bluuebunny/crossref_metadata_2025 huggingface dataset:
Low birth weight: an observational study of maternal and neonatal factors in a rural tertiary care hospital, Telangana, India
Authors: Nabhi Murty V. R. , S. Ramjyoti , B. Vydehi , K. Vasantha , Gillella Vijayalakshmi
Published: June 2021

Background: Poor maternal health among Indian women is of global significance because India is home to 1/5th of the world’s births. 27% of these newborn babies in India are low birth weight (LBW), an important cause of high infant mortality. This study was conducted among puerperal women who delivered LBW babies in our hospital to know the various factors pertaining to socio-demographic, obstetric and anthropometric characteristics.Methods: this observational study was conducted in the department of obstetrics and gynecology at Bhaskar medical college and hospital, Moinabad, Hyderabad from January 2016 to June 2017. The study sample were those who delivered LBW babies in our hospital and a set questionnaire was used to collect the relevant details.Results: 75% of these mothers were in the age group of 20-25 years, 73.5% had more than 10 years of schooling. About 64% of these women had their 1st antenatal visit in 1st trimester of pregnancy and 54% had their 1st ultrasound in 1st trimester. 36 babies had NICU admission, either at our hospital or at a level III NICU facility, and all had good neonatal outcome.Conclusions: The state must endeavor to make quality health free and easily accessible to pregnant women so that all can avail these services to better the maternal and neonatal outcomes. This will be helpful in improving the overall health of our population over the next few decades.
Maternal and perinatal outcome in pregnancy complicated by obstetric cholestasis: study from a tertiary care centre in North India
Authors: Jamwal Deepika , Kour Gurpreet , Mehta Anil
Published: June 2021

Background: Intrahepatic cholestasis of pregnancy (IHCP) is the most common pregnancy related liver disorder. It typically presents with troublesome itching and can lead to complications for both mother and foetus. Present study was carried out to study the incidence of Obstetric Cholestasis and its fetomaternal outcome in a tertiary care hospital.Methods: It was a prospective epidemiological study during a period of one year (May 2020 to April 2021) over 120 pregnant ladies suffering from pruritus and detected as having Obstetric Cholestasis. They were followed up and maternal as well as perinatal outcome recorded. Appropriate statistical analysis done as applicable.Results: The incidence of Obstetric Cholestasis in our hospital was 9.3%. Majority of cases delivered at term (78.3%). 41.6% patients delivered vaginally, 43.3% had emergency caesarean section, and 2.5% patients had instrumental delivery. Maternal morbidities are due to sleep disturbance (60%), coagulation abnormality (13.3%), increase chance of operative delivery (55.8%) and postpartum haemorrhage (12.5%). Neonatal complications include meconium aspiration (46.6%), NICU admission (36.6%), prematurity (5%) and perinatal mortality (3.3%).Conclusions: Cholestasis of pregnancy causes maternal pruritus with impaired liver function tests. Maternal morbidity is increased in terms of increased caesarean section rates and discomfort due to pruritus. A timely intervention at 37-38 weeks will reduce the adverse perinatal outcome.
Neonatal alloimmune thrombocytopenia: two different neonatal manifestations of the same disease
Authors: Pereira Miguel P. , Pinto Marta , Lucas Mafalda , Domingues Ana P. , Matos Cristina , Lima Jorge
Published: June 2021

Fetal and neonatal alloimmune thrombocytopenia is a rare disorder in which maternal alloantibodies cross the placenta and cause fetal thrombocytopenia. Most cases are mild but can be potentially fatal if there is an intracranial haemorrhage. Usually, the mother is asymptomatic during pregnancy and no screening is routinely recommended unless there is obstetric or family history. After birth, prompt identification is crucial so that the newborn is closely monitored and treatment is given, if needed, to prevent serious complications. In this article we present two clinical cases of fetal and neonatal alloimmune thrombocytopenia in first-born children, after uneventful pregnancies, with different outcomes and discuss the obstetric management and follow-up in future pregnancies.
Vulvar hamartoma in pregnancy: a case report
Authors: Mandrelle Kavita , Bhatti Sahir , Handa Shimul , Arnestina Sarah
Published: June 2021

Hamartoma is a benign lesion composed of various native tissues, but growing in a disorganized manner. It is not considered to be a malignant growth. It may be a diagnostic dilemma and challenge treatment options during pregnancy. We present the case of a rare vulvar hamartoma in a young pregnant woman.
Conservative surgical management of immediate post-caesarean uterine dehiscence and pelvis abscess due to proteus mirabilis infection: a rare complication of puerperal endomyometritis
Authors: Thyagaraju Chitra , S. Madhuri Makam , Yedla Deepthi , Papa Dasari
Published: June 2021

Cesarean delivery is the most commonly performed major abdominal operation in women with prevalence ranging from 12% in public sectors to 28% in private sectors in India (DLHS-3 survey). Parallel to this, the complications of surgery are increased. Among these complications, uterine dehiscence and pelvic hematoma with abscess collection is rare but serious complication which might end in hysterectomy. We hereby describe the conservative surgical management of a case of infected uterine incisional necrosis and dehiscence after primary cesarean delivery. We encountered a 25-years-old woman presenting to our emergency department (ED) with severe suprapubic pain and high-grade fever. She had an emergency cesarean delivery performed 14 days prior to presentation due to non-reassuring fetal heart rate. At the ED, ultrasonography revealed collection with septation around uterus with communication into uterine cavity. CT scan of pelvis was ordered and showed an intraperitoneal collection anterior to the uterus at the level of the uterine cesarean scar. Exploratory laparotomy showed a uterine rupture at the previous incision site. We performed resection of necrotic edges, peritoneal lavage, approximation of uterine edges with separate interrupted sutures, placement of a suction drain in the cul-de-sac. During postoperative follow up, patient was stable with no symptoms or signs of uterine/pelvic infection. Conservative management by drainage and resection of necrotic edges in addition to intravenous antibiotics may be considered as an option before resorting to hysterectomy in selected young patients.
May–Thurner syndrome causing deep vein thrombosis in the postoperative patient
Authors: L. Ashwini Vishalakshi , V. Meenakshi , Ganesh Amritha , P. Pallavee
Published: June 2021

May–Thurner syndrome is a rare cause of left iliac deep vein thrombosis due to an anatomical variant in which right common iliac artery overlies and compresses left common iliac vein against lumbar spine. Patients with May–Thurner syndrome usually present in their 2nd to 4th decade of life. Pregnancy and intra-abdominal surgeries are known precipitating factors in acute May–Thurner syndrome. We report the case of a woman in her 3rd decade of life who presented with May–Thurner syndrome following total abdominal hysterectomy. This case report hopes to bring attention to the high variant of patient population with May–Thurner syndrome and the necessity for surgical intervention of stent placement to prevent recurrence.
Acromegaly incidentally diagnosed at term in a pregnant woman presenting with ventricular premature complexes
Authors: Nair Aiswarya K. , Sagili Haritha , Dorairaj Jayalakshmi , Parvathi T.
Published: June 2021

Pituitary adenomas lead to increased growth hormone production and acromegaly. Pregnancy in acromegaly is rare as spontaneous conception is affected. We presented a case of 31 year old lady conceived by ovulation induction and presented at term gestation with ventricular premature complexes and was subsequently diagnosed with pituitary micro adenoma causing acromegaly. There has been no reported case of pregnancy with acromegaly presenting with premature ventricular complexes. Moreover, diagnosis of acromegaly in pregnancy is difficult and limited literature is available on its effects as well as management.
Angular pregnancy: an under-recognised entity presenting with retained placenta
Authors: Rajbhar Sarita , Keshkar Minu
Published: June 2021

Retained placenta accounts for most of the cases of postpartum haemorrhage and occurs commonly due to contracted lower half of uterus and closed os, it can rarely also occur if it gets trapped at the cornua of the uterus due to angular implantation. A 26 year old P3L3 was got referred for retained placenta, she was diagnosed with angular pregnancy after laparotomy after manual removal failed, she was managed with hysterotomy. Angular pregnancy may lead to preterm delivery and trapping of the placenta.
Role of intra-abdominal pressure monitoring in the management of patients with blunt injury abdomen
Authors: Punyapu Sridhar , Naredla Mallesh , Kola Chandrasekhara Reddy , Adusumilli Niharika , Gudimetla Prerana Raju
Published: June 2021

Background: Blunt injury abdomen is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. The aim was to study the role of intra-abdominal pressure (IAP) monitoring in the management of patients with blunt injury abdomen.Methods: Hospital based prospective observational study in 77 patients who presented to emergency medicine department with blunt injury abdomen for over a period of 22 months. Age ≥18 years, patients with acute blunt injury abdomen are included in study.Results: Our study population (77 patients) were a group of patients who presented with blunt injury to abdomen, out of which 66 were male (85.70%), 11 were female (14.30%). Most common age group involved in our study was 20-30 years, mean time of presentation to the hospital was 7.40 hours. SBP, DBP, SpO2 decreased significantly as IAP increases. P. R., R. R. increased significantly as IAP increases. U/O decreased significantly as IAP increases. Sr. Cr, B.U. increased significantly as IAP increases. Surgical abdominal decompression had helped in all operated patients to get statistically significant decrement of IAP during initial post-operative hours. 12 patients required ventilator support in surgically intervened group. Mean duration of hospital stay was 8.025 days. Mortality rate in our study was 3.9%.Conclusions: Before development of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS), the potential candidates should be offered surgical decompression at proper time.
Loose knots and surgical site infections in abdominal surgeries (clean-contaminated and contaminated wounds)
Authors: Madhusudhan Napa , Prabhakar R.
Published: June 2021

Background: Surgical site infections (SSIs) are associated with high healthcare costs and worsen the post-operative course of a considerable proportion of general abdominal surgical patients. SSIs raise the risk of post-operative morbidity and mortality, necessitating hospitalization, intravenous antibiotics, and potentially surgical reintervention. The aim of the study was to compare the outcome of intermittent loose knots and the conventional vertical mattress suturing in patients undergoing abdominal surgeries.Methods: This prospective comparative study was done in patients undergoing emergency abdominal surgeries for any cause. Patients were divided into 2 groups- (a) group 1 (45 patients): intermittent loose knots between conventional vertical mattress sutures; (b) group 2 (45 patients): conventional vertical mattress suturing.Results: In this study, 31% of patients were in the 41-50 years age group, 53.3% of patients were male. Among various abdominal surgery opted, laparotomy was the most commonly performed procedure (47%). In this study, group 1 patients shown a decrease in wound gap, secondary wound closure and delayed wound approximation than group 2 patients.Conclusions: Loose knots in between conventional vertical mattress sutures are better than conventional vertical mattress suturing in terms of wound gap, secondary wound closure and delayed wound approximation.
Laparoscopic common bile duct exploration with primary closure over an ante-grade biliary stent-our experience
Authors: Bashir Aarif , Jeelani Shaukat , Zaffar Saniya
Published: June 2021

Background: Aim of study was the assessment of laparoscopic common bile duct (CBD) exploration with primary closure over an ante-gradely placed endo-biliary stent for CBD stones in terms of operating time, rate of conversion to open procedure, hospital stay, postoperative complications and residual disease.Methods: Our data was analysed retrospectively over a period of 5 years (2015-2020) on all the patients who underwent laparoscopic CBD exploration with primary closure over an ante-gradely placed endo-biliary stent followed by cholecystectomy at SMHS hospital, Srinagar, J and K, India. Total of 30 such patients were identified.Results: The mean procedure time was 93.5±23.16 minutes. There were no intra operative complications encountered in the study. Four patients were converted to open (13.33%). The mean duration of hospital stay was 4.56±1.99 Days. The total number of patients that developed post-operative complications was 7 (23.33%). The most frequently encountered post-operative complication was stent migration (13.33%). The next most common post-operative complication was minor biliary leak (10%) which resolved spontaneously. There was no mortality experienced during the study. Two patients (6.66%) had residual stones and 28 (93.33%) patients had complete clearance of the CBD.Conclusions: Laparoscopic CBD exploration with primary closure over an ante-gradely placed endo-biliary stent is a feasible option and is a safe procedure. Endoscopic removal of the stent can safely be done after an interval of 6-8 weeks.
Prophylactic lumboperitoneal shunt in cases of cerebral venous sinus thrombosis with papilledema
Authors: Ranade Deepak , More Bhagirath , Kashyap Dushyant , Raghu Vybhav , Chhabra Shobhit
Published: June 2021

Background: Although the mainstay of cerebral venous sinus thrombosis treatment is medical, rarely surgical intervention is warranted. We aimed to determine the role of prophylactic lumbo-peritoneal (LP) shunt in cases of CVST with papilledema.Methods: This is a retrospective review of 70 cases of CVST managed between November 2019 to April 2020. Indications for surgical management included poor response to medical management and severe vision impairment.Results: The mean age of the patients included in the study was 39.44±4.76 years. The most common presenting complaint was headache (83%) and nausea/vomiting (69%). On examination, the common findings were papilledema (57%), blurred vision (31%), double vision (21%) and hemiparesis (11%). Two cases had sudden loss of vision, who underwent emergency LP shunt surgery. Of the 40 cases with papilledema, 8 had severe papilledema. Based on MRI venography, transverse sinus was involved in half of all patients, superior sagittal sinus was involved in 29% and 21% had both the sinuses involved, while 7% had cortical vein thrombosis. Anticoagulants was the first line of therapy for the patients. Papilledema was present in 40 cases, of which 10 showed complete resolution of symptoms, 15 cases had reduced severity of symptoms and symptoms persisted in rest of the 15 cases. The 10 cases who had complete resolution of symptoms included two patients who underwent LP shunt. There were no deaths.Conclusions: We recommend that a LP shunt insertion in a patient with severe papilledema with superior sagittal sinus thrombosis can prevent disease progress, preserve vision and facilitate re-canalisation.
A randomised study to evaluate wound outcome following delayed primary vs primary closure of skin in duodenal perforation peritonitis
Authors: Gupta Sajal , Bhandari Vimal , Dubey I. B.
Published: June 2021

Background: This study aimed to evaluate wound outcome following delayed primary versus primary closure of skin in duodenal perforation peritonitis.Methods: The present study was a randomised interventional study that included 90 patients on accrual of duodenal perforation peritonitis which were divided into primary closure (PC) and delayed primary closure (DPC) groups comprising 45 patients each. The outcome measures were complications, surgical site infections, hospital stay and final wound status during the follow up of 30 days. Data collected was compared taking P-value <0.05 as significant.Results: The patients were in the age group of 12–60 years, with men in majority in both groups. Mean SSI score in PC and DPC was comparable (2.67 SD 1.58 vs. 2 SD1.61, P=0.058). SSI was more in PC group than DPC group (11.11% vs. 2.22%, P<0.05). Wound/pus culture was positive in 62.22% in PC and 46.67% in DPC. Major complications like wound dehiscence was noticed mainly in PC group while minor Complications like Stitch abscess, granuloma, sinus was more in DPC group. Mean of duration of stay (days) was comparable between PC and DPC group (14.07 SD 7.64 vs. 13.96 SD 6.94, P=0.805). Final wound outcome after 30 days was healthy scar in majority of patients in PC and DPC group (57.78% vs. 66.67%) with no significant difference between them (p=0.434).Conclusions: In conclusion, DPC showed comparable results with PC with similar SSI and wound healing without significant complications.
Satisfaction level in patients with nasal bone fracture following closed reduction: a follow-up single-centre study from New Delhi, India
Authors: Kaladagi Raghavendra , Gupta Madhusoodan , Johar Manoj K. , Saleem Abid , Singh Pradeep K. , Chandra Rohit , Rathore Deepak , Shrivastva Vaishali , Varshney Deepti , Biswkarma Vishal K.
Published: June 2021

Background: Nose, because of its prominence and central location in the face is more prone to injury. Nasal bone fractures (NBFs) are one of the most common fractures in patients with maxillofacial injuries. The closed reduction of NBFs is well documented and results in varied clinical outcomes. There is paucity over detailed reports on patient satisfaction in terms of functional and aesthetic aspects as well as the reasons for dissatisfaction of the same.Methods: We had conducted a prospective cohort study of previously treated patients to evaluate the postoperative functional and aesthetic outcomes like patient satisfaction following closed reduction of NBFs in the department of plastic surgery.Results: The average age of patients was 40.61 years (SD±15.83), of which 63.7% were male and 36.21% female. The major cause of fracture was found to be RTA (55.17%). The satisfaction as happy (9-10 score) reported by 60.34% patients for functional aspect and 41.38% patients for the aesthetic aspect of closed reduction of NBFs.Conclusions: Our study demonstrated comparatively good satisfaction results in terms of functional and aesthetic aspects following closed reduction. Closed reduction technique of nasal bone fracture is simple, safe, and easy to perform with minimal potential morbidity.
The clinical efficacy of laboratory risk indicator for necrotizing fascitis score in early diagnosis of patients with necrotizing fascitis
Authors: Chowdary Murakonda Sowmya , D. Srinivasan , N. Sreeramulu P. , Pawar Tejaswini M. , K. Krishna Prasad
Published: June 2021

Background: Necrotizing fasciitis is a rare, rapidly progressive infection which causes extensive necrosis of the fascia and subcutaneous tissue. Early recognition and debridement are major prognostic determinants, and delay has been shown to increase mortality rate. We describe a novel, simple, and objective scoring system, the laboratory risk indicator for necrotizing fasciitis (LRINEC) score, based on routine laboratory investigations readily available at most centres, that can help to distinguish necrotizing fasciitis (nec fasc) from severe cellulitis or abscess.Methods: We performed a single centre, retrospective, all patients treated at the RLJ Hospital for necrotizing fasciitis between January 2017 and December 2019 were included in this study. The outcome of the study was based on comparing LRINEC score and Wang and Wong staging, which is useful to detect necrotizing fasciitis severity.Results: In our study, males were predominantly affected more common in lower limbs followed by perineum and abdominal wall in their fifties with diabetes mellitus and hypertension as dominant co-morbid diseases. In the study among subjects with high risk score, 83.3% required ICU stay, among subjects with moderate risk, 16.7% required ICU stay and among subjects with low risk, 12.5% required ICU stay.Conclusions: All patients with higher LRINEC scores and who were classified as ‘high risk’ in Wang and Wong classification required ICU stay and significant association with mortality rate.
Study of ergonomics in terms of angle of manipulation and angle of azimuth in laparoscopic splenectomy
Authors: Joshi Gaurav , Baig Khaja Abdul Moin , Chaturvedi Aparajita , Jayaram Jnaneshwari , Rathore Yashvant S. , Chumber Sunil
Published: June 2021

As per baseball diamond concept of port position, experimentally it is well known that putting camera port in the line of target organ and working port equidistant from camera port such that they form a 30º angle each gives optimum ergonomic advantage. However while performing laparoscopic surgeries in humans it is seldom possible to achieve such port position. No such study  has ever been attempted to find out value of angle of manipulation and angle of azimuth while performing laparoscopic procedure. Purpose of our study was to measure such angles in our patients during laparoscopic splenectomy (LS) and to verify the concept of baseball position of ports in the procedure. This was a prospective observational study where angle of manipulation between right and left working port of surgeon and angle of azimuth of both working instruments with the camera were measured intraoperatively. In our series of 12 patients who underwent LS in lateral position, we found angle of manipulation ranging from 41-85°. The azimuth angle between first working port (epigastric) and camera port was in the range of 22-45° and the azimuth angle between camera port and second working port was in the range of 19-40°. This was a first study that gave valuable insight into the application of theoretical concept of triangulation in port placement in LS. This study may guide the surgeons to measure and to modify the port position to gain advantage of better ergonomics and better long term health.
Leiomyoma an uncommon benign esophageal tumor
Authors: Abid Ambreen , Ahmad Tanveer , Mazcuri Misauq , Sikander Nazish
Published: June 2021

Leiomyoma are rare esophageal masses. Majority remain asymptomatic but may present with dysphagia when more than five centimeters in size. Barium swallow is the initial diagnostic investigation. Small lesion can be observed. Symptomatic and large lesion should undergo prompt surgical enucleation. Here we presented a case of a 35 year old female presenting with progressive dysphagia and gradual weight loss for 5 years along with regurgitation for one year. Clinical examination was unremarkable. Barium study was suggestive of smooth intramural defect with normal mucosa. Computed tomography showed well defined homogenous opacity located intramuraly at the level of junction of middle and distal third of esophagus with normal surrounding structures. Surgical enucleation was done through a right posterolateral thoracotomy. Muscle defect was repaired and checked for possible leaks. Liquid diet was commenced on 5th postoperative day. Patient was discharged on semisolid diet for two weeks with progression to solid meal.
Pelvic actinomycosis mimicking an advanced ovarian carcinoma: a rare case report with review of literature
Authors: Adhlakha Bhuvan , Khageshan Ashwin P. , Pradhan Supriya , Singh Anil Kumar
Published: June 2021

Actinomycosis is a rare subacute to chronic granulomatous bacterial infection caused by actinomyces species. Pelvic actinomycosis is rare, often pretends to be malignant and therefore it is difficult to diagnose preoperatively. Here we discuss a case of a 45-years-old female who was operated for a pelvic mass thought to be malignant, but on histopathological examination it turned out to be a case of ovarian actinomycosis.
Superficial venous aneurysm of the great saphenous vein: a case report
Authors: Patel Jayesh , Patel Arya , Patel Akash , Barot Ketul S.
Published: June 2021

Superficial venous aneurysms are rare clinical entity. They can remain asymptomatic to be detected incidentally or can present with pain. They can be readily diagnosed by duplex ultrasonography or discovered only during surgical exploration. The objective of this clinical case report is to highlight this rare occurrence and avoid misdiagnosis. A 69-year-old male presented at our tertiary care hospital with complaints of pain and swelling which was gradually increasing in size. Initially it was misdiagnosed to be femoral hernia, and the diagnosis of Great Saphenous Vein aneurysm was made following duplex ultrasonography. Following which, the patient underwent successful surgical excision.
Bowel obstruction in obturator hernia: a challenging diagnosis
Authors: Chemmangattuvalappil Nimisha Ramachandran , Pulluvelil Babu John , Chirukandath Ravindran , Thekoot Santosh Vijayan , Sebastian Bobby
Published: June 2021

The obturator hernia is a rare pelvic hernia that presents as bowel obstruction caused by the presence of an intestinal segment, more often ileum passing through obturator foramen. This type of hernia accounts for 0.5-1.4% of all hernias. We reported the clinical case of a 74 year old woman with no previous surgical interventions, presented to ER with abdominal pain and distension, features of intestinal obstruction, which she had experienced for previous three days. A CT scan revealed a right jejunal, obstructed obturator hernia. The patient underwent an emergency surgical intervention with emergency exploratory laparotomy and repair. This case was presented as obturator hernia was a rare type of hernia due to its diagnosis, which is often unclear with non-specific pain radiating to legs mimicking neurological symptoms. A prompt suspect based for the non-specific symptoms is crucial for the diagnosis. Surgical management depends on early diagnosis and it is the only possible treatment for this pathology.
Laparoscopic transabdominal preperitoneal repair of concurrent spigelian and groin hernias: a rare case
Authors: Oak Aditya C. , Kalikar Vishakha R. , Patel Ankur K. , Patankar Roy V.
Published: June 2021

Spigelian hernia is a rare type of abdominal wall hernia due to congenital defect in the transversus aponeurosis fascia. It has a prevalence of 2%. Traditionally, an anterior hernioplasty was used to repair these defects. Only a few cases have been reported in the literature. Here we discuss a case of a 66 year old female with chronic lower abdominal pain with swelling in left inguinal area diagnosed with spigelian hernia on ct scan along with left direct hernia as well as left femoral hernia found incidentally and repaired using totally extra peritoneal single mesh repair.
A rare case of abnormally high thoracic duct in neck
Authors: Padegaonkar Amol , Sehgal Anushree , Agrawal Shambhunath
Published: June 2021

Thoracic duct injury can be a cause of significant morbidity if its injury remain undiagnosed during surgery. Knowledge of its course and anomaly should be known to prevent its injury. Presenting a case of 40 year male who was diagnosed to have left buccal mucosa squamous cell carcinoma. During neck dissection, anomalous thoracic duct was found much above the omohyoid muscle. Adequate steps were taken to prevent injury to it. It is necessary to acknowledge thoracic duct and prevent its injury during neck dissection.  Knowledge about its anomalous path should be known to prevent its injury. Valsalva manoeuvre should be done at the end of neck dissection to find and thoracic duct injury by observing chyle leak and adequate measures should be taken immediately to prevent morbidity associated with it.
Goel’s technique of laparoscopic hysterectomy for endometrium carcinoma
Authors: Goel Vipin
Published: June 2021

The laparoscopic hysterectomy is the preferred choice in performing a hysterectomy in endometrial carcinoma. It is a great alternative to abdominal hysterectomy. The need for proper training, availability of adequate tools and infrastructure are some problems which have affected its wider reach in practice. The operating time required is more compared to abdominal hysterectomy but the merits of laparoscopic hysterectomy outweigh these problems. This technique has shown promising results due to a reduction in postoperative complications, hospital stay and a quick return to normalcy. This article described the technique of performing laparoscopic hysterectomy which the surgeon has introduced and has been practicing for the last few years. It is known as Goel’s technique after the name of the surgeon who had first described and successfully executed. This technique encompasses 10 operative steps which are fixed in a way to carry out laparoscopic hysterectomy in safe manner. It emphasizes the identification of anatomical structure before cutting down. The main attribute of this technique is that this procedure operates without the use of vaginal manipulators or Myoma screws which carries the risk of spreading malignancy in the systemic circulation. This technique has highlighted the safety factor during the operation. The technique is easy to understand for surgeons and has been well received in the patients.
Simplificando vidas: qualidade e satisfação com os serviços públicos: estados do Brasil 2018
Authors: Pareja Alejandro , Fernández Cecilia , Tawata Flora
Published: June 2021

O projeto Simplificando Vidas visa melhorar a prestação de serviços públicos, através da geração de conhecimento acionável sobre simplificação administrativa, digitalização e atendimento ao cidadão. Esta publicação corresponde à sua terceira medição (a primeira para o Brasil) realizada no primeiro semestre de 2018. Tem como foco os procedimentos-chave para as pessoas (em oposição aos das empresas), que so estudados sob duas perspectivas: a da oferta (como os órgãos responsáveis por cada processo gerenciam a qualidade) e a da demanda (como é a experiencia do usuário, ou seja, a satisfação cidadã). Com a mesma metodologia, cinco procedimentos de alto impacto para nossas vidas foram analisados em cinco estados do Brasil. As informações recolhidas mostram que, em média, houve uma satisfação cidadã levemente positiva e superior à média da América Latina; que o que os brasileiros mais valorizam é a eficiencia dos funcionários e o tempo que levou o procedimento; que houve já antes da pandemia de COVID-19 uma demanda reprimida por interação digital; e, finalmente, que existia uma variabilidade significativa em tempos y custos, o que se traduz em injustiças contra os cidadãos de diferentes estados.
Cultural Norms of Greetings in the African Context
Authors: Wojtowicz Beata
Published: June 2021

Knowledge of a foreign language facilitates communication. In order to be fluent in a foreign language, it is not enough to learn its words and grammatical rules, but one has to also be aware that there are additional, culture-bound norms that govern communication practices among various language groups. Even if one is not fluent in a foreign language, it is possible to make communication successful by applying appropriate non-verbal behaviour. In this article, I present communicative culture-related greeting rules among different African communities. I focus on the main factors that govern acts of greeting in different African languages.
Na styku religii, kultur i języków, czyli o polemicznych aspektach Paterykonu Sylwestra Kossowa
Authors: Hawrysz Magdalena
Published: June 2021

W opracowaniu obserwacji poddano szczególny zabytek ze zbioru poloników kijowskich, tj. Paterikon abo żywoty ss. Oycow pieczarskich Sylwestra Kossowa. Jest to piśmienne świadectwo wielokulturowości dawnej Rzeczpospolitej oraz wielopłaszczyznowych relacji polsko-ruskich. Celem szkicu jest wskazanie generycznych elementów polemiki z poziomu kompozycji i pragmatyki tekstu oraz identyfikacja podporządkowanego im repertuaru środków językowych realizujących perswazyjne cele tekstu polemicznego. Analizy pozwoliły wskazać, że polemiczny charakter utworu widać zarówno w strukturze tekstu, gdzie dominują elementy refutacji, jak i w specjalnym użyciu języka, związanym przede wszystkim z probacją. W tym drugim obszarze ujawniono dwie globalne strategie komunikacyjne: uwiarygodnienie treści (na które składa się powoływanie się na źródła historiograficzne i dokumenty oraz dokonywanie zabiegów etymologizujących) oraz apoteoza osób i miejsca (którą realizują strategie osadzania przekazu w przeszłości, odwołanie do genealogii, maksymalizacja cnót świętych, sakralizacja zakonnej rzeczywistości). Wśród środków perswazyjnych znalazły się m.in. sylogizmy, argumentum ad verecundiam, argumentum ad baculum, argument z tradycji, wyliczenie, kontrast. Sposób ukształtowania tekstu na opisywanych poziomach potwierdza wspólnotę europejskiej kultury retorycznej, a z Kossowa czyni modelowego reprezentanta humanistycznych wartości i sposobów ich wyrażania.
Методические особенности развития координационных способностей у девочек 10- 12 лет на внеурочных занятиях с элементами художественной гимнастики
Authors: Ахмедова К.О.
Published: June 2021

В статье рассмотрена и оценена эффективность применения методически правильной организации техники работы с мячом и лентой с использованием ручных утяжелителей в учебно-тренировочных группах для наиболее оптимального развития координационных способностей у девочек 10-12 лет в учебно-тренировочных группах с элементами художественной гимнастики в течение одного учебного года в период с сентября 2020 по май 2021 года. В исследовании принимали участие гимнастки учебно-тренировочной группы 1 года обучения в возрасте 10-12 лет и имеющие 2 и 3 спортивный разряд. Показана целесообразность применения данного подхода, что выразилось в повышении координационных способностей гимнасток, значительном улучшении их работы с предметом и технической подготовленности гимнасток в бросковых элементах.
К вопросу об обучении чтению и выполнению схем электрических в курсе инженерной графики в вузе
Authors: Басс Н.В. , Эманов С.Л.
Published: June 2021

Рассмотрена содержательная сторона обучения студентов вузов чтению и выполнению схем электрических принципиальных. Показано значение освоения данной темы в курсе инженерной графики для успешной профессиональной деятельности будущих инженеров. Представлены практические задания, позволяющие оптимизировать учебный процесс исходя подготовленности студенческой аудитории.
Психологические и педагогические особенности интерактивного обучения детей 5- 8 лет
Authors: Захарова Л.М. , Липицкая Ю.В.
Published: June 2021

В статье рассматриваются вопросы и особенности интерактивного обучения детей 5-8 лет. С помощью сравнительной оценки доказывается эффективность влияния интерактивной формы обучения на глубокое усвоение знаний, повышение мотивации к учению, а так же на психологическое самочувствие и здоровье детей.
Устойчивое развитие и решение деловых ситуаций на занятиях по иностранному языку
Authors: Калинина В.Д.
Published: June 2021

Данная статья обсуждает работу по активизации понимания об устойчивом развитии у студентов неязыкового вуза во время решения деловой ситуации на занятии иностранным языком. Являясь комплексным заданием кейс способствует развитию критического и творческого мышления у студентов через участие в разнообразных действиях, ведущих к решению проблемы.
Пути совершенствования системы аттестации государственных гражданских служащих и оценка эффекта от их реализации
Authors: Масько К.А. , Мамин А.С.
Published: June 2021

Данная статья направлена на рассмотрение отдельного процесса, происходящего в институте государственной службы- аттестацию государственных гражданских служащих, а именно пути совершения данной процедуры. Авторы предлагают ряд рекомендаций, которые позволят совершенствовать данную процедуру.
О необходимости формирования компетенций руководителей образовательных организаций в области командообразования
Authors: Петренко А.А.
Published: June 2021

В статье обосновывается потребность развития способностей руководителей образовательных систем к управлению педагогическими коллективами на принципах командообразования.
Воспитание патриотизма в процессе изучения природы родного края
Authors: Савватеева Ю.С.
Published: June 2021

В статье предпринята попытка решения актуальной для российского общества проблемы патриотического воспитания подрастающего поколения, рассматриваются пути организации данного процесса с младшими школьниками и использования краеведческой деятельности. Обобщен и представлен практический опыт автора статьи по созданию рекламного плаката об озере Байкал.
Использование электронных образовательных технологий в процессе обучения иностранных студентов в режиме онлайн
Authors: Синичкина О.В. , Андронова Т.А. , Дурнова Н.А. , Белоногова Ю.В. , Белянина С.И.
Published: June 2021

В работе представлен опыт преподавания биологии иностранным студентам 1 курса медицинского вуза, обучающихся по билингвальной программе. В дистанционном режиме обучения необходимым условием успешного обучения иностранных студентов является использование современных информационнообразовательных технологий. Обозначен круг технологий, применение которых целесообразно в данной ситуации, выявлены их сильные и слабые стороны, показаны конкретные примеры применения той или иной технологии для решения локальной задачи.
Классификация методов психологии управления
Authors: Ковтун Е.А. , Удалов Д.Э.
Published: June 2021

В статье дается определение и характеристика метода психологии управления, в контексте комплексного понимания способов регулирования деятельности и поведения человека в процессе управления. Рассматриваются основные концепции прикладных разделов психологии, раскрывающие и классифицирующие методы, используемые в психологии управления.
Взаимосвязь безработицы и инфляции – как факторов макроэкономической нестабильности
Authors: Боробов В.Н.
Published: June 2021

В научной статье раскрывается сущность, причины и виды безработицы. Довольно подробно рассматриваются различные подходы к безработице с точки зрения экономических школ. Раскрываются основные причины безработицы и инфляции. Предлагается комплекс мер антициклического регулирования, а также мероприятия по снижению безработицы.
Роль социальной работы в решении социальных проблем
Authors: Умархаджиева С.Р.
Published: June 2021

В данной статье рассматриваются ключевые моменты социальных проблем, с которыми сталкивается в повседневной жизни человек. И какое место занимает социальная работа в решении этих проблем.
Некоторые особенности структурно - морфологической реорганизации миокарда при гипотермических поражениях. Перспективы дальнейшего изучения
Authors: Корсиков Н.А. , Лепилов А.В. , Бобров И.П. , Долгатов А.Ю.
Published: June 2021

В данной статье представлен обзор литературы, касающийся структурной реорганизации миокарда в условиях воздействия на организм низких температур. В настоящее время изучению вопроса воздействия низких температур на сердечную мышцу человека и животных посвящено большое количество исследований. Основное место в этих исследованиях отводится диагностике и дифференциальной диагностике общего переохлаждения при сочетании этого вида смерти с различными интоксикациями, заболеваниями и иными состояниями. Однако несмотря на большое количество опубликованных на данный момент работ изучение процесса танатогенеза в результате воздействия низких температур от переохлаждения остается сложным и малоизученным процессом. Накопленные знания позволяют сделать вывод о том, что специфических признаков встречающихся во всех 100% случаев смерти от гипотермии не существует. Любой признак, характерный для гипотермии, хотя бы в единичных случаях встречается и при других причинах смерти. На данный момент практически неизученными остаются морфологические изменения происходящие в ядрах кардиомиоцитов.
Налоги и платежи в системе природопользования России
Authors: Бекмурзаева Р.Х. , Джандарова Л.Х.
Published: June 2021

В статье обозначено, что именно представляет собой экологический налог. Также здесь изучаются: функции, системы и разновидности выплат, нюансы регулирования оплат за отрицательное влияние на окружающую среду; замена выплат за отрицательное воздействие на окружающую среду соответствующим налогом, который укрепляет законность в области администрирования бюджетных поступлений; тенденции экологизации законов; примеры областей РФ с сильным загрязнением.
The adaptive potential of workers in greenhouse farms in the Voronezh region
Authors: Yatsenko L.A. , Dzen N.V. , Gabbasova N.V. , Mamchik N.P.
Published: June 2021

Adaptive potential is an indicator of the level of adaptability of the human body to various and changing environmental factors. The adaptive capabilities of the body are influenced not only by external factors, but also by internal - the state of the body as a whole, by the presence or absence of chronic diseases. Therefore, the adaptive potential was used as an integral indicator of a person's adaptability to production factors. The aim of the study was to assess the adaptive capabilities of the organism of workers in greenhouse farms in the Voronezh region. The study was carried out at the enterprises of the closed ground of the region by the method of questioning, the objects of the study were 125 women aged 27-45 years. In most cases, there are violations of the adaptive capabilities of the organism among the studied workers of greenhouse farms, and even a breakdown in adaptation was revealed in 0.8%. In less than half of the cases, the adaptive potential of the greenhouses was within the normal. The adaptive reserves of the greenhouses workers decrease with age.
Анализ индивидуальной предпринимательской активности населения в субъектах Российской Федерации
Authors: Чижова Л.А. , Ласкин А.А. , Лец О.В.
Published: June 2021

В статье на основе официальных данных Федеральной налоговой службы и Росстата проведен анализ показателей индивидуальной предпринимательской активности населения субъектов Российской Федерации, построены матрицы позиционирования в координатах «Доля индивидуальных предпринимателей в экономически активном населении страны - Доля самозанятых физических лиц в экономически активном населении страны». Авторы отмечают, что для индивидуальных предпринимателей сегодня существует широкий спектр государственной поддержки и акцентируют внимание на проблеме её практического отсутствия для физических лиц, не являющихся индивидуальными предпринимателями и применяющих специальный налоговый режим «Налог на профессиональный доход».
Цифровизация туристической отрасли
Authors: Насыбуллин С.С.
Published: June 2021

Данная статья посвящена исследованию цифровой трансформации туристической отрасли. Важной особенностью мирового туризма становится относительная устойчивость данного сектора в периоды экологического спада или геополитической нестабильности. Вместе с тем бизнес-процессы в туризме все чаще переходят в цифровое пространство. Использование современных алгоритмов повышает скорость работы, позволяя решать более масштабные проблемы.
Показатели эффективности выращивания гусят на мясо при использовании добавки Витаммин в рационах
Authors: Гришин Е.А.
Published: June 2021

При анализе экономических показателей по эффективности производства мяса гусят, потреблявших различные дозировки витаминной кормовой добавки Витаммин, можно сделать следующее заключение, что максимальный уровень рентабельности производства гусиного мяса был получен в группе, потреблявшей кормовую добавку Витаммин в дозировке 0,5 мл/л воды.
Влияние льняного жмыха в рационах молодняка лошадей на жирнокислотный состав мышечной ткани
Authors: Тарасова А.О.
Published: June 2021

Целью работы являлось изучение жирнокислотного состава мышечной ткани молодняка лошадей, потреблявшего льняной жмых в дозировках 300 и 500 г/гол в сутки. При исследовании жирнокислотного состава липидов мышечной ткани молодняка лошадей, потреблявших льняной жмых, идентифицировано 34 жирные Наука России: Цели и задачи – 63 – кислоты. Не установлено существенных (достоверных) различий в соотношении отдельных жирных кислот, ненасыщенных, насыщенных и полиненасыщенных между животными подопытных групп. Мясо лошадей, потреблявших льняной жмых, было более сбалансированным по содержанию жирных кислот.
Закрепление струны и протекание на ориентированной решетке
Authors: Иванов А.А.
Published: June 2021

Методом Монте-Карло исследуется плоское скольжение струны, взаимодействующей с точечными центрами закрепления. Устанавливается принадлежность рассматриваемой задачи к классу задач теории протекания. Исследуется критическое поведение заметенной площади при скольжении струны. Определены порог протекания и критический индекс для заметенной струной площади. Создан алгоритм исследования протекания на ориентированной квадратной решетке на основе алгоритма поиска механически устойчивой конфигурации струны. С помощью созданного алгоритма определены порог протекания на ориентированной решетке и критический индекс для заметенной площади. Исследованы детальные отличия задач поиска механически устойчивой конфигурации струны и поиска траектории протекания на решетке.
Разработка АОС программного блока вывода
Authors: Балтрашевич В.Э.
Published: June 2021

Рассматривается пример разработки автоматизированной обучающей системы (АОС) программного блока логического вывода экспертной системы. Блок вывода описан на языке эксперта, использующего правила продукций. АОС же строится на базе списка атрибутов без использования правил продукции. Таким образом, при разработке использовались две базы знаний с разными структурами. Приводится пример использования АОС.
Социально-правовые аспекты развития студенческого спорта
Authors: Вольский В.В. , Арбатский Н.В.
Published: June 2021

Состояние физического, социального и духовного благополучия, а также отсутствие каких-либо болезней, недомоганий, различных дефектов органов и систем организма, нормальное их функционирование – это и есть здоровье. Как мы знаем, для поддержания здоровья нам необходимо укреплять организм и всячески его поддерживать, как с физической стороны, так и с духовной. Здоровье и спорт – главнейшая потребность человека, которую необходимо сохранять и преумножать, как капитал. Для всего этого нам необходима система. Система студенческого является одной из ключевых частей физкультурно-оздоровительного воспитания молодежи. Для того чтобы лучше понимать как вся эта система работает, необходимо разобраться в ее социально-правовых аспектах.
Математика в деятельности инженера
Authors: Дёмина Т.И.
Published: June 2021

В последнее время развитие наук характеризуется проникновением в них математических методов и математического стиля мышления. В практической деятельности инженеров математика особенно важна, поскольку в своей деятельности инженер, прежде всего, опирается на знания фундаментальных и прикладных наук.
Исследования уроков физкультурной подготовки в США
Authors: Киселев И.В. , Вольский В.В.
Published: June 2021

Целью данной статьи является изучение роли школьных физкультурной подготовки в содействии немедленному и долгосрочному положительному воздействию на физическую активность. В статье представлена поддержка идеи о том, что учебная программа физического воспитания, во время и после школы, может помочь детям овладеть навыками участия в различных видах спорта, призванных облегчить активную жизнь на протяжении всей жизни.
Теоретические подходы к определению сферы бытовых услуг населения
Authors: Огородникова Д.А.
Published: June 2021

В статье анализируются подходы к определению понятия «услуга», рассматриваются тенденции и причины роста третичного сектора экономики. Особое внимание уделяется исследованию сущности бытовых услуг и бытового обслуживания населения, рассматривается динамика объема оказанных бытовых услуг, выявляются тенденции и намечаются возможные направления развития сферы бытового обслуживания.