bluuebunny/crossref_metadata_2025 huggingface dataset:
Ammonia and the Fertiliser Industry: The Development of Ammonia at Billingham
Authors: Brightling John
Published: January 2018

It is over 100 years since the Haber-Bosch process began in 1913 with the world’s first ammonia synthesis plant. It led to the first synthetic fixed nitrogen, of which today over 85% is used to make fertiliser responsible for feeding around 50% of the world’s human population. With a growing population and rising living standards worldwide, the need to obtain reliable, economic supplies of this vital plant nutrient for crop growth is as important as ever. This article details the historic background to the discovery and development of a process “of greater fundamental importance to the modern world than the airplane, nuclear energy, spaceflight or television” (, ). It covers the role of the Billingham, UK, site in developing the process up to the present day. The technology was pioneered in Germany and developed commercially by BASF. In 1998 ICI’s catalyst business, now Johnson Matthey, acquired BASF’s catalytic expertise in this application and now Johnson Matthey is a world-leading supplier of catalyst and technology for ammonia production globally.
Cement reinforcing and toughening agent microcrystalline brownmillerite: preparation and hydration
Authors: Cheng Xiaowei , Yang Yongsheng , Zhang Chunmei , Li Zaoyuan , Guo Xiaoyang
Published: January 2018

As one of the basement phases of cement, the performance of microcrystalline brownmillerite (MB) has attracted attention for a long time. Brownmillerite and MB were prepared using different raw meals and the effects of MB on the mechanical and hydration properties of cement after replacing cement with MB at 0%, 2%, 4%, 6%, 8% and 10% by weight at a constant water/binder ratio of 0·44 (25°C) were investigated. The results showed that the optimum temperature for the preparation of brownmillerite was 1350°C (held for 100 min). The addition of MB improved the compressive strength of cement. Specimens with 4 wt% MB (M4) had the highest compressive strength and the tensile strength and toughness of M4 specimens were better than those of specimens without MB (M0). In addition, MB prepared using calcium carbonate (CCMB; elastic modulus 3150 MPa) showed better mechanical properties than MB prepared with calcium hydroxide (CHMB; elastic modulus 4002 MPa) and calcium oxide (COMB; elastic modulus 3765 MPa). A model of the strength enhancement effect of MB on a cement matrix was established. Heat of hydration test results showed that the normalised heat flow of M4 was smaller than that of M0 and the cumulative heat of mortars was in the order M0 (160·29 J) > M4 (154·07 J, COMB) > M4 (152·25 J, CHMB) > M4 (151·98 J, CCMB).
Energy benefits of cement-based plaster containing hybrid phase-change material
Authors: Kheradmand Mohammad , Azenha Miguel , Castro-Gomes João Paulo , Aguiar Jose Luis Barroso de
Published: January 2018

This paper reports an experimental study regarding the energy-saving potential of an innovative concept of thermal energy storage, which consists of embedding three types of phase-change material (PCM) into a cement-based mortar for plastering the inside walls of buildings. The so-called ‘hybrid phase-change material mortars’ can enhance energy saving when compared with single PCM mortars. They increase the range of melting temperatures and enthalpies, thus providing a more staged and progressive energy exchange. The experimental programme comprised two hollow boxes, one internally rendered with hybrid mortar and the other with a reference mortar without PCM. They were then externally subjected to realistic daily winter temperature profiles. The prototypes were internally equipped with a heater programmed to keep the inside of the boxes at a comfortable room temperature. The energy consumption in the box rendered with hybrid mortar was nearly 20% less than that of the box rendered with standard mortar. The potential cost savings of hybrid PCM mortars for residential buildings are also discussed.
Offshore monopile in the southern North Sea: Part I, calibrated input sea state
Authors: Edesess Ariel J. , Kelliher Denis , Borthwick Alistair G. L. , Thomas Gareth P.
Published: January 2018

Safe, reliable access is an essential precondition for the successful maintenance of offshore wind farms. Access from vessels to wind turbines depends on the severity of the sea state in the vicinity of the turbine support structure. This paper presents a validation of a numerical boundary condition developed to reproduce the seasonal sea state at Teesside Offshore Wind Farm, off the coast of the UK. The boundary condition, called customSpectrum, was derived from wave energy spectra obtained by analysis of existing field measurements of wave free-surface displacement at the wind farm site and implemented in OpenFoam, the open-source computational fluid dynamics library. OpenFoam was then used to simulate typical spring, summer, autumn and winter sea states as uni-directional waves. Predicted surface elevations and significant wave heights were found to be in agreement with in situ buoy data, thus validating the OpenFoam model. Satisfactory agreement was achieved between analytical and numerically predicted spectral density functions for the horizontal and vertical water particle velocity components. It was found that the wave activity at Teesside is uni-modal in spring and autumn, and bi-modal in summer and winter. Extending the procedure to multi-directional waves in crossing seas is recommended.
Understanding Global Volatility
Authors: Londono Juan M. , Wilson Beth Anne
Published: January 2018

In this note, we identify a global component of equity option-implied volatilities and address two questions: What are its fundamental drivers? And, given these drivers, are recent levels of volatility unexpectedly low?
Isolation and cultivation of human mandibular osteoblasts v1
Authors: Sielker Sonja , Jung Susanne , Kleinheinz Johannes
Published: January 2018

Isolation and cultivation of human mandibular osteoblasts.
Migrating Servers, Elusive Users: Reconfigurations of the Russian Internet in the Post-Snowden Era
Authors: Ermoshina Ksenia , Musiani Francesca
Published: January 2018

In response to the growing censorship of their national Internet, Russian users, content producers, and service providers have developed several resistance tactics. This paper analyzes these tactics with particular attention paid to their materiality. It first addresses the different levels of Internet “governance by infrastructure” in Russia, then focuses on the different tactics of individual and collective resistance, and concludes by discussing how forms of control enacted at different levels of infrastructure are reconfiguring the geopolitics of the Russian Internet.
Aspectos Místicos e Científicos Acerca do Uso do Sangue em Diferentes Culturas da Antiguidade e na Contemporaneidade
Authors: Lemos Izabel Cristina Santiago , Sousa Jéssica Pereira de , Correia Denise Bezerra , Lima Junior Luiz De Beltrão , Kerntopf Marta Regina , Fernandes George Pimentel
Published: January 2018

Acerca da utilização do sangue em diversas culturas e etnias desde tempos remotos é notório que este fluido não tem sua importância somente em práticas medicinais, mas também em rituais religiosos. O objetivo do presente estudo é realizar levantamento bibliográfico acerca do uso do sangue em diferentes culturas da antiguidade e descrever o atual uso do sangue como agente terapêutico. O estudo é uma revisão narrativa/ clássica de literatura, em que foi consultada a Biblioteca Virtual de Saúde - BVS, utilizando as bases de dados Medline; Lilacs, Wholis e PAHO. Usando os descritores em Ciências da Saúde - DeCS: História da Medicina; Civilização; Religião e Ciência; Egito; Mundo Grego; Mundo Romano; Mundo Árabe; Medicina Tradicional Chinesa e Sangue. Deste modo, fica claro que o uso do sangue por civilizações antigas esteve relacionado às tradições religiosas, sendo compreendida sua relação direta com a vida humana, embora desconhecidas suas propriedades e composição. Ainda hoje alguns povos guardam esses traços históricos na incorporação de práticas cotidianas relacionadas ao uso do sangue. Conclui-se que esse fluido já foi e continua sendo empregado, em diversas práticas culturais, sendo o objeto de estudo de suma importância para a medicina contemporânea, como evidenciado pelo procedimento de hemotransfusão e de análises laboratoriais.Palavras-chave: Sangue. Religião e Ciência. Conhecimentos. Atitudes. Prática em Saúde.AbstractRegarding the use of blood in various cultures and ethnic groups since ancient times is well known that this fluid is important not only in medical practices, but also in religious rituals. The aim of this study is to accomplish a literature review about the use of blood in different antiquity cultures and describe the current use of blood as a therapeutic agent. The study is a narrative/classical literature review, which Virtual Health Library (VHL) was consulted, using the “databases” Medline; Lilacs Wholis and PAHO and the descriptors in Health Sciences (Decs): Historyof Medicine; Civilization; Religion and Science; Egypt; Greek world; Roman world; Arab world; Traditional Chinese Medicine and Blood. Thus, it becomes clear that the use of blood by ancient civilizations was related to religious traditions, being understood its direct relationship to human life, yet unknown its properties and composition. Even today some people keep these historical traces when incorporation their everyday practices related to the use of blood. It is concluded that this fluid has been and continues to be used in diverse cultural practices, being an important object of study for contemporary medicine, as evidenced by blood transfusion procedure and laboratory analysis.Keywords: Blood. Religion and Science. Health Knowledge. Attitudes. Practice
Nivel de actividad física cardiosaludable en Educación Física en educación primaria: expectativas y algunas evidencias
Authors: Moral Moreno Luis
Published: January 2018

El preocupante nivel de sedentarismo infanto-juvenil en España nos anima a identificar posibilidades y proponer alternativas que permitan revertir esta situación. El estudio transversal ex post facto, retrospectivo y comparativo consistió básicamente en identificar y comparar el nivel de actividad física (AF) alcanzado en Educación Física por 43 niños y 37 niñas estudiantes de 6º de Primaria (11,86±0,34 años) aleatoriamente seleccionados de 26 centros de la Comunidad de Madrid, según el nivel recomendado.Para el análisis de la AF, se registró de forma continuada la frecuencia cardiaca (FC) en las clases de EF de una semana escolar mediante monitores Polar®, derivando de dicho registro la cantidad de tiempo invertido en un esfuerzo de ≥50% FC de reserva (FCres) y equivalente a una AF cardiosaludable de moderada a vigorosa intensidad (AFMV). Los principales resultados del análisis estadístico, cuyo nivel de significación se estableció en p<0,05, mostraron que los sujetos acumularon en AFMV un promedio de tiempo equivalente al 21,3±18,1% del tiempo de EF programado siendo similar en los niños, 21,1±18,9%, y en las niñas, 21,5±17,5% (p=0,77). En la literatura se observa una gran diversidad de resultados. No obstante, nuestros hallazgos son similares a los informados en algunos estudios que, como el nuestro, muestran que el nivel de AF alcanzado es inferior al recomendado: ≥50% del tiempo de EF. Los resultados muestran que los niños y niñas de la muestra invirtieron en AFMV una similar proporción de tiempo de EF, un nivel de AF que, además, es considerado insuficiente para generar beneficios en la salud cardiovascular.
Impacto de un programa de actividad motriz con funciones ejecutivas fortaleciendo el desarrollo integral del niño
Authors: Garcia Fernandez David Arnoldo , Chávez Valenzuela Maria Elena , Cruz Chávez Concepción , Guedea Delgado Julio Cesar , Velázquez Saucedo Gabriela , Zubiaur González Marta
Published: January 2018

La presente investigación, consistió en analizar el impacto de la aplicación de un programa de actividad motriz vinculado con funciones ejecutivas, con la finalidad de contribuir al desarrollo de la cognición, funciones ejecutivas, motricidad, lectura, escritura y matemáticas. La muestra se conformó por 66 niños (35 grupo experimental y 31 grupo control) con un desarrollo normal y edades comprendidas entre 5.2 a 6.9 años, la media fue 6.2 ± 054, que cursaban tercero de educación infantil y primero de primaria de una escuela pública de la ciudad de León, España. Para desarrollar el programa, los niños elaboraron sus materiales y sus padres los apoyaron en el diseño de los materiales complejos. El programa se implementó en 45 sesiones 2 por semana, con una duración de 60 minutos cada una, durante 6 meses, siendo trascendental que una semana al mes los padres de familia participaban en la clase. Los instrumentos utilizados fueron: Escala de Desarrollo Merril Palmer Revisada, Test NEPSY II, Cuestionario de Madurez Neuropsicológica Infantil, Batería de evaluación del movimiento para niños-2 y la prueba de Competencia Matemática Básica. Los resultados más relevantes indican, que en el grupo experimental pre-test y pos-test existen diferencias significativas en: cognición motricidad, funciones ejecutivas, escritura y lectura con una p<0.05. Entre los grupos control y experimental pos-test se encontraron diferencias significativas p<0.05 en: cognición motricidad, funciones ejecutivas, escritura y lectura. En conclusión: enfatizando la importancia de crear programas motrices vinculados con las funciones ejecutivas con la finalidad de fortalecer la formación integral del niño.
Revisión sistemática sobre hábitos de actividad física en estudiantes universitarios
Authors: Moreno-Arrebola Rubén , Fernández-Revelles Andrés Bernardo , Linares-Manrique Marta , Espejo-Garcés Tamara
Published: January 2018

El presente trabajo realiza una revisión sistemática de la literatura, de artículos sobre hábitos de actividad física de estudiantes universitarios de diferentes países. Concretamente con este trabajo damos respuesta a interrogantes como: ¿Es un tema novedoso y por el cual se muestra interés?, ¿Qué instrumentos se utilizan con más frecuencia para medir los hábitos de actividad física? ¿En qué países se ha estudiado este tema?, ¿Coinciden los resultados y conclusiones de las investigaciones estudiadas? ¿Qué factores se estudian trasversalmente junto a los hábitos de actividad física en esta población?, ¿Existen diferencias entre sexos? Se ha seguido un procedimiento de revisión sistemática, en la Web of Science (WOS), extrayéndose estudios en base a unos criterios de selección determinados. Tras aplicar los criterios de selección, resultan un total de 10 investigaciones objeto de revisión en profundidad. Es un tema novedoso y con una tendencia ascendente en los últimos años. El instrumento más utilizado en los estudios revisados es el IPAQ (International Physical Activity Questionaire). Con respecto a los hábitos de actividad física de los estudiantes universitarios son débiles, y se han de potenciar.  Por último, con respecto al sexo, la mayoría de las investigaciones obtienen diferencias significativas entre hombres y mujeres, siendo los hombres los que tienen mayor apego a la actividad física.
Relación entre los niveles de actividad física y los rasgos definitorios de roles de situaciones de agresión-victimización en escolares
Authors: Sanz Martín Daniel , Vinuesa Matesanz Rubén
Published: January 2018

Existe una preocupación social por los bajos niveles de actividad física de la población, en especial de los niños. Por otro lado, son habituales las conductas violentas de agresión-victimización en los centros escolares, existiendo rasgos definitorios personales en función del rol alcanzado. Por eso, se diseñó un estudio con dos finalidades: 1) identificar si hay diferencias entre el nivel de actividad física, las percepciones de ser considerado fuerte, cobarde, que pega, víctima y de empezar las peleas, en función del sexo y curso del alumnado; 2) conocer el tipo de relaciones existentes entre los niveles de práctica de actividad física del alumnado de Educación Primaria y las percepciones de sus compañeros de clase sobre ser considerado fuerte, cobarde, que pega, víctima y de empezar las peleas. El diseño del estudio fue ex post-facto de tipo descriptivo y correlacional, de carácter epidemiológico. Participaron 94 niños de 8-12 años (M = 9,73, DS = 1,24) de dos centros rurales de Zaragoza. Los instrumentos administrados fueron el PAQ-C (Physical Activity Questionnaire for Older Children) y el Test de Evaluación de la Agresividad entre Escolares (BULL-S). Los resultados mostraron que los chicos obtienen valores superiores en el nivel de actividad física, en ser considerado fuerte, cobarde, que pega y que empieza las peleas, respecto al de las chicas, siéndolo significativamente a excepción del ser considerado cobarde. En función del curso del alumnado, todas las variables disminuyen de 3º a 6º de Educación Primaria. Además, existe correlación positiva y significativa entre el nivel de actividad física y ser considerado fuerte y que empieza las peleas.
Influencia de la satisfacción deportiva e interés deportivo en un programa de condición física de fuerza en alumnado de la ESO
Authors: Torres Navarro Vicente
Published: January 2018

El objetivo del estudio es comprobar la influencia de la satisfacción deportiva y el interés deportivo en la mejora de 3 pruebas físicas (salto vertical con impulso, salto horizontal a pies juntos y lanzamiento de balón medicinal, estas dos últimas desde parado) a partir de un pre-test y un pos-test en un grupo experimental (n=81) y un grupo control (n=79) tras un programa de entrenamiento de condición física de fuerza, en función del sexo (M=82; F=78) y del curso (1º de Enseñanza Secundaria Obligatoria -ESO- = 60; 2º ESO=51; 3º ESO= 49) en un centro escolar. La frecuencia del entrenamiento fue de 1 día/semana de aproximadamente 1 hora/sesión. Mediante ANOVA de medidas repetidas aplicando el post-hoc de Tukey hemos respondido a las hipótesis planteadas, concluyendo que los alumnos con menos satisfacción e interés con la práctica deportiva son los que más mejoran el rendimiento. No se ha encontrado que un determinado nivel de satisfacción e interés deportivos mejore significativamente la fuerza (p>0.05) en los alumnos del grupo experimental respecto a otros con distintos niveles de satisfacción e interés deportivo del grupo control.
Aprendizajes emergentes en la competición prebenjamín reglada del fútbol: hacia la adherencia, el abandono o la agresividad.
Authors: Merino Orozco Abel , Arraiz Pérez Ana , Sabirón Sierra Fernando , Usán Supervía Pablo , Jarie Laurane
Published: January 2018

El fútbol prebenjamín es un escenario formativo-deportivo con una alta participación de alumnos y familiares. Los aprendizajes que los niños construyen complementan los propósitos educativos del colegio. En la actualidad, existe preocupación por los comportamientos agresivos que se exhiben con recurrencia. Este estudio tiene por objetivo identificar los aprendizajes emergentes que el niño construye con origen en el deporte escolar.
Se desarrolla un estudio de caso etnográfico que se vertebra desde la observación participante con 10 equipos de fútbol prebenjamín, en el que se considera la participación de entrenadores, familiares y organizadores durante 207 sesiones de observación durante un curso académico completo. Se complementa con las estrategias metodológicas del dato cualitativo en la imagen y las entrevistas semiestructuradas con 21 maestros.
Los resultados más destacados evidencian un uso de la normativa del fútbol prebenjamín orientada hacia el resultado, desencadenando la capitalización de aprendizajes con un sentido de búsqueda de la victoria y justificación del fracaso. Según se gestionen estos aprendizajes favorecen la adherencia, el abandono e, incluso, la emergencia de comportamientos agresivos. El estudio reflexiona sobre la pertinencia de que el resultado considere los propósitos educativos implícitos al deporte escolar, con implicación proactiva del entorno adulto.
Causality assessment and pattern of adverse drug reactions in a tertiary care hospital
Authors: Badyal Dinesh K. , Kanish Bimal , Gulrez Gaurav
Published: January 2018

Background: Adverse drug reactions (ADRs) have become frequent cause for hospitalization and are coming up as an economic burden on health systems. Identification of ADRs and their reporting pattern can provide useful information for their management. Hence, this study was planned to evaluate causality and pattern of ADRs in a tertiary care hospital.Methods: The present study was undertaken in a tertiary care teaching hospital. A total of 200 ADRs reports collected in the ADR monitoring centre were analysed. The WHO definition of an ADR was adopted as well as WHO scale for causality assessment was used. Evaluation of the data was done for various parameters which included drug groups causing ADRs, body systems affected in ADRs, reporters and seriousness of reactions.Results: Overall occurrence of ADRs was slightly more in males (58%). Skin (72%) was the most commonly affected organ system. Antimicrobials (47%) were the drug group most commonly involved in ADRs. The causative drug was withdrawn for the management of the ADR in the majority (86%) of the patients. Upon causality assessment, majority of the ADRs were rated as probable (83.5%). Almost all of the reports were contributed by clinicians (99%).Conclusions: The causality assessment and pattern of ADRs reported in our hospital is comparable with the results of studies conducted in hospital set up elsewhere, although there are few differences. The study results revealed opportunities for interventions in ADR management especially for the preventable ADRs to ensure safer drug use.
Feto-maternal outcome in patients with couvelaire uterus: a 3 year study in a tertiary care hospital in rural Karnataka, India
Authors: N. Sunanda , T. Sruthi , S. R. Sheela
Published: January 2018

Background: Couvelaire uterus also known as uteroplacental apoplexy is a life threatening condition where abruptio placenta causes bleeding that penetrates into the uterine myometrium. It can only be diagnosed on direct visualization. Therefore, its occurrence is perhaps under reported and underestimated in the literature. The objective of this study was to determine the risk factors for couvelaire uterus and feto-maternal outcomes associated with couvelaire uterus in comparison with patients who presented with abruption without couvelaire uterus in a tertiary care hospital in rural Karnataka.Methods: All women who had abruptio placenta who were delivered by cesarean section were included in the study. Cases were women with couvelaire uterus and controls were women without couvelaire uterus observed intraoperatively during cesarean section.Results: Patients without couvelaire uterus had significantly more vaginal bleeding (22.2% vs 75%). However, patients with couvelaire uterus had a higher incidence of PPH (66.7% vs 28.6%), need for blood transfusion (5.9±3.2 pints vs 1.6±1.8 pints), DIC (22.2% vs 14.3%), maternal mortality (5.6% vs 0) and adverse neonatal outcome.Conclusions: We conclude that patients with couvelaire uterus had an increased risk of maternal complications such as postpartum hemorrhage and disseminated intravascular coagulation which resulted in increased need for blood transfusion, prolonged hospital stay and maternal morbidity and mortality. Present study further highlights that adverse neonatal outcomes such as low birth weight, low Apgar score and neonatal death were more frequently associated with couvelaire uterus. Thus, the presence of couvelaire uterus may be considered as a severe form of abruption and such patients should be anticipated for higher incidence and risk for maternal and neonatal morbidity.
Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study
Authors: Sleem Mostafa A. , Mohamed Ibrahim I. , Zakherah Mahmoud S. , Abbas Ahmed M. , Kamel Momen A.
Published: January 2018

Background: Polycystic ovary disease (PCOD) is the most common endocrine disorder in women of reproductive age, with a prevalence of approximately 5-10%. This study aims to assess the rate of spontaneous ovulation and pregnancy in patients. The present study was a cross sectional study conducted at Woman's Health Hospital, Assiut University, Assiut, Egypt.Methods: The current study was a cross sectional study carried out in Assiut Women's Health Hospital between the 1st October 2016 and 31st July 2017. The patients were selected as infertile patients with PCOD. The patient ages range between 20 and 35 years. The BMI is between 18 and 30 Kg/m2. The main outcome measure was the rate of spontaneous ovulation and spontaneous pregnancy in the 3 cycles.Results: The mean age of the study participants was 26.64±4.59 years and the mean BMI was 24.46±2.62Kg/m2. The sonographic ovarian volume was 12.47±0.69 mm3 for the right ovary and 12.74±0.73 mm3 for the left ovary. No difference in the serum FSH, LH, FSH/LH ratio and prolactin over the 3 consecutive cycles. The rate of spontaneous ovulation in the 3 cycles was 6 women (8.6%) and 2 cases (2.8%) became pregnant spontaneously during the study period. There is no statistical significant difference between ovulating and non-ovulating women according to the BMI and ovarian volume.Conclusions: The present study concluded that the rate of spontaneous ovulation was 8.6% in women with PCOD within 3 cycles with no adverse effects of drugs or surgical interference.
Severe anemia and adverse pregnancy outcome in a tertiary care hospital in North India
Authors: Yadav Premlata
Published: January 2018

Background: Anaemia is commonest medical disorder in pregnancy with 88% prevalence in India mainly due to ignorance, poverty and gender bias. 40-60% of maternal deaths in developing countries. According to the recent standard laid down by WHO anemia is present when the hemoglobin (Hb) concentration in the peripheral blood is less than 11 gm/dl. The most common cause of anemia in pregnancy is iron deficiency. Anemia is diagnosed by estimating the hemoglobin concentration and examining a peripheral blood smear for the characteristic red blood cell changes. The aim of the study was to determine the association between severe anemia, maternal and perinatal complications.Methods: Case control study was done in department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences Ranchi, India from February 2016 to July 2016. 100 pregnant women, admitted for delivery and having severe anemia were studied and compared with 100 non-anaemic women of similar demographic features. Maternal and perinatal complications were observed. Pearson, chi-square and Fischer exact tests were used to calculate significance of results.Results: Of the severely anaemic mothers, 36% babies were low birth weight (p=0.042) and 20% were small for gestational age (p = 0.026), as compared to 18% and 10% of controls, respectively.Conclusions: Severe maternal anemia carries significant risk of hemorrhage and infection in the mother. It is also associated with preterm birth, low birth weight.
Iodine status and its determinants in subpopulation of pregnant women in rural Central India
Authors: Tayade Surekha A. , Chhabra Shakuntala
Published: January 2018

Background: There is an increased demand for iodine and thyroid hormones, in pregnancy starting from the early weeks of pregnancy suggesting that there may be a need for additional supplements of iodine in high risk population to prevent iodine deficiency and its associated disorders. Hence this study was undertaken to determine the iodine status and its determinants in a subpopulation of pregnant women from a rural area of Central India.Methods: A hospital based, cross-sectional, observational study was carried out among pregnant women seeking antenatal care at Kasturba Hospital of MGIMS, Sewagram, a rural tertiary care institute in central India. Information was collected about demographic variables, use of iodized salt, iodine rich food and goitrogens as part of diet and other determinants. Spot urine samples were obtained, and assessment of urine iodine concentration was done by using Sandell-Kolthoff reaction.Results: Among 250 pregnant women of first trimester, iodine deficiency (ID) was present in 11.8 %, of which 59.25% had mild deficiency, 33.33% moderate deficiency and 7.4% severe deficiency. More women with iodine deficiency were of higher age, had less formal education and belonged to lower middle and lower economic class. Higher number of women with iodine deficiency had family history of thyroid disorders compared to iodine sufficient (18.51% versus 5.58%), more iodine deficient commonly had goitrogens (cabbage, cauliflower, radish, sweet potato, soya etc) as part of their meals (77.77% versus 68.60%), lesser women with ID ate iodine rich food (fish, milk yoghurt, bread) (18.51% versus 68.60%) and fewer of them used iodized salt during food preparation (25.92% versus 69.95%) compared to iodine sufficient, with a significant difference.Conclusions: Iodine deficiency is prevalent in pregnant women in this geographic region of central India. Age, low socioeconomic status, lack of education, family history, low intake of iodized salt and iodine rich food and more consumption of goitrogenic food as part of diet are risk factors. Appropriate health education, promoting use of iodized salt, quality assurance of universal salt iodization by household survey and screening in high risk group is suggested.
Correction with oral hydration improves maternal and perinatal outcome in women with third trimester isolated oligohydramnios
Authors: Aggarwal Pragati , Patra Sharda
Published: January 2018

Background: Oligohydramnios is related to serious maternal and fetal complications. In case of isolated oligohydramnios in third trimester maternal oral hydration has shown promising results in improving maternal and perinatal outcome.Methods: This study was conducted on 50 pregnant women complicated by idiopathic oligohydramnios (AFI<5) in third trimester. Their pre hydration daily fluid intake was noted and they were advised to take oral fluids more than their usual intake (according to their convenience). The daily fluid intake and AFI was measured on day1, day2, day3 then weekly till delivery. At delivery maternal and fetal outcome were measured.Results: The mean AFI of the study population at the time of enrolment was 4.25±1.01 and daily mean fluid intake was 1.46±0.41. The post hydration fluid intake per day was significantly high as compared to pre hydration fluid intake (4.40±0.51 litres vs 1.46±0.41 litres, p<0.001). A significant difference in the amniotic fluid index was seen post hydration. The mean AFI on day 1, day 2, day 3 was 6.19±0.93, 7.33±1.13, 8.0±1.07 as compared to pre hydration AFI 4.25±1.01 (p<0.001). The amniotic fluid index post hydration normalized (AFI>8) in 6%, 30%, 61% and 100% of women on day1, day2, day3 and after a week. The perinatal outcome was favourable in all the women with 100% live births and a mean birth weight of 2.77±0.29 kg.Conclusions: A simple correction of maternal dehydration by an adequate and sustained daily oral fluid intake in pregnancies complicated by isolated third oligohydramnios in third trimester significantly improves amniotic fluid index, maternal outcome and perinatal outcome.
A comparative study of ectopic pregnancy at a tertiary care centre
Authors: Pusuloori Radhika , Arora K. Dilzith
Published: January 2018

Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the Department of Obstetrics and Gynecology at Chalmeda Anandarao Institute of Medical Sciences, Karimnagar, Telangana from February 2014 to January 2017. A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.
Evaluation of uterine cervix with transvaginal ultrasonography in women with threatened preterm labor and or preterm labor
Authors: Shree Akila , A. K. Chitra
Published: January 2018

Background: Preterm delivery can be associated with substantial perinatal morbidity and mortality. Nearly in 5 to 13% of pregnancies, happening deliveries are preterm before 37 weeks' gestation. Thus, prediction of preterm labor in parturient can provide a window of opportunity to prevent these complications and to be better prepared to deal with them. Hence the current study has been conducted with an objective to assess the efficiency of cervical length and funneling as assessed by transvaginal ultrasonography in predicting preterm labor.Methods: The current study was a prospective study, conducted in the Department of Obstetrics Emergencies, Dhanalakshmi Srinivasan Medical College and Hospital between November 2015 to April 2017. The study population included 60 women with singleton pregnancy of gestational age between 28 + 0 and 36 + 6 weeks and with painful and regular contractions (>1/10 min for at least 1 hour). Cervical length, funnelling length measured at presentation and after 48 hours were considered as predictor variables. The outcomes of interest were delivery within 1 week, delivery before 37 weeks and delivery before 34 weeks.Results: There was a statistically significant difference in cervical length and funnelling length between term and preterm groups at the time of diagnosis and after 48 hours (P <0.001). The positive predictive value increased from 33.3% to 100% with cervical length ≤ 40 mm to ≤ 20 mm. The negative predictive value decreased from 100% to 79.2% with cervical length ≤40 mm to ≤20 mm. To predict a preterm delivery in threatened preterm delivery patients, the sensitivity of a cervical length of ≤25 mm was 77.7%, specificity was 95.2%, the positive predictive value was 87.5% and negative predictive value is 90.9%.Conclusions: Cervical length and funnelling as assessed by transvaginal ultrasonography are efficient in predicting preterm labor.
Aliskiren and losartan study in non-diabetic CKD: a comparison of patients in the clinical trial versus the usual care group
Authors: Woo Keng Thye , Chan Choong Meng , Fook Chong Stephanie , Lim Cynthia , Choo Jason , Choong Lina , Mohamad Suhail , Tan Han Khim , Wong Kok Seng , Foo Marjorie
Published: January 2018

Background: This is a comparative study of a 6 year retrospective analysis of the therapeutic efficacy and safety of Combined Aliskiren (150 mg a day) and Losartan (100 mg a day) in a Clinical Trial setting versus a Usual Care group of patients on Losartan (100 mg a day), Telmisartan (80 mg a day) and Combined Enalapril (10 mg a day) plus Losartan (100mg a day) in non-Diabetic Chronic Kidney Disease (CKD) patients. The objective of this study was to ascertain if there were any differences in the renal outcome of patients treated within a Clinical Trial setting versus a Usual Care setting. The study seeks to establish the relevance of having a Usual Care group as a comparator and whether its inclusion in the study would help to validate the findings in the Clinical Trial group

Methods: This is a 2nd Phase follow up study three years after the initial 1st Phase study in the Clinical Trial Group. Patients in the 2nd Phase study were those who continued to have proteinuria and were treated with Losartan 100mg a day. The 2nd Phase study seeks to document the incidence of remission of proteinuria following their initial 1st Phase therapy for proteinuria compared to those in the Usual Care group where treatment remained unchanged from year 1 to end of year 6. The rates of remission of proteinuria and improvement of renal function as well as associated comorbidities between the 2 groups are compared.

Results: Among the 154 patients in the Clinical Trial Group, 70/154 (45%) continued to have proteinuria, while 84/154 (55%) had no proteinuria (remission) compared to 41 (28%) in remission and 104 (72%) with continued proteinuria in the Usual Care group (p<0.001). There were more patients with hypertension and hyperkalaemia in the Clinical Trial group compared to the Usual Care group. Seven patients were in ESRF in the Usual Care group compared to only 3 in the Clinical Trial group but this difference was not significant. More patients in the Clinical Trial group compared to the Usual Care group had improvement in eGFR at the end of the 6 years (p<0.001).

Conclusions: This study shows that patients in a Clinical Trial setting do better than those in the Usual Care setting as they are more likely to have improvement in renal function with remission of proteinuria. 
Clinical study of community acquired pneumonia at MNR medical college and hospital, Sangareddy
Authors: Jain Sonal
Published: January 2018

Background: This study is done to study the clinical profile of community acquired pneumonia in patients admitted in medical wards at MNR Hospital, Sangareddy and to find out the associated risk factors of community acquired pneumonia.

Methods: 75 Patients admitted in the department of medicine of MNR Medical college and Hospital, Sangareddy with clinical manifestations of Community acquired pneumonia from august 2012 to January 2015 (Two years and 6 months) were taken into the study. All adult patients of both genders aged above 14 yrs, who presented with acute onset of fever associated with chills and rigors, having cough with expectoration and/ or chest pain and breathlessness were included in the study. All the patients were subjected for detailed clinical examination to make a provisional diagnosis of community acquired pneumonia (CAP). Patients with hospital acquired pneumonia, aspiration pneumonia and PCP pneumonia in patients with HIV were excluded.

Results: Among 75 cases studied, the mean patient age was 52.1 years with Male: Female patient ratio 3.17:1. The associated diseases in this study are COPD (30.67%) and DM (12.0%).The most common presenting symptoms were fever (100%), cough (100%), and expectoration (100%); other symptoms included chest pain (60%), dyspnoea (61.33%). The respiratory signs included bronchial breath sounds, increased VF and VR, and presence of whispering pectorolique in all subjects.  
Conclusions: Identification and determining the clinical patterns of community acquired pneumonia helps in adoption of regionally optimized diagnostic approach.
Study on sleep quality and associated psychosocial factors among elderly in a rural population of Kerala, India
Authors: George Sobha , Paul George , Paul Nimitha
Published: January 2018

Background: Sleep is an important physiological process with many restorative functions. Insomnia defined as difficulty in falling or staying asleep which is frequent in older people. Reduced sleep quality can result in impaired daytime function which can lead to severe consequences. This study was conducted to examine sleep quality of elderly and to determine its relationship with psychosocial factors, in a rural population of Kerala. Methods: A community based cross sectional study was done by interviewing 170 people who were 60 years or above, selected by simple random sampling, after getting consent. The study tools used were Pittsburgh sleep quality index (PSQI), General anxiety disorder 7 item (GAD-7) scale, geriatric depression score (GDS 5 items) and a self designed general sociodemographic questionnaire. Data was tabulated using MS Excel and analyzed using SPSS V-20. Results: The sleep quality according to global PSQI was good for 27.6%, while it was poor for 72.4% of respondents. The mean GPSQI of the study was 8.04±4.59. Absence of toilet inside home (p=0.036), current health problems (p=0.003), multiple (>3) health problems (p=0.006), regular use of current medications (p=0.033) had a significant association with poor sleep quality. Association between general anxiety disorder and GPSQI was significant with poor sleep quality among those with severe anxiety (p=0.017). Association between GDS-5 score and GPSQI showed a significant association between symptoms suggestive of depression and poor sleep quality (p=0.014). Conclusions: Questions on sleep quality should be routinely asked by clinicians as part of general health assessment of an elderly.
An evaluation of economic and education determinants on utilization of skilled delivery services by Maasai Women in Kiekonyokie sub location of Kajiado County in Kenya
Authors: Simel Laban Lebahati , Nanduri Lakshmi , Juma Pamela A. , Omuga Blasio
Published: January 2018

Background: Maternal health is one of the eight Millennium Development Goals,is central to poverty reduction and overall development efforts and it increased international attention for monitoring progress on maternal health and improving access to skilled attendants at deliveries. This research paper aimed to study economic and education determinants on the utilization of skilled delivery services by Maasai women, the study population belonging to a community of nomadic life style in North of Kajiado County in Kenya.Methods: The study design was a cross sectional descriptive study adopting both quantitative and qualitative methodologies. Results: Utilization of skilled delivery was higher among women who had a source of income (34%) compared to women who had no source of income (19%) indicating a statistical significance p=0.003. Women who had higher level of education were more likely to use skilled delivery 50% compared to 22% who had no education at all hence p=0.002. Education level had a statistical significance, (p-0.002). 69% of those who delivered in the hospital paid > 500 shillings compared to 8% of those who paid < 500 shillings. The amount paid for skilled delivery had a statistical significance, (p<0.001). 97.7% of the Maasai women in the Kajiado North study takes more than 1hour to reach to the nearest health facility while less than (1%) of them in this study takes less than 30minutes to reach to the health facility. Conclusions: In conclusion this study shows that high level of illiteracy, low economic status, distance away, cost to pay for skilled delivery hindered skilled delivery service utilization among the Maasai women.
Evaluation of chief complaints of patients and prevalence of self-medication for dental problems: an institutional study
Authors: Dhaimade Prita A. , Banga Kulvinder Singh
Published: January 2018

Background: The importance of oral heath in the general wellbeing of our health is still largely undervalued. The current study was designed to comprehend the details of chief complaints and self-medication of the patients visiting a dental hospital in Mumbai. The level of awareness of the patients and its association with the practice of self-medication was also explored in the study. Methods: 300 randomly selected patients reporting to Nair Hospital Dental College were surveyed to conduct this clinical, observational, cross sectional, single center study. A specially designed and validated questionnaire consisting of 14 close ended questions was provided to the patients in the language of their convenience. Results: The most common chief complaint recorded among the dental patients was dental pain. This was followed by swelling, mobility and tooth replacement. The patients reported that most of them had experienced multiple dental problems before and did not report to the dental healthcare provider. 81% of the patients reported that they had practiced some form of self-medication for dental problems. 56.33% of them used analgesics, the pharmacy and over the counter drugs were the most common sources. A number of reasons were reported for the use of these drugs and the most common reason was to get quick or temporary relief but the patients did not report to the health care provider unless the symptoms got severe. Finally a significant relationship was recorded between the level of awareness of patients about the ill effects of self- medication and the prevalence of its practice among dental patients. Conclusions: More attention should be drawn towards the big impact of dental and oral health on the general well-being of the patients. The ethical use of medication should be encouraged not only by ensuring stringent rules governing the distribution of drugs but also by educating patients about the numerous risks involved with the practice of self-medication.
Public private mix in tuberculosis control: is it really working in India?
Authors: Nautiyal Ram Gopal , Singh Rajesh Kumar
Published: January 2018

Background: As significant proportions of the tuberculosis (TB) patients in India are managed by the private sector, integration of the private sector with the revised national tuberculosis control programme (RNTCP) is crucial to achieve TB control in the country. The RNTCP of India has been therefore involving allopathic private practitioners (PPs) since its beginning through its RNTCP- Indian Medical Association public-private mix (RNTCP-IMA PPM) project for inclusive involvement of PPs in the programme to fight against TB. The objectives of the study were to evaluate whether or not the RNTCP-IMA PPM project in India could mobilize the support of the allopathic private practitioners (PPs) by analyzing their knowledge and perception about RNTCP, and their readiness to support the programme.Methods: A questionnaire based cross- sectional study was conducted in urban areas of districts of Kumaon division of Uttarakhand State of North India. Results: Of 71 PPs, almost 83% knew that in RNTCP sputum acid fast bacillus (AFB) examination was the most important diagnostic test for pulmonary tuberculosis, 66.2% knew that intermittent regimens under direct observation are practiced in RNTCP, 32.4% believed drug regimens in RNTCP of questionable efficacy, 29.6% felt ignored by the programme and only 2.8% felt RNTCP a successful strategy. 50.7% PPs showed readiness to support the programme with government support. Conclusions: The RNTCP-IMA PPM project seems to have performed sub-optimally as majority (97.2%) PPs did not perceive RNTCP as a successful strategy. For successful RNTCP-IMA PPM, India needs to upscale the existing PPM with strong political will and administrative commitment.