bluuebunny/crossref_metadata_2025 huggingface dataset:
The Words ‘Laughter’ and ‘Laugh’ in a selection of The English and Scottish Popular Ballads
Authors: ROUSE Andrew C.
Published: March 2022

This paper wittily addresses the theme of laughing and laughter in eight ballads selected from Volume 1 of Gutenberg's three volume collection of English and Scottish Popular Ballads, including Lady Isabel and the Elf-Knight, The Cruel Brothers, The Boy and the Mantle, The Laidley Worm, Clark Colven, The Broomfield Hill, King John and the Bishop and Captain Wedderburn’s Courtship, with a variety of other intertextual references. Drawing simultaneously on the two most comprehensive collections of English and Scottish Ballads: Francis James Child's and Steve Roud's, the paper demonstrates that laughter in ballads is "no laughing matter", and, indeed, the balladic laughter, no to be mistaken for (s)laughter, due to its social context of mediaeval times, prevails in various shades of negativity, as corroborated by Norbert Elias's sociological theory of laughter and Anca Parvulescu's study thereof. The paper provides a unique insight into the both merry and mirthless laughter prompted by a modern reading of English and Scottish folk ballads in today's cosmopolitan context.
Verbalisierung, Visualisierung und Verortung der Erinnerung im deutschsprachigen Generationenroman
Authors: JELEC Marijana
Published: March 2022

Der Beitrag nimmt zunächst eine der markanten Tendenzen der deutschsprachigen Gegenwartsliteratur, das Format des Generationenromans, in den Blick und fragt nach seinen durch die Erinnerungsproblematik bedingten besonderen Prägungen. Daran anknüpfend werden mögliche Zugänge zu tabuisierten bzw. verdrängten Aspekten der Vergangenheit als Grundlage für eine Rekonstruktion der Familiengeschichte untersucht. Es wird erarbeitet, welche Schwierigkeiten und Möglichkeiten die Individuen im Umgang mit der Vergangenheit haben. Das literarische Korpus bilden sechs Generationenromane der deutschsprachigen Gegenwartsliteratur: Eine sehr kleine Frau (2007) von Peter Henisch, Engel des Vergessens (2011) von Maja Haderlap, Das Foto (2016) von Elva Schevemann, Haus der Kindheit (2000) von Anna Mitgutsch, Pawels Briefe. Eine Familiengeschichte (1999) von Monika Maron und Kleine Zeiten. Die Geschichte meiner Großmutter (2012) von Fritz Dittlbacher. Die Romane entwickeln für Generationenromane typische Vergangenheitsperspektiven, womit die Wirkung der Vergangenheit auf die Gegenwart bzw. die Zugangsmöglichkeiten zur Vergangenheit in diesen literarischen Texten zentral sind.
Von ‚Ich liebe jede Falte’ bis ‚Hurra, wir leben noch!’ – der humoristische Umgang mit dem Älterwerden in Sandra Schönthals Shades of Fifty
Authors: Stosik Martin
Published: March 2022

Ziel des Beitrags ist es, am Beispiel ausgewählter Fragmente des Romans Shades of Fifty, der die Dilemmata einer Frau im Prozess des Älterwerdens beschreibt, die Möglichkeiten der Erzeugung von Humor in Sandra Schönthals Werk darzustellen. Die Analyse umfasst Stilmittel wie Ironie, Selbstironie und Sarkasmus, die im Roman komische Situationen schaffen.
Einsamkeit im Zwischenraum (Vor der Zunahme der Zeichen von Senthuran Varatharajah)
Authors: Majkiewicz Anna
Published: March 2022

Der virtuelle Raum wird in der Gegenwartsliteratur zu einem Ort des Erzählens. Am Beispiel des Debütromans Vor der Zunahme der Zeichen von Senthuran Varatharajah, einem deutschen Schriftsteller sri-lankischer Herkunft, wird erörtert, welche Art von Beziehungen, die in einer neuen Gemeinschaft aufgebaut werden können, die Protagonisten während ihrer Erzählungen zur Sprache bringen.
Histopathological Findings in Brain Tissue of Patients with Pharmacoresistant Focal Epilepsy
Authors: D Metodiev , K Minkin , M Penkov , P Dimova , S Nachev
Published: March 2022

Background: Pharmacoresistant epilepsy represents 30-40% of cases with intractable epilepsy in children, and up to 20% of adult cases. Various cerebral lesions can lead to drug-resistant focal epilepsy. They are medically refractory but the complete surgical resection correlates with good outcome.
The accusative/genitive alternation in Bosnian/ Croatian/Serbian
Authors: Husić Halima , Renans Agata Marie
Published: March 2022

There is an ongoing discussion in the literature on how the meaning conveyed by (in)definite determiners is expressed in languages which lack an (in)definite article system (see e.g., Chierchia 1998; Dayal 2004; Deal 2017). One proposal is that in Slavic languages the meaning conveyed by (in)definite determiners is expressed by case markers (e.g., Kagan 2007; Khrizman 2014; Borschev et al. 2008). In particular, the observation was that in the case of the accusative/ genitive alternation, the accusative is associated with the meaning conveyed by definites, while the genitive case is associated with the meaning conveyed by indefinites. We tested this observation in Bosnian/Croatian/Serbian (BCS) focusing on the alternation of the accusative with the partitive genitive in the direct object position of transitive verbs. The results of our research show that whereas the accusative conveys the inferences of maximality and weak familiarity of the discourse referent, the genitive case does not. We propose that the partitive genitive in BCS presupposes proper partitivity. The inferences of the accusative, on the other hand, arise as implicated anti-presuppositions yielded by the competition with the partitive genitive.
The Role of Observed and Unobserved Heterogeneity in the Duration of Unemployment Spells
Authors: Ahn Hie Joo
Published: March 2022

This paper studies the degree to which observable and unobservable worker characteristics account for the variation in the aggregate duration of unemployment. I model the distribution of unobserved worker heterogeneity as time varying to capture the interaction of latent attributes with changes in labor-market conditions. Unobserved heterogeneity is the main explanation for the duration dependence of unemployment hazards. Both cyclical and low-frequency variations in the mean duration of unemployment are mainly driven by one subgroup: workers who, for unobserved reasons, stay unemployed for a long time. In contrast, changes in the composition of observable characteristics of workers have negligible effects.
Study of the effect of the composition of the binder on the mechanical characteristics of dust briquettes of electric arc furnace production
Authors: Kozaev A. A. , Khabibulin E. E. , Khaidarov B. B. , Suvorov D. S. , Khaidarov T. B. , Lysov D. V. , Kuznetsov D. V.
Published: March 2022

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On the interaction of fused refractories with optical glass melts
Authors: Sokolov V. A. , Gasparyan M. D. , Kirov S. S.
Published: March 2022

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Superhard composite material based on titanium compound plated cubic boron nitride
Authors: Rudenok L. P. , Suvorov S. A. , Rumyantsev V. I. , Bulatov O. N.
Published: March 2022

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Research of the experimental platform electric furnace with heating elements placed under the subside plate
Authors: Nizhegorodov А. I. , Gavrilin A. N. , Moyzes B. B. , Ismailov G. M.
Published: March 2022

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The refractory industry in 2020, the trends of its development. Part 1
Authors: Axelrod L. M. , Garten V.
Published: March 2022

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Improvement of Qualitative and Quantitative Aspects of the Sports Performance of Young Players Through High Intensity Interval Training
Authors: D’Isanto Tiziana , Di Domenico Felice , Sannicandro Italo , D’Elia Francesca
Published: March 2022

Objective. One of the most widely used training methodologies in football is high intensity interval training (HIIT), which aims to improve performance through training sessions characterised by exercises that involve alternating percentage load intensity. In the literature, although there are studies that demonstrate the effectiveness of HIIT in improving quantitative aspects, i.e. different expressions of strength, there are not as many studies that attest to the same effectiveness in improving qualitative components, i.e. elements related to the precision of specific football gestures.
The study purpose was to verify whether the application of a specific HIIT protocol for football over a given period of time can be equally effective in simultaneously improving the quantitative and precision components. 
Materials and methods. The sample analysed consisted of 16 movement players from the ASD Nuova Antoniana sports club, aged between 14 and 15 years. The sample was subjected to a mesocycle of training lasting 8 weeks characterised by the HIIT methodology. Before and after this period, data were collected by means of a battery of tests aimed at assessing rapid, explosive, fast and resistant strength, and passing and shooting skills: the parameters relating to expressions of strength were assessed by means of quantitative tests specific to each parameter; passing and shooting skills were assessed by means of accuracy score tests (from 0 to 4 according to accuracy).
Results. The results showed an improvement in all tested parameters (p ≤ 0.05). Therefore, the effectiveness of the protocol in improving football performance in terms of quantity and accuracy is confirmed.
Conclusions. This study has increased knowledge of the effects of the HIIT protocol on the performance of young football players.
Education as a Source for Transformative Agency: Theoretical and Practical Issues
Authors: Sorokin Pavel , Froumin Isak
Published: March 2022

The issue of “transformative agency”, which proactively improves and transforms social structures, is relevant both for theoretical discussions and practical agenda. The field of education is of particular importance in terms of shaping the potential for agency. However, the dominant areas of research in education, including the sociology of education, focus, on the contrary, on the mechanisms and factors of reproduction of social structures and related activities. The authors propose to expand the research agenda by increasing attention to the conditions and mechanisms of the formation of “transformative agency” at different levels of education and in its various segments, with an account of the processes of de-structuration that weaken the forms of institutional coercion familiar to the 20th century. The article raises theoretical questions and suggests relevant empirical phenomena for further research.
Is the Academic Performance of Schoolchildren Linked to the Expectations of Their Teachers? Results of an Experimental Study
Authors: Yusupova Elen , Kapuza Anastasia , Kardanova Elena
Published: March 2022

Teachers’ expectations may affect the academic performance of their pupils, leading to the effect of “self-fulfilling prophecies”. Teachers form their expectations about the academic performance of their pupils based on the information they possess about the latter. The present study tested a hypothesis about a correlation between the teacher’s disposal of information about the pupil’s ranking on an initial diagnostic test at the beginning of the first grade and the pupil’s academic performance at the end of the first grade. It also tested the hypothesis that the teacher’s disposal of information about the pupil’s ranking can affect his or her expectations about the level of the pupil’s cognitive skills. In this large-scale cluster randomized controlled experimental study, the participants included 4,460 first-grade students from 188 schools in a Russian region. We divided the schools into the experimental and control groups randomly. The teachers in the control group received information about the basic skills of their pupils. In contrast, experimental group teachers additionally received information about their pupils’ ranking based on a combination of indicators of their cognitive (basic reading and math) and non-cognitive (personal and socio-emotional) skills. The study did not confirm the hypotheses.
Mastery or Performace Orientation: Russian Adaptation of the Approach to Instruction Scale (PALS) to Assess Classroom Goal Structures
Authors: Gerasimova Iuliia , Chirkina Tatiana
Published: March 2022

The present study aims to examine the construct of the classroom goal structure. Achievement goal theory of motivation suggests that two types of classroom goal structures can be identified: mastery goal structure and performance goal structure. The study presents the results of the Russian adaptation of the Approach to Instruction (Patterns of Adapted Learning Survey) scale which can be used to assess classroom goal structures from the perspective of teacher practices. The survey is built on a data which comes from a survey on a sample of fifth-grade teachers (N = 656) conducted in the fall of 2020. The study includes a description of the steps for adaptation of the scale into Russian. The study presents the results of confirmatory factor analysis and describes the adjustments to the initial model. The adapted scale demonstrated a good fit to the empirical data and adequate internal consistency. The Russian-language version of the scale can be used by researchers in future studies of the educational environment in the classroom in the context of learning motivation. The scale could potentially be employed in the future studies examining the factors that determine students’ educational outcomes as well as the development of social-emotional skills.
Water filtration withZymo Bashing Bead tubes andDNA/RNA Shield reagent for subsequent DNA and RNA extraction from microbial communities v1
Authors: Hempel Christopher
Published: March 2022

Filtration of water samples withZymo Bashing Bead tubes andDNA/RNA Shield reagent for subsequent DNA and RNA extraction from microbial communities.
Surface Rupture on a Secondary Fault Associated with the 8 August 2020 Mw 5.1 Sparta North Carolina Earthquake
Authors: Wicks Charles W. , Chiu Jer-Ming
Published: March 2022

On 8 August 2020, northwest North Carolina experienced an Mw 5.1 earthquake that caused damage to buildings and roads in the city of Sparta. A regional centroid moment tensor solution shows that the earthquake was the result of slip on a reverse fault with a minor strike-slip component. Interferometric Synthetic Aperture Radar (InSAR) data, from the Japan Aerospace Exploration Agency’s Advanced Land Observing Satellite #2 (ALOS2) satellite, reveal a deformation field that is more complex than expected from a single reverse fault earthquake. The data also reveal an apparent fault rupture at the Earth’s surface that caused damage to local roads. Modeling of the InSAR deformation field indicates the fault rupture is associated with a very shallow normal faulting event with an equivalent Mw of about 5.1 that overprinted the reverse fault deformation field and possibly occurred aseismically.
A Sustentabilidade no Espaço Empresarial: Reflexões sobre a Responsabilidade Sócio Empresarial no Setor da Indústria Têxtil da Cidade de Toritama/PE
Authors: Sousa José Paulo de , Oliveira Vanda de , Maracajá Kettrin Farias Bem
Published: March 2022

Resumo Este trabalho foi motivado pela necessidade de refletir a importância da sustentabilidade em contexto empresarial, assim como, direcionar estudos para o setor da indústria têxtil que vem se destacando em cenário nacional. Assim sendo, buscou-se como pergunta norteadora qual a importância destinada para sustentabilidade nas atividades da indústria têxtil da cidade de Toritama/PE? Desta forma, estabeleceu-se como objetivo geral, analisar a importância da sustentabilidade do setor da indústria têxtil da cidade de Toritama/PE. Diante disso, a pesquisa contornou-se de forma bibliográfica para gerar resultados para compreensão do tema em estudo. Pertinente a isso, os resultados alcançados mostram que a sustentabilidade propõe o uso econômico dos recursos naturais subordinados a proteção do meio ambiente para que exista o uso consciente dos recursos naturais para garantir a existência da natureza, saúde aos seres e permanência da vida. Contudo, a existência do desenvolvimento econômico, assim como o setor têxtil, deve estabelecer organizações em seus processos produtivos e atividades de consumo, tendo em vista que a sustentabilidade é o alicerce que sustenta alternativas de mudanças positivas, seja no contexto de sobrevivência humana ou econômica.
Palavras-chave: Gestão Ambiental. Industria Têxtil. Desenvolvimento Sustentável.
AbstractThis work was motivated by the need to reflect on the importance of sustainability in a business context, as well as, direct studies to the textile industry sector that has been standing out on the national scene. Thus, it was sought as a guiding question what is the importance attached to sustainability in the activities of the textile industry in the city of Toritama/PE? Thus, it was established as a general objective to analyze the importance of sustainability in the textile industry sector of the city of Toritama/PE. In view of this, the research went around in a bibliographic way to generate results for understanding the subject under study. Pertinent to this, the results achieved show that sustainability proposes the economic use of natural resources subordinated to environmental protection so that there is a conscious use of natural resources to ensure the existence of nature, health to beings and permanence of life. However, the existence of economic development, as well as the textile sector, must establish organizations in their production processes and consumption activities, bearing in mind that sustainability is the foundation that supports alternatives for positive changes, whether in the context of human or economic survival.
Keywords: Environmental Management. Textile Industry. Sustainable Development.
Motivaciones, compromiso y adopción del e-WOM en restaurantes
Authors: Haro-Sosa Giovanny Lenin , Moliner-Velázquez Beatriz , Gil-Saura Irene
Published: March 2022

El objetivo del presente trabajo fue estudiar el efecto que tienen las motivaciones para consultar y escribir e-WOM sobre el compromiso con el e-WOM y la influencia de dicho compromiso en la adopción del e-WOM consultado. Para analizar estas relaciones, se realizó una investigación empírica aplicada en el contexto de los restaurantes. El ámbito geográfico fue Ecuador, con una muestra de 461 consumidores. Se utilizó un modelo de ecuaciones estructurales y se validó la cadena de relaciones. Los resultados confirmaron las relaciones entre estas variables; además, se presentaron implicaciones académicas interesantes para profundizar en el estudio sobre el compromiso con el e-WOM, así como implicaciones para la gestión de restaurantes orientadas al manejo de sus plataformas virtuales o redes sociales.
Liderazgo compartido en equipos directivos y desempeño organizacional: el rol mediador del capital social
Authors: Chacón-Henao Juliana , López-Zapata Esteban , Arias-Pérez Jose
Published: March 2022

Este estudio buscó analizar el efecto mediador del capital social en la relación entre el liderazgo compartido en los equipos directivos de empresas colombianas y el desempeño organizacional. Se utilizó una metodología de modelos de ecuaciones estructurales con mínimos cuadrados parciales, a partir de una encuesta aplicada a 113 integrantes de equipos directivos de empresas colombianas. Se identificó que el liderazgo compartido del equipo directivo tiene un efecto positivo sobre el desempeño organizacional y el capital social ejerce una mediación total en esta relación. Los hallazgos permiten resaltar la importancia de compartir las responsabilidades del liderazgo para fomentar el capital social en las organizaciones y de esta forma alcanzar los objetivos organizacionales con un mejor desempeño.
Improving Product Quality Based on Supply Chain Effectiveness and T-JIT Production Implementation
Authors: Hosseini Seyede Somaye , Korani Ehsan
Published: March 2022

Success at the supply chain level requires a supply chain management strategy and its ability to handle organizational management and as result of that has effect on product quality. The research results show that T-JIT as a sustainable strategy, from supply chain management as a factor affecting product quality and supply chain capability as factors affecting product quality. Therefore, organizations that are willing to compete on the supply chain level are recommended to be among the JIT-productions, JIT-buyers, JIT-sellers and suppliers of JIT-information. In summary, production managers must take advantage of a T-JIT production strategy. The purpose of this study is to investigate the effect of T-JIT production system implementation and supply chain effectiveness on improving product quality. Statistical population of this research is 305 managers, supervisors and administrative staff of production industries. Data were collected using a questionnaire and analyzed with SPSS and AMOS software. Finally, it was observed that supply chain management strategy has a positive and significant effect on product quality, supply chain capability and T-JIT production. On the other hand, T-JIT production has a positive and significant effect on product quality and supply chain capability, and also the positive and significant effect of supply chain capability on product quality was confirmed.
Comparison of low dose magnesium sulphate regime with standard Pritchard regime in severe preeclampsia and eclampsia: a tertiary centre experience
Authors: Gaur Indu , Kumar Kanishka
Published: March 2022

Background: We tried to see if omitting the intravenous (IV) loading dose of magnesium sulphate (MgSo4) would result in similar outcome in comparison to the standard loading dose (intravenous+intramuscular) in eclampsia in preventing convulsions.Methods: Patients were randomized into 2 groups. In group A (modified Pritchard regimen), IV loading dose of MgSo4 was omitted (only IM loading dose was given) and maintenance dose was given for 12 hours. In group B, standard Pritchard regimen was followed, both IV and IM given as loading dose and maintenance dose was given for 24 hours. Our aim was to see if modified Pritchard regimen was as effective as the standard Pritchard regimen.Results: There was no difference in age, parity, gestational age at presentation, mode of child birth between both regimens. After 1 hour of loading dose, in both pre-eclampsia (PE) and eclampsia patients, in both groups A and B, therapeutic range of MgSo4 was reached with added benefit of less propensity of toxicity in group A (as IV dose was omitted). Out of 64 women with eclampsia, recurrent convulsions were seen in 6 women (20.68%) of group A and 11 women (31.4%) of group B (p=0.333). None of the women of severe PE had convulsion after loading dose of MgSO4 in either of the two groups.Conclusions: We conclude that efficacy of reduced loading dose regimen (omitting IV loading dose) and 12 hour maintenance dose of MgSo4 is similar to standard Pritchard regimen (which employs full loading dose and 24 hour maintenance dose) in both prophylaxis of convulsion in severe preeclampsia and controlling convulsion and preventing recurrent convulsion in eclampsia with the obvious lower propensity for MgSo4 toxicity.
A comparative study of three layered interrupted suturing versus continuous subcuticular suturing in episiotomy closure
Authors: Chaudhary Rachna , Sharma Shubhangi , Singh Shakun , Dhama Vandana
Published: March 2022

Background: Episiotomy is a surgically planned incision on the perineum and posterior vaginal wall during the second stage of labour. There are various types of episiotomy like midline, mediolateral, lateral and J-shaped. There are various maternal and fetal benefits of episiotomy like reduction in perineal injuries, preservation of pelvic floor muscle function and cranial protection etc. There are various ways of suturing of episiotomy like three layered interrupted suturing, single knot type, three layered subcuticuler and continuous subcuticular technique. Perineal pain is the most common complaint after episiotomy. Objective of the study was to compare between the two episiotomy suturing techniques, one is traditional three layered interrupted technique and the other is continuous subcuticular technique.Methods: It is prospective comparative interventional study conducted in department of obstetrics and gynaecology at Sardar Vallabh Bhai Patel (SVBP) Hospital, Meerut from January 2020 to July 2021. In this study, 100 primigravida who delivered vaginally with the aid of episiotomy in the hospital were included. The episiotomy of 50 patients were sutured by three layered interrupted technique (control) and 50 patients episiotomy were sutured by continuous subcuticular technique (cases). Both groups were compared in view of duration of surgery in minutes, amount of suture material used, and post-operative pain within 12 hours and within 48 hours of delivery and delayed complication if any.Results: The duration of surgery was significantly lower in the continuous subcuticular technique (9.94±1.17 min) p value <0.0001 as compared to three layered interrupted technique (13.04±1.38 min). The amount of suture material used is less in continuous group (81.18±5.61 cm) as compared to control group (85.22±5.40 cm) p value <0.0004. There was no need of extra use of local analgesia (p<0.0061) and patient had less post-operative pain at 12 hrs and 48 hrs of delivery in continuous subcuticular group (p<0.0001). There was not any delayed complication seen in continuous group.Conclusions: From my study it is concluded that continuous subcuticular episiotomy suturing technique is better than three layered traditional technique as it require less time, less suture material, less local analgesia and associated with less pain experience and complication.
Maternal and perinatal outcome in multifetal gestation
Authors: Patel Tejal L. , Diwan Bhargavi Ajit
Published: March 2022

Background: Multifetal gestation is a high-risk pregnancy associated with increased maternal and fetal complications. The rate of multiple pregnancy has dramatically increased during the past decades, along with the diffusion of assisted reproduction technology (ART). The present study aims to investigate maternal and perinatal outcome in multifetal gestation.Methods: The prospective study was carried in the department of obstetrics and gynaecology, B. J. medical college, civil hospital, Ahmedabad from August 2019 to July 2020. All cases of multifetal pregnancy either admitted from antenatal clinics or from labor room as emergency cases were included in the study.Results: Out of total 7786 births during this period, 103 were twin pregnancies and 3 were triplets. The incidence was 1 in 73.5 births. Maternal complications observed were anaemia in 27.3% patients, preterm deliveries in 58% patients, PROM in 20.7% patients, hypertensive disorders of pregnancy in 13.2% patients, APH in 1.8% patients and PPH in 4.7% patients. No maternal mortality occurred. Fetal complications like gross congenital anomalies in 6.13% cases, single fetal demise in 8.49%, growth discordance in 7.53%, fetal growth restriction in 5.18% cases and 82% babies were low birth weight. Still birth rate was 8.01% and perinatal mortality rate was 12.3%.Conclusions: Early detection of high-risk cases, timely referral, frequent antenatal visits and early hospitalization with optimum obstetrics care and intensive neonatal care set up are necessary to improve maternal and perinatal outcomes.
Study of patients with liver dysfunction during pregnancy and their maternal and perinatal outcomes
Authors: Hablani Kavisha , Goel Poonam , Takkar Navneet , Pandher Dilpreet Kaur , Kaur Jasbinder , Thakur Krishma
Published: March 2022

Background: Liver dysfunction in pregnancy can be associated with maternal and perinatal morbidity and mortality, therefore early recognition and timely management is of paramount importance to improve the outcome. The studies related to liver dysfunction in pregnancy and its outcome are sparse from this part of India and are retrospective in nature, so present study was planned.Methods: A total of 80 pregnant patients with liver dysfunction were enrolled as per the inclusion criteria after taking informed consent. Patients were investigated depending on the symptoms and pregnancy related complications with an aim to know the probable cause of liver dysfunction. Maternal and perinatal outcomes were noted in these patients.Results: Intrahepatic cholestasis of pregnancy was the most common cause of deranged liver function tests (71.3%) followed by HELLP syndrome (21.3%), viral hepatitis (6.3%) and AFLP (1.3%) respectively. The most common maternal complication seen was preterm labour (33.8%) followed by thrombocytopenia (11.3%), postpartum hemorrhage (7.5%), vaginal wall hematoma (7.5%) and coagulopathy (3.8%). 2 patients (2.5%) required ICU admission and both patients expired due to fulminant hepatic failure. The most common fetal complication was prematurity (33.8%). Intrauterine fetal demise occurred in 10% of the patients and there were 12.5% perinatal deaths observed in our study.Conclusions: The commonest cause of liver dysfunction in our study was IHCP (71.3%) followed by HELLP syndrome (21.3%). In spite of multidisciplinary approach, liver dysfunction during pregnancy was associated with high maternal and perinatal morbidity and mortality.
Efficacy of mifepristone in the management of fibroid
Authors: R. Priyanka , P. B. Hiremath , Sekar G. Sindhujha
Published: March 2022

Background: Uterine fibroids are the most common benign tumors of the uterus. The incidence has been shown to be as high as 70–80 percent in studies using histologic and sonographic examinations. Majority of fibroids are asymptomatic and when symptomatic, patients present with menstrual disturbances, infertility, lump abdomen or pressure effects. The complications associated are severe anemia, hyaline or red degeneration, urinary retention, hydronephrosis secondary to obstructive uropathy and rarely sarcomatous changes. The treatment depends upon the size, symptoms, location and age of the patient. The aim and objective of this study is to evaluate the effectiveness of Mifepristone in symptomatic improvement and reduction of the size of fibroid.Methods: The study was conducted in Sri Venkateswaraa Medical College Hospital and Research Centre (SVMCH and RC), Puducherry. This is a hospital based longitudinal study conducted in between December 2019 to June 2021 for a period of 18 months. 30 consecutive cases were studied based on inclusion criteria. All patients were treated with mifepristone 50 mg once weekly for 6 months. Analysis was performed by using statistical package for the social sciences (SPSS) version 23 software.Results: In this study we observed there was a significant improvement in the hemoglobin (Hb) level, significant reduction in uterine volume, fibroid size and endometrial thickness after 6th month follow-up.Conclusions: Mifepristone was able to significantly improve the patient outcome by reducing the amount of blood flow during menstruation and increasing the Hb levels and significantly reduce the size of myoma.
Endometriosis fertility index at laparoscope: a ray of hope and lots of scope
Authors: Kavya Vemparala Kalabhashini , Palanisamy Sindhuja T. , Palaniappan N.
Published: March 2022

Background: Endometriosis fertility index (EFI) is used to predict the fecundity in women with surgically and histologically confirmed endometriosis. Aim of the study is to evaluate the successful spontaneous pregnancy rates in patients with endometriosis after laparoscopic surgery in relation to EFI score.Methods: Observational cross-sectional study was conducted on 76 patients who desire to conceive with suspected endometriosis related infertility treated by laparoscopic surgery. EFI score was calculated and information on mode of conception (spontaneous or assisted reproductive technology-ART) was collected by contacting the patients.Results: In women who conceived spontaneously, mean age was 31.33+3.29 years. Factors found to be significant were age (pvalue-0.0001), time to achieve spontaneous pregnancy (median-9 months). Patients with higher EFI score (5-10) has good spontaneous conception rate (96.2%) compared to those with lower EFI score (0-4) that conceived better with ART (60%) women with lower least function score has better outcome for spontaneous pregnancy (p<0.001).Conclusions: EFI scoring system is effective in predicting postoperative successful spontaneous pregnancy rates in the patients with endometriosis. In our study patients with higher EFI score achieved successful spontaneous pregnancy.
A study of efficacy of ormeloxifene in abnormal uterine bleeding of ovulatory disorders
Authors: G. M. Nandhini , P. B. Hiremath , Banu A. Shameera
Published: March 2022

Background: Abnormal uterine bleeding (AUB) of ovulatory disorders is defined as the state of abnormal bleeding from the genital tract without any clinically detectable organic, systemic and iatrogenic cause. AUB is one of the common gynaecological issues among the patients visiting the hospital as it could affect at least 1/3rd of women in the child bearing age. Ormeloxifene, a nonsteroidal, nonhormonal and selective estrogen receptor modulator is a highly safe drug in treating acute and abnormal menstrual bleeding.   Methods: The 40 cases of heavy menstrual bleeding (HMB) with ovulatory disorder in the range of 40-52 years of age were treated with 60 mg ormeloxifene twice a week for first 12 weeks and once a week for next 12 weeks.  The patients were evaluated for haemoglobin, pictorial blood loss assessment chart (PBAC) score and endometrial thickness before and after treatment.Results: A significant decrease in endometrial thickness and PBAC score was observed. Also, the level of haemoglobin is found to increase significantly from 8.4±0.8 to 9.9±0.7. In this study, following 6 months of treatment with ormeloxifene, 90% of cases had marked improvement in their symptoms, while 10% of the patients required surgical management i.e., hysterectomy. Amenorrhea was observed in 7.5% of total cases and hypomenorrhea in 5% cases.Conclusions: Based on these results we could conclude that ormeloxifene could be the drug of choice in patients with AUB as it is very safe with manageable side effects. This simple drug-based therapy has facilitated compliance, tolerability and noticeable reduction of symptoms resulting in satisfaction towards the treatment.
Pipelle versus MVA cannula for endometrial biopsy: a comparative study
Authors: Garg Aakriti , Mukherjee Shobha
Published: March 2022

Background: Endometrial biopsy procedure is a prerequisite for evaluation of abnormal uterine bleeding, also performed to exclude the presence of endometrial carcinoma or in cases of infertility.Methods: A study was conducted at Rohilkhand Medical College and Hospital, Bareilly among 350 subjects to assess the efficacy and problems associated with endometrial biopsy technique by MVA cannula method and pipelle method of biopsy.Results: Mean age recorded was 45.14±10.11, mean parity was 3.18±1.8, mean endometrial thickness was 6.9±3.28 and mean BMI was 24.3±2.12. In our study, duration of MVA endometrial biopsy was (3.1±0.62min) and with Pipelle method was (3.01±0.77 min). Endometrial biopsy is a compulsory requirement for evaluation of endometrial causes of abnormal uterine bleeding especially malignancy, hence, it is a very frequently done procedure.Conclusions: This study concluded that manual vaccum aspiration using cannula No.4, an unconventional technique was comparable to Pipelle technique with comparable efficacy and results.
Infection prevention among pregnant women in the community by participating village health volunteers
Authors: Khwasaen Surijira
Published: March 2022

Background: Corona virus is an emerging disease that is spreading rapidly and spreading all over the world. Pregnant women are a risk group that needs to be monitored. This study aimed at learning about the self-protection behaviours of village health volunteers in preventing COVID-19 infections, roles and community management for preventing COVID-19 infections among pregnant women and studying the self-protection knowledge and behaviours of pregnant women in preventing COVID-19 infections.Methods: This study was mixed method research. The sample was 48 village health volunteers and 10 pregnant women. The research instruments consisted of questionnaires. This study was conducted in April-August 2021. Data were analysed using descriptive statistics, Wilcoxon Signed Ranks test, and Correlation (Kendall’s tau-b).Results: According to the findings, most of the village health volunteers had self-protection behaviours such as wearing masks, eating hot food, using private spoons, washing hands with soap, alcohol gel or sprays, maintaining social distancing and not entering community areas with COVID-19 outbreaks at a high level. Village health volunteer roles and community management with participation from village health volunteers to monitor, prevent and control COVID-19 outbreaks were at a high level (100%). In the area of pregnant women, most of the pregnant women had high overall knowledge of self-protection against COVID-19 infection in the area of COVID-19 infection prevention behaviours (=13.90, SD=0.73). Analysis of correlations found a positive correlation at the high level (r=0.770) with statistical significance (p=0.008). One pregnant woman was found to be infected with COVID-19 (10%).Conclusions: The findings showed There was a significant correlation between knowledge and behaviour in prevention of coronavirus 19 infection. Therefore, it is necessary to promote knowledge and behaviour in preventing corona virus 19 infection. to pregnant women continuously and effectively.
An open-label pilot study to evaluate the efficacy and safety of BC caps for women with abnormal vaginal discharge due to microbial infections: case series
Authors: Vikram Baburao , Rawal Neetu , Gupta Sunil
Published: March 2022

Herbal therapeutics advancement demand in management of abdominal vaginal discharge is increasing in women as it serves as an important housekeeping function in the reproductive system. This case series study evaluates the safety and effectiveness of birth control contraceptives capsules (BC caps) in women suffering from abnormal vaginal discharge. We conducted an open label interventional study of 15 female patients with in the age of 18-45 years (mean 33.7 years) with a history of abnormal vaginal discharge. Patients were asked to administer two BC caps (neem seed oil) capsule of 500 mg manually to vagina daily at night for 15 days followed by treatment assessment as per each schedule visit. Primary outcome includes change in microbiological parameters. Secondary outcomes included monitoring of adverse event (AE) and serious adverse event (SAE), changes in clinician’s assessment of symptoms and change in Subject’s global assessment of symptoms. The study showed the 93.33% and 87.5% improvement in abnormal vaginal discharge and cervical abnormalities. Microbiological cure rate found was 100% for pathogens. A constant decline was seen in the mean values of all the associated symptoms. Significant results in whiff and pH test were observed after treatment. The vaginal discharge was observed to be clear in 100% of the participants. Subject’s assessment of symptoms which were low back pain, vulval itching, general weakness, foul discharge, and burning sensation were improved. All results were significant at p value <0.05. The study found that BC caps is highly effective and safe in a treatment for abnormal vaginal discharge. It also showed improvements on associated symptoms with minimal to zero side effects.
Wernicke’s encephalopathy in pregnancy
Authors: Devi R. Auxeelia Packia , Naregal Basavaraj N.
Published: March 2022

Wernicke's encephalopathy (WE) is a reversible neurological emergency which is a rare but known complication of hyperemesis gravidarum due to thiamine deficiency. Prolonged vomiting in pregnancy results in thiamine depletion. Most frequently Wernicke's encephalopathy is found among persons suffering from excessive drinking. Unusually it can also be seen in women presenting with hyperemesis gravidarum with pre-existing malnutrition, as avitaminosis can result from the acute malnutrition associated with prolonged pregnancy-related hyperemesis. The early recognition of its clinical signs and symptoms is essential to establish the suspected diagnosis and can be confirmed by MRI. Most patients present with the triad of ocular signs, ataxia, and confusion. It can be associated with life-threatening complication like central pontine myelinolysis. Here we stress upon the importance of early diagnosis and prompt treatment of WE. The aim of this report is to present cases of Wernicke's encephalopathy induced by hyperemesis gravidarum except one case which was acute in onset. The course of the disease, clinical signs, diagnostic tools, treatment and its results are presented.
A case report on peritoneal inclusion cyst with entrapped ovary and an endometriotic cyst causing diagnostic dilemma
Authors: Stumpf Luciana , Zinzuwadia Shuchi , Ploussard Brett , Zinzuwadia Shweta , Bhrahmbhatt Elizabeth , Adam Kailynn , Jawahar Anugayathri
Published: March 2022

Peritoneal inclusion cysts (PIC) occur most frequently when abdominal adhesions attach to an ovary. These adhesions are commonly seen in patients with a history of abdominal surgery. Physiologic fluid following ovulation that would normally be absorbed by the peritoneum gets entrapped within these adhesions. Women most frequently complain of back pain or pelvic pain when peritoneal inclusion cysts are present. We present a patient with prior surgical history who presented with suprapubic pain and was found to have a complex cyst on imaging. Gynecologic oncology was consulted due to its complex imaging appearance and large size and was ultimately resected despite negative tumor markers. We present our case with pathologic correlation of imaging findings to emphasize this benign entity with no malignant potential. A confident imaging diagnosis in correlation with laboratory markers can help prevent aggressive surgical management.
Reversible cerebral vasoconstriction syndrome in a young primigravida woman with pre-eclampsia
Authors: Das Akansha , Dhanalakshmi M. G.
Published: March 2022

Reversible cerebral vasoconstriction syndrome (RCVS) is characterised by severe headache and is associated with reversible segmental vasoconstriction of cerebral arteries. Conditions associated with RCVS are commonly pregnancy with or without pre-eclampsia, neurological procedures, head trauma. Thunderclap headache is the chief clinical presentation. Visual disturbances and focal neurological deficits are also frequently encountered. Posterior reversible encephalopathy syndrome and RCVS are often overlapping and hence most cases of RCVS are diagnosed late. We reported a young primigravida who had no comorbidities presenting to the ER with elevated blood pressure and generalised tonic and clonic seizures. Post-delivery her headache persisted and clinically her neurological status started deteriorating. Later she was diagnosed as RCVS. Treatment is based on expert opinion. Nimodipine, nifedipine or verapamil have been used in most patients.
Assessment of serum zinc level in childhood malignancy at time of initiation of chemotherapy and to study its association with survival during initial first month of the treatment
Authors: Gautam Arun , Verma Nishant , Verma Sonali
Published: March 2022

Background: Survival in childhood malignancies continues to be a challenge in developing than in developed countries. Multiple factors have been implicated for this gap, like poor health infrastructure, over-population and malnutrition. Malnutrition and associated zinc deficiency may be implicated as one preventable factor for mortality in childhood malignancy. The main aim of this study was to assess serum zinc level in childhood malignancy and to study its role in survival of the subjects.Methods: This prospective observational study was conducted from August 2014 to July 2015 on 219 patients of various childhood malignancies, from age 2 months to 15 years (151 males, 68 females). Cases were enrolled at the initiation of chemotherapy and followed for 1 month.Results: Serum zinc level (mean ± SD) was 78.70±32.83 µg/dl in the cases and it was found to be significantly lower than in controls (p<0.05). During follow up, 51 patients died due to various complications and disease progression. Significant relationship between low serum zinc level and unfavourable outcome was found (p<0.05). Logistic regression analysis revealed zinc level to be a significant predictor of the final outcome.Conclusions: This study states that low serum zinc level has an association with mortality in pediatric malignancy. As this study did not include any intervention in form of zinc supplementation, a future study with intervention of zinc supplementation might help in implicating the role of zinc as a predictor of outcome in childhood malignancy.
A study of left ventricular diastolic dysfunction in patients of sickle cell disease
Authors: Shah Mohita , Kothari Prafful
Published: March 2022

Background: Left ventricular diastolic filling patterns are altered in patients with sickle cell anaemia and these diastolic abnormalities may be present in the absence of heart failure. These abnormal patterns suggest an intrinsic myocardial abnormality in patients with sickle cell anaemia and may prove to be early markers of cardiac disease. The ventricles do not properly relax and become stiff meaning they cannot fill with blood properly.Methods: This study was carried out in tertiary health care hospital in western India, where homozygous sickle cell disease patients and age and haemoglobin matched controls were taken into cross sectional observational study design.Results: The mean values of E, A, E/A, IVRT, DT, AT, were in normal range in controls. In cases although the mean values of E, A, E/A, IVRT, DT, AT were in normal range, there were 19 cases of sickle cell anaemia who had significant alteration in indices of diastolic LV function from normal range. Out of these 20 cases with diastolic dysfunction, 11 cases had significant increase in (E) velocity from normal range with E/A ratio more than 2 suggestive of restrictive filling pattern of diastolic dysfunction while in 8 cases E value was less than normal with increase in (A) velocity and E/A ratio was less than 1 suggestive of impaired relaxation pattern of diastolic dysfunction. When indices of diastolic LV function were compared in cases and controls, mean early peak filling velocity (E) was significantly higher in cases.  Conclusions: In present study, out of 37 cases 19 (51%) cases had LV diastolic dysfunction. Of these 19 cases with diastolic dysfunction, 11 cases had restrictive filling pattern and 8 cases had impaired relaxation pattern of diastolic dysfunction.
A rare case of abetalipoproteinemia
Authors: Agarwal Dheeraj , Barsode Supriya , Maindad Dadasaheb G. , Shah Nihal Uday , Maindarkar Apurva Ajay , Kulkarni Vijay S.
Published: March 2022

The disease studied here abetalipoproteinemia (ABL) is a very rare autosomal recessive disorder which is caused by microsomal triglyceride alteration in protein gene mutation. ABL is defined by a lack of lipids and apolipoprotein B in the plasma, as well as fat malabsorption and a variety of clinical symptoms. We report a 21-year-old male with a history of persistent diarrhea, steatorrhea, and growth retardation who was born to consanguineous parents. The patient was diagnosed with ABL and was treated with dietary changes and fat-soluble vitamin replacement, as well as being monitored on an outpatient basis.