bluuebunny/crossref_metadata_2025 huggingface dataset:
Gestão das águas e governança: panorama da produção científica brasileira de 1999 a 2019
Authors: Mansur de Moraes Souza Cristiane , Mantovaneli Junior Oklinger , Rosa Camila Cristina , Dornelles de Aguiar Patrícia
Published: October 2020

O objetivo deste artigo é explorar as tendências e padrões de pesquisa sobre o tema governança com ênfase na gestão das águas no Brasil nos últimos 20 anos e discutir como a gestão eficiente dos recursos hídricos pode contribuir com o desenvolvimento regional. A análise centrou-se em identificar as principais referências teóricas e as temáticas fundamentais abordadas nos estudos selecionados. A partir da análise dos artigos publicados com essa temática, busca-se compreender o papel da governança no que tange à gestão dos recursos hídricos no Brasil e o papel da sociedade civil nesse processo. A metodologia caracteriza-se por uma pesquisa bibliométrica tendo em vista a leitura do comportamento científico da área para a formação de um diagnóstico sobre as publicações relacionadas ao tema da gestão e governança da água. Os resultados encontrados demonstram que existe um alto interesse da comunidade científica nesta área, sinalizando uma busca pelo aprofundamento dos conhecimentos e da base conceitual sobre o tema. Desse modo, este trabalho busca fornecer um direcionamento sobre as oportunidades de pesquisa neste campo de estudos.
Funções Públicas de Interesse Comum e Governança na Região Metropolitana do Cariri
Authors: Moreira da Silva Francisco Raniere , Nascimento Diego Coelho do
Published: October 2020

Este artigo aborda o processo de institucionalização da governança metropolitana face às transformações decorrentes do Estatuto da Metrópole (Lei n. 13.089/2015) e seus reflexos nas dinâmicas de desenvolvimento regional. O objetivo é analisar o percurso de construção dos arranjos institucionais de governança interfederativa e os mecanismos de definição e execução das funções públicas de interesse comum na Região Metropolitana do Cariri (RM Cariri). Trata-se de um estudo exploratório descritivo, de caráter qualitativo. O referencial teórico se ancora no debate sobre metropolização, governança e funções públicas de interesse comum. O trabalho de campo inclui a caracterização dos problemas comuns da RM Cariri, a observação sistemática da estruturação das instâncias de governança e do Plano de Desenvolvimento Urbano Integrado (PDUI), bem como a análise de leis e documentos produzidos pelo Governo do Ceará. Os resultados evidenciam um processo de institucionalização recente, assinalado por avanços normativos e por fragilidades relacionadas a aspectos políticos e de gestão. O fato de ser recém-criada facilita a adequação da RM Cariri às diretrizes do Estatuto da Metrópole e abre caminhos para a estruturação de arranjos inovadores de gestão e governança metropolitana. Por outro lado, as alterações regulatórias no âmbito federal, somadas à mudança de orientação de políticas públicas na esfera estadual e ao baixo nível de engajamento dos entes municipais provocaram um arrefecimento do debate metropolitano ao longo dos últimos dois anos, ampliando as dificuldades à consolidação da RM Cariri como efetivo instrumento de desenvolvimento territorial.
Sistemas comunales, estatalidades y gobernanza. Las respuestas de comunidades en defensa de los bienes comunes en Santiago del Estero, Argentina
Authors: Suarez María Victoria , Villalba Ana Eliza
Published: October 2020

Os processos organizacionais dos sujeitos rurais têm sido o foco das políticas públicas do setor nas últimas décadas, onde longe de serem sujeitos passivos, receptores de políticas públicas, atores locais disputam os sentidos de seus mundos de vida, desemvolven estratégias que eles permitem entrelaçamento e diálogo com o que eles procuram impor de fora. Este trabalho analisa as representações, motivações e lógicas de comportamento que desdobrar instituições públicas e sujeitos rurais coexistem sistemas comunais em Santiago del Estero, Argentina. Mais precisamente, o que interessa estudar são as estratégias de adaptação/ resistência/ subsunção dos sujeitos em defesa dos bens comuns que participam dos processos de produção e comercialização, e institucionalidade resultante dessas reuniões para sustentar a governança desses bens e do território como um todo. Serão abordadas duas experiências de sistemas comunais, Colonia Jaime e o confinamento da comunidade de Santa Catalina. No estudo, o comunal é analisado a partir das práticas econômicas, do desenho institucional e dos princípios éticos compartilhados, reconhecendo o caráter dinâmico e processual. As informações foram obtidas a partir da observação participante, entrevistas em profundidade e fontes secundárias. Finalmente, encontramos nos sistemas comunais os dispositivos de controle, regulação e / ou apoio implantados pelos organismos estatais antes das práticas comunais (institucionais, produtivas e comerciais) e, por outro lado, os mecanismos de resistência, negociação e / ou adaptação pelos membros da comunidade.
The Academentia of ECAs: Navigating Academic Terrain Through Critical Friendships as a Life Jacket
Authors: Mbatha Nosipho , Satimburwa Nokukhanya , Msiza Vusi , Zonal Thabile
Published: October 2020

In this paper, we explore our experiences as early career academics (ECAs) and examine how we forged a collaborative, critical friendship to navigate the challenges that we faced in a South African higher education institution. Our inquiry is guided by the following question: "How are we learning to navigate the organisational academic space through critical friendships?" Grounded in the self-study methodology, we use personal narratives to share our experiences of marginalisation. We use liminal and intersectionality theories as lenses to highlight the formation of our critical friendship. The narratives suggest an organic formation of our critical friendship, which has become a life jacket to enhance ourselves and our practice. Through exploration of our critical friendship, we elaborate on the pleasure, power, and possibilities of collaboration among ECAs that might open up opportunities for professional development leading to social change and academic success.
Decolonial Reflections on the Zimbabwean Primary and Secondary School Curriculum Reform Journey
Authors: Bhurekeni John
Published: October 2020

The Zimbabwean curriculum reform journey is shaped by the weight of cultural technologies of domination employed in the country during British imperial rule (1890-1980). Moreover, these imperial forms of domination that, paradoxically, continue to exist today influence the sociocultural and political institutions in the country and delineate what is epistemologically feasible. In addition, the inherited education curricula, specifically at primary school level (the focus of this study) were theoretically and pedagogically disengaged from the lifeworlds of the learners they intended to educate. In this conceptual article, I challenge this colonially inherited education and the paradox of superficial interpretation of unhu/ubuntu (ironically, a doxa in the postcolonial Zimbabwean education system). Further, I suggest considering epistemic depth in pedagogy as an experience that transforms education and society.
REPERTOIRES OF PROTEST AND REPRESSION IN CONTEMPORARY CHINA*
Authors: Johnston Hank , Zhang Sheldon X.
Published: October 2020

This article reviews how protest events in China take forms that are notably distinct from those of the Marxist-Leninist regimes of the twentieth century. It chronicles the upward trajectory of protests in China, remarkable because the trend occurs in a governance structure that seeks to limit independent civil society and the collective expression of grievances. We review several dimensions in which claims and grievances cluster, most of which can be attributed to China’s rapid development, and which potentially could develop into large and coordinated protest campaigns. As part of the party’s concern with maintenance of social harmony, we trace the development of China’s unique repertoire of repression, most notably the various dimensions of the techno-security state, its control of the internet, and development of high-tech surveillance and social control. We close with speculations about the future of social movements in China and the role of its young generation. Today’s young generation is mostly politically quiescent, taking advantage of unprecedented prosperity and opportunities, but it is also potentially “triggered” by examples of numerous protests and potentially empowered by social media.
HOW PROTESTS EVOLVE: HONG KONG’S ANTI-EXTRADITION MOVEMENT AND LESSONS LEARNED FROM THE UMBRELLA MOVEMENT*
Authors: Ho Ming-sho
Published: October 2020

This article analyzes the Hong Kong’s 2019 anti-extradition movement and how it learned from the unsuccessful lessons of the 2014 umbrella movement. Existing theories, such as protest cycles, spillover, and abeyance provide inadequate explanations of the linkage between these two movements. This article contends that collective learning from the previous setbacks enabled Hong Kong’s protesters to launch a more challenging protest five years later. Such learning was made possible because (1) the occupation zones of the umbrella movement served as an incubator for new and experimental tactics that were later deployed, (2) post-occupy organizations sustained a network of participants scattered across different professions that emerged as the mobilizing infrastructure, and (3) in order to avoid the same mistakes, participants recognized the need for more decentralized decision making and tolerance for radical protests.
The effect of nitroglycerin on cardiac extrasystoles and heart rate variability in patients with ­stable angina pectoris class 1 and 2
Authors: Safronova E A , Kuzin A I , Kharlamova U V , Shamaeva T N , Ryabova L V
Published: October 2020

Aim. To study the effect of nitroglycerin on the heart rate and its variability in patients with stable angina pectoris class 1 and 2.

Methods. 85 men with stable angina pectoris class 1 and 2 pathologies were examined between 2007 and 2012 in the City Clinical Hospital No. 8 of Chelyabinsk (mean age 53.15.66 years). In addition to common methods, a rhythmocardiographic study was performed, which allows you to calculate heart rate variability. An electrocardiogram was recorded simultaneously with the rhythmocardiogram.

Results. After sublingual nitroglycerin, the number of ventricular extrasystoles decreased in the background test and during Valsalva maneuver, increased in the Ashner's test and an exercise stress tests and did not change in the orthostatic test. An increase in supraventricular extrasystoles after nitroglycerin administration occurred in 10.6% of patients. Nitroglycerin administration resulted in a decrease in the inter-systolic intervals, an increased in the proportion of slow low-frequency waves statistically significant in the background and an exercise stress test. Spectral indicators of cardiac sympathetic modulation significantly increased in the Ashners test and decreased in the background test, while spectral indicators of cardiac parasympathetic modulation decreased in all samples except in exercise stress tests.

Conclusion. Under the influence of nitroglycerin, supraventricular arrhythmias increased in all vegetative tests except for orthostatic, the number/severity of ventricular extrasystoles ambiguously changed: decreased in Valsalva manoeuvre the background test, did not change in orthostatic and increased in Aschner's and an exercise stress tests; after nitroglycerin, the proportions of sympathetic influence (in Ashner's test) and slow low-frequency waves in the spectrum of the vegetative modulation increased with a decrease in parasympathetic.
Assessment of the effect of exogenous fibrin monomer on post-traumatic bleeding in hypofibrinogenemia caused by administration of snake venom Agkistrodon rhodostoma
Authors: Vdovin V M , Momot A P , Orekhov D A , Shakhmatov I I , Lycheva N A , Momot D A
Published: October 2020

Aim. To assess the effect of fibrin monomer on the rate of blood loss after controlled liver injury in hypofibrinogenemia induced by systemic administration of Malayan pit viper venom (Agkistrodon rhodostoma).

Methods. A placebo-controlled study of the hemostatic effect of fibrin monomer administered intravenously at 0.25 mg/kg, and coagulation parameters in the controlled liver injury with profound hypofibrinogenemia caused by administration of Malayan pit viper venom was conducted in 34 male Chinchilla rabbits. The distribution of the studied parameters was investigated by the ShapiroWilk test. Statistical differences between groups were tested by Students t-test, MannWhitney U test, or Wilcoxon test, as appropriate. Differences in mortality rate were examined using Fisher's exact test.

Results. A model of experimental toxogenic disseminated intravascular coagulation was reproduced, manifested by high mortality of animals (50.0%), severe blood loss (increased blood loss by 1.78 times), hemolysis, a decreased platelet count (by 19.6% of median) and platelet dysfunction, fibrinogen consumption (protein content less than 0.9 g/l), hypocoagulation as well as intensive D-dimer production (increased concentration by 25.0 times of median). A high level of the fibrin derivative demonstrated activation of fibrin formation and fibrinolysis in the bloodstream of the animals. Systemic prophylactic administration of exogenous fibrin monomer after receiving snake venom did not lead to a decrease in post-traumatic bleeding, whereas earlier, during reproduction of disseminated intravascular coagulation caused by streptokinase infusion, such a hemostatic effect of fibrin monomer was shown.

Conclusion. The absence of fibrin monomer effect (at a dose of 0.25 mg/kg) on the severity of blood loss in toxogenic disseminated intravascular coagulation may be associated with more profound disseminated intravascular coagulation and a sharp 25-fold increase in D-dimer levels that can act as a fibrin monomer polymerization inhibitor.
Analysis of Local Seismic Events near a Large-N Array for Moho Reflections
Authors: Zeng Qicheng , Nowack Robert L.
Published: October 2020

Local seismic events recorded by the large-N Incorporated Research Institutions for Seismology Community Wavefield Experiment in Oklahoma are used to estimate Moho reflections near the array. For events within 50 km of the center of the array, normal moveout corrections and receiver stacking are applied to identify the PmP and SmS Moho reflections on the vertical and transverse components. Corrections for the reported focal depths are applied to a uniform event depth. To stack signals from multiple events, further static corrections of the envelopes of the Moho reflected arrivals from the individual event stacks are applied. The multiple-event stacks are then used to estimate the pre-critical PmP and SmS arrivals, and an average Poisson’s ratio of 1.77±0.02 was found for the crust near the array. Using a modified Oklahoma Geological Survey (OGS) velocity model with this Poisson’s ratio, the time-to-depth converted PmP and SmS arrivals resulted in a Moho depth of 41±0.6  km. The modeling of wide-angle Moho reflections for selected events at epicenter-to-station distances of 90–135 km provides additional constraints, and assuming the modified OGS model, a Moho depth of 40±1  km was inferred. The difference between the pre-critical and wide-angle Moho estimates could result from some lateral variability between the array and the wide-angle events. However, both estimates are slightly shallower than the original OGS model Moho depth of 42 km, and this could also result from a somewhat faster lower crust. This study shows that local seismic events, including induced events, can be utilized to estimate properties and structure of the crust, which, in turn, can be used to better understand the tectonics of a given region. The recording of local seismicity on large-N arrays provides increased lateral phase coherence for the better identification of precritical and wide-angle reflected arrivals.
Simultaneous Earthquake Detection on Multiple Stations via a Convolutional Neural Network
Authors: Yang Shaobo , Hu Jing , Zhang Haijiang , Liu Guiquan
Published: October 2020

In recent years, as the amount of seismic data has grown rapidly, it is very important to develop a fast and reliable event detection and association algorithm. Generally, event detection is first performed on individual stations followed by event association through linking phase arrivals to a common event generating them. This study considers earthquake detection as the problem of image classification and convolutional neural networks (CNNs), as some of the widely used deep-learning tools in image processing, can be well used to solve this problem. In contrast to existing studies training the network using seismic data from individual stations, in this study, we train a CNN model jointly using records of multiple stations. Because the CNN automatically synthesizes information among multiple stations, the detector can more reliably detect seismic events and is less affected by spurious signals. The CNN is trained using aftershock data of the 2013 Mw 6.6 Lushan earthquake. We have applied it on two very different datasets of Gofar transform fault, East Pacific Rise and Changning shale gas field in southern Sichuan basin, China. The tests show that the trained CNN has strong generalization ability and is flexible with the number of available stations, different instrument types, and different data sampling rates. It can detect many more events than the conventional short-term average/long-term average detector and is more efficient than template-matching methods.
Strange Warmings and other Close (Althusserian) Encounters: John Wesley’s Change of Heart at Aldersgate
Authors: Newcomb Matthew
Published: October 2020

John Wesley’s famous account of his heart being “strangely warmed” is often considered a conversion. However, his change is less about identity as a Christian, and is more about manner of being. Wesley’s change is best understood as an affective encounter. It is affective in being about bodily experience and initially pre-rational. However, that affective moment was possible due to previous encounters and intentional designs that prepared the possibilities for affective experiences. It is an encounter, following Louis Althusser’s theorization of the term, as a moment of change that might not have happened. Chance is taken seriously with the encounter, and combined with intentional design. Wesley might not have interacted with the Moravian sect in ways that set him up for his affective experience; rhetorical studies can use the encounter and affect to consider probability and chance more, and to think about rhetoric as the design of possible encounters.
On Socio-Cultural Situatedness in Style Attribution: A Study of Style in Hungarian
Authors: Tátrai Szilárd , Ballagó Júlia
Published: October 2020

Building upon the theoretical foundations of social cognitive linguistics, this paper makes the case for considering the speaker’s socio-cultural situatedness in the intersubjective context of joint attention as a key factor in the process of style attribution. Specifically, socio-cultural situatedness is regarded as a crucial component of the speaker’s perspective, playing a decisive role in the construal of style. In order to support this central assumption, the paper presents a two-phase empirical study of style in Hungarian. In the first phase, the authors conducted a questionnaire study to find out which everyday, intuitive labels of style give evidence of the speaker’s socio-cultural situatedness. The questionnaire made use of 12 excerpts of Hungarian university seminars to elicit reflections on style attributions. In the second phase, relying on the results of the first survey, a subsequent questionnaire was conducted. The aim of the second questionnaire was to operationalize folk categories of style attested in the first phase to describe style and measure stylistic markedness. Reconsidering earlier descriptive models, we found that the folk categories of style foreground different aspects of the speaker’s socio-cultural situatedness which – on a more abstract level – can be successfully described by the heuristic scientific categories of socio-cultural factors, which imply the speaker’s socio-cultural attitude to different aspects of style in the recipient’s interpretation. The speaker’s socio-cultural attitude comprises her attitude to the formation of discourse, to the discourse partner, to the value of the topic, to the temporality of constructions and to the norms of the register of the discourse.
An Andalusian View of Death in Translation: ‘Clamor’ by Federico García Lorca and its Polish Translation
Authors: Jamka Anna
Published: October 2020

Death, an essential part of life, is a mesmerizing topic for a number of reasons. Without a shadow of a doubt, it is a universal phenomenon. Nevertheless, the variety of death rites as well as myths and beliefs related to the act of passing, suggest certain differences in its understanding among individuals, communities, and cultures. Are such differences manifested in language? And if so, can they be examined in an analysis of translations of highly artistic, poetic texts? In this study I seek to reconstruct the linguistic view of death in ‘Clamor’ by Federico García Lorca and its latest Polish translation (2019) by Jacek Lyszczyna. Having in mind that language constitutes the raw material of literature (Pajdzińska, 2013), I believe that analyzing poetry in light of the linguistic worldview is crucial for its deeper understanding and, as a consequence, delivering a good translation. What is more, I am convinced that applying the analytical tools developed by cultural linguistics, and in particular, the Ethnolinguistic School of Lublin, in translation studies may be useful not only in an assessment of translation quality, but also as very telling of the role of translated texts in the target language, culture and literary system. Therefore, I intend to analyse Lyszczyna’s translation in view of the linguistic worldview to assess its quality and determine what such an ‘infected’ view of death may tell us about our own (Polish) take on this concept. Firstly, I will analyse García Lorca´s poem to identify the key linguistic exponents of death and reconstruct its non–standard linguistic view (Gicala, 2018) in ‘Clamor’. Secondly, I will capture the key linguistic exponents of death in the form of holistic cognitive definitions following the principles established by Bartmiński et al. (1988, 1996, 2006, 2010, 2013, 2018). Furthermore, I will do the same with their Polish equivalents used in Lyszczyna’s translation. On the basis of the outcomes of the study, I will reconstruct the ‘translated’ linguistic view of death and answer the research questions.
B.S. Johnson’s Liberatic Cityscape in Albert Angelo
Authors: Biela Katarzyna
Published: October 2020

For Bryan Stanley Johnson, a British post-war avant-garde author, space was a crucial aspect of a literary work. Inspired by architects and film makers, he was convinced that “form follows function” (“Introduction” to Aren’t You Rather Young to Be Writing Your Memoirs) and exercised the book as a material object, thus anticipating liberature – a literary genre defined in 1999 by Zenon Fajfer and Katarzyna Bazarnik, which encompasses works whose authors purposefully fuse the content with the form. The goal of this paper is to analyse the cityscape theme in Johnson’s second novel, Albert Angelo (1964), in which London is presented as space that accompanies the character in his everyday life and becomes a witness of the formation of his identity. The protagonist is an architect by profession, so special attention is paid to his visual sensitivity and the way the cityscape is reflected in his memories. Furthermore, Johnson’s formal exploitation of the book as an object and its correspondence to the content is analysed with reference to the metaphor of “[t]he book as an architectural structure” discussed by Bazarnik in Liberature. A Book-bound Genre.
Çapakçur Vadisi (Bingöl) Buğdaygil (Poaceae) Florası
Authors: BEHÇET Lütfi , YAPAR Yakup
Published: October 2020

Bingöl, bitki çeşitliliği konusunda çalışmaların oldukça yetersiz olduğu bir ildir. Bu araştırmada, Bingöl Çapakçur Vadisi Buğdaygil (Poaceae) familyası florası verilmiştir. Tespit edilen taksonların yayılışları ile Türkiye ve komşu ülke floralarında verilen betimlemelere göre 26 taksonda varyasyon belirlenmiştir. Bu taksonlardan özellikle Alopecurus arundinaceus türünde stolon yapısının bulunması, hem Türkiye hem komşu ülke floralarında verilen betimlemelerden farklılık göstermektedir. Yapılan çalışmalar ve teşhisler sonucunda, araştırma sahasından 59 cinse ait toplam 151 takson (104 tür, 39 alttür ve 8 varyete) tespit edilmiştir. 2015 yılında Bingöl’den toplanıp; bilim dünyasına kazandırılmış olan Pseudophleum anatolicum ve 2019 yılında tanımlanan Pilgerochloa major türleri sadece Bingöl’den bilinen dar yayılışlı endemikler olup; araştırma alanında da yetiştiği belirlenmiştir. Çalışmada belirlenen taksonların 10 adedi endemik (%6.62) ve 26 adedi B8 karesi için yeni kayıttır. Çapakçur Vadisi Poaceae florasını oluşturan taksonların 29 adedi (%19.21) İran-Turan, 20 adedi (%13.24) Avrupa-Sibirya ve 9 adedi (%5.96) Akdeniz fitocoğrafik bölge elementidir. Geriye kalan taksonlar ya çok bölgeli veya fitocoğrafik bölgesi bilinmeyenlerdir.
The embodied grounding of focal parts in English wh-dialogues with negative answers
Authors: Zeng Guocai
Published: October 2020

Negative answers are common types of responsive expressions to English wh-questions. From the theoretical perspective of Embodied-Cognitive Linguistics (Wang, 2014) and the dialogic view on meaning construction, this study takes English wh-dialogues with negative answers as the research object and regards such dialogues as a special group of dialogic constructions in conversation. This paper gives an account of the embodied properties of the semantic grounding process of dialogic focuses in such constructions, in terms of the types of the semantic grounding and the categories of semantic consistency of focal parts of wh-questions with those of negative answers, with the ultimate goal to decipher the cognitive mechanism by which wh-dialogues with negative answers are produced and construed in linguistic communication.
Post-operative maternal morbidity and mortality after caesarean delivery and laparotomy for uterine rupture at the gynecology and obstetrics service of the Ignace Deen National Hospital in Guinea
Authors: Balde Ibrahima S. , Balde Ousmane , Stylla Ibrahima , Sow Alhassane II , Keita Massa , Diallo Fatoumata B. , Diallo Ibrahima T. , Diallo Mariame , Barry Mamadou S.
Published: October 2020

Background: The aim of the work was to study post-operative maternal morbidity and mortality after caesarean delivery and laparotomy for uterine failure, to describe the main causes and to analyze the risk factors.Methods: It was a descriptive, comparative and analytical study lasting 2 years with data collection in 2 phases, one of which was a retrospective study lasting one year from July 2018 to June 2019 and the other a prospective study also lasting one year, from July 2019 to June 2020. It concerned all pregnant women who had been caesarized or had had a laparotomy for uterine rupture with complications and those who had not developed any complications. The parameters studied were types of complications, risk factors and maternal mortality. The Chi-square test was used to compare the two populations with a significance level p=0.05.Results: During the study period, 6141 hospitalizations were recorded among which 5682 surgical procedures were performed, i.e. 92.52% of hospitalizations. Caesarean delivery accounted for 90.55% of surgical procedures and laparotomy for uterine rupture for 1.10%. The overall maternal post-operative morbidity rate was 7.60%. Post-operative anemia was by far the most common complication (75.76%) followed by infection (23.46%). The maternal death rate was 0.92% with a ratio of 409.97 maternal deaths per 100,000 live births and more than 2/3 of these deaths were due to caesarean delivery. Anemia and septic shock were the main causes of death. Factors related to this post-operative maternal morbidity were: age greater than or equal to 40 years, multi-parity, illiteracy, emergency obstetric evacuation, low socio-economic level, poor quality of prenatal follow-up and rupture of membranes before admission.Conclusion: In the emergency context concerning majority of our cesarean deliveries and the totality of uterine ruptures predispose the mother to high significant morbidity and mortality.
Maternal factors influencing birth weight of term babies among women who received antenatal care at a Nigerian voluntary agency health care facility
Authors: Olafimihan Victoria I. , Ariba Adekunle J. , Egunjobi Ademola , Abiodun Olusanya
Published: October 2020

Background: Birthweight is an important indicator of babies’ health status and a reliable predictor of their postnatal survival. Maternal factors are regarded as major contributors to birthweight outcome due to their direct effects on foetal growth. Proper knowledge of these factors is essential for implementing preventive measures against suboptimal birthweight. Objective of the study sought to determine the proportion of term babies with normal birthweight and identify the maternal factors that influence birthweight.Methods: This cross-sectional study was conducted on 257 booked pregnant women and their newborns delivered at the Sacred Heart Hospital (SHH), Abeokuta, Nigeria between August and November 2017. Selection was by systematic random sampling method. Data were collected with a pre-tested interviewer-administered questionnaire and analyzed with SPSS version 21 program.Results: The mean age of the women was 30.73±5.17 years. Among the women, 95.7% had at least senior secondary education, 95% of them were married and employed. The mean birthweight was 3.25±0.47 kg and male babies had higher mean weight (male: 3.30±0.54 kg; female: 3.21±0.39 kg). NBW was recorded among 92.6% of the babies with 3.5 and 3.9% as LBW and HBW, respectively. Only maternal booking BMI (p=0.005) and chronic hypertension (p=0.007) were significantly associated with birthweight.Conclusion: Most babies in this study had normal birthweights reflecting the influence of optimal maternal biological and socio-demographic characteristics. Chronic hypertension and subnormal booking BMI undermined achievement of optimal birthweight, underscoring the need for pre-conception care for intending mothers.
Maternal and fetal outcome in cases of eclampsia
Authors: Dodiya Hetal N. , Shah Sapana R. , Vyas Rupa C. , Parikh Purvi M.
Published: October 2020

Background: Eclampsia refers to occurrence of generalized tonic clonic convulsions (GTCS) followed by confusion or coma during pregnancy or puerperium in patients with preeclampsia excluding other neurological conditions. Purpose of this study was to evaluate the risk factors, management protocols and determine maternal and perinatal morbidity and mortality in patients of eclampsia.Methods: This is retrospective study of 180 cases of eclampsia carried out from June 2017 to December 2019 including all the antepartum, intrapartum and postpartum cases at tertiary care centre. Immediate management was focused to control the convulsion and lower the blood pressure followed by NST and USG foetus with Doppler study.Results: In this study, 72.2% cases reported antepartum eclampsia while 27.8% cases were postpartum and overall incidence was 0.91% of total deliveries conducted during the study period. Incidence was higher in primigravida (74.4%) and below 25 years age (68.8%). Magnesium sulphate was effective in 94.4% cases. Study reports 63 normal vaginal delivery, 5 assisted vaginal delivery, 110 caesarean section and 2 women expired undelivered. There were 10 maternal deaths.Conclusions: Time interval between eclamptic seizures and initiation of therapy is an important prognostic factor affecting maternal and perinatal outcome. Public awareness regarding the importance of regular antenatal visits can help in reducing chances of development of eclampsia. Even though various drugs and methods have been tried for the treatment of eclampsia, the definitive management is the delivery of foetus after control of convulsion, hypertension and should be managed at tertiary care hospital.
Correlation of clinical, biochemical and radiological characteristics with histopathology of ovarian masses: hospital based descriptive study
Authors: Laul Poonam , Miglani Urvashi , Srivastava Atima , Sood Neelam , Miglani Sanjeev
Published: October 2020

Background: Ovarian cancer is an important cause of morbidity and mortality in the middle aged women. A systematic study of all ovarian tumours encountered in a large institute over a period of years is more likely to produce a significant amount of useful data regarding the clinical manifestations, the incidence of various types of ovarian tumours and the type of treatment offered. In this study we correlate various clinical presentations, ultrasound features, and various tumour marker levels with histopathology of ovarian masses.Methods: The study was conducted in the department of obstetrics and gynaecology in collaboration with department of radiology and pathology and lab medicine, Deen Dayal Upadhyay hospital from April 2015 to December 2016.Results: In the present study, 97 ovarian masses have been operated out of total 708 gynaecological surgeries in the obstetrics and gynaecology department of Deen Dayal Upadhyay hospital over the stipulated period. Prevalence of ovarian masses was 13.7%. Most of the ovarian masses were prevalent in the reproductive age group i.e. 21-40 years of age group in the present study though malignant masses were commonest in post-menopausal age group in the present study. 2 out 11 malignant ovarian masses were in the age group of 10-20 years which were dysgerminoma and immature teratoma respectively. Intra-operative findings like presence of mural nodule, haemorrhage and necrosis, ascites, papillary excrescences and omental caking were also found to have strong correlation with malignancy.Conclusions: A detailed preoperative workup and a simple tool loke RMI can differentiate between benign and malignant masses pre-operatively especially in post-menopausal women.
Measurement of cervical length using transvaginal sonography for prediction of preterm labour
Authors: Raval Bina M. , Sisodiya Viditsinh P. , Yadava Pushpa A. , Mehta Shital T. , Patel Sagar R. , Dadhania Bintu H.
Published: October 2020

Background: Preterm labour and delivery cause major health burden to the society due to high perinatal morbidities and mortality and long-term health implications and also affects maternal. An effective and objective way for predicting preterm delivery is measurement of cervical length by transvaginal sonography as it allows better quality and accurate visualization of uterine cervix. Cervical length (<25 mm) is good and accurate cervical biometry for prediction of preterm birth. The objective of this study was to measure cervical length by transvaginal sonography for predicting preterm labour and fetal outcome.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology, at SVPIMSR hospital, Ahmedabad from July 2018 to December 2019 in 150 antenatal women to assess cervical changes (cervical length, dilatation of internal OS, funnelling etc.) between 16 to 24 weeks of gestation and these cases followed till delivery and results were analysed.Results:150 antenatal women who fulfilled the selection criteria were studied using transvaginal ultrasound between 16-24 weeks of gestation, out of them 36 (24%) women delivered preterm babies. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) recorded in this study were 80.5%, 94.73%, 82.85% and 93.91% respectively.Conclusion: Transvaginal sonography is the most useful and better, safe, accurate, most effective, less expensive, objective and acceptable technique for assessing cervical length in all antenatal women and predicting the preterm labour when assessed between 16 -24 weeks of gestational age.
Antepartum haemorrhage: a retrospective analysis in a tertiary care centre
Authors: Rajoriya Mohini , Dubey Saurabh , Agarwal Sanju
Published: October 2020

Background: Aim of the present study was to found the incidence of APH, demographic profile risk factors and maternal outcome.Methods: This was a retrospective study carried out in Department of Obstetrics and Gynaecology, MGM Medical College and associated M.Y., Hospital, Indore from August 2019 to July 2020.Results: The incidence of APH was 3.27%. 68.7% cases of APH were associated with pregnancy induced hypertension suggesting PIH is one of the major risk factors. Maternal morbidity was very high with increased rates cesarean section 91.7%, postpartum hemorrhage (32.6%), need of blood transfusion (86%). There were 2 mortalities and 3.1 % patients underwent Obstetric Hystrectomy and 24% required CCU admission.Conclusions: There is very high maternal morbidity and mortality in APH.
Prevalence of anemia in pregnancy at booking: a retrospective study at a tertiary care centre in Lucknow India
Authors: Nigar Asma , Ahmad Ausaf
Published: October 2020

Background: Anemia in pregnancy is one of the most common nutritional deficiency disorders affecting the pregnant women in the developing countries. The aim of our study was to understand the prevalence of anemia among pregnant women, and factors associated with anemia.Methods: It was a retrospective record based study conducted in pregnant women, attending antenatal clinic and emergency in the Department of Obstetrics and Gynecology at Integral Institute of Medical Sciences and Research, Luck now, Uttar Pradesh, India. Data from 422 pregnant women regarding pregnancy were collected from 1st January 2018 to 30th June 2018 by referring the records.Results: Present study included 422 pregnant females in first, second and third trimester. In the present study, majority of the pregnant women belonged to the age group of 20-25 years (49.5%) followed by age group of 26-30 years (35.5%). The prevalence rate of anemia was found to be 57.6%, with moderate anemia being the most common (44.8%). Higher proportion of anemia was found in third trimester (75.3%) followed by second trimester (16.5%).Conclusions: High prevalence (57.6%) of anemia was observed in pregnant women. We are far away from achieving our target of Anemia Mukht Bharat by 2022. There is need to create awareness among females regarding ANC visits, birth spacing and iron and folic acid supplementation during pregnancy.
Prevalence and predictors of episiotomy and perineal tear at a tertiary hospital in Port-Harcourt, Nigeria
Authors: Awoyesuku Peter A. , John Dickson H. , Altraide Basil O.
Published: October 2020

Background: Despite many years of it being practiced, episiotomy has remained a controversial operation. The rate is on the decline in developed countries but remains high in developing countries. This study seeks to determine the prevalence of episiotomy and perineal tear, and to assess the associated factors, at the Rivers state university teaching hospital (RSUTH).Methods: A retrospective study over a two-year period, from 01 January 2018 to 31 December 2019, was carried out. All women who had singleton spontaneous vaginal deliveries (SVD) with episiotomy or perineal tear at the RSUTH with complete records were included, those with twin delivery and incomplete data were excluded. Data was retrieved from the birth registers and case notes using a proforma. Information on maternal age, parity, gestational age (GA), type of injury, birth weight, head circumference and Apgar scores were extracted. Data were analyzed using statistical package for the social sciences (SPSS) version 20.Results: There were 2150 vaginal deliveries, with 440 (20.5%) receiving episiotomy, while 21 (1.0%) had perineal tear. The mean age±standard deviation (SD) was 29.52±4.97 years, median parity was 1, and mean GA±SD was 37.35±1.71 weeks. The mean birth weight±SD was 3.33±0.52 kg and mean head circumference±SD was 34.76±1.90 cm. There was significant association between maternal parity and fetal birth weight with the occurrence of episiotomy and perineal tears.Conclusions: The rate of episiotomy and perineal tear was higher than recommended, with an increasing trend. The lower the parity and the higher the fetal birth weight, the likelihood to receive an episiotomy. More efforts are needed to reduce the rate.
Fetal absent/hypoplastic nasal bone: a single center follow up study from a tertiary referral hospital in India
Authors: Prasad Cini Sudhakar , Kunjukutty Radhamony , Krishnan Vivek
Published: October 2020

Background: This study was undertaken to determine perinatal outcomes in fetuses with absent/hypoplastic nasal bone (AHNB) when considered as a broad entity irrespective of time at which it is identified and identify subgroups with the highest risk of abnormal outcome based on screening status and associated findings.Methods: This was an observational study involving a total of 142 pregnant women whose fetuses were identified with AHNB by ultrasongraphy (USG) during a three year period from January 2016 to December 2018. These women were offered aneuploidy screening/non-invasive prenatal testing (NIPT) or direct invasive testing either alone or in combination. Outcome data was collected and a sub-group analysis was done by dividing them into 8 subgroups based on screening status and associated findings.Results: Out of 12758 scans done during the study period, 142 fetuses (1.11%) were identified with AHNB. 80 (56%) opted the biochemical screening test, 5 (3.5%) opted NIPT while 60 (42.9%) opted for invasive testing. 21 (14.8%) had an abnormal karyotype. In sub-group analysis, the best outcome was seen in group 1, where the biochemical screening was negative and no other aneuploidy markers or anomalies were seen.Conclusions: The present study confirms the association of AHNB with chromosomal disease. However, isolated AHNB with low risk in biochemical screening is rarely associated with aneuploidy. In contrast, a significant no of fetuses yielded abnormal chromosome results when AHNB was associated with high risk in biochemical screening, additional aneuploidy markers or associated anomalies.
Analysis of labor induction in a tertiary care hospital
Authors: Tanwar Meenakshi , Choudhary Anjali , Mishra Shweta
Published: October 2020

Background: Induction of labour (IOL) is a very common labour room procedure. Although labor is a natural physiological process, deliberate intervention in the form of induction may be required in many instances. It is needed in almost 20% of pregnant women for a variety of indications. The objective is to evaluate indications, different methods, and feto-maternal outcome of induced labour in tertiary care hospital.Methods: This was a retrospective study of IOL conducted in the department of obstetrics and gynecology, Shri Guru Ram Rai institute of medical and health sciences, Dehradun, Uttarakhand. Women who underwent IOL beyond 28 weeks gestation with single cephalic presentation with no contraindication for vaginal birth were included in the study. Statistical analysis was done with Microsoft excel.Results: A total of 1532 women delivered in the hospital during the study period. Among them, 498 women were induced (32.5%). Most common method of induction was misoprostol (40.36%) followed by prostaglandin E2 gel (26.90%).  Out of 498 inductions, 377 women delivered vaginally making success of induction around 75.70%. Among them, 335 women had normal delivery (67.26%) and 42 women required instrumental delivery (8.4%) and 121 women underwent lower segment caesarean section (LSCS) (24.29%).Conclusions: Elective inductions of labor in properly selected indications at optimized timings aid in achieving a favorable maternal and fetal outcome. Methods of inductions, timing and intrapartum monitoring plays an important role in influencing obstetric outcome.
Correlation of body mass index and abnormal uterine bleeding in premenopausal women
Authors: Akalyaa Kumarasamy , Shakuntala Pattacheravanda Nanaiah , Renuka Ramaiah
Published: October 2020

Background: As the rate of obesity is increasing in women in the recent years, the incidence of endometrial cancer increases as the body mass index (BMI) increases. Despite the clear evidence linking endometrial cancer and obesity, there is limited public awareness of this relationship. This study was undertaken to evaluate the association of BMI and endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB).Methods: An analytical case control study was conducted in 100 women between the age group of 40 to 55, with AUB in the Department of Obstetrics and Gynecology, ESIC-PGIMSR Bangalore between January 2018 and June 2019. The menstrual patterns and endometrial pattern by histopathology were analysed in women with BMI of 18.5 to 24.99 and ≥25.Results: The mean age of women participated in the study group of between 40- 55 years was 44.83. The mean duration of symptoms was 10.18 months in the cases group and 8.52 months in the control group. The menstrual patterns were comparable and there was no significant difference in both the groups. The mean endometrial thickness, mean BMI, hyperplasia with or without atypia were all higher in the cases group. The frequency of occurrence of atypical endometrial hyperplasia was higher in women with increasing BMI.Conclusions: We found increased BMI to be an important independent risk factor for the development of endometrial hyperplasia with atypia which is a precursor to endometrial carcinoma in premenopausal women with AUB.
A rare case of severe pulmonary hypertension in pregnancy
Authors: Banerjee Ramna , Rahman Farheen
Published: October 2020

Heart diseases in pregnancy have always been a source of major concern for both the patients as well as the caregivers because of the high risk of maternal morbidity and mortality and the need for specialist care by a multidisciplinary team preferably in a tertiary care hospital. Amongst the whole gamut of heart diseases, pulmonary hypertension is associated with high maternal morbidity and mortality (in the order of 20% in some studies) and hence is considered a contraindication for pregnancy. We report a rare case of a lady at 36 weeks gestation in her second pregnancy, with a previous caesarean section, who was incidentally diagnosed with severe pulmonary hypertension (PAP-110 mmHg) during her antenatal check-up in the third trimester of pregnancy and survived without any major complications after being promptly referred to and treated in a multispecialty hospital. Her previous pregnancy was absolutely uneventful and even in this pregnancy she had very mild symptoms as compared to the severity of the disease found on further investigation.