bluuebunny/crossref_metadata_2025 huggingface dataset:
Remembering Rosa María and Alejandro Rússovich, or How Gombrowicz’s Potty Travelled from Argentina to Poland
Authors: Freixa Terradas Pau
Published: September 2021

This text is a memoir of Rosa María and Alejandro Rússovich, Argentine friends of Witold Gombrowicz from the 1940s and 1950s. Due to the irreparable loss – the departure of Rosa María – the author of these words, a researcher of the reception of the Polish writer in Argentina, describes the long years of friendship with the Rússovich couple. He also emphasizes the importance of their eye testimony for the knowledge of Gombrowicz’s Argentine years and recalls some important moments of this relationship, as well as some items, such as letters, photos or the famous Gombrowicz’s potty, which are now on display in the Gombrowicz Museum in Wsola.
Stock Market Prediction using Machine Learning: A Systematic Literature Review
Authors: Vadlamudi Siddhartha
Published: September 2021

Different machine learning algorithms are discussed in this literature review. These algorithms can be used for predicting the stock market. The prediction of the stock market is one of the challenging tasks that must have to be handled. In this paper, it is discussed how the machine learning algorithms can be used for predicting the stock value. Different attributes are identified that can be used for training the algorithm for this purpose. Some of the other factors are also discussed that can have an effect on the stock value.
La poética colombiana contemporánea en Zamora, Michoacán (México)
Authors:   Universidad Libre, Cuevas Arias Adriana Constanza
Published: September 2021

El lector tiene en sus manos una antología con un abanico de temas y registros tan amplios que no tienen principio ni término. Todos estos poetas buscan, a través de señales, descifrar las claves del mundo: la identidad entendida como indagación, conflicto y redención. Identidades asumidas, perdidas, inventadas una y otra vez, muertas y renacidas identidades, recreadas a partir de los vínculos entre el individuo y la sociedad; las tensiones entre la inocencia y la lucidez, la desacralización de la realidad, el desarraigo de los lugares y seres amados y muchas veces perdidos –reencontrados por la gracia poética– y los retos de la libertad vital en este mundo y los otros mundos posibles; gracias a la imaginación.
Knowledge and acceptability of prenatal diagnosis among pregnant women attending antenatal clinic in a tertiary health institution in Sokoto, Nigeria
Authors: Ahmed Yakubu , Panti Abubakar A. , Umar Amina G. , Funtua Anas R. , Abdullahi Nafisa , Garba Jamila A.
Published: September 2021

Background: Technology and advances in research have made it possible for the fetus to become a patient whose illness can be investigated, diagnosed and treated in utero. The study was aimed at assessing the knowledge and acceptability of prenatal diagnosis among pregnant women.Methods: This was a cross-sectional study carried out between December 2016 and March, 2017. Pregnant women attending antennal care clinic at the Usmanu Danfodiyo University Teaching Hospital, Sokoto (UDUTH) were recruited via convenient sampling method using semi-structured interviewer questionnaire.Results: A total of 417 pregnant women were interviewed. The mean maternal age was 28.35±5 years with a range between 17 to 45 years. Up to 188 (69.10%) had at least secondary school level of education. There was an overall poor knowledge of prenatal diagnosis, as 406 (97.36%) had little to no idea. There was statistically significant association between knowledge and educational status at p value- 0.0001. Majority, 353 (87.8%) will accept prenatal diagnosis if offered. There was also statistically significant association between educational status and acceptability as well as knowledge of prenatal diagnosis at p value- 0.001 and 0.001 respectively. The noninvasive method, ultrasound was the most preferred by the majority, 332 (84.3%). Termination of pregnancy as an option of management in fetal abnormality was acceptable by up to 2/3 (63.1%) of the respondents.Conclusions: The knowledge of prenatal diagnosis among the respondents was generally poor. The identifiable factor that determined knowledge and acceptability of prenatal diagnosis was level of education.
Clinical correlates of plasma antithrombin and protein C levels in patients with pre-eclampsia and eclampsia in Sokoto, Northwest Nigeria
Authors: Musa Abubakar U. , Mamman Aisha I. , Panti Abubakar A. , Alhassan Abdul Wahab , Rabi'u Anas F.
Published: September 2021

Background: Hypertensive disorders of pregnancy complicate 17% of pregnancies in Sokoto, Nigeria with pre-eclampsia and eclampsia accounting for 6% and 4.29% respectively. Pre-eclampsia and eclampsia stand out as major causes of poor pregnancy outcomes with eclampsia contributing 46% of adolescent maternal mortality in Sokoto. These disorders increase risk of venous thromboembolism, DIC, placental abruption, IUGR, premature delivery and recurrent pregnancy loss. The roles of antithrombin and protein C in disease severity and outcomes of pregnancies in pre-eclampsia/eclampsia are subject of recent researches albeit with conflicting findings. The aim of the study was to determine the plasma antithrombin and protein C levels of pre-eclampsia and eclampsia in Sokoto with a view to assessing any relationship with clinical severity and pregnancy outcomes.Methods: Prospective comparative study involving 31 each of pregnant women with pre-eclampsia, eclampsia and normotensive pregnancy. Plasma antithrombin and protein C levels were determined via kinetic method using S4 Nortek semi-automated coagulometer. Data analysis was performed using SPSS version 21.0.  Results: The mean plasma antithrombin and protein C levels for eclampsia, pre-eclampsia and normotensive pregnancy were (61.17±9.13 and 60.00±5.76) vs (71.24±13.15 and 71.06±6.16) vs (85.54±8.77 and 89.64±7.61) respectively; p=0.0001. Severe pre-eclampsia when compared with mild pre-eclampsia had lower antithrombin (70.21±13.58 vs 73.74±12.43; p=0.507) and protein C (70.52±6.27 vs 72.40±6.00; p=0.451) levels respectively, though without statistical significance. Pre-eclampsia with low plasma antithrombin levels had increased risk of preterm delivery when age, gravidity and booking status were factored (OR, 1.2, 95% CI 0.035 to 0.348, p=0.017).Conclusions: Lower plasma antithrombin and protein C levels were found with eclampsia and severe pre-eclampsia suggesting consumptive depletion of anticoagulants with disease progression. Women with pre-eclampsia and low plasma antithrombin levels were found to have increased odds of having preterm delivery when age, gravidity and booking status were considered.
Surgical site infection in benign abdominal gynaecological surgeries
Authors: Kodiyath Haritha Kizhakke , Ramakrishnan Kunnath , Jacob Kadaviparambil
Published: September 2021

Background: Surgical site infection is the commonest complication after gynecological surgeries. Limited studies have been done in India to know the magnitude of the problem. This study aims to know the incidence of surgical site infection, analyze the risk factors and identify the causative organisms.Methods: A prospective observational study .All women who underwent abdominal surgeries for benign pathologies in department of obstetrics and gynecology, Government medical college, Thrissur from April 2016 to March 2017, were included in the study women more than 80 years old, evidence of infection preoperative or within 48 hours of surgery, laparoscopy procedures unless combined with open surgeries and emergency surgeries were excluded.Results: The incidence of SSI was found to be 7.9%. Re suturing had to be done in 24 patients. The risk factors found to be significant were age more than 50 years ,patients with education <7th std, diabetes, BMI>30,pre hospital stay >10 days, ASA score >3, duration of surgery >2 hours and peri-operative blood transfusion. Staphylococcus aureus was the most common causative organism and was sensitive to amikacin, vancomycin, cloxacillin and its combinations.Conclusions: SSI pose a significant problem in the post operative period that can affect recovery. It was associated with multiple predisposing factors which could be prevented if these risk factors are identified early and appropriate measures are adopted to support host defense system in the peri operative time.
A prospective study of clinicoepidemiology, metabolic and hormonal profile of women with hirsutism in Konaseema region of Andhra Pradesh
Authors: Smitha M.
Published: September 2021

Background: Hirsutism is defined as presence of excess coarse hairs appear in male pattern in women.There is various aetiology of hirsutism like Idiopathic hirsutism, PCOS, androgen secreting ovarian tumours, menopause, CAH, Cushing’s syndrome, drugs which increases testosterone level, insulin resistance and tumour secreting androgen. We have designed present study with an aim to study the clinicoepidemiology, metabolic and hormonal profile of women with hirsutism in Konaseema region of Andhra Pradesh.Methods: All patients with hirsutism attending gynaecology outpatient department were selected for study based on inclusion and exclusion criteria. After that patient were examined clinically, BMI was calculated for each patient. Patients were clinically evaluated for signs of excess androgen secretion, Cushing syndrome, metabolic syndrome and hyperprolactinemia. Modified Ferriman-Gallwey scoring system was used for evaluating and quantifying hirsutism.Results: The mean Fasting plasma insulin12.42±2.41 (mIU/dl), the mean of HOMA-IR was 3.14±1.18. The mean value of dehydroepiandrosteronesulphate (DHEAS) 355.78±15.41 mcg/dl. There was statistically significant reduction in modified Ferriman-Gallwey scoring in before and after treatment (12.38± 1.55 vs. 9.62±1.6), the p value was 0.00001. The number of patients with menstrual irregularities were reduced from 63.3% to 20% after treatment and this difference is statistically significant (p=0.04).Conclusions: Hirsutism is associated with insulin resistance and DHEAS concentration was high. Modified Ferriman-Gallwey score was significantly reduced and there was significant weight loss and improvement in menstrual irregularities after treatment.
Role of ferric carboxymaltose in the treatment of postpartum anemia in a tertiary care hospital in Andhra Pradesh
Authors: Krishna Kirtan , Krishna Achint , N. Divya Teja G.
Published: September 2021

Background: Postpartum iron deficiency anemia is common in India as a consequence of postpartum hemorrhage.  Recent studies have evaluated the use of parenteral iron as a better tolerated treatment modality. Compared with oral iron supplements, parenteral iron is associated with a rapid rise in serum ferritin and hemoglobin and improved maternal fatigue scores in the postpartum period.  Parenteral iron may be considered for the treatment of postpartum anemia. The objective of the study was to evaluate the efficacy, safety, and tolerability of intravenous ferric carboxymaltose, in women with postpartum anemia.Methods: A clinical observational study was undertaken in a tertiary care hospital,  50 women within six weeks of delivery with Hb ≥6 gm/dl and ≤10 gm/dl received 1000 mg/week,  over 15 minutes or less, repeated weekly to a calculated replacement dose (maximum 2500 mg) . Hemoglobin and serum ferritin levels were recorded prior to treatment and on day 21 after completion of treatment.Results: Ferric carboxymaltose-treated subjects achieved a hemoglobin greater than 12 gm/dL in a short time period (21 days), achieve a hemoglobin rise of ≥3 gm/dL more quickly, and attain higher serum ferritin levels. It is also associated with better patient compliance, and shorter treatment period. Drug-related adverse events occurred less frequently with ferric carboxymaltose. The only noted disadvantage was that it is more expensive when compared to other iron preperations.Conclusions: Intravenous ferric carboxymaltose was safe and well tolerated with good efficacy and better patient compliance in the treatment of postpartum iron deficiency anemia.
Fetomaternal outcome in pregnancies with reproductive tract anomalies
Authors: Jena Asit K. , Meetei Trinity L. , Begum Salma , Singh Rameswar M. , Priyadarshinee Lipsa , Begum Nasima , Subba Taneesha , Das Snehangshu
Published: September 2021

Background: Congenital reproductive tract anomalies result from abnormal formation, fusion or resorption of the mullerian ducts during fetal life. Pregnancies with reproductive tract anomalies are known to have higher incidence of spontaneous abortions, fetal malpresentations, preterm labour, preterm premature rupture of membranes and increased cesarean section rate. The present study was conducted to describe the fetal and maternal outcomes among pregnant women with uncorrected reproductive tract anomalies in a tertiary care centre, Manipur, India.Methods: A hospital based cross sectional study was conducted among pregnant women with uncorrected reproductive tract anomalies in regional institute of medical sciences, Imphal, Manipur, India between September 2018 to August 2020.Results: A total of 62 pregnant women with uterine anomalies were included in the study. Bicornuate uterus was the most common uterine anomaly (45.2%) followed by arcuate uterus (19.3%). Cesarean section was conducted in 72.6% of the pregnant women and its major indication was fetal malpresentation (breech). Maternal complications were present in56.5% of the pregnancies and fetal complications in 27.4% of the newborns.Conclusions: The current study has shown a significant association between uterine anomalies and maternal and fetal complications including premature rupture of membranes, fetal malpresentation and increased caesarean section rate. Further studies involving bigger sample size will help in understanding the problem more and hence in the prevention of the complications in future.
Coexistent molar pregnancy with a normal fetus-a rare presentation of gestational trophoblastic disease
Authors: Nascimento Catarina J. , Veiga Mariana , Silva Ana Rita , Cominho Joana
Published: September 2021

A coexistent molar pregnancy with a normal fetus is rare, with an incidence of 1 in 22.000 to 100.000 pregnancies-only 200 cases reported in the last two decades. The ultrasound is essential for an earlier diagnosis, and the management of these cases is challenging due to the increased risk of obstetrics complications and the possibility of posterior gestational trophoblastic neoplasia. Here we describe a 33-year-old healthy woman with a first-trimester twin pregnancy, presented with a normal fetus and a heterogeneous and vacuolar structure suggestive of complete hydatidiform mole. The pregnancy was interrupted, and a histological diagnosis confirmed complete hydatidiform mole in dichorionic/diamniotic twin pregnancy at 14 weeks. Molar twin pregnancy is a rare condition, and do not exist any consensus protocol to guide the clinical approach, so the decision to continue the pregnancy depends on the couple’s desire and maternal and fetal complications.
Challenge in challenging times: a case report of ruptured isthmic ectopic pregnancy in an asymptomatic COVID-19 positive patient
Authors: Gahlot Ankita , Raval Atri , Yadav Bindoo , Saxena Swarnima
Published: September 2021

Emergency surgical management of patients who are COVID-19 positive is extremely challenging for the treating doctors as there is a need to keep the balance between delivering optimal medical care to the patient, preventing spread to others and protecting ourselves. COVID-19 manifestations in pregnant women are similar to non-pregnant patients. The patient may be asymptomatic or may present with symptoms like cough, cold, fever and shortness of breath. In obstetric emergencies like ruptured ectopic pregnancy, when a patient presents in casualty with history of amenorrhea, pain abdomen and features of shock, main priority for the clinician is to stabilize them and treat the underlying cause so as to save their life. We report the emergency management of a hemodynamically unstable ruptured ectopic pregnancy at 9 weeks of gestation in a COVID-19 positive patient. It was stressful for the treating doctors because of high infectivity of the disease, scarcity of resources during the pandemic and precarious condition of the patient.
Aggressive angiomyxoma
Authors: Devi T. Ramani , Sangavi D. , Deepika A.
Published: September 2021

Angiomyxoma is a rare slow-growing, benign low-grade tumor occurring in women of reproductive age group which is known for its recurrence. The symptoms are variable. Mrs. K. aged 33 years, reached our outpatient department (OPD) with complaints of painless swelling on the right labial region which she was feeling uncomfortable while sitting. Mass was found to be mobile with no evidence of inflammatory change. The location of the mass made us think about, Bartholin’s cyst and hence surgical excision of the mass was done. The whole mass was found to be lying below the fat in the right labial region and wide excision was completed. The histopathology of the mass was reported as angiomyxoma. Angiomyxoma arises from the mesenchymal tissue and it is locally invasive with high recurrence rate. It is more common in females. Mostly seen in the vulvovaginal, pelvic cavity and perineum. The lesion can reach huge size. It has to be differentiated from gynecologic malignancies, cyst, abscess and hernia. Histology along with immune-histochemistry can confirm the lesion. Wide excision is the mode of treatment. Incomplete excision can lead to relapse. Relapse can happen in 35-72% of the cases. Local recurrence may occur between 2 months to 15 years following initial diagnosis. Hence, follow up is essential. Angiomyxoma is a very rare condition and only around 250 cases have been reported in the world literature. It has to be differentiated from other benign conditions. Diagnosed by non-invasive techniques like ultrasound sonography (USG), magnetic resonance imaging (MRI) and computed tomography (CT). Wide excision is the treatment of choice. Long term follow up is needed as recurrences are high.
A rare case report of cornual pregnancy
Authors: Bansal Priyanka , Aggarwal Gargi , Bansal Isha
Published: September 2021

Cornual pregnancy is a rare type of ectopic pregnancy in which embryo implants in the junction between the fallopian tube and uterus. Ectopic pregnancy is more common in the ampullary region of the fallopian tube. However, cornual (interstitial) pregnancy is seen in 2-4% of ectopic pregnancies. It is more dangerous than other ectopic as it may lead to catastrophic hemorrhage, shock with mortality rate of 2-2.5%. A cornual pregnancy is diagnosed at 7+3 week of amenorrhea in 27-year-old healthy woman. Ultrasound examination showed a right live cornual pregnancy with CRL corresponding to 6+4week of gestation with fetal heart pulsation. We performed right cornuostomy by laparotomy without any immediate or delayed postoperative complications. Cornual pregnancy poses significant diagnostic and therapeutic challenge; early diagnosis may help to select the proper management and treatment according to the clinical presentation, hemodynamic stability, serum b-hCG level and ultrasound findings. Early diagnosis and management remain the mainstay for tackling maternal mortality due to cornual pregnancy.
A rare case of recurrent paroxysmal supraventricular tachycardia in pregnancy managed with adenosine, a wonder drug
Authors: Pakhale Snehal W. , Gupta Sadhna D. , Bansal Anita , Sehra Angela
Published: September 2021

Paroxysmal supraventricular tachycardia (PSVT) is the most common sustained arrhythmia during pregnancy and a challenging situation due to lack of evidence based guidelines. About 50% of PSVT, who fail to respond to vagal maneuvres, responds to therapies as pharmacologic agents as adenosine and electrocardioversion. We reported a case of 29 years old primigravida women with no organic heart disease who presented at 21 weeks of period of gestation with complaints of palpitations and shortness of breath. Her ECG revealed PSVT for which she received adenosine as anti-arrhythmic for conversion to sinus rhythm. She was started prophylactically on tablet metoprolol 25 mg twice daily, as advised by cardiologist. In third trimester, she had recurrent episodes of PSVT for which she received adenosine in emergency department. She delivered a healthy female baby by an elective caesarean section done under spinal anesthesia. Fortunately, her intraoperative and postpartum was uneventful with no recurrence of PSVT during hospital stay. She was discharged on day 4 of caesarean section on tablet metoprolol 12.5 mg twice daily and followed in postpartum period for complications. To summarize, PSVT occurring during pregnancy, labour or at caesarean section is not uncommon. Treatment remains a challenge though, as clinical decision must be tackled with appropriate consideration of both maternal and fetal factors. So, multi-disciplinary approach is needed for treatment including obstetrician, cardiologists, physician and neonatologists. Our case highlighted the necessity of keeping anti-arrhythmic drugs such as adenosine readily available on the labour ward.
Poor ovarian reserve and male infertility in a rural in vitro fertilization setup: a case report
Authors: Harne Neha V. , Nadkarni Vaibhav K. , Nadkarni Purnima , Garasia Jigna
Published: September 2021

Female fertility begins to decline many years prior to the onset of menopause despite continued regular ovulatory cycles. Although there is no strict definition of advanced reproductive age in women, infertility becomes more pronounced after the age of 35. In the female, the number of oocytes decreases with age until the menopause. Oocyte quality also diminishes, due in part to increased aneuploidy because of factors such as changes in spindle integrity. Although older male age affects the likelihood of conception, abnormalities in sperm chromosomes and in some components of the semen analysis are less important than the frequency of intercourse. Age is as accurate as any other predictor of conception with assisted reproductive technology.
Vulvar lichen sclerosus: recent advances in understanding and management
Authors: Kumari Anupma , Singh Pushpendra K. , Rohatgi Renu
Published: September 2021

Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. It is one of the most common pathologies presenting to vulvar clinics. However, uncertainty continues to exist about its etiopathogenesis, diagnosis and treatment. Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal and local infectious background. There is often a delay in diagnosis of VLS due to its asymptomatic nature and lack of awareness in patients as well as physicians. Embarrassment of patients due to private nature of the disease and failure to examine the genital skin properly are the other reasons for delay in diagnosis. Conventionally, treatment includes topical corticosteroids as a first-line therapy with alternative options such as topical calcineurin inhibitors, topical and systemic retinoids, other steroid creams, various destructive techniques and surgical removal of affected tissues. New therapeutic approaches are coming into effect in gynecological practice due to potential risks of the above-mentioned methods. Stem cell and platelet-rich plasma therapy, energy-based modalities such as the fractional CO2 laser, photo dynamic therapy, and high intensity focused ultrasound, and new topical medicines, are some of the new options applied to improve the efficacy of treatment avoiding the side effects of conventional methods. Refinement of surgical techniques for restoring vulvar anatomy is leading to improved patient outcomes. This review summarizes current perspectives on the etiopathogenesis, diagnosis and treatment for vulvar lichen sclerosus.
Treatment seeking patterns of the COVID-19 first wave patients: a narrative study from Dhaka, Bangladesh
Authors: Kazi Nahida Sultana , Kazi Shahedul Halim
Published: September 2021

Background: The COVID-19 has already taken the lives of 4,088,281 people worldwide. To date, the deadly virus has killed 17,894 people in Bangladesh following a sharp increase in death per day. The current article focuses on the treatment-seeking patterns of COVID-19 patients during the first wave of the pandemic in the country. Methods: This is a qualitative study based on semi-structured interviews with 30 respondents selected purposively. The interviews were transcribed verbatim and analyzed narratively. Results: The study shows that 28 out of 30 participants pursued treatments from home, whilst, two individuals with comorbidity got admitted to the hospitals for weeks. This indicates that there is an association between comorbidity and hospitalization of the COVID-19 patients. The study reveals that the use of telemedicine service amidst COVID-19 has initiated a new era of health-seeking among people in Bangladesh. Similarly, media and the internet played a significant role in the quick access to information about the pandemic as well as to decide on the response and healing patterns of the participants. Besides the pharmaceutical drugs, using herbs was a common remedial process among the patients in the study. Conclusions: Like other countries, people in Bangladesh are also puzzled about the coronavirus and its treatment procedures. A proper response to the current situation, an effective preparedness policy, and public awareness are crucial for tackling the further destruction resulting from a highly infectious disease.
Compliance to antihypertensive therapy and associated factors among adults’ hypertensive patients attending medical clinics in Kilifi County Kenya
Authors: Moss John T. , Kimani Harun , Mwanzo Isaac
Published: September 2021

Background: Hypertension is both public health and medical problem worldwide. Compliance to antihypertensive therapy is key in avoiding hypertension complications. The purpose of this study was to establish compliance to antihypertensive therapy and associated factors among adults’ hypertensive patients in Kilifi county Kenya.Methods: A facility-based cross-sectional was undertaken in four public health facilities in Kilifi County Kenya. Two hundred and thirteen hypertensive patients were recruited in the study. Data was collected using a pretested questionnaire and analyzed using Statistical package for social sciences (SPSS) version 23 software. Chi-square test was utilized in establishing the relations, while logistic regression was adopted to determine independent risk factors for compliance.Results: Compliance to antihypertensive therapy was recorded in 31 (14.6%) of the patients. A statistically significant association was established between compliance to antihypertensive therapy and patients knowledge (p<0.001); age (p=0.024); education (p=0.04); income (p=0.013); duration on treatment (p=0.005); cost (p=0.029); health care provider advice (p=0.009); consistency of therapy (p=0.002); medicines availability (p=0.021); and health facility distance (p=0.013). Independent risk factors for compliance to antihypertensive therapy were the duration on treatment of (OR=0.383; 95%CI 0.151-0.972); Knowledge on hypertension (OR=2.715; 95%CI 1.598-4.615); Health care worker follow-ups (OR=0.452; 95%CI 0.282-0.726); and cost of medication (OR=2.682; 95%CI 1.134-6.345).Conclusions: Anti-hypertensive therapy compliance among patients was low. This could be attributed to factors that are socio-demographic, patient, and health service-related in nature. Prompt public health interventions that are patient-community centred are necessary to improve compliance to antihypertensive therapy.
Predictors of quality of life of Pakistani women with rheumatoid arthritis: a cross-sectional study
Authors: Sharma Sucheta , Eapi Srilatha , Muqtadir Abdul , Bokhari Ammar , Zulfiqar Mehak , Jiwani Kinza , Barkat Rahil
Published: September 2021

Background: Rheumatoid arthritis (RA) is characterized as a chronic inflammatory disease indicated by stiffness, pain, inflammation, and impaired mobility. This results in joint impairment, poor workability, productivity, and afterward, it curtails the quality and expectancy of life of an individual. The aim of this research is to assess the quality of life of Pakistan women with RA and assess various factors affecting it.Methods: It was a cross-sectional study conducted in the Orthopedics department of the Indus Hospital and Health Network, Karachi Pakistan, where we assessed quality of life in sample of women with RA. A consecutive sampling technique was used to enrol women with rheumatoid arthritis who were seen in the Orthopedics outpatient clinic during the study period (February to May 2021).Results: Of the 134 women with RA, 72.39% of women were unemployed, 54.48% of women had family monthly income of 16000 PKR or more and 44.03% of women reported at least one comorbidity other than RA. According to linear regression analyses, women having RA with severe disease activity tended to have tended to have low physical functioning, vitality, emotional wellbeing, social functioning, pain and general health as compared to patients with remission, low disease and moderate disease activity. Absence of family support in disease management can impact vitality and emotional wellbeing with decrease in scores of -85.20 and -120.66 respectively.Conclusions: Guidelines need to developed and implemented for assessing psychological domains of these patients for assessment of quality of life. This will help in maintaining and improving QoL of women with RA.
Impact of social isolation during COVID-19 on psychological well-being of the elderly: an Indian survey-based study
Authors: Sharma Rajni , Kumar Krishan , Saini Lokesh , Dhiman Deepanshu , Ghai Babita , Suri Vikas , Singh Subh Mohan , Mohendra Ritin , Tyagi Pooja , Prasad Barre Vijay , Gupta Nitin
Published: September 2021

Background: Since the onset of COVID-19 pandemic the elderly population has started experiencing higher levels of anxiety both because of fear of contracting infection and due to restricted social life. Study was done to assess impact of lockdown on mental health of elderly.Methods: This was a retrospective and observational study. 106 participants were enrolled aged above 60 years. A Google survey form was sent to the participants for filling, accompanied by sessions with a clinical psychologist. The socio-demographic data and various psychological parameters were assessed.Results: Depression was most commonly reported (39.6%). Global satisfaction had a significant and positive correlation with both social security index (p=0.004) and social network scale (p=0.000).Conclusions: The prevalence of anxiety, stress and depression increased during lockdown. Overall satisfaction with life was reduced. Psychological counselling and support should be readily available to elderly. The problem associated with social isolation and lockdown may seem to be acute but can have worse psychological outcomes in long term.
Anaemia in pregnancy: a cross sectional study
Authors: Bhaware Gautam Madhavrao , Muneshwar Sujata Namdeorao , Pundkar Rutuja Dinkar
Published: September 2021

Background: Aim of the study was to find the factors leading to anemia in pregnancy. The main objective was to study the various sociodemographic factors leading to anemia and to assess the knowledge about anemia among pregnant females.Methods: The present cross sectional study was carried out at urban health centre, to determine the factors leading to anemia in pregnancy. A total of 100 pregnant females were registered. Demographic data was collected by interview method. A pretested and pre designed questionnaire was used for data collection. Hb was estimated using Sahli’s hemoglobinometer and females having haemoglobin less than 11 mg/dl were considered anaemic. Data analysis was done using SPSS software. Results: The overall mean haemoglobin (Hb) was 9.58+2.2g/dl. It was seen that diet, family size, education, social class, gravida and parity are associated with anaemia in pregnancy. Conclusions: After adjusting for all the possible covariates there seems to be significant association between Hb levels and age group, education level, family size, diet, gravida and parity.
Assessment of nutritional status of adolescent school going boys of Himachal Pradesh
Authors: Pathania Neetu S. , Biswas Rajib
Published: September 2021

Background: Given the paucity of data on the nutritional standard of the Himachali children, the present study was conducted to assess the physical growth and malnutrition of adolescent school-going boys of Himachal Pradesh within the age group of 15-17 years.Methods: Boys were selected from both government and private schools of the non- hilly regions of Mandi district of Himachal Pradesh. Height, weight, and BMI were determined. Stunting was evaluated from height-for-age Z-score, and thinness, overweight, and obesity were estimated from BMI-for-age Z-score using the WHO recommended cut-off values.Results: Mean height varied between 167.2 to 168.7 cm. Weight varied between 52.4 to 56.1 kg with a corresponding BMI between 18.7 to 19.7 kg/m2.The overall prevalence of stunting and wasting were 5.7% and 15.8% respectively. The coexistence of stunting and wasting was not found in any of the age groups. The overall prevalence of overweight and obesity was 5.4% and 1.7% respectively.Conclusions: Himachali boys appeared to be taller than most of the Indian population of boys of similar age groups. Prevalence of the different categories of over nutrition and undernutrition were also lower as compared to that obtained for other Indian studies on adolescent boys. The existence of overweight and obese individuals points towards the double burden of malnutrition.
A prospective study to assess the social stigma, perceived stress and psychological distress among security guards during COVID-19 pandemic in All India Institute of Medical Sciences, New Delhi
Authors: Ahlawat Sheenu , Joshi Poonam , Susaimuthu Cecilia Mary , Goel Prabudh , Lodha Rakesh , Jain Vishesh , Sharan Pratap
Published: September 2021

Background: People working in the health sector were being labelled, stereotyped, discriminated against, stigmatized, and treated indifferently in the early phase of coronavirus disease 2019 (COVID-19) pandemic. To assess social stigma, perceived stress, and psychological distress among hospital security guards during the COVID-19 pandemic.Methods: A prospective study was conducted among security guards, working in a tertiary care health facility, during the early part of the COVID-19 pandemic. The data were collected using an online Google form. The stigma, perceived stress, and psychological distress were assessed using standardized tools.Results: The mean age of 280 (males: 219, 78.2%) guards enrolled in the study was 37.13±9.1 years. The mean stigma, stress, and psychological distress scores among security guards were 28.76±11.9, 17.64±6.4, and 4.35±2.8, respectively. A significant correlation was found between perceived stigma and psychological distress (r=0.197, p=0.009) and perceived stress and psychological distress (r=0.302, p=0.001). The predictor of perceived stress among the security guards were gender, [β=1.88; (1.13, 2.63), p=0.001] and loss of job by the family member during pandemic [β=2.8 (4.56, 1.03), p=0.001], similarly the predictors of psychological distress were gender and COVID positive status [β=0.06 (0.10, 0.33), p=0.001].Conclusions: The majority of the security guards had moderate to high perceived social stigma, and moderate level stress during the COVID-19 Pandemic and a few being psychologically distressed requiring referral to experts.
Acceptability and awareness of intrauterine contraceptive device among reproductive age women
Authors: Ramkumar S. , Vijayalakshmi S. , Soundararajan R. , Elakkiyachelvi M. , Elakkiya E. , Fathima S.
Published: September 2021

Contraception is the intentional prevention of conception through the use of various devices, sexual practices, chemicals, drugs or surgical procedures. An effective contraception allows a physical relationship without fear of an unwanted pregnancy and ensures freedom to have children when desired. In this article we are going to see their utilization and awareness about usage of intrauterine contraceptive device (IUCD).
Coronavirus disease 2019: an overview
Authors: Prahalad Ajna , Soti Varun
Published: September 2021

Coronavirus disease 2019 (COVID-19) has caused over four million deaths worldwide and continues to affect millions across the globe. This review aims to provide an overview of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the progress made to counter COVID-19 through therapeutics and immunizations. We searched preclinical and clinical COVID-19 literature published between January 2018 through June 2021 on PubMed. The medical subject headings used in the literature search were COVID-19, SARS-CoV-2, Treatment, Remdesivir, Cytokine Storm, Hydroxychloroquine, Epidemiology, Angiotensin-Converting Enzyme 2 Receptor, Vaccines, and Mitigation. There is credible evidence that shows that the spike protein in the SARS-CoV-2’s structure is crucial for the host to be infected. It spreads through different modes, primarily through aerosols and carriers. Pathophysiologically, SARS-CoV-2 triggers a cytokine storm leading to systemic inflammation, which can be fatal. Although treatment with Remdesivir and Dexamethasone and massive vaccinations have significantly reduced the mortality rate, COVID-19 remains a significant threat. The emergence of SARS-CoV-2’s different strains, notably the Delta variant, demonstrates that the COVID-19 pandemic is not over. More vaccine distribution and increased efforts in developing anti-SARS-CoV-2 drugs, social distancing, masking, and practicing good hygiene will be crucial in defeating COVID-19.
Mastoid cavity obliteration with bone dust: a retrospective study of 34 cases
Authors: Juvekar Meenesh , Sarkar Baisali
Published: September 2021

Background: Chronic suppurative otitis media leads to ear discharge with hearing loss with squamosal type often presents with cholesteatoma and mainstay of treatment is surgical. Modified radical mastoidectomy is the ideal surgical option in these cases but it results in open mastoid cavity formation with certain common cavity problems. This study done to find the results of mastoid cavity obliteration with autologous bone dust and how this technique is effective in avoiding long term cavity problems and assists in ossiculoplasty.

Methods: This is a retrospective observational study done in a tertiary care hospital. Patients presented with squamosal type of chronic otitis media were operated for a canal wall down modified radical mastoidectomy.The mastoid cavity was obliterated using bone dust. A follow up of the patients was done and the healing of the cavity with the hearing result assessed.

Results: The study includes total of 34 patients. 58.82% were male and 41.18% were female. All patients underwent canal wall down modified radical mastoidectomy and obliteration of the mastoid cavity was done with bone dust. The common cavity problems of discharge, debris were markedly reduced in an obliterated cavity with better healing of the cavity. The middle ear aeration was maintained assisting the ossicular reconstruction.

Conclusions: This study showed that mastoid cavity obliteration with bone dust offers significant long term benefits in providing dry, well epithelized cavity at the same time assisting in ossicular reconstruction.
A clinical study of traumatic tympanic membrane perforation
Authors: A. T. Fida Harish , Prasad K. U. Raghavendra
Published: September 2021

Background: Tympanic membrane (TM) which forms the partition between external auditory canal and middle ear may be ruptured by trauma. Traumatic TM perforation is a commonly observed condition. Though, several therapeutic interventions have been described, conservative follow-up until spontaneous complete recovery is the most common choice.

Methods: It was a prospective cohort study conducted during a period of 10 months from July 2020 to April 2021, carried out in 30 patients who presented to outpatient department of ENT and casualty of Hassan institute of medical sciences hospital with traumatic TM perforation.  After taking informed consent, detailed history was taken, thorough examination of ear was performed and characteristics of perforation were noted. Pure tone audiometry (PTA) was conducted, data was statistically analysed.

Results: Mean age group was 33.1 years and 73.3% were males. Ear pain was the commonest symptom with accidental trauma being the most common cause. 70% of them had left TM perforation and posteroinferior quadrant was mostly involved.

Conclusions: Traumatic TM perforation is commonly seen in young adults following accidental trauma and assault. Earache, sudden hearing loss and tinnitus are the common symptoms. Most of the cases heal spontaneously with conservative management.
Teratoma of larynx: case report
Authors: Srivastava Rakesh , Tandon Vini
Published: September 2021

Teratomas are embryonal neoplasm arises from totipotent germ cells. They are having tissues from all the three blastodermic layers. There are various locations of congenital teratoma. Naso-oropharyngeal site teratoma are either sessile or pedunculated. We describe a rare case of laryngeal teratoma in a five years old patient presented with change in voice and breathing difficulty. On flexible laryngoscopy, it appeared like supraglottic cyst but on CT scan it was confirmed as teratoma. Pre-operative tracheostomy and transoral carbon dioxide laser assisted excision done. Histopathological examination showed osteoid trabeculae, chondroid tissue with loose myxoid islands and adipose tissue. No recurrence of tumor on 18 months follow-up. This is the first case report of pediatric larynx teratoma reported in present century.
Retrospective study of lightning fatalities in Raigarh, Chhattisgarh
Authors: Ban Goswami Rajesh , Dutta A.
Published: September 2021

is a massive electrostatic discharge caused by the circulation of warm moisture-filled air through unbalanced electric field in the atmosphere, accompanied by the loud sound of thunder.

: The present study was conducted to ascertain the pattern of lightning cases along with distribution of cases based on age, sex, season, location, activity of the victim and injury pattern in the corpse.

: The present cross sectional retrospective study was carried out in the department of Forensic Medicine at Govt. Medical College, Raigarh, CG. All autopsy cases of lightning deaths from 2018 to 2019 (two years) were considered for the study.

: Most of the deceased were in the age group of 31-40 years. All incidents happened in open field. High incidence of lightning deaths occurred during monsoon season and peak incidence in evening hours. In most cases arborescent mark was found as pathognomonic finding.

: Lightning incidents are always accidental in nature. They are fatal and need prompt resuscitative measures. Lightning injuries have bizarre presentation in the body, therefore the autopsy surgeon needs meticulous and detailed methodical approach during autopsy.
Representations of Space and Past in the Context of Cognitive Sciences: Cognitive Maps, Lieux De Mémoire (Realms of Memory), Interpresentation Networks
Authors: Shpak George
Published: September 2021

The article deals with the main concepts developed within the framework of cognitive disciplines, focused on the interaction with the images of space and the past, which in psychobiological terms are equal. An attempt is made to compare the development of concepts determining the interaction of consciousness and “external” images in Geography and History. Based on the review of the subject of cognitive research, it is concluded that scholars engaged in the development of the issue of representation should establish interdisciplinary connections, which will enrich both cognitive history and cognitive geography.
The Cognitive Map of Barbarity: Term, Notion, Innovative Essence
Authors: Budanova Vera
Published: September 2021

The article presents a historical review and theoretical analysis of the cognitive map of barbarity as the basis for studying the basic terminology that has developed in barbaristics. For the first time, an attempt is made to analyze the cognitive potential of barbaristics, referring to its conceptual structure. The most significant terms, notions and innovative essences, their role in the structure of the barbarian's cognition are considered. It is emphasized that in the processes of symbol formation there was a movement from notion to innivative essence, in the study of the history of barbarity — from notional to conceptual cognition. The conditions of the general expansion of the archaic semantics of the term “barbarian” and the features of its translation and transmutation in time and space are considered. The key characteristics of the notion of “barbarity” as a stable socio-cultural phenomenon are identified and disclosed in historical retrospect. The emerging notions of «new» and «latent» barbarity are specially analyzed.
Theoretical Study on a Novel Temperature Breakpoint Cyclic Operation to Enhance Desiccant Packed Bed Performance
Authors: Murathathunyaluk Siripan , Kitchaiya Prakob
Published: September 2021

In a conventional desiccant packed bed dehumidification, the adsorption and desorption operations switched at a constant cycle. However, this Conventional Steady Cyclic (CSC) operation was not performed well under disturbances. Therefore, a Temperature Breakpoint Cyclic (TBC) operation is proposed. A numerical model of the desiccant packed bed dehumidification system has been constructed and validated. The model was then used to assess the desiccant packed bed dehumidification performances in term of moisture removal capacity (MRC) and dehumidification coefficient of performance (DCOP) under various cycle times and temperature factors. The calculation results showed that under CSC, larger amounts of energy were required in the desorption operation, while the TBC exhibited higher performances in term of both MRC and DCOP. Notably, at a high regeneration temperature, the MRC of the TBC was 10% higher than the CSC’s; moreover, the DCOP of the TBC was twice higher than the CSC’s. In other words, at high recovery temperature, both operations exhibited comparable capacities while the energy cost was halved under TBC operation.
Thermal Performance of Nanofluid Flow Inside Evacuated Tube Solar Collector
Authors: Yazdi Mohammad H. , Solomin Evgeny , Fudholi Ahmad , Divandari Ghasem , Sopian Kamaruzzaman , Chong Perk Lin
Published: September 2021

Solar collectors are systems for absorbing the sun's radiant energy and converting it into heat. The working principle of solar collectors are relying on the solar radiation incident upon the transparent surface, and the collected radiation heat is stored within the operating fluid. However, the conventional operating fluid is less than satisfactory in term of promoting the thermal efficiency of solar collector. Consequently, the aim of this paper is to investigate the use of nanofluid as an operating fluid in a single end evacuated solar collector. The expectation is that the flow behavior of nanofluid can lead to the improvement of thermal efficiency of solar collector. The design of solar collector is carried out using Gambit software and the heat transfer characteristics are simulated by nanofluid flow with 1%, 3% and 5% volumes by ANSYS Fluent software. The results demonstrate good agreement with existing experimental results. The numerical analysis shows the improvement of collector performance compared to pure water fluid. The results show that by increasing the nanoparticles volume fraction the efficiency of the collector improves significantly.