bluuebunny/crossref_metadata_2025 huggingface dataset:
“Man Får Inte Supa Ihjäl Sig Enligt Svensk Lagstiftning!”: Svenska socialarbetares tal om bruket av tvångsvård
Authors: Palm Jessica
Published: December 2017

The Swedish handling of drug users includes compulsory treatment (CT) for up to 6 months. Social services play a key role in the decisions about when and for whom CT is used. In this paper the aim is to get an understanding of how social workers reason about the use of CT through looking at the goals they set for their clients and how they are to be reached. Why they reason the way they do is a central question in the analysis as well as in the long term understanding of why Sweden uses CT. The social worker comments are contrasted against three principles central to modern society; the principle of liberty emphazising the autonomy of the individual, the egalitarian principle of social justice linked to paternalism and the utilitarian principle focused on maximizing happiness. The data used in this analysis comes from interviews with social workers and observations of meetings with clients as well as other professionals in 6 municipalities in Sweden.

Central goals for the social workers are that the client takes responsibility for her/his life (autonomy) and total rehabilitation (abstinence). However, their possibilities of reaching these goals are limited, and therefore they have modified them (a bearable life for the old and total rehabilitation for the young clients). The means to achieve these goals are ambitious treatment for the young and low threshold interventions for the old, in theory excluding CT for both groups. However, obstacles are identified also for these goals which allows for CT to be an alternative. Financial issues and expectations on social services also play a part in the understanding. Further the analysis shows the importance of the egalitarian principle and a strong paternalism, which minimizes the role of the liberty principle.
Designation Practices and Perceptions of Addiction – a Diachronic Analysis of Finnish Press Material from 1968–2006
Authors: Hellman Matilda
Published: December 2017

The study is a diachronic investigation into how addiction is designated in the leading Finnish daily newspaper in the period 1968–2006. It discusses how different designations practices for the concept of addiction are reflected in understanding of the phenomenon.

Material and Proceedings

Newspaper materials consisting of randomly sampled (n=432) issues of Helsingin Sanomat (HS) served as a base for the investigation. Texts were selected that discuss addiction in ways set out in the inclusion criteria. A total of 34 (=n) texts were analyzed more closely, taken from the years 1972, 1982, 1992 and 2002.

Results

Two main tendencies can be discerned from the 1990s and onwards. The journalistic pieces start to work an internalization of the problems, i.e. they mediate a perspective from within the problems. Simultaneously, the concept of addiction becomes conventionalized and its use expanded. The cultural unit of addiction starts to include all types of problematic repetitive behavior. The article discusses how these trends serve the general trends towards individualization and medicalization. The expert statements accounted for in the media guide the individual–-the citizen, the consumer, the potential or actual addict–-in the landscape of the logics and mechanisms of addiction.
School-based programmes that seem to work
Authors: Pape Hilde
Published: December 2017

H. Pape: School-based programmes that seem to work: Useful research on substance use prevention or suspicious stories of success?

School-based prevention programmes targeted at adolescent substance use rarely seem to have the desired effects on behaviour. It is true that some outcome studies do conclude that such programmes have been successful, but they are relatively few and far between. Even so, one may ask whether the body of published research in this field may originate from unrealistic optimism due to publication bias and underreporting of no or counterproductive effects. Thus, anecdotal evidence suggests that the literature is biased in favour of studies with positive findings. Moreover, nearly all these studies have been carried out by programme developers, and it is well known that researchers with vested interests are more likely to bring “good news” than independent researchers. Indeed, rather than approaching the field with critical reflection, some evaluators have intended to prove that school-based prevention works and have conducted their research accordingly. Examples of questionable analytical approaches and selective reporting of positive ifindings are consequently not hard to find. The external validity of evaluation studies with favourable outcomes is also often questionable because they almost exclusively have assessed the effects of programmes delivered under optimal rather than real-life conditions. In conclusion, the empirical “evidence” in favour of school-based substance use prevention programmes is generally weak and does not allow recommendation of widespread dissemination of any specific programme.
Vulnerable, guilty or on their own?
Authors: Kouvonen Petra
Published: December 2017

P. Kouvonen: Vulnerable, guilty or on their own? Institutional identities of substance abusing children and families within Finnish child welfare

In light of the multiple and sometimes contradictory demands within the current discourse on child welfare, this paper explores institutional approaches within Finnish child welfare to conceptualizing individuals with problematic substance use. The data consist of observations of everyday life and institutional client-meetings in three so-called professional foster homes in the Helsinki area. Three different interpretative repertoires dealing with problems related to substance use among children and their families were identified in the analysis. In the first approach a strictly regulated policy regarding the use of substances was combined with support. In the second approach, substance use was approached with stronger demands for self-regulation and with less support. The guiding principle seems to have been trust. In the final approach, severe and prolonged behavioral problems were dealt with. Punitive responses were also seen to be present. The main finding was that those with severe problems were met with less support and more demands for self-regulation. As a last resort, repressive approaches were suggested. It therefore seemed like the autonomy offered for those with very little resources created obligations and demands that were hard to meet for the child alone. A possible conclusion is that a more humane perception, which also takes into account possible unfavorable structural factors leading to behavioral problems, could benefit the single child. A more coherent, overarching substance use policy could further help professionals in charge of difficult and threatening situations.
Substituent-Dependent Stimuli Recognition of Luminescent Gold(I) Chloride Complexes Based on Diarsenic Ligands
Authors: Imoto Hiroaki , Nishiyama Shintaro , Naka Kensuke
Published: December 2017

Stimuli-responsive gold(I) chloride complexes were developed based on a diarsenic ligand, cis-1,4-dihydro-1,4-dimethyl-2,3,5,6-tetrakis(alchoxycarbonyl)-1,4-diarsinine (cis-DHDA). The crystals of the complexes showed intense luminescence due to the aurophilic interactions. Interestingly, methyl- and t-butyl substituted cis-DHDAs offered different stimuli-responsive behaviors accompanied with emission color changes. The crystal samples of the complexes with both ligands changed their emission colors by mechanical stimulus such as grinding in a mortar, but the effect of CH2Cl2-treatment for the recovery of the original emission was dependent on the substituent structures. Furthermore, only the crystals of the complex with t-butyl substituted cis-DHDAs showed vapochromic luminescence. These differences arise from steric hindrance of substituents at the ester groups. Relationship between chemical structure and emission behaviors was studied based on a simple ligand backbone.
Enhanced Adsorption Selectivity of Aromatic Vapors in Carbon Capsule Film by Control of Surface Surfactants on Carbon Capsule
Authors: Ji Qingmin , Qiao Xu , Liu Xinbang , Jia Hongbing , Yu Jong-Sung , Ariga Katsuhiko
Published: December 2017

Carbon capsules with mesoporous wall and hollow interior were used to fabricate the sensing thin films for volatile aromatic vapors. To grow the thin film based on convenient layer-by-layer (LbL) process, carbon capsules need precoating with surfactants to assist their dispersion into aqueous solution. The influence of the surface covered surfactants on the adsorption selectivity of the corresponding carbon capsule film on aromatic vapors is studied. The results showed that poly (styrene sulfonate) (PSS) which is mainly covered on the outer surface of carbon capsules may be of benefit for higher accessibility of vapors with benzonoid nature to the carbon surfaces. A more enhanced adsorption selectivity to aromatic vapors is thus achieved compared to the cases of (sodium dodecyl sulfonate (SDS) and poly(allylamine hydrochloride) (PAH)), which can be fully or partial filled into the pores of carbon capsule.
Growth and seed yield of Asalio (Lepidium sativum L.) as influenced by seed rates and sowing methods
Authors: Chundawat R.S , D.K Patidar , A Haldar , K.C Meena
Published: December 2017

The experiments were carried out during Rabi season for the three consecutive years of (2012 to 2014) at the Research Farm, College of Horticulture, Mandsaur (M.P.) under AICRP on M&AP, Rajmata Vijayaraje Scindia Krishi Vishwa Vidyalaya, Gwalior (M.P.). The treatments consisted of two sowing methods as M1- seed broad casting and M2- line sowing. Five seed rate S1- 6, S2-8, S3- 10, S4-12 and S5-15 kg/ha. These treatments were evaluated in Factorial Randomized Block Design with three replications. Significantly maximum plant height was recorded under treatment S5, maximum number of number of branches was recorded under treatment S2, maximum stem girth was recorded under treatment S2 and seed yield was recorded under treatment S2.
Seasonal Calendar and Gender Disaggregated Daily Activities of Indigenous Galo Farmers of Eastern Himalayan Region of India
Authors: Bhagawati Kaushik , Sen Amit , Kumar Shukla Kshitiz
Published: December 2017

Seasonal calendar and daily farming activities are vital in understanding the farming system of a community and identifying the period of intensive agriculture and lean period for better resources management and planning. The objective of the current study was to evaluate seasonal calendar and gender disaggregated daily activities of indigenous Galo farmers of Arunachal Pradesh. Phenomenological approach was used to understand the system as the native farmers perceive it. The result reveals the rice-based farming system of the tribe with seasonal calendar of major crops that is guided by the climate of the location. Also, it was found that farming is a family activity of the community with well defined task for each family member based on gender. Women play a major role in the farming and also have vital responsibility in preservation and conservation of indigenous local crop varieties and seeds for next season. Generally it was seen that the labor burden of tribal women exceed than that of their male counterpart. Though the farmers seem to remain in the field throughout the year, their involvement in agricultural activities is actually very low. Monocropping nature of farming, long duration crop varieties and excessive dependence on natural factor leads to poor production and productivity of crops. The seasonal calendar may help the researchers and policy makers to understand the specific need of farmers and device tailored measures for sustainable development of the farming sector and livelihood improvement of the specific community under study.
Acid lime Growers’ Feasibility Perception of Contract Farming.
Authors: Anavrat Vinod , Bante Ropan , Mokde Mamta
Published: December 2017

Contract farming is generally practiced by food processing firms wherein the risk is allocated between the company and its growers. Its key aspect is risk sharing and risk reduction. Hence we made an attempt to know the perception of acid lime growers and ascertain the prospects of contract farming. The sample comprised of 200 acid lime growers in 3 districts of Maharashtra, using random walk sampling technique. The data collected through a structured interview schedule were analyzed using the t-test of significance of difference between sample and population means. The study revealed significant relationship between occupation (t=1.596) and perceived acceptability of contract farming in citrus at 5 per cent level of significance. Similar relationship prevailed between annual income from acid lime (t=0.391) and perceived acceptability of contract farming in citrus. Guaranteed and fixed pricing structures was perceived to be the main advantage of contract farming which attracted attention of the maximum respondents (RBQ=175). As regarding risk factors, inadequate water for irrigation ranked the topmost factor followed by price uncertainty. In case of issues governing profitability, unfair market price has been ranked as the number one issue (RBQ=181.33) followed by over production and less market price (RBQ=178.33) to the produce. It is expected that this study will help policy makers to develop more appropriate marketing policies in India.
Addition of low-grade phosphate rock for improvement of soil fertility on plant models: A preliminary case study
Authors: Maharana Rojali , Basu Aradhana , Kumar Dhal Nabin
Published: December 2017

To sustain food production in the course of time and for efficient utilization of available resources, it is essential to approach improved methodologies and techniques for enhancing crop productivity. Commercial agricultural production has achieved this through the external application of synthetic inorganic fertilizers which has some detrimental effects on the soil structure, composition, microflora and additional characteristic properties of soil. The mining and industrial waste is an unwanted by-product of mining. Reusing and recycling of these wastes is possible therefore recovery and recycling is the most excellent environmental resolution to save raw resources and to diminish the number of industrialized waste materials produced, and also control the contamination of the environment. In the present study, an attempt has been made to utilize low-grade phosphate rock as a fertilizer and its effects on soil fertility. The raw phosphate rock samples are subjected to physicochemical test followed by elemental analysis by EDXRF (Energy Dispersive X-ray Fluorescence). The tests confirmed that it is possible to use this raw phosphate rock as fertilizer for plant growth in a simple process. Different soil and plant parameters were measured. Data on pot experiment revealed higher plant growth is in PR amended soil than normal soil. The greatest positive effect on growth was recorded in the treatments that received phosphate rock (8g) per kg of soil. Thus, observations indicated that direct application of this PR could be an alternative, promising technology for simultaneous waste minimization, waste utilization, and improved resource-use efficiency.
A Study on Physico-Mechanical Properties of Onion Varieties Under Koppal District, (Karnataka).
Authors: Shoba H. , Rajeshwari N. , Nagaraja G.
Published: December 2017

The physico-mechanical properties of four popular cultivable onion varieties i.e., Ballari red, Arka kalyan, Satara (local verity), Kalasa (local variety) in Koppal (Karnataka)were studied to form an important database for designing of storage structures, cleaning, grading, sorting and harvesting equipments. The equatorial diameter of all size category Ballari red onion variety ranged from 4.01 to 8.35 cm, polar diameter ranged from3.82 to 6.62 cm and thickness of Ballari red onion variety ranged from 1.25 to 2.51 cm where as the lowest values of equatorial diameter was observed in Kalasa (local variety) i.e., 3.2 to 7.12 cm, polar diameter ranged from 2.89 to 5.12 cm and thickness from 1.22 to 2.01 cm, respectively. Shape index of three out of four was oval in shape. The geometric mean diameter (Dgm) and arthematic mean diameter (Dam) of large, medium and small size verities as Ballari red, Arka kalyan, Satara, Kalasa had 2.65 to 5.09, 2.5 to 4.58, 2.35 to 4.43 and 2.23 to 4.13 cm, respectively. The highest mean value of bulk density from 678.9 to 390.42 kg/cm3was observed in Ballari red onion followed by Arka kalyan of 662.7to 390.42 kg/cm3, Satara 628.4 to 390.23 kg/cm3, Kalasa 618.59 to 385.24 kg/cm3and highest mean value of angle of repose which was observed in Ballari red i.e, 37o (large size) and lowest was observed 20.90o in Kalasa (small size) variety.
Effect of Tied Ridging and Fertilizer on the Productivity of Sorghum [Sorghum Bicolor (L.)Moench] at Raya Valley, Northern Ethiopia
Authors: Sibhatu Berhane , Berhe Hayelom , Gebrekorkos Gebremeskel , Abera Kasaye
Published: December 2017

Water deficit and poor fertility of soil are among the main constraints to sustain production of sorghum in the semi-arid regions of northern Ethiopia. Thus, one experiment was conducted to determine the appropriate tied-ridging practice and planting method that maximizes sorghum productivity under rainfed conditions. It was carried out in 2015 and 2016 cropping seasons. Treatments comprised flatbed planting as control; open tied ridge, furrow planting; open tied ridge, planting on ridges; closed tied ridge, furrow planting; and closed tied ridge, planting on ridges were tested separately under fertilized and unfertilized conditions. These treatments were laid out in Randomized Complete Block Design with three replications. According to the current result, days to heading, plant height and panicle length were not significantly (P>0.05) influenced while grain and biomass yields were significantly influenced in both fertilized and unfertilized conditions. Accordingly, the maximum grain yield (3226.70 - 4621.00 kg ha-1) under fertilized and (2678.00 - 4318.80 kg ha-1) unfertilized conditions was obtained from closed tied ridge with planting in furrow. Moreover, the highest biomass yield (6844.40 - 11471.00 kg ha-1) was produced from closed tied ridge integrated with fertilizer in furrow planting. On the other hand, the minimum average yields were obtained from flat planting (farmers' practice) with and without fertilizer. It is concluded that closed tied ridge with planting in furrow can be recommended for sorghum growers in Raya Valley areas and other places with similar agro-ecologies to enhance sorghum yield.
Porto Alegre e Pelotas: duas experiências de municipalização do saneamento no Rio Grande do Sul da Primeira República
Authors: Rückert Fabiano Quadros , Maropo Felipe
Published: December 2017

O artigo aborda o processo de municipalização do saneamento em duas cidades do Rio Grande do Sul, no período da Primeira República (1889-1930). Explorando documentos do poder público, projetos de engenharia e matérias publicadas na imprensa da época, a pesquisa realizada destaca as estratégias jurídicas e financeiras usadas pelas duas municipalidades para interferir nos serviços de saneamento – abastecimento de água e coleta de esgoto – que estavam sob o controle de empresas particulares no começo da República. Dentro deste contexto, as discussões sobre salubridade urbana ganham importância e serão contempladas pelo artigo.
Comparison of strength and anaerobic characteristics of sedentary women and men according to flexibility variable
Sedanter kadın ve erkeklerin esneklik değişkenine göre kuvvet ve anaerobik güç özelliklerinin karşılaştırılması
Authors: Aslan Cem Sinan , Eyuboğlu Ender , Dalkıran Oguzhan , Özer Uğur
Published: December 2017

The aim of the study was to determine whether the levels of flexibility capacity of sedentary individuals are effective on vertical jump, leg strength and anaerobic power characteristics. Flexibility, vertical jump, leg strength and anaerobic power characteristics of 250 sedentary participants (137 male and 113 female) were determined. The median value of the participant’s flexibility measurement results was found, and groups were formed based on their low and high flexibility capacity and gender. Differences between the groups were determined using the "Independent Sample t-Test" analysis method included in the SPSS 13 statistical program. Significance was set as 0,05. As a conclusion, comparison results of groups that were formed according to low and high flexibility capacity without gender discrimination, the group with higher flexibility has significantly higher values than lower flexibility group in point of leg strength and anaerobic power. There was no significant difference on vertical jump between groups. According to these results, the level of flexibility in sedentary individuals causes difference between leg strength and anaerobic power properties.Extended English abstract is in the end of Full Text PDF (TURKISH) file.ÖzetBu çalışmada amaç; sedanter bireylerin esneklik kapasitesinin düşük ya da yüksek olmasının dikey sıçrama, bacak kuvveti ve anaerobik güç özellikleri üzerinde etkili olup olmadığının belirlenmesidir. Çalışmaya dâhil olan 137 erkek, 113 kadın toplam 250 sedanter katılımcının esneklik, dikey sıçrama, bacak kuvveti ve anaerobik güç özellikleri belirlendi. Katılımcıların esneklik ölçüm sonuçlarının medyan değeri bulunarak, bu değere göre düşük ve yüksek esneklik kapasitesi ve cinsiyet göz önüne alınarak gruplar oluşturuldu. SPSS 13 istatistik programı içerisinde yer alan “Independent Sample t-Test” analiz yöntemi kullanılarak gruplar arası farklılıklar tespit edildi. Anlamlılık 0,05 olarak kabul edilmiştir. Sonuç olarak; cinsiyet ayrımı olmadan, sadece düşük ve yüksek esneklik kapasitesine göre oluşturulan grupların karşılaştırılma sonuçlarına göre, yüksek esneklik değerlerine sahip grubun bacak kuvveti ile anaerobik güç değerleri, düşük esneklik kapasitesine sahip gruba göre anlamlı derecede yüksek çıkmıştır. Dikey sıçrama değerleri açısından iki grup arasında fark çıkmamıştır. Bu sonuçlara göre; sedanter bireylerde esneklik kapasitesinin yüksek ya da düşük olması bacak kuvveti ve anaerobik güç özellikleri arasında anlamlı fark oluşturmaktadır.
THE STRUCTURE OF PHARMACOTHERAPY OF ARTERIAL HYPERTENSION AND ADHERENCE IN YOUNG PATIENTS
Authors: Tuleutayeva R. Ye. , Musina A. Ye. , Cebotarenko N. A. , Makhatova A. R.
Published: December 2017

Aim: To determine the indicators of adherence to drug therapy in young patients with arterial hypertension (АН) and the correlation between the indicators and therapy management.Materials and methods: The study enrolled 514 patients aged 25 to 45 years diagnosed with essential hypertension. We studied the structure of antihypertensive pharmacotherapy and adherence to treatment using the Moriski−Green test and the original questionnaire. The patients were distributed depending on the degree of blood pressure increase, administered treatment, age, economic factor, and drug source.Results: The adherence level by Moriski−Green test was 36.8%; according to the original questionnaire: high adherence level was 38.3%, incomplete adherence ― 33.7%, and poor adherence ― 28.0%. The monotherapy with ACE inhibitors predominated in the majority of cases; the fixed combinations were more typical for the treatment of the stage II AH, drug combinations ― for stage III AH. The highest therapy adherence was registered in patients with stage III AH receiving treatment with combinations of drugs in a single dosage form. The life quality of respondents and the drug source did not influence the adherence significantly.Conclusion: In young patients with arterial hypertension, some features of treatment structure determine the therapy adherence.
THE MECHANISMS OF IMMUNE ESCAPE BY HEPATITIS B VIRUS
Authors: Sokolova M. V. , Konopleva M. V. , Semenenko Т. A. , Akimkin V. G. , Tutelyan A. V. , Suslov A. P.
Published: December 2017

The high prevalence of the hepatitis B virus (HBV) in population occurs mainly due to numerous mechanisms formed in the process of the virus evolution, contributing to its survival under immunological pressure. The review presents the most complete systematization and classification of various HBV protective mechanisms basing on their influence on different parts of congenital and adaptive immune response. The analysis of literature data allows for the conclusion that two basic principles underlie the mechanisms: the strategy of the «stealth virus» (virus’s escape from recognition by the immune system) and strategy of immunosuppression. The stealth virus strategy is performed as follows: special strategy of the HBV replication which prevents the recognition by the receptors of congenital immune system; occurrence of the vaccine escape mutants; isolation of the virus in host cells and tissues providing its inaccessibility to T-cells along with hyperproduction of subviral particles as traps for specific antibodies. The core principle of the immunosuppression implemented in hepatitis B therapy is based on the phenomenon of the viral apoptotic mimicry. The result of this interaction strategy is dysfunction of NK and NKT-cells, inactivation of dendritic cell functions, and suppression of the adaptive immune response. The review demonstrates that interaction between HBV and the immune system of the macro organism is in some kind of «dynamic equilibrium» depending on numerous factors. Specific molecular targets of the viral impact are described. We propose to expand the research on the influence of the host’s genetic factors on the development of congenital and adaptive immune response against HBV, especially during the real infectious process which results in the improvement of approaches to the therapy by developing personalized treatment methods.
AB0 BLOOD TYPES AND MALIGNANT COLORECTAL NEOPLASMS OF DIFFERENT LOCATION: A RETROSPECTIVE ANALYSIS OF 1570 CASES
Authors: Kerimov R. A. , Seksenbayev B. D. , Galimov O. V. , Nurmashev B. K. , Znanteyev M. E.
Published: December 2017

Background: AB0 blood type antigens are unequally expressed in different portions of the colon resulting in so-called proximal-distal gradient. In most research studies considering the link between blood types and colorectal cancer, this gradient has not been taken into account. In the present context the findings of such studies are not convincing, no evidence-based results are reflected in literature. Valid studies of this association require antigenic distribution of the colon and malignant tumor location to be taken into account.Aim: To assess the possible relation between AB0 blood type antigens and malignant tumors located in different parts of the large intestine.Materials and methods: We performed a case-control study with retrospective analysis of medical records on patients with the presented disease (cases) and patients who did not suffer from it (controls). Required data was obtained from regional oncological centers of South Kazakhstan, Karaganda, East Kazakhstan, and Mangystau regions. Every third case of colorectal cancer registered in 2011−2016 years was included in the survey. The studied association was estimated by means of a chi-square test. A multinomial logistic regression was used to calculate the odds ratio (OR) with confounding risk factors to be taken into account. Shares of the samples were compared by means of Student’s t-test. A critical level of statistical significance (p-value) was considered to be 0.05.Results: Each group included 1570 patients. Gender, age, and ethnic distribution did not differ statistically in cases and controls (p0.4 for all comparisons). When blood type distributions were compared between groups regardless of tumor locations, any significant difference was not revealed (p=0.141). When similar calculations were applied to specific parts of the large intestine, the association between 0 blood type and malignancies of distal portions of the colon was demonstrated (p=0.0002). When we calculate the odds ratio for the disease development in the colon parts (using a multinomial logistic regression), the following results were obtained: 1.518 (p=0.004) for 0, 0.781 (p=0.099) for A, 0.785 (p=0.143) for B, and 0.965 (p=0.884) for AB blood types.Conclusions: The results of the present study revealed a statistical correlation between the 0 blood type and malignant tumors located in the distal portions of the colon.
THE ROLE OF DIFFUSION-WEIGHTED MRI IN DIFFERENTIAL DIAGNOSIS AND PREDICTION OF SURVIVAL IN PATIENTS WITH BRAIN METASTASES
Authors: Byvaltsev V. A. , Stepanov I. A. , Kichigin A. I. , Kanigin V. V. , Stupak V. V.
Published: December 2017

Background: Brain metastases are observed in up to 40% of all intracranial tumors. Some types of metastatic tumors cause difficulties in differential diagnosis, since they have similar signal characteristics with other pathological entities in neuroimaging. Obviously, the additional diagnostic methods to determine the prognosis and tactics of further management of this group of patients should be implemented.Aim: To study the role of diffusion-weighted magnetic resonance imaging (MRI) in differential diagnostics and predicting the survival rate in patients with brain metastases. Materials and methods: The study included data from MRI and morphological studies of 23 patients with brain metastases. The obtained values of the apparent diffusion coefficient (ADC) of tumors were compared with their histological type, cell density, and the index of proliferative activity Ki-67. In addition, the influence of ADC values on the overall survival rate was assessed.Results: A reliable inverse correlation of ADC values and the index of proliferative activity for various types of brain metastases (r=-0.74, p=0.014) was established. The dependence of ADC values and overall survival rate of patients with metastases in the brain is presented. The overall survival rate in patients with an ADC value greater than 947.2 mm2/sec was 9.8 months (95% CI: 8.6−11.3), and with ADC value less than 947.2 mm2/sec ― 6.4 months (95% CI: 3.7−9.1).Conclusion: The technique of diffusion-weighted MRI plays an important role in the differential diagnosis of brain metastases; it can be used as a tool of comprehensive preoperative assessment when planning the surgery and as a prognostic factor of overall survival rate for this group of patients.
NAT2 GENE POLYMORPHISM AS A PREDICTOR OF FAILURE FOR SURGICAL TREATMENT OF PELVIC ORGAN PROLAPSE: RESULTS OF A PROSPECTIVE COHORT CLINICAL STUDY
Authors: Dubinskaya Е. D. , Коlesnikova S. N. , Khamoshina М. B. , Lebedeva М. G. , Sounov М. А. , Коstin I. N. , Sokhova Z. M.
Published: December 2017

Background: Pelvic organ prolapse (POP) is the most frequent disease component in the structure of gynecological pathology (from 28 to 38.9%) and its incidence is increasing. Most of the research studies were initiated to develop various kinds of operative treatment for common prolapse cases (POP-Q III−IV); however, a large number of surgical interventions associated with a high percentage of complications and a high rate of relapses confirm the difficulty for problem-solving. In this regard, there is a need to expand ideas about the pathogenesis of the disease and develop approaches to the prediction of recurrence surgical treatment, choosing the correct and timely treatment strategy. Currently, great importance is given to the study of genetic control of connective tissue metabolism. The evidence demonstrated that polymorphism of NAT2 gene results in genetically determined disorders of connective tissue catabolism which increases the possibility of disease development approximately in 2 times. Point mutations in NAT2 lead to the so-called slow-acetylation which determines the predominance of the decay rate of collagen over its synthesis.Aim: Analyze the significance of NAT2 polymorphism as a predictor for failure of surgical treatment of pelvic organ prolapse.Materials and methods: The prospective cohort clinical trial enrolled 140 women of the reproductive age (from 28 to 42 y.o.) with symptomatic prolapse (POP-Q Stage II−III) who were examined and received treatment in the period from 2008 to 2014. All patients underwent surgical treatment of POP. The treatment included colpoperineorrhaphy with levatorplasty. In 12.9% of patients who had stress urinary incontinence — in combination with a loop urethropexies transobturatory access (Transobturator Vaginal Tape, TVT-O). Long-term results of treatment effectiveness were assessed in 3−5 years. Results: The findings revealed that the incidence rate of point mutations of NAT2 gene was 2-fold higher in patients with POP included in the ineffective treatment group (61.8%) if compared to the rate registered in the effective treatment group (30.6%).Conclusions: The obtained data indicate that the presence of point mutations in NAT2 gene is a poor prognostic factor for general types of genital prolapse and a predictor for failure of surgical treatment.
M-health for maternal health- bridging the gaps!!
Authors: Marwah Sheeba , Mittal Pratima
Published: December 2017

This article reviews significance, potential and principles to consider when setting up a telemedicine (TM) program to provide care to women in the field of obstetrics and gynecology, essentially deploying mobile technology. There are various benefits of such TM clinical applications. The consensus among patients and health care providers is that this technology is convenient to provide needed subspecialty medical care, even when it is not available locally. Such innovations are clinically successful, but economic and cost-effectiveness data are lacking.
Study of primary caesarean section in multigravida patients
Authors: Rajput Neelam , Singh Priyanka , Verma Yogendra Singh
Published: December 2017

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients.Methods: It was a prospective study of primary caesarean section in multigravida admitted at Kamla Raja Hospital, G.R. Medical College and J. A. Group of Hospitals, Gwalior (Madhya Pradesh, India) during the period of 1 year from September 2014 to August 2015. Multigravida with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of > 20 weeks gestation were included. Women with previous abortions and previous section and Pregnancy with medical disorders were excluded.Results: During the study period of one year, total 8185 deliveries occurred, out of which 3061 (37.39%) underwent caesarean section and 386 (12.61%) were primary caesarean section in multigravida. Out of these multigravida patients who underwent primary caesarean section- most of the patients were unbooked (77.72%). Majority of the cases were direct admission in the hospital (61.13%). Maximum number of the patients were in the age group of 25-30 years (55.95%). Two third of the patients were literate (69.44%) Maximum number of patients were Gravida 2 (49.72%). Almost all of them (95.85%) underwent emergency caesarean section. The most common indication for primary LSCS in multigravida patients was Malpresentation 115 (29.79%) followed by Fetal distress in 71 (18.39%) patients, APH in 71 (18.39%), Obstructed labour in 33 (8.55%), Severe preeclampsia and Antepartum eclampsia in 39 (10.1%), Twin pregnancy in 21 (5.44%). Most common maternal complication was pyrexia 40 (10.36%). Postoperative morbidity was 21.24% among unbooked, 14.25% in Referred, 23.58% in those operated as an emergency, 12.43% in patients belonging to of low socioeconomic status and 3.88%, in patients with moderate to severe anemia. Birth asphyxia was found in 6.21% of neonates. Neonatal mortality was 2.33%. Neonatal mortality is more in Unbooked cases (90.47%).Conclusions: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.
Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management
Authors: U. Sreelakshmi , V. Tushara Bindu , T. Subhashini
Published: December 2017

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management.
Reproductive age mortality survey: a tool to determine level of underreporting of maternal mortality
Authors: Badalia Sonika , Parashar Anupam , Dhadwal D. S. , Sharma Deepak
Published: December 2017

Background: For achieving sustainable development goals, tracking all maternal deaths without missing any is a crucial step. Underreporting of maternal deaths is an issue especially in developing countries like India. Objectives of this study were to estimate maternal deaths using Reproductive Age Mortality Survey (RAMOS) methodology in a district of North India and to study medical causes responsible for maternal deaths.Methods: A Reproductive Age Mortality Study (RAMOS) was carried out in a district of North India for the period 2009 to 2012. Records of female deaths in the reproductive age group were reviewed using multiple sources and verbal autopsy was conducted. Maternal deaths thus identified were compared with the officially reported maternal deaths for the same period for finding out the under reporting. Verbal autopsy was conducted to find out causes of maternal deaths.Results: A total of 16 women were identified as maternal deaths using RAMOS methodology. The officially reported maternal deaths were 8, thus under reporting of 100%. The 16 maternal deaths consisted of 14 (87.5%) direct maternal deaths and 2 (12.5%) indirect maternal deaths. One or the other form of delay was recognized in 8 of 16 maternal deaths. There was delay in recognizing the warning signs for urgent health care requirement (first delay) in 4 of 16 maternal deaths. There was delay on part of health facility to diagnose the complication and act appropriately (third delay) in 4 cases.Conclusions: It is concluded that the reporting system for maternal deaths need to be strengthened. Health workers should be adequately trained on reporting maternal death cases. On this foundation verbal autopsy should be conducted for all the reported deaths of women of reproductive age group to know the circumstances leading to maternal deaths.
Obstetric outcome of floating head in primigravida at term
Authors: Pahwa Sangeeta , Kaur Arshdeep , Nagpal Madhu
Published: December 2017

Background: Engagement of head is the most important event in labor which decides obstetric outcome. Floating head in primigravida at term is considered an important obstetric risk factor. Cephalopelvic disproportion, occipito-posterior position and deflexed head should be suspected in most cases of floating head. Present study was conducted to determine the outcome of labor in primigravida with floating head at term. The primary objectives of the study was to analyse the progress of labor, need of medical and surgical interventions and fetomaternal outcome. The secondary objective was to find out the rate of caesarean section for floating head in all situations whether elective or emergency in labor.Methods: This study was conducted in department of Obstetrics and Gynaecology SGRDIMS and R, Sri Amritsar on 100 primigravida subjects with floating head at term admitted through OPD admissions for induction of labor /spontaneous labor or referred from outside directly in early labor.Results: In present study the mean age was 24.95±3.01 years. The youngest case was 19 years old and eldest being 32 yrs old. The mean height was 151±3.41. At the time of admission 21% of cases had floating head, 55% cases were at -3 station, 17% of cases had -2 station, with only 7% of cases had -1 station.  56% of women delivered by caesarean section, 8% by forceps assisted vaginal delivery and 36% by normal vaginal delivery. The mean duration of labor was more in free floating and -3 stations in comparison to -2, or -1 stations. The need for augmentation was more in higher head stations.  Mean birth weight was 2.84±0.31, it was more in higher fetal stations in comparison to lower fetal stations. No significant maternal and fetal morbidity was seen. There was no significant difference in the Mean APGAR score of higher head stations in comparison to lower fetal stations.Conclusions: Primigravida with floating head at term and during labor should be managed cautiously. By proper monitoring and maintenance of partogram most of these cases deliver vaginally and without any maternal and fetal morbidity. The attitude of watchful expectancy and timely intervention will be used in all cases, especially in those appearing to be taking a protracted course.
Need of premarital care
Authors: Bansiwal Reeta , Mittal Pratima , Jyotsna . , Sharma Yogita
Published: December 2017

Background: Marriage is considered a remarkable event in an individual’s life. It provides people with a sense of belonging, support, security and responsibility. We put so much of efforts to find a good match for our younger and loved ones but we forget to match the most important wealth of our life “Health”. This study aimed to know the knowledge, attitude and practice of the population through a structured questionnaire.Methods: A cross-sectional study was conducted using a self-administered questionnaire which was distributed to 110 males and 110 females attending Medicine and Gynae OPD at Safdarjung hospital, New Delhi. Participants were questioned according to the self administered questionnaire and their answers were evaluated.Results: Only 11% of males new of premarital counseling and none of the females were aware of premarital care. Contraception knowledge was also poor among females as 7% females new only I-Pill as the method of contraception. After knowing the importance of premarital counseling and screening 92% males and 52 % females agreed for premarital counseling and screening.Conclusions: Marriage provides people with a sense of belonging, support, security and responsibility. Premarital care nurtures it and fill its “Neev” with the goodness of health. Therefore, it is recommended that premarital care is important before every marriage for the happy and healthy family ahead.
Gestational diabetes mellitus: does treatment modality predict the obstetric and neonatal outcome?
Authors: John Lopamudra B. , P. Reddi Rani , Ghose Seetesh
Published: December 2017

Background: Gestational diabetes mellitus (GDM) may be controlled with dietary modifications alone or may require insulin treatment. This study aims to find out the impact of these two treatment modalities on the maternal and neonatal outcomes.Methods: This retrospective observational study divided the GDM patients into two groups, A and B, treated with diet and insulin therapy respectively and the maternal and neonatal outcome parameters were compared.Results: 299 (6.7%) GDM patients over a period of two years were divided into group A (n=222) and group B (n=77). Need for induction of labour was significantly higher in group B (p=0.02). More number of history of previous abortions were seen in group A (p=0.1) and higher number of emergency Caesarean sections were observed in group B (p=0.1). Previous history of intrauterine deaths, gestational hypertension and hypothyroidism in the present pregnancy, meconium stained liquor, large for gestational age babies and need for neonatal intensive care were comparable in the two groups.Conclusions: There are no significant differences in the pregnancy outcomes of GDM treated with diet therapy alone or insulin except for a higher number of induced labours in the insulin treated group.
Thyroid abnormality in abnormal uterine bleeding: an observational study from Medical College in Eastern UP, India
Authors: Singh Prachi , Dubey Prashant , Yadav Shweta , Yadav Sachin Singh
Published: December 2017

Background: Abnormal Uterine Bleeding (AUB) is one of the commonest gynecological complain in reproductive age group. Menstrual abnormalities are commonly seen when there is any alteration in thyroid function. Objective of present study was to investigate the prevalence of AUB and to determine the menstrual pattern in cases with thyroid dysfunction.Methods: The present cross sectional observational study was conducted Teerthankar Mahaveer Medical College and Research Center Moradabad. Total 400 cases presenting with AUB were included in the study. Routine blood test, ultrasonography and thyroid function tests were done in these cases.Results: Among all the cases presenting with menstrual abnormalities 26% had hypothyroidism and 9% have hyperthyroidism and rest had euthyroid status. Menorrhagia (45.2%) and polymenorrhoea (37.5%) were commonest menstrual abnormality seen in cases with hypothyroidism. Most cases with hyperthyroidism presented with hypomenorrhoea (27.8%).Conclusions: Thyroid function abnormality is common in cases presenting with AUB and it gets relieved in correcting hormonal imbalance.