bluuebunny/crossref_metadata_2025 huggingface dataset:
ON THE LOCALISATION OF THE CRONICLE CITY UNENIZH
Authors: Kedun Ivan , Parkhomenko Oleksiy
Published: February 2020

The article explores the problem of localization of the chronicle city of Uneniz, which, from one of the existing points of view, relates the origin of the modern city of Nizhyn. The authors analyze the historiography of this issue (MM Karamzin, MA Maksimovich, OM Lazarevsky, MP Vasilenko, MN Petrovsky, etc.) and provide data on the history of the archaeological study of the area traditionally identified with Unizez. It is an archaeological study in the residential district of the modern Nezhin in the tract of the Commune (primary place name - Gorodok) by V. Kovalenko (1981), who first tried to confirm the hypothesis of the presence of an ancient Russian settlement here, the excavation of Y. Sitogo (1989–1990) and I. Kedun and O. Parkhomenko (2011–2013). Based on the analysis of the available archaeological materials, the authors confirm the existence in the area of ​​the Commune of the ancient Russian settlement. However, it had rather primitive fortifications (a moat with a palisade established at the bottom), most likely to have arisen in the XII century. and a rather small period was used. As such simple fortifications are atypical for the ancient settlements of Russia, it is concluded that it was most likely a fortified settlement.This thesis is supported by a comparative analysis of the number of ceramic fragments found in the Commune and in the settlement of Novo Mesto, which is closest to it. On the investigated 12.4 square meters of the New City the number of fragments of ceramic vessels was 618, while 87 square meters of excavations in the Commune, their number, together with the lifting material, amounted to 285 units. On the basis of such a comparison, we can speak of a weak saturation of the cultural layer in the territory of the Commune, which does not allow, according to the authors, to assume the existence of a large ancient Russian settlement here, which could be correlated with the Chronicle of Unise. However, the authors do not rule out that the future expansion of the research area may significantly change the findings.
GORODNYA – KYIV DEFENSIVE WALLS IN IX–XIII CENTURIES. PART ONE. RAMPARTS
Authors: Lukyanchenko Vadym
Published: February 2020

The article examines the issues of structural and functional features of ground shafts as a component of defensive structures of the city of Kyiv IX – XIII centuries. Based on a detailed analysis of the scientific literature on the problem and the available written sources, materials of archaeological research, scientific and hypothetical reconstruction of urban defensive fortifications of the Slavs of a certain time, as well as the experience of reproduction of the fortifications of medieval Europe in the territory of modern Ukraine, Poland and Denmark, it is suggested to own the evolution of the earthen fortifications of.The author denies the widespread idea about the widespread development in the Ancient Rus in the ninth and thirteenth centuries defence structures, which were a complex timber structure that consisted of a reinforced earth shaft and wooden fortifications of various kinds above it. It is argued that the division of earth shaft structures into "complex" (tree-reinforced) and "simple" (non-reinforced) types are erroneous. According to the author, the reinforcement of earth shafts at the beginning of their erection was never performed. It has been concluded that, first, virtually all earthen shafts and their wooden structures, which functioned for a long time, were not preserved in their original form; second, the fortification builders of that time did not have the proper education to design and construct such structures. In the course of construction, they were guided by their own experience and circumstances; therefore, "complex shaft type structures" are not the product of a single design; they are the result of multiple repairs and remodelling of initially low timber fortifications; thirdly, the complexity of the fortifications was influenced solely by the duration of the active functioning of the monument.The article is accompanied by numerous illustrative material, including the author's reconstructions of the evolution of tree-walled defensive walls and methods of their strengthening at various stages of construction.
BATH-HOUSES IN THE PLANNING STRUCTURE OF ANCIENT KYIV-PODIL
Authors: Taranenko Serhiy
Published: February 2020

The article presents archaeologically fixed objects of wooden architecture of ancient times in Podil Kyiv, which scientists first interpreted as baths. Although there have been attempts in the national scientific literature to interpret the structures as baths (a monumental stone building of the XI century in the yard of the Kyiv Metropolitan, a wooden structure on the site 34 in Petrovsky's estate), first, these interpretations provoked debates. Secondly, they involved data only from Upper Kyiv - there was no case of identifying as a bath an archaeologically fixed object of wooden architecture in Podil. In the article, based on the analysis of available written, ethnographic and archaeological sources, the author proves the possibility of the existence of similar structures in the largest area of ​​Ancient Kyiv.The author addresses several issues regarding the mass development and planning structure of the ancient Russian hem. The first is the selection of more than 300 fixed objects of wooden architecture of this period, actually a bath. In doing so, it is proposed to use the technique of Khoroshov, which he proposed and implemented at the excavations of Ancient Novgorod. The second question concerns the revision and re-interpretation of the functional purpose of the investigated objects of ancient Russian architectural architecture recorded at the hem of Kyiv. Three buildings of the XII century are presented for consideration. (building No. 4, Obolonskaya St., 4, 1989, building No. 1, Pochayninska St., 27/44, 2003, building No. 8, Nizhniy Val St., 43, 1989), which the author proposes considered as baths that were part of the city planning structure. The author states that confirmation of the existence of bath-houses will allow to investigate the objects related to hygiene in the Old Rus and to expand not only the life of ancient Kyiv significantly. Also, it will be possible to make adjustments to the general reconstructions of the ordinary old-Russian manor and quarter.
THE REPORT OF NIZHYN VOIVODES IN THE «ACTS OF SOUTH WESTERN RUSSIA»
Authors: Lesyk Lyudmyla
Published: February 2020

The author analyzes the economic documentation sent by the Nizhyn governors to the Malorossiyskyi Prykaz in the 1650s and 1670s. The excerpts published in the Acts relating to the History of Southern and Western Russia. This source the author used to show the nature of the interaction between the Nizhyn Voivodship and the government, to identify the main issues voivode had to report on and the tasks he had to solve, as well as to consider the situation of the Russian military contingent in Nizhyn.The author notes that the royal pledges led by the voivods appeared in Chernihiv, Nizhyn, Pereyaslav and other Ukrainian cities in the late 1650s. The names of the Nizhyn voivods, who served in the 1650-1670s, were identified, and the author described their activities. She found out that the voivode had to build a fortress in the city to defend against enemies, manage the affairs of their garrisons, send to Moscow financial statements of expenditures, to issue a sovereign's pay to the archers, to fight against their escape, which was very common, and in addition to monitor on the activities of the local Cossack administration and internal policy in the territories subordinate to them, submit to the king petitioners and petitions, provide information on events in the Ukrainian lands and in the neighboring territories, involve the local population in the work . Under the rule of Ivan Bryukhovetsky, voivode had to collect taxes from inhabitants of the Hetmanate (except for Cossacks and clergy). The author concludes that it was through regular reports that the voivode in Moscow knew about the state of affairs in the Hetmanate region and, following the information received, adjusted their policy towards the Ukrainian lands. Therefore, the voivodship runoff can be considered a valuable source from the history of the hetman's Ukraine itself.
THE EXPENDITURES OF THE CITIES BUDGETS OF THE UKRAINIAN SSR ON THE DEVELOPMENT OF THE EDUCATIONAL AND CULTURAL INSTITUTIONS (1923–1928)
Authors: Antonenko Victoriya
Published: February 2020

The searching for new ways to finance Ukrainian education, science and culture leads to the studying of the historical experience of the previous years. These lessons could be very helpful. Nevertheless, this topic is still less researched in the Ukrainian historiography.The article deals with the problems of the material support of the educational and cultural institutions in the cities of the Ukrainian SSR during the 1920s. The main attention is paid to the highlighting of the role of the cities budgets to the problem mentioned above. The process of the legislative regulation of the financing of the educational and cultural spheres and in particular – the division of the funding for the institutions of the social education, the vocational education and the political literacy between the state and local budgets is traced on the basis of the analysis of the normative legal acts of the Ukrainian Soviet authorities. The working out the operational and reporting documentation of the different departments, statistical data and the materials of the periodicals make it possible to reveal the practical consequences of transferring a large part of education spending to the local finances. In the early 20’s XX century this decision led to the reducing of the educational institutions, the number of teachers and, of course, the number of children covered with education.Studying the expenditure part of the cities budgets allows us to determine how much money was allocated to the development of the educational and cultural institutions in 1923–1928, to outline the priority of the financing of the certain spheres and to highlight the specific appointment of the educational expenditures.The research showed that budget spending on education had been steadily increasing. Ukrainian cities spent more than 80 million rubles on the item during that period. Most of these funds were absorbed by social education institutions. The institutions of the political literacy were on the second place and the institutions of the vocational education were the last. At the same time, more than half of all the educational expenditures were spent on the salary of the pedagogical and technical workers. The Ukrainian cities directed the average 19.5 % of the total cities budgets to the development of the education and culture at the end of the 1920s. However, it was not enough to satisfy all the needs of the urban citizens. This problem waspartly solved by the transferring of some institutions on the system of patronage, partly – by the introduction of tuition fees, but mainly – by self-taxation of the population of the Ukrainian SSR.
THE MIDDLE 19TH CENTURY – EARLY 21ST CENTURY FUNCTIONING OF LVIV’S HORONYMS
Authors: Dolynska Maryana
Published: February 2020

There are official and traditional names of places upon the territory of the town or the city. They have existed from the ancient times till contemporary days. The official ones have been given by the executive body, and the traditional names are describing the place by nearby locations, buildings or natural objects. Toponyms are divided into different classes and subclasses.

Horonyms describe nonlinear structures (territories) and were used to call any places on the town’s area, except for streets or squares. Horonyms do not provide the information about the official administrative division of the contemporary time but were putting traditional names in use.In order to answer the question - how long this class of the city’s names lasted, one has to base on retrospective comparison of the pre-statistical source. The contemporary vocabulary of Lviv’s dialect (“Leksykon lvivskyy povazhno i na zhart”) have fixed 65 horonyms of Lviv’s area, which currentlyare being used by city dwellers. That was the basement of analysis by the retrospective method. This data was compared with such sources: late 19 c.-early 20 c. guidebooks and middle 19 c. maps with their accompaniment notes.The administrative units’ division of Lviv’s territory was applied in this article because during the long 19 century Lviv was a part of Austro-Hungary Empire. That’s why 4 groups of horonyms were excluded: 1. the names of the former city’s villages that are currently preserved as the city’s horonyms because those villages were absorbed into the city only during 20th century. (Today names of those former villages do not reflect the administrative units’ division); 2. village Sygnivka, which was founded only in the 20th years of 19thcentury on the area of the former suburb Halytskie of Lviv’s early modern period; 3. the names of villages, which surrounded town’s area, but were not under the rule of the town hall; 4. all names of objects, which were upon the area of these villages.So after the exclusion, we have 48 names (horonyms). The analysis showed that one name came into being in the late 20th century and eight other ones during its first half. Fifteen horonyms, as well, as their names were founded during the 19th century. So, that leaves us with twenty-four names, which were established during the earlier period and are being used now in the city. We need to continue research on a retrospective comparison of the named recorded in the early modern serial sources.
“Take Out This Thing”: A Teen’s Decision About Removal of a Gastrostomy Tube
Authors: Gutiérrez Hazel M. , Nakashima Yuri , Derrington Sabrina , Lantos John D.
Published: February 2020

Medical decision-making in children is not a static process. In pediatrics, parents and health professionals actively participate in clinical decision-making. They always consider what is in the child’s best interest and sometimes weigh that against other considerations. As children get older, the level of participation in this process may change according to their own cognitive development and maturity level. In this article, we present a case of an adolescent with a life-limiting condition at the end of life. He wants to participate in his health management and speak for himself. He does not always prefer interventions that his parents think are best. Health care practitioners must include mature minors in the decision-making process and be willing to listen to their voices.
Evaluation of the Prevalence of Psychiatric Disorders in Geriatric Outpatients: A Difficult Patient Group
Authors: OZEN Murat Eren , ORUM Mehmet Hamdi , KALENDEROGLU Aysun
Published: February 2020

Objective: The elderly population is progressively enhancing, and this increase is expected to be more evident in the near future. As the elderly population grows, there will be an increasing need for health services, following in rapidly rising medical, psychiatric, and social healthcare issues. The aim of the current investigation is to define the prevalence of the psychiatric disorder, including gender-based differences, demographic characteristics, and dispersion within all elderly age groups, among patients applying the general psychiatry outpatient clinic.Material and Methods: This is a prospective study for the elderly (≥65 years) patients who applied the general psychiatry outpatient clinic of our university hospital between April 2018 and July 2018. Axis I diagnose was made according to DSM-5 criteria. Patients’ demographic characteristics were recorded.Results: The number of patients who visited the general psychiatry outpatient clinic was 1950, and the geropsychiatric patients (≥65 years) constituted 10.4% (n=203) of the total patients. The female/male ratio was 1.44 (n=120/83). The most common psychiatric disorder was major depressive disorder (38.40%). Generalized anxiety disorder (GAD, 18.70%), adjustment disorder (AD, 9.30%), schizophrenia (7.30%) followed as the most common disorders in the geropsychiatric patient group. GAD was statistically significantly higher in females (X2=6.83, p=0.008) and the AD was statistically significantly higher in males (X2=10.38, p=0.002). Conclusion: Determining the frequency of psychiatric disorders in elderly patients and addressing the differences between genders is important for developing treatment strategies.
Hylaeus (Hylaeana) dominicalis, a new species and the first colletid bee recorded from Dominica, Lesser Antilles
Authors: Gibbs Jason
Published: February 2020

A new species of colletid bee, Hylaeus (Hylaeana) dominicalis Gibbs, new species, is described and figured from the Commonwealth of Dominica. The new species can be distinguished from consubgeneric species in the Caribbean Islands based on the integumental coloration, facial fovea, and pubescence. A list of all known Hylaeus from the Caribbean Islands is provided.
İKİNCİ DÜNYA SAVAŞINDA TÜRKİYE’NİN SAVAŞ DIŞI KALMA POLİTİKALARI VE SONUÇLARI
Authors: ÜNALP Fatma Rezzan
Published: February 2020

1 Eylül 1939 günü Almanya’nın Polonya’ya saldırmasıyla İkinci Dünya Savaşı başladığında Türkiye’nin temel endişesi ulusal egemenliğine ve toprak bütünlüğüne zarar gelmeden bu badireyi en güvenli şekilde atlatabilmekti. Dünyayı kasıp kavuran bu altı yıllık savaş süresince, Türk başkenti yabancı istihbarat teşkilatlarının mücadele alanı haline geldi. Hitler Almanya'sı, Türkiye'yi kendi safına çekmek için her yolu denedi. Kasım 1940’da Nazi-Sovyet pazarlığının başarısız olması, savaşın bundan sonraki gelişimini önemli bir şekilde etkiledi. Türkiye bu nedenle savaş süresince bloklar arasındaki gelişmelere bağlı olarak karşılıklı saldırmazlık ve güvenlik taahhütleri içeren anlaşmalar imzalayarak sınırlarının güvenliğini garanti altına almaya çalışmıştır. İkinci Dünya Savaşı 7 Mayıs’ta Almanya, 2 Eylül 1945’te Japonya’nın kayıtsız koşulsuz teslim antlaşmalarını imzalamasıyla sona erdiğinde, Türkiye bütün dünyada etkilerini hissettiren büyük bir yıkımdan savaş dışı kalarak tek kurşun atmadan kurtulmuş oluyordu. Fakat bundan sonra Alman yenilgisi nedeniyle doğu Avrupa’daki dengenin SSCB lehine bozulması sonucu ortaya çıkan tehlike, şimdi başka bir biçimde Türkiye’nin tam karşısındaydı.
Bu makalede, İkinci Dünya Savaşı süresince Türkiye’nin savaşa girme konusunda iki taraftan maruz kaldığı yoğun baskılar ve bu baskılara karşı gösterdiği direnç, takip ettiği dış politikalar çerçevesinde açıklanmaya çalışılacak, ayrıca bu politikaların savaşın seyrine etki eden yönleri ve Türkiye açısından sonuçları değerlendirilecektir.
“Trailer Trash” Stigma and Belonging in Florida Mobile Home Parks
Authors: Kusenbach Margarethe
Published: February 2020

In the United States, residents of mobile homes and mobile home communities are faced with cultural stigmatization regarding their places of living. While common, the “trailer trash” stigma, an example of both housing and neighborhood/territorial stigma, has been understudied in contemporary research. Through a range of discursive strategies, many subgroups within this larger population manage to successfully distance themselves from the stigma and thereby render it inconsequential (Kusenbach, 2009). But what about those residents—typically white, poor, and occasionally lacking in stability—who do not have the necessary resources to accomplish this? This article examines three typical responses by low-income mobile home residents—here called resisting, downplaying, and perpetuating—leading to different outcomes regarding residents’ sense of community belonging. The article is based on the analysis of over 150 qualitative interviews with mobile home park residents conducted in West Central Florida between 2005 and 2010.
Városi zsugorodás és lakóhelyi szegregáció az ezredforduló után
Authors: Koós Bálint
Published: February 2020

A csökkenő népességű ­– zsugorodó – városok társadalmi problémáinak fokozódásával nagyszámú tanulmány foglalkozik, ám ezek döntően nagyvárosi folyamatokra fókuszálnak, figyelmen kívül hagyva zsugorodó kis– és középvárosokat. Jelen vizsgálat célja, hogy a KSH 2001 és 2011-es Népszámlálásának mikroadatai felhasználásával meghatározza egy kedvezőtlen társadalmi helyzetű csoport (képzetlen, nem foglalkoztatott, aktív korúak) lakóhelyi szegregációjának mértékét és a változás irányát. Az eredmények azt mutatják, hogy a magyar városok esetében bár jellemzően alacsony mértékű a lakóhelyi elkülönülés mértéke, egyetlen évtized alatt is számottevő polarizáció ment végbe. A zsugorodó városokra nagyobb mértékű szegregáció jellemző, mint a népességüket növelőkre, ám – szemben a külföldi nagyvárosok tapasztalataival – az elkülönülés mértéke jellemzően nem emelkedett a vizsgált időszakban.
Optimasi Pati-Alginat sebagai Bahan Pengkapsul Bakteri Probiotik terhadap Karakteristik Beads
Authors: Miskiyah Miskiyah , Juniawati Juniawati , Widaningrum Widaningrum
Published: February 2020

Enkapsulasi merupakan proses pembungkusan (coating) suatu bahan inti dengan menggunakan bahan pengkapsul tertentu. Pemanfaatan maltodekstrin, pati sagu, dan maizena sebagai bahan pengkapsul probiotik belum banyak dikembangkan sehingga dapat dijadikan kandidat bahan pengkapsul baru. Tujuan penelitian ini adalah untuk menentukan perbandingan konsentrasi pati-alginat terbaik yang dapat digunakan untuk enkapsulasi probiotik. Rancangan percobaan yang digunakan adalah rancangan faktorial menggunakan 2 faktor, yaitu jenis bahan pengkapsul dan perbandingan konsentrasi bahan pengkapsul. Faktor jenis bahan pengkasul terdiri dari 3 taraf yaitu maltodekstrin-alginat, pati sagu-alginat, dan maizena-alginat, sedangkan faktor konsentrasi bahan pengkapsul terdiri dari 3 taraf yaitu 1:1; 1:2; dan 1:3 (b/b). Hasil penelitian menunjukkan bahwa perbandingan pati-alginat secara bervariasi menghasilkan karakteristik beads dari segi rendemen, diameter beads, dan bentuk beads yang spesifik. Kesimpulannya, bahan pengkapsul probiotik yang terbaik yaitu perbandingan pati:alginat sebesar 1:3.Optimation Starch-alginate for Probiotic Bacteria Encapsulant Based on Beads Characteristic Abstract Encapsulation was known as process of coating a core material using specific materials. The use of maltodextrin, sago starch, and corn starch as a probiotic material for encapsulation has not been widely developed as new material. The aim of the study was to determine the best ratio of starch-alginate concentrations. The experimental design used was factorial design using 2 factors, namely the type of material and the ratio of the concentration. The type of material for encapsulation consisted of: maltodextrin-alginate, sago-alginate starch, and corn starch-alginate, while the concentration was 1:1, 1:2, and 1:3 (w/w). The results showed that the varioys types of materials and concentration provided specific beads characteristic, i.e. yield, beads diameter, and beads shape. As conclusion, the optimum ratio of starch-alginate as probiotic encapsulating could be determined at a ratio of 1:3.
Hidrolisis Pati dari Batang Kelapa Sawit dengan Kombinasi Perlakuan Asam Sitrat dan Steam Explosion Terhadap Sifat Fisiko Kimia Dekstrin
Authors: Yusra Syarifah , Pranoto Yudi , Anwar Chairil , Hidayat Chusnul
Published: February 2020

Modifikasi pati dilakukan untuk memperbaiki sifat fungsional pati dan memperluas penggunaan pati dalam produk pangan. Modifikasi pati menjadi dekstin dapat dilakukan baik secara fisik, kimiawi, atau kombinasi fisiko-kimia. Pada penelitian ini dilakukan modifikasi pati dengan kombinasi pregelatinisasi-steam explosion (Pregel-SE), dan kombinasi pregelatinisasi-asam sitrat-steam explosion pada pH 4 (pregel-pH-SE4) dan pH 3 (pregel-pH-SE3) untuk produksi dekstrin. Tujuan dari penelitian ini adalah untuk memperoleh metode hidrolisis terbaik dalam pembuatan dekstrin. Produk yang dihasilkan diamati tingkat kelarutan, berat molekul (Mw), dextrose equivalent (DE), Spectra Fourier Transform Infrared (FTIR), SEM, dan viskositas pasta. Hasil menunjukkan bahwa kondisi terbaik modifikasi pati menjadi dekstrin diperoleh pada perlakuan pregel-pH3-SE. Pada perlakuan ini diperoleh kelarutan 75,94 %, berat molekul 60100 g/mol dan DE 15,92%. Pita vibrasi baru terlihat di wilayah bilangan gelombang 1717 cm-1 pada analisis FTIR. Hasil SEM menunjukkan bahwa bentuk granula pati yang bulat sudah tidak terlihat setelah kombinasi perlakuan. Pengujian RVA menunjukkan penurunan viskositas berkorelasi positif terhadap penurunan berat molekul, peningkatan kelarutan dan DE setelah kombinasi perlakuan ditingkatkan. Starch modification is performed to improve the functional properties of starch and starch utilization in food products. Modification of starch, such as dextrin, can be performed by physical and chemical methods, or a combination method, such as physico-chemical. In this research, starch modification was carried out by a combination between pregelatinization and steam explosion (Pregel-SE), a combination between pregelatinization, citric acid and steam explosion at pH 4 (Pregel-pH-SE4) and at pH 3 (Pregel-pH-SE3) for the production of dextrin. The objective of this research was to obtain the best method for dextrin production. The results were observed, such as levels of solubility, molecular weight (Mw), dextrose equivalent (DE), Spectra Fourier Transform Infrared (FTIR), SEM, and pasting properties (RVA). The results showed that the best condition of starch modification for dextrin production was obtained by Pregel-pH3-SE. Solubility, molecular weight, and DE of dextrin were 75.94%, 60100 g/mol, and 15.92%, respectively. A new peak was observed in the region of the wavenumber 1.717 cm-1 at FTIR analysis. SEM analysis indicated that the round form of starch granules did not observed after the treatments. RVA analysis showed that the decrease in viscosity was correlated with a decrease in molecular weight, an increase in solubility, and DE after the treatments.
Spatial and Relational Representations of Economic Well-being and the Kahumana Farm Hub, Waiʻanae, Hawaiʻi
Authors: Mello Christy , Azizi Saleh , Kama Shea-Lah
Published: February 2020

Seeking to identify solutions for improving growers' economic well-being by supporting ʻāina (land)-based practices, ethnographic research explored economic opportunity possibilities through Kahumana Organic Farms' Farm Hub (KFH), located in Waiʻanae on Hawaiʻi's island of Oʻahu. Major described findings include identified assets on ideas for improving economic well-being (e.g., a gift economy), barriers faced by growers, policy considerations for KFH and the region, as well as proposed solutions that have broader implications for sustainable land use practices. Designed to highlight agricultural abundance in Waiʻanae, rather than focus on existing socioeconomic disparity, our interdisciplinary and community-led project fused Western-based methodology with the Hawaiian methodological framework of Māʻawe Pono. Discussion addresses how, in doing so, we created reciprocal relationships and prioritized the production of deliverables to directly benefit community. It further explores how growers' utilization of the gift economy and Indigenous wisdom is instrumental for achieving well-being in terms of culture, physical health, economics, and the environment. As a part of a larger collaborative effort entitled ʻImi Naʻauao: Hawaiian Knowing and Well-being, this article also details the mapping subproject integrated into this larger effort and related to the KFH research.
Impact of gum chewing on recovery of bowel activity after caesarean section
Authors: . Manisha , Duhan Nirmala
Published: February 2020

Background: Childbirth is a memorable part in every woman’s life. Each labour experience is unique and calls for a celebration. Objective of this study was to evaluate the effect of gum chewing on recovery of bowel motility after caesarean section.Methods: This prospective randomized controlled trial was conducted on 220 women who had undergone cesarean section and were further sub-divided into two groups of 110 women each Group I (Study group, n=110) in whom chewing gum was advised postoperatively and Group II (Control group, n=110)  who were managed as per standard departmental postoperative feeding protocol.Results: Mean age in Group A women was 24.86±3.89 years and 25.28±3.34 years in Group B. There was no statistically significant difference between the study and control group regarding their age, parity, occupation, LSCS/previous abdominal surgery, type of cesarean section, indications of cesarean section, skin incision, intraperitoneal adhesions. The mean time of bowel sound appearance in Group A was 3.27±0.95 and it was 8.22±2.0 hours in Group B. The mean time of passage of flatus was found to be 9.77±3.21 hours in Group A and 7.15±3.07 hours in Group B. In Group A, the mean time of passage of stools was 18.79±4.23 hours and it was 39.12±6.56 hours in Group B. Mean duration of hospital stay was significantly lesser (3.23±0.60 days) in gum chewing group than in the non-gum chewing group (4.18±1.28 days).  Seventy-six (69.09%) women of Group A needed only one chewing gum before appearance of bowel sound / flatus / feces. Only three women required three chewing gums. Out of 31 cases, who required two chewing gums, five were of previous 1 LSCS and 12 were previous 2 LSCS, thus suggesting delayed return of gut motility in women with > 1 previous LSCS.Conclusions: It was evident that gum chewing, a form of sham feeding is considered as an effective and inexpensive method which hastens the return of gut motility after caesarean section.
The neonatal outcomes of Dexamethasone administration before scheduled cesarean delivery at term: a randomized clinical trial
Authors: Elbohoty Shereen B. , Dawood Ayman S. , Abbas Ahmed M. , Elgergawy Adel E.
Published: February 2020

Background: Caesarean delivery (CD) rates in developing countries are rising beyond the recommended rates of World health organization. Objective of this study was to evaluate whether Dexamethasone injections reduce neonatal incubation admissions when given before scheduled caesarean delivery (CD) at term or not.Methods: A double blinded, two armed, randomized clinical trial was conducted at Tanta University hospitals in the period from October 2017 to March 2019. Four hundred pregnant women admitted for scheduled CD with gestational age ≥37 weeks were included. Patients were randomized into study group and control group. The study group was given 3 dexamethasone doses, 8 mg each while control group was given saline injections simultaneously as a placebo drug. The primary outcome was the neonatal incubatory admissions.Results: Demographic data in both groups were comparable. Transient tachypnea of newborn (TTN) was 15.47% in study group versus 20.33% in control group with p=0.227. The respiratory distress (RDS) in study group was 6.63% versus 9.89% in control group with p=0.260. The incubation admissions were nasal oxygen 12.71% versus 15.38%, continuous positive airway pressure ventilation (CPAP) 5.52% versus 8.24% and mechanical ventilation was 3.87% versus 6.59% in the study and control groups respectively.Conclusions: Although Dexamethasone administration before scheduled CD at term reduced both respiratory morbidity and incubation admissions, the differences between study and control groups were not significant.
Varicella meningitis in pregnancy: a clinical conundrum
Authors: Gholkar Baljeet K. , Verghese Lynda
Published: February 2020

Authors present this experience of managing a case of Varicella meningitis in pregnancy in a patient presenting with headache in the third trimester. There was no history of dermatomal pain or rash. After intracranial hemorrhage and thrombosis were ruled out by imaging, a decision to perform a lumbar puncture was taken. The diagnosis was made following a PCR analysis on the cerebro-spinal fluid. Retrospective testing revealed immunity to varicella at booking, thus confirming reactivation of the infection. Treatment was done using intravenous acyclovir with complete recovery. It also created a clinical dilemma for the best possible monitoring plan for the fetus to rule out affection. A fetal medicine scan revealed no structural defects in the fetus. The subsequent pregnancy period was uneventful. A well grown normal baby was born at term. This case highlights the significance of considering a lumbar puncture in cases of intractable headache and also highlights the dilemma for fetal monitoring in such rare presentations.
A case report on ACUM: a rare mullerian anomaly
Authors: Malhotra Khushboo , Bajaj Bindu
Published: February 2020

Accessory and cavitated uterine mass (ACUM) is a rare, newly recognized mullerian anomaly. It is an accessory cavity lined by functional endometrium within an otherwise normal uterine cavity, in contrast to the other mullerian anomalies in which the uterus is malformed. It is often misdiagnosed as myoma, adenomyosis or adenomyoma. The entity needs expertise to diagnose as it is a rare but treatable cause of severe dysmenorrhea and chronic pelvic pain in young females with a wide range of differential diagnosis. A 30 years old female with history of one abortion 2 years back, came to infertility OPD with complaints of lower abdominal pain with severe dysmenorrhea, dyspareunia and inability to conceive since 2 years. Her menstrual cycle was regular with normal flow. USG pelvis showed subserosal fibroid of 4×3 cm in fundus region of uterus. On HSG, bilateral fallopian tubes were patent. MRI-pelvis revealed normal uterus with thick walled cavitatory lesion of size 4.1×3.6 cm with thick T2W hypointense wall similar to myometrium in continuation with right fundal wall of uterus containing blood products suggestive of ACUM. Both ovaries were normal, no obvious adnexal lesion/collection/free fluid noted in peritoneal cavity. Laparoscopy followed by laparotomy with excision of ACUM was performed. The MRI findings of an accessory cavitated uterine mass located below the attachment of round ligament with haemorrhagic contents, normal shaped uterus with normal bilateral tubes and ovaries should suggest the diagnosis of ACUM pre-operatively.
Clinical and microbiological profile of type 2 diabetic patients with urinary tract infections
Authors: Deepa Sandinti , Lakshmaiah V. , Natarajan Arvind , K. Prabhakar , A. Raveesha
Published: February 2020

Background: Diabetes Mellitus is reported to increase the risk of Urinary Tract Infection (UTI) with higher probability of drug resistant organisms. Understanding the burden, microbiological profile and antibiotic sensitivity pattern is vital for effective prevention and management. To assess the microbiological profile and antibiotic sensitivity pattern of Urinary Tract infections among type 2 diabetes mellitus patients.Methods: The study was A prospective observational study done on 117 type 2 diabetic subjects aged above 18 years presenting with symptoms of UTI in a tertiary care hospital Urine was analyzed for urine routine examination, culture and antibiotic sensitivity using standard testing methods on a midstream urine sample. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.Results: The mean age of the study population was 57 years. Females constituted 62.39% of participants. Burning micturition (52.99%) was the most common presenting symptom. The prevalence of culture positive UTI was 51.28%. Among gram-negative bacilli, Escherichia coli (20.51%), Klebsiella (6.85%) dominated the culture reports. Enterococcus (4.27%) and Staphylococcus aureus (2.6%) were the common gram-positive organisms isolated.  Meropenem was the most effective antibiotic against E. coli (87.5%) and Klebsiella (95%) Vancomycin had 100% sensitivity against Enterococci and S. aureus.Conclusions: More than half of diabetic patients presenting with symptoms of UTI had culture positive UTI, predominantly caused by gram negative organisms. There is a need for comparative studies of Diabetes and controls to explore the key differences in the pattern of UTI.
A comparative study of inflammatory marker highly sensitive C- Reactive Protein in depression patients exhibiting suicidal behaviour and depression patients without suicidal behaviour
Authors: Mudgal Varchasvi , Pal V. S. , Rastogi Pali , Lohokare Rajeev
Published: February 2020

Background: Recent research have found a link between inflammatory pathway and suicidal behaviour. hs-CRP, IL, TNF have been shown to have significant alterations in suicidality, however multiple covariates influence this relationship. One of the main limitations of most of the studies is that they have evaluated the CRP in patients demonstrating suicidal behaviour but not in depression. No study has been conducted in Indian subpopulation with parameters of our study. Aims of the study was to compare hsCRP levels between depression patients with suicidal behaviour and without suicidal behaviour.Methods: Authors compared 50 depression patients with suicidal behaviour and 50 depression patients without suicidal behaviour, diagnosed using ICD10. Hamilton Depression Rating Scale (HDRS‑17), Suicide behaviour Questionnaire- Revised (SBQ-R), Beck Scale for Suicidal Ideation (BSSI) were applied for assessment of depression and suicidality. Highly sensitive CRP was measured using autoanalyzer.Results: hsCRP levels were significantly high in depression patients with suicidal behaviour (4.12 mg/dl) than depression without suicidal behaviour (2.42 mg/dl). Duration of illness, HAM-D, BSSI and SBQ-R scores correlated positively with hsCRP levels.Conclusions: Depression with suicidal behaviour patients have a significantly higher hs-CRP levels than depression without suicidal behaviour. Patients of depression with suicidal behaviour group have a strong positive correlation between hs-CRP levels and HAM-D, BSSI and SBQ-R scores.
Palestinian emergency nurses’ knowledge and role perception about disaster management: a need for immediate actions
Authors: Saidam Mohammed N. , Eljedi Ashraf Y.
Published: February 2020

Background: Preventing, preparing for, responding to, and recovering from disasters have become a priority for everyone. Gaza Strip in Palestine is constantly exposed to wars and disasters. One of the most prominent respondents to disasters in the health care system is emergency nurses. This study aimed to identify the role perception of Palestinian emergency nurses in Gaza Strip during disaster and their level of knowledge about disaster management.Methods: The analytical descriptive cross-sectional approach was used.  The study sample consisted of all nurses working in emergency departments at the governmental hospitals in Gaza Strip. The eligible nurses were 180; only 162 filled the questionnaire with response rate 90% after signing the consent form. Data were analyzed using mean, t test and ANOVA.Results: The findings indicated that 75.9% of emergency nurses were male. About 53% were 20-29 years old. Most of them hold bachelor degree (73.5%) while only 4.3% had a master degree. The study found that the level of “role perception of nurses during disasters” was 81.5% (e.g., ability to participate in an emergency plan, provide psychosocial support, have high confidence during emergencies, etc.), followed by field of “nurses’ knowledge of disasters” with 78.03% (e.g., past experience, updated information, etc.).Conclusions: Although the Palestinian emergency nurses have an acceptable level of knowledge and role perception during disasters, they still need to raise their level of knowledge, preparedness and skills by integrating clearly defined theoretical and training sessions on disaster management in nursing curricula and through in-service activities for employees.
A situation model of integrated health information platform in India: an anticipated review
Authors: Ka Mogan , Periyasamy Aravind Gandhi , U. Venkatesh , Kishore Jugal
Published: February 2020

Health system in India is fragmented with different kinds of health care providers engaged in the delivery of health services across rural and urban areas. The integration of health information in a single platform aids in strengthening the public health surveillance systems, better decision support system, improvement in the efficiency and effectiveness in the context of health education and monitoring. In order to integrate the public health data and strengthen the surveillance and monitoring, the integrated health information platform (IHIP) was launched as pilot project following the report of the joint monitoring mission of the World Health Organization. IHIP integrates the electronic health records of the citizens on a pan-India basis aids in providing a comprehensive health profile of the population. Integrated disease surveillance programme (IDSP) module of integrated health information platform (IHIP) was the earliest initiative of integrating various health programmes. It is a web-based real-time, village wise, case-based electronic health information system that will aim to provide details about epidemic-prone diseases with geographical information system (GIS) thus reducing the morbidity and mortality and lessening disease burden in the populations. GIS information obtained via IHIP provides information in the form of a geographical map as interface data with real-time monitoring thus contributes to Geospatial Epidemiology in addition to information by IDSP. This article aims to describe the anticipated model of IHIP in the context of providing ‘One Health’ by the integration of health sectors.
Effects of hypothyroidism in Indian women of reproductive age group – A review article
Authors: Kotur Pushpa , Kumar Selvi
Published: February 2020

Thyroid diseases are the commonest endocrine disorders worldwide. Thyroid dysfunction is 10 times more common in women than in men. Hypothyroidism among women of reproductive age group is linked to menstrual irregularities, polycystic ovaries, recurrent pregnancy loss and infertility

The aim of the present review is to provide a comprehensive view of the literature regarding the association of hypothyroidism in reproductive age group women 15-45 years.

: A literature search was performed using electronic databases like Pubmed/ Medline to identify from 2000 to 201 8. The search yielded around 18 original research articles.

In Correlation of Hypothyroidism with Reproductive Health Problem, the various studies results show that menorrghia is the commonest menstrual irregularity in 27%-72%, next common menstrual irregularity is oligomenorrhea varying from 5 - 26 %. As reviewed from various other studies on association of hypothyroidism with PCOS was found to be between 21% - 32%, Hypothyroidism with Infertility was 22% - 32% and hypothyroidism with recurrent pregnancy loss was found to be 4-15%.

In reproductive age women with hypothyroidism have reproductive health problems like menstrual irregularities, polycystic ovarian syndrome, miscarriages and infertility. Hence thyroid function test should be routinely recommended for all women in reproductive age as it helps in early detection of hypothyr oidism that can be treated medically with hormones and is cost-effective. Unnecessary surgery can be avoided in menstrual irregularities like menorrhagia and complications of pregnancy can be prevented which will reduce burden on the health system and society.
Analysis of cesarean sections using Robsons classification system in a tertiary hospital in New Delhi
Authors: De Arpita , Tripathi Reva , Gupta Neha
Published: February 2020

To analyze cesarean section rates using Robsons 10 group classification system in a tertiary hospital over a period of five years (July 2014-Dec 2018).

To analyze the main contributors of cesarean sections based on the ten groups under Robsons classification and to further analyze the main indications of cesareans in the relevant groups.

All women with one or more previous cesareans with cephalic presentation (group V) contributed to the maximum number of cesareans, (32.5%), closely followed by group I (22.86%) and group IIA (10.25%). 31.65% of the total cesareans were elective cases, 17.23% were in women with inductions and 51.1% of the cesareans were in spontaneously laboring women.

Robsons Ten Group Classification system (TGCS) found to be easy to understand, clear, mutually exclusive, reproducible system for classifying cesareans in all levels of Institutions. Among women who had elective cesareans, maximum were done in those in Group V who were not willing for TOLAC or those who has previous two cesareans. In spontaneously laboring women, 34% were due to meconium stained liquor and 32.9% were due to fetal distress, thus leaving a huge scope for reduction in cesarean rates.

All institutions should routinely monitor cesareans based on Robsons TGCS to monitor time trends and for interinstitutional comparisons. Interventions should be targeted at maximizing normal deliveries, reducing primary cesareans and offering TOLAC where possible. There should be institutional protocols for defining indications like fetal distress, nonprogress of labour, failed induction and protocols for their managements.
A study to assess the use oftranexamic acid intraoperative & post cesarean section to reduce blood loss
Authors: Jahangir Juveria , Zahra Shaik Mohd Fatima
Published: February 2020

The connection between cesarean bleeding is comprehended both during and after C. section. The post-partum bleeding remains the principle reason of maternal complications. This investigation was directed to assess the impact and wellbeing of tranexamic acid to de crease cesarean blood loss (LSCS) and any reactions.

Normal 100 women planned cesarean were analyzed somewhere in the range of 37 and 40 weeks. They were partitioned into two groups. The main group 50 individuals received 1 gm IV of tranexamic acid before 15 min of caesarean and the control set of 50 individuals didn't get tranexamic acid.

The patient age, tallness, weight, gestational age in the two gatherings were comparative, measurably same. Haemoglobin fell marginally after labour in the two gatherings, however no measurable distinction between the two gatherings was watched. There were no thrombosis events in the investigation. Tranexamic acid drops the blood loss from the minute the placenta was conveyed to 2 hours after labour (P <0.001) and from the finish of the LSCS to 2 hours after labour (P <0.001).

Tranexamic acid assumes a powerful job in diminishing blood loss during LSCS without making an unfavourable response. Hence, it tends to be utilized viably to diminish maternal bleeding during LSCS.