bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapeamento da vegetação e do uso do solo no Centro de Diversidade Vegetal de Cabo Frio, Rio de Janeiro, Brasil
Authors: Bohrer Claudio Belmonte de Athayde , Dantas Heloisa Guinle Ribeiro , Cronemberger Felipe Mendes , Vicens Raul Sanchez , Andrade Sandra Fernandes de
Published: January 2018

RESUMO A região de Cabo Frio é reconhecida como um importante centro de diversidade vegetal (CDVCF) da Região Neotropical, devido à presença de diversos taxa endêmicos e comunidades vegetais singulares, o que pode ser relacionado tanto ao clima relativamente seco quanto à heterogeneidade do ambiente físico. Embora diversos estudos realizados na região tenham produzido informações importantes sobre a estrutura e composição florística de algumas comunidades vegetais, existe ainda uma considerável lacuna na classificação e definição dos tipos de vegetação bem como de sua distribuição espacial. Este trabalho tem como objetivo analisar e descrever os tipos de vegetação da região e sua relação com o ambiente físico, através do mapeamento da cobertura vegetal e uso do solo, baseado na análise integrada de imagens de satélite, fotografias aéreas, mapas temáticos e dados pontuais provenientes de levantamentos estruturais e florísticos e trabalhos de campo, com apoio do processamento digital de imagens e de sistema de informações geográficas. Os resultados são apresentados acompanhados de um mapa da vegetação e uso do solo da área do CDVCF, que poderá ser utilizado como base para novos estudos florísticos e ecológicos, para estudos da dinâmica da paisagem e para apoio ao planejamento ambiental e a conservação da biodiversidade da região.
Mapeamento da vegetação e da paisagem do município de Armação dos Búzios, Rio de Janeiro, Brasil
Authors: Dantas Heloisa Guinle Ribeiro , Lima Haroldo Cavalcante de , Bohrer Claudio Belmonte de Athayde
Published: January 2018

RESUMO O município de Armação dos Búzios, que faz parte do Centro de Diversidade Vegetal de Cabo Frio, é caracterizado por uma grande variação de fisionomias vegetais, relacionadas à sua fisiografia e ao clima da região. Nos últimos quarenta anos o crescimento urbano vem reduzindo e fragmentando a sua cobertura vegetal natural. O objetivo deste estudo é fornecer informações sobre a extensão, distribuição e estado de conservação dos remanescentes de vegetação natural do município, através da elaboração de um mapa de vegetação e uso do solo, baseado na interpretação de fotografias aéreas, com o auxílio de mapas temáticos (geologia, solo e relevo) digitais, e trabalhos de campo, com coleta de material botânico, posteriormente identificado em herbário.
Área de Proteção Ambiental de Massambaba, Rio de Janeiro: caracterização fitofisionômica e florística
Authors: Araujo Dorothy Sue Dunn de , Sá Cyl Farney Catarino de , Fontella-Pereira Jorge , Garcia Daniele Souza , Ferreira Margot Valle , Paixão Renata Jacomo , Schneider Silvana Marafon , Fonseca-Kruel Viviane Stern
Published: January 2018

RESUMO A Área de Proteção Ambiental (APA) de Massambaba, criada em 1986 e administrada pela FEEMA, abrange 76,3 km2 de restingas, lagoas e morros baixos. Está situada nos municípios de Saquarema, Araruama e Arraial do Cabo, em uma área de restinga constituída por um sistema de dois cordões arenosos, coberto em parte por um campo de dunas. A região de Cabo Frio possui um clima sui generis para o litoral sudeste, com menos de 900 mm anuais de pluviosidade. A diversidade florística desta região é a mais alta do litoral, constituindo um dos 14 Centros de Diversidade Vegetal no Brasil. São descritas 10 formações vegetais e 664 espécies de plantas vasculares distribuídas em 118 famílias. As famílias mais ricas em espécies são Leguminosae e Myrtaceae. Das formas de vida, as mais abundantes são as ervas (30%), seguido pelos arbustos (23%), árvores (21%), lianas (19%), epífitas (6%) e parasitas/saprófitas (1%). Esta unidade de conservação abriga diversas espécies ameaçadas de extinção.
Plant morpho-physiological variation under distinct environmental extremes in restinga vegetation
Authors: Scarano Fabio Rubio , Barros Cláudia Franca , Loh Roberta Kuan Tchuen , Mattos Eduardo Arcoverde de , Wendt Tânia
Published: January 2018

ABSTRACT This paper is a synthesis of over ten years of research on inter- and intra-population variation in morphophysiology of six plant species at the Jacarepiá restinga: the shrubs Alchornea triplinervia, Andira legalis, Clusia fluminensis and Myrsine parvifolia, the bromeliad Aechmea maasii (formerly identified as Aechmea bromeliifolia, now recognized as a species only found in Central Brazil) and the geophyte palm Allagoptera arenaria. Individual shape, stature and growth, leaf anatomy, photoinhibition, and carbon, nitrogen and water use were the main parameters studied. The isolated study of intra-specific variation in one or a few of the above-mentioned traits often does not allow a distinction between acclimation and stress symptoms. Thus, we used an approach that integrated morphology, anatomy, physiology and also population parameters. Variation in morphological, anatomical and physiological traits was found for the majority of these species, and often indicated great acclimation capacity to distinct environmental extremes. This acclimation capacity may be partly responsible for the broad colonization success of extreme habitats in restingas, by species often originating in mesic forest environments. This phenomenon is an additional element to be accounted for as an important component of the high biodiversity of the Atlantic forest complex. Finally, we discuss implications for biodiversity conservation of intra-specific variation at the population level.
Comunidades lenhosas no cerrado sentido restrito em duas posições topográficas na Estação Ecológica do Jardim Botânico de Brasília, DF, Brasil
Authors: Silva Júnior Manoel Cláudio da , Sarmento Thaise Rachel
Published: January 2018

RESUMO A topografia afeta o regime hídrico e propriedades edáficas determinantes da vegetação do cerrado. Este estudo avaliou a distribuição espacial de árvores do cerrado sensu stricto em duas posições topográficas, interflúvio (I) e vale (V) na Estação Ecológica do Jardim Botânico de Brasília. No total 15 parcelas, 20x50m cada, foram locadas, 10 no cerrado I e cinco no cerrado V, para amostrar árvores, DB≥ 5cm. O número(30cm) de árvores por parcela serviu para a classificação por TWINSPAN. A comparação da densidade e área basal de espécies preferenciais aos cerrados I e V em 18 localidades elegeu aquelas potencialmente indicadoras de condições ambiente no Brasil central. A topografia contribuiu para diferenças florísticas e estruturais nas comunidades I e V. Para o interflúvio foram indicadoras Blepharocalyx salicifolius, Dalbergia miscolobium, Miconia ferruginata, M. pohliana, Piptocarpha rotundifolia, Ouratea hexasperma, Pterodon pubescens, Qualea parviflora e Sclerolobium paniculatum em Latossolos. Byrsonima coccolobifolia, Caryocar brasiliense e Erythroxylum suberosum em Latossolos, solos Litólicos ou arenosos. Pouteria ramiflora em Latossolos e Neossolos Quatzarênicos. Para o vale e Cambissolos foram indicadoras Dimorphandra mollis, Eremanthus glomerulatus, Eriotheca pubescens, Guapira noxia, Plenckia populnea, Qualea multiflora e Symplocos rhamnifolia. As espécies Byrsonima verbascifolia, Kielmeyera coriacea, Qualea grandiflora, Stryphnodendron adstringens e Schefflera macrocarpa foram generalistas.
Anatomia foliar de halófitas e psamófilas reptantes ocorrentes na Restinga de Ipitangas, Saquarema, Rio de Janeiro, Brasil
Authors: Arruda Rosani do Carmo de Oliveira , Viglio Natasha Sanfilippo Fontes , Barros Ana Angélica Monteiro de
Published: January 2018

RESUMO O presente trabalho aborda a anatomia foliar de Blutaparon portulacoides (A. St.-Hil.) Mears. (Amaranthaceae), Ipomoea pes-caprae (L.) R. Br. e I. imperati (Vahl) Griseb. (Convolvulaceae), Canavalia rosea (Sw.) DC. e Sophora tomentosa L. (Leguminosae), Sporobolus virginicus (L.) Kunth (Poaceae) e Miegia maritima (Aubl.) Willd. (Cyperaceae). A maioria das espécies investigadas tem folhas suculentas e epiderme uniestratificada coberta por espessa camada cuticular. A densidade de tricomas apresenta-se distinta entre as espécies. Os estômatos ocorrem em uma ou ambas as faces da folha estando as células estomáticas situadas ao mesmo nível ou ligeiramente abaixo das demais. Tecidos aquíferos foram observados em todas as espécies estudadas, assim como cristais, fibras e estruturas secretoras. A estrutura do mesofilo varia entre as espécies, sendo dorsiventral, isobilateral ou Kranz. Em todas as espécies estudadas foram identificados caracteres xeromorfos.
Fenologia reprodutiva, síndromes de polinização e dispersão em espécies de Leguminosae dos campos rupestres do Parque Estadual do Itacolomi, Minas Gerais, Brasil
Authors: Dutra Valquíria Ferreira , Vieira Milene Faria , Garcia Flávia Cristina Pinto , Lima Haroldo Cavalcante de
Published: January 2018

RESUMO A fenologia reprodutiva e as síndromes florais e de dispersão em 45 táxons de Leguminosae foram estudadas nos campos rupestres do Parque Estadual do Itacolomi (PEI), Minas Gerais, Brasil, entre setembro/2003 e outubro/2004. A floração na comunidade ocorreu durante todo o período de estudo, com o maior pico observado em março (66,6% dos táxons), havendo correlação positiva com a precipitação e a temperatura. A maioria dos táxons estudados (88,8%) apresentou características florais da síndrome de melitofilia. Foram descritos, para as espécies de Chamaecrista, dois padrões de deposição de pólen no corpo do polinizador, o direto e o indireto. Houve frutificação durante todo o período de estudo, com o maior pico em abril (57,7%), havendo correlação significativa dessa fenofase com a temperatura. A autocoria foi a síndrome de dispersão mais frequente (66,6%), associada principalmente aos frutos dos tipos legume e folículo. Os resultados indicam que a sazonalidade climática é importante para a floração, frutificação e dispersão dos diásporos nos campos rupestres do PEI e reforçam a importância das espécies de Leguminosae como uma importante fonte de recursos alimentares (pólen e néctar) para as abelhas.
Challenges and Opportunities in Fast Pyrolysis of Biomass: Part I
Authors: Bridgwater Tony
Published: January 2018

Fast pyrolysis for liquids has been developed in recent decades as a fast and flexible method to provide high yields of liquid products. An overview of this promising field is given, with a comprehensive introduction as well as a practical guide to those thinking of applying fast pyrolysis liquids (bio-oil) in various applications. It updates the literature with recent developments that have occurred since the reviews cited herein. Part I contains an introduction to the background, science, feedstocks, technology and products available for fast pyrolysis. Part II will detail some of the promising applications as well as pre-treatment and bio-oil upgrading options. The applications include use of bio-oil as an energy carrier, precursor to second generation biofuels, as part of a biorefinery concept and upgrading to fuels and chemicals.
Tolerancia a la violencia de pareja en tres historias de vida de mujeres de estrato económico alto de Lima
Authors: Mujica Jaris , Bedoya Silvana
Published: January 2018

Objetivo: esta investigación analiza la presencia de violencia física y psicológica ejercida por la pareja (hombre) a una víctima (mujer) en el estrato económico alto de Lima. Materiales y métodos: se recolectaron los datos a través de la técnica “historia de vida”, en un registro profundo de los discursos de tres mujeres adultas de estrato económico alto. Resultados: los resultados ratifican deducciones de la literatura precedente (concentrada en sectores de recursos económicos medios y bajos) en las formas, el ciclo y la tolerancia hacia la violencia. Esto fortalece el argumento de que el sector económico no es una variable determinante ni un inhibidor de la violencia. Discusión: el estudio muestra las formas de violencia ejer cidas durante la relación, los mecanismos de dominación y control, y las formas en que las mujeres toleraron la violencia durante un periodo prolongado, debido no solo al temor a las represalias físicas y el control económico, sino también a la importante presencia del discurso sobre la conservación de la familia y el cuidado de la descendencia en una estructura biparental. Conclusiones: los casos ratifican resultados precedentes según los cuales la violencia física, psicológica y económica suele manifestarse en periodos largos y cíclicos, en los que las víctimas y el entorno social se muestran tolerantes a la violencia, a pesar de ser reconocida como negativa, dañina y dolorosa.
Zebrafish (Danio rerio) Environmental Summary, Aquatic Resources Program, Boston Children's Hospital 2017 v1
Authors: Lawrence Christian , Best Jason , James Althea , Hurley Shane , Shia Mitchel
Published: January 2018

Environmental and housing conditions experienced by laboratory animals exert profound effects on their biology, physiology, and behavior. These parameters are important and often overlooked sources of potential variation in experiments, and should be reported in peer-reviewed publications in order to promote scientific reproducibility. To that end, here we provide a summary of the environmental conditionsin zebrafish (Danio rerio) aquaculture facilities at Boston Children's Hospital (BCH). We include data on the physico-chemical, health, and nutrition of zebrafish in three separate facilities at BCH: Karp, Enders SSB, and Enders Lobby. This information will be applicable to any study involving zebrafish conducted in one of these three facilities during the year of 2017.
YNB-BSA-agar method v1
Authors: LM Barros
Published: January 2018

Detection of Sap activity
Antologia da memória poética da guerra colonial
Authors: Sedlmayer Sabrina
Published: January 2018

Resenha de Antologia da memória poética da guerra colonial, com organização de Margarida Calafate Ribeiro e Roberto Vecchi.
Implicações dos Resíduos Sólidos a Saúde Humana: Explorando Publicações de Enfermagem
Authors: Castro Josiane Marcia , Souza Elaine Anastácia , Espirito Santo Jose Geraldo Venâncio do , Andrade Pereira Giselle Cristina , Alves Rodrigo Nascimento , Patrocíni Edson Gonçalves
Published: January 2018

O artigo trata de uma revisão de literatura, utilizando a Análise Temática, com o objetivo de identificar a relevância das implicações dos resíduos sólidos para a saúde humana desde o manejo ao descarte a partir de publicações em dois periódicos brasileiros de enfermagem, de circulação internacional, no período de janeiro de 2015 a janeiro de 2016. Os textos foram selecionados com base nos títulos, nos resumos e nas palavras-chave, sendo analisados 318 artigos. Reconheceram-se unidades temáticas: manejo e descartes que podem acarretar sérios problemas à instituição, ao meio ambiente e à saúde da população. Entretanto, percebe-se que poucas são as publicações acerca do assunto, visto que a sua importância deveria ser enfocada em todas as áreas do conhecimento, uma vez que a mesma é interdisciplinar. É necessária reflexão acerca das características da geração de resíduos sólidos, em especial, para a saúde considerando seus limites e possibilidades para almejar sustentabilidade, no sentido de desenvolver ações de preservação e de proteção da qualidade de vida humana.Palavras-chave: Resíduos Sólidos. Implicações. Saúde. Meio Ambiente.AbstractLiterature review, using the Analysis Thematic, in order to identify the relevance of of solid waste implications to human health from management disposal originating in publications from two Brazilian nursing journals with international circulation within the period fromJanuary 2015 to January 2016. The texts were selected based on the titles, abstracts and key-words, being 318 articles analyzed. Thematic units were recognized: management and disposal that can cause serious problems to the institution, the environment and health. However it is clear that there are few publications on the subject, since its importance should be focused on all areas of knowledge, since it is interdisciplinary. It is necessary to reflect on the characteristics of the solid waste generation, particularly health, considering its limits and possibilities to target sustainability, to develop actions to preserve and protect the human life’s qualityKeywords: Solid Waste. Implications. Health. Environment.
Impact of awareness about hypertension on compliance to antihypertensive medication
Authors: Gupta Mansi , Gupta D. D. , Sood Atal
Published: January 2018

Background: Hypertension, a common cardiovascular disorder accounts for 20-50% of all deaths. This risk can be greatly ameliorated by creating awareness about disease and its effective treatment alongside regular medical check-ups. Therapeutic failures result from patient non-compliance, manifested as intentional or unintentional errors in dosage or schedule, overuse or underuse of prescribed drugs and early termination of therapy. Adherence is helpful for management of hypertension and cost minimization. Non-adherence to the drug treatment is an important factor for uncontrolled hypertension and its complications.Methods: Patients were interviewed individually after taking informed consent, using pretested, predesigned, self- administered and closed ended questionnaire both before and 4 weeks after creating awareness about hypertension and its complications. Compliance measured by self-reporting in which knowledge of the patient about number of antihypertensive drugs being used, formulations of drugs, frequency of administration, duration of taking the drugs and knowledge of complications due to uncontrolled and untreated hypertension were assigned 1 score each. Patient having score of at least 4 out of total 5 was considered compliant.Results: No significant association of compliance with demographic and other variables like age, sex, marital status, economic status, education, urbanization, duration of treatment and drug procurement were noted. A significant increase in compliance in patients on antihypertensive medication was found 4 weeks after creating awareness about hypertension and its complication. A significant increase in compliance scores was also seen in non-compliant patients showing their shifting from non-compliance to compliance group. Overall compliance increased from 59.38% to 84.38%. A percentage decrease from 58.82% to 25% in patients having uncontrolled hypertension was also observed after the awareness about hypertension.Conclusions: Demographic variables, duration of hypertension and drug procurement have no significant effect on compliance to antihypertensive medication. There is persistence and improvement in compliance to antihypertensive medications after an education of the patients about hypertension and its complications.
Incremental cost-effectiveness and tolerability of Diclofenac + Proton pump inhibitor compared to tramadol in the treatment of knee osteoarthritis
Authors: Majeed Mehwish , Rasool Shaheena , Ahmad Afkat
Published: January 2018

Background: In a climate of economic uncertainty, cost effectiveness analysis is a potentially important tool for making choices about health care interventions. Patients with knee osteoarthritis are treated mostly with Diclofenac (NSAID) + Proton Pump Inhibitors (PPI) and Tramadol (Opioids) in everyday practice.Aim: Present study was aimed to assess clinical effectiveness, adverse events and cost-effectiveness between Diclofenac + PPI and Tramadol.Methods: Authors conducted prospective randomised control open label study on 40 patients at Orthopedic OPD of tertiary care hospital. Patients were given either Tramadol controlled releases tablets (200mg CR OD) or Diclofenac sustained release tablets (100mg SR OD) + PPI (Omeprazole 20mg OD) for two weeks. Clinical effectiveness was assessed by KOOS osteoarthritis index score consisting of five parameters and visual analogue scale. Suspected ADRs were recorded and incremental cost effective ratio for both drugs was calculated.Results: After application of KOOS questionnaire Authors found net quality gain in symptoms was 24.45 in diclofenac +PPI group which was much higher against 14.15 found in tramadol group. Again ADR profile of tramadol was 29 with nausea and somnolence topping the list which was far more than only 10 in DIC +PPI group. Lastly cost-effective analysis was done where again DIC+PPI showed average cost effective ratio 5.73 verses tramadol 11.8 with an incremental cost-effectiveness ratio (ICER) of -2.72.Conclusions: Diclofenac +PPI is as effective as tramadol in the treatment of pain due to knee osteoarthritis with the potential for feAuthorsr side effects. Diclofenac + PPI was also found to be cost-effective when compared with tramado.
Study of uterine artery embolization: a newer modality in secondary PPH
Authors: Agrawal Sweta , Thakur Ratnamala , Sonker Shikha
Published: January 2018

Background: Postpartum hemorrhage remains a major cause of both maternal mortality and morbidity worldwide. This study reflects the clinical outcomes including clinical effectiveness, and safety of uterine artery embolization (UAE) for the treatment of obstetrical uterine hemorrhage at a tertiary-care hospital, in terms of secondary PPH.Methods: The data were collected as a retrospective study from SAMC and PGI obstetric and gynecology department 12 women with secondary pph were included in the study.Results: With the use of uterine artery embolization 12 women were successfully treated amongst them maximum patients were in 26-35 yrs of age and mean age of women were 32.4yrs and gravidity of patients presenting with pph is 3 or more.Conclusions: Selective UAE is a safe and effective method to control obstetric hemorrhage. Blood product requirements after UAE were low, and the surgical risks and absolute loss of fertility associated with hysterectomy were avoided.
Foetal instrumental extractions (IE) at the maternity at Nabil Choucair Health Center (Senegal) from 2005 to 2016: epidemio-clinical and prognostic aspects
Authors: Gassama Omar , Faye Ndeye Astou , Diouf Abdoul Aziz , Niang Mouhamadou Mansour , Mbaye Magatte , Ndour Daouda , Dieme Marie Edouard Faye , Thiam Ousmane , Ndiaye Abdou , Diouf Alassane , Moreau Jean Charles
Published: January 2018

Background: The main objective was to take stock of practices on instrumental extractions at the maternity of Nabil Choucair Health Center.Methods: This was a prospective, descriptive study from 1 January 2005 to 31 April 2016. The collection was carried out through the data sheet completed on the basis of an analysis of files, the delivery register and the anaesthesia register of the operating room. The data was entered using the Sphinx software version 5 and the data analysis performed by Epi info version 3.5.Results: 240 instrumental extraction cases were compiled, and their frequency was 0.4%. The mean age of patients was 24.8 years. Obstetric vacuum was the most commonly used instrument (66.4%) and an episiotomy was performed in 73.6%. Maternal complications were dominated by simple perineal tears (6.2%).Conclusions: Instrumental extractions should be rehabilitated in our maternity facilities to combat the outbreak of the caesarean section. Instrumental extractions indications and techniques should be controlled to avoid complications
An epidemiological study to assess bone mineral density and its association with contributing factors among premenopausal and postmenopausal women in selected villages of District Shimla, Himachal Pradesh, India
Authors: Garg Nancy , G. Viji Mol , Sethi Deepika
Published: January 2018

Background: Development of peak bone mass and premenopausal bone loss is determined by the menstrual status of women. Decline in bone mass with age becomes accelerated during menopause. Menopausal bone loss refers to the accelerated bone loss that occurs during the BM) of premenopausal and post-menopausal women, to identify the contributing factors associated with BMD among pre and post-menopausal women, to compare the level of BMD and the contributing factors of pre-menopausal women with post-menopausal women.Methods: It was quantative research approach and epidemiological analytic research design was used. Total enumeration technique was adopted in this study.Results: Analysis of data was done in accordance with the objectives of the study. Findings show that among premenopausal women 45.10% of the women had osteopenia and 8.20% of the women had osteoporosis, among postmenopausal women 50.00% of the women had oestriopenic and 41.2% of the women had osteoporosis. The analysis shows that factors such as BMI, Health status, life style, age, economic status and dietary patter plays important role to accelerate the level of T-score more than -1 in both group either premenopausal women or post-menopausal women. It shows the significance at the level of p<0.001.Conclusions: The study was completed in July 2016, concludes that there are many factors that can lead to have risk of osteoporosis related fracture. As age is increased the risk is also increased to get the fracture. Every woman can go for screening of BMD test to control the risk of fracture.
Acute pancreatitis in pregnancy: 5-year experience from a multidisciplinary centre
Authors: Srikumar Saranya , Nair Sobha S. , Reghunath Reshma , Raj Sharanya , K. Radhamany
Published: January 2018

Background: Acute pancreatitis is rare in pregnancy, but it is associated with increased incidence of maternal and fetal mortality. It should be one of the differential diagnosis of upper abdominal pain with or without nausea or vomiting. S. amylase, lipase and ultrasound abdomen were the diagnostic methods. Conservative management is the main stay in mild cases. Severe cases have multiorgan involvement and needs multidisciplinary approach. The objectives of this study were to study the maternal and fetal outcome in pregnant women diagnosed with acute pancreatitis and to identify the risk factors for acute pancreatitis in pregnancy.Methods: Retrospective descriptive study of pregnant women diagnosed with acute pancreatitis in Amrita Institute of Medical Sciences, Kochi during the period of 5 years from January 2011 to December 2016. A proforma having patients age, parity index, gestational age, symptoms with duration, blood investigations, ultrasonography, interventions done, mode of delivery, supportive treatment, complications were developed. Fetal weight, Apgar score, fetal complications were also noted.Results: The mean gestational age of presentation was 30 weeks of pregnancy. Upper abdominal pain radiating to back, vomiting, fever was the commonest clinical presentation in majority of cases. The diagnostic methods were S.Amylase ,Lipase and Ultrasound abdomen. The mean age of the patients were 26 years and 66.7% were primigravidas in the present study. There were 4 patients in SAP and 5 in MAP groups. Complications in SAP group were ARF, ARDS, DIC, MODS, metabolic acidosis etc. SAP group had 3 maternal and 3 fetal loss.Conclusions: Severe acute pancreatitis has adverse maternal and fetal outcome due to multi organ failure and sepsis.
Comparison of ultrasound parameters for diagnosis of IUGR
Authors: Gangadhar Pardeshi Yogeshwari , Pillai Nancy S.
Published: January 2018

Background: An active approach to the diagnosis of IUGR should be undertaken so that the foetus can be closely monitored and when indicated, be promptly delivered.Methods: Study was conducted at Department of Obstetrics and Gynaecology, Pushpagiri Institute of Medical Sciences, Thiruvalla. All pregnant women whose gestational ages were assessed by ultrasonography in 1st trimester was included in the study. An ultrasonographic biometric evaluation was done between 22-24 weeks and repeated at 32-34 weeks of gestational age and their ratios compared, using standard formulae.Results: We has observed that at 22-24 weeks of gestational age abdominal circumference (AC) has a better sensitivity, specificity, NPV and PPV when compared with femur length (FL), head circumference (HC), FL/AC and HC/AC. AC has got lowest FP and FN with a highest accuracy rate of 83% as compared to FL, HC, FL/AC and HC/AC at 22-24 weeks of gestational age. At 32-34 weeks of gestational age AC remains better in sensitivity, specificity, NPV, PPV, FP and FN values as compared to FL, HC, FL/AC and HC/AC.Conclusions: AC has a better sensitivity, specificity, NPV and PPV for diagnosis of IUGR when compared with FL, HC, FL/AC and HC/AC. AC has got lowest FP and FN with a highest accuracy rate at both 22-24 weeks of gestational age and 32-34 weeks of gestational age. The sensitivity, specificity and accuracy of AC is more at 32-34 weeks of gestation than at 22-24 weeks for diagnosis of IUGR.
Obstetric and neonatal outcome in women with a history of recurrent miscarriage at tertiary care hospital, Karnataka: a retrospective cross-sectional study
Authors: Upadhyay Chintan , Upadhyay Nisha
Published: January 2018

Background: When clinical pregnancy is established, the risk of spontaneous pregnancy loss is ~12-14%, and therefore the incidence of Recurrent Pregnancy Loss (RPL) by chance alone would be in the order of 0.35%. It occurs in 0.5-3% of women. The objective of this study was to evaluate the obstetric outcome in pregnancies with history of one or more abortions.Methods: It is a retrospective cross-sectional study done at Obstetrics and Gynecology Department, Dr. B. R. Ambedkar Medical College and Hospital, Bangalore. Record review of cases was done from January 2005 to December 2009. Inclusion criteria were pregnancies with history of previous abortions.Results: There were 400 cases with previous history of abortions. There were 266 (66.4%) booked cases while 134 (33.5%) were unbooked cases. 272 (68.0%) patients crossed viable period of pregnancy (more than 28 weeks). Around 56 (14.0%) cases had repeat abortions, 276 (69.0%) cases underwent vaginal delivery and 124 (31.0%) underwent cesarean section. Almost 91 (22.8%) of Babies were low birth weight while others were above 2.5 kg. There were 52 (13.0%) preterm babies and 28 (7.0%) Intrauterine demise of fetuses.Conclusions: Patients with previous history of abortions are at increased risk of adverse maternal and perinatal outcome.
Feto-maternal outcome in subject undergoing epidural labour analgesia with Ripovacaine and Fentanyl
Authors: K. N. Madhu , H. R. Dileep Kumar
Published: January 2018

Background: Epidural anaesthesia is regional anaesthesia that blocks pain in particular region of the body. The present study was done to observe the effect of epidural analgesia and active management of labour on duration of labour and mode of delivery.Methods: Main source of data were Primigravida inpatients from hospitals attached to JJM Medical College, Davangere from October 2016 to September 2017. It was a clinical cross-sectional study.Results: It was observed that duration of labour was comparatively less in epidural group than control group. There was no significant increase in duration of II stage of labour in epidural group. There was no increase in both the instrumental delivery rate and caesarean section rate and also noted higher newborn APGAR score rate in parturient who received epidural analgesia.Conclusions: The present study showed that there is no increase in the duration of labour or any increase in the rate of instrumental delivery or caesarean section in parturient receiving epidural analgesia, instead, there is a downward trend in all the above outcomes.
Successful maternal and fetal outcome in patients with Takayasu arteritis: two case reports of Type I and Type IV in stage 2
Authors: Upadhya Rekha , Poojari Vidyashree G. , Pai Muralidhar V. , Nambiar Jayaraman
Published: January 2018

Takayasu's arteritis, is a rare, chronic, idiopathic, inflammatory disease of the large arteries, primarily involves the aorta, its main branches as well as the coronary and pulmonary arteries. It is mostly seen among women with child bearing age group (80%). During pregnancy, the increased intravascular volume impair circulation and exacerbate aortic regurgitation, hypertension, and congestive heart failure. Hypertension is one of the serious complication that can develop, leading to intrauterine growth restriction, maternal heart failure, and fetal haemorrhage and during postpartum period.
An institutional comparative study of self-gripping progrip mesh with prolene mesh in repair of inguinal hernia: a single center study
Authors: Sahoo Rashmiranjan , Samal Debasish , Abdullah Md. Omar
Published: January 2018

Background: The type of inguinal hernia repair used depends on many factors predominantly surgeon’s training, interpretation of the literature and personal preference. This prospective cohort study describes a consecutive series of open mesh inguinal hernia repairs (modified Lichtenstein technique) performed in this hospital with two different mesh types.Methods: Analysis was undertaken on 60 consecutive patients who underwent inguinal hernia repair during last one year. Short-term outcomes were compared between those repaired with conventional polypropylene mesh and those with Covidien Progrip mesh.Results: All patients were male, and the mean age was 60 years. The median operative time was 60 minutes for unilateral hernias and 90 minutes for bilateral hernias. The use of Covidien Progrip mesh reduced the operative time to 40 minutes for unilateral hernias and 60 minutes for bilateral hernias. After unilateral hernia repair, 10% of the patients repaired with Progrip mesh were discharged home within 1 day of operation. Almost 99% of Progrip repair cases were discharged within 48 hrs. Twenty-four hours postoperatively, 74% of the patients were either totally pain free or had minimal discomfort. At 4weeks, 99%of the patients were either pain free or had minimal discomfort. Patients who underwent unilateral inguinal hernia repair with progrip mesh had the most rapid return to normal activities. All these parameters are slight longer in polypropylene mesh repair cases.Conclusions: Open anterior mesh repair is safe and results in minimal postoperative pain and early return to normal activities. Progrip mesh resulted in a shorter operative time and more rapid return to normal activities and decrease in long term postoperative pain compared with polypropylene mesh.
A hospital based clinical study of 100 patients of solitary thyroid nodule
Authors: Chakraborty Mayank , Dnyanmote Anuradha , Balasubramanian Sree Ganesh , Bendre Mahendra
Published: January 2018

Background: Thyroid nodules present as a challenge in their diagnosis, evaluation and management. Often these lumps are large in size and develop at the edge of thyroid gland so that they are felt or seen as a lump in front of the neck. The prevalence of these nodules in a given population depends on number of factors like age, sex, diet, iodine deficiency and even therapeutic and environmental radiation exposure. Prevalence increases with age with spontaneous nodules occurring at a rate of 0-0.8% per year, beginning early in life and extending till the eighth decade. In this study, the basic aim is to depict the various clinical presentations of solitary thyroid nodule and thereby find out the best diagnostic modality so as to plan out the most effective treatment strategy for such lesions.Methods: A hospital based prospective study was done with 100 patients to assess the various clinical presentations of solitary thyroid nodule and thereby find out the best diagnostic modality so as to plan out the most effective treatment strategy for such lesions.Results: Thyroid nodules are common in females of age group 31-40 years. Commonest presenting complaint is swelling in the front of lower neck. Most of the patients presented between 6 months to 3 years of onset of swelling.Conclusions: In present study, the sensitivity and specificity of FNAC was 85.71% and 100% respectively. All malignant lesions on FNAC were confirmed by histopathology indicating its excellence. Therefore, FNAC helps in planning the correct management and avoids second surgery.
Age distribution pattern of female breast cancer patients in Bangladesh- developing early and presenting late
Authors: Nessa Ashrafun , Hussain Tanvir , Alam Syed M. , Faruk Imtiaz , Jahan Ishrat
Published: January 2018

Background: Carcinoma of the breast is the most common malignancy in females. At present carcinoma breast is the leading cancer in Bangladesh and is competing cancer cervix in incidence. Epidemiological studies at regional and global levels suggest the occurrence of carcinoma breast at a younger, premenopausal age in Indian and Asian women as compared with western women. Knowledge of this factor emphasizes the need to modify the timing of modalities of detection of early carcinoma and its management. According to literature, majority of carcinoma breast cases in the western countries present in Stages I and II of the disease whereas in Bangladesh majority cases present in Stage III of the disease. The objective of this study is to observe age of occurrence of breast cancer and stage of cancer in SSMC and MH.Methods: A cross sectional observational study was conducted in 34 patients of histopathologically confirmed breast cancer.Results: Mean age of subjects was 46.24±7.4 years. Age distribution showed peaks at 41-50 years with 18 patients. This study shows that 82.35% of the total patients were having advanced carcinoma breast (Stage III, IV) and 77% of these patients were below 50 years of age.Conclusions: Breast cancer is increasingly occurring in younger age groups in Bangladesh when compared with western countries and a more aggressive nature of the disease strikes in their reproductive period suggesting the need for change in modalities of early cancer detection and adjusting preventive and therapeutic efforts. This small study may provocate thought for larger scale population study to evaluate the scenario in Bangladesh.
Comparison of the outcomes of home based and supervised individually designed exercise programme amongst the patients in chronic phase after guillain barre syndrome: study protocol for a randomized control trial
Authors: Shah Nehal , Shrivastava Manisha , Kumar Sanjeev , Rai Nirendra
Published: January 2018

Background: Guillain barre syndrome (GBS) is an immune mediated polyneuropathy characterized by progressive weakness and variety of symptoms including muscle paralysis, autonomic dysfunction and respiratory involvement that affect one or two persons in 100,000 population. Although immunotherapies including therapeutic plasma exchange (TPE), immunoglobulins (IVIg) and corticosteroids are the available beneficial modes of treatment, the residual symptoms are disabling and long lasting and require long term rehabilitation. Observational studies and RCT on multi-disciplinary care has proven exercises to be an answer to residual long lasting disability. Supervised individually designed exercise prescription after physiotherapy assessment may play a major role in minimizing disability.

Methods: The present study is an open-level, parallel, superiority randomized control trial with blinding of outcome assessors to evaluate the results of the individually designed exercise programme over home based exercise programme. 74 adult referred GBS patients will be recruited and randomize in two groups either to receive 12 weeks individually designed exercise programme or home based exercise programme. The primary outcome shall be assessed as functional independence in activities of daily living and secondary outcomes shall be evaluated in terms of muscle strength, fatigue, pain, and quality of life at baseline, six months and twelve months duration.

Conclusions: This is the first randomized control trial to compare the effect of supervised individually designed exercise over home based exercise programme on pwGBS.

Trial registration: Currently the trial is ethically approved, prospectively registered CTRI/2016/08/007150 and in the process of recruiting its first subjects.
A study of breast feeding practices among mothers of infants in an urban slum, South Indian city, Nellore
Authors: Kishore E. , Junapudi Syam Sundar
Published: January 2018

Background: The benefits of breastfeeding are well established and for the most part it is rather beneficial for children to drink their mother's milk One of the most commonly cited benefits of breastfeeding is that it helps connect mothers and their children; the baby feels its mother's body warmth and heartbeat (reminiscent of the womb it has left) and can become familiar with its mother's smell. Studies have shown that babies who are breastfed are more likely to reach adulthood. Breast milk is the ideal food for the infant under any circumstance. Objective of present study was to assess the breast feeding and infant feeding practices among mothers of infants aged 0- 12 months.Methods: A Community based cross-sectional study among mothers of infants aged 0-12 months at field practice area of Narayana Medical College, Nellore. This Study was undertaken during March to May 2016. A sample size of 112 respondents were included in this study.Results: 112 mothers of infants aged 0-12 months were included in this study. The source of knowledge regarding breast feeding among these mothers was health personnel 60 (53.57%), Family members was the second most common source 35 (31.25%) fallowed by others 17 (15.18%).Conclusions: Family support and mother’s literacy play important role in promoting breast feeding among mothers. Health education given to mothers helps them to establish breast feeding and take care of their infants.
Evaluation of serum placental growth factor in predicting pregnancy outcomes in women with suspected pre-eclampsia
Authors: Kahnamouei-aghdam Fariba , Pourfarzi Farhad , Ehsani Samaneh
Published: January 2018

Background:Amount of Placental Growth Factor (PLGF) in the blood at 9 to 11 weeks before the onset of clinical signs of pre-eclampsia is reduced. So, diagnostic tests based on the pathophysiology of disease such as PLGF as an ideal marker for early screening in the diagnosis and management of women with preeclampsia, may be useful. The aim of this study was to investigate PLGF in predicting pregnancy outcome in women with suspected pre-eclampsia.Methods: A case - control study was conducted on 30 women with suspected pre-eclampsia and 101 healthy pregnant women which selected randomly among all pregnant women referred to clinic. Both groups were followed until pregnancy termination and in terms of pregnancy outcomes (Gestational age, Type of delivery and birth weight). Two groups were matched in terms of age, weight, education, substance abuse and socio-economic status. Placental growth factor assay was done by ELISA kit. Data collected by a checklist and analyzed by statistical methods in SPSS.19.Results:The mean PLGF level was lower for women who experienced preeclampsia compared with healthy women (71.5 pg/ml vs 272.1 pg/ml, p=0.001). Also, PLGF concentrations was very low in women with preeclampsia who had a preterm birth prematurity.Conclusions:Study findings identified PlGF as an ideal, simple and non-invasive marker for primary screening at prenatal care for women at risk of pre-eclampsia.
Study of lipid profile in cases of non-diabetic stroke
Authors: Kar Ayaskanta , Dash Chinmayananda , Murmu Malati , Mahesh K. P. Karun
Published: January 2018

Background: To study serum lipid profile in non-diabetic patients with stroke and to determine whether there is any significant correlation between them and to compare the serum lipid profile between ischaemic and haemorrhagic group. Design: Case control study.Methods: The current study was done in the Department of Medicine VIMSAR, Burla, Odisha. Total 100 patients of completed stroke (Ischaemic63 and haemorrhagic37) and 30 controls were included in the study. All cases were adult (more than 14 years of age). Patients with suspected embolic stroke, diabetes (Type 1 and 2) and patients on lipid lowering drugs were excluded from the study. Routine investigations and fasting serum lipid profile was done.Results: 45 patients had elevated serum total cholesterol levels out of which 75.56% had Ischaemic stroke and 24.49% had haemorrhagic stroke. 24 cases had elevated serum Triglyceride levels of which 66.67% had Ischaemic stroke and 29.17% had haemorrhagic stroke. 76.47% of cases having elevated serum LDL cholesterol suffered from Ischaemic stroke where as 20.59% had haemorrhagic stroke.Conclusions: A statistically positive correlation was found between serum total cholesterol, Triglyceride, LDL levels and the risk of stroke.
Systemic evaluation of febrile thrombocytopenia
Authors: Katiyar Vivek , Khare Rajesh
Published: January 2018

Background: Febrile patient with thrombocytopenia is commonly encountered by physicians especially during monsoon and perimonsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia. Occasionally these patients can go on to develop a stormy course with multiorgan dysfunction requiring intensive care unit admission associated with high morbidity and mortality. Though thrombocytopenia is encountered in various diseases, it is for sure that potentially fatal bleeding due to thrombocytopenia is rare. The study was intended to know the underlying etiology of febrile thrombocytopenia in our community, the various presentations and relationship between platelet level and severity of disease and prognosis.Methods: This study was carried out in 218 adult patients (age above 18 years) presenting with fever having thrombocytopenia (platelet count <1,50,000/mm3) in Dept. of medicine in IIMS and  R Lucknow UP.Results: Dengue was the commonest cause of fever with thrombocytopenia (58.71%) followed by P. falciparum malaria 8.71% and P. vivax malaria 6.88%. Bleeding manifestations were seen in 24.31% of patients. 58.49% of patients had patechie/purpura as the commonest bleeding manifestation followed by hematuria in 16.98 %.Conclusions: Fever with thrombocytopenia consists of occult presentations of common diseases rather than rare disease. Infection is the commonest cause of fever with thrombocytopenia. Among infections, dengue was the commonest cause. Treatment of underlying condition will lead to rapid improvement in platelet count with complete clinical recovery.
Study on relationship of total bilirubin with acute coronary syndrome (ACS) and associated risk factors
Authors: R. Purushotham , Gudage Nitin , Ambali Anand
Published: January 2018

Background: Cardiovascular risk factors for ACS are on the rise in people of Indian origin and ACS is now the leading cause of death. More recent evidence suggests that bilirubin is a potent physiological antioxidant that may provide important protection against atherosclerosis and inflammation. Substantial evidence has documented that the development of CAD involves lipid oxidation and formation of oxygen radicals as atherosclerosis and inflammation are associated with formation of oxygen and peroxyl radicals. Keep of these points in mind, the present study was undertaken to find relation between Serum Bilirubin and Acute Coronary Syndrome.Methods: The present descriptive cross-sectional study conducted at A.J Institute of Medical Sciences and Research Centre, Mangaluru from October 2016 to April 2017. A detailed history, general physical examination, systemic examination and investigations was performed on all patients who fulfill the inclusion criterion and age >18yrs, both sexes who are admitted in CCU.Results: Hypertension had statistically significant correlation with ACS. All risk factors were more associated with STEMI compared to unstable angina or NSTEMI. On Correlation of LDL and Total leucocyte count with bilirubin both were statistically significant when compared to bilirubin levels.Conclusions: The study showed an inverse correlation of bilirubin with ACS, which in shows fact that bilirubin acts as an antioxidant and has cardioprotective action and patients with ACS have lower levels of bilirubin. This can use as a factor for screening individuals who have high risk for ACS and preventive strategies applied in them before the onset of overt ACS.