bluuebunny/crossref_metadata_2025 huggingface dataset:
PERFILES OCUPACIONALES ACTUALES Y CON VISIÓN PROSPECTIVA PARA LOS CLUSTER DEL ATLÁNTICO
Authors: Senior Roca Diana , Pacheco Castro Gustavo
Published: September 2017

El presente artículo es producto de una investigación, cuyo objetivo consistió en caracterizar la demanda actual y futura del talento humano en los cluster del Atlántico. Se aplicó el método exploratorio con la técnica de investigación mediante el instrumento de encuesta, a una muestra no probabilística por cuota a un total de 236 empresas. En este tipo de investigación que es cualitativo, se encontró como resultado que las empresas presentan grandes dificultades para hallar un capital humano idóneo, lo cual es un reto para las instituciones de formación a fin de fortalecer las competencias específicas y transversales antes que se gradúen los jóvenes, así como la creación de alianzas para establecer programas de capacitación dual que permitan formar a los estudiantes directamente en la empresa. De otra parte se concluyó que las empresas valoran mucho las competencias relacionadas con el trabajo en equipo, planificación del tiempo e identificación y resolución de problemas. Adicionalmente presentan dificultades en bilingüismo, manejo de las TICs, y en analizar y tomar decisiones asertivas bajo presión. Además, las empresas de los cluster estudiados no identifican el área de recursos humanos como estratégica que puede potenciar su crecimiento y competitividad. ABSTRACTThe present article is a result of a research which main objective consisted in characterizing the current and with forward-looking approach of the occupational profiles for the Atlantico clusters. The applied method was exploratory with the instrument of survey as the research technique with a non-probabilistic sample quota of 236 companies. In this type of qualitative research, it was found as a defining result that the companies have great difficulties to find suitable human capital, which is also a challenge for the educational institutions in order to strengthen the specific and soft skills before the youth graduate, as well as the creation of alliances to establish dual training programs that allow training and educating students directly in the company. Another conclusion was that companies value very much the skills related to teamwork, time planning and effective problem solving, additionally they encountered lack of skills in bilingualism, IT, and analyzing and taking assertive decisions under pressure. In addition, the companies of the studied clusters did not identify the human resource departments as a strategic area that could promote growth and competitiveness.
MARCAS REGISTRADAS, ESTRUCTURA DEL TEJIDO EMPRESARIAL Y COMPETITIVIDAD DEL NORTE DE SANTANDER
Authors: Cáceres Caballero José Ascensión
Published: September 2017

El presente es un artículo de reflexión cuyo objetivo consistió en analizar la información contenida en la investigación titulada “Estudio sobre el registro de marcas en productos y servicios y análisis del impacto en la ciudad de Cúcuta”, relacionando los resultados con la situación que presenta el tejido empresarial y el índice de competitividad regional. El enfoque es cualitativo de tipo descriptivo porque se interpreta y reflexiona con base en información de fuentes documentales como el referido estudio sobre marcas, boletines del Observatorio Económico de la Cámara de Comercio, el Informe de la Superintendencia de Industria y Comercio y el Índice de Competitividad Departamental. La información de fuentes primarias fue recolectada, siguiendo técnicas de la metodología etnográfica, mediante entrevistas semi-estructuradas aplicadas a una muestra intencional de empresarios y gremios de los sectores estratégicos de la economía regional. Los resultados obtenidos señalan la correspondencia y reciprocidad existente entre las variables estudiadas, así como las principales debilidades observadas en la estructura del tejido empresarial, las dificultades en la evolución y dinámica empresarial y especialmente, el descenso en la posición competitiva del Norte de Santander durante los últimos años.
PRINCIPIOS GERENCIALES DESDE EL ENFOQUE SOCIOCRÍTICO EN INSTITUCIONES BINACIONALES DE EDUCACIÓN SUPERIOR
Authors: Moya Camacho Fabio , Mendoza Fernández Darcy Luz , López Juvinao Danny Daniel
Published: September 2017

El presente artículo tiene como propósito identificar los principios gerenciales desde el enfoque sociocrítico en instituciones binacionales de educación superior. El estudio se enmarca como descriptivo, de campo, su diseño fue no experimental, transversal. Metodológicamente, se aplicó como instrumento un cuestionario tipo escala de Likert, conformado por 60 ítems, a una población conformada por 5 decanos y 17 directores de la Universidad Simón Bolívar en Colombia y la Universidad del Zulia en Venezuela, con una confiabilidad del 82 %. Se encontró que los principios gerenciales fueron identificados en una categoría moderada, con resultados favorables para los aspectos de fortalecimiento de la ciudadanía, la reducción de la pobreza y la desigualdad, sin embargo, se logró una percepción menos favorable para el caso del fortalecimiento de la ciudadanía. Se concluye que el cambio, en las instituciones de educación superior, debe ser progresivo, partiendo de un cambio en la concepción y modos de trabajo para que prevalezca el verdadero sentido de lo social y se encamine hacia la generación de profesionales cónsonos con la realidad de su entorno próximo
FORMACIÓN BRUTA DE CAPITAL FIJO EN EL PRODUCTO INTERNO BRUTO VENEZOLANO EN EL PERÍODO 1997-2015
Authors: Urdaneta Montiel Armando , Prieto Pulido Ronald , Hernández Ariza Orlando
Published: September 2017

El artículo tiene como objetivo determinar el impacto de la formación bruta de capital fijo sobre el producto interno bruto (PIB) durante el período 1997-2015 en venezolana. La investigación fue de tipo documental, descriptiva, correlacional y analítica. Se utilizaron los agregados macroeconómicos del Banco Central de Venezuela (BCV) y se estudiaron las setenta y seis (76) últimas variaciones trimestrales de la formación bruta de capital fijo y el PIB total y por sectores; se efectuaron análisis de series de tiempo con suavización exponencial en aras de evaluar la posible existencia de componentes tendenciales, cíclicos, irregulares y estacionales en la serie; se realizaron estimaciones de correlación, elasticidad y prospección entre las variables utilizando vectores autorregresivos. Dando como resultados un bajo impacto de la formación bruta de capital fijo público en el PIB de dicho sector; a diferencia del sector privado donde la inversión real tiene una alta incidencia en producto interno bruto, lo cual se termina reflejando en comportamiento global. Por ello, se concluye la existencia una alta correlación de la formación bruta de capital fijo total con el PIB total de la economía, es de 0,96, con un coeficiente de elasticidad 0,81 denotando un componente de inelasticidad de la formación bruta de capital con respecto al PIB; al realizar prueba de raíz unitaria a las variables sujetas a estudio y el test de causalidad de Granger a los vectores autorregresivos estimados, se observaron elementos de estacionareidad, presencia de raíz unitaria y una relación causal entre ellas.
CULTURA DEL EMPRENDIMIENTO EN INSTITUCIONES DE EDUCACIÓN SUPERIOR: ESTRATEGIA DE INCLUSIÓN SOCIAL
Authors: Valdivieso Oscar Zambrano , González Sandra Espitia , Ardila José Hernández
Published: September 2017

La presente investigación tuvo como objetivo determinar la importancia de la cultura del emprendimiento en las Instituciones de Educación Superior como estrategia de inclusión social; metodológicamente, el estudio fue de tipo exploratorio y descriptivo, con enfoque cualitativo y un método deductivo a partir del análisis documental recolectado. Se empleó como instrumento de recolección de la información secundaria la ficha de registro de datos. Los resultados demostraron que, si bien existe una normatividad expresa y claramente definida sobre la aplicación de la cultura del emprendimiento, aun no es clara su aplicabilidad como estrategia de inclusión social en las Instituciones de Educación Superior (IES). En conclusión, las IES deben revaluar sus Proyectos Educativos Institucionales (PEIs), Programa Curricular de los Programas (PCPs) y esquemas curriculares en donde se involucre el emprendimiento, ya que son realmente pocos los esfuerzos y escasos los éxitos que sobre el tema pueden analizarse. Se recomienda continuar con el seguimiento a los procesos que la normatividad ha permitido iniciar para lograr que la cultura del emprendimiento en las IES se convierta en una estrategia real de inclusión social.
Protests, "acting-out", group psychology, surplus enjoyment and neoliberal capitalism
Authors: Olivier B
Published: September 2017

How should one make sense of the recent student protests across South Africa, which seem to be motivated by grievances relating to various forms of financial exclusion, from registrationandtuitionfeesto costs ofaccommodation, and later pre-election protests, triggered by competition among would-be party candidates? It appears that Freud and Lacan's countervailing psychoanalytical concepts of "acting-out" and "transference" cast explanatory light on this variegated phenomenon - the former insofar as it is an index of repressed, unarticulated motives manifesting themselves in irrational behaviour resistant to "analysis", instead of ethically accountable "acts", and the latter, on the contrary, designating a process according to which subjects are receptive to, and act (or speak) according to the requirements of "successful analysis", including the "subject supposed to know". Cognisance must also be taken of the fact that the protestors constitute(d) groups, and that it should therefore be approached as such in psychoanalytical terms. Recourse to the Freudian notion of "group psychology" is heuristically helpful in this regard. This is augmented by focusing on what has, it is argued, functioned to trigger the protest behaviour, namely neoliberal capital, by way of considering Lacan's account of capitalist discourse in Seminar 17 - together with its insightful interpretation by Juliet MacCannell - particularly the relation between surplus value and surplus enjoyment.
Numerical optimisation of a small-scale wind turbine through the use of surrogate modelling
Authors: Erfort Gareth , Von Backström Theodor Willem , Venter Gerhard
Published: September 2017

Wind conditions in South Africa are suitable for small-scale wind turbines, with wind speeds below 7 m.s−1. This investigation is about a methodology to optimise a full wind turbine using a surrogate model. A previously optimised turbine was further optimised over a range of wind speeds in terms of a new parameterisation methodology for the aerodynamic profile of the turbine blades, using non-uniform rational B-splines to encompass a wide range of possible shapes. The optimisation process used a genetic algorithm to evaluate an input vector of 61 variables, which fully described the geometry, wind conditions and rotational speed of the turbine. The optimal performance was assessed according to a weighted coefficient of power, which rated the turbine blade’s ability to extract power from the available wind stream. This methodology was validated using XFOIL to assess the final solution. The results showed that the surrogate model was successful in providing an optimised solution and, with further refinement, could increase the coefficient of power obtained.
The impact of political objectives on optimal electricity generation and transmission in the Southern African Power Pool
Authors: Trotter Philipp A. , Maconachie Roy , McManus Marcelle C.
Published: September 2017

Southern Africa’s electrification is at odds with United Nations goals to provide modern energy for all by 2030. Electricity planning, a crucial tool to optimally match future supply and demand, has largely focused on minimising costs in southern Africa, sometimes complemented by a discussion of a discrete set of environmental scenarios. Political objectives, although their significance is well documented, had been overlooked in Southern African Power Pool (SAPP) quantitative electrification planning research. This study created a novel geo–referenced, multi–objective linear programming (MOLP) model that combines continuous cost and carbon dioxide (CO2) emission minimisation objectives with the political goal of achieving national electricity self–sufficiency, yielding the optimal trade–off between these three objectives. It solved the MOLP for three different political risk scenarios in order to examine a further political objective. The results revealed a sharp monetary trade–off between CO2 emission reductions and national electricity sovereignty objectives in the SAPP. Furthermore, curtailing international political risks had significant consequences for trade and the optimal generation mix. While the optimal size of the frequently recommended Grand Inga dam in the Democratic Republic of Congo was considerably reduced when either national electricity sovereignty or political risk constraints were imposed on the model, solar energy shares increased significantly in both cases. This was the case especially when CO2 emissions were simultaneously curtailed. Increased technological, institutional and policy–making efforts to implement solar PV at scale would therefore imply immediate political and environmental merits for national governments in the SAPP, and present a sustainable development opportunity for the region.
Image Western Blots for quantitative immunoblotting using the Bio-Rad VersaDoc CCD camera v1
Authors: Campbell Doug , Donaher Natalie
Published: September 2017

The Campbell Lab protocol for imaging Western Blots using ECL Select chemi-luminescent detection and the Bio-Rad VersaDoc imager for immunoquantitation of phytoplankton samples.
The movement of the Paleosuchus palpebrosus and Paleosuchus trigonatus in Santo Antônio Hidro-electric dam, Brazil v1
Authors: Campos Zilca , Mourão Guilherme , E. Magnusson William
Published: September 2017

The movement of the four adults Paleosuchus palpebrosus and four adults Paleosuchus trigonatus before and after the inundation of the Santo Antônio hydro-electric dam, Brazil.
Vanishing Mandible in a 7-year Old Child: Response to Radiation Therapy
Authors: Mohapatra Mounabati , Jena Ashok Kumar , Dandapat Arun Kumar , Singh Sombir
Published: September 2017

Massive osteolysis in a 7-year old child is a rare condition. The etiology of massive osteolysis is unknown and it results in the progressive destruction of bony structures. There is no standard therapy available in the literature. Conservative treatment is often used for its management. Radiotherapy is considered as an accepted form of treatment with greater chance of success when it is used in the early course of disease. There are few case reports in the literature in which radiotherapy has been used for the treatment. This article highlights the literature update on various treatment modalities and a case managed by radiation therapy.
Direct Pulp Capping in Primary Molars using Mineral Trioxide Aggregate: An in Vivo Study
Authors: Luczaj-Cepowicz Elzbieta , Marczuk-Kolada Grazyna , Pawinska Malgorzata , Obidzinska Marta
Published: September 2017

Objective: To do a clinical and radiographic evaluation of the effectiveness of MTA when used as a direct pulp capping material in primary molars. Study design: Clinical and radiographic follow-up was performed on 30 primary molars with deep caries lesions in 30 patients from 3 to 9.75 years of age. Pulps exposed during cavity preparation were treated by direct pulp capping with MTA. The follow-up clinical and radiographic examinations were carried out at different time intervals: 6, 7–12, 13–18, 19–24, and >24 months after treatment. Results: Twenty-four teeth were evaluated during the entire observation period. Positive clinical and radiographic outcomes were achieved in 19 teeth (13 teeth were saved and 6 were exfoliated). In five teeth, complications were observed only in children under 7 years old. Conclusion: Based on these clinical and radiographic results, MTA was found to be successful when used as a direct pulp capping material in primary teeth.
Supernumerary Teeth in the Maxillary Anterior Region: The Dilemma of Early Versus Late Surgical Intervention
Authors: Sarne Ofer , Shapira Yehoshua , Blumer Sigalit , Finkelstein Tamar , Schonberger Shirley , Bechor Naomi , Shpack Nir
Published: September 2017

Supernumerary teeth are the most common developmental dental anomalies in the maxillary anterior region causing interference to the developing permanent incisors resulting in poor dental and facial esthetics. Two different opinions regarding the timing for surgical removal of the supernumerary teeth are presented. In this case report, three brothers with supernumerary teeth in the maxillary anterior region are presented, their surgical and orthodontic management and outcome are discussed.
The Effect of MMP-13, MMP-12, and AMBN on Gingival Enlargement and Root Deformation In a New Type of Gingival Fibromatosis
Authors: Kang Chung-Min , Lee Jae-Ho , Jeon Mijeong , Song Je Seon , Kim Seong-Oh
Published: September 2017

This case compared gene-expression between a new type of idiopathic gingival fibromatosis (IGF) and normal gingiva, to clarify the nature of the gingival overgrowth and dental anomaly. A 6-year-old girl with generalized gingival overgrowth and root deformations was diagnosed with IGF. Gene expression profiles were compared between normal gingiva (N=9) and one IGF gingiva using cDNA microarray. Genes related to regulation of cell proliferation and proteolytic degradation were expressed strongly in IGF. MMP-13 and MMP-12 expression were 120 times and 96 times lower in IGF, respectively, whereas AMBN expression was 79 times higher. RT-PCR and immunohistochemical staining supported the microarray results. Reduced proteolytic activity due to low MMP-13 and MMP-12 expression appears to be a potential mechanism for gingival overgrowth. Genetic investigations, such as expression levels of MMP-13, MMP-12, and AMBN, may enable classification of a new syndrome characterized by gingival enlargement with abnormal root development.
A prospective cross-sectional study on prescribing pattern of antibiotics on patients suffering from ENT infections in tertiary care hospital, Pokhara, Nepal
Authors: Gupta Surendra P. , Poudel Salikram , Gupta Anil P. , Bashyal Basanta , Baskota Bishal , Sah Anil K. , Pandaya Subash , Shrestha Dhiraj
Published: September 2017

Background: This survey was designed to assess and evaluate the prescribing pattern of antibiotics used in patients suffering from ENT (Eye, Nose, and Throat) infections in ENT outpatient departments (OPD) at Manipal Teaching Hospital (MTH), Phulbari, Pokhara, Nepal.Methods: A prospective cross-sectional study was conducted in out-patients of ENT department at MTH for 6 month in which a total of 216 prescriptions were observed randomly and data filled patient profile forms were collected and analyzed.Results: Out of 216 patients, 126(58.33%) were male and 90 (41.67%) were female. Patients of age group 21-30 were maximum (29.16%) followed by age group of 11-20 (22.22%). Only 6.7% of drugs were prescribed from their generic names. Data analysis revealed that about 72.24%, 24.53% and 3.23% of prescription contained one, two and three antibiotic drugs respectively. All together 970 drugs were prescribed in 216 prescriptions out of which 251 (25.87%) were antibiotics drugs. This suggested that the average no. of antibiotics per prescription was 1.16. Among prescribed antibiotics, Amoxicillin (7.56%) of penicillin group, Azithromycin (8.36%) of macrolides, Cefuroxime (9.56%) of 2nd generation cephalosporin followed by Cefpodoxime (32.27%) of 3rd generation cephalosporin and Ofloxacin (6.37%) of quinolones group were frequently prescribed. From analysis, we found that other concomitant medications were also prescribed such analgesics, antihistamines, PPI (Proton Pump Inhibitors) and vitamins, minerals and dietary enzymes. The prescribed antibiotics accounted for large percentage of oral dosage forms (89.90%) followed parental injection dosage forms 5.05%.Conclusions: Prescribing more than one antibiotics was commonly encountered indicating the occurrence of polypharmacy which were based on empirical therapy without any culture and sensitivity test report. Therefore, local hospital culture sensitivity database for ENT infections has to be developed and prescribing with generic name from existing essential drug list or formulary should be encouraged for rational drug therapy.
Pharmacovigilance study in psychiatry out-patient department of a tertiary care teaching hospital
Authors: R. Nalini
Published: September 2017

Background: Adverse drug reactions are important in psychiatry practice like any other branch of medicine. Adverse drug reactions associated with psychotropic drugs causes either noncompliance or at times discontinuation of therapy. The objective of the study was to evaluate the incidence and nature of adverse drug reactions in psychiatry outpatient department and to assess the causality and severity of the documented adverse drug reactions.Methods: Prospective observational study was done in the psychiatry outpatient department. All the patients were interviewed for basic details, history of medications and relevant history for adverse drug reactions. The causality, severity and modes of management assessment of the documented adverse drug reactions were done.Results: 2,727 patients attended psychiatry outpatient department, of which 582 patients developed at least one adverse drug reaction. The incidence of adverse drug reaction observed to psychotropic drugs was 21.34%. Majority of adverse drug reactions were seen with antidepressants 298 (10.93%) followed by antipsychotics 187 (6.86%), sedative hypnotics, anticonvulsants and antimanics. The most common adverse drug reactions were sedation 3.44%, weight gain 3.04%, and extrapyramidal symptoms 2.79%. Reported adverse drug reactions were assessed for causality and maximum belonged to probable (15.6 9%). The severity assessment of the reported adverse drug reactions revealed that most of the adverse drug reactions were mild (16.83%) in nature and majority of patients were made to continue the same treatment.Conclusions: Active monitoring of adverse drug reactions in psychiatry outpatient department can help in early detection and management of adverse drug reactions.
Adverse drug reaction profile at psychiatry outpatient department of a tertiary care centre
Authors: Gawali Ujwala P. , Kesari Harshad V. , Gawand Komal S.
Published: September 2017

Background: Monitoring adverse drug reactions (ADRs) helps in alerting physicians and developing strategies to prevent and minimize the risk of developing ADRs. Data regarding pattern of ADRs due to psychotropic medications is scanty. Hence, the study was planned to assess ADRs among psychiatry outpatients of a tertiary care hospital in Maharashtra.Methods: A prospective, observational study was conducted in psychiatry outpatient department of a tertiary care centre for 3 months. Cases were enrolled by active and passive surveillance after obtaining informed consent. Demographic details, adverse event details, history of medications were recorded. Pattern of ADRs was studied according to demographic parameters, drug class, organ system affected, causality (WHO - Uppsala Monitoring Centre Scale) and severity (modified Hartwig and Siegel Scale).Results: Out of total 1200 patients screened, 77 qualified the inclusion and exclusion criteria and 92 ADRs were reported; overall incidence rate of 6.41%. Maximum ADRs were reported in the age group of 31- 40 years. 63.63% subjects received more than 2 psychotropic drugs. Among 24 types of ADRs observed, tremor (13.04%) was the commonest, closely followed by somnolence. Antipsychotics (45.65%) were most frequently incriminated and central nervous system (46.73%) the most often affected. Trifluoperazine (11.96%) was the commonest drug, followed by olanzapine and haloperidol (10.53% each). Causality analysis yielded 66 ADRs as “probable” and on severity analysis 80.43% were mild.Conclusions: The study provides an insight into pattern of ADRs in psychiatry outpatients. It is prudent to communicate this to treating physicians as well as counsel patients (and caregivers). Initiatives and concerted efforts involving all stakeholders in healthcare can go a long way in decreasing drug-related morbidity and health costs.
Evaluation of awareness about pharmacoeconomics in postgraduate students of a tertiary care teaching hospital: a questionnaire based observational study
Authors: Gupta Rohini , Malhotra Pavan
Published: September 2017

Background: Pharmacoeconomics identifies, measures and compares the costs and consequences of drug therapy to health care systems and society. The per capita income of all middle class people is limited and the drug prices are growing extensively. Therefore, it is the responsibility of the health-care professionals to balance both cost and quality of treatment. Hence, this study was planned among the postgraduate students who form the major part of health care delivery system to assess their awareness about pharmacoeconomis.Methods: This was a questionnaire based cross-sectional study. Self-administered questionnaire was distributed among 72 residents, out of which 61 completely filled questionnaires were finally used for statistical analysis. The questionnaire contained questions relating to awareness, knowledge, method of application and students’ attitude about pharmacoeconomics.Results: The willingness to participate in the study among postgraduates was extremely poor. Those who have participated, almost 39% of participants were having awareness about the topic. Nearly 31 % of the participants were having knowledge regarding pharmacoeconomics and around 21 % of participants have learnt the method of application in various aspects.Conclusions: Study has revealed that that the knowledge and perception level of postgraduates in day to day use of pharmacoeconomic concepts are poor and limited. Therefore, it is very necessary to make them aware about the concept of pharmacoeconomics by incorporationg it in their medical curriculum and by conducting CMEs and Workshops on pharmacoeconomics.
Benefits of maternal vaccination to prevent pertussis in infants
Authors: Monterrosa-Castro Alvaro , Ramirez-García Andrea , Beltrán-Barrios Teresa
Published: September 2017

Pertussis, also called whooping cough, is an infectious and preventable pathology that generates important child morbidity and mortality worldwide. There are different biological preparations for its use in infants, while for adolescents and adults is Tdap, (acellular vaccine of purified extracts of Bordetella pertussis (BP), combined with tetanus and diphtheria toxoid) that has been proposed as maternal vaccination (MV). The objective was to identify the benefits of MV in the prevention of childhood pertussis, a review was made in PubMed, Science Direct, EBSCOhosT, OvidSP and Embase databases (years 2008-2016) and an electronic alert system (January-April 2017). 1083 titles were identified and 44 articles were selected. After the MV (administered between 27 and 36 weeks of gestation) the passage of IgG-BP to the fetus is sufficient to generate adequate infant protection, generating two benefits: reducing infant morbidity (number of cases and hospital admissions) and decreasing mortality by pertussis. The MV offers 93% of effectiveness [95%CI: 81-97] and OR: 0.09 [95%CI: 0,03-0,25]. The MV is more favorable in each pregnancy than cocoon strategy, vaccination before pregnancy, before 26 weeks of gestation or in the postpartum. The use of MV is a safe and cost-effectiveness tool to prevent childhood pertussis.
Indications and rate of caesarean delivery at tertiary care hospital: a retrospective study
Authors: Sharma Reena , Dogra Poojan
Published: September 2017

Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. Objective of the study was to assess the prevalence and different indications of caesarean section in this institute.Methods: The aim of the study is to analyse the rates and indications of lower segment caesarean section (LSCS) in our institution. We conducted a retrospective study over a period of six months; 1st September 2016 to 1st March 2017 at SLBSGMC Mandi at Nerchowk. Total number of patients who delivered in our hospital during the defined study period was recorded and a statistical analysis of various parameters was done.Results: The total number of women delivered over the study period was 2075, out of which caesarean sections (CS) were 473. The overall CS rate calculated was 22.8%. Previous LSCS was the leading indication to the CS rate.Conclusions: Routine obstetric audits should be done to analyse the various indications of emergency and elective caesarean sections so that protocols and guidelines can be implemented to curtail the increasing trend of caesarean delivery.
A study of etiology and outcome of preterm birth at a tertiary care centre
Authors: Garg Shaveta , Kaur Tajinder , Saran Ajayveer Singh , Yadav Monu
Published: September 2017

Background: Preterm births are still the leading cause of perinatal mortality and morbidity. It is a major challenge in the obstetrical health care.Methods: This study was conducted over a period of eight months from September 2016 till April 2017 at a tertiary care hospital. All patients who delivered a live baby before 37 weeks of gestation were included in the study.Results: Present study was conducted on 100 eligible women out of which 7 delivered before 30 weeks but majority of them (55%) delivered after 34 weeks of gestation. In our study, most of the patients (66%) presented in active phase of labor which resulted in preterm birth of baby. The most common risk factor of preterm labor was genitourinary tract infections (34%) followed by Preterm Premature rupture of membranes (22%). Past obstetric history of preterm delivery and abortions also had a significant impact on the present pregnancy outcome.Conclusions: Preterm labour and birth still have a high incidence causing significant neonatal mortality and morbidity as well as economic burden on family and hospital. The causes of preterm birth are multifactorial and modifiable. This incidence can be reduced by early identification of established risk factors, as revisited and reemphasized in our study, with the help of universal and proper antenatal care.
Reproductive surgery in infertility
Authors: Sud Shilpi S. , Sud Suneet K. , Upadhye Jayshree J.
Published: September 2017

Background: With recent improvements in the assisted reproductive technology (ART), there has been a growing tendency that bypasses diagnostic laparohysteroscopy and proceeds directly to ART. Therefore, the value of diagnostic laparohysteroscopy in current fertility practice is under debate. In the present study, we evaluated the usefulness of diagnostic laparoscopy and hysteroscopy for patients with infertility.Methods: This retrospective study was conducted at Safal Hospital, Nagpur from January 2017 to July 2017. 80 patients were selected for this study who had undergone diagnostic laparohysteroscopy for infertility.Results: In present study, out of 80 patients studied, 66.25% patients had normal hysteroscopy findings, in 10% of patients, tubal cannulation was done for cornual block, in 6.25% of patients, resection of uterine septum was done, adhesiolysis for asherman’s syndrome was done in 5% of patients, endometrial polyp was removed in 5% of patients, 2.5% patients had resection of submucous fibroid. In 5% patients, cervical dilatation for fibrosis was done in 5% of patients. 68.75% had normal laparoscopy findings, in 8.75% of patients, ovarian drilling for PCOS was done, adhesiolysis for peritubal adhesions was done in 6.25% patients, fulguration of endometriosis was done in 6.25% patients, salpingectomy for hydrosalpinx was done in 5% patients, aspiration of ovarian cyst was done in 2.5% patients.Conclusions: Diagnostic hysterolaparoscopy is an effective diagnostic and therapeutic modality for certain significant and correctable abnormalities in pelvis, tubes and uterus which are missed by other imaging modalities.
Post Hysterectomy morbidity: a suburban teaching hospital experience in Kanchipuram, Tamil Nadu, South India
Authors: Lakshmi P. Vijaya , Sheela Wills G. , Munusamy M. Mohanambal
Published: September 2017

Background: Hysterectomy is the removal of uterus for benign uterine tumor and uterine descent in perimenopausal women. Post hysterectomy and follow up morbidity in rural women is studied over a period of 1 year. They were reviewed during hospital stay to identify morbidity and risk factors for prolonged hospital stay and formulate modalities to reduce morbidity. Risk factors assessed were fever, wound sepsis, anemia, previous post-operative adhesions and injury to other organs. Follow up was done at 4 weeks. 72% women were morbidity free. 46% women had more than one morbidity. The aim of this study is to analyse immediate and late post hysterectomy morbidity in a rural setup and to identify risk factors for prolonged hospitalization and formulate modalities to reduce morbidity and duration of hospital stay.Method: Perimenopausal women who underwent hysterectomy for benign uterine conditions and uterine descent were studied for post-operative morbidity at SSSMCRI over a period of one year. Post hysterectomy morbidity was clinically assessed from day one of surgery till discharge, for early and late morbidity. Abdominal skin incision smear, vault smear, urine culture and USG pelvis for collection of fluid was done in woman who developed fever. Follow-up morbidity was done at 4 weeks. Hysterectomy done for malignant conditions were excluded from the study.Results: In rural women, postoperative morbidity was assessed in 81 abdominal, 32 vaginal hysterectomy. Post-operative pain was felt by all 113 women for first 3 days. Fall of hemoglobin due to haemorrhage was seen in 43 (38%) women. 33 needed post-operative blood transfusion. Surgical site infection was seen in 13, needed re-suturing in 7. Fever was seen in 50 women (44%) due to UTI (E coli 13, Klebsiella 5). Pelvic fluid collection was seen in 9 with vault infection. We had one burst abdomen, one re-laparotomy, 3 bladder injuries. Prolonged hospital stay was seen in 41 women. 46% had more than one morbidity. Follow-up at 4 weeks, 72% were morbidity-free. Prolene granuloma 2, Stitch abscess 9, vaginal discharge 14, vault granuloma 3 were observed. Vaginal smear showed 9 Staphylococcus aureus and 5 bacterial vaginosis infection. 12 women had E. coli and 6 Klebsiella infection in urine culture.Conclusion: Pre-operative risk factors for post op morbidity like anemia, urinary and vaginal infection should be properly treated prior to surgery. Awareness of risk factors for morbidity, anticipation of complications due to size, site, nature of tumour and previous surgery adhesions, timely intervention by experienced surgeons and adequate blood transfusion will reduce morbidity and prolonged hospital stay.
Pattern of utilization of blood and blood components in obstetrics at tertiary care hospital
Authors: Bangal Vidyadhar Bangal , Gavhane Satyajit P. , Aher Kunal H. , Bhavsar Dhruval K. , Verma Priyanka R. , Gagare Swati D.
Published: September 2017

Background: Obstetric emergencies occur suddenly and unexpectedly. Blood transfusion becomes one of the live saving measures in such situations. Severe anaemia due to nutritional deficiency, obstetric haemorrhage either during pregnancy, labour or in postpartum period are the commonest indications for blood transfusion worldwide. Blood bank services play important role in saving lives in obstetric emergencies. Health institutions must carry out internal blood transfusion audits to reassure optimal and judicious use of blood and blood components.Methods: Analysis of 755 Obstetric patients requiring blood transfusion in eighteen months period was done to find out the incidence and indications for blood transfusion at tertiary care hospital.Results: Overall, 5.33% of obstetric admissions required transfusion of blood or its components. Severe anaemia (36.55%), accidental haemorrhage (20.92%), postpartum haemorrhage (8.34%), placenta praevia (5.03%) and caesarean section (10.33%) were the common indications for blood transfusion. In more than 65% cases, two or three unit of blood were transfused. In majority of cases (96%) components were used.Conclusions: Blood transfusion helped to save many lives in the present study. Severe anaemia and obstetric haemorrhage of varied aetiology were the common indications for blood transfusion. Component therapy helped to correct specific deficiency. Voluntary blood donation should be encouraged in the younger generation to keep adequate stock of blood in blood bank for emergency use. Preventive measures like improving dietary iron intake and prophylactic iron therapy will go a long way in reducing the need for blood transfusion in Obstetrics.
Successful maternal and fetal outcome in a case of BOH with APLA positive status
Authors: Vaidya Annal , Mali Kimaya , Satia Meena
Published: September 2017

The Antiphospholipid antibody syndrome is an autoimmune disorder that occurs when body’s immune system makes antibodies that attack and damage the tissues. These antibodies that mistakenly attack phospholipids found in the lining of the blood vessels result in formation of clots. The effect of thrombophilia on pregnancy is uncertain. Here we discuss a case of preterm abruption at 30 weeks of gestation in a patient with Lupus positive status in a patient without preeclampsia.
Prevalence, risk factors and causative organisms of asymptomatic bacteriuria in pregnancy
Authors: Patnaik Manasi , Panigrahi Kumudini , Das Banya , Pathi Basanti , Poddar Nirmala , Lenka Priya Ranjan , Pattnaik Dipti
Published: September 2017

Background: Asymptomatic bacteriuria (ASB) is a relatively common condition occurring due to the morphological and physiological changes in the genitourinary tract during pregnancy. If left untreated, it may lead to acute pyelonephritis and adverse fetal and maternal outcomes. The objective was to determine prevalence, risk factors and etiological agents with susceptibility for ASB among pregnant women attending an antenatal clinic at a tertiary care hospital, Odisha, India.Methods: A prospective study with 200 pregnant women was conducted, over a period of 4 months, starting from 1st April 2017 to 31st July 2017. The mid- stream clean catch urine specimen was collected and processed in all the cases and other data were collected from the questionnaire given to them. The isolates from all the cases of ASB were identified and antimicrobial susceptibility was tested by Kirby- Bauer disc diffusion method and interpreted.Results: Prevalence of ASB in our study was 25.3%, with maximum prevalence among age group 21-30 yrs, during 3rd trimester, among multigravidae. Previous history of urinary tract infection (UTI), anaemia and diabetes have significant association with ASB. Klebsiella spp. was the predominant isolate in this study followed by Escherichia coli. Nitrofurantoin and Cefixime are safe and effective antibiotics against urinary pathogens in pregnancy.Conclusions: Undiagnosed and untreated asymptomatic bacteriuria is associated with complications during pregnancy. Hence routine screening of antenatal women for ASB during all trimesters must be considered for preventing the adverse maternal and foetal outcomes particularly with known risk factors like increasing age, multiparity and previous history of UTI.
Evaluation of creatine kinase and lactate dehydrogenase for liver abnormalities: a biochemical study
Authors: Pujara Nishant , Chaudhary Anand
Published: September 2017

Background: Lactate dehydrogenase (LDH) is an enzyme found in nearly all living cells. LDH catalyses the conversion of lactate to pyruvic acid and back. The aim of the present study was to determine lactate dehydrogenase (LDH) level as an indicator of liver, muscular or cancer abnormalities in patients of more than 40 years of age.Methods: Two hundred and twenty patients had been tested for LDH and liver function tests (LFTs). Creatine kinase (CK) levels were measurement only in patients who had high levels of LDH.Results: High levels of LDH had been observed in many patients suggestive as an indicator of liver abnormalities. For muscular damage, measurement of CK in patients with elevated levels of LDH. Whereas high LDH levels, as an indicator for cancer abnormalities, were found in six males and two female who had normal values of LFTs and CK.Conclusions: LDH can be regarded as a good biomarker for diagnosis of liver, muscular and cancer abnormalities. There is little variable between males and females in the elevated value of LDH. Patients who had high values of LDH and CK are proposed to have unidentified cancer abnormality.
Evaluation of the epidemiology of pneumothorax in Bhuj district: a population based survey
Authors: Chaudhary Anand , Pujara Nishant
Published: September 2017

Background: Pneumothorax is an abnormal collection of air in the pleural space that causes an uncoupling of the lung from the chest wall. It may be spontaneous or traumatic. The spontaneous pneumothorax is usually the result of rupture of superficial emphysematous bullae and may occur in apparently healthy persons or in association with chronic pulmonary disease. It is usually unilateral but may be bilateral. If air reaches the mediastinum and rupture into both the pleural cavity.Methods: 25 consecutive cases of pneumothorax admitted at the Gujarat Adani institute of medical science Bhuj from December 2011 to April 2012 were studied. Each patient was interrogated and examined in detail according to the attached proforma, with a view to identify the nature of pneumothorax.Results: The incidence of pneumothorax was maximum in the 4th decade of life. The youngest one was a boy ages 14 year, while the oldest case was 75 years. 36 cases were under the age of 50 years, while only 2 cases were more than 70 years of age.Conclusions: The prevalence of pneumothorax was greater in male as compared to female. Most of the cases treated with needle aspiration of air and the intercostal drainage through indwelling polyethylene catheter developed surgical emphysema on the affected side which disappeared within 2-3 days after aspiration if air with needle or after removal of polyethylene tube from intercostal space.
Serum C- reactive protein level and lipid profile in periodontitis and coronary artery disease in people of Bhuj region
Authors: Dave Dinesh , Desai Vishal
Published: September 2017

Background: Many epidemiological studies have investigated the relationship between periodontal disease and coronary artery disease but their result is heterogeneous. This review article is designed to update the association between periodontal disease and cardiovascular events. Hence, the aim of the present study was to assess whether there is a link between periodontal and coronary artery disease (CAD).Methods: This study includes 90 subjects, which were divided into 3 groups: 30 subjects -healthy individuals, 30 subjects- having Periodontitis, 30 subjects-  suffering from coronary artery diseases.Results: The mean OHI-S scores for group 1, 2 and 3 were 0.95±0.60, 2.91±0.90, 1.54±0.74 respectively. CRP level group 2 and 3 were significantly higher than group 1 (p =0.002 and 0.00 respectively) whereas difference between group 2 and 3 was not significantly significant. Lipid profiles, cholesterol, low density lipoprotein (LDL), triglycerides higher in group 2 as compare to 1 and 3. High density lipoprotein (HDL) levels between groups were not significantly different.Conclusions: Based on results and other reports Periodontitis may be a risk factor for CAD and possibly there can be an association between periodontal diseases.
Epidemiological profile of snake bite at tertiary care hospital, East India
Authors: Srivastava Anubha , Gupta Animesh , Singh Sanjay K.
Published: September 2017

Background: Snakebite is a common medical emergency and an occupational hazard for majority of Indian population especially farmers. Epidemiological data on snake bite from the East India is sparse.Methods: This hospital based prospective study was conducted from March 2013 to February 2014. 200 cases of snakebite poisoning were admitted to the hospital during the study period.Results: Majority of victims belonged to the age group of 15-45 (60%), resident of rural areas (92%) and were involved in agricultural activities (60%). The study population was predominately bitten outdoors (66%), in the lower extremity (86%), at night (82%). Respiratory muscle paralysis (66.7%), ptosis (66.7%), coagulopathy (60%), acute renal failure (55.6%), shock (55.6%) were the signs associated with poor prognosis.Conclusions: Snakebite is an important occupational hazard, though preventable in principle remains to be one of the common medical emergencies.
Spirometry and mannitol bronchial challenge test among firefighters in Bhuj district: a questionnaire based study
Authors: Buch Kashyap , Chauhan Vinayak
Published: September 2017

Background: Asthma is a common chronic lung disease that inflames and narrows the airways. It causes recurring period of wheezing, chest tightness, shortness of breath and coughing.Methods: A questionnaire, spirometry, direct and indirect airway challenge tests, exhaled nitric oxide, and skin-prick tests were administered prospectively to 100 out of 120 firefighters employed in Bhuj district, Gujarat, India. Asthma was defined as the combination of respiratory symptoms with airway hyper responsiveness.Results: Twenty out of 100 firefighters (12%) had physician-diagnosed asthma, which could be confirmed in 8 firefighters. In contrast, asthma was diagnosed in 28% (28 of 100 firefighters). Wheezing was the most sensitive symptom for the diagnosis of asthma (sensitivity, 88%; specificity, 90%).Conclusions: Asthma was considerably under diagnosed in firefighters. The combination of a structured symptom questionnaire with a bronchial challenge test allows identifying patients with asthma and should routinely be used in the assessment of active firefighters and may be of help when evaluating candidates for this profession.
Uveitis of spondyloarthritis in Indian subcontinent: a cross sectional study
Authors: Ninan Fini , Mathew John , Philip Swetha Sara , John Deepa , Danda Debashish , John Sheeja Susan
Published: September 2017

Background: The seronegative spondyloarthritis (SpA) are known to have intimate association with ocular inflammatory disease. While anterior uveitis accounts for 50-92% of all cases of uveitis in the West, it ranges between 28 and 50% in the Asian countries. The aim of this study was to document the clinical profile of uveitis in patients with spondyloarthritis in the Indian subcontinent.Methods: In our hospital based cross sectional study, 166 patients fulfilling Assessment of SpondyloArthritis international Society’ (ASAS) criteria for spondyloarthritis (SpA) were evaluated for evidence and nature of uveitis, including by a slit lamp bio microscope. The characteristics of Uveitis were defined as per the SUN (Standardization of Uveitis Nomenclature) Working Group criteria. 84.3% (140) of the patients were male.Results: Ankylosing spondylitis was the commonest type of spondyloarthritis accounting for 69.3% patients. Evidence of past or present uveitis was found in 16.3% patients. Of the patients with uveitis 96.3% had anterior uveitis. 88.9% of the patients had redness of the eye, and 85.2% reported pain in the eye during an episode of uveitis. Mean duration of musculoskeletal symptoms prior to the diagnosis of SpA was 4.36 years. Of the 24 patients who could recall the course of uveitis 70.8% (17) had recurrent episodes. As a complication of uveitis 18.5% had cataract, and 14.8% had posterior synechiae. 78.3% patients were HLA-B27 positive. 19.2% of HLA-B27 positive patients had uveitis, whereas only 5.6% out of the 36 HLA-B27 negative patients had uveitis.Conclusions: The proportion of patients with uveitis in our study (16.3%) was considerably less than in other studies. The characteristics and profile of uveitis in our cohort of SpA patients from the Indian subcontinent were similar to those previously reported in literature.