bluuebunny/crossref_metadata_2025 huggingface dataset:
Histopathological study of endometrial stromal sarcomas
Authors: Bhat Salma , Beigh Ambreen , Farooq Summyia
Published: November 2018

Background: Endometrial stromal sarcomas (ESSs) are rare malignant uterine tumours comparatively affecting younger women and the mean age is 42 to 58 years. The World Health Organization (WHO) classification categorises endometrial stromal neoplasms and related tumors as: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS).Methods: Present study is a retrospective one and includes 6 patients with histologically proven endometrial stromal sarcoma for a period of 3 years. Authors examined every slide available from each case and new HE-stained slides generated from formaline-fixed, paraffin-embedded tissue were reviewed to confirm the diagnoses. Demographic information, pathologic, and treatment information were collected from the clinic and hospital charts. All had primary surgical management in the form of total abdominal hysterectomy and salpingo-oophorectomy.Results: The mean patient age was 41 years. All of the patients had presented with abnormal uterine bleeding. Diffuse growth of small cells closely resembling those of the normal proliferative endometrial stroma was the characteristic feature of these tumors. All of these patients had a low grade ESS on histopathology. They had regular follow-up visits until the end of study.Conclusions: Endometrial stromal sarcomas are rare malignant tumors of the uterus and a proper preoperative diagnosis is difficult. Their differential diagnosis from typical submucosal uterine myomas or benign endometrial polyps can be difficult. The histological examination of the specimen is necessary to exclude malignancy and establish the final diagnosis.
Prevalence of vitamin D deficiency and effect of vitamin D supplementation on feto-maternal outcome in tertiary care centre
Authors: Yadav Munmun , Verma Mahendra Kumar , Bairwa Mohan , Meena Govardhan , Rajoria Lata
Published: November 2018

Background: Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency. Hypovitaminosis D in pregnancy has been reported to cause various fetomaternal effect, i.e. increased risk of preeclampsia (PE), gestational diabetes mellitus (GDM), caesarean section, hypocalcemia, subclinical myopathy, neonatal tetany, hyperbilirubinemia congenital rickets and infantile rickets, etc. Only few Indian studies are available in this regard. The objectives are to find prevalence of vitamin D deficiency in pregnant women and to evaluate the effect of supplementation with cholecalciferol in improving vitamin D levels in pregnant women and evaluate its correlation with feto-maternal outcome.Methods: A prospective observational was conducted on 120 Pregnant women on their first visit to hospital irrespective of gestational age were offered the test and on the basis of inclusion and exclusion criteria are included in study and vitamin D level was done to know the prevalence of vitamin D deficiency. Apart from routine obstetrical investigation, serum vitamin D (total) level was estimated. All results were recorded and analyzed statically.Results: Out of 120 patients 101 (84.1%) were found to be vitamin D deficient. Mean age of vitamin D deficient group was 28.31±3.86 and sufficient group was 26.37±2.83.81 (67.5%) were vegetarian and 39 (32.5%) were nonvegetarian.75 (92.59%) vegetarian and 26 (66.66%) non-vegetarian found to be vitamin D deficient. (p<0.05). Vitamin D supplementation has been observed to reduce risk of preeclampsia. (p<0.05) and vitamin D sufficiency associated with reduced risk of low birth weight babies.Conclusions: Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes.
Pelvic pressure packing for intractable obstetric and gynaecological hemorrhage in a tertiary care hospital
Authors: Bhosale Archana , S. Kavya H. , Nandanwar Yogeshwar Sadashiv , Ansari Ayesha
Published: November 2018

Background: Haemorrhage is one of the most common complication of any surgery. Haemorrhage can be arterial, venous or capillary ooze. Massive haemorrhage if not timely managed may lead to fatal consequences. There are various medical and surgical methods to control haemorrhage. This study aims to achieve hemostasis with the help of pelvic pressure pack in Obstetric and Gynaecologic surgeries when standard methods are failed and to evaluate efficacy of simple and modified technique of pack preparation.Methods: This is an observational study of 11 cases conducted over a period of 4yrs. This study reports modification of standard packing techniques which overcomes some of its limitations. Here the pack was used in different gynaecologic and Obstetric cases, where intractable haemorrhage was the major problem and standard methods to control haemorrhage had failed. Here a simple foley’s catheter rolled with condom and filled with normal saline was used to prepare a pack and kept over the bleeding surface. This specific pack will adopt the shape of the body cavity it is inserted into, thereby causing pressure tamponade against bleeding surfaces. Pack was removed after 48-72 hours of insertion. Postoperative control of bleeding, patient stability and morbidity were studied.Results: The pelvic pressure pack successfully controlled bleeding in 100% of cases without any morbidity and mortality.Conclusions: In the contemporary management of post-hysterectomy or adhesiolysis induced uncontrolled pelvic bleeding and venous oozes, the pelvic pressure pack appears to be valuable and effective option, affording correction of coagulopathy and further stabilization. We believe all Obstetricians and Gynaecologists should be familiar with this simple safe and cheap potentially lifesaving technique.
Awareness about cervical cancer risk factors and symptoms
Authors: Singh Sadhana , Narayan Nutan , Sinha Rupam , Sinha Pragya , Sinha Virendra Prasad , Upadhye Jayshree J.
Published: November 2018

Background: Lack of awareness of risk factors and symptoms for cancer may leads to late diagnosis and poor prognosis. A Cross-sectional population-based survey was conducted to assess community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer.Methods: The cross-sectional study included 200 married women aged 18 years and above who consented for the study.Results: In present study, out of 200 respondents, the risk factors for cervical carcinoma known to females were HPV infection in 30 (15%), multiparity and reproductive tract infection in 24 (12%) each, frequent childbirth in 22 (11%), early marriage in 18 (9%) and multiple sexual partners in 12 (6%).158 (79%) females knew vaginal bleeding between menses as symptom of cervical cancer. 132 (66%) knew symptom as foul-smelling vaginal discharge, 86 (42%) as lower abdominal pain, 82 (41%) as loss of appetite and weight while 52 (26%) females knew the symptom as postcoital bleeding. 54 (27%) respondents knew that pap smear test should be done as screening test to detect cervical cancer in early stage while 22 (11%) respondents knew about HPV vaccine as preventive measure.Conclusions: Recognition of cervical cancer risk factors and symptoms was low among study participants. Targeted interventions including increasing availability of HPV vaccination, population-based cervical screening and diagnostic services can translate high awareness into actual benefits.
Comparison between sublingual 600 and 800 microgram misoprostol after mifepristone for MTP up to 9 weeks gestation
Authors: Thakur Srishti , Pratap Charu
Published: November 2018

Background: The objective of the present study was to compare the efficacy between sublingual 600 and 800 microgram Misoprostol after administration of Mifepristone up to 9 weeks gestation, to compare the incidence of side effects between the two doses. To compare the acceptability between the two doses.Methods: This study is a single-center, randomized study. The study is conducted at Fortis Escorts Hospital and Research Centre, Faridabad, during period of May 2014 to June 2015. 160 Pregnant women with singleton pregnancy up to 9 weeks gestation, visiting OPD of Obstetrics and Gynaecology, who wanted MTP by drug, after taking care of inclusion and exclusion criteria. An informed consent was taken from all the women.Results: In terms of efficacy, both the groups were comparable (p value 0.509). Blood loss was comparable in both the groups (p value 0.147). In terms of side effects, itching and rashes (p value 0.004) and abdominal cramps (p value 0.001) was found to be more in women taking 800ug Misoprostol. Also, need for analgesia (p value 0.001) was found to be more in women taking 800ug Misoprostol.Conclusions: Sublingual Misoprostol is comfortable and easier administration when compared to other routes and it has potential to be developed as a self-administered regimen. 600ug Sublingual Misoprostol is as efficacious as 800ug sublingual Misoprostol with significantly lesser side effects up to 7 weeks of gestation.
Effect of early maternal newborn skin to skin contact in labour room on third stage of labour and success at breastfeeding
Authors: Parikh Purvi M. , Agrawal Saumya P. , Vyas Rupa C. , Shah Sapana R. , Joshi Khushi P.
Published: November 2018

Background: Immediate postpartum period and birth pose many challenges for the mother and the new-born. Initiation of early skin to skin contact in the labour room can be beneficial to both of them.Methods: Randomized control trial conducted over a period of 7 months in a tertiary care centre enrolling 400 laboring women.200 in the control group were given routine care. In the 200women in the study group, the newborn was given immediate skin to skin contact by placing him/her on the mother’s chest.Results: Duration of third stage of labour was less than 10 minutes in 95%women of study group compared to 56% women in the control group(p<0.01). Placenta was expulsed as a whole in 98% cases in the study group compared to 81% in the control group. Successful breastfeeding was observed in 88% women in study group compared to 54%in the control group(p<0.01). Breastfeeding was initiated within 30 minutes of birth in 96%women in the study group compared to 41% in the control group.Conclusions: Uterus could contract faster with the complete expulsion of placenta and shortening of the third stage of labour with early skin to skin contact. The newborn showed early initiation, success at breastfeeding and longer first breastfeeding with early skin to skin contact.
Prevalence of multidrug resistance (MDR) and extended spectrum beta-lactamases (ESBLs) among uropathogenic Escherichia coli isolates from female patients in a tertiary care hospital in North India
Authors: Das Bhaskar , Mittal Natasha , Goswami Rajni , Adhana Deepti , Rathore Neha
Published: November 2018

Background: Urinary tract infection (UTI) is a common bacterial infection in women. It is very common during pregnancy and may present as asymptomatic bacteriuria. Escherichia coli is the primary urinary pathogen accounting for 74-90% of uncomplicated urinary tract infection. The aim of the study was to evaluate in-vitro antibiotic susceptibility among urine isolates of Escherichia coli and prevalence of resistance marker like ESBL producer and MDR status.Methods: Mid-stream urine samples of 205 female patients were processed for culture and sensitivity. All the samples were inoculated on culture media and growth showing significant bacteriuria (>105 cfu/ml) were subjected to identification and antibiotic sensitivity testing on Automated system BD Phoenix 100. ESBL status was detected by the system and MDR status was evaluated by standard guidelines.Results: Out of 205 urine samples, 47 samples (22.93%) showed growth of organism. Out of the 47 growth positive samples, 36 (76.60%) samples showed growth of Escherichia coli and out of which 13 (36.11%) were ESBL producer and 23 (63.89%) were ESBL non-producer. Escherichia coli was mostly isolated from younger age group (21-40 years) (61.11%). Antimicrobial susceptibility showed very good sensitivity towards Amikacin, Tigecycline, Carbapenems, Fosfomycin, Piperacillin-tazobactam and Nitrofurantoin. All the isolates of ESBL producer are MDR (100%) and 21.7% of ESBL non-producer are MDR. There is evidence of transfer of resistance genes for non-β-lactam antibiotics along with ESBL resistance marker.Conclusions: Escherichia coli was the predominant uropathogen isolated from female patients and Amikacin, Nitrofurantoin and Fosfomycin can be used as first line drug.
Study of endometrial pathology in women with abnormal uterine bleeding
Authors: Varghese Jessy , J. Jeyashambavi , S. Deepa
Published: November 2018

Background: Abnormal uterine bleeding is one of the most common complaint that reproductive age women bring to their clinicians. Causes are varied and study of endometrium by dilatation and curettage with histopathological examination is an important aspect of treating patients with Abnormal uterine bleeding (AUB). The present study was done for evaluation of the histopathology of the endometrium for identifying endometrial causes of AUB.Methods: A prospective study was conducted over a period of one year from July 2017 to July 2018 in the department of Obstetrics and Gynaecology in collaboration with the department of Pathology at Aarupadai Veedu Medical College, Puducherry. A complete clinical history, complete clinical examination, laboratory investigations, pelvic scan and endometrial biopsy were done to diagnose causes of AUB.Results: A total of 152 cases are included. The age of the patients having AUB was ranging from 21 to 70 years. AUB was more common the age group in the age group 41-50 years (49%) followed by 31-40 years (36%). Majority were multiparous (74%). Menorrhagia (61%) was the commonest presentation. Majority of the cases showed a disordered proliferative endometrial pattern (34.2%), followed by secretory pattern (25%). 9.8% had polyp and 1.3% showed simple hyperplasia and 0.62% revealed complex hyperplasia without atypia and carcinoma endometrium.Conclusions: Abnormal uterine bleeding was more common in the perimenopausal age group and majority had disordered proliferative endometrium and secretory changes. Endometrial sampling followed by histopathological examination helps us to diagnose the underlying pathology and will help in treating the patients appropriately including ruling out premalignant and malignant conditions of the uterus.
Dengue infection in pregnancy and outcome in a tertiary care centre
Authors: L. Veena , Srinivas Srinivas , Aruna Aruna
Published: November 2018

Background: Dengue is a mosquito borne viral infection with significant disease burden across the country. With the recent resurgence of the disease, increasing number of people are affected including pregnant women. Risk of exposure is 1% in a given pregnancy in highly endemic areas. The objective is to study the morbidity and mortality profile of dengue in pregnancy on mother and neonate.Methods: It is a time bound retrospective study conducted on 25 pregnant women with positive dengue serology in Department of Obstetrics and Gynecology BMCRI Bangalore India between May to October 2016.Results: 25 seropositive dengue infected pregnant women were diagnosed in the period. Multiorgan failure leading to intrauterine fetal and maternal death occurred in one case of dengue shock syndrome at 28 weeks. Perinatal outcomes of the other cases were satisfactory. No cases of perinatal transmission to the neonate occurred.Conclusions: Pregnancies complicated by dengue infection needs close monitoring in a tertiary care for potential fetal and maternal complications. Early detection of the critical phase, with judicious fluid management can decrease the mortality and morbidity associated with dengue infection.
Analysis of maternal mortality at a government teaching hospital GMKMCH, Salem, Tamil Nadu, India: a retrospective study
Authors: G. Sridevi , L. Shanmugavadivu
Published: November 2018

Background: Mother is the pillar of the family. Maternal death is a great loss to the baby, family, society and country. Pregnancy although being considered as a physiological state carries risk of serious maternal morbidity and mortality . This is due to various complications that may occur during pregnancy, labour or thereafter. Maternal mortality ratio is a very sensitive index that reflects the quality of healthcare provided by the community to the women population.Methods: A retrospective study of 204 maternal deaths over a period of 56 months from July 2013-february 2018. Demographic data were collected from maternal death review form and records. Data studied and analyzed.Results: During the study period, there were 33968 deliveries and 204 maternal deaths with a MMR of 600.5/1,00,000 live births. Eclampsia was the leading direct cause of death. Anemia was the leading indirect cause of death. Most of the women died within 24 hours of admission suggesting that majority of patients reached the tertiary care hospital quite late. Majority of deaths occurred in the age group of 20-30 years and in postpartum period.Conclusions: Most maternal deaths are preventable by optimal utilization of existing MCH facilities, identifying the bottleneck in health delivery system, early identification of high-risk pregnancy and therein timely referral to tertiary care centre.
A study of pregnancy outcome in patients with cardiac disease
Authors: Kamble Pradnya D. , Bava Amarjeet Kaur
Published: November 2018

Background: Cardiac disease is a leading cause of maternal mortality and morbidity. Timely diagnosis and appropriate management can significantly improve the maternal and perinatal outcome.Methods: This prospective observational study was performed over a period of 18 months at a tertiary care centre in Mumbai. A total of 100 women with heart disease were included in the study. The subjects were followed up during the antenatal, intrapartum and postpartum period to study the maternal and perinatal outcome.Results: Out of 14791 confinements 100 consenting patients were included in the study. The incidence of heart disease came out to 0.9%. Rheumatic heart disease (RHD) was seen more commonly as compared to congenital heart disease (CHD) and peripartum cardiomyopathy. 64% patients delivered vaginally out of which 8% had instrumental delivery and 28% underwent a lower segment caesarean section (LSCS). 21% patients had cardiac complications like pulmonary edema, arrhythmias, sepsis, DIC etc. and there were 3 maternal mortalities. 58% of the babies were born low birth weight, 90.9% of the babies had an Apgar score of >7. 60% of the babies were born at term whereas 26% had a preterm delivery.Conclusions: Patients of cardiac disease with pregnancy need to be managed at a tertiary care centre by a multidisciplinary team of doctors. Early diagnosis of heart disease and stringent management of complication is of utmost importance. Vaginal delivery is favourable and LSCS should be performed for an obstetric indication. Maternal heart disease leads to an increased incidence of preterm delivery and hence a joint care of neonatologist is mandatory in managing these patients.
A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor
Authors: Sharma Reena , Sharma B. R. , Dogra Poojan
Published: November 2018

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone.
Outcome of pregnancy following IVF/IUI complicated by ovarian torsion: case reports
Authors: Sachdeva Garima , Gainder Shalini
Published: November 2018

Ovarian torsion though uncommon after in vitro fertilization (IVF)/ intrauterine insemination (IUI), but if not diagnosed early can lead to ischemic necrosis of the ovary. The reported incidence of ovarian torsion after IVF/IUI is 0.025-0.2% and is primarily attributed to controlled ovarian stimulation (COS). Here we present three case reports of ovarian torsion after IVF/IUI reported in a government hospital, India. The first case was referred to our institute after IVF with acute onset abdominal pain. Diagnosis of ovarian torsion was made. In this patient, ovaries could be salvaged by early diagnosis and intervention and she even delivered a 2.95 kg girl baby in the same pregnancy. The second case also followed IVF done in our institute and by early diagnosis and intervention, we could salvage the ovary. The third case followed IUI, but due to delayed presentation, the patient had to undergo ipsilateral salpingo-oopherectomy.  A total of 1562 IUI and 98 IVF were done at our institute last year, of which only one case each of IUI and IVF landed up in ovarian torsion. The significance of this article is to discuss the diagnosis and management of ovarian torsion and to reiterate the importance of early diagnosis and management.
Sildenafil citrate therapy in absent end diastolic flow in umbilical artery in an early onset fetal growth restriction (FGR) fetus
Authors: Choudhary Rana A. , Patrawala Khyati , Desai Kavita , Ganla Kedar
Published: November 2018

Fetal growth restriction (FGR), a pregnancy complication still poses as a challenge for obstetricians worldwide. This is because of its association with severe morbidity and mortality outcomes. Obstetrical management becomes a dilemma in determining the optimal time of delivery and weighing the risks of prematurity against the risks of a potentially hostile intrauterine environment. There may be placental insufficiency characterized by insufficient blood flow in the umbilical artery. This is termed as abnormal umbilical artery flow with absent or reversed end diastolic flow on Doppler USG. Worsening of this condition demands an earlier delivery of the fetus. Authors report a case of structurally normal foetus showing severe early onset FGR with absent end diastolic flow in umbilical artery on Doppler, which was managed using vaginal Sildenafil citrate. Sildenafil citrate led to improvement in uterine artery and umbilical artery Doppler parameters; thereby improving the utero-placental blood flow with a favorable fetal outcome at delivery. The gestation was prolonged by 51 days. Thus, Sildenafil citrate can be used as promising agent in early onset FGR in selected cases.
A case of methotrexate resistant gestational trophoblastic neoplasia
Authors: Singh Sanjay , Singh Akhileshwar , Vardhan Shakti
Published: November 2018

Gestational trophoblastic neoplasia (GTN) is a subset of gestational trophoblastic disease (GTD) which has a propensity to invade locally and metastasize. Patients with low risk GTN generally respond well to single agent chemotherapy (methotrexate (MTX) or actinomycin-D (ACT-D). However, high risk cases may develop resistance or may not respond to this first-line chemotherapy and are unlikely to be cured with single-agent therapy. Therefore, combination chemotherapy is used for treatment of these cases. Here we present a 25 years old P2 L2 A1 lady, who was initially treated at a peripheral hospital with multiple doses of Injection methotrexate with a working diagnosis of persistent trophoblastic disease. She didn’t respond to this treatment and reported to our centre for further management. On evaluation she was found to be a case of high risk GTN (invasive mole) (I:8) for which she was put on combination chemotherapy in the form of Etoposide-Methotrexate-Actinomycin-Cyclophosphamide-Oncovin (EMA-CO) regime. She responded to this treatment and is presently asymptomatic and is under regular follow up.
MRKH syndrome: a review of literature
Authors: Jain Nidhi , Kamra Jyotsna Harlalka
Published: November 2018

Primary amenorrhea is defined as failure to achieve menarche till age of 14 years in absence of normal secondary sexual characters or till 16 years irrespective of secondary sexual characters. The most common cause of primary amenorrhea is gonadal pathology followed by Mayer-Rokitansky-Küster-Hauser syndrome (MRKH syndrome). MRKH syndrome is a rare congenital disorder characterised by uterine and vaginal aplasia. It occurs due to failure of development of Müllerian duct. Its incidence is 1 per 4500 female births. Mostly girls present with primary amenorrhea. It is characterised by presence of normal secondary sexual characteristics, normal 46 XX genotype, normal ovarian function in most of the cases and absent or underdeveloped uterus and upper part (2/3) of vagina. It is of two types: type A is isolated type while type B is associated with other renal/skeletal/cardiac anomalies. Treatment includes psychological counselling and vaginoplasty. Vaginoplasty can be done by various non-surgical and surgical techniques. The authors hereby review the literature of MRKH syndrome regarding its embryology, etiopathogenesis, approach to work up and management.
A preliminary clinico-mycological study of dermatophytes infection
Authors: Tiwari Shivanshi , Kumar Deepesh
Published: November 2018

Background: Superficial fungal infections are the most common skin diseases, affecting millions of people throughout the world. Aim of the study was carried out to find, the effect of seasonal variation and socio-economic status on the prevalence of dermatophytes.Methods: A total of fifty clinically suspected cases of dermatophytosis were subjected to mycological studies.Results: Out of which 32 (64%) were culture positive Tinea corporis was the most common clinical type followed by Tinea cruris. Tricophoton rubrum 17/32 (53.12%) was the most common isolate followed by T. mentagrophytes 9/32(28.12%), T. tonsurans 3/32(9.37%), T. verrrucosum 2/32(6.25%) and T. schoenleinii 1/32(3.12%). Most of the patients belonged to the middle socio-economic group (28/50) followed by lower socio-economic group (19/50) maximum cases of dermatophytosis were reported from June to August revealing the fact that hot and humid weather during the monsoons has a great impact on the occurrence of dermatophytosis.Conclusions: It may therefore be concluded that dermatophytosis is now a days a serious public health problem in view of its high occurrence in the world wide population.
Prospective evaluation of causes of infertility at a tertiary care hospital
Authors: Soni Monica , Kumari Santosh
Published: November 2018

Background: Infertility is defined as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, its prevalence is approximately 8-12%. There are numerous factors such as anatomical, physiological, genetic, environmental and acquired factors that cause infertility. The aim of the present study was to determine the causes and clinical pattern of infertility in infertile couples in North West India.Methods: It was a hospital based observational study carried out on 211 infertile couples in reproductive age group attending infertility clinic of Sardar Patel Medical College and associated PBM Hospital, Bikaner, Rajasthan between September 2016-February 2017. Collection of data was performed by means of a specifically designed questionnaire, which apart from the demographic data also included questions concerning the causes of infertility. Cases of infertility diagnosed after detailed history, clinical examinations and laboratory tests were included.Results: Out of 211 infertile couples, female factor was predominant in 60.18%, male factor in 15.16%, unexplained in 15.16% while a combination of both factors was seen in 9.47% cases in our study. 33.17% women had ovulatory dysfunction diagnosed by menstrual history and ultrasonography. Tubal block was observed in 9.47% infertile women. 6.63% women had hypothyroidism and 1.89% infertile women were diagnosed to have endometriosis. Husband semen analysis was also done to assess male factor. Nearly 5.21% of their male partners suffered from oligospermia, 4.73% had azoospermia and oligoasthenospermia was observed in 3.79% male partners.Conclusions: Predominant cause of infertility can be reported in male or female partner or both so, either partner should be counselled and investigated properly. Our study reports a predominance of female factors as a cause of female infertility but male factors also accounted for a significant number of cases.
Knowledge regarding diabetes among expectant mothers attending ante natal clinic of a tertiary care institution of Kolkata: a cross sectional study
Authors: Biswas Prabir , Majumdar Das Sonali , Das Bibekananda
Published: November 2018

Background: Prevalence of gestational diabetes (GDM) has increased tremendously in India. Prevention of the condition is possible through health education. However, knowledge regarding diabetes is poor among Indian women. Thus, examining the basic knowledge regarding diabetes among expectant mothers is necessary to identify areas of deficit.Methods: An observational, analytical study of cross-sectional design was undertaken to assess the knowledge regarding diabetes among 173 expectant mothers attending the ante-natal clinic of R. G. Kar Medical College, Kolkata using a pre tested schedule.Results: Mean score of the respondents were less than 3 out of 8 which was a poor score. The overall mean diabetic score was similar for the antenatal mothers irrespective of the number of pregnancy (p=0.3154) but the score was greater than that for the non-pregnant women (p=0.0000). The expectant mothers showed better response compared to the controls when asked whether a person can have diabetes but be unaware of the condition; whether diabetes can harm a person’s body before diagnosis; long term complications of the disease(P<0.05). However, answers were similar across all groups with respect to queries like the age group in which the condition is more commonly diagnosed and whether diabetes is curable (p>0.05). The pregnant women had less reported leisure time physical exercise and first degree relative with diabetes (p<0.05).Conclusions: Mean knowledge score of the expectant mothers was more than the women controls though the overall score was poor. A structured awareness program is urgently needed which would first address diabetes in general and then the specifics of GDM.
Predicting the need for ventilatory support in organophosphorous compound poisoning
Authors: Philip Sudha Mary
Published: November 2018

Background: Organophosphorus compound poisoning is one of the most common poisonings often requiring ICU care and ventilatory support. Hence this study was undertaken to identify the factors, which predict the need for ventilation in these patients.Methods: All the patients who were diagnosed to have consumed organophosphorus compound poison admitted in RLJ Hospital and SNR District Hospital Kolar, Karnataka, India who presented within 24hours of consumption were included in the study. Patients with concomitant respiratory illness, double poisoning and those treated outside were excluded from the study.Results: A total number of 50 patients were studied. 30(60%) were males and 20 (40%) were females. 18 patients required ventilation. 100% of patients with respiratory rate>25 breaths/minute and 55% of patients with a fasciculation score of >4 required ventilation. Ventilation was required by 84.6% of patients who has a GCS Score of <10. 21.7% of patients with mild and 33.3% with moderate poisoning required ventilation. In contrast 66.6% of patients with severe poisoning required ventilation. Of the patients admitted to the hospital >4hours after consumption of poison, 36% required ventilation. Of the 19 patients who had oxygen saturation levels <89%, 18 patients (94.7%) required ventilation. Patients who were ventilated required a higher dose of atropine within 48hours of admission as compared to those who were not ventilated.Conclusions: Patients who presented with higher respiratory rate, accessory muscles of respiration in action, higher fasciculation score, GCS score of 10, greater lag time between consumption of poison and admission to hospital (4hours), severe grade of poisoning and O2 saturation <89% were more likely to require ventilation. There is no relationship between the age group, sex, pulse rate, pupil size and type of organophosphorous compound consumed with the need for ventilation.
Antibiotic susceptibility profile and extended spectrum β-lactamases production by uropathogenic Escherichia coli from tertiary care hospital of rural settings
Authors: Rahman Mustafa Sofiur , Garg Ritu , Singh Varsha A. , Biswas Dipankar
Published: November 2018

Background: Escherichia coli are the most common cause of urinary tract infections in community as well as hospital settings. Emergence of drug resistance in Escherichia coli due to various mechanisms makes the treatment options very limited. This study was undertaken to detect ESBLs in uropathogenic Escherichia coli isolates and to determine their antimicrobial susceptibility pattern in rural setting.Methods: A prospective study was done on 502 E. coli isolates from clinically suspected cases of urinary tract infections (UTI) patients of all age groups. All samples were inoculated on Cysteine Lactose Electrolyte Deficient Agar (CLED). Organisms grown in pure culture were identified by standard biochemical tests. Antibiotic susceptibility test was done by the Kirby Bauer Disc diffusion method on Muller Hinton agar. ESBL detection was done as per CLSI guidelines.Results: Of the 502 isolates of Escherichia coli, nitrofurantoin (82%) was found be most sensitive antimicrobial followed by amikacin (73%), gentamycin (71%) and imipenem (64%). Common empirically used antibiotics like fluroquinolones and Cotrimoxazole drugs showed alarming rate of resistance. 60% isolates were found to be multidrug resistant. ESBL production was detected in 31% isolates. ESBL producing strains were found to be more drug resistant than non ESBL producing strains.Conclusions: So, drug resistance due to production of ESBLs in Escherichia coli is a serious threat for clinicians. Strict infection control measures and early detection of beta lactamase producing isolates are the need of the hour to contain the emergence of this type of resistance.
Congenital constriction band syndrome: a case report
Authors: Kumar Sunil , Marwah Poonam , Marwah Ashish , Arya Ashish
Published: November 2018

Congenital constriction bands are anomalous bands formed during antenatal period that encircle a digit or an extremity in a fetus leading to a wide spectrum of manifestations, ranging from shallow grooves to acrosyndactyly and amputations. It is also associated with skeletal and other birth defects like craniofacial abnormalities, spinal dysraphism, porencephaly, hydrancephaly and visceral body wall malformations. We hereby present one such case which presented to us with below knee amputation of the lower limb and syndactyly.
Awareness and acceptance of family planning methods amongst women undergoing MTP: a prospective study in Himalayan region
Authors: Sharma B. R. , Dogra Poojan , Sharma Reena , Kaushal Sushruti
Published: November 2018

Background: Family planning services have important role in improving the quality of the lives of a couple and their economic welfare. The objective of the study was to assess the level of awareness and acceptance of different family planning methods among women undergoing to medical termination of pregnancy (MTP).

Methods: This study was done at IGMC KNSHM&C Shimla on 1168 women who reported for MTP in department of Obstetrics and Gynaecology. This study was conducted to find out the awareness about the contraceptive practices, source of information and knowledge, the most preferred method and impact of MTP on acceptance of contraception.  

Results: Majority about 97.5% had knowledge about the contraceptive methods and only 2.5% were unaware of any method. Source of information was health and family planning staff. The next source was friends, relatives and mass media, teaching institutions had least role. In spite of knowledge only about 49% were practicing contraception prior to MTP that too OCP and CC only.

Conclusions: Majority of women had optimal knowledge but only less than half of them were using contraceptives. Lacuna is still there, we need to educate and motivate couples to improve family planning services. There is a great need to strengthen the awareness, education and communication regarding various family planning methods in women of reproductive age group.
OLD FRISIAN INSULTS IN CULTURAL-HISTORICAL PERSPECTIVE
Authors: Pospelova K. V.
Published: November 2018

This paper discusses Old Frisian swear words used in the Medieval society to insult another member. These include 8 simplexes and compound words attested in the Old Frisian sources. The Old Frisian corpus can be characterized as a minor one, limited not only in terms of its volume, but also in terms of the genre spectrum. To be more precise, all Old Frisian texts, be that codices, charters or private letters, are related to the legal domain. As blood vengeance was widely practiced in the Middle Age Frisia, the continuous sequence of vendetta was limited through a compensation system covering a vast variety of illegal cases. The concept of honour was of great importance for the Frisians, and any offence was to be compensated in the court. At this, a persons honour could be offended not only through causing bodily harm or property damage, but through verbal insults as well.
The paper analyses four semantic groups of insults: insults related to or addressed to females; social status understatement; intellectual abilities understatement; comparison with animals. Each of the eight cases considered in the paper are discussed within a wider cultural-historical context. First of all, the female-related swear words are connected with, on the one hand, the pan-Germanic idea of female night spirits choking the sleeping person, or, on the other hand, emphasize the bastardly status of the addressee, which would negatively predetermine their position in the Frisian society. Secondly, the addressee could have been insulted by a direct statement of their limited or completely absent property, which would assert their low social status as well. Thirdly, and this case is still relevant for the contemporary world, an insult could have been based on a statement of the addressees limited intellectual capabilities. Finally, the fourth group includes designations of animals associated with aggression or indecency.
An analysis of Old Frisian swear words and their functions as insults in a wider context allows to touch upon and reflect basic linguo-historical features of the Old Germanic data despite the minimal volume of the lexical selection.
NON-LINEARITY AS SYSTEMIC PROPERTY OF FUNCTIONAL SPACE OF BUSINESS ENGLISH DISCOURSE
Authors: Ponomarenko E. V. , Parshutina G. A.
Published: November 2018

The article discloses the notion of non-linearity in terms of functional (pragmasemantic) characteristics of business English discourse. The authors support the traditional concept of linearity in reference to speech structural organisation; but at the same time they note that the formation of the sense system makes a much more multifaceted process than a successive addition of text components.Firstly, numerous links are established in a speech chain not only between adjacent units, but also between distant parts of the text. Secondly, even successive phrases acquire additional connotations and sense accretions, as in the course of speech build-up pragmatic and semantic components accrue as specific properties peculiar to this very context and disappear or transform in a different medium. Thirdly, such interaction of all the text elements results in generating new senses which the famous linguist, academician L.V. Shcherba, considered even more important than the text syntax. Thus, multisided and diverse discourse links and relations create its aggregate non-linear functional space, which actualises sense accretions on the principle of synergism (figuratively speaking, 2 + 2 = 5).The authors analise this phenomenon based on the examples of different business English registers. The authors come to the conclusion that irrespective of the genre, style, national variant of English the property of non-linearity is always realised in communicants actual interaction. This property must be used intentionally and appropriately for enhancing the efficiency of rhetoric impacts and harmonising partners interaction, especially in international communication.
«WE WILL WAKE THE SLEEPING DEPTHS OF EARTH UP!» (FROM THE HISTORY OF OIL DISCOVERY IN THE URAL AND VOLGA REGION)
Authors: Kuryatnikov V. N.
Published: November 2018

The article is devoted to the milestone event in the Russian oil industry history discovery of the 1stoil field in the territory of the Perm district of the Ural region in the village Verkhnetchusovskie Gorodki. In 1929 the oil availability in this landscape was established.
The objective of the study is to follow the effect of the report about the oil discovery in the Kama Region on Moscow and the subsequent based on this report deployment of oil prospecting works in the Ural and Volga Region, which has resulted in the foundation of the new 2ndoil base of the Soviet Union known as the 2ndBaku. The particular aim is to analyze different points of view on the interpretation of some questions of geological and productive nature associated with tchusovskaya oil. The next aim is to find out the effect of the oil discovery on the perspectives of development of the Perm Region, on the advancement of this region to the most important industrial regions of the USSR as well. The further aim is to follow in detail the massive program for development of the Tschusovskoye oilfield with identification of its strength and weaknesses. Moreover the aim of the study is to demonstrate the sweeping changes in the village life, leading to the development of the infrastructure, to the appearance of new plants in its territory and in the final analysis to the transformation of the village in the urban settlement.
The material in the article has proved that the using of administrative methods in takeover of lands for oil-field development has dominated. The result of the oil discovery was the acceleration in the rates of the collectivization in the district relating to the resettlement of oil industry workers from the southern regions of the USSR to this region.
The author has drawn a conclusion, that the value of the oil field Tchusovskie Gorodki is great, but not due to its oil production, but rather thanks to its role in the history of the oil industry development in the Ural and Volga Regions.
SOCIALISTS-REVOLUTIONARIES AND THE FIRST REVOLUTIONARY DEMONSTRATION OF THE XX CENTURY IN MOSCOW
Authors: Leonov M. I.
Published: November 2018

The article examines the first armed revolutionary demonstration initiated by the SRs on December 5–6, 1904 in Moscow, during which there were acute clashes and which, according to the level of preparedness, scope and immediate consequences, was a landmark event in the life of the ancient capital. The beginning of the Socialist-Revolutionary organization in Moscow at the end of 1896 was put by prominent figures of the Union of Socialist-Revolutionaries, founded in Saratov: Argunov, M.E. Argunova, S.I. Barykov, V.I. Evreinov, A.S. Martynov, V.N. Pereverzev, A.A. Chepik, N.M. Chernov. The Socialist-Revolutionary organization of Moscow by the end of 1904 was considered exemplary in the party of the Socialist Revolutionaries. It conducted active agitation among students, students, intellectuals, workers. In autumn 1904, given the worsening of social tension, the Moscow Committee of the Socialist-Revolutionary Party began organizing an armed demonstration, appointing it on December 5 and 6. Special hopes were placed on the workers of the Prokhorovka Manufactory. December 5, 1904 in the demonstration were involved about two thousand people, mostly students and intellectuals. During the demonstration, violent clashes occurred with the use of weapons, at this time more than 30 people were injured. In the demonstration on December 6, about 300 people participated.The demonstration on December 5–6 was sympathetically received by students and intellectuals. On the leaders of the dispersal of the demonstration, Grand Duke Sergei Aleksandrovich and D.F. Trepov, the SRs organized assassinations. The demonstration on December 5–6, 1904, was the first mass armed revolutionary manifestation in Moscow in the early 20th century. In 1905 armed clashes between demonstrators and government troops became commonplace.
SAMARA TOWN COUNCIL VS CENTRAL COUNCIL OF RESIDENTIAL QUARTERS: THE FINISHING TOUCHES TO THE FEATURE OF POLITICAL REGIME OF CONSTITUENT ASSEMBLY COMMITTEE MEMBER
Authors: Rynkov V. M.
Published: November 2018

Researchers define the political regime of Komuch as a democracy or a dictatorship that used democratic rhetoric as cover. To have a deep understanding of the problem the article considers a particular topic – a conflict of Samara Central council of residential quarters and Samara Town Council. In historiography, there are some different variants of the conflict events’ description and its interpretation.In summer 1917, Samara residential quarters emerged, and in spring 1918 they came into conflict with Soviet regime. Samara Central council was organized. After anti-Bolshevist take-over, the Central council of residential quarters got a subsidy from Samara Town Council and the rights to temporary perform some of its functions, but claimed to participate in making decisions on wider range of problems, actively interacted with government and military institutions. Towards the end of July – beginning of August 1918, Samara Town Council limited interference of quarters organizations in its work. Komuch flabbily resisted, then supported the Town Council. The Central council of residential quarters lost the subsidy and self-occupied premises, polled 0,5 votes during city elections, and left the political arena. Society and government referred the Central council of residential quarters to the democratic organizations, evaluating its position, but not lawfulness of its work and legitimacy of its origin.The author comes to the conclusion that Komuch was not able to develop a clear position concerning the place of voluntary organizations in the government structure, was a hybrid political regime (dictablanda), functioning without any distinct regulatory grounds.