bluuebunny/crossref_metadata_2025 huggingface dataset:
Autoridades eclesiales y medios de comunicación: La actitud de los feligreses frente al plebiscito en Colombia.
Authors: Bolaños Orejuela Juan Camilo , Alcazar España Laura Isabel
Published: May 2022

La iglesia es una institución social que se configura como un conjunto de valores, creencias y reglas de juego que permean al individuo; en particular, la iglesia cristiana protestante se ha distinguido por la presencia de autoridades eclesiales que han jugado un papel determinante en el comportamiento de sus feligreses, no solamente en términos morales o espirituales, sino políticos. De ahí que sea posible entender un tipo de cultura política influenciada por la religión, como factor definitivo en las decisiones políticas de una sociedad.En este sentido, el objetivo fundamental es comprender la actitud de los feligreses frente a un hecho de coyuntura política relevante en Colombia; en este caso el plebiscito realizado el pasado 2 de octubre, con el cual se buscó refrendar el acuerdo de paz entre el gobierno y las FARC-EP. Con dicho mecanismo se le preguntó a la ciudadanía si apoyaba el acuerdo final para la terminación del conflicto y la construcción de una paz estable y duradera; sorpresivamente ganó por una pequeña diferencia quienes votaron NO.Finalmente, a través de una perspectiva que involucre a los medios de comunicación y la cultura política, es posible conocer el accionar político de los feligreses, y la consecuente actitud de las autoridades eclesiales frente a determinado evento de coyuntura nacional; todo ello con el ánimo de evocar una perspectiva académica en el marco de la política, cultura, ideología y discurso.
Metodología para la construcción del estado del arte del sector turístico: Validación en el sur del Huila.
Authors: Vinasco Guzmán Martha Cecilia
Published: May 2022

El presente artículo expone la propuesta metodológicade un estado del arte para facilitar el análisis de los documentos referentes al turismo.  El objetivo es el de proponer y validar una metodología que permita recopilar, caracterizar, sistematizar y analizar el estado del conocimiento actual de los documentos relacionados con el turismoy validarlo con los documentos emitidos por las instituciones dedicadas a promocionar el turismo sostenible en los municipios de Pitalito, San Agustín e Isnos.  Se construyó un esquema categorial en torno a esferas referidas a actores involucrados (institucional - estatal – local, privada – colectiva); ámbitos: político-sustentable, competitivo-productivo e investigativo-social; categorías para análisis y síntesis y subcategorías como una clasificación adicional. En los hallazgos, dada la reiteración de los mismos aspectos, indica una baja capacidad de ejecución de las estrategias por parte de gobiernos nacionales, departamentales y locales, en especial en la zona sur del Huila.  La metodología permite realizar una investigación sistemática en torno a los documentos turísticos a través del tiempo, para determinar las necesidades de información y para posibilitar la toma de decisiones que se traduzcan en mejoras en la prestación de los servicios turísticos.
Bioprinted Gelatin-Recombinant Type III Collagen Hydrogel Promotes Wound Healing
Authors: Huang Jianghong , Lei Xiaoling , Huang Zhiwang , Rong Zhibin , Li Haihang , Xie Yixin , Duan Li , Xiong Jianyi , Wang Daping , Zhu Shihui , Liang Yujie , Wang Jianhao , Xia Jiang
Published: May 2022

Artificial skins are biomaterials that can replace the lost skin or promote the regeneration of damaged skin. Skin regenerative biomaterials are highly applauded because they can exempt patients with severe burns from the painful procedure of autologous skin transplantation. Notwithstanding decades of research, biocompatible, degradable, and printable biomaterials that can effectively promote skin regeneration as a transplantation replacement in clinical use are still scarce. Here, we report one type of all-protein hydrogel material as the product of the enzymatic crosslinking reaction of gelatin and a recombinant type III collagen (rColIII) protein. Doping the rColIII protein in gelatin reduces the inflammatory response as an implant underneath the skin. The all-protein hydrogel can be bioprinted as scaffolds to support the growth and proliferation of 3T3 fibroblast cells. The hydrogel used as a wound dressing promotes wound healing in a rat model of skin damage, showing a faster and healthier recovery than the controls. The rColIII protein in the hydrogel has been shown to play a critical role in skin regeneration. Altogether, this work manifests the development of all-protein gelatin-rColIII hydrogel and demonstrates its use in wound healing. The gelatin-collagen hydrogel wound dressing thereby may become a promising treatment of severe wounds in the future.
Novel High-Speed 3D Printing Method Using Selective Oil Sintering with Thermoplastic Polyurethane Powder Printing
Authors: Yi-Wu Jun , Hsieh Chih-Hua , Lin Zheng-Ying
Published: May 2022

Present methods used in three-dimensional (3D) printing, such as selective laser sintering (SLS) and multijet fusion (MJF), have limited applications, especially in relation to the manufacturing of biomedical products. The speed of SLS printing is too low, and high-speed 3D printing technology with MJF uses carbon black particles as a fusing agent, which cannot be removed from the completed 3D printed products. Carbon black and high-energy lasers are not suitable for biomedical applications, especially human implants. A new high-speed 3D method is therefore required. In this study, we used hot oil droplets (175°C) as a new type of fusing agent to melt the biomaterial thermoplastic polyurethane (TPU) powder particles to define the print area. This method replaces lasers and the carbon black fusing agent in high-speed 3D printing technology and is more energy efficient. In addition, this method can be used to not only print on TPU, but also on other flexible materials.
3D-Printed β-Tricalcium Phosphate Scaffolds Promote Osteogenic Differentiation of Bone Marrow-Deprived Mesenchymal Stem Cells in an N6-methyladenosineDependent Manner
Authors: Jiao Xin , Sun Xin , Li Wentao , Chu Wenxiang , Zhang Yuxin , Li Yiming , Wang Zengguang , Zhou Xianhao , Ma Jie , Xu Chen , Dai Kerong , Wang Jinwu , Gan Yaokai
Published: May 2022

Bone defect is a serious orthopedic disease which has been studied for a long time. Alternative degradable biomaterials are required for bone repairing and regeneration to address the limitation of autogenous bone. β-tricalcium phosphate (β-TCP) is an alternative material with good cytocompatibility and has been used in bone defect treatment. However, whether β-TCP contributes to osteogenesis of bone marrow stem cells (BMSCs) through N6-methyladenosine (m6A) modification remains unknown. To address this issue, we verified the effects of β-TCP on osteogenesis of BMSCs. We also studied the expression of m6A-related enzymes in BMSCs after β-TCP treatment. Furthermore, the m6A level and stability of Runt-related transcription factor 2 (RUNX2) mRNA were investigated after β-TCP treatment. Finally, rat calvarial defect models were performed to detect expression level of osteogenic factors and m6A-related enzymes after the stimulation of three-dimension (3D)-printed β-TCP scaffolds. We found that β-TCP showed good biocompatibility and was osteoinductive. Meanwhile, methyltransferase-like 3 (METTL3) increased, causing the elevation of m6A level of RUNX2, results in stabler RUNX2 mRNA level. At last, based on the animal experiments, we demonstrated that the increase of RUNX2 and METTL3 levels was induced by β-TCP. These findings suggest that METTL3 increases the m6A level of RUNX2 mRNA after β-TCP induction, contributing to its stability, and the results in vivo also confirmed the osteogenic and bone-repair properties of β-TCP.
Validity of a Soft and Flexible 3D-Printed Nissen Fundoplication Model in Surgical Training
Authors: Zhang Yangyi , Xia Jianfu , Zhang Jiye , Mao Jinlei , Chen Hao , Lin Hui , Jiang Pan , He Xinzhong , Xu Xiaodong , Yin Mingzhu , Wang Zhifei
Published: May 2022

Rapid development of three-dimensional (3D) printing technique has enabled the production of many new materials for medical applications but the dry laboratory surgical training model made of soft and flexible materials is still insufficient. We established a new 3D-printed Nissen fundoplication training model of which materials simulate the real mechanical properties. In this study, 16 participants were divided into two groups: Experimental group and control group. The validity of model was tested using Likert scale by the experts and the experimental group. To evaluate the efficacy, performances of the experimental group were scored at the first, fourth, and eighth training by OSATS system and the duration of procedure was compared through the use of recorded video. Meanwhile, an ex vivo model was used to compare the performance of the experiment group and control group after the training in the same way. Our results showed that the 3D-printed model can support the future surgical applications, help improve surgical skills, and shorten procedure time after training.
Additively Manufactured Multi-Morphology Bone-like Porous Scaffolds: Experiments and Micro-Computed Tomography-Based Finite Element Modeling Approaches
Authors: Noroozi Reza , Tatar Farzad , Zolfagharian Ali , Brighenti Roberto , Shamekhi Mohammad Amin , Rastgoo Abbas , Hadi Amin , Bodaghi Mahdi
Published: May 2022

Tissue engineering, whose aim is to repair or replace damaged tissues by combining the principle of biomaterials and cell transplantation, is one of the most important and interdisciplinary fields of regenerative medicine. Despite remarkable progress, there are still some limitations in the tissue engineering field, among which designing and manufacturing suitable scaffolds. With the advent of additive manufacturing (AM), a breakthrough happened in the production of complex geometries. In this vein, AM has enhanced the field of bioprinting in generating biomimicking organs or artificial tissues possessing the required porous graded structure. In this study, triply periodic minimal surface structures, suitable to manufacture scaffolds mimicking bone’s heterogeneous nature, have been studied experimentally and numerically; the influence of the printing direction and printing material has been investigated. Various multi-morphology scaffolds, including gyroid, diamond, and I-graph and wrapped package graph (I-WP), with different transitional zone, have been three-dimensional (3D) printed and tested under compression. Further, a micro-computed tomography (µCT) analysis has been employed to obtain the real geometry of printed scaffolds. Finite element analyses have been also performed and compared with experimental results. Finally, the scaffolds’ behavior under complex loading has been investigated based on the combination of µCT and finite element modeling.
Correlations between colposcopy findings and histopathological results from colposcopy directed biopsy in cervical pre-cancerous lesions
Authors: Bhattacharjee Sulekha , Begum Khadiza , Waddader Priyanka , Biswas Supran
Published: May 2022

Background: Pap smear test has been less successful in identifying those women with the highest risk for pre-malignant disease, so the patients with equivocal Pap smear would need further evaluation with colposcopy. Performing the colposcopy with more accuracy would result in better prognosis of pre-malignant lesions. However, performing a comparison with directed biopsy is required to obtain more definite results. The aim of this study was to determine the correlation between colposcopic impression according to Reid colposcopic index and biopsy histology in VIA positive cases.Methods: This observational study was conducted at the Department of Gynaecology and Obstetrics in Chittagong Medical College Hospital, Chittagong from September 2014 to February 2015. A total 72 women of VIA positive cases attended at colposcopy clinic of CMCH were included in this study. These patients were selected nonrandomly according to inclusion criteria. All patients were sign a written informed consent before recruitment into the study. According to colposcopy diagnosis was done by Reid colposcopic index. All patients were undergone directed biopsy followed by histopathology. Data were collected under guidance and advice of the supervisor through a structured questionnaire.Results: Almost two-thirds of the cases were 30-39 years age group. Among the 72 cases the presentations were mainly excessive vaginal discharge 61.1%, dyspareunia 16.7%, post-coital bleeding 9.7% and abnormal inter-menstrual bleeding 12.5%. Colposcopically 90.3% had CIN and invasive lesions, while 9.7% was normal. Colposcopically directed punch biopsy revealed in 84.7% cases positive lesions and 15.3% had not any CIN or invasive lesions.Conclusions: This study demonstrated high accuracy and correlation between colposcopy and histology, comparable with results from similar studies in the literature. Sensitivity is lower in our studies, probably because biopsies were performed in all cases.
HELLP syndrome on the rise: a major cause of maternal deaths
Authors: Devabhaktuni Pratibha , Ponnuru Malathi , Vangala Lahari Reddy , Bommakanti Lavanya , Nawinne Maljini , Komatlapalli Suneetha
Published: May 2022

Background: In the recent years, 2021 to 2022, there has been a sudden rise in the number of HELLP syndrome cases admitted to Modern Government Maternity Hospital, (MGMH) / Osmania Medical College. There were maternal deaths due to complications secondary to HELLP syndrome. Complications like placental abruption, DIC, PPH, PRAKI, pulmonary edema, were responsible for maternal deaths. The need for blood products has increased enormously. In our earlier study of eclampsia and imminent eclampsia from the same Institute, during 2004 to 2007, we did not find HELLP syndrome to be a major cause of maternal deaths. Hence, we proceeded with in depth study of the complications, morbidity and mortality and some management issues related to HELLP syndrome. All 70 cases of HELLP in this study had associated Preeclampsia/eclampsia.Methods: This is a prospective analytical observational study of 70 cases of HELLP syndrome.Results: Recurrent preeclampsia was noted in 6÷45=13.33%. Cases of hypothyroidism were observed in 6÷45=13.33%. There were four sets of twins, 8.88%. Placental abruption was noted in 10/70 women with HELLP, 14.28%, DIC occurred in 15÷70=21.42%, PPH occurred in 11÷45 cases, 24.44%, PRAKI was recorded in 16/70 patients, 22.85%, Pulmonary edema occurred in 5/70, 7.14%, PPCM in cases with HELLP syndrome were 2÷70=2.85%, Abdominal delivery was needed in 53÷70=75.71%, Maternal mortality in the present study was10÷70=14.28%, The perinatal mortality was 21.33%. Blood products were needed in 22/45 cases, (9.136) units on the average.Conclusions: Dissemination of knowledge that immediate delivery should be planned in all cases of HELLP, irrespective of gestational age is the need of the hour. Postponing delivery would lead to complications.
A comparative study of antenatal and fetal complications in pregnant women with and without history of polycystic ovary syndrome
Authors: Meghwal Suman , Rajoriya Lata , Shankar Ambika , Malik Rupal , Dhaka Sunita
Published: May 2022

Background: Polycystic ovary syndrome in the present generation is a very common reproductive disorder and the prevalence is on the rise. Aim of the current study was to compare the maternal outcome in normal and women with PCOS.Methods: This study was a case-control study conducted in Department of Obstetrics and Gynaecology, SMS Medical College and attached group of hospitals, Jaipur from May 2019 to August 2020. Pregnant women with history of PCOS were taken as cases and with no such history were controls.Results: 9.49% women developed gestational diabetes mellitus (GDM) in cases as compared to 1.61% women in control group. The difference in the incidence of GDM in the two groups was statistically significant. When hypertensive disorders of pregnancy were considered, a statistically significant difference was observed as 11.2% cases and 2.42% controls showed HDP. Mean birth weight of neonate in cases was 2.43±0.31 kg and in control group was 2.71±0.29 kg. Mean APGAR score at 1 minute in cases was 6.21±1.23 and in controls was 7.21±0.24. APGAR score at 5 minutes in PCOS group was 7.89±1.40 and in control group was 8.12±0.21. 12 neonates from the cases group were admitted in NICU. The difference was statistically significant when comparedConclusions: With a detailed comparative analysis of this case-control study, it can be concluded that many antenatal and fetal complications are per se increased in women with a history of PCOS.
Hysteroscopy today: is it yet a conventional diagnostic technique in abnormal uterine bleeding?
Authors: Vithal Aditi , Nakum Kanaklata , Patel Disha , Patel Juhi
Published: May 2022

Background: To assess the efficacy of hysteroscopy over dilatation and curettage in diagnosis of abnormal uterine bleeding. Methods: A total of 51 women in reproductive and peri- menopausal age group (19-55 years) with complaints of abnormal uterine bleeding were enrolled in the study. All the patients underwent hysteroscopic examination followed by D&C/histopathological evaluation. Hysteroscopic findings were compared against histopathological findings.Results: Majority of patients belonged to 36-40 years of age group. Majority (40%) presented within 6 months of complaints. Hysteroscopically, 46% had abnormal findings 12% had cervical polyps, 12% fibroid polyps, 18% endometrial polyps, 2% had adhesions (Ashermann’s syndrome) and 2% had a forgotten intrauterine contraceptive device. On histopathology (D&C) 64% cases had normal/proliferative/atrophic endometrium, 12% had hyperplasia and 6% had polyp.Conclusions: Hysteroscopy provided additional information for some of the pathologies which would otherwise be undiagnosed by HPE.
Reproductive and sexual rights of women: ground reality
Authors: Singh Sunayana , Kumar Mukesh , Sharma Subrat
Published: May 2022

Background: Inequality exists in different societies of the world. Discrimination and exploitation are done based on caste, color, creed, gender, region and religion by mighty people. However, international bodies like United Nations and International Commission of Human Rights are very sensitive about the human rights. Reproductive and sexual rights are also part of human rights. The most sufferers of this discrimination and sexual exploitation are women. Woman suffers in silence because her exploiters are generally close ones. The study was done in rural areas of Bharatpur, Rajasthan, to investigate the awareness status of reproductive and sexual rights of women.Methods: Questionnaires pertaining to the awareness of contraceptive choice, age of pregnancy, planned/unplanned and delivery place, family size and sexual life was prepared. Woman of 20 to 40 years of age volunteered to participate for this research.Results: Majority of women were not having the basic knowledge of pregnancy, contraceptive choices. 60% of women got pregnant before reaching to the age of 20 and second pregnancy occurring between 21 to 25 of age. Majority of women had unplanned pregnancy and delivered the baby at home. 2-5 kids were per family of studied group. 65-70% of their husband treated their wives as a sex object and slaves. They tortured their wife during sexual act. These women were not aware of their reproductive and sexual rightsConclusions: This study shows early marriage, pregnancy. Majority of husband tortured their wives during sex (or forced) sex and treated them sex slaves. Reproductive and sexual rights are distant dream for women in rural areas of India.
Maternal and perinatal outcome in pregnancies complicated by preeclampsia: a hospital based prospective study
Authors: Priyamvadha P. Meenakshi , Kala R. , Kumar A.
Published: May 2022

Background: The aim was to study maternal and fetal outcomes in pre-eclamptic mothers and to study sociodemographic distribution, severity of preeclampsia.Methods: This was a prospective observational study conducted in the department of obstetrics and gynaecology at Government head quarters hospital, Cuddalore, Tamil Nadu, for 12 months (October 2019 to September 2020). 108 preeclamptic mothers between 32-39 weeks of gestational age who met the inclusion and exclusion criteria were studied consecutively.Results: Among 108 participants, 52.7% were primi, 69.4% belonged to SE class-IV, 45.4% were between 21-25 years, 44.4% were referral cases, 60.1% had BMI >25 kg/m2, 79.6% had late onset preeclampsia, 11.1% had preterm delivery. LSCS rate was 81.5% with most common indication fetal distress 22.7% then oligohydraminos 18.2%. Recurrent preeclampsia among patients with previous childbirth was 48.6%. Maternal complications were 17.6% severe preeclampsia, 13% PPH, 3.7% abruption, 3.7% antepartum eclampsia, 1.9% postpartum eclampsia. 25.9% patients got admitted in maternal ICU. 68.4% of the severe preeclamptic patients were treated with MgSO4 regimen. 6.48% of patients had imminent symptoms. 11.1% neonates had APGAR score 4-6. Neonatal complications 30.5% LBW, 33.3% SGA, 14.8% FGR, 1.9% still birth and 0.9% IUFD. 48.6% neonates were admitted in NICU. There was no maternal mortality in this study.Conclusions: Fetomaternal morbidities of preeclampsia is reduced by emphasising early registration and admission, providing adequate nutrition through existing government schemes, educating women on significance of routine antenatal check up at PHCs with BP monitoring, albuminuria evaluation and clinical evaluation of fundal height at each visit. Screening Doppler and growth scan done for timely intervention.
A case control study on obstetric outcome following a previous spontaneous abortion
Authors: Jayakumar Sai Priya Remadevi , Jacob Elizabeth , Somanathan Rajani , Kanagasabhapathy Karen
Published: May 2022

Background: Spontaneous abortion is pregnancy resulting in miscarriages without the application of any deliberate methods to terminate it, during the early weeks after conception. Studies on effects of recurrent miscarriages on subsequent reproductive adverse outcomes are many in literature. However, studies showing outcome of pregnancy following a spontaneous complete abortion is scanty in literature.This study looks for association between a previous spontaneous abortion and recurrence of adverse maternal outcome like recurrence of abortion, preeclampsia, premature rupture of membrane (PROM), operative delivery, and fetal outcome like preterm labour (PTL), low birth weight (LBW) to that of primi gravida.Methods: A case control observational study was done on 200 antenatal women who attended the obstetrics department and fulfilling the inclusion criteria. Of this, 100 pregnant women were with history of a spontaneous abortion (case group) and 100 primi gravida (control group). Maternal and fetal adverse outcome were compared between the two groups.Results: Recurrence of adverse maternal outcome like recurrence of abortion, PROM, caesarean delivery and adverse fetal outcome like PTL, LBW were more in women with prior spontaneous abortion than that of primi gravida.Conclusions: Women with a history of previous one spontaneous abortion are at an increased risk of maternal and fetal complications. So, these women should be considered as high-risk group and hence frequent antenatal visits and close antenatal surveillance should be provided to such women for early detection of complications and for its effective management.
Fertility benefits of controlled ovarian stimulation and intrauterine insemination in different stages of endometriosis in a fertility centre in Southern India: a retrospective study
Authors: Sebastian Nikhil , Radhakrishnan Abhishek
Published: May 2022

Background: To determine the fertility benefit of controlled ovarian hyperstimulation and intra uterine insemination (IUI) in different stages of Endometriosis. It was a retrospective observational study done in Kinder women’s hospital and fertility centre, Cherthala, Kerala, India.Methods: A retrospective analysis of 100 patients with isolated endometriosis (I and II vs. III and IV) who underwent IUI between January 2018 to December 2019 were selected. Cycle fecundity rates and clinical pregnancy rates and pregnancies above 28 weeks were measured. Clinical pregnancy rates with COH and IUI were also compared between grade I/II vs III/IV endometriosis.Results: A total of 16 (16%) pregnancy were achieved with controlled ovarian hyperstimulation (COH) and IUI in patients with endometriosis which included 11 (11%) clinical pregnancies and 5 (5%) miscarriages. 10% clinical pregnancies were achieved in grade I/II endometriosis and 1% in grade III/IV endometriosis. 68.75% of the pregnant patients progressed to pregnancy of >28 weeks.Conclusions: The grade of endometriosis affected the clinical pregnancy rate in COH with IUI. The treatment success of COH with IUI was noted to be greater in minimum or mild endometriosis i.e., grade I/II. The treatment modality is ineffective in moderate to severe grades of endometriosis i.e., III/IV.
Obstetric outcome of pregnancies with borderline versus normal amniotic fluid index at term: an analytical cross sectional study
Authors: Bhangale Siddhika , Kose Varsha
Published: May 2022

Background:Amniotic fluid plays a vital role in the normal growth of fetus and promotes normal musculoskeletal development. Amniotic fluid index (AFI) is preferred method of amniotic fluid measurement in pregnancy which is done by ultrasonography. The normal range of AFI is between 5-24 cm. Any value above 24 cm is considered hydramnios and below 5 cm as oligohydramnios. More accepted range for borderline amniotic fluid index is 5-8 cm. The objective of this analytical cross-sectional, study was carried out to characterize maternal and fetal risks associated with borderline AFI in pregnancies, compared with normal amniotic fluid index.Methods:This study included 180 women fulfilling inclusion criteria. 90 women were in borderline AFI group and 90 women in normal AFI group. Both were compared based on maternal outcome such as mode of delivery- normal vaginal delivery, instrumental, LSCS. Indication of instrumental, caesarean section and associated maternal morbidity, perinatal morbidity and mortality was compared.Results:Out of 90 women, 41 women delivered vaginally (45.55%), 30 by instrumental (33.33%) and 19 by LSCS (21.11%).  26 NICU admission in borderline AFI group 13 were due to neonatal jaundice, 5 were due to respiratory distress, 3 due to sepsis, 2 due to seizures, 1 had necrotizing enterocolitis, 1 was due to persistent tachypnea, 1 due to severe hypoglycemia. In borderline AFI group 3.3% perinatal mortality was reported.Conclusions:Maternal morbidity, perinatal morbidity and mortality was higher in borderline AFI group as compared to normal AFI group. There is a significant association of amniotic fluid volume with the maternal morbidity, perinatal morbidity and perinatal mortality.
Early trimesterprediction of hypertensive disorders in pregnancy using pregnancy associated plasma protein A
Authors: N. Usha B. , Prajwala A.
Published: May 2022

Background: The prediction of hypertension in first trimester is fairly a new concept in recent years , studies combining various parameters in the first trimester of pregnancy have been undertaken but an combination with high predictive value is to be developed. The objective of this study is to predict preeclampsia in first trimester using pregnancy associated plasma protein A.Methods: A prospective cohort study was done at the department of obstetrics and gynaecology JJM medical college, Davangere, Karnataka with pregnant women attending the antenatal OPD at 11-14 weeks of gestation. A pre-formed questionnaire was filled for the enrolled women then blood pressure was recorded, pregnancy associated plasma protein A (PAPPA) done at 11-14 weeks of pregnancy. IBM SPSS version 22 for windows was used for statistical analysis of data.Results: Low PAPPA itself is not a strong indicator of preeclampsia; studies have previously shown a significant improvement in detection by combining with other biophysical, biochemical parameters.Conclusions: In the present study, PAPPA was not found to be the predictor of preeclampsia.
Successful removal of 34 fibroids in uterus-preserving myomectomy: a case report
Authors: Hasabe Rakesh , Tripathi Neha S. , Bhoyar Kanchan D.
Published: May 2022

When uterine preservation is of the essence, myomectomy is the preferred standard of surgical care for removal of myomas, the commonest tumors of the female genital tract. This case report describes the evaluation and treatment of a 42-year-old female with a multi-fibroid uterus, who desired uterine preservation in order to conceive. Diagnostic hystero-laparoscopy with myomectomy resulted in the removal of 34 leiomyomas of varying sizes from different locations within the uterus. Our case study is of particular importance as it emphasizes that effective removal of even a large number of multiple fibroids is attainable in rural, low-resource settings by strict adherence to the established myomectomy protocol and the achievement of as bloodless an operative field as possible using various available techniques.
Hemoperitoneum due to spontaneous rupture of venous plexus overlying a fibroid in pregnancy: a case report
Authors: Pegu Bhabani , Sankar Priya
Published: May 2022

Spontaneous venous rupture overlying a fibroid causing hemoperitoneum in pregnancy is uncommon but highly lethal. A 31-year-old woman, second gravida at 32 weeks of gestation, presented with pain abdomen. On examination, she had mild tachycardia and tachypnea; uterus size was 26 to 28 weeks. Ultrasound revealed intrauterine fetal demise and retro-placental clot without free fluid. Induction of labor was initiated, but the patient’s vitals deteriorated. Repeat ultrasound illustrated intra-abdominal free fluid. On emergency laparotomy, the hemoperitoneum was revealed. Stillborn fetus, placenta, and clots of 100 mg were delivered by cesarean section. On exploration, multiple subserous fibroids were seen, and profuse bleeding was noticed from the venous plexus overlying a fibroid in the posterior left lateral wall. The bleeder was held with Green Armitage and ligated. The patient was discharged in satisfactory condition on post-operative day 10. Immediate surgical intervention is the best modality to diagnose and control bleeding.
Interstitial pregnancy: a case report
Authors: Aafreen Asna , Pankaj Apoorv , Pankaj Aprajita
Published: May 2022

Interstitial pregnancy is a life-threatening event. Strong clinical suspicion and prompt action can reduce maternal morbidity and mortality. Specific ultrasound features point towards the diagnosis. Various treatment modalities are available as there is no consensus for a treatment of choice. The management option depends upon the general condition of the patient and also on fact whether the ectopic pregnancy has ruptured or not. Here we present a case of an unruptured interstitial pregnancy.
Acute thrombosis of left subclavian artery in association with abnormal uterine bleeding: an interesting case report
Authors: Jose Ashwin Antony , A. Padma , Archana Naidu
Published: May 2022

Subclavian artery thrombosis arises secondary to damage to the intimal layer of the vessel along with occlusion of blood flow. Etiological factors include atherosclerosis, diabetes, hypertension, arteritis, inflammation due to radiation exposure, compression syndromes, fibro muscular dysplasia. The aim of the study is to determine the association between acute thrombosis of left subclavian artery and abnormal uterine bleeding in a perimenopausal woman. Patient usually presents with upper limb claudication and upper extremity pain at rest. Complications: coronary artery disease, transient ischemic attack, cerebrovascular ischemia or infarct. Diagnosis is by duplex ultrasonography, computed tomography angiography and magnetic resonance angiography. Endovascular intervention is the best modality currently available for relieving subclavian artery thrombosis including percutaneous transluminal angioplasty with stenting or ballooning. Uncontrolled diabetes could be the etiological factor of extensive thrombosis in a patient presenting with abnormal uterine bleeding leading to severe anemia. Severe iron-deficiency anemia with thrombocytosis may be a risk factor for thrombus formation.
Manual removal versus spontaneous delivery of the placenta at caesarean section: a randomized controlled trial by Abdelfattah et al: a letter to the editor
Authors: Mahale Arun Ramkrishnarao
Published: May 2022

I highly admire the article “Abdelfattah LE, Bastawy AMA, Fahmy MSED. Manual removal versus spontaneous delivery of the placenta at caesarean section: a randomized controlled trial in International journal of reproduction, contraception, obstetrics and gynecology”.1 Really there is dearth of randomized control trials (RCTs) on this issue of managing third stage of labour during caesarean section, and this is making obstetricians to continue practicing MRP (manual removal of placenta) during caesarean section.2 The general reason for MRP at caesarean section is to save time of surgical procedure of caesarean section. The authors of this article have rightly pointed out by RCT that this does not save time and in fact add many other complications to the outcome of caesarean section surgery.
A comparative study of efficacy of silver stream versus povidone iodine in healing the diabetic ulcers
Authors: Kumar Ashwani , Bajaj Satinderjit S. , Bajaj Jagminder K.
Published: May 2022

Background: Diabetic ulcers affect morbidity, mortality and QOL of patients. Wound debridement and dressing using antiseptics are part of standard treatment. Silver stream solution containing silver ions, menthol, glycerol and surfactant has shown promising results in chronic DFU. But no clinical trials have been conducted yet. The aim of the study was to compare effectiveness of silver stream solution with traditionally used povidone iodine in healing diabetic ulcers.Methods: 100 diabetic ulcer patients randomly divided into 2 groups A and B of 50 each, received ulcer dressing with silver stream solution or povidone iodine respectively every 48 hourly. Ulcer size and healing was evaluated at 2 weeks intervals for 8 weeks or till ulcer healed.Results: Patients of both groups were comparable in their age/sex distribution, duration, control of diabetes and pre-treatment mean ulcer size. At end of 8 weeks, percentage reduction in mean ulcer size was much more in group A (89.51%) than in group B (33%). All patients treated with silver stream responded, though response was partial in (10%). Patients having poor glycemic control. In contrast only 46% showed complete response to povidone iodine, 42% had partial response and 12% did not responded.Conclusions: Response rate with silver stream dressing is significantly higher and reduction in mean ulcer size at end of 8 weeks treatment is significantly more than with povidone iodine.
A study of factors associated with conversion of laparoscopic cholecystectomy to open cholecystectomy
Authors: Yadav Pawan , Agarwal Sanjeev , Modhia Dishank , Joshi Arpit
Published: May 2022

Background: Gall stones are among the most common gastrointestinal illness requiring hospitalization. Laparoscopic cholecystectomy is the procedure of choice for majority of patients. Factors responsible for conversion to open cholecystectomy are adhesions, obscure anatomy at calot’s triangle, CBD injury etc. Aim was to study patients admitted in surgery department and undergoing laparoscopic cholecystectomy in GMCH, Udaipur. Primary objective was to determine factors of conversion of laparoscopic to open cholecystectomy in tertiary care center Secondary objectives were to evaluate the age, sex and etiological factors of cholelithiasis.Methods: It is a prospective observational study done in 1oo patients admitted in GMCH during January 2020 to June 2021 after informed consent and ethical clearance approval from IRRC. Patients having cholelithiasis were diagnosed with USG, MRCP and/ or ERCP and laparoscopic cholecystectomy was planned. Factors associated for conversion from laparoscopic to open cholecystectomy were studied.Results: Out of 100 patient 9 were converted to open, adhesion was the most common (8%), (2%) CBD injury, bleed of cystic artery, (1%) bowel injury, (3%) presence of unclear anatomy.Conclusions: Laparoscopic cholecystectomy is a safe and minimally invasive technique, with only low conversion rate and the commonest cause of conversion in this study was the presence of dense adhesions at Calot's triangle.
Endotracheal bleed after intra cardiac repair in tetralogy of fallot patients: a diagnostic challenge
Authors: Sinha Lakshmi , Solanki Hardik J. , Ali Muzaffar , Agarwal Saket , Naqvi Sayyed Ehtesham Hussain , Geelani Muhammad Abid , Datt Vishnu
Published: May 2022

Background: Tetralogy of Fallot (TOF) is the most common congenital cyanotic heart disease (CCHD) in children. With the development and advancement of paediatric cardiac surgery and intensive care units, a large number of TOF are presenting for cardiac surgery. Operated TOF may suffer from endotracheal (ET) bleeding in postoperative period which results in delayed extubation of patients. ET bleeding is multifactorial with MAPCAs, coagulopathy residual VSD, and high LA pressure being usual causes. The objective of this study was to evaluate those children of TOF who suffered from ET bleeding, their causes and management after intracardiac repair.Methods: This was a single center retrospective study that included patients with a diagnosis of TOF. Total of 27 patients were operated at GB Pant Hospital, Department of CTVS from February 2021 to November 2021. After taking ethical approval we conducted a retrospective study to analyse the cause of endotracheal bleed. Statistical analyses were performed using STATA software version (16.0). Continuous variables were presented as mean±standard deviation (SD) or median (interquartile range [IQR]. Inclusion criteria was- all diagnosed case of tetralogy of fallot patient with age –1.5-8 years, both male and female. Exclusion criteria was- patients having co-morbidities, like juvenile diabetes, hypothyroidism, syndromic patients.Results: Endotracheal bleed noted in majority of patient in those MAPCAs were not coiled, not able to be ligated intaoperatively, they bleed in postoperative period which further delayed extubation of patients. Of the patients with Endotracheal bleed none had a residual cardiac defect. Post-operative mortality was 1/27.Conclusions: We hereby conclude that cause of endotracheal bleed after intracardiac repair of tetralogy of fallot patients can be due to left uncoiled, non- ligated major aorto-pulmonary collateral arteries (MAPCAs).
Evaluation of outcome in laparoscopic and open ventral hernia repair: a prospective study
Authors: Aggarwal Shubhankar , Sachan P. K. , Mittal Vinamra
Published: May 2022

Background: Ventral hernias are categorized as epigastric, umbilical, spigelian, parastomal, and incisional hernias. Hernias occurring in epigastrium and umbilical region are considered as primary ventral hernias. There are various ways of hernia repair, in which the tension free repair remains the most important one. For doing a repair by laparoscopy, first of all the contents of the hernia are reposited back in the abdomen, followed by placement of mesh transabdominally which should be of optimum size and typeMethods: The present study is a prospective observational study that emphasizes to analyse and evaluate outcome in open and laparoscopic mesh repair of ventral hernia that presented to the Himalayan hospital over a period of 1 year. Results: Study shows that more than 50% of the cases were recorded in the age group between 26-50 years (mean 47 years) with majority being females. Umbilical hernia (45.1%) was the most common followed by incisional hernia (28.2%), paraumbilical hernia (22.5%) and epigastric hernia (4.2%). Diabetes mellitus was the most common comorbidity (88.7%) followed by hypertension (64.8%). VAS score was statistically significant between individuals who got surgery by laparoscopy when compared with open approach. A significant difference was also observed between period of mobilization and surgical procedure.Conclusions: Surgery of ventral hernia by laparoscopy has less post-surgical pain, less problems, lesser stay in hospital and had lesser impact on economy as the individuals returned to their normal routine in lesser time.
Hemi-high tibial osteotomy: technical note and case report
Authors: Alkhayarin M. , Alburdeni Salah , Ibrahim Talal , Babikir Elhadi , Salman Loay A.
Published: May 2022

High tibial osteotomy (HTO) is a widely performed procedure, with several surgical techniques described to treat varus mal-alignment and medial compartment arthrosis of the knee. In our case report, we present a new surgical technique for performing a medial open wedge HTO in a young patient with proximal varus deformity of the right knee to avoid the clinical complications of HTO. A longitudinal medial incision was made medially over the proximal tibia, the medial collateral ligament (MCL) split, and an osteotomy was made from the medial cortex exiting into the “lateral tibial spine”. The osteotomy was then opened. A wedge measured 12.5 mm, and a bone graft harvested from the right iliac crest was used to fill the defect, followed by a Puddu plate placement. We had planned to have the osteotomy exit in the centre of the knee. Two years postoperatively, complete osteotomy healing and full range of right knee movement with no pain were observed. Radiographs confirmed deformity correction. Many surgical techniques have been described for HTO, including closing wedge osteotomy, opening wedge osteotomy, dome osteotomy, progressive callus distraction, and chevron osteotomy. We believe that in this technique, the risk of nonunion is less, the construct is more stable, and the patient will have a faster rehabilitation program with early weight-bearing. Hemi-HTO is a new surgical technique that can be used to treat proximal varus deformity of the knee, especially if the lateral tibial plateau appears radiologically normal.
Biloma a pseudocyst mimic
Authors: M. S. Kalyan Kumar , V. Vijayalakshmi , B. Sampath Kumar , M. Mohamed Farook , R. Kannan
Published: May 2022

Bilioma is defined as an encapsulated collection of bile inside or outside of the biliary tree within the abdominal cavity. We report a case of a 56 years old male presented with complaints of abdominal distention and abdominal pain for 1 month whom on initial imaging, a diagnosis of pseudocyst of pancreas was suspected but on further imaging with MRCP, a biloma formation was found. Intervention involving Hepatobiliary tree is the most common etiology of a biloma formation. Biloma can also be caused by abdominal trauma and choledocholithiasis. In terms of treatment, small and uncomplicated cases need no intervention as spontaneous resolution is expected and in severe cases a combined approach using percutaneous drainage of biloma and endoscopic retrograde cholangiopancreatography (ERCP)-guided biliary stent placement across the site of the biliary leak or surgical hepaticojejunostomy or just image guided percutaneous drainage alone would be the treatment choice. Biloma should be included in the differential diagnosis of a large cystic lesion of the abdomen.
Effect of cartoon viewing habits on developmental skills and attention span of preschool children
Authors: Skariah Fijo , V. J. Dhanya
Published: May 2022

Background: Mass media has an important role in the development of behaviour of children as they are exposed to it at very young age itself. Computers, television, video games and other entertainment media have become a part of their day-to-day life. The present study aimed at identification of the effect of cartoon viewing habits on developmental skills and attention span of preschool children.Methods: The correlational research study was conducted on consecutively selected 200 preschool children from selected schools of Calicut district. A semi-structured questionnaire was used to identify the cartoon viewing habits of children and four tests (colour cancellation test, number cancellation test, colour trails test and Knox cube test) were used to detect the attention span and Vineland social maturity scale was used to detect the developmental skills. Through individual interview data from 200 preschool children and their parents were collected during a period of 6 weeks after validating the tools and the data analysed using descriptive and inferential statistics.Results: Children who watched fewer cartoons have more social quotient (98%). Developmental skills are more in younger children (96%). Cartoon viewing habits have significant association with age, gender, birth order, number of siblings, and the class of study. Significant relationship between cartoon viewing habits and developmental skills.Conclusions: The study concluded that to assess the impacts of cartoon viewing habits on developmental skills and attention span of preschool children revealed that increased duration of cartoon viewing can have detrimental effect on the attention span and developmental skills of preschool children.
Incidence and outcomes of acute kidney injury in term neonates with hypoxic ischemic encephalopathy: an observational study
Authors: . Zainab , Ali Syed Manazir , Afzal Kamran
Published: May 2022

Background: Hypoxic ischemic encephalopathy (HIE) is one of the devastating birth related complication. It predisposes the babies to serious outcomes, an important one being acute kidney injury (AKI).Methods: A prospective crossectional observational study was conducted in Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh between November 2019 and October 2020. 153 term neonates with perinatal asphyxia were enrolled. HIE staging and AKI staging done according to Sarnat and Sarnat classification and KDIGO classification respectively. Outcome in terms of recovery, persistent deranged renal function at discharge or mortality noted.Results: In our study, incidence of Acute Kidney Injury in Hypoxic Ischemic Encephalopathy neonates was 37.7%. There was around 39-fold increase risk of developing AKI in HIE stage III versus HIE stage I. Mortality rate was found to be 51.6%. Mortality was significantly high in HIE stage III. There was around 5-fold increase risk of mortality in HIE neonates with AKI as compared to HIE neonates without AKI. 50% of the subjects who had AKI and discharged recovered of renal function before discharge and 50% recovered at 1 month follow up. In addition, there was no association found between different stages of HIE with different stages of AKI.Conclusions: It is better to screen all the birth asphyxia cases for AKI so that they can be detected early and managed accordingly.