bluuebunny/crossref_metadata_2025 huggingface dataset:
Онтологические основания ценностной детерминации научного познания
Authors: Нуруллин Рафаиль Асгатович
Published: December 2018

Рецензия на книгу: М. В. Клёцкин. Онтологические основания ценностной детерминации научного познания. М. : БИБЛИО-ГЛОБУС, 2018. 290 с. ISBN: 978-5-907063-01-3.

Как отмечается в рецензии, работа посвящена проблеме философского переосмысления аксиологических оснований современной науки. Автор монографии пытается по-новому переосмыслить познавательно-ценностные установки античной философии и вернуть идеи Аристотеля в лоно аксиологических оснований современной науки.
Проектный подход в решении проблем прекаризации занятости современной молодежи
Authors: Федорова Наталья Васильевна , Коврижкина Мария Михайловна
Published: December 2018

В статье анализируется проблема временной занятости (прекаризации) молодежи России, которая распространилась сегодня на рынке труда. При этом молодежь не рассматривается как единое поколение, в ее составе есть различные поколенческие группы. Выделяются следующие категории работающей молодежи: стабильно занятые, успешные фрилансеры, работающие низкооплачиваемые молодые специалисты и прекаризованная группа молодежи. Заработков молодежи, относящейся к последней группе, хватает на выживание, но не более того. Молодежь этой категории не может сменить профессию или место жительства, она недостаточно грамотна с правовой точки зрения, чтобы найти работу и заключить хороший контракт. Выживание ей обеспечивают родители или более успешные родственники.

Главная особенность этой группы — восприятие рынка труда как безусловно враждебного к ним. В отличие от молодых людей с низким доходом прошлого, современные представители низшей прекаризованной группы молодежи менее склонны к асоциальному поведению, проявляя низкую политическую и криминальную активность.

Прекаризацию молодежи как явление можно связать с развитием острых поколенческих конфликтов, действующих в трех социальных плоскостях: в системе образования (между преподавателями и обучающимися), на рынке труда (между работодателями и молодыми специалистами) и в среде самой молодежи (внутриролевой конфликт).

Общей рекомендацией  может стать не только выработка профессиональных компетенций в рамках образовательного процесса, но и проведение мероприятий со стороны работодателей.  Это касается  разработки системы поиска перспективных выпускников и организация стажировок. Успешной показывает себя практика взаимодействия работодателей с учебными заведениями для  целевой подготовки будущих сотрудников.

В целом прекаризация молодежи может быть расценена как негативное явление современного рынка труда. Негативное влияние ее может быть снижено за счет трансформации образовательного процесса в учебных заведениях и более тесной работы с будущими работодателями. Такое взаимодействие усиливается через деятельность профессиональных и бизнес-сообществ по созданию и корректировке профессиональных стандартов и развитию у молодых специалистов надпрофессиональных компетенций, что в конечном счете  позволит  преодолеть прекаризацию занятости молодежи.
The effectiveness of using modern technologies in early recovery period treatment of post-stroke patients
Authors: Mizieva Z. M. , Shirshova E. V.
Published: December 2018

This study presents the results of investigation «Amadeo», «Armeo» effectiveness in treatment of 61 post-stroke patients during early recovery period with upper limbs motor dysfunction. Comparative characteristics of treatment effectiveness in patients with ischemic and hemorrhage stroke are given. The results of investigation represent positive effect of using robotic technologies in post stroke patients rehabilitation therapy.
Methods of diagnosis in cardio-oncology
Authors: Plokhova E. V. , Sorokin A. V. , Staferov A. V. , Dundua D. P.
Published: December 2018

Early diagnosis and advances in treatment have led to improved survival of patients with cancer, but have also increased morbidity and mortality due to treatment side effects. Cardiovascular diseases (CVDs) are one of the most frequent of these side effects. As a result of the direct effects of radiation therapy and chemotherapy on heart and vessels сan be: acceleration of atherosclerosis, damage of cardiomyocytes and endothelium, and arterial and venous thrombosis. The direct effect of the cancer treatment on the heart is called cardiotoxicity. Early diagnosis and identification of patients at high risk of cardiotoxicity is the first step towards successful prevention of CVD in cancer patients without compromising cancer care, which ultimately leads to a reduction in mortality. Echocardiography is the method of choice for the detection of myocardial dysfunction during and after cancer therapy. New methods of imaging like three-dimensional echocardiography, speckle-tracking echocardiography, cardiac magnetic resonance show a higher sensitivity in detecting of early myocardial dysfunction during cancer therapy. This review outlines the main diagnostic algorithms and approaches used in cardiooncology.
Information note on the work of the multi-republican medical center at the Federal Research and Clinical Center of the Federal Medical and Biological Agency of Russia (Yalta, Republic of Crimea)
Authors: Khabazov R. I.
Published: December 2018

Information note on the work of the multi-republican medical center at the Federal Research and Clinical Center of the Federal Medical and Biological Agency of Russia (Yalta, Republic of Crimea)
İkinci basamak hastanede perkütan endoskopik gastrostomi deneyimlerimiz
Authors: ŞENLİKÇİ Abdullah , KUZU Ufuk Barış , DEDE Fatma , YÜCE Kerime
Published: December 2018

Giriş ve Amaç: Perkütan
endoskopik gastrostomi, herhangi bir nedenle oral yoldan beslenemeyen ve gastrointestinal
sistemi sağlam olan hastalarda enteral beslenmenin sağlandığı en güvenli
gastrostomi çeşididir. Bu çalışmadaki amacımız 2. basamak hastanemizdeki perkütan
endoskopik gastrostomi takılma endikasyonlarını, işlem sonrası erken ve geç
dönem komplikasyonlarını ve takipleri ile ilgili verileri sunmaktır. Gereç ve Yöntem: Bitlis
Devlet Hastanesi endoskopi ünitesinde Eylül 2016-Ekim 2017 tarihleri arasında
perkütan endoskopik gastrostomi tüpü takılan hastalar retrospektif olarak
incelendi. Bulgular: Çalışmaya
26 olgu dahil edildi. Olguların yaş ortalaması 64,23 (18-101) idi. Olguların
13'ü erkek ve 13'ü kadın idi. Olguların 11'ine (%42,3) serebrovasküler
hastalık, 5'ine (%19,23) demans, 3'üne (%11,53) amyotrofik lateral skleroz, 1'ine
(%3,84) nöro-Behçet, 1'ine (%3,84) hidrosefali, 1'ine (%3,84) akromegali, 1'ine
(%3,84) elektrik yanığı, 1'ine (%3,84) Erb-Duchanne Musküler distrofisi, 1'ine (%3,84)
serebral palsi ve 1'ine (%3,84) epidural kanama nedeniyle perkütan endoskopik
gastrostomi yapıldı. Olguların ortalama takip süresi 137,65 (4-388) gündür. 2 (%11,53)
olguda erken dönem komplikasyon gözlendi. Bir olguda batın içi serbest hava ve
bir olguda da üst gastrointestinal sistem kanaması gözlendi, ek olarak bir
hastamızda, uyumsuzluk nedeniyle perkütan endoskopik gastrostomi kanülünü
çekerek çıkardığı gözlendi. İşleme bağlı mortalite gözlenmemiştir. 1 aylık
mortalite oranımız %3,8 ve 3 aylık mortalite oranımız ise %26,9'dur. Sonuç: Perkütan
endoskopik gastrostomi enteral beslenme amacıyla yapılan gastrostominin en
güvenilir yoludur. 2. basamak hastanelerde de güvenle uygulanabilir.
Kolorektal Kanserde Endoskopik Özelliklerler Tümör Patolojisini ve Tümör Evresini Predikte Edebilir mi?
Authors: AKPINAR Muhammet Yener , UZMAN Metin , GÖKTAŞ Zeynep , ŞİMŞEK Gülçin Güler , KAHRAMANOĞLU AKSOY Evrim , SAPMAZ Ferdane , NAZLIGÜL Yaşar
Published: December 2018

Giriş ve Amaç: Kolorektal kanserli hastalarımızın demografik

özelliklerini ve tanı anındaki endoskopik özelliklerinin kolorektal kanserin

patolojik özellikleri ile olan ilişkisini incelemeyi hedefledik. Gereç ve Yöntem: Hastanemiz Endoskopi Ünitesinde Ocak 2010-Ekim 2017

tarihleri arasında kolonoskopi esnasında kolorektal kanser ön tanısı ile

biyopsi alınan ve patolojileri kolorektal kanser gelen hastalar çalışmaya dahil

edildi. Tümöre bağlı lüminal obstrüksiyon, tümörün makroskopik özellikleri gibi

endoskopik özellikler ve kolorektal kanserin patolojik özellikleri retrospektif

olarak incelendi.  Bulgular: Çalışmamıza 168 hasta dahil edildi. Hastaların en

sık başvuru şikayeti kabızlık olup kolonda kanserin en sık izlendiği yer

sigmoid kolondu. Hematokezya sol kolon yerleşimli kanserlerde diğer

bölgelerdekine göre anlamlı olarak daha sık izlendi (p=0.02). Cinsiyetler

arasında başvuru şekli, kanser lokalizasyonu ve endoskopik obstrüksiyon

farklılık göstermedi. Endoskopik obstrüksiyonu olan hastalarda kolorektal

kanserin kötü diferansiasyonu anlamlı olarak daha fazlaydı (p=0.015). Sonuç: Endoskopun geçemeyeceği şekilde lüminal obstrüksiyonu

olan hastaların yakından izlenmeleri, ameliyatlarının geciktirilmeden yapılması

ve ameliyat sonrası daha kısa aralıklarla takibi bu hastaların sağkalımları üzerine

etkili olabilir.
Endoskopik transpapiller safra kesesi drenajı: Tek merkez deneyimi
Authors: KAPLAN Mustafa , ÖDEMİŞ Bülent , DİŞİBEYAZ Selçuk , PARLAK Erkan , ÖZTAŞ Erkin , GÖKBULUT Volkan , COŞKUN Orhan
Published: December 2018

Giriş

ve Amaç: Bu çalışmada

komorbit durumların eşlik ettiği sistik kanal veya safra kesesi ilişkili

hastalıklarda ERCP ile transpapiller safra kesesi drenajının teknik ve klinik

başarısını ve komplikasyonlarını araştırdık. Gereç ve Yöntem: Bu çalışma 2011-2017 yılları arasında koledok

taşı, kolanjit veya Mirizzi sendromu nedeniyle endoskopik retrograd kolanjiopankreotografi

endikasyonu zaten konulan ve eşlik eden akut kolesistiti olan toplam 19 hasta ile

yapıldı. Endikasyona göre koledok taşları ve sistik kanal taşları çıkarıldıktan

veya koledoğa stent yerleştirildikten sonra tüm hastalarda nazosistik dren veya

pigtail stent ile transpapiller safra kesesi drenajı sağlandı. Transpapiller

safra kesesi drenajının teknik ve klinik başarısı ve işlemin komplikasyonları

değerlendirildi. Bulgular: Hastaların 15’inde (%79) en az bir komorbid hastalık vardı.

10 hastada sistik kanalda taş izlendi. Sistik kanalında taş olan tüm hastalara

balon ile lavaj, 3 hastaya basket ve mekanik litotripsi ve bir hastaya da

sistik kanal girişine balon dilatasyonu uygulandı. Transpapiller safra kesesi

drenajı 8 hastada 7F nazosistik dren, 6 hastada 7F nazobiliyer drenden yapılma

stent, 3 hastada 7F double pigtail stent ve 2 hastada 10F double pigtail stent

ile sağlandı. Çalışmada transpapiller safra kesesi drenajının teknik başarısı

%100 ve klinik başarısı %89 olarak bulundu. İşleme bağlı ölüm dahil herhangi

bir komplikasyon görülmedi. Sonuç: Komorbit durumların eşlik ettiği safra

kesesi veya sistik kanal ile ilişkili hastalıklarda endoskopik retrograd kolanjiopankreotografi

ile transpapiller safra kesesi drenajı başarılı ve komplikasyonu az bir

yöntemdir.
El primogénito de Albuquerque, de R. López Soler: la lucha por la corona de Castilla
Authors: Rubio Cremades Enrique
Published: December 2018

La novela El primogénito de Alburquerque, de R. López Soler, puede considerarse como una de las obras más importantes de la narrativa histórica del Romanticismo. En el presente estudio se analizan lasfuentes históricas relacionadas con Pedro I el Cruel y su hermanastro Enrique de Trastámara, desde laCrónica de López de Ayala hasta los romances referidos a dichos personajes. Hechos históricos que se entrecruzan con las aventuras y desventuras de Martín Gil, el primogénito de Alburquerque, un héroeliterario cuyos hechos se engarzan con las rivalidades entre estos dos personajes históricos.The novel El primogénito de Alburquerque, by R. López Soler, can be considered one of the most importantworks of the historical narrative of Romanticism. In the present study we analyze the historical sourcesrelated to Pedro I the Cruel and his stepbrother Enrique de Trastámara, from the Crónica of Lopez de Ayala to the romances that refer to these characters. Historical events that intersect with the adventures and misadventures of Martín Gil, the firstborn of Alburquerque, a literary hero whose events are intertwined with the rivalries between these two historical characters.
Historia y ficción: La corona de perlas de Pilar Sinués
Authors: Ayala María de los Ángeles
Published: December 2018

En el presente artículo se analiza la novela histórica La corona de perlas (1857) de Pilar Sinués de Marco(1835-1893), resaltando sus características más peculiares y relevantes: fuentes, datos históricos, elementos folletinescos y principales recursos utilizados por la escritora.This article analyzes the historical novel La corona de perlas (1857) by Pilar Sinués de Marco (1835-1893),highlighting its most peculiar and relevant characteristics: sources, historical data, folletinesque elements and main resources used by the writer.
Juan Alfonso de Baena y los poetas de la corte de don Juan II en las novelas populares de Manuel Fernández y González
Authors: Préstamo Landín María Teresa del
Published: December 2018

A comienzos de la década de los 50, Manuel Fernández y González publica El condestable Don Álvarode Luna (1851) y Don Juan el Segundo o el bufón del rey (1853). En ambas historias recrea la corte literariade Juan II, en la que se entremezclan Juan Alfonso de Baena, Juan de Mena, Jorge Manrique y RodrigoCota, cuya presencia resulta determinante para las diferentes intrigas que se gestan contra Luna. En elpresente artículo abordaré la función que los poetas representados adquieren en ambas novelas.At the beginning of the decade of the 50, Manuel Fernandez and González publishes El condestable DonAlvaro de Luna (1851) and Don Juan el Segundo o el bufón del rey (1853). In both histories recreates the literary court of Juan II, in which Juan Alfonso de Baena, Juan de Mena, Jorge Manrique and Rodrigo Cota intermingle and whose presence is determined for the different intrigues that are generated againstLuna. In the present article I will address the role that the represented poets acquire in both novels.
Ceferino Suárez Bravo al compás de los tiempos: El tigre y la zorra, reescritura del texto dramático Los dos compadres, verdugo y sepulturero
Authors: Codeseda Troncoso Fátima
Published: December 2018

Ceferino Suárez Bravo, erudito ovetense de mediados del XIX, no será ajeno al tiempo de inestabilidadpolítica y social en el que vive, y publica, con motivo de las revueltas que precedieron a la segundaguerra carlista, el drama Los dos compadres, verdugo y sepulturero. Es este argumento el que le serviráreelaborado, años más tarde, para un poema del estilo de los grandes romances históricos de Rivas,Espronceda o Zorrilla. El tigre y la zorra, divulgado en el Semanario Pintoresco Español, representa esteel auge del Romancero, así como de la fábula, la leyenda y la temática medieval, con Álvaro de Luna yJuan II como telón de fondo.Ceferino Suárez Bravo, an Ottoman scholar from the mid-nineteenth century, will not be unaware of thetime of political and social instability in which he lives, and published, in the wake of the revolts thatpreceded the Second Carlist War, the drama Los dos compadres, verdugo y sepulturero. It is this argumentthat will serve, reworked, years later for a poem of the style of the great historical romances of Rivas,Espronceda or Zorrilla. El tigre y la zorra, published in the Semanario pintoresco español, represents fromthis the rise of the romancero, as well as from the fable, the legend and the medieval theme, with Álvarode Luna and Juan II as a backdrop.
Los estribillos en los romances de juventud de Lope de Vega = The choruses in the romances of Lope de Vega’s youth
Authors: Llamas Martínez Jacobo
Published: December 2018

Lope de Vega indicó en el prólogo de las Rimas de 1604 que los versos de los romances «obligan a la corresponsión de las cadencias», términos con los que parece aludir a la armonización de los patrones rítmicos o cadencias. En este trabajo se estudian los estribillos de los romances «El lastimado Belardo»; «Sentado en la seca yerba»; «¡Oh, gustos de amor traidores!»; «Al pie de un roble escarchado»; «De pe­chos sobre una torre»; «Ya vuelvo, querido Tormes»; «Cuando las secas encinas»; «Hermosa Lucinda mía»; «Riyéndose va un arroyo»; y «Ardiendo se estaba Troya», atribuidos con gran fiabilidad a Lope y cuya ajustada distribución y repetición acredite tal vez la importancia que Lope concedió a la «corres­ponsión de las cadencias» en sus romances.Lope de Vega points out in the prologue of Rimas that the verses of the romances «obligan a la corres­ponsión de las cadencias»; Lope seems to refer to the harmonization of the rhythm patterns or cadencias. This article studies the chorus of the romances «El lastimado Belardo»; «Sentado en la seca yerba»; «¡Oh, gustos de amor traidores!»; «Al pie de un roble escarchado»; «De pechos sobre una torre»; «Ya vuelvo, querido Tormes»; «Cuando las secas encinas»; «Hermosa Lucinda mía»; «Riyéndose va un arroyo»; and «Ardiendo se estaba Troya», attributed with high probability to Lope. The distribution and repetition of these choruses prove the importance that Lope gives to the «corresponsión de las cadencias» in his romances.
La casa y su dimensión fantástica en “El cuarto de vidrio”, de Norah Lange = The house and its fantastic dimension in “El cuarto de vidrio” by Norah Lange
Authors: Ferreira Prado María Cecilia
Published: December 2018

El cuarto de vidrio (póstuma-2006) es la última novela de la escritora argentina Norah Lange. En ella se privilegia el espacio de la casa, la cual aparece aquí profundamente personificada, lo que tiñe el total del relato del sello fantástico que caracteriza a los escritores del boom. Lange reanuda, en esta novela, la estética de lo increíble que se había iniciado en Antes que mueran (1944), había conocido el éxito y el reconocimiento con Personas en la sala (1950), y había llegado a Los dos retratos (1956), sin que la crítica literaria se hubiera percatado de que estábamos ante una literatura plenamente fantástica o, dicho de otro modo, que sin descifrar ese elemento fantástico no se podía interpretar el sentido último de la na­rrativa de Lange; una estética que se inserta en la línea de la literatura fantástica promocionada por su primo político Jorge Luis Borges y que tuvo amplia repercusión en Hispanoamérica, especialmente en el Río de la Plata.El cuarto de vidrio (posthumous work-2006) is the last novel of the Argentine writer Norah Lange. In it is privileged the space of the house, which appears here deeply personified, which dyes the history of the fantastic seal that characterizes the writers of the Boom. In this novel, Lange reiterates the aesthetics of the incredible stories, that had begun in Antes que mueran (1944), had known success and recognition with Personas en la sala (1950), and had come to Los dos retratos (1956), without the literary criticism having realized that we were in front of a totally fantastic literature or, in other words, that without deciphering that fantastic element could not be interpreted the ultimate meaning of Lange’s narrative an aesthetic that is inserted in the line of fantastic literature promoted by his cousin in-law, Jorge Luis Borges, and that had wide repercussion in Hispanic America, mainly in the Río de la Plata.
Construct validity and factor structure of the Pittsburgh Sleep Quality Index (PSQI) among physicians in Jeddah, Kingdom of Saudi Arabia
Authors: Malik Ahmad Azam , Bakarman Marwan A. , Butt Nadeem Shafique
Published: December 2018

Sleep disorders continue to rise and have been estimated to affect around half of the global population. Poor sleep quality and insomnia are also linked to various health issues in different populations. The Pittsburgh Sleep Quality Index (PSQI) is one of the most commonly used tool to assess sleep quality. It has been tested in various clinical and non-clinical settings and populations but mostly in developed world. Literature is limited from Arab region and further scarcity of studies is observed among health providers from the region. This study aimed to assess the construct validity and factor structure of PSQI among physicians in Jeddah, Kingdom of Saudi Arabia. This cross-sectional study used the PSQI tool with 19 items and 7 components on 330 physicians working in Jeddah. Data was entered and analyzed in IBM SPSS and AMOS version 22. Cronbach alpha was 0.745. Construct validity showed satisfactory results. Exploration of factor structure with Confirmatory factor analysis (CFA) showed 1-factor model as better fit. Among three models, 3-factor model showed least fit indices. The study findings showed some similarities as well as differences to comparable studies using PSQI in other settings that requires further as well as continuous exploration of the dynamic issue in similar and diverse settings.
Effect of tranexamic acid in prevention of postpartum hemorrhage in elective caesarean delivery: a randomized controlled study
Authors: Abd El-Gaber Abd El-Naser , Ahmed Hazem H. , Khodry Mustafa M. , Abbas Ahmed M.
Published: December 2018

Background: Postpartum hemorrhage is the ugly ghost that most obstetricians believe because many cases unpredicted and may be associated with rapid patient deterioration that may lead mortality or developing serious long-term morbidities. The objective of this study is to assess the efficacy of slowly intravenous administration of tranexamic acid in prevention and decline the severity of postpartum hemorrhage immediately prior to elective caesarean section.Methods: A double blinded, randomized, case control trial carried out at Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt from May 2017 to April 2018. This study was conducted on 500 full term pregnant women underwent elective caesarean section. The patients were divided randomly into: Group A (study group) included 250 patients received tranexamic acid 1gm slowly iv over 2 minutes at least 10 minutes before operation started and Group B (control group) included 250 patients that received placebo (normal saline NaCl 0.9%).Results: Incidence of PPH in group A and group B were (4.4% and 6.8) respectively, 1.2% in group A and 2.8% in group B had severe degree of PPH. Amount of blood loss immediately after placental delivery up to first 6 hours postoperative was statistically significant increase in placebo group than tranexamic acid group with p value <0.001.Conclusions: Tranexamic acid administration few minutes prior to elective cesarean section was effective in reducing the incidence and severity of PPH and decreased the use of additional uterotonic drugs and additional surgical interventions.
Maternal and perinatal outcome in women with eclampsia: a retrospective study at the University of Benin Teaching Hospital
Authors: Okoror Collins E. M.
Published: December 2018

Background: Eclampsia is a serious obstetric complication with attendant high maternal and perinatal morbidity and mortality especially in the developing countries. This study aims to assess the maternal and perinatal outcomes of eclampsia and suggest ways to improve them.Methods: This was a 5-year retrospective study (2009-2013) of cases of eclampsia managed at the University of Benin Teaching Hospital, Benin City, Nigeria. The number of cases managed was obtained from records at the emergency room, labour ward, theatre, lying-in wards and special care baby unit and case notes of patients satisfying the inclusion criteria retrieved from the medical records library.Results: The prevalence of eclampsia was 1.99% of total deliveries. It was highest in teenagers (29%), nulliparous (3.1%) and the unbooked (8.5%). Antepartum eclampsia accounted for 69.6% of the cases and a majority (74.6%) was delivered by emergency caesarean section. Eclampsia resulted in 27.78% of total maternal mortality, case fatality rate of 15.96% and eclampsia-related maternal mortality ratio of 318/100,000 deliveries. Perinatal mortality rate was 131/1000 eclamptic deliveries.Conclusions: The maternal outcome worsened with increasing blood pressure, number of convulsion episodes prior to presentation, the time interval between 1st convulsions to delivery, level of proteinuria on dip stick and reduced urine output. Vaginal delivery was associated with more early neonatal deaths and birth asphyxia. More awareness and enabling factors should be created for more women to access antenatal facilities. The government should be committed to providing emergency obstetric care facilities in our hospitals for effective management of eclampsia.
The spindle of oocytes observed by polarized light microscope can predict embryo quality
Authors: Nguyen Tung T. , Doan Hang T. , Quan Lam H.
Published: December 2018

Background: The aim is to evaluate spindle position of metaphase II oocyte and the development of embryos originated from oocytes with spindle and without spindle.Methods: Cross-sectional analysis Research: 250 MII oocytes were analyzed with polarized microscope in Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University.Results: Spindles were detected in 170 (77.98%) of 218 metaphase II oocytes, 115 spindles (67.65%) of MII oocytes is beneath or adjacent to the first polar body, 55 oocytes had the spindle located between 300 and 1800 away from the first polar body. Fertilization rate and the rate of good quality embryos in oocytes with a visible spindle (77.98% and 61.02%) were higher than those in oocytes without a visible spindle (22.02% and 36.84%), the difference was statistically significant with p <0.001 and p <0.05.Conclusions: The spindle position of metaphase II oocytes is not always beneath or adjacent to the first polar body. Fertilization rate and the rate of good quality embryos in oocytes with a visible spindle were higher than those in oocytes without a visible spindle.
Analysis of Caesarean section rate in a government teaching institute based on Robson’s ten group classification
Authors: Sambharam Kavita , Verma Mansi Lalit , Sambarey Pradip W.
Published: December 2018

Background: Caesarean section rate is a qualitative health care indicator in India. With increasing rates of caesarean sections and no defined method to audit present institutes it is the need of the hour to use tools like Robson’s classification to understand present system. The aim of this study was to determine the rate and analyse Caesarean sections in a tertiary care institute using Robson’s ten group classification system.Methods: This is a retrospective analytical study in which all Caesarean section done over a period of 3 years (July 2014-June 2017) were included which were performed in single unit (out of 6) of Department of Obstetrics and Gynecology of Sassoon General Hospital. Women were classified in 10 groups according to Robson’s classification, using maternal characteristics and obstetrical history. For each group, authors calculated its relative size and its contribution to the overall caesarean rate.Results: Total deliveries were 4750 out of which 985 were Caesarean section, incidence was calculated as 20.7%. The main contributors to the overall Caesarean rate were primiparous women in spontaneous labour (group 1- {18.3%}) and women with previous caesarean section (group 5- {34.9%}).Conclusions: The Robson’s classification is an easy tool to use and identify the current changing dynamics in any hospital setup. Its implementation as an obstetric audit can help lower the Caesarean rates and improve the standards based on WHO criteria.
Comparison between intramuscular oxytocin versus oxytocin with sublingual misoprostol in blood loss reduction among risk of postpartum hemorrhage vaginal deliveries
Authors: Vanitha M. , Sujathasenthil S. , Anandan Heber
Published: December 2018

Background: This study compares the efficacy of intramuscular oxytocin and oxytocin with sublingual misoprostol administration among the primary postpartum hemorrhage (PPH) mothers of vaginal deliveries. The aim is to compare the effectiveness of intramuscular oxytocin versus oxytocin with sublingual misoprostol in blood loss reduction among women at risk of PPH undergoing vaginal deliveries.Methods: Each group, 50 mothers were selected from the risk of PPH vaginal mothers in the labour ward of the study area.Results: The two groups’ mothers were not statistically significantly differed (P>0.05) in respect of their demographic and clinical variables such as age, gravida, risk factors, the onset of labour and type of delivery. The mean blood loss of group I was 315.4±111.4 ml and group II mean blood loss was 241.4±191.2 ml. The difference between the two groups’ blood losses was statistically significant (P<0.05).Conclusions: Oxytocin with sublingual misoprostol significantly reduced the blood loss during 3rd stage labour than only oxytocin administration.
Study on knowledge and experience about emergency contraception at a tertiary care centre family planning clinic
Authors: M. Lakshmidevi , H. S. Sheela , Venkatesh Shreedhar
Published: December 2018

Background: Unintended pregnancies and unsafe abortions are the major reproductive health challenges faced by women of developing countries. According to WHO 42 million induced abortions occur annually and out of which 20 million are performed in unsafe condition and by unskilled providers.Methods: It is a questionnaire-based study planned to be conducted in the family planning clinic of Department Of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Statistical analysis is done by percentage analysis, paired T test or Wilckoxer signed rank test and Mcnemer test.Results: This is a questionnaire-based study conducted on 300 urban educated women seeking termination of pregnancy. Among 300 women studied majority were in the age group of 21-30 years i.e. 174 women (58%). Among 300 women studied about 126 women who had some knowledge about EC and Medias (like TV, radio and magazine) constitutes the major source of knowledge i.e. 60 women (47.6%) then Doctors and nurse i.e. 36 women (28.5%) and other sources like friends, relative and Teachers i.e. 30 women (23.8%). Knowledge about the side effects of EC was very limited in present study, i.e. 30 women (23.8%) were unaware of side effects, 60 women (47.6%) were aware of minor side effects like nausea, vomiting and pain abdomen, and only 36 women (28.5%) were aware of hormonal side effects like menstrual irregularity.Conclusions: From present study it is shown that even among urban educated women knowledge about emergency contraception is very limited. For the proper use of emergency contraception, women should have basic knowledge about fertility and contraception. According to present study only 23.8% of urban educated women have knowledge about safe and unsafe period only (42.8%) had knowledge about timing of use of Emergency contraception.
A novel approach to meet the unmet need for family planning
Authors: Samanta Subrata , Dutta Sujoy , Samanta Sudipta , Mullick Agrima
Published: December 2018

Background: Post-partum intra-uterine contraceptive device is one of the important methods of spacing to meet up the unmet need of family planning. The low complication rate, ease and certainty of insertion and one-time adoption advantages made it an option of family planning by Government of India. In the background of recent trends in family planning, the study aims to establish the efficacy and draw-backs of PP-IUCD among the clients in a tertiary care hospital of West Bengal.Methods: Prospective observational study on 1680 women during January 2016 to December 2016, where the PP-IUCD was given to the patients after vaginal delivery or Cesarean section and were followed up to 3 months.Results: During the study 1.37% patients did not turnup in either follow-up. The most common complication encountered was missing thread (4.64% at 6th week follow-up and 6.67% at 3rd month follow-up). Expulsion rate was much lower (2.02% at 6th week and 2.5% at 3rd month). Heavy bleeding per-vagina was in 1.55% at 6th week and 2.08% at 3rd month. Pain abdomen was .83% at 6th week and 1.67% at 3rd month. Incidence of perforation and failure was both nil at either follow-up. Dysmenorrhea was complained 2.44% at 6th week and 3.33% at 3rd month. Overall satisfaction rate at 6th week (86.05%) was higher than non-satisfaction (13.95%). This was also true for 3rd month where satisfaction rate (77.85%) was higher than non-satisfaction rate (22.15%).Conclusions: PP-IUCD appears to be a safe, efficacious, acceptable and accessible method of contraception.
Evaluation of the uterine cavity by office hysteroscopy in patients with infertility and recurrent pregnancy loss: a cross sectional study
Authors: A. Mitwally Abo Bakr , Badran Esraa Y. , Arby Tamer , Abbas Ahmed M. , Nasr Ahmed , Kamel Momen A.
Published: December 2018

Background: The aim of the present study is to determine role of hysteroscopy in women presented with primary or secondary infertility and in women presented with recurrent pregnancy loss.Methods: This cross-sectional study was conducted at Obstetrics and Genecology Department, Women Health Hospital Assiut University, Egypt from October 2016 to February 2018. Reproductive aged women who are suspected as having intrauterine pathology, such as submucosal myoma, endometrial polyps or other endometrial pathological findings based on the transvaginal ultrasound were enrolled. All patients were scheduled for office hysteroscopy as an outpatient. An informed consent was obtained prior to participation in the study.Results: Hysteroscopy was performed in 139 infertile women and 41 cases of repeated pregnancy loss. With regard to infertile patients; 67.6% of the patients had normal findings, 10.1% of the patients had intrauterine adhesion, 8.6% of the patients had intrauterine polyp. 5.8% of the patients had septate uterus and 3.6% of the patients had depressed fundus. With regard to patients with recurrent pregnancy loss; 51.2% of the patients had normal findings, 21.9% of the patients had partial septum, 9.8% of patients had intrauterine adhesions, 7.3% of patients had intrauterine polyp and 4.9% of the patients had submucous myoma.Conclusions: It was concluded that hysteroscopy should be considered as routine investigation in evaluation of women with primary and secondary infertility.
Midwives’ skills in the application of non-pneumatic anti-shock garment for the management of postpartum haemorrhage in Ondo State, Nigeria
Authors: Sowunmi Christiana Olanrewaju , Iwaola Olufunke Mercy , Ogbeye Gbemisola Bolanle
Published: December 2018

Background: Non-pneumatic Anti-shock garment (NASG) has been identified as a device for effective management of postpartum haemorrhage especially in developing countries where maternal mortality is high. Hence, it is important that midwives are skilled and knowledgeable about its use. This study therefore assessed the midwives’ skills in the application of Non-Pneumatic Anti-Shock Garment (NASG) in the management of postpartum hemorrhage.Methods: This study adopted quasi-experimental research design. The study was done in two secondary health facilities in the state. Sixty-eight midwives participated in the study. Simple random sampling technique was used to select 37 and 31 midwives into experimental and control groups respectively. Written consent was obtained from all the participants. The study involved three stages; Pre-test, an intervention and a post test. Questionnaire and observation rating scale that elicited demographic characteristics, knowledge and skills on the application and removal of NASG was used to collect data pre and post intervention. Data was analyzed using descriptive and inferential statistics.Results: Mean knowledge score of midwives in the control group in the use of NASG in the management of PPH was found to be 10.32±4.17 compared with 12.24±5.05 in experimental group pre-intervention. There was a significant increase in knowledge and skills of NASG application, nonetheless the post intervention from experimental group had the highest increase from 6.32±4.97 to 17.14±0.95.Conclusions: Educational intervention enhanced skills of midwives in the use of NASG. Therefore, continuous education units in hospitals should include periodic training of midwives on the use of NASG.
Association of maternal plasma or serum zinc concentration with the birth weight of the child
Authors: Bellad Girija C. , K. S. Laxmi
Published: December 2018

Background: Zinc is a divalent cation first isolated in 1509 and since then its importance has been increasingly recognised in human health and nutrition. Present study has been undertaken to confirm the association between maternal plasma or serum zinc concentration and birth weight.Methods: Present study was cross-sectional study conducted in tertiary care hospital. Newborns with a birth weight of < 2.5kg and their mothers labelled as study group while newborns with a birth weight of > 2.5kg and their mothers were considered as control group. The analysis for the serum concentration of zinc was done using the Atomic Absorption Spectrophotometric method (AAS), this method analytically the most reliable for routine assessment of serum zinc levels. The results deduced from the analysis were accordingly grouped to the study group / control group. We had a sub-group analysis based on the gestational age, as Preterm and Term.Results: Maternal serum levels of zinc 67.04 μg /dl±16.66, in the study group, was less as compared to the maternal serum levels of zinc in the control group with a mean level of 75.39 μg/dl±17.89. The results show a significant association between zinc levels and birth weight. Mean Maternal serum levels of zinc 67.04 μg /dl±16.66, in the study group, was less as compared to the maternal serum levels of zinc in the control group with a mean level of 75.39 μg/dl±17.89. The results show a significant association between zinc levels and birth weight.Conclusions: Present study showed a positive correlation of maternal zinc levels with birth weight and prematurity. Hence, we recommend routine zinc supplementation could be included with other nutritional supplements during pregnancy.
Effect of maternal education on antenatal care utilization, maternal and perinatal outcome in a tertiary care hospital
Authors: Chopra Isha , Juneja Sunil K. , Sharma Sarit
Published: December 2018

Background: Antenatal Care (ANC) utilization facility is available but poorly utilized because of many factors which play indirect role in inadequate utilization of antenatal care facility: low social status of women in the society, less opportunity for basic education, less ability to make decisions. Therefore, the present study is an attempt to study the effect of maternal education on antenatal care utilization, maternal and perinatal outcome in a tertiary care hospital.Methods: A prospective study was carried out on 525 cases delivered during period of one year at Dayanand Medical College and Hospital, Ludhiana, Punjab, India; a tertiary care hospital catering both urban and rural population. All cases were categorized into two groups: booked and unbooked. The age, parity and education of each patient in booked and unbooked cases was noted. Further, its impact on antenatal care utilization, maternal and perinatal outcome was studied.Results: On studying education pattern, among illiterate subjects 50% were booked and 50% were unbooked; For graduate and above were 80.6% and 19.4%respectively. Among mothers who were illiterate 90.9% had low birth weight babies and 13.6% had stillborn. Among those graduates and above 38.7% had low birth weight babies,1.5 % stillborn and 1.2% neonatal deaths.Conclusions: The educational status of the women came out as a significantly important variable and predictor of perinatal outcome. Hence, whole hearted efforts should be directed in educating women population and also improving health care facilities in rural areas to provide early referral to higher centers.
Primary lower segment caesarean section in multipara: materno-fetal outcomes
Authors: Agrawal Grishma P.
Published: December 2018

Background: All-natural birth has a purpose and a plan; who would think of tearing open the chrysalis as the butterfly is emerging? Who would break the shell to pull the chick out?” ~ Marie Mongon. It is of particular interest, in light of increased incidence of abdominal delivery throughout the country and in the world, to judge the validity of this procedure when used for the first time in the multipara.Methods: All the cases of Primary caesarean delivery in multipara over a period of 18 months were studied with regards to the indication, associated risks factors, and perinatal morbidity and mortality. The primary objective of the study was to find out the status of primary Lower Segment Caesarean Section (LSCS) in multipara in tertiary care center.Results: The overall incidence of LSCS was 30.7%. The incidence of Primary LSCS in multipara was 23.4%. The most common indication of LSCS was Foetal Distress i.e. 40.8%. Almost all caesarean sections were done in Emergency (99.2%). 12.3% of patients underwent PPH intra-operatively with 0.7% patient requiring Obstetric hysterectomy. Majority of the neonates were admitted in NICU for Respiratory Distress (30%). Major cause of Post-operative morbidity was wound gape seen in 10.8% patients.Conclusions: The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic criteria for spontaneous delivery of the pregnancy at hand. Hence a multiparous woman in labour requires the same attention as that of primigravida and may still require a caesarean section for safe delivery. Good antenatal and intrapartum care and early referral will help reduce the maternal and perinatal morbidity.
Outcomes of prolonged preterm premature rupture of the membrane: a report of six cases
Authors: Dixit Asha
Published: December 2018

Preterm premature rupture of the membranes (PROM) is associated with significant maternal morbidity and perinatal mortality. With an increasing era of infertility, the main interest of an assisted reproductive technology specialist is to increase the take-home baby rate. Here authors present report on the outcomes of prolonged preterm PROM cases facilitated with expectant management. Report is based on the medical records of six women with preterm PROM between 16-31 weeks of gestation who gave their consent to continue the pregnancy. These women were diagnosed with PROM by the litmus test and per speculum examination. Ultrasound scan and clinical investigation, which included complete blood count and C-reactive protein level, were performed in all cases. Prophylactic antibiotics were administered to prevent the infection and increase the latency period. All six babies (100%) were delivered successfully. There was no foetal mortality and maternal morbidity observed. Expectant management in preterm PROM cases can increase the survival rate and hence the take-home baby rate.
Heterotopic pregnancy: case report of a successful first trimester metacyesis management and a viable third trimester outcome
Authors: Singh Arvind Kumar , Khan Shazia
Published: December 2018

Heterotopic pregnancies are rare combined intra and extrauterine pregnancies, the incidence of which has shown an increase over the past decade with the rising trend in assisted reproductive technologies (0.75-1.5%). Authors report a case of a 29 year old primigravida, a post IVF conception who presented at 6 weeks POG with a ruptured tubal and a viable intrauterine pregnancy. She underwent an emergency laparoscopic right salpingectomy and continued with her intrauterine pregnancy successfully till term. The article emphasizes the need of scanning the adnexa carefully in early pregnancy to diagnose and manage heterotopic pregnancy as early as possible to prevent catastrophic haemorrhage and maternal morbidity and mortality later.
Study of fibrinogen levels in patients of acute stroke
Authors: Khandait Vinod , Barai Pratik
Published: December 2018

Background: Stroke is a disease of paramount public health significance. The role of plasma fibrinogen in determining incidence and severity of stroke has been postulated time and again. Present study was undertaken to determine the correlation between mean plasma fibrinogen level and infarct volume on CT scan in patients with acute stroke.Methods: Present prospective observational study of two years duration at our tertiary care government centre entailed enrollment and radiological assessment (CT scan/MRI) of 50 consecutive patients with first-ever stroke admitted within 24 h after stroke onset along with measurement of their plasma fibrinogen levels at admission.Results: Thirty (60%) cases reported ischemic stroke while haemorrhagic stroke was observed in 20 (40%) cases. The mean fibrinogen levels in ischemic (584±62mg/dl) and haemorrhagic stroke (52±28mg/dl) were found to be significantly higher (p<0.05) than normal range of (200-400mg/dl). The mean infarct volume in patients with ischemic stroke was 62.79±9.51cm3 while mean plasma fibrinogen level was 584±62mg/dl. There was significant correlation between infarct volume and fibrinogen levels (r coefficient =0.61; p<0.05). The fibrinogen levels in patients who died was insignificantly higher as compared to patients who survived.Conclusions: We report significantly higher than normal mean fibrinogen levels in ischemic and haemorrhagic stroke with the correlation between infarct volume and fibrinogen levels being significant in ischemic stroke. Limited mortality numbers probably didn’t allow the present study to reach the level of significance. Similar studies with larger sample size are recommended.
Evolutionary profile of patients with hemoglobin SC disease regularly followed in Côte d'Ivoire
Authors: Méité N'dogomo , Nanho Clotaire D. , Sangaré Mahawa , Kouakou Boidy , Kamara Ismael , Silué Alexis D. , Packo Saint-cyr , Botti Renée P. , N’dahtz Emeraude , Koffi Gustave K. , Sanogo Ibrahima
Published: December 2018

Background: West Africa is recognized as the elective focus of hemoglobin C. The S and C combination in the same patient gives a major sickle cell syndrome. In our country, very few series dealing with the evolutionary features of this SC form have been published contrary to the homozygous SS form. The aim of this study was to describe the evolutionary profile of double heterozygous SC sickle cell patients.Methods: This was a retrospective and prospective study with descriptive and analytical purpose of 174 SC sickle cell patients.Results: The median age was 26 years with extremes of 6 years and 57 years. 96% of patients had less than 4 vaso-occlusive seizures per year. The evolutionary complications were mainly ischemic (56.30%) and infectious (39.10%). Among ischemic complications, sickle cell retinopathies and aseptic osteonecrosis are the most common with 59.20% and 31.63% respectively. Infectious complications were dominated by ENT (36.76%) and osteoarticular (35.29%) infections. Only age had an influence on the occurrence of ischemic complications (p = 0.0001). The probability of survival at 5 years was 99.38% and that at 20 years was 91.57%. The overall survival was not influenced by evolutionary complications.Conclusions: Infectious and ischemic evolutionary complications show the importance of vaccination and an early screening program.