bluuebunny/crossref_metadata_2025 huggingface dataset:
What decreases low back pain? A qualitative study of patient perspectives
Authors: Setchell Jenny , Costa Nathalia , Ferreira Manuela , Hodges Paul W.
Published: April 2019

Background and aims

This study aimed to determine, from the perspective of individuals living with the condition, what decreases their low back pain (LBP). LBP affects most people at some point during their life. The condition has a meaningful effect on people’s lives including pain, reduced physical and social function, mood fluctuations, and a reduced ability to work. Despite a considerable amount of research on the topic, few strategies to reduce LBP are considered successful, and there has been little investigation into what individuals with the condition believe reduce it. This study aimed to address this gap in the literature by investigating what individuals with the condition believe reduces their LBP.

Methods

We employed a descriptive qualitative design using a custom-built online survey. Participants were 130 adults in Australia who self-identified as having current or having had previous LBP with or without co-morbidities. Data from the survey responses were analysed using content analysis to determine which management approaches participants considered to be effective in reducing their LBP.

Results

Participants most commonly said that they believed their LBP was reduced by: heat/cold (86, 66%), medication (84, 64.1%), and rest (78, 60%). Next most common was activity/exercise (73, 55.7%). Other factors such as consulting a health professional (52, 39.7%), stretching/therapeutic exercise (50, 38.1%), resting from aggravating activities (45, 34.3%), and psychological changes (41, 31.3%) were mentioned, but considerably less often.

Conclusions

Current literature points to the inefficacy of many of the factors participants reported as helping to reduce the effects of their condition, including the treatments that were most commonly listed by the participants in this study, namely: heat/cold, medication and rest. A possible cause of this discrepancy might be that individuals with LBP consider temporary relief (on a scale of hours) to be an acceptable outcome, whereas clinical trials tend to consider efficacy by long term outcomes (on a scale of weeks, months or years).

Implications

There are several implications of this research. From one perspective, there is the implication that public education about efficacious treatments may need to be enhanced as there is a discrepancy between research findings and the perspectives of individuals living with LBP. On the other hand, these findings also suggest that it is timely to re-examine the focus of LBP research to consider outcomes that are valuable to people living with the condition, which this study implies should include short term or temporary effects. The findings may also help clinicians tailor management to suit the individual patients by increasing the awareness that patient and research perspectives may at times diverge.
EEG-based quantitative analysis of aesthetic emotion in clothing design
Authors: Wang Jingjing
Published: April 2019

This paper combines the perceptual aesthetic sentiments with the objective physiological responses of the human brain. By analysing the characteristics of the brain electrical activities in processing of different types of sentiments, this paper uses the specific physiological indicators of the brain to quantify the aesthetic sentiments about clothing. The purpose is to introduce the EEG quantitative analysis method for sentiment perception into the aesthetic field of clothing, and establish a theory of quantifying aesthetic sentiments towards clothing design through the brain electrical physiological responses.
Computational neuroscience applied in surface roughness fiber optic sensor
Authors: He Wei
Published: April 2019

Computational neuroscience has been widely used in fiber optic sensor signal output. This paper introduces a method for processing the Surface Roughness Fiber Optic Sensor output signals with a radial basis function neural network. The output signal of the sensor and the laser intensity signal as the light source are added to the input of the RBF neural network at the same time, and with the ability of the RBF neural network to approach the non-linear function with arbitrary precision, to achieve the nonlinear compensation of the sensor and reduction of the effect of changes in laser output light intensity at the same time. The Surface Roughness Fiber Optic Sensor adopting this method has low requirements on the stability of the output power of laser, featuring large measuring range, high accuracy, good repeatability, measuring of special surfaces such as minor area, and the bottom surface of holed etc. The measurements were given and various factors that affect the measurement were analyzed and discussed.
The role of meditation in college students' neuroticism and mental health
Authors: Liu Wenqing , Lin Jiayan
Published: April 2019

A large number of empirical studies have found evidence that neuroticism is related to personality traits, but no one has integrated the relationship between neuroticism and mental health through meta-analysis. As a personality trait, neuroticism reflects the stable tendency of how individuals experience, feel, evaluate negative emotions and make corresponding behavioural responses. By means of meta-analysis, a preliminary dimension of neuroticism is constructed through an open questionnaire and literature review. On this basis, a preliminary neuroticism questionnaire for college students is compiled. The structural model of College Students' neuroticism questionnaire fits well, and has a high correlation with the neuroticism subscale of the simple version of Big Five Personality Questionnaire, which shows that it has a good structural validity. The positive orientation indicators of subjective well-being, life satisfaction and other mental health indicators were also selected. In addition, self-assessment indicators of physical health were selected. It was found that neuroticism was highly correlated with appeal indicators, indicating that the questionnaire of College Students' neuroticism had good validity.
Role of Fear in a Predator–Prey Model with Beddington–DeAngelis Functional Response
Authors: Pal Saheb , Majhi Subrata , Mandal Sutapa , Pal Nikhil
Published: April 2019

In the present article, we investigate the impact of fear effect in a predator–prey model, where predator–prey interaction follows Beddington–DeAngelis functional response. We consider that due to fear of predator the birth rate of prey population reduces. Mathematical properties, such as persistence, equilibria analysis, local and global stability analysis, and bifurcation analysis, have been investigated. We observe that an increase in the cost of fear destabilizes the system and produces periodic solutions via supercritical Hopf bifurcation. However, with further increase in the strength of fear, system undergoes another Hopf bifurcation and becomes stable. The stability of the Hopf-bifurcating periodic solutions is obtained by computing the first Lyapunov coefficient. Our results suggest that fear of predation risk can have both stabilizing and destabilizing effects.
The Human World as Augmented Reality: Transcendentalism and Anthropological Difference
Authors: Chiurazzi Gaetano
Published: April 2019

[full article, abstract in English; abstract in Lithuanian]

In this paper, I discuss, first of all, the positions of Perter Singer and Jacques Derrida regarding the difference between humans and animals. Singer’s animalism seems to me grounded in a naturalist substantialism (since it aims at dissolving the abovementioned difference in a common genus, animality), whereas Derrida’s approach ends in a phenomenological primitivism (since it aims at grasping the gaze of the animal through an epoché of the human cultural world). The result is, on the one hand, an essentialist reduction to the One, and, on the other, the nominalist multiplication of the Many. As an alternative to both these perspectives, I share a certain “transcendentalist” approach, in which human difference appears as a capacity to form a world in the Heideggerian meaning, which increases natural reality. The symbol of this new capacity is the upright position, a certain elevation above nature, the sign of which is consciousness. I call this new capacity “diagonal,” since, like the diagonal of the square, it is irreducible to its side – to nature (the plane of immanence) –, as much as the human world of “augmented reality” is indeed irreducible to every flat ontology, that is, to an onticology.
Pesan Dakwah dalam Novel Bait Surau
Authors: Ripai Muhamad , Muksin Ucin , Anugrah Dadan
Published: April 2019

This research is to know the form of dakwah message contained in novel Bait Surau, both in terms of appeal message that is rasoinal appeal, emotional appeal, appeal of fear, appeal ganharan and motivational appeal. And also in terms of the category of the message category of substance and form categories. Substance categories include morals, worship and sharia. Categories of form include informative, persuaasif and instructive. The method used in this study is the method of content analysis (content analysis). The results showed that based on the results of the study can be concluded that this novel there are many cargo messages of Islamic da'wah. The messages are manifested in the Immunizations and Categories of messages that indicate the message of da'wah. Researchers collect these phrases through the categorization of da'wah messages. there are two messages of da'wah by type, namely: the message of da'wah of the appeal and message propaganda of the message category. The message of da'wah in terms of appeal is the most widely mentioned motivational appeal. As for the terms of Substance Category namely Morals and Informative Form Categories, the most widely mentioned. Besides the Temple of Surau is a novel that tells of a man who has a dark time, he wants to change towards a better and struggling to build a surau whose condition is apprehensive.

 

Penelitian ini untuk mengetahui bentuk pesan dakwah yang terdapat dalam novel Bait Surau, baik dari segi imbauan pesan yaitu imbauan rasional, imbauan emosional, imbauan takut, imbauan ganjaran dan imbauan motivasional, dan juga dari segi kategori pesan yaitu kategori substansi dan kategori bentuk. Kategori substansi meliputi akhlak, ibadah dan syariah. Kategori bentuk meliputi informatif, persuasif dan instruktif. Metode yang digunakan dalam penelitian ini adalah metode analisis isi (content analysis). Hasil penelitian menunjukkan bahwa berdasarkan hasil penelitian dapat disimpulkan bahwa novel ini terdapat banyak muatan pesan-pesan dakwah Islam. Pesan-pesan tersebut terwujud dalam imbauan dan kategori pesan yang mengindikasikan pesan dakwah. Peneliti menghimpun ungkapan-ungkapan tersebut melalui kategorisasi pesan dakwah. Terdapat dua pesan dakwah berdasarkan jenisnya, yaitu: pesan dakwah dari imbauan dan pesan dakwah dari kategori pesan. Pesan dakwah dari segi imbauan terdapat imbauan motivasional yang paling banyak disebutkan. Adapun dari segi kategori substansi yaitu akhlak dan kategori bentuk  informatif, yang paling banyak disebutkan. Selain itu Bait Surau merupakan sebuah novel yang bercerita tentang seorang tokoh yang mempunyai masa kelam yang ingin berubah ke arah yang lebih baik dan berjuang membangun surau yang kondisinya memprihatinkan.
Organizing Solikamsk Coach Station and Coachman Service in Great Perm in 1607
Authors: Rybalko Natalia
Published: April 2019

Introduction. The city of Solikamsk on the territory of Great Perm was located on the first land road from Moscow to Siberia. This road was built in the late 16th century. The research is devoted to the problem of establishing a permanent coachman service in Solikamsk in 1607.

Methods and materials. This issue has not been studied yet. The article is based on documents from Fund no. 21 “Solikamsk Acts” (Archive of St. Petersburg Institute of History of the Russian Academy of Sciences): monarch’s decrees, letters from Permian clerks, petitions. We have reconstructed the Solikamsk archive using the method of mutual compliance of documents and their source study analysis.

Analysis. In the course of the study we were able to restore the chronology of events, find out the coachman service form of organization, material support, service operation conditions, staff of the Vyatka coach station by name. The paper reveals the mechanisms of managing Great Perm territory, the ways of solving problems of management and transportation.

Results. The article reveals the duality of the situation in Great Perm in the early 17th century. On the one hand, we can see functioning of a strictly centralized management system, on the other hand, we observe a strong local government in provinces. Perm’s clerk Prince S.Yu. Vyazemsky had to clearly execute the orders of Moscow and was prevented from making his own decisions. At the same time, key financial issues influencing stable work of coachman service were not originally planned in Moscow. Decisions arrived late. The central government was more concerned with the timely dispatch of tax collections to Moscow. After Solikamsk coach station coachmen dissolution, the problem of transportation on the Siberian road remained.
Captain Jacques Margeret: a Remarkable Huguenot Soldier in Russia’s Time of Troubles
Authors: Dunning Chester
Published: April 2019

Captain Jacques Margeret (fl. 1591-1621), a brave and highly intelligent French Huguenot soldier, was an active observer-participant in the Time of Troubles who contributed to Russia’s military modernization. Margeret also wrote one of the most valuable foreign accounts of early modern Russia: Estat de l’Empire de Russie et Grand Duché de Moscovie (1607). In this essay, Chester Dunning surveys two hundred years of scholarship about Margeret and his famous book, and he lays the foundation for a more objective biography of the remarkable French captain who served Tsar Boris Godunov, Tsar “Dmitrii”, Tsar Vasilii Shuiskii, the Tushinite pretender Dmitrii, “Tsar” Wladyslaw, King Sigismund III of Poland-Lithuania, Prince Janusz Radziwiłł, and finally King Gustav II Adolf of Sweden. This essay challenges recent scholarship concerning Margeret’s identity, his religious affiliation, his early career in France, his controversial career in Russia, his later career, and the composition of his book. This essay is based on fifty years of research by the translator of Jacques Margeret’s book into English as The Russian Empire and Grand Duchy of Muscovy: A 17th-Century French Account (1983). In addition to reading most published sources and scholarship about Margeret and his account of Russia, the author has examined documents related to Margeret’s biography in French, Russian, Polish, and British archives. In the process, Dunning discovered a letter Margeret wrote to King James I in 1612 encouraging English military intervention in north Russia to counter Polish and Swedish intervention.
Phase equilibria in the Na,Ca//SO4,CO3,HCO3-H2O system at 0 °C
Authors: Soliev L. , Jumaev M. T.
Published: April 2019

Phase equilibria in the Na,Ca//SO4,CO3,HCO3-H2O system have been studied at 0 °C. The studied system at 0 °C involves 4 invariant points, 13 monovariant curves and 15 divariant fields. The obtained results served as a basis for the construction of phase diagram (phase complex) of the studied system at 0 °C.
Structural-technological solutions for the construction of roads on permafrost soils
Authors: Makarov Aleksei , Kraev Alexey , Shankhoev Zurab
Published: April 2019

In this article, the authors briefly reviewed the problem of building roads on permafrost soils, according to the first engineering principle. The probable causes, affecting the thermal regime of the frozen soil at the base of the road, are also considered. In order to stabilize the road structure on permafrost soils, the team of authors of this article proposed 3 structural-technological solutions for the construction of roads, depending on the moisture levels of the upper soil mass, calculated for geotechnical and temperature-humidity conditions typical for the Yamalo-Nenets Autonomous district. The scheme, description and assessment of the effectiveness of each proposed structural-technological solution is given. Efficiency of the assessment is based on a comparison of the numerical modeling results of the water-thermal mode of mound with the proposed structural-technological solutions and ground embankments of roads on permafrost. The results of the numerical modeling of road embankments on permafrost soils are presented. The main conclusions of the research are formulated.
Experimental investigation of an asphalt concrete mixture cooling characteristics with the aim of reducing heat loss during transportation from the asphalt plant to the roadbed construction site
Authors: Dzhabrailov Khizar , Soltamuradov Magomed-Emi , Gaziev Salam
Published: April 2019

In connection with the sharp increase in the traffic flow, the problem of the durability of asphalt concrete pavements comes to the fore – their ability to maintain their properties within a certain period of time within certain limits. In many respects, the quality of future coverage is laid by the adaptability of the laying process, strict compliance with the requirements of project documentation and existing building codes and regulations (SNiP, GOST, ISO, etc.). However, the technology itself of the process of making asphalt concrete pavements is constantly evolving – new complexes are emerging, changes are being introduced to existing structures of machines for building coatings. Addition, reduction and combination of operations of the technological process, including, against the background of improving the quality and, as a result, the durability of the coating, reduce the complexity of the work performed, reduce the number of necessary staff – all of this has a positive effect on the economic component of construction, frees up additional funds. And, as you know, there is already enough evidence that the main factor hindering the development of the road network in the Russian Federation is, just the same, the need to spend huge budget funds (in 2016, about 30 billion rubles were allocated from the federal budget to repair existing roads due to their poor condition). In turn, the road-building industry, which is developing at a high pace, sets stringent requirements to ensure the required level of quality throughout the entire process, starting from the places of production of asphalt-concrete mixture (ABZ).
Feasibility of Bronchial Washing Fluid-Based Approach to Early-Stage Lung Cancer Diagnosis
Authors: Ryu Jeong-Seon , Lim Jun Hyeok , Lee Myoung Kyu , Lee Seung Jae , Kim Hyun-Jung , Kim Min Jeong , Park Mi Hwa , Kim Jung Soo , Nam Hae-Seong , Park Nuri , Yong Seok Joong
Published: April 2019

A blood-based approach such as circulating tumor DNA remains challenging in diagnosis for early-stage disease. Bronchial washing (BW) is a minimally invasive procedure that yields fluids that may contain tumor DNA. Therefore, we prospectively enrolled 12 patients with early-stage non-small cell lung cancer without endoscopically visible tumors. Somatic mutations were analyzed using ultra-deep next-generation sequencing in 48 paired specimens (primary tumor tissue, normal tissue, BW supernatant, and BW precipitate). In primary tumors, 130 missense mutations/indels (5–16 per patient) and 20 driver mutations (0–3 per patient) were found. Concordance of driver mutations between BW fluids and primary tumors was 95.0%. The allele frequencies for missense mutations/indels in BW supernatants significantly correlated with those in primary tumors and were higher than those in BW precipitates. These findings suggest that BW supernatants are reflective of tumor-associated mutations and could be used for early-stage lung cancer diagnosis.
Exploring factors associated with crash severity on motorways in Pakistan
Authors: Ahmad Numan , Ahmed Anwaar , Wali Behram , Saeed Tariq Usman
Published: April 2019

The enormous loss of life, as well as economic loss, incurred by road traffic crashes means that rigorous research efforts, especially in developing countries, are needed to investigate risk factors that significantly influence crash severity. The objective of this study is to explore empirically the impact of driver and vehicle characteristics, environmental conditions and collision pattern on motorway (freeway) crash severity. The past 7 years’ worth of data (2009–2015) on motorway crashes, collected by the National Highway and Motorway Police Pakistan, are used in the study. An ordered probit model is estimated using four levels of injury severity: property damage only, minor injury, major injury and fatal injury. Ten explanatory variables show a significant association with crash severity on motorways. Major risk factors that are found to increase the propensity for severe injury are speeding, drowsiness, head-on collision due to driving the wrong way, illegal pedestrian crossing and increasing age of drivers. The model's predictive performance is also discussed. The study findings emphasise the need for enhanced road safety enforcement measures for reducing crash severity on high-speed limited-access facilities.
İkna Etme Tekniğinin Konuşma Tutumu Üzerindeki Etkisi
Authors: YANGİL Muharrem Kürşad , TOPÇUOĞLU ÜNAL Fulya
Published: April 2019

İletişim ve konuşma bireyin günlük hayatının her
alanında kullandığı bir süreçtir. Konuşma esnasında birey bazen karşısındakini
kendisiyle uzlaşma noktasına getirmeye çalışır. İkna, iki kişinin uygun bir
çözümde buluşmasıdır. Öğretmenlerin, iletişim alanında başarılı olmaları ve
iletişim sürecini iyi bir şekilde oluşturarak ikna etme tekniğini kullanmaları
öğrencilerin motive edilmeleri ve başarıya ulaşmalarında önemli yardımcıları
olacaktır. Bu nedenle çalışmanın amacı, ikna etme tekniğinin öğretmen adaylarının
konuşma tutumuna etkisinin incelenmesidir. Araştırmanın çalışma grubu 2017-2018
öğretim yılında, bir devlet üniversitesi, Eğitim Fakültesi Türkçe ve Sosyal
Bilimler Eğitimi Bölümü, Sözlü Anlatım dersini alan toplam 65 öğretmen
adayından oluşmaktadır. Araştırma sürecinde, ikna etme tekniğiyle oluşturulan 6
haftalık ders planı uygulanmıştır. Zayıf deneysel desende tasarlanan
araştırmada tek grup öntest-sontest desen kullanılmıştır. Veriler bağımlı
gruplar t-testi ile analiz edilmiştir. Yapılan analizler sonucunda ikna etme
tekniğiyle oluşturulmuş dersin konuşma tutumunu olumlu yönde etkilediği tespit
edilmiştir. Ancak ikna etme tekniğinin konuşma tutumu üzerinde cinsiyete göre
anlamlı bir farklılık oluşturmadığı sonucuna ulaşılmıştır.
1.-8. Sınıf Türkçe Ders Kitaplarındaki Metne Dayalı Anlama Sorularının İncelenmesi
Authors: ÇELİKTÜRK SEZGİN Zuhal , GEDİKOĞLU ÖZİLHAN Yasemin Gül
Published: April 2019

Bu
araştırmanın amacı Türkçe ders kitaplarındaki (1.-8. Sınıf) metne dayalı anlama
sorularını metin türüne, cevap kaynaklarına ve Barrett taksonomisine dayalı
olarak incelemektir. Nitel yaklaşıma dayalı olarak yürütülen çalışmada veriler
doküman incelemesine dayalı olarak elde edilmiştir. Araştırmanın çalışma
materyallerini Milli Eğitim Bakanlığı tarafından 2018-2019 eğitim-öğretim yılı
için hazırlanmış 1.-8. sınıflarda okutulan Türkçe Ders Kitapları
oluşturmaktadır. Yapılan incelemenin sonunda 179 metne yönelik 960 anlama
sorusu çözümlenmiştir. Verilerin çözümlenmesi süreci araştırmanın alt sorularına
dayalı olarak gerçekleştirilmiştir. Araştırmada ilk bulgu olarak, Türkçe ders
kitaplarındaki metin türlerinin yaklaşık yarısının öyküleyici türde (%49,7),
geri kalanların ise bilgilendirici (%28,5) ve şiir (%21,7) türünde olduğu, bu
bulguya paralel olarak da en çok sorunun öyküleyici metin türünde olduğu belirlenmiştir.
İkinci olarak, Türkçe ders kitaplarındaki metne dayalı anlama sorularının büyük
bir kısmının metin içi anlama sorularından oluştuğu (%78,3), metin dışı
sorulara az yer verildiği (%21,7), metinler arası soruların ise hiç sorulmadığı
anlaşılmıştır. Üçüncü olarak, metne dayalı anlama sorularının Barrett
taksonomisine göre, büyük bir kısmının basit anlama (%66,8) düzeyinde olduğu belirlenmiştir.
Yeniden organize etme (%10,4), çıkarımsal anlama (%8,8), değerlendirme (%12,6)
ve takdir (%1,4) türünde sorulara da az oranlarda yer verildiği belirlenmiştir.Anahtar Kelimeler: Okuduğunu anlama, metin türü, Barrett
taksonomisi
Soil collection and preparation for pot experiments v1
Authors: LE Imakumbili Matema , Semu Ernest , Semoka Johnston
Published: April 2019

This protocol describes how to collect and prepare soil that will be used as a potting medium (potting soil) in a pot experiment.
EVALUATION OF OPERATIONAL RISK MANAGEMENT IN TECHNICAL IMPLEMENTATION UNITS OF MOTOR VEHICLES IN SUPPORTING THE CONTINUATION OF LOGISTIC PATHWAYS IN WEST JAVA
Authors: Sumartini Sumartini
Published: April 2019

Risk management is important in supporting all objectives of the West Java Province Motor Vehicle Testing Technical Implementation Unit, namely providing technical safety guarantees for the use of motorized vehicles, trailer trains and postage trains on the road, supporting the realization of environmental sustainability from possible pollution caused by motorized vehicle use. trailer and train carts on the road, and provide public services to the community. Vehicles operated on the road include bus cars, goods cars, articulated cars, train carts, special vehicles and public transportation.The application of risk management can be used in all fields of work and even in various activities, including decision making, operations, processes, functions, projects, products, services and assets (ISO 31000, 2009). In Indonesia transportation has an important role in supporting national development. Indonesia is an archipelagic country where the development of the transportation sector is designed to support the movement of the economy, national stability and also reduce development inequality between regions by expanding the reach of the distribution of goods and services throughout the archipelago. With the existence of transportation, the economy of the community is more evenly distributed so that it is expected that people's welfare will increase, because the community is easier to get the goods and services needed. One of the important facilities in the land transportation sector is motorized vehicles.Keywords: Environmental, Sustainability, Pollution, Transportation
Polymorphism of the testis-specific serine/threonine kinase 2 gene and risk of asthenozoospermia in Côte d'Ivoire
Authors: N'zi Konan G. S. , Ayekoue Jules E. H. , Yaye Yapi G. , N'guessan Marie F. , Ako Ako A. B. , Coulibaly Founzégué A. , Djaman Allico J.
Published: April 2019

Background: The testis-specific serine/threonine protein kinase (TSSK2) is an indispensable protein responsible for the mobility of spermatozoa expressed specifically in the germ cells during spermatogenesis and present in the mature spermatozoa. Its gene mutation could constitute a risk of infertility. The aim of this study is to investigate the polymorphism of this TSSK2 gene in men with asthenozoospermia.Methods: The ejaculates were obtained from patients attending the reproductive biology unit of Institut Pasteur of Côte d’Ivoire for their spermiological evaluations. The semen analyses are performed with the automatic sperm analyzer SQA-Vision. 30 sperms, including 20 asthenozoosperms and 10 normosperms, were selected from their spermiological results and the spermatozoa DNA was extracted by the phenol/chloroform method. Direct Sequencing of the spermatozoa DNA fragments was done using the Sanger method. The frequencies of mutation were analysis with the Fisher and Mann-Whitney tests.   Results: It was revealed 17 mutations in 22 ejaculates. The frequent mutations are c.839C>T (T280M), c.816G>C (L372L), c.1026G>A (R342R), c.785A>C (H262P) and c.80A>G (K27R) with respectively frequencies of 50.0%, 26.67%, 16.67%, 13.33% and 10.0%. The analysis of these mutations indicated a significant difference in the frequency of occurrence of mutations between normosperms and asthenozoosperms (p-value = 0.01).Conclusions: This study shows that mutations in the TSSK2 gene are more common in asthenozoosperm ejaculates than normosperm ejaculates. This fact suggests the probable association of mutations in the TSSK2 gene with asthenozoospermia.
Role of antenatal care in reducing incidence of eclampsia in eastern Uttar Pradesh, India
Authors: Kapoor Babita , Verma Namrata , Shrivastava Reena
Published: April 2019

Background: Eclampsia is characterized by sudden onset of generalized tonic-clonic convulsions or coma in pregnancy or postpartum. It is a major cause of maternal and perinatal morbidity and mortality in developing countries. This study was conducted to determine the incidence of eclampsia and role of antenatal care in reducing the incidence.Methods: This was a prospective study (July 2015-June 2016) conducted in labour room of department of obstetrics and Gynecology, BRD Medical college, Gorakhpur, Uttar Pradesh, India. A total no. of 141 women presenting with eclampsia were included in the study. Risk factors like antenatal care and sociodemographic status were studied for their role in increased incidence of eclampsia.Results: There were 141 eclampsia cases out of 3536 deliveries, during the study period. The incidence of eclampsia was found to be 4%. Out of 141 eclampsia cases 35.5% did not receive any antenatal care. 56.7% received substandard care in less than 4 antenatal visits. Out of those who received antenatal care (91/141), 67% received irregular, substandard care in primary health centre of their locality. Majority of eclampsia cases were between 16-25 years of age (85.1%) and were primigravida (62.4%). Majority of eclampsia cases were uneducated (89.4%), of lower socioeconomic status (71.4%) and belonged to rural area (67.4%).Conclusions: High incidence of eclampsia in B.R.D. Medical College reflects the status of eclampsia in eastern Uttar Pradesh, India. To prevent eclampsia our health care centres should be strengthened by well trained medical officers, other health care workers and adequate antenatal care facilities.
Cholestasis of pregnancy: a prospective analysis from a South Andaman teaching hospital
Authors: Pegu Bhabani , Mehrotra Manju , Yadav Anita , Sahoo Pinky S. K.
Published: April 2019

Background: Intrahepatic cholestasis of pregnancy (IHCP) is one of the commonest pregnancy related liver disorder. Although the maternal course is usually benign, there is an increased risk of spontaneous preterm delivery, fetal compromise, meconium stained amniotic fluid and even intrauterine fetal demise. The objective of this study was to study the incidence of IHCP and its impact on maternal and perinatal outcome.Methods: A prospective study carried out in 68 number of IHCP cases. Diagnosis was done on the basis of clinical and laboratory parameters. All the cases were followed up to the puerperium to find out maternal and perinatal outcome.Results: The incidence of cholestasis of pregnancy was 2.73%. Most (88%) of the cases were presented with generalized pruritus, relived with ursodeoxycholic acid and complete recovery was observed after delivery. The rate of instrumental delivery was 8.82% and caesarean section rate was 30.88%. Most common indication of caesarean section was fetal distress and non-progress of labour. There was one stillbirth at 35 weeks however none of the mother had complication during labour or puerperal period.Conclusions: Increased level of liver enzymes in patients of IHCP associated with poor perinatal outcome. Therefore, careful monitoring during antenatal period and termination of pregnancy at term will result in favourable outcome of both mother and baby.
Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomized controlled trial
Authors: Alam Anjuman , Zakaria S. M. A.
Published: April 2019

Background: To compare intravenous labetalol with oral nifedipine in terms of rapidity at which they control blood pressure in acute hypertensive emergencies of pregnancy.Methods: A randomized controlled study. Pregnant women with severe gestational hypertension with BP ≥160/110 mmHg after ≥20 weeks of gestation were randomized with computer generated numbers, either to receive IV labetalol with an escalating dose of 20, 40, 80, 80 and 80 mg or nifedipine capsule orally in a dose of 10 mg every 15 minutes (upto 5 doses) until a BP of ≤150/100 mmHg is achieved. Crossover treatment was to be effected if initial treatment regimen was unsuccessful. Primary outcome was time taken and number of doses required to achieve the target BP of ≤150/100 mmHg. Secondary outcomes were volume of urine output, maternal heart rate changes, fetal heart rate abnormality, perinatal and maternal outcome and side effects.Results: Oral nifedipine achieved the target BP (≤150/100 mmHg) more rapidly in (26.25±12.60) minutes in comparison to (32.62±12.19) minutes with IV labetalol (p= 0.024). Nifedipine group also took less number of doses to achieve the target BP of (≤150/100 mmHg) mmHg than IV labetalol (1.75±0.840 vs. 2.18±0.83), p= 0.024. Volume of urine output was also significantly more in nifedipine group (94.90±1.84 ml) at 1 hour and thereafter till 24 hour of treatment in comparison to IV labetalol (41.28±2.14 ml), p= 0.000. Side effects are few and not serious. No patient required crossover treatment.Conclusions: Both the drugs are equally effective in controlling acute hypertensive emergencies of pregnancy, however oral nifedipine is more rapid in controlling severe hypertension and also it is associated with significantly increased urine output.
A prospective study of efficacy of ultrasound guided transversus abdominis plane block for postcesarean analgesia
Authors: Manam Sravani , Swetha R. N. V. , Rao A. S. Kameswara , Murthy S. G. K.
Published: April 2019

Background: The ultrasound guided transversus abdominis plane (TAP) block which provides effective analgesia after lower abdominal surgeries including caesarean section. It is a simple and reliable technique. In this prospective, randomized double-blind study, we determined the efficacy of TAP block using 0.25% Bupivacaine and 0.9N Saline with respect to VAS for pain, postoperative Tramadol consumption and post-operative ondansetron usage.Methods: This study was conducted on 100 adult patients of ASA physical status I and II in the   age group of 18 to 40 years undergoing elective lower segment cesarean section under spinal anaesthesia. Study group received TAP block with 0.25% Bupivacaine and control group received 10 ml of 0.9N saline on each side. Patients were analyzed for postoperative pain by pain score (at rest, on movement, on cough) using VAS was recorded at 0, ½, 1, 2, 4, 6, 12 and 24 hours postoperatively. Need for rescue analgesia was assessed by time to first dose of Tramadol requirement and total dose of Tramadol over 24 hours of postoperative period. Ondansetron (4 mg i.v.) was administered whenever nausea score was more than 2 or the patient vomited. All the data was noted using uniform performs.Results: Patients received TAP block with 0.25% Bupivacaine had better pain scores at first hour of postoperative period during rest, cough and movement which was statistically significant (p<0.0010) in comparison to group B. There was a statistically significant difference (p <0.001) in the requirement of total dose of Tramadol as a rescue analgesia in patients who received transversus abdominis block with 0.25% Bupivacaine (138.77 mg) in comparison with other group(240 mg).The mean time to first request for Tramadol was significantly longer in group A (5.8 hrs)  in comparison to group B (1.93 hrs) with p value <0.001. Patients received TAP block with 0.9N saline needed more dose of Ondansetron, however, the difference was not statistically significant (p >0.001).Conclusions: TAP block using ultrasound provides substantial reduction in Tramadol consumption, time to first dose of rescue tramadol when compared with control group. This study reinforces the recommendation for TAP as a part of multimodal post-operative analgesic regimen.
Structural uterine anomalies in recurrent pregnancy loss
Authors: Habib Rizwana , Mufti Asma Hassan , Wani Nasir Jeelani
Published: April 2019

Background: To determine frequency of different structural uterine anomalies in patients with recurrent pregnancy loss.Methods: This observational study was conducted over a period of one and half year at a tertiary care Hospital, included 40 women with recurrent pregnancy loss who underwent combined laparoscopy and hysteroscopy.Results: Twenty-eight patients (70%) had 3 episodes of miscarriage, eight patients (20%) had experienced 4 abortions and three patients (7.5%) had five abortions. Only one patient (2.5%) had six abortions. 32.5% patients had normal hysteroscopy while as 65% patients had no abnormal finding on laparoscopy. Hysteroscopy was abnormal in 67.5% patients with uterine septum (25%) being the most common finding followed by submucous myoma(20%), polyp (12.5%), cervical incompetence (7.5%) and intra uterine adhesions (2.5%). Laparoscopy was abnormal in 35% patients with endometriosis(17.5%) being the most common finding followed by intra pelvic adhesions (15%) and bicornuate uterus (2.5%).Conclusions: Women with recurrent pregnancy loss have increased association with structural uterine anomalies than general population. Both congenital and acquired uterine anomalies are associated with recurrent abortions.
Evaluation of perinatal outcome in high-risk pregnancy at tertiary care centre
Authors: Rani Anupam , Karya Urmila , Kumari Sweta
Published: April 2019

Background: A high risk pregnancy is one in which mother, fetus or neonate is at increased risk of morbidity or mortality before or after delivery. Hence a relatively small percentage of high risk obstetric population gives rise to a disproportionately high percentage of perinatal and maternal morbidity and mortality. The perinatal outcome can be changed significantly by early detection and special intensive care to high risk pregnancies. Hence Identification of women at risk for these complicated pregnancies with poor outcome is fundamental to antenatal check-up.Methods: 86 high risk antenatal patients attending the outpatient department and labour room were recruited after informed consent.70 normal pregnancy was taken as control group. Perinatal outcomes were compared between high risk and normal pregnancies.Results: Adverse perinatal outcomes were more in high risk pregnancies as compared to normal pregnancies.Conclusions: This study emphasizes on pregnancy related complication leading to adverse perinatal outcome so evaluating patients for high risk factors, early diagnosis, proper antenatal care, prompt treatment, regular follow up, and timely management thus can improve maternal and perinatal outcome.
Changing trends of cesarean section using Robson’s Ten-group classification in tertiary centre: a retrospective study
Authors: Singh Anamika , . Sadiqunnisa
Published: April 2019

Background: The aim of this study was to investigate and compare the CS rates at a tertiary care medical college setting centre which has a high referral rate of complicated pregnancies and make analysis based on the 10-group classification.Methods: This is a retrospective study carried out department obstetrics and gynecology of a tertiary care medical college hospital in Mangalore and includes all deliveries over a period of five years from Jan 14 to Dec 2018 and it was compared with the c-section from January 2007 to December 2011.Results: The overall CS (cesarean section) during the period 2014-18 was 31.85 which were significantly greater then 2007-11 period (20.59%). The main contributing groups to the overall CS rate were the previous CS (Group 5) and Primigravida groups, (Groups 1 and 2) 80%.Conclusions: It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate. The application of Robson’s Ten-group classification (TGCS) in centre has helped to identify the main groups of subjects who had the overall maximum CSR.
Chronic non-puerperal uterine inversion in the absence of risk factors: a rare case report
Authors: Tile Rajesh , Jamkhandi Supriya
Published: April 2019

Non puerperal chronic uterine inversion is a rare entity; representing 1/6th of all uterine inversions. Usually precipitated by risk factors like fibroid uterus, endometrial polyp, endometrial malignancies. We present a case of 25 year old P2L2 with irregular vaginal bleeding and pain abdomen, with severe anemia. On per abdomen examination no abnormality detected, per speculum revealed a red friable mass 5*5cms protruding through vagina and per vaginal examination same findings confirmed. A diagnosis of fibroid polyp made initially and planned for polypectomy after correction of anemia. Under spinal aneasthesia diagnosis was changed to uterine inversion. Exploratory laparotomy done, which revealed characteristic flower pot appearance. Inversion was corrected by Haultens method, where in posteriorly incision was given to cut the tight cervical ring, and uterus was repositioned back to normal anatomic positon. Bilateral tubal sterilization was done as per patients request. Post operative period was uneventful and she was discharged in stable condition. Thus chronic non puerperal uterine inversion can be difficult to diagnose in the absence of risk factors.
Recurrent vaginal discharge: an unusual presentation of embryonal rhabdomyosarcoma of uterine cervix in an adolescent girl
Authors: Sarin Divya , Singh Urmila , Mehrotra Seema , Solanki Vandana
Published: April 2019

Embryonal rhabdomyosarcoma (ERMS) is a rare tumor of the female genital tract. It tends to occur during childhood in the vagina and rarely it can arise in the uterine cervix, with a peak incidence in the second decade. We report a case of 15 year old adolescent girl who presented with recurrent vaginal discharge not responding to medical treatment. Examination under anesthesia showed friable growth arising from the cervix. Histopathological examination revealed embryonal rhabdomyosarcoma (botyroid variant) of the cervix. Patient underwent local excision of growth followed by IRS-4 protocol based chemotherapy and now patient is under follow up at our side and pediatric oncology and doing well. Young girls presenting with recurrent vaginal discharge not responding to medical treatment must undergo proper clinical examination and EUA and any suspicious lesions should be examined so as to avoid missing rare but aggressive etiology like rhabdomyosarcoma. Due to the young age of affected patients, embryonal rhabdomyosarcoma (sarcoma botyroides) poses a management challenge as the preservation of hormonal, sexual and reproductive function is essential. Awareness of such as uncommon lesion and its clinical implications is important for the counseling and management of the patient.
Efficacy of bipolar transurethral resection of the prostate using TURIS: our short term experience
Authors: Singh Praveen , Khan Mohd Mubashir A.
Published: April 2019

Background: Objective of the study was to report our short term experience regarding efficacy of bipolar transurethral resection of prostate using TURIS (transurethral resection in saline) system.Methods: Between May 2016 to April 2017 49 consecutive patients underwent bipolar transurethral resection of prostate (B-TURP) at our institute. All patients were evaluated preoperatively by physical examination, ultrasonography and laboratory studies, including measurement of hemoglobin, serum sodium, and prostate specific antigen levels. Patients were assessed postoperatively at three, six and 18 months.Results: The mean age of the patients was 64.83±7.47 years and mean preoperative prostate volume was 64.73±13.59 ml. The mean preoperative hemoglobin was 13.32±0.9 g/l and mean postoperative hemoglobin was 12.09±1.11 g/l. The mean resection time was 57.02±14.37 minutes and mean resected specimen weight was 41.69±12.15 gm. The mean preoperative maximum urinary flow rate (Qmax) was 8.6±1.17 ml/s and mean Qmax at three, six and 18 months follow up was 18.85±2.15, 19.43±1.49 and 18.98±1.6 ml/s respectively. The mean preoperative international prostate symptom score (IPSS) was 26.32±2.69 and mean IPSS at three, six and 18 months follow up was 6.68±1.36, 6.47±0.79 and 6.30±0.9 respectively. Only one patient developed urethral stricture during follow up.Conclusions: The B-TURP is efficacious and results in significant improvement in IPSS and Qmax. The urethral stricture rate after B-TURP is not different from monopolar TURP.
A study on the role of raised serum bilirubin levels in acute appendicitis and its outcomes
Authors: Madhavan Abhilash , Raman Lakshmana
Published: April 2019

Background: Acute appenidictis is the most common general surgical emergency and early surgical intervention improves outcomes. Despite the increased use of ultrasonography, computed tomography and laparoscopy, the rate of misdiagnosis of appendicitis has remained constant (15.3%) as has the rate of appendicular perforation. Thus, elevated serum bilirubin level will help in the early and accurate diagnosis of acute appendicitis and if so does it have the predictive capacity to warn us about appendicular perforation.Methods: In this study 100 patients were selected as per satisfaction of the inclusion criteria. This study was carried out at SRM medical college hospital between July 2017 to October 2018. All the data findings were recorded and were analysed.Results: In this study 100 patients were selected on satisfying the inclusion criteria. The serum bilirubin levels were recorded for all these patients. Based on the study it was found out that the serum bilirubin levels was elevated in majority of the cases of acute appendicitis and markedly elevated in case of perforated appendicitis. Though the results were not statistically significant the study seems to be clinically significant.Conclusions: Serum bilirubin level seems to be a reliable diagnostic marker for predicting acute appendicitis and perforated or gangrenous appendicitis.
Laparoscopic versus open complete mesocolic excision with central vascular ligation in right colon cancer
Authors: El-Fol Hossam Abdelkader , Ammar Mohamed Sabry , Abdelaziz Tamer Fakhry , Elbalshy Mohammed A. , Elabassy Mahmoud M.
Published: April 2019

Background: The purpose of this study was to compare between laparoscopic and open complete mesocolic excision (CME) with central vascular ligation (CVL) in right colon cancer.Methods: From January 2016 to December 2018, a prospective cohort study of 60 patients who diagnosed as operable right sided colon cancer was performed. The patients were classified into laparoscopic CME with CVL and open CME with CVL groups. Demographic variables, comorbidities, tumor location, intraoperative parameters, duration of hospital study, histopathological findings, postoperative complications and follow up data were compared between the two groups. Demographic variables included age and sex distribution. Intraoperative parameters included incision length, operative time and operative blood loss.Results: 60 patients were selected in this study. Both groups were the same in the age and sex distribution, potential comorbidities and tumor location. Patients in the Laparoscopic CME with CVL group had shorter incision lengths, longer operative times, less operative blood loss, shorter hospital stay, less number of retrieved  lymph nodes , the same TNM (tumor nodes metastasis) classifications, similar histopathological findings and comparable incidence of postoperative complications.Conclusions: Laparoscopic CME with CVL procedure is a safe, valid and feasible surgical method for right colon cancers.