bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Study: The Use of Downhole Control Valves To Sustain Oil Production From the First Maximum Reservoir Contact, Multilateral, and Smart Completion Well in Ghawar Field
Authors: Mubarak S. M. , Pham T. R. , Shamrani S. S. , Shafiq M.
Published: November 2008

This paper describes a case study that details the planning, completion, testing, and production of the first maximum reservoir contact (MRC), multilateral (ML), and smart completion (SC) deployment in Ghawar Field, Saudia Arabia.

A well was drilled and completed as a proof of concept. It was set up as a trilateral and was equipped with an SC that encompassed a surface-remotely-controlled hydraulic-tubing-retrievable advanced system coupled with a pressure- and temperature-monitoring system.

SC provides isolation and downhole control of commingled production from the laterals. The well was managed to improve and sustain oil production by eliminating water production by use of the variable-positions flow-control valve. Monitoring the rate and the flowing pressure in real time allowed for optimal well production.

The appraisal and acceptance portions of the completion process were achieved when this well was completed, put on production, and tested. The concept was approved when the anticipated benefits were realized during monitoring of the performance of the well.

Leveraged knowledge from this pilot has provided an insight into SC capabilities and implementation. Moreover, it has set the stage for other developments within Saudi Aramco.
PROSOCIAL ORIENTATION MAY SENSITIZE TO AGGRESSION-RELATED CUES
Authors: Schwenzer Michael
Published: November 2008

Prosocial orientation may increase sensitivity to aggression-related cues. In the present experiment, prosocial orientation, but not aggressiveness, correlated to a cognitive bias towards violence words. Ninety-six advanced students and postgraduates, 45 male, mean age = 25.6 ±
3.5 years, completed a prosocial orientation scale and an aggressiveness scale (Fahrenberg, Hampel, & Selg, 2001). In each scale, twelve statements were answered by “correct” or “not correct”, then scores were summed. To test if there was a cognitive bias towards
aggression, participants named – as quickly as possible – the color of each word of two modified Stroop tables, each table displaying three columns of 24 words with alternating colors (red, green, blue, yellow). This arrangement resembled an established Stroop test (Bäumler,
1985) but words referring to an emotion rather than a color should slow down responses (e.g., Williams, Mathew, & MacLeod, 1996). One table displayed neutral words (“fruit”, “move”, “frame”, “water”, “journey”, “umbrella”),
the other table displayed violence words (“murder”, “slaps”, “threat”, “punishment”, “command”, “contempt”). In an unpublished exploration, the author identified the aggression-related and neutral words lists using a factorial
analysis of ratings of whether or not words described an interpersonal conflict. The reaction time (RT) of the neutral table was subtracted from the RT of the violence table in each subject. After median splits according to the questionnaire scores, groups were compared.
EFFECT OF HUMAN CAPITAL INVESTMENT ON ORGANIZATIONAL PERFORMANCE
Authors: Wang I-Ming , Shieh Chich-Jen , Wang Fu-Jin
Published: November 2008

Based on 150 valid questionnaires, an investigation was undertaken through correlation analysis and multiple regression analysis to examine the following: the correlation between human capital investment and organizational performance, between organizational culture and human capital
investment, between organizational culture and organizational performance, and finally the effect of organizational culture on the correlation between human capital investment and organizational performance. The relationship between staff training and development and internal trust relations
positively correlated with organizational value. That same relationship was enhanced by organizational identification. On the other hand, the correlation between the 3 dimensions of organizational performance and the other 2 dimensions of human capital investment (staff recruitment; staff
inspiration) was not influenced by the presence of either organizational identification or organizational value.
ATTITUDES OF PREINITIATES TOWARDS TRADITIONAL MALE CIRCUMCISION IN THE CONTEXT OF HIV IN THE EASTERN CAPE, SOUTH AFRICA
Authors: Peltzer Karl , Nqeketo Ayanda , Petros George , Kanta Xola
Published: November 2008

The aim of this study was to assess attitudes of preinitiates towards traditional Male Circumcision (MC) in the context of HIV. The sample included 350 Xhosa preinitiates recruited from 3 different recruitment sites during the preparation prior to MC in the Eastern Cape province. Results
indicated that: 10% were to be circumcised before their sexual debut and reported a great deal of sexual risk behavior; 9% had been diagnosed with a sexually transmitted infection in the past 12 months; 20% reported that they had had 3 or more sex partners in their lives;
and 47% had not used a condom the last time they had sex. Reasons and attitudes, including barriers, towards MC as well as risky sexual behavior found in this study need to be considered in MC programming.
GENDER DIFFERENCES IN SEXUAL INFORMATION SOURCES, AND SEXUAL ATTITUDES AND BEHAVIORS OF UNIVERSITY STUDENTS IN TURKEY
Authors: Gelbal Selahattin , Duyan Veli , Öztürk Aslihan Burcu
Published: November 2008

Gender differences in sexual information sources and sexual attitudes and behaviors of college students in Turkey were examined. Results show that the attitudes and behaviors of Turkish college students as regards sexuality are becoming more liberal, although the conservative culture
still has some effects, especially concerning gender differences. Sources of sexual information have increased as a result of technological advances, and usage of these differs according to gender.
PERSONALITY AND MOTIVATIONS FOR PLAYING ONLINE GAMES
Authors: Jeng Shih-Ping , Teng Ching-I
Published: November 2008

Using the five-factor model of personality and a previously theorized motivation typology, the authors investigated the relationship between personality and motivation for playing online games. The results indicated that openness was positively related to discovery and roleplaying motivation,
and conscientiousness was positively related to escapism motivation. In addition, extraversion was positively related to teamwork motivation, and agreeableness was positively related to advancement motivation. However, neuroticism was negatively related to teamwork motivation. These findings
have several implications and could provide further research directions.
RACIAL ATTITUDES AMONG SOUTH AFRICAN UNIVERSITY STUDENTS: A FOLLOW-UP STUDY AFTER FOUR YEARS
Authors: Pillay Neeshi Singh , Collings Steven J.
Published: November 2008

In 2002, moderately high levels of modern and old-fashioned racism were documented in a representative sample of 433 students registered in undergraduate courses at a South African university (Pillay & Collings, 2004). In 2006, this survey was replicated using identical methods
of data collection and a sample which was representative of university enrolments for 2006 in terms of gender and race: N = 543, gender = 50% female; race = black (40%), Indian (40%), white (17%), colored (3%). Over the four-year period, there was
a significant increase in mean item-scores for old-fashioned racism [M = 1.95 vs. 2.15; F(1,971) = 15.16, p < .01], and this finding was supported by a significant study x race interaction, F(3,971) = 6.33, p < .05. Mean item scores increased
significantly over time among Indians (2.11 vs. 2.29) but not among blacks (1.74 vs. 1.76), coloreds (2.01 vs. 2.04), or whites (2.33 vs. 2.35). A significant increase in levels of modern racism over the four-year period [M = 2.74 vs. 3.10; F(1,971) = 8.48, p <
.01] was indicated by a significant study x race interaction, F(3,971) = 7.31, p < .05, with mean item scores increasing significantly over time among Indians (2.94 vs. 3.62) and whites (3.00 vs. 3.58) but not among blacks (2.04 vs. 2.06) or coloreds (2.47 vs. 2.49).
Together these findings suggest that both overt and covert forms of racism persist, with levels of racism varying as a function of racial group membership.
CRITICAL INCIDENT, ADULT ATTACHMENT STYLE, AND POSTTRAUMATIC STRESS DISORDER: A COMPARISON OF THREE GROUPS OF SECURITY WORKERS
Authors: Bogaerts Stefan , Daalder Annelies L. , Van Der Knaap Leontien M. , Kunst Maarten J.J.M. , Buschman Jos
Published: November 2008

In this paper the authors render the results of research investigating adult attachment and posttraumatic stress disorder (PTSD) in a sample of Belgian security workers. The sample contained 3 subsamples: 68 individuals who had directly experienced a critical incident, 67 individuals
who indirectly went through a critical incident, and 77 individuals who had not experienced a critical incident in the last six months. The analysis of the research results shows that the secure attachment style and the three PTSD trauma symptom clusters in DSM-IV - intrusion, avoidance/numbing,
and hyperarousal - discriminate between the three subsamples. In other words, security workers who were directly and actively confronted with a critical incident were significantly more insecurely attached and suffered significantly more from PTSD symptoms than the groups who had no or indirect
experience of a critical incident. Furthermore, trauma-focused cognitive-behavioral therapy is widely and quite efficiently used in the treatment of PTSD. Interest has been expressed in medical approaches.
DIFFICULTIES THAT ELDERLY PEOPLE ENCOUNTER AND THEIR LIFE SATISFACTION
Authors: Karataş Kasim , Duyan Veli
Published: November 2008

The number of elderly people in Turkey is increasing. The purpose of this study was to examine the life satisfaction levels of elderly people who live in the Ankara, Kocatepe region. Most of the participants had migration experience, and an occupation, and lived in their own houses.
Approximately one third of the participants had serious health problems and encountered difficulties in sustaining their daily life. Life satisfaction of the elderly who have an occupation and their own house was found to be high, but those who had health problems encountered difficulties
in activities such as paying bills, performing small repairs, shopping, reading, and organizing transport. Moreover, the life satisfaction of people whose income levels were low was found to be significantly lower than for those with higher income levels.
ORGANIZATIONAL COMMITMENT AND LONELINESS AND LIFE SATISFACTION LEVELS OF SCHOOL PRINCIPALS
Authors: Yilmaz Ercan
Published: November 2008

The aim of this study was to investigate the organizational commitment of school principals in relation to loneliness and life satisfaction levels. The sample of the study consisted of 548 school principals chosen using a random clustering method from primary schools in Central Anatolia,
Turkey. The results of the study showed that there was a positive correlation between the loneliness levels of school principals and the compliance levels of organizational commitment, and a negative correlation between loneliness and the internalization and identification levels of organizational
commitment. There was also a negative correlation between life satisfaction levels of school principals and the compliance level of organizational commitment. A positive correlation was found between life satisfaction and the internalization and identification levels of organizational commitment.
In addition, loneliness and life satisfaction levels of school principals accounted significantly for their organizational commitment. A possible explanation for this is that psychological support is given to those school managers whose loneliness levels are high and whose life satisfaction
levels are low.
ALLOCENTRISM AND CONSUMER ETHNOCENTRISM: THE EFFECTS OF SOCIAL IDENTITY ON PURCHASE INTENTION
Authors: Huang Yu-An , Phau Ian , Lin Chad , Chung Hsien-Jui , Lin Koong Hao-Chiang
Published: November 2008

In this article the authors examine the effects of allocentrism and consumer ethnocentrism (CET) on intentions to purchase domestic versus imported products, focusing on the current phenomenon of the “Korean Wave” in Taiwan. Results based on data collected from 433 mall
intercept interviews in Taiwan indicate that there is a strong positive relationship between allocentrism toward parents and CET. However, a significantly negative relationship between allocentrism toward friends and CET was also found. It was also found that friends' in-group attitude
toward Korean television dramas has a mediating effect of allocentrism toward friends on CET and CET on intention to buy Korean products. In this study, it was found that CET played a mediating role between allocentrism toward parents and friends and purchase intention. This ethnocentric effect
was attributed to parental and friends' in-groups which significantly enhanced and reduced, respectively, the impact of intergroup discrimination, making national identification a less obvious and important social category. These findings have significant implications for domestic and
foreign marketers.
AN INVESTIGATION OF PRIMARY AND HIGH SCHOOL TEACHERS' PERCEPTION LEVELS OF EFFICACY OF MEASUREMENT AND EVALUATION IN EDUCATION IN TURKEY
Authors: Karaca Erol
Published: November 2008

Primary and high school teachers' perception levels of the efficacy of measurement and evaluation in education were investigated to determine whether or not their perception of efficacy differs according to their gender, age, place of employment, branch, years of teaching experience,
and taking a measurement and evaluation course or instructional planning and evaluation course. 225 teachers were selected randomly from 5 primary schools and 7 high schools in Eskişehir, Turkey. Data which were collected through the Perception of Efficacy Scale about Measurement and
Evaluation in Education revealed that their perception of efficacy levels of measurement and evaluation in education were at a high level and were significantly associated with their branch and place of employment. However, there were no significant relationships between the teachers'
perceived levels of the efficacy of measurement and evaluation in education and the other variables examined.
A TRIPARTITE MODEL OF IDIOGRAPHIC RESEARCH: PROGRESSING PAST THE CONCEPT OF IDIOGRAPHIC RESEARCH AS A SINGULAR ENTITY
Authors: Krauss Stephen
Published: November 2008

This paper is an attempt to bring clarity to idiographic theory and research in psychology by delineating 3 different types of idiographic research: research not assuming general laws, unique manifestation research, and intraindividual research. These 3 research types use different
methods, make different assumptions, and have different relationships to the nomothetic mainstream. The relatively harmonious relationships between unique manifestation research, intraindividual research, and the nomothetic mainstream suggest that these research lines will form an essential
part of 21st century psychology, whereas the original conception of idiographic research as research that does not assume general laws will continue slowly to die out. These conceptual advances imply that the single debate over nomothetic-idiographic research should be closed.
SCHOOL ADJUSTMENT AMONG CHILDREN OF IMMIGRANT MOTHERS IN TAIWAN
Authors: Chin Joseph Meng-Chun , Yu Sen-Chi
Published: November 2008

This study compared children of Southeast Asian immigrant mothers with those of native-born Taiwanese in terms of their school adjustment. A sample comprising 258 adolescents of Southeast Asian immigrant mothers (including mothers from Vietnam, Thailand, Indonesia, and the Philippines)
and 769 children of native-born Taiwanese mothers was examined. This study used the item response theory (IRT) approach to develop a school adjustment inventory (SAI). Results showed that adolescents of Southeast Asian immigrant mothers had poorer school adjustment than did adolescents of
native Taiwanese mothers. The adolescents of Southeast Asian immigrant mothers gained significantly lower scores for “academic performance” and “teacher-student relationship” than did the adolescents of native Taiwanese mothers. However, the 2 groups did not differ
in terms of “learning motivation” and “peer relationship”.
β-Cell Autoimmunity in Pediatric Celiac Disease: The Case for Routine Screening?
Authors: d'Annunzio Giuseppe , Giannattasio Alessandro , Poggi Elena , Castellano Emanuela , Calvi Angela , Pistorio Angela , Barabino Arrigo , Lorini Renata
Published: November 2008

OBJECTIVE—To evaluate the prevalence of β-cell autoimmunity and the usefulness of a type 1 diabetes screening in patients with celiac disease.

RESEARCH DESIGN AND METHODS—We measured GAD antibodies (GADAs), insulinoma-associated protein 2 antigens (IA-2As), and insulin autoantibodies (IAAs) in 188 young Italian patients with celiac disease (66 male [35.1%]). Mean age at celiac disease diagnosis was 5.4 years (0.5–17.1), and mean celiac disease duration was 4.2 years (0–28.8). Celiac disease was diagnosed by jejunal biopsy after positivity for endomysial and tissue transglutaminase antibody was confirmed.

RESULTS—GADAs were positive in seven patients (3.7%), and IA-2As were positive in two patients. IAAs were negative in all cases. Metabolic evaluation was normal, and no patients developed diabetes during follow-up. There was no significant association among β-cell autoimmunity and sex, age, pubertal stage, family history, or coexistence of other autoimmune disorders; compliance to a gluten-free diet was confirmed.

CONCLUSIONS—Our results showed a low prevalence of β-cell autoimmunity and do not support a precocious screening for β-cell autoimmunity in young celiac disease patients.
Respiratory Viruses in Pediatric Necropsies: An Immunohistochemical Study
Authors: hong Débora C. C , Raboni Sonia M. , Abujamra Karla Bueno , Marani Daniele M. , Nogueira Meri B. , Tsuchiya Luine R.V. , Neto Herberto J. Chong , Flizikowski Fabiane B.Z. , de Noronha Lúcia
Published: November 2008

Infections of the respiratory system are responsible for the majority of hospitalizations and deaths in pediatric patients in developing countries. We selected 177 necropsies of pediatric patients who died as a result of serious respiratory infections. The histopathological findings and epidemiological data were reviewed, and lung tissue samples were separated for immunohistochemistry testing. Conventional immunohistochemistry techniques were used to detect viral antigens in formalin-fixed, paraffin-embedded (FF-PE) lung tissue samples using a pool of monoclonal antibodies against respiratory viruses (respiratory syncytial virus, influenza A and B, adenovirus, and parainfluenza 1, 2, and 3 viruses) as primary antibodies. The histopathological findings were classified into bronchopneumonia (BCP) and interstitial pneumonitis (IP) patterns. The immunohistochemistry results were compared with histopathological patterns and epidemiological data. Positive results for viruses were found in 34% and 62.5% of the BCP and IP cases, respectively. Males and infants below 1 year of age were more frequent in the group that had positive results for viruses. Acute enteritis was the main cause of hospitalization and sepsis the most frequent cause of death in this group. A clear seasonal distribution was observed, with the majority of cases occurring in the 2nd and 3rd trimesters (autumn and winter) of each year in the period studied. Immunohistochemistry is an affordable and easy-to-perform method for viral-antigen detection in FF-PE tissue samples. Although BCP is a classic histopathological pattern found in bacterial infections, it is possible that children with serious respiratory infections had concomitant viral and bacterial infections, regardless of their previous immunologic state.
Tailored hybrid blank production—New joining concepts using different solders
Authors: von der Haar C. , Engelbrecht L. , Meier O. , Ostendorf A. , Haferkamp H.
Published: November 2008

A consistent lightweight concept necessitates the combination of different lightweight materials. Because of the significant weight reduction, multimaterial design is becoming more and more interesting for the transportation industry. Mixed material concepts are partially limited because of the insufficient deformation behavior of the joining seams. To overcome this limitation, a brazing process has been developed in which aluminium and steel can be joined, with an enhanced deformation behaviour. Tailored hybrid blanks with deep drawing ratios of 1.9 are possible. Process studies, metallographic analyses, and tensile tests were carried out for AA6016 sheets in combination with DX56D. The AA6016 surface has to be activated using a noncorrosive flux. Although it is possible to avoid melting of the aluminium base metal, intermetallic FeAl compounds occur and were characterized using energy dispersive x-ray analysis. It was proven that the intermetallic compounds affect the mechanical characteristics of the seam. During tensile tests, butt seams show approximately 70% of the strength of the weaker base metal. The results of cupping tests show the ultimate possibility of using tailored hybrid blanks in a various number of applications.
Laser-enhanced electroless plating of silver seed layers for selective electroless copper deposition
Authors: Dellas Nicholas S. , Meinert Kenneth , Mohney Suzanne E.
Published: November 2008

Copper (Cu) has been patterned using a laser direct-write metallization technique for fabrication of printed wiring boards. The approach consists of writing a silver (Ag) seed layer with a subsequent step of electroless Cu plating to increase thickness and electrical conductivity. Ag seed layers were patterned with a frequency tripled Nd:YVO4 (λ=355 nm) laser with a spot size of approximately 50 μm. Final Cu linewidths after electroless plating were found to be 150 μm with a thickness of 2 μm and electrical resistivity of 5 μΩ cm. An optimal laser power of 0.81 W was found by a factorial-type design experiment. A modern prototype circuit was also patterned with this technique, demonstrating its compatibility with current resolution requirements.
Prenatal ultrasonographic diagnosis of axillary cystic hygroma
Authors: Thapa Narayan Bikram , Dangal Ganesh
Published: November 2008

Cystic hygromas are characterized by single or multiple cysts within soft tissue. They may occur in isolation or may be associated with other congenital malformations and can lead to obstructed labour or neonatal asphyxia. Ultrasonography in the prenatal period can be carried out to diagnose congenital cystic hygromas. Keywords: ultrasonography, cystic hygroma       doi:10.3126/njog.v2i1.1478 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 53 - 55 May -June 2007
Hemoperitoneum from suspected uterine perforation: Nonsurgical management of a case of choriocarcinoma. A case report
Authors: Pradhan Pramila
Published: November 2008

A case of choriocarcinoma presented as an acute abdomen because of intraperitoneal haemorrhage from uterine perforation, 4 weeks after second and 11 weeks following first suction evacuation with high serum hCG level and metastases to vagina and lungs. Once the uterine perforation occurs following gestational trophoblastic neoplasia, immediate laparotomy has been performed usually followed either by local resection or hysterectomy depending on situation. This case is an exception, which was conservatively managed by chemotherapy, EMA-CO regime successfully with no remission on follow up. Keywords: choriocarcinoma, intraperitoneal haemorrhage, uterine perforation.       doi:10.3126/njog.v2i1.1483 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 71 - 73 May -June 2007
The major breakthrough of the 21st century- HPV Vaccine
Authors: Singh Mita
Published: November 2008

doi:10.3126/njog.v2i2.1445N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 1 - 2
Surgical treatment of vaginal vault prolapse
Authors: Withagen MIJ , Van der Weiden RMF , Vierhout ME
Published: November 2008

Vaginal vault prolapse can cause limitations in physical and social functioning. This problem will enhance with the increasing age in women. New surgical techniques, like tension free vaginal mesh and laparoscopic sacrocolpopexy reduce surgical strain in patients and make prolapse surgery achievable in elderly women. doi:10.3126/njog.v2i2.1446 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 3 - 8
Importance of placental localisation in early pregnancy
Authors: Agrawal Veena , Kulshresta Sonal
Published: November 2008

Objectives: To determine the incidence and rate of persistence of placenta praevia diagnosed as low lying placenta in d" 20 weeks' gestation using sonography (USG) and to establish its' co-relation with pregnancy outcome. Methods: Randomized 230 pregnant women studied by USG at d" 20weeks gestation. Among them 42 were recruited for study as they were having low lying placenta. These cases were rescanned at e" 28 weeks. Results: In 230 cases, the incidence of low lying placenta at d" 20weeks was18.26% (42/230); 90.5% had lateral, 2.4% had marginal and 7.1% had total placenta praevia. A total of 26 (61.9%) cases, had threatened abortion and two patients aborted. On longitudinal follow-up, 80% of remaining 40 cases had normally situated placenta at rescan. However those with total placenta praevia at d" 20weeks persisted as such with 100% persistence while only 10.5% with lateral low lying placenta persisted. APH was presentation in 3(7.1%), all of them undergoing cesarean sections for placenta praevia. Conclusion: Ultrasonography at < 20 weeks gestation showing low lying placenta has been useful in predicting placenta praevia at third trimester. Total placenta at this gestation has invariably persisted as placenta previa at third trimester. Key words: Placenta, Low lying Placenta, Placenta Praevia, APH  doi:10.3126/njog.v2i2.1449 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 16 - 19
Active management of third stage of labour: comparison between prophylactic intramuscular methylergometrine and intramuscular oxytocin
Authors: Adhikari Shilu , Rana Ashma , Bista Kesang D
Published: November 2008

Aim: Aimed at comparing the efficacy of prophylactic intramuscular methylergometrine with intramuscular oxytocin in reducing blood loss in the third stage of labour (TSL). Methods: This is a randomized, comparative, clinical trial to compare the efficacy of intramuscular methylergometrine with intramuscular oxytocin in the third stage of labour for the prevention of postpartum hemorrhage Two hundred women undergoing normal vaginal delivery were recruited, 100 in each group- Group A receiving .2mg methylergometrine intramuscularly and Group B receiving 10U oxytocin intramuscularly immediately after the delivery of the anterior shoulder of the baby. The efficacy and the safety of these two drugs were analyzed on the basis of percentages fall in haemoglobin (Hb) and haematocrit (Hct) level from before delivery to 24 completed hours after delivery, need for additional uterotonic agents, need for exploration and uterine evacuation, need for blood transfusion, duration of third stage of labour and the numbers of retained placenta and need for MRP. Results: Intramuscular methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post partum haemorrhage (PPH) [defined as fall in Hb and /or Hct level³ 10% from before delivery to 24 hours after delivery]. There was no difference in the risk of prolonged third stage, need for additional uterotonic agents, need for exploration and uterine evacuation and need for blood transfusion in the two groups. The side effects were all mild in nature and the overall incidence was too low for statistical significance to be elicited. Conclusion: Intramuscular methylergometrine is as efficacious as intramuscular oxytocin in the prevention of third stage blood loss with comparable side effects. Keywords: Third stage of labour, postpartum hemorrhage, methylergometrine, oxytocin.   doi:10.3126/njog.v2i2.1451   N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 24 - 28
Female genital tract tuberculosis in Tribhuvan University Teaching Hospital: A retrospective one year histopathological study
Authors: Jha Abhimanyu , Sayami Gita , Adhikari Ram , Jha Roona , Chaudhari Rashmi
Published: November 2008

Aim: To determine frequency of female genital tract (FGT) tuberculosis (TB) in the gynecological biopsies received in the Department of Histopathology of Tribhuvan University Teaching Hospital. Methods: This is a retrospective study conducted in the Department of Pathology of Tribhuvan University Teaching Hospital. Histopathology records of one year (14th April 2006 to 13th April 2007) were retrieved and searched for the cases of female genital tract TB. Relevant histopathological findings and clinical data were recorded and analyzed. Results: We analyzed 5696 histopathological cases during one year period for FGT tuberculosis. There were 1565 cases of gynecological biopsy and 9 cases were diagnosed as FGT tuberculosis based on histopathological and clinical findings. Ovarian tuberculosis was seen in three cases, bilateral fallopian tubes were involved in 2 cases and endometrial tuberculosis was diagnosed in 2 cases. 3 cases of omental biopsy and 1 case of peritoneal biopsy showed tubercular granulomas. Conclusion: FGT tuberculosis was usually seen in age 16-28 years and constituted 0.57% of total gynecological cases and 0.15% of total biopsies. Fallopian tubes, ovaries and endometrium were affected with the involvement of peritoneum or omentum, common event being tubercular endosalpingitis. Histopathology in association with clinical findings still remains gold standard for the diagnosis of FGT tuberculosis in our country despite advancement in diagnostic modalities; however, incidental histological detection in clinically unanticipated cases is not an uncommon event. Key Words: Female genital tract TB, histopathology, clinical findings.   doi:10.3126/njog.v2i2.1452 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 29 - 34
Pelvic organ prolapse in rural Nepalese women of reproductive age groups: What makes it so common?
Authors: Gurung Geeta , Rana Ashma , Amatya Archana , Bista Keshang D , Joshi Ananda B , Sayami Jamuna
Published: November 2008

Aim: To find out the prevalence, aetiopathogenesis and the magnitude of problems of pelvic organ prolapse (POP) among married women of reproductive age (MWEA) in the rural Nepalese community. Methods: A cross-sectional descriptive study conducted in eight selected districts (mountain/ hills to terai region) of Nepal linking community to health services. Proportionate samples of MWRA (15-49 years) in total samples of 2849 were interviewed using questionnaires and clinical examinations were made in health facililities. Results: Among 2849 women who agreed to take part on the study when interviewed (by enumerators with pretested questioners) 2070 (72.6%) came for assessment. POP was diagnosed in 207/2070 giving the incidence as 10% being commoner in the planes (8:1) than mountains. POP formed 2.8% of adolescent due to early marriage d" 15 years in (50%) and unsupported delivery by skilled birth attendant (SBA) out of health facilities (99.2%). Resumption of manual labor after delivery less than a month was (83.8%) and parity was responsible to some extent as P(1-3) occupied by T!. Mean duration of suffering being 7.8 years (e" 10 years in ¼.) having II°/III° or procidentia rectovaginal/ vesicovaginal fistula, urinary incontinence (stress/urge), bleeding, discharge from sore and ulceration, coital problem, urination/ defecation problem walking, sitting, back ache and chronic abdominal pain S!. Conclusion: In this large reproductive morbidity study including women in the rural community of varied ethenic groups from diverse ecology, basic community survey linked to clinical assessment in the health facility found the incidence of POP to be much higher in planes than hills giving unusually lower prevalence rate for POP as 10% than other clinic based studies.  doi:10.3126/njog.v2i2.1453 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 35 - 41
Cervical cytological study in unhealthy and healthy looking cervix
Authors: Pradhan Neelam , Giri Kanti , Rana Ashma
Published: November 2008

Aim: To compare cervical cytology in women with healthy/unhealthy cervix. Methods: A prospective study on Pap smear was performed including 200 women, 100 with healthy and 100 with unhealthy cervix, attending outpatient Gynaecology clinic of the Department of Ob/Gyn TU Teaching Hospital, Kathmandu. The cytology report was compared in the two groups. Results: Cervical dysplasia was seen in 8 women with unhealthy cervix, 7 were mild and one was severe dysplasia. In the women with healthy cervix, 5 had mild and one had moderate dysplasia. Eighty two percent of women with healthy cervix and 83% of women with unhealthy cervix had non-specific inflammation. Women who were married before 20 years (p=0.04) and had higher parity (3.3 Vs 2.8) were more likely to have unhealthy cervix (p=0.03). Excessive vaginal discharge was common in women with unhealthy cervix (p=0.0009). Conclusion: Dysplasia was slightly higher among the women with unhealthy cervix in comparision to healthy cervix but the difference was not statistically significant. Hence this study emphasizes on the importance of universal screening of both the healthy and unhealthy looking cervix. Key Words: carcinoma cervix, visual screening, Pap smear, cervical cytology, cervical dysplasia   doi:10.3126/njog.v2i2.1454 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 42 - 47
Safety, efficacy and acceptability of medical abortion with mifepristone and misoprostol in Nepalese women
Authors: Shrivastava Veena
Published: November 2008

Unsafe abortion is a major health issue. Therefore safe abortion services which is effective. acceptable and techniquely easy to perform should be available. Aim- To confirm effectiveness, side effects, safety and patient satisfaction with medical termination of early pregnancy. Methods- It was a prospective study 150 women who were less than 63 days pregnant and consented for medical termination of pregnancy were given! 200mg 0 Mefepristone orally and 48 hrs later 800 micro gram Misoprostol was inserted vaginally. They were followed up in 14 days. Bleeding, pain G.I symptoms any other side effects were recorded. Abortion was complete or not was confirmed clinically and by USG. Failure and success was documented depending upon need for surgical evacuation. Results- The success rate with this regime was 92.6% and failure rate was 7.3%. There were no major side effects with Mifepristone. The average bleeding after misoprostol insertion was 10 days and 80% women had more bleeding than normal period. All of them had pain. Only 13.3% needed analgesic. women (96%) were satisfied with the method. Conclusion- combination of mifepristone and misoprostol is a safe and effective of early pregnancy Keywords- medical termination, pregnancy, mifepristone, misoprostol.   doi:10.3126/njog.v2i2.1456 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 54 - 58
Caesarean myomectomy - a safe procedure: A retrospective case controlled study
Authors: Owolabi Alexander T , Kuti Oluwafemi , Loto Olabisi M , Makinde Oluwafemiwa N , Adeyemi Adebanjo B
Published: November 2008

Objective(s): The aim of the study is to determine whether myomectomy at the time of caesarean section leads to increase incidence of intrapartum and postpartum complications. Methods: Fourteen women, with uterine fibroids in pregnancy who were treated by caesarean myomectomy between January 2001 and June 2007, were compared retrospectively with fourteen women, without uterine fibroids who had routine caesarean section during the same period. Myomectomy for all types of myoma was performed at caesarean section after the delivery of the baby. Haemorrhage was controlled with the use of Foleys catheter tourniquet and high dose oxytocin infusion. The cases and control were analysed for age of the patient, parity, pre and post-operative haematocrit levels, duration of operation, blood loss, blood transfusions, and incidence of postpartum fever. Results: Caesarean myomectomy resulted in the mean blood loss of 589 ml (range 300-1300 ml) compared with 518 ml (range 350-850 ml) in the control group (p=0.376). The mean duration of operation was longer in the cases of caesarean myomectomy (66.8 mins) than those of the controls (56.4 mins). There were no significant differences between the two groups in the incidence of intraoperative haemorrhage, the need for blood transfusion, post partum fever, and length of hospital stay. Conclusions: This study shows that myomectomy during caesarean section is a safe procedure in experienced hands and is not as dangerous as generations of obstetricians have been trained to believe. Further research is necessary to establish the cost effectiveness of the procedure. Key words: myomectomy, cesarean section, hemorrhage      doi:10.3126/njog.v2i2.1457 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 59 - 62
Prenatal ultrasonographic diagnosis of limb body wall complex
Authors: Thapa Narayan B , Dangal Ganesh , Karki Aruna
Published: November 2008

In this report, a case of limb body wall complex (LBWC) diagnosed by ultrasonography is presented. Limbbody wall complex refers to a rare combination of disruptive and lethal abnormalities which start early in the gestational process. Abnormalities commonly associated with this disorder include cranio-facial abnormalities, scoliosis, ventral body wall defect (thoraco-abdominoschisis), limb deformations, short umbilical cord, and others. Other terms used to describe similar findings include short umbilical cord syndrome, body-stalk anomaly, and amniotic band syndrome. This complex should be distinguished from other body-wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall complex is uniformly poor. The diagnosis of limb-body wall complex can be made by prenatal sonography. Key words: limb body wall complex, abdominal wall defects, amniotic bands, amniotic band syndrome, ultrasonography.     doi:10.3126/njog.v2i2.1460 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 72 - 74
Rupture of rudimentory horn pregnancy with catastrophic haemorrhage
Authors: Joshi Lalita
Published: November 2008

A 20 yrs primigravida who had attended antenatal clinic 2 weeks back, presented with shock acute abdomen and jaundice at 18 weeks of gestation. Clinically their was evidence of free fluid in the abdominal cavity. Ultrasonography showed dead fetus with haemoperitoneum which was massive at laparotomy. There was rupture of the rudimentary horn on the left side. This was attached to the normal uterus with the broad band. The placenta and fetus in a sac was lying in the peritoneal cavity. The tubes and ovaries on both sides were found normal. Key Words: Rudimentary horn, hemoperitoneum, acute abdomen in second trimester.   doi:10.3126/njog.v2i2.1461 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 75 - 77
Current and future in FHR monitoring
Authors: Okai Takashi
Published: November 2008

doi:10.3126/njog.v2i2.1465 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 86 - 88
Maternal intensive care: Near-Miss mortality in obstetrics
Authors: Pradhan Pramila
Published: November 2008

doi:10.3126/njog.v3i1.1430NJOG 2008 May-June; 3(1): 1-2
New concepts in pathogenesis and management of polycystic ovarian syndrome: Insulin resistance and role of insulin sensitizers
Authors: Yadav Rashmi Prasad
Published: November 2008

Polycystic ovarian syndrome (PCOS) is classically characterized by the clinical triad of androgen excess, anovulation infertility and obesity. Anovulation occurs due to functional ovarian and/or adrenal hyperandrogenism. The etiology and patho physiology of PCOS is unknown .Proposed theories include excess of gonadotropins; the effect of which is amplified by disturbances in intrinsic regulatory peptides, such as inhibin or extrinsic regulatory peptides, such as insulin or insulin like growth factor ( IGF). For over 25 years insulin resistance has been known to be associated with PCOS. Improvement in insulin resistance with the use of insulin sensitizers, such as metformin and thiazoldinediones (TZDs) have been seen to be associated with better ovulation and reduced testosterone levels in patients with PCOS. Aims: The aim of the present review is to discuss the new concepts in the pathogenesis of PCOS and to know usefulness of insulin sensitizers in such patients. Methods: Over 50 articles extending the span of more than 25 years have been reviewed and an attempt has been made to know the etiopathogenesis of PCOS and also to assess the validity for the uses of insulin sensitizers in patients of PCOS. Results: With the advancement of knowledge regarding etiopathogenesis, the management of PCOS has changed in recent years. In view of positive association between hyperinsulinemia and PCOS, improvement in insulin resistance through weight loss and use of insulin sensitizing drugs has been recommended. Conclusions: Besides symptomatic treatment, recent studies recommend use of insulin sensitizers in management in PCOS for better outcome in them. Key words: Polycystic ovarian syndrome (PCOS), Insulin resistance (IR) Insulin sensitizers (IS).doi:10.3126/njog.v3i1.1431 NJOG 2008 May-June; 3(1): 3 - 9
Experience with surgical options for managing atonic post-partum haemorrhage
Authors: Saha Rachana , Karki Chanda , Padhye Saraswati M
Published: November 2008

Aim: To analyse the measures taken for controlling primary Post-partum haemorrhage (PPH). Methods: A hospital based descriptive and retrospective study was carried out from 1st January 2005 to 31st December 2006 in the department of Obstetrics & Gynaecology at KMCTH. All patients of having primary Post-partum haemorrhage were analysed for the treatment they received. Results: There were 15 cases of primary Post-Partum Haemorrhage (PPH) from a total delivery of 700 in the year 2005. 9 cases were solely of atonic post-partum haemorrhage. 2 cases were genital tract injuries, 1 case of retained placenta, 1 case of vulval haematoma and 2 cases were of combined cervical tear and atonic primary post-partum haemorrhage. Atonic post-partum haemorrhage remained most important cause. The most common treatment was use of oxytocic. Surgical procedure bilateral uterine artery ligation was frequently performed in 6 cases but it was not effective as a single procedure. B-Lynch brace suture was applied in 5 cases and was successful without further intervention. There were 2 maternal deaths from post-partum haemorrhage. In the year 2006 total number of deliveries was 835 and there were total 11 cases of post partum haemorrhage. The trend changed to from atonic PPH to traumatic PPH. There were 8 cases of traumatic PPH and there were 2 cases of placenta accrete. There was one case of atonic PPH. The overall incidence in two years was 1.6%. Conclusion: Among the various surgical methods adopted B-Lynch brace suture was found to be simple, effective and minimally invasive. Keywords: Atonic post-partum haemorrhage (PPH), surgical management of PPH.  doi:10.3126/njog.v3i1.1432 NJOG 2008 May-June; 3(1): 10 - 13
A study of reproductive morbidity of women in the Eastern Terai Region of Nepal
Authors: Dangal Ganesh
Published: November 2008

Aim: This study aims to fill the gap of information of reproductive health (RH) of women living in rural eastern Terai by providing baseline data on reproductive morbidity (RM) leading to pelvic organ prolapse (POP), reproductive tract infections (RTIs), menstrual problems and subfertility. Methods: This is a descriptive analysis of women who attended mobile RH camps in eastern Terai of Nepal organized at different villages falling in three districts namely Rautahat, Mahottari and Saptari during December 2005 and 2006. The diagnoses were made mostly on clinical evaluation and treatment provided. The leading reproductive morbidity of POP was dealt in detail and surgeries were performed in the district headquarters. The data were recorded and analysed manually. Analysis was done by standard statistical methods and a two tailed P value less than 0.05 was considered to indicate a significant difference. Results: Total number of women treated in the camps was 7750. Majority of the women in this study were found to be suffering from STI (30.1%), followed by POP (20.1%), menstrual disorders (16.7%) and subfertility (9.3%). Among POP patients majority received ring pessary insertion (43.8%) followed by counselling plus pelvic floor exercise (32.9%) and surgical correction (23.3%). Third-degree POP (38.6%) was commonest among all POP cases. Majority (60%) developed POP after first and second child birth. Conclusion: The major reproductive morbidity in this study was STI, POP (most of the women having thirddegree uterovaginal prolapse), menstrual disorders and sub-fertility. Surgical treatment at the camps could only be provided to small number, suggesting expansion of health services in rural Nepal by reproductive health barriers like poverty, education. Key words: menstrual disorders, pelvic organ prolapse, reproductive morbidity, reproductive tract infections, sub-fertility.   doi:10.3126/njog.v3i1.1436 NJOG 2008 May-June; 3(1): 29 - 34
Bacteriuria following Foley catheterization after gynecological and obstetrical surgery
Authors: Ojha Neebha
Published: November 2008

Objective: To find out the frequency of bacteriuria associated with Foley catheterization after gynecological and Obstetric (cesarean section) surgery and to analyze the factors associated with bacteriuria. Methods: This is a retrospective study conducted in the Department of Obstetrics and Gynecology of TUTH. Hospital chart records of one of the four functional units for a period of one year (1st January 2007 to 31st December 2007) were collected in all postoperative women who had undergone major gynecological surgery (like abdominal hysterectomy, laparatomy, vaginal hysterectomy etc) and cesarean sections in obstetrics. Charts were reviewed and relevant clinical findings and bacteriological studies of catheter tip culture and sensitivity were noted. Results: There were total 390 major operations (both Gyne & Obs) during the study period. In obstetrics there were a total of 211 cesarean section. Files obtained were 186. Urine and catheter tip culture were obtained in 165 out of 186 cases. Positive culture was found in 76 out of 165 (46%). In gynecology, there were 179 major operations, out of which 130 files were obtained. Urine and catheter tip culture reports were available in 121 cases and 56 (46%) were found to be positive. In cesarean section, duration of catheterization was not associated with increased bacteriuria (p=0.926), while in gynecological surgery there was significant impact of catheterization duration on bacteriuria (p=0.042). In gynecological surgery, increasing patients' age had important impact on bacteriuria (p=0.0004). Overall 46% had positive catheter tip culture. The most common organisms isolated were E coli, Enterococcus fecalis and Staph aureus. Conclusion: This study establishes that Foley catheter was associated with increased risk of bacteriuria in postoperative women following obstetrical and gynecological surgery. Key words: Bacteriuria, Foley catheterization, Catheter tip culture and sensitivity   doi:10.3126/njog.v3i1.1437 NJOG 2008 May-June; 3(1): 35 - 38