised blood glucose levels on their 1st visit.Results: Prevalence of GDM (2.87%) is observed to be comparable to various other centres. Highest number of GDM cases was observed in age group of 26-30 years (62.96%). Control of glycemia with diet could be achieved in majority of women (53.85%) at 3 months post-partum as reflected by FBS levels. Incidence of Macrosomia (29.63%) and LSCS (77.78%) could not be lessened by glycemic control with diet in women with GDM.Conclusions: Prevalence of GDM was comparable to that of other studies. Rate of caesarean section was very high and main indications being foetal distress and cephalopelvic disproportion. Maternal and perinatal morbidity increases as duration of GDM increases. Control of glycemia with dietary treatment can help reduce occurrence of complications in mother and baby. It requires proper compliance, absence of which calls for need of insulin in most of patients with uncontrolled glycemia since first.
PCOS in adolescence: effect of metformin on menstrual irregularities
Authors: Sontakke Bhavana Vaikunth
Published: July 2017

Background: PCOS is an endocrine disorder affecting women across lifespan, initially a disease of the females in the child bearing age group, nowadays maximum adolescent females also present with PCOS. Adolescence PCOS is a heterogenous endocrine disorder diagnosed in 5% to 10% of adolescent girls and is one of the major causes of adolescent hyperandrogenism and menstrual irregularity. Thus, this study was carried out to study the effect of Metformin on adolescent patients with PCOS on Weight reduction and Regularization of Menstrual cycle. Secondary objective is to study the occurrences of various manifestations in patients with PCOS.Methods: Patients aged 10-20 years diagnosed PCOS attending the outpatient department of OBGY over a period of two years were included in the study. Out of 100 patients, 20 patients were excluded because of other causes of anovulation viz thyroid abnormalities, prolactin level abnormalities and patients who did not turn up for follow up. Study was done on 80 patients of PCOS. Patients were divided into two groups A and B. Group A (n=40) received 500 mgs Metformin and Group B (n=40) received placebo. Results were analysed using statistical package of social sciences (SPSS) 21.0. Statistical significance was set at p ≤0.05.Results: In the present study Irregular cycle was the commonest occurring menstrual irregularity. Menstrual Cycle was regularised in 95% of the study group while only 35% of the control group. 85% patients in the present test group had lost weight at the end of 6 months while only 55% in the control group had lost weight in 6 months. Thus A 6-month course of metformin improves menstrual cyclicity in women with the PCOS.Conclusions: In patients with PCOS, the addition of insulin sensitizers viz metformin along with diet and lifestyle modifications has resulted in significant weight loss and improvement in cyclicity of menstrual cycle. Thus, Insulin-sensitizing agents provide a rational approach to the treatment of the metabolic and endocrine abnormalities in PCOS women
Perception and correlates of excessive vaginal discharge in rural women
Authors: Mammen Sheena A. , Singh Shavinder , Rajesh Isaac , Goyal Sunita
Published: July 2017

Background: Vaginal discharge is one of the most common symptoms of gynecological morbidity. Vaginitis is the most prevalent cause. Gynecological disorders have substantial impact on female health and behaviour. Recent evidence suggests that the association between the complaint of vaginal discharge and the presence of Reproductive Tract Infections is weak. Women who are overanxious, introspective or suffering from fears of venereal disease and cancer tend to exaggerate the complaint of vaginal discharge into something pathological. The objective of the study was to study rural women’s perception and health care seeking behaviour regarding excessive vaginal discharge. To study various psychological and biological correlates of excessive vaginal dischargeMethods: This was a community based cross sectional study, conducted in the rural field practice areas under the Department of Community Medicine, Christian Medical College, Ludhiana. House to house surveys were conducted with semi-structured questionnaire and GAD 7 (Generalised Anxiety Disorder) scale, using systematic random sampling.Results: 160 rural women were interviewed to collect data. Of them, 27.5% reported having excessive vaginal discharge. There was no association observed between menstrual hygiene methods and excessive vaginal discharge (p= 0.77). Association couldn’t be observed with selection of barrier and other non-barrier methods of contraception (p= 0.09) either. Statistically significant association was observed between presence of anxiety and vaginal discharge (p=0.01).Conclusions: All vaginal discharges are not pathological. Causative factor of excessive vaginal discharge may not be infections always. There was a statistically significant association between anxiety and perceived vaginal discharge.
The study of maternal and fetal outcome in pregnant women with thyroid disorders
Authors: S. Sreelatha , Nadagoudar Seema , Devi L. Asha
Published: July 2017

Background: Thyroid disorders are among the common endocrine disorders in pregnant women after diabetes mellitus. Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effect on mother and the fetus, like miscarriages, preterm delivery, preeclampsia, eclampsia, polihydromnios, placental abruption, post-partum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorders on pregnancy and its maternal and the fetal outcome.Methods: The present study was conducted in ESI Hospital Rajaji Nagar, Bangalore. It is a prospective study which involved 100 patients diagnosed to have thyroid disorder during their antenatal checkup in the first trimister. It also includes known cases of thyroid disorder. TSH level was estimated. If it is deranged, then FT3 and FT4 levels estimated. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted.Results: In our study out of 100 cases, 96 cases are subclinical hypohyroid and 4 cases are subclinical hyperthyroid. Subclinical hypothyroidism in pregnancy are associated with abortions (2.1%), Anaemia (4.20%), PIH (14.7%), GDM (4.2%), Preterm labour (3.1%), oligohydromnios (16.67%), Lscs (22.9%), PPH (6.3%), LBW (21.9%), Hyperbilirubinemia (9.4%), NICU admission (14.6%), Which are co-relatine with other studies and hyperthyroid cases in our study were not sufficient for outcome analysis.Conclusions: Thyroid disorders in pregnancy have adverse effects on maternal and fetal outcome emphasizing the importance of routine antenatal thyroid screening.
Third trimester Doppler ultrasound as prediction of obstetric outcome in high-risk pregnancy, Gujarat, India
Authors: Ghosh Runoo , Oza Hina , Meel Shikha
Published: July 2017

Background: Doppler ultrasound has emerged as beneficial tool in the assessment of the fetal and placental circulation and in the prediction of adverse pregnancy outcome. Umbilical artery Doppler has proved helpful to supervise the growth restricted fetuses and compromised vasculature as in hypertensive disorders high risk pregnancies. Objective of present study was to investigate the association between third-trimester uterine artery Doppler assessment and adverse obstetric outcome.Methods: This prospective study was done among 110 high risk pregnancies. Vessel like uterine artery, umbilical artery, middle cerebral artery and ductus venosus were studied in present study. Indices calculated: Peak systolic velocity, End diastolic velocity, Mean velocity, Systolic/diastolic ratio, Pulsatility index (PI) and resistance index (RI) of middle cerebral artery (MCA), Ductus venosus S/A ratio.Results: bilateral notch was present statistically significant (p<0.05) in 18.1% and absent in 28.2% among cases of adverse perinatal outcome. UA S/D ratio was >3 in 22.7% and <3 in 11.8% among cases of adverse perinatal outcome and findings were statistically significant (p<0.05). End diastolic velocity was reduced in statistically significant (p<0.05) in 9.1% and normal in 20.1% among cases of adverse perinatal outcome. MCA PI was <lower limit statistically significant (p<0.05) in 24.5% and >lower limit in 18.2% among cases of adverse perinatal outcome. MCA PI/UA PI ratio was <1 statistically significant (p<0.05) in 25.5% and absent in 17.3% among cases of adverse perinatal outcome.Conclusions: Increase in UA PI and decrease in MCA PI are early marker for detection of fetal compromise. Ratio of indices between MCA PI and UA PI reflects brain sparing effect as well as placental insufficiency and these are more specific in detection of IUGR than individual artery indices.
Prevalence and outcome of hypothyroidism in women attending antenatal clinic at J. J. M Medical College
Authors: I. S. Sapna , Mehazeena Zainab
Published: July 2017

Background: Pregnancy induces physiological and metabolic changes, when overlapped with endocrine imbalance leads to undesirable consequences for both mother and fetus. Thyroid pathology has major negative impact on both mother and fetus. Hypothyroidism may be pre-existent or may begin during pregnancy; severity depends on how early and appropriately treatment is initiated. Aim of this study is to evaluate the prevalence of hypothyroidism in pregnancy and its outcome.Methods: 150 pregnant women obstetric files were studied based on their TSH value, women with TSH levels greater than 3mIU/ml who were on L-Thyroxin were included. All others who had diabetes, collagen disease, heart disease with pregnancy were excluded from the study.Results: Prevalence of hypothyroidism in pregnancy is 1.2%.Conclusions: Hypothyroidism presents with complex and serious complications with increase in maternal morbidity and perinatal mortality. To identify potential and overt hypothyroid patient thyroid screening is must during pregnancy. TSH levels should be kept less than 2mIU/L for adequate control.
PC-PNDT act: perspectives of medical undergraduates in a Sub-Himalayan state
Authors: Gupta Rajiv Kumar , Singh Parveen , Hussain Shahid , Kumari Rashmi , Langer Bhavna , Gupta Riya
Published: July 2017

Background: Sex selective abortions have grossly distorted the child sex ratio in India. Role of medical technology in declining sex ratio at birth cannot be undermined. To combat this social evil, PC-PNDT (Pre-conception Prenatal Diagnostic Test) was promulgated in 2003 by Government of India. Enhancing the knowledge of medical fraternity with focus on undergraduate students can imbibe an enduring commitment towards this predicamentMethods: The present cross-sectional study was conducted in Government Medical College of Jammu. Students of 1st year MBBS of Batch 2016-2017 were administered the pre-designed and pretested questionnaire. Information was collected regarding sex determination as well as PC-PNDT Act.Results: 80% respondents knew about the declining sex ratio and 95% knew that sex determination is possible during pregnancy. Only 24.29% had heard about PC-PNDT Act although 95% knew that prenatal sex determination is punishable. Higher proportions of female respondents were aware of both fine and imprisonment as punishment under the act. (p<0.05). Regarding technique used for sex determination, males had better knowledge about ultrasonography than their female counterparts (p<0.05). More females would like to have male child as preferred first child (p<0.05) and 87.14% of respondents preferred that sex determination be punished more vigorously.Conclusions: Awareness about some of the parameters about PC-PNDT Act among the medical undergraduates was poor and it would be pertinent to hold more educational sessions for them.
A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel
Authors: Agarwal Shruti , Bharadwaj Neelam , Rajoria Lata , Lamba Indira
Published: July 2017

Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value <0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section.
Maternal factors associated with large for gestational age babies and its outcome when compared with those of appropriate for gestational age
Authors: John Lopamudra B. , Rani P. Reddi , Ghose Seetesh
Published: July 2017

Background: Large for gestational age (LGA) babies are known to have a higher incidence of birth trauma, difficult delivery and Caesarean sections. Knowledge about maternal factors associated with this can help in prediction and prevention of complications.Methods: Maternal factors in 112 cases of LGA babies was studied along with its outcome and compared with an equal number of controls.Results: 0.05% deliveries resulted in LGA babies. Age and parity were not significantly different in the two groups and so were the associated medical disorders of hypothyroidism and gestational hypertension. Significant association was found with post-dated pregnancies (p=0.04) and gestational diabetes mellitus (p=0.05). Also, higher number of primary Caesarean sections resulted in the case group.Conclusions: Post dated pregnancies and gestational diabetes were maternal factors associated with LGA babies and higher number of primary Caesarean sections resulted in these cases.
Eclampsia: a retrospective study in a tertiary care centre
Authors: Dhanapal Mohana , Sengodan Subha Sivagami , Murugesan Praveena
Published: July 2017

Background: This study was done to analyse the maternal mortality, morbidity and fetal outcome in eclampsia complicating pregnancy.Methods: This study was conducted in Government Mohan Kumaramangalam Medical College and Hospital, Salem. It was a retrospective study from May 2016 to May 2017.Results: Majority were referral 82.8%. 78.8% were in the age group of 20-30 years. Primi gravida was the commonest sufferer. In our study 67.02% had antepartum eclampsia and 31.2% had postpartum eclampsia. Only 1.8% patients had intrapartum eclampsia. While taking gestational age majority were preterm. Regarding mode of delivery 61.3% were delivered by LSCS. 29.2% of patients had pulmonary edema which was the commonest complication followed by Hellp syndrome (17.7%), Acute renal failure (10.6%), Cardiovascular accident (8.8%). There were 9 maternal deaths due to eclampsia (8.3%). Preterm delivery and Low birth weight were higher in eclamptic patients. Preterm birth occurred in 67.17% of patients. Intrauterine death occurred in 8 patients. Still birth occurred in 10.6% of patients.Conclusions: High maternal morbidity and mortality has been attributed to the late referral, delay in the timely management of preeclampsia. So coordinated efforts of medical and paramedical staffs and health education is needed to fight against eclampsia.