bluuebunny/crossref_metadata_2025 huggingface dataset:
Lantana camara invasion along road–river interchanges and roadsides in Soutpansberg, Vhembe Biosphere Reserve in South Africa
Authors: Ruwanza Sheunesu , Mhlongo Edward S.
Published: September 2020

Roads and rivers act as conduits of alien plant invasion; however, little is known regarding the abundance and invasion extent of Lantana camara, an invasive shrub, along road–river interchanges and roadsides in South Africa. We assessed the effects of road–river interchanges and roadsides as invasion corridors that facilitate L. camara invasion. A road survey method was used to measure the invasion extent of L. camara along road–river interchanges and roadsides from national and regional roads covering 446 km in Soutpansberg, Vhembe Biosphere Reserve, South Africa. L. camara occurred along 21 of the 48 surveyed road–river interchanges and its abundance and cover were similar between road–river interchanges and roadsides, although height and diameter of L. camara were greater along road–river interchanges than roadsides. Other alien species that dominated road–river interchanges were Solanum mauritianum, Caesalpinia decapetala and Rubus rigidus. Our results indicate that L. camara dominates both road–river interchanges and roadsides, therefore roads and bridges should be considered important targets for L. camara control.
Significance:

Despite the huge efforts by the South African government to control invasive alien plants, roads and rivers continue to act as important conduits for invasion and therefore there is a need to manage them.
We propose that South African roads be considered important targets for efforts to control invasive alien plants.
A policy and legislative framework around invasive alien plant removal during routine road maintenance operations is required.
La adaptación versus la estandarización visto desde el paradigma de marketing esencial
Authors: París Jose Antonio
Published: September 2020

La literatura actual del marketing internacional acerca de la controversia de aplicar una política de adaptación o de estandarización de producto a la hora de lanzarlos a los mercados externos. Ahora, toda ella se refiere a la consecuencia de utilizar una u otra, pero ningún autor se ha detallado a identificar cuáles son las causas esenciales que nos permitan tomar tan importante decisión del marketing internacional. Este documento analiza esta problemática desde la óptica del paradigma del marketing esencial y trabaja básicamente sobre el análisis del impacto de los cuatro aspectos esenciales que son los activadores del consumo, y de qué manera estos impactan sobre esta problemática en cuestión. Para abordar esta problemática se ha ingresado de manera decidida tanto en la mente del consumidor, como en la mente del mercado. Y se presentan en este documento no solo los cuatro activadores o motivadores de compra, sino también cuáles son sus motores impulsores, además de lo que los mismos representan desde la neurociencia.Luego para completar dicho documento se argumenta apologéticamente, como esta conceptualización teórica impacta sobre las decisiones de marketing internacional, por lo menos, a la hora de decidir si el producto o servicio en cuestión se puede estandarizar o habrá que realizar algún tipo de adaptación al mercado de destino internacional. Finalmente, se propone un modelo de valor en forma de patronage del consumo, y del cual se puede apreciar toda la problemática esencial.Luego para completar dicho documento se argumenta apologéticamente, como esta conceptualización teórica impacta sobre las decisiones de marketing internacional, por lo menos, a la hora de decidir si el producto o servicio en cuestión se puede estandarizar o habrá que realizar algún tipo de adaptación al mercado de destino internacional. Finalmente, se propone un modelo de valor en forma de “patronage” del consumo, y del cual se puede apreciar toda la problemática esencial.
Publicidad social y su influencia en la percepción de las campañas sociales de prevención de accidentes de tránsito en Ecuador
Authors: Cárdenas Rebelo Amy , Orozco-Toro Jaime Alberto
Published: September 2020

El presente artículo analiza las percepciones que el público adulto de la ciudad de Cuenca en Ecuador tiene sobre las campañas sociales de prevención de accidentes de tránsito. El marco teórico lo constituyen las teorías asociadas al mercadeo social y a la publicidad social, analizando la relación que existe entre los agentes de cambio y los adoptantes objetivo. La metodología se apropia de una investigación mixta, la cual permitió la aplicación de entrevistas y 400 encuestas a ciudadanos, entre los 18 y 49 años de la ciudad de Cuenca. Los objetivos fundamentales estaban dirigidos a conocer la percepción de la ciudadanía respecto a las campañas sociales de prevención de accidentes, identificar el nivel de conciencia ciudadana respecto a la problemática de los accidentes de tránsito en Ecuador, e investigar la opinión de los ciudadanos respecto a la corresponsabilidad de la seguridad vial en la ciudad. Los resultados evidencian que hay un desconocimiento generalizado sobre las campañas de prevención vial, y que, además, los mensajes emitidos por los agentes de cambio no son claros. Se concluye que el adoptante objetivo recuerda los mensajes de manera muy dispersa, no se empodera de las campañas a pesar de comprender la información de los mensajes emitidos. Finalmente, tanto agentes de cambio como adoptantes objetivo están de acuerdo que las campañas de publicidad social son necesarias para cambiar la conducta pública, disminuir la accidentalidad y mejorar la calidad de vida de los ciudadanos.
Efectos del Covid-19 en el comportamiento del consumidor: Caso Ecuador
Authors: Ortega-Vivanco Mayra
Published: September 2020

El confinamiento como una de las medidas decretadas en la emergencia sanitaria por el gobierno ecuatoriano para contrarrestar el impacto del virus SARS-CoV-2 o Covid-19, se ha visto reflejado en el comportamiento del consumidor. El propósito de este estudio es conocer los efectos que esta medida emergente ocasiona en el consumo de las personas, utilizando la medición de variables relacionadas con los factores personales, sociales, psicológicos y culturales. Se encuestó una muestra de 658 consumidores en cinco ciudades del Ecuador: Cuenca, Guayaquil, Loja, Machala y Quito. Se utilizó el Modelo de Ecuaciones Estructurales (SEM) para comprobar las hipótesis teóricas. Estas teorías fueron aceptadas considerando tres dimensiones: las cargas de los indicadores analizadas a través del test Loadings >0.7; la confiabilidad de consistencia interna medida a través del test de confiabilidad compuesta (CR) y Cronbach Alpha >0.7, para los constructos de comportamiento de compra, factores sociales, personales, psicológicos y culturales; y la validez convergente observadas a través del test Average Variance Extracted (AVE) > 0.5 para los cinco constructos. Los resultados muestran que las relaciones entre el comportamiento del consumidor y los factores personales, sociales, psicológicos y culturales se encuentran asociadas significativamente, lo cual proporciona algunas pautas para entender el comportamiento del consumidor y satisfacer mejor las necesidades en tiempo de crisis.
Actitud, satisfacción y lealtad de los clientes en las Cajas Municipales del Perú
Authors: Ramírez-Asís Edwin Hernan , Maguiña Palma Misael Erikson , Huerta-Soto Rosario Mercedes
Published: September 2020

El propósito del estudio fue extender el modelo SERVQUAL adicionando la actitud del cliente a las tres principales dimensiones como componentes de la medición de la calidad del servicio e investigar la influencia en la satisfacción y la lealtad de los clientes en el sector microfinanciero, específicamente de las cajas municipales de ahorro y crédito que poseen agencias en la Región Ancash, Se utilizó la técnica de la encuesta donde se recopilaron datos de 391 clientes a través del cuestionario mediante el muestreo aleatorio simple. Por tratarse de una metodología de modelos de ecuaciones estructurales (SEM) para evaluar el modelo teórico se empleó la técnica de análisis de Mínimo Cuadrado Parcial (PLS) mediante el uso del software Smart PLS 3.3.0. El hallazgo reveló que el modelo extendido tiene un impacto significativo en la satisfacción y la lealtad de los clientes en las cajas municipales de ahorro y crédito. Los coeficientes de determinación fueron; satisfacción del cliente (r2=0.637) y lealtad del cliente (r2=0.510), con un error cuadrático medio de aproximación (SRMR) de 0.06 que hace relevante el modelo confirmatorio. Además, los resultados de este estudio serán útiles para que los gerentes y los encargados de formular políticas mejoren la calidad del servicio en las cajas municipales. Se recomienda extender este estudio en otros países en vías de desarrollo, ya que se contextualizó en la realidad del sistema financiero peruano.
Análisis de las estrategias de marketing relacional en instituciones de educación superior de Colombia y España
Authors: Gómez-Bayona Ledy , Arrubla-Zapata Juan Pablo , Aristizábal Valencia Julián , Restrepo-Rojas María José
Published: September 2020

Las estrategias de marketing en las universidades han permitido una mejor comprensión de las audiencias y la clasificación de acciones que le generen valor a la marca universitaria. Es por esto que el presente proyecto investigativo pretende identificar la importancia de las estrategias de marketing relacional en el sector educativo, especialmente en las principales universidades de Colombia y España para conocer de qué manera implementan acciones mercadológicas que generan valor. La metodología utilizada para lograr este objetivo fue a partir de una revisión de literatura, donde se analizó la evolución y los modelos de marketing aplicados en educación; de igual manera, se examinaron las principales variables de marketing con enfoque relacional y se hicieron comparativos entre los países mencionados para encontrar la diferencia en las estrategias que cada uno implementa. Se concluye que, tanto en Colombia como en España, se empiezan a planear estrategias de marketing con enfoque relacional que generan valor a la gestión académica y administrativa; así mismo se evidencia que las principales variables —creación de valor, satisfacción y confianza— para las diferentes acciones implementadas en las universidades de los países analizados son pilares fundamentales para la incorporación de un buen marketing relacional en educación.
Un marco exploratorio para el emprendimiento desde una perspectiva evolutiva
Authors: Montiel-Méndez Oscar Javier , Soto-Maciel Argentina
Published: September 2020

La investigación en emprendimiento está evolucionando más que nunca (Carlsson et al., 2013). Como una línea de investigación que está ganando cada vez más atención, es imperativo entenderla más profundamente, dada la relevancia del emprendimiento, el emprendedor y las empresas en la economía global actual y bajo una lente multidimensional. A través de una extensa revisión de la literatura, se realizó una visión exploratoria de su perspectiva evolutiva, tomando como punto de partida aquella darwiniana, donde se encontró la falta de un marco formal y, por tanto, se propone un modelo teórico tridimensional (Emprendimiento, Emprendedor y Empresa, EEE) para su estudio, donde el contexto multidimensional y la participación que generalmente tiene la familia influyen en las relaciones ida y vuelta e iterativas que aparecen entre las dimensiones y que están influenciadas por la perspectiva evolutiva. Los resultados sugieren que existe un gran interés en la academia en esta visión evolutiva, una necesidad de explorar más este enfoque, teórica y empíricamente bajo las relaciones que el modelo propone entre las diversas líneas de investigación en emprendimiento, empresa familiar, economía y teoría de la empresa, ecología de la población y la elección estratégica, así como en el propio emprendedor y en su cognición y aprendizaje emprendedor, para desarrollar estrategias y políticas públicas que apoyen a las empresas y al ecosistema emprendedor.
Деятельность НКО в сфере социальных услуг: общественные ожидания и региональные практики
Authors: Старшинова Алевтина Викторовна , Бородкина Ольга Ивановна
Published: September 2020

В статье рассмотрены противоречия вхождения в сферу социальных услуг социально ориентированных НКО в двух регионах (Санкт-Петербург и Екатеринбург). Трансформация межсекторного взаимодействия в смешанной системе социального благосостояния повышает значение некоммерческого сектора, но эти процессы в силу многообразных региональных практик имеют неоднозначный характер и по-разному воспринимаются их участниками. В фокусе внимания авторов находятся вопросы взаимодействия некоммерческого сектора с государственными сервисными учреждениями, причины усиления коммерческих интересов НКО, взаимодействие с региональными органами управления и риски, сопровождающие становление смешанной системы производства общественных благ в регионах. Тео­ретическую рамку исследования составили современные концепции социального государства, его трансформации в социально-сервисное государство, а также подход к НКО, как к ключевому актору социальных услуг, регулируемых государством. В исследовании использованы эмпирические данные, полученные методом уличного и телефонного опросов городских жителей, интервью с представителями НКО, государственных сервисных учреждений, региональных органов управления. В проведенном анализе показано, что основными сдерживающими факторами развития НКО как негосударственных исполнителей услуг выступают административные барьеры доступа к бюджетному финансированию, несоответствующие меняющимся условиям способы взаимодействия региональных органов управления с новыми производителями общественных благ, а также недоверие преобладающей части населения к деятельности негосударственных организаций. При отборе негосударственных исполнителей социальных услуг завышенные бюрократические требования к отчетности, предоставляемой организациями для возмещения затрат, неоправданно избыточный контроль их деятельности со стороны органов управления, несвоевременность информирования о конкурсах на гранты, непрозрачность конкурсных процедур определяют низкую представленность НКО в региональных реестрах поставщиков социальных услуг. Формальный подход чиновников свидетельствует о том, что во внимание не принимаются институциальные преимущества некоммерческих организаций, их способность к социальным инновациям при решении проблем социальных групп, в интересах которых они создаются и работают. Преодоление обозначившихся барьеров, затрудняющих вхождение региональных НКО в сферу социальных услуг, одновременно следует рассматривать как ресурс повышения доверия к ним среди получателей услуг.
SARS-CoV-2 Genomic Variation - African perspective v1
Authors: Omotoso Olabode
Published: September 2020

This protocol outlines the methodology for the acquisition and analysis of SARS-CoV-2 genomic sequences.
Penerapan Metode Latihan 8-Point Star Drill Terhadap Peningkatan Kecepatan Reaksi Penjaga Gawang Cabang Olahraga Futsal
Authors: Fadi Gustian Yusup , Sutresna Nina
Published: September 2020

Reaksi bagi penjaga gawang futsal sangat dibutuhkan, untuk mengantisipasi agar bola tidak masuk kegawang. Tujuan penelitian ini untuk meningkatkan kecepatan reaksi penjaga gawang futsal dengan metode latihan 8-point star drill. Metode latihan 8-point star drill merupakan suatu bentuk latihan untuk meningkatkan kecepatan langkah pertama secara multi arah dan waktu bereaksi. Metode penelitian yang digunakan adalah eksperimen. Subjek dalam penelitian ini adalah keseluruhan penjaga gawang Unit Kegitan Mahasiswa futsal sebanyak 6 orang. Dengan mengunakan desain penelitian pretest postets group dengan seluruh sampel diberikan eksperimen. Dari hasil pengolahan data penelitian, maka diperoleh bahwa hasil output uji paired samples test latihan 8-point star drill terhadap kecepatan reaksi penjaga gawang futsal terdapat pengaruh yang signifikan, maka dapat diambil kesimpulan metode latihan 8-point star drill memberikan pengaruh yang signifikan terhadap peningkatan kecepatan reaksi penjaga gawang futsal.
The Preservation of Productive Activities in Brussels: The Interplay between Zoning and Industrial Gentrification
Authors: De Boeck Sarah , Ryckewaert Michael
Published: September 2020

Urban activities such as housing, productive space, green space, offices, etc., compete for scarce urban land, especially in cities with population growth, such as London and Brussels. Thereby, low-value uses such as production have a more vulnerable position in a private property market governed by real estate dynamics in comparison to high-value uses such as offices and housing. While local authorities of post-industrial cities grow more susceptible to revitalizing their relationship with productive activities, they risk losing the space to do so due to industrial gentrification. Based on the disappearance of production space in the case of the Brussels Capital Region (BCR), this article aims at evaluating how the BCR supports urban production, with a clear focus on zoning and the provision of production space. Although the BCR is a post-industrial city, it continues to lose production space at a rapid pace. Employing an analytical framework of urban settlement patterns of production, we analyse the production-related zone typologies in inner-city areas as well as in more peripheral mono-functional and mixed areas of the BCR. Our analysis of the production-related zone typologies of the BCR land-use plan demonstrates that industrial gentrification plays an important role in current deindustrialization processes. This article presents zoning strategies to regulate the private property market as well as public land strategies to preserve urban production space.
La Ética en los Negocios: Una Perspectiva Desde los Stakeholders
Authors: Cardona-Arbeláez Diego Alonso , Mejía-Reatiga Camilo , Hernández-Cobos Juan Sebastián
Published: September 2020

El objetivo del presente artículo es mostrar cómo se ha incorporado la ética en la teoría de los stakeholders, aportando elementos constructivos a la forma como se hacen los negocios en la actualidad. Los resultados se estructuran en dos secciones. Inicialmente se plasma un análisis conceptual de los stakeholders y la utilidad de su apuesta teórica; luego se enfatiza en la definición de los aportes realizados por la ética de los negocios a tal la teoría. El análisis realizado se basó en la revisión aplicada a las publicaciones consignadas en la base de datos Scopus teniendo en cuenta las palabras clave business ethic y stakeholders; entre los artículos arrojados solo se contemplaron los que incluyeran los criterios business, management and accounting y economics, econometrics and finance. La priorización se hizo a partir del número de publicaciones realizadas por los principales autores y el número de citaciones que tienen estos en la base de datos. En la revisión, se llega a la conclusión de que en la teoría de los stakeholders es fundamental el concepto de la ética basada en la confianza y la cooperación que debe existir entre la empresa o negocio y los stakeholders, así como la responsabilidad de la gerencia por reconocer quiénes son estos últimos y qué puede hacer por ellos desde sus prácticas empresariales.
Effect of Line Loading on An Irregular Elastic Medium Possessing Cubic Symmetry
Authors: Gaba Aanchal , Madan Dinesh Kumar , Kumari Agin , Raghav Jyoti Singh , Gupta I. S.
Published: September 2020

In the present paper, the closed form analytical expressions due to an inclined line-load in an irregular elastic medium with cubic symmetry have been obtained. The irregularities are considered in the shape of rectangular and parabolic. Numerically, the effect of irregularities have been studied by variation of displacements with the horizontal distance by considering different sizes of irregularities (e) of parabolic and rectangular. At different values of 'e' the comparisons are made at different values of angle of inclinations.
Frequency and pattern of gynecological problems of adolescent girls attending outpatient department, department of obstetrics and gynecology, Bangabandhu Sheik Mujib Medical University, Bangladesh
Authors: Pervin Hasna H. , Kazal Rezaul K. , Parveen Tabassum , Fatema Kaniz , Chowdhury Saima A.
Published: September 2020

Background: Adolescent is a stage of development tangent, like a bridge of childhood and adulthood. It is the healthiest age group of our society which is almost 20% of our total population. World health organization (WHO) defines adolescents are in the 10-19 year in age group. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding and dysmenorrhea.Methods: This cross-sectional observational study was carried out in 668 female adolescent aged 10-19 years irrespective of their marital status visiting the OPD of obstetrics and gynecology department of BSMMU. All data was analyzed using SPSS program version 22.0.Results: Results were expressed in frequencies or percentages. Of the 668 adolescent girls, 418 (62.6%) had different type of menstrual disorder. Of these 418 cases about 127 (30.38%) of them were a case of puberty menorrhagia, 109 (26.07%) cases were oligomenorrhoea and 91 (21.77%) were amenorrhea. Other presentations were pre-vaginal discharge, vulval itching, lower abdominal pain, dysuria, feeling lump in lower abdomen, mastalgia, feeling lump in the breast, discharge from breast, acne, hirsutism.Conclusions: This study shows more than half of adolescent girls are having menstrual disorder. Adolescent gynecology needs increased awareness and greater attention to improve the quality of their life. Setting up a separate adolescent clinic is necessary for efficient management of adolescent problem.
Ramadan fasting during pregnancy: characteristics and outcomes
Authors: Ghazal Kariman , Khazaal Janoub , Khazaal Janoub , Chahine Rabih , Chahine Rabih , Hajjar Charlotte , Hajjar Charlotte , Hasan Jihad El , Hasan Jihad El , Naser Liliane , Naser Liliane , Koulaymi Eva , Koulaymi Eva , Yared Georges , Yared Georges
Published: September 2020

Background: The primary aim of this study was to measure the prevalence of pregnant women who fast during Ramadan. The secondary outcome was their beliefs and motivations regarding fasting during Ramadan in addition to the consequences of fasting on maternal and neonatal outcome.Methods: A retrospective review of pregnant patients aged between 18-45 years who presented for antenatal care in the private clinic in Beirut, Lebanon during or after the month of Ramadan between 2010 and 2019 was performed.Results: A total of 502 pregnant patients were included in the study, of which 426 (84.9%) fasted during Ramadan and 76 (15.1%) did not fast at all. Of those who fasted, 148 (34.7%) fasted between 1 and 15 days while 278 (65.3%) fasted more than 15 days. Multiparous and non-Lebanese women had significantly higher rate of fasting compared to primiparous and Lebanese women. Adherence to fasting was associated with the spiritual environment that accompanies the month of Ramadan while non-adherence was mainly related to the fear from adverse effects on the mother and fetus. Fasting was not significantly associated with maternal complications or decreased neonatal birth weight.Conclusions: The present study showed that Ramadan fasting is important to pregnant Muslim women. This was manifested by the relatively high rate of fasting even in summer and spring seasons. Understanding the beliefs and motivations of pregnant women would provide valuable insight to physicians to appropriately advise these women without compromising the maternal or fetal well-being.
Benefits of sexual practice during pregnancy: myth or reality? Comparative study and outcome of childbirth in Douala (Cameroon)
Authors: Henri Essome , Egbe Thomas O. , Mve Valère K. , Nana Théophile N. , Boten Merlin , Tocki Grâce T. , Halle Gregory E.
Published: September 2020

Background: Pregnancy is the term used to describe the period in which a foetus develops in the uterus and lasts 40 weeks measured from the last menstrual period. Anatomic and physiologic changes in pregnant women usually make couples to change their emotional and sexual activities that may impact childbirth. There are few studies in our setting that describe the roles of sexual practice during pregnancy and maternal-foetal outcomes of childbirth.Objective of this study aimed at assessing the benefits of sexual practice during pregnancy in a target population and to assess the outcome.Methods: We carried out a comparative cross-sectional study from February 2018 to May 2018, at the maternity of Laquintinie Hospital in Douala. Socio-demographic, obstetric, sexual history in pregnancy, birth and neonatal data were collected using a structured questionnaire. Univariate and multivariate analyses were conducted at a 95% confidence interval.Results: A total of 300 respondents completed study and 69.6% were favourable to sexual intercourse during pregnancy. Induction or augmentation of labour was common in the unfavourable group [OR: 2.52 (1.53-4.15); p=0.004]. Almost one in two participants gave birth by caesarean section and the indications for caesarean section were similar in both groups. Participants without sexual intercourse in pregnancy had a 9-fold increased risk of perineal tears [OR: 8.99 (4.02-10.1); p=0.001] and 5.4-fold risk of cervical tears [OR: 5.44 (2.44-8.73); p=0.0001].Conclusions: Sexual practice in pregnancy appears to be protective against excessive use of oxytocin, perineal and cervical tears.
A study of causes, investigation and management of structural causes of abnormal uterine bleeding in reproductive age group
Authors: Rohidas Vibhusha S. , Chavan Niranjan N.
Published: September 2020

Background: Abnormal uterine bleeding (AUB) is debilitating condition affecting 14-25% of women of reproductive age. It has significant impact on women’s personal, social, physical and quality of life. Present study is planned to study causes, investigation along with management of structural causes of abnormal uterine bleeding in reproductive age group.Methods: Consecutive type of non-probability sampling was used for selection of study subjects. A total of 100 gynaecology OPD women diagnosed with menorrhagia of 15-45 years age group were enrolled in study.Results: Mean age of the study subjects was between 26-35 years (47%). 67% were from low socio-economic class while 33% were from middle class. Maximum number of women (66%) had symptoms for less than 6 months. 47% presented with Menorrhagia. 89% were Multiparous, and 11% were Nulliparous. Most common structural causes of AUB was leiomyoma (41%) followed by polyps (23%), adenomyosis (17%), endometrial hyperplasia (15%) and endometrial carcinoma (4%). Prevalence of anemia was 73% in present study. Maximum leiomyoma were treated medically while higher percentage of polyps and hyperplasia was treated surgically. Most commonly performed surgery was polypectomy (20%) followed by dilatation and curettage (17%) and myomectomy (15%). Total abdominal hysterectomy was done in 8% cases while radical hysterectomy was done in 2% cases.Conclusions: Benign lesions of endometrium account for majority of cases presenting with AUB in reproductive age group. Other premalignant and malignant causes should also be considered. High prevalence of anemia was observed in these cases. A comparative clinicopathological study will help in arriving at the cause and correct diagnosis. Histopathological examination is one of the major tools in evaluation of abnormal uterine bleeding and helps us in proper management and treatment of cases.
A clinical study of primary caesarean section at a tertiary care hospital in coastal city: an observational study
Authors: T. Chaitanya K. , M. Lakshmi Manjeera
Published: September 2020

Background: Caesarean section represents the most significant operative intervention in obstetrics and its development and application has saved the lives of countless mothers and infants. However there has been a steady increase in the rate of caesarean sections worldwide. In this study, we aim to find the primary caesarean section rates and strategies to cut it down.Methods: This was a prospective observational study done from January 2018 to June 2019 at Justice K. S. Hegde Charitable Hospital, Deralakatte, Mangaluru which included 379 cases of primary cesarean sections. All patients undergoing primary caesarean section with gestational age >28 weeks confirmed by dates, clinical examination and ultrasound were included in this study. Patients who had undergone previous caesarean section or were less than 18 years of age or were less than 28 weeks of gestation were excluded from the study.Results: In this study the rate of primary caesarean section was found to be 14.5% and the majority of the study subjects belonged to the age group of 18-27 years (62.3%). With respect to parity, primigravida were high in number (71.2%), followed by multigravida. The number of emergency caesarean sections were (79%) more than elective (21%). The most common intra-operative complication was post-partum haemorrhage (PPH) in 2.8% and the most common postoperative complication was wound gape in 2.1%.Conclusions: Maximum efforts should be made to allow progression of vaginal delivery in primigravida which helps us to bring down the primary caesarean rate.
Antenatal care during the COVID-19 pandemic
Authors: Pitale Devdatt Laxman
Published: September 2020

Background: COVID-19 pandemic has affected the daily living globally. It has added to the stress of day to day life. COVID-19 is associated with severe disease in high-risk population groups with increased mortality risk. COVID-19 and it’s impact on pregnancy needs extensive research. Early research data does not suggest any increased risk in the pregnant population and Vertical transmission is yet to be confirmed. As of now no standard protocol is available for management of COVID-19 .Social distancing is the best possible mechanism available to protect patients and health care personnel from COVID-19. The aim of this study is to know the effectiveness of protocol based Antenatal care during COVID-19 pandemic.Methods: This study was conducted at the Antenatal clinic. A total of 40 antenatal cases who satisfied inclusion and exclusion criteria were selected for the above study. They were assessed at the antenatal clinic following a modified protocol.Results: Majority of the pregnant women in the study group were primigravidas and belonged to the age group of 21-25 years. They were called for Antenatal check-ups as per the protocol specifically modified taking into consideration the COVID-19 pandemic. 80% of the deliveries in present study were normal delivery and only in obstetric emergencies LSCS was performed.Conclusions: Antenatal care in COVID-19 pandemic is challenging yet essential. Following a protocol based approach is the key to management of Antenatal care amidst the pandemic. It is cost-effective and has an easy learning curve.
The menace of caesarean scar pregnancy: a management challenge in modern obstetrics
Authors: Choudhary Anjali , Tanwar Meenakshi , Nimonkar Shweta , Singh Shailly
Published: September 2020

Background: With the increasing caesarean section rates a new challenging evil of caesarean scar pregnancy (CSPs) has emerged. As a variant of ectopic pregnancy caesarean scar pregnancy is the rarest of all. Diagnosis and management of CSP can be challenging especially when there are no early symptoms and even lessor index of suspicion.  Objective of this endeavour was to present one institute experience of management of caesarean scar pregnancies.Methods: This are a retrospective analysis of women admitted with CSP. Detailed history, investigation, management protocols and complications were noted.Results: Of the total cases maximum women (60%) had history of previous two caesarean section. 90 % of cases were managed successfully with intra-sac or systemic methotrexate, and surgical evacuation with Foley’s catheter tamponade, only two women needed hysterectomy for uncontrolled bleeding.Conclusions: Caesarean scar pregnancy is a diagnostic and management challenge in modern obstetrics. Early ultrasound diagnosis helps in planning a successful medical treatment and serves to preserve uterus and fertility. Treatment with transabdominal intra-sac methotrexate and Foley’s catheter for tamponade is safe and effective method of treating CSPs.
Effect of abnormal liver function test on maternal and perinatal outcome in pregnancy: observational study
Authors: Tripathi Rashmi , Brahmane Madhuri , Jain Sapna Bajaj
Published: September 2020

Background: The present study was conducted with the objective to assess the spectrum of liver disease in pregnancy, and its course and effect on maternal and fetal outcomes.Methods: The present study was conducted as a prospective follow up study in the department of Obstetrics and Gynaecology, J. K. Hospital for a period of 1 year. The pregnant women between the ages of 18-35 years presenting with symptoms suggestive of underlying liver disease were selected. Socio demographic details and clinical history was obtained from all the participants and they were subjected to liver function test (LFT). All patients were followed till 2 weeks post-partum period. The maternal and fetal outcomes were noted.Results: The following results were obtained: pregnancy-induced hypertension (PIH) was the most common cause of abnormal LFT (46.66%), about 57.5% patients delivered at term, 63.3% patients delivered vaginally, mostly cases delivered a term healthy neonate between 2.5-3.0 kg weight with Apgar score >7 at 5 minutes after birth and maternal complications were seen in 10.82% cases.Conclusions: Our study shows that though liver disease is uncommon in Indian pregnant women, but it is associated with high maternal and perinatal morbidity. A high index of suspicion of liver disease, early diagnosis, prompt referral to a higher centre when required, appropriate supportive management, and a proactive policy of early delivery when indicated may improve the maternal and fetal outcomes in pregnant women with liver disease. Thus LFT should be conducted as a routine investigation in all pregnant females during first and second trimester.
Histo-pathological pattern of endometrial biopsy in females with abnormal uterine bleeding: a retrospective study in tertiary care hospital of Haryana
Authors: Lata Gagan , Sharma Susmita , Kaur Sukhbir Pal , Gulia Sandhya Panjeta
Published: September 2020

Background: This study aimed to know the various histo-pathological patterns of endometrial biopsy and their incidence in patients of AUB.Methods: Patients in the age group between 21-75 years who had presented with AUB and underwent endometrial biopsy from 1st January 2017 to 31st December 2019 were included. The endometrial biopsy specimens which were already taken from patients with AUB were scrutinized for histopathological pattern. Various patterns of histo-pathology of endometrial biopsy were noted and studied.Results: Most common age group which was affected was between 36-40 years. The endometrial biopsies and curetting’s on histopathology revealed various patterns ranging from normal endometrium to malignancy. Patterns of normal cyclical endometrium (proliferative and secretory phases) were the most common patterns.Conclusions: Evaluation of women with AUB is important around the perimenopausal age group to detect any atypical and malignant changes and intervene early. Histopathological examination in correlation to radiological findings remain the standard procedures for diagnosis.
Comparative study on cervical ripening and labour induction with dinoprostone versus foley’s catheter with extra amniotic saline infusion
Authors: A. Rachel Alexander , A. Gigi
Published: September 2020

Background: Induction of labour is defined as initiation of uterine contractions before spontaneous onset of labour. This observational study compares the effect of prostaglandin E2 (PGE2) and extra amniotic saline infusion (EASI) for pre-labour ripening of unfavourable uterine cervix.Methods: This was a prospective study conducted on 100 pregnant women with gestational age ≥37 weeks during a year period in the department of obstetrics and gynaecology of government TD medical college, Alappuzha, Kerala. The period of study was for one year from June 2002 to July 2003. All patients were divided into two groups. Group-1 contains 47 patients who received intracervical PGE2, (Dinoprostone gel, 0.5 mg). Group-2 contains 53 patients who were induced with EASI. The main outcome variables were the number of subjects with favourable Bishop's score, mode of delivery, maternal complications and neonatal outcomes.Results: Majority of the patients in both the groups were in the age of 21-30 years. There was significant difference in age, parity and gestational age of both groups. In this study it was found significant difference in the occurrence of hyper stimulation among PGE2 and EASI; whereas, there was no significant difference in the occurrence of maternal pyrexia among two groups. High incidence of caesarean section was found in EASI. APGAR score of new born babies was high in labour induced with PGE2.Conclusions: PGE2 and EASI have similar efficacy in induction of labour, but EASI is associated with more side effects. Cost wise EASI is more cost effective than PGE2.
Study of thyroid hormones in pregnancy
Authors: Juneja Madhu , Barsode Salil , Panchanadikar Tushar
Published: September 2020

Background: Thyroid disorder is often overlooked in pregnant women this is because of nonspecific symptoms and hyper metabolic state of normal pregnancy. To evaluate the thyroid function in pregnant women in all the three trimesters and to study their impact on pregnancy outcome.Methods: A prospective study in 200 randomly selected antenatal cases was carried out during a period of two years in a tertiary care medical college in Western Maharashtra. A detailed general and systemic examination was carried out and Thyroid stimulating hormone (TSH) was done in all cases. Any case with an abnormal TSH level was further tested for T3 T4 levels.Results: The mean TSH level was 1.6 µIU/l which was less than the standard cut off of 2.5 µIU/l. 61% had decreasing level of TSH with advanced gestation. An abnormal thyroid function was seen in 8.5% cases.Conclusions: Standardization of TSH, T3, T4 is still a concern as it varies significantly in different studies. Estimation of TSH with T3 T4 could not be correlated during pregnancy with advancing gestational age. The real impact of hypo/hyperthyroidism on fetal outcome could not be statistically established.
A study of association between thyroid dysfunction and serum anti-mullerian hormone levels in women presenting with infertility
Authors: Vedantham Haripriya , Tanuku Prathyusha , Jahagirdar Nandini Joshi Nee , Kamineni Vasundhara
Published: September 2020

Background: This study was conducted to study the association between thyroid dysfunction and serum AMH levels in women presenting with infertility.Methods: An institution based cross-sectional study including, was conducted at Kamineni hospital fertility clinic among 70 women presenting with infertility during a two year period from May 2016 to April 2018 after fulfilling inclusion criteria.Results: Hypothyroidism was the most common thyroid dysfunction observed in the study participants and subclinical hypothyroidism was seen predominantly. Age of the women did not seem to influence the prevalence of thyroid disease. Low serum AMH indicating poor ovarian reserve was observed in 70% of women over 34yrs suggesting a significant correlation. All the women diagnosed with overt hypothyroidism had low serum AMH levels and half of the women with subclinical hypothyroidism also had low serum AMH levels suggesting a close association between thyroid dysfunction and ovarian reserve. Women with hyperthyroidism had normal AMH levels.Conclusions: Serum AMH levels in infertile patients, were inversely correlated with TSH levels.
Immediate postpartum intrauterine contraceptive device insertions in caesarean and vaginal deliveries: a comparative study
Authors: . Ritu , . Mini
Published: September 2020

Background: Post-partum family planning is prevention of unintended and closely spaced pregnancies during first 12 months following childbirth. Postpartum IUCD is the best method of all as it is the safest, most effective, has no effect on breast feeding, reliable and with minimum complications.Methods: The cross-sectional study was conducted in AIMSR Bathinda on 400 postpartum patients. It was a prospective, observational study of women who received PPIUCD in our region.Results: Out of total 400, 58% had normal vaginal delivery and 42% had cesarean section. PPIUCD was done in all cases after applying exclusion criteria and the females were called for follow up.  53% cases who had cesarean and 47% of normal vaginal delivery turned up for follow up. Acceptance is more in multipara (20.7%) than in primi patients (13.7%). Almost 90% patients had good continuation rate. There were few problems faced by patients like irregular bleeding for first few months, pain lower abdomen, leucorrhea etc. which were removed by good counseling and some treatment like NSAIDs for bleeding.Conclusions: The acceptance of PPIUCD was high in present study in both types of females delivered by normal vaginal delivery or post LSCS but with good counseling efforts. It was safe and effective and had high retention rate when done at good timing by trained service provider that is within 10 minutes of placental delivery. So the need of time is creating awareness of public towards it and removing fear from minds, breaking taboos and myths.
Clomiphene versus letrozole: a better agent for ovulation induction
Authors: Maji Aritra , Ramani Manisha V. , Kiran Kajal
Published: September 2020

Background: Anovulatory dysfunction is a commonly encountered problem which is responsible for about 40% of female infertility. One of the leading causes of female infertility is polycystic ovarian syndrome (PCOS). Clomiphene citrate has been the drug of choice in treating women with anovulatory infertility. However, in recent years, letrozole, an aromatase inhibitor, has emerged as alternative ovulation induction agent. Aim of this study was to compare efficacy of clomiphene citrate and letrozole as first line therapy for ovulation induction in polycystic ovarian syndrome.Methods: This study was a hospital based prospective comparative study done in MVJ MC and RH involving 100 females suffering from infertility due to anovulation. They were divided into 2 groups of 50 each. One group was given clomiphene citrate 50 mg while another group was given letrozole 2.5 mg from day 3 to day 7 of menstrual cycle. Ultrasonographic follicular monitoring was done and injection beta HCG 5000 IU was given once follicle reached optimum size (≥18 mm) and endometrial thickness was adequate (≥7 mm). Patients were advised for timed intercourse after 24-36 hours of HCG administration. Ovulation was detected by sonographic findings of follicular rupture done after 48 hours. Primary outcomes measured were number of growing follicles (≥18 mm), endometrial thickness, ovulation rate and pregnancy rate.Results: In our study there was significant difference in the outcomes of ovulation induction between letrozole group and clomiphene group.  Women who received letrozole showed improved endometrial growth (8.44 mm versus 7.86 mm), ovulation rate (72% versus 56%) and pregnancy rate (22.2% versus 14.3%) than those who received clomiphene. However, variation in follicular growth was negligible between the two groups (1.28 versus 1.36).Conclusions: Letrozole is a superior alternative to clomiphene citrate for ovulation induction in cases of PCOS with anovulatory menstrual cycle, and can be considered as first-line therapy for ovulation induction in such women.
Risk factors associated with ectopic pregnancy in our sociodemographic setup
Authors: Gandotra Nikita , Zargar Shazia
Published: September 2020

Background: Ectopic pregnancy (EP) is assuming greater importance because of its increasing incidence and its impact on woman’s fertility.Aim: To assess the frequency and to determine an association between the studied risk factors and ectopic pregnancy.Methods: A retrospective study was conducted for the role of several risk factors in the occurrence of EP in department of obstetrics and Gynaecology, SMGS Hospital. A total of 110 cases and 110 controls were compared for socio demographic characteristics, cigarette smoking, obstetrical and gynaecological history, PID, past exposure to Chlamydia, surgical histories, the presence of assisted conception and contraceptive usage.Results: The main risk factors for ectopic pregnancy were history of tuberculosis (TB) (odds ratio (OR)=12.11), history of infertility (p=0.001), abortions (p=0.01) and a history of prior ectopic pregnancy (OR=8.549). Other risk factors found to be associated with an increased risk for ectopic pregnancy were Pelvic inflammatory disease (PID)/Chlamydia infection (OR=5.63), endometriosis (5.40), induced conception cycle (OR=3.063), intrauterine device usage (OR=3.55), prior caesarean section (OR=2.83) and appendectomy (OR=2.25). On the contrary, barrier methods (OR=0.28) and oral contraceptive use (OR=0.28) were protective from ectopic pregnancy.Conclusion: Pelvic infection particularly TB was found to be a major etiological factor for EP in our setup. Furthermore, other factors found to be associated with ectopic pregnancy, such as prior ectopic pregnancy and infertility history may be the result of a previous pelvic infection that caused tubal sequele. Thus, these factors are potential targets for intervention and modification. Further, patients with previous abortions, pelvic surgeries, induced conception cycle and intrauterine contraceptive device (IUCD) users should be counselled about the possible risk when they conceive.
Study of fetomaternal outcome in eclampsia
Authors: Agarwal Manju , Gautam Akanksha
Published: September 2020

Background: Eclampsia is a life-threatening emergency that continues to be a major cause of maternal and perinatal mortality. The purpose of our study was to analyse the trend of eclampsia in a tertiary care teaching institute and to find out the fetomaternal outcomes of eclampsia.Methods: A retrospective epidemiological study was undertaken in the department of Obstetrics and Gynaecology, Jhalawar medical college, Jhalawar during the period ‘September 2018 to August 2019’. Women who presented as eclampsia or developed eclampsia during hospital stay were included in the study. Data analysed included various maternal parameters, fetal parameters, and the outcome of the pregnancy.Results: The incidence of antepartum eclampsia was (0.92%). High risk associated factors were primigravida (65.90%), low maternal age (21-30 years), illiteracy, and inadequate antenatal care. Caesarean section was the mode of delivery in 48 cases (54.54%) most common indication was unfavourable cervix, 80.6% women had antepartum eclampsia and 68.18% women had severe preeclampsia. There was 6.8% maternal mortality, attributed to pulmonary edema and acute renal failure. Perinatal mortality was 14.77% with 8 still births and 5 neonatal deaths. Prematurity complicated 46.66% pregnancies. Thirty neonates were admitted to NICU.Conclusions: Eclampsia is one of the important causes of maternal and perinatal morbidity and mortality due to lack of proper antenatal care, low socio-economic status, and lack of education. It can be concluded that better antenatal care, early recognition of disease, timely referral, early initiation of treatment and termination of eclamptic patients improves outcome. Management of eclamptic patients should be performed at tertiary care centres, where ICU facilities, NICU facilities, and multidisciplinary units are available.