bluuebunny/crossref_metadata_2025 huggingface dataset:
Межпоколенная трансмиссия паттернов группового сплочения в разных социокультурных контекстах: на примере букварей для детей русской эмиграции и Советской России
Authors: Козлова Мария Андреевна
Published: February 2019

Мария Андреевна Козлова – кандидат исторических наук, доцент, Департамент социологии, Национальный исследовательский университет «Высшая школа экономики». Адрес: 101000, Москва, ул. Мясницкая, д. 9. E-mail: makozlova@yandex.ru

Цитирование: Козлова М.А. (2019) Межпоколенная трансмиссия паттернов группового сплочения в разных социокультурных контекстах: на примере букварей для детей русской эмиграции и Советской России // Мир России. Т. 28. № 1. С. 124–139. DOI: 10.17323/1811-038X-2019-28-1-124-139

В статье рассматривается проблематика межпоколенной культурной трансмиссии, и,  поскольку публикации последних лет вынуждают усомниться в возможности экстраполяции выводов, полученных при анализе трансмиссии ценностей и паттернов поведения в доминирующих группах на меньшинства, мы обращаемся к анализу содержания школьных учебников, выпускавшихся для детей русскоязычных эмигрантов, оказавшихся в принципиально различных социокультурных условиях. Межпоколенная трансмиссия рассматривается на основе анализа текстового и иллюстративного материала учебников для начальной ступени образования, издававшихся для русскоязычных детей в Латвии (N=2) и Польше (N=1), а также для детей Советской России (N=2) в период 1920-х гг. В  учебнике, изданном для русскоязычных детей в Польше, мы фиксируем классический постфигуративный тип межпоколенной культурной трансмиссии. «Неизменность» транслируемых ценностей, иллюзия стабильности, гомогенизируя сообщество как в горизонтальном, так и в вертикальном измерениях, обеспечивают внутригрупповую сплоченность, защищая группу от культурной диффузии и ассимиляции. Поддерживает и усиливает эту стратегию сплочения репрезентация в польских учебниках внешней среды как враждебной. Анализ контента букварей, изданных в Советской России, позволяет говорить о реконструировании постфигуративного типа межпоколенной культурной трансмиссии. При  фактическом разрыве культурной преемственности здесь применяется стратегия экстраполяции внутрисемейной модели на общество в целом. Это позволяет нормализировать происходящие социальные трансформации и легитимирует установившуюся социальную иерархию. Модель межпоколенной трансмиссии в проанализированных латвийских эмигрантских букварях, напротив, основана на побуждении ребенка к самостоятельной выработке ценностей и ориентиров, апробированию поведенческих практик с  использованием рекомендованных взрослым сообществом средств – знаний и образования. Таким образом, латвийские буквари «позволяют» ребенку включиться в сеть «слабых» связей, тем самым снижая внутригрупповую сплоченность эмигрантского сообщества, но готовя ребенка к интеграции в доминирующую культуру.
«Не работают и не учатся»: молодежь NEET на рынке труда в России
Authors: Зудина Анна Алексеевна
Published: February 2019

Анна Алексеевна Зудина – кандидат социологических наук, научный сотрудник, Центр трудовых исследований, Национальный исследовательский университет «Высшая школа экономики». Адрес: 110100, Москва, ул. Мясницкая, д. 20. E-mail: azudina@hse.ru

Цитирование: Зудина А.А. (2019) «Не работают и не учатся»: молодежь NEET на рынке труда в России // Мир России. Т. 28. № 1. С. 140–160. DOI: 10.17323/1811-038X-2019-28-1-140-160

В международной статистике молодежь в возрасте 15–24 лет, которая не учится, не  работает и не участвует в профессиональной подготовке, получила особое название  – NEET (Not in Employment, Education or Training). Ее представители оторваны от сферы образования и рынка труда, что в будущем может привести не только к проблемам с  трудоустройством, но и к сложностям с полноценной социализацией. В настоящей работе масштаб, динамика и социально-демографический портрет молодежи NEET в России анализируются на основе данных Обследования населения по проблемам занятости (ОНПЗ) Росстата за 1995–2015 годы. Полученные результаты свидетельствуют о том, что в обозреваемый период доля этой группы в России значительно сократилась благодаря преимущественно активному вовлечению молодежи в обучение. Согласно данным ОНПЗ, российская молодежь NEET никак не реагировала на макроэкономические шоки: она не росла в период кризисов 2008–2009 и 2015 годов. В составе российского NEET устойчиво преобладают те, чья связь с рынком труда наиболее слаба, – так называемые экономически неактивные, а подавляющее большинство безработной молодежи NEET вообще не имеет опыта работы. Социально-демографические характеристики этой категории указывают на то, что наиболее значимыми причинами попадания в нее являются несоответствие полученного образования требованиям рынка труда и его низкий уровень, а также дефицит рабочих мест в сельской местности. При этом значительная часть безработной молодежи NEET в России имеет высшее профессиональное образование, и в том случае, если массовизация высшего образования будет продолжаться, важной частью этой категории россиян могут стать выпускники некачественных вузов, чьи знания и навыки не найдут применения.
Youth Policy Practice in Post-Soviet Russia and Belarus: Past and Present
Authors: Silvan Kristina
Published: February 2019

Kristina Silvan – PhD Candidate in Political History, University of Helsinki, Finland. Address: Snellmaninkatu 14 A, 00014, University of Helsinki, Helsinki, Finland. E-mail: kristiina.silvan@helsinki.fi

Citation: Silvan K. (2019) Youth Policy Practice in Post-Soviet Russia and Belarus: Past and Present. Mir Rossii, vol. 28, no 1, pp. 161–171. DOI: 10.17323/1811-038X-2019-28-1-161-171

This article examines the changes and continuities in youth policy practice in the Russian Federation and the Republic of Belarus from the mid-1980s until the present day. The article finds that while there were notable similarities between Belarus and Russia in the early 1990s, the practice of youth policy has since developed distinctively in the two countries, with Belarus currently demonstrating a mass organization model and Russia a complex model of youth policy practice. The focus on a patriotic upbringing and an approach that tends to ignore young people’s agency are recognized as features that stem from the two countries’ shared Soviet past and their present authoritarian tendencies and thus distinguish the Belarusian and Russian approaches to youth policy practice in comparison with other countries, although the aim of youth policy, to bring up “ideal citizens”, remains universal.
Дилемма сверхдержавы
Authors: Карачаровский Владимир Владимирович
Published: February 2019

Владимир Владимирович Карачаровский – кандидат экономических наук, доцент Департамента прикладной экономики, заместитель заведующего Лабораторией сравнительного анализа развития постсоциалистических обществ, Национальный исследовательский университет «Высшая школа экономики». Адрес: 110100, Москва, ул. Мясницкая, д. 20. E-mail: vvk@hse.ru

Цитирование: Карачаровский В.В. (2019) Дилемма сверхдержавы // Мир России. Т. 28. № 1. С. 32–53. DOI: 10.17323/1811-038X-2019-28-1-32-53

 Сегодня в общественное сознание возвращается критерий оценки страны в категориях «державности», «мощи державы», «сверхдержавы». Вместе с тем спецификой такого фундаментального общественного блага, как мощь державы, является его превентивный характер, что не дает возможности всегда справедливо оценивать приносимые этим благом выгоды. Как следствие, для таких благ становятся вероятными ситуации несовпадения их подлинной, справедливой цены с ценой общественной, исчисляемой готовностью населения платить. В настоящей работе предлагается и тестируется на эмпирических данных основанный на экспериментальном решении классической бюджетной дилеммы подход к измерению общественной цены блага «дополнительная мощь державы» в сравнении с двумя альтернативами – экономической (в альтернативном росте материального благосостояния граждан) и гуманитарной (в альтернативном усилении институтов охраны жизни и здоровья граждан). Показано существование биполярной мировоззренческой структуры российского общества. Даются количественные оценки общественно допустимых альтернативных издержек дополнительного финансирования общественного блага «мощь державы» в двух ее коннотациях: (1) как инструмента защиты суверенитета и обеспечения независимости в международных отношениях и (2) как инструмента восстановления геополитического равновесия. Выявляются социально-групповые факторы, определяющие общественный выбор в рассматриваемой системе альтернатив.
Контрактный раздаток и солидаризм – новая веха российской матрицы
Authors: Бессонова Ольга Эрнестовна
Published: February 2019

Ольга Эрнестовна Бессонова – доктор социологических наук, ведущий научный сотрудник, Институт экономики и организации промышленного производства СО РАН. Адрес: 630090, Новосибирск, просп. Лаврентьева, д. 17. E-mail: beol@ngs.ru

Цитирование: Бессонова О.Э. (2019) Контрактный раздаток и солидаризм  – новая веха российской матрицы // Мир России. Т. 28. № 1. С. 7–31. DOI: 10.17323/1811-038X-2019-28-1-7-31

В статье раскрывается содержание интегрально-институциональной парадигмы, которая является новым теоретическим инструментом анализа социально-экономической эволюции. В новой парадигме происходит смена интеллектуальных координат: на глобальном уровне рынок и раздаток (нерыночные институты) рассматриваются как универсальные механизмы координации, а на локальном практическом уровне – как «равноценные руки» государства. Переосмыслена версия общемировой и российской эволюции в ракурсе цивилизационной, формационной и институциональной проекций. Обосновывается тезис, что социальное государство и демократия в развитых западных странах – результат инклюзивного синтеза рынка и раздатка. Вскрывается институциональная дилемма современности – не социализм (план) или капитализм (рынок), а  квазирынок или контрактный раздаток. Главный практический результат новой парадигмы – это обоснование необходимости перехода России к демократическому порядку открытого доступа на базе институциональной матрицы контрактного раздатка и  идейной платформы солидаризма с целью преодоления системного институционального кризиса квазирынка.
Трудовые протесты в России: территориальная и отраслевая локализация в 2008–2016 гг.
Authors: Бизюков Петр Вячеславович
Published: February 2019

Петр Вячеславович Бизюков – ассоциированный научный сотрудник, Институт социологии РАН; Социологический институт РАН – филиал Федерального научно-исследовательского социологического центра Российской академии наук. Адрес: 190005, Санкт-Петербург, ул. 7-я Красноармейская, д. 25/14. E-mail: petersk@yandex.ru

Цитирование: Бизюков П.В. (2019) Трудовые протесты в России: территориальная и отраслевая локализация в 2008–2016 гг. // Мир России. Т. 28. № 1. С. 75–100. DOI: 10.17323/1811-038X-2019-28-1-75-100

Статья посвящена распространению трудовых протестов в географическом и экономическом пространствах. В ее основе лежат данные Мониторинга трудовых протестов, начатого в Центре социально-трудовых прав в 2008 г. В статье описывается методика Мониторинга, в соответствии с которой трудовые протесты – это публичные конфликты, используемые работниками для защиты своих интересов. В тексте перечисляются основные показатели, которые фиксируются по каждой акции. Количество трудовых протестов за 108 месяцев наблюдений (с января 2008 г. до декабря 2016 г.) увеличилось более чем в три раза. Всего в базу данных Мониторинга включена информация о 2516 протестах. В начале рассматривается динамика изменения количества протестов по годам, нарастающая на протяжении всего периода наблюдений. Для того чтобы дать количественную оценку числа протестных акций в России, производится сравнение с двумя странами – Грузией и Кыргызстаном, где с 2016 г. ведется сбор данных по методике Мониторинга.

Главный фокус статьи – это распределение протестов по регионам и отраслям. На основании данных о числе акций по регионам делается вывод о том, что их распространенность близка к возможному максимуму, а среднее количество протестов, приходящееся на один регион, постоянно увеличивается. Отраслевая структура акций значительно изменилась: за последние годы выступления работников стали чаще происходить в отраслях, где превалирует неформальная занятость, где нет профсоюзов, т.е. там, где отсутствуют или слабо развиты институциональные механизмы регулирования трудовых отношений. И наоборот, доля протестов в промышленности, на крупных предприятиях уменьшилась, и данные Мониторинга показывают, что в промышленном секторе экономики в регулировании трудовых отношений, а значит, и конфликтов, активное участие принимают профсоюзы. Снижение числа протестов в промышленных отраслях приводит к сокращению включенности профсоюзов в протесты. При этом нарастает число стихийных акций в отраслях, где профсоюзов нет или они слабы (бюджетные отрасли). Это позволяет сделать вывод о том, что профсоюзы, опираясь на право и механизмы социального партнерства, т.е. на институциональные регуляторы, смогли снизить уровень напряженности, а там, где их нет, уровень конфликтности повысился.
Relationship of clinical efficacy of glucose lowering agents, gut microbiota, diet, and patient’s genotype in diabetes mellitus type 2
Authors: Urakov Aleksandr L. , Gurevich Konstantin G. , Sorokina Iuliia A. , Lovtsova Liubov V. , Zanozina Olga V. , Barsuk Aleksandr L.
Published: February 2019

The review is devoted to revealing the connection between the intestinal microflora, diet and the effectiveness of glucose – lowering therapy in patients with type 2 diabetes. Potential targets and the effects of oral and injectable hypoglycemic agents on microbiota in this category of patients are considered. The work reflects modern views on hypoglycemic drugs from the standpoint of the science of metabolomics within the framework of personalized medicine.
Prospects for the use of new generation of anti-tuberculosis drugs in treatment of drug-resistant tuberculosis (experimental and clinical study)
Authors: Pavlova Mariia V. , Vinogradova Tatiana I. , Zabolotnykh Natalia V. , Ershova Elena S. , Sapozhnikova Nadezhda V. , Chernokhaeva Irina V. , Archakova Liudmila I. , Vitovskaya Mariia L. , Dogonadze Marine Y. , Starshinova Anna A. , Grishko Alevtina N. , Yablonsky Petr K.
Published: February 2019

The aim of this work was an experimental and clinical study of increasing of the efficiency of therapy of respiratory tuberculosis with drug resistant pathogen by including a combination of anti-tuberculosis drugs of new generation – Bedaquiline (Bq) and Thioureidoiminomethylpyridinium perchlorate (perchlozone, Tpp) into treatment regimens. The presented results were obtained: in the experiment on a model of tuberculosis infection in 103 male C57black / 6 mice, reproduced by inserting into the lateral vein of the tail of a suspense of clinical strains of Mycobacterium tuberculosis with multi-drug resistance and with various combinations of mutations in the genes; in the clinic – on the basis of examination and treatment of 148 patients with multidrug-resistant respiratory tuberculosis. It is shown that the application of the therapy schemes for multiple and broad drug resistant tuberculosis, containing Bq and Tpp in combination with drugs, selected taking into account the drug sensitivity of mycobacteria, allows to significantly reduce the periods of relief of symptoms of intoxication, regression of inflammatory changes, abacillation and achieving positive X-ray dynamics. Undesirable phenomena against the background of combined prescription of new generation drugs, as a rule, corresponded to light and moderate severity, and in frequency of development and expression did not differ from control groups of observation.
The effectiveness of the antioxidant aminothiol series on the model of multiple sclerosis
Authors: Okunevich Irina V.
Published: February 2019

In the experiments on an reproducible adequate model of multiple sclerosis – experimental autoimmune encephalomyelitis as a result of the creation of pathological condition by immunization of guinea pigs with an encephalitogenic mixture in the complete Freund’s adjuvant, a pronounced inhibitory effect of the Ttriafen preparation was shown. The synthesized preparation of Ttriafen with antihypoxic and antioxidant properties on the experimental autoimmune encephalomyelitis model was used for chronic administration for 35 days, orally at a dose of 50 mg/kg. This drug is known to be free radical scavenger. A number of immunological indices and the clinical picture of neurological complications and the severity of central nervous system damage in experimental guinea pigs were studied. The circulating antibody production was estimated using the complement fixation test. In the peripheral blood, the content of lipid peroxidation products and antioxidant defense enzymes was evaluated. In another series of experiments, the lethality of animals after inoculation of the encephalitogenic mixture in Freund’s complete adjuvant and the protective effect of Triafen’s preparation were reproduced. In the present study, it has been established that the synthetic preparation of the aminothiol Triafen series on the experimental model of multiple sclerosis shows a neuroprotective and immunomodulating property, and increases the resistance to the intensification of LPO processes.
Orexin A content in brain structures correlates with behavioral patterns in stressed rats
Authors: Khokhlov Platon P. , Tissen Ilia Yu. , Lebedev Andrei A. , Bychkov Eugenii R. , Shabanov Petr D.
Published: February 2019

The aim of this investigation was to reveal correlations between some behavioral patterns and orexin concentrations in the brain structures in rats after an acute psychoemotional stress. A group of rats was placed into a chamber with a tiger python for 25 mi nutes and then as a treatment these rats received orexin A or its antagonist SB-408124 administered intranasally for 7 days. Then the quantitive indexes of behavioral patterns in open field and elevated plus maze were registered. The orexin A level was investigated in the brain structures (amygdala, hippocampus, hypothalamus) of such rats by means of high-sensitive ELISA. The correlations were assessed with Spearman’s rank correlation test. As a result, a correlation between orexin A content in the amygdala and hypothalamus and a number of ambulations (line crossings) characterizing motor activity in open field test has been revealed. Therefore, the level of orexin A in the amygdala and hypothalamus demonstrates a direct and reverse link with locomotor activity of rats respectively. Also a correlation between orexin A level in the hippocampus and amygdala and the time of staying in the dark alleys of the elevated plus maze has been revealed. So, the content of orexin A in the hippocampus and amygdala reflects anxiety level of a rat. It is concluded there is a positive correlation between the orexin A content in the limbic structures of the brain and emotional behavior of rats.
Vegetative polysaccharides: new target and direction of clinical use
Authors: Chernykh Ivan V. , Shchulkin Alexey V. , Popova Natalya M. , Kirichenko Ekaterina E. , Yakusheva Elena N.
Published: February 2019

P-glycoprotein (Pgp, ABCB1-protein) is a membrane efflux protein transporter located in hepatocytes, enterocytes, epithelial cells of the proximal renal tubules, histogematic barriers, and also in tumor cells, which releases the substrates from cells and plays an important role in pharmacokinetics of drugs. Inhibition of Pgp functional activity is promising for increasing the effectiveness of drug treatment of oncological diseases and pharmacoresistant epilepsy, but today no synthetic inhibitor of the transporter can be used in clinical practice because of side effects development. The aim of this review is to prove the relevance to use polysaccharides of plant origin, their derivatives and chemical modifications as effective, safe and cost-effective inhibitors of the transporter protein. The article describes the chemical structure of Pgp substrates and inhibitors, the ability to predict the drugs belonging to the transporter protein substrates or inhibitors. Some results of investigations of the belonging of oligo- and polysaccharides to Pgp substrates and inhibitors are presented. They are premises for carrying out appropriate experiments for polysaccharides of plant origin both in vitro and in vivo.
Sensitivity to placebo therapy in patients with alcohol dependence in postwithdrawal period
Authors: Vostrikov Viktor V. , Shabanov Petr D.
Published: February 2019

40 patients with alcohol dependence in post-abstinent period was used to study the psychological peculiarities of emotional-motivational sphere during the course of placebo therapy. The placebo-reactor was 62.5%, placebo preaction – 15%, placebo-negative reactors of 22.5%. There are significant differences in the compared groups of patients. After a course of placebo-therapy all patients showed positive changes in emotional state, most pronounced in placebo-directoru. The least pronounced changes in the placebo group-negative patients (but to lessen the desire for alcohol most pronounced). The conclusion about the need for a differentiated approach to the treatment of alcohol withdrawal syndrome and postdetoxification state.
Analysis of efficiency of integrated preparations of medicinal plants in regulation of decadaptatic disorders in a practically healthy person
Authors: Sambukova Tatyana V. , Yatmanov Aleksey N. , Yusupov Vladislav V. , Shabanov Petr D.
Published: February 2019

Relevance. In recent years, the popularity of phytotherapy, despite the great success in the development of chemical medicines, is increasing. Interest in natural healing substances and preparations created on their basis is increased due to both the unique properties of phytopreparations and rapidly developing research technologies in biology, medicine and the production of medicines.

Methodology. The analysis of the publications studying medicinal plant preparations in the VINITI databases, in the electronic resource of the Russian National Library, search engines Yandex, Google, Cyberleninka and Scholar Google for 2000-2014 was carried out.

Results. Studies conducted with human participation are few and account for 15% for drugs with names and 25% for drugs presented as original studies without a name from the total number of complex drugs studied. The spectrum of the revealed pharmacological effects was extremely wide, and the revealed effects, as a rule, were multicomponent. The greatest number of publications is devoted to the results of the study of Noofit. The drug was studied primarily in experimental studies.
Evaluation of antidepressant activity of tramadol in albino mice using forced swim model
Authors: K. Ramachandra , M. D. Jayalakshmi
Published: February 2019

Background: The fact that tramadol can be used as an antidepressant, has been already proved by some animal studies. The objective of the present study was to evaluate antidepressant activity of tramadol in albino mice using forced swim model.Methods: Forced swimming test (FST) model was used to evaluate the antidepressant effect. Mice in the group "I" were given normal saline. Mice in the group II were given imipramine. Mice in the group III were given tramadol 10mg/kg. Mice in the group IV were given tramadol 20mg/kg. Mice in the group V were given tramadol 40mg/kg. All doses in all groups were given by intra peritoneum route.Results: The average values of immobility in group I were higher significantly compared to group III, IV and V. The values of group I and group II were found to be comparable. It was found that the baseline mean value was 196.33 which reduced to 5.16 with the effect of imipramine where imipramine was given to those mice. But in tramadol 10mg group, it was highest, and it came down to 40.66 and as the dose of tramadol was increased, the immobility time reduced from 40.66 at 10mg dose to 31.33 at 20mg dose and finally to 13.33mg at 40mg dose.Conclusions: Considering the results of two different animal models of depression it can be concluded that Tramadol has antidepressant activity at 10mg, 20mg, 40mg which was almost similar to Imipramine.
Prospective observational study of drug utilization in neonatal seizure at a tertiary care hospital with Pharmacoeconomics
Authors: Patil Ketan A. , Jeevangi Santoshkumar R. , . Sharanabasappa
Published: February 2019

Background: Seizures are the most common indicator of significant neurologic dysfunction in neonatal period with incidence of 11.7/1000 live births. Phenobarbitone is used as first line of treatment since 1900s. Newer anti-epileptic drugs (AED) available are Levetiracetam, Topiramate etc. Present study focused on utilization pattern of AED, treatment outcomes and to study economic burden of disease.Methods: An observational study was done on 100 neonates admitted to Neonatal Intensive Care Unit in Basaveshwara hospital, Kalaburagi (June 2016-May 2017). Prescription data was entered into specially designed proforma, WHO core indicators were determined. The data was analyzed using descriptive statistics and presented as means and percentages.Results: Majority of neonates were male (58%) and 63% were diagnosed with subtle seizure. Out of 458 drugs prescribed, 201 were antiepileptics. 41% cases were successfully managed by monotherapy. Most commonly used drug was phenobarbitone (82%) and phenytoin (31%). Leviteracetam, newer AED was used in 3 refractory cases. The major combination of drugs used was Phenobarbitone-Phenytoin (24%). AED were rationally prescribed, but antibiotic was over-utilized(68%). 31% cases had adverse drug reaction. On average per prescription, number of drugs used were 4.6 and drug cost was Rs.3803/-. The total cost of illness per patient was Rs.16363/-.Conclusions: AED utilization in neonatal seizures was in accordance to guidelines, with phenobarbitone being extensively used despite its potential neurotoxicity. The utilization of newer AED would increase if clinicians are supported with the safety and efficacy data. Although monotherapy was preferred with respect to AED, antibiotics were highly prescribed; hence awareness is needed to curb this practice.
Intraoperative complications after total laparoscopic hysterectomy: a retrospective study in training institute
Authors: Patel Richa , Moray Arun
Published: February 2019

Background: Hysterectomy is a common gynecological surgery performed in premenopausal and menopausal age group. Different types of approaches are there with their advantages and disadvantages, it is mainly indicated for noncancerous conditions. Till today three different surgical approaches to hysterectomy are available: vaginal, abdominal and laparoscopic. TLH has been reported to result in shorter procedure durations, lower blood losses, and shorter hospital stays.Methods: This is a retrospective case study, was carried out over a 5-year period in a tertiary care institute. Study done on patients attending gynecology OPD at our tertiary care institute during the period since September 2013 to September 2018.Results: In present study out of 646 endoscopic hysterectomies in last five years authors studied 420 Total Laparoscopic Hysterectomies. Conversion to open surgery rate was 0.3%. Mean age was 49.26 years (SD-9.53), Performed for various indications with various BMI patients. Mean surgical duration was 116.55 minutes with SD 26.27. Major complication rate was 2.85% with 2 cases of bowel injuries and 3 cases of urological injuries.Conclusions: Total laparoscopic hysterectomy appears safe and effective approach for variety of indications with minimal morbidity. Beneficial for all age group all nulliparous /multiparous patients as well as obese patients. With the knowledge of all complication and its prevention, maximum surgeons can give benefit of advantages of total laparoscopic hysterectomy to all women. More and more randomized clinical trials will motivate surgeons for this approach.
Effect of eclampsia on pregnancy outcome at tertiary care center, Gujarat, India
Authors: Patel Nidhi , Shah Sumant
Published: February 2019

Background: Eclampsia, a common medical emergency of pregnancy mainly seen in 5% to 10% of all pregnancies. The objective of the present study was to study the effect of eclampsia on maternal and perinatal outcome.Methods: This cross-sectional study was conducted among 50 clinically diagnosed women with eclampsia in their third trimester of pregnancy. Inclusion criteria for the study was; females with singleton pregnancy, all in the third trimester which were diagnosed to have PIH based on the development of hypertension for the first time, proteinuria with or without edema, with no history of previous urinary tract troubles and no evidence of UTI.Results: Almost 84.0% participants were belonged to age group of 20 to 30 years age, 54.0% were belonged to rural area and 92.0% were belonged to lower socio-economical class, 88.0%% participants were registered as emergency case, 34.0% participants were stayed more than 10 days at hospital and 36.0% were completed ANC visit. Almost 24.0% participants were anemic, 6.0% pre-eclampsic and 4.0% have tween pregnancy. Severe hypertension at the time of admission were noted in 50.0% participants followed by absent knee jerk (12.0%), proteinuria (78.0%) and edema (62.0%) respectively. Maternal mortality and still birth observed in 2.0% and 18.0% cases respectively.Conclusions: Early age, lower socio-economic class, anemia, less ANC clinic visit, higher hospital stay and primigravida observed more among study participants and these factors may play an important role in the pathogenesis of eclampsia.
A clinical study of maternal outcome among pregnant mothers suffering from preeclampsia with thrombocytopenia
Authors: H. S. Kavyashree , K. Rajeshwari
Published: February 2019

Background: The thrombocytopenia in preeclampsia is mild to moderate, but severe thrombocytopenia can occur. Patients with eclampsia were at even greater risk for developing severe thrombocytopenia. And more likely to have HELLP syndrome, which is a subset of preeclampsia. Thrombocytopenia is a key and necessary component of this syndrome. The objective of the present study was to observe a clinical study of maternal outcome among pregnant mothers suffering from preeclampsia with thrombocytopenia.Methods: A Hospital based Study was conducted at Mysore Medical College from January 2018 to December 20180 in the department of Obstetrics and gynecology. A total of 100 cases of Pregnancy from the records / case sheets of pregnant women with pregnancy induced hypertension admitted in the labor ward of the department of obstetrics and gynecology, Mysore Medical College, Mysore, Karnataka, India.Results: Majority of the study subjects in present study were aged between 21-25 years (42%) followed by <20 years (26%). Nearly 55% of the study group were prim parous. In the above table out of 100 cases included in the study, 28 and 40 cases presented with mild and severe pregnancy induced hypertension, 8 cases were diagnosed as eclampsia and 24 cases presented with HELLP syndrome. The association between the mode of delivery and the variants of PIH was found to be statistically not significant. The Association between Mode of delivery and gestation weeks among the eclampsia cases was found to be not significant.Conclusions: Thrombocytopenia in pregnancy induced hypertension carries a risk for both the mother and her fetus. The associated causes like abruption, retain dead fetus, septicemia and disseminated intravascular coagulation aggravates the complication for thrombocytopenia.
Prevalence of type 2 diabetes association with rheumatoid arthritis among different obese and non-obese populations of Patna, India
Authors: Singh Amrandra Prasad
Published: February 2019

Background: Type 2 Diabetes mellitus (T2DM) is the most common non-communicable chronic diseases in developed and developing countries around the world. The study reported the prevalence of diabetes association with rheumatoid arthritis (RA) among different obese and non-obese populations of Patna, India.Methods: This clinic based descriptive study was conducted in Patna city from 1st August 2017 to 30th September 2018. A total 250 patients with diagnosed RA were enrolled. DM was defined according to the ADA recommendations as FBS ≥126mg/dl or oral glucose tolerance test OGTT2 ≥200mg/dl and HbA1c≥6.5. On the basis of the BMI calculated, patients were categorized either as obese or non-obese. Random diabetic detection was done to detect T2DM and followed by proper investigation at clinical laboratories. Patients also asked for hyperglycemic events during initial counselling.Results: Mean BMI in obese was found to be 29.22±3.22 and in non-obese it was 22.99±1.38 (p<0.001). Most of the patients had been type 2 diabetes for more than 5 years duration. In both genders, an increasing trend was observed in the prevalence of type 2 diabetes with increasing BMI. Among these, a total of 198 (79.2%) were found to have diabetes, 115 (58.08%) of these were obese and 83 (41.91%) non-obese (p=0.003).Conclusions: BMI is directly correlated to type 2 diabetes, as T2DM was significantly more common in obese patients with RA compared to non-obese patients with RA. Obese patients with RA had significantly more frequent diabetes.
A prospective randomised double-blind study of comparison of efficacy and safety of dexmedetomidine and clonidine as adjuvants to intrathecal isobaric ropivacaine 0.75% in lower limb surgeries
Authors: Kallapur Basavaraj , H. S. Yashavanthi , Sheikh Safiya I.
Published: February 2019

Background: Studies comparing the efficacy of dexmedetomidine and clonidine as adjuvants to ropivacaine 0.75% in spinal anesthesia are few. The objective was to study the safety and efficacy of dexmedetomidine in comparison to clonidine as an adjuvant to ropivacaine in subarachnoid block.Methods: Patients were randomly allotted into 3 groups. Group R (n=30) patients received 3ml of 0.75% isobaric ropivacaine +0.5ml of 0.9% normal saline to a total volume of 3.5ml. Group RD (n=30) patients received 3ml of 0.75% isobaric ropivacaine +5μg of dexmedetomidine +0.9% normal saline to a total volume of 3.5ml. Group RC (n=30) patients received 3ml of 0.75% isobaric ropivacaine +30μg of clonidine +0.9% normal saline to a total volume of 3.5ml. The patients and the investigator were blinded for the study.Results: Time to reach T10 level of sensory block in group R was 7.6±1.3 min, group RC was 7.8±1.4 min and in group RD it was 7.9±1.4 min which was statistically not significant with p value 0.66. Time to reach motor onset to Bromage scale 4 was 9.8±1.4 min in group R, 10±1.4 min in group RC, 10.5±1.5 min in group RD which was statistically not significant with p value 0.24. Time to reach maximum sensory block in group R was 10.7±1.4 min, 10.6±1.1 min in group RC, 11±1.7 min in group RD which was statistically insignificant with p value 0.51.Conclusions: Intrathecal dexmedetomidine had superior anaesthetic effects with respect to duration of sensory blockade, motor blockade and duration of analgesia compared to intrathecal clonidine.
Comparative study of two different doses of nalbuphine attenuating hemodynamic response to laryngoscopy and intubation in patients undergoing general anesthesia
Authors: Kallapur Basavaraj , Kiran Bharath , Sheikh Safiya I.
Published: February 2019

Background: Various anaesthetic agents have been tried to attenuate pressor response to laryngoscopy and intubation. Among the recommended groups intravenous nalbuphine satisfies without much undesired effects. The objective was to study efficacy of two different doses of nalbuphine to attenuate pressor response to laryngoscopy and intubation.Methods: This was hospital based comparative study was carried out at Karnataka institute of Medical Sciences Hospital, Hubli, India. Patients were divided into two groups of 50 each randomly. First group was named as N1 and the second group was named as N2. Patients in N1 were given 0.1mg/kg Nalbuphine in 10ml of normal saline and patients in N2 were given 0.2-0.1mg/kg Nalbuphine in 10ml of normal saline. Appropriated statistical tests were applied like t test, ANOVA. P value if found less than 0.05 was recorded as statistically significant.Results: There was marked increase in HR, SBP, DBP and MAP immediately following laryngoscopy and intubation in the both the groups. Intravenous Nalbuphine given 5 minutes before intubation in the dose of 0.2mgkg-1 body weight effectively attenuated the hemodynamic response after laryngoscopy and intubation. However, there was a rise in HR, SBP, DBP and MAP immediately following intubation in group N2 which was clinically not significant though statistically significant. Side effects like nausea, vomiting, respiratory depression and sedation was not observed in both study groups.Conclusions: Authors concluded that 0.2mg/kg body weight dose of Nalbuphine was found to be more effective than 0.1mg/kg body weight dose of nalbuphine in maintaining the haemodynamics of the patients.
Comparison of midupper arm circumference and weight-for-height z score for assessing acute malnutrition in children aged 6-60 months: an analytical study
Authors: Mehta Nirali , Bhatt R. G. , Vora Hetal , Parmar Bharat
Published: February 2019

Background: In clinical settings, wasting in childhood has primarily been assessed with the use of a weight-for-height z score (WHZ), and in community settings, it has been assessed via the mid upper arm circumference (MUAC) with a cutoff <115mm for severe wasting and 115-125mm for moderate wasting. Our recent experience indicates that many wasted children were not identified when these cutoffs for MUAC were used.Methods: Authors determined the cutoffs for MUAC to detect wasting in Indian children aged 6-60 mo. A secondary analysis was carried out on data from 1446 children aged 6-59 mo. The area under the receiver operating curve was used to indicate the most appropriate choice for cutoffs that related MUAC with WHZ. The MUAC measurement of each subject was taken using standard technique. Following the World Health Organization (WHO) age and sex-specific cut-off points, nutritional status of children was determined.Results: The mean±SD age for the entire group was 19.8±13.6 mo, MUAC was 132±13mm, and 45% of subjects were girls. Age-stratified analyses revealed that, for ages 6-24 mo, MUAC cutoffs were <120mm for a WHZ <-3 and <125mm for a WHZ <-2 with a sensitivity of 68.3% and 64.7%, respectively, and a specificity of 82.6% and 83.4%, respectively; for ages 25-60 mo, MUAC cutoffs were <135mm for a WHZ <-3 and <140mm for a WHZ <-2 with a sensitivity of 63.7% and 65.4%, respectively, and a specificity of 81.6% and 78.3%, respectively.Conclusions: The respective cutoffs for MUAC to better capture the vulnerability and risk of severe (WHZ <-3) and moderate (WHZ <-2) wasting would be <120 and <125mm for ages 6-24 mo, <135 and <140mm for ages 37-60 mo.
Are adolescents studying in private schools more obese? a comparative study among adolescents from different types of schools in Kerala, India
Authors: Varghese Aby Dany , Mathew Geethu , Benjamin Anoop Ivan
Published: February 2019

Background: Adolescent obesity is a serious public health challenge of this century. It is associated with many factors including sleep patterns among adolescents.Methods: This cross-sectional study was conducted in Pathanamthitta district, Kerala. Adolescents studying in high school and higher secondary classes were included using stratified random sampling. Study tools included a structured questionnaire and anthropometric measurements.Results: 657 students were enrolled from Government, Government-aided and Private schools. The mean age of the participants was 15.09±1.33 years. The overall prevalence of overweight and obesity was 13.8% and 6.5% respectively. Students in private schools were found to have higher prevalence of overweight (17.8%) and obesity (9.8%) compared to Government-aided (15.3% and 5.4%) and Government schools (8% and 4.5%). Students with lesser sleep duration had higher BMI values. Factors such as higher age, family income, parental education, lack of regular physical activity were associated with obesity. Students with more siblings and family members had low BMI compared to others.Conclusions: High prevalence of overweight and obesity was observed among adolescents especially among private school students. Inadequate sleep duration was also found to be associated with obesity. Primary prevention approach aimed at spreading adequate awareness among students, parents and teachers should be practiced.
SNAPPE II score: predictor of mortality in NICU
Authors: Rachuri Sujana , Paul Saritha , M. D. Jaidev
Published: February 2019

Background: Advances in the NICU (neonatal intensive care unit) have significantly decreased mortality and morbidity and increased survival rate in neonates. SNAPPE II (Score for Neonatal Acute Physiology-Perinatal Extension II) score, which is a modified version of the SNAP score (Score for Neonatal Acute Physiology) helps in predicting the neonatal mortality. The aim of the study was to assess the risk of mortality using SNAPPE II score in neonates admitted to NICU.Methods: It was a prospective validation study done in a tertiary care hospital. Data was collected from 116 new borns admitted to NICU within 48 hours of birth who required respiratory support between December 2017 to June 2018.Results: A total of 116 newborns admitted to the NICU was included in present study. Out of 116 babies, 56 (48%) had mild SNAPPE-II score, 44 (38%) had moderate score and 16 (14%) had severe score. Among the 44 babies with moderate score, 12 (27%) died, which was statistically significant (P<0.001). Among 16 babies with severe score, 13 (81%) babies died, which was highly statistically significant (P<0.0001). Urine output, seizures, serum pH in the first 24 hours of life are independent predictors of mortality with significant p value (0.001).Conclusions: The SNAPPE-II score recorded in the first 48 hours of life could be a good predictor of mortality in babies admitted to NICU.
How safe are our children in our own homes? accidental ingestion in children: a 6 year retrospective study from a tertiary care centre
Authors: Earan Sujay Kumar , Krishnakumar Revathi , Sangili Sivaraman , Arunagirinathan Arulkumaran , Reddy Duvvur Preethika , Maheshwari R. Uma
Published: February 2019

Background: According to the World Health statistics, in 2016 more than 100000 deaths were caused due to unintentional poisonings. Children are vulnerable due to their smaller body surface area, an inherent behaviour of negation, curiosity in exploring their surroundings, their initial phallic stage where they tend to put any objects they come across into their mouth.Methods: This study is a hospital based retrospective observational study where the records of all the children admitted due to poisoning, accidental or intentional from June 2012 to November 2018 were reviewed. All the children admitted due to food poisoning and idiosyncratic drug reactions were excluded from the study.Results: A total of 203 cases of accidental ingestion were admitted during the study period, of which the majority of the patients were male children. The age group varied from 5 months to 14 years. Majority of the accidental ingestions were due to kerosene (108), followed by insecticides (25) and cleaning agents (20).Conclusions: Poisoning in young children is unintentional and accidental; hence the introduction of safe child resistant containers should be encouraged in storing harmful chemicals. Knowledge about the chemicals, awareness about their hazardous effects and education of the care givers about safe storage would be the first step in the prevention of accidental ingestion. Establishment of a reporting system from all the health care centres and establishment of poison information system at all the levels is the need of the hour.
Are dipeptidyl peptidase-4 inhibitors effective and safe in long term when added to ongoing therapies of diabetics? a real-life study in tertiary referral center
Authors: Avci Deniz , Cetinkaya Ali
Published: February 2019

Background: The aim of this study was to determine how HbA1c, lipid, renal functions and such parameters were affected in the long term by adding dipeptidyl peptidase-4 inhibitors to the ongoing treatment regimens of patients with Type 2 diabetes mellitus.Methods: The study was conducted in diabetes mellitus outpatient clinic of Kayseri Training and Research Hospital between February 2012 and May 2017, with patients who did not achieve the sufficient success in diabetes their controls at the time of admission. From these patients, those who added (dipeptidyl peptidase-4 inhibitors) to their treatments were selected. Patients were followed up as long as they continued to these new treatments and the parameters at the baseline were compared with final values.Results: A total of 80 diabetic patients were followed in the study. The median age of the patients was 56.08±9.71 years. During this follow-up, an average decrease of 1.03% was noted when patients were compared with 9.53±1.87% of the initial hemoglobin A1c, and 8.50±1.48% of the Hemoglobin A1c values at the end of follow-up. This decrease was statistically significant (p <0.001). However, differences in the initial and final values of the lipid parameters of the patients were not statistically significant.Conclusions: Addition of dipeptidyl peptidase-4 inhibitors to patients' treatments causes significant decreases in Hemoglobin A1c mean values. This decline is long lasting. However, there are no positive or negative effects on biochemical parameters such as lipids, kidney and liver functions.
Lipid profile in type 2 diabetes mellitus: a case-controlled study
Authors: Rajendran Babu , Mallampati Seetha Rami Reddy , Jha J. Sheju Jonathan , Hakkim Shameer
Published: February 2019

Background: Atherosclerosis is caused by the combination of type 2 diabetes mellitus and dyslipidemia. Combination of DM and dyslipidemia is associated with increased mortality and morbidity. Hence, it is of utmost importance to know the nature of dyslipidemia in DM for its effective management. The major lipid abnormalities seen in DM are elevated triglyceride levels and lowered HDL-C levels.Methods: A case-controlled study was initiated in Vinayaka Missions Medical college and hospital for a period of 2 year. Pre-prandial and post-prandial lipid profile was assessed in 50 cases of type 2 DM and was compared with age and sex matched healthy controls satisfying the inclusion and exclusion criteria.Results: At the end of the study, the mean age±SD was 48.5±5.68 years. The mean HbA1c±SD of the study population was found to be 7.48±1.517. Looking at the lipid profile all cases in fasting state had elevated VLDL-C levels (mean 50.39±60.27), elevated TC (mean 169.70±39.917), elevated TGL (mean 146.04±60.140) and low LDL-C (mean 92.3±27.699) when compared to control group. In the postprandial state, there was a significant raise in TGL level (mean 188±68.59), raised TC (mean 180.74±38.46), decreased HDL-C (mean 38.761±9.028) compared to the fasting state.Conclusions: Lipid profile of type 2 DM in pre-prandial 12 hour fasting state showed elevated TC, VLDL-C levels and low LDL-C and HDL-C levels. Where as in post prandial state TGL levels were markedly elevated with elevated TC and low HDL-C levels.