bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of rehabilitation treatment on the electroencephalography results and the course of epilepsy in children with cerebral palsy
Authors: Bobylova M. Yu. , Shanavazova M. D. , Askevova M. A. , Abusueva B. A.
Published: February 2021

Introduction. Cerebral palsy is often combined with epilepsy and epileptiform electroencephalographic (EEG) activity. Currently, the question of how rehabilitation with cerebral palsy is dangerous in relation to the provocation of epileptic seizures is relevant. Objective: to study the effect of cerebral palsy rehabilitation on epilepsy in a standard rehabilitation center. Material and methods. We examined 80 children with various forms of cerebral palsy and epileptiform EEG activity. The patients were divided into two groups: children of Group 1 never had epileptic seizures, children of Group 2 had a history of epileptic seizures of more than 6 months ago. The follow-up was 12 months during which children underwent EEG before and after rehabilitation courses. Depending on the risks associated with provoking epileptic seizures, patients were prescribed rehabilitation procedures of various intensities: Vojta kinesiotherapy, massage, physiotherapeutic treatment in the form of transcranial micropolarization and paraffin therapy. Results. During the study, epileptic seizures developed in 5 patients (12.5%) from Group 1 and in 7 children (17.5%) from Group 2. In all cases, rare focal seizures were recorded (1–2 times a year). All patients with seizures during our study had a history of seizures under the age of 1 year. The onset of seizures was quickly stopped by the basic antiepileptic drugs in monotherapy. Epileptic seizures developed in children with moderate to severe cerebral palsy on GMFCS (Gross Motor Function Classification System) and a history of neonatal seizures. We attributed both of these to risk factors. In children with cerebral palsy and epilepsy in remission of 6 months or more, massage and Vojta therapy did not provoke epileptic seizures. The effect of epileptiform activity on the severity of motor status and on cognitive functions in cerebral palsy has not been established in our study. Conclusion. According to our data, rehabilitation measures do not have a significant impact on the risk of developing epilepsy.
Conditions for Creditors to Exercise Special Rights during Reorganization
Authors: Kuznetsov A. A.
Published: February 2021

The business reorganization regulation has traditionally been associated with creditor’s rights protection. The main difficulty in this case lies in the fact that in attempts to provide comprehensive protection of creditors to prevent them from losing the main thing for which the reorganization is needed—in fact, to enable enterprises to adapt to changing economic conditions—because in the presence of excessively burdensome rules, entrepreneurs will not be able or not want to take advantage of such a legal regime. In other words, any law and order is forced to seek a balance between the interests of reorganized entities and creditors. The Russian doctrine is largely isolated from the European tradition and focuses on the discussion of private issues of the application of Russian rules and lacks clear conceptual guidelines for development of these very rules. Special rights that the creditor has in connection with the reorganization of the company constitute the basis for the protection of the creditor’s legitimate interests. The shortcomings of domestic rules give rise to practical problems in the implementation of reorganizations. The creditor’s exercise of special rights during reorganization creates many risks for the company. In this regard, all legal orders impose restrictions on creditors exercising their rights. The paper discusses expedient restrictions of such rights on the basis of the European doctrine.

The author concludes that each law and order has developed its own restrictions regarding the circle of creditors protected during reorganization. Concurrently, from the point of view of the previously considered rationale for the protection of creditors the only restrictions we can justify are the restrictions on the exercise of special rights in the event of reorganization of those creditors whose obligations arose after the reorganization started (disclosure of information about reorganization), as well as creditors who have other means of protecting their legitimate interests (for example, a counter-non-performance objection or the right to demand termination of the contract).
"Monarchists" and "Republicans" in the Western European Political and Legal Thought of the 17th Century
Authors: Galkin I. V.
Published: February 2021

The paper is devoted to the problem of theoretical approaches to monarchical and republican forms of government that were reflected in the works of representatives of Western European political thought of the 17th century. The seventeenth century is the century that opens the period of Modern Times. It was a turning point not only in the history of Western European civilization, but also in the history of philosophical knowledge and "positive" sciences, including in such a specific field as political thought, which developed at the intersection of philosophy and science. The political theory of the period, was able to rise to the realization of the objective of the imperfection of existing political institutions and give its recommendations for addressing the identified deficiencies, as far as it was possible in terms of initial imperfections is given to us in sensations of the world. The political thought of the historical period under consideration showed a lively theoretical polemic between the supporters of the monarchical and republican forms of government. The revolutionary situation developed in some of the advanced European states during the alarming seventeenth century made it possible to understand the advantages or disadvantages of the existing forms of government. It seems quite natural that the formation of the theoretical views of specific political thinkers or jurists was formed under the influence of the dominant ideology (or competing ideologies) of that time. Moreover, it should be noted that the monarchist or republican views of specific authors are not always theoretically well-reasoned, but are often based on the subjective preferences of thinkers. Thus, this paper highlights a rather ambiguous problem of the features of monarchical and republican forms of government in the political thought of the 17th century.
Quality of health care perceived by users in Catalan prisons
Authors: García-González L , Mendioroz-Peña J , Armenteros-López B , Sole-Zapata N , Alonso-Gaitón P , Cuadro-Pena E
Published: February 2021

Objectives: To describe inmates’ perceptions of healthcare quality in Catalonian prisons. Material and method: Transversal study of 6,856 inmates in Catalan prisons in September 2017. Randomized simple screening was used to randomly distribute 1,048 polls in which different aspects of perceived quality of healthcare were evaluated. The results were also categorized according to age, sex, time spent in prison, background and academic levels. We also analysed the differences between results in healthcare quality according to socio-demographic variables. Results: 84.87% of patients show satisfaction with the quality of healthcare received. Women are more satisfied with consultations than men (OR: 2.04; p = 0.009). Patients with a higher educational level are less satisfied than those with a lower educational level, with significant differences in 11 of the 14 items. Those over 65 years of age were more satisfied than the rest in 11 of the 14 items evaluated. Foreign patients were more satisfied than Spanish inmates in time flexibility (OR: 0.69; p = 0.018) and in waiting times for visits (OR: 0,63; p = 0.006), whereas they are less satisfied with the healthcare professionals’ image (OR: 1.97; p = 0.03). Discussion: Noteble features of our study include the fact that although global satisfaction is high, some dimensions, like reliability, could improve. The results were submitted to the General Directorate to enable more in-depth study of the variables where there is less satisfaction and to design further improvements.
Psychological symptomatology in a prison population: an exploratory study of age, psychopathological history and time in prison
Authors: Molina-Coloma V , Lara-Machado R , Pérez-Pedraza B , López-Rodríguez D
Published: February 2021

Objectives: Identify psychological symptoms relating to age, psychopathological history and time in prison in women and men incarcerated in a prison. Material and method: Cross-sectional study. The sample was made up of 100 inmates, 50 men and 50 women and the symptom Checklist-90-Revised (SCL-90-R) was used to assess psychopathological symptoms. Results: This study shows that inmates with a psychopathological history prior to entry to prison, younger inmates (18-29 years) and inmates who have been a short time in prison present more psychopathological symptoms. Discussion: The results found suggest the implementation of a protocol for psychological care of prisoners in general, but highlights a particular interest in the care of cases with people with a psychopathological history prior to entering prison, in those who are younger and those who have been in prison for a short time.
Analysis of burden of sexual assaults at Abuja: a 4-year retrospective study
Authors: Ayogu Malachy Emeka , Abdullahi Habiba Ibrahim , Adewole Nathaniel D.
Published: February 2021

Background: Sexual assault is a worldwide crime associated with traumatic experience and largely affects women and girls. It is greatly underreported, more especially in the low income countries due to our peculiar culture.Methods: A retrospective study of sexual assault victims managed at the Hospital from January 1, 2015 to December 31, 2018. Case notes were retrieved and relevant data extracted and analyzed.Results: A total of 58 cases were seen and mostly involving pupils/students 44 (75.9%) and singles 52 (89.7%). The ages ranged from 3 to 37 years with a mean of 14.1±7.8. The assailants were known to the victims in 63.8% of cases. Sexual assault through vaginal route was the commonest type 57 (98.3%) and perpetrated by one person in majority of cases (79.0%). Physical force (43.1%) was major method used to subdue victims. About 60.3% of assaults occurred during the daytime and mainly occurred (60.4%) at home/office. The time interval between assault and presentation in the hospital ranged from 6 hours to 96 hours; majority presented within 24 hours (59.6%). Only 35 (60.3%) reported to the police. About 48.3% received post exposure prophylaxis. About 37.7% eligible for emergency contraception received it. Only 32.8% of the victims completed 3- month follow-up.Conclusions: Sexual assault is common in our environment with most victims being less than 14 years of age and assailants were mostly persons known to them. Some victims presented late.
Maternal death audit at tertiary care centre: changing trends
Authors: Sivakumar Sudha , Xavarina Sophia G. , Srianand Ashmitaa
Published: February 2021

Background: The aim of the study was to analyse the trend in maternal mortality ratio in a tertiary care centre.Methods: This was a four-year retrospective analysis of maternal deaths that occurred at Government Rajaji Hospital, Department of Obstetrics and Gynaecology, Madurai from January 2017 to December 2020. Cases were stratified based on cause of death. Epidemiological data was collected from the hospital register.Results: The total number of maternal deaths at GRH during the study period is 228, in which death due to obstetric cause was 82 (36%) and non-obstetric cause was 146 (64%). The most common cause in each year was PIH (23%-2017, 29%- 2018), heart disease (22%- 2019) and infection (46%- 2020).Conclusions: We concluded by this study that the maternal death due to non-obstetric causes were more than the obstetric causes due to improved antenatal, post-natal care, institutionalized deliveries and timely referral to the CEmONC (comprehensive emergency obstetric and new-born care) centres and management.
Antenatally diagnosed congenital anomalies-trend in tertiary care hospital
Authors: Kishore Kamal , Dey Madhusudan , Gaba Ashisha , K. P. Shijith , Bhatt Reema Kumar
Published: February 2021

Background: Antenatally diagnosed, congenital abnormalities of the fetus are frequently offered antenatal surgical consultation in all tertiary care hospitals to adequately counsel prospective parents. We aimed to assess the current trends in antenatally diagnosed congenital malformations of fetus in patients who had presented to our hospital for reassessment or surgical consultation and these patients were counselled and prognosticated after confirmation of anomaly at our centre accordingly.Methods: This was a retrospective study of all the cases diagnosed antenatally with fetal abnormalities. All cases were referred to either pediatric surgery outpatient department or fetal medicine subunit of a tertiary care centre from January 2017-December 2018. The complete records of these pregnant women were perused, presence and type of anomaly confirmed at our centre and trends about types of anomalies analysed.Results: A total of 209 women were analyzed for antenatal anomalies, out of these patients medical termination of pregnancy was offered to 27 (12.9%) patients, in which 38 anomalies were detected and in 182 (87%) patients pregnancy was continued to delivery. A total of 223 anomalies were detected in this group with some patients having fetuses with more than one anomaly. Gastrointestinal abnormalities were present in 94 (51.6%) patients of those who delivered and accounted for the most common anomaly followed by CNS abnormality which accounted for 39 (21.4%) of total abnormalities and genitourinary abnormalities contributed to 28 (13.3%) of abnormalities. A total of 85.2% of patients were referred after 20 weeks.Conclusions: The significant number of patients with major congenital anomalies are still diagnosed at a date later than permissible time for termination of gestation (20 weeks). There were cases where anomaly scan was done at a later gestation and then there were others where inadequate counselling made patient to present late for prognostication. However, there are certain anomalies that are picked up late and are likely to be missed in the routine anomaly scan. Therefore, antenatal detection and early referral helps in offering early counselling and better outcome for pregnancy.
Role of dual biomarkers and uterine artery doppler study in predicting PIH and IUGR in antenatal patients registered in a tertiary care centre
Authors: Bapat Alka C. , Kashikar Rupesh , Goyal Shashi R.
Published: February 2021

Background: The incidence of IUGR is between 3 to 7%, whereas that of Hypertensive disorders of pregnancy is about 10% of pregnant women around the world. These conditions are associated with a high rate of perinatal morbidity and mortality, posing a need for the detection of the potential causes of maternal and foetal morbidity and mortality and for the prediction of these conditions early during pregnancy.Methods: Patients with first antenatal visit before 10 weeks gestation underwent routine NT scan between 11–13 weeks with bilateral UAD-RI of the maternal uterine arteries. The placental volume was assessed. Serum dual biomarker test (β hCG and PAPP-A) was performed after this scan and analysed as multiples of median (MoM). Blood pressure was recorded at every ANC visit till 2 weeks after delivery. Neonatal head and chest circumference, birth length and weight were recorded.Results: The mean values of PAPP-A levels of Non-PIH and PIH groups were 1.32±0.91 MoM and 0.68±0.39 MoM respectively, showing statistically significant difference.  The serum PAPP-A levels showed statistically significant difference between Non-IUGR and IUGR groups (1.24±0.87 MoM and 0.46±0.20 MoM respectively).Conclusions: In our study, PAPP-A level is observed as a good indicator for possible prediction of PIH and IUGR whereas levels of β hCG and UAD-RI were not good predictors. The role of Placental volume in prediction of IUGR needs to be explored further with larger sample size. Future studies are needed with a larger group with inclusion of measurement of PI values.
Role of dinoprostone gel in induction of labour
Authors: Patel Meet S. , Jani Shashwat K. , Patel Babulal S. , Shah Akshay C.
Published: February 2021

Background: Labour induction is one of the most common intervention in obstetric practice. A simple application of PGE2 intracervical gel can ripen the cervix effectively and improve Bishop’s score there by helping in successful vaginal delivery. Considering its good performance, the dinoprostone slow-release vaginal insert is the first choice for elective induction of labour in postdate pregnancy and in patients with term pregnancy of premature rupture of membranes.Methods: This was a single year retrospective study conducted in a tertiary care center of western India from May 2019 to May 2020.Results: In group I women who delivered within 24 hours were included, in group II women who required re-instillation were included. The most common indication for induction in both the groups was past dates (accounting for 36.1% in group I and 47.3% in group II). The success rate in group I was 68.1% while in group II was 36.8%.  The rate of cesarean delivery in group I was 25.9%, while in Group II, it was 60.1%. Negligible maternal and neonatal complications were seen in both the groups.  Conclusions: The study showed that intracervical application of prostaglandin E2 is an effective, safe and acceptable method for induction of labor in women with unfavorable cervix and indications for induction. All these effects were achieved without increasing maternal and neonatal morbidity
Preemptive use of adjunctive IV lidocaine for enhanced recovery after abdominal hysterectomy for overweight and obese women: a prospective, randomized, double-blind, placebo-controlled study
Authors: Shady Nahla Waer , Farouk Hassan Ahmed , Sallam Hany Farouk
Published: February 2021

Background: This investigation planned to evaluate the clinical results of adjunctive IV lidocaine bolus dose plus infusion for one hour after surgery in patients who underwent an abdominal hysterectomy in obese and overweight women.Methods: We performed a double-blind, placebo-controlled study, (ClinicalTrials.gov identifier: NC03748108), with patients undergoing abdominal hysterectomy divided into 2 groups: one group received intravenous lidocaine single bolus dose preoperatively and IV infusions till one hour after the surgical procedure, and the opposite received normal saline infusion (placebo). We assessed postoperative results, including pain scores rankings on a visual analog scale (VAS) in rest and movement, administration frequency of pethidine. Postoperative nausea and vomiting, the period of hospital stay (LOS), time to ambulate, and patient satisfaction at forty-eight hours had been evaluated. Chi-square test and Monte Carlo test have been used for comparison among groups.Results: There were 120 patients in our study. The visual analog scale (VAS), pain scores, length of hospital stay (LOS), and administration frequency of pethidine were significantly lower in the lidocaine group. The total amount of consumed pethidine was significantly lower in the lidocaine than the placebo group. There was a significant reduction in post-operative pain which was assessed by visual analog scale (VAS) after 2,4,8,12, and 24 hours either during movement or during rest in the lidocaine group compared to the placebo group, p=(0. 0001,0.0001,0.0001,0.0001 and 0.0001).Conclusions: The administration of adjuvant intravenous lidocaine infusion reduces pain during the postoperative period after abdominal hysterectomy, is associated with early recovery, decreased postoperative opioid analgesic requirement, and better patient satisfaction in overweight and obese women undergoing abdominal hysterectomy.
Analysis of indication of caesarean sections according to Robson’s ten group classification system at a tertiary care teaching hospital in South Rajasthan
Authors: Saharan Saroj , Rastogi Radha , Chyaunal Deepti
Published: February 2021

Background: The objective of this study was categorization and evaluation of the caesarean section rate at our institute as per Robson’s formula.Methods: This retrospective study was conducted at department of obstetrics and gynecology, RNT Medical college, Udaipur, a tertiary care teaching hospital in South Rajasthan. The data was collected retrospectively from December 2020 to February 2020 over a period of 2 months and percentage were calculated in various groups as per Robson’s ten group classification system.Results: Among a total of 1195 women delivered during study period, 420 (35.14%) delivered by CS. Women with previous CS (group 5) contributed maximum (35.95%) to the total number of CS followed by group 2 (27.14%).Conclusions: Standardization of indication of caesarean deliveries, regular audits and definite protocol in hospitals will aid in curbing the rate of caesarean deliveries in hospitals.
Prevalence of thyroid disorders among pregnant women at a tertiary care hospital in Rajasthan
Authors: Singh Shalini , Shree Pragya , Kanti Vaibhav , Kumari Kalpana , Suchdeva Rajeev
Published: February 2021

Background: Hormonal changes and metabolic demands during pregnancy result in profound alterations in the biochemical parameters of thyroid function. Screening for thyroid disorders and initiation of its management at the earliest stage during first trimester is essential as maternal thyroid failure during the first half of pregnancy has been associated with several pregnancy complications and intellectual impairment in offspring. Aim was to evaluate the prevalence of thyroid dysfunction during the first and second trimester of pregnancy among women of Rajasthan state in India.Methods: The study comprised a cohort of 313 consecutive pregnant women in the first and second trimester that attended the OPD and were admitted as pregnant women in Obstetrics and Gynecology Department of the NIMS Medical College and Hospital, Jaipur, Rajasthan. Thyroid stimulating hormone (TSH) levels and free T4 (fT4) were estimated. The subjects were grouped into six groups based on the value of serum TSH and fT4.Results: Out of 313 antenatal women enrolled in the study, 213 (68%) attended antenatal clinic in first trimester of pregnancy and 100 (32%) women in their second trimester. The prevalence of thyroid dysfunction was 15.97% (overt hypothyroidism 1.28%, subclinical hypothyroidism 4.79%, isolated hypothyroxinemia 4.47%, overt hyperthyroidism 1.92%, and subclinical hyperthyroidism 3.51%). The women with overt hypo- or hyperthyroidism and subclinical hypothyroidism were older than euthyroid women. Maternal weight was high in pregnant women with overt hypothyroidism (58.22±6.18 kg) and subclinical hypothyroidism (52.04±2.94 kg). Gravid status was high in pregnant women with overt hypothyroidism, subclinical hypothyroidism and isolated hypothyroxinemia, but low in hyperthyroid group. History of miscarriage was high in pregnant women with subclinical hypothyroidism.Conclusions: With this study, it was concluded that there is high prevalence of thyroid dysfunction in pregnancy predominantly in rural population of Rajasthan. Majority among these being subclinical hypothyroidism and hypothyroxinemia.
Survey on common practice in management of preeclampsia by obstetricians
Authors: Chavan Komal , Chavan Niranjan , Rajput Hitendrasing D. , Mirza Hera , Venkateswaran Sneha , Mahapatra Shalini
Published: February 2021

Background: Approximately 72,000 pregnant women all over the world die every year due to direct or indirect complications related to eclampsia and severe preeclampsia. Incidence of hypertensive disorders in pregnancy in India is found to be 10.08% as per the data collected by the National Eclampsia Registry (NER). Here we present the results of a survey conducted among obstetricians in India to know the common practices in the management of pre-eclampsia followed in our country.Methods: Observational study of survey which was conducted for the period of 1 month from 22nd May 2020 to 22nd April 2020. Questionnaire was prepared on surveyheart.com and sent to obstetricians via Social media platforms to the members of FOGSI. all answers 'collected' and results were prepared from given answers. The survey was answered online by 289 obstetricians.Results: For mild to moderate pre-eclampsia Labetalol is still first line antihypertensive agent being used by many of the obstetricians. In our study also we found out Tab Labetalol 100mg BD is the most preferred type (278, 96.19%) of first line anti-hypertensive in cases of pre-eclampsia followed by Cap Nifedipine 5mg QID and Tab Amlodipine 5mg OD respectively.Conclusions: Comprehensive educational efforts and skill building modules are need of hour to keep every practicing obstetrician regarding recent advances in standard practice protocols.With close monitoring of all cases and well selected anti-hypertensive treatment, it is possible to achieve favourable outcomes for the mother and the baby.
COVID-19 and pregnancy: the fruitful experience of the university hospital of Tangier Morocco with hydroxychloroquine and anti-retroviral treatment
Authors: Aouali Karima , Moustaid Houda , Moustaid Houda , Benkirane Saad , Benkirane Saad
Published: February 2021

The coronavirus disease 2019 (COVID-19) caused by the emerging virus, severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), was announced as a pandemic by the World Health Organization as a global public health emergency. Since the first case of COVID-19 was declared the Moroccan government set up drastic preventative measures to deal with the spread of the virus such as compulsory containment, telework, distance education, use of masks in public places, and many other preventive measures. Pregnant women require special attention in relation to prevention, diagnosis and management. We herein reported a prospective observational study that aims to evaluate the security and effectiveness of hydroxychloroquine on pregnant women with corona virus disease. Our study is a prospective study performed in the three hospitals specialized on corona virus disease 2019 in tangier morocco. We included pregnant women hospitalized with COVID-19 and reproductive-aged. Most cases took the hydroxychloroquine treatment. The maternal outcomes under hydroxychloroquine appear good in most cases for both mother and child and seemed to be safe according to several studies on its use for rheumatic diseases. In the absence of more robust data, this treatment might be best practice in countries that can’t afford the expensive antiviral treatment in this outbreak especially in emergency situations.
Pregnancy in a didelphic uterus: a case report of an unusual phenomenon and review of literature
Authors: Ekanem Emmanuel , Lalrinawmi Lalrinawmi , Sinha Anita , Abdelrazik Tamer
Published: February 2021

Mullerian anomalies are defects in the embryological development of the urogenital systems as these organs begin to form at about the 5 and 6th week of intrauterine life. Uterine didelphys is one of the Mullerian or paramesonephric duct anomalies occurring as a result of duplication of the uterine canal with two cervical canals and a single vagina. The incidence uterine didelphys has been quoted as 1 in 2000 women.  This case report elucidates the presentation of a multiparous lady with uterine didelphys who has a had a previous successful pregnancy in of the uterine canals but presented in the second pregnancy with a missed miscarriage at 12 weeks gestational age.  She also has a single right kidney. These were all diagnosed on ultrasound scan. She had an initial unsuccessful surgical management of miscarriage with uterine perforation of one of the uterine cavities, hysteroscopy and diagnostic laparoscopy and subsequently had a repeat examination under anaesthesia and second attempt at evacuation of retained products or a laparoscopy plus hysterotomy.  This was particularly challenging as the cervix was flushed with the vaginal vault making delineating and dilatation of the cervical OS difficult hence sustaining a perforation of the left uterine cavity.  The second attempt of surgical management was successful, and she was subsequently discharged. This is one of the few case reports in literature and will further add credence to the body of knowledge of a different aspect to the presentation and management of cases of Mullerian anomalies.
Imperforate hymen: a case report
Authors: V. Kalaivani , Gopalan Ushadevi
Published: February 2021

Imperforate hymen is one of the rare causes of primary amenorrhea due to uterovaginal developmental anomaly. We report a case of imperforate hymen in a 14-year girl with primary amenorrhea who presented to us with cyclical abdominal pain, mass abdomen and dysuria. Local examination showed bulged and bluish hymen. Ultrasonography showed hematocolpos. She underwent hymenotomy through a cruciate incision and recovered well postoperatively. Hematocolpos should always be considered in a prepubertal girl who presents with primary amenorrhea, mass abdomen and urinary problems.
Systemic infection of Staphylococcus aureus in postnatal woman: a unique finding
Authors: Prasanthi Annie , Mathews Jiji Elizabeth , Bharathy Muruga , Rathore Swati
Published: February 2021

Staphylococcus bacteraemia is the leading cause of hospital acquired and community acquired bacteraemia. Complications associated are difficult to recognise. Mortality is 20 to 40%. This is a unique case discussing the metastatic spread of Staphylococcus infection following a wound infection. An informed consent was taken from the patient before publishing this case report.
A case of amniotic fluid embolism and its sequelae during COVID-19 pandemic: a success story
Authors: Vishal Anish Kumar , Bhasin Dinesh , Prasad Krishna
Published: February 2021

Amniotic fluid embolism (AFE) is an unforeseeable, life-threatening complication of pregnancy with an extremely high mortality rate. This is a complex disorder classically characterized by the abrupt onset of hypoxia, hypotension and consumptive coagulopathy. We experienced a patient who underwent caesarean delivery because of sudden cardiovascular collapse. Intra op she had DIC and was hemodynamically unstable. Surgery was able to complete with inotropes and vasopressors. In subsequent post op period, she had sepsis with MODS. The diagnosis of amniotic fluid embolism was made after other differential diagnosis had been ruled out.  The successful outcome in our case is attributable to early recognition with immediate delivery of the fetus, high-grade resuscitation, timely hysterectomy and aggressive treatment of coagulopathy by blood and blood-products, involvement of multidisciplinary team, constant supervision by nursing staff with positive approach. From a grim situation of near death, the final outcome was a successful story.
Genital tuberculosis mimic as a genital malignancy in post menopausal women
Authors: Mahajan Monalisa
Published: February 2021

Genital tuberculosis tends to be an indolent infection and the disease may not manifest for year after initial seeding. The most common presentation reported in general population are pelvic pain, postmenopausal bleeding, ascites, abdominal mass, ovarian mass. The diagnosis is made by histopathological examination. Surgery is indicated as presence of abdominal pelvic mass with severe pain. Preoperative diagnosis of genital tuberculosis is often difficult because of confusion with ovarian malignancy. A 60 years old women present with weight loss, palpable abdominal mass with ascites, prominent bilateral ovaries and increase level of CA125. Pelvic malignancy was initially suspected but a diagnosis of tuberculosis was made following postoperative peritoneal wash biopsy. Patient managed with surgical laparotomy under a provisional diagnosis of ovarian malignancy but the final diagnosis was genital tuberculosis followed by anti tubercular regimen. Genital tuberculosis with high level of CA125 mimicking ovarian carcinoma.
Endometrioma masquerading an ovarian carcinoma
Authors: Sidhu Amanat , Bala Ripan , Tandon Pooja , Chhina Rajdeep
Published: February 2021

Endometriosis is the presence of endometrial tissue outside the uterus. Endometriosis affects 10-15% of all women in reproductive age group and 70% of the women with chronic pelvic pain. The risk of malignant transformation in an endometrioma has been reported to be low, though there is an increased risk for certain gynecological as well as non-gynecological carcinomas with endometriosis. We present a case diagnosed as having endometrioma transforming into a malignant tumor in a young female. We intend to emphasize that all the clinicians should make their patients aware of the malignant potential of endometriosis and a strict follow up of all cases being treated conservatively should be a must.
An unusual case of interstitial pregnancy: a case report
Authors: Sebastian Nikhil , Radhakrishnan Abhishek , Murugesan Vennila
Published: February 2021

Ectopic pregnancy (EP) has been found to be a common cause of morbidity, and on occasion, mortality among women in the reproductive age groups. The incidence of EP is 1-2% of all pregnancies. 93-97% of EP are tubal with the interstitial type consisting only 3-4%. A 31-year-old female patient with primary infertility underwent IVF (In Vitro Fertilization). Pregnancy was confirmed by βHCG (beta human chorionic gonadotropin). Her ultrasonography reported a mass in the right cornual region. The uterine cavity was empty. Laparoscopy was performed followed by resection of the right cornua with tubes. Histopathology report confirmed the diagnosis of Interstitial Pregnancy (IP). The patient had an uneventful post-operative period and was discharged the next day. EP is a common complication seen in cases undergoing IVF, and IP is a rare form of EP. Hence, early diagnosis and prompt intervention is required to avoid a potentially life-threatening situation.
HIV in pregnancy
Authors: Kore Gauri S.
Published: February 2021

HIV is a disease caused by retrovirus (HIV-1 or HIV-2) the that attacks the immune system of the body, leaving it susceptible to various dangerous infections. HIV can have profound effects on pregnancy and pregnancy may in turn cause an aggravation of signs and symptoms HIV.A pregnant woman living with HIV can pass on the virus to her baby during pregnancy, childbirth and through breastfeeding. This is called Vertical transmission of HIV. Without any intervention, the rate of vertical transmission of HIV is as much as 15-45%. National PPTCT program of India run by NACO (National AIDS Control Organization) aims at preventing HIV transmission from mother to child. Women who are known HIV positives or those who are diagnosed as HIV positive for the first-time during pregnancy, are given Triple Dose Anti Retro-viral therapy comprising of Tenofovir, Lamivudine and Efavirenz. Special precautions are taken during their delivery. Whether LSCS is to be performed depends on the indications and on which guidelines are followed. Infant- feeding is advised to be carried out as per the guidelines stated in the PPTCT act so as to minimize the chances of HIV transmission to the infant.
Socio-demographic factors of patients who underwent free cataract surgery in Kafanchan, Nigeria
Authors: Sano Ulus Stanley , Sarki Pamela Diyale
Published: February 2021

Background: The aim of this study is to determine the socio-demographic profile of people accessing cataract surgery at a free cataract surgical Camp in Kafanchan.Methods: One hundred and nine participants had manual small cataract incision surgery with intraocular lens over a three-month period (September to November 2018) and were followed up for two months. Visual acuity was assessed at first day and two months post-op along with refraction and best corrected visual acuity. Their socio-demographic features along with duration of lost vision and cause of delay in cataract surgery were also noted.Results: Fifty-five males and fifty- four females had cataract surgery and were followed up for two months post-op. Fifty (45.9%) had no formal education while fifty-nine (54.1%) had formal education. Among those with formal education 59% (34) were males while 41% (20) were females. Majority of participants earned less than two hundred and fifty thousand naira (six hundred and twenty-five US dollars) annually. Eighty-two (75%) of participants were Christians and 71 (65%) lived in rural areas. Sixty-five (60%) had lost vision in the index eye more than one year prior to presentation for surgery and the main reason in this study for delay in having cataract surgery was immaturity of the cataract.Conclusions: Some socio-demographic factors are barriers to cataract surgery.
Dietary preferences and traditional practices according to the desired gender of the baby among pregnant women in South Eastern Turkey
Authors: Cevik Semra Akkoz , Karacan Emine , Kılıçlı Aysegul
Published: February 2021

Background: Superstition and traditional practices regarding pregnancy exist in various cultures around the world and are passed down from generation to generation. As a result of the literature review, it was observed that there weren't prospective and cross-sectional studies involving traditional practices and dietary preferences of pregnant women before and after determining the gender according to the gender of the baby they want. The purpose of this study was to determine dietary preferences, superstitions and traditional practices before and after determining the gender of the baby according to the desired gender of the baby among pregnant women.Methods: The research was a descriptive cross-sectional study and adopted the pretest-posttest research design. As the data collection tool, both investigators-designed questionnaire forms and the non-functional beliefs and practices scale (NFBPS) related to pregnancy to the same pregnant women were applied before and after the determination of baby gender in the first and second trimesters respectively.Results: The study found that 85% of the pregnant women thought that dietary preferences during pregnancy have an impact on the gender of the true baby. The results showed that superstitions and traditional practices were known and practiced by pregnant women at a young age, uneducated, living in the province and having a large family type (p<0.05).Conclusions: Health professionals, should pay attention to less educated, younger pregnant women to reinforce positive cultural health practices, discourage to them from using harmful ones superstition and traditional practice by providing non-critical scientific explanations.
Sleep quality among students in Ibn Sina National College
Authors: Yasawy Murad A. , Mohammed Rehab A. , Yasawy Mahmood A. , Hafiz Nada Mohammed , Turkistani Haneen A.
Published: February 2021

Background: Aim of the study was to assess the sleep quality among medical students and explore its relation to many variables as BMI, smoking and chronic diseases.Methods: A descriptive cross-sectional study, conducted among medical students at Ibn Sina national college, Jeddah, KSA. This study was approved by Research Center. A total of 408 participants; Participants are who admitted to hospital for last two days, pregnant and who under 18 years were excluded. We consider p value=0.05 as significant statistically and our confidant interval (CI) is 95%. We used bivariate and univariant variables, for categorical variables we used Chi-square and Fisher exact test.Results: The participants’ mean age was 22.6±2.7 (87.9%) of them were females. Most of our participants were Single (89.8%). A total of 85.9% of the students had poor sleep quality. Those who had less than 6 Hours of sleeping per day had poor sleep quality by 92.2% and statistically affecting their sleep quality p value =0.000. There was no statistically significant relation between sleep quality and academic year or with Gender (p=0.139, p=0.263) respectively. There was no statistical correlation between Sleep quality and Nightmares or Snoring (p value =0.063, 0.055) respectively.Conclusions: Poor sleep quality was prevalent in all class years of the undergraduate medical course and more common between females. This study revealed high prevalence of poor sleep quality. Sleep educational programs, stress management courses and lifestyles modifications are required.
Upsurge in the incidence of scabies (a neglected tropical disease) in some rural communities of Southeast Nigeria: any nexus with climate change?
Authors: Umegbolu Emmanuel I.
Published: February 2021

Background: Scabies is characterized by the presence of burrows, erythematous papules, and generalized pruritus which is usually worse at night. Recently an upsurge in the incidence of scabies has been reported in many settings, including the area of the study. The study aimed to determine if there is a nexus between scabies and climate change as a risk factor.Methods: This was a case-control study carried out in a Cottage Hospital. Case files of 18, 000 patients who attended the hospital between 2016 and 2019 were reviewed. The diagnosis was mainly clinical, i.e. based on the presence of itching in the typical scabies locations, presence of scabies burrows and history of similar itching in the other members of the patient’s household. 112 cases of scabies were diagnosed within this period.Results: From 2016 to 2019, the incidence of scabies rose from 3 to 50. Prevalence among males was 59.8%, and in females 40.2%, although the difference was not significant (p=0.0.53). Compared to other age groups, prevalence was highest in the 6-17 years age group (37.5%), but the difference among the age groups was also not significant (p=0.84).Conclusions: Within four years (2016-2019), the incidence of scabies had risen from 3 to 50 in the area of the study, being higher in males (59.8%) than females (40.2%), and in children less than 18 years (37.5%). Community survey, prompt diagnosis, adequate treatment and avoidance of overcrowding might help to stem the observed rising incidence of the disease.
A study on predictors of complete immunization in children aged 12-23 months in slums of Kanpur Nagar, India
Authors: Chaturvedi Ruchi , Sharma R. P. , Martolia D. S. , Midha Tanu
Published: February 2021

Background: Kanpur is one of the major industrial hub of Uttar Pradesh. Migration of people in the search of jobs led to formation of slums in many part of city which is 20% of total population of the city. A large number of below poverty line (BPL) population (about 60%) also live-in slums. Little data is known about immunization status of children residing in these slums. With this background this study is planned to predict various demographic factors affecting immunization status and to study various factors responsible for partial/non immunization of children.Methods: Cross sectional observational study. 30 cluster sampling technique was used to select 30 clusters from 380 identified slums of Kanpur Nagar.Results: More children were completely immunized with increase in educational level of mothers. (χ2= 16.62, df=2, p=0.000) ; mothers having institutional delivery (χ2 =31.8, df=1, ,p=0.000; belonged to general category (χ2=25.3, df=2, p=0.000) and Hindu by religion. (χ2=7.34, df=1, p=.006). No significant difference was seen in immunization coverage with respect to gender (χ2 =2.7, df=1, p=.09). Obstacles (45.2%) were the most common reason for partial immunization whereas lack of information (52.63 %) was most common reason cited in case of non-immunized children.Conclusions: Educational status of the parents particularly mothers and the economic status of the family have great bearing on the immunization coverage of under 5 children. So female empowerment measures may prove helpful in improvement of the immunization status.
Prevalence and associated factors of malaria in Pushparajgarh block of district Anuppur, Madhya Pradesh, India
Authors: Dwivedi Manish Kumar , Bakshi Sanjeev , Shyam Birjhu Singh , Shukla Ravindra , Singh Prashant Kumar , Sharma Naveen Kumar
Published: February 2021

Background: The current study aimed to determine the prevalence of malaria and its association with seasonality of malaria and socio-demographic variables in a tribal dominated district Anuppur (Madhya Pradesh).Methods: This cross-sectional study was based on blood films for malaria parasites (BFMP) data obtained from primary health centers, sub-health centers, community health centers and district hospital. This study was also based on household survey for information on malaria awareness and type of treatment preferred for malaria. From 2014-2016, a household survey was conducted regarding the type of treatment available, assessment of the influence of demographic factors, knowledge, awareness and education on malaria occurrence. Odds ratio were used to analyse the association between the gender, age group, season and types of malaria infection.Results: Annual blood examination rate (11.81%) and slide vivax rate (0.66%) was highest in 2016. There was decrease in slide falciparum rate in 2016 (1.52%). Slide positivity rate was 3.78%, 3.73% and 2.74% in the years 2014-16. Annual parasite incidence rate was 3.20%, 3.82% and 3.07% in the years 2014-16. Plasmodium falciparum positivity rate was 78.13%, 78.17% and 54.49% in the study years and was highest among the females and in the age group of 26 years and above. Distinct seasonality was observed correlating with population dynamics of the vector and climatic and socio-demographic conditions.Conclusions: The prevalence of malaria in tribal dominated Pushparajgarh area showed seasonality that was governed by mosquitogenic factors, their transmission and socio-demographic status of the population.
Study of determinants of cardiovascular morbidity among diabetes patients
Authors: Kundu Subha Sankha , Majumdar Kunal Kanti , Mukherjee Dipankar , Sikder Rajib , Dey Rituraj , Joardar Gautam Kumar
Published: February 2021

Background: With the change in lifestyle and behavior among individuals, the prevalence of T2DM is on rise. Many modifiable and non-modifiable risk factors are attributable for the cardiovascular morbidity among the diabetics which is the leading cause of mortality and morbidity among them, also increasing their burden of expenditure. The purpose of this study was to determine the prevailing factors responsible and its associate co morbidities among the Type 2 Diabetes Mellitus patients.Methods: It was a descriptive, observational and cross sectional study conducted for 30 days. 226 patients who visited the diabetes OPD of the Medical College were interviewed using a pre-designed questionnaire, anthropometric measurements, systemic and general examinations were performed. The data was analysed using suitable statistical analysis.Results: Out of 226 patients, 47.8% were suffering from cardiovascular morbidity, majority being heart failure (57.4%). Most of them were contributed 46.3% and 38.9% by age group 50-59 years (46.3%) and 60-69 years (38.9%), 55.6% were smokers and 64.4% were overweight. 70.4% complained of stress in their daily life while 48.1% were unaware of their heart conditions until checkup. 18.5% of the patients also suffered from retinopathy and 37.03% from diabetic foot ulcer. 64% of them had hypertension and 67.2% had sedentary life style.Conclusions: Many modifiable and non-modifiable risk factors were found associated with cardiovascular morbidity among the type 2 diabetes mellitus patients. So a proper awareness and life style modifications might be necessary to decrease cardiovascular morbidity among them.