bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of the technical feasibility of complete salpingectomy versus tubal ligation as a method of tubal sterilisation during caesarean delivery
Authors: Gupta Taru , Baruhee Divya , Agarwal Sunaina
Published: November 2021

Background: Recent theory on ovarian malignancy suggests its origin from primary foci in fallopian tubes. Prophylactic salpingectomy may benefit in risk reduction of ovarian cancer. The aim of the study was to compare the feasibility of complete salpingectomy with bilateral tubal ligation was made during caesarean delivery in women desirous of permanent sterilisation.Methods: We conducted a prospective interventional randomized control study in department of obstetrics and gynaecology, ESI-PGIMSR Basaidarapur, New Delhi from October 2018 to February 2021. 70 women participated in this study desiring permanent sterilisation during caesarean delivery. Patients were randomized into two groups who either underwent bilateral tubal ligation [group A (N=35)] or complete bilateral salpingectomy [group B (N=35)].Results: Procedure was completed in 91% patients in group A and 77% in group B (p >0.05) making both the procedures feasible.  Total operative time (min) in group A and B were 47 and 55 respectively (p<0.01). Mean sterilisation procedure time (min) in group A was 5 and group B was 6 (p=0.13). No significant difference was seen in intra-operative blood loss (400 ml in group A vs 300 ml in group B), percentage decrease in post-op haemoglobin (g/dl) (4.56±2.96 in group A vs 3.91±2.7 in group B), post-operative serum Anti-mullerian hormone (AMH) levels (ng/ml) (group A-0.965±0.12 vs 0.7±0.09 in group B) in the two groups.Conclusions: Salpingectomy as an alternative to tubal ligation should be discussed with suitable patients desirous of permanent sterilisation during caesarean delivery.
Role of oral inositol supplementation in women with polycystic ovarian syndrome
Authors: Malik Najma , Dubey Navneet
Published: November 2021

Background: PCOS is one of the most common endocrine disorder in women of reproductive age, it affects about 5-10% of women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. 30-40% of PCOS women have impaired glucose tolerance.Methods: This was prospective observational study carried out on 100 patients of PCOS visiting outpatient Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur from 1st July 2018 to 30th June 2019. Patients were diagnosed as PCOS on basis of Rotterdam criteria. In these 100 patients, oral inositol 2 gm twice daily was given for 3 months to 6 months depending upon the response of the patient and patients were examined every 4 week for menstrual regularity, acne improvement, hirsutism, spontaneous ovulation and pregnancy.Results: With inositol supplementation, menstrual abnormality corrected in 80% cases, 45% cases having acne improved. Ovulation occurred in 75.5% cases and 66.6% cases conceived with inositol supplementation.Conclusions: Insulin resistance is the basic pathophysiology for PCOS hence inositol supplementation is supposed to be very good medicine for management of PCOS to improve insulin sensitivity. Inositol leads to improvement in regularity of menstrual cycle, insulin resistance, hyperandrogenic features like hirsutism, acne, restores ovulation and improves oocyte quality.
A study of maternal and fetal outcome in meconium-stained amniotic fluid-a prospective hospital-based study
Authors: Dandale Aparna U. , Bava Amarjeet Kaur , Shinde Nikhil R.
Published: November 2021

Background: Meconium is a collection of secretions and desquamated cells from the digestive tract, and waste products from ingested amniotic fluid. It is a viscous, dark-green substance composed of intestinal epithelial cells, lanugo, mucus, and intestinal secretions. Intra uterine passage of meconium occurs in case of fetal distress; Important causes of in utero passage of meconium are oligohydramnios, placental insufficiency, preeclampsia.Methods: The present prospective observational study is conducted at department of obstetrics and gynecology of tertiary care centre, Lokmanya Tilak municipal medical college and hospital, Mumbai. All antenatal women attending hospital in active phase of labour who fulfilled the inclusion criteria of single term pregnancy in cephalic presentation were included. A predesigned pretested interview schedule questionnaire was prepared in accordance with study objectives and was conducted in the language which they best understood. Permission was obtained from the institutional ethics committee. Maternal outcome: Increased incidence of cesarean and instrumental deliveries, wound infection, post-partum hemorrhage. Perinatal outcome: Birth asphyxia, meconium aspiration syndrome (MAS), respiratory distress syndrome (RSD), septicemia.Results: Maximum women 71% were having gestational age of 37-40 weeks. most common maternal high-risk factors were post-dated pregnancy (29%) followed by oligohydramnios (19%). Deliveries by caesarean section were more (71.4%), most common indication being fetal distress (44.7%). Perinatal complications were birth asphyxia, MAS, RDS, low Apgar score.Conclusions: Early identification of meconium-stained amniotic fluid (MSAF) in labouring women during intra-partum monitoring and availability of operation theatre for immediate intervention is required to reduce the perinatal morbidity and mortality.
Seroprevalence of rubella in pregnant women
Authors: Tripathy Sumeet R. , Menon Aruna , Bhardwaj Bikram , Namaji Mohammed Ashraf Ali S. , Khardenavis Nilesh A. , Gupta Neha
Published: November 2021

Background: Rubella is a droplet infection characterized by self-limiting illness. However infection during pregnancy may result in miscarriage, congenital birth defects leading to long term morbidity. The aim of the study was to estimate the seroprevalence of rubella immunity in pregnant women.Methods: Antenatal patients, irrespective of period of gestation, fulfilling the inclusion criteria were tested for rubella IgG antibodies.Results: A total of 258 pregnant women were included in the study. The estimated seroprevalence of immunity against Rubella infection was 70.5% (n=182) whereas 29.5% (n=76) were seronegative and thus susceptible to rubella infection. The distribution of seroprevalence of rubella immunity based on age group and gravidity were also evaluated.Conclusions: The results reveal high level of rubella sero positivity, which indicates continued transmission of rubella infection in the community.
Pregnancy associated plasma protein A: an early predictor of fetal growth restriction
Authors: Chandramohan Pavan Bhargava , Agrawal Sarita , Shrivastava Chandrashekhar , Rajbhar Sarita , Nayak Prasanta , Singh Vinita
Published: November 2021

Background: The aim of our study was to determine the association of low levels of pregnancy associated plasma protein-A (PAPP-A) levels estimated at 11-13+6weeks of gestation with fetal growth restriction (FGR).Methods: A prospective observational study of a total of 203 pregnant women with PAPP-A levels were followed up and the outcome data were collected at childbirth.Results: The incidence of FGR was 7.3%. A significant association was found between low levels of PAPP-A MoM (≤0.49) with FGR (p=0.000) with unadjusted odds ratio of 11.6. At PAPP-A multiples of median (MoM) ≤0.49, FGR had a median (Q1, Q3) of 0.46 (0.42, 1.54) versus 1.87 (0.59, 3.11) which was statistically significant (p=0.05) with moderate strength of prediction [minus 0.58 (95% CI, minus 1.113, minus 0.055), p=0.03]. At the cut-off considered in our study i.e., ≤0.49 MoM, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 73%, 81%, 23%, and 97% respectively with a positive LR of 3.82 and negative LR of 0.32. Karl Pearson’s correlation showed positive correlation (r=0.308, p<0.001) between PAPP-A MoM and birthweight and showed that for every unit increase in PAPP-A MoM, birthweight increased by 0.082 times (approximately 90 gm). We also found an association of low PAPP-A with pre-eclampsia, preterm delivery and increased caesarean delivery births.Conclusions: We conclude that low PAPP-A MoM levels are good reflectors of placental function and adverse outcomes. PAPP-A, a part of the dual marker, may be extrapolated for suspecting FGR. This could guide in instituting appropriate feto-maternal surveillance.
Fetomaternal outcomes in pregnancy complicated by epilepsy: a retrospective study
Authors: R. Chithra , Dixit Siddhi Shree , M. K. Janu , . Sandhya
Published: November 2021

Background: This study is conducted to find out possible course and complications of epilepsy and its treatment in mother and fetus as many women will be anxious regarding this high-risk condition.Methods: This is a retrospective study conducted in department of obstetrics and gynaecology, AIMS Kochi from 2012-2019. Out of a total of 7045 deliveries during that period, we identified 64 patients with epilepsy complicating pregnancy. Antepartum, intrapartum and postpartum details of 57 patients whose data was available in electronic medical records was collected and analysed using SPSS 17 software.Results: In this study we noted that the incidence of epilepsy was 0.009%. the 50% of patients were in 25-30 years age group. More than 98% were on long term antiepileptic drugs. Majority were on monotherapy, most commonly on leviteracetam and were well controlled with monotherapy. The 38.5% had recurrence of seizures during pregnancy, mostly in latter half of pregnancy. Patients with seizure free interval of 9 months prior to pregnancy did not have any further epilepsy episodes. The incidence of other medical and obstetric complications was found to be similar to general population. There was 10% incidence of IUGR and fetal anomaly.Conclusions: The seizures were well controlled with monotherapy and we found that generally pregnancy and delivery is well tolerated and overall neonatal outcomes were good.
Serum lactate dehydrogenase as a biochemical marker for maternal outcome in pre-eclampsia
Authors: Kumari Gitanjali , Taralekar Vaishali , Dabhadakr Suchita
Published: November 2021

Background: LDH is a cytoplasmic intracellular enzyme present in the heart, kidney, muscle, leukocytes and erythrocytes, of all major organ systems. The presence of LDH in extracellular space points towards cellular damage, endothelial dysfunction. Preeclampsia is a multisystem disorder during pregnancy causing cellular damage or death. Hence, serum LDH levels can be helpful in determining the extent of cell damage and the seriousness of this disease. The present study aimed to correlate the maternal serum lactate dehydrogenase levels with maternal and perinatal outcomes in women with pre-eclampsia.Methods: It was a prospective observational study. A total of 120 antenatal patients diagnosed with hypertensive disorder of pregnancy were included in this study. Serum LDH levels were estimated by enzymatic method on the autoanalyzer. Patients were grouped into 3 categories according to serum LDH levels: a) <600 IU/l, b) 600-800 IU/l c) >800 IU/l. Clinical manifestation of development of complications of hypertensive disease and its relation with serum LDH in respective patients were analyzed.Results: An LDH level of more than 800 IU/l was seen in 19.2% while between 600 to 800 IU/l was seen in 16.7% cases. A significant association was observed between incidence of maternal complications with high LDH levels (p<0.01). High LDH levels were observed to be associated with development of ante-partum haemorrhage, eclampsia and requirement of ICU admission. No significant association was found between different categories of LDH and deep tendon reflexes, levels of proteinuria at the time of admission in these preeclamptic women.Conclusions: Close monitoring and early intervention of the preeclampsia patients with elevated serum LDH levels can help avoid adverse effects of the disease and thereby help improve maternal and perinatal outcomes in pregnant women with preeclampsia.
Successful maternal and fetal outcome in an uncorrected case of tetralogy of fallot
Authors: Nimbkar Aditya R. , Panchbudhe Shruti A. , Deshmukh Prasad Y. , Nayak Arun H.
Published: November 2021

Tetralogy of Fallot (ToF) is the most common congenital heart defect which is associated with systemic cyanosis. Pregnancy and delivery cause dramatic alterations in cardiovascular physiology and pregnancy in women with unrepaired TOF may have a worsening in right to left shunt with an increase of the cyanosis. This possesses an elevated risk of maternal and foetal morbidity and even mortality. We report and discuss a case of a 24 years old Primigravida with uncorrected ToF. A multidisciplinary team was involved in the management of the case with the aim to minimize maternal and foetal complications. The target of the management was to perform adequate maternal surveillance by maintaining an adequate oxygen saturation and good haemoglobin levels and perform timely foetal surveillance tests in the form of Obstetric doppler. A caesarean section was performed at 35 weeks and 5 days of gestation without any maternal or fetal complications. Without optimal obstetrical or medical management, prognosis of pregnancy in patient with uncorrected ToF is poor.
Multiple urinary bladder calculi: a rare cause of irreducible uterovaginal prolapse
Authors: Mohi Manjit Kaur , Kaur Manjeet , Kaur Balwinder , Kaur Satinder Pal , Aggarwal Sangeeta
Published: November 2021

A case of irreducible prolapse with multiple bladder calculi in a 65-years-old multiparous, postmenopausal woman is reported. Inability to walk, constipation and urinary incontinence were her primary complaints. Routine ultrasound of the abdomen and pelvis failed to reveal multiple vesical calculi as the prolapse was lying outside the pelvis. However, targeted plain X-ray of the prolapsed mass showed multiple vesical calculi. The patient was managed with single-stage vaginal hysterectomy and laparotomy. First vaginal hysterectomy was done then prolapsed cystocele was reduced and extraperitoneal vesicolithotomy done. Currently, the patient is relieved of all symptoms. Management of an irreducible procidentia and a hard mass in the anterior compartment, as in this case, can be challenging and requires a diligent effort to confirm the diagnosis and to execute the appropriate surgical protocol to achieve optimal outcome with minimal intra- and post-operative complications.
Von Willebrand disease in pregnancy: a case report
Authors: G. Rashmi A. , Kumar Riya , S. Dayamayi A. , Nallapilli Spandana
Published: November 2021

Von Willebrand disease (VWD) is a hereditary bleeding disorder that can be severe and potentially life-threatening, particularly in pregnant women during labor and subsequently during early puerperium. There is no optimal treatment or management for this disorder. Hence, all efforts aim at early diagnosis and the focus is mainly on minimising and controlling blood loss. We described the case of a woman in the post-partum period with severe VWD, admitted in the obstetrics and gynaecology ward at Rajarajeswari Medical College and Hospital, Bangalore. Prompt diagnosis, initiation of pre-partum and intra-partum Von Willebrand factor (VWF)/clotting factor replacement therapy, vigilant post-partum monitoring of blood loss and systematic follow up will help expedite recovery and prevent adverse outcomes.
Safe obstetric anesthesia practice-COVID-19
Authors: Thakur Sunil , Kaushal Sushruti , Kaur Harpreet , Kaundal Asmita
Published: November 2021

COVID-19 or Corona virus disease 2019 was declared a pandemic by the WHO on 11th March 2020. Cesarean delivery is a commonly performed major surgery around the world. Important considerations while performing a cesarean section on a confirmed or suspected case of COVID19 are safety of the woman and the fetus; and prevention of transmission of SARS-CoV2 infection to the fetus as well as the healthcare providers. Woman and her birthing partner should be screened for the symptoms of COVID-19 before scheduled admission. Cesarean section in a woman suffering from COVID-19 should be managed by a multidisciplinary team consisting of anesthetists, obstetricians, labor and delivery nurses, neonatologist, critical care experts and infectious disease specialists, all members working in tandem with each other. General changes in workflow, reorganization of obstetric anesthesia services and proper use of personal protective equipment (PPE) are required for safe delivery of obstetric anesthesia during the COVID pandemic. Regional anesthesia is the preferred method of anesthesia for cesarean delivery. Using regional anesthesia reduces the need of aerosol generating procedures and avoids the use of mechanical ventilation. It also decreases the possibility of exacerbating the respiratory complications due to intubation. General anesthesia is recommended when a COVID-19 parturient presents with desaturation (oxygen saturation≤ 93%) for emergency cesarean delivery. Use of mechanical barriers around patient’s head during intubation and extubation might reduce exposure. The patient should be allowed to remain in the operating room itself till sufficiently recovered to be shifted directly to the isolation room.
Premaxillary and maxillary sinus mucormycosis post COVID: a rare case report
Authors: Shrestha Deependra , Dev Reskey
Published: November 2021

Mucormycosis, previously termed as zygomycosis, is an opportunistic infection and is caused by fungi belonging to the order Mucorales. It is found in patients with predisposing conditions such as diabetic ketoacidosis, chronic kidney disease malignancy long-term steroid use and immunosuppressant drugs. Mucormycosis involving paranasal sinuses is a rare life-threatening opportunistic infection in a covid positive patient. The unprescribed use of corticosteroid in covid positive patient, the lymphopenia in severe covid 19 cases, preexisting diseases like uncontrolled diabetes mellitus, hematological malignancy, stem cell transplant causing weak immune system are the factors which are responsible for mucor infection in covid positive patients. We herein report the case of maxillary and premaxillary mucormycosis infection in the uncontrolled diabetic patient with post covid status in recovering phase of acute respiratory distress syndrome.
Case report of malignant peripheral nerve sheath tumor of parotid in a patient with neurofibromatosis type 1
Authors: P. Anuradha , Reddy Bathi , Gaur Suhail
Published: November 2021

Malignant peripheral nerve sheath tumor (MPNST) refers to spindle cell sarcomas arising from or separating in the direction of cells of the peripheral nerve sheath. The MPNST of the parotid gland is an extremely rare tumor, accounts for <5% of all soft tissue sarcomas, and carries a poor prognosis. Diagnosis of MPNSTs is usually based on histopathology aided by IHC, which reflects the Schwann cell differentiation in this neoplasm. Approximately 50-90% of MPNSTs are positive for S-100 protein. A 56-year-old male presented with right parotid swelling for 3 months and incomplete right eye closure. The patient was diagnosed with neurofibromatosis 1 (NF-1) and pulmonary tuberculosis in the past. On Examination, a hard, tender swelling measuring 5×4 cm involving the right parotid gland and right grade 2 LMN facial palsy was noted. Histopathology was suggestive of a MPNST.

 
Bilateral maxillectomy via mid-facial degloving approach in an extensive case of post-Coronavirus disease invasive fungal sinusitis
Authors: Singh Sampath Kumar , K. Gayathri , Reddy Y. Mounika
Published: November 2021

Coronavirus disease associated invasive fungal sinusitis has affected many and several have succumbed to the disease during the second wave of COVID-19 pandemic. Mucormycosis is a rare, opportunistic, fulminant, angioinvasive fungal infection caused by Rhizopus species of the order Mucorales. It mainly affects immunocompromised individuals, predisposed by diabetes mellitus, corticosteroids, immunosuppressive therapy, haematological malignancies and organ transplantation. We reported here a case of a 45 years old male with past history of Coronavirus disease, presenting with symptoms of invasive fungal sinusitis. With this case we emphasised on use of an alternate approach for bilateral total maxillectomy via midfacial degloving approach instead of a classical external Weber Ferguesen incision in extensive cases with several associated co-morbidities. Mid facial degloving approach is a combination of intraoral and intranasal incisions made to access the midface without any external incision. This approach is advantageous in comparatively having less complication rate, less morbidity and excellent cosmetic outcome.
Condylar aplasia: a case report
Authors: Japatti Sharanbasappa , Dhoke Bhavesh , Dhalwale Georgina , Taneja Priyanka
Published: November 2021

Aplasia of mandibular condyle is one of the several facial manifestations of many syndromes. It is considered as an extremely exceptional stipulation, if it is not seen as a part of any syndrome. The incidence expected 1 in 5600. It occurs due to the growth instability in development of condyle in the intrauterine life, late in the first trimester. It is not discernible at birth and seems to be steadily acquired during the growth. We report a case of condylar aplasia on the right side in an 18-year-old female. The patient reported to the department of Oral and Maxillofacial Surgery at ACPM dental College, Dhule, with a chief complaint of underdeveloped lower jaw. The etiology of this condition was unknown, clinical examination and conventional radiographs revealed complete absence of condyle on the right side. A proper diagnosis along with the differentiation from the syndromic cases is of importance. The aim of this article is to present a case with peculiar type of non-syndromic condylar aplasia.
Cochlear implant and tinnitus: a review
Authors: Swain Santosh Kumar
Published: November 2021

Tinnitus is the perception of a sound without any external auditory input and patient experiences as a ringing or buzzing sound in the ear or head. Tinnitus is a common and troublesome clinical entity that has existed for centuries. However, the exact etiology for tinnitus is not known. Electrical suppression of the tinnitus by cochlear implant is a secondary benefit to many cochlear implant recipients. Cochlear implants are often helpful to improve speech perception for those suffered with severe to profound hearing loss where hearing aids are no longer beneficial. There is high prevalence of tinnitus among patients with profound hearing loss which often reduced after cochlear implant. Although only few cochlear implant recipients show complete elimination of tinnitus after implantation and many uses result in improvement or stabilization. Cochlear implant causes appearance of homolateral tinnitus in small percentage of the cases. However, none of the cases of tinnitus which appear after cochlear implantation are thought to be severe to the patient. All literatures of cochlear implant and tinnitus were identified via Scopus, Google scholar, Medline and PubMed and analysed individually. Articles of cochlear implant and tinnitus included according to specified eligibility criteria. The review article analysed case series, case reports and original research on cochlear implant and tinnitus published in the English language. The aim of this review article is to provide a comprehensive review of the cochlear implant and its role in tinnitus.
Avaliação como aprendizagem: conceptualização e mapeamento de estudos
Authors: Alcântara Caio Mário Guimarães , Loureiro Maria João , Linhares Ronaldo Nunes
Published: November 2021

Apresenta-se uma revisão sistemática da literatura sobre a Avaliação como Aprendizagem (AcA), modelo no qual o aluno torna-se o centro da avaliação do próprio percurso de aprendizagem. A revisão considera os procedimentos de Cardoso, Alarcão e Celorico (2010) e Faria (2016). Foi estabelecido um protocolo para seleção de um corpus de 11 artigos. A pesquisa teve dois objetivos: mapear a produção acadêmica sobre a AcA, considerando período de surgimento do conceito, estudos publicados até o presente, autores de referência e revistas em que os artigos foram publicados; e analisar a conceptualização da AcA dos autores de referência. Infere-se que AcA é um conceito recente e que os estudos relacionados têm sido publicados sobretudo na última década, centrados no ensino básico.
Maternal and perinatal outcomes of pregnancies complicated by cardiac disease at a tertiary level hospital
Authors: Chaudhary Niharika , Pulakhandam Naga Veni Prapurna , Annapoorna Y
Published: November 2021

Heart disease in pregnancy is one of the leading non-obstetric causes of maternal mortality and is the leading cause of maternal intensive care unit admissions in the world.

To study the prevalence of heart disease in antenatal mothers and fetal outcome with obstetric management.

The presence of comorbidities and the occurrence of obstetric, fetal, and cardiovascular complications during delivery among women with heart disease hospitalized for delivery were studied in 35 women at GSL Medical College, Rajahmundry for a period of 1 year from 01/01/2019 to 1/1/2020

: Over a period of 12 months, 35 subjects were recruited. During this period, there were 5005 deliveries. The majority of women were aged between 20-25yrs and were unbooked cases belonging to NYHA class I or II. Cesarean section and operative vaginal delivery were more common. Despite the multidisciplinary approach, 3 women succumbed to the disease of which one was a case of severe rheumatic heart disease with valve failure, the second was a case of postpartum cardiomyopathy and the third was a case of severe pulmonary arterial hypertension. Fetal outcome in cardiac patients is usually good and only a little different from those patients who do not suffer from heart disease.

Pregnant women with heart disease were more likely to experience adverse events during delivery. These women require a multidisciplinary team for optimal maternal and foetal outcomes.
The effect of COVID-19 on maternal and neonatal outcome - A retrospective study
Authors: Garg H , Rai Swati , Ahuja M , Goel N , Srivastava R , Agrawal S
Published: November 2021

The pandemic of coronavirus disease (COVID-19) has caused serious adverse effects on the human race. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19.

An observational descriptive study was conducted in the department of obstetrics & gynaecology at SMSR and Sharda hospital located in Greater Noida, Uttar Pradesh. This medical college drains patients from entire Greater Noida and as well as from far-away places as referrals. All pregnant patients were included that came to this hospital from 1 April to 31 May 2021. These were the two dreadful months for the entire country in which so many lives were lost. All pregnant patients were labelled COVID-19 positive after undergoing either Rapid antigen test/RTPCR test taken from nasopharyngeal and oral swab.

: This included assessment of the maternal morbidity and mortality, comorbidities & worsening of outcome due to COVID-19 infection in pregnant patients as well assessment of the effect of COVID-19 infection on fetus and newborn.
A retrospective analysis of clinical profile of patients with cancer cervix in a rural medical college in Karnataka
Authors: Bhavya H U  , Ellian Muna , Doppa Geeta J
Published: November 2021

Cancer cervix is most common cause of cancerous deaths in females especially in developing countries. The pre-invasive stage of cervical cancer lasts for a long period and a small proportion progresses to an invasive lesion. In Indian set up, majority of the patients are presenting with an invasive lesion.

To describe the clinical profile of patients presented with cervical cancer and to describe various treatments received by those patients.

: The present study is a retrospective observational study done on confirmed cases of carcinoma cervix who attended rural medical college in Karnataka. Clinical records of the patients, who presented between November 2019 and November 2020 and were diagnosed with cervical cancer, were retrieved. The data related to demographic and clinical variables like age, socioeconomic status, education, symptoms, clinical staging, treatment and histopathology report were recorded. Data collected were entered in Microsoft Excel Office 2007and data analysed. Data were presented using descriptive statistics. The data was expressed in the form of frequencies and percentages

A total of 30 patients with the median age of 46 years were studied. Most common presentation was post coital bleeding (40%) followed by white discharge per vagina in 33%. Majority were under low socioeconomic status (70%). 60% presented in stage II and 30% in stage I. Chemoradiation was treatment of choice in 60% followed by surgery in 33% and 7% were lost to follow up. On histopathology, majority had squamous cell carcinoma (70%).

The appropriate management of Cervical intraepithelial neoplasia(CIN) can prevent invasive cervical cancer. In this study most of them presented in advanced stage which could have been prevented with the regular screening and awareness among women in the reproductive age group.

: Detection of pre invasive lesions or in situ cases remains important key to decreasing cervical cancer morbidity and mortality.
Effect of traditional versus site specific anterior repair in reduction of urinary symptoms in women with pelvic organ prolapse
Authors: Sawant Aditi , Bhalerao Anuja , Bhalerao Kritika
Published: November 2021

The present study was undertaken to evaluate effect of traditional anterior repair versus site specific anterior repair in reduction of urinary symptoms in women with Pelvic organ Prolapse. During the study period of 2 years 140 women belonging to reproductive, peri-menopausal and postmenopausal age groups were included in the study. Employing past literature, the sample size calculated was 140. All women were assessed pre-operatively by the assessment method – Pelvic organ prolapse quantification (POP-Q) system. 70 women belonging to Group A were treated according to vaginal hysterectomy with traditional anterior repair and 70 women belonged to Group B who were treated according to vaginal hysterectomy with site specific anterior repair.Post-operatively, all women were followed up till 7th post-operative day and were assessed for anatomical and functional improvement to determine a better method for repair in reduction of urinary symptoms in women with pelvic organ prolapse.

Our study shows functional and anatomical outcomes of traditional anterior repair and site specific anterior repair. 48 of 70 women (68.2%) who were subjected to traditional anterior repair and 52 of 70 women (73.4%) who were subjected to site specific anterior repair had marked functional improvement after surgery. 58 of 70 women (83.2%) belonging to traditional anterior repair group and 67 of 70women (95.3%) belonging to Site specific anterior repair group had considerable anatomical improvement post-operatively. This impresses the role of site specific anterior repair in women with pelvic organ prolapse for attaining better functional and anatomical outcome.
Comparing effectiveness of COBAS HPV test with VIA/VILI, pap smear and colposcopy for screening of cancer cervix
Authors: Subramanian Lalitha , Indirani T V , Suji I Igena Sharo
Published: November 2021

Cancer cervix is the second leading cancer causing 21% of all cancer deaths. Cervical cancer can be prevented if detected by premalignant changes and is curable in its earliest stage. Various procedures including VIA/VILI, pap smear have been routinely used for the purpose of screening cervical cancers. Infection with Human Papilloma virus is the principal cause of cancer cervix. Roche COBAS HPV test was approved by US FDA on April 24, 2014 as one of the first line primary screening method for cancer cervix based on the presence of high risk HPV DNA. The FOGSI guidelines in January 2018 has suggested cobas HPV test for cancer cervix screening.

This study was conducted on 100 women with high risk cervical lesions during the period of 18 months. Women attending the NCD clinic of Government Thoothukudi Medical college hospital were taken for the study. The women were to undergo VIA/VILI, Pap smear study and subjected to COBAS HR HPV Test after their consent.

Cervical specimens collected in PreservCyt solution using an endocervical brush/ spatula or collected in SurePath preservative fluid using a cervical broom were sent for COBAS HR HPV test. Collected sample kits were recruited in Department of Radiation oncology, Government Thoothukudi medical college for storage at low temperature for a short period, after pooling of samples, these were sent through the Department of radiation oncology to Adayar cancer institute, Chennai, with which the department has treated with for COBAS HPV test. The results were analysed and proceeded.

This study has proven that screening for high risk HPV test in cervical specimen can easily pickup the premalignant lesion with high sensitivity, specificity when compared with other screening tests. Hence, this study emphasizes the importance of implementing HPV tests that can provide a 3-year screening free interval, compared to yearly pap screening. The other advantage is that the results are available immediately reducing the frequency of visits to hospital for further follow up on colposcopy/biopsy.
Study of bad obstetric history cases attending tertiary care centre, Tirupati
Authors: Gowthami B  , Kumari J Sowjanya , Narayanamma V Lakshmi
Published: November 2021

To assess the obstetric and medical risk factors in patients with bad obstetric history (BOH) and outcome of pregnancy in case of BOH.

A prospective cross-sectional study was conducted in Government maternity hospital, Tirupati for a period of 1 year from December 2017 to November 2018. All pregnant women who were fulfilling inclusion criteria of BOH, as study group and all possible variable were compared with control group, who got selected randomly from the rest of deliveries. And analysed the results in terms of sociodemographic factors, risk factors, pregnancy complications, mode of delivery, maternal and foetal outcome.

Of 102 pregnant women in BOH, 76.5% were in age group between 21-30yrs, and 14.7% in age group >30yrs. Primary Recurrent pregnancy loss (RPL) was 51% and that of secondary recurrent pregnancy loss was 49%.History of hypertensive disorders including preeclampsia, eclampsia and chronic hypertension, noted in 11.8% cases, which was higher than previous studies, indicating changing trends in incidence.In foetal complications IUGR (0% vs 9.8%, p=0.026) and IUFD (0% Vs 7.8%, p=0.05) were more in BOH group and statistically significant also. Even though the maternal complications were more in BOH group, there was no statistical significance (P=0.075).Among the various causes of RPL found in the present study, endocrine causes were seen in 12.7%, Anatomical causes were found in 11.8% and in about 63.7% cases no definite cause was found and aetiology was unexplained.

Present study, supporting the change in definition of recurrent pregnancy loss from 3 consecutive losses to 2. So early evaluation and with appropriate interventions in most of couples outcomes were fruitful.
Resurgence of classical caesarean section in current obstetric practice- A case series
Authors: Mathe Priyanka , Wadhwa Sanjana Narula , Gupta Taru
Published: November 2021

Although, the incidence of placenta accreta spectrum (PAS) and large fibroids is rare but still these cases contributes to a large number of maternal morbidity and mortality. Major obstetric hemorrhage is one the dreadful complication of these types of cases and thus early diagnosis and intervention in such cases helps the physician to minimize the risk to mother and the fetus. Also, current widespread use of ultrasound has helped us to manage these cases judiciously, predict and prevent life threatening obstetric hemorrhage. Here we present three complicated obstetric cases of placenta accreta, large lower segment uterine fibroid and large cervical fibroid which necessitated classical cesarean sections (CCS) thus emphasizing prowess in CCS in modern obstetric era.

High index of suspicion, Multidisciplinary approach alongwith expert surgical personnel should be available in high risks cases like placenta accreta syndrome and large fibroids in pregnancy.
A histopathological study of unusual findings in appendectomy specimens in a tertiary care hospital of Andhra Pradesh
Authors: Kona Suneetha , Kande Srinivasulu , Prasanna Boddu Penchala , Kancharla Sushma Chandulee
Published: November 2021

Acute appendicitis is sudden inflammation of the appendix, usually initiated by obstruction of the lumen. This results in invasion of the appendix wall by gut flora, and it becomes inflamed and infected.

: To investigate retrospectivelythe prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis.

This is retrospective assessment of hospital records of 150 patients who were diagnosed as acute appendicitis and underwent appendicectomy during March 2018 to February 2020 at Government Medical College, Bhagya Nagar, Ongole, Andhra Pradesh .Data of the patients were assessed based on age, sex, histopathological diagnosis, coexisting pathologies and uncommon findings on histology.

According to histopathology report, negative for acute appendicitis were noted in 82 cases (55%), whereas positive for acute appendicitis in 68 cases (45.3%) . Rare findings were foundin 38 (55.8%) cases out of 68 cases. Parasites were found in 7 (18.4%) (Enterobius Vermicularis, Balantidum Coli, Schistosoma Haematobium), Mucocele in 12 (32%), carcinoid tumour in 8(21%), B cell malignant lymphoma in 2 (5%), leiomyoma in 2 (5%), Primary appendiceal adenocarcinoma in 3 (8%), Acute appendicitis with dysplastic changes in 2 (5%) and inflammatory bowel polyp was reported in remaining two cases(5%).

: Even though unusualpathologies can be seen rarely during appendectomy, this should be kept in mind for further evaluation of each cases.
Type I cutaneous meningioma of dorsal thoracic spine (Rudimentary Meningocele): A rare entity at an unusual site
Authors: Jagdale Rakhi V , Kripalani Mamta V , Pol Jaydeep N , Patil Sachin J , Kullolli Santosh S
Published: November 2021

Cutaneous meningiomas (CM) are rare variants of meningiomas which are further classified into three subtypes. Type I CM (TICM) or Rudimentary meningocele (RM) is an uncommon developmental anomaly in which meningothelial elements are displaced into the skin and soft tissue. We present a case of 11 year boy with an upper back swelling since early childhood. His MRI spine showed a lesion at T4-T7 level with a fistulous tract connecting it to dural sac. Histopathology revealed clusters of oval to spindle cells arranged in whorls amidst collagen bundles and psammoma bodies. On immunohistochemistry these cells expressed EMA and Vimentin. A diagnosis of TICM was rendered based on these characteristic clinico-radiological & histopathological features. TICM pose a diagnostic challenge clinically and histopathologically and have an excellent prognosis. This is the 4 Indian case of RM and the 1 case of RM to be located in the spine in the Indian literature.
The missing umbilical artery – A case report
Authors: Pari Priyatharsini , U Bharathi , Velu Pradha , S Sowndaravel
Published: November 2021

Single umbilical artery (SUA) is a condition where one umbilical artery exists. Normally, the umbilical artery contains two umbilical artery and one umbilical vein. The incidence of SUA varies from 0.2% to 0.8%. We present a case of SUA in a term baby with birth weight of 1.7kg delivered by a 28-year-old mother. SUA is a condition which must be kept in mind during histopathological examination since it helps in improving the neonatal and maternal care.
Performance Evaluation of Asphalt Binder Modified by Natural Rock Asphalt
Authors: Mohammed Khalid Awadh , Mansi Ali I. , Hussein Yasir R.
Published: November 2021

Rock asphalt is one of the widely distributed resources in nature. Therefore, this study employs natural rock asphalt as an additive. The focus of this study is to look at the potential of using natural rock asphalt as an asphalt binder modifier. The study looks at five different percentages of modified asphalt (NRA) concentration from Anbar factory asphalt for oxidized bitumen: 0%, 5%, 10%, 20%, and 30%. The results show that using modified natural rock asphalt increased the mechanical qualities of basic asphalt, such as penetration and softening point, flash point, and viscosity. In addition, the current results show that the asphaltic materials that can be used in paving according to the measuring of conventional tests such as ductility, penetration, and others. Furthermore, the findings indicate that modified asphalt has lower temperature sensitivity.
A Contribution to Analytical Solutions for Buckling Analysis of Axially Compressed Rectangular Stiffened Panels
Authors: Ibeabuchi Victor Tochukwu , Ibearugbulem Mathias Owus , Njoku Kelechi Okechukwu , Ihemegbulem Ezekiel Onyinyechi , Okorie Princewill Obumneke
Published: November 2021

Analytical solution to the buckling problems of stiffened panels subjected to in-plane compressive loads is presented. The total potential energy functional of stiffened panel is obtained by the summation of that of a line continuum and stiffened panel derived from elastic principles of mechanics. Minimizing the resulting equation with respect to deflection coefficient and rearranging gives the expression for obtaining the buckling load of stiffened panel. Exact deflection functions were substituted directly in the new solution and various edge conditions were considered in this analysis. Obtained results were compared with analytical results of previous works. The method is computationally efficient for complex edge conditions and gives high numerical accuracy.
Structure of second-grade diminutives in Czech and Slovak.
A corpus-based synchronic-diachronic analysis
Authors: Gregová Renáta
Published: November 2021

In Slavic languages, diminutivization is a highly productive morphological process. A diminutive marker can be attached to nouns, adjectives, verbs and adverbs. Secondary or even multiple diminutives are also possible. Considering the combinability of diminutive suffixes in nouns, Manova and Winternitz (2011) claim that only productive DIM1 suffixes function as DIM2 suffixes. The aim of this paper is to verify this idea on the basis of the analysis of data from Czech and Slovak. The DIM2 for the analysis were excerpted from the corpora. Neither Czech nor Slovak current sources apprehend diminutive markers as combinations of primary and secondary diminutive suffixes. The complex character of secondary diminutivizers is understood as a diachronic issue. Therefore, a historical analysis of all secondary diminutives was necessary. The research proved the assumption about the combinability of diminutive markers. The analysis also revealed that unproductive DIM2 suffixes are attached by substitution in both languages.
Discursive structures in political communication
Authors: Tribunskaya N. A. , Shevchenko V. D.
Published: November 2021

This article is devoted to the study of discursive structures in political sphere, represented in the English-language source Twitter of the President of the United States. The purpose of the study is to analyze the discursive structures that arise as a result of the interaction of political discourse with other types of discourses. To achieve it, the authors set the following tasks: identifying specific markers in the political discourse that characterize the presence of other discourses, analyzing the features of the communicative situation of message transmission, identifying the features of interdiscursiveness and polydiscursivity. The material for the analysis was the statements of Donald Trump on Twitter from November 1, 2019 to November 1, 2020. The authors of the article use various methods: descriptive, contextual analysis, comparative, methods of observation, content analysis and discourse analysis. The study uses the linguistic concept of the American scientist D. Himes S-P-E-A-K-I-N-G, which includes an analysis of the components of the situation: Participants, Ends, Act Sequence etc. Using the situation model in the messages, participants, their actions and other characteristics were highlighted. President is the author of the messages, while the addressee is a collective one. The same participants, depending on the context of the message, become participants of other types of discourses. The article examines such types of discourses as economic, educational, medical, which are part of political discourse. Their choice is due to the socio-economic significance of the issues of economics, education and health care in the life of society. In addition, the media function of political communication is reflected. The texts are posted on the Internet platform, due to which the political discourse is drawn into the space of the Internet discourse. The analysis made it possible to identify the features of large-scale interdiscursiveness and to highlight the levels of discursive heterogeneity.
Poly-predicative conditional constructions in Catalan (in comparaison with Spanish and French)
Authors: Repnina T. V.
Published: November 2021

By poly-predicative conditional constructions we mean complex sentences that contain at least three simple sentences, each representing either a condition or a consequence. Poly-predicative sentences can in addition contain other simple sentences that represent neither condition, nor consequence. Poly-predicative constructions that, apart from one condition and one consequence, also include other simple sentences, are not classified here as poly-predicative conditional constructions. While poly-predicative constructions in general have already been in the focus of researches attention, this article seems to address them on Catalan material for the first time. The purpose of this article is an analysis of syntactic relations in poly-predicative conditional constructions. Its objectives include their comparison in Catalan, Spanish, and French, identification of the main types of these constructions, and an analysis of their characteristics. Since the use of tenses and moods in the constructions addressed coincides with that in prototypical bi-predicative conditional constructions, we do not examine it here. The methods, used in this study, included: sampling during corpus collection, classification, description, comparison, transformational analysis and synthesis. The study is based on Catalan texts and their translations into Spanish and French. The findings of the study include: 1) Poly-predicative conditional constructions with several condition and/or consequence clauses are possible. Condition and consequence clauses can occupy different positions in poly-predicative conditional constructions; 2) In contrast to Catalan and Spanish, French admits the replacement of the conditional conjunction si by que; 3) Prototypical conditional and poly-predicative constructions are invariably characterized by subordination relations, with coordination parataxis possible as well. In addition, more complex syntactic structures are possible like, e. g., parallel co-coordination; 4) A prototypical conditional construction being a complex sentence, this limits possible syntactic types of poly-predicative conditional constructions. They cannot be structured as a string of simple sentences connected by coordination or subordination. Consecutive subordination of three or more subordinate sentences is not characteristic of conditional constructions; 5) The study identified a similarity between poly-predicative conditional constructions in Catalan, Spanish, and French. The present research is a contribution into the syntax of Romance languages.