bluuebunny/crossref_metadata_2025 huggingface dataset:
María del Mar López-Cabrales.“Alma gitana” y “Carmen y Lola”: dos miradas transversales a la violencia contra la mujer en la etnia gitana. Revista Comunicación y Género, vol. 2, nº. 2, pp. 223-232, 2019.
Authors: López-García-Torres Rocío , Saneleuterio Elia
Published: June 2020

“Alma gitana” y “Carmen y Lola”: dos miradas transversales a la violencia contra la mujer en la etnia gitanaAutora: María del Mar López-Cabrales.Revista Comunicación y Género, vol. 2, nº. 2, pp. 223-232, 2019. ResumenEsta reseña muestra cómo el ensayo que analiza las películas Alma gitana (1996) de Chus Gutiérrez, y Carmen y Lola (2018) de Arantxa Echevarría, se cuestiona la violencia contra la mujer en la comunidad gitana y se propone la necesidad de que las generaciones más jóvenes vayan cambiando y construyendo sus vidas desde la igualdad, sin por ello tener que desestimar totalmente la cultura ni las tradiciones de sus ancestros. Tanto Chus Gutiérrez como Arantxa Echevarría son mujeres que, sin pertenecer a la etnia gitana y partiendo de un conocimiento profundo y con gran respeto, intentan articular en sus textos fílmicos posibles respuestas constructivas para enfrentar el tema de la violencia machista en la comunidad gitana.AbstractThis review shows how the essay that analyzes the films Alma gitana (1996) by Chus Gutiérrez, and Carmen and Lola (2018) by Arantxa Echevarría, addresses and questions violence against women in the gypsy community. The two films also call for younger generations to change and build their lives around equality, without totally dismissing the culture or traditions of their ancestors. Both film makers, Chus Gutiérrez and Arantxa Echevarría, are women who do not belong to the gypsy ethnic group but relying on deep knowledge and respect for it, articulate in their films constructive questions to the issue of gender violence in the gypsy community.
Elegir ingeniería TIC ante el riesgo de exclusión en el futuro mercado digital=Choosing ICT engineering against the risc of exclusion in the future digital market
Authors: Sánchez Hernández María Pilar
Published: June 2020

ResumenEste artículo analiza desde una perspectiva de género los factores económicos por los que las grandes multinacionales tecnológicas quieren atraer a las mujeres al mercado laboral TIC. El análisis de contexto presenta un sector masculinizado, con un 80% de titulados en ingeniería informática y en el que, de cada cien profesionales, setenta y ocho son hombres. El artículo ahonda en los factores sociales por lo que persiste la segregación ocupacional de género y las relaciones de género que alejan a las mujeres de la tecnología. Las múltiples formas de organizar el trabajo en este sector abren nuevas posibilidades para la conciliación laboral y familiar.AbstractThis article analyses from a gender perspective the economic factors by which large technology multinationals want to attract women to the ICT labour market. The context analysis presents a masculinized sector with 80% of graduates in computer engineering and in which, out of every one hundred professionals, seventy-eight are men. The article delves into social factors so that occupational gender segregation persists and gender relations keep women away from technology. The multiple ways of organising work in this sector open up new possibilities for reconciling work and family life.
Personas trans y procesos de tecnificación de la existencia. Apropiaciones e innovaciones en torno al uso de artefactos=Transgender people and processes of technification of existence. Appropriations and innovations aroud the use of artifacts
Authors: Dellacasa María Alejandra
Published: June 2020

ResumenIniciamos este análisis identificando una serie de aristas políticas asociadas a las tecnologías de intervención corporal para el caso de personas trans. Ello constituye una invitación abierta a repensar, por un lado, el papel de los pacientes/ usuarixs/ consumidores y, por otro, los efectos sociales que se desprenden de la actualización de los sentidos y los propósitos con que fueron idealmente concebidos los artefactos. Sostenemos que la Ley de Identidad de Género en Argentina propició un proceso de politización de las demandas y las subjetividades de las personas trans. Al tiempo que habilitó una instancia de democratización de las tecnologías de intervención corporal, tanto en lo que respecta al acceso, como a la direccionalidad y los fines con que son utilizadas.AbstractWe begin this analysis by identifying a series of political edges associated with body intervention technologies in the case of transgender people. This constitutes an open invitation to rethink, on the one hand, the role of patients / users / consumers and, on the other hand, the social effects that arise from the updating of the senses and the purposes with which the artifacts were ideally conceived. We maintain that the Gender Identity Law in Argentina promoted a process of politicization of the demands and subjectivities of transgender people. At the same time, it enabled an instance of democratization of body intervention technologies, both in terms of access, as well as the directionality and the purposes for which they are used.
Percepción del profesorado español de diferentes etapas educativas respecto a cuestiones de igualdad de género en el ámbito docente=Perception of Spanish Professors of different educational stages regarding gender equality issues in the educational field
Authors: Rodríguez-Rodríguez Ignacio , Rodríguez José-Víctor , Ramallo-González Alfonso , Elizondo-Moreno Aránzazu
Published: June 2020

ResumenEn el presente trabajo, se pretende analizar la percepción del profesorado respecto a la introducción de la perspectiva de género en el ámbito educativo. Para ello, se presentan los resultados de un sondeo de opinión que se llevó a cabo entre más de doscientos docentes que acudieron a una jornada de formación, en el que se plantearon diferentes cuestiones relativas a la igualdad de género en el campo de la educación. El análisis de estos resultados muestra que, aunque se atisban mejoras −a tenor de la percepción del profesorado− con respecto a ciertas cuestiones concretas, aún queda un largo camino por recorrer para lograr la igualdad real entre mujeres y hombres en el sector docente.AbstractIn the present work, an analysis of the perception of professors regarding the introduction of the gender perspective in the educational field is carried out. For this purpose, the results of an opinion questionnaire that was carried out among more than two hundred teachers who attended a training session are presented, in which different questions related to gender equality in the field of education were raised. The analysis of these results shows that, although some improvements can be noticed –according to the perception of the professors– with regard to certain specific issues, there is still a long way to go to achieve real equality between women and men within the educational field.
Discriminazioni e rapporti di lavoro: l’inversione dell’onere della prova = Discriminación y relaciones laborales: la inversión de la carga de la prueba = Discrimination and Working Relationships: the Reversal of the Burden of Proof
Authors: Fiorenza Katia
Published: June 2020

Nella sentenza annotata (caso González Castro), la Corte di giustizia ha avuto modo di affrontare nuovamente, seppure attraverso profili innovativi, la questione relativa all’onere della prova, con riferimento a una vicenda che vede coinvolta una lavoratrice in periodo di allattamento che svolge un lavoro notturno. Secondo il giudice europeo la donna ha diritto alla tutela specifica contro i rischi ai quali tale lavoro può essere associato e, pertanto, sussiste l’inversionedell’onere della prova.In the judgment note on the González Castro case law, the European Court of Justice has addressed once again the question of the proof burden. Specifically, by considering the case of a breastfeeding woman working at night, the Court has deliberated that González Castro is entitled to receive protection against the specific risk factors related to her breastfeeding condition, thus admitting the possibility of the reversal of the burden of proof. This essay formulates some considerations on this judgment.
La adaptación del ámbito tributario estatal a la crisis del Covid-19 desde una perspectiva crítica = The Adaptation of State Tax Regulations to the Crisis of COVID-19 from a Critical Perspective
Authors: Carbajo Nogal Carlos , Mata Sierra María Teresa
Published: June 2020

En el presente estudio se analizan las diferentes medidas tributarias recientemente aprobadas como consecuencia de la crisis generada por la pandemia del COVID-19 apuntando, desde un punto de vista crítico, los problemas que generan para los contribuyentes.This study analyzes the different tax measures recently approved as a consequence of the crisis generated by the COVID-19 pandemic, pointing out the problems they generate for taxpayers.
Study of the influence of etoxidol on expression of follistatin-like protein-1 (FSTL-1) in myocardium after experimental infarction in rats
Authors: Parfenova E.V. , Zubkova E.S. , Boldyreva M.A. , Tsokolaeva Z.I. , Olefir Yu.V. , Romanov B.K. , Prokofiev A.B. , Kukes V.G. , Goroshko O.A. , Aleksandrova T.V. , Gazdanova A.A. , Parfenova O.K. , Sidorov N.G. , Andreev A.D.
Published: June 2020

In heart attack, FSTL-1 is actively secreted by cardiomyocytes, accelerates growth of heart myofibrils and stimulates of vascular endothelial growth factor expression. The aim of this work was to investigate the effect of Etoxidol on synthesis of FSTL-1 in rats after myocardial infarction. The experiments were performed on Wistar rats weighing 250-350 g with simulated myocardial infarction or intact (group 5). Animals of control groups (groups 1, 2) were treated with saline for 7 and 14 days; Ethoxidol (24 mg/kg) was injected to animals of experimental groups (group 3, 4) (the daily dose was 6.36 mg/animal) for 6 or 14 days. The injection volume was 0.2 ml. At the beginning and at the end of the study plasma concentrations of FSTL-1 were determined by the ELISA method. Myocardial FSTL-1 gene expression was determined by real-time PCR. At the end of the experiments, the hearts were also used for histochemical analysis. To determine the size of the scar formed after the modeled heart attack, we used the classic Mallory staining method. The results show that the development of experimental acute myocardial infarction is accompanied by a significant increase in FSTL-1 expression in the heart, which was detected on the 7th day and stored increased by 14 days after a heart attack. After therapy with Ethoxidol, a tendency to a decrease in the expression of FSTL-1 by the 14th day was observed; it coincided with the dynamics of the plasma protein FSTL-1 level. It can be assumed that the downregulation trend in the FSTL-1 expression is associated with a more effective repair process after a heart attack, since FSTL-1 increases precisely in response to myocardial damage and decreases when the incentives for its expression from damaged heart tissue are reduced. Indirectly, this assumption is confirmed by the detected tendency to reduce the size of post-infarction fibrosis in the treatment with Ethoxidol. The results indicate the ability of Ethoxidol to influence FSTL-1 synthesis of in rats after myocardial infarction.
The development of the physicochemical characteristics of the new original nootropic substance TST-9
Authors: Brkich G.E. , Pyatigorskaya N.V. , Beregovykh V.V. , Zyryanov O.A. , Demina N.B. , Bakrushina E.O.
Published: June 2020

Physicochemical properties of the original pharmaceutical substance TST-9 based on the 3,7-diazabicyclo[3.3.1]nonane derivative with the chemical name IUPAC 6-[4methoxy-3-(1H-pyrazol-1-ylmethyl) benzyl]-1,11-dimethyl-3,6,9-triazatricyclo[7.3.1.1]tetradecane-4,8,12-trion, were studied. TST-9 is used as an active substance for the development of the composition and technology for the preparation of an innovative oral drug. The pharmaceutical substance TST-9 is an amorphous white powder, odorless, soluble in chloroform, acetonitrile, methylene chloride, acetone, dimethyl sulfoxide, dimethylformamide and alcohol, sparingly soluble in diethyl ether, dioxane and is very slightly soluble in water, hexane, and heptane. The melting point ranged from 94°C to 96°C without visible decomposition of the substance. The microbiological purity corresponds to category 2.2. Residual organic solvents in the form of chloroform did not exceed 0.006%. The amount of impurities was not more than 0.15%. The loss in mass upon drying was not more than 0.5%. The “identity” was confirmed using nuclear magnetic resonance spectroscopy and HPLC with UV detection. The data obtained in the study will contribute to the further development of the dosage form, the choice of the route of administration and the dosage regimen, as well as the selection of analytical methods for analyzing the quality of the finished dosage form and the effective, high-precision determination of the content of the active substance and its likely decay products.
Knowledge, attitude and practice of down syndrome screening among pregnant women attending clinic in Sharjah, United Arab Emirates
Authors: Salvi Meena Bhati
Published: June 2020

Background: Down syndrome (DS) is the most common chromosomal abnormality found in live-born babies. It is associated with mental retardation, physical disabilities and growth problems. Prenatal screening to identify genetic disorders gaining importance now a days. The aim of this study was to assess the knowledge, attitude and practice among pregnant women about prenatal screening of Down syndrome.Methods: This was a prospective study done in the department of obstetrics and gynecology in Prime Medical Centre, Sharjah. All pregnant women who attended antenatal clinic and gave the consent for the study were included. The study was conducted from April 2019 to September 2019. A self-structured questionnaire was given to these women and data was collected. Responses to pregnant women’s knowledge, attitude and practice were evaluated.Results: A total of 217 pregnant women were included in the study. Of the 217 women 64.97% had good knowledge about Down syndrome but only 23.04% women had good Knowledge regarding Down syndrome screening. Although 42.85% had right attitude towards screening but only 14.74% patients had followed good practice. Expensive test 43.65% and religious beliefs 25.39% were stated as major reasons for denial for screening tests.Conclusions: Pregnant women have good knowledge of Down syndrome but low awareness of screening tests. Although they had positive attitude towards screening test but less patients followed good practice.
Sexuality and behaviour of adolescents in relationship to sexually transmitted diseases in Libreville: a cross-sectional study
Authors: Ambounda Nathalie L. , Woromogo Sylvain H. , Yagata Moussa Felicite E. , Kouanang Alain J. , Simo Tekem Vicky N.
Published: June 2020

Background: The World Health Organization (WHO) defines a sexually transmitted infection (STI) as an infection that is transmitted during unprotected sexual intercourse. Indeed, the highest rates of STIs are usually found among young people aged 15 to 24. In Gabon, adolescents' knowledge of sexuality and STIs remains insufficient and early sexual intercourse is the most important factor favouring them. Improving adolescents' knowledge of sexuality education could influence their behaviour.Methods: A cross-sectional study was conducted among 1256 adolescents in schools in Libreville. Their socio-demographic characteristics, knowledge about STIs, the description of their sexuality and their behaviour towards STIs were obtained through ratings and frequencies. Authos calculated the overall average of adolescents on their knowledge of STIs. Odds ration were used to establish the link between the different variables.Results: Adolescents reported knowledge of STIs (1163/1256). AIDS was the most frequently cited STI by 94.50% of adolescents. Sexual intercourse was the main route of STI transmission and was cited by 687 adolescents who estimated that they knew at least one mode of STI transmission. Almost all female and male adolescents had poor knowledge of STIs, with 98.2% and 98.8% respectively. 84.96% of those with a sexual partner had ever had sex. More than half of sexually active adolescents had multiple partners.Conclusions: Adolescents have a poor overall knowledge of STIs. Sexual risk behaviour remains very high, regardless of gender. To contain the scourge, awareness campaigns using all the means of communication at our disposal and especially the media.
Relationship between the amniotic fluid index at term and the perinatal outcome
Authors: Dobariya Bhumika H. , Jani Shree A. , Desai Ajesh N.
Published: June 2020

Background: Amniotic fluid index (AFI) is commonly used to estimate amniotic fluid volume. A proper AFI is between 10 and 24 centimetres. If it is below 5 cm, it is can represent oligohydramnios, and in case AFI is above 24 cm, it can represent polyhydramnios. This study was undertaken to determine whether measuring AFI at term is useful in the prediction of perinatal outcome.Methods: A prospective study of 250 pregnant women with gestational age between 37 and 42 weeks was conducted at Sola Civil Hospital. AFI was measured in each patient using the Phelan’s technique and the perinatal outcome was studied. The results were analysed and presented in the form of tables and graphs.Results: Total 250 patients were studied. Out of them, 33 patients (13.2%) had AFI <=5, 215 (86%) had AFI between 6 and 24; and 2 patients (0.8%) had AFI >=25.19 out of 33 (57.57%) patients with AFI <= 5, had to undergo caesarean section, out of which, 12 caesarean sections (63.15%) were taken for non-reassuring foetal status. 36.27% (78/215) of patients with AFI between 6 and 24 underwent caesarean section, out of which 38.46% (30/78) underwent caesarean section for non-reassuring foetal status.Conclusions: In the presence of oligohydramnios, the rates of LSCS due to foetal distress, the occurrence of low Apgar score and of low birth weight are higher than in patients with normal liquor at term. Thus, measuring the amniotic fluid index at term can be helpful in the prediction of perinatal outcome.
Prevalence of thyroid dysfunction in women with abnormal uterine bleeding in reproductive age
Authors: R. Hema K. , L. Girish B. , S. Dhananjaya B. , Kalaburgi Riyaj Ahmad
Published: June 2020

Background: Abnormal uterine bleeding (AUB) is one of the commonest presentations encountered in gynecological outpatient department. Menstruation is also regulated by many mechanisms, including thyroid hormone. So, for definitive management of AUB, it becomes imperative to assess thyroid status in those with abnormal uterine bleeding.Methods: Cross sectional study was conducted on all woman attending to OPD at Sri Siddhartha Medical College, Tumukuru, with complaints of abnormal uterine bleeding (AUB). Thyroid test was done for those who were eligible under inclusion criteria. Incidence of thyroid disorders among AUB and type of abnormal menstrual pattern associated with specific type of thyroid dysfunction were noted in this study.Results: Total of 522 presented with AUB. AUB was most common among woman age >40 years at 49.23% (257 of total 522 cases). AUB was more common in Multipara at 61.49% (321 of 522 cases). Menorrhagia was commonest pattern in AUB accounting for 51.34% (268 of 522cases). Thyroid dysfunction was present in 12.27% (64 of 522) of cases with AUB. Among them hypothyroid was most common accounting for 8.81% (46 of 522 cases). Hyperthyroidism was present in 3.44% (18 of 522 cases). Menorrhagia was most common pattern in Hypothyroidism at 65.21% (30 of 46 cases, followed by polymenorrhea at 17.39% (8 of 46 cases). Oligomenorrhea was most common in hyperthyroid group at 55.54% (10 of 18 cases) closely followed by hypomenorrhea at 44.44% (8 of 18 cases).Conclusions: Abnormal uterine bleeding (AUB) is one of the commonest gynecological complaint at gynecological OPD.  Thyroid dysfunction is noted consistently in cases of AUB. So, evaluation of thyroid profile should be part of evaluation of AUB, especially during perimenopause.
Effectiveness of bundled interventions in reducing surgical site infections in elective caesarean sections and caesarean hysterectomies in a tertiary care centre
Authors: Yadav Gunjan , Yadav Kalpana , Waddar Parasuram
Published: June 2020

Background: Surgical site infections are the most common and easily preventable infections complicating surgeries. CDC recommends certain bundle interventions for the prevention of SSIs. Hence the present study was undertaken to see the effectiveness and feasibility of the bundle interventions in the elective caesarean sections and caesarean hysterectomies.Methods: A total of 600 patients were taken. Bundled interventions were applied in 278 caesarean sections and 26 caesarean hysterectomies. Routine care was implemented in 262 caesarean sections and 34 caesarean hysterectomies. Rate of SSI, risk factors associated and treatment outcomes were studied.Results: 8 out of 304 cases of the bundled intervention group developed SSI, giving a rate of 2.6%. 52 cases out of 296 in the routine care group developed SSI, the SSI rate being 17.5%. Anemia and diabetes were the most common risk factors.Conclusions: Adherence to bundled interventions can significantly and easily reduce the incidence of SSI.
Comparative maternal outcomes of oral nifedipine and intravenous labetalol for severe hypertension during pregnancy: an open label randomized controlled trial
Authors: Sharma Monika , Thakur Sita , Singh Kamal , Shekhar Shashank
Published: June 2020

Background: Hypertensive diseases are commonly seen during pregnancy and remain one of the leading causes of maternal morbidity and mortality. Mostly commonly preferred drugs by health care providers for treatment of severe hypertension during pregnancy are labetalol and hydralazine. However, they require proper storage, intravenous access, and adequately trained staff for usage. Oral nifedipine in contrast is easier to use and widely available.  Objective of this study was to report the efficacy and safety of oral nifedipine as compared to intravenous labetalol for treatment of severe hypertension during pregnancy.Methods: It was an open label randomized controlled trial in which 100 women with severe hypertension during pregnancy were enrolled. They were randomized to receive either incremental doses of intravenous labetalol every 20 minutes (total 300 mg) or 10 mg oral nifedipine every 20 minutes (up to 50 mg) to lower the blood pressure to safer levels.Results: Women receiving oral nifedipine took significantly less time to achieve target blood pressure [(37.6±23.3) minutes (SD) as compared to those receiving intravenous labetalol (52.0 minutes±27.95 (SD)]. Women receiving nifedipine for treatment also required significantly lesser doses to control the blood pressure [mean dose 1.8±1.1 (SD) versus 2.6±1.2 (SD) p=0.006]. There were two failures in labetalol group and one failure in nifedipine group. No serious adverse events were reported in either group.Conclusions: Oral nifedipine is equally efficacious to I.V. labetalol for treatment of severe hypertension during pregnancy and is easier to use in low resource settings.
Choice of postpartum contraception and its socio-demographic and cultural determinants
Authors: Bangal Vidyadhar B. , Thitame Sunil , Somasundaram K. V.
Published: June 2020

Background: Postpartum contraception is essential for avoidance of unwanted pregnancy and for adequate spacing between two pregnancies. There are many socio demographic and cultural factors that influence the choice of contraception in rural community in India. Third trimester of pregnancy is ideal time for counselling the women regarding breast feeding and contraception. The objective of the present study was to find out the choice of postpartum contraception among antenatal women and the socio demographic and cultural determinants that influence this choice.Methods: Six hundred pregnant women were interviewed regarding their choice of postpartum contraception during their antenatal visit in third trimester of pregnancy, using a pre-validated and pre-tested brief questionnaire. The choices were compiled and analysed to draw conclusions.Results: Postpartum sterilization was choice of 30% of multiparous women. Primi-parous women either opted for barrier contraception like condom (10%), intrauterine contraception (9%) or oral steroidal pills (8%). The progesterone injectable contraceptives and centchroman each were chosen by 2% respondents. There was strong influence of education, parity, sex of the living children on the choice of contraception. It was observed that 40% of women did not want to use hormonal pills and intrauterine contraceptives due to strong age old misbelieves associated with them.Conclusions: Women in rural area prefer permanent method of contraception in the form of tubectomy operation after having desired number of children. There is insufficient spacing between pregnancies due to either non-use of contraception or inconsistent use of temporary method of contraception. More than 50% women are dependent on the husband regarding the choice and practice of contraception. The level of education of woman, age at marriage, socio economic class, desired sex combination of children are strong determinants of choice of contraception.
A comparative study between nifedipine and isoxsuprine in the suppression of preterm labor pain
Authors: Khoiwal Susheela , Patidar Vandana , Rastogi Radha , Tailor Bharat
Published: June 2020

Background: A prospective study was conducted to compare the effectiveness of Nifedipine and Isoxsuprine in suppression of preterm labour pain as tocolytics drug. As preterm labour pain is major contributor for perinatal morbidity and mortality. The aims of this study were to assess the effect of nifedipine and isoxsuprine in threatened preterm labour with the aim of preventing preterm birth and its sequelae.Methods: This study was conducted on 100 patients coming to Pannadhay Rajkiya Mahila Chikitsalaya, RNT Medical College, Udaipur and attending OPD and IPD with complain of uterine contractions between 28-36 weeks of gestation.Results: Nifedipine was more effective than isoxsuprine hydrochloride as tocolytic agent.Conclusions: There is high incidence of preterm labour in India which leads to neonatal morbidity and mortality. Nifedipine is a better tocolytic drug compared to isoxsuprine hydrochloride.
Vitamin D deficiency and adverse fetal outcome
Authors: Chandel Anu B. , Sharma Anoop , Mittal Rita , Mittal Shivika
Published: June 2020

Background: Vitamin D deficiency is recognized as the most untreated nutritional deficiency in the world. It is plausible that vitamin D deficiency could make the fetal heart more vulnerable to distress/birth asphyxia. Vitamin D deficiency has been hypothesized to be associated with low birth weight, low Apgar score at birth, higher rates of still births and admission to NICU. The aim of present study was to study prevalence of vitamin D deficiency in pregnancy and evaluate perinatal outcome.Methods: The study was conducted in the department of obstetrics and gynecology, Kamla Nehru Hospital, Shimla, India over a period of 12 months. Six hundred women were included in the study.Results: All the mothers who had still births suffered from vitamin D deficiency and the severe vitamin D deficiency was there in 90.91% (30) of these subjects. Severe vitamin D deficiency was seen in 78.95% (75) of the subjects having babies with birth weights <2.5 kg compared to 61.16% (288) subjects of the other group.Conclusions: Adverse fetal outcome are more common in vitamin D deficient group.
A study on the correlation of clinical and ultrasonography diagnosis with histopathological outcome in cases of hysterectomy
Authors: Saha Debapriya , Parikh Prince , Thakkar Nimesh Bharatkumar
Published: June 2020

Background: Hysterectomy is the most commonly performed gynaecological operation throughout the world due to different causes of pelvic pathology. Fewer studies have been performed describing the relationship between preoperative clinical, ultrasonological diagnosis and histopathological outcome.Methods: Authors report 100 cases with benign gynecological disorders who underwent hysterectomy. Authors excluded malignant cases from the study. A preoperative diagnosis was formed based on clinical and ultrasound examination and it was compared with the histopathological report of the hysterectomy specimen.Results: In this study the most common preoperative diagnosis for hysterectomy was fibroid uterus (39%) among which 94.87% showed positive correlation with HPE. Correlation for adenomyosis was 100% between preoperative diagnosis and HPE outcome. Correlation for DUB was poor. 57.14% of the preoperatively diagnosed DUB cases showed adenomyosis on HPE. One case of fibroid showed adenocarcinoma of endometrium on HPE.Conclusions: The study fulfills the aim of finding the efficacy of clinical and USG findings in diagnosing gynecological disorders accurately. Clinical examination is not always adequate. USG is the most important, simple and easily accessible investigation. There is one missed malignant case in this study which is a major shortcoming of clinical evaluation.
Study of prevalence of insulin resistance and other metabolic abnormalities in various phenotypes of polycystic ovary syndrome in central India
Authors: Gupta Deepti , Upadhyaya Rini , Bhati Anjlina
Published: June 2020

Background: Till recent times, defining symptoms of PCOS remained a debatable topic. In 2012, National Institute of health consensus panel proposed diagnostic criteria based on phenotypes. Evidence showed higher incidence of diabetes mellitus, insulin resistance and compensatory hyperinsulinemia among women with PCOS. So, the present study was undertaken to compare the clinical, metabolic and hormonal profile among various phenotypes in women with PCOS and to find out the prevalence of insulin resistance among the PCOS phenotypes.Methods: The prospective, observational study was done on 292 women with PCOS-related infertility. These women were divided into 4 phenotypes. Ferriman-Gallwey score, HOMA-IR, OGTT, lipid parameters, hormonal parameters, mean ovarian volume and mean antral follicle counts were compared among the 4 phenotypic groups. One-way ANOVA followed by post-hoc Tukey was applied.Results: Mean weight, BMI, waist circumference, SBP, DBP and Ferriman-Gallwey score, fasting glucose, fasting insulin, OGTT (1 hour) and HOMA-IR was highest in phenotype A, while fasting glucose / insulin ratio was lowest in phenotype A. Total triglycerides, total cholesterol, LDL were higher and HDL was lowest, testosterone, mean ovarian volume and mean antral follicle count were highest and vitamin D was lowest in Phenotype A.Conclusions: Phenotype A is the group with all features of PCOS syndrome, while phenotype D is associated with milder metabolic profile. Women with phenotype A and B are at a higher risk for metabolic syndrome. Identifying various phenotypes will assist in providing appropriate treatment and prognosticating the patients with PCOS-related infertility.
Prophylactic use of tranexamic acid to reduces blood loss and transfusion requirements in caesarean section
Authors: Sunda Urmila , Bhadana Priyanka
Published: June 2020

Background: Postpartum haemorrhage (PPH) is most dreaded complication which occurs worldwide, more prevalent in developing countries after both vaginal and caesarean delivery. Prophylactic administration of a uterotonics immediately after delivery is the only procedure that has been proved to reduce rates of postpartum haemorrhage. Tranexamic acid, an antifibrinolytic is recommended by WHO for management of PPH, its role to reduce blood loss in caesarean section as a prophylactic agent is not well studied.Methods: This study was conducted in a tertiary care hospital at New Delhi total 100 pregnant women with age ≥18 and <35 years and singleton alive fetus who underwent caesarean section were included for this study.  Study population was divided in two group. Women assigned to the study group received 1 gm tranexamic acid slowly intravenously over 10 minutes after delivery of the baby as per existing unit protocol. Those women who received tranexamic acid was compared with other group who did not received tranexamic acid. The primary outcomes were mean blood loss (ml) and mean fall in hemoglobin level within 48 hours after surgery.Results: Amount of blood loss was significantly low (mean 369 ml) in tranexamic acid group as compared to control group (488 ml), the difference was statistically significant (p value 0.001).  Mean fall in haemoglobin level was also low (1.17 mg/dl) in group who received tranexamic acid as compared to control group (1.87 mg/dl), the difference was statistically significant (p value 0.001). Postpartum hemorrhage (blood loss more than 1000 ml) was observed in 1 patient in control group and no case of PPH was observed in study group.Conclusions: Tranexamic acid administration prior to caesarean section was effective in reducing the blood loss intra and postoperative period, without any immediate maternal and neonatal adverse events as well as reduces the need of blood transfusion.
Role of peri-partum counselling in improving choice of postpartum contraception
Authors: Bangal Vidyadhar B. , Thitame Sunil , Somasundaram K. V.
Published: June 2020

Background: The choice of a contraceptive method is a complex decision. Health care providers have an important role in providing information and supporting patients' decision making about contraceptive choices through counselling. Non-use of contraceptive methods, use of less effective methods, and incorrect and inconsistent use of methods underlie the high frequency of unintended pregnancy. Prospective cross-sectional study was undertaken to study the role of peri-partum counselling in improving choice of postpartum contraception at Pravara Rural Hospital Loni, Ahmednagar, Maharashtra, India.Methods: Four hundred and fifty women in third trimester of pregnancy were individually counselled about the postpartum contraception, using educational material and pamphlets. The choice of postpartum contraception before and after the counselling was noted.Results: Among primi gravidas, the most favored choices for postpartum contraception before counselling were condom (25%) and lactational amenorrhea method (12%). In the same group of women, the post counselling choices were PPIUCD (45%), condom (17%) and interval IUCD (7%). Among multi-gravida, the most favored choices for postpartum contraception before counselling were postpartum tubal ligation (26%), condom (20%) and lactational amenorrhea method or calendar method (17%). In the same group of women, the post counselling choices were postpartum tubal ligation (32%) PPIUCD (12%), condom (8%).Conclusions: The study supports the usefulness of good quality counselling both with respect to the interpersonal relationship between the patient and the provider and quality of information that is provided during counselling. Postpartum intrauterine contraceptive device (PPIUCD), a long acting reversible contraceptive, will fulfil the felt need of postpartum contraception in near future.
A comparison of hysterosalpingography and laparoscopy in the evaluation of tubal factors in female infertility
Authors: Gupta Ankita , Upreti Purnima
Published: June 2020

Background: WHO defines infertility as “failure to conceive after having regular, unprotected intercourse for one year. Factors responsible - male factors (20-30%), female factors (40-55%), combined male and female factors (10-40%) and unexplained infertility (10-20%). Amongst female factors, tubal factors are responsible for 25-30% of infertility. Hysterosalpingography and diagnostic laparoscopy with chromopertubation are widely used in the evaluation of tubal factors of infertility. The aim of this study was to compare findings of HSG and diagnostic laparoscopy with chromopertubation for tubal patency in infertile women.Methods: An observational study, done on a total of 125 females suffering from primary and secondary infertility who underwent HSG and then 97 patients who gave consent, underwent diagnostic laparoscopy with chromopertubation. The data was entered in MS excel spreadsheet and analysis was done using statistical package for social sciences (SPSS) version 21.0.Results: Primary infertility cases were more than secondary infertility cases. Mean age of patients was found to be 28.92±5.33 years. Most common tubal abnormality found on hysterosalpingography and chromopertubation was bilateral tubal block. Inter rater kappa agreement used and significant agreement found between hysterosalpingography and chromopertubation with kappa value of 0.612.Conclusions: From this study authors conclude that HSG and laparoscopy with chromopertubation are complimentary to each other. Laparoscopy helps in identification of tubal and non-tubal factors like intra-abdominal and pelvic adhesions, endometriosis etc. and simultaneously they can be treated while HSG helps in evaluation of tubal factors as well as of intra-uterine factors like synechiae, polyps etc.
Pseudo-Meigs syndrome: a rare presentation of pedunculated fibroid
Authors: Dubey Sunita , Goel Poonam , Pandey Nidhi , N. Pavithra H.
Published: June 2020

Serosal fibroid of uterus are usually asymptomatic but rarely; it may present with atypical symptoms to simulate malignancy and needs extensive evaluation. Authors are reporting a case of 26 years old P1L1 female with history of asymptomatic multiple intramural fibroids since 6 years came with complained of progressively increasing abdominal distension and mild pain abdomen from 2-3 months. On evaluation, she had ascites, pleural effusion and raised Ca-125. MR imaging of pelvis revealed moderate ascites and pedunculated serosal fibroid in addition to intramural fibroids with normal bilateral ovaries. She was evaluated to rule out uterine sarcoma and tuberculosis but diagnosis of them could not be established. Finally, conclusion of Pseudo-Meigs syndrome was made. Myomectomy of single pedunculated fibroid relieved her symptoms. Though, subserosal fibroids are benign in pathology, timely surgery is must to avoid morbidity and mortality owing to massive ascites and pleural effusion.
The missing gonadotropin-releasing hormone agonist trigger leading to missing oocytes
Authors: Kadam Rama S. , Jassawalla Navroze M. , Vora Priyanka H. , Jassawalla Mehernosh J.
Published: June 2020

Authors present a case of Genuine EFS in a young woman where no oocytes were retrieved in the first stimulation cycle after single ovulation trigger. However, a repeat stimulation performed with double ovulation trigger yielded enough oocytes.
A rare case of triplet heterotopic pregnancy with a live intrauterine and bilateral tubal ectopic
Authors: Agarwal Poonam , Goyal Kiran Raman , Agarwal Apurv
Published: June 2020

Heterotopic pregnancy (HP) is a condition characterized by the coexistence of an ectopic pregnancy (EP) with a viable intrauterine pregnancy (IUP). The occurrence of a triplet heterotopic pregnancy is an exceptionally rare medical condition. Hence, timely diagnosis and management are challenging, but essential to prevent mortality. Authors report the case of a young woman who presented with a heterotopic triplet pregnancy, after in-vitro fertilization (IVF), at 12 weeks of gestation. She had been misdiagnosed as a case of severe ovarian hyperstimulation syndrome but had a ruptured tubal ectopic on the right side and an unruptured ectopic on the left side. Both the ectopics were managed by performing an emergency laparotomy with bilateral salpingectomy. The live intrauterine pregnancy was continued till term with the delivery of a healthy baby. High clinical suspicion and timely treatment can preserve the intrauterine gestation thus, ensuring a successful outcome.
Current results of arterial injuries seen at femoral and popliteal arteries in civil society
Authors: Beyaz Metin O. , Demir Ibrahim , Ata Emin C.
Published: June 2020

Background: Lower extremity arterial injuries caused by penetrating or fired-gun trauma may result in limb or loss of life. Early intervention has critical importance. The aim of this study was to investigate the importance of early intervention and outcomes.Methods: We retrospectively reviewed the data on 144 patients (18 females, 126 males) who were treated in Istanbul Medipol University Hospital between January 2016 to 2018. All patients had an arterial injury at level of femoral and popliteal arteries. Standard statistical methods were used for data analysis.Results: Revascularization was performed to all 144 (18 females, 126 males) patients. Autologous saphenous vein graft interposition was performed in 96 patients. End-to-end repair was performed in 39 patients. 9 patients underwent a polytetrafluoroethylene graft (8 mm ringed) interposition.Conclusions: All viable limbs should be revascularized rapidly. The primary goal is to provide bleeding control rapidly and to prevent the prolongation of ischemic time. It should be kept in mind that in addition to surgical technique, fasciotomy may be required in arterial injuries with ischemic time of more than 6-8 hours.
The effectiveness of Dakin’s solution in wound care after debridement in Fournier’s gangrene
Authors: Karsli Onur , Gokalp Fatih
Published: June 2020

Background: Fournier's gangrene (FG) is a specific form of necrotizing fasciitis seen in the external genital organs and perianal region. The basic management of Fournier's gangrene is based on critical surgical debridement. Dakin's solution (sodium hypochlorite) was originally developed to treat war wounds. In this study, we aimed to show potentially efficient of Dakin’s solution on wound healing and reoperation rate.Methods: Thirty-three patients who were debrided due to Fournier Gangrene during 2012-2020 were included in the study. After debridement, wound care was done twice a day by dressing with a sponge moistened with Dakin's solution. Patients' age, concomitant disease, involvement site, re-debridement requirement, complications, and discharge times were recorded.Results: The mean age of 33 male patients who participated in the study was (51-74) 63.93±15.36. Although all patients had scrotal involvement, nine patients had perineal (27.2%), 12 patients had inguinal (36.3%), four patients had a penis and pubic spread (12.1%). The mortality rate was 6%. The average length of hospital stay was 13.1±4.2 days, and the average number of debridements was 1.Conclusions: Fournier gangrene is an important disease characterized by necrotizing infection of the genital, perineal, and perianal region and progresses with high mortality. Our mortality rate was lower than literature and we have linked our mortality rate to using Dakin's solution for wound care. Dressing with Dakin's solution is an effective and reliable method for wound care in FG patients.
Routine baseline serum carcinoembryonic antigen as a negative predictor of peritoneal metastasis in colorectal malignancies: a cost-effective tool in South India
Authors: Vinoth D. , Bhat Sunay N. , Samuel Joshua
Published: June 2020

Background: Colorectal cancer, a formidable health problem worldwide has upto 8% synchronous peritoneal carcinomatosis. As only diagnostic laparoscopy can identify them, in countries with economic burden, selection of patients for laparoscopy is ideal. Our aim is to evaluate whether the baseline Carcinoembryonic antigen (CEA) is a good selection tool.Methods: A retrospective study of 125 patients, who were diagnosed to have colorectal malignancy (any stage) and underwent elective surgery at our institution from 2012 till 2019 were included. The baseline serum CEA was compared with the intraoperative findings. The threshold levels of serum CEA compared were 6.5 and 100 ng/dl. The sensitivity, specificity, positive predictive value and negative predictive value for both thresholds were compared in 3 categories of patients, namely peritoneal metastasis (9 cases), metastasis to other organs (36 cases) and cases with no metastasis either in peritoneum or other organs (85 cases). The results were analysed using SPSS software.Results: The mean age was 65, sex ratio (male:female) was 72:53. The sensitivity, specificity, positive predictive value, negative predictive value (NPV) for CEA threshold of 6.5 ng/dl was 44.44%, 60.34%, 8% and 93.33% for category 1. For CEA threshold of 100 ng/dl, it was 33.33%, 97.41%, 50% and 94.95% for category 1. NPV was 96.55% for category 3 (the highest value).Conclusions: If the baseline CEA levels are less than 100 ng/dl,   96.55% of cases will not require a diagnostic laparoscopy. This hopefully will cut down the cost of unnecessary diagnostic laparoscopies, and reduce the morbidity of unnecessary laparotomies.
A study on the incidence of abdominal malignancies presenting as acute abdomen in an emergency department
Authors: Joseph Pauly T. , P. Lisha N. , Roshan Roshjo , Neduvanchery Saheer
Published: June 2020

Background: Acute abdomen is one of the most common symptoms that bring a patient to an emergency department. An abdominal malignancy may be the cause of acute abdomen at least in a number of cases. The problem with this is the poorer outcome associated with it due to the lack of preoperative evaluation and preparation and also possible contamination that occurs in case of a perforation. This study aimed at studying the incidence of abdominal malignancies in the patients presenting as acute abdomen and the various presentations in which they present.Methods: Patients who presented with non-traumatic acute abdominal pain in the emergency department at our hospital who required surgery for acute abdomen were taken for the study and the incidence of malignancy in these cases were statistically assessed.Results: Out of the 375 patients who were operated for non-traumatic acute abdomen 62 patients i.e. 16.53% were found to have intraabdominal malignancy. Carcinoma colon was the commonest malignancy, 51.6%. Carcinoma stomach and rectum were the next most common malignancy. Commonest presentation was as a case of intestinal obstruction, 72.6% followed by perforation, 20.9%.Conclusions: In the era were the incidence and early detection of abdominal malignancies are on a rise, a significant portion of these cases present with acute abdominal symptoms and the morbidity associated with such a presentation is of importance. Early detection of the disease by screening is the solution for this.
Designing a module for improving communication skills amongst interns in a surgical setting
Authors: Krishnappa Rohit , Rajagopalan S.
Published: June 2020

Background: Healthcare professionals are at the receiving end of a large number of violent incidents directed against them. One of the reasons cited is the abysmal levels of communication skills of young qualified doctors. We feel there is an urgent need for training them in this area of behavioral skill.Methods: It was a quantitative interventional study. We measured the communication skills before and after training, by a scale devised for the study and pre validated by peers and piloted as a project.Results: The training is effective in improving their knowledge and communication skills giving them confidence to face the challenges of day to day clinical work in surgical setting.Conclusions: This small training module on consent taking needs to be incorporated in the internship training. Faculty need to be sensitised regarding improvement of communication skills and knowledge of the students by adopting this training module and workplace based assessment for all surgical interns.