bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Trends in Mobile
Authors: de Prato Giuditta , Simon Jean Paul
Published: April 2016

This chapter aims at providing a comprehensive overview of the mobile landscape. It bridges the global trends affecting the mobile industry as a whole, with the creation and distribution of contents, emphasizing the new patterns of production and distribution. It shed light on the drivers of the changes taking place. The first part of this chapter identifies and sums up the main trends in a global landscape, namely the role of mobile communications (devices, networks) combined with the rise of the “app economy”, the spread of “Big Data”, and the move toward a multiscreen / cross-media paradigm. It provides a synthesis of available data. The first section tracks the evolution of the global market and the emerging geography with the rise of Asia as a leading player in the mobile world. The second section analyses the smartphone phenomenon. The third section deals with the rise of the “app economy”. The fourth section reviews the new modes of data driven management, stemming from “Big Data”. The fifth section follows the move a multi-screen world. The second part investigates some of the impacts of this fast evolving environment on the production of an array of mobile contents (portable movies, video, video games…) tracking the way content industries, while standing at the nexus of technology and content, are rapidly changing. The section documents the way mobile industry is indeed an innovation platform for new services. The section delineates the growing role of the consumer in a mobile world, its various modes of involvement in the production and distribution of digital content. We conclude with some elements about the new challenges brought by these trends, by the entry of new players in both the content and the mobile field.
From Personal to Mobile Healthcare
Authors: Villalba-Mora Elena , Peinado Ignacio , Rodriguez-Mañas Leocadio
Published: April 2016

mHealth is an emerging field that comprises the delivery of health through mobile technologies, being part of a broader concept: eHealth. With the rapid advances and adoption of mobile technologies and applications, mHealth opens new opportunities to deliver healthcare and wellness promotion through personal mobiles. This will transform the current delivery of services linked to particular places to a delocalization and personalization of services delivery. Although the adoption and integration of mobile technologies is high across the globe, the particular adoption of mHealth remains low and scattered due to some remaining challenges. This chapter presents the current picture of mHealth and it later discusses the opportunities both at market level and with regards to healthcare delivery. Then, it presents future research directions as big data; and it closes with conclusions on this challenging emerging field.
Future Networked Healthcare Systems
Authors: Mehmood Rashid , Faisal Muhammad Ali , Altowaijri Saleh
Published: April 2016

Future healthcare systems and organizations demand huge computational resources, and the ability for the applications to interact and communicate with each other, within and across organizational boundaries. This chapter aims to explore state-of-the-art of the healthcare landscape and presents an analysis of networked healthcare systems with a focus on networking traffic and architectures. To this end, the relevant technologies including networked healthcare architectures and performance studies, Health Level 7 (HL7), big data, and cloud computing, are reviewed. Subsequently, a study of healthcare systems, applications and traffic over local, metro, and wide area networks is presented using multi-hospital cross-continent scenarios. The network architectures for these systems are described. A detailed study to explore quality of service (QoS) performance for these healthcare systems with a range of applications, system sizes, and network sizes is presented. Conclusions are drawn regarding future healthcare systems and internet designs along with directions for future research.
Organizational Justice
Authors: Tran Ben
Published: April 2016

Wide range of human behaviors in the context of organizations can be explained by how the workplace perceives distributive, procedural, interactional, and relational fairness. That is why numerous researchers investigated the role of justice perceptions on job satisfaction, withdrawal behaviors, organizational citizenship behavior, organizational commitment, and productivity. However, there is a gap in the research arena regarding the role guanxi plays in organizational justice, especially in organizational injustice. Guanxi in organizational injustice, is a concept derived from the concept of network and the concept of nepotism. Network and nepotism (are more taboo and) are common topics of research in the arena organizational studies, whereas in the arena of education and higher education institutions, are still lacking. Guanxi is a form of social capital that aims to amass symbolic capital, and the more powerful one's symbolic capital, the more influential one's standing becomes.
The Effects of Mistreating Management Variability on Work Attitudes and Behaviors
Authors: Maroofi Fakhraddin , Kahrarian Fatemeh
Published: April 2016

The finding of this research indicates that individuals in a work unit are likely to develop negative attitudes and engage in deviate behaviors in response to a manager who is more mistreating toward some unit members but not toward others. These effects were found to be strong after explaining for each individual's personal experience of misuse from the manager. The findings are significant because they highlight the importance of mistreating management variability as a distinct unit-level construct. In sum, the findings highlight the importance of examining mistreating management at both the individual and unit levels of analyzes. This research shows that, in a work unit, non-targeted members are caused some of these negative outcomes because they are the unfair interpersonal treatment of others. Organizations should educate managers on how contradictory interpersonal treatment of subordinates impacts the fairness of the work unit and the negative implication on both targeted and non-targeted subordinates.
The Roles of Organizational Justice, Social Justice, and Organizational Culture in Global Higher Education
Authors: Kasemsap Kijpokin
Published: April 2016

This chapter reveals the roles of organizational justice, social justice, and organizational culture in global higher education, thus describing the practical and theoretical concepts of organizational justice, social justice, and organizational culture; the significance of organizational justice in global higher education; the significance of social justice in global higher education; and the significance of organizational culture in global higher education. The appropriateness of organizational justice, social justice, and organizational culture is influential for global higher education that seeks to serve practitioners and researchers, increase educational performance, sustain competitiveness, and fulfill expected accomplishment in global higher education. The chapter argues that applying organizational justice, social justice, and organizational culture has the potential to improve educational performance and reach strategic goals in global higher education.
Quality Control and Standards of Organisational Justice in Nigerian Higher Education
Authors: Muraina Monsuru Babatunde
Published: April 2016

Organisational justice improves overall organisational effectiveness, prudency, efficacy and efficiency. Previous studies examined the relationship between organisational justice and job satisfaction in manufacturing companies. This study therefore x-rayed the quality control and standards of organisational justice in Nigerian higher education: the roles and interplay of various agencies. To do this, efforts were made to examine the concept, types and models of organisational justice. A brief history of higher education in Nigeria was discussed as well as the principles of organisational justice within the context of education, empirical studies on the link among organisational justice, job satisfaction, organisational commitment and turnover intention were reviewed and the roles of various agencies in ensuring quality and standards of organisational justice in Nigerian higher education. It was therefore recommended that there should be regular and periodic workshops, conferences, seminars and symposium for the heads of the various institutions of higher learning with a view to gearing them on the relevance of organisational justice in the effective management and administration of higher educational institutions.
Angolan Higher Education, Policy, and Leadership
Authors: Manuel Nicolau Nkiawete
Published: April 2016

Since the end of the armed conflict in 2002, Angola has witnessed rapid socio-economic development characterized by the stabilization of macro-economic indicators. In this context, the government has been implementing important structural and economic reforms, including in the area of education. The purpose of this chapter is to reflect on these developments and the implication they might have on development of sustainable higher education, access, quality education, equity, leadership, and education policy. The chapter provides a brief comparative analysis of tertiary education funding among the countries of Southern Development Community (SADC) and other African countries in order to draw the attention of the decision makers about the relevance to invest more on education and protect the investments that the state has been making in education. In addition, the chapter calls for transformative leadership for social justice and change in organizational culture as an alternative avenue for enforcing current policies.
The Need for Separating University Management and Administration from Service Delivery
Authors: Bishop Jonathan
Published: April 2016

This chapter looks at how suitable the current equality policies of Wales's universities are to compete in the current economic climate and the changes needed to deliver best value to people with disabilities and all other taxpayers. The chapter makes the finding that universities are too bloated, by carrying out functions, which in Wales could be better handled by the public sector that is under direct control of the Welsh Government's education minister. This would involve learning from how the telecoms and energy companies work UK wide, so that HEFCfW becomes an infrastructure provider, Estyn would become responsible for ensuring the equality of access to higher education and ensuring the standards of university education. Universities would thus consist mainly of teaching and research staff, optimising how they use the infrastructure to attract the most students to their degrees, which are homogenised. The chapter makes clear, however, that whilst this policy would likely work in Wales, it would be unlikely to in England, perhaps allowing “clear red water” between governments.
Individual, Institutional, and Environmental Factors Promoting Patient Retention and Dropout
Authors: Arnan Precious , Adugu Emmanuel
Published: April 2016

The primary purpose of this chapter is to determine factors that shape client dropout and adherence to Cardiac Disease Prevention and Rehabilitation Programs. The sample consists of 68 individuals, including those currently in the program (adherents) and those who have dropped out (dropouts). Findings show that clients undergoing rehabilitation are much likely to drop out when they are in the critical zone. This is a point where institutional factors, individual factors and environmentally-related factors are not favorable to clients. The risk of clients dropping out can be drastically reduced through the provision of an enabling environment comprising a set of factors that foster adherence such as financial sponsorship, institutional support, high intrinsic motivation, improved illness perception. In that context, there is the need for program administrators to closely monitor at-risk clients, especially those whose social, economic and psychological profiles predict non-adherence.
Accountability and Public Reporting
Authors: Tanzariello Maria , Bucci Sabina , Ricciardi Walter , Giulio de Belvis Antonio
Published: April 2016

Patient engagement is based on the assumption that making patients co-producers of their health might enhance their satisfaction and responsibility with the healthcare system and it strictly linked with the health provider choice. Making patients active participants in their healthcare is considered a crucial component of high-quality healthcare services. Quality of care is a central concern for health systems: accountability, transparency, and public reporting are some key factors in promoting healthcare improvement. In the healthcare field, public reporting is one of the major tools in supporting patients' decisions making process, by providing structure, process and outcome measures. We performed a web-based analysis of the major initiatives of public reporting in order to highlight their main characteristics: properties (public or private), data source (health providers, ad hoc surveys, etc.), general information reported (i.e. size, language spoken, amenities), doctors' information, patients' ratings (satisfaction /experience), clinical indicators.
Management of Scheduling and Trading in Hybrid Energy Trading Market
Authors: Wu Yuan , Tan Xiaoqi , Qian Li Ping , Tsang Danny H. K. , Song Wen-Zhan , Yu Li
Published: April 2016

We introduce a novel hybrid energy trading model in SG and illustrate the associated optimal energy scheduling and trading management. The hybrid model consists of an external retail market and a local energy trading market managed by a local trading controller (LTC) whose purpose is to coordinate the local transactions between energy consumers and suppliers. The flexibility in trading with the utility company and the LTC provide a new opportunity for benefiting the energy consumers and suppliers. We quantify such benefits and formulate the mathematical optimization problems, with the objective of optimizing the consumers' and suppliers' rewards through controlling their energy demands and provisionings, and controlling the pricing of the LTC. We model two different types of the LTC's objective when it manages the local trading, i.e., the nonprofit-oriented one and the profit-oriented one. Furthermore, we consider that multiple LTCs coexist in the hybrid market, and present the mathematical optimization problems regarding the optimal energy scheduling and trading problems.
Battery Management Based on Predictive Control and Demand-Side Management
Authors: Dongol Deepranjan , Bollin Elmar , Feldmann Thomas
Published: April 2016

The chapter is intended to introduce the predictive control based energy management strategy for the grid connected renewable systems in order to achieve an effective demand side management strategy. Grid connected Photovoltaic battery system as being popular and extensively used has been discussed in this chapter .Conventionally, battery storage has been used to store surplus energy produced and meet the load demand with this stored energy. However, such systems do not respond to the grid conditions and violate grid constraints of permissible grid voltage and frequency limits. The operation of the battery depends on the forecast of photovoltaic output and the load demand and as such a predictive control based energy management strategy is needed. A simple optimization problem for such scenarios has also been formulated in great detail to provide readers with an idea for solving such problems. The results of simulations are also discussed.
Measuring Cascading Failures in Smart Grid Networks
Authors: Tauch Sotharith , Liu William , Pears Russel
Published: April 2016

Smart Grid is the next generation of the electrical power systems that form from interdependent networks. Cascading failures in such interdependent critical infrastructure is very crucial which can cause wide spread disruption. This chapter is intended to evaluate four different topological metrics in which can be best described and approximated the behavior of cascading failures in interdependent networks by employing two interlinks strategies such as random interlinks addition and degree-degree correlation interlinks. The four chosen topological metrics are algebraic connectivity, effective graph resistance, average betweenness centrality, and average distance. Throughout the chapter, analytical study of each metric are discussed and also compared with numerical simulation based on sandpile dynamics load distribution.
Swarm Intelligence Approaches to Shelf Space Allocation Problem with Linear Profit Function
Authors: Ozcan Tuncay , Esnaf Şakir
Published: April 2016

The efficient management of shelf space carries critical importance on both the reduction of operational costs and improvement of financial performance. In this context, which products to display among the available products (assortment decision), how much shelf space to allocate the displayed products (allocation decision) and which shelves to display of each product (location decision) can be defined as main problems of shelf space management. In this paper, allocation problem of shelf space management is examined. To this end, a model which includes linear profit function is used for the shelf space allocation decision. Then, heuristic approaches are developed based on particle swarm optimization and artificial bee colony for this model. Finally, the performance analysis of these approaches is realized with problem instances including different number of products and shelves. Experimental results show that the proposed swarm intelligence approaches are superior to Yang's heuristics for the shelf space allocation model.
A Genetic Algorithm-Based Multivariate Grey Model in Housing Demand Forecast in Turkey
Authors: Eren Miraç , Çelik Ali Kemal , Huseyni İbrahim
Published: April 2016

Housing sector is commonly considered as a very strong economic industry in terms of both its contribution to creating employment and its impact on other associated sectors. By means of its featured characteristics, the sector also plays an important role on economic growth and development of emerging countries. In this respect, any evidence that determines factors affecting housing investments and future demand behavior may be remarkably valuable for monitoring possible future excess supply and deficits. This chapter attempts to determine factors affecting housing demand in Turkey during a sample period of 2003-2011 using a genetic algorithm-based multivariate grey model. Housing demand forecasts are also employed until the year 2020. Results reveal that several factors including M2 money supply, consumer price index and urbanization rate have an impact on housing demand. According to housing demand forecasts, a significant housing demand increase is expected in Turkey.
Image Mining
Authors: Taşci Tuğrul
Published: April 2016

In today's World, huge multi-media databases have become evident due to the fact that Internet usage has reached at a very-high level via various types of smart devices. Both willingness to come into prominence commercially and to increase the quality of services in leading areas such as education, health, security and transportation imply querying on those huge multi-media databases. It is clear that description-based querying is almost impossible on such a big unstructured data. Image mining has emerged to that end as a multi-disciplinary field of research which provides example-based querying on image databases. Image mining allows a wide variety of image retrieval and image matching applications intensely required for certain sectors including production, marketing, medicine and web publishing by combining the classical data mining techniques with the implementations of underlying fields such as computer vision, image processing, pattern recognition, machine learning and artificial intelligence.
Comparative Analysis of Statistical, Machine Learning, and Grey Methods for Short-Term Electricity Load Forecasting
Authors: Ozcan Tuncay , Küçükdeniz Tarik , Sezgin Funda Hatice
Published: April 2016

Electricity load forecasting is crucial for electricity generation companies, distributors and other electricity market participants. In this study, several forecasting techniques are applied to time series modeling and forecasting of the hourly loads. Seasonal grey model, support vector regression, random forests, seasonal ARIMA and linear regression are benchmarked on seven data sets. A rolling forecasting model is developed and 24 hours of the next day is predicted for the last 14 days of each data set. This day-ahead forecasting model is especially important in day-ahead market activities and plant scheduling operations. Experimental results indicate that support vector regression and seasonal grey model outperforms other approaches in terms of forecast accuracy for day-ahead load forecasting.
A Soft Computing Approach to Customer Segmentation
Authors: Hiziroglu Abdulkadir
Published: April 2016

There are a number of traditional models designed to segment customers, however none of them have the ability to establish non-strict customer segments. One crucial area that can meet this requirement is known as soft computing. Although there have been studies related to the usage of soft computing techniques for segmentation, they are not based on the effective two-stage methodology. The aim of this study is to propose a two-stage segmentation model based on soft computing using the purchasing behaviours of customers in a data mining framework and to make a comparison of the proposed model with a traditional two-stage segmentation model. Segmentation was performed via neuro-fuzzy two stage-clustering approach for a secondary data set, which included more than 300,000 unique customer records, from a UK retail company. The findings indicated that the model provided stronger insights and has greater managerial implications in comparison with the traditional two-stage method with respect to six segmentation effectiveness indicators.
A Brief Review of Metaheuristics for Document or Text Clustering
Authors: Büyüksaatçı Sinem , Baray Alp
Published: April 2016

Document clustering, which involves concepts from the fields of information retrieval, automatic topic extraction, natural language processing, and machine learning, is one of the most popular research areas in data mining. Due to the large amount of information in electronic form, fast and high-quality cluster analysis plays an important role in helping users to effectively navigate, summarize and organise this information for useful data. There are a number of techniques in the literature, which efficiently provide solutions for document clustering. However, during the last decade, researchers started to use metaheuristic algorithms for the document clustering problem because of the limitations of the existing traditional clustering algorithms. In this chapter, the authors will give a brief review of various research papers that present the area of document or text clustering approaches with different metaheuristic algorithms.
On the Comparison of Quantitative Predictabilities of Different Financial Instruments
Authors: Karaçor Adil Gürsel , Erkan Turan Erman
Published: April 2016

Huge amount of liquidity flows into a number of financial instruments such as stocks, commodities, currencies, futures, and so on every day. Investment decisions are mainly based on predicting the future movements of the instrument(s) in question. However, high frequency financial data are somewhat hard to model or predict. It would be valuable information for the investor if he or she knew which financial instruments were quantitatively more predictable. The data used in the model consisted of intraday frequencies covering the period between 1993 and 2013. An Artificial Neural Network model using Radial Basis Functions containing only past data of three different types of instruments (stocks, currencies, and commodities) to predict future high values on six different frequencies was applied. A total of 72 different artificial neural networks representing 12 different instruments were trained five times each, and their prediction performances were recorded on average. Considerably clear distinctions were observed on prediction performances of different financial instruments.
Automated Classification of Vowel Category and Speaker Type in the High-Frequency Spectrum
Authors: Donai Jeremy J. , Motiian Saeid , Doretto Gianfranco
Published: April 2016

The high-frequency region of vowel signals (above the third formant or F3) has received little research attention. Recent evidence, however, has documented the perceptual utility of high-frequency information in the speech signal above the traditional frequency bandwidth known to contain important cues for speech and speaker recognition. The purpose of this study was to determine if high-pass filtered vowels could be separated by vowel category and speaker type in a supervised learning framework. Mel frequency cepstral coefficients (MFCCs) were extracted from productions of six vowel categories produced by two male, two female, and two child speakers. Results revealed that the filtered vowels were well separated by vowel category and speaker type using MFCCs from the high-frequency spectrum. This demonstrates the presence of useful information for automated classification from the high-frequency region and is the first study to report findings of this nature in a supervised learning framework.
Oncoplastic surgery in elderly patients with breast cancer: overtreatment or a goal worth pursuing?
Authors: Chiodi Stefano , Catrambone Ugo , Verrina Giuseppe , Decensi Andrea , Guglielmini Pamela , Filauro Marco
Published: April 2016

Breast cancer is the most common cancer in women in Western countries, which increases with age. The improvement of reconstructive methods in light of the principles and techniques borrowed directly from cosmetic surgery has helped raise the quality in terms of aesthetic results in conservative treatment. This approach has reached results, which merits a more precise role of self-autonomy and the name of oncoplastic breast surgery. Today this approach is becoming, in the centers dedicated to the treatment of breast cancer, the gold standard in the surgical treatment of patients with this cancer. So if the role of oncoplastic in the surgical treatment of breast cancer is to be established, it remains crucial to have a selection of patients who could benefit from this approach: today, age is one of the determining factors in the selection of patients and, in fact, patients over 75 years, are often excluded from surgery of this type. In our opinion, after a multidisciplinary assessment, also the older women could be able to receive this type of surgical approach.
Impact of non-pulmonary visceral metastases in the prognosis and practice of metastatic testicular germ cell tumors
Authors: Rossi Lorena , Martignano Filippo , Gallà Valentina , Maugeri Antonio , Schepisi Giuseppe
Published: April 2016

Non-pulmonary visceral metastases, in bones, brain and liver, represent nearly the 10% of metastatic sites of advanced germ cell tumors and are associated with poor prognosis. This review article summarizes major evidences on the impact of different visceral sites on the prognosis, treatment and clinical outcome of patients with germ cell tumors. The clinic-biological mechanisms by which these metastatic sites are associated with poor clinical outcome remain unclear. The multimodality treatment showed a potential better survival, in particular in patients with relapsed disease. Patients with advanced germ cell tumors with visceral metastases should be referred to centers with high expertise in the clinical management of such disease.
Cervical cytology as a diagnostic tool for female genital schistosomiasis: Correlation to cervical atypia and Schistosoma polymerase chain reaction
Authors: Pillay Pavitra , van Lieshout Lisette , Taylor Myra , Sebitloane Motshedisi , Zulu Siphosenkosi Gift , Kleppa Elisabeth , Roald Borghild , Kjetland Eyrun Floerecke
Published: April 2016

Background:

Female genital schistosomiasis (FGS) is a tissue reaction to lodged ova of Schistosoma haematobium in the genital mucosa. Lesions can make the mucosa friable and prone to bleeding and discharge. Women with FGS may have an increased risk of HIV acquisition, and FGS may act as a cofactor in the development of cervical cancer.

Objectives:

To explore cytology as a method for diagnosing FGS and to discuss the diagnostic challenges in low-resource rural areas. The correlation between FGS and squamous cell atypia (SCA) is also explored and discussed. Cytology results are compared to Schistosoma polymerase chain reaction (PCR) in vaginal lavage and urine and in urine microscopy.

Materials and Methods:

In a clinical study, 394 women aged between 16 and 23 years from rural high schools in KwaZulu-Natal, South Africa, underwent structured interviews and the following laboratory tests: Cytology Papanicolaou (Pap) smears for S. haematobium ova and cervical SCA, real-time PCR for Schistosoma-specific DNA in vaginal lavage and urine samples, and urine microscopy for the presence of S. haematobium ova.

Results:

In Pap smears, S. haematobium ova were detected in 8/394 (2.0%). SCA was found in 107/394 (27.1%), seven of these had high-grade squamous intraepithelial lesion (HSIL). Schistosoma specific DNA was detected in 38/394 (9.6%) of vaginal lavages and in 91/394 (23.0%) of urines. Ova were found microscopically in 78/394 (19.7%) of urines.

Conclusion:

Schistosoma PCR on lavage was a better way to diagnose FGS compared to cytology. There was a significant association between S. haematobium ova in Pap smears and the other diagnostic methods. In low-resource Schistosoma-endemic areas, it is important that cytology screeners are aware of diagnostic challenges in the identification of schistosomiasis in addition to the cytological diagnosis of SCA. Importantly, in this study, three of eight urines were negative but showed Schistosoma ova in their Pap smear, and one of them was also negative for Schistosoma DNA in urine. In this study, SCA was not significantly associated with schistosomiasis. HSIL detected in this young population might need future consideration.
Using Telehealth to Reduce All-Cause 30-Day Hospital Readmissions among Heart Failure Patients Receiving Skilled Home Health Services
Authors: O’Connor Melissa , Dempsey Mary , Huffenberger Ann , Jost Sandra , Flynn Danielle , Norris Anne , Asdornwised Usavadee
Published: April 2016

The reduction of all-cause hospital readmission among heart failure (HF) patients is a national priority. Telehealth is one strategy employed to impact this sought-after patient outcome. Prior research indicates varied results on all-cause hospital readmission highlighting the need to understand telehealth processes and optimal strategies in improving patient outcomes.

The purpose of this paper is to describe how one Medicare-certified home health agency launched and maintains a telehealth program intended to reduce all-cause 30-day hospital readmissions among HF patients receiving skilled home health and report its impact on patient outcomes.

Using the Transitional Care Model as a guide, the telehealth program employs a 4G wireless tablet-based system that collects patient vital signs (weight, heart rate, blood pressure and blood oxygenation) via wireless peripherals, and is preloaded with subjective questions related to HF and symptoms and instructional videos.

Year one all-cause 30-day readmission rate was 19.3%. Fiscal year 2015 ended with an all-cause 30-day readmission rate of 5.2%, a reduction by 14 percentage points (a 73% relative reduction) in three years. Telehealth is now an integral part of the University of Pennsylvania Health System’s readmission reduction program.

Telehealth was associated with a reduction in all-cause 30-day readmission for one mid-sized Medicare-certified home health agency. A description of the program is presented as well as lessons learned that have significantly contributed to this program’s success. Future expansion of the program is planned. Telehealth is a promising approach to caring for a chronically ill population while improving a patient’s ability for self-care.
Uterine Atony: An Innovative Dutta's Scoring System for Elective Cesarean Section
Authors: Dutta Indranil , Dutta Indranil
Published: April 2016

Uterine atony appears suddenly and is mostly unpredictable and accounts for 80% of causes of postpartum hemorrhage (PPH), it is also one of the important causes of maternal death.

Objective

To analyze the efficacy of Dutta's score for early diagnosis and management of uterine atony during elective lower segment cesarean section (LSCS) to prevent PPH.

Study methods: This study was undertaken at JNM, NSGH, CN at Kalyani, Nadia, West Bengal, India, from 1st June 2008 to 31st Dec 2012. Six hundred cases undergoing elective LSCS were selected for randomized trial. Clinical observations were made after placental expulsion for scoring which includes shape and size of uterus, rugosity, tone, placental localization and time of placental expulsion. Scores of 0, 1, 2 were given on each observation. Three groups are created depending on scoring: group A (n = 300)—8 to 10, group B (n = 220)—5 to 7 and group C (n = 80)—<5 for better management.

Management protocols were formulated in the three groups for prevention of PPH: group A—oxytocin 10 U (5U IM + 5U IV 30 drops/min in Ringer's lactate 500 ml), group B—oxytocin 15U (5U IM + 10U IV 30 drops/min in Ringer's-lactate 500 ml) + methylergometrine (0.25 mg IM) + anterior posterior uterine wall compression, group C—oxytocin 20 U (5U IM plus 15 U IV 30 drops in ringer lactate 500 ml) + methylergometrine (0.5 mg IM) + carboprost (250 mcg IM) + lateral followed by anterior posterior uterine wall compression + isthmus compression of uterus + misoprostol 800 mg per rectal during postoperative period.

Results

After adopting Dutta's score and management protocols, it was interesting to observe that intra and postoperative, blood loss (within 2 hours) were found to be significantly reduced in group A—73.3% (<300 cc), 88% (<200 cc) and group B—63.6% (<300 cc), 81.8% (<200 cc). Intraoperative blood loss >500 cc were also found to be reduce in group A—14.7%, group B—16.3%. In group C, intraoperative blood loss >500 cc were seen in 41.25% and postoperative —37.5% respectively. Hemoglobin level below 11 gm% were found to be not reduced in group A (1.4%), group B (2.6%) and group C (8.7%) after 24 hours of delivery hemodynamic status in all groups were found to be uneventful. Maternal mortality was found to be nil.

Conclusion

Early diagnosis and management of uterine atony during elective LSCS after adopting Dutta's score were found to be not only reduce intra- and postoperative blood loss but also was found to maintain a satisfactory hemoglobin level and hemodynamic status. Maternal mortality was found to be nil. This randomized trial highlighted the importance of prompt treatment in group C to reduce intra- and postoperative blood loss and maternal mobidity and mortality.

How to cite this article

Dutta DK, Dutta I. Uterine Atony: An Innovative Dutta's Scoring System for Elective Cesarean Section. J South Asian Feder Obst Gynae 2015;7(3):113-117.
The Role of Natural Progesterone Administration on the Levels of Progesterone-induced Blocking Factor, Interleukin-10 and the Prolongation of Gestational Length in Impending Preterm Delivery
Authors: Thipasary Yanne , Effendi Jusuf Sulaeman , Anwar Anita Deborah
Published: April 2016

Progesterone plays an important role in maintaining pregnancy. The success of pregnancy depends on the balance of immune response between the mother and the fetus. Progesterone regulates the immunological response through progesteroneinduced blocking factor (PIBF) which is synthesized by lymphocytes. Progesterone-induced blocking factor inhibits the production of arachidonic acid, reduced NK cell activity, and modulates the cytokine balance by increasing interleukin-10 (IL-10) level that is produced by Th2. This study aims to determine the roles of natural progesterone administration on PIBF and IL-10 levels and the increase in gestational length.

This is an experimental research with pre- and post-test design. Subjects were pregnant women who met the criteria (n = 22). The treatment was done for 7 days. Progesteroneinduced blocking factor and IL-10 levels were measured before and after the administration of natural progesterone and the length of gestation were noted. The study was conducted at Dr Hasan Sadikin Hospital within July to December 2013.

Results showed that after the administration of natural progesterone, there were increases on PIBF (p = 0.039) and IL-10 levels (p = 0.031). A positive correlation was noted between PIBF and IL-10 levels (r = 0.549; Spearman rank correlation test). There was also positive correlation between PIBF serum level (moderate strength correlation) and the length of gestation (r = 0.428; Point biserial correlation test). Progesterone-induced blocking factor serum level had more influence on the prolongation of the pregnancy compared to IL-10 level (OR: 1.016, 95% CI: 1.001 to 1.03; p = 0.033).

Increased levels of PIBF and IL-10 after the administration of natural progesterone on the impending preterm delivery may prolong the gestation. Progesterone-induced blocking factor serum level have more dominant role in prolongation of gestation compared to IL-10.

How to cite this article

Thipasary Y, Effendi JS, Anwar AD. The Role of Natural Progesterone Administration on the Levels of Progesterone-induced Blocking Factor, Interleukin-10 and the Prolongation of Gestational Length in Impending Preterm Delivery. J South Asian Feder Obst Gynae 2015;7(3):118-125.
Low Serum Calcium Levels in Pre-eclampsia
Authors: Rashid Bushra , Richard Mariam Malik , LNU Gul-E-Rana
Published: April 2016

Background

Pre-eclampsia remains the most threatening obstetric complication in Pakistan, resulting in high fetomaternal morbidity and mortality. Etiology of pre-eclampsia is not still clearly established. Association of low serum calcium levels with pre-eclampsia may be a factor in poorly nourished women, and some preventive measures may help to reduce the burden of disease.

Objective

To compare mean serum calcium levels in preeclamptic and normotensive pregnant women at third trimester of gestation.

Study design

Cross-sectional study.

Place and duration of study

The Department of Obstetrics and Gynecology, Unit-1, Sir Ganga Ram Hospital, Lahore, from July 2012 to July 2013.

Methodology

Two hundred patients were enrolled in the study. One hundred each in case and control group. History and examination performed. Proteinuria was checked by dip stick methods. Peripheral venous blood samples were taken to determine mean serum calcium levels of both the groups. Oral calcium supplementation was analyzed through stratification. Data was analyzed through SPSS by applying student's t test and calculating p-value.

Results

The mean serum calcium levels of the case group were 8.313 ± 0.377 while that of control group were 9.40 ± 0.427 with p-value 0.016. With increasing proteinuria (determined by dipstick method) and so the severity of pre-eclampsia, a gradual fall in serum calcium levels was observed.

Conclusion

Serum calcium levels in pre-eclamptic pregnant women are lower than in normal pregnant women and so hypocalcemia is associated with pre-eclampsia.

How to cite this article

Rashid B, Richard MM, Gul-E-Rana. Low Serum Calcium Levels in Pre-eclampsia. J South Asian Feder Obst Gynae 2015;7(3):126-129.
Oral Clindamycin to prevent Preterm Birth: A Randomized Placebo Controlled Trial in South India
Authors: Bellad MB , Chalasani Pallavi , Ganachari Madiwalayya S , Goudar Shivaprasad S , Sloan Nancy L , Hoffman Matthew K , Derman Richard J
Published: April 2016

Objectives

Clindamycin is the only antibiotic shown effective, in a single study conducted in the United Kingdom, to prevent preterm birth, the leading cause of neonatal mortality. The study objective was to confirm whether oral clindamycin reduces preterm birth by two-thirds in women with vaginal pH > five in a developing country.

Materials and Methods

All women presenting to antenatal care were screened for study eligibility. Two hundred and ten consenting women were randomized at 13 to 17 weeks gestation in this double-blind randomized trial to 300 mg oral clindamycin twice daily for 5 days or an identical placebo at Jawaharlal Nehru Medical College, Belgaum, India. Outcomes were assessed using Chi-square and Student's t-tests.

Results

Twelve women lost to follow-up and three women with unexpected multiple gestation were excluded from analysis. The study group characteristics (n = 100 clindamycin, n = 95 placebo) were similar. The incidence of birth <37 and <34 weeks were 12.0 and 6.0% in the clindamycin compared with 24.2 and 14.7% in the placebo groups (p = 0.026 and p = 0.044, respectively).

Conclusion

Gestational infection accounts for ~40% of preterm births. This is the first confirmation of the only published trial demonstrating that oral clindamycin provided to women with vaginal pH > 5.0 early in gestation substantially reduces preterm birth.

How to cite this article

Bellad MB, Chalasani P, Ganachari MS, Goudar SS, Sloan NL, Hoffman MK, Derman RJ. Oral Clindamycin to prevent Preterm Birth: A Randomized Placebo Controlled Trial in South India. J South Asian Feder Obst Gynae 2015;7(3):191-196.
Mono Fetal Demise in Twin Gestation and Outcome
Authors: Sinduja TP , Sadique Nazira , LNU Pavithra
Published: April 2016

We present two cases of dichorionic diamniotic (DCDA) twin and one monochorionic diamniotic (MCDA) twin during their third trimester with single intrauterine fetal demise (IUFD) and their outcomes. These cases were not found to be associated with any of the high-risk factor for fetal demise in twin like abruption placenta, velamentous insertion of cord or cord entanglement.1 Between the DCDA twins, one case developed coagulation disorder, the other case developed acute fatty liver of pregnancy after 2 weeks of diagnosing IUFD and emergency termination was done. Whereas the MCDA twin showed, hypoxic ischemic encephalopathy (HIE) changes in fetal magnetic resonance imaging (MRI) and emergency termination of pregnancy was done.

How to cite this article

Sinduja TP, Sadique N, Pavithra. Mono Fetal Demise in Twin Gestation and Outcome. J South Asian Feder Obst Gynae 2015;7(3):199-201.
Labial Adhesion in Adult Female
Authors: Ghose Seetesh , Pallavee P , Begum Jasmina , John Lopamudra B , Samal Sunil Kumar
Published: April 2016

A 23 years old female presented to gynecological outpatient department (OPD) with complain of passing urine and menstrual blood through a single small opening for 5 years. On examination, she had well developed secondary sex characters but fused labia minora with a single pinpoint opening through which she was passing both urine and menstrual blood. Radiological investigation revealed normal female genital tract. So, the case was diagnosed as labial fusion and surgically treated as medical management failed.

How to cite this article

Ghose S, Pallavee P, Begum J, John LB, Samal SK. Labial Adhesion in Adult Female. J South Asian Feder Obst Gynae 2015;7(3):207-209.
Transabdominal Ultrasound-guided Follicular Aspiration in Case of Müllerian Anomaly with Ovarian Malposition
Authors: Mishra Vineet V , Goyal Preeti A
Published: April 2016

Objective

To describe the approach of transabdominal ultrasound-guided oocyte retrieval in a patient of müllerian anomaly and ovarian malposition.

Setting

A tertiary referral reproductive medicine unit.

Patient

A 23-year-old patient with müllerian anomaly (right unicornuate with left rudimentary horn uterus) and ovarian malposition.

Intervention

Controlled ovarian hyperstimulation, transabdominal ultrasound-guided oocyte retrieval.

Main outcome measure

Total and mature oocytes retrieved, fertilization rate, embryo number and quality.

Result

Five oocytes were retrieved transabdominally using percutaneous needle puncture under ultrasound guidance.

Conclusion

In in vitro fertilization (IVF) protocols, patients with müllerian anomaly with inaccessible ovaries vaginally, transabdominal ultrasound-guided follicular aspiration is a safe and efficacious alternative technique for oocyte retrieval.

How to cite this article

Mishra VV, Choudhary S, Goyal PA, Aggarwal R. Transabdominal Ultrasound-guided Follicular Aspiration in Case of Müllerian Anomaly with Ovarian Malposition. J South Asian Feder Obst Gynae 2015;7(3):213-215.
Intensive Care Management of Prostodin-induced Acute Pulmonary Edema in a Parturient
Authors: Chanu Sairem Mangolnganbi , Panda Subrat , Maurya Indubala
Published: April 2016

Pulmonary edema in parturient can be because of various reasons. Parturients are at risk of pulmonary edema because of the physiological changes. Here, we report successful management of a case of pulmonary edema caused by prostodin (Carboprost) given within a maximal dose limit. Prostodin acts as a smooth muscle stimulant and is a recognized second-line agent for use in the management of postpartum uterine atony unresponsive to oxytocin/ergometrine. It may induce pulmonary edema but rare in limited doses. However, vigilant monitoring and timely intensive care management helped us successfully to manage the case.

How to cite this article

Chanu SM, Dey S, Panda S, Maurya I. Intensive Care Management of Prostodin-induced Acute Pulmonary Edema in a Parturient. J South Asian Feder Obst Gynae 2015;7(3):218-219.
Mayer-Rokitansky-Küster-Hauser Syndrome with Rare Findings of Crossed Fused Renal Ectopia and Ovarian Serous Cystadenoma
Authors: Inam Lubna
Published: April 2016

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome occurs in one of 4,000 to 5,000 female births and is characterized by normal development of secondary sexual, congenital aplasia of uterus and upper part (2/3) of vagina, and normal fallopian tubes and ovaries. Therefore, individuals with MRKH syndrome are at normal risk of developing ovarian neoplasms.

We report a case of 19 years old unmarried female who was admitted to the hospital with pain in lower abdomen for 7 months. She was having primary amenorrhea. Gynecological examination revealed a blind vaginal pouch. Rectal examination revealed a large left-sided 8 cm cystic mass which was mobile with a smooth surface. Uterus was not palpable. Phenotypic sex was female. Breast development, axillar and pubic hair development were normal. Abdominopelvic ultrasonography showed left-sided crossed fused renal ectopia and a heterogeneous hypoechoic cystic mass with dense internal echoes on left-side. Uterus was not visualized. Intravenous pyelography also confirmed the finding of left-sided crossed fused renal ectopia. At laparotomy, a 10 × 8 cm cystic hemorrhagic ovarian mass with a single twist of pedicle was found, with a normal right ovary and bilateral tubes. A small hypoplastic unicornuate uterus was present. Cervix was absent. Left-sided Salpingo-oophorectomy was done and tissue was sent for histopathology, which revealed ovarian serous cyst adenoma.

All patients with vaginal agenesis must be regarded primarily as a MRKH syndrome and they must be investigated to establish whether there were any associated congenital anomalies.

How to cite this article

Asnani M, Srivastava K, Inam L, Kunwar S. Mayer-Rokitansky-Küster-Hauser Syndrome with Rare Findings of Crossed Fused Renal Ectopia and Ovarian Serous Cystadenoma. J South Asian Feder Obst Gynae 2015;7(3):220-222.