bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy Innovations: Organizational and Legal Aspects
Authors: Vypkhanova G. V. , Zhavoronkova N. G.
Published: January 2021

Recently, legal literature has given attention to the problems of innovative energy. Despite the negative consequences of the current global economic crisis, the ways out of it are in the mainstream of the country’s transition from the export of raw materials to the resource-innovative development with a qualitative renewal of the energy sector. These tasks are set in the strategic planning documents that determine the vector and prospects of energy, scientific and technological and other areas of development. Achievement of goals and long-term quality guidelines for the development of the energy sector on an innovative development path is associated, among other things, with alternative energy, the expansion of the use of renewable energy sources. The paper shows the possibilities and prospects of their use for small energy facilities, energy-deficient areas, and regions with decentralized energy supply. The advantages of using green technologies, renewable types of energy are manifested in energy conservation, energy security, reducing the negative impact on the environment, and solving environmental problems. The absence of a regulatory legal framework for the development of alternative energy is revealed; gaps in energy legislation in terms of innovative energy, stimulation of the introduction of innovative technologies, and the use of renewable energy sources are highlighted. The necessity of highlighting this direction in the energy strategy, other strategic documents in the field of environmental, economic development, energy efficiency and safety has been substantiated. The result of the study is new approaches to the formation and implementation of state policy, as well as the improvement of legislation in the field of innovative energy development.
Medical criterion for special rigidity
Authors: Menshikova Anna G.
Published: January 2021

Based on the doctrine of criminal law and law enforcement practice, the article analyzes the concept of suffering as a key characteristic of the particular cruelty manifested in the commission of a crime. It is determined that pain is the main characteristic of suffering, and individual indicators of pain characterize particular suffering as a result of particular cruelty. In conclusion, the author concludes that the medical criterion of particular cruelty should be determined by establishing and clearly fixing the fact of causing pain to the victim, which can be measured and established from the standpoint of the current state and level of development of medicine. Signs of pain constitutively necessary and legally significant for establishing the desired criterion are its intensity and (or) duration, the question of determining which seems logical to relate to the competence of medical science.
Application of the wavelet phase method of signal study to the analysis of asymmetric barycentric motions of the Sun and changes in processes occurring on the Sun, near-earth space and in the interior of the Earth
Authors: Alekseev Valeriy I.
Published: January 2021

A set of studies has been carried out, indicating that solar activity and processes associated with the activity of the Sun: changes in the main magnetic fluxes, areas of polar spots, the number of polar torches at the poles of the Sun; -index of geomagnetic activity and -index of the ratio of plasma pressure to magnetic solar wind (SW), slow and high-speed flows of SW, cosmic ray intensity (CR); average annual values of the interplanetary magnetic field vector and its components; the temperature, density, and flow rate of the SW plasma, the synodic period of the revolution of the Sun as a star, and the radius of the Sun in relative units; the distance of the Earths geographic pole from the conventional international origin, the rate of change of the position of the Earths north magnetic pole, the main ionospheric parameters; the angle of the Earth's axis of rotation and volcanic eruptions; asymmetric movement of the Sun around the solar system of the solar system (in fractions of the solar radius); the distances from the solar systems CM to the Sun in km, the distances from the solar systems CM to the Earth, with high accuracy, are consistent with the movement of the Sun relative to the barycenter. The research is based on the wavelet transformation of the observations listed above variables in various time intervals with the subsequent calculation of their phase-frequency and phase-time characteristics, correlation matrices between characteristics. The studied variables are divided into groups, which include the barycentric movement of the Sun and changes in solar activity. The calculated two correlation matrices of the wavelet characteristics of the group of variables and the graphs of these characteristics in two coordinate systems reflect the consistency of changes in the group.

The studies carried out indicate that the thermonuclear reaction occurring in the interior of the Sun, the external manifestation of which is solar activity, is controlled by the movements of the large planets of the Solar System relative to the Sun.
Current state of criminal legislation on liability for crimes committed exclusively by women
Authors: Kudaeva Larisa A.
Published: January 2021

The article attempts to analyze the state of modern criminal legislation on responsibility for crimes committed exclusively by women. The article examines the problems of privilege of the composition contained in Article 106 of the Criminal Code of the Russian Federation. The author's conclusions are confirmed by the results of a social survey conducted among 400 female respondents.
Experiências de cardiopatas submetidos à cirurgia cardíaca: um estudo exploratório
Authors: FREZ Carolina Soraggi , CASTRO Emma Elisa Carneiro de
Published: January 2021

This paper aims to investigate and describe significations of the experience of cardiopaths who were submitted to cardiac surgery, using the Gestalt-therapy as theoretical basis. The sample was composed by five post surgical pacientes, one woman and four men, ageing between 52 and 65 years old, married, self-declared white and brown, with scholarly between fundamental and medium levels. After the semiestructered intervieweds were done, the data was analysed through the tematic content analysis. The results of this study expose that the main significations related to the cardiac surgery refer to the threat to surviving, lost of control over yourself, lost of authonomy and independence. The surgical process demands a constant work of the pacient orientation system in order to exist the maintenance of the homeostasis in the organism, existing a diversity of individual regulatory reactions which contributes for the restauration of the balance of the environment in which they are located.
A mundaneidade do corpo: (re)pensar a cultura individualista e suas implicações para a Gestalt-terapia
Authors: LINS Rafael de Oliveira , ALVIM Mônica Botelho
Published: January 2021

Solidified in modernity, with the emergence of individualism, the dichotomies mind x body, person x world, organism x environment, subject x culture emerge from the same process that, as the anthropologist Le Breton points out, anatomized man, separated him from his environment and from others and objectified nature. Both Gestalt therapy and the philosopher Merleau-Ponty propose an understanding of the human being who seeks to overcome these dichotomies. For Merleau-Ponty we are incarnated in a world, woven with it, affirming the mundaneity of the body. For Gestalt therapy, both the body and the notion of organism/environment field also points to this non-individualistic understanding of human being. The objective of this work is, from these interdisciplinary references, to reaffirm the non-individualistic condition of existence and to deepen this perspective in Gestalt therapy theory.
O Complexo Cultural e o Complexo do Comer: Um Estudo com Mulheres Obesas
Authors: FIGUEIREDO Maria do Desterro de , NASSER Stella Nabuco , SILVA Armando de Oliveira e , RADOMINSKI Rosana Bento.
Published: January 2021

Obesity is considered an epidemic problem, which causes serious damage to the physical and emotional health of individuals. In order to investigate the psychological and cultural phenomena involved in obesity, we propouse a comprehensive and symbolic view of the discourses of obese women, patients from a General Hospital in Curitiba-Pr. The study was based on theoretical constructs such as: Jung's Complex Theory, Henderson's Cultural Unconscious, Singer and Kimbles' Cultural Complex. From these theories, it is aimed to propose a new theoretical construct: the Eating Complex, which is represented by experiences related to the theme of food, and relate it to the Cultural Complex. It is observed from the discourses that both Complexes paradoxically express themselves in a way to incorporate unconscious ideas of an ideal body, that rests in an archetypal image of hunger and lack. In a context of health, this lack marks the need for a filling that is often excessive and denatured, which should be considered in the multidisciplinary treatment of obesity, through therapeutic strategies that contemplate this reality and the vision of psyche totality.
O Estágio de Atendimento nos Anos Iniciais: Experiência com Plantão Psicológico
Authors: NUNES André P. , MORATO Henriette T. P.
Published: January 2021

The present investigation intended to explore how four students experienced their first practicum in the university project of Psychological Attendance, from the second year of the Psychology Course. It revealed how that practicum is organized to take care of the student, as well as how the project showed itself as singular, allowing the students' narrative for this investigation. It was possible to comprehend how the psychological attendance opened to the participants many possibilities to learn through experience, by learning in action. At the same time, by the supervisors' careful psychological attention, the students referred how they incorporated such knowledge in their acting by their reflexions about the experiences at the supervisions as well as with clients. It revealed the possibility of significative learning in action as pertinent to comprehend the meaning of psychologist's attention, even when the practicum occurs for Psychology freshmen students. This investigation points to the urgency to changes in the curriculum of Psychology courses in order to contemplate projects that open new possibilities, directing them to the clients' actual needs.
História de Lino: A Psicopatologia na Perspectiva da Fenomenologia e do Existencialismo
Authors: HAVRELHUK Jucimar , LANGARO Fabíola
Published: January 2021

From the 1950s-60s onwards in Europe, initiatives for a rupture with the existing hegemonic psychiatric model were established, consolidating an antithesis to the psychiatrizing logic, which can be characterized as a critical psychopathology. Thereby, some psychiatrists began to adopt a comprehensive attitude towards psychic illness instead of searching for causalities, understanding suffering as the result of the construction of a personality. The research on which this article was based aimed at a phenomenological and existential understanding of Lino's psychopathology, an adult man diagnosed with schizoaffective disorder. The life-history method was applied, several interviews were conducted for data collection, and narrative analysis was used to prepare results and discussions. In the analyses, a process of division of the being was found, forged by contradictory sociological forces, which were the basis of Lino's psychopathology. In this sense, the beginning of madness may be considered as a break with the subject's network of concrete and significant symbolic relationships and the consequent loss of his sense of reality. Therefore, thinking psychopathology from a critical perspective implies understanding subjects in their relationships as a whole, with the appropriation of mediations they do throughout their biography.
À Sombra de um Diálogo: Heidegger e a Poética de Augusto dos Anjos
Authors: SILVA FILHO Francisco Bento da , MELO Symone Fernandes de
Published: January 2021

This article seeks to promote a meeting between Heidegger's philosophical thinking and the poetics of Augusto dos Anjos. Heidegger's thinking, at a time called turning, departs from the terminology of phenomenology and hermeneutics. The proposition of the philosopher, henceforth, begins to turn to language and to be called the topology of being. Therefore, the work of art, with special emphasis on poetry, is the source from which the unveiling and the revelation of world and earth, in the Heideggerian terms, spring forth. Based on this understanding, a study was made of Heidegger's contributions to existential phenomenology, with emphasis on the second moment of his production or path. From then on, it appeared necessary to tangentiate the singularity of Augustus of the Angels, expressed in his history and his poetics, in dialogue with Heidegger's philosophical thought. Augustus of the Angels rescues the world in its pure state and language as a possibility of meaning. In a convergent direction, Heidegger walks toward the unveiling of the Being, which occurs in the face of the anguish of existence and the extreme possibility of non-being, in the face of its being-to-death condition. The dialogue between the philosopher and the poet was thought provoking and fruitful.
The Analysis Effect of Islamicity Performance Index on the Financial Performance of Sharia Commercial Banks in Indonesia
Authors: Felani Herman , Wahyuni Sri , Pratama Bima Cinintya
Published: January 2021

This research aims to find empirical effect evidence of Islamicity Performance Index on the financial performance of sharia commercial banks in Indonesia. The index of Islamicity Performance Index used in this research was the profit-sharing ratio, zakat performance ratio, equitable distribution ratio, directors-employees welfare ratio, Islamic income vs non-Islamic income, Islamic investment vs non-Islamic investment. This research used a quantitative approach and used secondary data in the form of sharia commercial bank financial statements for the periode of 2010-2018. The sampling technique in this research used purposive sampling and obtained 13 samples of sharia commercial banks with 117 observational data.  The analytical method used in this research is multiple linear regression. Based on the result of this research, it can be concluded that zakat performance ratio, equitable distribution ratio, directors-employees welfare ratio, Islamic investment vs non-Islamic investment do not affect financial performance. While the profit-sharing ratio, Islamic income vs non-Islamic income have negative effects on financial performance
Distribution of aetiological types of stroke among the diabetic adults admitted with stroke in a referral hospital: an observational study
Authors: Mahapatra Umakanta , Ganai Saikot , Pulai Debabrata , Saha Dipan , Swaika Bikash Chandra
Published: January 2021

Background: Stroke is one of the most devastating disorders worldwide, in terms of morbidity and mortality. Association of comorbid conditions increase severity and chances of unfavourable outcome in stroke patients. Diabetes is one of the vital comorbidity risk factors reported to be associated with occurrence, poor outcome in stroke patients. An increased incidence of stroke has been reported in advanced age among diabetic patients. The aim of this study was to determine the relative distribution of aetiological types of stroke among the stroke patients having diabetes.Methods: All adults (18-65) admitted in medicine indoor of Midnapore medical college and hospital with a provisional diagnosis of stroke having random blood glucose level ≥200 mg/dl and/or h/o diabetes were enrolled and screened for different etiological factors e.g., hypertension, dyslipidemia. Age group and gender wise distribution pattern were also obtained.Results: A total 384 subjects were included in the study. Hypertension was found to be most common (75%) comorbid condition among participants, followed by dyslipidemia (56%). 77.9% of subjects presented with random glucose level of >200 mg/dl.Conclusions: stroke of either types is very much prevalent among diabetes. Uncontrolled diabetes along with hypertension and dyslipidemia increases the chance many times. Early detection and prompt therapeutic intervention may reduce the mortality rate overall.
Paracetamol induced erythema multiforme major: a rare case report
Authors: Kumar Mukesh , Soni .
Published: January 2021

Paracetamol is the most quotidian drug used for fever and pain. Adverse drug reaction to paracetamol in India are rare, at times they can lead to lethal situations like erythema multiforme. The most common drug induced erythema multiforme are due to drugs like barbiturate, NSAIDs, penicillin, sulfonamide, nitrofurantoin, phenothiazines and anticonvulsants. There are very few detailed case reports of erythema multiforme due to use of paracetamol. We report a case of erythema multiforme which occurred due to use of paracetamol. The clinical feature and management of patient are described in brief.
Platelet rich plasma following hysteroscopic adhesolysis: a randomized clinical trial
Authors: Ahmed Mortada E. , Amer Mohamed I. , Ahmed Walaa E.
Published: January 2021

Background: Intrauterine adhesions (IUAs) is an uncommon condition that occurs after endometrial trauma, still it affects many women seeking fertility. Hystroscopic adhesolysis is the standard management procedure for IUAs, yet many concerns arise about the incidence of recurrence. This study evaluates the efficacy of Platelet rich plasma in decreasing adhesion recurrence following hystroscopic adhesolysis of severe intrauterine adhesions.Methods: A prospective randomized clinical trial held in the Endoscopy Unit of Ain Shams University Hospital, Cairo, Egypt. 160 women with grade-III intrauterine adhesions, according to American Fertility Society criteria, were randomized to either receiving 5ml platelet rich plasma injection into the uterine wall in the most affected parts of the endometrium and lining the uterine cavity by 5ml platelet rich plasma gel followed by intrauterine insertion of folley’s catheter balloon left for two weeks (study group), or only insertion of folley’s catheter balloon for two weeks with injection of placebo solution and using placebo gel (control group). Second look office hysteroscopy was performed 3 months post-operative to assess the grade of intrauterine adhesions. The primary outcome was the incidence of recurrence of intrauterine adhesions. Secondary outcomes were the post-operative improvement of menstrual duration and flow, and pregnancy rate within 1 year post-adhesolysis.Results: 70/81(86.4%) patients showed grade-I adhesions, 8/81 (9.9%) grade-II and 3/81 (3.7%) remained grade-III in the study group compared to 42/78 (53.8%) grade-I, 21/78 (26.9%) grade II and 15/78 (19.2%) grade-III in the control group (p<0.001).Conclusions: Platelet rich plasma shows better improvement of adhesion score, menses duration and menses amount following hystroscopic dissection of severe intrauterine adhesions.
Study of menstrual pattern changes in patients accepting injection depo-medroxyprogesterone acetate versus levonorgestrel intrauterine system
Authors: Jain Saloni , Mani Poonam
Published: January 2021

Background: Changes in menstrual bleeding patterns are a major cause of hormonal contraceptive discontinuation. DMPA and LNG IUS both are hormonal contraceptives and are used by most of the women worldwide for various gynaecological conditions. The aim of the present study was to compare menstrual pattern changes in patients accepting injection DMPA and LNG-IUS for various gynaecological indications.Methods: This randomized controlled trial was conducted among 70 women aged 18 years or older with heavy menstrual bleeding in the department of Obstetrics and Gynaecology, Chhatrapati Shivaji Subharti Medical College, Meerut. The study comprised of two groups having 35 patients each i.e. Group 1 (patient who opted for LNG IUS) and Group 2 (patient who opted injection DMPA). The menstrual pattern changes were assessed at 1month, 3month and 6th month interval. Patient were asked to maintain a menstrual calendar wherein she would keep a record of the no. of days along with dates when she has spotting per vaginum/bleeding per vaginum and the amount of blood loss explained to her through the pictorial blood assessment chart.Results: Reduction in median menstrual blood loss was significantly greater in the LNG IUS group (-128.12mL, range -393.6 to 328.5 mL) than in the DMPA group arm -17.8 mL, range -271.5 to+78.6 mL, p<0.001).Conclusions: LNG IUS reduces menstrual blood loss more effectively than DMPA.
Comparative study of non-descent vaginal hysterectomy and laparoscopy assisted vaginal hysterectomy
Authors: Soren Surendra Nath , Chattar Ghanashyam , Dash Jitendra Kumar
Published: January 2021

Background: We aimed to assess and compare intra operative and post-operative parameters and complications associated with non-descent vaginal hysterectomy group (NDVH) and laparoscopic assisted vaginal hysterectomy group (LAVH).Methods: In this observational study 100 patients with uterine size not exceeding 12 weeks of gravid uterus, adequate uterine mobility, fibroid uterus, dysfunctional uterine bleeding, chronic cervicitis, adenomyosis and post-menopausal bleeding were divided into two groups to undergo either NDVH and LAVH. Their intra-operative and post-operative parameters were compared.Results: The mean operating time was significantly less in NDVH group as compared to LAVH group cases (65.44 vs 83.12 mins; p<0.01). Blood loss (210.22 vs 261.58 ml; p-0.03) during the procedure and drop in haemoglobin (1.22 vs 1.62 gm%; p-0.08) was also lower with NDVH group as compared to LAVH group respectively. Requirement of blood transfusion, adnexotomy and incidence of anaesthesia related complications were similar between the two study groups. Median VAS score was significantly less in NDVH group as compared to LAVH group at immediate post-op period and at day 1 respectively (p<0.01). We observed a comparable mean hospital stay for the patients in the two study groups (5.52±1.33 vs 6.01±1.39 days, p value=0.71).Conclusions: Based on the results of the present study, we conclude that NDVH is safe and should be offered as the first surgical choice in women with uterine enlargement due to benign pathology and non-prolapsed uterus.
Maternal and perinatal outcome in cardiac disease complicating pregnancy
Authors: Mange Krupa R. , Bangal Vidyadhar B.
Published: January 2021

Background: Maternal cardiac disease associated with pregnancy is considered as a high-risk pregnancy. Various physiological and hemodynamic alterations during the course of pregnancy make these women prone for various complications and related morbidity and mortality.Methods: A prospective cross-sectional study of 105 cases of pregnancy complicated by cardiac disease, reporting to tertiary care hospital for delivery, was carried out to find out the maternal and perinatal outcome.Results: The incidence of cardiac disease in pregnancy in the present study was 0.54%. Most of the women (91%) belonged to low socioeconomic class. Rheumatic heart lesions constituted 87% of the cases. Mitral stenosis alone or in combination, was the commonest (57%) valvular lesion. Incidence of spontaneous vaginal delivery was 53 percent and for ventose or outlet forceps was 12 percent. Incidence of caesarean section was 35%. There were 2 maternal deaths, one each due to complication like pulmonary oedema and atrial fibrillation. The perinatal mortality was 36 per 1000 live births, mainly due to combination of factors like prematurity, low birth weight, neonatal sepsis and birth asphyxia.Conclusions: Early diagnosis of heart disease, regular antenatal checkup, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease.
Diagnostic efficacy of Striae Gravidarum in predicting intraperitoneal adhesions and uterine scar thickness in women undergoing repeat caesarean section
Authors: Mohanty Akanksha , Anand H. P.
Published: January 2021

Background: Striae gravidarum (SG) are stretch marks on the skin which develop during pregnancy. Cesarean section is one of the most common operation performed worldwide which carries a potential risk of complications due to the intra-peritoneal adhesions and thickness of previous uterine scar. The aim of this study was to find the diagnostic efficacy of striae gravidarum in predicting intra-peritoneal adhesions (IPA) and uterine scar thickness in women undergoing repeated caesarean delivery.Methods: It was a cross-sectional study done over a period of 18 months duration. One hundred women with previous cesarean section scheduled for elective LSCS were enrolled for the study. Striae gravidarum was calculated according to the Atwal numerical scoring system. Presence of intra-peritoneal adhesions were graded intraoperatively according to modified Nair scoring system. After extraction of baby, the thickness of lower uterine segment at midpoint of lower flap of uterine incision was measured by metallic screw gauge.Results: Significant positive correlation was seen between striae gravidarum and intra-peritoneal adhesions. A negative association was established between striae gravidarum severity and thickness of LUS. Owing to its moderately high sensitivity and low specificity in predicting IPA Grade 3 or 4 and LUS scar thickness<3.74mm, striae gravidarum cannot be used as a diagnostic indicator, but can be a useful mass screening method.Conclusions: Striae gravidarum is a zero-cost simple quick and easy technique which can be universally used with minimal intra-observer variation to predict perioperative complications in low resource settings.
Analytical survey of scenario for permanent method of contraception
Authors: Agarwal Vandana , Mehani Rekha , Jain Swati
Published: January 2021

Background: This study has analysed the average completed family size with relation to parity, average age of both partners accepting permanent contraception, the percentage of women who finished their family with only female children and comparison of practice observed in rural and urban population.Methods: A retrospective analytical study was conducted at RKDF medical college and research centre Bhopal M.P. from 1 January 2017 to 31 August 2020 (3 Years 7 months) on 286 patients. Data of the patients who had undergone tubal ligation after normal vaginal delivery, caesarean section, with medical termination of pregnancy and interval tubectomy was collected at RKDF medical college and research centre Bhopal M.P.Results: Parity wise maximum number of cases completed their family with two issues i.e. (51%). Permanent sterilisation was done in even one issue in (0.6%) minimum number of cases were observed in 9 issues (0.34%). Rural versus urban distribution was 25 and 75% respectively. Maximum age observed was 47 years of husband and 42 years of wife.Conclusions: For the desire of male child, number of female children increased thereby increasing the family size.
Role of transvaginal sonography in the diagnosis of early pregnancy failure
Authors: Khanam Rosy , Nath Pranoy
Published: January 2021

Background: The most crucial period of intra uterine life are the first twelve weeks of gestation, where history and clinical examination may often be inconclusive. Ultrasonography plays an important role in confirming the pregnancy, its site and viability. The objective of this study was to determine the first trimester ultrasonographic findings of a normal intrauterine pregnancy, early pregnancy failure and to have a comparative evaluation of transvaginal with transabdominal ultrasonography in the diagnosis of early pregnancy failure.Methods: Cross sectional study done in the Department of Obstetrics and Gynaecology, Silchar Medical College and Hospital from 1st June 2019 to 31st May 2020. Data were collected from 80 patients presenting to the Antenatal and Gynaecology OPD of Silchar Medical College, with positive urine beta HCG test with signs and symptoms suggestive of early pregnancy. The study was conducted during the said study period. General physical and pelvic examination done for in the cases provisional clinical diagnosis and subjected to ultrasound. Sonography by both abdominal and transvaginal method was done and findings were compared.Results: 70% of cases in this study came out to be of normal pregnancy while 30% of the total cases were of abnormal pregnancy. Various fetal developmental markers such as gestational sac, yolk sac, fetal pole, fetal heart motion, double decidual sac sign were visualised in better number of cases by transvaginal sonography than by abdominal. Amongst cases of abnormal pregnancy, parameters such as detection of abnormality in shape of gestational sac, abnormality in yolk sac were found to be better seen with transvaginal sonography than with transabdominal sonography. Measurements of mean sac diameter, crown rump length were found to be similar by both the methods.Conclusions: Combination of abdominal sonography and transvaginal sonography complements the defects of two methods and thus improves the accuracy of diagnosis. Thus it can be said that transvaginal sonography should not be used as a substitute but as a conjunct with abdominal sonography for better visualization, improved diagnosis thereby leading to better management of the patients.
Analysis of fetomaternal outcome of COVID-19 antenatal mothers-initial experience
Authors: Bhadana Priyanka , Kumar Ashok , Chawla Indu , Sarkar Bani
Published: January 2021

COVID-19 is an infectious disease caused by newly discovered single stranded RNA virus of Coronaviridae family. A retrospective study conducted in ABVIMS and RML hospital, Delhi in antenatal patients with COVID-19 infection detected by RT-PCR in nasopharyngeal and oral swab. It was found that patients with mean age of 27.2 years and mean gestational age of 39 weeks, mostly asymptomatic. Three patients undergone c section for obstetrical indications, while rest delivered vaginally. COVID-19 in pregnancy in small group of cases had good feto-maternal outcome but warrants further study.
Placenta accreta in a referred post hysterotomy case: a bold step into the unknown
Authors: Gadappa Shrinivas N. , Gaikwad Rupali A. , Sonawne Anurag A. , Shah Ankita R. , Makde Shrutika O. , B. Sowjanya S.
Published: January 2021

Placenta accreta spectrum encompasses a range of pathological adherence of placenta and causes significant maternal and neonatal morbidity and mortality. With the increase in the number of cesarean deliveries over the last few decades, there has been an 8 fold increase in the incidence of placenta accreta. The single most important risk factor reported in about half the cases of PAS disorders is placenta previa. Management involves a standardized approach with a comprehensive multidisciplinary care team accustomed to management of placenta accreta. We discuss a rare case of a patient who underwent hysterotomy in an outside hospital and was referred to our tertiary care centre as atonic PPH. Undiagnosed antenatally and at the time of hysterotomy, she was diagnosed as a case of placenta accreta on exploration at our institute and was surgically managed.
Pseudo broad ligament fibroid mimicking ovarian malignancy: a case report
Authors: Naghma Shahida , Meena Mamta Kumari
Published: January 2021

Fibroids are smooth muscle benign tumors. They arise most commonly from the uterus but may also rise from extra uterine sites like broad ligament. Uterine fibroids are the most common myomas, while uterine cervix and intraligamentary fibroids are statistically less frequent. This case report of Pseudo broad ligament fibroid with extensive cystic degeneration is presented for its rarity and diagnostic challenges as they mimic pelvic adenexal tumors. Following is the case report of a 40 year old, P4L4, postmenopausal female admitted in the department due to a diagnosed solid lesion in the left adnexa. Patient was asymptomatic 3 months back when she noted gradual swelling and distention over the abdomen. On abdomen examination, a generalized mass was palpable with minimal ascites. On ultrasonography, a large heterogenous mass measuring 200X215 mm seen in pelvic region, arising from left adnexa and extending towards abdomen. During laparotomy, left sided fibroid was removed and sent for frozen section analysis. Histopathological reports revealed spindle cells arranged in fascicles and interlacing bundle with focal areas of myxoid degeneration. Huge pseudo-broad ligament leiomyoma with cystic degeneration may present diagnostic difficulties in differentiating ovarian malignancies even on ultrasound and MRI. This differential diagnosis must be considered prior to surgical management.
A rare case of primary vaginal carcinoma in prolapsed uterus
Authors: C. Sanjay , Rao Bharathi , Rai Sharadha
Published: January 2021

Primary carcinoma is rare in gynaecological neoplasia. Vaginal carcinoma in prolapse uterus is extremely rare. We hereby present a case of 55-year-old P3L3 postmenopausal woman with complete uterine prolapse with fungating growth of 6x8 cm with two decubitus ulcers of 1x1 cm. Marginal biopsy showed well-differentiated squamous cell carcinoma of vagina. Investigation was done showed no metastasis. Patient was diagnosed with stage 2 disease. Patient underwent 5 cycles of chemotherapy with 2 cycles of radiotherapy and is being followed up. The importance of biopsy of ulcer in cases of UV prolapse in order to exclude malignancy to avoid incomplete treatment has been illustrated through this case. The need of careful evaluation of vaginal erosions in pelvic organ prolapse has been highlighted. As there is lack of well-defined treatment protocols for vaginal cancer with concurrent prolapse, the case also underlines the importance of a multidisciplinary approach involving gynaecological oncology, urogynaecology, medical oncology, surgical oncology and radiation oncology.
Ovarian torsion in infertility treatment
Authors: Swapna Yaramareddy , Elanchezhian M. , Chegireddy Supraja , Badipati Raju , Devadharshini V.
Published: January 2021

Ovarian torsion, a rare problem in women can lead to serious consequences if not diagnosed and treated at the earliest. It is one of the complications that needs to be included in the differential diagnosis of any girl with abdominal pain or a pelvic or abdominal mass as the symptoms and signs are nonspecific and it can be related to other clinical causes. A 29-year-old woman who was under ovulation induction was diagnosed with ovarian torsion which was treated by performing laparoscopy. Investigations for ovarian torsion should be carried out for all the patients treated for infertility presenting with abdominal pain to minimize the risk before it is too late.
Ectopia cordis about a case at Ourossogui regional hospital center
Authors: Diakhate Abdoulaye , Guèye Mame D. N. , Diallo Abdou K. , Wade Mouhamadou , Ndour Simon B. , Diop Daba , Dieng Cheikh , Mbodji Ameth , Guèye Mamour
Published: January 2021

We report in this work, an extremely rare and major case of anterior body wall defects included ectopia cordis define by abnormal location of heart outside of the thorax. This case was diagnosed at the maternity of Ourossogui regional hospital center, in Senegal. Any scan was performed during the pregnancy. Newborn died 10 minutes after birth. Ectopia cordis is related to a possible ventral midline developmental abnormality. It’s associated to other midline abnormalities and is a part of pentalogy of Cantrell. An X-linked genetic abnormality.
Association between gastroesophageal reflux disease-questionnaire factors and gastroesophageal reflux disease incidence at Kardinah general hospital inpatient wards
Authors: Gosal Darren , Santoso Rachman Edi , Firmansyah Yohanes
Published: January 2021

Background: Gastroesophageal reflux disease (GERD) is a condition where an acid reflux into the esophagus with can resulted some symptoms. GERD is one of the most common disease in around the world. The most common symptom is heartburn, with its various risk factors. Diagnosing GERD based on the clinical examination or more advanced examination. One simple tool to help diagnosing is GERD questionnaire (GERD-Q). This study aims to find out the association of GERD-Q factors to GERD incidence at Kardinah inpatient wards.  Methods: This study is cross sectional design, with the subjects are all patients in the inpatient wards, and asked with the Indonesian version of GERD-Q plus other questions. All data will be assessed with chi Square test.  Results: Total of 84 respondents are in this study, where the relationship of each factors with GERD incidence are: gender (p value: 0.191), surgery (p value: 0.428), spicy foods consumption (p value: 0.920), fatty foods consumption (p value: 0.916), sour foods consumption (p value: 0.557), and irregular eating habit (p value: 0.023).Conclusions: Irregular eating habit is significantly associated with GERD incidence.
Expression of e-cadherin and vimentin in lesions of oropharynx
Authors: Thankam Dhanya R. , A. Aria Jyothi
Published: January 2021

Background: Oral squamous cell carcinoma is the 6th most common malignancy in the world and ranks as first in males in Indian sub-continent. Vimentin is an intermediate filament found in mesenchymal cells and e-cadherin is an adhesion molecule found in epithelial cells. The objective of the study is to evaluate the expression of e-cadherin and vimentin in lesions of oropharynx and to assess the sensitivity, specificity and positive predictive value of e - cadherin and vimentin in oropharyngeal squamous cell carcinoma (OPSCC), against routine H and E stained histopathological diagnosis.Methods: 100 oropharyngeal biopsy specimens taken and routine H and E stained histopathological slide diagnosis made. E-cadherin and vimentin expression studied in OPSCC, moderate to severe dysplasia, mild dysplasia and benign cases and its sensitivity, specificity, positive predictive value and negative predictive value analysed using appropriate statistical tools.Results: Vimentin positivity was observed in 70 out of 79 OPSCC, 2 out of 3 cases of moderate - severe dysplasia, 0 out of 2 mild dysplasia and 2 out of 16 benign lesions. Out of 79 cases of OPSCC, 15 were e-cadherin negative, 27 showed low and 37 cases showed high membraneous positivity.Conclusions: We observed a significant decrease in e-cadherin membrane expression from dysplasia to carcinoma insitu to invasive carcinoma and a significant increase in vimentin expression with progression of the tumor. E-cadherin is a good prognostic marker whereas vimentin expression indicates a poor prognosis.
Hepatic cirrhosis causes pancytopenia: a case report
Authors: Dana I. Made Bayu Surya , Mediana Sherly , Murti Wangsit Warsito , Ariodhanu Widodo
Published: January 2021

Hepatic cirrhosis is a slow process liver disease, persisting over a long period of time, resulting in a progressive destruction, and is the final common pathological pathway. We report a case of 60-year-old man with hepatic cirrhosis and pancytopenia. He came to emergency room with chronic fatigue, light headed, and abdominal pain. In laboratory examination, hemoglobin 6.0 g/dL, red blood cell counts 2.8×106/mm3, platelets 58.000×103/mm3, leukocytes 3.800×103/mm3, and reactive HbsAg. Abdominal ultrasound revealed small liver with irregular edges, ascitic fluid, and enlarged spleen. The patient was treated with furosemide, spironolactone, lactulose and propranolol. The liver, or the hepatocyte constitutes a significant storage site for iron, produce erythropoietin and thrombopoietin. Hypersplenism causes retention of a large number of leukocytes, erythrocytes, and platelets in the spleen, and the number of retained blood cells can be 5.5-20 times higher than the normal level, thus facilitating capture, phagocytosis or destruction of blood cells by phagocytes resulting in peripheral cytopenias. This case illustrated that hepatic cirrhosis can cause pancytopenia. Therefore, we must look for any cause of pancytopenia in a patient with chronic liver disease. Lack of thrombopoietin and erythropoietin production, lack of iron storage in damaged hepatocyte, also splenic sequestration were the reason of pancytopenia in hepatic cirrhosis. Bone marrow examination is one of modalities that can be use, and still being recommended examination.
Empiric treatment of diarrhea in patient with HIV infection: a case report
Authors: Susanto Lisa A. , Dana I. Made Bayu S. , Suryana Ketut
Published: January 2021

Diarrhea is common opportunistic infection in patient with Human immunodeficiency virus (HIV) infection. Diarrhea in patient with HIV infection that contributes the negatively to quality of life. The etiology of diarrhea in patient with HIV infection is multifactorial include infectious, non-infectious, ART-association diarrhea. In addition, this diarrhea can be associated with empiric therapy. This article a 31 years old male patient with 3 days fatigue and diarrhea. Physical examination dry mucous membranes, abdominal pain especially in in the upper abdomen and increase small bowel peristalsis. Stool examination test doesn’t have blood, parasites, and fungi. Stool cultures for Salmonella, Shigella, Campylobacter organisms no presence. The treatment metronidazole oral 500 mg every 8 hours was again performed. Metronidazole is available for the management of diarrhea in patient with HIV that can’t be treated with other antibiotics.
Dopamine: a modulator of circadian rhythms/biological clock
Authors: Kant Ravi , Meena Mahendra K. , Pathania Monika
Published: January 2021

Circadian rhythm describes the physical, psychological, and behavioural patterns of living organisms that respond to day and night light levels. The important bodily functions like hunger, sleep, gastrointestinal motility, mood, coordination, body temperature, gene transcription, sensory perceptions, sleep-wake cycles and hormone release etc are influenced by circadian rhythm. Abnormal circadian rhythm may result obesity, depression, diabetes, seasonal affective disorder, bipolar disorders and various sleep disorders. The neuromodulator dopamine, originate from small groups of neurons in the mesencephalon (the ventral tegmental area, the substantia nigra) and in the diencephalon. In the retina, olfactory bulb, striatum, midbrain, and hypothalamus, it has been shown to have that dopamine shows circadian like activities, where it regulates, clock genes in some of these areas. Thus, it is likely that dopamine is essential to mechanisms that maintain proper rhythmicity of these five brain areas. Dopamine receptors are located centrally and peripherally. Growing evidence that dopamine is involved in regulating circadian rhythms, either directly or indirectly, in the brain areas through various pathways and dopaminergic receptor groups centrally and peripherally, and plays vital role.
Self-medication with antibiotics among patients attending a Malaysian primary care clinic: a preliminary study
Authors: Zubaidi Zati Sabrina Ahmad
Published: January 2021

Background: Research on self-medication with antibiotic in Malaysian primary care clinics are limited. This study aimed to assess the practice of self-medication with antibiotic, self-recognized complaints to self-medicate, antibiotic knowledge, attitudes towards antibiotic and potential association to self-medicate in a primary care clinic.Methods: This was a community-based pilot study using a self-administered questionnaire among 281 respondents. Chi square test and independent T test were performed to identify potential associations to self-medication.Results: The prevalence of self-medication with antibiotic was 13.3%. The most common complain to self-medicate was for upper respiratory tract infection (58.8%). Majority of them were able to self-purchased antibiotics (55.9%). 70.6% of respondents who SMA understood that overuse of antibiotic results in antibiotic resistance. Interestingly, antibiotic knowledge among respondents who self-medicate was higher (6.50±1.93) compared to those who did not (5.85±2.46) albeit not statistically significant. However, respondents who self-medicate had poorer attitude towards antibiotic compared to those who did not and this was statistically significant, t (254)=0-4.25, p=0.0001. 95% CI (-4.653, 1.709). This includes keeping antibiotics at home and using leftover antibiotics for respiratory illness.Conclusions: Self-medication with antibiotic in this population is low. Inappropriate attitude towards antibiotic is associated with self-medication with antibiotic. Antibiotic campaigns should focus on improving the community’s attitude towards antibiotic especially pertaining to educating the public against keeping antibiotic at home and using leftover antibiotics for upper respiratory tract infection. The findings demonstrated the need and feasibility of the study protocol for future research.
Qualitative enquiry on the perceptions related to MCQ based discussion through WhatsApp status among medical students and teaching faculty during COVID-19 lockdown
Authors: Doddaiah Sunil Kumar , Kulkarni Praveen , Mohandas Aparna , M.R Narayana Murthy
Published: January 2021

Background: Ever since the government of India announced countrywide lockdown, medical institutions across the country has shifted to virtual learning. Being in an era of smartphone users, the utility of a popular social media platform like WhatsApp in efficient learning needs to be explored. The aim of the study was to determine the perceptions related to multiple choice question (MCQ) discussion through WhatsApp status among medical students and teaching faculty.  Methods: This longitudinal study was conducted among 154 participants (medical students and faculty) for three months. MCQs on COVID-19 were disseminated through WhatsApp status of the investigator and feedback regarding the same was taken at the end of three months. The qualitative data collected as descriptions were compiled and analyzed as per classical content analysis. Specific codes were assigned to responses and were put under different categories with similar characteristics.Results: A total of 154 participants took part in the study. Participants felt that the approach to convert a popular social media like WhatsApp to a learning platform was innovative. According to them, the activity motivated them to learn more and kept them updated on COVID-19. A major advantage of WhatsApp based learning, being that it can be used anytime and anywhere, which is relevant in the lockdown period.  Conclusions: In this study, participants found learning via WhatsApp to be interesting and motivating. Learning through this platform helped the participants to keep themselves engaged in the academics in spite of lockdown and also provided opportunity to clarify their doubts.