bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of management of the health system (on the example of the Arkhangelsk region)
Authors: Shelygin Kirill V. , Ushakova Tatyana N. , Zykova Natalia V. , Lozhkina Lada I. , Mikityuk Valentina A.
Published: March 2023

BACKGROUND: Currently, health care occupies an exceptional place in a socially oriented economy. To assess the effective functioning of the health care system, it is necessary to constantly monitor performance indicators that allow you to determine the level of saving the health of the population.
AIM: Determine the degree of effectiveness of health system management based on a comparative analysis of certain target indicators with their actual values.
MATERIALS AND METHODS: An analysis of the indicators contained in the State program of the Arkhangelsk region "Health care development in the Arkhangelsk region" was carried out. The following parameters were chosen as targets: life expectancy at birth; maternal mortality per 100 000 live births; infant mortality per 1000 live births; total fertility rate; number of doctors per 10 000 population; number of average medical personnel per one doctor. Analysis period 20102020. The study is retrospective, descriptive, not randomized. The level of performance was calculated from the ratio of target and actual indicators and their subsequent integration. The analysis of dynamic series for the presence of anomalous values (outliers) was carried out by the Irwin method.
RESULTS: The main indicators that ensure the level of performance are maternal mortality and availability of doctors. The availability of doctors per 10,000 population was significantly higher than the target indicators over the entire time period by an average of 32.8%. The target indicators of maternal mortality were lower than the actual ones on average by 50.1%, which seems to be due to overestimation of the target indicator.
CONCLUSION: Target indicators of health care system performance tend to overestimate against the background of the lack of a clearly defined methodological apparatus for their calculation, which, in most cases, leads to a mismatch between their dynamics and the dynamics of actual indicators, increasing the calculated level of health care system management performance.
Expression of the serotonergic system components in the placenta in various types of preeclampsia
Authors: Bettikher Ofelia A. , Belyaeva Olga A. , Dukovich Albina I. , Vorobeva Olga M. , Tral Tatiana G. , Tolibova Gulrukhsor Kh. , Bart Viktor A. , Kogan Igor Yu. , Zazerskaya Irina E.
Published: March 2023

BACKGROUND: The serotonergic system plays an important role in the formation and development of the feto-placental complex. The study of the expression of the serotonin system components, including placental 5-HT2A (serotonin receptor) and SERT (serotonin transporter), in preeclampsia will create prerequisites for discovering new ways to correct hypertensive pregnancy complications and methods of influencing pregnancy outcomes.
AIM: The aim of this study was to compare the expressions of 5-HT2A and SERT in placental tissue in pure preeclampsia and its combinations with other complications of pregnancy.
MATERIALS AND METHODS: A comparative cohort study was conducted among patients with different preeclampsia phenotypes: preeclampsia (n = 6), preeclampsia and gestational diabetes mellitus (n = 6), gestational diabetes mellitus and superimposed preeclampsia (preeclampsia + chronic arterial hypertension) (n = 6), and normal pregnancy without pregnancy complications (n = 6). The expression of 5-HT2A (Abcam, USA) and SERT (BiossAntibodies, USA) was studied in placenta samples from all study groups by immunohistochemical method. Morphometric analysis was performed using the VideoTest-Morphology 5.2 program (Videotest Ltd., Russia). The database was constructed and statistical processing was performed using Microsoft Excel 2007 (Microsoft Corporation, USA) and the StatTech program v. 2.6.4 (Stattech Ltd., Russia).
RESULTS: The expression of SERT and 5-HT2A is higher in the studied pregnancy complications when compared to the normal one. The relative 5-HT2A expression area in the placenta among the studied nosologies is higher in preeclampsia without gestational diabetes mellitus or in superimposed preeclampsia in combination with chronic arterial hypertension compared to expression in placentas in preeclampsia in combination with gestational diabetes mellitus or in preeclampsia in combination with gestational diabetes mellitus and chronic arterial hypertension (p = 0.02 and p = 0.017, respectively). The relative area of SERT expression is higher in preeclampsia without gestational diabetes mellitus or chronic arterial hypertension and in preeclampsia in combination with gestational diabetes mellitus compared to preeclampsia in combination with gestational diabetes mellitus and chronic arterial hypertension (p = 0.002 and p = 0.012, respectively).
CONCLUSIONS: The highest expressions of 5-HT2A and SERT among the studied preeclampsia phenotypes were found in placentas in preeclampsia without gestational diabetes mellitus or chronic arterial hypertension.
Repeated clinical case of fetal congenital malformation in a family with hereditary short-rib thoracic dysplasia type 3
Authors: Shengelia Margarita O. , Bespalova Olesya N. , Pachuliia Olga V. , Shengeliia Nodari D. , Baldin Alexander V. , Nasykhova Yulia A. , Glotov Andrey S.
Published: March 2023

The article shows the genetic causes of recurrent fetal malformations on the example of a clinical case of hereditary short-rib thoracic dysplasia type 3.
Congenital malformations of the fetus are most often sporadic; however, in rare cases, this pathology can recur in one married couple, and the formation of congenital anomalies during subsequent pregnancy can both have general syndromes and affect various systems and organs.
Short-rib thoracic dysplasia type 3 is a rare genetic disorder with autosomal recessive inheritance. Patients for whom the carriage of pathogenic alleles in genes associated with congenital skeletal anomalies has been confirmed require a detailed clinical examination. Such married couples want expert-level medical genetic counseling with performing additional genetic tests, if necessary. This may clarify the diagnosis, which will determine further tactics for preparing the couple for the next pregnancy on their own or using assisted reproductive technology programs and / or surrogate motherhood.
Chronic kidney disease and pregnancy: an interdisciplinary assessment of gestational risks and complications. A literature review
Authors: Grigoryeva Olesya A. , Bezhenar Vitaly F.
Published: March 2023

Chronic kidney disease represents a heterogeneous group of diseases characterized by changes in the kidneys structure and functions. It significantly increases the risks of adverse maternal and perinatal outcomes. These risks increase with worsening renal dysfunction corresponding to an increase in the degree of proteinuria and arterial hypertension. Anatomical and physiological changes in the kidneys during pregnancy are characterized by dilatation of the pelvicalyceal system, a decrease in systemic and renal vascular resistance, and an increase in the glomerular filtration rate. These clinically significant changes can complicate the diagnosis of the renal dysfunction, as well as its progression. Pregnancy can affect the kidney as it can manifest as declining kidney function, especially in the context of concomitant arterial hypertension and proteinuria, while chronic kidney disease, regardless of the stage, contributes to a higher risk of adverse pregnancy outcomes including preeclampsia, premature birth and fetal growth restriction.
Optimization strategies of pregnancy outcomes include strict control of blood pressure, treatment of hypertension and proteinuria, and prevention of preeclampsia. The latter is difficult to diagnose in pregnant women with chronic kidney disease. Serum markers such as soluble fms-like tyrosine kinase 1 and placental growth factor may aid in definitive diagnosis. The choice of delivery mode in women with chronic kidney disease should be based on common obstetric indications. A multidisciplinary team, including an obstetrician-gynecologist, a nephrologist, an anaesthesiologist and a neonatologist, must focus on preconception medical care, antenatal care and treatment of pregnant women with chronic kidney disease for a successful pregnancy outcome.
The influence of reproductively significant autoantibodies determined in the follicular fluid on the quality of the obtained oocytes and embryos, as well as on the implantation rate in assisted reproductive technology cycles
Authors: Safarian Galina Kh. , Dzhemlikhanova Lyailya Kh. , Kogan Igor Yu. , Niauri Dariko A. , Bespalova Olesya N. , Krikheli Inna O. , Ob’edkova Ksenia V. , Lesik Elena A. , Komarova Evgenia M. , Gzgzyan Alexander M.
Published: March 2023

BACKGROUND: According to reports, the efficiency of in vitro fertilization and intra cytoplasmic sperm injection protocols is decreased in patients positive for various autoantibodies, as opposed to autoantibody negative patients. However, there are contradictory data indicating no autoantibody effect on the outcome of infertility treatment using assisted reproductive technology.
AIM: The aim of this study was to evaluate the embryological outcome and clinical efficiency of infertility treatment in in vitro fertilization and intra cytoplasmic sperm injection protocols in women in the presence of reproductively significant autoantibodies.
MATERIALS AND METHODS: This prospective study enrolled 90 infertile patients undergoing assisted reproductive technology treatment. The follicular fluid obtained on the day of oocyte retrieval was evaluated for a wide autoantibody panel using commercial ELISA kits. The main group (n = 52) included women with autoantibody levels determined in the follicular fluid of more than three standard deviations from the mean values determined among all patients. The comparison group consisted of 38 women with autoantibody levels of less than three standard deviations from all subjects. The intergroup comparative analysis included clinical and anamnestic data, hormonal parameters, ovarian reserve, embryological data, and in vitro fertilization and intra cytoplasmic sperm injection efficiency.
RESULTS: Reliably lower ovarian reserve parameters (anti-Mullerian hormone levels 1.9 (1.4; 4.0) vs. 3.3 (2.2; 6.5) ng/ml; p = 0.005; number of antral follicles 8.5 (6.0; 12.0) vs. 11.0 (9.0; 17.0); p = 0.003) have been noted in the main group relatively to the comparison group. The autoantibodies to thyroid peroxidase and cardiolipin content in the follicular fluid has been shown to be negatively associated with the number of two-pronuclear zygotes, the presence of autoantibodies to aromatase correlating negatively with the fertilization rate. Furthermore, the follicular fluid levels of autoantibodies to thyroid peroxidase (105 IU/ml) and cardiolipin (5.1 IU/ml) are reliably associated with a higher frequency of a suboptimal response to previous controlled ovarian stimulation, a lower incidence of high quality embryos on days 3 and 4 of in vitro cultivation, a decreased number of top-quality blastocysts, and the clinical efficiency of in vitro fertilization and intra cytoplasmic sperm injection programs.
CONCLUSIONS: The presence of reproductively significant autoantibodies is an independent risk factor for reducing the total efficiency of assisted reproductive technology treatment.
To the 90th anniversary of Professor Leonid Andreyevich Susloparov
Authors: Tatarova Nina A. , Darmogray Nikolay V. , Dudnichenko Tatyana A.
Published: March 2023

The article presents the life path of Doctor of Medical Sciences, Professor Susloparov Leonid Andreyevich, his scientific achievements, pedagogical and clinical work.
Aykırı Kültür (Kitap İncelemesi)
Authors: KARAL Sedat
Published: March 2023

Aykırı Kültür (Kitap İncelemesi)

Birmingham Üniversitesi bünyesinde 1964 yılında kurulan, ağırlıklı olarak kültürel çalışmalara odaklanan ve bunu yaparken de anti-elitist bir tavır takınan Çağdaş Kültürel Çalışmalar Merkezi’nin ya da diğer adıyla Birmingham Okulu’nun mezunlarından biri olan Paul E. Willis’in “Aykırı Kültür” (2022) adlı kitabı, Gökben Demirbaş tarafından Türkçeye kazandırılarak Ayrıntı Yayınları’nca yayımlandı. 1960’lı yılların sonu ve 1970’li yılların başlarında İngiltere’de yapılmış iki farklı etnografik çalışmanın bir araya getirilmesinden oluşan kitap, “motorcular”ın ve “hippiler”in dünyasına odaklanmaktadır. Bu nedenle kitap, farklı kültürel dünyalardan elde edilen verileri yorumlayarak analiz eden iki ana bölümden ve ayrıca çeşitli gruplar hakkında etnografik araştırma yapmak isteyenler için bir nevi kılavuz denilebilecek teorik ek bölümden oluşmaktadır. Bu değerlendirme yazısında ilk olarak motorcuların sonrasında ise hippilerin, diğer bir deyişle iki farklı kültürel dünyanın yazar tarafından nasıl sorunsallaştırılıp ele alındığı kitapta sunulan çeşitli gözlemlerden hareketle incelenecek, daha sonra kitabın zayıf ve güçlü yanları üzerinde durulacaktır.
Hipertensión arterial resistente
Authors: Rivera Martínez Wilfredo Antonio , Mejía Cardona Andres Felipe , Valderrama Cometa Luis Alfonso
Published: March 2023

Introducción: La hipertensión arterial resistente es una entidad común que se asocia a accidente cerebrovascular, arteriopatía coronaria y mortalidad por todas las causas asociadas, encontrándose en estudios de carga de la enfermedad en el 1.5%, 2.1% y 1.6%, respectivamente y además se relaciona con un deterioro de la función renal.
Objetivo: Se busca discutir sobre los aspectos más importantes de la enfermedad, partiendo de la definición y la fisiopatología, los criterios para lograr un diagnóstico temprano, específico, usando estudios ampliamente disponibles y finalmente revisar el manejo adecuado.
Resultados: Múltiples factores fisiopatológicos y genéticos contribuyen al desarrollo de la hipertensión arterial resistente. Por tanto, esta puede tener diversos fenotipos clínicos, así mismo como diversos niveles de respuesta al tratamiento antihipertensivo. Pero antes de elegir una terapia farmacológica específica es indispensable realizar el diagnóstico con una técnica de medición de la presión arterial y unas condiciones adecuadas, descartar la presencia de pseudoresistencia o de hipertensión arterial secundaria.
Conclusión: La relación entre la hipertensión arterial resistente con eventos cardiovasculares mayores y el desarrollo de comorbilidades hace necesario hacer énfasis en su diagnóstico y manejo adecuados por un personal multidisciplinario capacitado
Sistema de Creencias Familiares e Infidelidad en Parejas Convivientes de Tarapoto
Authors: Rojas Ramón Ruth Nora , Vecco Giove Melissa Valentina
Published: March 2023

El presente artículo analiza y explica el vínculo entre el sistema de creencias familiares y la infidelidad en parejas convivientes que reciben asistencia en una institución pública de Tarapoto - Perú. El objetivo del estudio fue explorar y dar a conocer la influencia de los sistemas de creencias familiares en las conductas de infidelidad. Este estudio se realizó empleando el método cualitativo. El análisis de resultados de las entrevistas individuales a profundidad a ambos miembros de la pareja estuvo enmarcado en un enfoque sistémico.

De la investigación se obtuvo que existen similitudes entre los miembros de la pareja respecto a sus creencias, lo cual genera una mayor tolerancia hacia la conducta infiel masculina.  Es decir, que hay afinidad en las creencias de varón y mujer sobre los roles de género, el amor, la familia, las diferencias biológicas entre varones y mujeres, entre otros. Las creencias personales, familiares y sociales se encuentran arraigadas y difícilmente son cuestionadas, sino que tienden a ser reforzadas. En tal sentido, la investigación permitió aproximarse a una mayor comprensión de la relación entre el sistema de creencias y la conducta infiel, tanto en varones como mujeres. El presente estudio será de ayuda para conocer en profundidad esta realidad psicosocial, que afecta el bienestar psicológico de las personas.
Propiedades psicométricas de la Escala de Autoeficacia General en universitarios de Lima en tiempos de crisis sanitaria
Authors: Anicama Gómez José Carlos , Talla Biffi Karina Alejandra , Bruno Conza Brunela Bruna , Caballero Calderon Nelly Graciela , Pineda López Carolina Estefany
Published: March 2023

La Escala de Autoeficacia General se ha empleado para evaluar diversas poblaciones alrededor del mundo, puesto que, esta variable es importante para desarrollar comportamientos sociales alternativos a los psicopatológicos. El objetivo: fue obtener las evidencias psicométricas de la Escala de Autoeficacia General. Metodología: 1100 universitarios fueron evaluados con la Escala de Autoeficacia General de Baessler y Schwarzer modificada por Anicama y Cirilo (2012). Resultados: Se halló una distribución normal y coeficientes de correlación ítem-test corregidas mayores a .30. Se identificaron índices de ajuste adecuados para un modelo unidimensional con covarianza de ítems (x2/gl=4.465; GFI=.974; CFI=.973; TLI=.964; RMSEA=.056; SRMR=.0273; AIC=191.329). Asimismo, se hallaron correlaciones inversas con el Cuestionario de Ansiedad Social para adultos (CASO) de Caballo et al. y con la Escala de Estrés ante enfermedades transmisibles APA de Anicama et al. El Alfa de Cronbach y el Omega de McDonald’s tuvieron valores mayores a 0.70. Conclusiones: Este estudio reafirma la validez y fiabilidad psicométrica de la Escala de Autoeficacia General en una muestra de universitarios de Lima.
FOTÓLISE DE GELO DE ÁGUA POR RAIOS-X MOLES E A PRODUÇÃO DE H2O2 DURANTE AS FASES DE IRRADIAÇÃO E AQUECIMENTO
Authors: Oliveira Sergio Pilling Guapyassu de , Da Silva Rita de Cassia
Published: March 2023

Astrophysical water-rich ices are always exposed to ionizing radiation in space, as well as, are exposed to eventual temperature changes. In the laboratory, the studies of such ices allow us to understand their behavior and chemical changes, allowing also the quantification of important physicochemical parameters of the ice. In the present work, a sample of water ice at 12 K was irradiated by soft X-rays in the SGM beamline of LNLS/CNPEM until reaching chemical equilibrium, and then it was heated up to 220 K. Using infrared spectroscopy (IR), we mapped the chemical evolution of the sample and quantified the production of its main product, the H2O2 molecule. The study has implications for the chemistry of star-forming regions as well as cold regions of the solar system.
A Survey on Timelike-Spacelike Involute-Evolute Curve Pair
Authors: BİLİCİ Mustafa
Published: March 2023

This paper concentrates on the requirements of being an integral curve for the geodesic spray of the natural lift curves of spherical indicatrices of the timelike-spacelike involute-evolute curve pair in Lorentz 3-space. In addition, the obtained results were supported by one example.
Digitized and Automated a University Process with Robotic Process Automation
Authors: OLUÇOĞLU Müge , DOĞAN Onur , AKKOL Ekin , KESKİN Burak
Published: March 2023

Due to the changing student demographics and technological advances in research and teaching, both public and private higher education institutions offer services in an increasingly competitive environment. At the same time, the service quality expectations of the stakeholders continue to rise. For these reasons, technology solutions are needed for cost savings, efficiency gains, and improved service delivery. Like many other industries, higher education institutions have processes that can benefit from robotic process automation (RPA). RPA can be used to run student/staff jobs that manage back-office functions. It enables to ease the workload of their employees charged with doing these tasks and improve the user experience for students. This study examines an administrative process carried out at İzmir Bakırçay University. At least one administrative personnel assigned for the business process at the beginning of the research. The process consists of repetitive activities defined by specific rules. It was recommended to improve the process, considering the multitude of human errors and the length of the processing time. At the end of the study, the same process completed within 16 minutes for 240 students without making mistakes. Moreover, 75% of personnel needs were reduced, and 96.97% of the time was saved.
Programming the Measurement System by using VEE Pro to Determine Cyclic I-V Characteristics: Resistive Switching Device Application
Authors: TEMEL Ersin , AKKAYA Abdullah
Published: March 2023

In this study we introduce a simple program for cyclic current–voltage (I–V) measurements for bipolar and unipolar resistive switching devices. This program (Cyclic I-V, CYC-IV) was developed under the Keysight VEE Pro (Visual Engineering Environment Program) software and has a graphical interface. CYC-IV was developed for programming the Keysight B2912 Precision Source/Measure Unit (SMU) for I-V measurement of resistive switching devices in sweep mode. CYC-IV can be used in six different sweep mode. Moreover, the ramp rate, upper and lower limits of bias, cycle delay time and number of cycles easily define by user. Measurement results were visualized in three graphs that can be viewed simultaneously with the measurements.
Agonistic Effects of Deinoxanthin on Tamoxifen Antiproliferative Activity on HER2 Positive Breast Cancer: An In vitro Study on MDA-MB-453
Authors: GÜNAY Nihan , KUZUCU Mehmet
Published: March 2023

A good understanding of the pathogenesis of breast cancer, in which in 2020 an estimated 684,996 women across the world died, plays a vital role in the development of treatment methods. In recent years, estrogen receptor (ER), progesterone receptor (PR), and Epidermal Growth Factor receptor-2 (HER2) expression levels have been substantial prognostic markers.
The combinational therapy approach is the use of two or more active ingredients or methods. The most important benefit of this treatment method is to reduce the development of drug resistance since the probability of the carcinoma being resistant to more than one drug at the same time is low.
Tamoxifen, an estrogen receptor competitive and nonsteroidal drug, has been used for nearly 20 years to treat patients with hormone receptor-positive breast cancer.
Deinoxanthin is a xanthophyll derivative purified from the cell wall of a radiation-resistant bacterium, Deinococcus radiodurans. This xanthine derivative has been shown in some studies to have proapoptotic and antiproliferative effects on some types of cancer.
Within the study's scope, it aimed to increase the effectiveness of Tamoxifen with deinoxanthin. Using the ACTB gene as a reference to investigate the synergistic effect of Tamoxifen and deinoxanthin on the MDA-MB-453 breast cancer cell line; Expression levels of BAX, CASP-3, BCL-2, and HER2 genes were examined by RT-qPCR method. The ELISA method determined the amounts of BAX, CASP-3, BCL-2, and HER2 proteins and compared them with RT-qPCR results. It was determined that the antiproliferative effect of Tamoxifen on the HER2 positive breast cancer cell line was increased with the combination of deinoxanthin.
A prospective study of effect of delayed cord clamping in term babies as well as in preterm babies
Authors: Priya Shaloo , Biswas Arati , Rani Saba
Published: March 2023

Background: Delayed cord clamping (DCC) is lengthening the time between delivery of newborn and the clamping of their umbilical cord. It is usually performed 25 seconds to 5 minutes after birth, which increases the  newborn’s iron storage, vital for healthy brain development.
Methods: This prospective observational study was conducted on 100 late preterm and term newborns delivered in the obstetrics and gynaecology department of Calcutta national medical college and hospital, Kolkata over a period of one and half years (March 2019 to August 2020). The umbilical cord was clamped between 60 to 90 seconds after birth of baby. Babies’ weight measurement and blood investigations (Haemoglobin (Hb) level, total serum bilirubin (TSB) and serum ferritin) were performed at birth, after 24 hours of birth and at 6 weeks of age.
Results: In this study after DCC, there is significant increase in Serum Ferritin levels after 24 hours and 6 weeks as compared to the birth values. As far as the values of TSB and hemoglobin is concerned, the values first showed increment after 24 hours and then decreased at 6 weeks, which is statistically significant (p=0.001). Birth weight which first decreased after 24 hours, increased at 6 weeks. None of the babies needed blood transfusion during the study period. Out of 100 cases, 9 were admitted in NICU and required phototherapy which was not directly associated with umbilical cord clamping time or bilirubin values at birth.
Conclusions: Based on the results of this study, we conclude that newborns with DCC had statistically significant higher levels of Hb and ferritin after birth. This may ensure better iron status throughout infancy along with reduced need of blood transfusion and its related adversities. Delaying cord clamping seems to be beneficial in late preterm and term neonates without causing additional morbidities in the first 6 weeks of life.
Maternal mortality: a 6-year experience of the triumph achieved and the hardships faced in a tertiary care centre of Chhattisgarh
Authors: Nagaria Tripti , Naik Smrity , Punshi Himani
Published: March 2023

Background: Maternal death reflects the health care system of a country and majority of them are preventable. India’s MMR declined to 103 in 2017-19. However, SDG3 targets of reducing MMR to 30 is still far and a lot has to be done to achieve it.
Methods: In this retrospective study, a 6-year analysis of the trends of maternal mortality for age group, booking status, parity, referral status, obstetric and non-obstetric causes of maternal death and the challenges faced in their management have been observed. The data obtained was tabulated and analysed for trends in maternal mortality over past 6 years.
Results: Hypertensive disorders of pregnancy remains the major obstetric cause of death with significant decline in septic abortions. Liver and respiratory disorders have surpassed anemia as the major non-obstetric cause of death. A gradual shift from pulmonary edema to emergence of AKI and CVA as the immediate cause of death has been observed.
Conclusions: Knowledge about fluid therapy, aggressive resuscitative measures and critical care management resulted in decline in cases of pulmonary edema. Improvement in anaemia at the cost of medical disorders was seen due to improved coverage of Iron folic acid prophylaxis, deworming and easy availability of blood banks. Trainings for ANMs and medical officers, early detection of warning signs, timely referrals, adolescent health clinics, improved booking status and increased institutional deliveries have led to reduction in MMR. Regular auditing of each maternal mortality can improve the scenario.
Vaccine hesitancy: a major hurdle even among women healthcare workers
Authors: Kamath Anusha , Yadav Anita , Baghel Jyoti , Mundle Shuchita
Published: March 2023

Background: One of the major threats to the COVID-19 vaccines rollout and successful mitigation of the pandemic is vaccine hesitancy. Vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. The COVID-19 vaccine trials generated very limited data on safety and efficacy for pregnant women and children, since pregnant women were not included in any of the phase I/II or III trials. Hence the authors made an attempt to understand vaccine hesitancy among women healthcare and frontline workers with a focus on vaccination during pregnancy and lactation.
Methods: The recruitment of participants was done by purposive snowballing technique over a period of 15 days. The data collection was done through an online questionnaire generated with the help of Google forms. After excluding women who exceeded the age criteria and incompletely filled questionnaires, 101 responses were considered for analysis. Data analysis was done using SPSS software version 22.
Results: From a total of 101 responses for analysis, 26% had comorbidities. Of the 9 women who were pregnant, majority was in the second trimester (55.6%). Majority of the women, 63.6% had been feeding for more than six months. Of the respondents who had refused vaccination, most wanted to wait longer for further research on safety and efficacy (47.8%).
Conclusions: The reasons for pregnant women to decline COVID-19 vaccination during pregnancy even if the vaccine were safe and free were that they did not want to expose their developing baby to any possible harmful side effects, would like to see more safety data among pregnant women and unclear recommendations from the healthcare provider. As HCWs are envoys for evidence based medical interventions, and they are critical in promoting vaccine acceptance amongst the general population, it is important to design effective strategies to improve vaccine acceptance amongst this population.
Comparison study of metformin versus insulin in the treatment of gestational diabetes during pregnancy
Authors: Nanda Pratibha , Kabra Shashi L. , Madaan Richa , Priya
Published: March 2023

Background: Gestational diabetes was traditionally treated with insulin. Metformin is a peroral drug used worldwide in the treatment of type 2 diabetes and also in a few studies on patients with gestational diabetes. This study aimed to analyze and compare insulin and metformin in the treatment of gestational diabetes and to compare their effects on the pregnancy outcomes.
Method: This comparative prospective observational study was conducted at Deen Dayal Upadhyay Hospital, New Delhi, a tertiary care teaching hospital. The data was collected over a period of 15 months (April 2021 till June 2022). So pregnant females in the age group 18-45 years with 20-30 weeks period of gestation, are diagnosed with gestational diabetes as per the diabetes in pregnancy India (DIPSI). The study group was divided into 2 groups of 40 each, one receiving oral metformin and the other group receiving insulin for treatment.
Results: Metformin was found to be a better drug in controlling blood sugars vis a vis insulin in our study. GDM patients controlled on insulin were found to be associated with; higher weight gain, higher incidence of neonatal hypoglycemia, hyperinsulinemia and higher and longer ICU admission
Conclusions: Metformin was better in controlling blood sugar in GDM than insulin, with better neonatal outcome.
Clinicopathological correlation of abnormal uterine bleeding according to PALM-COEIN classification in reproductive age group in a tertiary care center, North India
Authors: Rattan Akshita , Gulia Manish , Gulia Sandhya Panjeta , Joshi Neharica , Kaur Satwant
Published: March 2023

Background: AUB is a common problem encountered by women of reproductive age group with increased risk during perimenopausal period. International Federation of Gynecology and Obstetrics (FIGO) has designed a new classification system PALM-COEIN in order to standardize the causes of AUB. Aims and Objectives were to stratify causes of AUB in women of reproductive age group in context to PALM-COEIN classification system. To establish a clinico-pathological correlation among causes of AUB taking aid of radiology wherever required.
Methods: All women of reproductive age group presenting with complaints of AUB in department of gynecology from January 2018 to December 2021 were included in the study. The cause were classified based on PALM-COEIN classification both clinically and histopathologically. Radiological investigation was carried out wherever required.
Results: Total 560 women of reproductive age group were registered. Majority 321 (57.32%) women were between 41-50 years of age and commonest complaint was heavy menstrual bleeding in 401 (71.60%). PALM and COEIN groups accounted for 40% and 60% respectively. Among structural causes, leiomyoma was the commonest cause 153 (27.32%) of AUB whereas among the functional causes most common was endometrial 188 (33.57%). The clinico-histopathological correlation was statistically significant in cases of AUB-P, AUB-A, AUB-O and AUB-E.
Conclusions: The PALM-COEIN classification system helps to understand the causes of AUB and gives simpler terminology, diagnosis and investigations of the causes of AUB and offers better patient management. It can provide better means of quality assurance and appropriateness of treatment.
Gender identity disorder: role of the gynecologist
Authors: Kondapalli Saraswathi , Gopalan Ushadevi , Karthika
Published: March 2023

Gender dysphoria refers to distress that is caused by a sense of incongruity between an individual's self-identified gender and natal sex. Over 1.4 million adults are identified as transgender. Transpatients face many barriers when it comes to basic health needs including education, housing, and health care. Because of these barriers, many patients do not receive proper health care that they need. Additionally, because of certain high-risk behaviours as well as long-term hormonal therapy, transpatients have different routine health care needs that should be addressed in the primary care setting. Diagnosis is made in accordance with the diagnostic and statistical manual of mental disorders and treatment first involves psychiatric therapy, which can help determine a patient's true goals in regards to achieving gender identity. Patients who wish to undergo transition to the opposite sex must undergo a supervised real-life test and often are treated with hormonal therapy to develop physical characteristics consistent with their gender identity. Many of these individuals have undergone, or plan to undergo, gender-affirming surgery. While not all gender-affirming surgeries are provided by obstetricians and gynecologists (OBGYNs). It is a multi-disciplinary team which involves psychiatrist, endocrinologist, gynecologist and plastic surgeon. OBGYNs are uniquely skilled to perform certain gender-affirming surgeries such as hysterectomies, bilateral oophorectomies. In this case report we discuss the medical and surgical options available for the transgender population. In addition, it also highlights the role of gynecologists in having care for this population, and should be knowledgeable about the general principles of transgender health.
A case of caesarean scar ectopic pregnancy presented as post medical termination of pregnancy with cervical hematoma
Authors: Sonawane Pundalik , Swami Khushboo , Parulekar Aditi
Published: March 2023

A 36 years old woman (P2L2MTP2 with previous 2 LSCS) came with complaints of pain in abdomen and bleeding per vaginum with severe anaemia. Patient had a history of surgical MTP done 3 weeks back. USG was suggestive of hematoma at the isthmico-cervical junction. A provisional diagnosis of post-surgical MTP ruptured/perforated uterus with hypovolemic shock was made. A laparotomy was carried out. Intraoperatively, the isthmico-cervical junction was ballooned up and after incision over the isthmic scar of previous LSCS a large blood clot was retrieved. Histopathology of the scar tissue confirmed the diagnosis of scar ectopic pregnancy. In all cases of previous caesarean scar uterus, ultrasonography must be performed before first trimester surgical MTP to rule out the caesarean scar ectopic pregnancy. If USG is not performed preoperatively and with persistent postoperative vaginal bleeding, then always rule out the partial disruption of unknown caesarean scar ectopic pregnancy by USG and serum Beta hCG levels.
Association between BMI and plantar fasciitis among hospital staff in a selected hospital of Dhaka city
Authors: Al-Ansary Mohammad Yaqub , Rahman Mohammad Habibur , Kakuli Samena Akter , Kabir Mohammad Feroz , Ali Mohammad Ershad
Published: March 2023

Background: Plantar fasciitis described as the inflammation of planter fascia, particularly hampering an individual’s daily living activities related to ankle and foot that impact on quality of life. The study aimed to identify the association between BMI and planter fasciitis among hospital staff in a selected hospital in Dhaka city.
Methods: A descriptive cross-sectional study.
Results: Mean±SD age of the respondents were 29.03±6.56 years. Among the hospital staff, the majority of the respondents were nurses 31.25%, 13.02% respondents were physician and 2.07% of respondents were physiotherapists, others were pharmacist, lab technician, administration staff, cleaner, security, information technologists and officers from the maintenance department of selected hospital. According to BMI scale the 65% were normal weight, 23% were overweight and only 12% were obese. In this study respondents who have only two family members, have strong relationships with BMI (p<0.00). Besides, the duration of work has a slightly significant relation with BMI (p<0.03) and BMI has a strong impact on level of pain (p<0.01) among respondents.
Conclusions: The recommendation for risk variables that have a strong correlation with plantar fasciitis is the working status, duration, and BMI.
Smartphone based 12 lead ECG as decision support in STEMI: a prospective, cross sectional study, non-randomised, single blinded and single-center study
Authors: Mahajan Sahil , Garg Salil , Sharma Richa , Singh Yogendra , Chandola Nitin , Bhatia Tanuj , Bansal Basundhara
Published: March 2023

Background: When a severe heart attack called a ST segment elevation myocardial infarction (STEMI) is not treated, heart muscle is killed per minute. Hence, early detection and treatment are essential for patient survival. The objectives of this study were to evaluate the accuracy for detection of (a) the ST elevation myocardial infarction of smartphone 12 lead ECG system in comparison to 12 lead gold standard hospital ECG machine; and (b) classification of STEMI in smartphone ECG and hospital ECG.
Methods: This prospective, cross sectional study, non-randomised, single blinded and single-center study was carried out at Shri Mahant Indresh Hospital (SMIH), Dehradun, Uttarakhand, India from 30 May 2022 to 17 January 2023. All patients (n=154) with chest pain, shortness of breath, palpitation under the observations before and after the Percutaneous coronary intervention (PCI) like Coronary angioplasty, bypass surgery were enrolled from Critical care unit (CCU) and intensive critical care unit (ICCU).  
Results: Mean age (SD) was 53.90±11.7 years. The male gender (83.12%) shows the maximum frequency than female gender. True positive cases derived from confusion matrix for 12 lead standard ECG and smartphone ECG in comparison to cardiologist diagnosis was 113 as compared to 129 from 12 lead Gold standard. Sensitivity of smartphone Spandan ECG (87.5%) was comparable to gold standard 12 lead ECG (98.4%). And, specificity and PPV of smartphone Spandan ECG was recorded to be better than gold standard 12 Lead ECG. STEMI was detected correctly in 132 (86.3%) cases and 141 (80.85%) cases by smartphone ECG and 12 lead Gold standard, respectively.
Conclusions: Spandan ECG device scored a high accuracy and sensitivity. The overall accuracy of smartphone ECG in detecting the STEMI increased by 5.45%, i.e. the significance rise in accuracy of computer interpretation when compared to the cardiologists’ diagnosis.
A study to explore patterns and factors of depression, anxiety and stress among students preparing for competitive exams in central India
Authors: Pachole Neeti , Thakur Aditya , Menon Manish , Peepre Kunal
Published: March 2023

Background: Depression, stress and anxiety among students is being increasingly recognized as a major mental health problem. Depression is a common but grave mood disorder. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children. Objectives of current study were to explore the level of depression, anxiety and stress and to identify various factors associated with it.
Methods: A descriptive, cross-sectional study on 400 students preparing for competitive exams, using a questionnaire having socio demographic profile and DASS 21 scale was carried out. Then data was entered in MS excel and SPSS Software was used for relevant inferential statistical tests of associations.
Results: 65.8 % of participants were less than 18 years of age and 57.3 % were males.20.3 % of students were found to be having moderate depression, 8.8 % having severe depression, 17.8 % having moderate anxiety, 27.3% having severe anxiety, 14.8 % having moderate stress, 12 % having severe stress. Stress was found to be significant in females and those having more than 2 siblings. Significant anxiety was found in those having non supportive teachers. Significant depression was found in those having non supportive teachers and parents, those who sleep for less than 6 hours and those spending less than 2 hours on study.
Conclusions: Study highlighted common factors leading to depression anxiety and stress among students. Parents and teacher are recommended to develop proper communication and be aware of this problem.
Monophasic synovial sarcoma of the ethmoid sinus
Authors: Chowdhary Stuti , Sekar Raghul , Saxena Sunil Kumar , Srinivas Bheemanathi Hanuman
Published: March 2023

Sino-nasal synovial sarcomas are rare mesenchymal tumours, most arising primarily from the paranasal sinuses. Very few have been described with an extension to the nasal cavity. Due to a range of non-specific symptoms and local aggressiveness, diagnosis tends to be confusing. Here we describe a case of a primary sino-nasal monophasic synovial sarcoma, diagnosed by histopathology and treated by excision and adjuvant radiation therapy. On follow-up, the patient had minimal residual disease and was further offered revision surgery and chemotherapy. She declined surgery and received chemotherapy, and remains symptom-free to date. A wide range of diagnoses should be considered for nasal masses since all tissue types coexist in this region.
Do-it-yourself aligners – safe, cheaper option or hazardous gamble?
Authors: Vishnupriya TR  , Attri Sonal , Joshi Divya , Sharma Prashant , Misra Vaibhav , Yadav Ashish
Published: March 2023

: Online businesses that actively promote DIY (Do it yourself) aligners and DIY braces on social media have caused a significant shift in patient attitudes toward orthodontic treatment in particular.

With the development of 3D printing and aligner technology, DIY orthodontics made the transition to home aligners/DIY aligners, in which patients were asked to send dental impressions on a preselected tray or have their homes scanned by non dental professionals, who then made the appropriate aligners without undergoing a clinical and radiographic evaluation by a qualified orthodontist

To conduct a survey between general dental practitioner and orthodontists assessing the esthetic outcomes of pre and post orthodontic treatment photographs posted by DIY aligner companies in their website.

15 random pre and post treatment photographs posted by DIY aligner companies for their promotion in their websites were chosen. Also, 15 random pre and post treatment photographs were chosen from professionals. These photographs were jumbled and a comparative survey to assess the esthetic perception of 110 general practitioners and 110 orthodontists with the help of Likert’s scale was created and sent via Google form to them.

Descriptive statistics was obtained from google form; the results obtained were statistically analysed with Chi-Square test. Likert’s scale favoured the photographs of treatment rendered by Professionals and were considered as best.

Although, DIY aligners may sound attractive and cost effective, when compared to the therapy provided by orthodontists, it causes substantial and permanent damage to the tooth and gums, as well as being cosmetically unappealing.
Modified bracket holder with magnifying lens: A precise bracket positioner
Authors: Balakrishnan Priya , Shashikumar M Balasubramanyam  , Prabhu Praveen Kumar , Naik Roopak D
Published: March 2023

Awell finished orthodontic case is a result of precise bracket positioning during initial bonding. Orthodontists strive for accurate positioning of brackets so that we can avoid / minimize finishing arch wire bends. During the Bonding procedure, placing the bracket on tooth surface and then adjusting it to ideal position is time-consuming, also bracket displacement will reduce the bond strength. Therefore, to avoid these drawbacks this modified bracket holder with magnifying lens gives magnified image of tooth surface with precise visibility, so that bracket placement can be accurate according to the tooth contour with respect to mesio –distal and vertical position of tooth.
The effect of sintering time on the tribological properties of automotive brake pads
Authors: AKBULUT Furkan , MUTLU İbrahim
Published: March 2023

In this study, the effect of sintering temperature on the physical, chemical and tribological effects of sintered automotive friction materials was investigated. Using the powder metallurgy method, 3 different samples were produced with the codes A1, A6 and A11. Mixing, pressing and sintering processes were applied respectively as production steps. Mixing time is 90 minutes, speed is 15 rpm. The pressing pressure is 250 MPa and the duration is 1 min. The sintering temperature was 800 °C and the sintering time was 1, 6 and 11 hours, respectively. The sintering process was carried out in the sintering mold using Argon gas. As the sintering time increased, it was observed that there was an increase in the time-dependent friction coefficients of the samples. Increasing the sintering time also increased the density of the samples. As the sintering time increased, the gap in the sample decreased, as it provided better bonding of the dustsers.
Klasyczna filozofia prawdy a koncepcja wiedzy obiektywnej Karla R. Poppera
Authors: Kowalczyk Stanisław
Published: March 2023

Artykuł składa się z dwóch części. Pierwsza część traktuje o koncepcji prawdy klasycznej filozofii chrześcijańskiej św. Augustyna i św. Tomasza z Akwinu, którzy podają definicję prawdy jako adaequatio ludzkich intelektualnych sądów i rzeczy. Błędne interpretacje prawdy są konsekwencją lekceważenia jednego elementu prawdy: przedmiotu wiedzy – rzeczy (idealizm filozoficzny) lub podmiotu wiedzy – działania umysłu (sensualizmu epistemologicznego). Według filozofii klasycznej prawda jest nie tylko obiektywna, ale także stała i uniwersalna. Zwolennicy marksizmu, liberalizmu i postmodernizmu akceptują relatywizm epistemologiczny i aksjologiczny. Druga część artykułu wyjaśnia pojęcie obiektywnej wiedzy Karla Poppera. Odrzuca on epistemologię neopozytywizmu i skrajnego racjonalizmu, ale proponuje nadkrytyczną teorię wiedzy obiektywnej. Proponuje również metodę prób i błędów w naukowym poszukiwaniu prawdy. Popper wyróżnia trzy światy: rzeczy fizyczne, świadomość człowieka i obiektywne idee/wartości. Obiektywna wiedza jest możliwa tylko w ostatnim świecie, ale nie jest pewna.
Digital Platform, Financial Literacy and Motivation on Generation Z's Decision to Invest in Islamic Stocks: A Structural Equation Modelling Analysis
Authors: Fitriyah Any Tsalasatul , Rahmawati Naili
Published: March 2023

This study aims to determine the relationship between the measurement and structural models of digital platform, financial literacy, motivation, and Generation Z's decision to invest in Islamic stocks. Furthermore, this study uses Structural Equation Modeling (SEM) analysis and involves more than two variables, with 123 respondents from West Nusa Tenggara, Indonesia, who actively invest in Islamic stocks, providing accurate information through multivariate analysis. The study found that digital platforms and motivation have a significant impact on Generation Z's decision to invest in Islamic stocks, while financial literacy has an insignificant effect. However, the analysis results indicated that financial literacy has indirectly motivated them to invest in these types of stocks through motivation. This suggests that digital platforms and motivation play a crucial role in investment decisions. Therefore, service providers need to continuously develop digital applications as transaction tools to cater to the needs of Generation Z. Additionally, improving financial literacy is crucial to increasing people's investment skills, even though it may not directly affect investment decisions.