bluuebunny/crossref_metadata_2025 huggingface dataset:
Internal iliac artery ligation to combat post partum haemorrhage: an institutional review of case series
Authors: Jain Anushree , Sapkal Rekha Uttam
Published: May 2017

Background: Internal iliac artery supplies the pelvic viscera. IIAL is a valuable surgical procedure to control intractable pelvic haemorrhage with the mainstay aim of uterus preservation. There is a reduction of 85% in pulse pressure and 48% in the blood flow in the arteries distal after internal iliac artery ligation. Thus, the expertise to perform IIAL should be present in armamentarium of every obstetrician and gynaecologist.Methods: Retrospective review of 22 cases who have undergone IIAL or Peripartum hysterectomy for management of Post- Partum haemorrhage in the study period of January 2012 till December 2015 in the Department of Obstetrics and Gynaecology of People’s College of Medical Science and Research Centre, Bhopal.Results: Internal iliac artery ligation was performed in 53% out of which 31.8%% was for placenta previa, 4.54% for adherent placenta, 9.1% IIAL for Atonic PPH. Whereas peripartum hysterectomy was performed in 38% cases out of which 13.6% had perforation of uterus. 9% underwent hysterectomy as well as IIAL. Blood loss more than two 2 liters within period of 60-90mins was effectively and dramatically controlled with IIAL. Thus, maternal mortality reduced while preserving fertility. Control of Pelvic hemorrhage was achieved in 100% of cases.Conclusions: Bilateral ligation of the internal iliac arteries is a safe, rapid and very effective method of controlling bleeding from UTERUS and genital tract. It plays a major role in safe guarding the patient from undergoing life threatening consequences due to pelvic haemorrhage.
Clinical study of post partum haemorrhage from a teaching hospital in Maharashtra, India
Authors: Tasneem Fasiha , Sirsam Shyam , Shanbhag Vijayalakshmi
Published: May 2017

Background: To study the cases of postpartum haemorrhage, their causes and management in a tertiary care centre.Methods: A retrospective study of cases of postpartum haemorrhage for a period of 3yrs was conducted in Dept. of OBGY at a rural tertiary care center and teaching hospital in Maharashtra. The major causes, management modalities, morbidity and mortality associated with it were discussed.Results: Out of 37515 deliveries over the period of 3 years (2014-2016), there were 1333 cases of PPH out of which accounted for a prevalence of 3.55%. Study showed that 86% of cases were due to atonic PPH, 9.9% due to traumatic PPH, and 0.97% were due to both atonic and traumatic PPH. 2.7% of cases were due to retained placenta, 0.07% were due to bleeding diathesis.Conclusions: In an era with availability of excellent uterotonics and active management of 3rd stage of labour even today postpartum haemorrhage stands first as the cause of maternal morbidity and mortality. Even though with excellent medical and surgical interventions, maternal mortality due to PPH has been significantly reduced, the field still needs extensive research and new modalities to prevent and manage post-partum haemorrhage.
Reappraisal of risk factors in neoplastic lesions of the cervix uteri
Authors: Rohilla Minakshi , Gupta Hem Prabha , Aggarwal Anjoo
Published: May 2017

Background: Carcinoma of uterine cervix is most common cancer amongst women in developing countries and rates the second most common cancer in women throughout the world. Despite possible correlation with factor like age, sexual activity, multiparity, smoking, alcohol, oral contraception and low socio economic status, suggested by various researchers, the exact role and a true causal association between these factors and carcinoma cervix has not been proved as yet.Methods: Two hundred and fiftyfour (254) patients with cervical lesions were screened for carcinoma of the cervix and 195 were found to be suffering from malignant and intraepithelial lesions. 59 patients had benign lesion of the cervix.Results: The commonest risk factor encountered in the study was early age at intercourse (84.25%) followed by multiparity (64.56%), illiteracy (64.56%), sexually transmitted disease (61.02%), bad hygiene (43.70%), low socio-economic class (42.91%), and tobacco use in decreasing order. These factors have complex interrelationship with each other e.g. low socioeconomic status is commonly associated with bad hygiene, illiteracy, multiparity and early age at first intercourse (p<0.001).Conclusions: Early detection of benign lesions and decrease in number of risk factors in an individual being minimum at lower age is probably associated with benign part of the spectrum of disease while constant presence of these factors leads to cervical intraepithelial neoplasia followed by truly invasive disease. Intervention at any point with decrease of or absence of risk factors can stop these premalignant lesions to become malignant.
A randomised controlled trial of preinduction cervical ripening-dinoprostone versus foleys catheter
Authors: M. Mumtaj , M. Harilakshmi
Published: May 2017

Background: Cervical ripening before induction of labour in women with unfavourable cervix is essential to shorten the induction to delivery interval and avoid unnecessary interventions.Methods: The study was carried out at Raja Sir Ramasamy Mudaliar hospital, Chennai during the period August 2012 to July 2013. 200 antenatal women were recruited and randomly allocated to Foleys and prostaglandin E2 gel group for induction. The change in bishops score, induction to delivery interval, mode of delivery, vaginal delivery within 24 hours, maternal complications, fetal outcome between both groups were compared.Results: The commonest indication for induction in both groups was postdated pregnancy followed by oligohydramnios in Foleys group and preeclampsia in PGE2 group. Foleys catheter induction improves bishops score better compared to PGE2 gel whereas PGE2 gel causes a significant reduction in the mean induction to delivery interval between the two groups. However, there was no significant difference between mean caesarean deliveries between the two groups. In both Foleys and the PGE2 group, failed induction was the commonest indication for caesarean section. The number of patients delivering vaginally within 24 hrs was similar between the two groups.Conclusions: Though prostaglandins are a better method of induction, this study shows that Foleys induction has reduced side effects and is also cost effective, making it a superior method for cervical ripening.
Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre
Authors: Gupta Divya , Mital Premlata , Meena Bhanwar Singh , Benwal Devendra , Saumya . , Singhal Sunita , Ainani Richa
Published: May 2017

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.
Correlation of reduced amniotic fluid index with neonatal outcome
Authors: Chaudhary Rachna , Dhama Vandana , Singh Shakun , Singh Madhumita
Published: May 2017

Background: Amniotic fluid assessment is an essential part of evaluation of fetus health in terms of fetal distress, meconium aspiration, IUGR, Non-reassuring fetal heart rate patterns, birth asphyxia, low birth weight, low Apgar-scores and NICU Admissions.Methods: This prospective observational study included 200 antenatal patients of term gestation of which 100 cases with AFI<8 and 100 controls with AFI ≥8 but ≤ 15 were included in study. Ultrasonography and NST were done and results of both groups compared for the presence of meconium passage, non-reactive NST, birth asphyxia, low Apgar-scores, low birth weight, NICU admissions and neonatal deaths.Results: There was increased incidence of non-reactive NST (40% vs 12%), meconium stained (33% vs 10%) in oligohydramnios group. In cases 49% of patients had vaginal delivery while in controls 78%. 51% underwent LSCS in cases while in controls 22%. Apgar score <7 was found in 7% vs 4%. Birth weight was <2.5 kg in 35% vs 13%. NICU admissions in study group was 15% vs 11%. The neonatal death was similar in both cases groups.Conclusions: Oligohydramnios affect the neonatal outcome in terms of meconium stained liquor, non-reassuring fetal heart rate, low birth weight, birth asphyxia, low Apgar-scores and NICU Admissions and neonatal death but the difference was not statistically significant. Early detection of oligohydramnios and its management may help in reduction of perinatal morbidity and decreased caesarean deliveries.
Antenatal breast milk expression at term increases postnatal lactational performance
Authors: Uikey P. A. , Agrawal Palak , Khandale Surekha
Published: May 2017

Background: Breast milk contains balanced nutrients for the complete growth of body and brain of neonates and infants. Breast feeding is rich in anti-infective factors and improves immune system, thus reducing the child mortality rate. Objective of present work was to study the effect of antenatal breast milk expression at term in improving lactational performance as compared to control group.Methods: The prospective, comparative study was conducted for 2 years to observe effects of antenatal expression of breast milk on postnatal lactational performance in a tertiary care centre   in Central India.  200 Subjects after 37 weeks of pregnancy divided in two groups of 100 each 1) study group 2) control group by systematic random sampling technique. Prior examination was done to exclude any inverted or cracked nipples and appropriate treatment instituted. The women with diseased breast and conditions, high risk pregnancy, congenitally anomalous fetus and drugs affecting lactation were excluded from study. Study group women were counselled to express milk 2-3 times every day preferably during bathing. All women were followed up in hospital and postnatal lactation performance was observed in both groups.Results: The study group did not find it difficult to initiate breast feeding after vaginal or caesarean delivery  and in 78% of patients time interval from initiation of lactation to establishment of lactation was less than half hour as compared to control group (38%) P value <0.001. Statistical analysis showed significant difference in the results of those groups.Conclusions: Daily antenatal breast milk expression after 37 weeks of pregnancy significantly reduced the time for establishing full breast feeding and reduced breast feeding failures.
Congenital cystic adenomatoid malformation (CCAM): antenatal and postnatal management
Authors: Kanavi Jayashree V. , Thangaraj Jasmine , Thomas Annamma
Published: May 2017

Background: Congenital cystic adenomatoid malformation (CCAM) is a rare abnormality of lung development. The estimated incidence ranges from 1: 10,000 to 1.35,000 live births. It is diagnosed by prenatal screening at 18-20 weeks of gestation. Surgical excision of symptomatic lesions is relatively straight forward, but management of asymptomatic lesions is controversial.Methods: Among women who delivered at St. Johns medical college and hospital, Bangalore between Jan 2011 to Dec 2016, those with the diagnosis of CCAM during anomaly scan were included in the study. Antenatal and Post-natal period and their outcomes were evaluated. Follow up was extend up to the childhood in the affected foetus.Results: There were 5 cases of CCAM in 13057 deliveries during 5-year study. Incidence was 1:2611. Mean gestational age at diagnosis was 21.6±2.5weeks. All foetus had CVR (CCAM volume) ratio more than 1.6 and there was no compromise on lung volume. Mean lung volume was 62.8±8.6 cc. and mean Apgar score at 1minute was 6.8±2.7 and at 5 minutes was 8.0±2.2. Among 5 foetuses, 2 foetuses had regression of cyst by birth and 3 underwent surgery for resection after birth.Conclusions: CCAM remains a challenge for obstetricians, neonatologists and paediatric surgeons. The combination of prenatal MRI and serial ultrasound studies optimize foetal surveillance and postnatal care. In asymptomatic CCAM, babies should be followed up to adolescence and adulthood, as they can manifest with malignant changes.
Risk factors for perinatal mortality: a case control study from Thiruvananthapuram, Kerala, India
Authors: Brahmanandan Mayadevi , Murukesan Lekshmi , Nambisan Bindu , Salmabeevi Shaila
Published: May 2017

Background: The greatest risks to life are in its very beginning. Although a good start in life begins well before birth, it is just before, during, and in the very first hours and days after birth that life is most at risk. This prospective case control study was designed on maternal risk factors for perinatal mortality.Methods: This was a case control study conducted in the Department of Obstetrics and Gynecology and Department of Paediatrics, Medical College Trivandrum for one year period in 2004-2005. The cases were all the fresh and macerated still births and early neonatal death cases during the study period. The controls were chosen as the next delivery entry in the OR register.Results: During this period, the total number of deliveries was 14,796 and there were 431 perinatal deaths. The perinatal mortality rate was 29.12. This was much higher compared to Kerala’s perinatal mortality rate of 10, the reason being that the study is conducted in a tertiary referral hospital with one of the best new born care nurseries and a large number of referrals. The most significant risk factors for perinatal mortality were low socio-economic status, referrals, late registration, prematurity, low birth weight, intra-uterine growth restriction, maternal diseases like gestational hypertension and gestational diabetes and intrapartum complications like abruption.Conclusions: Perinatal mortality rate serves as the most sensitive index of maternal and neonatal care. Good antenatal care and prevention of preterm birth may play a key role in further reduction of PMR.
Maternal and perinatal outcome in preterm premature rupture of membranes
Authors: M. V. Jameela Diraviyam , Karunakaran Lalithambica
Published: May 2017

Background: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for approximately one third of all preterm births. Objective of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6daysMethods: A descriptive study was conducted on 141 antenatal patients between 28 to 36weeks+6days with PPROM admitted to Department of Obstetrics and Gynecology, Government TD Medical College, Alappuzha, Kerala, India from September 2014 to September 2015. After establishing the diagnosis of PPROM patients were monitored and Maternal and perinatal outcomes were studied.Results: 77% patients had late PPROM. 60% of early PPROM latency period >24 hrs and were managed conservatively till 34 weeks. 18% had chorioamnionitis and immediate termination of pregnancy. 73% of newborns in this group needed admission due to complications of prematurity like RDS (54.54%). Perinatal mortality (2.12%) was due to sepsis. 80% of late PPROM had latency period <24 hrs and only 4% had chorioamnionitis.18.5% babies in this group had hyperbilirubinemia. There was statistically significant association between latency period and perinatal complications (p=0.001). RDS was 33% in latency period <24hrs, 18% in >24hrs and sepsis was 36% in >24hrs and 10% in <24hrs.Conclusions: The most common cause of perinatal mortality in early PPROM is prematurity and its complications. Hence conservative management to prolong pregnancy is recommended under strict monitoring for evidence of chorioamnionitis. At the earliest evidence of chorioamnionitis termination irrespective of gestational age is warranted. In late PPROM, perinatal outcome is good. So, termination is advised as conservative management shall add to the fetal and maternal morbidity due to sepsis.
CPK: The new tool in the diagnosis of ectopic pregnancy
Authors: Ganta Suvarna Jyothi , Kulkarni Sunanda R. , Muralidhar Vidya
Published: May 2017

Background: Ectopic pregnancy is still a diagnostic dilemma presenting with various complaints. The classic triad of amenorrhea, abdominal pain, vaginal bleeding and /or syncope is not always seen. Misdiagnosis can lead to delay in treatment, blood loss is found to be the major cause of death. Early and accurate diagnosis is critical in bringing down the maternal mortality and morbidity. Prompt and effective treatment of an ectopic pregnancy can help preserve the chances of future healthy pregnancies. Aim of present study was to investigate whether creatinine phosphokinase (cpk) can be used as an effective diagnostic tool in the early diagnosis of ectopic pregnancy which can help in decreasing the maternal mortality and morbidityMethods: This observational comparative three group clinical study was conducted at Chinmaya Mission Hospital, Bangalore, between May 2016 to January 2017.120 women in their early trimester were studied of which 40 were diagnosed cases of ectopic pregnancies, 40 women presented with intrauterine abortive pregnancies and 40 women had normal healthy pregnancies. Serum CPK, serum B-HCG, vaginal scans were done in all, along with routine investigations.Results: The mean CPK values in normal, abortive and ectopic pregnancies were 36.92±6.44, 43.95±11.96 and 91.55±30.43 respectively. It was found to be significantly higher in ectopic Pregnancies. Also, the mean CPK in ruptured and unruptured ectopic pregnancy were 97.26±25.97 and 63.82±34.92 respectively.Conclusions: Present study shows that maternal CPK levels are significantly higher in women with ectopic pregnancies. CPK can serve as the reliable biochemical marker to diagnose ectopic pregnancy particularly ruptured. CPK can be used to increase the diagnostic efficacy in ectopic pregnancy, which followed by rapid and appropriate treatment can reduce the mortality, morbidity and preserve future fertility.
Induction of labour: a randomized controlled trial
Authors: Reshme Nivedita , Samal Rajnish , P Padmaja , S. Shalini , K. Radhika
Published: May 2017

ABSTRACTBackground: Clinical trial between Foley’s catheter and Dinoprostone gel for change in Bishop Score after 12 hours of labour induction, mode of delivery, maternofoetal outcome and cost effectiveness. Induction of labour is necessary if the woman does not get timely, adequate and appropriate labour pains. Bishop’s score is used to assess cervical ripening. Hence, we note the change in Bishop Score after 12 hours of labour induction to assess the success rates, time taken for active labour and delivery, maternofoetal outcome and the cost effectiveness.Methods: Block randomized controlled clinical trial between Foley’s catheter and dinoprostone gel for a sample size of 76 in each group was done.Results: In women administered dinoprostone gel, there was significant change in Bishop score with a mean score of 7. Shorter induction active labour interval and induction delivery interval proved it to be a faster inducing agent. No significant difference was noted in terms of mode of delivery. A higher rate of fetal distress was noted in Foley’s group probably as a result of prolonged labour and need for further augmentation with oxytocin for a long duration.Conclusions: In terms of cost of labour Dinoprostone gel though more expensive than the Foley’s catheter, eventually proved to be equally economical for the patients considering the faster labour induction, considerable vaginal delivery rates and hence shorter stay in hospital.
Relapse of cervical cancer 12 years after the treatment
Authors: Enes Pedro Vieira , Brandão Pedro , Rocha Juliana , Pinto Ana Rita , Costa Fernanda
Published: May 2017

Cervical cancer is the third most common gynecologic cancer in women and it remains one of the main causes of death. With rare exceptions, it results from an HPV infection and about 5% of this infection will culminate in the development of CIN 2 or CIN 3 lesions. After treatment with surgery or radiotherapy, 10 to 20% of the patients will have a relapse and/or metastases usually in the first two years after completing their treatment. In this article, we present a clinical case of a lymph node relapse 12 years after treatment in a 43-year-old patient with a microinvasive cervical cancer history, Figo stage IA1, without lymphovascular invasion.
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for sarcomatosis from uterine adenosarcoma
Authors: O'Leary Michael P , Dumitra Sinziana , Goldner Bryan , Wakabayashi Mark , Lee Byrne
Published: May 2017

Uterine adenosarcoma has poor prognosis and management of this disease is controversial. We describe a case of sarcomatosis secondary to recurrent uterine adenosarcoma who underwent cytoreductive surgery (CS) and hyperthermic intraoperative peritoneal chemotherapy (HIPEC). A 52 year-old female presented with perimenopausal menometrorrhagia. She underwent laparoscopic hysterectomy and bilateral salpingo-oopherectomy with pathology showing uterine adenosarcoma. She developed a pelvic recurrence 2 years later. A pelvic exenteration was then performed and within 8 months, she recurred. CS/HIPEC with Cisplatin was performed. Six weeks post-operatively, the patient was found to have recurrence again. This case describes the use of CS/HIPEC as a treatment modality for uterine adenosarcoma with sarcomatosis. Despite CS and HIPEC, the patient developed an aggressive recurrence within six weeks of her surgery date. We recommend a multidisciplinary approach to this disease with the recognition that CS/HIPEC may offer little benefit as a salvage therapy based on this case.
Hamman’s syndrome: spontaneous pneumomediastinum and subcutaneous emphysema during second stage of labour
Authors: Lou Ying Yiing
Published: May 2017

Subcutaneous emphysema with pneumomediastinum in labour is also known as Hamman's Syndrome. Maternal pneumomediastinum associated with subcutaneous emphysema is a rare complication of pregnancy. The incidence rate being between 1:2000 and 1:10,000. Pneumomediastinum occurs most frequently in the second stage of labour in a healthy primiparous women with prolonged labour. A 29-year-old primigravida, who had no relevant medical history, had an uneventful spontaneous vaginal delivery at term. She used Entonox as analgesia in labour. She developed facial and neck oedema associated with mild breathing discomfort towards the end of her second stage. Crepitus was felt in her cheek, neck and anterior chest wall. Observations were stable including oxygen saturation. Chest X-ray demonstrated gross and extensive surgical emphysema across the chest and up into the neck and with no evidence of pneumothorax. She was managed conservatively and the subcutaneous emphysema was found to have considerably better within 24 hours. She recovered uneventfully and was discharged within 3 days of admission. A future pregnancy is planned. Hamman’s syndrome is generally a self-limiting condition. The key to successful management is early recognition followed by appropriate measures to prevent further complications in order to reduce the morbidity and mortality associated with this condition. Supportive measures alone may be the only requirement for resolution. Recurrence of the condition is rare but the appropriate management of subsequent pregnancies is unclear. Our case was appropriately managed with multidisciplinary input in the HDU on labour ward.
Laproscopic intravesical vesicovaginal fistula repair after removal of an old vaginal drain tube-a rare case
Authors: Rahman Hafeez , Trehan Nikita , Gohil Dhruv P. , Aggarwal Ajay
Published: May 2017

The management of vesicovaginal fistula is difficult and challenging We are presenting a rare case of a 24-year-old unmarried girl with history of vaginoplasty and multiple surgeries done in the past, with a vaginal drain tube kept for 12 years and a Vesicovaginal fistula at the bladder trigone. Patient was successfully treated with a laproscopic Intravesical vesicovaginal Fistula repair. As advances in understanding the etiology of VVF have been made, the laproscopic approach has become the gold standard. Laparoscopy allows an excellent view, good exposure of pelvic structures, provides direct access to the fistula and for repair of complex VVF that may not be amenable to vaginal repair.
Endometriosis in broad ligament: a rare case
Authors: Chauhan Rooplekha , Dadhich Ruchita , Sahu Bharti , Sahni Sonal
Published: May 2017

Endometriosis is a relatively common entity among females presenting with abdominal pain and infertility. The endometriosis of broad ligament is a very rare yet interesting condition. In majority of the reported cases, endometriosis of broad ligament had recurrence after surgical excision. We are reporting one such case in a young nulliparous woman from Jabalpur Madhya Pradesh.
Clinical study of necrotizing fasciitis and its management
Authors: Shukla Archana , Sharma Ashish
Published: May 2017

Background: Necrotizing fasciitis is a severe flesh-eating disease of soft tissue infection. It is characterized by widespread infection of the fascia with necrosis. It may lead to MODS and shock in a very short period of time. In this study we have evaluated the predisposing factors, clinical manifestation and different modalities of investigation which helps in management of this near fatal disease.Methods: This study was conducted in Department of Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India for 3 years (October 2013-September 2016). A total of 107 patients having necrotising fasciitis were admitted in this period. The diagnosis was confirmed by detailed history and physical examination followed by haematological, microbiological and radiological investigations priority wise. After initial resuscitation patients were taken to OT where debridement of dead necrotic tissue was done, laying open of deeper planes with proper and effective drainage of pus. Most of the dressings used were silver sulfadiazine or iodine depending upon the sensitivity to sulpha group.Results: Diabetes mellitus was the most common predisposing factor (65.4%) followed by trauma (28%). Perineum and thigh were the most commonly affected site (70%). Most of the patients (84%) presented with skin erythema and blistering. Fever and tachycardia were seen in almost all the patients (95%). Leukocytosis and neutrophilia were seen in 91.5%. Most common organisms isolated were E. coli and proteus. Mortality rate was 24.29%.Conclusions: Necrotizing fasciitis is a flesh eating, highly lethal disease. Early diagnosis, early and radical surgical debridement supported by appropriate antibiotic and correction of metabolic disorder are the cornerstones of successful management.
Study of graft uptake in honey dressed wound: a 2 year experience
Authors: Pal Gaurav , Jain S. C. , Jajoo S. N. , Swarnkar Manish
Published: May 2017

Background: Plenty of newer dressing material are available in market but mostly are not cost effective and not easily available especially in a rural set up. Honey being a traditional dressing material used from medieval time is cheap, readily available and can be applied easily by any person without any assistance. The objective was to study the effect of honey dressing on graft uptake.Methods: It was a prospective study conducted at Acharya Vinobha Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India from July 2014 to August 2016. The study contains 117 patients with ulcers over various aetiology and at various sites, which were divided into two groups; one group contains 61 (52.13%) patient where the wound was dressed with honey dressing while in other group 56 (47.88%) patients were dressed with normal saline. Outcome measures were calculated in terms of proportion of acceptance of graft on day 5 and day 14 after the wound is grafted. Patients were followed-up for a maximum of 30 days post grafting.Results: It was found that in 57 (93.44%) patients in honey group showed nearly 100% graft acceptance on day 5 while only 18 (32.14%) patients in saline group showed nearly 100% graft acceptance. On day 14 it was found that in honey group 45 (73.77%) patients showed nearly 100% graft acceptance while only 8 (14.29%) patients in saline group showed nearly 100% graft acceptance.Conclusions: The present study concludes that wound dressed with honey shows greater graft acceptance as compared to wound dressed with normal saline.
Intercultural Manifestations of Racial, Language, and Class Privilege in Schooling: An Autoethnographic Tale
Authors: Marx Sherry
Published: May 2017

In this autoethnographic tale, I tell the story of my own family’s experience with race, class, and language privilege. In particular, I focus on my children’s experience with elementary schooling in the United States and Hungary. Their intercultural education experience vividly illuminates the socially and culturally constructed nature of race, class, and language privilege and the many ways these privileges are manifest in schooling.
CONTROLE DE ESTÍMULOS E CONTRASTE COMPORTAMENTAL EM UMA TAREFA DE COOPERAÇÃO
Authors: Azevedo Rafaela Meireles Fontes , Todorov João Claudio
Published: May 2017

Metacontingência, definida como um conjunto de contingências comportamentais entrelaçadas que produzem um produto agregado mantido por uma consequência, é uma unidade de análise no nível cultural, análoga à tríplice contingência. Estudos realizados na área têm tratado a metacontingência como uma relação condicional de dois termos, desconsiderando a função dos estímulos antecedentes. Em função da importância dos estímulos discriminativos sobre a emissão do comportamento, e buscando estudar os processos básicos envolvidos, o presente estudo teve como objetivo investigar os efeitos do processo de discriminação em tarefas de cooperação. O procedimento foi realizado a partir de um jogo colaborativo em um tabuleiro de xadrez virtual e teve como produto agregado o encontro dos cavalos. O experimento contou com quatro fases: Linha de Base, Treino de Discriminação, Teste de Discriminação e Teste de Generalização. Participaram do experimento 22 estudantes universitários, distribuídos em 11 duplas. Cada dupla passou pelas quatro fases e participou da atividade apenas uma vez. As medidas observadas foram: taxa de produto agregado ao longo das quatro fases, número de movimentos realizados e índice de dispersão. Os resultados indicam que ocorreu responder diferencial entre os estímulos que sinalizavam as diferentes metacontingências em vigor, embora os dados no Teste de Generalização não tenham sido sistemáticos. Outro efeito observado foi o de contraste comportamental, quando foi introduzida uma condição de extinção na fase de Treino. Os dados relacionados ao número de movimentos e índice de dispersão demonstraram a estereotipia gerada pelo reforçamento e variabilidade induzida pela extinção, ambos efeitos observados no comportamento operante.Palavras-chave: metacontingência, controle de estímulos, discriminação operante, estímulo discriminativo, contraste comportamental
ANÁLISE DE DEFINIÇÕES DE PUNIÇÃO EM TESES E DISSERTAÇÕES BRASILEIRAS: CONSIDERAÇÕES SOBRE SIMETRIA E ASSIMETRIA
Authors: Dos Santos Bruna Colombo , Pereira Maria Eliza Mazzilli
Published: May 2017

Duas definições de punição são comumente citadas por analistas do comportamento: a de Skinner e a de Azrin e Holz. A definição de Skinner é operacional; a de Azrin e Holz é operacional e processual, sendo a mais citada na literatura internacional. O objetivo deste trabalho foi caracterizar as definições de punição apresentadas em teses e dissertações brasileiras e identificar os autores utilizados para referenciá-las. A busca pelos trabalhos foi feita em bases de dados e currículos Lattes. Foram analisadas 17 teses e dissertações. Foi identificado se os estudos apresentavam ou não definição de punição e, no caso dos estudos que apresentavam, as definições foram classificadas em: Operacional; Operacional/Processual; Ambas. Verificou-se que o número de trabalhos sobre punição vem crescendo desde os anos 2000 e que a maior parte dos estudos ou não apresentou definição de punição ou apresentou ambas as definições. A maioria dos estudos que apresentaram ambas as definições tinham como foco a temática da simetria versus assimetria entre reforçamento e punição, e os estudos que não apresentaram definição investigaram efeitos da punição sobre diferentes operantes. Embora a análise indique uma tendência ao posicionamento simétrico nos estudos que não apresentaram definição, nota-se que, recentemente, trabalhos sobre o debate simetria versus assimetria têm sido realizados.Palavras-chave: Análise do comportamento; Punição; Revisão de literatura.
Corporate Governance System and Entrepreneurial Orientation in the Banking Sector: Evidence from a Developing Country
Authors: Olori W. O. , Sylva Waribugo
Published: May 2017

Streams of literature on Corporate Governance System (CGS) and Entrepreneurial Orientation (EO) dwelt mainly on the association or effect of CGS dimensions: such as board structure, board size and tenure, on limited aspects of EO. Whereas these dimensions are observable in companies’ documents and end of year reports, stakeholders may have limited understanding of behavioral tendencies exhibited by boards, and the manner in which tasks are being executed. This study was therefore conducted to ascertain the nexus between behavioral indicators of CGS and EO. Specifically, we analyzed whether boards’ effectiveness, knowledge, commitment and involvement correlate with innovativeness, proactiveness and risk-taking. Copies of the questionnaire were self-administered to 101 senior managers of deposit money banks. The data extracted from responses were analyzed using Kendall’s tau-b. Results show that CGS correlates positively with innovativeness and proactiveness; while risk-taking has a moderately positive association with effectiveness, knowledge and commitment, but correlates negatively with boards’ involvement. Based on the results and findings, it was recommended that boards should employ moderate control and supervision; existing corporate governance mechanism should be redesigned to foster innovativeness by promoting flexible business culture for reasonable risk-taking.
Cost Accounting and Financial Health: Analysis of Cost Reduction Policy Effect in Selected Enterprises of Metallurgy Industry in Uzbekistan
Authors: Abdusalomova Nodira
Published: May 2017

Cost accounting is an emerging trend of business accounting in developing economies. Deep-in-root accounting reforms and advances in business climate involve the cost accounting techniques which could embrace technological, market and financial healthiness factors of a business. As a developing economy, Uzbekistan has been reforming accounting system and developing the coverage of accounting in providing financial data in all sectors. Moreover, the government is ensuring cost reduction initiatives to stabilize the price volatility and mitigate the demand shock for particular enterprises. Metallurgic industry, in this line, has been benefiting from this initiative and reducing the output cost within the established target. Cost reduction policy is directly influencing on the cost accounting and costing methods of metallurgic industry enterprises. Consequently, a need for introduction of modern cost accounting techniques to the accounting system has been emerging as a part of accounting system reform. This article examines the relevance of cost accounting by analyzing the effect of cost reduction policy on financial health of selected metallurgy industry enterprises. When it comes to methodology, it was chosen to apply Enyi’s solvency model, which evaluate how the firm gets solvency and this model contains four prime steps.
Jakość życia łódzkich szóstoklasistów w perspektywie przestrzennej
Authors: Petelewicz Marta
Published: May 2017

Łódź jest miastem silnie zróżnicowanym przestrzennie zarówno w kontekście fizycznym, jak i społecznym. Zróżnicowanie poziomu jakości życia dotyczy również najmłodszych mieszkańców. Celem artykułu jest przedstawienie zależności pomiędzy jakością życia respondentów a statusem okolicy, w której mieszkają. Badania empiryczne stanowiące podstawę analiz przeprowadzone zostały techniką ankiety audytoryjnej wśród szóstoklasistów uczęszczających do szkół podstawowych o najwyższym i najniższym wskaźniku uczniów dożywianych. Analiza wymiarów jakości życia przeprowadzona została w oparciu o koncepcję having, loving, being E. Al-lardta, ponadto szczególną uwagę poświęcono ocenie okolicy zamieszkania. Wykazano, że wymiary having i being oraz stosunek do okolicy zamieszkania wiążą się z zamieszkiwaniem w okolicy o określonym statusie. Zgodnie z aplikacyjną funkcją badań jakości życia informacje na temat dobrostanu najmłodszych mieszkańców powinny zostać uwzględnione przy projektowaniu strategii i ewaluacji działań podejmowanych w ramach polityki miejskiej.
Kontrurbanizacja a jakość życia na wsi
Authors: Dej Magdalena , Zajda Katarzyna
Published: May 2017

W artykule poruszono kwestię kontrurbanizacji oraz jej związków z jakością życia na wsi. W pierwszej części artykułu zarysowano rozumienie pojęcia kontrurbanizacji i przedstawiono szeroki przegląd literatury międzynarodowej, jaka na przestrzeni ostatnich kilkudziesięciu lat powstała na ten temat. Odniesiono się zwłaszcza do tych prac, które wskazują na potrzebę prowadzenia badań z zakresu kontrurbanizacji w Europie Środkowo-Wschodniej. W dalszej części przeanalizowano różne motywy migracji na peryferyjne obszary wiejskie, zwłaszcza w kontekście powiązań pomiędzy procesami kontrurbanizacji a jakością życia. Zwrócono uwagę zarówno na motywy pozytywne – migracja na obszary wiejskie powodowana chęcią podniesienia jakości życia, oraz negatywne (migracje powodowane presją sytuacji życiowej) – wybór wsi jako miejsca za-mieszkania wynikający z chęci redukcji kosztów utrzymania czy konieczności zaopiekowania się najbliższymi krewnymi. W końcowej części artykułu, na podstawie istniejącego stanu wiedzy sformułowano propozycję kilku problemów badawczych, które zdaniem autorek powinny w najbliższym czasie zostać podjęte na gruncie polskim, w ramach szerokich interdyscyplinarnych studiów z zakresu geografii, socjologii i innych nauk społecznych.
Kłótnia – jako akt komunikacji małżeńskiej. Próba analizy
Authors: Holak Izabela
Published: May 2017

Problematyka podjęta w artykule, związana jest z pewnym typem relacji małżeńskich. Skupiłam się w nim na kłótniach, do jakich dochodzi między partnerami, ponieważ to one, w moim przekonaniu, decydują w dużej mierze o całokształcie tych relacji. Moje rozważania rozpoczynam od ustalenia znaczeń takich terminów, jak: „kłótnia”, „spór”, „konflikt” czy „kryzys”. Służą one bowiem do opisu zachowań, stanowiących przedmiot moich zainteresowań, są zatem kluczem do ich zrozumienia. Przyjęłam, że to, co decyduje o charakterze małżeństwa, związane jest przede wszystkim z komunikacją między jego partnerami. Komunikację rozumiem tutaj dość szeroko i włączam w jej zakres zarówno wszelkie zachowania werbalne, jak i niewerbalne, które decydują o porozumiewaniu się i wzajemnym okazywaniu uczuć. Wszelkie bariery utrudniające tak rozumianą komunikację prowadzą do konfliktów i kryzysu, a te z kolei przyjmują postać „kłótni” czy „sporów”. Dlatego też centralnym problemem tego artykułu stała się analiza przebiegu i rezultatów kłótni i sporów, do których dochodzi w tego typu związkach.
Translacja i dominacja. Struktura przepływu tłumaczeń w światowych i polskich naukach społecznych
Authors: Warczok Tomasz
Published: May 2017

Artykuł przedstawia hierarchię światowych nauk społecznych, zarysowaną przez pryzmat struktury przepływu tłumaczeń książek. Stojąc na stanowisku, że wymiany translatorskie są uwikłane w globalne relacje władzy, autor, posługując się danymi z bazy UNESCO (Index Translationum) analizuje strukturę i ewolucję tak rozumianego systemu. Wprowadzone zostaje kluczowe rozróżnienia na „eksport” i „import” translacji (tłumaczenie „na” dany język i „z” danego języka) oraz możliwość dokonywania obliczeń „bilansu wymian translatorskich” (analogicznie do salda importu i eksportu w ekonomii wymian międzynarodowych). Wszystko to służy określaniu pozycji poszczególnych języków i krajów na znanej z teorii systemu światowego płaszczyźnie centrum– peryferie. Przedstawione w artykule obliczenia wskazują na powiększający się, silny rozdźwięk między centrum i peryferiami, prowadzący do sytuacji, w której idee zachodnie stają się coraz popularniejsze w świecie, zaś idee wytwarzane na peryferiach i półperyferiach są konsekwentnie marginalizowane. Pozycja polskich nauk społecznych w tak zarysowanym układzie, pomimo otwarcia na zachodnie idee po 1989 r., pozostaje stabilna i lokuje się półperyferiach systemu.
Przypadki niemieckiego odkrywcy i konkwistadora Philippa von Hutten, zwanego Felipe de Utre
Authors: Elbanowski Adam
Published: May 2017

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Opis wizyty dziekańskiej kościoła parafialnego w Małogoszczu z roku 1830
Authors: Karkocha Małgorzata
Published: May 2017

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Przemysław M. Żukowski, Profesorowie Wydziału Prawa Uniwersytetu Jagiellońskiego, t. II (1780–2012), pod red. Doroty Malec, Wydawnictwo Uniwersytetu Jagiellońskiego, Kraków 2014, ss. 682
Authors: Przeniosło Małgorzata
Published: May 2017

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Characteristics and freezability of Assam Hill goat semen
Authors: Deori S. , Deka B. C. , Biswas R. K. , Nahardeka N. , Arangasamy A. , Bhuyan D C. , Kalita D. J. , Borah R. S. , Phookan Arundhati
Published: May 2017

Assam Hill goat (AHG) is an important goat germplasm found in Assam and its adjoining areas of India. The study was designed with an objective to study the semen characteristics and freezability of AHG buck semen using Tris -Egg yolk-Citrate-Fructose diluent. The mean values of fresh semen characteristics in AHG bucks viz., ejaculate volume (ml), initial sperm motility (%), sperm concentration (x106/ml), live sperm (%), sperm abnormality (%), HOST-reacted sperm (%) and intact acrosome (%) recorded were 0.39 ± 0.01, 77.97 ± 0.73, 3201.00 ± 143.78, 83.02 ± 0.65, 7.66 ± 0.73, 66.95 ± 0.74 and 93.34 ± 0.51, respectively. Mean values for post-thaw semen characteristics i.e., sperm motility (%), live sperm (%), HOST-reacted sperm (%) and intact acrosome (%) were 55.39 ± 0.97, 71.01 ± 0.78, 54.77 ± 0.55 and 82.16 ± 0.43, respectively. It can be concluded that AHG bucks donate acceptable quality of semen which can be frozen successfully in Tris-Egg yolk-Citrate-Fructose diluents for using in Artificial Insemination.
Afecciones oculares, su relación con factores de riesgo ocupacional y uso de elementos de protección personal en una empresa metalmecánica en Bogotá
Authors: Jiménez Barbosa Ingrid Astrid
Published: May 2017

Esta investigación descriptiva buscaba conocer si existe alguna relación entre los factores de riesgo físicos, químicos, mecánicos y el uso de Elementos de Protección Personal Visual (EPPV) en las afecciones oculares de los trabajadores de una empresa metalmecánica. La muestra por conveniencia fue de 100 trabajadores (50 expuestos a los riesgos y 50 no expuestos). Se elaboró una encuesta para identificar la exposición extralaboral a los factores de riesgo y la comodidad del trabajador con los EPPV; se diligenció una historia clínica visual y se llevó un formato para evaluar la calidad óptica de los elementos de protección visual. Como resultado, se observó que al valorar la óptica de los equipos no se encontraron aberraciones, sin embargo frente al confort, el 40% de los trabajadores usuarios reportaron que su EPPV estaba rayado y un 14% ajustado. Entre los riesgos visuales están, 45% humos metálicos, 44% esquirlas metálicas, 6% ácidos y 5% soldadura. Las afecciones oculares encontradas en el grupo expuesto fueron 42% Hiperemia, 26% secreciones y 18% blefaritis. En el no expuesto 38% Hiperemia, 24% conjuntivitis y 17% pterigion. El grupo expuesto usuario de EPPV presentó secreciones 8% (p=0,006) y conjuntivitis 6% (p=0,49) quienes lo utilizan de manera permanente presentaban hiperemia en un 20% (p=0,16) y secreciones en un 14% (p=0,12) y quienes tenían su EPPV rayado, presentaron hiperemia en un 16% (p=0,20) y conjuntivitis en un 4% (p=0,22). Hubo disminución de 6,6% en la agudeza visual lejana y próxima quizás porque el EPPV en un 40% de los casos estaba rayado.
Citología de impresión una técnica novedosa y sencilla para el diagnostico de alteraciones de la superficie ocular
Authors: Rodríguez A. Martha Fabiola , Hernández Rodríguez Patricia
Published: May 2017

El presente artículo es una revisión de la técnica de citología de impresión como herramienta diagnóstica para las alteraciones de la superficie ocular. Se han utilizado un amplio rango de técnicas adaptadas a la citología de impresión de conjuntiva y cornea, como son: diferentes coloraciones para observar las muestras en microscopio óptico, microscopia electrónica, inmunofluorescencia, inmunohistoquimica, reacción en cadena de la polimerasa (PCR) y citometría de flujo. Actualmente, esta técnica es muy utilizada como una alternativa no invasiva para obtener «biopsias» muy delgadas y células epiteliales de la superficie ocular, especialmente porque no presenta efectos colaterales o contraindicaciones. Ha sido demostrado que es una ayuda diagnostica muy utilizada en optometría y oftalmología, en una gran variedad de procesos a nivel ocular. Durante la última década, su uso como herramienta de investigación y diagnóstico ha experimentado un enorme crecimiento y ha contribuido ampliamente en el conocimiento de las patologías de la superficie ocular.
Líneas de defensa contra la producción de radicales libres en diabéticos con retinopatía
Authors: Hernández Rodríguez Patricia
Published: May 2017

La actividad de los radicales libres en pacientes diabéticos es alta. Estas moléculas se originan cuando el oxígeno (O2) se reduce de manera incompleta formando intermediarios químicos altamente reactivos y tóxicos como el anión superóxido (O2¯) y radicales hidroxilo (OH•). Los diabéticos con hiperglicemia tienen una actividad antioxidante disminuida, lo que altera la susceptibilidad al daño oxidativo causando un desequilibrio en los mecanismos de oxidación y antioxidación con incremento significante de radicales libres de oxígeno, asociados directamente con inactividad de las líneas de defensa antioxidante y con disfunciones endoteliales que generan complicaciones microvasculares (Nefropatía y/o Retinopatía). La primera línea constituida por enzimas antioxidantes: superóxido dismutasa (SOD), catalasa, glutatión peroxidasa (Gpx) y la glutatión reductasa. Segunda línea: captadores de radicales libres (sustancias naturales con efecto antioxidante como vitamina C, E, medicamentos como el Allopurinol). Tercera línea: enzimas reparadoras de ADN. Con este artículo se pretende realizar una revisión sobre la implicación de las líneas de defensa antioxidante y su importancia en las complicaciones microvasculares que se producen en el paciente con diabetes.