bluuebunny/crossref_metadata_2025 huggingface dataset:
Client-Server Based Authentication Against MITM Attack via Fast Communication for IIoT Devices
Authors: KARA Mustafa , FURAT Murat
Published: April 2018

Security is an important issue that should

be taken care of by every system. In recent years, however, attackers are

constantly developing themselves with new techniques to obtain personal

information on the network. As systems evolve, the data that needs to be

protected is increasingly appreciated and carries a higher risk of attack. As

with many attacks such as MITM, there are solutions against this attacks.

Nevertheless, these safety measures must be developed continuously. For this

reason, we have developed a new system architecture with user-defined

authentication against the intruders for the systems having large amount of data

transmission rate. To maintain integrity of data, over a reliable system is

that all incoming data are authenticated when data send to the server, on the

other hand, in this system, the user-defined authentication can provide fast

communication and it can decrease authentication time. The proposed system

introduced in the present study checks for any changes in our instantaneous

data. Moreover, we control the data integrity on simple devices such as sensors

and motors or other industrial devices. Instead of using encryption, basically

client-server based authentication system is used to avoid complex operations

and protect the big data.
Новый гуманизм (неогуманизм) как идеологическая парадигма ХХI века
Authors: Водолазов Григорий Григорьевич
Published: April 2018

Текст доклада автора на Всероссийской научной конференции «Культура между Логосом и Мифом: к проблеме бессознательного (к 80-летию А. Э. Воскобойникова)», которая прошла в Московском гуманитарном университете 26–27 октября 2017 года.
Эволюция культурного смысла жертвоприношений
Authors: Горелов Анатолий Алексеевич , Горелова Татьяна Анатольевна
Published: April 2018

В работе рассматривается изменение смысла жертвоприношений в процессе эволюции духовной культуры.

Текст доклада авторов на Всероссийской научной конференции «Культура между Логосом и Мифом: к проблеме бессознательного (к 80-летию А. Э. Воскобойникова)», которая прошла в Московском гуманитарном университете 26–27 октября 2017 года.
Characterization and identification of naturally transgenic species Linaria vulgaris pathogenic mycromycetes
Authors: Sokornova Sofia V. , Gasich Elena L. , Bemova Victoria D. , Matveeva Tatiana V.
Published: April 2018

In nature there are species containing homologs of T-DNA genes of agrobacteria (сT-DNA) in their genomes. Such plants are called naturally transgenic ones. Interaction with the microbiota is one of the possible functions of cT-DNA, discussed in the literature. Linaria plants are the most suitable for the investigation of the probable ecological role of T-DNA, since they widely spread. The first stage in the evaluation of plant-microbial interactions involving these plants is the description of isolates with contrasting virulence for toadflax. The search and DNA-barcoding of such isolates of Phoma-like fungi was the goal of this work. 14 strains isolated from the plants of the families Plantaginaceae and Scrophullariaceae were analyzed. The of multilocus analysis included amplification and sequencing of internal transcribed spacers, a large subunit of RNA, a tubulin gene. Based on molecular data, 9 strains were assigned to the species Boeremia exigua, which has a wide range of habitats and a wide specialization. Strains of this species were virulent against L. vulgaris, but differed in aggressiveness with respect to this plant. Thus, a collection of strains was characterized, which can later be used for a more detailed study of the immune response of the naturally-transgenic L. vulgaris plant in response to inoculation with the B. exigua phytopathogen. As a result of the work, we identified the narrow host range fungi Heterophoma novae-verbascicola, and broad host range pathogens Plectosphaerella cucumerina, Phoma herbarum and Trichothecium roseum. Among them, only P. cucumerina was a weak pathogen of L. vulgaris. These results confirm the early data on the depleted mycobiota of L. vulgaris.
Ecological genetics of beetles of the genus Adalia: population structure of A. bipunctata of the Crimea depends on climatic factors
Authors: Zakharov Ilya A. , Rubanovich Alexander V.
Published: April 2018

The composition of 12 populations of Adalia bipunctata L. of the Crimean peninsula was studied. The proportion of black individuals varies from 4.8% to 64.6%. Comparison of the composition of color forms with climatic parameters of habitats showed that the proportion of black individuals in the population positively correlates with the value of moisture during the period of reproduction of beetles (May-July) and negatively correlates with the mean temperatures of these months.
A molecular genetic research of the Triticum sinskajae A. Filat. et Kurk. by RAPD analysis and by comparing the nucleotide sequences of the variable intergenic region of the petN-trnC-GCA chloroplast genome and intron of the histone H3.2 gene
Authors: Kuluev Azat R. , Matnijazov Rustam T. , Kuluev Bulat R. , Chemeris Alexey V.
Published: April 2018

Background. Triticum sinskajae A. Filat. et Kurk. was discovered in the early 70th in the last century at the regular reproduction in the Central Asian and Dagestan VIR-stations of T. monococcum samples.

Materials and methods. The objects of the study were 4 species of diploid wheat Triticum urartu Thum. ex Gandil. (lines k-62477, k-62465), Triticum monococcum L. (lines k-20970, k-39471), Triticum boeoticum Boiss. (lines k-59161, k-28132, k-40118) and Triticum sinskajae A. Filat. et Kurk. (line k-48993).

Results. We found differences between T. sinskajaeand T. monococcum in the variable region of the histone gene H3.2, and the RAPD analysis showed the presence of unique polymorphic loci in T. sinskajae.

Conclusion. In gene ral, T. boeoticum, T. monococcum, and T. sinskajae are most likely to be closely related species of diploid wheat, whereas T. urartu is quite significantly different from them.
Association between cytokine gene polymorphisms and squamous cell lung cancer depending on the duration of smoking in men
Authors: Gordeeva Lyudmila A. , Mun Stella A. , Voronina Elena N. , Polenok Elena G. , Magatina Alina D. , Titov Viktor A. , Ragozhina Svetlana E. , Vafin Ilgiz A. , Romanova Elizaveta L. , Glushkov Andrey N.
Published: April 2018

Background. Squamous cell lung cancer (SCLC) is the most common form of lung cancer among men smokers. Mediators and products of inflammation can contribute to the initiation of carcinogenesis in smokers. The aim of study is to investigate the association between IL1B(rs1143634, rs16944), IL1RN (rs2234663), TNFA (rs1800629), IL6 (rs1800795), IL10 (rs1800896) genes and SCLC depending on the duration of smoking in men.

Materials and methods. We studied 324 patients with SCLC and 168 healthy men smokers. The typing of the IL1RN(rs2234663) gene polymorphism has analyzed by polymerase chain reaction (PCR). Detection of the IL1B (rs1143634) and IL6 (rs1800795) polymorphisms have performed by restriction fragment length analysis, as a restriction enzyme TaqI was used. The IL1B (rs16944), TNFA(rs1800629) and IL10 (rs1800896) genes polymorphisms have determined through TaqMan-real-time PCR.

Results. The study showed, the age, duration of smoking and the number of cigarettes smoked per day were the main risk factors for SCLC in men (p 0.0001). The IL6 -174G allele was detected an additional risk factor of SCLC at a smoking duration of less than 35 years (OR = 1.68; 95 % CI: 1.12-2.51; pcor = 0,04). No association of IL1B (rs1143634, rs16944), IL1RN (rs2234663), TNFA (rs1800629), and IL10 (rs1800896) genes with the risk of SCLC in men was identified.

Conclusion. The duration of smoking and rs1800795 IL6 gene polymorphism may influence on the susceptibility to SCLC in men. Our results can be useful in understanding the molecular mechanisms of development of SCLC.
The study of the effects of dipeptide mimetic of a brain derived neurotrophic factor with antidepressant activity during prolonged use and after withdrawal
Authors: Garibova Taisiya L , Krayneva Valentina A , Valdman Elena A , Gudasheva Tatyana A , Kotelnikova Svetlana O , Seredenin Sergey B
Published: April 2018

The antidepressant activity of the GSB-106, dipeptide mimetic of the 4th loop of BDNF, during long-term use was studied in doses of 1.0 mg/kg and 5 mg/kg for. When comparing antidepressant activity in the “forced swimming Porsolt test” on the 14th and 28th day of administration, it was established that the antidepressant effect did not change. It was shown that a withdrawal of prolonged administration for 28 days did not lead to an increase in anxiety in the “elevated plus-maze test” and to the development of disturbances in the exploratory behavior of animals and motor activity in the “open field” test. It was concluded that during long-term administration of GSB-106 the tolerance for the main antidepressant effect did not developed, and cessation of long-term administration of GSB-106 did not lead to the development of withdrawal syndrome. (For citation: Garibova TL, Krayneva VA, Valdman EA, et al. The study of the effects of dipeptide mimetic of a brain derived neurotrophic factor with antidepressant activity during prolonged use and after withdrawal. Reviews on Clinical Pharmacology and Drug Therapy. 2018;16(1):28-33. doi: 10.17816/RCF16128-33).
Biological activity of fullerenes - reality and prospects
Authors: Dumpis Marina A , Nikolayev Dmitrii N , Litasova Elena V , Iljin Viktor V , Brusina Mariya A , Piotrovsky Levon B
Published: April 2018

The review deals with the properties of fullerenes and their derivatives and the possibility of their use in biology and medicine. Fullerenes can exert an antioxidant effect in biological systems, catching active forms of oxygen, and oxidative, giving the fullerene photosensitizing properties. The lipophilic fullerene molecules possessing membrane - tropic action interact with various biological structures and can change the functions of these structures, increasing the lipophilicity of the active molecule (amino acids, nucleic acids, proteins, etc.). Data on the biological effect of fullerenes in in vitro and in vivo experiments are given. Examples of targeted delivery of known therapeutic agents. (For citation: Dumpis MA, Nikolaev DN, Litasova EV, et al. Biological activity of fullerenes - reality and prospects. Reviews on Clinical Pharmacology and Drug Therapy. 2018;16(1):4-20. doi: 10.17816/RCF1614-20).
Behavioral, biochemical and morphological characteristics of experimentally changed thyroid status of female mice C3H-A
Authors: Kozyrko Elena V , Glushakov Ruslan I , Shabanov Petr D
Published: April 2018

The purpose of the paper was to study changes in neurogenesis and functional state of the central nervous system in female mice С3Н-А predisposed to hormone-dependent tumors in experimental hypo- and hyperthyroidism. Methods. Experimental hyperthyroidism was modeled by intraperitoneal administration of L-thyroxine 50 ug/day and hypothyroidism by oral administration of propylthiouracil 0.4 mg/day for 40 weeks to female mice С3Н-А. Results. Chronic hypo- and hyperthyroidism was characterized by motor (motility) and emotional disorders in mice beginning with 18 day of the experiment, with preferable increase of quantitative indexes of all component of explorative activity and grooming in hyperthyroid mice and disturbance of explorative activity (decrease of hole reflex) in hypothyroid animals. Behavioral disorders was increasing progressively within the experiment (till 40 weeks). In hyperthyroid mice, the dopamine level in the cortex and hippocampus was elevated and in hypothyroid animals, the level and turnover of serotonin was reduced in the same structures of the brain. The changes in thyroid status of С3Н-А mice (hypo- and hyperthyroidism) effected on expression of neurogenesis and angiogenesis factors contradirectory. In hypothyroidism, the expression of GFAP and VEGF was reduced preferably with elevation of expression of PDGFR-α in the neocortex and hippocampus, and in hyperthyroidism, on the contrary, the expression of GFAP and VEGF was increased with decrease of PDGFR-α expressionin the same structures of the brain. In the cortex of С3Н-А mice with hyperthyroidism, the stable structural signs of strengthening the protein synthesized activity in the cytoplasm was observed, that was appeared with reduction of heterochromatin density in the nucleus, increase of polysomes number and hypertrophy of Golgi complex. At the same time, there were mediate signs of destruction of myelin fibers and disturbances in axon-spine synapses, capillarostasis and signs of dystrophic changes of endotheliocytes and perivascular space. In hypothyroidism, disorders involved myelin fibers preferably, spine apparatus and only slight changes of presynaptic terminals. Conclusion. Therefore, it is concluded on the base of behavioral, biochemical and morphological characteristics that hypothyroidism can provoke depressive state development. (For citation: Kozyrko EV, Glushakov PI, Shabanov PD. Behavioral, biochemical and morphological characteristics of experimentally changed thyroid status of female mice C3H-A. Reviews on Clinical Pharmacology and Drug Therapy. 2018;16(1):43-53. doi: 10.17816/RCF16143-53).
The heterogeneity of drug response as the basis of identification of essential tremor subtypes
Authors: Muruzheva Zamira M , Karpenko Marina N , Klimenko Victor M
Published: April 2018

Introduction. Essential tremor (ET) is one of the most common movement disorders. It is mainly characterized by postural and kinetic tremor, affecting arms and other body parts. Progression of ET violates social activity, lowers self-esteem, and occasionally leads to the patient’s disability. Selection of an effective drug therapy for ET is mostly carried out empirically and takes long time, which causes additional negative psycho-emotional effects, distrust of the doctor and abandonment of the treatment. Present study is aimed at the implementing a novel approach to the segregation of ET subtypes based on the heterogeneity of the pharmacological response. Results. Neuroanatomical, electrophysiological and biochemical data published to date are outlined in the current paper, to designate parameters for identification of ET subtypes with deterministic pharmacological response. Before prescribing pharmacotherapy for patients with ET, it is necessary to perform asurface electromyography to identify the patterntype of antagonist muscles contractions. In addition, the concentration of glutamate and gamma-aminobutyric acid in peripheral blood should be determined. Conclusion. The heterogeneity of pharmacological response among patients with ET necessitates a more subtle classification within the syndrome by neuroanatomical, electrophysiological and biochemical indicators. The approach proposed in the review will increase the effectiveness of therapy and improve the lifequality of patients with ET. (For citation: Muruzheva ZM, Karpenko MN, Klimenko VM. The heterogeneity of drug response as the basis of identificationof essential tremor subtypes. Reviews on Clinical Pharmacology and Drug Therapy. 2018;16(1):54-59. doi: 10.17816/RCF16154-59).
Breast columnar alteration with prominent apical snouts and secretions
Authors: EZER Ali , PARLAKGÜMÜŞ Alper
Published: April 2018

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Lefkoşa’nın bir bölgesinde altmış beş yaş ve üzeri bireylerin sosyal yaşama katılımı
Authors: AŞUT Özen , VAİZOĞLU Songül , BOZYEL Funda , SUCUOĞLU Asya , PEKTEKİN Ceren , ASİF Günay , KARAHANCI Esat Cihan , İNCEBIYIK Mehmet , CALİ Sanda
Published: April 2018

Amaç: Bu araştırmanın amacı, Lefkoşa’nın bir bölgesindeki 65 yaş ve üzeri bireylerin sosyal yaşama katılım düzeyini belirlemek olarak tanımlanmıştır. Gereç ve Yöntem: Tanımlayıcı nitelikte olan araştırmanın evrenini, Lefkoşa ilçesi Göçmenköy bölgesinde yaşayan ve 2011 nüfus sayımına göre belirlenen 65 yaş ve üstü 515 birey oluşturmaktadır. Nüfusun tümüne ulaşılması hedeflenmiş, araştırmacılar evlerde yüz yüze anket uygulayarak veri toplamışlardır. Bulgular: Katılımcıların %57’si kadın, yaş ortalaması 73.0±6.6 yıl, %68’i evlidir. Katılımcıların %78’inde en az bir hastalık bulunmaktadır. Katılımcıların yalnızca %2.4’ü gelir getirici bir işte çalışmakta; %16’sı günlük etkinliklerde yardıma gereksinim duymaktadır. Teknoloji kullanımı cep telefonu dışında %50’nin altındadır. Araba ve cep telefonu kullanımı erkeklerde önemli derecede daha yüksektir. Evli olanlarda ve eğitim düzeyi ortaokul ve üstünde olanlarda teknoloji kullanımı, alışveriş yapma, dışarı yalnız çıkma ve yürüyüş yapma düzeyleri istatistiksel olarak önemli derecede daha yüksektir.Sonuç:  Bu çalışmada, yaşlı nüfusun, özellikle kadınların sosyal katılımı yetersiz bulunmuştur. Yaşlılığa bağlı kısıtlılıklar, sosyal ve fiziksel diğer belirleyiciler, yaşlıların sosyal katılımını engelleyebilmektedir. Oysa sosyal katılım yaşlıların yaşam kalitesini artırmakta, ayrıca topluma sosyoekonomik katkı sağlamaktadır. Bu nedenle, kamunun görevi engelleri ortadan kaldırmak olmalıdır.
Mesane kaynaklı inflamatuar miyofibroblastik tümör
Authors: SARITAŞ Ahmet Gökhan , DALCI Kubilay , GÖNLÜŞEN Gülfiliz , ERDOĞAN Şeyda , RENCÜZOĞULLARI Ahmet
Published: April 2018

İnflamatuar myofibroblastik tümör , etyolojisi tam olarak belirlenememiş lokal agresif davranışlı bir neoplazmdır. Pulmoner, gastrointestinal, genitoüriner sistem ,retroperitoneal bölge sıklıkla görüldüğü yerlerdir. Tanıda ,anamnez, fizik muayene ,labaratuar ve görüntüleme yöntemlerinin yeri sınırlıdır. Nüksetme potansiyeli mevcuttur. Bu yazıda pelvik ağrı ve disüri yakınmaları olan kadın hastada tespit edilen mesane inflamatuar myofibroblastik tümörü sunulmuştur.
Osteoartrit hastalarında ağrı şiddeti: yeni bir ölçek
Authors: ATAOĞLU Safinaz , ANKARALI Handan , ANKARALI Seyit , KOÇAK Sona
Published: April 2018

Amaç: Bu çalışmada, osteoartrit tanısı almış hastaların, ağrı eşiği, ağrı şiddeti ve ağrının bıraktığı etkileri değerlendirmek için görselliğe ve kolay anlaşılabilirliğe önem veren, şiddeti daha ayrıntılı tanımlayan yeni bir ölçek geliştirilmesi planlandı. Gereç ve Yöntem: Çalışma, kesitsel tipte planlanan bir anket ve ölçek araştırmasıdır. Gönüllü olup araştırmaya alınma kriterlerine uyan, osteoartrit tanısı almış 76 hastaya anket uygulandı. Geliştirilen ölçekte, 3’ ü çok şiddetli, 3’ ü az şiddetli ağrı deneyimini ve 2’ si oteoartrit kaynaklı ağrı etkisini sorgulamaktaydı. Ölçekte, görsellik ve kolay anlaşılma ön plana çıkartıldı, ağrıyı daha ayrıntılı değerlendirme fırsatı sunuldu ve ağrı eşiğini belirlemede alternatif bir yaklaşım sunuldu. Bulgular: Ölçeğe uygulanan faktör analizi ile yapı geçerliliğinin olduğu ve 3 faktör içerdiği belirlendi. Ölçek maddelerinin iç tutarlılıkları iyi düzeyde ve istatistik olarak anlamlı bulundu. Sorulara verilen cevaplardan elde edilen puanlar arası uyum yüksek düzeyde çıktı. Çok ve az şiddetli ağrıları sorgulamaya yönelik hazırlanan sorulara verilen cevaplar birlikte dikkate alınarak hastalar ağrı eşiği düşük ve yüksek olarak iki gruba ayrıldı. Ayrıca osteoartrit ağrı şiddetinin, deneyimlenmiş en kötü karın ağrısından anlamlı farklılık göstermediği, ancak en kötü diş ve baş ağrısına göre daha hafif olduğu belirlendi. Sonuç:. SH-ağrı şiddeti ve ağrı eşiği ölçeğinin, yapı geçerliliğinin olması, iç tutarlılığa sahip olması, ölçekte yer alan sorulara verilen cevaplar arası uyumun yüksek olması ve ağrı şiddeti ile ağrı etkileri arasında anlamlı korelasyonun bulunması nedenleriyle geçerliliği ve güvenilir sonuçlar ürettiği söylenebilir.
Yenidoğanda dev konjenital melanositik nevüs
Authors: YAŞARTEKİN Yüksel , AKPINAR Melis , ÖZCAN Murat , SARICI Serdar Ümit
Published: April 2018

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Intestinal Ischemia in a Young Male with a History of Foreign Drug Abuse
Authors: Kaymak Şahin , Şenocak Rahman , Hançerlioğulları Oğuz , Can Mehmet Fatih , Kılbaş Zafer
Published: April 2018

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Pelizaeus-Merzbacher Hastalığına sahip pediatrik bir hastada rehabilitasyon deneyimi
Authors: Akaltun Mazlum Serdar , Aras Berke , Tezel Kutay , Demir Yasin , Yaşar Evren
Published: April 2018

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Crouzon syndrome in two siblings
Authors: MADİ Medhini , BABU Subhas , BHAT Supriya , MADİYAL Ananya , Castelino Renita
Published: April 2018

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Oxidative stress and outcome of antioxidant supplementation in patients with polycystic ovarian syndrome (PCOS)
Authors: Panti Abubakar A. , Shehu Constance E. , Saidu Yusuf , Tunau Karima A. , Nwobodo Emmanuel I. , Jimoh Abdulgafar , Bilbis Lawal S. , Umar Atteque B. , Hassan Mairo
Published: April 2018

Background: PCOS is a condition with significant decrease in antioxidant with an increased risk of oxidative stress. Antioxidant supplementation has been shown to improve insulin sensitivity in PCOS and may improve outcome of management of PCOS. Objectives of this study were to determine the oxidative stress level of PCOS patients, to assess the effect of antioxidant supplementation on the outcome of management of PCOS and to compare with a control group.Methods: The study was a single blind randomised control trial involving 200 patients with PCOS. The study was conducted at Usmanu Danfodiyo University Teaching Hospital Sokoto. They were randomly divided into intervention and control groups and base line serum levels of oxidative stress marker, antioxidant enzymes, vitamins and minerals were determined. Antioxidant supplementation and placebo were given to the intervention and control groups respectively. All the patients had ovulation induction with clomiphene citrate and were followed up for 6 months. Outcome measures were clinical pregnancy or menstrual regularisation. Level of significance was <0.05.Results: There was statistical significance in the serum levels of oxidative stress marker, antioxidant enzymes, vitamins and minerals between the two groups (post intervention). Glutathione peroxidase (p = 0.001), superoxide dismutase (p = 0.0001), catalase (p= 0.0369), melondialdehyde (p= 0.007), Vitamin A, Vitamin C, Vitamin E (p = 0.0001), zinc and copper (p = 0.0001). The clinical pregnancy outcomes were 22 (22%) versus 2 (2%); live births 18 (18%) versus 2 (2%) and menstrual regularisation 48 (48%) versus 46 (46%) in the intervention and control groups respectively.Conclusions: Antioxidant supplementation in this study significantly affected pregnancy rate in patients with PCOS. Larger studies are suggested to revisit the conclusion of the Cochrane review that antioxidants supplementation had no significant role in female infertility.
Genital prolapse at university hospital of Cocody: clinical aspects and therapeutic management
Authors: Kakou Charles , Adjoby Roland , Kasse Raoul , Assuikwe Victorine , Mian Boston , Boni Serge
Published: April 2018

Background: To determine the epidemiological aspects of genital prolapse; to describe the different clinical aspects of genital prolapse observed and to evaluate the therapeutic management of genital prolapse at the University hospital of Cocody (UH-C).Methods: We did an observational and transversal study with a descriptive purpose over 5 years from 2012 to 2016 in the Gynecology and obstetrics department of UH-C. The studied population was all cases of genital prolapse diagnosed and treated in the service during the period of the study. A follow-up over one year after surgery has been observed to evaluate surgical outcomes and recurrences. Genital prolapse was generally a uterine prolapse at stage 3 or 4. It was associated to cystocele in 31.4%. We did not find stress urinary incontinence associated with prolapse in our study. The surgical intervention performed was, in the majority case, the triple perineal intervention with success of 95.6%. A case of recurrence in the form of cystocele has been observed to a year of decline.Results: Genital prolapse was relatively common. It accounted for 0.5% of all gynecological visits. Women were young with an average age of 39.5 years. 62.9% were multiparous. 62.5% had given birth at least once at home without medical assistance. The reason for consultation the most watched was the projection of body at the vulva.Conclusions: Genital prolapse is a condition under estimated in Côte d'Ivoire. It represented 0.5% of the gynecological visits. Obstetric traumas were frequently found in our young patients with genital prolapse. The sociocultural considerations have contributed to delay consultations, to observe very advanced stages. The surgery performed was mainly the perineal triple surgery.
What can a mother die of at the Parakou University Hospital Center in Africa?
Authors: Adisso Sosthene , Agbossaga Gisele-Estelle T. , Ntakwinja Mukanire
Published: April 2018

Background: Maternal mortality is a scourge that severely undermines Benin and affects its development. The fact is that despite the efforts that have been made for decades, the causes remain unchanged. What is the evolution of maternal deaths in the maternity CHUD of the Borgou-Alibori which serves the departments of the Borgou and the Alibori populated by 1,245,264 inhabitants? The objectives of the present study aim to assess the ratio of maternal deaths, profile of deceased women, causes of death.Methods: This study took place at the maternity CHUD-B and covered a five-year period from January 1, 2010 to December 31, 2014. This is a retrospective, cross-sectional, analytical and descriptive study covering 113 cases of maternal death.  Results: During this period, we noted from 2010 to 2014 an evolution from 953 to 1388 deaths for 100,000 live births. The deceased women were for the most part illiterate, without any profession and married. The main direct causes of maternal deaths in order of frequency are hemorrhage 47.7%, eclampsia 19.5%, infection 9.8%, dystocia 3.5%. Indirect causes account for 19.5% of maternal deaths. The administration of emergency obstetric care has occurred under conditions where the third delay is found in 22.1% of cases with as the dominant factor the non-availability of blood products.  Conclusions: In the face of these circumstances, it is necessary to revise the system of the management of the Gravido-puerperium in the peripheral formations and in the maternity of the CHUD-B and then the conditions of transfer in order to positively influence the reduction of the mortality Maternal.
Characteristics of deliveries at a tertiary care hospital in Turkey: results from a retrospective analysis (2012-2016)
Authors: Pek Eren , Beyazit Fatma
Published: April 2018

Background: Although the choice of a particular method of birth delivery by the pregnant woman is a modern, complex and controversial subject all over the world, the rate of caesarean delivery has risen to nearly 50% in western countries. Apart from medical reasons, several non-medical factors are also involved in this choice, and they comprise the socioeconomic conditions, ethical/legal concerns and psychological and cultural characteristics of the patients and doctors. In this study, we aimed to evaluate the demographic and clinical characteristics of pregnant women who gave birth in a tertiary care hospital between October 2012 and June 2016.Methods: The patients’ charts of pregnant women who presented to the Canakkale Onsekiz Mart University hospital between October 2012 and June 2016 and who gave birth through either vaginal or caesarean delivery were retrospectively analysed. The patients’ age, delivery type, weeks of pregnancy at delivery, number of pregnancies and caesarean indications were recorded.Results: In this study, we retrospectively analysed 2012 pregnant women. The mean age of the pregnant women was 28.9 ±5.4 years. The mean gravida and parity of pregnant women were 1.9±1.0 and 1.5±0.7, respectively. Regardless of the delivery type, the mean pregnancy weeks were found to be 38.6±1.9 weeks. The mean pregnancy weeks of patients undergoing caesarean delivery were 38.4±1.8 weeks. The primary caesarean rates were 52.81%. The most common caesarean delivery indications were foetal distress, cephalopelvic disproportion and presentation anomalies.Conclusions: The steady increase in caesarean delivery rates has become a major cause of concern worldwide. The reasons for this phenomenon are mostly related to advanced age; foetal distress, especially one that is detected in continuous foetal monitoring; intrauterine growth retardation; presentation anomalies and multiple gestation. To avoid unnecessary caesarean births, mothers, especially nulliparous mothers, should be persuaded to undergo vaginal delivery.
Practice of diagnostic hysteroscopy after myomectomy in the prevention of intrauterine adhesions: experience of Ouakam military hospital (Dakar, Senegal)
Authors: Faye Dieme Marie Edouard , Niang Mouhamadou Mansour , Gassama Omar , Diouf Abdoul Aziz , Coulibaly Marietou Thiam , Diouf Alassane , Moreau Jean Charles
Published: April 2018

Background: Surgical treatment of myomas may be the cause of some complications, including intrauterine adhesions. The objective of the study was to evaluate the incidence of intrauterine adhesions in patients who underwent myomectomy by laparotomy or hysteroscopic resection.Methods: We carried out a prospective single center study from August 1st 2016 to May 31st 2017 in the gynaecological and obstetrical department of Ouakam the Military Hospital (Senegal). We included patients who underwent myomectomy by laparotomy with opening of the uterine cavity or myomectomy by hysteroscopy. A diagnostic hysteroscopy was performed to search post-operative intrauterine adhesions. For each patient, we studied the socio-demographic aspects, the surgical approach, the delay of diagnostic hysteroscopy, the appearance of uterine cavity and the tolerance of hysteroscopy.Results: 54 patients underwent the diagnostic hysteroscopy. The mean age was 36 years old. The main indication of myomectomy was menorrhagia. 37 patients underwent myomectomy by laparotomy and 17 by hysteroscopy. Each case was followed by a post-operative diagnostic hysteroscopy with a mean delay time of 58 days. We found post-operative intrauterine adhesions in 7 patients (5 in the laparotomy group and 2 in hysteroscopy group).Conclusions: Early diagnostic hysteroscopy after myomectomy should be done in our context to reduce post-operative intrauterine adhesions and preserve the patient’s fertility.
Current trends of consanguineous marriages and its association with socio-demographic variables in Pakistan
Authors: Khan Fouzia Zahid Ali , Mazhar Syeda Batool
Published: April 2018

Background: A high proportion of marriages in South and Middle East Asia are contracted between close biological relatives due to cultural preference as it is a deeply rooted social fashion among these societies. The aim of this study was to determine the frequency of consanguineous marriages and ascertain their relationship to relevant sociodemographic variables.  Methods: This was a cross sectional descriptive study conducted in tertiary care hospital of Islamabad. Data were collected on a specially designed questionnaire form. Age of participants, their education, socioeconomic status, castes and number of anomalous children born to these participants, degree of consanguinity and reasons of preferences were inquired.  Results: Out of 300 women chosen by convenience sampling technique, 62% had consanguineous marriages, and 38% had a non-consanguineous union. The mean age of women presenting to maternal and child health centre was 27 years. The average age of a woman having consanguineous marriage was 21 years in contrast to 24 years for non-consanguineous nuptial. About 18% of women in consanguineous marriages were illiterate as compared to 5.4% (p = 0.001) of women in non-consanguineous unions. First cousin marriages were more common among certain castes like Rajput and Awan. None in the consanguineous group had any anomalous baby in contrast to non-consanguineous who had two anomalous children (p = 0.0001). There was no significant association between type of marriage and the number of miscarriages (p=0.69).Conclusions: This study showed UA-S/D ratio and UA-RI>2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted.
Determinants of uterine rupture in Dessie Referral Hospital, North East Ethiopia, 2016: case control design
Authors: Workie Amare , Getachew Yemmiamrew , Temesgen Kibir , Kumar Prem
Published: April 2018

Background: Uterine rupture remains a major obstetric problem particularly in less developed countries. The aim of this study was to identify determinants of uterine rupture among mothers getting delivery services in Dessie Referral Hospital from January 2016 to June 2016, North East Ethiopia.Methods: A prospective unmatched case control study was conducted recruiting 42 mothers with uterine rupture as case group and 168 for control group. Pretested, structured questionnaire was used to collect data.Results: Descriptive statistics and Logistic regression models were utilized considering 95% confidence interval and p-value of 0.05 to determine the presence and strength of association between dependent and independent variables. Majority (94.2%) of cases came from rural areas, 76.2% had obstructed labor and 55% had prolonged labor. Of 85.7% of cases have reported number of pregnancies ≥ 5. Mothers who encountered obstructed labor and previous Caesarean section scar were at higher risk of uterine rupture (AOR=22.2, 95% CI=2.8-4.1 and AOR=13.6, 95% CI=2.16-17.84 respectively). Mothers living in urban area, having Antenatal Care follow-up, shorter labor stay and primi-parity were found to have lower risk of uterine rupture.Conclusions: This study revealed that living in rural areas, absence of Antenatal Care follow-up, prolonged labor, obstructed labor, grand multiparity and previous Caesarean section scar were determinants of uterine rupture. Viable strategies have to be designed and implemented to tackle these determinants of uterine rupture.
Use of the Robson classification to assess caesarean section trends in tertiary hospital
Authors: Gomathy E. Gomathy , Radhika Kondareddy , Kondareddy Triveni
Published: April 2018

Background: With caesarean sections on the rise WHO proposes that health care facilities use the Robson's 10 group classification system to audit their C-sections rates. This classification would help understand the internal structure of the CS rates at individual health facilities identify key population groups, indications in each group and formulate strategies to reduce these rates.Methods: This was a cross sectional study for a period of 6 months at a tertiary care hospital in a rural area in Karnataka, South India. Women who delivered during this period were included and classified into 10 Robson's classes and percentages were calculated for the overall rate, the representation of groups, contribution of groups and Caesarean percentage in each group.Results: Highest contribution was by Group 5 and Group 2. Together these two groups contributed to 50.3% of the total Caesareans. Followed by Group 1 and 10. A Groups 6, 4, 8 and 9 by themselves did not contribute much but within their groups had a 100% C-section rate.Conclusions: Robson 10-group classification provides easy way in collecting information about Caesarean section rate which obtains good insight into certain birth groups. Reducing primary section rates, adequate counselling and encouraging for VBAC, changing the norms for non-reassuring fetal status, training and encouraging obstetricians to perform versions when not contraindicated could reduce the contribution of Robson's groups towards the absolute C-Section rates.
Correlation of efficacy of cerebro placental ratio with adverse perinatal outcome in clinically suspected IUGR pregnancies
Authors: Singh Geeta , Gupta Neerja , Singhal Sangeeta , Sharma Pramod Kishor
Published: April 2018

Background: IUGR is a most common and complex problem in modern obstetrics. Most commonly use methods to assess fetal condition are BPP and NST which are not sensitive for predicting better perinatal outcome.  Present study was an effort to evaluate the role of ratio of pulsatility index (PI) of middle cerebral artery and umbilical artery which is called cerebro placental ratio as the most sensitive, specific and accurate predictor of adverse perinatal outcome in clinically suspected IUGR Pregnancies.Methods: 50 clinically suspected IUGR Pregnancies attending antenatal clinics Muzaffarnagar Medical College and Hospital, Muzaffarnagar were subjected to Doppler ultrasound evaluation Doppler velocity wave form of umbilical artery and fetal middle cerebral artery were obtained. Pulsatility index ratio of MCA and umbilical artery (cerebro placental ratio) was evaluated in each case. Abnormal ratio is defined as CPR<1.08 considered as cut of value. Ratio was coo related clinically with perinatal outcome.Results: Out of 50 antenatal cases, 63% neonates had birth weight <2.5 kg. There were 6 IUD’S and 44 live births, 9 neonates were admitted to NICU, 7 neonates had 5 min. APGAR score <7 and 13 neonates were born by emergency CS. Of the 6 IUDS, 4 cases had reversal of blood flow umbilical artery and 2 cases had absent diastolic flow. In all cases of reversal Diastolic flow, IUD occurred within 7 days of diagnosis. Conclusions: CPR is the most sensitive, specific and accurate parameter in prediction of adverse perinatal outcome and thus can help in decreasing perinatal mortality.
Pregnancy with previous caesarean section: an overview of adverse fetomaternal sequelae
Authors: Bhowmik Joyita , Kyal Amit , Das Indrani , Berwal Vidhika , Das Pijush Kanti , Mukhopadhyay Partha
Published: April 2018

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.
Maternal outcomes in patients with previous one lower segment caesarean section undergoing trial of labour: prospective observational study
Authors: . Veeramma , Mahajan Puneeta
Published: April 2018

Background: The incidence of caesarean section is on the rise and has increased 2-3 folds from the initial rate of 10% during the last decade.  The objective of the present study was to compare maternal outcomes in successful and failed trial of labour in women with previous one LSCS.Methods: This prospective observational study was carried out in Department of obstetrics & Gynaecology, Sanjay Gandhi memorial Hospital, New Delhi during 2015-2016 and included 150 gravid women with previous LSCS.   The study was undertaken during March 2015 to May 2016. The ethical committee approval for the study has been taken.Results: out of 150 patients who had given a trial of labour, 64.7% (97) underwent successful VBAC and 35.3 %( 53) underwent emergency repeat LSCS. Majority of cases 59.3% were in age group <25 years followed by 36.7% in age group of 25-30 years. Most of the cases are para one 72.7% and remaining are multipara (27.3%). LSCS group: 83% para1 and 17% are multipara. VBAC group: 67.01 % para 1 and 32.9% multipara. There is no significant statistical difference between parity and mode of delivery. (p=0.591). Majority of cases 52.7% were in between 37-39 weeks and 47.3% cases were in between 39-42 weeks. Majority cases 89.3% had Bishop’s score 4-6 and 10.7% had Bishops score >6.Conclusions: This study reveals that successful VBAC rate was 64.7% and 35.3% emergency repeat caesarean section.
Correlation between β-HCG and Doppler in post molar surveillance
Authors: S. Priyadarsini , A. Gigi
Published: April 2018

Background: Gestational trophoblastic disease encompass a spectrum of neoplastic disorders that arise from placental trophoblastic tissue after abnormal fertilisation. Most molar pregnancies spontaneously resolve after uterine evacuation with no further sequelae. However, at any time during or after gestation malignant transformation may occur in approximately 10% to 20% of molar pregnancies. Quantification of βHCG is considered as the ideal method of post molar surveillance. The regression of the disease could be reliably assessed by observing the changes in low resistance flow which paralleled the gradual decrements in serial βHCG levels. To correlate uterine artery blood flow characteristics to serum βHCG levels in the follow up of patients with gestational trophoblastic disease after molar evacuation.Methods: 50 patients with gestational trophoblastic disease after evacuation were followed up by serum βHCG titres and Doppler ultrasonography of uterine arteries. The relationship between the Doppler indices and the serum βHCG titres were evaluated by paired –t test and Pearsons correlation analysis.Results: Significant negative correlations were observed between Systolic/Diastolic (S/D) ratios, Resistance Indices(RI) and Pulsatility indices (PI) and the absolute values of serum βHCG levels, with correlation coefficients of -0.5, -0.46 and -0.40 (p<0.01). The mean values of βHCG showed a decreasing trend from 1st week to 4th week. The mean value of RI, PI and S/D Ratio showed an increasing trend from 1st week to 4th week. However, the difference in mean values of βHCG and Doppler indices at 1st week and 4th week were analysed by paired t test and found to be statistically insignificant(p>0.05) in patients with spontaneous remission.Conclusion: Uterine artery Doppler indices can be used as an adjunct to βHCG for the surveillance of patients with gestational trophoblastic disease after molar evacuation to predict remission of the disease.
Obstetrics ICU admissions: challenges faced at a tertiary referral centre
Authors: Jamal Shehla , Mehta Archana , Goel Neerja , Ahuja Mayuri , Afreen Naima , Malik Sweety
Published: April 2018

Background: Management of critically ill patients in obstetrics is a challenge owing to the changed physiology and unpredictability of the disease behaviour. Stratification strategy for early admission to obstetric ICU is imperative to reduce maternal morbidity and mortality. Due to lack of formal surveys regarding obstetrical ICU in our country, there is lack of precise national data on obstetrical ICU mortality. Aim of the present study was to estimate the obstetric ICU admission rate, to study the pattern of causative aetiology and to study the complications developed in ICU.Methods: The present study is a retrospective analytical study done in the Department of Obstetrics and Gynecology, from January 2015 to August 2017.Results: During the study period there were a total of 8466 obstetrical admissions, 2508 deliveries and 104 ICU admissions. Out of 104, analysis was done on 71 patients. Hypertensive disorders of the pregnancy were associated with maximum number of admissions (47.8%), followed by postpartum haemorrhage (12.6%). Maximum admissions were in postpartum period (63.4%). Anaemia was associated with 35.2% of the cases and it was closely followed by sepsis (28.2%). Mechanical ventilation was required for 30.9% of the patients.Conclusions: Hypertensive disorders of the pregnancy, haemorrhage and sepsis are the major risk factors for ICU admission in obstetric population.
Study of the cases of severe acute maternal morbidity at a tertiary care centre
Authors: Jamal Shehla , Srivastava Ruchi , Jain Arpit , Chutani Nimmi , Agarwal Shelly , Mehta Archana , Gupta Samta
Published: April 2018

Background: Reduction in the maternal morbidity has been the key strategy towards achievement of Millennium Development Goal. Despite exhaustive measures at all levels, the decline has been slow. WHO in 2007 established a technical working group to identify cases of severe acute maternal morbidity. It served dual goals to identify the causes and pointing out delays leading to SAMM. SAMM is now an established superior indicator of surviving women’s health and allows uniform comparisons. The present study was conducted with an aim to identify cases of SAMM at our centre. The objective is to determine the frequency of maternal near miss and conduct an epidemiological survey.Methods: This retrospective study was conducted in the department of Obstetrics and Gynecology and ICU of School of Medical Sciences and Research, Greater Noida, from November 2014 to October 2017. All the cases identified as SAMM, as per WHO 2009 criteria (modified according to the local protocol), were included in the study.  Results: During the study period there were a total of 2252 delivery, out of which 2051 were live births. There were 123 SAMM cases and 47 were excluded out of study. So, study was done on 76 cases of SAMM, and on 11 maternal deaths in the study period. Calculated MNM incidence ratio was 37.05 per 1000 live births. A mortality index of 12.64% was calculated. MNM to maternal death ratio was 6.9:1. Major identifiable cause for SAMM was hypertension (35.5%)), followed by haemorrhage (18.4%). Haematologic system was the commonest organ system involved. 67.8% of the admissions were done in critical condition.Conclusions: Maternal mortality and SAMM cases shared characteristics, and study of SAMM cases can provide an insight into the causative etiology and give time for early intervention.