bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPARATIVE ANALYSIS FOR FUZZY NONPARAMETRIC REGRESSION MODELS
Authors: YILDIZ Münevvere , MEMMEDLİ Memmedağa
Published: December 2021

Statistical modeling is essential in revealing the relationships between variables. These models can be classified as parametric and nonparametric methods in studies using crisp values. However, most of the data collected are inherently fuzzy. In this framework, it has been a subject that has been studied from past to present that the methods derived for exact values are expressed as methods with fuzzy valued input and output variables. The study aims to describe nonparametric local polynomial regression models in fuzzy structure to examine the results for cases where an input variable is a crisp number, and the output variable is a symmetrical triangular and trapezoidal fuzzy number. According to the results, the bandwidth parameter was smaller in models where the degree of the polynomial was taken as one and larger in the case of three. In addition, the bandwidth parameter was found to be larger in models using the Epanechnikov kernel.
ONE-POT SYNTHESIS OF CARBON QUANTUM DOTS AND THEIR APPLICATION AS A FLUORESCENT INKS
Authors: ESKALEN Hasan , KAVGACI Mustafa , KAYIŞ Ali , ÖZĞAN Şükrü
Published: December 2021

A facile, low cost, and one-pot hydrothermal reaction method is utilized to synthesized highly stable and durable carbon quantum dots (CQDs) by using laurus nobilis leaves as a carbon source. Laurus nobilis leaves were subjected to hydrothermal reaction at 175 °C for 10 h. The color of obtained CQDs under UV-light is bright blue fluorescence. The excitation dependent fluorescent emission of the prepared CQDs was observed and the obtained CQDs gives maximum emission at 425 nm when excited at 344 nm. The absorption peak of the CQDs is located at 279 nm. Furthermore, the synthesized CQDs can be consumed as a fluorescent ink for security, encryption and information storage applications. Combining with good stability and water solubility, unique fluorescence properties and its low-cost, CQDs can also be used as a next generation fluorescent ink alternative to traditional fluorescent ink for anti-counterfeiting.
COVID-19, vacunación obligatoria y derechos fundamentales al hilo de la sentencia del Tribunal Europeo de Derechos Humanos Vavricka y otros c. República checa: un falso dilema
Authors: González-Hernández Esther
Published: December 2021

El presente paper analiza una de las cuestiones más debatidas desde que se declarase la pandemia mundial por Covid-19: la consecución de una vacuna eficaz como la mejor fórmula de combatir el contagio y que permita el regreso a la normalidad. Si bien la reflexión que se aporta en estas páginas se desarrolla desde parámetros algo alejados de lo usual en la doctrina constitucionalista, después de una reflexión profunda y de la lectura de algunos textos de carácter científico-experimental sobre tres cuestiones fundamentales: cómo se han desarrollado las actuales vacunas, sus posibles (o) inciertas consecuencias futuras en la salud de los receptores y su verdadera efectividad en el control de la transmisión de la enfermedad y la consecución de la denominada inmunidad de rebaño.
El derecho de acceso a la justicia de las víctimas de violaciones de derechos humanos en Perú: la Corte Interamericana de Derechos Humanos ante el indulto de Alberto Fujimori
Authors: Serranò Agata
Published: December 2021

Este artículo se propone abordar la falta de tutela del derecho de acceso a la justicia de las víctimas del periodo de violencia que interesó el Perú desde 1980 a 2000, durante el cual tanto grupos terroristas como agentes del Estado perpetraron graves violaciones de derechos humanos. Después de describir los patrones de victimización de las desapariciones forzadas y ejecuciones extrajudiciales cometidas, se examinarán los innumerables tentativos para obtener impunidad por parte de los responsables de las masacres de Barrios Altos y La Cantuta, por las cuales el expresidente Alberto Fujimori fue antes condenado, luego indultado y, finalmente, tal indulto le fue revocado, mediante un control de convencionalidad. En conclusión, se pondrá en evidencia cómo el control de convencionalidad está logrando fijar estándares de tutela de los derechos de las víctimas de la violencia padecida en la región, favoreciendo la consolidación de un ius constitutionale commune promovido por la Corte IDH.
Production and internalization of extracellular vesicules in normal and under conditions of hyperglycemia and insulin resistance
Authors: Yunusova N.V. , Dandarova E.E. , Svarovsky D.A. , Denisov N.S. , Kostromitsky D.N. , Patysheva M.R. , Cheremisina O.V. , Spirina L.V.
Published: December 2021

Extracellular vesicles (EVs) are spherical structures of cell membrane origin, ranging in the size from 40 nm to 5000 nm. They are involved in the horizontal transfer of many proteins and microRNAs. The mechanisms EV internalization include clathrin-dependent endocytosis, caveolin-dependent endocytosis, raft-mediated endocytosis, and macropinocytosis. Type 2 diabetes mellitus (T2DM) is a common group of metabolic disorders in adults; the incidence and prevalence increase in parallel with the obesity epidemic. Since adipose tissue plays a crucial role in the development of insulin resistance, EVs secreted by adipose tissue can be a kind of information transmitter in this process. EVs of adipocytic origin are predominantly absorbed by tissue macrophages, adipocytes themselves, hepatocytes, and skeletal muscles. This contributes to the M1 polarization of macrophages, a decrease in glucose uptake by hepatocytes and myocytes due to the transfer of functionally active microRNAs by these EVs, which affect carbohydrate and lipid metabolism. Patients with T2DM and impaired glucose tolerance have significantly higher levels of CD235a-positive (erythrocyte) EVs, as well as a tendency to increase CD68-positive (leukocyte) and CD62p-positive (platelets/endothelial cells) EVs. The levels of CD31+/CD146-positive BB (endothelial cells) were comparable between diabetic and euglycemic patients. EVs from diabetic patients were preferably internalized by monocytes (mainly classical and intermediate monocyte fractions and to a lesser extent by non-classical monocyte fractions) and B cells compared to euglycemic patients. Internalization of EVs from patients with T2DM by monocytes leads to decreased apoptosis, changes in differentiation, and suppression of reactions controlling oxidative stress in monocytes. Thus, insulin resistance increases secretion of EVs, which are preferentially internalized by monocytes and influence their function. EVs are considered as sources of promising clinical markers of insulin resistance, complications of diabetes mellitus (endothelial dysfunction, retinopathy, nephropathy, neuropathy), and markers of EVs can also be used to monitor the effectiveness of therapy for these complications.
The effect of lipid derivative of anti-tumor drug sarcolysin embedded in phospholipid nanoparticles in the experiments in vivo
Authors: Tereshkina Yu.A. , Torkhovskaya T.I. , Sanzhakov M.A. , Kostryukova L.V. , Khudoklinova Yu.Yu. , Tikhonova E.G.
Published: December 2021

To improve the therapeutic properties of the antitumor agent Sarcolysin, we have previously developed and characterized a dosage form representing its ester conjugate with decanol embedded in ultra-small phospholipid nanoparticles less than 30 nm in size (“Sarcolysin-NP”). The effect of the resulting composition was investigated in vivo in comparison with the free substance of sarcolysin. The composition intravenous administration to mice showed an improvement in the pharmacokinetic parameters of sarcolysin associated with its initial higher (by 22%) level in the blood and prolonged circulation, which was also observed in mice with P388 tumor. In mice with three types of tumors — lymphocytic leukemia P388, lymphocytic leukemia L1210, and adenocarcinoma of the mammary gland Ca755 — administration of two doses of sarcolysin over a period of 7 days showed its predominant antitumor effect. The maximum tumor growth inhibition was noted for lymphocytic leukemia L1210 and adenocarcinoma of the mouse mammary gland Ca755 (at a dose of Sarcolysin-NP — 8,4 mg/kg), which was higher in comparison with free substance by more than 24% and 17%, respectively. Differences in the life span of the treated animals were revealed significantly at a dose of 10 mg/kg and amounted to 25% and 17,4% for lymphocytic leukemia P388 and L1210, respectively, and 11% for adenocarcinoma Ca755. In an experiment on rats, acute toxicity of Sarcolysin-NP administered intravenously showed that an average LD50 value 2-3 times exceeded a similar parameter for commercial preparations of free sarcolysin (Melphalan and Alkeran), which indicates its lower toxicity.
Prenatal exposure to alcohol alters TLR4 signaling in the prefrontal cortex in rats
Authors: Airapetov M.I. , Eresko S.O. , Bychkov E.R. , Lebedev A.A. , Shabanov P.D.
Published: December 2021

Prenatal alcohol exposure (PAE) can lead to developmental disorders of the central nervous system (CNS) and mental retardation. Toll-like receptor (TLR) 4 plays an important role in the development of defects in the nervous system caused by PAE. However, how PAE affects the TLR4 response in the brain remains unclear. Using the model of semi-forced alcoholization of pregnant rats, we investigated TLR4-mediated signaling on the 30th day of postnatal development in their offspring. Rats exposed to PAE showed a higher expression of proinflammatory cytokines in the prefrontal cortex, but TLR4-mediated signaling in response to lipopolysaccharide (LPS) was weakened. These data suggest that PAE can lead to neuroinflammation and suppression of the TLR4-mediated response to LPS in the prefrontal cortex of young rats. Since innate immunity plays an important role in brain development, PAE-induced suppression of the TLR4-mediated response may be one of the mechanisms for the development of CNS pathology.
Determination of the Bacteriostatic Activity of Glycophorin Preparations from Red Blood Cell (RBC) Membranes of Yellow Tail and Red Sea Bream
Authors: Aoki Takahiko
Published: December 2021

Glycophorins (GPs) in red blood cell (RBC) membranes of carp (Cyprinus carpio L.) exhibit bacteriostatic activity against various gram-negative and gram-positive bacteria. To clarify the physiological activity of teleost fish GPs other than those from carp, we performed a sensitivity test using GP preparations from the RBC membranes of yellow tail and red sea bream. The sensitivity test for the growth of Micrococcus luteus was performed using the disc-plate method. These results suggested that the yellow tail and red sea bream GPs exhibit antibiotic activities.
Management of constant proptosis after traumatic orbital roof fracture caused by firearm projectile
Authors: Czyz Craig , Greenlee Tyler , Bergstrom Reece
Published: December 2021

Orbital injuries causing severe proptosis are most often caused by high-energy, blunt force trauma, but can also be associated with penetrating traumas, such as firearm projectiles. Head trauma resulting in orbital roof fracture and significant communication between the anterior cranial fossa and posterior orbit are rare events, with herniation of brain tissue and cerebrospinal fluid into the orbit even more uncommon and found in only a small percentage of cases. When present, the herniating tissue and/or fluid can cause significant proptosis and potentially orbital compartment syndrome that increases the risk of damage to the optic nerve and its surrounding structures. Often this condition is managed surgically in an urgent manner to preserve visual acuity and the ocular tissues. In cases of constant proptosis in the setting of orbitocranial injuries, practitioners should balance the risks and benefits of intervention ensuring the best possible clinical outcomes. It is imperative to remember that the proptosis is a clinical finding that is itself not pathognomonic for any particular disease entity. The following case describes a 20-year old male that presented with multiple gunshot wounds, one of which caused a penetrating injury to the orbit and subsequent brain tissue herniation and cerebrospinal fluid leak with associated constant proptosis and orbital compartment syndrome. This case report examines the treatment options in severe cases of traumatic, constant proptosis, with or without orbital compartment syndrome, and the methods used to preserve vision, anatomy, and prevent severe complications.
C-skeleton in the genetic code from a basic series 5 → 0, guiding valences and other numeral features in the code
Authors: Wohlin Åsa
Published: December 2021

The search for regularities in the background for the genetic code and its codon assignments is here further developed, earlier shown to have many correlations with numeral series of integers 5 →0 with different exponents. The atomic mass analysis here counts on 20 + 4 double-coded amino acids, here including Ile AUA as such. A central finding here is that the C-skeleton seems to build on an hierarchical development of the mentioned basic series giving top numbers equal to those returning in side-chain divisions and on first three levels those of C-atoms in base-pair domains. It can very elementary explain the 3/2-division in the weight series. A few main results from earlier articles are shortly recapitulated, since it’s shown here that an x­3-series times 15 (x = integers 5 → 0) joins those earlier aspects and add new ones. It’s found also that atoms with valences 4 + 3 relative those with 2 + 1 make up a 3 to 1-division in both base-pair groups of codon domains, strengthening the earlier observation of valences as one important guiding principle in the relation between codons and domains of amino acids; valences of the atoms which in themselves make up a basic series 5 → 0 in the code when phosphorus P is included. Finally, fundamental factors in the code are gathered, where step 4 →3 seems reign at bottom of the code and number 7, exactly mean value of all atoms.
Comparative study between bone ages: Carpal, Metacarpophalangic, Carpometacarpophalangic Ebrí, Greulich and Pyle and Tanner Whitehouse2
Authors: Torné Bernardo
Published: December 2021

We have carried out a review study in order to remind the pediatrician of the differences in bone age (EO) between the existing Greulich-Pyle (GP) or Tanner-Whitehouse 2 (TW2) methods compared to Ebrí ages: EO Ebrí-carpal (EOIC) metacarpophalangic (EOIMF) and Carpometacarpophalangic (EOICMF). The study was carried out in Spanish longitudinal casuistry “Andrea Prader”. It comprises 160 healthy children: 73 males and 87 females, distributed by sex and age from 0.5 to 20 years. By obtaining the EO for each method, a comprehensive study can be carried out between them, and thus, observing if there are differences, being able to offer a quantification to the pediatrician for him to take them into account. In previous studies, the equations for obtaining the EO were expressed by the Ebrí methods. These quantifications are presented throughout this review.
A Case of Myopericarditis and the HPV vaccine
Authors: Pegram Angela , Bush Tara
Published: December 2021

Introduction: Human Papillomavirus (HPV) is the underlying etiology of numerous cancers and genital warts in both males and females. Vaccines were developed against HPV to prevent transmission and arrest development of cancers caused by the virus. Gardasil 9â is the newest vaccine, covering 9 serotypes of HPV and is recommended by the CDC for both males and females over 9 years of age in a series of vaccinations. Myopericarditis (including myocarditis and pericarditis) is not reported as an adverse reaction in the Gardasil 9â package insert. Case Report A healthy 18-year-old male with no significant past medical or social history received dose number 3 of HPV vaccine at his physician’s office. Within 24 hours, he developed chills and a fever (normal HPV reactions) and then recovered without sequelae within 48 hours. Three days later, he developed crushing chest pain, with arm tingling and jaw pain. He was triaged directly to the emergency room where he had troponins of greater than 11000 and T wave inversions on his EKG. Other diagnostic tests and labs showed normal heart anatomy and no early coronary artery disease. He was diagnosed with myopericarditis by cardiology. He was treated and recovered fully within 3 months. Discussion Using the WHO tool for adverse vaccine reactions, this case has a consistent causal relationship with vaccination. This is the eleventh case of myopericarditis reported to the Vaccine Adverse Effects Reporting system for the HPV vaccine. Conclusion Although rare, myopericarditis should be considered as a possible adverse effect from the human papillomavirus vaccine.
Effect of maternal anemia on cord blood haemoglobin of newborn
Authors: Rathoria Richa , Rathoria Ekansh
Published: December 2021

Background: Anemia during pregnancy is linked to major maternal and fetal problems. The aim of the study was to find any correlation between maternal anemia and neonatal cord blood haemoglobin (Hb) levels.Methods: This cross-sectional study was done in the department of pediatrics and department of obstetrics and gynaecology at the Hind Institute of Medical Sciences, Barabanki over 9 months from January 2021 to September 2021. A total of 308 pregnant females more than 34 weeks of gestation who delivered participated in the study and cord blood hemoglobin of their new-born was collected. The mean maternal hemoglobin and mean cord blood hemoglobin were compared using the Pearson correlation coefficient in different groups i.e., non-anemic, anemic, mild, moderate, and severe anemic groups.  Results: Out of 308 pregnant women, 198 (64.3%) were anemic, and 110 (35.7%) were nonanemic. The mean maternal hemoglobin among non-anemic mothers and anemic mothers was 11.91 (0.70) and 9.14 (1.56) respectively. The Pearson correlation coefficient of non-anemic, anemic, mild, moderate, and severe anemic groups were 0.6985, 0.8453, 0.7772, 0.6321, and 0.7226 respectively with a statistically significant p value<0.05 showing a positive correlation between maternal hemoglobin and cord hemoglobin.Conclusions: From this study, we concluded that maternal anemia affects neonatal cord blood hemoglobin. According to the findings, anemic women deliver new-born with lower hemoglobin levels than non-anemic mothers. The findings revealed a linear correlation between maternal hemoglobin and cord blood hemoglobin of their new-born.
Histopathological evaluation of endometrial tissue in patients of abnormal uterine bleeding
Authors: . Zothansangi , . Vanremmawii , P. Naveen
Published: December 2021

Background: Abnormal uterine bleeding (AUB) is one of the commonest complaints in the gynecology OPD. It is also one of the most common reason for hysterectomy among Mizo women. Endometrial biopsy is a gold standard and first step for diagnosis of AUB in a low resource setting like the North-east states of India. The aim of the study was to evaluate the histopathology of endometrium for proper management of AUB cases.Methods: This was a prospective study done to evaluate the histopathology of all the cases of AUB who attended gynaecology OPD, from the year 2018 to 2020. This study comprised of 668 AUB cases and material of the study was endometrial tissue of the cases of Abnormal uterine bleeding collected by dilatation and curettage, and sent for histopathological study to the department of pathology.Results: Most of the abnormal uterine bleeding patients was in the age group of 40 to 49 years, and the most common histopathological finding was proliferative endometrium, 35.5% followed by disordered proliferation, 21%. 14 cases of carcinoma endometrium were found among the age group above 40 years.Conclusions: The research evident that all the women above 40 years old need to undergo screening, keeping in mind the higher risk of carcinoma in the older age group of women.
Role of uterine artery Doppler indices for predicting intrauterine pathology inconclusive on 2-dimensional transvaginal imaging among infertile women undergoing frozen embryo transfer cycle
Authors: Sindhu Lavi
Published: December 2021

Background: Objective of current study was to correlate uterine artery Doppler parameters with endometrial findings on hysteroscopy and its importance for the prediction of intrauterine pathology inconclusive on 2-dimensional transvaginal imaging prior to frozen embryo transfer.Methods: This was a retrospective study conducted at Medicover fertility center, New Delhi, India. The study population comprised of women with infertility who have undergone hysteroscopy before frozen embryo transfer. Total 70 patients were recruited based on inclusion/exclusion criteria. Intrauterine pathology found in 57.2% (n= 40) patients and 42.8% (n=30) had normal endometrial cavity on hysteroscopy, they were categorized as group 1 and group 2 respectively based on their findings. Both the groups were compared for pre hysteroscopy uterine artery Doppler parameters, resistivity index and pulsatility index. Further clinical pregnancy rate and miscarriage rate were determined in both groups.Results: Both the groups were comparable for age, body mass index, duration, and type of infertility. Mean RI and PI was significantly higher in group 1 as compared to group 2 (0.90±0.025, 2.89±0.291 vs. 0.76±0.043, 1.82±0.27; p value <0.001). The best cut-off value of uterine artery RI was ≥0.87 with sensitivity of 90% (95% CI=0.7634-0.9721), specificity of 100% (95% CI=0.8843-1.0000) and PI was 2.46 with sensitivity of 100% (95% CI=0.9119-1.0000), specificity of 96.7% (95% CI=0.8278-0.9992).Conclusions: Uterine artery Doppler is a non-invasive, cost- effective useful add-on tool for routine endometrial evaluation and can be a good predictor for screening intrauterine pathology and valuable in decision making for pre-IVF hysteroscopy.
Efficacy of prophylactic tranexamic acid administration in prevention of postpartum hemorrhage in placenta previa cesarean section: an interventional study
Authors: Rathore Monika , Gupta Anjali , Kumari Nidhi
Published: December 2021

Background: Postpartum hemorrhage accounts for the major part of the mortality as well as morbidity like severe anemia, need for blood transfusion, hospital stay and infection. Aim and objectives of the study were to determine the efficacy and safety of prophylactic tranexamic acid and intravenous tranexamic acid in preventing postpartum hemorrhage in women undergoing caesarean section for placenta previa.Methods: Seventy women with placenta previa over 1 year, randomized into 2 groups: group 1 (n=35): Women who received 10 IU oxytocin intravenous infusion after placental delivery and group 2 (n=35): Women who received 1 gm (10 ml) tranexamic acid IV before skin incision plus 10 IU oxytocin intravenous infusion after placental delivery.Results: The mean age was similar in 2 groups i.e., 26.34±4.78 years in group 1 and 27.31±5.62 years in group 2. Most women in the present study presented with type IV placenta previa i.e., 34.3% in group 1 and 48.6% in group 2. Mean pre-operative hemoglobin was 9.57±1.54 g/dl in group 1 and 9.59±1.35 g/dl in group 2. Intra-operative mean blood loss was 729.31±172.45 ml in intravenous oxytocin group and 464.86±28.00 ml in intravenous tranexamic acid group. A total of 74.3% women in group 1 and 20% women in group 2 developed postpartum hemorrhage. Mean post-operative hemoglobin was 8.04±1.34 g/dl in group 1 and 8.85±1.26 g/dl in group 2. In group 1, 5.7% neonates were born with very low birth weight and while none in group 2. 51.4% neonates in group 1 and 45.7% in group 2 had low birth weight.Conclusions: It is concluded that tranexamic acid used prophylactically intravenously before skin incision in patients undergoing cesarean section for placenta previa significantly reduces intra-operative blood loss.
Role of parents, teachers at home and school in prevention of female sexual abuse: an analysis
Authors: Nainar Anithathamaraiselvi A. , Ramasamy Sivapriya , Shanmugam Mekala
Published: December 2021

Background: Sexual assault is an act performed by one person on another without the person’s consent or on a victim who is incapable of giving consent. The purpose of this article is to analyze the female sexual assault cases reported in one year –and the role of parents, teachers, at home and school in prevention of child sexual abuse.Methods: Data of victims who were admitted in GDMCH in the department of obstetrics and gynaecology in the year 2020 were collected from the medico legal register retrospectively and analyzed.Results: Age wise distribution showed 70% of cases were in the age group 15-19 years. 57% of assaults were with consent and 43% without consent. 93% of the perpetrators were known to the victim. Around 48% of the assaults were multiple episodes by a single perpetrator. The place of assault in 39% of cases was perpetrator’s house, 35% was in friend’s or relative’s house.Conclusions: 86% of the victims were <19 years of age, hence, educational awareness services are to be given to high school students and teachers .School authorities and teachers should implement strict vigilance against improper use of the internet and mobile phones by the students. Most common location of assault was the perpetrator's house (39%), followed by their friend’s house (22%). Hence parents should take every care to watch over the child and never leave them unsupervised.
Feto-maternal outcomes in near miss events in obstetrics
Authors: Kamboj Apoorva , Mandrelle Kavita
Published: December 2021

Background: Maternal near miss is defined by world health organization as a woman, who being close to death survives a complication occurring during pregnancy, delivery or upto 42 days after her end of pregnancy.It is a retrospective diagnosis. Evaluation of near miss maternal morbidity and mortality is a surveillance method to assess the quality of obstetric care and determinants of poor maternal outcome. It is an indicator of quality of obstetrical care. Aims and objectives for current study was to evaluate the cause of near miss maternal morbidity in our hospital which occurred either in admitted patients or were referred from elsewhere and to study the maternal and fetal outcomes in all near miss cases.Methods: A retrospective review of obstetrical records as well as prospective analysis was done at Christian medical college and hospital, a tertiary care teaching institute in North India and referral centre. The study was done for a period of one year from November 2018 to October 2019 retrospectively and for 6 months from November 2019 to April 2020 prospectively. The maternal near miss cases were taken as per WHO criteria.Results: The age ranged from 19 years to 49 years with maximum belonging to age group of 20-24 years. Maximum number of cases was primigravida and was in third trimester. The primary obstetric complication evaluated were hypertensive disorders followed by hematological diseases, viral hepatitis, haemorrhage, and obstructed labour or ruptured uterus.Conclusions: All the causes of MNM observed in this study are preventable causes, which can be identified timely and treated early to prevent maternal mortality, thereby, improving obstetrical and neonatal outcome.
Fetal head circumference versus fetal weight at term as a predictor of labour outcome
Authors: Shettian Nishita , Pitty Nikita
Published: December 2021

Background: Several models have been proposed to predict the need for an LSCS. With reference to this, the impact of the size of the fetal head traversing the birth canal is an important determinant of delivery outcomes. We examined the association between the head circumference and mode of delivery and perinatal outcomes, when compared to birth weight predicted by scan.Methods: This was a retrospective study, on 800 electronic delivery records between December 2019 and May 2021. Sociodemographic data, obstetrical parameter, term scan findings of head circumference and estimated fetal weight, and labour and perinatal outcomes were collected and analysed.Results: HC >95th centile was found to be comparatively more predictive and statistically significant compared to EFW >95th centile in the prediction of LSCS, with the most common indication being cephalopelvic disproportion. Prolonged second stage of labour was statistically significant in both cohort A and B, undergoing vaginal delivery. It was also noted that a significant number of newborns in cohort A required NICU admissions, while NICU admissions after emergency LSCS was significantly higher in the cohort B (p=0.0032) though the overall 5 and 10 minute APGAR scores and duration of stay were comparable in the groups classified on basis of EFW and HC.Conclusions: The above statistics observed on an Indian population may aid obstetricians in the planning of the mode of delivery, improve pre-labor counselling and efficient management of mothers of large babies.
A study of knowledge, awareness, and acceptance of contraception among reproductive age women at tertiary care hospital, Ahmedabad
Authors: Bamniya Jaishree , Patel Devanshi , Singh Pooja , Chakravarti Nisha
Published: December 2021

Background: India is projected to be the most populous country according to United Nations’ report; therefore, the knowledge and awareness of contraceptive methods is of utmost important for small family norms and to increase inter-pregnancy interval, so that we can achieve optimum maternal and child outcomes. This study was conducted to assess knowledge, awareness, and acceptance of contraceptive methods among reproductive-age women during Corona pandemic.Methods: A prospective observational questionnaire-based study involving 513 women belonging to the 15-49 years of age group were interviewed with consent. This was a knowledge, attitude and practice (KAP) study regarding socio-demographic profile, knowledge, awareness, and acceptance of the contraceptive method.Results: Statistical analysis of data was done by using chi-square and percentage. Out of 513 participants, 63 participants were not using any method of contraception. Barrier method is the most commonly preferred method of contraception. There was significant association of education of women and husband, occupation with usage of contraception (p<0.001, p=0.016 and p<0.001). During corona pandemic acceptance of tubal ligation had taken a hit.Conclusions: During corona pandemic barrier method and oral contraceptive pills were preferred methods. In comparison with pre-COVID era data, tubal ligation was least preferred method. Acceptance of IUCD and Injectable contraception remained same. Higher education level and better financial status had correlation with increased awareness and acceptance of contraceptive methods.
Comparative study of oxytocin bolus and oxytocin infusion during caesarean section
Authors: Bannihatti Teena C. , K. R. Hema , N. M. Pradeep
Published: December 2021

Background: The incidence of postpartum haemorrhage varies from 2-11%. Postpartum haemorrhage complicates approximately 4% of deliveries in most large obstetric services. Postpartum haemorrhage is the third major cause of maternal mortality next to pregnancy induce hypertension (pre-eclampsia) and infection. Prevention, early recognition and prompt appropriate intervention are keys to minimizing its impact. Conventionally loss of more than 500 ml of blood following vaginal delivery and 1000 ml of blood following caesarean section is defined as postpartum haemorrhage. In this study we compared the efficacy of intravenous oxytocin bolus (2 IU) dose followed by infusion (160 mIU/minute) and only i.v. oxytocin infusion following delivery of fetus in elective and emergency LSCS with regard to uterine tone.Methods: This study was a prospective observational study. 200 low risk patients scheduled to undergo elective and emergency caesarean section under spinal anaesthesia in Department of obstetrics and gynecology, SSMC, Tumkur. Group A included i.v. bolus + i.v. injection, group B: i.v. infusion.Results: There was significant drop in haemoglobin and PCV in both group A and group B. But it was comparable among two groups. At 15th minute MBP was 77.2 mm of Hg and 80.04 mm of Hg in Group B. In group A better uterine tone was achieved earlier compared to group B at 2, 5, 10, 20 minutes.Conclusions: It was concluded from this study that oxytocin i.v. bolus with infusion causes earlier attainment of better uterine tone when compared with only infusion.
Spontaneous heterotopic pregnancy: a case report
Authors: Sharma Shikha , Chandel Anu Bala , Sharma Anupam , Ranaut Aditi
Published: December 2021

Heterotopic pregnancy is defined as multiple gestation in which intrauterine and extrauterine gestational sacs co-exist. The extra uterine gestational sac is most commonly tubal ectopic pregnancy. We presented case of a 26 years old multigravida who presented to emergency with complaints of pain abdomen and giddiness for 2-3 days. She was at period of gestation (POG) 7 weeks and on clinical examination patient was anxious with mild pallor, mildly tachycardiac and blood pressure (BP) was 90/60 mm of Hg. After thorough clinical examination and sonography diagnosis of heterotopic pregnancy with ruptured tubal ectopic was made. She was taken up for Emergency laparotomy after investigations and consent. Left salpingectomy was done and she was discharged with a single intrauterine live pregnancy on 6th post op day. For early detection of cases of heterotopic pregnancy careful evaluation of adnexa is mandatory in early gestation scan.
African traditional abdominal massage in pregnancy resulting in antepartum uterine rupture, abruptio placenta and foetal demise – a case report
Authors: Amadi Simeon C. , Awoyesuku Peter A. , Iwo-Amah Rose S. , Ibeabuchi Sandra U.
Published: December 2021

The practice of abdominal massage dates to years ago and associated with foetal and maternal morbidity and mortality when undertaken by untrained traditional birth attendants in our setting. We present a 30-year old G3P2+0 with uterine rupture and intra-uterine foetal death following abdominal massage. She was resuscitated and had emergency exploratory laparotomy and repair of uterine rupture.
Cervical leiomyoma: a rare case with unusual presentation
Authors: Wakode Shamrao Ramji , Lodha Roshni Vinod
Published: December 2021

Leiomyomas or fibroids are the most common benign pelvic tumors in females that grow mono-clonally from the smooth muscle cells of the uterus. Most common tumors of the uterus are fibroids but cervical fibroid is rare during pregnancy with different management difficulties but cervical leiomyomas are less than 5% of all leiomyomas. A middle-aged female patient came to the obstetric opd with complaints of amenorrea for 2 months, per vaginal spotting and abdominal pain for 5 days. Her obstetric score is gravida 2 para 1 living 1. She has no h/o of urinary retention, urgency, constipation or mass per vagina. There is no history of bleeding during coitus. This case is of great importance not only because of its atypical presentation, but because we are dealing with rare pathology that can have consequences as serious as a total uterine inversion or a complete uterovaginal prolapse. Decision of myomectomy SOS hysterectomy may be considered intra operatively based on 1. Age, 2. Parity, 3. Severity of symptoms and 4. Experience of surgeon
Acute pancreatitis masquerading as an ovarian torsion: a rare case report
Authors: Goyal Ankita Bansal , Goyal Lata , Goyal Nilesh , Jain Saket
Published: December 2021

Ovarian torsion is a common diagnostic challenge constituting 2.7% to 7.4% of all gynaecological emergencies. It commonly occurs in women of reproductive age however pre-pubertal girls and postmenopausal women can also be affected. Ovarian torsion accounts for approximately 3% of all cases of children with acute abdominal pain and requires immediate surgical intervention. Other common acute adnexal pathologies include simple ovarian cysts (OCs) with or without rupture. Owing to the nonspecific clinical presentation and poor specificity of radiologic tests, the diagnosis of OT in girls remains challenging. Here we are reporting a case of acute abdomen with large cyst on ultrasound clinically presented as torsion later on in the post-operative period diagnosed with acute pancreatitis.
Associated factors of precocious sexual intercourse among schooled teenagers in Antsirabe town, Madagascar
Authors: Rafamatanantsoa Florent J. , Razanatsila Armel M. A. , Razanatsimba Miora H. R. , Rakotoson Lina , Raobela Lea , Randriamanantsoa Lova N. , Rakotonirina Julio
Published: December 2021

Background: Teenagers are defined by world health organization as persons between 10 and 19 years of age. When this generation has a sexual intercourse, it is considered to be early. The main aim of this investigation is to identify associated factors of precocious sexual intercourse.Methods: A cross-sectional study was conducted at the high schools in Antsirabe town among teenagers.Results: Among 636 teenagers, 19.8% are prematurely initiated. The median age of first sexual experience is 16 years of age. The average age for this first sexual experience takes place at 15.5 (1.4) years of age for boys and at 16.6 (1.2) years for girls. One kind of sociodemographic profile is associated to the first precocious sexual intercourse. Poor school performance, urban life, alcohol, tobacco and drug use are also significantly associated with this precocious sexual experience. From the relationship standpoint, 6= lack of sexual education by the head of household, the absence of religious diligence, the influence of customs, internet access and accession a social network are indeed associated to this problem.Conclusions: In order to meet these results, the ministry of public health should design on Facebook, education program about forward sexuality.
A study on socio-clinical profile and associated risk factors of stroke patients admitted to neurology department of SCB medical college, Cuttack, Odisha
Authors: Mohanty Minakshi , Sahu Saswati , Jena Sushanta K.
Published: December 2021

Background: Non-communicable diseases (NCDs) are ragging reality of today’s world and have moved up the priority list of most countries worldwide including India. Objectives were to find out prevalence of different types of strokes among the patients admitted in neurology department of SCB medical college, to study socio-clinical profiles of admitted stroke patients and to find out associated risk factors with different types of strokes.Methods: Cross-sectional hospital-based study in neurology ward of SCB MCH, Cuttack, Odisha in 2019-20.Results: The mean age 60.93±12.8, males are more affected, 60-69 years were more affected, 76% were ischemic strokes, 85% cases weakness of limbs reported, hypertension, diabetes, alcoholism, smoking, dyslipidemia were major risk factors. Hypertension and smoking found to be highly significant in case of young stroke patients.Conclusions: Major modifiable risk factors were hypertension (63.3%) followed by alcohol intake 53.9%.
Intravenous ibutilide versus intravenous amiodarone for post-operative management of atrial fibrillation following coronary artery bypass grafting: a prospective randomized controlled double blinded trial
Authors: Gandhi Ankur , Verma Aradhaya , Sharma Aditya , Gandhi Sanjay , Salman Mohammed Abdul , Singh Deependra
Published: December 2021

Background: Increased incidence of post-operative atrial fibrillation (POAF) is responsible for more post-operative complications, length of hospital stay and subsequent higher costs of hospitalization. This study was done to compare the efficacy and safety of ibutilide versus amiodarone for treatment of POAF following coronary artery bypass grafting (CABG).Methods: In this prospective, randomized, double blind controlled study, 60 patients posted for CABG developing POAF, divided randomly into 30 patients each in groups A and group I. Group A received IV amiodarone at 3 mg/kg over 20 minutes and group I received IV ibutilide at 0.01 mg/kg over 10 minutes (weight <60 kg) or 1 mg over 10 minutes (weight >60 kg). Patients underwent standard anesthetic technique and monitoring for CABG. All the demographic data, hemodynamic data were recorded in a structured manner.Results: Ibutilide showed significantly faster resolution of AF at 12.47±5.3 versus 22.9±7.68 minutes by amiodarone (p=0.000). Ibutilide was found to have significantly higher incidences of recurrence at 23.3% versus 0% by amiodarone (p=0.0048). Ibutilide showed significantly lesser hypotension 0% versus 26.67% with amiodarone (p=0.002).Conclusions: This study concluded that ibutilide was found to be better suited to treat POAF patients, who underwent CABG; due to its early and efficient resolution and reduced risk of hypotension.
Risk factors and coronary angiographic profile in young STEMI patients: results from a tertiary care centre in south-central India
Authors: Golla Abhishek , Kadloor Parvaiz , Gurrala Rajashekar R. , Hussain Kazi Jawwad , Sivadayal Kolli , Rao K. Laxman , Hidayathulla Mohammed , Shaikani Shabbik Ali
Published: December 2021

Background: Compared to older counterparts, a significant distinction has been found related to risk factors, clinical presentation, and prognosis of ST-segment elevation myocardial infarction (STEMI) in younger patients. To date, a lack of studies has been looked, specifically at-risk factors and angiographic profile of STEMI among younger patients; with this in mind, we conducted the present study.Methods: This hospital-based, cross-sectional, open-label study was carried out at Deccan College of Medical Sciences between April 2018 and December 2019. Patients under 40 years with the presentation of STEMI were included. All patients were subjected to electrocardiography, 2D echocardiography, and coronary angiogram. Baseline demographics, risk factors, and procedural characteristics were recorded.Results: Of 51 young STEMI patients, 41 (80.4%) were male and 10 (19.6%) were female. The most common risk factors associated with the development of STEMI in young patients were smoking (58.8%), followed by diabetes (45.1%), and dyslipidaemia (45.1%). Anterior wall MI was the most frequent presentation (84.3%). The left anterior descending artery was the most frequently (62.8%) involved vessel, followed by left circumflex artery (9.8%), and right coronary artery (5.9%).Conclusions: Insights gained from the study can aid in identifying clinical characteristics of STEMI in young patients, which may be beneficial to achieve appropriate and timely management. Further, the young population should be educated as to control modifiable risk factors and smoking cessation to prevent coronary artery disease since they belong to the highly productive group in the community.
Clinico-radiological and pathological correlation of interstitial lung diseases: a prospective single centre study
Authors: Nair Ankita Dhiman , Thakur Vijay , Sarkar Malay
Published: December 2021

Background: Current investigation was done to study the role of HRCT chest in the diagnosis and characterization of interstitial lung diseases, yield of transbronchial lung biopsy and role of multidisciplinary approach of diagnosis.Methods: We prospectively analyzed clinical features and radiological findings in 38 patients of ILD. Radiological diagnosis on HRCT was made in every case depending on type of predominant abnormality and pattern of involvement. Following this, TBLB was done in every case.Results: ILD was diagnosed in all cases on HRCT. Most common ILD type was UIP (31.5%) followed by sarcoidosis (21%) and NSIP (15.7%). Other ILD subtypes encountered were, RB-ILD, AIP and acute silicosis. In 68.4% cases, there was definitive diagnosis on TBLB. Out of which in 15.7% cases, HRCT and TBLB diagnosis were different. In 15.3% cases, TBLB gave diagnosis of only non- specific ILD.Conclusions: HRCT can detect ILD in 100% cases & can characterize ILD into various patterns. But, HRCT alone without clinical correlation and pathology can cause diagnostic confusion in many cases. However, multidisciplinary approach by engaging clinician, radiologist and pathologist can lead to accurate diagnosis in many cases of ILD. TBLB is a safe, minimally invasive procedure which can establish correct diagnosis in many cases especially in broncho-centric diseases.
Burden and quality of life in caregivers of obsessive-compulsive disorder and schizophrenia: a case-controlled study
Authors: Afzal M. , Mohanty Sandhyarani , Sisodia Anil Kumar
Published: December 2021

Background: Obsessive–compulsive disorder (OCD) and schizophrenia both are chronic and disabling mental illness which imposes considerable burden on caregivers. Many studies have also reported that both of them have a negative impact on the quality of life (QOL) of both the patients and the caregivers living with the patients. The aim of the study was to assess and compare the burden of care and quality of life (QoL) in the care givers of patients with Obsessive–Compulsive Disorder (OCD) and Schizophrenia.Methods: The present study is a hospital based, cross-sectional and comparative study. 30 patients with schizophrenia and 30 Obsessive-Compulsive Disorder patients and their caregivers attending the OPD and family ward of Institute of Mental Health and Hospital, Agra were selected through purposive sampling with specific inclusion and exclusion criteria. World Health Organization Quality of Life Scale (BREF version), Burden Assessment Schedule, Positive and Negative Syndrome Scale (PANSS), Yale–Brown Obsessive Compulsive Scale (Y-BOCS) were used for assessment.Results: The findings of this study revealed remarkable burden in the caregivers of OCD and Schizophrenia patients along with considerable and comparable impairment of their quality of life. Caregivers of Schizophrenia patients experienced more burden and have poor quality of life than the caregivers of OCD patients.Conclusions: It is suggested to develop effective strategies for family intervention with the purpose of supporting the caregivers and improving their quality of life.
Ocular manifestations and clinical profile of multisystemic inflammatory syndrome in children during COVID-19 pandemic
Authors: Mandal Arnab , Kumari Ekta , Roy Amaresh , Bandyopadhyay Mousumi
Published: December 2021

Background: Multisystemic inflammatory syndrome in children (MIS-C) is a new childhood disease, which is associated with Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). To evaluate ocular manifestations and clinical characteristics of MIS-C during COVID-19 pandemic.Methods: A cross-sectional observational study was conducted among 48 MIS-C patients (≤19 years) at Burdwan Medical college and hospital in West Bengal, India from April 2021 to June 2021. History taking, clinical examination and necessary investigations of all the patients were done.Results: Out of 48 patients, 18 patients (37.5%) presented with conjunctivitis, 4 (8.3%) with eyelid swelling, 2 (4.2%) with episcleritis, 2 (4.2%) with papilledema, 1 (2.1%) with subconjunctival haemorrhage, 1 (2.1%) with uveitis, 1 (2.1%) with retinitis and 4 (8.3%) with decreased vision. Other clinical manifestations included fever, skin rash, loose stool, vomiting, abdominal pain, cough, peripheral oedema, myalgia, breathlessness, altered sensorium, cervical lymphadenopathy, shock, oliguria, chest discomfort and joint swelling. Serum inflammatory, coagulation and cardiac markers were deranged.Conclusions: Ocular and other clinical manifestations in MIS-C were due to post-COVID immuno-dysregulation resulting in “cytokine storm” and hyper-inflammatory response. Conjunctivitis was the most common ocular manifestation. There was a positive correlation between severity of the conjunctival hyperaemia and level of serum inflammatory markers.