bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights into endometrial cancer profiles and its pattern of recurrences: a study from a leading health center in eastern Morocco
Authors: Chatbi Zainab , Ghizlane Graiti , Ahmed Mimouni , Hanane Saadi , Taheri Hafsa
Published: January 2025

Background: Endometrial cancer (EC) is a rising gynecological malignancy, particularly in low- and middle-income countries. This study explored the demographic, clinical, and pathological features of women with EC in eastern Morocco.Methods: A retrospective review of 60 cases of histologically confirmed EC was conducted at Mohammed VI University Hospital, Oujda, from January 2016 to January 2024. Data included demographics, clinical symptoms, diagnostics, treatments, and risk factors. Results: The mean age was 56 years, with 80% aged 50-70. Most patients (60%) resided in urban areas, and 90% were nonsedentary housewives. Vaginal bleeding was the main symptom (87%). Early-stage disease (stage I) was predominant (70%), with endometrioid carcinoma accounting for 65% of cases. Tumor grades were 40% grade I, 45% grade II, and 15% grade III, with >50% myometrial invasion in 45%. Risk factors included postmenopausal status (80%), nulliparity (43%), and overweight (46%), while hypertension and diabetes affected 30% and 20%, respectively. Treatment involved total hysterectomy with bilateral salpingo-oophorectomy (45%) or radical hysterectomy (18.3%). Adjuvant therapy was administered to 76.7%, with 11.7% receiving combined chemo-radiotherapy. Based on ESMO-ESGO-ESTRO risk classification, 60% were low-risk, while high-risk cases showed higher recurrence and poorer outcomes.Conclusions: EC in Morocco is often detected at an early stage, predominantly affecting postmenopausal women. Efforts should focus on early diagnosis and customized treatment strategies for high-risk patients to improve outcomes.
Evaluating the efficacy of anti-Müllerian hormone as a predictor of ovarian reserve and fertility treatment success
Authors: Holy Mirza Farzana , Jahan Esmat , Al-Maruf Abdullah
Published: January 2025

Background: Ovarian reserve assessment is crucial for predicting fertility treatment outcomes, with Anti-Müllerian Hormone (AMH) emerging as a key biomarker. This study aimed to evaluate the efficacy of AMH as a predictor of ovarian reserve and its correlation with fertility treatment success among women in Bangladesh.
Methods: This retrospective study analyzed medical records of 100 women aged 20-40 years who underwent fertility treatment at a specialized clinic in Bangladesh over five years. AMH levels were measured using VIDAS and ovarian reserve was assessed via antral follicle count (AFC) using transvaginal ultrasound. The correlation between AMH levels, AFC, oocytes retrieved and clinical pregnancy rates was analyzed using Pearson's correlation coefficient with statistical software SPSS 26.
Results: The study found a significant positive correlation between AMH levels and AFC, with 80% of women with high AMH levels also having a high AFC. Additionally, women with high AMH levels had higher oocyte retrieval rates and clinical pregnancy rates (70%) compared to those with medium (50%) and low AMH levels (29.4%). The nearly equal distribution of clinical pregnancy outcomes (49% achieving pregnancy) highlighted the varied success of fertility treatments in this population.
Conclusions: AMH is a valuable predictor of ovarian reserve and fertility treatment outcomes, particularly when combined with AFC and other patient-specific factors. This study supports the use of AMH in clinical settings to enhance individualized fertility treatment strategies, potentially improving success rates.
Association of serum irisin with gestational diabetes mellitus
Authors: Sultana Abeda , Joarder M. Akhtanur Rahman , Begum Khadiza , Shamsunnahar Nafisa , Ferdous Sharmin , Parveen Tabassum
Published: January 2025

Background: Gestational diabetes mellitus (GDM) is a condition characterized by glucose intolerance with onset during pregnancy, increasing risks to both mother and child. Recent studies have focused on irisin, a hormone linked to energy metabolism and insulin sensitivity, to understand its role in GDM. This study aimed to explore the relationship between serum irisin levels and the incidence of GDM.
Methods: This prospective diagnostic accuracy study was conducted at the outpatient Department of Fetomaternal Medicine and the Department of Obstetrics and Gynecology at BSMMU in Dhaka from July 2021 to June 2022. According to the inclusion criteria, 65 pregnant women who were non-GDM at 11-14 weeks were selected purposively. Serum irisin levels were measured in these non-diabetic participants using an enzyme-linked immunosorbent assay (ELISA) kit. The participants were divided into two groups: those with reduced irisin levels and those with normal irisin levels. Data were then analyzed using statistical package for the social sciences (SPSS) version 23.0 software.
Results: Among the low irisin group, 36.4% were diagnosed with GDM, while 63.6% remained euglycemic. In the high irisin group, 97.7% remained euglycemic, and 2.3% developed GDM. Overall, 14% of respondents were with GDM across both groups. The ROC analysis for detecting GDM based on irisin levels showed statistically significant results with an AUC of 0.834. A cut-off value of ≤0.287 had 88.9% sensitivity and 75% specificity, leading to 76.9% accuracy. The PPV was 36.4%, and the NPV was 97.7%. The mean serum irisin level was significantly lower in mothers with GDM compared to non-GDM mothers (p=0.001).
Conclusions: The maternal serum irisin level is found to be lower in pregnant women with GDM compared to those without GDM. Therefore, in pregnancy, maternal serum irisin levels may be useful as a biomarker for detection of GDM.
Treatment modalities and clinical outcomes in patients with gestational trophoblastic disease
Authors: Laila Nousheen , Azim Nazma , Nasim Rehnuma , Islam Farzana , Khan Sadia Sultana
Published: January 2025

Background: Gestational trophoblastic disease (GTD) encompasses a diverse group of disorders characterized by abnormal trophoblastic tissue proliferation, including premalignant conditions like hydatidiform moles and malignant types such as choriocarcinoma and persistent trophoblastic disease, which carry significant malignant potential. The purpose of this study was to evaluate the effectiveness of various treatment modalities and the clinical outcomes in patients diagnosed with gestational trophoblastic disease. The aim of the study was to evaluate the effectiveness of various treatment modalities and the clinical outcomes in patients diagnosed with gestational trophoblastic disease.
Methods: This descriptive cross-sectional study, conducted at the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College and Mitford Hospital, Dhaka (November 2012 - November 2013), included 50 cases of gestational trophoblastic disease (GTD). Inclusion criteria were fresh, incompletely treated, and recurrent GTD cases. Data were collected via a pretested questionnaire, analyzed using SPSS, and presented as descriptive statistics. Ethical approval and informed consent were obtained from all participants.
Results: Among 50 GTD cases, 60% were complete moles, with 94.44% of persistent disease linked to prior molar pregnancies. P/V bleeding was the most common symptom. Choriocarcinoma showed 50% metastasis, mainly to lungs, and 86% remission with EMACO therapy. Suction evacuation treated 56% of molar pregnancies, with 13.5% progressing to persistent mole and 4.5% to choriocarcinoma.
Conclusions: This study highlights the importance of early detection, timely treatment, and regular follow-up in improving outcomes for patients with gestational trophoblastic disease.
Correlation between pregnancy-induced hypertension and ocular disorders
Authors: Halim Tanzila , Islam M. Saiful , Khatun Hasina , Khan Amena , Hasan M. Mehedi , Kulsum Umme
Published: January 2025

Background: Pregnancy-induced hypertension (PIH) is a common condition that can lead to significant maternal and fetal complications. Ocular manifestations, including hypertensive retinopathy, are frequently observed in PIH and may reflect the severity of the disease. This study aimed to evaluate the correlation between PIH and ocular disorders, as well as the associated maternal and fetal outcomes.
Methods: This retrospective observational study was conducted in the department of obstetrics and gynaecology at Mymensingh Medical College Hospital, Mymensingh and BSMMU, Dhaka, Bangladesh, from June 2018 to May 2020. A total of 120 pregnant women diagnosed with pregnancy-induced hypertension (PIH) were included based on specific inclusion criteria, which required a clinical diagnosis of PIH, gestational hypertension, preeclampsia, or eclampsia. Data were collected from medical records, including demographic details, clinical findings and ophthalmic evaluations.
Results: Among the participants, 25% had hypertensive retinopathy, 12.5% exhibited visual field defects and 20.8% had no ocular complications. Severe PIH was significantly associated with ocular disorders (p=0.001). Maternal complications occurred in 37.5% of those with ocular changes, while 25% experienced preterm delivery and 20.8% had fetal growth restriction. All associations were statistically significant (p<0.05), highlighting the impact of ocular complications on maternal and fetal outcomes.
Conclusions: The study demonstrated a strong correlation between the severity of PIH and ocular disorders, with hypertensive retinopathy being the most prevalent. Ocular complications were linked to adverse maternal and fetal outcomes, highlighting the importance of early ocular screening in PIH patients.
Hormonal therapy versus hysterectomy in the management of symptomatic adenomyosis
Authors: Parveen Mehera , Zabin Fahmida , Sultana Nigar , Begum Kazi F. , Ara Rowson , Munmun Salma A. , Wahid Fatima
Published: January 2025

Background: Adenomyosis is a uterine disorder marked by symptoms such as pelvic pain, abnormal uterine bleeding (AUB), and infertility. The purpose of this study was to assess the effectiveness and patient outcomes of hormonal therapy versus hysterectomy in the management of symptomatic adenomyosis. The aim of this study was to evaluate the effectiveness and patient outcomes of hormonal therapy versus hysterectomy in the management of symptomatic adenomyosis.
Methods: This prospective observational study included 85 patients with symptomatic adenomyosis treated with hormonal therapy (n=45) or hysterectomy (n=40) at Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2022 to 2023. Inclusion criteria were adult females aged 20 years and above, while those with other gynecological disorders or severe comorbidities were excluded. Data on demographic characteristics, symptom relief, and patient satisfaction were analyzed using statistical package for the social sciences (SPSS) version 22.0, employing both descriptive and inferential statistics.
Results: Most patients (n=85) were aged 40-49 years, with 55.6% receiving hormonal therapy. Hormonal therapy was used in 52.9% of cases, slightly surpassing hysterectomy at 47.1%. Treatment outcomes showed that 75.0% of hysterectomy patients experienced complete symptom relief, while only 44.4% in the hormonal therapy group reported the same, and 70.0% of hysterectomy patients were very satisfied compared to 33.3% in the hormonal therapy group. Hysterectomy patients had a shorter hospital stay, with 25.0% discharged within 2-3 days compared to 11.1% of hormonal therapy patients.
Conclusions: Hysterectomy provides superior symptom relief and patient satisfaction compared to hormonal therapy in the management of symptomatic adenomyosis.
Knowledge, practice and awareness of adolescent girls on human papillomavirus vaccine
Authors: Akhter Nusur , Nasrin Sonia
Published: January 2025

Background: Human papillomavirus (HPV) is a significant public health concern, particularly among adolescents, as it is a leading cause of cervical cancer and other HPV-related diseases. Despite the availability of an effective vaccine, knowledge and awareness about HPV and its prevention remain limited, especially among young girls. This study aims to assess the knowledge, practice, and awareness of adolescent girls regarding the HPV vaccine.
Methods: The study was conducted at department of obstetrics and gynaecology, Anwer Khan modern medical college and hospital, Dhaka, Bangladesh from July, 2023 to June, 2024. A cross-sectional descriptive study design was employed, targeting adolescent girls aged 13 to 19 years. The study population consisted of students from five secondary schools within the urban and peri-urban areas of the district. A total of 300 participants were included in the study.
Results: The study of 300 participants reveals that the majority are aged 15-16 years (40%), followed by 17-18 years (30%). Most participants are in senior secondary (1-2) (50%), and 60% are aware of HPV, with school programs being the most common source of awareness. Knowledge of HPV transmission and the HPV vaccine is limited, with 40% having correct knowledge about transmission and 30% possessing adequate vaccine knowledge. Vaccination rates are low, with only 40% vaccinated, primarily due to a lack of awareness. Most participants recommend increasing awareness campaigns (50%) and reducing vaccine costs (25%).
Conclusions: This study concludes that a majority (60%) of the participants were aware of HPV, only 40% demonstrated correct knowledge of its transmission, and an even smaller proportion (30%) had adequate knowledge about the HPV vaccine itself. The low vaccination rate of 40% reflects the challenges in increasing uptake, with the primary barrier being a lack of awareness.
Prevalence of sexually transmitted infections in symptomatic women of reproductive age group in a tertiary care centre
Authors: Verma Aruna , Sirohi Payal , Garg Amit
Published: January 2025

Background: Sexually transmitted infections (STIs) remain a significant global health challenge, affecting millions of individuals daily. This study aimed to investigate the prevalence and causative organisms of common STIs in women aged 18-49 years who presented with symptomatic vaginal discharge at a tertiary care hospital in India. The primary objective was to assess the prevalence of common STIs, including syphilis, gonorrhoea, chlamydia, trichomoniasis, human immunodeficiency virus (HIV), and candidiasis, through the use of specific diagnostic tests.
Methods: A total of 100 non-pregnant women aged 18-49 years with vaginal discharge (excluding physiological discharge) were enrolled in the study. The research was conducted in the Department of Obstetrics and Gynecology LLRM Medical College, Meerut. Each participant was subjected to a detailed medical history and clinical examination. Vaginal and cervical swabs were taken for laboratory testing, and specific tests were performed for the detection of syphilis, gonorrhea, chlamydia, trichomoniasis, HIV, and candida. Data were analyzed using Microsoft Excel and statistical software such as GraphPad Prism 8.4.2 and statistical package for the social sciences (SPSS) version 25.
Results: The study found that 15% of participants were diagnosed with an STI, with Candida infection being the most prevalent, affecting 66.67% of those with STIs. Chlamydia and Trichomonas infections each accounted for 13.33% of the cases, while one case of syphilis was reported. Significant correlations were observed between the type of vaginal discharge and the presence of STIs, with blood-stained and mucopurulent discharge being more common among STI-positive women.
Conclusions: The prevalence of STIs observed in this study was consistent with findings in the broader epidemiological literature. Candida infection was the most frequently diagnosed, underscoring the need for targeted interventions, early detection, and awareness among women of reproductive age in both urban and rural settings.
First trimester diagnosis of fetal cardiac anomalies: a sonopathological correlation study
Authors: Charmariya Sumit
Published: January 2025

Background: Accurate diagnosis of structural cardiac anomalies in the first trimester is critical due to its impact on anxiety and pregnancy management. This study aims to evaluate the correlation between first-trimester ultrasound (USG) findings of cardiac anomalies and perinatal pathological evaluations.
Methods: This retrospective study was conducted at Mediscan systems, a tertiary care fetal medicine center in South India, analyzing first-trimester scans from January 2012 to December 2017. Singleton pregnancies with detected cardiac anomalies were identified from the sonocare database. Only those cases with subsequent perinatal autopsy were included in the study cohort.
Results: In the study cohort, the mean maternal age was 26.6 years (range 19-44), mean BMI was 26.1 (range 17.5-42.8), and mean crown-rump length was 65 mm (range 48-82 mm). Ultrasound findings and autopsy results were in complete agreement in 62% of cases. Autopsies provided additional information in 28% of cases, while 10% of cases had discordant findings. Notably, the accuracy improved in the second cohort, with complete agreement rising from 49% to 76% and mismatches reducing from 21% to zero.
Conclusions: The study highlights that a systematic checklist enhances the accuracy of first-trimester cardiac assessments, achieving correct diagnoses in 90% of cases. The improvement over time underscores the effectiveness of refined diagnostic protocols. Despite these advances, challenges in differentiating certain anomalies persist, but no prenatally diagnosed anomalies were found normal on autopsy, reinforcing the reliability of early diagnoses and the ability to provide confident counselling.
A study of 44 cases of pure dysgerminoma of the ovary: a single institutional experience
Authors: K. Sangeetha , Kumar Ajay
Published: January 2025

Background: The extent of surgery and additional therapy required in patients with dysgerminoma is debated. This study evaluated the clinicopathologic characteristics, treatment modalities, long-term survival, and menstrual and fertility outcomes of women with ovarian dysgerminoma managed at our institute.
Methods: A total 44 histologically proven pure ovarian dysgerminoma cases were identified in this retrospective study. Patients who received treatment between 2006 and 2017 at Gujarat Cancer and Research Institute, either surgery or chemotherapy, or both were included.
Results: About 60.6% of patients presented with stage I, 9.09% with stage II, 27.27% with stage III, and 3.03% with stage IV disease. Initial management was surgery followed by observation in 9 (20.45%), surgery followed by adjuvant chemotherapy in 25 (56.81%), and neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) and adjuvant chemotherapy in 9 (20.45%) patients. Recurrence occurred in 1 (2.32%) patient with stage III disease after 1 year and 5 months (17 months) post-chemotherapy successfully salvaged with platinum-containing chemotherapy. The 3-year disease-free survival (DFS) and overall survival (OS) were 93.18% and 95.45%, respectively. Thirteen patients attempted conception and 6 (46.15%) delivered after treatment completion. Thirty-five patients underwent fertility-sparing surgery. Out of these, thirty patients (85.7%) got regular menstrual cycles. All three prepubertal girls attained menarche.
Conclusions: Regardless of the stage, fertility-sparing surgery can be offered to the patient with good reproductive outcomes expected after fertility-sparing surgery followed by chemotherapy. Adjuvant chemotherapy is associated with significant improvement in DFS. NACT followed by surgery is a reasonable option for patients with advanced-stage dysgerminoma.
Comparison of the effect of vaginal progesterone and oral nifedipine for maintenance tocolysis after arrested preterm labour, to prolong the pregnancy and the neonatal outcome
Authors: Bairwa Mahendra Kumar , Taneja Charu , Sharma Monika , Yadav Khushboo
Published: January 2025

Background: Preterm birth is a major determinant of neonatal morbidity and mortality and has long term adverse consequences. It is defined as childbirth occurring at less than 37 weeks of gestation. Various drugs with different doses and routes have been used for maintenance tocolysis has been used. Aims and objectives were to compare the effect of vaginal progesterone and oral nifedipine for maintenance tocolysis after arrested preterm labour and their effect concerning the neonatal outcomes.
Methods: This study was conducted in the department of obstetrics and gynecology, Mata Chanan Devi hospital, New Delhi in collaboration with the department of pediatrics. The 90 pregnant women who fulfilled inclusion criteria were recruited and were randomized into 2 groups namely nifedipine and progesterone group.
Results: The mean gestational age at delivery in the nifedipine group was 35 weeks, while in the progesterone group it was 37 weeks, and it was a significant difference (p=0.002). There was a significant difference in the prolongation of pregnancy between both the groups (p<0.001). Mean prolongation of pregnancy in the nifedipine group was 18 days, and 38 days in the progesterone group which was significant (p=0.000). The mean APGAR score at five minutes was 7 for the nifedipine group and 8 for the progesterone group. The mean duration of the NICU stay was 5 days in the nifedipine group and 2 days in the progesterone group.
Conclusions: Progesterone was found to be a better drug for maintenance tocolysis compared to nifedipine. It is associated with better maternal and perinatal outcomes when used as a maintenance tocolytic as compared to nifedipine.
From symptoms to surgery: clinicopathological correlation in women undergoing hysterectomy for abnormal uterine bleeding
Authors: Banmeru Ashwini P. , M. Narayanaswamy
Published: January 2025

Background: Abnormal uterine bleeding (AUB) is one of the most frequently encountered conditions in women which is defined as any variation from the normal menstrual cycle which includes changes in regularity, frequency of menses, duration of flow, or amount of blood loss. The PALM-COEIN system classifies different causes of AUB and is composed of nine basic categories arranged according to the acronym PALM-COEIN as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory disorders, endometrial, iatrogenic, and not yet classified. Definitive treatment of AUB is hysterectomy even though less invasive options are also available. This study explored clinicopathological correlation in women undergoing hysterectomy, analysing the diagnostic criteria, clinical presentations, histopathological findings with an aim of establishing better therapeutic strategies and improving patient management and in further research for comparative and epidemiological studies in diagnostic approaches for AUB in various population.
Methods: This was prospective observational type of study which included 126 women with abnormal uterine bleeding (AUB) planned for hysterectomy at SNR district hospital, Kolar during the study period. Detailed history, required investigations were done. Study material was from hysterectomy specimens of the patients who underwent total abdominal hysterectomy (TAH) or vaginal hysterectomy for abnormal uterine bleeding (AUB). Data of clinically diagnosed cases, USG report and histopathological reports (of endometrial tissue) was collected and compared to find the correlation.
Results: A total of 126 women underwent hysterectomy in the study period.  Heavy menstrual bleeding (HMB) was commonest presentation (60%) followed by dysmenorrhoea (55%) and irregular menstrual bleeding (52%). AUB-L was commonest cause for AUB clinically (51.58%), sonologically (51.58%) and histopathologically (49.20%), followed by adenomyosis on USG (17.46%) and histologically (16.66%) and clinically followed by the cases without any organic pathology (AUB-O) (42.85%).
Conclusions: The present study confirms a good correlation between clinical findings and histopathology especially in benign conditions.
Study the effect of lifestyle modifications on fetomaternal outcomes in gestational diabetes mellitus
Authors: Agarwal Aayushi , Dwivedi Seema , Tyagi Preeti , Dwivedi Divya
Published: January 2025

Background: GDM leads to varied outcomes on both mother and foetus. However, most of the adverse effects are preventable. Timely diagnosis, proper counselling, adequate follow up plays a vital role. Lifestyle modifications include dietary interventions, weight management, adequate physical activity and stress management and prevention of any ill habits affecting health of the patient.
Methods: A study included pregnant women in their first trimester at their first antenatal visit. patients with DIPSI report >140 were taken into study. all of them were counselled regarding lifestyle interventions. Patients were followed and healthy lifestyle score was calculated. The patients who followed the advices were taken in group 1 and those that didn’t followed were taken in group 2. 100 participants of each group were followed. Follow ups were done to see the outcomes till postpartum period.
Results: The study found that Group 1 had better glycaemic control, more vaginal deliveries, and a shorter labor duration. The average baby weight was 97% in Group 1, slightly lower than in Group 2. NICU admissions were also lower in Group 1, and significant differences were observed in antepartum, intrapartum, and postpartum complications.
Conclusions: The study shows that lifestyle modifications are an important part of management of GDM. Adherence to these changes leads to better glycaemic control and thus better maternal and foetal outcomes.
A critical study to association between bleeding pattern and ultrasonographic findings in AUB patients in perimenopausal age in a tertiary care hospital
Authors: Devi Jyoti , Singhal Sunita , Sharma Rupali , Saurabh
Published: January 2025

Background: Abnormal uterine bleeding (AUB) is a prevalent gynecological condition, particularly among perimenopausal women, which significantly affects their quality of life. The International Federation of Gynaecology and Obstetrics (FIGO) introduced the PALM-COEIN classification to categorize the causes of AUB into structural and non-structural factors. Ultrasonography (USG), particularly transvaginal sonography (TVS), plays a pivotal role in diagnosing AUB by assessing endometrial thickness and identifying structural abnormalities like fibroids, adenomyosis, and endometrial polyps. However, the correlation between bleeding patterns and USG findings remains complex, and further research is necessary to improve diagnostic accuracy and management.
Methods: This prospective observational study was conducted at GS Medical College and Hospital, Hapur, between November 2022 and February 2024. A total of 120 perimenopausal women, aged 40-50 years, presenting with various AUB patterns, were enrolled. Inclusion criteria included heavy menstrual bleeding, irregular cycles, intermenstrual bleeding, and continuous uterine bleeding. Exclusion criteria involved pregnancy, unstable hemodynamic, visible genital tract lesions, use of certain medications, and chronic systemic diseases. Data collection included clinical examinations, blood tests (haemoglobin, random blood sugar, thyroid-stimulating hormone), and transvaginal ultrasonography (TVS) for assessing uterine pathologies. Histopathological analysis was performed using endometrial biopsies. Data were analysed using SPSS version 26, with p-values <0.05 considered significant.
Results: Among the 120 women, the most common bleeding pattern was menorrhagia (48.3%), followed by menometrorrhagia (19.2%), metrorrhagia (18.3%), and polymenorrhagia (14.2%). The ultrasonographic findings revealed fibroid uterus in 55.8% of cases, adenomyosis in 41.8%, endometrial polyps in 1.6%, and malignancy in 0.8%. There was a significant association between fibroid uterus and menorrhagia, and adenomyosis was more commonly found in polymenorrhagia cases. The cross-tabulation of bleeding patterns and USG findings demonstrated a strong correlation, particularly between fibroids and heavy menstrual bleeding.
Conclusions: The study highlights a significant association between bleeding patterns and ultrasonographic findings in perimenopausal women with AUB. Menorrhagia was most commonly associated with fibroid uterus and adenomyosis. Transvaginal sonography plays a crucial role in identifying underlying structural uterine pathologies, facilitating accurate diagnosis, and enabling personalized treatment strategies. Future research should expand the sample size and incorporate advanced imaging techniques like MRI for comprehensive evaluation and better management of AUB in perimenopausal women.
Fetomaternal outcomes beyond 40 weeks of gestation: a retrospective study
Authors: S. Jayashalini , Shinde Ranoji
Published: January 2025

Background: Pregnancies extending beyond 40 weeks, categorized as late-term (40–41+6 weeks) or post-term (≥42 weeks), are associated with increased risks of adverse maternal and neonatal outcomes. This study aims to evaluate and compare fetomaternal outcomes in late-term and post-term pregnancies.
Methods: This retrospective observational study was conducted at the department of obstetrics and gynecology, Chettinad health and research institute. Medical records of 300 women aged 18-45 years, who delivered after 40 weeks of gestation between January 1, 2023, and December 31, 2023, were analyzed. Exclusion criteria included teenage pregnancies, elderly gravida (>45 years), past caesarean sections, and breech/transverse presentations. Data on demographic characteristics, induction methods, maternal and neonatal outcomes, and complications were collected and statistically analyzed using SPSS version 25.0.
Results: Out of 300 participants, 225 (75%) delivered at late-term, while 75 (25%) delivered post-term. Caesarean delivery rates were higher in post-term pregnancies (55%) compared to late-term (35%) (p<0.01). Maternal complications, including postpartum hemorrhage (PPH) (15%), perineal tears (10%), and uterine rupture (5%), were significantly more prevalent in post-term pregnancies (p<0.05). Neonatal complications were also higher in post-term deliveries, with increased rates of macrosomia (30% vs. 15%), NICU admissions (27% vs. 15%), and meconium-stained amniotic fluid (40% vs. 20%) (p<0.01). Stillbirths were exclusive to post-term pregnancies (7%).
Conclusions: Post-term pregnancies are associated with significantly higher maternal and neonatal risks compared to late-term pregnancies. Timely induction of labor and enhanced surveillance in pregnancies beyond 40 weeks are crucial to minimizing complications. These findings support the implementation of evidence-based management strategies to improve fetomaternal outcomes in prolonged pregnancies.
Atypical polypoid adenomyoma: insights into recurrence, malignant transformation and management: a case report
Authors: Mammen Kitty E. , Sheeba Asiya , Pillai Swapna S. , Praseeda Indira , Thomas Chandni
Published: January 2025

Atypical polypoid adenomyoma (APAM) is a rare, benign mixed epithelial-mesenchymal tumor of the uterus. It is characterized by its polypoid growth pattern and atypical histological features. This study aims to consolidate current knowledge regarding its clinical presentation, diagnostic criteria, treatment options, and potential for malignancy. There is a significant rate of recurrence associated with this tumor. It consists of unusual endometrial glands interspersed with bundles of smooth muscle fibers. It is frequently diagnosed in young women and may coexist with or progress to atypical endometrial hyperplasia or endometrioid endometrial carcinoma. We report a case of a 35-year-old woman affected by APAM treated with hysteroscopic resection. Given the risk of recurrence and progression, APAM might be treated via hysterectomy in patients with no desire for pregnancy.
Emaciation and immobility due to enormously growing degenerating subserosal fibroid up to mid-thorax during pregnancy and following childbirth-an unusual presentation managed by multidisciplinary approach
Authors: Bhadra Avishek , Mukhopadhyay Arunima , Dey Ramprasad , Biswas Rumela
Published: January 2025

Uterine fibroids (leiomyomas) are common neoplasms in women of childbearing age, with prevalence of approximately 10.7% in pregnancy. Subserosal fibroids are typically less symptomatic but can lead to significant complications during pregnancy, such as degeneration and hemorrhage. Large, rapidly growing fibroids, particularly those causing compression and degeneration, present challenges in clinical management, requiring careful consideration of delivery routes, timing, and the preservation of fertility. This case report addresses the complex management of a patient with enormously growing degenerating subserosal fibroids during pregnancy and postpartum. A 32-year-old nulliparous woman presented at 8 weeks gestation with large subserosal fibroids. Despite adequate fetal growth, the fibroids grew substantially during pregnancy, resulting in cachexia, immobility, and dyspnoea by the third trimester. The patient required multiple blood transfusions and frequent monitoring. At 32 weeks, after delivery via category 3 cesarean section, complications arose including postpartum hemorrhage, which was managed with uterotonics. Postpartum, the patient experienced a significant increase in fibroid size, causing further complications such as respiratory distress and abdominal distension. This required a laparotomy followed by myomectomy. The patient underwent successful laparotomy for the removal of the degenerated fibroid cyst, with along with drainage of 38 litres of cystic fluid. Postoperative care involved intensive monitoring, including respiratory management and fluid replacement. Histopathological analysis confirmed the presence of a benign degenerated leiomyoma. The patient’s postoperative recovery was gradual, with significant improvement in her symptoms. This case highlights the rare and challenging scenario of rapidly growing subserosal fibroids in pregnancy and postpartum. The multidisciplinary approach was crucial for managing both phases of the patient’s care during pregnancy to ensure fetal well-being and manage complications, and postpartum to address the growing fibroids. Though uterine subserosal fibroids generally do not impact pregnancy significantly, in rare cases, such as this, they can lead to severe complications requiring surgical intervention.
Ruptured ovarian ectopic pregnancy: a rare and challenging diagnosis
Authors: A. Archana , Jaget Nirmala , Saranya Sri , Sekar Sindhujha , R. Priyanka
Published: January 2025

Ovarian ectopic pregnancy is a rare and serious condition that can result in significant maternal morbidity and mortality. This report details the presentation, diagnosis, and surgical management of a 27-year-old woman with a ruptured ovarian ectopic pregnancy. Due to their nonspecific symptoms, ovarian ectopic pregnancies are often only diagnosed intraoperatively and confirmed through histopathological analysis. Prompt diagnosis and timely treatment are essential to prevent life-threatening complications. Whenever possible, fertility preservation should be prioritized through conservative surgical techniques or medical management for carefully selected patients. This case underscores the critical need for heightened awareness and prompt intervention in managing ovarian ectopic pregnancies.
Maternal wellbeing: a concept analysis
Authors: Bahuguna Ekta , Pugazhendi Sanchita , Juyal Ruchi
Published: January 2025

Pregnancy and childbirth cause many physiological, psychological and social changes thus it is considered as critical period in every woman’s life. Wellbeing during perinatal period is influenced by many factors as it is a unique and complex process. Therefore, importance of conceptualizing concept of maternal wellbeing has recently gained attention. Objective of study is to provide more precise definition of concept maternal wellbeing. Walker and Avant method of concept analysis, was adapted to facilitate concept analysis on maternal wellbeing. Electronic bibliographic database was searched to identify the published paper related to the maternal wellbeing; which includes: (Google scholar, PubMed, Taylor and Francis, Ovid) and websites (WHO, Maternal and child health bureau (MCHB), NHM). By undertaking a detailed literature review attributes, antecedents, consequences and empirical referents of maternal wellbeing were identified. The attributes of maternal wellbeing during perinatal period includes: cognitive/affective self-evaluation of life, and multidimensional elements (physical, social, psychological, economical. This concept analysis will provide new insight into maternal wellbeing concept used for midwives and nurses in their practice. Also, findings can help expand or develop theories and models for improving maternal wellbeing during perinatal period.
Exploring the link between genetic disorders and early-onset periodontal disease
Authors: Balkhair Ola Jamal , Badahdah Rasha Ahmed , Alajmi Almaram Abdullah , Almutairi Khulud Mukhlid , Alqahtani Atheer Mutlak , Alkhaldi Hayfa Hmoud , Almotari Nouf Safar , Alsharif Haifa Mohammed , Almutairi Sarah Hamad
Published: January 2025

Periodontal disease is a complex, multifactorial condition characterized by chronic inflammation and progressive destruction of the tooth-supporting structures. Among its various forms, early-onset periodontitis is particularly aggressive and often associated with genetic predispositions. Genetic and epigenetic factors play pivotal roles in shaping host susceptibility to this disease by influencing immune responses, inflammatory regulation, and tissue homeostasis. Single-nucleotide polymorphisms (SNPs) in genes encoding cytokines, such as interleukin-1β and tumor necrosis factor-alpha, are linked to heightened inflammatory responses, amplifying tissue damage and accelerating disease progression. Additionally, polymorphisms in genes like TLR2 and TLR4 impair microbial recognition, promoting chronic inflammation and dysbiosis. Epigenetic modifications, including DNA methylation and histone acetylation, further modulate gene expression, contributing to the dynamic interplay between genetic predispositions and environmental factors like smoking or poor oral hygiene. Emerging research has also highlighted genetic markers such as human leukocyte antigen (HLA) alleles and matrix metalloproteinase (MMP) variants as predictors of disease severity and therapeutic outcomes. These insights have driven the development of targeted therapies, including inhibitors of pro-inflammatory mediators, MMP inhibitors, and potential miRNA-based interventions. High-throughput technologies, such as genome-wide association studies (GWAS), have expanded the understanding of genetic pathways involved in periodontal disease. These advances enable earlier disease detection and personalized treatment strategies, offering the potential to mitigate progression and reduce the burden of severe periodontitis. The integration of genetic and epigenetic research into clinical practice marks a significant step toward precision medicine, providing a framework for tailored prevention and therapeutic interventions aimed at improving patient outcomes. Future research must continue to explore these genetic mechanisms to uncover novel biomarkers and refine targeted treatment approaches for periodontal disease.
Diversidad e ideología. Desafíos de descripción científica del español en contacto con lenguas amerindias
Authors: Pfänder Stefan , Palacios Azucena
Published: January 2025

Ciertas ideologías subyacentes en la sociedad pueden afloran de manera consciente o inconsciente en los análisis lingüísticos de situaciones de contacto. Para mostrarlo, presentamos algunos sesgos ideológicos en el tratamiento de la diversidad lingüística encontrados en la Nueva gramática de la lengua española (NGLE) y el Diccionario Panhispánico de Dudas (DPD), dos obras académicas relevantes de 2010 y de 2005. Contrastamos estas afirmaciones con estudios empíricos que analizan con rigor el español andino y profundizamos en dos tipos de cambio provocados por el contacto lingüístico, así como en las actitudes de quienes hablan las variedades de español aquí descritas. Concluimos con algunas reflexiones finales sobre la ideología y la descripción científica de la diversidad lingüística en los Andes.
“Señora Doña Fulana de Tal”: una carta de amor en las tolderías indígenas de la Pampa
Authors: Perna Carlos Gabriel
Published: January 2025

Entre las cartas del archivo conservado de las tolderías de Salinas Grandes se halló una carta de amor. Esta carta tenía una función didáctica inmediata y modélica mediata, al igual que las demás del cuaderno que integraba, lo cual confiere a estas cartas un valor cultural destacado, ya que se trata no solamente del mero uso de la escritura, sino además de los esfuerzos de la sociedad indígena por asegurar su transmisión en el futuro. La carta de amor es un efecto de la introducción de la escritura y nos da acceso a procesos de transformación profundos que estaban teniendo lugar en el interior de las sociedades pampeanas y patagónicas al momento de su conquista militar.
A la hora del mundo, sobre el plano de inmanencia. Una lectura de Sistema Nervioso de Lina Meruane
Authors: Navarro Morales Marcelo
Published: January 2025

Este artículo analiza la novela Sistema nervioso (2018) de Lina Meruane desde la perspectiva de la noción de plano de inmanencia propuesta por Deleuze y Guattari (1997). En virtud de la coartada que les proporciona la trama narrativa, los narradores intra/extradiegéticos de esta novela se deslizan desde el plano de organización de las formas sustanciales, hasta el plano de consistencia de la materia inestable y no formada. El plano de inmanencia, que agrupa estos planos, les permite hacer ver y pensar las zonas de comunicación aberrante entre reinos, géneros y especies; atender a la coexistencia y simultaneidad de diversas temporalidades y escalas de tiempo y espacio; y les permite aproximarse a las complejas encrucijadas que enfrenta el mundo contemporáneo.
La crisis de la voz poética en El hilo atroz (2021) de Beverly Pérez Rego
Authors: Aguirre-Bernal Miguel
Published: January 2025

En El hilo atroz (2021), Beverly Pérez Rego equipara la escritura con el tejido, y, a partir de aquí, plantea una crisis de la voz poética que involucra tres niveles de profundidad: la tradición literaria, el sujeto poético y la creación artística. Este artículo se propone explorar las implicaciones de esta metáfora y analizar las distintas modulaciones que la crisis adopta a lo largo del poemario, las cuales se revelan muy en consonancia con los presupuestos de la posmodernidad y terminan por desarrollar una escritura hiper e intertextual a partir de hilachas. Concluye demostrando cómo la autora postula la tachadura de la tradición –el corte del hilo atroz– como una necesidad literaria, en lo que denominamos un imperativo de destrucción.
Religious Ideology Dissemination And Contestation In Indonesian Islamic Educational Institutions
Authors: Junaidi Junaidi , Afrinaldi Afrinaldi , Artika Febria Sri , Al-Momani Mohammad Omar
Published: January 2025

Islamic education in Indonesia is currently in the spotlight due to rivalries among Islamic groups that have turned educational institutions into battlegrounds. This study aimed to identify the process of spreading religious ideology in educational institutions, analyze its educational aspects, and explore the implications of competition among religious groups. This study employed a qualitative approach with phenomenological and sociological research designs. The data sources were collected from school administrators, teachers, students, and stakeholders.  In-depth interviews, observation, and documentation were used to gather data in three different locations: Aceh, West Sumatra, and Yogyakarta. The results show that educational institutions spread religious ideology through classroom learning activities, subjects, and books. In addition, the spread of ideology also occurs through religious rituals, extracurricular activities, school policies, and culture. The spread of ideology has implications for the emergence of diverse religious understandings in students and different religious identities between groups. It creates a depth of ideological differences in society. Ideological rivalry in Islamic education in Indonesia is a significant challenge that needs to be addressed to ensure quality education that supports the holistic development of individuals and society.
Circuitos curtos de comercialização e agroecologia: experiências do Brasil e da Espanha
Authors: Costa Bianca Lima , Padilla Mamen Cuéllar
Published: January 2025

O presente artigo tem como objetivo analisar duas experiências de circuitos curtos de comercialização das cidades de Viçosa, Minas Gerais, Brasil, e Córdoba, Andaluzia, Espanha, buscando compreender suas trajetórias, formas de organização, características, diferenças e similaridades, assim como os principais aprendizados destes processos para o debate sobre Desenvolvimento Local. O tema vincula-se aos estudos sobre sistemas alimentares contemporâneos e à construção de alternativas de relocalização alimentar em contextos socais e econômicos distintos. A metodologia utilizada foi de tipo qualitativo, e os dados e as informações desse trabalho basearam-se em revisão bibliográfica, observação participante e consultas a materiais informativos. A pesquisa foi realizada no período de 2018 a 2019. Os dados coletados foram analisados seguindo cinco fases: 1) compilação da base de dados; 2) decomposição dos dados; 3) recomposição dos dados; 4) interpretação dos dados e; 5) conclusão. Dentro dos resultados, ressalta-se a importância da participação de diferentes atores e atrizes na construção de circuitos curtos de comercialização, que vão além da venda de alimentos e produtos, revitalizando mercados de proximidade a partir de outros padrões de qualidade e confiança entre produtores e consumidores. Além disso, as experiências contribuem para processos de Desenvolvimento Local a partir de processos de governança local e potencialização de forças endógenas.
Energy efficiency retrofitting for old buildings in a low-income district of Amman, Jordan
Authors: Jaber Jamal O. , Marahleh Ghazi , Al-Lubani Suleiman , Khrisat Mohammad
Published: January 2025

This study aimed to contribute to the limited literature on energy efficiency (EE) retrofitting of old buildings, focusing on urban and low-income districts. The case study considered a small zone consisting of approximately 80 old family dwellings in Amman city. The conducted field survey was designed to collect basic data about occupants’ demographics, building conditions, energy consumption, awareness, and willingness to invest in EE measures. A large fraction of residents confirmed that no- or low-cost measures, such as switching off lights and bulb replacement, are already implemented. However, most of them had not even considered investing in EE measures to improve the thermal performance of dwelling envelopes. Equally important, none of the interviewed residents indicated that they would consider replacing old inefficient household appliances in the near future or acquiring new highly efficient machines unless there is direct financial aid or a grant program supported by the government or local authorities to enhance EE. The small fraction of people who showed some understanding of EE remain reluctant to invest in costly items, such as thermal insulation of external walls or replacing windows, most likely due to their very limited financial capability. It is recommended to introduce a tailored scheme to cause a positive shift in current energy consumption behaviors toward more efficient practices, leading to greenhouse gas (GHG) reductions in old residential buildings. This could only be achieved by creating and allocating a special fund to assist poor families in improving EE in their dwellings. Further investigations are highly needed to explore various subjects, including occupant psychological behaviors and responses related to energy use and EE in the residential sector.