bluuebunny/crossref_metadata_2025 huggingface dataset:
Antinomias del Proceso Contencioso Administrativo Ecuatoriano. Breve comparación con el sistema Español y Colombiano
Authors: Costa Cevallos Marcelo
Published: December 2022

¿Por qué el Derecho Procesal Administrativo en Ecuador no alcanzó la madurez como en otros países latinoamericanos? ¿Por qué su reconocimiento como una materia especializada no ha tenido el mismo impacto desde la academia? ¿Por qué no hay jueces de primera instancia en la jurisdicción contencioso administrativa? ¿Por qué el ciudadano que litiga contra el estado tiene negada la posibilidad de impugnar la sentencia del Tribunal? Dar respuesta a estas premisas es un imperativo moral y jurídico, el problema tiene algunas vertientes como la inercia legislativa, el escaso aporte doctrinario, en cierto modo los precedentes jurisprudenciales no han sido ejes conductores efectivos para el desarrollo y comprensión de este Derecho. El proceso de importación de normas europeas principalmente, y su adaptación al ordenamiento legal doméstico, no se ha dimensionado atendiendo los antecedentes y realidades disparejas entre administraciones públicas, niveles de descentralización, estructuras jurisdiccionales y el factor cultural, cuestiones que han sido determinantes para diagnosticar el estancamiento de este derecho en el Ecuador.
Competencias de la administración local para la realización de los derechos sociales fundamentales. La agenda social única de Galicia
Authors: Rey Varela Jose Manuel
Published: December 2022

El artículo 25 de la Declaración Universal de los Derechos Humanos reconoce el derecho de toda persona “a un nivel de vida adecuado que le asegure, así como a su familia, la salud y el bienestar, y en especial la alimentación, el vestido, la vivienda, la asistencia médica y los servicios sociales necesarios. Desde entonces las Constituciones de los Estados optimizan el mandato de las Administraciones Públicas para la realización de los derechos sociales fundamentales donde la dignidad de la persona y los derechos que le son inherentes en un “Estado Social” son el interés general que de acuerdo con los principios de eficacia, jerarquía, descentralización, desconcentración, coordinación y solidaridad convoca a todos los niveles de la Administración a sumar esfuerzos para responder a los ideales de libertad, igualdad y fraternidad.
Análisis de la regulación de la calidad alimentaria diferenciada en el Anteproyecto de Ley de la calidad alimentaria de Galicia
Authors: Pensado Sande Jaime
Published: December 2022

En este trabajo se aborda el estudio de los aspectos más relevantes en materia de calidad alimentaria diferenciada en el Anteproyecto de Ley de la calidad alimentaria de Galicia. El objetivo es destacar las diferencias entre la regulación actual, contenida en la Ley 2/2005, de 18 de febrero, de promoción y defensa de la calidad alimentaria gallega, y el mencionado Anteproyecto, con la intención de atisbar cuál es el camino seguido por el legislador gallego en esta materia. Galicia es una de las regiones de España y de Europa con un mayor número de productos registrados como denominación de origen protegida y como indicación geográfica protegida, por lo que resulta de gran interés tanto para los productores como para los consumidores conocer cuál podría ser el futuro regulatorio en esta materia, íntimamente relacionada con otros sectores de la actividad económica, como el turismo y el desarrollo del medio rural.
A modificación dos contratos públicos a propósito da terceira prórroga da concesión da Autoestrada do Atlántico
Authors: Vázquez Rodríguez Adrián Agustín
Published: December 2022

Este traballo vén ollar cara a prórroga da concesión administrativa da principal vía de comunicación automobilística de Galicia realizada no ano 2000 realizada polo Real Decreto 173/2000, de 4 de febreiro. En primeiro lugar, encádrase este acto administrativo na regulación vixente no momento en que foi adoptado, desde o punto de vista tanto estatal como comunitario. Á mesma vez, examínase o contido de dito Real Decreto e as súas causas e consecuencias, destacando o aumento na concesión por 25 anos. Finalmente, reflexiónase sobre a natureza desta modificación e o seu posíbel carácter ilícito á luz dos principios do Dereito da Unión Europea na contratación pública.
Expolio en el museo De Rerum Natura: propuesta de Ciencias naturales para Educación Primaria basada en el juego
Authors: Izárbez Sara , Calvo Guiomar
Published: December 2022

Los museos de ciencias naturales pueden ser empleados como recurso en los diferentes niveles educativos para fomentar el interés por las ciencias. Sin embargo, no siempre sus contenidos o actividades, cuando estos existen, están adaptados o ni son motivadores para el alumnado. En este trabajo se presenta una propuesta, basada en el juego, que se desarrolla en el museo “De Rerum Natura” del Instituto de Enseñanza Secundaria Ramón y Cajal (Huesca). En ella se trabajan, de forma transversal, distintos contenidos de la asignatura de Ciencias de la naturaleza para el nivel de 6º de Educación Primaria. Siguiendo una metodología activa, los estudiantes deben resolver una serie de retos. Esta propuesta, diseñada específicamente para los ejemplares y recursos que contiene el museo, podría adaptarse a otros museos o recursos presentes en centros escolares.
Las labores de costura y la educación femenina en la narrativa de Emilia Pardo Bazán
Authors: Rodríguez Garabatos Blanca Paula
Published: December 2022

Emilia Pardo Bazán ha dejado constancia en sus relatos y novelas de la importancia de la costura como elemento fundamental en la educación de las mujeres de su tiempo. La costura se aprendía desde la niñez en el ámbito privado o en escuelas de menaje y garantizaba la calidad de futuro ángel del hogar de las alumnas. Las labores permitían a las mujeres ociosas entretenerse y a las más menesterosas, ganarse la vida o procurarse un ingreso extra. No obstante, Pardo Bazán, siempre preocupada por la formación femenina, advierte a través de su obra de ficción, acerca de las inquietudes intelectuales de muchas mujeres que no se ven satisfechas con las labores de aguja. La costura, de acuerdo con los textos de la autora, puede servir como elemento de sumisión femenina o como instrumento para forjarse cierta independencia. En todo caso, queda clara la necesidad de que su ejercicio sea libremente elegido y no vaya en detrimento de la vocación real de las mujeres.
El canon del cuento literario español desde la democracia en los manuales de Bachillerato
Authors: Bartolomé Porcar Cristina
Published: December 2022

Desde la transición española ha habido un auge en la diversidad creativa y temática en el terreno del cuento literario. Tras cuarenta años de desarrollo, el fenómeno ha llamado la atención de la crítica y el mundo académico y, fruto de ello, ha pasado a formar parte del temario de la asignatura de Lengua castellana y Literatura II de segundo de Bachillerato, y por lo tanto, del contenido de los manuales de texto de este nivel. En el presente trabajo se analiza una muestra de trece libros de texto con el objetivo de comprender cómo se está construyendo el canon del cuento literario correspondiente a esta época. Se ha recabado el listado de los narradores destacados así como su frecuencia de aparición para conocer los nombres en proceso de consagración. Se han revisado los volúmenes de cuentos seleccionados con el fin de descubrir la temática a la que se le está dando mayor importancia. Los resultados obtenidos demuestran que el canon todavía está en proceso de consolidación y precisa de una constante revisión de las nuevas voces. En estas descripciones historiográficas, en las que se destaca la heterogeneidad del cuento literario contemporáneo, se apuntan algunos asuntos que pueden ser relevantes para la formación literaria de nuestro estudiantado como el acceso al mundo editorial, el tratamiento de lo fantástico, la cercana realidad o la hibridación genérica.
Uluslararası Ticaret ve Ekonomik Büyüme ile Çocuk Sağlığı İlişkisi: Yeni Sanayileşen Ülkeler İçin Ampirik Bir Analiz
Authors: ERDEMLİ Muhyettin , ÇELİK Hüseyin
Published: December 2022

Ekonomik küreselleşme ile birlikte önemi artan uluslararası ticaretin, ülkelere ait pek çok ekonomik gösterge üzerinde önemli etkileri olmaktadır. Ancak uluslararası ticaretin iktisadi sonuçlarının yanında iktisadi olmayan sonuçlarının da olabileceği göz ardı edilmemelidir. Uluslararası ticaretin ülkelerin sağlık alanını da etkilediği düşünülmektedir. Yeni teknolojilerin gelişmesi ve artan uluslararası ticaret yolu ile bu teknolojilerin ülkeler arasındaki ticari alışverişe konu olması, ülkelerin sağlık sektörlerini etkilediği gibi sağlık göstergelerini de etkilediği düşünülmektedir. Bu düşünce ile yapılan bu çalışmada uluslararası ticaretin çocuk sağlığı üzerindeki olası etkileri Yeni Sanayileşen Ülkeler (Newly Industrialized Country, NIC) için 1981-2019 arası dönemini kapsayan yıllık veriler alınarak, panel veri analizi yardımı ile araştırılmıştır. Çalışma sonuçları, uluslararası ticaretin çocuk sağlığı üzerinde pozitif bir etkiye sahip olduğunu ve artan uluslararası ticaretle birlikte çocuk sağlığı alanında olumlu gelişmelerin yaşandığını göstermektedir.
Odun plastik kompozitlerin gerilme-gevşeme davranışlarının incelenmesi
Authors: ÇAVUŞ Vedat , MENGELOĞLU Fatih
Published: December 2022

Bu çalışmada, iki farklı tür ve oranda; dolgu maddesi kullanılarak üretilen odun plastik kompozitlerin gerilme- gevşeme davranışlarının belirlenmesi hedeflenmiştir. Bu amaçla %10 ve 20 oranında polimer matris içerisine magnezyumoksisulfat, lignoselülozik dolgu maddesi (Pinus brutia Ten.) Maleik Anhidrit Grafted Polipropilen (MAPP) ve vaks %3-oranında karıştırılmış; ekstrüzyon ve enjeksiyon kalıplama yöntemi kullanılarak test örnekleri üretilmiştir. Odun plastik kompozitlerin, çekmede gerilme-gevşeme davranışını belirlemek amacıyla ASTM D 638 (2004) standardına belirtilen esaslar dikkate alınarak Kompozit üretim reçetesindeki oranlara uygun olarak test örnekleri hazırlanmıştır. Test örnekleri; 600 Newton kuvvet, çekme hızı 5mm/dakika ve 2 saatlik çekmede gerilme-gevşeme davranışları belirlenmiştir. Denemeler oda şartlarında (yaklaşık 200C sıcaklık ve %55 bağıl nem) gerçekleştirilmiş ve test yapılan odanın sıcaklığı klima ile ayarlanmıştır. Test sonuçlarından elde edilen verilere göre; gerilme-gevşeme değerlerinde dolgu maddesi türü ve oranının etkisinin önemli olduğu tespit edilmiştir. Lignoselülozik ve sentetik dolgu maddesi oranı ve türünün test örneklerinin gerilme-gevşeme değerlerinde etkili olduğu ve dolgu maddesi katılım oranının artmasına bağlı olarak gerilme-gevşeme değerlerini açık bir şekilde düşürdüğü tespit edilmiştir. Dolgu maddesi katılımı ile polimer zincirleri arasında mekanik etkilere bağlı olarak gerçekleşen hareket kabiliyetinde azalma meydana gelerek gerilmesinin zaman içerisinde azaldığı ve dolgu miktarının artması durumunda gerilme-gevşeme oranında azalmanın arttığı tespit edilmiştir Gerilme-gevşeme davranışının önemli olduğu uygulamalarda dolgu maddesi oranının dikkate alınarak uygulamanın planlanması önemlidir.
Bazı turunçgil türlerinin budama artıklarının kimyasal bileşimi ve lif özellikleri
Authors: DÖNMEZ İlhami Emrah , BAŞOL Koray , GÜLSOY Sezgin Koray
Published: December 2022

Turunçgil ağaçları, verim artırmak, arız olan hastalıklardan ağaçları korumak ya da ağaca form vermek amacıyla belli dönemlerde budanmakta ve bu şekilde lignoselülozik artıklar ortaya çıkmaktadır. Bu artıklar budama artıkları olarak adlandırılmakta ve yakma dışında bir kullanım alanı bulunamamaktadır. Türkiye genelinde turunçgiller familyasında birçok tür bulunmakta olup ülkemiz meyve üretimi bakımından söz sahibi ülkeler arasındadır. Bu çalışmada, turunçgil bahçelerinde budama sonrası açığa çıkan ve atık malzeme olarak değerlendirilen portakal (Citrus sinensis), mandalina (Citrus reticulata), limon (Citrus limon) ve greyfurt (Citrus paradisi) odun ve kabuklarının hücre çeperi ana bileşenleri, yan bileşenleri ve odunlarının lif özellikleri ortaya konmuştur. Yapılan kimyasal analizlerde holoselüloz miktarı %66.45-80.82 değerleri arasında α-selüloz miktarı %41.54-55.24 arasında ve klason lignin miktarı ise %14.37-19.67 arasında tespit edilmiştir. Çözünürlük değerleri odun ve kabuk örneklerinde birbirine yakın değerlerdedir. %1’lik NaOH çözünürlüğü %19.38-78.17 arasında değişirken heksan ekstraksiyonu sonrası çözünen madde miktarı ise 2.61-8.24 mg/g arasında bulunmuştur. Lif uzunluğu ve genişliği sırasıyla 0.64-0.77 mm ve13.00-14.90 µm olarak belirlenmiştir.
Mifepristone alone versus mifepristone-misoprostol combination regimen for management of intrauterine fetal death
Authors: Akhter Salma , Islam Mohibul , Zaman Latifa , Alam S. K. Tasnuva , Banu Ferdous Ara
Published: December 2022

Background: Early pregnancy failure is a common complication of pregnancy. If women do not abort spontaneously, they will undergo medical or surgical treatment in order to remove the products of conception from the uterus. Curettage, although highly effective, is associated with a risk of complications; medical treatment with misoprostol is a safe and less expensive alternative. Unfortunately, after 1 week of expectant management in case of EPF, medical treatment with misoprostol has a complete evacuation rate of approximately 50%. Misoprostol treatment results may be improved by pre-treatment with mifepristone; its effectiveness has already been proven for other indications of pregnancy termination. The study objective was to compare the outcome of Mifepristone alone with the Mifepristone- Misoprostol combination regimen for the management of IUFD.Methods: This was a Prospective clinical trial at the department of obstetrics and gynecology, Chittagong Medical College Hospital, Chittagong. From March 2016 (Actual patient enrolment started after obtaining ethical clearance i.e. March 2018) to September 2018.Results: A subjects delivered earlier than group B and the mean induction delivery interval in Group A is significantly less in comparison to Group B (p=<0.001). Out of 50 women, 2(4%) and 10(20%) women in Groups A and B required oxytocin infusion to establish good contractions, and completion of termination who regarded as a failure. In the mifepristone alone group, the success rate is significantly higher than in the combination group.Conclusions: The efficacy of mifepristone alone was found superior to that of the mifepristone misoprostol combination regimen in the present study.
Lower uterine segment scar thickness as a predictor of successful vaginal birth after caesarean section at the Federal Medical Centre, Yenagoa: a prospective cohort study
Authors: Ikoro Chima , Omietimi James Enimi , Kiridi Enefia Kelvin , Fumudoh Bassey , Samuel Aigere Egbaname O. , Oriji Peter Chibuzor , Mbah Kanayochukwu Michael , Tekenah Ebiye Serena
Published: December 2022

Background: Successful conduct of vaginal birth after caesarean section is dependent on a number of foetal and maternal factors including integrity of the previous caesarean section scar. The objective of this study was to determine the average lower uterine segment (LUS) scar thickness for women being planned for VBAC.Methods: This was a prospective cohort study of pregnant women with one previous caesarean section, who were recruited to undergo transvaginal ultrasound scan in preparation for VBAC at the Federal Medical Centre (FMC) Yenagoa. It was conducted between May, 2018 and September 2019. The women were allocated into three groups A (<2.5mm), B (2.5-3.4 mm) and C (≥3.5 mm) according to the thickness of the LUS scar. Data analysis was done using the statistical product and service solutions version 22.0, p<0.05 was taken as statistically significant.Results: The range of lower uterine segment thickness in the study was 1.5 mm to 6.8 mm (mean 3.89±0.95 mm). With cut-off value of 3.5 mm, the sensitivity for successful VBAC was 78.8%, specificity was 55.4%, PPV was 78.1%, NPV was 62.0% and accuracy was 71%. The rate of uterine defect increased as the lower uterine segment thickness decreased from 3.5 mm (p=0.001).Conclusions: This research has clearly shown that full LUS thickness of ≥3.5 mm at 36 weeks of gestation is associated with an increased chance of successful VBAC while LUS thickness of <3.5 mm is at increased risk of uterine rupture and uterine dehiscence during a Trial of VBAC.
Evaluation of outcome of mode of delivery in severe preeclampsia
Authors: K. S. Raveena , S. R. Sheela
Published: December 2022

Background: Preeclampsia is new onset hypertension of more than 140/90 mmHg on 2 occasions, 4 hours apart in pregnancy, which occurs after 20 weeks of gestation and frequently near term. If there are other symptoms like as headache, blurred vision from end organ damage, and thrombocytopenia, it is characterized as severe preeclampsia. Regardless of the foetal outcome, treatment for severe preeclampsia is immediate delivery. The goal of the current study is to assess how different delivery methods affect individuals with severe preeclampsia.Methods: It is a retrospective study conducted in RL Jalappa hospital, Kolar from January 2021 to February 2022. Out of 2568 deliveries at our facility throughout the study period, 150 singleton pregnancies complicated by severe preeclampsia delivered at 24-34 weeks of gestation were chosen for the study. Women who had additional obstetric, foetal, or medical difficulties were not included in the study.Results: 110 study participants had an LSCS form of delivery out of the total. Among them, non-reassuring fetal heart rate, obstructed labor, and malpresentation were the most typical indicators for LSCS. The difference between Bishop's score and the mode of delivery was statistically significant. There was no discernible difference between the newborn's APGAR score immediately following delivery and the method of delivery.Conclusions: There are strong chances of a normal vaginal birth if the Bishop score at the time of admission and induction is more than 4.
A study of the socio demographic and obstetric factors in pregnant women with COVID-19 infection at a tertiary care hospital, Kollam, Kerala, India
Authors: Menon Sangeetha , R. Renjini
Published: December 2022

Background: The first wave of the COVID-19 pandemic took the world to task. Pregnant women needed care without actually knowing if the treatment schedules outside of pregnancy could be extrapolated to the pregnant state. Obstetric protocols were adhered to as far as was feasible, yet world over there was an increase in cesarean section rates. The so-called alpha variant that we saw at the time appeared to infect pregnant women too with equal frequency but they fared well. The issues regarding infectivity and the use of personal protective equipment (PPE) assumed mammoth dimensions. The objectives of this paper were to explore the demographic data and the epidemiological risk factors and study the symptomatology, severity and course of COVID-19 in pregnancy.Methods: This was an observational study conducted on all the COVID-19 positive pregnant women admitted to the department of obstetrics and gynecology at the designated COVID hospital for the district - Government Medical College Kollam - for a period of 6 months from October 2020 to March 2021. These women were studied with respect to their socio demographic details and their Obstetric risk factors and performance. Data was collected and analyzed using statistical package for the social sciences (SPSS) software.Results: 377 antenatal COVID-19 positive women were admitted and analyzed during the study period. Nulliparous women (48.5%%) in the age group 20 to 30 years (74.28%) formed the major group. Third trimester and near date admissions were the majority (48.80%). Most women (79.31%) were asymptomatic. Most common symptoms were fever in 35% and flu like upper respiratory symptoms (20%). Breathlessness and lung involvement was seen in 2.91%. Contact tracing revealed a travel history or contact with infected persons at 15.64%. However, 84.8% had no contact history. All antenatal women were tested at admission and reverse transcriptase-polymerase chain reaction (RTPCR) was done in 73.21%. Rapid antigen and nucleic acid amplification test (NAAT) detected the rest. 46% had some co morbidity gestational diabetes mellitus (GDM), gestational hypertension, thyroid disease and anemia were the common co morbidities detected. The presence of GDM in 24.14% of the study population is noteworthy.Conclusions: Pregnancy being an immune compromised state, unpredictable outcomes are possible with COVID-19 infection. Asymptomatic patients too can experience complications. Frequent hospital and lab visits could be a source of infection. The growing incidence of GDM in the midst of the COVID-19 pandemic is a point for concern.
A study of maternal outcome in heart disease in pregnancy in a tertiary care centre
Authors: Kurude Vilas N. , Raut Shruti U.
Published: December 2022

Background: Cardiovascular disease in women is associated with 4% complications during pregnancy and is the most frequent leading cause of maternal mortality reaching up to 15%. It stands third among the most common causes of maternal mortality after obstetric haemorrhage and preeclampsia respectively.The objective of this study is to study the maternal outcome of heart disease in pregnancy. Methods: An Observational study was conducted over a period of 8 months over 50 antenatal patients with heart disease from January 2020 to August 2020 in the department of obstetrics and gynaecology, grant government medical college and JJ group of hospitals, Mumbai with appropriate inclusion and exclusion criteria. Prevalence of congenital and acquired heart disease complicating pregnancy, complications, age wise and parity wise distribution were mainly studied.Results: The incidence of heart disease was 1.8% amongst the 2,750 total deliveries conducted. In this study 46 (92%) were registered and 4 (8%) were unregistered antenatal cases. 45 (90%) belonged to upper lower class and lower class as per Kupuswamy scale with poor nutrition and antenatal care. 34 (68%) of patients had rheumatic heart disease and 11 (22%) patients had congenital heart disease. Mitral stenosis was found to be the dominant valvular lesion in rheumatic heart disease in 12 (24%) cases. Over 25 (50%) of the patients had normal vaginal delivery and 9 (18%) had instrumental vaginal deliveries, 7 (14%) with vacuum and 2 (4%) with forceps. Congestive cardiac failure was found to be the major complication found in 4 (3.9%) cases. About 8 (16%) patients required intensive care unit admission. Maternal maternity is about 4% (2 patients) in the present study.Conclusions: Maternal mortality in heart disease patients can be brought down significantly by effective preconceptional counselling, and improvements in medical, surgical, antenatal, intranatal, and postnatal care and effective motivation for contraception.
Maternal factors associated with low birth weight babies
Authors: Kathrani Sulay R. , Patel Rutwa D. , Jamkhandi Sheetal B. , Chandnani Kavita A.
Published: December 2022

Background: To identify and evaluate various maternal factors associated with low birth weight babies delivered at term and to find out prevalence of LBW babies delivered at term at Dhiraj hospital.Methods: A single arm cross-sectional observational study was conducted in obstetrics & gynaecology department of Dhiraj Hospital, from June 2021 to December 2021. A total 250 patients fulfilling inclusion and exclusion criteria were enrolled. Data was collected from the labour room register statistics as reference for comparison. Maternal factors like-maternal age, parity, anemia, booking status, pregnancy induced hypertension, ante-natal iron and protein supplements, tobacco addiction, placenta previa, gender of newborn etc were studied. Data were analyzed with the help of chi-square test and were also presented by visual diagrams.Results: From the study, the prevalence of LBW at term in Dhiraj hospital was around 22.36%. Out of 250 in sample group, 63.6% mothers were anemic. Almost over 50% mothers with LBW had not taken regular iron supplements. Around 67% mothers not adequately visited (4 antenatal visits) hospital during antenatal period. Primipara mothers (58%) associated more with LBW babies than Multipara (42%). Pregnancy induced hypertension and placenta previa significantly affects birth weight. Around 30% LBW show maternal history of tobacco addiction.Conclusions: Although the prevalence of LBW in India has declined over the past decade, it remains still high. Anemia is the most important modifiable factors contributing birth weight. Iron and Protein supplementation need to be attention to prevent LBW. A comprehensive global strategy is required to reduce LBW which must include multiple elements: improving maternal status, treating PIH (or other associated condition), and providing adequate maternal care.
HIV in pregnancy: a study of 30 cases in a tertiary care center in Mumbai, India
Authors: Kulkarni Sejal , Palve Tushar , Bulchandani Priya , Devnikar Komal , Thatikonda Rajashree
Published: December 2022

Background: HIV/AIDS infection is a significant cause of perinatal morbidity/mortality. Appropriate antiretroviral therapy should be given to all HIV-positive pregnant women to reduce the burden of the infection on mothers and children. The objective of this study was to evaluate the prevalence of HIV infection in pregnant women among age, parity, and mode of delivery and to observe the clinical features, co-existing infections, and various pregnancy outcomes in HIV-positive pregnant women.Methods: It is a type of research article. The present study was conducted in Unit 2, Department of Obstetrics and Gynaecology, Cama and Albless Hospital, Mumbai, Maharashtra, India, from a period of January 2022 to July 2022, 30 HIV-positive ANC mothers were examined.Results: About 30 ANC mothers participated in the study in which most of the subjects belonged to the 23-39 years of age group. Maximum patients are multipara.Conclusions: We found most (66.6%) of the ANC women with HIV-positive status delivered a healthy baby at term.
COVID-19 in pregnant women: a comparative observational study of pregnancy outcome in three waves of COVID-19 in district hospital, Ballari
Authors: Joshi Suyajna D. , G. Vijayalakshmi , Banu Ruksar , G. Jayasakthi , A. Shrilakshmi R.
Published: December 2022

Background: A three wave pattern of corona virus has been seen in many countries during the 2020 pandemic. Observed data show that the effects of the virus do vary between the three waves. Differences in severity of the disease have been reported, although the comparative characteristics of the three waves still remain largely unknown.Methods: This was a prospective cross sectional study continuation of our first paper comparing 133 pregnant COVID- 19 positive patients in the first wave and 251 patients admitted during second wave and 92 patients in third wave who delivered at district hospital, Bellary.Results: In the present study 72.8% patients were in the age of 20-30 years, 85.87% patients belong to lower socio- economic status, mild anaemia about 32.6% in third wave, moderate anaemia seen in 10.8% in third wave, and 3.44% had severe anaemia. Non-severe pre-eclampsia was present in 10.8% of the patients, severe pre-eclampsia was seen in 6.52% of the cases and. Mode of delivery was 29.34% FTND, 3.26% FTVD emergency LSCS was 63.06% in third wave, and preterm delivery was seen in 4.34% in third wave. Elevated levels of D-dimer were found 25% in third wave. 0 deaths being reported in third wave.Conclusions: This study compared the obstetric and clinical outcome in COVID-19 positive patients who are in labor in first, second, and third wave of COVID-19 infection. Although our conclusions are limited, the finding so obtained are important for understanding the clinical parameters, obstetric parameters and perinatal outcome in three waves.
Correlation of estimated fetal weight by ultrasound and birth weight in low risk pregnancy: a prospective study
Authors: Marla Shreesha , Ganiga Pradeep
Published: December 2022

Background: Sonographic fetal weight estimation is an important aspect of antenatal care. It is one of many important factors used to determine when and how to terminate pregnancy. This study was therefore carried out to sonographically estimate fetal weight with actual birth weight, to analyze various demographic parameters with birth weight and thus predict neonatal outcomes. Aim of the study was to correlate estimated fetal weight by ultrasound and actual birth weight in all low-risk antenatal women attending regular antenatal check-ups at tertiary care centerMethods: This was time bound prospective study, was conducted in pregnant women undergoing antenatal check-up in a tertiary care center from April 2022 to August 2022. During antenatal check-up, the subject was advised to undergo ultrasound imaging at 32-36 weeks and at term to look for BPD, AC, HC, FL, EFW. Clinically estimated fetal weight noted. Following delivery of baby, birthweight is recorded. Estimated fetal weight and actual birth weight are correlated and neonatal outcomes assessed.Results: As per the study sonographically estimated fetal weight at 32-36 weeks and at term, clinically estimated fetal weight correlated positively with actual birth weight.Conclusions: The statistics as per this study conducted in tertiary care centre in mangalore could be applied to Indian population, which may aid obstetricians in planning the mode of delivery, improve pre-labour counselling and efficient management of antenatal mother and large babies. Clinically estimated fetal weight could be used as a diagnostic tool sufficient to manage labour and delivery efficiently in low resource setting.
Prevalence of vitamin D3 deficiency and its correlation with high-risk pregnancy pre-eclampsia and eclampsia study from central India
Authors: Nandedkar Aditya Madhav , Bachewar Paraji , Memon Madiha
Published: December 2022

Background: To study the relationship between vitamin D3 deficiency and pre- eclampsia and eclampsia.Methods: It is case control study, The study was conducted in the department of medicine Pt. J. N. M. and BRAM hospital, Raipur (CG) among the patients diagnosed as pre-eclampsia and eclampsia admitted in Obs. and Gynae wards. Study group (Group A) comprised of 80 patients diagnosed as pre-eclampsia and eclampsia presented at term Control group (Group B) comprised of 50 individuals from normal healthy population (ANC patient at term which was normotensive)Results: It is case control study. In this study 130 patients were included of which study group comprised of 80 patients and control group comprised of 50 patients. it has been observed that vitamin D deficiency was prevalent among the study group and control group however statistically significant higher number of cases in study group (toxemia of pregnancy) were vitamin D deficient as compared to control group. In our study 95% cases had lower level of vitamin D (35% insufficient and 60% deficient) as compared to 72% (46% insufficient and 28% deficient) in control. Out of these 60% of cases in study group vs. 28% cases in control group were seriously vitamin D deficient (vitamin D level <30 nmol/l).Conclusions: Vitamin D deficiency and insufficiency was found to be associated with normal pregnancy (control group), preeclampsia and eclampsia. In present study direct correlation was observed in preeclampsia and eclampsia with low vitamin D levels.
Insight into epidemiology of male infertility in central India
Authors: Agarwal Ayushi , Srivastava Aviral , Fathima Farheen , Lodhi Bharti
Published: December 2022

Background: Approximately 10% to 15% of couples in developing countries are infertile. Male infertility is responsible for 20-43% of infertility cases and contributes to another 12-20% of cases. Azoospermia, oligozoospermia, asthenozoospermia, teratozoospermia, and oligoasthenoteratozoospermia are abnormal sperm parameters causing male infertility. Male infertility is often poorly responsive to primary treatment and often requires supportive secondary measures. The understanding of causes and modifiable risk factors for male infertility would enable their prevention and primary treatment. Aims and objectives of current study was to analyze the epidemiology and clinical factors of male infertility in Central India and identify its risk factors.Methods: 100 male patients attending outpatient for treatment of infertility were evaluated using a questionnaire. Semen samples were collected and spermatozoa were assessed according to WHO 2021 data for semen analysis. The results were tabulated and analyzed.Results: Amongst patients were semen abnormalities, the majority (34%) of patients had oligoasthenoteratozoospermia. All semen abnormalities were most common in the age group 35-45 years and in patients with 5-10 years duration of infertility. All semen abnormalities except azoospermia were most common in people with a monthly income of >2,000-5,000. The majority of the patients had a past history of urogenital tract infection, except oligoasthenospermic males in whom the majority had varicocele. All semen abnormalities were more common among businessmen and also more prevalent among smokers.Conclusions: Couples should be educated about infertility causes and the contribution of male infertility to it. Multifactorial analysis along with clinicopathological analysis should contribute to accurate diagnosis of the cause of male infertility and proposal of adequate measures.
A study on implementation of WHO labour care guide in low-risk pregnant women and its impact on maternal and perinatal outcome
Authors: N. Srividya , Lakshmi M. Sri Jhansi
Published: December 2022

Background: WHO Labour Care Guide is a labour monitoring tool that is developed to support respectful maternity to provide positive childbirth experience with evidence-based recommendations.Methods: This is an observational study comparing WHO labour care guide with WHO modified partograph in low-risk pregnant women who are in active phase of labour. The study included 80 labouring women who are divided into two groups with 40 participants in each group. In group 1 WHO modified partograph was used and in group 2 WHO labour care guide was used as a tool to assess the course of labour. Maternal and perinatal outcomes were analysed for both the groups.Results: There is no significant difference in the caesarean section rates and instrumental deliveries between the two groups. There is a rise in the incidence of PPH and meconium-stained liquor in group 2 compared to group 1. None of the participants had labour beyond 12 hours. NICU admissions were higher in group 2.Conclusions: In our study, the WHO modified partograph was found as equivalent to WHO labour care guide in identifying prolonged labor. Also, maternal and perinatal outcomes were equally identified by both types of partograph. WHO labour care guide did not prove to be beneficial over WHO modified partograph in terms of maternal and perinatal outcomes in Indian parturient women.
Study of feto-maternal outcome in twin pregnancy
Authors: Sheth Kenan , Sheikh Amira M. , Shah Margi A.
Published: December 2022

Background: In modern obstetrics with advanced ultrasonographic techniques and color Doppler, multiple pregnancy and associated condition like chorionicity, growth discordance, vascular complications, twin to twin transfusion syndrome, intrauterine death of one or more fetus and congenital anomalies can now be diagnosed at early stage of gestation. Vigilant obstetric care during antepartum, intrapartum and postpartum period decreases maternal morbidity and mortality as well as improves fetal outcome in twin pregnancy.Methods: This is a randomized prospective study of 250 patients of multiple pregnancy admitted at our institute from July 2020 to June 2022 including all emergency as well as registered patients. In all cases a detailed history was taken and all routine investigations were done. All information was entered in a proforma and the fetomaternal outcome of twin pregnancy was analysed.Results: Around 67% patients had onset of labor after 32 weeks of gestation, rest 32% patients had onset of labor at or before 32 weeks of gestation. The 55% patients underwent lower segment caesarean section and 45% patients delivered vaginally. We observed highest incidence of twins in age group 21-30 years. Maximum number of patients 59% were multigravida compared to primigravida.Conclusions: Multiple pregnancy is considered as “high risk pregnancy”. hence early diagnosis of multiple pregnancy is essential in reducing maternal and perinatal morbidity and mortality.
Myasthenia gravis in pregnancy: a case report
Authors: Assudani Lata , Notwani Ashish
Published: December 2022

Myasthenia gravis is an autoimmune neuromuscular disorder characterized by weakness and fatigue of skeletal muscles of the face and extremities. It affects the people of both sexes and all ages, but twice as many female patients are affected as male patients. Myasthenia gravis usually strikes women in their third decade of life. Although disease course is variable, pregnant patients face risks of exacerbation, respiratory failure, adverse drug response, crisis and death.Because the severity of symptoms, as well as maternal mortality, is highest in the first 2 years following onset of myasthenia gravis, it is advisable for women to delay pregnancy for at least 2 years following diagnosis. Severity of symptoms and risk of maternal mortality is lowest 7 years after onset of the disease. We report a case of 26-year-old patient with G2P1IUFD1 at 37 weeks of gestation with myasthenia gravis.
A rare case of extraovarian dysgerminoma in pregnancy
Authors: N. Sumathi , N. Rajasekaran P. , S. Valarmathy , V. Divya , Deivasikamani Deenadayalan , . Jayashree
Published: December 2022

Extraovarian germ cell tumors are very rare and their occurrence in pregnancy is extremely rare. We presented a case of extraovarian dysgerminoma on the anterior abdominal wall in a G2P1L1, 34 weeks. It is challenging to manage such tumors, obstacles in the way namely are diagnosis as the presentation can be different from classical ovarian GCTs, limitations in the investigatory modalities in pregnancy, and management involving three independent entities-tumor, mother, fetus.
An undiagnosed case of placenta increta: a nightmare for obstetricians
Authors: Marla Shreesha , Ganiga Pradeep
Published: December 2022

Placenta increta, one type of morbidly adherent placenta, is characterized by entire or partial absence of the decidua basalis, and by the incomplete development of the fibrinoid or Nitabuch’s layer and villi actually invading the myometrium. The major clinical problem in placenta accreta spectrum disorder is failure of placenta to separate normally from the myometrium after fetal delivery. It is associated with high morbidity and sometimes with a lethal outcome, mainly as a result of severe bleeding, uterine rupture and infections. 33-year-old Mrs. X primigravida at 38 weeks 5 days admitted in our hospital for elective LSCS with the indication of hysteroscopy and laproscopic ACUM (accessory and cavitated uterine mass) excision in the past. Adherent placenta diagnosis was done on table, senior anesthetic team was called and decision was taken to remove the placenta manually with adequate resuscitative measures i/v/o torrential bleeding. Defect of 4×6 cm on the anterolateral part of the upper uterine segment (previous ACUM excision site). Decision was done to go ahead with vigilant watch, keeping ready for systematic devascularization of the uterus followed by caesarean hysterectomy in case torrential bleeding continues. With a multidisciplinary approach, Patient was serially monitored with USG, beta hCG levels, attempting to preserve uterus in this case. This was a very rare case of asymptomatic placenta previa with placenta increta in a post ACUM scarred uterus and it was successfully managed by sequential monitoring with backed up uterine embolization team if secondary PPH occurs.
Headache in pregnancy-a diagnostic dilemma: an unusual case of advanced glioblastoma multiforme in pregnancy: a case report and review of literature
Authors: N. Sunanda , K. Mythreyi
Published: December 2022

This was a case report of a twenty year old patient with a obstetric score of G2P1L1 with 28 weeks of gestation presented with persistent intractable headache leading to a diagnostic conundrum. Magnetic resonance imaging of the brain revealed an advanced glioma in the right frontal lobe with a mass effect and a midline shift for which emergency surgical resection was sorted followed by chemoradiation which eventually lead to a satisfactory obstetric and perinatal outcome.Glioblastoma multiforme is a rare diagnosis during pregnancy which carries unique challenges to the mother, foetus and the health care providers. A combined effort from a multidisciplinary team is the key for a successful outcome.
Evaluation of open reduction and internal fixation with closed reduction and external fixation in distal radial fracture
Authors: Belbase Rupesh Jung , Limbu Kumud , Basnet Anil Kumar , Chaudhary Pratik
Published: December 2022

Background: Radial fracture frequently occurs in osteoporotic disorders, or in low-energy injuries. It is most frequent fracture of the upper extremity. Open reduction or closed reduction is done but there is debate between the two about its efficacies. Aims and objectives were to find out the efficacy and safety of open reduction and internal fixation (ORIF) with that of closed reduction and external fixation (CREF) among patients with distal radial fracture of all ages.

Methods: This prospective study was conducted with patients of distal radial fracture. They underwent interventions, namely, ORIF (Open reduction group) or CREF (Closed reduction group). DASH score was measured before the intervention and during several follow ups at 4th week to 15th week. DASH score was statistically analyzed between the two groups. Additionally, the complications of the patients in each group were evaluated and sick leaves of the patients was recorded to assess their quality of life.

Results: The study has found that the number of days taking patients took sick leave from field work is significantly more in "closed reduction" group as compared to "open reduction" group (p<0.05). The number of days patients took sick leave is significantly higher in “closed reduction” group as compared to “open reduction” group (p<0.05).

Conclusions: The study has concluded that the disability of the patients who received ORIF decreased significantly as compared to those who received external fixation and the patients who received open reduction significantly improved from the fracture.
Clinical efficacy of the radius bone plates for the fixation of radius bone fractures
Authors: Kumar Tarun , Beriwal Mridul , Chawale Bhawana , Kumar Mohit , Luthra Gaurav
Published: December 2022

Background: The purpose of this study was to evaluate the clinical efficacy of the radius bone plates fixation for treating radius bone fracture.

Methods: Forty-Five patients with fracture of the radius involving the distal part were treated with fixed angle plate fixation approach. This was a retrospective study in which 45 patients (39M, 6F) were treated at different hospitals and countries between August 2020 to October 2021 with a mean follow up of year (1month, 3months, 6months and 12months). All patients were followed using radiographs, physical examination, ASA and VAS score.

Results: All patients with radius fracture treated with specific fixation of plate system were enrolled and received continuous physiotherapy by physiotherapists, which helped in early healing. The clinical treatment results showed decline in the VAS score percentage after 1 year follow up. About 91.1% patients were satisfied with no pain and 8.8% patients were unsatisfied due to mild pain. A successful surgical outcome was reported without any complications related to implant breakage, loosening, corrosion or other factors.

Conclusions: The radius plate system results in more efficient, stable fixation and better subjective results early in the postoperative period. It has minimal complications requiring reoperation and risks.
Real world evidence of effectiveness and safety of an oral formulation containing un-denatured type-II collagen 40 mg and aflapin 100 mg (HAPID®) in the management of osteoarthritis of knee: findings of a prospective, multi-center, observational study
Authors: Pal A. K. , Sen Sanjoy , Behera Sanatan , Anand Rajeev , Bhattachayya Chandradhur , Kalidoss K. , S. Arumugam , . Shivarajaiah , Jagadeesh P. C. , Karvir Sagar , Patil J. C. , Anand Rajeev , Jethwah Jawahar , Suryavanshi Ashok , Sangtani H. J. , Jadhwar Sameer , Debnath Khokan , Panghate Atul , Moonot Pradeep
Published: December 2022

Background: Osteoarthritis (OA) of knee is a common progressive multifactorial joint disorder affecting the quality of life, and surgical repair is the final option which has substantial impact on healthcare costs. This real-world study evaluates the efficacy and safety of an oral formulation containing UC-II and aflapin (Boswellia serrata extract enriched in 3-O-acetyl-11-keto-beta-boswellic acid) for treatment of OA of knee.

Methods: Data of 505 ambulatory adult patients (study duration-Jul-21 to Jul-22) of either gender (227 M, 278 F) having OA of knee, and who received study treatment (capsule HAPID®, Wockhardt, India) once daily for a period of up to 90 days were included for the study after obtaining informed written consent. Primary outcomes were mean change in Western Ontario and McMaster universities OA index (WOMAC) scores from baseline through day 90 (total and sub-scales for joint pain, joint stiffness, and physical function), and change in 0-10 visual analogue scale (VAS) score for pain.

Results: About 285 (56.4%) patients were newly diagnosed, majority (63.4%) were having grade 2 severity of OA (Kellgren and Lawrence grade). The mean (SD) baseline total WOMAC scores improved from 60.94 (23.60) at baseline to 26.42 (22.19) on day 90. Significant improvements were seen starting from day 5 (p=0.023) and progressively up to day 90 (p<0.0001).

Conclusions: The excellent safety and efficacy profile of combination therapy with aflapin and UC-II makes it a desirable pharmacological treatment modality for management of patients of knee OA.
Prospective study comparing early functional outcome and gait analysis in femoral neck fracture treated by cemented hemiarthroplasty using modified Hardinge approach and conventional posterior approach
Authors: Jadhav Shivsagar V. , Murkute Kishor G. , Swamy Amit P. , Badgujar Omprakash
Published: December 2022

Background: A prospective study was done to compare the outcomes of management of fracture neck of femur by cemented hemiarthroplasty using modified Hardinge approach and conventional posterior approach

Methods: The 2019 to 2022 50 patients underwent bipolar hemiarthroplasty for femoral neck fracture. Group A (Femoral neck fracture treated using conventional posterior approach) and group B (Femoral neck fracture treated using modified Hardinge approach) with 25 patients in each group. Outcomes were evaluated based on mean surgical time and Harris hip score and SF-36.

Results: Mean duration of surgery in minutes was more for modified Hardinge approach. Harris hip score with standard deviation for modified Hardinge Approach for follow-ups was better and statistically significant than posterior approach. Similarly, quality of life after surgery, in terms of mean SF-36 score with standard deviation for modified Hardinge approach was better and statistically significant than posterior approach. Modified Hardinge approach has fewer complications in comparison to the posterior approach. With the advantages comes a longer learning curve to operate without complications. Hence, with proper surgical technique, and proper tight closure, we prefer the modified Hardinge approach over other approaches as it had nil dislocations and abductor lurch.

Conclusions: Modified Hardinge approach for hip arthroplasty in elderly people with femoral neck fracture provide significant benefit in the early post operative period when compared to conventional posterior approach in terms of post operative pain, time of recovery, dislocation rate and quality of life.