bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytotoxicity Assay Protocol v1
Authors: Jaffery Roshni
Published: February 2024

This is the protocol for cytotoxicity assay in cancer cell lines using flow cytometry.
Rotarod (40 RPM and 20 RPM with docking) v1
Authors: not provided daniel.dautan , Svenningsson Per
Published: February 2024

This protocol describes motor function testing in mice using the rotarod by the Svenningsson lab. Two options for the protocol are included: 1) 40 RPM constant speed after habituation and 2) 20 RPM with docking.
α-Synuclein sedimentation assay v1
Authors: Sokratian Arpine
Published: February 2024

The protocol describes step-by-step instructions on how to set a sedimentation assay to monitor the aggregation of alpha-synuclein over time. The protocol allows for precise quantification of fibril formation kinetics using SDS-PAGE. This methodology enhances our understanding of the underlying mechanisms involved in protein misfolding and offers a reliable tool for investigating potential therapeutic interventions targeting alpha-synuclein aggregation.
alpha-Synuclein pre-formed fibrils preparation and stereotactic injection into Mus Musculus brain v1
Authors: Parmasad Jean-Louis
Published: February 2024

Preparation of seed-competent alpha-Synuclein pre-formed fibrils and subsequent stereotactic injection into Mus Musculus brain as a model of synucleinopathy.
Open Field v1
Authors: not provided daniel.dautan , Svenningsson Per
Published: February 2024

Behavioral assay for general locomotion in mice.
La Educación Sexual Integral en Chile: Barreras y Oportunidades para Implementar Programas Educativos
Authors: Poblete-Inostroza Roxana Nicol
Published: February 2024

La literatura científica ha enfatizado la importancia de abordar la educación sexual integral (ESI) en los entornos educativos formales. En la última década, se han desarrollado diversas normas jurídicas que promueven la implementación de programas de ESI en Chile. Sin embargo, todavía existen dificultades para garantizar el derecho a la ESI en los centros educativos chilenos. El objetivo de este estudio es identificar las barreras existentes a través de la perspectiva de equipos directivos de diferentes escuelas. Además, se ha incorporado la mirada de docentes que militan en agrupaciones feministas, debido a que durante años han impulsado un discurso en favor de la ESI. Esto, nos ha permitido identificar las oportunidades para la implementación de programas que favorezcan la salud sexual de niños y jóvenes del país. La presente investigación es un estudio exploratorio a través de métodos cualitativos, en el cual se entrevistó a 30 profesionales de la educación, 15 directivos y 15 docentes feministas. Concluimos que los planes de ESI se enfrentan a las barreras internas de docentes y equipos directivos. Muchas de estas dificultades vienen asociadas a las ideologías y creencias de los profesionales, pero también a las presiones externas de familias y grupos ideológicos.
The Role of Future Generations in Place Branding: The Case of Huelva City
Authors: Ginesta Xavier , Cristòfol F. J. , De San Eugenio Jordi , Martínez-Navarro Javier
Published: February 2024

The process of creating place brands must position the citizen at the center of the debate. The City Council of Huelva, a city in Southern Spain with a population of 142,538 inhabitants, promoted a territorial brand in 2022 in order to seek a new positioning for the city in tourism markets, investment, and talent attraction. Its development was based on a qualitative and quantitative methodology, previously tested out in other cities and locations in Spain, which is shaped by research groups, semi-structured interviews, and surveys of the citizens. This method aims to place the citizen, who ultimately is the user of the brand, at the center of the social research process that determines the tangible and intangible values associated with the brand narrative. The main objective of this article is to highlight, based on the case study of the brand Huelva Original, the importance of two groups in the construction and deployment of a place brand (Millennials and Generation Z and the political class). Firstly, out of the 1,194 people who participated in the fieldwork, 47.92% were under 40 years old. These two generations are crucial for creating a brand narrative that has long-term viability and presence in the digital environment. Secondly, the development of the brand narrative facilitated a cooperative process among the different political groups in the City Council, especially the two most represented (conservatives and social democrats), which enables the search for collaborative workspaces among political groups to ensure that the implementation of the brand transcends the term of a mandate and goes beyond short-termism political actions. The results indicate that the new brand uniquely differentiates Huelva, emphasizing internal pride and co-creation. Open innovation facilitates cooperation among stakeholders, improving governance. Both Millennials and Generation Z citizens, as well as politicians, are key to the long-term sustainability and reach of the brand.
İlköğretim Fen Eğitiminde Kavram Yanılgılarıyla İlgili Tezlerin İncelenmesi: 2012-2022 Yılları Arası
Authors: MERT Ebru , APAYDIN Zeki , ÇOBANOĞLU Elif Omca
Published: February 2024

Pek çok alanda karşımıza çıkabilen kavram yanılgıları Fen eğitiminde de bireylerin sıklıkla karşılaştığı durumlardan biri olduğundan ve ilerideki öğrenmeleri etkilediğinden dolayı incelenmesi gereken konular arasındadır. Bu araştırmanın amacı Fen bilimleri dersi kapsamında kavram yanılgıları konusuyla ilgili ülkemizde 2012-2022 yılları arasında yazılmış olan yüksek lisans ve doktora tezlerinin incelenmesidir. Bu amaç doğrultusunda toplamda 111 adet doktora, 14 adet yüksek lisans olmak üzere 125 adet tez incelenmiştir. Çalışmada Doküman inceleme yöntemi kullanılmıştır. Tezlerin analiz sürecinde betimsel analiz yönteminden yararlanılmış, çalışmalar uygun temalara yerleştirilmiştir. Yapılan analizler doğrultusunda fen eğitiminde kavram yanılgıları konusunda yapılan çalışmaların son yıllarda azaldığı görülmüştür. İlköğretim ilk kademede yazılan tez sayısının diğer sınıf seviyelerine göre oldukça az olduğu tespit edilmiştir.
Indonesia social progress: the role of access to basic education in escaping from poverty trap
Authors: Haidir Andi Ahmad , Setyari Ni Putu Wiwin
Published: February 2024

As Indonesia enters the post-pandemic world, it faces high uncertainty, especially in terms of access to basic education. According to the Central Bureau of Statistics (BPS), the education sector grew by 0.42%, the second-lowest of all sectors. However, its contribution to economic growth was the highest at 3.02%, surpassing six other sectors with higher growth. Despite this potential, access to education remains low. This research aimed to examine the role of access to basic education in alleviating poverty in Indonesia with the social progress perspective. The analytical framework for this research was based on the approach of Amartya Sen, who view poverty as capability deprivation. This research used educational data from BPS in 2022 from 34 provinces in Indonesia. The data were used to construct a social progress index, which measures access to basic education. The index was developed using nine indicators, namely primary school enrolment, secondary school attainment, population with no schooling, gender parity in secondary attainment, teacher-student ratio, teacher qualification, school proportion, classroom condition, and availability of water and sanitation. The index of access to basic education was then regressed along with other variables that are relevant to capability deprivation, as proposed by Hick. These variables include the Happiness Index, Democracy Index, Level of Health Inequality, and Crime Rate. The results indicated that all these variables had a significant impact on the poverty level. Among all the variables, access to basic education demonstrated the greatest influence compared to the other four variables. This suggests that access to basic education plays a critical role in poverty reduction. The research findings highlight the potential of using the Social Progress Index as a comprehensive metric for development, which offers a more inclusive understanding of progress. This index encompasses a broad framework comprising 60 indicators, and does not rely solely on GDP measurements.
Application of Odometry and Dijkstra Algorithm as Navigation and Shortest Path Determination System of Warehouse Mobile Robot
Authors: Ubaidillah Achmad , Sukri Hanifudin
Published: February 2024

One of the technologies in the industrial world that utilizes robots is the delivery of goods in warehouses, especially in the goods distribution process. This is very useful, especially in terms of resource efficiency and reducing human error. The existing system in this process usually uses the line follower concept on the robot's path with a camera sensor to determine the destination location. If the line and destination are not detected by the sensor or camera, the robot's navigation system will experience an error. it can happen if the sensor is dirty or the track is faded. The aim of this research is to develop a robot navigation system for efficient goods delivery in warehouses by integrating odometry and Dijkstra's algorithm for path planning. Holonomic robot is a robot that moves freely without changing direction to produce motion with high mobility. Dijkstra's algorithm is added to the holonomic robot to obtain the fastest trajectory. by calculating the distance of the node that has not been passed from the initial position, if in the calculation the algorithm finds a shorter distance it will be stored as a new route replacing the previously recorded route. the distance traversed by the djikstra algorithm is 780 mm while a distance of 1100 mm obtains the other routes. The time for using the Djikstra method is proven to be 5.3 seconds faster than the track without the Djikstra method with the same speed. Uneven track terrain can result in a shift in the robot's position so that it can affect the travel data. The conclusion is that odometry and Dijkstra's algorithm as a planning system and finding the shortest path are very efficient for warehouse robots to deliver goods than ordinary line followers without Dijkstra, both in terms of distance and travel time.
Implementation of Automatic DC Motor Braking PID Control System on (Disc Brakes)
Authors: Budiarto Hairil , Triwidyaningrum Vivi , Umam Faikul , Dafid Ach
Published: February 2024

The vital role of an automated braking system in ensuring the safety of motorized vehicles and their passengers cannot be overstated. It simplifies the braking process during driving, enhancing control and reducing the chances of accidents. This study is centered on the design of an automatic braking device for DC motors utilizing disc brakes. The instrument employed in this study was designed to accelerate the vehicle in two primary scenarios - before the collision with an obstacle and upon crossing the safety threshold. It achieves this by implementing the Proportional Integral Derivative (PID) control method. A significant part of this system comprises ultrasonic sensors, used for detecting the distance to obstructions, and rotary encoder sensors, which are utilized to measure the motor's rotational speed. These distance and speed readings serve as essential reference points for the braking process. The system is engineered to initiate braking when the distance value equals or falls below 60cm or when the speed surpasses 8000rpm. During such events, the disc brake is activated to reduce the motor's rotary motion. The suppression of the disc brake lever is executed pneumatically, informed by the sensor readings. Applying the PID method to the automatic braking system improved braking outcomes compared to a system without the PID method. This was proven by more effective braking results when the sensors detected specific distance and speed values. Numerous PID tuning tests achieved optimal results with K_p = 5, K_i = 1, and K_d = 3. These values can be integrated into automatic braking systems for improved performance. The PID method yielded more responsive braking outcomes when applied in distance testing. On the contrary, the braking results were largely unchanged in the absence of PID. Regarding speed testing, the PID method significantly improved the slowing down of the motor speed when it exceeded the maximum speed limit of 8000 rpm. This eliminates the possibility of sudden braking, thus maintaining the system within a safe threshold. The average time taken by the system to apply braking was 01.09 seconds, an indication of its quick responsiveness. This research is a valuable addition to control science, applying the PID control method to automatic DC motor braking. It provides valuable insights and concrete applications of PID control to complex mechatronic systems. It is also noteworthy for its development and optimization of suitable PID parameters to achieve responsive and stable braking. The study, therefore, offers a profound understanding of how PID control can be employed to manage braking systems on automatic DC motors, thereby advancing knowledge and application of control in control science and mechatronics.
Nonlinear Cascaded Control for a DC-DC Boost Converter
Authors: Mansouri Amirhosein , Gavagsaz-Ghoachani Roghayeh , Phattanasak Matheepot , Pierfederici Serge
Published: February 2024

The Boost Converter is a type of DC-DC converter that operates using switching techniques and is designed to elevate the voltage level. This paper presents a cascaded control for a boost converter to ensure that the inductor current and output capacitor voltage remain in a safe operating zone. Ensuring safe operating conditions and stable closed-loop poles is crucial because it guarantees that both current and voltage remain within the designated operating range. This preventive measure prevents any damage to components like capacitors (C), inductors (L), and switches. Unstable operation, on the other hand, could lead to oscillations and an undesirable increase in the amplitude of current and voltage, posing a risk to all components involved. The research contribution involves an investigation of cascaded control, utilizing power and energy concepts due to their advantageous effects on system performance and design. By implementing nonlinear controllers based on a large-signal averaged model, the closed-loop poles remain independent of operating points, eliminating the need for small-signal linearization. Small-signal linearization makes the controlled system dependent on the operating point. Two controllers are introduced based on power and energy concept, which is easy to understand. The potential practical application of the proposed cascaded control approach is in high-power applications. Tracking the energy stored in the output capacitor is first investigated to validate the proposed control scheme by varying the output voltage reference from 32 V to 50 V. Then, the regulation of the energy voltage is explored by varying the load resistance for the output voltage at 50 V. Both are done using a switched model using MATLAB/Simulink software. Simulation results are given to demonstrate the effectiveness of the proposed method. The key metrics used to assess the effectiveness of the proposed control scheme are the undershoot voltage and robustness. The results show that the studied system's tracking, regulating operations and robustness properties are as expected. The proposed method faces a challenge with the number of sensors required. To address this, observers can be utilized to reduce sensor usage while maintaining measurement accuracy. The proposed method can be applied to other power electronic systems.
Safe Experimentation Dynamics Algorithm for Identification of Cupping Suction Based on the Nonlinear Hammerstein Model
Authors: Suresh Kavindran , Ghazali Mohd Riduwan , Ahmad Mohd Ashraf
Published: February 2024

The use of cupping therapy for various health benefits has increased in popularity recently. Potential advantages of cupping therapy include pain reduction, increased circulation, relaxation, and skin health. The increased blood flow makes it easier to supply nutrients and oxygen to the tissues, promoting healing. Nevertheless, the effectiveness of this technique greatly depends on the negative pressure's ability to create the desired suction effect on the skin. This research paper suggests a method to detect the cupping suction model by employing the Hammerstein model and utilizing the Safe Experimentation Dynamics (SED) algorithm. The problem is that the cupping suction system experiences pressure leaks and is difficult to control. Although, stabilizing the suction pressure and developing an effective controller requires an accurate model. The research contribution lies in utilizing the SED algorithm to tune the parameters of the Hammerstein model specifically for the cupping suction system and figure out the real system with a continuous-time transfer function. The experimental data collected for cupping therapy exhibited nonlinearity attributed to the complex dynamics of the system, presenting challenges in developing a Hammerstein model. This work used a nonlinear model to study the cupping suction system. Input and output data were collected from the differential pressure sensor for 20 minutes, sampling every 0.1 seconds. The single-agent method SED has limited exploration capabilities for finding optimum value but excels in exploitation. To address this limitation, incorporating initial values leads to improved performance and a better match with the real experimental observations. Experimentation was conducted to find the best model parameters for the desired suction pressure. The therapy can be administered with greater precision and efficacy by accurately identifying the suction pressure. Overall, this research represents a promising development in cupping therapy. In particular, it has been demonstrated that the proposed nonlinear Hammerstein models improve accuracy by 84.34% through the tuning SED algorithm.
The aftermath of 'Beirutshima': the role of nursing quantum leadership in primary health care centers
Authors: Yared Georges J. , Tarrieh Rima Abou , El Hajjar Charlotte A. , Al Hasssan Jihad M. , Abou Hammin Saad A. , Ghazal Kariman S.
Published: February 2024

Background: The healthcare system in Lebanon faced unprecedented challenges following the COVID-19 pandemic and the devastating beirut blast on August 4th, 2020. The aftermath highlighted the system's vulnerability, corruption, and incapacity to provide essential services, leading to an urgent need for leadership transformation within primary healthcare centers (PHCs).
Methods: This qualitative cross-sectional study assessed the quantum leadership skills of nurses in 30 PHCs within a 5-kilometer radius of the blast site. Data were collected six months post-blast using a self-administered questionnaire based on a binary outcome scale of agreement and disagreement, analyzed with IBM SPSS-19 software to evaluate the potential for leadership improvement.
Results: The findings indicate a significant correlation between quantum leadership skills and the operational effectiveness of PHCs, particularly those managed by the Ministry of Public Health, which exhibited superior quantum leadership skills compared to others.
Conclusions: The study underscores the necessity for a new leadership paradigm rooted in quantum theory to navigate the healthcare system through crises effectively. A quantum leader, characterized by heightened organizational consciousness and energy, is pivotal for ensuring a seamless transition towards recovery and resilience, ultimately fostering a breakthrough in the face of systemic breakdowns.
Knowledge, perception, and uptake of cervical cancer screening among women attending antenatal clinic at a tertiary hospital in north eastern Nigeria
Authors: Jomusu Cyril A. , Noel Nathaniel B. , Abubakar Umar , Bakari Maisaratu A. , Ameen Hafsat A.
Published: February 2024

Background: This study assessed the knowledge, perception, and uptake of cervical cancer screening among women attending the antenatal clinic in Modibbo Adama University Teaching Hospital Yola, Nigeria.
Methods: This was a cross-sectional study among 141 ante-natal clinic clients where data was collected using an interviewer-administered questionnaire. Data collected were analyzed using the IBM SPSS software. Multivariable logistic regression was used to determine the predictors of the uptake of cervical cancer screening. A p value of <0.05 was considered statistically significant.
Results: Thirty-six (25.5%) respondents had good knowledge of cervical cancer screening, 12 (9%) had a positive perception of cervical cancer screening, and 14 (9.9%) had previously undergone screening. Health worker request was the major reason for undertaking screening while lack of awareness of the screening was the chief reason for not screening previously. Multivariable logistic regression showed knowledge to be the only predictor of the uptake of cervical cancer screening, respondents with good knowledge were about six times more likely (AOR: 5.97, 95% CI: 1.57-22.66, p=0.009) to have ever been screened.
Conclusions: The predominantly poor knowledge, negative perception, and poor uptake of cervical cancer screening in this study suggest the need to improve clients' education to boost the uptake of screening services.
Impact of timely obstetric simulation on vaginal breech delivery management
Authors: Yared Georges J. , Al Hasssan Jihad M. , El Hajjar Charlotte A. , Ghazal Kariman S.
Published: February 2024

Background: The management of breech presentations represents a significant challenge in obstetrics, necessitating advanced skills for optimal clinical outcomes. Simulation-based training has emerged as a promising approach to enhance the proficiency of healthcare professionals in assisted vaginal breech deliveries, potentially improving neonatal outcomes.
Methods: This research study was conducted at Rafic Hariri University Hospital, Beirut, to evaluate the impact of simulation-based training on the management of breech presentations. Using Robson’s classification, a comparative analysis was performed on the outcomes of breech deliveries before and after the implementation of this training. The focus was primarily on assisted vaginal deliveries within the R6 (all nulliparous women with a single breech baby, cesarean section) and R7 (all multiparous women with a single breech baby, cesarean section) groups.
Results: Post-training, there was a notable increase in the rate of assisted vaginal deliveries in the R6 category, indicating the effectiveness of the simulation-based training. However, the rate of assisted vaginal deliveries within the R7 group showed no significant change. Additionally, the positive impact of the training demonstrated a time-sensitive decline, underscoring the necessity for ongoing practice and reinforcement of skills.
Conclusions: Simulation-based training offers substantial benefits in managing breech presentations, particularly evident in the increased rate of assisted vaginal deliveries among nulliparous women (R6). However, the absence of change in the multiparous women (R7) group and the time-sensitive reduction in training effectiveness highlight the critical need for continuous skill development and reinforcement.
Proteinuria assessment in preeclampsia: a comparative study
Authors: Sneha Shriti , Mittal Rita , Rigveda Richa
Published: February 2024

Background: Preeclampsia, a severe pregnancy-related hypertensive disorder, presents substantial maternal and fetal health risks. Accurate proteinuria assessment is crucial but traditional methods are cumbersome and error-prone. This study compares the spot urinary protein/creatinine ratio with 24-hour urine collection for proteinuria estimation in preeclampsia at Kamla Nehru State Hospital for Mother and Child.
Methods: A cross-sectional study with 90 eligible pregnant women collected comprehensive medical data. Both spot urinary protein/creatinine ratios and 24-hour urine collections were analyzed. Strong correlation (r=0.942, p<0.0001) was observed.
Results: Spot urinary protein/creatinine ratio demonstrated moderate diagnostic accuracy (AUC=0.3). Sensitivity was 100%, specificity 87.9%, with PPV and NPV at 90.4% and 92%, confirming its clinical utility for proteinuria diagnosis.
Conclusions: This study validates the spot urinary protein/creatinine ratio as an efficient method for proteinuria assessment in preeclampsia, with a strong correlation and high diagnostic value. Widespread adoption has the potential to expedite diagnosis, enhance outpatient care, and improve outcomes for preeclampsia patients, addressing a crucial healthcare challenge in maternal and fetal health.
The need for life saving interventions in near miss cases
Authors: Selvam Santhiya Swathy , Srinivasan Uvajanani Sundararaj
Published: February 2024

Background: A maternal near-miss case or severe acute maternal morbidity is “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. Near miss cases are more common than maternal deaths. The major reasons and causes are the same for both maternal near miss and maternal death, so review of maternal near miss cases is likely to yield valuable information regarding severe morbidity, which could lead to death of the mother, if not intervened properly and in time. The met need for emergency obstetric interventions is one such indicator that has been estimated to show levels of health facility utilization in improving safe motherhood.
Methods: A prospective study with subjects admitted with severe maternal morbidity and mortality to the Department of Obstetrics and Gynaecology, Government Rajaji Hospital, Madurai. The duration of study was 6 months from May 2022 to October 2022.
Results: The total live births during the study period were 7821, maternal near miss was 64 and maternal deaths was 17. Women with life threatening conditions was 81 during the study period. Maternal near miss incidence ratio was 8.18 per 1000 and severe maternal outcome ratio was 10.3 per 1000 and maternal near miss: mortality ratio was 3.76. Maternal near miss cases with CNS, renal and endocrine disorders had poor antenatal care with more than 50% of the cases lacking antenatal care. More than 40% of the cases with hemorrhage and infection did not have antenatal care. Almost all causes of maternal near miss cases were higher among LSCS patients compared to vaginal delivery patients and the difference was statistically significant. Except heart disease, almost all causes of maternal near miss cases had higher proportion of admission by referral compared to self-admission and the difference was statistically significant. Hemorrhage was most common in post-natal period.
Conclusions: The main aim of the study was to assess the incidence and type of near miss events, emergency, their presentation, diagnosis, critical care interventions that can be lifesaving, and the outcome of such interventions. The recommendations are proper preparation of standard of protocol and its implementation should be done. Further study to assess various levels of failure among near miss cases should be conducted. The assessment of health literacy among the subjects should be ascertained.
A cross sectional study of indications and complications of primary cesarean section at District Hospital Patiala
Authors: Phool Divya , Pandove Aarti , Aggarwal Ramita , Salunke Shital
Published: February 2024

Background: Caesarean section is one of the major oldest surgical procedure that has been performed all over world to save life of mother and fetus. The steadily increasing global rates of caesarean section have become one of the most debated topics in maternity care, as its prevalence has increased alarmingly in recent years. The aim is to assess the indications and complications of primary caesarean section in primigravida and multigravida.
Methods: A cross sectional study carried out over a period of 1 year from April 2022 to March 2023, among 300 pregnant women from labour room in Mata Kaushalya District Hospital, Patiala by simple random sampling method.
Results: Majority 54.7% of cesarean section were of primigravida and 45.3% were of multigravida. Maximum number of caesareans was between 26-30 yrs of age group. 68% women underwent emergency caesarean section and 32% underwent elective caesarean section. 6% underwent caesarean section at <37 weeks gestational age, maximum 83%caesarean section were at 37- 40 weeks gestational age and 11% caesarean section were at >40 weeks gestational age. Among primigravida, majority 35%were fetal distress, 24.29% CPD, malpresentation and malposition were 6.77%, 5.08% NPOL, 3.38% were placenta previa, 2.25% were IUGR, 3/177 (1.69%), severe oligohydroamnios 1.69%, preeclampsia and 1/177 (0.56%) were abruptio placenta. Among multigravida women 41.46% had most common indication was fetal distress, 2.43% had non progress of labour, 14.63% had malpresentations and malpositions.
Conclusions: The proportion of primigravida undergoing primary Caesarean delivery was much more than multigravida. However, complications related to primary CS was much higher in multigravida.
A retrospective study on epidemiology and outcomes of peripartum hysterectomy
Authors: Gupta Kamna , Maurya Aditi , Bhandari Aditi , Jorwal Anju
Published: February 2024

Background: Peripartum hysterectomy is a rare condition which is associated with maternal morbidity and mortality, and the last resort to control hemorrhage when all the other methods fail. The main aim of this study was to evaluate the indications, incidence and complications, maternal and perinatal outcome and compare the risk of peripartum hysterectomy in women who underwent LSCS previously with the women who did not have previous LSCS.
Methods: A retrospective study was done over one year at a tertiary care teaching hospital in southern Rajasthan. All the women who underwent peripartum hysterectomy were included. Patients were divided into two groups, one who did not have any previous lower segment caesarean section (LSCS) and other who had history of previous LSCS, and their data was compared. The, results were calculated and represented as mean, frequency or median as appropriate.
Results: 34 women underwent peripartum hysterectomy yielding the incidence of 2.21/ 1000 deliveries. The main indication of peripartum hysterectomy was abnormally adherent placenta followed by rupture uterus. 73% cases of peripartum hysterectomy were associated was the history of LSCS.
Conclusions: The indication of peripartum hysterectomy has changed from atonic PPH to placenta spectrum syndrome. A major change can be brought about by the reduction of index cases of LSCS which has been on the rise in the recent years. Strict protocols should be made. Early transportation facility and institutional deliveries should be promoted to prevent the emergency peripartum hysterectomy.
Study of the response of PCOS patients to clomiphene citrate based on hormonal Parameters and body mass index
Authors: Dhurve Kiran , Narvekar Nitin , Dhanvij Minal
Published: February 2024

Background: Our study aimed to evaluate the response of polycystic ovarian syndrome patients to clomiphene citrate based on hormonal parameters and body mass index.
Methods: It is a prospective observational study that was carried out on 48 women with PCOS-related infertility. They were treated with an incremental dose of clomiphene citrate starting with 50 mg/day to a maximum of 100 mg. The response was recorded as either the presence or absence of ovulation. Hormonal parameters such as serum FSH, LH, testosterone, fasting insulin, DHEA, prolactin, and body mass index (BMI) were evaluated. The correlation of each of these parameters in predicting non-responsiveness (failure to ovulate with 100 mg clomiphene) was calculated.
Results: Among 48 PCOS patients who were enrolled in the study, 14 patients responded to CC 50 mg, 26 patients responded to CC 100 mg and 8 patients were CC non-responders. We concluded that serum LH, fasting insulin, and BMI were significant predictors of response to ovulation with CC in PCOS patients.
Conclusions: In our study, we concluded that among the hormonal and biochemical parameters we studied serum LH, fasting insulin, and BMI are significant predictors of response of ovulation with CC in women with PCOS-related infertility. This may help physicians to counsel and select the proper infertility treatment for women with PCOS experiencing infertility so that it should be less time-consuming and cost-effective.
Analysis of symptoms and management modalities of endometriosis in a tertiary care hospital
Authors: Khandkar Sharvari A. , Jain Mahima
Published: February 2024

Background: Endometriosis is a progressive disease characterized by the growth and placement of endometrial tissue outside the uterine cavity. Endometriosis affects 10-15% of all women of reproductive age and 70% of women with chronic pelvic pain. We have aimed to study the demographic factors, symptoms and management of endometriosis. Certain risk factors are discussed which may be helpful in early diagnosis of the same.
Methods: A one year hospital based retrospective study involving detailed medical records of patients presenting with endometriosis between 1st November 2022 and 31st October 2023.
Results: Majority of cases of endometriosis were found in the reproductive age group. Several patients presented with multiple symptoms, of which common ones were pelvic pain, dysmenorrhea, dyspareunia and infertility. Management modalities include medical management using GnRH agonist like injection leuprolide and surgical management techniques involving laparoscopy and laparotomy depending upon the extent of involvement. The most common site of endometriosis was found to be the ovary, while other peroperative findings included distorted anatomy and a concomitant infective focus owing to pelvic inflammatory diseases.
Conclusions: Endometriosis can decrease quality of life due to severe pain, fatigue, infertility. No preventative measures have yet been found. But early diagnosis and management may be extremely helpful in improving the quality of life.
Improving efficiency in preeclampsia diagnosis: spot urinary protein/creatinine ratio
Authors: Sneha Shruti , Rigveda Richa
Published: February 2024

Background: Preeclampsia poses significant challenges to maternal healthcare due to its potential complications. Timely and accurate diagnosis is crucial for maternal and fetal well-being. Traditional methods like the 24-hour urine collection for assessing proteinuria have limitations. The spot urinary protein/creatinine ratio offers a quicker alternative, but its clinical significance remains underexplored.
Methods: This cross-sectional study, conducted from July 1, 2018, to June 30, 2019, aimed to compare the spot urinary protein/creatinine ratio with the conventional 24-hour urine protein collection method in pregnant women with preeclampsia. A total of 90 inpatients were included, meeting specific inclusion and exclusion criteria.
Results: In our study, 6.66% of subjects exhibited abnormal fundus examination findings, lower than a similar study (13%). No subjects had papilloedema, and conservatively managed abnormalities were comparable between studies. The mean urine protein creatinine ratio in our study was 1.75±2.32.
Conclusions: This study highlights the potential of the spot urinary protein/creatinine ratio as an efficient diagnostic tool for preeclampsia at Kamla Nehru State Hospital for Mother and Child. Swift identification of significant proteinuria can streamline patient care, benefiting maternal and fetal outcomes in resource-constrained healthcare settings.
Laparoscopic surgical correction of endometriosis improves fertility rates in infertile patients: a retrospective analysis of 119 cases
Authors: Parmar Prakash , Kannar Avani , Ghodasara Rukesh , Patel Sweta
Published: February 2024

Background: Endometriosis is a common cause of infertility, affecting up to 50% of women with infertility. Surgery is a widely used treatment option for endometriosis, and the removal of endometriomas, nodules, and total posterior compartment peritonectomy has been shown to improve fertility rates in affected patients. The aim of the present study was to evaluate the role of laparoscopic surgical correction of endometriosis by removal of endometriomas, nodules, and total posterior compartment peritonectomy in improving rates of fertility in patients with endometriosis.
Methods: A retrospective analysis of 119 patients who underwent laparoscopic surgical correction of endometriosis for infertility between May 2021 and April 2023 at Venus Women’s Hospital and IVF Center, Rajkot, India, was conducted. Inclusion criteria were documented endometriosis confirmed on Ultrasound and/or laparoscopy or accidentally detected during laparoscopy. All patients underwent laparoscopy for diagnosis confirmation. The primary outcome was pregnancy.
Results: A total of 119 patients with endometriosis-related infertility were included in the study. Of the 119 patients who underwent laparoscopic surgical correction of endometriosis, 11 were lost to follow-up, leaving 108 patients for analysis. Of these, 76 patients (70.4%) conceived within one year of surgery. Of those who conceived, 34 (44.7%) did so spontaneously, without any medical treatments. A total of 42 patients (55.3%) conceived with ovulation induction only or ovulation induction with intrauterine insemination (IUI). Twenty-two patients (28.9%) underwent in vitro fertilization (IVF) and conceived, while 10 (13.2%) did not conceive with the first cycle of IVF and were still undergoing infertility treatment. The majority of patients (95%) reported relief of dysmenorrhea and dyspareunia after surgery.
Conclusions: Study suggests that laparoscopic surgical correction of endometriosis by removal of endometriomas, nodules, and posterior peritonectomy can improve rates of fertility in patients with endometriosis-related infertility. The procedure was also found to be effective in relieving pain symptoms in most patients.
Effectiveness of patterned breathing techniques on maternal and newborn outcome among intranatal primi women at Government Doon Medical College and Hospital Dehradun, Uttarakhand, India
Authors: Arti  , Mohanta Bijaya
Published: February 2024

Background: Aim and the objectives of the study were to assess the maternal and newborn outcome, effectiveness of patterned breathing technique on maternal and newborn outcome among intranatal primi women at Government Doon Medical College and Hospital Dehradun, Uttarakhand.
Methods: This was a quasi-experimental research study conducted at the department of obstetrics and gynecology, Government Doon Medical College and Hospital Dehradun, Uttarakhand, India from June 1st to June 30th, 2023. The study comprised 60 samples selected through purposive sampling technique, adhering to specific inclusion and exclusion criteria. Microsoft office tools were employed for data processing and analysis. The analytical approach employed was descriptive and inferential in nature.
Results: There was significant difference (p<0.001) between mean maternal and newborn outcome among experimental and control group after performing patterned breathing exercise.
Conclusions: The patterned breathing technique is statistically significant. Thus, the investigator concluded that patterned breathing exercise helps in improving the maternal and newborn outcome among intranatal primi women.
Endometrial study of abnormal uterine bleeding in perimenopausal women
Authors: E. Gomathy , V. Vandana , Sathyashree
Published: February 2024

Background: AUB accounts for 70% of gynecological pathology. Prevalence of AUB is 3%-30% among reproductive aged women. Early diagnosis by endometrial biopsy is the most effective way to rule out malignancy in peri-menopausal women with AUB. TVS can be used as an aided diagnostic tool. Aims and objectives of this study is to evaluate endometrial causes of abnormal uterine bleeding in perimenopausal women and to correlate transvaginal sonography findings with histopathology by endometrial biopsy.
Methods: This prospective observational study was conducted on 80 perimenopausal women with abnormal uterine bleeding. Uterine pathology, endometrial thickness, was assessed by TVS. Endometrium was considered hyperplastic if thickness is ≥10 mm in perimenopausal women and was taken up for endometrial sampling. Endometrial biopsy by Pipelle’s curette was done as an outpatient procedure and sent for HPE.
Results: Total of 80 women with perimenopausal bleeding were examined during the study. Majority of the patients with AUB presented in 40-44 years age group and belonged to second parity. As per the TVS findings, 42 (52.5%) subjects had normal findings, 25 (31.3%) showed endometrial hyperplasia and remaining had other benign uterine pathology. Majority of women had ET 10 mm. The most common finding on histopathological examination was Proliferative endometrium.
Conclusions: Trans vaginal scan when incorporated along with bimanual pelvic examination and Pipelle’s aspiration can enhance our anatomic diagnosis. This study proves that transvaginal findings correlate well with the histopathology findings.
Wernicke’s encephalopathy complicating hyperemesis gravidarum: a case series
Authors: Moukit Mounir , Belaabas Soufiane , Rahmoune Mohammed , Allilou Ismail , Babahabib Abdellah
Published: February 2024

Wernicke’s encephalopathy is an acute neuropsychiatric syndrome due to thiamine deficiency. In most cases, it is associated with alcoholism and malnutrition and rarely can be secondary to hyperemesis gravidarum and arise during the first trimester of pregnancy. The clinical signs are specific to this disorder. However, they are unknown by most clinicians, especially obstetricians, delaying treatment and leading to serious problems including maternal mortality. We report a case series of three patients diagnosed with Wernicke’s encephalopathy during the first trimester based on clinical symptoms and radiological signs in two cases and only on clinical findings in case 2. A high dose of thiamine was started intravenously in all patients and the majority of symptoms resolved. Unfortunately, case 3 died, probably to a delay of diagnosis. Given this severity even with rapid treatment, prevention measures with low doses of thiamine supplementation remain at present the best treatment and should be applied in any patient presenting with hyperemesis gravidarum.
Xanthogranulomatous inflammation of female adnexa: diverse clinical presentations - a series of 7 cases
Authors: Singh Neha , Ahuja Arvind
Published: February 2024

Xanthogranulomatous inflammation, a form of destructive chronic inflammation is a rare occurrence in female genital tract, especially ovary and fallopian tube. Its clinical and radiological presentation mimics ovarian malignancy which poses a diagnostic dilemma at times. Histopathology plays a pivotal role in diagnosis of this entity. We described seven cases in total, out of which two cases showed xanthogranulomatous oophoritis and five had both xanthogranulomatous oophoritis and salpingitis, all diagnosed on histopathology. Majority of the patients had abdominal pain, fever and adnexal mass on examination. Most women were treated based on the working diagnosis of malignancy or severe pelvic inflammatory disease. Histopathology remains the gold standard for diagnosis in all these cases, and with the aid of clinical and radiological details helps in ruling out other differential diagnosis.
Hysteroscopic management of osseous endometrial metaplasia causing secondary infertility
Authors: Parulekar Maitreyee , Patvekar Meenal , Telang Milind , Naidu Saranya , Venkateswaran Sneha
Published: February 2024

Osseous endometrial metaplasia is a rare pathological condition frequently associated with infertility. Despite multiple theories about its development, the exact mechanism, the source of the osseous tissue and the possible treatment outcomes are not clearly defined. Moreover, it is yet not clear whether surgical removal of the osseous tissue can restore fertility in the patients. We present three patients who presented to us with secondary infertility and were diagnosed to have osseous endometrial metaplasia. They were then treated with hysteroscopic removal of the osseous fragments. All three patients had spontaneous conception after the procedure. Hysteroscopic removal of bony spicules can provide reasonable chances of spontaneous conception in such patients provided the metaplasia does not extend deep into the myometrium.
Uterine perforation by Bakri balloon following management of secondary postpartum haemorrhage: a case report and review of literature
Authors: Bahuguna Gunjan , Kalaskar Anjali , Viswanatha Radhika
Published: February 2024

The objective of this study was to decipher the efficacy and safety of the Bakri balloon as a tamponading device for managing secondary postpartum haemorrhage. A 37-year-old lady presented to us with a secondary postpartum haemorrhage after 17 days of vaginal birth. Due to ongoing heavy bleeding per vaginum, she underwent an examination under anaesthesia, and manual removal of placental tissue along with the insertion of a Bakri balloon under ultrasound guidance. However, after 6 hours of the procedure, she deteriorated and the bedside ultrasound showed rupture of the uterus at the fundus with the Bakri balloon in situ. She was resuscitated and had an emergency laparotomy with repair of the uterine perforation following which she recovered completely and was discharged home on day 6. Uterine rupture following balloon tamponade is a rare but life-threatening complication, especially when placed during the management of secondary PPH in a septic postpartum uterus. This occurred despite placing the balloon under ultrasound guidance in an unscarred uterus. Keeping a low threshold of suspicion of uterine rupture and prompt treatment can save the uterus. The safety of the use of the Bakri balloon in secondary PPH needs to be reviewed in a larger population as the uterus is more likely to rupture because of underlying infection.
Laparoscopic vaginoplasty with cervical neo vaginal anastomosis in a case of complete vaginal agenesis in a young girl
Authors: Chatterjee Abhinibesh , Dutta Annesha , Chatterjee Polly
Published: February 2024

Complete vaginal agenesis is an extremely uncommon mullerian abnormality. In this case report, we described a case of a female patient, age 14, a known case of complete vaginal agenesis presented with severe cyclical dysmenorrhea. MRI suggested no vagina with a normal uterus and cervix with hematometra. She underwent laparoscopic vaginoplasty with cervico-neovaginal anastomosis. After surgery, the patient experienced regular menstrual cycles without dysmenorrhea. On follow-up, hysteroscopy showed a patent anastomosis, and she continued to have regular menstrual cycles.
Severe immune thrombocytopenia in pregnancy: a case report
Authors: Wakode Shamrao Ramji , Sharma Sakshi Pramod
Published: February 2024

Pregnancy when complicated with severe immune thrombocytopenia is a challenge both during labour and peripartum period. It’s management requires a multidisciplinary care approach. Severity of ITP may have adverse consequences on both maternal and fetal outcome. Present case report is of a patient with findings of chronic thrombocytopenia who came to antenatal outpatient department at 28 years of age with 7 months of amenorrhea with history of bleeding gums and purpura. She was monitored throughout third trimester of pregnancy. Ultrasonography findings showed severe oligohydramnios at 38 weeks and based on obstetric indications, elective cesarean section was planned after consultation with anesthetist and hematologist. Patient landed in intraoperative postpartum hemorrhage and was managed with medical management along with glove balloon tamponade. Patient was discharged on day 10 day along with her newborn. It shows that close monitoring of the clinical course and multidisciplinary care is critical to reach the correct treatment implication as well as potential management of such cases.