bluuebunny/crossref_metadata_2025 huggingface dataset:
Distance and Cross-Border Shopping for Alcohol
Authors: Bygvrå Susanne
Published: December 2017

Since 1973 when Denmark joined the EEC, Danes have flocked to Germany to buy alcoholic beverages more cheaply than in Denmark. In the decades since accession to the EU, the Danish duty-free allowances and the price relations between Denmark and Germany have changed several times. Each change has been followed by adjustments in consumers' shopping behaviour. As people living at different distances from the border face different travel costs, it is likely that they have different purchasing behaviour and react dissimilarly to changing terms.

The purpose of this paper is to explore how people at different distances to the border use the opportunity for purchasing alcoholic beverages in Germany and how their purchases have changed. The analyses are based on data gathered by face-to-face interviews with Danes crossing the border on their way back from Germany. Eight surveys carried out between 1986 and 2003 are included in the study. It is concluded that distance plays a decisive role in cross-border shopping for alcoholic beverages. In general, those living within 25 km from the border exhibit behaviour significantly different from travellers from larger distances.
Changes in Private Alcohol Importation after Alcohol Tax Reductions and Import Allowance Increases in Denmark
Authors: Grittner Ulrike , Bloomfield Kim
Published: December 2017

Aims

This paper examines changes in alcohol import in Denmark between 2003 and 2006, after the excise tax on spirits in Denmark was lowered by 45% on October 1, 2003, and travellers' allowances for alcohol import were increased on January 1, 2004. Additionally, the paper seeks to develop a profile of alcohol importers and analyse the relation between the distance to the German border and import behaviour, as Germany is the main alcohol import country for Denmark.

Data

Cross-sectional and panel data from Denmark, from 2003 to 2006, were analyzed. Samples were collected by telephone interviews, using random digit dialing.

Results

While the percentage of people who imported alcohol fell over time, the amount of alcohol purchased rose for those who did import. Distance to the German border was inversely related to the likelihood of importing and the level of imported amounts. Heavy drinkers and those with higher incomes were more likely to import, and heavy drinkers imported higher amounts than moderate drinkers or abstainers.

Conclusion

Distance of residence from the German border, socio-economic status and drinking behaviour are related to private alcohol import in Denmark. Policy changes resulted in a shift to fewer people importing higher amounts of alcohol so that the overall import level did not change substantially.
Travellers' Alcohol Imports to Sweden at the Beginning of the 21st Century
Authors: Svensson Johan
Published: December 2017

Background

Privately imported alcohol has increased during the last decade in Sweden. Estimates suggest an increase from 1.1 liter (pure alcohol) per inhabitant in 1996 to 2.7 liters in 2004, and a decrease to 1.8 liters by 2007. Privately imported alcohol represented approximately 20% of total consumption in Sweden during the period 2001–2007 and thus represents a large amount of all alcohol consumed. However, the drinking habits of importers have been rarely studied.

Aim

The main aim of this paper is to examine drinking patterns and experiences of alcohol-related problems among Swedes who bring alcohol in from abroad and to investigate whether these differ according to the levels of importing. In addition those who bring alcohol in from abroad are compared with those who do not.

Data & Methods

Data on private import of alcohol, alcohol consumption, adverse consequences of alcohol and socio-demographics were obtained from a monthly telephone survey for the period January 2002 until December 2007 and were aggregated into annual data. For each month a randomised population of 1,500 individuals where asked whether they had returned to Sweden from abroad. If they responded affirmatively they where then asked questions on how many times abroad, during the last 30 days, and if they had brought any alcohol to Sweden the last and or the second-to-the-last time. Irrespective of the respondent had been abroad or not questions on alcohol consumption, drinking patterns, adverse consequences and socio-demographics were asked. On average the telephone interviews lasted for approximately ten minutes. Logistic regressions was used to estimate the association between drinking habits (and problems) and different amounts of alcohol imports.

Results

The findings of this study indicate that those who import alcohol drink more and engage in binge drinking more frequently than those who do not. However, adverse consequences of alcohol consumption were not reported to the same degree as among the non-importers.
En Påtvingad Relation: Stöd och Kontroll i Kontaktmannarelationen Inom LVM-Vården
Authors: Billquist Leila , Skårner Anette
Published: December 2017

This article explores how the dual role of support and control is staged and managed in the compulsory treatment of adult alcohol and drug addicts, particularly how it is expressed in the relationship between clients and their key staff members (KSM).

The study on which this article is based was performed in Sweden. The empirical data consists of observations of everyday life in four residential treatment centres where compulsory care takes place as well as qualitative interviews with clients and their KSMs.

The findings show the different strategies clients and KSMs use and develop to deal with the tension between support and control. The article emphasises that compulsory treatment of drug addicts is permeated by contradictory and complex situations and interaction patterns that may be seen as paradoxical.

The results show that, under certain conditions, it is possible to develop therapeutically helpful relationships within compulsory addiction treatment. However compulsory elements as such reduce the potential for these kinds of relationships.
What's in a Name?: Alcohol and Drug Treatment and the Politics of Confusion
Authors: Edman Johan
Published: December 2017

Aims

The aim of this article is to investigate the use of a rather vague medical conceptual framework within the compulsory treatment of alcohol and drug users in Sweden during the 20th century. The focus lies on exploring how a phenomenon came to be described as pathological, what the causes are for certain actions being suddenly interpreted in medical terms, and what consequences that might lead to.

Design

Supported by theoretical speculations on medicalization processes and conceptual history, two empirical cases (the compulsory care of alcohol abusers in the 1950s and the legislative process leading to psychiatric compulsory care of drug users in the late 1960s) are investigated. The first case draws mainly upon official reports and archive material from alcohol treatment institutions, whilst the second case is built from reading official reports and parliamentary material. The research task for the two empirical cases has not quite been the same: whereas the first case is illustrated by the discrepancies between the labelling of treatment activities and the treatment actually carried out, the second case rather draws upon the enlargement of the field of signification of the disease concept to cover most aspects of drug use.

Results

A medicalization process on different levels is traced both in the post-war compulsory treatment of alcohol abusers as well as the compulsory psychiatric care for drug abusers that was introduced from the late 1960s onwards.

Conclusion

The investigated cases show how the medicalization processes benefited from conceptual vagueness, leading to a widening of the conceptual dimensions of both the treatment and disease concepts. In this, the medicalization of alcohol abuse in the 1950s and drug abuse in the 1960s made way for a paternalistic justification of compulsory care measures that might otherwise have become politically troublesome.
Limits of Evidence – the Case of Psychosocial Interventions in a Swedish Review of Maintenance Treatment Research
Authors: Ekendahl Mats
Published: December 2017

In Sweden, maintenance treatment (MT) with methadone has been a controversial exception to drug-free treatment. However, efficacy, prescription control and the provision of simultaneous psychosocial treatment (PST) have provided MT with political legitimacy. This view, notably stressing that PST is an important complement to medication, was presented in central Swedish policy documents that paved the way for less strict MT regulations in 2005.

Aim

The present study aims to analyse how the various stakeholders involved in this policy process described and evaluated the efficacy and legitimacy of PST within the framework of the MT discussion.

Data & Method

The data consists of a document authored by a state agency (a preliminary review of MT research) and various stakeholders' written commentaries on it. different representations of PST (so-called constructions) were coded thematically and analysed using discourse analytical concepts.

Results

The results show that stakeholders' constructions of PST draw on different discourses related to the governance of Swedish opiate addiction treatment. Four constructions were identified, PST as: “mere complement” (narrow empirical discourse); “underrated intervention” (practitioner discourse); “preferred intervention” (ideological discourse) and “complex intervention” (antireductionist discourse). The study illustrates how the narrow empirical discourse's construction of PST as a mere complement was challenged by the three other discourses, but shows that the former remained the dominant influence on subsequent MT regulations. It also highlights that references to beliefs and alleged facts are intertwined in stakeholders' rhetorical efforts to assign meaning to PST. This suggests that science and ideology are interrelated in policy discussions on opiate addiction treatment, and that firm conclusions about the value of help interventions rely as much on scientific evidence as on strategic argumentation.
Internet poker
Authors: Tryggvesson Kalle
Published: December 2017

K. Tryggvesson: Internet poker – Prevalence and problems in Sweden 2006

This paper examines the prevalence of internet poker gambling and gambling-related problems in Sweden in 2006. The sample consists of 16,500 random digit dialling quantitative telephone interviews that were completed with Swedes aged 16–80 during the last 11 months of 2006. Respondents were asked questions about their gambling activity with regard to type of gambling, level of gambling activity and gambling-related problems. The relationship between type of gambling activity and gambling-related problems was examined by means of Chi-square and logistic regression analyses. The paper shows that internet poker gamblers were more likely to report gambling-related problems than other gamblers. This effect was related to several factors; internet poker attracts a vulnerable population, internet computer-based games increase the risk due to the high level of availability and for reasons associated with the technology itself, and finally, the game itself, poker, increases the risk for problematic gambling behaviour.
The investment strategy of the region
Authors: Новоселова Наталья , Novoselova Natal'ya , Хубулова Вероника , KHubulova Vyeronika
Published: December 2017

In the textbook the content of the main stages, principles, conditions and factors of formation of investment strategy in the region, the necessity of its development; explored the specifics and peculiarities of management of the investment process and the participants of the investment market in the region; analyzed industry-specific strategies of optimum use of investment resources of the region.
Effect of Continuous Contour Trenches on Nutrient Status of the Micro-catchment
Authors: Wankhade R. M. , Patode R. S. , Nagdeve M. B. , Gabhane V. V. , Pande C. B.
Published: December 2017

The adoption of in-situ soil and water conservation techniques are the need of the day all over the country. Taking into consideration this logic, the experiment on practical implementation of the conservation measures along with impact assessment was undertaken at AICRP for Dryland Agriculture Dr. PDKV, Akola. In which impact assessment of continuous contour trenches (CCTs) on hydrological, agronomic, soil nutrient status has been made. In this paper the results related to soil nutrient losses are presented. The small catchment was divided into two parts one is treated with CCTs and other is without CCTs. From the recorded data and nutrient status analysis, it was observed that in CCT treated (T1) micro-catchment Nitrogen, Phosphorous and Potassium was more by 25 %, 15.31% and 9.96% respectively over untreated (T2) micro-catchment. The micro-nutrients viz. Zinc, Ferrous, Magnesium and Copper in CCT treated micro-catchment was observed more by 15.56 %, 7.70%, 23.07% and 37.54% respectively over untreated (T2) micro-catchment. The pH and EC was also observed to be more in CCT treated (T1) micro-catchment as compared to untreated (T2) micro-catchment. These results conclude that in CCT treated micro-catchment the losses of nutrients had been reduced which ultimately useful for plant growth. Thus continuous contour trenches are useful for conservation of soil nutrients.
Integrated Physiological, Biochemical, Anatomical and Molecular Studies Reveals Salt Stress Responsive Mechanism Associated with Popular Rice Land-Races in Eastern Part of India
Authors: Ganesh Pushpalatha , Ganduri Pavan Kumar , Sri Pondala Ramya , Marthala Venkat Reddy , Gedala Sridevi
Published: December 2017

The present study aims towards examining physiological, biochemical, anatomical and molecular traits in the high-yielding rice landraces of the eastern part of India at germination and seedling stage for low-to-moderate salinity stress tolerance. The germination percentages of 12 high-yielding varieties were analyzed under seven different concentrations of salt (0, 50, 100, 150, 200, 250 and 300 mM). Although, Lalat performed very well with 63.66 % germination rate at 300 mM salt stress conditions, higher levels of salinity exhibited detrimental effects on other varieties. Hence, the salt concentrations 150 mM and 250 mM were optimally selected to screen the varieties for physiological and biochemical traits. The high-yielding varieties Lalat, Vamsi and Pratiksha exhibited lowest and similar trend of reduction over control (ROC) with relative water content (RWC) for 250 mM salt concentrations. The level of proline, increased with increasing concentrations of NaCl among most of the varieties and significantly high content was found in Vamsi. The chlorophyll content was high in Lalat as well as Pratiksha and reduction over control was highest in Vamsi under 150 mM salt concentrations. Interestingly, Lalat emerged as the most salt-tolerant landrace for physiological and biochemical traits. It was compared with salt-sensitive MTU7029 for anatomical changes on adaxial surface of the leaf blade and noticed out to be with less widened and few number of stomatal pores in response to salt stress. Further, expression analysis of salt-specific genes OsHKT1;5 and OsNHX1 resulted in identification of novel salt-stress responsive alleles/motifs like W-boxes, Box-W1, E2Fb and MBS in Lalat (salt-tolerant). Thus, the study disclosed the anatomical changes in adaxial surface of leaf and association of potential cis-acting regulatory elements (CARE) in regulation of salt-stress responsiveness in these two-contrasting rice landraces in the eastern part of India. Further, the study laid a foundation to explore transcriptional gene regulation to open-up the pathway towards crop improvement for salt-stress tolerance.
Study the manifestation of growth and yield attributes of Broccoli through application of boron, molybdenum, zinc and their combination treatments in Terai agro-ecological region of West Bengal.
Authors: Chowdhury Rimansaha , Sikder Subhomay
Published: December 2017

Broccoli (Brassica oleracea L.) is an important winter vegetable under the cole groups, which has great market potential in India and Gulf countries. The climatic condition of Terai region of West Bengal is highly suitable for broccoli cultivation that argued for the possibility of getting more net profit of the farmers from cultivation of this high valued crop. But due to the micronutrient deficiency in the soil of terai region, broccoli not gives good return for this reason the experiment was done to give a recommendation to the farmers for better yield. The present experiment was carried out to examine the effect of boron, zinc and molybdenum on broccoli (cv-green magic) with sole doses of these three micronutrients were fixed 0.3% for borax, 0.5% and 1.0% zinc sulphate as per and 0.03% and 0.05% per ammonium molybdate solutions as sole as well as their combined treatments on the yield and growth parameters of the broccoli. Among the sole treatments, application of zinc showed significantly higher effect on leaves per plants, leaf area, total chlorophyll content of the leaf and ascorbic acid content in the head. Significantly higher plant height showed by the treatments 0.03% Mo+1% Zn (59.10cm) and 0.05% Mo + 1% Zn (59.05cm), respectively. Irrespective of the treatments Zn had significantly positive influence in increasing the number of leaves per plant, especially at 0.5% dose. Significantly highest ascorbic acid was recorded at i.e., 61.54mg/ 100g of fresh head weight along with this significantly highest leaf area were recorded at combination treatment of 0.3%, 0.03% Mo and 0.5% Zn (454.35 cm2) and sole treatment of 0.5% Zn (452.33 cm2). Combination of 0.3% borax, 0.03% ammonium molybdate and 0.5% zinc sulphate were recorded to be best for most of the traits.
Organic Mulching- A Water Saving Technique to Increase the Production of Fruits and Vegetables
Authors: Ranjan Prem , Patle G. T. , Prem Manjeet , Solanke K R
Published: December 2017

In the present situation of globalization and health awareness demand of the virtuous horticultural crops has increased worldwide. The increasing demand for the fruits and vegetables and market competition has forced the farmers to produce more and high-quality fruits and vegetables for sustaining in the international market. Use of organic mulching is one of the suitable methods which could help the horticultural growers to increase the production with good quality of produce. Looking to the water scarcity and the challenges that arise due to climate change, adoption of organic mulching at large scale by the Indian farmers would help the farmers to overcome several problems considering the advantages of organic mulching. From the findings of the several studies shown that mulching with organic materials increases the soil nutrients, maintains the optimum soil temperature, restricts the rate of evaporation from the soil surface, restricts the weed growth and prevents the soil erosion. It also helps to improve the soil health. Organic mulches are cheap materials; therefore, the cost of mulching is also economical. In this paper, an attempt has been made to overview on the various types of mulching, mulching techniques, benefits and limitations of mulching.
Studies on weed cover and diversity in coriander (Coriandrum sativum L.) as influenced by weed management and balanced fertilization techniques
Authors: Kumar Nagar Raj , Kumar Jain Dinesh
Published: December 2017

A field experiment was conducted to analyze the types of flora, intensity, cover and effects on yields of coriander. Pooled analysis of data indicated that Goose foot (Chenopodium murale L.), Corn spurry (Spergula arvensis L.) among dicots and Purple nutsedge (Cyperus rotundus L.) among monocots were found most dominant weeds at all stages of crop growth. Of the total eight weed species reported dicot weeds were found most dominating weed species and comprises 78-80 percent of total weed density throughout crop cycle. All weed management practices significantly reduced the density of monocot and dicot weeds and improved the yield (seed and biological yield) of crop as compared to control. Two hand weeding at 30 and 45 DAS resulted in maximum reduction in total weed density and gave the highest seed (15.84 q/ha) and biological yield (41.11 q/ha) of coriander. However, seed and biological yields was obtained at par by pendimethalin 1.0 kg/ha + one hand weeding at 45 DAS. This treatment also resulted in favorably lowest weed competition index as compared to rest of other practices. Balanced fertilization with N+P+K+S also improved monocot and dicot weed density but the effect was not significant over N+P and N+P+K fertilization. N+P+K+S fertilization significantly enhanced crop seed and biological yields over N+P (1.86 q/ha and 4.36 q/ha, respectively) and N+P+K application (0.94 q/ha and 2.20 q/ha, respectively). Weed management and balanced fertilization practices also found to have significant interaction effect on seed and biological yield of coriander.
El servicio público de abastecimiento de agua en España (siglos XIX y XX): El proceso de acumulación de competencias de los ayuntamientos
Authors: Matés-Barco Juan Manuel
Published: December 2017

Este trabajo presenta una visión a largo plazo de la evolución experimentada por el servicio público de agua potable en España. Este sector, que se ha desarrollado entre la confluencia de los intereses públicos y privados, muestra la cambiante dirección tomada por los diversos agentes que participan en su gestión. Ayuntamientos y empresas privadas fueron protagonistas en diferentes etapas de este proceso. A lo largo del siglo XIX y primeras décadas del siglo XX, las empresas privadas gestionaron el servicio. Sin embargo, a partir de 1924, y especialmente 1939, cambió la tendencia hacia una progresiva municipalización. En esta investigación se pretende describir, a grandes rasgos, esta cambiante situación y mostrar las causas que la motivaron.
CIRCULATING TUMOR CELLS: CLINICAL SIGNIFICANCE IN BREAST CANCER (REVIEW)
Authors: Kaigorodova E. V.
Published: December 2017

Circulating tumor cells (CTCs) constitute a heterogeneous population. Some tumor cells are cancer stem cells (CSCs), while others are in the process of the epithelial-mesenchymal transition (EMT); however, most CTCs are neither stem cells nor participants in the EMT. There is increasing interest in the study of the molecular biological characteristics of CTCs. Many researchers consider circulating tumor cells (CTC) as one of the variants of «liquid biopsy in real time». In this review, we discuss the clinical significance of CTCs in breast cancer and in particular the prognostic and predictive significance both in early stage and metastatic breast cancer, as well as the pathogenetic role of CTCs in venous thromboembolism. Evaluation of various characteristics of CTCs is promising for the study of new biomarkers and targets for targeted therapies. The clinical importance involves the determination of the heterogeneity of the CТC and in particular of the stem subpopulation of these cells, cells with signs of EMТ, with no evidence of stem cells, and with a combination of these features.
Pharmaco-prophylaxis of deep vein thrombosis for in-patients at risk, in a tertiary care hospital
Authors: John Sheetal , Faruqui Atiya R. , Umesh Soumya
Published: December 2017

Background: There is limited data from India on Deep Vein Thrombosis (DVT) Prophylaxis. This study was done in hospitalised patients at high risk for DVT, to determine the patterns and rates of pharmacoprophylaxis, drugs used and their clinical outcomes.Methods: This prospective study screened patients for risk of DVT using the Padua risk assessment model. Padua score ≥4 were included and data on disease demographics, prophylaxis and outcomes of DVT at 12 weeks were collected. Factors affecting prophylaxis were assessed using multivariate logistic regression.Results: Out of 453 screened, 200 eligible patients were recruited. 48.5% were females; mean age was 54.6±16.6; 50.5% received some thromboprophylaxis, of which 24%, 35.5% and 9% received pharmacoprophylaxis, mechanoprophylaxis and a combination of both respectively. Low Molecular Weight Heparin was the most commonly used drug (77.1%). Adverse drug reactions reported were 24, none related to anticoagulant use. At 12 weeks, 18 (9%) patients gave history suggestive of DVT. 5 deaths were reported, but the cause could not be ascertained. Patients who had cardiac/ respiratory failure [OR =5.2 (95%CI - 1.13, 24.6), p = 0.03], acute MI or stroke [OR = 9.0 (3.5, 23.09), p <0.001], those admitted to medical specialties [OR = 3.4 -1.4, 7.9), p = 0.004] and to private wards [OR = 7.4 (3.13, 17.5), p <0.001] had significantly higher chances of receiving prophylaxis.Conclusions: Underutilisation of effective prophylaxis, despite high prevalence of DVT risk. Emphasis on routine risk assessment of hospitalized patients and administration of appropriate prophylaxis to those at high risk is required.
The relationship between lifestyle and the frequency of polycystic ovary syndrome in Saudi female residing in Riyadh
Authors: Ibrahim Gehan , AlNowaiser Dima , AlAbbasi Howaida , Abuhaimed Joud , AlBukhari Maha , AlHarthi Maria , AlSaleh Muneera , AlMudaiheem Najd , AlQahtani Nouf , Binzaid Halaa , Al-Jaroudi Dania
Published: December 2017

Background: Polycystic Ovary Disorder (PCOS) is perceived as the most widely recognized endocrinopathy in reproductive women. This study aimed to assess the relationship between the lifestyle and frequency of polycystic ovary syndrome in Saudi Arabia.Methods: This is a case-control study conducted on females at princess Nourah University (PNU), King Fahad Medical City (KFMC) and malls in Riyadh city, Saudi Arabia. The study included females in the reproductive age including 401 controls and 122 PCOS cases.Results: History of pregnancy related disorders was higher among the PCOS women in comparison to controls, while abortion represented the highest percentage in both cases and controls. Family history of polycystic ovary syndrome was doubled in cases than controls. There was significant increase in the percentage of hypothyroidism and hyperlipidemia in polycystic ovary syndrome patients (P <0.001). Snoring, use of oral contraceptives, high prolactin level, incidence of menorrhagia and urinary tract infection were significantly higher in cases than controls (P <0.001). In addition, there was no difference between controls and polycystic ovary syndrome cases regarding their dietary intake. On the other hand, physical activity was significantly higher in controls compared to polycystic ovary syndrome group.Conclusions: This study supports previous studies that revealed a relation between polycystic ovary syndrome and endocrinological disorders such as hypothyroidism, hyperprolactinemia, and obesity. On the other hand, there is no relation between dietary intake and PCOS, however exercising regularly can decrease the possibility of having the disease.
Intravenous Carbetocin to decrease blood loss during open myomectomy: a randomized placebo-controlled study
Authors: Sallam Hany F. , Shady Nahla W.
Published: December 2017

Background: Uterine leiomyomas are benign tumors of the uterus, which represent the most common neoplasms in women of reproductive age, and have a lifetime incidence of approximately 70% in the general population. The objective of this study was to assess the effect of using a single pre-operative dose of IV 100 μg Carbetocin on intra-operative blood loss in abdominal myomectomy surgeries.Methods: In a randomized double-blind placebo-controlled trial, 86 women undergoing abdominal myomectomy for symptomatic uterine leiomyomas were randomly assigned to receive a single dose of pre-operative of IV 100 μg Carbetocin (n = 43) or placebo (n = 43) just before the operation. The primary outcome was intra-operative blood loss.Results: Intra-operative blood loss was significantly lower in those women randomized to receive IV Carbetocin versus the placebo group (714.19±186.27 ml versus 1033.49±140.9 ml), p = 0.0001 The incidence of blood transfusion was increased in placebo group (69.8%) compared with (18.6%) in Carbetocin group, (P = 0.0001). Also, there was a significant reduction in operative time in Carbetocin group (66.35%±10.18) compared with placebo group (95.95±9.16), (P = 0.0001).Conclusions: A single pre-operative dose of IV Carbetocin (100 μg) is a simple applicable method for reducing intra-operative blood loss and operative time in abdominal myomectomy.
Acute complications of preeclampsia: prognosis and management at Pikine National Hospital in Dakar (Senegal)
Authors: M. Diallo , A. A. Diouf , A. C. Niassy , C. E. G. Gombet , Lydie D. , A. Niass , O. Gassama , M. D. N. Gueye , M. Gueye , M. M. Niang , S. Coulbary , A. Diouf
Published: December 2017

ABSTRACTBackground: The objective of this study was to evaluate the prevalence of acute complications of preeclampsia in order to describe the epidemiological profile of the disease, to assess its prognosis and management.Methods: This was a retrospective study of patients admitted to the Pikine National Hospital from 1 January 2010 to 31 December 2013 (48 months) with severe complicated pre-eclampsia. Included in this study were patients admitted or diagnosed with severe complicated pre-eclampsia and having given birth in the structure or not.Results: The incidence of severe preeclampsia in childbirth varied from 9.7% to 11.5% during the four years of our study. Patients were largely paucigest (55.7% of cases) and paucipares (58.5% of cases). The mean age was 28.14 years with extremes of 14 and 47 years. More than half of the patients (57.7%) were between 21 and 34 years of age. They were mostly married (90.7%). Three-quarters of the patients (76.8%) had proteinuria with ≥ 3 cross-bands. Thrombocytopenia was found in 9.7% of patients, hepatic cytolysis in 12.1%, and elevation of serum creatinine in 13.8%. The level of transaminases was found to be greater than 2 in the normal range in 12.1%. Complicated forms were the most represented in our study. These were acute complications, with 715 cases, or 57.3% of the patients. They were either isolated (52.8%) or associated (4.5%). These included eclampsia (24.9%), followed by retroplacental hematoma (24.6%), fetal death in utero (23.7%), HELLP syndrome (3.4%). , Acute edema of the lungs (1.5%), and acute renal failure (1.4%). The lethality was 2.4%. The causes of maternal death were dominated by eclampsia (14 cases), DIC (3 cases) and OAP (2 cases). We counted 77.7% of live births and a stillbirth of 254.5 ‰.Conclusions: Pre-eclampsia is a serious complication of pregnancy. Its frequency is still high in sub-Saharan Africa. In the presence of signs of severity, maternal (vital and functional) and neonatal prognosis are inevitably involved. If management is based on fetal extraction, resuscitation measures are a guarantee of maternal survival.
Management of Vesicouterine fistulae during fistulae surgical caravan in Cote d'Ivoire
Authors: L. E. Djanhan , J. M. Dia , M. M. Menin , E. Bohoussou , B. Kouamé , Y. Samaké , K. P. Kouakou , Y. Doumbia
Published: December 2017

Background: The urogenital fistula (UGF) which designate a solution of continuity between the urinary and genital tracts in women, are divided into several entities of variable gravity. The objective of this study was to describe the epidemiological, clinical and therapeutic characteristics of patients treated for vesicouterine fistula during ‘fistulas surgical caravans’.Methods: This was a prospective and descriptive study on a cohort of 34 patients treated for Vesico-uterine fistulae during ‘‘fistulas surgical caravans '' from 1st January 2012 to 31st December 2016.Results: Vesico uterine fistulae represented 2.1% of all urogenital fistulae treated. At the time of occurrence of fistulas, the average age of the patients stay was 33.3 years, and the majority was not educated (88.2%), lived in rural areas without occupations (73.5%). All the fistulae were secondary to childbirth, the majority of which took place on a scarred uterus (67.6%). And this childbirth responsible for the fistula was done by caesarean section in 97.7% of cases. Then the average duration of the fistula before management was 6 years. Finally, all the patients were operated by the same surgical technique, made by abdominal extra peritoneal transvesical way. The cure rate after this surgical technique was 97.1% (33 patients). The only case of failure required a second operation by another technique which permitted the healing of the patient.Conclusions: The vesicouterine fistulae were rare and the satisfactory results of their management invite us to sustain these surgical caravans and ensure their widespread.
Diagnostic, therapeutic and prognostic aspects of uterine synechiae managed by hysteroscopy in the gyanecological endoscopic surgery and human reproductive teaching hospital
Authors: Belinga Etienne , Tompeen Isidore , Noa Ndoua Claude Cyrille , Ntsama Junie Metogo , Mendibi Sandrine , Kasia Jean Marie
Published: December 2017

Background: Uterine synechiae refers to a total or partial union of the inner walls of the uterus resulting from endometrial trauma. It is a cause of reproductive failure. Until now, synechia was not optimally treated and has remained understudied in Cameroon. Objective of present study was to Evaluate the diagnostic, therapeutic and prognostic aspects of uterine synechiae treated by hysteroscopy.Methods: We conducted a descriptive cross-sectional study with an analytical component from January 1st 2015 to July 31st 2017 at Yaounde. All patients diagnosed with uterine synechiae and treated with hysteroscopy were our sample. Sampling was consecutive. The chi-square test was used for the comparison of qualitative variables and Fisher's test for ANOVA variance analysis. The comparison of the averages was made by the Student's test. P-value less than 0.05 was considered as statistically significant.Results: Hysteroscopies were indicated for uterine synechiae in 14.50%. Nulliparous were 56.67%. A history of curettage/aspiration was present in 66.66%. All of the patients had a form of infertility and 83.33% had menstrual disorders. Hysterosalpingography showed a better sensitivity (88%). After hysteroscopic treatment, 63.30% had a complete anatomical restitution. There is a significant correlation between the stage of severity of synechia and anatomical restitution (p=0.008; Spearman correlation coefficient=-0.477).Conclusions: Uterine synechiae represent one-sixth of all indications for hysteroscopy and present clinically as menstrual disorder associated with infertility. A past history of uterine curettage is common. Hysterosalpingography has a better preoperative diagnostic sensitivity. Hysteroscopy allows optimal treatment.
Effectiveness of planned health education on knowledge of nurses working at tertiary care hospital regarding early detection of cancer cervix Karad, Western Maharashtra, India
Authors: Tata Sunita , Joshi Radhika , Pratinidhi A. , Vhaval Vaishali , Philip Simi Elsa , Mulla Rabnna I. , Kakade S.
Published: December 2017

Background: Cervical cancer is a major and devastating cause of mortality worldwide with an estimated global incidence of 5 lakhs new cases and 2.7 lakhs deaths annually among women. The objective of this study was to assess the existing level of knowledge and to determine the effectiveness of planned health education among the nurses regarding early detection and prevention of ca cervix.Methods: Evaluative approach with Quasi experimental one group pre-test-post-test design was used.168 sample were selected with simple random sampling technique, who those are working in tertiary care hospital, Karad. A pre-test given related to cervical cancer questionnaires followed by planned health education imparted for the duration of 45 minutes. Post-test using the same questionnaire were conducted after 7 days.Results: The study results showed that, the planned health education was effective in increasing the knowledge at the level of P <0.001.Conclusions: It is seen that training of nurses less than 30 years, even with lesser experience lesser than 5 years and with unmarried status benefited most. In service education training at the time of induction program and also frequently to refresh to sensitize the nurses with updating knowledge is recommended so that they can motivate the symptomatic and asymptomatic women who those are attending hospital as an outdoor patient or coming with the indoor patient as caretakers.
VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients
Authors: Paswan Anita , Kumar Anil , Jha Kumudini , Sinha Shail Kumari
Published: December 2017

Background: Cervical Cancer is the second most common cancer in women worldwide and India alone contribute the 1/4th of the world’s cases of cervical cancer. In view to this huge burden there was need to establish a feasible screening programme to detect cervical carcinoma at earliest in developing country.Methods: This is a prospective study of 500 women who fulfil the selection criteria. 50 pregnant patients for VIA (Visual inspection with acetic acid), 50 pregnant patients for VILI (Visual inspection with lugol’s iodine) and 400 non-pregnant women for VIA, VILI and colposcopy were enrolled. In positive cases, cervical biopsy with histopathological examination was done. The sensitivity, specificity and positive predictive value of each test were obtained and compared. Chi-square (X2) test was used to test the significance of difference between two proportions of a quantitative data.Results: The sensitivity, specificity, positive predictive value and negative predictive value for VIA (85.1%, 84.1%, 41.7%, 97%), VILI (95.7%, 92.4%, 62.5%, 93.4%) and Colposcopy (83%, 86%, 51.3%, 96.6%) were statistically significant with its histopathological report.Conclusions: In a poor developing country like India where pap smear and colposcopy is not available in low resource setting VIA and VILI can prove a very helpful tool in picking up abnormal looking cervix which can then be confirmed by pap or colposcopy. It will go a long way in reducing the incidence of cervical carcinoma.
Maternal mortality: a retrospective analysis of 6 years in a tertiary care centre
Authors: Parmar Monika , Shriastava Sushruta , Kanhere Anjali , Patel Shweta
Published: December 2017

Background: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labour or thereafter. Worldwide 3,03,000 women are dying of pregnancy related complication annually.Methods: The medical records of all maternal death occurred over a period of last five years between August 2011 to August 2017 in the Department of Obstetrics and Gynaecology at our tertiary care hospital were reviewed and analysed.Results: It is observed that out of total 30 patients, 24 (80%) deaths were from 20-30 year of age followed by 5 (16.67%) deaths from above 30 years of age. In the study period, 40% of maternal deaths were due to direct causes, haemorrhage (8/12; 66.67%) was main direct causes of obstetric death.Conclusions: The complications leading to maternal death can occur without warning at any time during pregnancy and childbirth. Most maternal deaths are preventable by optimum utilization of existing maternal and child health care facilities. Complications require prompt access to quality obstetric services equipped with life-saving drugs, intensive care unit, and the ability to provide blood transfusions and to perform surgical interventions as per the need.
A clinical study of large ovarian cyst with various presentations: prospective interventional study
Authors: Nalini Yellapragada Lakshmi , Sharma Deepak , Chandra A. Sarath , Deepshika B. S. Lakshmi
Published: December 2017

Background: The definition of huge ovarian cysts is not well described in the literature. Some authors define large ovarian cysts as those that are more than 10 cm in diameter as measured by preoperative scans. An ovarian cyst is a common gynecological problem and is divided into two main categories; physiological and pathological. Aims and objectives of this study was to find out various presentations of large ovarian tumour.Methods: It was a prospective interventional study done for a period of two year from March 2015 to March 2017 in Department of Obstetrics and Gynecology as well as in Department of General Surgery. During the study period a total of 30 study participants were enrolled.Results: Majority of the study participants were in the age group of 18-28 years (66.66%) and 33.33% were in the age group of 28-38 years. Near about 33.33% were uncomplicated. Near about 33.33% presented with tortion, 7% with rupture of cyst, infection was seen in 13.33%. About 13.33% were malignant cyst.Conclusions: Large ovarian cysts are a clinical challenge for Gynaecologists. Quite a good number of these cases can end up with complications and hence, all of them have to be subjected to surgery.
A study on risk factors, maternal and foetal outcome in cases of preeclampsia and eclampsia at a tertiary care hospital of South India
Authors: Sailaja Bandaru , Cooly Vijayalakshmi , Sailcheemala Bhuvaneswari , Sailaja Surayapalem
Published: December 2017

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.
Preventive gynaecology: awareness, attitude and practices of gynecologists
Authors: Patne Smita S. , Upadhye Aditi J. , Shembekar Shantanu C. , Shembekar Chaitanya A. , Upadhye Jayshree J.
Published: December 2017

Background: Gynecologists are aware of screening tests of all gynecological malignancies. However, attitude and practices do not match with this. Present study was conducted in 214 gynecologists to evaluate awareness, attitude and practices of preventive gynecology.Methods: A survey was conducted among 214 gynecologists of Nagpur, using a questionnaire. This evaluated implementation of screening and preventive measures used by them for self-protection as well as for the women seeking their services. Their attitude regarding HPV vaccine as a preventive measure was also noted.Results: In present study, 160 (74.76%) gynecologists routinely advice pap smear to the patients, 54 (25.23%) gynecologists advice pap smear to the patients only if it is indicated. 102 (47.66%) gynecologists and spouses have got their own pap smear done. 192 (89.71%) were doing their self breast examination regularly and 66 (30.84%) had done their mammography. 168 (78.50%) had their ultrasound done and 98 (45.79%) had their P/V done. 132 (61.68%) are advising HPV vaccination to the patients routinely and 48 (22.42%) gynecologists had given HPV vaccination to their daughters.Conclusions: Proper and effective utilization of available facilities would depend on creating better understanding and change in their outlook. Stepping up and strengthening of preventive health care services is essential.
A clinical study of tramadol as an analgesic in labour
Authors: B. Shyamsundar , M. B. Vinutha
Published: December 2017

Background: Labour is a painful event, may be the most painful event that women has even experienced. It is unpleasant disturbing and extremely unbearable for many.Methods: The clinical trial was conducted from July 2016 to June 2017 at Karnataka Institute of Medical Sciences, Hubballi. 200 parturients which included both primigravidae and multigravidae in labour at term were alternatively divided into two groups. The study group (n = 100) received 50mg-100mg of Tramadol and control group (n = 100) received no analgesic at the onset of active labour. Degree of pain relief, type of delivery, duration of labour, maternal and foetal morbidity were noted.Results: Pain relief in stage I was grade I (no pain) in 24% V/s 2%, grade II (mild pain) in 62% V/s 40%, grade III (moderate pain) in 13% V/s 56% and grade IV (severe pain) in 1% V/s 2% in study and control groups respectively (p < 0.001). Pain relief in stage II was grade I (no pain) in 8% V/s 0%, grade II (mild pain) in 47% V/s 7%, grade III (moderate pain) in 33% V/s 49% and grade IV (severe pain) in 12% V/s 43% in study and control groups respectively (p < 0.001). Duration of labour was significantly shorter in study group as compared to control group. There was minimal maternal morbidity in study group and no significant difference in the incidence of foetal morbidity in both the groups.Conclusions: Tramadol is an effective and safe labour analgesic. Besides it also shortens the duration of labour.
Lamellar body count as a predictor of neonatal respiratory distress syndrome in preterm premature rupture of membranes
Authors: Arora Sheetal , Chauhan Varsha , Rana Deepshikha , Dhupia J. S.
Published: December 2017

Background: Lamellar bodies are present in amniotic fluid and their quantity increases with increased gestational age. Preterm premature rupture of the membranes (P-PROM) is one of the most common complications of pregnancy and is a major cause of preterm deliveries and thus the important cause of RDS. Fetal pulmonary maturity can be assessed by direct or indirect measurement of surfactant phospholipids secreted by the fetal lungs into amniotic fluid. Lamellar body count (LBC) has been introduced as an alternative to other methods.Methods: The study’s prime aim is to establish LBC as a predictor of RDS in P-PROM. We included pregnant women with P-PROM and gestational age between 28 weeks and 37 weeks and singleton live pregnancy. The lamellar body counting from amniotic fluid was done with the use of a standard hematology cell counter, sysmex KX-21. There was statistically significant co-relation between lamellar body count and period of gestation (by applying ANOVA).Results: Lamellar body counts were significantly less in cases of RDS as compared to non RDS cases.Conclusions: LBC count was selected among all other tests because the test can be performed with equipment found in most clinical analysis laboratories and is reliable in predicting fetal lung maturity.