bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevention of vault prolapse in cases of procedentia using combined vaginal and laparoscopic approach for vault suspension: Agrawal’s technique
Authors: Agrawal Priti , Agrawal Rishi , Chandrakar Jyotirmay
Published: December 2020

Background: The objective of the current study was to assess the need of vault suspension after completion of hysterectomy in all cases of procedentia to prevent vault prolapse and to reduce the operating time for sacrocolpopexy using combined vaginal and laparoscopic approach by two surgeons.Methods: A total of 25 women undergoing surgery for procedentia were included. After completion of hysterectomy the need for vault suspension was assessed intraoperatively. In all cases polypropelene mesh was fixed vaginally to the uterosacral and cardinal ligaments. Vaginal vault was closed vaginally. Laparoscopic surgeon did laparoscopic sacrocolpopexy (LSC). Intraoperative and post-operative complications were then evaluated.Results: Our average operating time was 35 minutes for vaginal hysterectomy and 15 minutes for LSC. The shorter duration of surgery was because mesh was fixed vaginally and trackers were used to fix the mesh to sacral promontory. Intraoperative complications like bladder, ureteric, bowel injuries and hemorrhage were nil in our series. Postoperative stay in hospital was uneventful and all cases were discharged on second postoperative day. Conversion rate to laparotomy was nil. All cases have completed follow up for 5 years with 100% subjective and objective improvement.Conclusions: Restoration of vagina to its normal anatomic position remains the most important fact to prevent vault prolapse. Our technique is very easy, less time taking with negligible complication rates.
Study the acceptance, compliance and efficacy of injection depot medroxy progesterone acetate as contraception: a prospective observational study
Authors: Mane Nupur S. , Rokade Jyoti V.
Published: December 2020

Background: India was the first country in the world to launch a family planning programme, as early as 1952, with the main aim of controlling its population. Depot medroxy progesterone acetate, or DMPA is a progestin-only method of contraception. It is a 3-monthly intramuscular injectable that delivers 150 mg of medroxyprogesterone acetate in microcrystalline suspension form that delays absorption of the hormone after the injection. It provides long acting, effective and reversible contraception. In this study, we evaluated patients in reproductive age group 18-35 years who were willing to use injectable DMPA as a method of contraception to study the acceptance, compliance and efficacy of injection depot medroxyprogesterone acetate as contraception.Methods: It is a prospective observational study carried out at Government medical college Miraj on 150 patients who fulfil the inclusion criteria. The postpartum, interval and postabortal categorisation of patients done and they are councelled about the benefits and side effects and drawbacks of DMPA. Injection is given deep intramuscularly after written informed consent and a DMPA card is given to beneficiary. Follow up date explained and patients are observed for follow up and any evidence of bleeding weight gain or any other side effects of DMPA are noted.Results: The mean age of subjects was 24.48±3.494 years. 2) 3.3% of the patients were nullipara, primi para 46.7%, 36% were second para, 11.3%  were third para and  2.7% were fourth par. 3) After 1st injection, 47.3% patients were lost to follow-up i.e., they did not turn up for their second dose of injection. 4) Out of 150 patients who accepted the injection as contraception, only 79 patients turned up for their 2nd injection after 3months, out of which only 37 patients turned up for their 3rd dose of injection after 6 months and only 5 patients turned up for their 3rd injection. Thus showing that the compliance is poor among this study population. 5) At 2nd injection, 39.2% discontinued due to amenorrhea, 10.7% discontinued due to irregular bleeding, 18.5% due to weight gain and 31.6% due undergoing permanent method. 6) No patients who came for follow up reported any pregnancies during the course of injection, therefore the efficacy of injection depot medroxy-progesterone acetate, as a method of contraception is 100% in this study.Conclusions: The DMPA is a good method of long acting reversible method of contraception with good acceptance and efficacy with less compliance.
Five-years review of obstetric hysterectomy at tertiary care center
Authors: Pawar Anita G. , Shinde Mangala A. , M. Sarasjothi , Nemagouda Priyanka B.
Published: December 2020

Background: Obstetric hysterectomy (OH) is indicated as last resort operation to save the life of the mother  and associated with high complication rates, so  requires a highly experienced and skilled medical team ,to solve any complication. Objective was to identify incidence, demographic profile, indications, risk factors, complications, maternal morbidity and mortality associated   with   obstetric hysterectomy.Methods: Retrospective   analytical study of 47 case records is done over period of last 5 years   from October 1st October 2015 to 30th September 2020 at VDGIMS, a tertiary care center, Latur. Results are expressed in frequency and percentages.Results: In our study, the rate of OH was 1.1/1000 deliveries. Most common (68%) age group was 21-30 yrs, majority (70%) were multipara, and booked (76%). Most common indication of OH was atonic PPH (65%), followed by traumatic PP, including rupture uterus (21%), and placenta acreta (10%). Most OH was performed on emergency basis (91%) and of subtotal type (95%). Major mode of delivery  was cesarean 65% and vaginal delivery in 21% cases. Most common risk factors were placental causes (55%), previous LSCS (48%) and hypertensive disorder (31%). High maternal morbidity in form of 100% blood transfusion rate, 93% ICU admission, inotropes and ventilator support in 59% cases and prolonged hospital stay in 75% cases seen. Most common complication were hemorrhagic shock 21%, DIC (29%), renal failure (12%) and septic shock (14%) with maternal death rate of 23% was noted.Conclusions: Obstetric hysterectomy is a necessary life-saving operation, but also associated with high maternal morbidity and mortality, which can be minimized with timely done procedure by experienced person.
Maternal and perinatal outcome in trial of labour after caesarean at tertiary care hospital: a prospective observational study
Authors: Prabhakarrao Ingle Sharad , Bansode Shalaka , Balakuduru Sumathi
Published: December 2020

Background: To compare maternal and perinatal outcomes in trial of labor after cesarean (TOLAC) and Emergency repeat cesarean delivery (ERCD).Methods: Prospective observational study at tertiary care center for one year. Selection of candidates for Vaginal Birth after caesarean section (VBAC) was based on the 2010 American College of Obstetricians and Gynecologists’ (ACOG) recommendation. The maternal outcome was observed in the form of VBAC success rate, maternal complications, number of days in a hospital stay, The perinatal outcome was observed as 5 minute Apgar score and need for neonatal intensive care unit (NICU) admission.Results: 250 patients were given trial for vaginal delivery. VBAC success rate was 169/249 (67.9%). 80/249(32.1%) patients required repeat CS. Cases with Bishop score >6 had more rate of vaginal delivery (89.6%) as compared to Bishop score ≤6 (17.4%) (p=<0.01). Spontaneous labour had better VBAC success rate (91.8%) than induced labour (55.5%) (p=<0.01). 8/12 (66.6%) subjects with history of previous vaginal deliveries delivered vaginally. 5/169 of VBAC babies had low 5-minute Apgar score as compared to 3/80 from repeat CS.Conclusions: VBAC has the benefits of short hospital stay, decreased morbidity and less expenditure. Considering the fact that fetal morbidity and mortality due to TOL is comparable with the women labouring without a scar, TOL may be encouraged. Women can be given TOL with careful monitoring and taken for emergency LSCS on minimal indication and can be the best answer to management of previous one CS in labour.
Cardiotocography in early labour: a screening test for predicting fetal outcome
Authors: Anandabaskar Vinothini , B. Hiremath P. , B. Sanjeevkumar , Arthi Nivedhana , R. Rathnapratheep
Published: December 2020

Background: Fetal surveillance during labour is important to ensure delivery of a healthy baby with minimum intervention. Various parameters can be used to assess the fetal wellbeing like fetal movements perceived by the mother and monitoring of fetal heart rate. The objective of this study is to evaluate the efficacy of cardiotocography in early labour in predicting fetal outcome.Methods: A prospective hospital based cross sectional study was conducted on a total of 160 antenatal women in early labour with gestational age ≥ 37 weeks of gestation. Cardiotocogram was recorded for 20 minutes with the antenatal women in left lateral position. They are followed up till delivery and the mode of delivery of the baby was recorded. After delivery of the baby, the presence of fetal distress was assessed by careful examination of the neonate and colour of liquor.Results: Among the antenatal women, cardiotocography findings were normal in 74.4%, suspicious in 15% and pathological in 10.6%. The sensitivity of CTG in evaluating fetal outcome was found to be 84.6%, and the specificity was found to be 85.8%. The positive predictive value was 53.7% and the negative predictive value was 96.6%.Conclusions: Hence from the above study, it is can be concluded that the false positive rate of CTG is higher. Hence CTG cannot be used a sole indicator of fetal hypoxia. But in a resource limited setting, CTG is definitely a good screening test to predict the fetal outcome.
A prospective study of hypothyroidism during pregnant attending tertiary care hospital in south India
Authors: Sravani G. , Smitha M.
Published: December 2020

Background: Disorder of thyroid function is common during pregnancy and hypothyroidism is more common then hyperthyroidism affecting 3–5% of all pregnant women. Maternal hypothyroidism is associated with both maternal adverse effects like preeclampsia, ecclampsia, pregnancy induced hypertension and gestational diabetes mellitus and foetus complication like low birth weight, pre term birth, neurological deformities and abnormal presentation.Methods: In present study 120 patients with overt and subclinical hypothyroidism were included in this study. Detailed histories of patients were taken and clinical examination was done and data was collected in a predesigned Performa. We used standard diagnostic criteria for diagnosis of overt and subclinical hypothyroidism.Results: Pregnancy induced hypertension was found in 10% patient, Chronic hypertension was present in 1.6% patients, abortion in second trimester 1.6% patients, incomplete abortion in 4.18% patients. Missed abortion was present in 2.5% patients.Conclusions: Hypothyroidism during pregnancy is more common in primi. Most common age group was third decade and was commonly detected before 10 weeks of gestation. Pregnancy induced hypertension, oligohydramnios and preterm delivery was more common than abortion in second trimester and missed abortion.
Salpingectomy for ectopic pregnancy: Does length really matter?
Authors: Gaughran Jonathan , Mitchell Sian , Holland Tom
Published: December 2020

This abstract describes a case of a tubal stump ectopic. The aetiology, presentation and management of such rare cases are described. The evidence bases for the rationale for leaving a short versus a long stump at salpingectomy is reviewed.
How OBGYNs can assist in the prenatal care and delivery of western lowland gorillas
Authors: Beste Mary E. , Armstrong Amber , Cook James W. , Weber Switch Martha
Published: December 2020

Prenatal care and perinatal planning are paramount for successful delivery outcomes in human pregnancies and has been shown to be equally as important with non-human primates. The authors describe two pregnancies and deliveries of a 12-year-old primigravid western lowland gorilla, Macy. Macy’s first pregnancy resulted in a stillbirth and was complicated by breech positioning, while her second pregnancy resulted in a viable infant. This case report outlines the prenatal care Macy received in her pregnancies and highlights the importance of ultrasound for dating and fetal evaluation. The authors discuss options for breech positioning and considerations for cesarean section. This article showcases how obstetricians and veterinarians can implement human obstetrical recommendations with non-human primates to improve delivery outcomes.
Isolated fallopian tube torsion in an adolescent: a diagnostic challenge
Authors: Bivar Leonor , Castro Ana , Teixeira Neusa
Published: December 2020

Torsion of the fallopian tube without ovarian involvement is an extremely rare event and often difficult to diagnose, but noteworthy, cause of lower abdominal pain. The authors describe a case related to a 14- year-old adolescent with acute lower abdominal pain and vomiting presented to the gynaecological emergency department. Blood tests exhibited modest biochemical parameters of inflammation and a transvaginal ultrasound showed a left adnexal tubular cystic mass with normal ovarian appearance. A diagnostic laparoscopy revealed an isolated fallopian tube torsion. The tube was able to be untwisted with restoration of pelvic anatomy and the follow-up was uneventful. The authors describe a challenging diagnosis in an adolescent in which delayed intervention could compromise her reproductive future. Tubal torsion should however be kept in mind in the differential diagnosis of lower abdominal pain in women of all ages.
Intra-operative diagnosis of an adult ureterocele complicated by hydronephrosis: a case report
Authors: Ileri Alper , Onur Zeynep Yasemin , Ozmus Dogay Nurtac , Atci dogdu Irmak , Budak Adnan , Ozmus Duygu Cebecik , Baris Pinar Tugce , Akpak Yasam Kemal
Published: December 2020

Ureterocele is a cystic dilatation of the terminal ureter. Hydronephrosis is less commonly reported in individuals with ureterocele. We report a unique case of an incidental ureterocele with hydronephrosis in a 47-year-old woman; diagnosed with intraoperative control cystoscopy while performing total laparoscopic hysterectomy and bilateral salpingo- oophorectomy.
Fetus papyraceous, a rare complication of twin pregnancy: case report
Authors: Vashistha Preeti , Kashyap Poonam , Kumar Ashok , Sethi Chetna A. , Rana Shivangini
Published: December 2020

Fetus papyraceous or compressus is the mummified fetus associated with multiple gestation, where one fetus dies in early second trimester, flattened, mummified and compressed between the membranes of the living fetus and the uterine wall. It is more common in monozygotic twins but may occur in dizygotic variety. However, the maternal and fetal complications in affected cases can be severe. We present a case that was diagnosed as dichorionic diamniotic twin gestation in early pregnancy which subsequently resulted in the fetal demise of one twin in second trimester leading to fetus papyraceus, but careful maternal and fetal monitoring leads to successful healthy outcome of mother and surviving fetus.
Severe acute respiratory distress syndrome in COVID-19 infected pregnancy: a case report
Authors: Undinti Nagashree , R. Charumathi , Narasimhan Rama , Alex Neetu Mariam
Published: December 2020

Corona virus 2019 is an emerging disease with a rapid increase in cases and deaths. Limited data is available about its progress and consequences in pregnancy. We present clinical challenges and potential strategies for optimal materno fetal surveillance by a case report on how we successfully managed a COVID -19 infected elderly primigravida with twin gestation and severe acute respiratory distress syndrome.
Stump tumour in a post-menopausal lady
Authors: Devi Thulasi , Sinha Kavita
Published: December 2020

An interesting case of uterine smooth muscle tumours of uncertain malignant potential is a rare tumour and is between classification of benign and malignant. It is diagnosed based on histomorphology with ill-defined criteria which as yet has no consensus and is technically challenging.
A successful case of rescue encerclage in the mid trimester taken upto term: a case report
Authors: A. Sheelamoni , Mithilag Fathima , Prasannan Anuradha , A. Bincy
Published: December 2020

Cervical encerclage has been used to treat repeated second trimester pregnancy losses. Rescue cerclage is done in cases of advanced cervical dilatation with membranes protruding into the vagina. If done correctly after proper patient selection, it can successfully prolong a nonviable pregnancy to viability. Here, we present a case report of a multiparous lady with advanced cervical dilatation at 22 weeks who had a successful rescue cerclage where the pregnancy was taken upto 38 weeks.
Case report of aplastic anaemia detected in third trimester of pregnancy: dilemmas faced
Authors: Kamath Gayathri Dinesh , Udgire Sunil Prabhakar , Katewa Divya
Published: December 2020

Aplastic anaemia with pregnancy is rarely encountered. Management of aplastic anaemia in pregnancy primarily involves a multidisciplinary approach offering supportive care. Our case was challenging as she developed aplastic anaemia during the third trimester and had refractory thrombocytopenia. She required platelet transfusions on a daily basis for few weeks as well as packed red blood cells frequently. Her leucocyte count was low initially but improved quickly unlike the platelet counts. Initiation of immunosuppressive therapy turned out to be beneficial and culminated in a good outcome. After starting immunosuppressive therapy with eltrombopag and cyclosporine she drifted through term and achieved a normal vaginal delivery.
Conservative management of a case of a cardiac anceps twin reversed arterial perfusion sequence misdiagnosed as vanishing twin: a case report
Authors: Behura Jharna , Sinha Ayushi , Naaz Aafreen , Bharti Soni
Published: December 2020

Twin reversed arterial perfusion (TRAP) sequence is a specific, rare and severe complication of monochorionic multiple pregnancy, which is characterized by one normal fetus (pump twin) and another with no cardiac activity and variable degree of deficient development of the head and upper limbs. The management of these pregnancies are a real challenge due to the parasitic hemodynamic dependence of the acardiac twin on the pump twin. The aim of management is to maximize the chances of survival of the pump twin with some intervention. The preferred management suggested is elective ultrasound-guided laser coagulation or radiofrequency ablation of the umbilical cord vessels at 11-13 weeks when the survival is 70-75%. Delay in intervention until 16-18 weeks is associated with spontaneous cessation of blood flow in the acardiac twin in 60% of cases and in about 50% of these there is death or brain damage in the pump twin. However, pregnancies diagnosed late need to follow a tailored approach with expectant management. The authors report a case of TRAP twin sequence which on ultrasound was diagnosed as a case of vanishing twin at 20 weeks. Subsequently on follow up ultrasound, it was diagnosed as a trap sequence with the pump twin developing polyhydramnios at 30 weeks. She was counselled regarding the prognosis of the pump twin and she opted for conservative management. Weekly ultrasound and color doppler were done. The amniotic fluid index (AFI) decreased gradually at 33 and 35 weeks, there were no signs of congestive cardiac failure of the pump twin on Doppler studies and she had a spontaneous delivery of a healthy male child and an acardiac anceps fetus at 36weeks and 5 days. The perinatal mortality of a pump twin managed conservatively ranges from 35 to 55%. It is essential to diagnose the presence of trap sequence at an early gestational age through improved imaging techniques to plan a timely and effective intervention to salvage most of the pump twins.
Florid genital tuberculosis co-existing with adenomyosis and evading diagnosis
Authors: Thangappah Radha B. P. , Meda Sahitya , Tabassum Roohi
Published: December 2020

When tuberculosis affects genital organs of young females, the disease often remains silent or may present with symptoms which are common to other Gynaecological conditions as well. The diagnosis of genital tuberculosis is challenging and the diagnosis can be missed even with extensive investigations including molecular studies. A case of florid tuberculosis affecting the uterus, cervix, ovaries and tubes, co-existing with adenomyosis of the uterus and the cold abscess masquerading as bilateral ovarian endometriomas is reported.
Fetal body stalk malformation-a rare case report
Authors: Balachandran Roshini , Samal Sunil Kumar
Published: December 2020

Body stalk anomaly is a rare sporadic defect of the abdominal wall with evisceration of the thoracic and abdominal organs. Body stalk anomaly is reported in about 1 in 7500 births. Here we report about a primigravida with a fetus with posterior encephalocele, hyperextended cervical spine, kyphoscoliosis, large ventral body wall defect involving the entire thorax and abdomen with herniation of vital organs-heart, liver and intestine into the amniotic cavity. Prognosis of the fetal outcome was explained and medical termination of pregnancy was carried out. Body stalk malformation is a lethal condition either in utero or in early neonatal period which can be diagnosed in early trimester ultrasound. The association of chromosomal abnormalities and genetic syndromes in this condition is rare and the risk of recurrence in next pregnancy is less.
Detection of spontaneous hemoperitoneum in a pregnancy complicated with endometriosis during caesarean section - a case report
Authors: Chauhan Sonali , Sharma Jiten , Arora Bhumika , Mittal Shivika , Mittal Rita
Published: December 2020

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. During pregnancy endometriosis and its related pain symptoms improve due to various metabolic, hormonal, immune and angiogenesis changes that occur in pregnancy. Spontaneous hemoperitoneum in pregnancy (SHiP) is a rare but serious pregnancy complication, which is associated with high rates of maternal and foetal morbidity and mortality. Endometriosis may be a potential risk factor for SHiP. Preformation of IVF on women with endometriosis may be a potential risk factor for SHiP. In gravid females with a history of endometriosis, severe abdominal pain, and a reduction of haemoglobin, physicians should always suspect SHiP because it is a life-threatening condition for both the mother and the baby. We are reporting a case of a primigravida with term gestation, taken up for emergency caesarean section in view of non-reassuring foetal heart rate. Intraoperatively there was evidence of hemoperitoneum and multiple endometriotic lesions on the posterior surface of uterus and Pouch of Douglas, Bilateral ovaries were adherent to the endometriotic growth on the posterior surface of uterus. Postoperatively, patient was stable and was discharged on postoperative day 4.
Giant mucinous cystadenoma of ovary in an adolescent girl: a case report
Authors: Singh Gaurav , Narain Anupriya , Dhawan Shashi , Kulshrestha Rajeev
Published: December 2020

Ovarian masses are rarer in children and adolescent than adults. Simple ovarian cysts are most common non-neoplastic masses in children. We report this case to emphasize that mass abdomen in adolescents can be missed being asymptomatic. A 16-year-old girl presented intermittent pain abdomen, nausea and decreased appetite for 3 months. Her menstrual cycles were normal and regular. Tumor markers were within normal limits. Exploratory laparotomy with decompression of cyst followed by cystectomy was done. The histopathology revealed the mass to be a mucinous cystadenoma. Post op course was smooth. The patients’ age, size of the cyst and menopausal status of the patient are the important deciding factor in the plan of management. A conservative surgical procedure should be the primary aim in order to preserve patient’s fertility.
Scrub typhus in third trimester of pregnancy: dilemmas in diagnosis and management
Authors: Jain Geeta , Priyadarshani Preeti , Sisodia Garima
Published: December 2020

Scrub typhus is an acute febrile illness rarely diagnosed in pregnancy. Here we report a case of scrub typhus in the third trimester of pregnancy, its associated complications and its management to ensure a favourable fetomaternal outcome. Mrs X, a 22- year old primigravida, was diagnosed with scrub typhus at 38 weeks of pregnancy after developing high- grade fever for 12 days. An atypical eschar was seen on one foot. Her ultrasonography revealed foetal tachycardia and severe oligohydramnios. She was started on tab azithromycin 500 mg OD but remained febrile even after two days. Fever subsided at dose of 1gm/day. When she was afebrile for 48 hours and adequately hydrated, labour was induced and she delivered vaginally a full-term alive baby of 2.2 kg. Vertical transmission was not observed in the baby. Scrub typhus is an easy-to-treat cause of acute undifferentiated febrile illness in the Indian subcontinent, and should always be a differential diagnosis even in the absence of a pathognomic eschar. Timely treatment ensures a favourable fetomaternal outcome.
A case of atypical leiomyoma mimicking as endometrial cancer
Authors: Bhadana Priyanka , Kiran Abha , Bhakuni Kriti , Malla Veena G.
Published: December 2020

Atypical leiomyoma or leiomyoma with bizarre nucleus is diagnosed on histopathological examination characterized by severe cytological atypia in the form of nuclear enlargement, multi nucleation, hyperchromasia, coarse chromatin and prominent nuclei. These tumours do not have typical features of necrosis or mitotic figures to characterize them as leiomyosarcoma. There are 2% risk of these tumours to convert to leiomyosarcoma. 50-year P3L3A1 postmenopausal for past 6 years presented to gynaecology outpatient department (GOPD) with complains of pain in lower abdomen for past 1 year. Patient was examined and investigated. On clinical examination there was no apparent finding. On radiological examination a well-defined hypoechoic lesion of 6.4×5.7 cm2 was found arising from uterus. Contrast enhanced computed tomography (CECT) abdomen showed heterogenous mass involving endometrium and myometrium likely neoplastic. Total abdominal hysterectomy with bilateral salpingoophrectomy was done. Histopathological examination (HPE) report revealed features of atypical leiomyoma. Patient is under follow up in GOPD.
A case of non-pueperal chronic uterine inversion managed successfully
Authors: Fonseca Michelle , Desai Ashwini , Kapote Deepali , Gawai Swati , Syed Anam
Published: December 2020

Uterine inversion is prolapse of the uterine fundus and corpus turned inside out towards or through the cervix. The non-puerperal type of uterine inversion is a quite rare occurrence and it accounts for only 17% of all uterine inversion cases. We present a case of 45 year old multiparous female who presented to us with polymenorrhagia with fibroid polyp. Ultrasonography confirmed the clinical findings however Intraoperatively examination under anaesthesia revealed uterine inversion. On table we proceeded with Haultains method of uterine reposition followed by total abdominal hysterectomy. Patient recovered well and thus case was successfully managed.
Use of emergency contraceptive pill in India: boon or bane
Authors: Verma Anjana , Mathur Medha , Meena Jitendra Kumar , Kabra Mukesh , Choudhary Suresh
Published: December 2020

It has been almost fifteen years since emergency contraceptive pills (ECPs) have been made available over the counter in India. There have been concerns about the overuse/misuse of ECPs and probability to replace regular contraceptive methods. This article presents various facets of the use of emergency contraceptive pills in India and highlights the importance of potential research to prevent its misuse.
Cranial nerve involvement: its role in intracranial tuberculosis
Authors: Synmon Baiakmenlang , Kayal Ashok
Published: December 2020

Background: Tubercular meningitis is the most severe form of extra pulmonary involvement. Lack of specific and sensitive test calls for a multi-displinary and combined approach to make the diagnosis at the earliest. Various factors guide us to the etiology of meningoencephalitis but cranial nerve involvement has the highest predictive value.Methods: A prospective study from August 2013 to September 2015 carried in GMCH, Guwahati where 93 patients of intracranial tuberculosis was included.Results: This present   study comprised of 36 females (38.7%) and 57 males (61.3%) with a mean age of   32.3±17.05 and a range of 2-72 years. The typical clinicalfeatures of meningitis was found in 78.6%. Focal neurological deficit and cranial nerve involvement was seen in 40 (43%) and 58 (62.4%) respectively. Among the cranial nerves (CN), the most commonly involved is the 2nd CN seen in 33 (35.5%), followed by 6th (16.1%), 7th (11.8%), 3rd (7.5%), 8th (3.2%), 9th  and 10th, (2.2%) 4th (1.1%) and 5th (1.1%). Six patients developed visual loss and two patients hearing loss as sequelae. The presence of cranial nerve involvement and focal neurological deficit was shown to be associated with a poor prognosis (p value=0.04**, significant; Fisher’s exact test).Conclusions: Bedside clinical examination of patients of meningoencephalitis to detect cranial nerve involvement will definitely help us with the diagnosis and prognosis of tubercular meningitis.
Study of blood donor complications after whole blood donation in our center
Authors: Vijayvergiya Garima , Fulzele Parag , Vairyamoorthy Naveen
Published: December 2020

Background: Despite the advent of many synthetic and semi-synthetic products, the importance of biological blood products cannot be undermined in the current era. The blood donors are the backbone of any health care delivery system that has a well-organized blood transfusion service.Methods: A prospective study conducted for the period of 16 months aimed to find out various complications and their frequencies before, during or after the blood donations. The donors who developed any complications were followed up for at least three weeks to assess the late reactions if any. Blood donation was carried out with proper precautions and asepsis by experienced phlebotomists.Results: Out of 10346 blood donations, 9887 were from replacement donors, while 459 were from voluntary donors. Total donation associated complications were 113, out of which the majority were VVRs (n=74), followed by venous hematomas (n=34) and arterial punctures (n=5). Of the 74 donors who had a VVR after blood donation, the incidence was higher in females (1.64% versus 0.69%). A higher incidence of VVRs was seen among the donors who had a history of previous blood donation.Conclusions: This study strengthened the fact that though blood donation is relatively safe, it still has a complication rate of nearly 1%. To encourage for blood donation at a regular interval, all the possible steps should be taken to minimize the rate of complications. More medical attention should be given to the “at-risk” donors.
Accuracy of triple assessment as a clinical tool in detection of carcinoma breast
Authors: . Akshdeep , Bhatia Amritpal Singh , Uppal Manjit Singh
Published: December 2020

Background: One of the commonest clinical presentation of breast diseases is a lump. A definite diagnosis of any breast lump is very important to decide the course of treatment. The study evaluated that how effectively “triple assessment” helps in diagnosing carcinoma breast.  Methods: The present study is a diagnostic study which was conducted on 50 patients. Each patient underwent a detailed history, CBE, mammography and FNAC. In this study the results of each examination were divided into three groups: benign, suspicious and malignant. The final result was compared with the HPE findings and diagnostic accuracy of triple assessment was assessed. Results: Total 86% of cases were found to be malignant on triple assessment and 14% cases were found out to be malignant later on histopathology. Among the malignant lesions, infiltrating ductal carcinoma had the lead 96%, followed by lobular carcinoma 1 case. Sensitivity, specificity, PPV, NPV for clinical breast examination was 97%, 100%, 66%, 100%. Sensitivity, specificity, PPV and NPV for imaging was 88.89%, 100%, 100%, 88.46%. Sensitivity, specificity, PPV for FNAC was found to be 87.76%, 100%, 100%.Conclusions: The TT was concordant in 43 cases (86%). Sensitivity of triple assessment was 95%, specificity was 100% and negative predictive value to be 100%. The TT was concordant in 43 cases (86%). In rest of the 7 lesion which were non-concordant 6 were suspicious of malignancy and 1 was probably benign entity which were later on proven to be malignant lesions by histopathology. Sensitivity of triple assessment was 95%, specificity was 100% and negative predictive value to be 100%.
Profile of intraoperative complications in cataract surgery SEHEDS: Sitapur eye hospital eye disease study
Authors: Jaiswal Nikita , Bhardwaj Rahul , Tomar Vijay Pratap Singh , Sharma Sandeep , Kapoor Niraj , Kohli Anupriya , Siddiqui Ruheen , Chaudhary Prakhar
Published: December 2020

Background: Over the past several decades there have been many advances in the equipment, instrumentation and techniques of performing cataract surgery. This article will address the profile of intraoperative complications in cataract surgery.Methods: In this retrospective study all cataract procedures performed (n=18775) during the two years period (i.e. 2017 and 2018) were analysed and total 1401 (7.46%) valid cases (those having complications) were seen with 686 (49.0%) and 715 (51.0%) cases in the year 2017 and 2018 respectively. The age, gender, and side of the eye operated on were noted. The yearly incidence of the profile of complications was analysed. Results: Out of the total 1401 cases of eventful cataract surgery majority of the cases were of the age range of 51-70 years 1140 (6.07%) males were slightly higher in number i.e. 710 (3.78%) whereas females were 691 (3.68%), right eye was majorly operated for cataract i.e. 760 (4.05%). Manual small incision cataract surgery (MSICS) was done in the majority of the patients followed by phaco. The patients faced the complications due to cataract surgery in which posterior capsular rent- vitreous disturbance was the major complication occurred in majority of the patients 965 (5.15%).  Conclusions: Patients who underwent eventful cataract surgery the most common intra-operative complications which were mainly posterior capsular rent- with vitreous disturbance and iridodialysis. Patients with higher risk factor should be identified and appropriate measures must be taken to minimize intraoperative complications to get better visual outcomes.
La valeur sémantique ajoutée et perdue dans la traduction en italien du drame polonais Przed sklepem jubilera de Karol Wojtyła
Authors: Jezierska Beata
Published: December 2020

Wartość semantyczna dodana i utracona we włoskim tłumaczeniu polskiego dramatu Przed sklepem jubilera Karola Wojtyły

Celem artykułu jest opisanie zjawiska wartości dodanej i utraconej na poziomie leksykalnym i semantycznym w tłumaczeniu literackim. Podstawę badania stanowi analiza tekstu równoległego polsko-włoskiego obejmującego dramat Przed sklepem jubilera Karola Wojtyły. Porównanie tekstu polskiego oryginału z jego włoskim tłumaczeniem pozwoliło na wyróżnienie pewnych utraconych na poziomie leksykalnym odcieni semantycznych, natomiast działanie odwrotne (porównanie tekstu docelowego po włosku z tekstem wyjściowym po polsku) wykazało obecność wielu elementów leksykalnych „dodanych” w tekście finalnym – mowa szczególnie o kombinacjach wielowyrazowych o różnym stopniu idiomatyczności, to znaczy o związkach frazeologicznych. Zarówno ślady strat semantycznych, jak i wszelkie elementy dodane wskazują jasno na kreatywną rolę tłumacza literackiego, który w ten sposób staje się „drugim autorem” tekstu.

La valeur sémantique ajoutée et perdue dans la traduction en italien du drame polonais Przed sklepem jubilera de Karol Wojtyła

L’objectif de l’article consiste à décrire un phénomène de valeur ajoutée et perdue au niveau lexical et sémantique dans la traduction littéraire. L’étude est basée sur l’analyse du texte parallèle polonais-italien du drame Przed sklepem jubilera de Karol Wojtyła. La comparaison du texte original polonais avec sa traduction italienne a permis de distinguer des nuances sémantiques perdues au niveau lexical de la traduction. En revanche, le résultat de l’opération inverse (comparaison du texte d’arrivée en italien avec le texte de départ en polonais) prouve la présence de nombreux éléments lexicaux « ajoutés » dans le texte cible. Ce sont surtout des combinaisons d’un certain degré du figement, autrement dit, des unités phraséologiques. Des traces de pertes sémantiques aussi bien que des éléments ajoutés indiquent clairement un rôle créatif du traducteur littéraire qui devient ainsi le « deuxième auteur » d’un texte.
A Nineteenth-Century Processional from the Archive of the Bonifratres in Cracow (Kraków). A Contribution to Research into Latin Monody
Authors: Wiśniewski Piotr
Published: December 2020

XIX-wieczny procesjonał z Archiwum Konwentu Bonifratrów w Krakowie. Źródło do badań monodii łacińskiej

W Archiwum Konwentu Bonifratrów w Krakowie znajduje się rękopiśmienny procesjonał z 1811 roku. Autor artykułu dokonał krytyki źródła i porównał jego zawartość z Processionale Andrzeja Piotrkowczyka z 1621 r., stanowiącym podstawę wykonywania śpiewów procesyjnych w Polsce przez około 200 lat, oraz wybranymi kancjonałami XIX wieku. Egzemplarz krakowski, będący prawdopodobnie jedną z ostatnich powstałych wówczas tego typu ksiąg, jest dowodem wysokiej kultury muzycznej kultywowanej w środowisku, dla którego powstał oraz świadectwem pielęgnowania żywej tradycji organizowania procesji. Potwierdza w tym względzie wyraźną przewagę ksiąg polskich nad rzymskimi, z coraz większym udziałem ludu wykonującego śpiewy w języku polskim. Przedruk znacznej zawartości procesjonału w wydawanych następnie kancjonałach potwierdza ewidentnie wartość i przydatność tej księgi.
Formy wsparcia rodziny w aspekcie duchowo-religijnym na podstawie badań w Hospicjum Dobrego Samarytanina w Lublinie
Authors: Kalinowski Mirosław
Published: December 2020

Pomoc rodzinie w wymiarze duchowo-religijnym w przeżywaniu trudnej egzystencjalnie sytuacji choroby nowotworowej w fazie terminalnej bliskiej osoby należy do holistycznego wymiaru medycyny paliatywnej i opieki hospicyjnej. Komplementarność obu oddziaływań determinuje aktywność we wszystkich obszarach choroby nowotworowej: somatycznej, psychicznej, socjalnej i duchowej. Wszystkie płaszczyzny wymagają pracy zespołowej z zakreśleniem zadań związanych z posiadanymi kwalifikacjami, uprawnieniami i umiejętnościami oraz doświadczeniem. Podjęte zagadnienie zwraca uwagę na aspekt duchowy i religijny we wsparciu rodziny u kresu życia ich bliskiej osoby na podstawie badań w Hospicjum Dobrego Samarytanina w Lublinie.
The role of glucosylceramide and glucosylceramide synthase in liver disease: from bench to bedside
Authors: Gan Jian , Zheng Su Jun , Mao Xiao Rong , Li Jun Feng
Published: December 2020

The cell membrane, which is lipid-rich, is not only a simple mechanical barrier but also an important and complex component of the cell. It also communicates with the external environment. Sphingomyelin is an important class of phospholipids in the membrane that performs many functions. Interest in sphingomyelin-based liposomes, which are a critical component of cell membranes, have become the focus of intense study in recent years. Through additional research, the function of sphingomyelin and its derivatives in diseases can be gradually elucidated. Sphingomyelin consists of ceramide and its derivatives including ceramide-1-phosphate glucosylceramide and sphingosine-1-phosphate. The metabolism of glucosylceramide is regulated by glucosylceramide synthase (EC: 2.4.1.80) which is the key enzyme in the glycosylation of ceramide. The activity of glucosylceramide synthase directly affects the level of glucosylceramide in cells which in turn affects the function of cells and may eventually lead to diseases. Recently, the relationship between glucosylceramide and its metabolic enzymes, with diseases has become a relatively new area of study. The purpose of this paper is to address the relationship between glucosylceramide, glucosylceramide synthase, and their possible association with liver diseases at the theoretical level.
On the use of mango fruits in the production of chocolate
Authors: Kuzmicheva E.I. , Tumanova A.E.
Published: December 2020

The product of processing mango fruits obtained by freeze-drying was used in the production of chocolate. We conducted a tasting evaluation of chocolate with a different proportion of additives. The range of possible use of mango sublimate in the production of chocolate is established. A new chocolate recipe has been developed.
Development of an algorithm for the operation of an automated control system car tire tests
Authors: YAroshenko E.A. , Dubinin G.V.
Published: December 2020

В статье описывается алгоритм автоматизированной системы, обрабатывающая визуальную информацию для динамической оценки состояния качества резинотехнических изделий в процессе их старения.
Modern management methods that ensure financial sustainability municipalities
Authors: Kliment'eva N.M. , Anohina A.A. , Loginova E.E.
Published: December 2020

Авторами статьи исследованы современные методы управления направленные на развитие предпринимательства в городах, обеспечивающих инфраструктуру «умного города», развитие «зеленого предпринимательства», что в совокупности позволит обеспечить финансовую устойчивость муниципальным образованиям. Исследованы проблемы и предложены авторские суждения о необходимости снижения уровня централизации бюджетной и налоговой систем для развития финансового потенциала муниципальных образований.
Entanglement of atoms induced by thermal noise in the presence of initial atomic coherence
Authors: Bashkirov Evgeny K.
Published: December 2020

In this article, author investigated the dynamics of entanglement of two dipole-coupled natural or artificial two-level atoms (qubits) interacting nonresonantly with the intensive one-mode cavity thermal field. Author found an exact solution of the quantum Liouville equation for the full density matrix of the system two atoms + field mode for a coherent initial state of atoms in the dressed states representation. The full system density matrix is used to calculate the two-atom reduced density matrix and to calculate the quantitative criterion for atom-atom entanglement ‒ negativity. The results of computer simulation of the time dependence of negativity showed that in the case of a model with nonresonant interaction, the presence of initial atomic coherence leads to a significant decrease in the maximum degree of atomic entanglement, in contrast to the model with resonant interaction of atoms and a field. For the resonance model, the initial atomic coherence greatly enhances the degree of atomic entanglement.
Four-wave interaction in a multimode waveguide with a thermal nonlinearity in a circuit with codirectional pumping waves
Authors: Ivakhnik Valery V. , Kapizov Darkhan R. , Nikonov Vladimir I.
Published: December 2020

The spatial selectivity of a four-wave radiation converter in a multimode waveguide with thermal nonlinearity in a circuit with incident pump waves is analyzed. It is shown that the half-widths of the modulus of the point spread function, which characterizes the image conversion quality, are mainly determined by the transverse dimensions of the waveguide. With an increase in the angle of incidence of the pump waves on the front face of the waveguide, it decreases both the maximum value and the half-width of the modulus of the point spread function. The recording of two temperature gratings in the waveguide leads to a modulation of the point spread function with a period inversely proportional to the angle of incidence of the pump waves.
On the convergence the barycentric method in solving diffraction problems on conductive thin screens
Authors: Il’inskii Anatolii S. , Polyanskii Ivan S. , Stepanov Dmitry E. , Kuznetsov Nikolay I.
Published: December 2020

Annotation In this article, the use of the barycentric method is proposed for the numerical solution of problems of diffraction of electromagnetic waves on infinitely thin perfectly conducting screens of arbitrary shape. The numerical solution is formed in the projection formulation of the Galerkin method. The essence of the barycentric method is to form a global system of basic functions for opening the screen when determining the approximation of the desired function of the current plane on its surface. Basis functions are defined by Bernstein-type polynomials in terms of barycentric coordinates that are entered for opening the screen when it is represented as a closed simply connected polygonal region. The features of the algorithmic implementation of the barycentric method in solving diffraction problems on conducting thin screens are considered. The rate of convergence is estimated. Comparative results of calculations performed under equivalent conditions using the barycentric method and the RWG method are presented.
Research of electromagnetic characteristics of planar chiral metastructures based on composite helices components taking into account the heterogeneous Bruggeman model
Authors: Aralkin Mikhail V. , Dement’ev Andrei N. , Osipov Oleg V.
Published: December 2020

In this work a mathematical model of a chiral metamaterial is constructed which based on composite fine-wire helices components, which takes into account the properties of chirality, heterogeneity and dispersion. When constructing the model the chiral metamaterial was considered as a heterogeneous system and described by the Bruggeman model. Inthis work, analytical relationships were obtained for calculating the resonance frequencies of composite helices components. Thedispersion properties of the metamaterial were described using the well-known Condon model. As an example of using the constructed mathematical model, we solved the problem of the reflection (transmission) of a plane electromagnetic wave of linear polarization from a planar layer of the chiral structure under study based on composite helices microelements. A system of linear algebraic equations was obtained to determine the reflection and transmission coefficients of the main and cross-polarized field components. As a result of the numerical simulation, the frequency-selective properties of the metastructure were discovered and the frequencies at which the electromagnetic wave is captured by the planar layer of the metastructure were revealed. A similar effect can be used to creation of frequency selective concentrators (hubs) of microwave energy.
Thin-wire radiating structures with double symmetry
Authors: Tabakov Dmitry P. , Morozov Sergey V. , Kurakov Vladislav A.
Published: December 2020

The problems of electrodynamic analysis of thin-wire radiating structures with double symmetry are considered. New generalized integral representations of the electromagnetic field are obtained for the case of structures with single and double symmetries. Based on the obtained expressions, mathematical models of two - and four-way elliptical spiral antennas are constructed. It is shown that taking into account double symmetry in solving the internal electrodynamic problem leads to a set of independent Fredholm integral equations of the first kind written with respect to the distributions of normal current waves, which significantly simplifies the solution of the internal electrodynamic problem. Comparisons of current distributions along conductors, their input resistance dependences on the radius of the structure, and normalized radiation patterns for two- and four-way spiral emitters are presented.