bluuebunny/crossref_metadata_2025 huggingface dataset:
MURCIÉLAGOS DISPERSORES DE SEMILLAS EN GRADIENTES SUCESIONALES DE LA ORINOQUIA (SAN MARTÍN, META, COLOMBIA)
Authors: Casallas-Pabón Diego , Calvo-Roa Nathaly , Rojas-Robles Rosario
Published: August 2017

La dispersión de semillas por fauna juega un papel fundamental en la reproducción vegetal. Los murciélagos son unos de los dispersores de semillas más importantes en los ecosistemas neotropicales. El objetivo en esta investigación fue describir la comunidad de murciélagos y las semillas que potencialmente dispersan, en el gradiente sucesional (sabana, arbustal, borde de bosque y bosque ripario), de una localidad de la altillanura colombiana. Se midió abundancia, riqueza, diversidad de murciélagos y las semillas de sus heces. Se capturaron 534 individuos pertenecientes a cuatro familias y 39 especies. Las especies más abundantes fueron Carollia perspicillata, Artibeus obscurus y Molossus molossus. C. perspicillata y A. obscurus  presentaron los mayores valores en el índice de dispersión de semillas (DII). Los registros pertenecen a seis gremios, siendo más abundantes los frugívoros (sedentarios y nómadas). El hábitat con mayor abundancia y riqueza de especies de murciélagos fue el borde de bosque. Se recolectaron un total de 11808 semillas, siendo Cecropia engleriana la especie más abundante. Los estados sucesionales difieren significativamente en abundancia de semillas, mas no en riqueza; mostrando dominancia de determinados géneros de semillas. Se resalta el arbustal como dinamizador de la sucesión, con un flujo potencial de semillas diversas, donde los murciélagos juegan un papel clave para su dispersión, pues aquellos que vuelan sobre las áreas abiertas tienen la misma carga de semillas para dispersar que los hallados en el bosque, evidenciando un potencial de regeneración coadyuvado por una comunidad de murciélagos con una estructura diversa en grupos tróficos y especies.
CARACTERIZACIÓN TEMPORO-ESPACIAL DEL PATRÓN DE MARCHA EN ROEDORES COMO MODELO ANIMAL DE LESIÓN CEREBRAL CEREBROVASCULAR
Authors: Cucarián Jaison D , León Laura A , Luna Gloria A , Torres Martha R , Corredor Karen , Cardenas P. Fernando
Published: August 2017

En la investigación sobre movimiento, la experimentación animal ha proporcionado fundamentación científica para la investigación clínica, mejorando procedimientos diagnósticos y de rehabilitación. Lesiones cerebrales en roedores pueden ser usadas para modelar síntomas locomotores, sensoriales y/o cognitivos. Con el propósito de determinar la funcionalidad locomotriz y sensorial en roedores, se han propuesto varios métodos de evaluación y pronóstico clínico para identificar y evaluar adaptaciones estructurales y mecanismos de neuro-recuperación. Esto ha permitido que métodos de intervención terapéutica, como el ejercicio físico, sean utilizados para restaurar funciones sensitivo-motoras y cognitivas en roedores y humanos. La extrapolación (translación) de los resultados de investigaciones en ciencias básicas a áreas clínicas supone la continua cooperación y retroalimentación entre investigadores y profesionales de la salud, favoreciendo la formulación de intervenciones terapéuticas más eficaces basadas en resultados obtenidos de la experimentación animal. El objetivo de esta revisión es exponer las principales deficiencias motoras y los métodos empleados para determinar la dificultad motriz en la marcha en roedores con lesión cerebrovascular, para lo cual se realizó una revisión de literatura, sobre términos definidos (MeSH), en las bases de datos PsychINFO, Medline y Web of Science, entre enero de 2000 y enero de 2017. Se excluyeron artículos de carácter cualitativo o narrativo, sin revisión por pares, disertaciones, tesis o trabajos de grado y resúmenes de conferencias. Se revisan algunas manifestaciones clínicas, su efecto en la locomotricidad en roedores, algunas metodologías usadas para generar lesiones y para estudiar la función motriz, los principales métodos de medición y algunos aspectos translacionales.
What do we know about Cassis tuberosa (Mollusca: Cassidae), a heavily exploited marine gastropod?
Authors: Dias Thelma Lúcia Pereira , Mota Ellori Laíse Silva , Duarte Rafaela Cristina de Souza , Alves Rômulo Romeu da Nóbrega
Published: August 2017

Cassis tuberosa is a key species in reefs and sandy beaches, where it plays an essential role as a predator of echinoderms (sea urchins and sand dollars). Due to the beauty of its shell, it is one of the most exploited species for trade as marine souvenirs throughout its distribution in the Western Atlantic. Despite its ecological importance, there is little available information about population and biological data or the impacts of its removal from its natural habitats. Considering the economic and ecological importance of this species, this study provides a short review of existing studies and highlights research and conservation needs for this highly exploited marine gastropod.
Incidence of primary school age children with post-trumatic stress disorder
Authors: Ershova Irina B. , Glushko Yuliya V.
Published: August 2017

Presents the results of evaluations of morbidity 123 primary school children suffering from post-traumatic stress disorder (PTSD), caused by the military actions in the Donbass region. By us the data analysis was conducted patient cards (f. 112/u) and medical statements (f. 027/u) children study groups, over the period of appealability throughout the year. Revealed an increase the incidence of somatic pathologies in children survived the military events that were recorded in 2.5 times more likely than in the comparison group (children who have not experienced combat operations). The first place in the structure meets pathology occupied somatoform dysfunction of the autonomic nervous system, recorded in 100% of children, who experience the stress of combat operations. Second place among children 7-9 years with PTSD, occupied acute respiratory diseases, with a prevalence frequencies of of developing complications after them 2.1 times, which was interpreted as lowering infectious resistance of the organism under the influence of strong stress factor. By the multiplicity of handling of children to the doctor by us highlighted a group of frequently ill children. Is noted that the the number of younger schoolboys for a long time and frequently ill in the main group predominated вy 2.3 times. Among children 7-9 years with PTSD was not a single child who during the school year never would not been sick. Additional psychoemotional load on the body caused by adaptation to school loadings can exacerbate the health conditions and increase the incidence rates of primary school children.
Qualitative analysis of the nephrotoxicity of gold nanoparticles in case of enteral administration
Authors: Lipatova Veronika A. , Botchey Veronika M. , Knyazeva Lyudmila A.
Published: August 2017

The experiments on animals show the different effects of gold nanoparticles. Gold particles of various sizes may have a variety of toxic effects on the tissues, and more damage is often produced by small nanoparticles. In this work histological and ultrastructural changes of renal parenchyma caused by enteric administration of gold nanoparticles of small sizes (2 nm) were studied used different concentrations of colloidal solutions of gold nanoparticles: 10 µg/ml; 50 μg/ml; 100 µg/ml in drinking water within 7, 14 and 28 days. There were 9 groups of animals (non-linear mice weighing 20-25 g) on different dates of the experiment, as well as 3 control groups of mice, respectively, each term of experiment. Histological and ultrastructural changes were detected in the material of all groups of experimental animals compared with control. In general all small focal alterations relate to a small number of vessels, individual profiles of tubules and single cells. Light microscopy analysis of the overall picture of integrity of renal parenchyma showed that the most pronounced changes are observed in the cortex of the organ. Medulla is less affected. It identifies, first of all, microvascular disorders, then the renal tubular epithelium changes and finally, a minor involvement of interstitial elements in the response. Tubules of nephrons compared with the renal corpuscles undergo more changes at all dose levels of exposure and in all periods under study. Signs of dystrophy and necrobiosis often relate to the cell cytoplasm and less of their nuclei. Evidence of microvessel disorders detected in the renal cortex is not dependent on the dose of administered nanoparticles already in the early stages of the experiment. Histological findings as a whole are confirmed by the presence of ultrastructure alterations, that points to the primacy of cell damage.
Features of total hip arthroplasty in the treatment of secondary coxarthrosis of different genesis in older children
Authors: Khrypov Sergey V. , Krasavina Diana A. , Veselov Alexander G. , Komolkin Igor A. , Aphanasiev Ardan P.
Published: August 2017

Total hip arthoplasty (THA) in school children with secondary hip arthritis is the least studied treatment in orthopedic surgery. The need for THA arises much less often in children than in adults, but is a pressing problem. Indications for joint replacement at the age of 12–17 years include secondary hip arthritis of various etiologies such as dysplastic (congenital and paralytic), posttraumatic, infectious allergic (juvenile rheumatoid arthritis and Bechterew’s disease), postinfectious (osteomyelitis and tuberculosis of the joints hip joint) associated with severe pain, joint contractures, and decreases in motor activity. The aim of this study was to evaluate the effectiveness of THA in adolescents with stage 3 hip arthritis. A two-stage method of surgical treatment in cases of limb shortening of >4 cm is proposed. We present the results of the treatment in 45 patients. The proposed surgical technique achieved satisfactory results in 68% of the cases. The method allowed the restoration of hip joint function and limb length in all patients. Based on these results, we recommend the use of this method in the treatment of severe forms of secondary coxarthrosis as a result of dysplastic, paralytic, postinfection, systemic autoimmune, and posttraumatic processes.
Potentially Pathological Alpha-Pattern as a Variant of Vigilance EEG in Drug-Resistant Epilepsy
Authors: Chukhlovin Aleksandr A. , Aleksandrov Mikhail V. , Lytaev Sergey A. , Kasumov Vugar R. , Pavlovskaya Marina E. , Arkhipova Nastasia B.
Published: August 2017

As a result of pathomorphosis affecting the mechanisms of electrical activity generation interictal EEG may show reduced epileptiform changes whereas clinically apparent epileptic seizures may be present. In these cases patterns of dominant alpha activity are sometimes recorded on the scalp. In this study variations of alpha activity in patients with refractory epilepsy are classified. A group of 50 refractory epilepsy patients aged between 20 and 55 years who were submitted to Polenov Russian Scientific Research Institute of Neurosurgery in 2014-2017 was included in this study. They underwent scalp EEG as a part of their presurgical assessment. In 12 cases patterns of potentially pathological alpha activity were observed. Three variations of alpha-patterns were described: 1) alpha-rhythm with decreased regional diversity and a marked synchronization in temporal areas; 2) alpha-rhythm with reduced epileptiform complexes integrated into the spindles, 3) decelerated non-rhythmic alpha activity distorted by the higher frequency components. Distinguished varieties of potentially pathological alpha-activity according to their order here represent gradual functional decline of normal thalamo-cortical interaction. Considering clinical manifestation of drug-resistant epilepsy with frequent seizures in these patients, reported varieties of alpha activity can not be interpreted as Landolt’s syndrome (forced normalization of EEG). Invasive electrocorticographic monitoring demonstrated that bursts of sharpened polyphasic waves coinciding with alpha-rhythm on scalp EEG are consistent with epileptic discharges on the brain cortex surface. This allows to think of these components as correlates of epileptic activity. Therefore, on a number of occasions in patients with epilepsy a dissonance between clinical signs and electroencephalographic patterns recorded during restful wakefulness may be observed, when epileptiform components are absent or reduced to nonspecific complexes.
Clinical assessment of detection of ventricular extrasystoly in patients without structural changes of heart: a prospective study
Authors: Koziy Anastasia V. , Olesin Alexander I. , Litvinenko Vadim A. , Konstantinova Irina V.
Published: August 2017

Aim. The aim of the study was a clinical assessment of the integrated determination of predictors of life-threatening ventricular arrhythmias (LVA) in patients with ventricular extrasystole (VE) without structural changes in the heart to predict the development of cardiovascular disease in a prospective study.

Material and methods. From 1997 to 2014 199 patients with neurocirculatory dystonia (NCD), complicated with VE II-V class EE at the age of 18-35 years (mean 27.3-2.6 years) were observed in District Military Clinical Hospital of the Ministry of Defense of the Russian Federation, City Hospital named after St. Martyr Elizabeth. All patients, in addition to a general clinical examination, determined late potentials of the ventricles (LPV), QT interval variability (QTd), heart rate turbulence (HRT), and also indicators reflecting the possible mechanism of VE development.

Results. The results of the study showed that in patients with NCD complicated by VE, the detection of indicators reflecting the presence of VE caused by the mechanisms of early post-depolarization and re-entry is a predictor of the development of coronary heart disease (CHD) and hypertension (HB). The positive prognostic significance of the indicators showing the presence of VE with these development mechanisms for the development of CHD and HB averaged 74% and 44% respectively, and with the appointment of сlass III drugs for elimination of VE and (or) development of unstable ventricular tachycardia, the risk of developing CHD increased to an average of 93%. Identification of NDC patients with indicators reflecting the presence of VE due to delayed post-depolarization is a predictor of the development of gastrointestinal tract (GT) diseases with positive prognostic significance, averaging 61%. Positive prognostic significance with respect to the development of CHD, HB, GT diseases for the detected LPV, QTd > 80 ms, pathological values of HRT VE did not exceed 30%. Indicators and predictors, which characterize the mechanism of development of VE and the risk of LVA occurrence in patients with NCD complicated by VE, were highly correlated (r > 0.50) with risk factors for cardiovascular and gastrointestinal system diseases.
Modern forms of dental preventive care for children
Authors: Kim Andrey V. , Rubezhov Alexander L. , Koloskova Tatiana M. , Bezhenar Sergey I.
Published: August 2017

Diseases of teeth and oral cavity have a high prevalence in pediatric population. In adolescents of 15-17 years, the incidence of caries in permanent teeth is higher than in children of 0-14 years. Epidemiological studies of dental health of children in various regions of the Russian Federation in 2010-2015 years showed no tendency to decrease the level of diseases of mouth and teeth. Prevalence and intensity of diseases remains at a high level. More than 80% of the surveyed children are in need of complex dental treatment. The current situation of pathology of teeth and mouth in children is due to several reasons such as low level of hygiene education, environmental degradation, poor nutrition, presence of chronic diseases, among older children, the presence of harmful habits, health-care organizations lack of effective preventive work. In turn, untreated inflammatory diseases of the oral cavity and teeth, being the source of the infection, may lead to somatic pathology of different organs and systems. The existing organization of children dental care is focused more on treatment than on prevention of diseases of teeth and oral cavity. As a rule, parents bring children to dental clinic for treatment of already developed disease. Referrals to the dentist for preventive measures are rare. In this regard, it is necessary to develop new organizational forms of dental care, from the point of view of the preventive orientation, close to children's educational organization.
Dienogest versus gonadotropin-releasing hormone analogue for the clinical treatment of endometriosis: a systematic review and meta-analysis
Authors: De Oliveira Sofia Andrade , Melo Bárbara Souza , Pereira Marina Fernandes
Published: August 2017

Endometriosis is a chronic inflammatory disease, defined by the presence of endometrial tissue outside the uterine cavity. It causes symptoms such as dysmenorrhea, chronic pelvic pain, dyspareunia, infertility, with great loss of quality of life for the patient. The objective of the study was to compare, through a meta-analysis, GnRH analogues, which are considered clinical first line treatment for endometriosis, versus dienogest, a selective oral progestin in the treatment of endometriosis. A systematic review was conducted to select the studies. In total, 31 articles were found. Four studies met criteria, the following variables were analyzed: pelvic pain, dyspareunia and induration of the Pouch of Douglas after treatment and it was evaluated the presence of side effects during treatment: hot flushes, headache and BMD loss. There was no difference between the dienogest group and GnRH analogue group when it was evaluated maintenance of lower abdominal pain, dyspareunia, induration of the Pouch of Douglas after treatment and hot flushes during treatment. Besides those results, the dienogest group had a lower incidence of headache and less BMD loss. The treatment of endometriosis continues to be a challenge, even with new treatment options such as new drugs (dienogest) and surgical procedures. This meta-analysis provides evidence of the absence of dienogest inferiority compared with GnRH analogues with less BMD loss and less headache incidence.
Timing and reasons for antenatal care booking among women in a tertiary health care center in Southern Nigeria
Authors: Utuk Ntiense Macaulay , Ekanem Anyiekere , Abasiattai Aniekan Monday
Published: August 2017

Background: Antenatal care is one of the four pillars of safe motherhood and its benefits in preventing adverse feto-maternal outcome is proven. Commencement of antenatal care early has been shown to be key for this benefit to be fully realized. The aim of this study was to determine the antenatal booking pattern of pregnant women and its determinants in our environment.Methods: A cross sectional study of women attending the booking clinic in the University of Uyo Teaching Hospital, Akwa Ibom State, Southern Nigeria over a three-month period.Results: The mean age of the respondents was 28.5 years. The mean gestational age at booking was 18.3 weeks. The majority of the patients were married (94.1%). 68.1% had a post-secondary education. 33.5% of patients were nultiparous, while 3.5% were grand multiparous. The majority of patients (72.4%) booked late for antenatal care. Age group, marital status, mode of delivery was not significantly associated with timing of booking. High levels of patient’s education, high levels of husband’s education as well as grand multiparity were significantly associated with late booking (P<0.05). Majority (65.4%) of patients claimed that it was safe to book at any time during pregnancy.Conclusions: The majority of women booked late for antenatal care. In our study, we have found that general and health education, subsidisation of cost for antenatal care and introduction of focused antenatal care will help to reverse this trend.
X-ray pelvimetry: prognosis of delivery by cephalous-pelvic confrontation in Cotonou
Authors: Adisso S. , Atrevy N. , Adisso E. L. , . Mukanire , Perrin R. X. , Alihonou E.
Published: August 2017

Background: The mechanical dystocia constitutes one of the causes of maternal death during labour. Reducing the incidence of complications of dystocia means recognize the factors induce dystocia. That justifies X-ray pelvimetry and cephalic fetal ultrasonography to predict the outcome of labour. This survey aims at establishing the prognosis of labour by a cephalous-pelvic confrontation.Methods: This study was realised at CUGO and HOMEL, reference maternity hospitals in Cotonou from 28th March to 4th August 2006. That was a prospective study. During prenatal visit, pregnant women who had pelvis abnormality were recruited after their consent after counselling about exploration of their pelvis and fetal cephalic diameters. Pregnant women in their ninth month underwent to X-ray pelvimetry and fetal biometric ultrasonography.Results: During that study, 122 pregnant women in their ninth month were recruited. Favourable prognosis (36.89%): natural delivery 31.15%; (concordance rate is 84.44%). Uncertain prognosis (18.85%): caesarean section (10.66%), natural delivery (7.37%). Unfavourable prognosis (44.26%): 40.16% deliveries by caesarean section. Concordance rate is 90.74%.Conclusions: The cephalous-pelvic confrontation is a reliable prognosis method. It is recommendable in our maternity hospitals to prevent complications of dystocia, a cause of maternal death.
Intimate partner violence: prevalence, contributing factors and spectrum among married couples in Southeast Nigeria
Authors: C. Anolue F. , I. Uzoma O. , I. Uzoma O.
Published: August 2017

AbstractBackground Intimate partner violence is a globally acknowledged public health problem. Violence against women is unsurprisingly common albeit under reported in both developing and developed nations. It impacts the physical and mental health of affected women adversely. Even though it appears in different forms it is a malady that deserves increased attention. It is a social menace that is common in Africa with Nigeria being no exception. This study sets out to determine its prevalence, contributing factors and the spectrum of violence against married women in Southeast Nigeria. Materials and MethodsA cross sectional study of prospectively consenting women within a community based setting was done in Orlu, Nigeria during a period between 1st August to 31st August 2016. A total of 695 respondents were initially recruited and given structured questionnaires, of this number 13 failed to answer questions on intimate partner violence and hence were excluded, thus the final study population was actually 682.Using a 95% confidence interval, 5% margin of error, population proportion of 0.5, the minimum sample size was calculated as 384 using the Cochran’s formula for sample size. The data was then analyzed using Statistical Package for Social Sciences (SPSS) version 20.ResultsA total of 682 (100%) respondents met the criteria for the study, of this number 382 (56%) had experienced some form of IPV while 300 (44%) had not. The factor most frequently associated with abusive behavior was financial requests/constraints accounting for 123 cases (32.2%). Injuries were sustained by 130 women (34%) with 66 of them suffering miscarriages (17.28%). Two hundred and twenty four women (32.8%) had experienced only one form of abuse while 158 (23.17%) reported multiple forms of abuse. Intimate partner violence was most prevalent among women within the 25 – 34 years age range constituting a total of 170 (44.5%) cases of abuse. Those married women with only primary education were the subset of the study population that had the greatest number of abused women; 138 cases (38.1%).ConclusionIntimate partner violence is a pervasive problem in Nigeria with a prevalence of 56% in this study. Various factors particularly financial constraints, incitement, alcoholism and substance abuse were contributing factors in cases of IPV. Intimate partner violence may appear as a single form or as multiple forms of abuse.
Correlates of genital Chlamydial trachomatis infection in a cohort of infertile women in Ibadan, Nigeria
Authors: Ajani Tinuade A. , Oluwasola Timothy Abiola Olusesan , Anaedobe Chinenye G. , Ajani Mustapha A. , Fayemiwo Samuel A. , Bakare Rasheed A
Published: August 2017

Background: Genital Chlamydial trachomatis infection, though often asymptomatic, is an established indirect causative agent of female infertility via its activities on the tubal physiology. Many risk factors are postulated for its acquisition and the main thrust of this study was to establish the organisms’ correlates among infertile women attending gynaecologic clinic in Ibadan.Methods: A systematic sampling technique was used on each selected day to recruit women who met the inclusion criteria into the study using a sampling frame of 2. Interviewer-administered questionnaires were used to obtain attributes considered as risk factors for acquiring genital Chlamydia trachomatis infection from 150 consenting infertile women between January and November 2015. These attributes included sexual history, social status, alcohol intake and past history of sexually transmitted infections (STIs). Blood samples and endocervical swabs were subsequently taken for detection of C. trachomatis infection using polymerase chain reaction (PCR). Data analysis was done using SPSS version 20.0.Results: The mean age of the respondents was 34.1±5.6 years and 7.30% were positive for C. trachomatis. Chlamydia trachomatis infection was significantly associated with past history of gonorrhoea, history of multiple sexual partners, husband that has other sexual partners and lifetime sexual partners greater than one.Conclusions: The prevalence of asymptomatic C. trachomatis among infertile women indicated the pathogen as a potential aetiologic agent of female infertility and supported the asymptomatic nature of the infection. The risk factors found to be associated with the organisms’ infection lend out further support to the sexual transmissibility of C. trachomatis.
To study the prevalence of HIV infection amongst antenatal women in a tertiary care hospital in Gujarat, India
Authors: Jain Mahima , K. Nimavat Bhargavkumar
Published: August 2017

Background: India has an estimated 2.1 million persons living with HIV in 2011. The prevalence of HIV among adult population has consistently declined over the last one decade from 0.4% in 2000 to 0.27% in 2011.HIV transmission from infected mother to baby is known to occur. The effective use of Antiretroviral drugs is known to reduce the risk significantly.Methods: This is a retrospective data analysis to know the prevalence of HIV infection among antenatal women attending a tertiary care hospital. All antenatal females are offered pretest counseling, sample collected and tested as per NACO guidelines by Rapid test and ELISA. Results of the test are disclosed after posttest counseling and kept confidential.Results: The seroprevalence over five years in the present study ranges from 0.466% to 0.278%. Women in the age group 21-25 years shows high prevalence due to peak sexual activity in this age group. 56.66% Husbands of these females are reactive which shows the major source of infection.Conclusions: The present study stresses the need to target the population mainly between 21-30 years in various Government programmes, thereby to reduce the transmission from parent to child.
DMPA: acceptance and compliance in a tertiary care hospital in Mumbai, India
Authors: Fonseca Michelle , Deshmukh Prasad Yeshwant , Kharat Deepali
Published: August 2017

Background: The use of safe and effective contraception is the need of the hour in India, which has one of the world’s largest and fastest growing population. Contraceptive advice is a vital component of good community health.Methods: The present study was conducted in one of the premier teaching medical institute of Mumbai. The aim of this study was to assess the acceptance and compliance of DMPA (Depot Medroxy Progesterone Acetate) among women attending family planning OPD. The study was conducted over the period of 3 years. Meticulous follow up was kept for all the women recruited in the study.Results: The study concluded that DMPA is highly effective contraceptive with low failure rate, when women are effectively counselled. Also, it should be made freely and easily available through health care facilities.Conclusions: It should be available as a first line method to all who wish to opt for reversible methods of contraceptive.
Obstetric outcome in pregnancy with thrombophilia: a comparative study of two different thromboprophylaxis regimes
Authors: Asthana Shilpa , Sodhi Bandana , Kumar Satish
Published: August 2017

Background: Thrombophilia in pregnancy is a leading cause of both maternal and fetal mortality and morbidity. Thromboprophylaxis is administered to the patients with thrombophilia with an aim to improve the obstetric outcome. Although various studies have proven the benefits of treating pregnant women with thrombophilia, few studies comparing the usage of Unfractionated Heparin (UFH) and Low Molecular Weight Heparin (LMWH) along with low - dose ecosprin in terms of obstetric outcome, incidence of IUGR, pre-eclampsia, mode of delivery, neonatal birth weight and adverse effects of therapy have been published. This study was undertaken to compare two different treatment modalities using either UFH or LMWH (along with low dose ecosprin) in pregnant patients with thrombophilia with respect to obstetric outcomes and incidence of adverse effects of therapy.Methods: This randomised, prospective study was conducted in patients with a previous history of recurrent pregnancy losses or previous adverse pregnancy outcomes. Sixty patients diagnosed with thrombophilia were randomly divided into two groups of 30 patients each (Group I and II). Patients in Group I received Inj Unfractionated Heparin 5000 I.U. (s.c) twice daily and Tab Ecosprin 75 mg once daily and those in Group II received Inj LMWH (enoxaparin) 40 mg (s.c) once daily and Tab Ecosprin 75 mg once daily. These pregnancies were followed and the obstetrical outcome was determined. The data collected was analysed using the Student’s `t`test and Chi-square test. P values < 0.05 were considered statistically significant.Results: There was no significant difference observed between two treatment groups with respect to pregnancy outcomes, incidence of IUGR, pre-eclampsia and mode of delivery (vaginal or by caesarean section). Treatment with a combination of LMWH and ecosprin administered to patients in Group II resulted in significantly higher neonatal birth weights.Conclusions: Treatment with a combination of LMWH and ecosprin resulted in significantly higher neonatal birth weights as compared to a regime that comprised of UFH and ecosprin. There was no significant difference seen in patients who were treated with either UFH or LMWH along with low dose ecosprin in terms of obstetric outcome, incidence of IUGR, pre-eclampsia and mode of delivery. No thromboembolic events or side effects were witnessed in patients subjected to either of the two regimes using LMWH or UFH with low dose ecosprin, thus, highlighting the safety of the antithrombotic therapy during pregnancy as used in this study.
Factors determining successful intrauterine insemination
Authors: Sinha Parul , Pandey Kiran , Srivastava Anand
Published: August 2017

Background: Infertility is defined as failure to conceive even after one year of regular, frequent and unprotected intercourse. Infertility can be attributed to male causes in approximately 25-40% cases, female causes in 40-50% cases, both in 10-20% and unexplained causes in 10-15% cases. Artificial insemination (Intrauterine Insemination) involves placement of processed sperms from husband (AIH – artificial insemination homologous) or from donor (AID – artificial insemination donor) into the female genital tract.Methods: Objectives of the study were to do sperm preparation to obtain normal good quality motile sperms, to perform intrauterine insemination using husband semen around the time of ovulation, to study factors responsible for successful pregnancy rates by this method. Out of 100 infertile females recruited for the study 34 underwent artificial insemination by IUI with controlled ovarian hyper stimulation. Sperms were washed by density gradient centrifugation or by a direct swim-up technique that does not involve centrifugation.Results: Overall pregnancy rate per patient for male factor infertility was 23.52%. None of the patients consented for more than three cycles of IUI. Maximum pregnancy was achieved in third cycle of IUI. Sperm motility >40% was related with pregnancy in 8 cases. Duration of infertility didn’t influence pregnancy rate. The majority of pregnancies were achieved in the age group of 25-29 years (50%). No pregnancy occurred with >15 years of infertility.Conclusions: This study concluded that intrauterine insemination after ovarian stimulation or controlled ovarian hyperstimulation is a successful and efficacious therapy for infertility.
Role of leutenising hormone LH and insulin resistance in polycystic ovarian syndrome
Authors: Ambiger Sudha , B. Patil Sadanand , M. Rekha , Dhananjaya Shobha
Published: August 2017

Background: Polycystic ovary syndrome (PCOS) is the most frequent endocrine disorder seen in pre-menopausal women, affecting 5-10% of this population. It is characterized by menstrual irregularities and clinical hyperandrogenism such as hirsutism, seborrhoea and acne. PCOS women have insulin resistance, which results in compensatory hyperinsulinemia. A number of findings suggest that hyperinsulinemia may play a central role in the development of hyperandrogenism. This study is under taken to measure insulin resistance and leutenising hormone (LH) in PCOS patients and to see the relationship of insulin resistance with leutenising hormone (LH).Methods: Case control study was done taking 60 women PCOS and 60 age matched healthy women as controls. In all the subjects, concentrations of fasting plasma glucose estimated using enzymatic methods in semiautoanalyser. Fasting serum insulin and leutenising hormone (LH) measured by CLIA using Lumax-CLIA microplate reader. HOMA IR was calculated from estimated parameters.Results: The concentration of fasting serum insulin,fasting plasma glucose,HOMA –IR and leutenising hormone(LH) in controls are 9.33±3.08 µIU/ml,94.38±10.36mg/dl,12.16±0.67and 4.67±1.94 mIU/ml respectively; in PCOS cases they are 24.50±10.03µIU/ml,114.20±30.38 mg/dl,7.29±4.08 and 15.75±7.51 mIU/ml respectively. The mean concentrations of all the parameters were significantly (p value<0.05) increased in women with polycystic ovarian syndrome when compared with healthy women.Conclusions: This study shows that 75% of pcos women were insulin resistant and HOMA IR shows a positive correlation (r value 0.48, p<0.05) with serum leutenising hormone(LH).
Methods of induction of labor in intrauterine fetal demise: a comparative study
Authors: Maheshwari Saurav , Borgohain Deepa
Published: August 2017

Background: This study was undertaken to evaluate and compare the efficacies of two different regimen for induction of labour in IUFD in an effort to find a better management of woman with IUFD.Methods: It was a hospital based prospective comparative study taken up in the Department of Obstetrics and Gynaecology, Assam Medical College and Hospital (AMCH), Dibrugarh for a period of 1 year. A total number of 90 cases were selected and randomly divided into 2 groups. The two groups were induced using regimen recommended by the RCOG. Group A was induced with Mifepristone - Misoprostol Combined Regimen while Group B was induced with only Misoprostol.Results: Both the groups were found to be comparable with respect to mean Pre – induction Bishops score. The mean Induction to Onset of Labour Interval and Induction to Delivery Interval were significantly less in Group A as compared to Group B. Mean dose of Misoprostol required was less in Group A compared to Group B. In terms of side effects tolerance to Group A was better than Group B.Conclusions: It was observed in the study that both the regimen were equally safe, easy to administer and affordable but the Combination Regimen had a slight edge over misoprostol alone regimen in terms of tolerance, fewer side effects and efficacy with regard to early onset of labour, shorter Induction to Delivery Interval and relatively less dose of misoprostol than misoprostol alone regimen.
Risks and benefits of two different entry techniques for laparoscopic gynecological surgeries
Authors: Agarwal Poonam , Yadav Ritu , Agarwal Apurv
Published: August 2017

Background: Primary abdominal access still remains a challenge for laparoscopic surgery despite rapid advances. This study was conducted to prospectively analyse and compare risks and benefits of two different entry techniques namely, veress needle and direct trocar in laparoscopic gynaecological surgeries so as to obtain consensus on the optimal method to be followed to create pneumoperitoneum.Methods: This was a prospective randomized study conducted at Deen Dayal Upadhyay hospital, under Delhi government. During the period January 2014 to June 2016, 800 patients (20-65 years) operated laparoscopically by the same team of surgeons for various gynaecological conditions, were randomized in two groups: Veress needle group (VN) and Direct trocar group (DT). Each group comprised of 400 patients. Comparison of various parameters was done between the two groups.Results: Incidence of major complications in terms of visceral injuries was 0.75% (3/400) in DT group and nil in VN group. Open conversion rate (2/400 i. e. 0.5%) and number of attempts required to create pneumoperitoneum were also more in DT group. Failed access in previous surgery cases was 1.2% (1/38) in VN and 14.8% (4/27) in DT group. Incidence of port site bleeding (n=3) was also more in DT group. Although the incidence of minor complications such as extraperitoneal insufflations (n=5) and no. of failed access (n=6) were more in VN group, there was no incidence of any life-threatening complication.Conclusions: In our experience, there is clear evidence of advantage of using veress needle in preventing major complications. Veress needle is therefore safer, convenient and effective technique of creating pneumoperitoneum.
Maternal and fetal outcome in pregnancy with heart disease in tertiary care hospital in India
Authors: Salam Samia , Mushtaq Saba , Mohi-ud-Din Khalid , Gul Irfan , Ali Asifa
Published: August 2017

Background: Cardiac disease is an important cause of maternal mortality and morbidity both in antepartum and postpartum period. The overall incidence of heart disease in pregnancy is <1%. Objective of present study was to determine maternal outcome in pregnant women with heart diseases in terms of fetal complication, maternal complication and Mode of delivery.Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Government Lalla Ded Hospital, an associated of Government Medical College, Srinagar which is the sole tertiary care referral centre in the valley. 90 women with heart disease which were previously established   or diagnosed during pregnancy were enrolled in the study.Results: In 90 women pregnancies was complicated by heart disease in the study. The prevalence of heart disease amongst all pregnancies found in hospital was 4.3%. The principal cause of cardiac lesion was Rheumatic heart disease (RHD) (56.6%) while congenital heart disease was seen in 13.3%. Among the women who had RHD, mitral stenosis seen in 21 (23.3%) was most common lesion and Multiple cardiac lesions 21 (24.4%) women. Among the women with congenital cardiac disease, mitral valve prolapse was most common constituting 5 (5%) cases. Cardiomyopathy was the most common constituting 7 (7.3%). Heart failure developed in 10 (11.1%) whose NYHA class changed from class I/II to class III/IV. Majority of the women delivered by caesarean section 33 (36.7%) while (35.6%) had a normal vaginal delivery with spontaneous onset of labour. 7% had assisted instrumental vaginal delivered.  9% women had first trimester abortion. There were 4 maternal deaths. 85.6% live births were observed in these women. No baby had congenital heart disease.  72.8% babies born weighed more than 2kg.Conclusions: This study concluded that pre- pregnancy diagnosis, counselling, appropriate referral, antenatal supervision and delivery at equipped centre improve the pregnancy with heart disease outcome for both mother and baby.
Oral mifepristone as adjuvant to prostaglandin E2 (PGE2) gel for preinduction cervical ripening and induction of labour in third trimester
Authors: Mane Jitendra D. , Singh Sanjay , Kumar Singh Anil
Published: August 2017

Background: Whenever the intrauterine milieu is not conducive for the foetus and continuation of pregnancy may affect adversely to mother and the fetus, termination of the pregnancy is planned. Objective of this work was to study the safety and efficacy of oral mifepristone as adjuvant to PGE2 gel in pre-induction cervical ripening and induction of labour in third trimester.Methods: 150 patients in third trimester were recruited in this single blind randomized control trial that were planned for delivery with unfavourable cervix. They were randomly allocated into two groups i.e. study group (n = 75) who received Tab. Mifepristone 200 mg orally and control group (n = 75) who received placebo orally. At the end of 48 hours (h), change in the Bishop’s Score was assessed and those with unfavourable cervix or not in labour, were administered PGE2 gel intracervically every 6h, for maximum of 3 doses for pre-induction cervical ripening of cervix. Analysis regarding safety and efficacy of the drug was done with regards to maternal and perinatal outcome.Results: Out of 150 patients, 75 received mifepristone and 75 received placebo. Mean Bishop’s Score showed significant improvement after 48h in study group (R R 5.135, 95% CI 4.78 to 5.48) compared to control group (RR 3.43, 95% CI 3.21 to 3.65). Significant number of women went in spontaneous labour in study group (39 v/s 20) (p - 0.035) in each dose category of PGE2 application. The opportunity to induce labour (with oxytocin) was better in study group in each dose category of intracervical PGE2 gel application. Moreover, lesser number of PGE2 gel was used in study group comparing control group. However, there were no statistical differences in both the groups as far as number of vaginal deliveries and caesearean sections are concerned. Duration of labour in both the groups was same. Neonatal and maternal morbidity was comparable in both the groups.Conclusions: Mifepristone improves Bishops score when given 48 h prior to labour induction along with increased number of spontaneous labour and reduced need for PGE2 gel applications, without increasing maternal or neonatal morbidity.
Physico-analytical study of ghrita formulation indicated in Vataj Artava Dushti with special reference to hypomenorrhoea and oligomenorrhoea
Authors: Kumar Ajay , . Neelam , Suman Sunita , Saxena Riden
Published: August 2017

Background: To establish safety profile for oral use of a classical Ayurvedic Ghrita formulation indicated in menstrual disorder known as Vataj Artava Dushti recent scientific techniques were used to fulfill the criteria of WHO guidelines for herbal drug formulations like heavy metal content and microbial load estimation, chromatography and others physic- analytical characteristic.Methods: In the present study formulated ghrita sample was selected for estimation of refractive index, total ash value acid, iodine, saponification, loss on drying, PH, fat content, sugar content, heavy metals namely lead (Pb), cadmium (Cd), mercury (Hg), acid value, iodine value, by ICP-MAS, TLC and HPTLC.Results: SEM- EDX shows presence of elements like Carbon, Oxygen and Aluminum, Lead, Calcium, Magnesium, Zinc. Refractive index 1.459, total ash 12%, saponification technique 55.26, Iodine value 4.32, acid value 6.6, PH 5.23 Loss on drying 0.32 fat 76.58% and sugar content 13.37%, Mercury <10 ppb, Lead 2.33 ppm, Cadmium 0.20 ppm. Total bacterial count 0.5×103, total fungal count <103. TLC and HPTLC results reveals presence of active compound.Conclusions: The Physico-analytical, heavy metals, microbial and chromatographic study of the formulated ghrita follows the standard parameters. This study can be helpful for the future research regarding establishment of safety profile and therapeutic efficacy of ghrita formulations.
The value of the middle cerebral to umbilical artery doppler ratio in the prediction of neonatal outcome in patients with high risk pregnancy
Authors: Deora Ramkanwar , Gara Nikhila
Published: August 2017

Background: To investigate the diagnostic value of MCA/UA pulsatility index ratio for the prediction of adverse perinatal outcome in patients with high risk pregnancy.Methods: We included in the study 170 patients recovered in our hospital with the diagnosis of preeclampsia and gestational hypertension, twins, postdated, IUGR, BOH from June 2016 to May 2017. All the patients underwent accurate color Doppler velocimetry examination available in our hospital. Outcome variables were intrauterine and early neonatal death, admission to neonatal intensive care unit and the duration of treatment, APGAR score below 7 at 5 minutes, cesarean delivery for foetal distress, gestational age at delivery, neonatal birth weight, IUGR.Results: In 102 patients, we found abnormal values of CPI ratio. Neonates of mothers with abnormal CPI ratio had significantly lower gestational age at delivery, lower birth weight, significantly greater risk for perinatal death, significantly greater risk of admission to intensive care unit, longer duration of treatment in NICU, greater rate of cesarean delivery for foetal distress, increased number of fetuses IUGR.Conclusions: CPI ratio is a very good predictor of adverse outcome in the fetuses of women with pre-eclampsia and other high-risk pregnancy.
A study of aetiology and prevalence of malignancy in patients with post menopausal bleeding
Authors: D. Sharma Deepti , A. Chandnani Kavita
Published: August 2017

Background: Post-menopausal bleeding (PMB) is a frequent and alarming sign and exclusion of genital tract malignancy should be the primary aim of investigation. Approximately 1 in 10 women experiences this problem. Increasing time interval between menopause and onset of post-menopausal bleeding is highly indicative of malignancy. Objectives of this study were to study the various etiologies and risk factors of post-menopausal bleeding and to find the prevalence of malignant pathology in women with post-menopausal bleeding.Methods: Prospective observational study carried out in Obstetrics and Gynecology department of SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, comprising of 150 consecutive cases of postmenopausal bleeding occurring after one year of menopause, presenting in OPD or admitted in Gynecology or emergency ward with the same complaint. Patients were assessed clinically as well as thoroughly investigated to find out exact etiology. Pap smears, tranvaginal ultrasound, fractional curettage and biopsies were done. Statistical analysis of data was done after compiling and tabulation of data. Mean±SD for age and percentages for etiologies were calculated and compared with other studies.Results: Benign aetiology was seen in 74% of the cases, malignant aetiology in 24% which is a significant proportion of menopausal women presenting with Post-menopausal bleeding. 58% (87/150) patients were in the age group 50-59 and presented after five to ten years of menopause. Commonest benign aetiology was atrophic endometrium 25.4% and another 32.5% had functional endometrium as cause of PMB (proliferative 13.2%, hyperplasia 13.2% and secretory 6.1%). Among malignancies carcinoma cervix was the commonest, 52.7%, (12.6%) of study population followed by carcinoma endometrium, 25% (6% of total population), thus making thorough and proper evaluation of all cases of PMB mandatory to pick up malignant lesions at early stage and initiate treatment accordingly.Conclusions: Post-menopausal bleeding has become a common complaint in gynecology OPD and considering its possible association with malignancy, even slightest amount of bleeding demands proper work up.