bluuebunny/crossref_metadata_2025 huggingface dataset:
Análisis comparativo de los planes de estudio de los programas de pregrado en filosofía en Colombia, segunda parte: contenidos
Authors: Farieta Barrera René Alejandro
Published: June 2018

Se presenta un análisis de los planes de estudio de los 55 programas de pregrado en filosofía en Colombia. Se tipifican de acuerdo con cinco criterios: título otorgado (profesional/licenciado); especificidad disciplinar (filosofía-filosofía y otras disciplinas); tipo de registro (calificado/ alta calidad); modalidad (presencial/distancia) y sector (oficial/privado). Se presenta un modelo de clasificación de espacios académicos de los programas y lo aplicamos a todos los planes de estudio. A continuación, se presenta las medias y tendencias de acuerdo con la clasificación de los programas; primero comparando todos los programas, luego examinando por aparte los programas profesionales y posteriormente las licenciaturas. Se concluye que las principales diferencias significativas se dan entre los programas de universidades públicas y de las privadas, y también entre los programas presenciales y los que son a distancia. Por último, se muestran las implicaciones que tendrá la entrada en vigencia de una nueva normatividad para las licenciaturas en Colombia, de manera que a futuro sea posible hacer una evaluación del impacto de las nuevas políticas en la enseñanza en filosofía a nivel universitario en Colombia
El avatar: un modo de ser cibernético cualitativamente estacionario
Authors: Jaramillo Gaviria Clara Inés , Cabarcas Bolaños José Miguel , Villamil Pineda Miguel Ángel , Vallejo Molina Rubén Darío , Soto Urrea Wilson Hernando
Published: June 2018

El propósito de este artículo de investigación es presentar algunas líneas críticas sobre la ontología que sirve de base a la sociedad cibernética. Para ello, partimos de las siguientes preguntas: ¿Cuáles son las características del modo de ser cibernético?; ¿cuáles son los encuentros y desencuentros entre el avatar, en cuanto modo de ser cibernético, y la persona, en cuanto modo de ser humanista? Las tesis que intentamos defender son: a) el hombre cibernético es un avatar que desarrolla un modo de ser que se desenvuelve en el seno de una realidad digital cuantificable; b) el avatar presupone una ontología en la que solo adquiere consistencia de realidad aquello que es reductible a operaciones digitales entre ceros y unos; c) en dicha ontología digital cuantificable los fenómenos cualitativos no tienen lugar o son simulados por el avatar, lo cual propicia el desarrollo de un modo de ser estacionario que compromete la salud de potencias cualitativas como: problemáticas, valorativas y vocacionales. Para el desarrollo de estas tesis planteamos la siguiente estructura: en primer lugar, presentamos algunos elementos clave de la ontología cibernética; en segundo lugar, analizamos los rasgos constitutivos del “avatar” en cuanto tipo de subjetividad cibernética; en tercer lugar, caracterizamos el “avatar” como un modo de ser impersonal y cualitativamente estacionario; finalmente, concluimos que la ontología cibernética tiende a constituir una sociedad “avatar” que restringe el carácter cualitativo de las personas y del mundo.
Preparation of Single-Cell RNA-Seq Libraries for Next Generation Sequencing v1
Authors: J. Trombetta John , Gennert David , Lu Diana , Satija Rahul , K. Shalek Alex , Regev Aviv
Published: June 2018

For the past several decades, due to technical limitations, the field of transcriptomics has focused on population‐level measurements that can mask significant differences between individual cells. With the advent of single‐cell RNA‐Seq, it is now possible to profile the responses of individual cells at unprecedented depth and thereby uncover, transcriptome‐wide, the heterogeneity that exists within these populations. This unit describes a method that merges several important technologies to produce, in high‐throughput, single‐cell RNA‐Seq libraries. Complementary DNA (cDNA) is made from full‐length mRNA transcripts using a reverse transcriptase that has terminal transferase activity. This, when combined with a second “template‐switch” primer, allows for cDNAs to be constructed that have two universal priming sequences. Following preamplification from these common sequences, Nextera XT is used to prepare a pool of 96 uniquely indexed samples ready for Illumina sequencing.Curr. Protoc. Mol. Biol. 107:4.22.1‐4.22.17. © 2014 by John Wiley & Sons, Inc.
Postural stability, body weight distribution, and foot typology of sportsmen  v1
Authors: Marencakova Jitka , Zahalka Frantisek
Published: June 2018

The protocol describes guidelines and steps for taking repeated measurements of sportive population: postural stability, body weight distribution during quiet stance, and the foot type diagnostic. The parameters calculated from repeated measurements can be used for separate analyses: analysis of center of pressure displacement, represented by total travelled way parameter; analysis of body weight distribution and loading of the lower limbs; and foot typology. The guidelines are mostly based on recommendations of the literature, partly on our own research experiences. It is important to remain consistent during all of the measurements and follow the guidelines as they control important aspects of the measurements. Any changes of any aspects can signifficantly alter the final results.
Sudan Black staining of zebrafish larvae v1
Authors: Rosowski Emily
Published: June 2018

Stains zebrafish larvae with Sudan Black B, which marks neutrophil granules.
Araştırma Sorgulamayla İlgili Verilen Eğitimin Öğretmen Adaylarının Planlama ve Uygulama Süreçlerine Etkisi
Authors: SAKA Tolga , AKCANCA Nur , KALA AYDIN Nesli , SUNGUR ALHAN Selcan
Published: June 2018

Çalışmanın amacı, açık uçlu araştırma sorgulamaya

dayalı öğretim yaklaşımı (AASDÖY) hakkında verilen eğitim sonrası, fen

bilimleri öğretmen adaylarının ders planlama süreçlerinde meydana gelen

değişimi ve uygulama süreçlerini incelemektir. Bu amaçla çalışmada, zayıf

deneysel araştırma tasarımlarından tek gruplu son test tasarımı kullanılmıştır.

Çalışma, Türkiye’deki bir devlet üniversitesinin eğitim fakültesinde öğrenim

görmekte olan 12 fen bilimleri öğretmen adayı ile yürütülmüştür. Fen bilimleri

öğretmen adaylarının planlama ve uygulama süreçlerine ilişkin veri toplamak

amacıyla çalışma kapsamında, Ders Planları Değerlendirme Rubriği ve Ders Gözlem

Formu geliştirilmiştir. Çalışma, öğretmen adaylarının ilgili öğretim

yaklaşımına göre planlamayı öğrendikleri “Planlama Aşaması” ve hazırladıkları

planları uyguladıkları “Uygulama Aşaması” olmak üzere iki bölümden oluşmakta ve

yaklaşık bir dönemi kapsamaktadır. Çalışma sonucunda, planlama bölümünde,

örneklemdeki tüm öğretmen adayları aşamalı olarak verilen eğitimle AASDÖY’e

göre gelişim gösterdikleri belirlenmiştir. 
Examination of The Epistemological Beliefs of The Teacher Candidates According to Some Variables
Authors: ŞEKERCİOĞLU Ayşe Gül , YILDIRIR Hasene Esra
Published: June 2018

This study aimed to determine the epistemological

beliefs of 1004 teacher candidates studying at the Education Faculty, Secondary

Grade Science and Mathematics Education departments, and the teacher candidates

attending the Primary Grade Mathematics and Science Education departments and

to examine whether these epistemological beliefs differ on the basis of gender,

learning style, academic average, class level and department.  The study made use of the Epistemological Beliefs

Inventory and the Kolb Learning Styles Questionnaire.  According to the analysis results, there were

differences seen in dependent variables based on gender.  Also, there was a negative relationship found

between the learning styles and epistemological beliefs.  The analysis results suggest that the teacher

candidates mostly possess a strong belief that learning is dependent on effort

and that they possess a weak belief that there is only one truth that

epistemological beliefs of the candidates show meaningful differences on the

basis of each dimension and class levels and that females possess more

developed beliefs than males.  
Disiplinler Arası Öğretim Yaklaşımının Fen Bilgisi Öğretmen Adaylarının Enerji Kavramına Yönelik Bilişsel Yapılarına Etkisinin İncelenmesi
Authors: GÜVEN Gökhan , SÜLÜN Yusuf
Published: June 2018

Bu çalışmanın amacı, disiplinler arası öğretim yaklaşımına dayalı

enerji eğitiminin fen bilgisi öğretmen adaylarının enerji kavramına yönelik

bilişsel yapılarına ve kavramlar arası bağlantı kurmalarına olan etkisini

incelemektir. Araştırma 2016-2017 öğretim yılı güz döneminde bir devlet

üniversitesinin Fen Bilgisi Öğretmenliği Anabilim Dalı’nın

4. sınıfında öğrenim gören 66 öğretmen adayı üzerinde 10 hafta boyunca

gerçekleştirilmiştir. Araştırmada iki çalışma grubu belirlenmiş ve bu grupların

birinde disiplinler arası öğretim yaklaşımı ile, diğerinde ise mevcut

yaklaşımlar ile enerji eğitimi verilmiştir. Çalışmada veri toplama aracı olarak

“bağımsız kelime ilişkilendirme testi” ve “çizme-yazma tekniği” kullanılmıştır.

Verilerin analizinde, betimsel ve içerik analizleri kullanılarak veriler

çözümlenmiştir. Araştırma sonucunda, disiplinler arası öğretim uygulamalarının

öğretmen adaylarının enerji kavramına yönelik bilişsel yapılarını geliştirdiği

ve zenginleştirdiği görülmüştür.
Araştırma Tabanlı Öğretimin Fen Bilgisi Öğretmen Adaylarının Bilim ve Dünya Barışıyla İlgili Görüşlerine Etkisi
Authors: DİLEK EREN Canan , MUŞLU KAYGISIZ Gülfem , BENZER Elif
Published: June 2018

Bu çalışmanın amacı fen

bilgisi öğretmenliği 3. sınıfta okuyan öğretmen adaylarının bilimin dünya

barışındaki rolü ile ilgili görüşlerine Bilimin Doğası ve Bilim Tarihi dersinin

araştırma tabanlı uygulanmasının etkisinin olup olmadığını araştırmaktır. Bu

amaç doğrultusunda 77 öğretmen adayıyla öntest sontest tek gruplu deneysel bir

çalışma düzenlenmiştir. Çalışmada uygulama araştırma tabanlı öğrenme ile bir

dönem sürmüştür. Veri toplama aracı olarak öğretmen adaylarının bilimin dünya

barışındaki rolü ile ilgili görüşlerini almak için iki tane açık uçlu soru ve

dört tane görüşme sorusu kullanılmıştır. Sorulardan elde edilen veriler içerik

analizi ile çözümlenmiş ve bulgular öntest ve sontestten elde edilen kodların

sıklık ve sayı bakımından karşılaştırılmasıyla sunulmuştur. Çalışma sonucunda

öğretmen adaylarının bilimin dünya barışındaki rolüne yönelik görüşlerinin

sontestte daha olumlu olduğu, dolayısıyla da araştırma tabanlı öğrenmenin bu

bağlamda etkili olduğu bulunmuştur.
Öğretimde Analoji Kullanımının Etkisi: Lamba Parlaklığını Nasıl Değiştirebiliriz?
Authors: HARMAN Gonca , ÇÖKELEZ Aytekin
Published: June 2018

Bu

araştırmada lamba parlaklığını nasıl değiştirebileceğimizin öğretiminde analoji

kullanımının öğrenme ve kavram yanılgılarının giderilmesi üzerindeki etkisinin

incelenmesi amaçlanmıştır. Araştırmaya 49’u deney, 49’u kontrol grubunda olmak

üzere beşinci sınıfta öğrenim görmekte olan 98 öğrenci katılmıştır. Araştırmada

eşitlenmemiş kontrol gruplu ön ve son test desen kullanılmış, yarı

yapılandırılmış görüşmeler yapılmıştır. Dersler deney grubunda analoji, kontrol grubunda analoji

kullanılmadan işlenmiştir. İki sorudan

oluşan veri toplama aracıyla toplanan veriler içerik analizi ile çözümlenmiştir.

Araştırma sonucunda analoji kullanımının öğrenme ve kavram yanılgılarının

giderilmesi üzerinde etkili olduğu saptanmıştır. 
Kimya Eğitiminin Etkililiğini Belirleyen Faktörlerin Balık Kılçığı Analizi ve AHP-PROMETHEE Teknikleri ile İncelenmesi
Authors: YÜKSEL Mehmet , DAĞDEVİREN Metin , KABAK Mehmet
Published: June 2018

Ortaöğretim düzeyinde kimya dersinin

temel amacı bilimsel düşüncenin temel ilke ve kavramlarını kimya bilim alanı

bağlamında eğitim ve öğretimidir. Böylece öğrencinin kimyanın ilgi alanındaki

olgu ve problemleri anlama bilgi ve becerisini kazanması sağlanır. Bu çalışmada

kimya eğitiminin etkililiği makro boyutta kimya eğitiminin amaçları bağlamında

analiz edilmiştir. Araştırma kapsamındaki öğretim programının analizi

neticesinde kimya eğitiminin amaçları belirlenmiştir. Bu çalışmanın kapsamında

kimya eğitimi amaçları olarak kimya okuryazarlığı, çalışma yaşamına hazırlık ve

akademik ilerleme olarak belirlenmiştir. Çalışmada Balık Kılçığı Analizi,

Analitik Hiyerarşi Prosesi (AHP) ve PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluations) teknikleri kullanılmıştır.

Araştırmanın kapsamındaki analiz birimi lise düzeyinde eğitim yapan bir

okuldur. Kimya eğitimi amaçlarının göreli ağırlıkları AHP ile hesaplanmıştır.

Balık kılçığı analizi ile lise 9. sınıf seviyesinde verilen kimya dersi

eğitiminin etkililiğindeki olası faktörler literatürde yer alan çalışmalar esas

alınarak belirlenmiştir. Uzman ekibin görüşüne göre kimya eğitimi etkililiğinde

belirleyici olan faktörler altı grupta toplanmış olan 29 faktörden oluşmuştur. Balık

kılçığı analizi neticesinde belirlenmiş olan faktörlere ilişkin veriler Decision Lab programına aktarılmış ve PROMETHEE

tekniği ile analiz edilmiştir. PROMETHEE I ve PROMETHEE II analizi sonuçlarına

göre kurumsal düzeyde lise 9. sınıf kimya dersi eğitimi etkililiğinde belirleyici

olan faktörlerin kısmi ve tam sıralaması belirlenebilmiştir. Çalışmada öğretim

programının güncelliği, öğretim program etkinlikleri, genel eğitim sistemi,

yönetici yeterliliği, öğretim kadrosunun motivasyonu, öğrencilerin motivasyonu

kimya eğitimi etkililiğinde birinci derecede önemli bulunmuştur. 
Üniversite Öğrencilerinin Sosyal Ve Öğrenme Amaçlı Teknoloji Kullanım Becerileri
Authors: YOLCU Hacı Hasan , HAN Turgay
Published: June 2018

Bu çalışmada, araştırmacılar tarafından Türkçeye

uyarlanan Öğrencilerin Teknoloji Beklentileri ve Deneyimleri” (Gosper vd. 2009)

anketi ile kuruluş tarihlerine göre Türkiye’de köklü (n=109), genç (n=352) ve

yeni kurulmuş (n=108) üç üniversitedeki toplam 569 lisans öğrencisinin

teknolojiyi sosyal ve öğrenme amaçlı kullanım alışkanlıklıklarını incelemiştir.

Sosyal ve öğrenme amaçlı kullanım farklılıkları üniversite türüne göre

kıyaslanmıştır.  Elde edilen bulgulara

göre,  öğrenciler sosyal amaçlı en çok

WhatsApp gibi anlık mesajlaşma uygulamaları, SMS, cep telefonundan sesli

görüşme ve sosyal paylaşım sitelerinin kullanılırken, öğrenme amaçlı ise en çok

kullandıkları teknoloji araç internet arama motorları olarak belirlenmiştir. Bu

üç üniversite türündeki öğrencilerin teknolojiyi öğrenme amaçlı kullanım

seviyeleri benzerlik göstermektedir. Öğrencilerin bu teknolojileri sosyal

amaçlı kullanım seviyeleri öğrenme amaçlı kullanım seviyelerinin en az iki

katıdır. Bu fark genç ve yeni üniversitelerde köklü üniversitelerdeki

öğrencilere kıyasla daha fazla olduğu belirlenmiştir. Bu çalışma

üniversitelerin öğrenme teknolojilerini planlamada ve kullanımında yol

gösterici bir nitelik taşımaktadır. 
Сознательное и бессознательное: к историографии вопроса
Authors: Магаррамов Магаррам Джабраилович
Published: June 2018

Текст доклада автора на Всероссийской научной конференции «Культура между Логосом и Мифом: к проблеме бессознательного (к 80-летию А. Э. Воскобойникова)», которая прошла в Московском гуманитарном университете 26–27 октября 2017 года.
Management of prolonged second stage of labor
Authors: Singh Sanjay , Kohli Uttara Aiyer , Vardhan Shakti
Published: June 2018

Second stage of labour has been often neglected leading to increased maternal and perinatal morbidity. Recognising and managing prolonged second stage is a challenge even to an experienced obstetrician. This article reviews the changes in the definition of prolonged second stage over the years. It discusses the causes, recognition and management options along with the difficulties in delivering a patient with prolonged second stage of labour. Though adding an extra hour to the definition of second stage in patients may reduce the rate of caesarean section but some studies also show a rise in maternal and perinatal morbidity. Obstetricians are familiarized to the different techniques of delivery of the impacted head. Once diagnosis of prolonged second stage is confirmed, causes should be identified and addressed, and treatment should be individualised, and timing and mode of intervention planned.
Clinical profile and outcome of patients with placenta previa: a study at a tertiary care referral institute in Northern India
Authors: Jaiswal Ekta , Aggarwal Neelam , Suri Vanita , Bagga Rashmi , Kalra Jasvinder , Gupta Pradeep
Published: June 2018

Background: The aim of this study was to determine clinical profile, evaluate our antenatal and intraoperative management and see the maternal and perinatal outcome in patients with placenta previa.Methods: A prospective study was carried out in 130 women with placenta previa in the Department of Gynecology, PGIMER, Chandigarh, India between Jan 2015–April 2016. The profile of these patients was recorded in a predesigned proforma and maternal and perinatal outcome analyzed in detail.Results: One third (46/130) of the patients with placenta previa had a history of previous caesarian section, 27% had previous uterine curettage and 82% were multiparous.18% were asymptomatic placenta previa whereas 82% had one or more bleeding episodes. Expectant management was given to 67% patients after first bleeding episode. Majority (92/130) of patients required emergency cesarean section. Due to invasive placentation, 25 patients required cesarean hysterectomy. Ninety percent patients required delivery at ≤37 weeks and neonatal outcome improved with increasing gestation as expected.Conclusions: Reduction in cesarean rate is the major key factor for decreasing the incidence of placenta previa as, as well as placenta accreta and other associated complications as there were no patients diagnosed to have placenta accreta when placenta previa was present without any previous cesarean scar. In cases of invasive placenta, performing a classical CS, not trying to remove the placenta and proceeding directly to hysterectomy resulted in reduced blood loss. Neonatal outcome as well as maternal outcome is best when cesarean is done between 36-37 weeks.
A study on perinatal outcomes in antenatal mothers with abnormal pulmonary function tests
Authors: Sengodan Subha Sivagami , Palanivelu Anandeswari , Pandian Anbarasi
Published: June 2018

Background: This study was done to assess the lung volumes by spirometry in all the three trimesters in antenatal mothers and to observe the effect of pulmonary function abnormality in mode of delivery and birth weight of babies.Methods: Our study included 100 antenatal mothers attending antenatal clinic in Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu during the period of Jan 2017 to Dec 2017. It was a prospective observational study. Mothers were subjected to detailed physical and clinical examination. Basic investigations were done. Considering test by spirometry. The changes in the lung volumes were noted according to gestational age. The effect of pulmonary function abnormality in the mode of delivery and birth weight was observed.Results: One hundred antenatal mothers selected randomly were evaluated for the lung volumes by using spirometry. Out of the 100 cases, 17 belonged to I trimester, 46 belonged to II trimester and 37 belonged to III trimester. We noted a significant reduction in FVC in II and III trimester. This reduction was little more in II trimester. There was significant reduction in FEV1 in II trimester. The reduction in FEV1 and FVC did not influence the mode of delivery but it significantly affected the birth weight of babies. FEV1/FVC reduction had no influence in the mode of delivery and birth weight of babies.Conclusions: The present study highlighted that there was reduction in lung volumes in II and III trimester of pregnancy and it influenced the birth weight of babies. Hence it becomes essential to pay special attention to pulmonary functions during antenatal period.
Use of combination method (uterine sandwich technique) to control postpartum hemorrhage
Authors: Dhillon Atmajit Singh , Dhillon Karminder
Published: June 2018

Background: Uterine atony is the most common cause (75%-90%) of primary postpartum hemorrhage (PPH) and Christopher B Lynch was the first to highlight the use of Uterine Compression Sutures (UCS) for the management of atonic PPH. In combination therapy, the (UCS) is combined with intrauterine balloon tamponade, known as (uterine sandwich), for combined external as well as internal compression for more effective hemostatic control of uterine bleeding.Methods: The uterine sandwich technique was used in a total of twelve patients managed in a tertiary care service hospital during caesarean deliveries. In four cases of uterine atony, the sandwich technique was used, for patients unresponsive to the conservative management. In eight patients the sandwich technique was used as a prophylactic measure, where according to the clinical profile of the patient there was high risk of PPH and where either blood was not available or availability was limited.Results: In the four cases of uterine atony, the uterine sandwich technique was used therapeutically. All the patients were multigravidae. The period of gestation ranged from 34 weeks to 37 weeks. Average operating time was 50- 60 mts, average estimated blood loss was 1600 ml, average distension of Foleys catheter was 90 ml and average duration of the intrauterine Foleys catheter balloon being in situ was 12 hrs. In eight patients, the sandwich technique was used as a prophylactic measure, for varied indications. In all the cases there was successful outcome. Post-operative outcome was uneventful in all the cases.Conclusions: The uterine sandwich technique can be used either prophylactically or therapeutically for control of PPH. It is simple, safe, easy, effective and is easier to perform than internal iliac artery ligation and should be considered prior to proceeding for hysterectomy in a hemodynamically stable patient, in whom uterine conservation or fertility preservation is essential.
Comparative evaluation of two commonly administered regimens of mifepristone and misoprostol for first trimester abortion
Authors: Devi L. Thulasi , Nimonkar Ravi
Published: June 2018

Background: The objective of this study was to compare and evaluate the efficacy of two commonly administered regimens as per existing guidelines of Ministry of Health and Family Welfare for Outpatient MTP services. This study is aimed at evaluation of subjective and objective stastical benefits and side effects in performance of first trimester abortion on OPD basis in popularly used drugs as advised by MOHFW by different routes of administration. The drugs used were Tab Mifepristone (RU – 486) and Tab Misoprostol.Methods: This prospective randomized study was conducted in Out Patient Department of Obstetrics and Gynaecology in a tertiary care hospital over a period of 1 year after due clearance was obtained from Ethical Committee. This was prospective study involving 400 ladies reporting for Outpatient MTP services within the given time period as per existing guidelines at a tertiary care hospital. Patients were assessed at the end of 7, 15and 56 days, the mean age of the patients was 24.5±0.5 and 33±1 years and treatment duration was an average of 3 days with follow up for 15 days post administration. Few cases of failure required a follow up of approximately 56 days. All patients were on follow up for a period of 3 months for determination of menstrual irregularities and contraception management.Results: Between the 2 groups, in the sublingual Misoprostol group 100% aborted successfully at the end of 56 days. Whereas in the vaginal Misoprostol group 99% aborted successfully at the end of 56 days, only two patients requiring MVA as an OPD procedure.Conclusions: Patients were assessed at the end of 7, 15 and 56 days and between both the groups; Mifepristone with administration of misoprostol sublingually showed better success rate in completion of procedure, quicker action with better patient satisfaction and acceptance compared to conventional administration of Mifepristone and vaginal administration of misoprostol. Misoprostol administered sublingually under medical supervision is a superior, faster abortificient and has lesser incidence of Retained Products of Conception (RPOC) or need for Suction & Evacuation (S&E) as compared to vaginal route. Side effects observed need more evaluation with larger sample size to be statistically significant.
A case control study to evaluate correlation of anemia with severe preeclampsia
Authors: Gupta Garima
Published: June 2018

Background: Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality worldwide. This study aims to evaluate correlation of anemia with severe preeclampsia.Methods: It is a prospective case control study conducted in Sultania Zanana Hospital, Bhopal over one year period. Patients were grouped as cases (severe preeclampsia with severe anemia, n=180) and controls (severe preeclampsia with no/mild/moderate anemia, n=180). Collecting data were compared using the Pearson chi square, fisher’s exact test and the independent t-test as appropriate. Logistic regression analysis was performed. Odds ratio (OR) and their corresponding 95% confidence intervals were calculated.Results: Higher incidence of maternal complications abruption (8.88% v/s 0.5%), ARF (2.2% v/s 0.5%), PPH (2.8%), pulmonary edema (5%), CCF (3.3%), HELLP (1.6%), CVA (1.1%), pulmonary embolism and DIC in 0.5% and maternal mortality seen in cases. Perinatal complications like pregnancy wastage (22.8% v/s 7.8%), IUGR (55.8% v/s 32%), early neonatal death (7.5% v/s 2.4%), NICU admission (31.3% v/s 20.7%) were more in cases.Conclusions: Perinatal and maternal complications are significantly associated with severity of anemia in preeclampsia women. Anemia being a easily detectable and modifiable risk factor, detection of anemia in early gestation can be a key to prevent or decrease the severity of preeclampsia.
A prospective study on effect of maternal BMI on fetal outcome
Authors: Sharma Bali Ram , Sharma Reena , Dogra Poojan
Published: June 2018

Background: The extremes of BMI have a major impact on pregnancy outcomes. The objective of this study was to assess antenatal, intra-partum complications, perinatal outcome in pregnant women with high BMI.Methods: This study was conducted in Department of Obstetrics and Gynecology, Kamla Nehru State Hospital for Mother and Child IGMC Shimla, on 1000 women attending antenatal outpatient department over one year w.e.f. 01-05-2011 to 30-04-2012. Detailed information regarding different variables like maternal age, parity, education status, occupation socioeconomic status and weight gain during pregnancy were recorded on a proforma, master chart framed and analyzed using Student’s t test.Results: The study observed that both being overweight and underweight predisposes women to complicated pregnancies. The incidence of preterm is more in underweight women and post- dated deliveries increased with increase in BMI. Incidence of stillbirth was maximum in obese women. Incidence of low birth weight babies was more among underweight and the incidence of macrosomia was more in obese women.Conclusions: Maternal BMI have strong association with pregnancy complications and outcome.
Audit of caesarean deliveries in a tertiary care hospital of northern Andhra Pradesh using modified Robson criteria
Authors: V. Prabhavathi , B. Krishnamma , V. Prasad D. K. , K. Bhavya , R. Satyavathi
Published: June 2018

Background: Today, there is an increased trend in the incidence of caesarean section (CS) rate worldwide particularly in India, even with the lack of evidence supporting considerable maternal and perinatal benefits with higher CS rates. The main objective of our study was to find the incidence of CS rate, auditing the data on the basis of modified Robson criteria, factors responsible for the most common group, to know the changing trends of CS and finally put forth the strategies to reduce CS rate.Methods: This is a retrospective study of 472 CS cases carried out in a tertiary care hospital during the year 2016. All the cases were grouped according to the modified Robson criteria and the data was analyzed. The data were grouped into 3 different slots of 4 months each (FF = first four months; MF = middle four months and LF = last four months of the year 2016).Results: A significant increasing trend was observed in the groups of 2B and 5C where as a significant decreasing trend was noticed in 6C and 7C. The most common indications for caesarean delivery were cephalo-pelvic disproportion (CPD) (28%) and fetal distress (22%) in group 1 whereas in group 2A CPD, fetal distress and failed induction were found to be 12%, 24% and 30% respectively.Conclusions: The change in trend has been noticed in the last few months particularly in 2B and 5C groups suggesting that there is a change in the attitude of obstetricians in conducting caesarean deliveries before the onset of labour rather than performing CS after the onset of labour. Targeting 2B along with 5C would help our efforts in reducing the CS rate.
Pattern and features of menstruation among adolescent girls in Haldwani: a cross-sectional study
Authors: Goyal Neha
Published: June 2018

Background: Menstruation becomes an important aspect in life of an adolescent girl once she attains puberty and is often associated with variable characteristics. Being a development process and a reported significant source of morbidity too, it becomes important to study its pattern and characteristics. The purpose of this study was to determine the pattern of menstruation among adolescent girls.Methods: A cross sectional study was conducted among 574 adolescent girls of 10-19 years age of 6th to 12th grades in four selected government and private schools of Haldwani. Data was collected using a predesigned semi-structured questionnaire with brief interview and examination. Analysis of data was done with help of SPSS version 21.Results: Mean age of the girls was 14.95±1.41 years. Mean age at menarche was 12.94±1.01 years. Majority of girls 441 (76.82%) had cycle length of 21-35 days and it was found that 95 (16.55%) girls had irregular menstrual periods. Rural and urban differences in regularity of menstruation were statistically significant. Duration of flow in majority 300 (52.26%) of girls was 2-4 days followed by 5-7 days in 222 (38.68%). Dysmenorrhoea was reported by 422 (73.52%) of adolescent girls and of them 259 (61.37%) have never used analgesics while 66 (15.63%) have always used analgesics. Girls with absence of pallor were 1.2 (0.8-1.9) times more likely to have regular menstruation as compared to those showing pallor.Conclusions: Irregular menstruation was common among girls and significant association was found with place of residence. Dysmenorrhoea was present in three-fourth of adolescent girls still majority of them have never used analgesics. Daily routine was affected in more than 80% of girls during menstruation.
Holistic approach in the management of PCOS: a pilot study of an online PCOS-reversal program
Authors: Mehta Manthan N. , Jayaraman Mahesh , Agarwal Sharda
Published: June 2018

Background: Polycystic ovary syndrome (PCOS) is a complex disorder that can be managed but not permanently cured. Each woman has her own PCOS symptoms and its own root causes. A number of medications are prescribed to women with PCOS. However, a holistic approach could be the best way forward in managing a disease as complex as PCOS. Authors conducted this pilot study called the Sepalika 5-petal PCOS reversal program which consisted of individualized diet plans, magnet acutherapy, fitness regimens, dietary supplements and herbal products to evaluate whether these interventions improve PCOS symptoms, insulin resistance and hyperandrogenism.Methods: A total of 30 patients were recruited online from all parts of India using the PCOS symptom quiz. Various baseline investigations were performed at recruitment. They were suggested personalized diet plans, followed by exercise videos, magnetic acutherapy and herbal and micronutrient supplements. The program spanned over a period of 90 days and patients outlook and quality of life were also assessed at the end of the program.Results: The main goal of most participants was improvement in weight and energy issues, and regularization of periods. Each of these goals were achieved in all participants of the program. Patient-reported outcomes showed a definite improvement in the quality of life of the participants at the end of 90 days.Conclusions: PCOS is a physical - sexual, psychological and social syndrome; therefore, it is necessary to taking a more holistic approach to patient care beyond treating physical symptoms. Larger studies with more objective and subjective endpoints is the way forward.
A rare case of urothelial carcinoma arising in mature cystic teratoma
Authors: Maurya Nitesh R. , C. Bhavsar Urvi
Published: June 2018

Mature cystic teratoma is a common benign adnexal tumour in females. It is composed of all the three germ layers (mesoderm, endoderm and ectoderm). Malignant transformation in a mature cystic teratoma of the ovary is rare, occurring in only 1-2% of cases. The most common malignancy is squamous cell carcinoma, which consists of about 80% of malignant transformations. Here we report malignant transformation of MCT in a 74year old post-menopausal female. Grossly the ovary was large cystic occupying the entire abdomen. Trial dissection was done and only 50% of the mass could be dissected due to gross adhesions. HPE reported as urothelial carcinoma in mature cystic teratoma. MCT is easily diagnosed via sonography, but malignant transformation is difficult to identify before surgery. For patients with malignant transformation, squamous cell carcinoma is the most common malignancy arising from MCT, and accounts for 80% of all cases. Other malignancies, such as adenocarcinomas, sarcomas or malignant melanomas have been reported; however, urothelial carcinoma arising from MCT is rare.
Tissue expansion in operated cases of transposition flap of scalp for correction of donor site alopecia and patient’s satisfaction
Authors: Goil Pradeep , Singh Abhimanyu , Kumari Hiranmayi , Jain Ayush
Published: June 2018

Background: Scalp defects managed by local transposition flaps with donor site alopecia are aesthetically not acceptable to patients. Scalp expansion with tissue expanders is needed for proper correction of this deformity.Methods: Authors retrospectively reviewed all cases of post traumatic and post burn scalp defects that were managed initially by local transposition flap and later by scalp expansion by tissue expanders at our institute over a period of 5 years and conducted an outcome survey. Authors’ institutional protocol in such patients and results of the review are presented.Results: Twenty-eight patients were included in the study. Eight patients had post traumatic and 20 cases had post electric burn scalp defect. The mean age of patients was 28.92±8.26 years. Thirty-eight tissue expanders of various sizes (200-600 ml) were used in 28 patients. The mean follow-up time was 9.07±1.92 months. Major complication rate in present study was 2.63%. Results of outcome survey revealed more than 90% patients were satisfied after third surgery.Conclusions: Scalp transposition flap donor site alopecia can be easily corrected by tissue expansion. The complications are not severe and can be managed easily. It should be offered to all such types of patients, as it leads to proper social rehabilitation and satisfaction among these groups of patients.
Factors associated with exclusive breastfeeding in the first six months of life in Northern India
Authors: Saqib Najmus , Qazi Mahvish
Published: June 2018

Background: Breast milk is a complete food for growing children until 6 months of age, and mothers play a important role in their growth and development. So, promoting their attitude towards the benefits of breastfeeding ensures guarantee child health in the future. The objective of this study was to assess the knowledge and practice of Breast feeding with their determinants among mothers in Jammu.Methods: In this cross‑sectional study, 200 mothers attending the well‑baby clinics in Jammu from June 2017 to Febuary 2018 were selected, data was collected by face-to-face interviews using a structured questionnaire.Results: Of the 200 women, 70% were 21–30 years of age and 61% of mothers have studied only up to primary school. Majority of deliveries (80%) took place in government run hospitals. 75% of the infants were born out of normal delivery. 47.5% of mothers did not feed colostrum to their babies. Breastfeeding was initiated in only 13% of babies within one hour after birth. 52.5% babies were fed with pre-lacteals. In 7% of babies bathing was done immediately after birth.Conclusions: Maternal knowledge and attitude towards exclusive Breast feeding was moderate. It is essential to plan for mothers by officials in order to promote breast-feeding in the first 6 months of baby's life to enhance positive maternal attitude in this regard.
Study of acute viral hepatitis with special reference to fulminant hepatic failure
Authors: Pankhaniya Rajesh N. , Parikh Yogesh N. , Mohan Dhanya Soodhana
Published: June 2018

Background: Fulminant hepatic failure is a complication of viral hepatitis and is one of the leading causes of death in hospitalized children with viral hepatitis in India.Methods: All the patients suspected to have acute viral hepatitis and/or fulminant hepatic failures with hepatic encephalopathies were included in the study and the diagnosis was made on the basis of history, clinical examination including a detailed neurological examination. Triage scoring, Glasgow coma scale, encephalopathy grading were recorded at the time of admission and necessary investigations were carried out.Results: The occurrence of acute viral hepatitis and fulminant hepatic failure was 200 (2.004%) and 40 (0.401%) respectively during study period. Highest occurrence of 35.50% in the age group of 4-6 years, yellowish discoloration of the eyes or the urine was the most common presenting complaint. Only 45 % of the children who had fulminant hepatic failure survived and mortality was found to be 100% in those children who had grade 4 hepatic encephalopathy. Mortality was higher in those children who had duration of more than 10 days between the onset of jaundice and encephalopathy. Mortality was higher in those with prothrombin time between 41 to 50 seconds and with serum ammonia level more than 200 mmol/l.  Hepatitis A virus was the most common cause of fulminant hepatic failure and Hepatitis E virus with hepatic encephalopathy was associated with 100 % mortality.Conclusions: Hepatitis A infection though associated with a good prognosis, younger age group (< 6 years) and co infection with Hepatitis E virus have a poor prognosis. Good hygiene practices and early immunization could be a step towards the prevention of Hepatitis A infection.
Iron deficiency anemia among hospitalized children in a rural teaching hospital: a cross sectional study
Authors: Santokh Inderpreet , Gaur Bablu Kumar , Narayan Raghvendra , Maini Baljeet , Bharadwaj A. K.
Published: June 2018

Background: Iron deficiency anemia is the most common nutritional deficiency disorder in the world. The present study was conducted to know the prevalence and severity of iron deficiency anemia among of 6 months to 60 months old children. A large proportion of iron deficiency is preventable with appropriate and timely intervention.Methods: This cross-sectional study was done on 100 children clinically suggestive of anemia with hemoglobin level less than 11gm/dl admitted in pediatrics ward of tertiary care hospital. 5 ml of blood sample was taken and complete hemogram, peripheral blood film and serum ferritin estimation was done. Case were studied in reference to history, age, clinical examination, hemoglobin level and confirmation of iron deficiency anemia was done by serum ferritin levels.Results: The prevalence of iron deficiency anemia in present study was 56%. It was most prevalent in the age group of 6 to 24 months. Exclusively breastfed children showed higher prevalence of iron deficiency anemia in present study, however no statistical correlation was found. Low Serum ferritin levels have statistically significant result with socioeconomic status, with as many as 69.4% suffering from iron deficiency anemia belonging to low socioeconomic status.Conclusions: Prevalence of iron deficiency anemia remains alarmingly high and major health problem in our country. All anemia are not iron deficiency anemia. Low socioeconomic status is a huge hurdle in child health and greatly influences prevalence of iron deficiency anemia. Serum ferritin is a most sensitive marker of iron deficiency anemia, helps diagnose it early in its course, which can be missed on clinical or routine blood investigations.
Efficacy of probiotics in acute diarrhoea in children
Authors: Bhat Sinchana , G. N. Shreekrishna , Savio Christi D.
Published: June 2018

Background: Gastroenteritis is a major public health problem worldwide and remains the second leading cause of death among children under five globally. Objective of this study was to investigate and compare the efficacy of commonly available probiotics in the treatment of acute watery diarrhoea (AWD) in children.Methods: This was an open label randomised controlled trial conducted in a tertiary care hospital in Bangalore for 2 years. 120 children aged 6 months to 5 years admitted with AWD of less than or equal to 48 hours duration were randomized into three groups – Group I (control) received oral rehydration therapy and zinc, Group II received Bacillus clausii in a dose of 2 billion spores twice a day and Group III received Saccharomyces boulardii as 250 mg twice a day. The primary outcome measures were total duration of diarrhoea, mean number of stools per day, consistency of stools and secondary outcome measures were duration of vomiting, fever and hospital stay. ANOVA, Student t test, Mann Whitney U test and Chi square test were used for analysis.Results: The duration of diarrhoea and hospital stay significantly reduced (41.68 hrs) in Group III compared to Group I (57.65 hrs) and Group II (53.33 hrs). (p< 0.05). The frequency of stools reduced significantly on Day 4 and the consistency of stools improved significantly on Day 3 in both the probiotic groups (p<0.05). Both the probiotics reduced the duration of fever significantly but had no effect on the duration of vomiting.Conclusions: Saccharomyces boulardii is effective in reducing the duration of diarrhea and hospital stay in children with acute gastroenteritis.
Assessment of under nutrition with composite index of anthropometric failure (CIAF) among under-five children in a rural area of West Bengal, India
Authors: Roy Keya , Dasgupta Aparajita , Roychoudhury Nivedita , Bandyopadhyay Lina , Mandal Shamita , Paul Bobby
Published: June 2018

Background: Malnutrition among under-five children is an important public health problem in developing countries, and a major cause of morbidity and mortality in India, hence the present study was conducted to find out the nutritional status of under-five children and to elicit the factors associated with it.Methods: This community based cross-sectional study was conducted among 142 under-five children during May to June 2017 in the areas under the jurisdiction of Nasibpur Primary Health Centre, Singur, West Bengal, India. Data on socio-demographic characteristics, feeding habits and other biological factors were obtained from structured questionnaire, followed by anthropometric measurement. Assessment of nutritional status of the children was done with the help of Composite Index of Anthropometric Failure (CIAF). Descriptive statistics and logistic regression were performed to analyse the data by using SPSS version 16.0.Results: The mean (standard deviation) age of the sample was 28.4 (±15.2) months. About 36.1% children were found to have anthropometric failure using CIAF (wasting only 2.1%, wasting and underweight 14.5%, wasting, stunting and underweight 5.5%, stunting and underweight 6.3%, stunting only 4.9%, underweight only 2.8%). Education of mother [AOR = 3.6 (1.2–10.8)], birth order [AOR = 3.7 (1.4-9.9)], and exclusive breast feeding practice [AOR = 7.3 (2.9–18.1)] remained the significant correlates when adjusted with other variables in the multivariable analysis.Conclusions: The high prevalence of malnutrition in the community requires multipronged approach regarding nutritional education, intensive information education and communication (IEC) activities for exclusive breast feeding through antenatal clinics and adoption of family planning methods.
Determinants of hospital waiting time for outpatient care in India: how demographic characteristics, hospital ownership, and ambulance arrival affect waiting tim
Authors: Sriram Shyamkumar , Noochpoung Rakchanok
Published: June 2018

Background: Waiting time in hospital outpatient clinics affects patient satisfaction, access to care, health outcomes, trust, willingness to return and hospital revenue. Only a few studies have explored length and variability of waiting times among patients. This study is an attempt to understand factors affecting waiting time experienced by patients in outpatient clinics.Methods: For this study, data were collected in 2012 from 830 patients seeking care from outpatient clinics located in 30 randomly selected hospitals in the district of Nellore, India. Linear regression and logistic regression models have been used to identify the effect of various determinants on hospital waiting times.Results: The average waiting time in government hospitals was 20.3 minutes compared to 15.5 minutes in private hospitals and 39.71 minutes in voluntary hospitals. Waiting time of men was about six minutes lower than women. After controlling for other patient related and hospital related factors, median wait time was 19% lower for male patients compared to females. Length of waiting declines with patient's age. Patients arriving by ambulance waited 64% less that patients not arriving by ambulance but this pattern was not valid for public hospitals.Conclusions: Significant gender bias was present in all facility-types implying that policy and legal interventions would be required. For-profit hospitals had lower waiting time of patients to ensure higher demand for their services by the economically better-off sections of the population. The results highlight the importance of lowering the waiting time in public sector hospitals, especially for patients arriving in ambulances.
Factors associated with quality of life among cancer patients in Sri Lanka
Authors: Rukshani Dilka , Kahandawala Pabasara , Jayawardana Kasun , Karunarathne Dilan , Galgamuwa Lahiru S. , Kumara Chandima , Gamage Charuni
Published: June 2018

Background: Quality of life (QOL) is individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is an effective modern method of early identification of chronic incurable disease patients. This study was designed to determine the level and the possible contributory factors of quality of life in heterogeneous groups of cancer patients in Sri Lanka.Methods: This study was conducted at National Cancer Institute of Sri Lanka. WHOQOL-BREF questionnaire was used to assess QOL of cancer patients. Multivariate linear regression model was used to evaluate the associations of demographic variables, clinical characteristics, and social support status with the quality of life measures.Results: 167 of cancer patients were participated. The mean overall QOL score was 53.07±SD 12.68. Higher QOL was associated with patients who were married, higher educated, employed, had good family support and longer duration of illness. Significantly lower QOL was found in those who involved on radiotherapy treatments and feeling alone. Marital status, education status, comorbidity, family support and feeling alone were identified as predictors for QOL among the study group.Conclusions: The overall QOL score was considerably low in our study. Continuous family support and good education may significantly improve the QOL of cancer patients. Psychosocial and awareness programs to the family members and neighbours should be implemented to enhance the quality of life of cancer patients.