bluuebunny/crossref_metadata_2025 huggingface dataset:
Pregnancy and labor in gonadal dysgenesis (Case report)
Authors: Isakova E. V. , Arjanova O. N. , Shlyahtenko T. N. , Korsak V. S.
Published: November 2021

At the age of 20 Patient K. passed the operation of laparotomy and excision of rudimentary gonads and uterine tubes due to dysgenesis of the gonads (46XY). Histological identification found cells of Leidig type whose existence proves presence of Y- chromosome in the patients karyotype. As a result of the treatment the recipient got pregnant with a triplet. As a result, she delivered a boy with the weight of 2750 gr. and height of 49 cm and a girl with the weight of 2850 gr. and height of 49 cm. The recipients lactation in the postnatal stage was sufficient.
From the history of the Otts' stock
Authors: Yakovenko T. G.
Published: November 2021

The article contains the information about D.O.Ottss genealogy. D.O.Ott (1855-1929) was one of the founders of the original Russian obstetrical and gynecological school and the director (since 1893) of the Emperors Clinical Institute of Midwifery and Gynecology, which is known today as the Institute of Obstetrics and Gynecology named by D.O.Ott under the Russian Academy of Medical Sciences. The article is written on the basis of the archive and historical documents.
Hygienical aspects of military service of women in Russia
Authors: Lizunov U. V. , Tsutsiev S. A. , Terentiev L. P. , Mesniankin V. N. , Kira E. F. , Bezhenar V. F.
Published: November 2021

In this article the necessity of strict scientifical reglamentation of conditions and peculiarities of military service in women for providing the preservation and improvement of their reproduction health status.
An Educational Leader’s E-Mails to the Parents During COVID-19 Pandemic
Authors: KIRAL Bilgen , BRİON Corinne
Published: November 2021

This study was conducted to determine what kinds of e-mails an education leader (school principal) sent to
the parents of the students at the beginning, during, and end of the term during the COVID-19 pandemic
process. In this study, the expression “educational leader” was used instead of the school principal.
The reason for this is that the school principal fully assumes the role of educational leadership during
the pandemic period. The subject of the study is the transformation process in communication due to
the pandemic. This transformation is e-mails, one of the digital communication tools that aim to reach
everyone at the same time. The e-mails in this study were chosen from non-personal and non-private
e-mails. The data included from 74 e-mails sent to the parents by an educational leader in Ohio State in
the United States. E-mails were analyzed using document and content analysis method. Most of the e-mails
contained more than one subject. In each of the e-mails was written the education leader’s good wishes and
not be hesitate from contact. The education leader sent e-mails about health, and cleaning, technology,
information, activities, family-related, and other topics. At the end of the study, recommendations such as
sending a survey to the parents to determine communication preferences at the beginning of the school
year, and e-mails translated into their own language were offered who did not speak English.
Wybrane aspekty prawne dotyczące przetwarzania danych biometrycznych pracowników
Authors: Zaborska Sylwia
Published: November 2021

Given the growing popularity of biometrics, doubts about the conditions for biometric data processing can be noticed in practice. These inaccuracies take place in various areas of law, including labour law. This article provides a theoretical discussion on the processing of special categories of data. It aims to point to the need for appropriate legal regulations to ensure the security of the processing of biometric data of employees and candidate employees. The article starts with clarifying the concept of biometric data and discusses the practical aspects of the use of biometric tools. Further on, the author analyses the legal regulations concerning the processing of biometric data in the relations between the employer as the personal data controller and the employee as the data subject. As a result of the studies carried out, a position was presented which indicates that the employer who processes biometric data of employees and candidates for employment should always find out whether he has legal justification to process the data in question. This article is one of the few studies on the processing of biometric data in Polish literature on the subject. The main purpose hereof is to present situations under the current legislation, in which the employer can process biometric data of its employees. The article is a form of universal presentation of the problem and may be of interest especially to legal practitioners.
Императивы перехода на новую модель социально-экономического развития
Authors: Энтин Марк , Энтина Екатерина , Братерский Максим
Published: November 2021

В статье ставится вопрос об острой необходимости перехода на новую модель социально-экономического развития, в основе которой должно лежать коренным образом переосмысленное понимание прогресса во всех его элементах и проявлениях. Как доказывают авторы, в постковидном мире он будет все стремительнее приобретать характер экосистемного прогресса, экосистемного не в смысле экологии, а в смысле набора характеристик и процессов, объединенных в обществе и государстве. Экосистема, в таком понимании, проникает во все ключевые сферы жизни государства и общества и дает синергетический эффект, т.е. экосистема здесь — это концепция бизнес-экосистемы, но примененная к государству и обществу. Его отличительной чертой становится одновременное взаимоподдерживающее изменение всех сторон человеческой жизни на основе непрерывного создания, освоения и тиражирования новых технологий, дающее экспоненциальное повышение эффективности функционирования всех элементов человеческого социума и общества в целом. Переход от прогресса “старого” типа к экосистемному прогрессу потребует времени и усилий. Но благодаря тем результатам, которые будут достигаться на этом пути, он будет постоянно ускоряться. Те страны, которые вовремя оседлают волну экосистемного прогресса, поставят перед собой эту задачу и раньше других приступят к ее осуществлению, выиграют от этого в наибольшей степени. Они станут образцом для других и провозвестником новой линейки ценностных ориентиров и построенной на них цивилизации.
Политика и контроль над вооружениями
Authors: Ознобищев Сергей
Published: November 2021

На протяжении всего периода холодной войны гонка вооружений была обусловлена идеологизированным противостоянием двух сверхдержав, представлявших антагонистические общественные системы. Сегодня представители элит США и России пытаются воссоздать элементы новой “фарсовой” холодной войны за счет русофобии одной стороны и антизападничества – другой. Начиная с эпохи горбачевской перестройки их взаимоотношения пережили несколько циклов, начинавшихся с надежд по установлению отношений нового типа – тесного сотрудничества и партнерства и заканчивая периодом ухудшения отношений. По ряду вполне рациональных соображений США и СССР, как основные проводники и участники гонки вооружений, инициировали процесс контроля над вооружениями, который, как считалось, приобрел свою собственную позитивную инерцию. Однако оказалось, что этот процесс гораздо больше, чем предполагалось, привязан к состоянию политических отношений и мало способен на достижение позитивных результатов вне политической конъюнктуры. В итоге под воздействием неблагоприятных политических условий различные направления контроля над вооружениями, одно за другим, зашли в тупик. Более того, стало ясно, что наработанная десятилетиями система контроля над вооружениями может оказаться на грани полного разрушения, что почти стало реальностью после украинского кризиса 2014 г. и, особенно, в период президентства Д. Трампа. Продление СНВ-3 (Пражского ДСНВ), состоявшееся практически на грани политического и переговорного “фола”, ставит вопрос не столько о технике компромиссов на пути к новому договору, сколько об обеспечении непрерывности и результативности процесса контроля над вооружениями, являющегося ключевым элементом стратегической стабильности.
Освещение выборов в Казахстане и Украине российскими СМИ
Authors: Кольцова Олеся , Юдина Дарья , Пашахин Сергей , Колычева Алина
Published: November 2021

Проявления политической пристрастности в освещении политических событий за рубежом, несмотря на большой объем исследований, слабо изучены в двух аспектах. Во-первых, не изучается, как это освещение может быть связано с наличием конфликта между страной, чьи СМИ анализируются, и освещаемой страной в сравнении с бесконфликтными конфигурациями. Во-вторых, пристрастность, или систематическое смещение (bias) обычно рассматривается как атрибут всей медиасистемы страны, без попыток изучить дифференциацию освещения разными типами СМИ. Чтобы частично закрыть эти лакуны, мы изучили, как фреймирование новостей о выборах в стране, которая находится с Россией в бесконфликтных отношениях (Казахстан), и в стране, чьи отношения с Россией конфликтны (Украина), различается в российских медиа разных типов: подконтрольных государству, оппозиционно-либеральных и нейтральных. Для этого были отобраны 30 популярных российских интернет-изданий, разделенных экспертами на три перечисленных типа. Из сплошной выборки новостей этих СМИ были отобраны 792 новости о выборах в Украине и Казахстане, принадлежащие трем типам СМИ в равных пропорциях, и размечены по трем видам медиафреймов: провластному, либеральному и нейтральному. Преобладание одного из полярных фреймов в СМИ расценивалось как наличие систематического смещения. Исследование показало, что провластное смещение наблюдается только в одной, хотя и преобладающей группе СМИ – подконтрольной. В остальных группах распространен нейтральный фрейм, что говорит о доступе заметной части российской аудитории к отличным от провластного способам освещения зарубежных событий. Однако при этом в освещении Украины распределение долей всех трех фреймов по трем типам СМИ смещено в провластную сторону по сравнению с освещением Казахстана. Одновременно оказалось, что тексты оппозиционных СМИ о Казахстане – единственная группа новостей, где наблюдается либеральное смещение. Таким образом, освещение бесконфликтной страны оказывается более поляризованным, чем освещение страны, с которой есть конфликт, чему в статье дается ряд интерпретаций.
Политические провокации в электоральных дебатах кандидатов на пост президента США
Authors: Тумский Станислав
Published: November 2021

Провокации, а также их составляющие в речетворческой деятельности политиков разного толка, направленной на формирование выгодного им общественного мнения, играют все более заметную роль в сегодняшних политических процессах в мире, в частности в США. В статье рассматривается применение провокаций и манипулятивно-провокационных техник в электоральных дебатах на примере выступлений Д. Трампа в предвыборных теледебатах в 2020 г. С целью проведения исследования был проанализирован полный текст выступлений кандидатов на пост президента США Д. Трампа и Дж. Байдена в рамках предвыборных теледебатов в октябре 2020 г., включая две коммуникативные ситуации с применением провокаций. В работе использованы методы “обоснованной теории” (grounded theory), семантического, концептуального, дискурсивного, контент-анализа, анализа документов (данные из СМИ), case study. Семантический и концептуальный анализ позволил выделить имплицитные смыслы и случаи использования провокаций участниками теледебатов. Статистический анализ дал возможность определить частотность использования провокационных техник коммуникантами, сгруппировать случаи применения провокаций. Проведенное исследование выявило случаи использования провокаций в рамках коммуникативных тактик оправдания, виктимизации, виртуализации реальности, создания ложных образов и обвинения. Автор пришел к выводу, что активное применение провокаций политиками в электоральном дискурсе обусловлено необходимостью скрытого воздействия на общественное сознание и может представлять собой эффективную стратегию укрепления своих позиций при отсутствии явных преимуществ перед соперником. Также было сделано заключение, что высокая частотность провокаций и манипулятивно-провокационных техник в речи политиков может создать репутационные риски и снизить вероятность победы кандидата-провокатора на выборах.
Динамика представлений россиян о соотношении интересов индивида и государства: эмпирический анализ
Authors: Тихонова Наталья
Published: November 2021

В последние годы в России идет быстрый рост числа сторонников приоритетности прав человека за счет сокращения численности сторонников приоритетности интересов государства. Конфликт между взглядами этих групп является, однако, не столько глубинным ценностным конфликтом, сколько результатом разного видения путей достижения желаемого будущего России. Разница взглядов членов этих групп на соотношение интересов государства и прав человека связана прежде всего с их социально-психологическими особенностями (ориентация на нонконформизм, фрустрация из-за невозможности реализовать свои базовые жизненные цели и т.д.), а не с их объективным положением или идеологическими воззрениями. Группа сторонников приоритетности интересов государства имеет два массовых “ядра” (одно – стихийно-патриархальное, второе – с осознанной консервативной идеологией). Что же касается сторонников приоритетности прав человека, то гетерогенность этой группы очень велика и продолжает расти, поскольку ее расширение происходит прежде всего за счет жителей малых и средних городов, а также россиян старших возрастов (в итоге сейчас нет уже ни одной возрастной когорты, где число сторонников приоритетности интересов государства было бы больше числа сторонников приоритетности прав человека). Представителей групп, образующих базу для формирования российского среднего класса, с большей вероятностью можно встретить среди сторонников приоритетности интересов государства. Сторонников приоритетности прав человека волнуют не столько ценности демократии, сколько такие социально-экономические проблемы, как избыточные неравенства, наступление бюрократии на личное пространство россиян, неуверенность в завтрашнем дне и т.п. Состав, специфика взглядов и электоральные предпочтения группы сторонников приоритетности прав человека говорят о том, что они не могут выступить базой ни для системной, ни для несистемной оппозиции, хотя и характеризуются повышенной готовностью к “уличной” протестной активности.
Клиентелизм и неформальные сети региональных элит в России: опыт сетевого анализа на примере Свердловской области
Authors: Мельников Кирилл
Published: November 2021

Изучение неформальных аспектов политических взаимодействий стало влиятельным исследовательским трендом в анализе российского и, шире, постсоветских политических режимов. Чаще всего концептуальной основой для этого становятся категории патрон-клиентских отношений и неформальных сетей. Несмотря на очевидные коннотации, в изучении последних исследователи крайне редко пользуются возможностями аппарата сетевого анализа (SNA). В то же время он позволяет не только визуализировать сеть и математически оценить различные ее параметры, но и выдвигает гораздо более строгие требования к концептуализации неформальных сетей по сравнению с качественными подходами, в которых понятие неформальной сети до сих представляет собой скорее метафору, чем аналитически обоснованную категорию. В рамках настоящего исследования с помощью метода SNA проанализированы неформальные сети административных элит Свердловской области. Этот регион сумел довольно быстро преодолеть серьезные экономические трудности, вызванные распадом СССР, преуспел в торге с федеральным центром относительно усиления своего правового статуса, а его первый губернатор, Эдуард Россель, традиционно рассматривается как значимая фигура когорты “региональных тяжеловесов” конца 1990-х – начала 2000-х годов. Эти особенности Свердловской области исследователи нередко объясняют силой неформальных сетей, сформировавшихся в регионе, однако такое предположение до сих пор не подвергалось количественной верификации. С этой целью в настоящем исследовании проанализированы неформальные сети руководителей региональных органов исполнительной власти в разрезе двух периодов, совпадающих со сроками полномочий экс-губернаторов Э. Росселя и А. Мишарина. Неформальные сети строились на основе анализа биографий. Поэтому эмпирической базой исследования стала собранная автором база данных биографий для 78 чиновников, состоящая из 665 строк, каждая из которых содержит информацию о карьерном пути включенных в выборку акторов. Далее с помощью кода, написанного на языке R, были найдены пересечения в карьерных путях всех возможных пар чиновников до их попадания на элитные позиции. На основе полученных пересечений были сформированы сети личных связей. Оценив структуру сетей, плотность, наличие сообществ, а также сетевые позиции акторов, мы увидели, как могут различаться паттерны структурирования неформальных сетей в зависимости от стратегий их лидеров.
Robust Parameter Design of Shielded Metal Arc Welding (SMAW) for Optimum Tensile Strength
Authors: Setiawan Moh. Dedy Indra , Pradana Yanuar Rohmat Aji , Suprayitno Suprayitno
Published: November 2021

Shielded Metal Arc Welding (SMAW), an arc welding process, is widely used in applications. In practice, SMAW is widely applied to the welding process on hollow square pipe. Performance expected from this welding is the tensile strength of weld joint. The tensile strength is influenced by parameters process which have possibility for an optimization process to become ‘robust’. Robust is a design which less sensitive to the effect of uncertain quantities or noise factors. Taguchi method is the most efficient optimization method which accommodates the noise factors effect and requires less experiment. This study is focusing on optimizing the welding process on hollow square pipe. Parameters process such as welding current (I), electrode angle (θ), root gap (d) and electrode type (E) are adopted as parameters design. Taguchi method are chosen as a strategy and L9 fractional orthogonal array are chosen as the design experiment, which only 9 experiment samples needed from 81 experiments that should have been carried out for full factorial design. The objectivity is to maximize the tensile strength of weld joint. Three replications of L9 fractional orthogonal array Taguchi had been performed to generate the tensile strength and estimates the fluctuation of the output caused by noise factors. This study found that the welding current of 100A (I), electrode angle (θ) of 90°, root gap (d) of 2 mm, and electrode type (E) of E7018 produce the optimum results. Tensile strength improved from this robust parameter design is about 98.39 MPa based on initial parameter design.
Comparative Studies on Combustion Characteristics of Blended Crude Jatropha Oil with Magnetic Liquid Catalyst and DEX under Normal Gravity Condition
Authors: Nanlohy Hendry Y.
Published: November 2021

A comparative study on the combustion characteristics of a single droplet fueled by DEX, crude jatropha oil (CJO), and a mixture of CJO with a magnetic liquid catalyst of rhodium trisulfate has been carried out under normal gravity conditions. The high viscosity of crude jatropha oil makes it difficult to burn under normal conditions (room temperature and atmospheric pressure), therefore the addition of a magnetic liquid catalyst rhodium trisulfate is needed to improve the properties of crude jatropha oil. As a catalyst, rhodium trisulfate has the potential to improve combustion performance while improving the physical properties of crude jatropha oil as an alternative fuel for the better. Furthermore, performance tests were also carried out with DEX fuel with a cetane number (CNs) 53. The results showed that compared to DEX, it was seen that the liquid metal catalyst rhodium trisulfate succeeded in making crude jatropha oil more charged so that the combustion process was better. This is evidenced by a significant change in the dimensions of the flame and an increase in the combustion temperature. Moreover, it is also seen that the burning rate increases and the ignition delay become faster.
Implementation of Internet of Things (IoT) in a Plastic Blow Moulding Machine and Its Performance Measurement
Authors: Faqih Muhammad Fadhlurrohman , Darsin Mahros , IMuttaqin Aris Zainul , Yudistiro Danang
Published: November 2021

Efficiency and effectiveness are indispensable things in the production process. Accurate use of existing resources and the shorter cycle time of production are of particular concern to optimize the production process. This research aims to implement automation to a conventional blow molding. An advanced attempt was carried out to use the Internet of Things (IoT) to increase its efficiency while maintaining the quality of the products. The use of the nodeMCU microcontroller and the blynk application allows the operator to operate the machine without having to come into or having direct contact with the machine. The performance of automation and IoT were tested by examining the products using Taguchi design using quality criteria of nominal the best. The efficiency of the system was also considered by comparing the cycle production time. S/N ratio of Taguchi analysis showed that the optimum volume of the bottle would be achieved when applying the temperature, injection time, and holding time of 190 oC, 14 minutes, and 5 minutes respectively. The error or deviation is only 0.41%. The application of the IoT system takes 34.45 seconds for a cycle time production, which is 3.76 seconds faster than a conventional system.
Characterization of Bacterial Nanocellulose - Graphite Nanoplatelets Composite Films
Authors: Susilo Bili Darnanto , Suryanto Heru , Aminnudin Aminnudin
Published: November 2021

Bacterial cellulose (BC) was synthesized from pineapple peel extract media with addition of fermentation agent bacteria Acetobacter xylinum. BC was disintegrated from the pellicle into bacterial nanocellulose (BNC) by using a high-pressure homogenizer (hph) machine, which has a three-dimensional woven nanofibrous network. The synthesis of composite films started when BNC, graphite nanoplatelets, and cetyltrimethylammonium bromide (CTAB) were homogenized using an ultrasonic homogenizer then baked on a glass mold at a temperature of 80 degrees Celcius for 14h. A scanning electron microscope (SEM) was used to analyze its morphology. X-Ray diffraction spectra were used to analyze the composite films structure. The functional groups of the composite films were analyzed using the FTIR spectrum. SEM micrograph shows that GNP was evenly distributed into BNC matrix after CTAB addition. GNPs are shown as flat and smooth flakes with sharp corners. Some peak corresponds O-H, C-H, C≡C, and CH3 stretching was identified by using FTIR spectroscopy at wavenumber 3379, 2893, 2135, and 1340 cm-1, respectively. XRD analysis shows that Crystalline Index (C.I) of BNC increases after 2.5 wt% addition of GNP. The presence of CTAB decreases C.I value of composite films. BNC/GNP composite films have the best mechanical properties with Young’s modulus about 77.01 ± 8.564.
Relación entre APGAR al minuto y oligohidramnios en gestante a término atendidas en el hospital
Authors: Muñiz Algarín Flabia Katherine , Romero Ozuna Ana Jacinta , Julio Mendoza Mario , Bolaño Cervantes Marco
Published: November 2021

Objetivo: Determinar la relación entre APGAR al minuto y la presencia de oligohidramnios en gestantes a término atendidas en el Hospital Niño Jesús de Barranquilla durante el período 2018 a 2019. Materiales y métodos: Estudio descriptivo, trasversal, retrospectivo, tipo serie de casos. Se incluyeron 203 mujeres embarazadas que fueron atendidas en el Hospital Niño Jesús, con embarazo a término y diagnostico ultrasonográfico de oligohidramnios (ILA menor o igual a 5 cm), durante los años 2018 y 2019. Se relacionaron variables sociodemográficas y gineco obstétricas con el resultado del APGAR y del ILA y se compararon los resultados utilizando Chi2 y prueba de Fisher. Resultados: El promedio de edad de las participantes fue de 23,6 años (DE+/-: 5,7); 48,8% provenían de municipios del departamento del Atlántico y 18,2% de Venezuela; 48,3% tenían un ILA de 4 a 4,9 y 8,4% tuvieron APGAR al minuto menor a 7; 4,9% tuvieron productos con bajo peso al nacer; 15,3% de los que tuvieron ILA de 1 a 3 tuvieron APGAR menor de 7, frente a 5,6% de los que tuvieron ILA de 4 a 5 (Chi2: 5,13; p: 0,024). Así mismo, 40% de las que tuvieron bajo peso al nacer presentaron APGAR <7 en contraste con 6,7% de las que tuvieron productos con peso normal (Fisher: 0,005). Conclusión: Se encontró una relación directamente proporcional entre el valor del ILA y los resultados del APGAR al minuto, y esta relación debe analizarse mediante un estudio de casos y controles. De igual forma se dedujo que el nivel inferior más seguro de líquido amniótico con el que se pueden presentar menos resultados perinatales adversos como la asfixia perinatal es con un ILA igual o mayor de 4 cm.
Uso de metformina en pacientes diabéticos con falla cardiaca y riesgo de mortalidad: una revisión sistemática
Authors: Beltrán Castro Marvin , Bravo Duque Andrea
Published: November 2021

Objetivo. Evaluar el riesgo de mortalidad de la metformina frente a otros antidiabéticos pacientes con  diabetes mellitus y falla cardiaca. Diseño. Revisión sistemática. Fuentes de datos. PUBMED,  MEDLINE y SCIENCE DIRECT. Selección de estudios. Se encontraron 43 artículos relacionados en idioma inglés, de los cuales se seleccionaron 4 estudios con diseño de tipo Cohorte, por cumplimiento de criterios de inclusión. Extracción de datos. Dos investigadores extrajeron los datos y evaluaron la calidad de los mismos. Resultados. Se analizaron 4 estudios, los cuales reportaron mayor beneficio frente a otros antidiabéticos en mortalidad total: Josie MM Evans et al. con un OR: 0,67    (IC 0,51 a 0,88, P <0,05); David Aguilar et al. con un HR: 0,76           (IC 0,63 a 0,92, P <0,01); Arkadiusz Retwiński et al. con un HR: 0,85 (IC 0,81 a 0,89, p 0,023); y Brian A Bergmark et al. con un OR: 0,75 (IC 0,59-0,95, P > 0,10). Conclusiones. Hay evidencia sostenida de que el tratamiento en monoterapia o combinado con Metformina en comparación con otra medicación antidiabética resulta en efectos beneficiosos en cuento a reducción de mortalidad en pacientes con diabetes mellitus y falla cardiaca concomitante.
Implementasi Ratifikasi Agreement on Trade Related Aspects of Intellectual Property Right (Trips Agremeent) terhadap Politik Hukum di Indonesia
Authors: Setyoningsih Erika Vivin
Published: November 2021

Penelitian Yuridis normatif ini dilakukan untuk mengkaji ratifikasi perjanjian internasional terkait Hak Kekayaan Intelektual (HAKI) apakah sudah sesuai dengan kondisi politik hukum di Indonesia.  HAKI merupakan hak ekslusif yang tumbuh dari hasil olah pikir rasio manusia yang diekspresikan kepada khalayak umum dalam berbagai bentuk barang dan jasa, yang mengandung manfaat dan berguna dalam menunjang kebutuhan hidup umat manusia, serta mempunyai nilai ekonomi dan nilai moral. Indonesia adalah negara yang menandatangani kesepakatan terhadap pembentukan organisasi perdagangan dunia (World Trade Organization).  Perjanjian yang ditandatangai oleh Indonesia yang terkait dengan aspek perdagangan internasional yang berhubungan dengan HAKI adalah Agreement on Trade Related Aspect Of Intellectual Property Right (Trips Agreement), yang telah diratifikasi oleh Pemerintah Indonesia ke dalam Undang-Undang No. 7 Tahun 1994 tentang Pengesahan Agreement Establishing The World Trade Organization (Persetujuan Pembentukan Organisasi Perdagangan Dunia). Penelitian menemukan fakta bahwa ratifikasi perjanjian internasional ini menimbulkan dampak yang dapat mempengaruhi iklim politik hukum di Indonesia. Seharusnya kesepakatan dalam ratifikasi TRIPs Agreement ke dalam hukum nasional disesuaikan dengan politik hukum bangsa Indonesia, sehingga implementasi ratifikasi perjanjian internasional HAKI terhadap politik hukum di Indonesia berjalan dalam koridor yang sesuai.
Study of mode of delivery and maternal morbidity in preterm and term COVID-19 positive pregnant women
Authors: Dholakiya Saksha , Singh Pooja S. , Bamniya Jaishree , Doshi Haresh U.
Published: November 2021

Background: Pregnant women are likely to represent a high-risk population during current coronavirus 2019 pandemic caused by severe acute respiratory syndrome coronavirus-2. The aim and objective of this study was to evaluate how COVID-19 pandemic has affected the mode of delivery and whether complications of the disease and mortality rate are higher in pregnant women than in non‐pregnant women.Methods: This ambispective observational study was conducted in department of obstetrics and gynaecology of our institute. Pregnant women diagnosed with positive for COVID-19 via the SARS-CoV-2 RT-PCR test in the third trimester and all neonates with complete COVID-19 testing and delivery data. This data was analysed.Results: Out of total 66 cases studied, 48 patients (72.7%) were asymptomatic, while 13 (19.7%) had mild respiratory or gastro intestinal symptoms on initial assessment at admission, including cough, sore throat, fever, weakness or diarrhoea. Cesarean sections were performed in 57.6% of cases. There were no cases of maternal or neonatal mortality.Conclusions: The study revealed that COVID-19 positive pregnant women are usually asymptomatic or mild-moderately symptomatic, similar to COVID-19 positive non-pregnant women. There was a noted rise in the rate of caesarean sections as a mode of delivery.
Study of mode of delivery and fetal outcome in pregnancies with oligohydramnios
Authors: B. Lavanya , Prajwala A.
Published: November 2021

Background: The significance of amniotic fluid volume as a marker of fetal status is an ongoing turn of events. Oligohydramnios causes adverse fetal outcomes like meconium-stained liquor, meconium aspiration syndrome, fetal heart rate abnormalities, poor APGAR scores, fetal growth restriction and fetal prematurity. It is associated with maternal hypertension, infections, and placental insufficiency. It causes maternal complication because of increased incidence of induction of labour and operative intervention.Methods: Hundred cases of oligohydramnios were included in our study conducted at the Navodaya medical research, hospital and research centre, during a period of two years after obtaining the informed consent of patients and institutional ethical clearance. All gravidas were included with a gestational age greater than 28 weeks with singleton pregnancies with oligohydramnios. Associated fetal and maternal risk factors were observed. The amniotic fluid index (AFI) was measured by ultrasound. The nonstress test, the fetal biophysical profile and the Doppler study were carried out to evaluate the fetal condition. Then we have observed for delivery and fetal outcome.Results: Incidence of oligohydramnios was 2.85% in our study. The 53% of cases had LSCS while 47% had normal delivery. Fetal distress was the commonest indication for LSCS. Poor neonatal APGAR score was 16.9% in LSCS while 36% in vaginal delivery.Conclusions: From the above study, the caesarean delivery seems to be a safer mode of delivery than vaginal delivery because it is associated with a good perinatal outcome.
A study to identify clinical and laboratory parameters in cases of excessive vomiting in early pregnancy
Authors: Dubey Dyuti , Agrawal Usha , Sapkal Rekha
Published: November 2021

Background: Around half of all pregnant women experience vomiting, and more than 80% of women experience nausea in the first 12 weeks. Women with severe nausea and vomiting during pregnancy may have hyperemesis gravidarum (HG), an entity distinct from nausea and vomiting of pregnancy (NVP), which if left untreated may lead to significant maternal and foetal morbidity. In our study, we studied, clinical and laboratory parameters in patients presenting with excessive vomiting. The study may help in evaluating what is the major clinical problem encountered during treatment and how many days of care are needed in such cases.Methods: The study design was a prospective observational study. Patients attending the ANC clinic and emergency indoor cases at Peoples college of medical sciences, Bhopal were considered as study population. 100 patients who satisfied inclusion and exclusion criteria were included in the study. Patient’s sociodemographic variables, detailed obstetric history, clinical and laboratory parameters were recorded. Results obtained were analysed and tabulated.Results: Persistence of vomiting in the first trimester leading to dehydration and hospitalization was documented in 12% of patients. The 5% of then had metabolic acidosis and 1% required correction of starvation ketoacidosis, but there was not significant weight loss observed in any of the case. Liver function test were normal in almost in all cases except 9% had raised serum alkaline phosphatase levels.Conclusions: All cases with vomiting in early pregnancy should receive attention and exclusion of all emergency clinical conditions. Patient should be screened for urine tract infection and diabetes in all cases.
A prospective observational study on maternal near miss cases in a rural teaching hospital
Authors: Mahajan Mamta , Soni Anjali , Sharma C. D. , Moudgil Shelley
Published: November 2021

Background: Women who have survived complications during pregnancy and child birth have been studied and termed Maternal near miss (MNM). All near misses should be interpreted as free lesson and opportunities to improve the quality of service provision. The aim of the study was to know the incidence, risk factors and underline causes of MNM in our setup as there is limited data from Himachal Pradesh.Methods: The present study was a prospective observational study that was carried out in the department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College Kangra at Tanda (HP), from 1st January 2018 to 31st December 2018. The patients in this study were, pregnant women who nearly died but survived a complication that occurred during pregnancy, child birth or within 42 days of termination of pregnancy as per WHO MNM criteria 2009.Results: A total of 9690 live births, 5 maternal deaths and 116 MNM cases were reported during the study period.  Incidence of MNM observed was 12%. Hypertensive disorders of pregnancy 39.6% cases were most common cause for MNM followed by obstetric hemorrhage 31.03% cases. Majority of neonates i.e.; 58% were admitted to NICU and only 52.7% survived the postnatal complications.Conclusions: Critical analysis of MNM cases will help us in identifying the deficiencies in obstetric care. Maternal mortality and morbidity can be reduced if timely and effective care can be given to women experiencing acute pregnancy related complications. There is need for validation of ‘MNM’ criteria at peripheral levels which will enable them in early identification and timely referral of such cases to tertiary centers.
Role of diagnostic hysteroscopy in evaluating patients with abnormal uterine bleeding in a tertiary care centre
Authors: Mohite Apeksha M. , Kapote Deepali S. , Fonseca Michelle
Published: November 2021

Background: Abnormal uterine bleeding is one of the commonest conditions amongst patients attending gynaecology OPD which also leads to significant disruption in a normal lifestyle. The causes of abnormal uterine bleeding are heterogeneous and complex. A systematic evaluation with detailed history and physical examination is foremost important in reaching diagnosis. Hysteroscopy is not only safe, quick and observes entire uterine cavity but also helps in precision in sampling and increases accuracy of diagnosis. It is also curative in conditions such as polyps, fibroids, uterine synechiae, menorrhagia and lost intrauterine contraceptive device. The aim of the study is to evaluate the role of hysteroscopy as a screening method in patients with AUB & compare to their USG findings and to the histopathological reports of the endometrial biopsy.Methods: This is a prospective observational study conducted at a tertiary healthcare centre over a period of 18 months, in 50 females belonging to pre, peri and post-menopausal age group. Sampling was done based on selection criteria after obtaining valid consent from the study group.Results: Hysteroscopy has a definitive role in evaluation of patients presenting with abnormal uterine bleeding with high sensitivity, specificity, PPV and NPV with immediate results.Conclusions: The above study concludes that the accuracy of diagnosing the cause of abnormal uterine bleeding is more with hysteroscopy followed by D and C then USG combined with D and C.
A randomized comparative study of effect of intramuscular valathemate bromide (epidosin) and intramuscular camylofin dihydrochloride (anafortan) on cervical dilatation in labour
Authors: Mehra Dinesh , Chouhan Madhubala , Goyal Shatendra
Published: November 2021

Background: Our aim is to search for a good cervical dilating agent which is not only more efficacious in cervical dilatation but also effective in relieving pain during labour with no or very little harmful effects on mother and foetus.Methods: The type of study was simple randomized comparative study. The present study was conducted in R. N. T. Medical College, Udaipur between October 2019 and December 2020. 118 patients were selected randomly. Two groups were made each consisting of 59 patients. First group received intramuscular camylofin dihydrochloride, second group received intramuscular (IM) valethamate bromide. Patients included in study group were: primigravidae/multigravidae, singleton full term gestation (37-40 weeks) with vertex presentation, cervical dilatation of ≥3 cm and patient excluded from study group with preclampsia, eclampsia, antepartum haemorrhage, any obstetric complications: cephalo pelvic disproportion, abnormal presentations.Results: Mean duration of active phase of first stage of labor was shorter in group I (313.17 minutes) than in group II (356.3 minutes) but not statistically significant. Mean cervical dilatation rate was significantly more in group I (2.02 cm/hour) than group II (1.81 cm/hour). Anafortan was effective in pain relief with mean pain score 5.31±1.06 while mean pain score for epidosin group was 7.37±1.07.Conclusions: In our study we observed that intramuscular camylofin dihydrochloride (anafortan) was more efficacious than IM valethamate bromide (epidosin) in shortening the duration of labor as well as in pain relief.
Case series on uterine rupture depicting the atypical presentations in the labour room
Authors: Aggarwal Srishti , Jindal Monika , Minhas Santosh
Published: November 2021

Uterine rupture is the complete division of all the three layers of uterus. Most uterine ruptures occur during labor in pregnant women, most commonly seen in previously scarred myometrium. Consequences of uterine rupture depend on the time between diagnosis of uterine rupture and intervention, and can be as grave as fetal and maternal death. Vigilance and avid action by the obstetrician can lead to better outcomes. Case 1 represented a 28-year-old moderately anemic G4P2L2A1 having previous 2 LSCS at POG 39 weeks 1 day presented in COVID emergency in active labour and was found to have a uterine scar rupture (5 cm rent) extending towards bladder wall with shoulder presenting on rent. A live female baby with thick meconium staining was delivered and uterine repair along with bilateral tubectomy was performed. Case 2 represented a 21-year-old primigravida with breech presentation at a gestation of 34 weeks 6 days with preterm labour pains who had been referred to our centre. Decision for LSCS was taken and on entering the abdomen rupture uterus with an inverted T-shaped rent in the upper segment extending up to the fundus was seen. A stillborn male fetus was delivered through the rent, followed by successful uterine repair. In spite of massive blood loss, the mother had survived. Case 3 represented a 30-year-old grand multipara at a gestation of 38 weeks 3 days with ultrasound documented fetal demise with fetal hydrocephalus and holoprosencephaly with labour pains was taken up for laparotomy due to suspicion of uterine rupture based on examination findings. Intra-operatively, baby was found lying in the peritoneal cavity with an unsalvageable uterus with a rupture in lower uterine segment and left lateral wall extending upto round ligament above and cervix below. A stillborn male fetus was delivered and peripartum subtotal hysterectomy with left salpingoophorectomy and right salpingectomy was done with a good maternal outcome. The above series suggest that the signs and symptoms of uterine rupture are usually variable and nonspecific, hence posing a challenge for the diagnosis. Early diagnosis and timely intervention by the obstetrician, can help us to improve the fetal and maternal outcome drastically.
Primary malignant melanoma of the nipple: a case report
Authors: Mounir Moukit , Bazine Aziz , Rahmoune Mohammed , Allilou Ismail , Elmoubakkir Bouchra , Ennouhi Amine , Laghzaoui Omar
Published: November 2021

Primary melanoma origi­nating on the female nipple remains an extremely rare variant of malignant melanoma and only a few cases haves been reported in the literature. We describe a case of a patient admitted for a black pigment deposition on the left nipple. Surgical resection of the left nipple and areola with clear margins and an axillary lymph node dissection was performed confirming the diagnosis of non-invasive superficial spreading melanoma.
Severe megaloblastic anemia in twin pregnancy mimicking partial hemolysis, elevated liver enzymes and low platelet count syndrome: a case report
Authors: Singh S. Momon , Thakur Vaidehi , Singh P. Manisana
Published: November 2021

Vitamin B12 is well known cause of megaloblastic anemia. However, it is uncommon in pregnancy, occurs in 10-28% of uncomplicated pregnancies, and is associated with few complications. Present case of 32 years old woman with twin-pregnancy at late gestation who was diagnosed with severe anemia in a local private clinic. On arrival to medical center, lab findings together with her clinical picture warranted the concern for differential diagnosis of partial hemolysis, elevated liver enzymes and low platelet count (HELLP), but later it was found to be a case of vitamin B12 deficiency since additional lab findings. Blood transfusions were given, and patient responded well to B12 supplementation. Pregnancy was carried to term and delivered twin live babies but otherwise well at birth and had normal developmental milestones thereafter. Our case emphasizes the importance of screening for B12 deficiency in pregnancy, especially in at-risk women (twin-pregnancy in pure vegetarian women) with unexplained anemia/r thrombocytopenia.
Microvascular free flap for head and neck reconstruction: our experiences with 218 free flaps for head and neck reconstructions
Authors: Shunyu N. Brian , Chakraborty Suvamoy , Ronrang Lomtu , Lynrah Zareen , Aktar Hanifa , Medhi Jayanta , J. Das Deepanava , Sayoo Chanmiki , Momin Clement
Published: November 2021

Background: Defect following radical resection for advance head and neck cancers are complex and without doubt microvascular free flap offer the best reconstructive option. The purpose of this study is to investigate the flap survival rate and review each vascular compromised flaps.

Methods: This is a reviewed of 218 microvascular free flaps done for reconstruction of 204 head and neck patients. There were 112 (51.3%) radial forearm flaps (RFF), 82 (37.6%) fibula flaps (FF) and 24 (11%) anterior lateral thigh (ALT) flaps.  

Results: There were 16 complete flap loss and 3 partial flap loss, giving an overall flap survival rate 91.8% (19/218) and flap survival in turn of complete loss 92.7% (16/218). In RFF, there were 7 complete and 1 partial flap loss, giving an overall flap survival rate 92.9% (8/112) and flap survival in turn of complete loss 93.8% (7/112). In FF, there were 6 complete flap loss, giving a flap survival rate 92.7% (6/82). In ALT flap, there were 3 complete and 2 partial flaps loss, giving an overall flap survival rate 79.2% (5/24) and flap survival in turn of flap complete loss 87.5% (3/24). In our series vascular flaps complications rate was 12.3% (27/218), with a salvageable rate of 29.6% (8/27). The most salvageable flap was RFF 46.6% (7/15).

Conclusions: The study re-enforce the learning curve in microvascular free flap and RFF is a good flap for a beginner. 
A clinicopathological study and management of tumor and tumor like lesions of larynx
Authors: Jayakumar Varunkumar , Atmaram Jaiswal Shubhalaxmi
Published: November 2021

Background: The aim of the study was to (a) determine the incidence and distribution of cases according to age, sex, etiology etc; (b) to know common etiology for the different diseases; (c) to understand pathophysiology of the disease; (d) to know various presentations of the disease; (e) to determine various diagnostic tools; and (f) to know modalities of treatment available.

Methods: Prospective observational study, method of sampling: non-random, purposive. department of ENT, Government medical college and tertiary care centre. Fifty-one patients with benign and malignant lesion of larynx were analysed. Only cases with persistent hoarseness for more than three weeks were selected. Benign lesions included neoplastic and non-neoplastic lesions. All cases underwent a thorough ENT examination. Once suspected the cases were examined under direct laryngoscope, fibreoptic laryngoscope and if needed microlaryngeal examination was also done.   

Results: The study showed 86.6% benign lesions and 41.1% malignant lesions of larynx with male preponderance. It was observed that vocal polyp was the commonest benign non-neoplastic lesion and papilloma was the commonest neoplastic lesion. Squamous cell carcinoma accounted predominantly in malignant lesions and was commonly found in glottis.

Conclusions: Thus, this study reflects there is an urge to raise awareness and educate people regarding detrimental effects of vocal abuse, alcohol and tobacco consumption, preventive measures, early symptoms and availability of diagnostic tools, so that early diagnosis and appropriate treatment can be executed to reduce the morbidity and mortality.
Congenital muscular torticollis: an Orl’s perspective
Authors: Swapna C. A. , Siva Kumar E. , Karanam Lavanya
Published: November 2021

Congenital muscular torticollis usually results from the shortening or excessive contraction of sternocleidomastoid muscle. Delay in diagnosis and appropriate early therapeutic evaluation can lead to permanent disability. We would like to report two rare cases with congenital muscular torticollis who underwent surgery followed by aggressive physiotherapy. We would like to emphasise the need of an early diagnosis and intervention which leads to best outcome. This can prevent progressive physical deformity. Surgeons should offer the patient with option of release and repair of sternocleidomastoid muscle as it gives excellent result in view of mobility and appearance for child.
Lingual thyroid with absent thyroid gland in neck
Authors: Dhingra Rachna , Singh Gurbax , Kumar Kuldeep , A. K. Vignesh , Singh Pavail , Dhanoa Simran
Published: November 2021

Lingual thyroid is defined as an ectopic thyroid gland tissue located in the midline of the tongue base. Patients with lingual thyroid tissue usually present with symptoms such as dysphagia, choking, haemorrhage, dyspnea and occasionally life threatening airway obstruction. Lingual thyroid is a rare anomaly with an incidence of 1 in 3000 of the thyroid cases seen, with overall prevalence of 1 in 100,000. Here we presented a case with complaint of difficulty in swallowing and foreign body sensation throat. The intraoral examination showed spherical mass with 2 cm of diameter, covered with intact mucosa, located midline at base of tongue. She was diagnosed clinically as lingual thyroid and evaluated further. By proper transdisciplinary approach correct diagnosis can be made and patient can be managed. In present case, thyroid profile, USG neck and thyroid scintigraphy helped in diagnosis. Patient was managed medically with tablet levothyroxine which relieved her symptoms. Surgical management was not considered as patient improved with levothyroxine and surgical excision would have made patient further hypothyroid as there was no thyroid gland in neck.