bluuebunny/crossref_metadata_2025 huggingface dataset:
Influencias de los factores conductuales en la evasión de impuestos en Colombia
Authors: Cardoso-Canizales David Edgardo , Navarro Pérez Paula
Published: September 2022

La tributación conductual se considera una rama de las ciencias sociales que ayuda a explicar cómo los individuos se ven influenciados por variables comportamentales y contextuales que ocasionan que lleven a cabo actos como evadir impuestos. Consecuentemente, el objetivo de este artículo consiste en determinar posibles influencias de los factores conductuales en la evasión de impuestos en Colombia. Para ello, se utiliza un enfoque de investigación mixto en el cual, a través de revisión de literatura y análisis documental, se plantean encuestas a 256 individuos seleccionados aleatoriamente entre contribuyentes personas naturales de Bogotá con la finalidad de caracterizar sus percepciones y comportamientos sobre factores que posiblemente pueden generar motivaciones para la evasión fiscal. Como resultado, se encuentra que efectivamente variables como la confianza, la noción de justicia y equidad y los valores culturales inciden sobre las decisiones de evasión.
Loud and Negative: Exploring Negativity in Voter Thoughts About Women and Men Politicians
Authors: Rohrbach Tobias
Published: September 2022

Negative information about political candidates is readily available in contemporary political communication. Moreover, negativity is tightly connected to gendered expectations about what constitutes appropriate behavior for politicians. Yet, existing theoretical models of negativity and candidate evaluation typically do not address the role of gender and the available empirical evidence remains inconclusive regarding the electoral consequences of the interaction of negativity and gender. This article tackles these gaps in two studies to investigate how negativity manifests in voters’ thoughts about women and men politicians in response to negative media cues and how these thoughts affect vote preference. Study 1 uses a mixed methods think-aloud approach to trace the first impression formation and subsequent decision-making process (N = 78). Study 2 replicates the design as an online thought listing survey experiment (N = 142). A similar quantitative pattern emerges across both studies: (a) Negative cues elicit similar amounts of negativity in voters’ thoughts for women and men politicians, (b) these negative thoughts strongly lower candidates’ electoral chances, (c) but less so for women candidates. The qualitative analysis suggests that negative cues heuristically affect earlier stages of impression formation while voters are likely to rely on gender cues when they rationalize their vote decision.
Propuesta multiobjetivo basada en lógica borrosa para microrredes renovables residenciales hibridadas con hidrógeno
Authors: Rey Jesús , Segura Francisca , Andújar José Manuel , Vivas Francisco José , Noguera Miguel , Millán Borja
Published: September 2022

La necesidad de adecuar en todo momento la producción a la demanda energética de los hogares hace necesario, para microrredes basadas en fuentes de energías renovables (FER), el uso de sistemas de almacenamiento energético, para así acumular los excesos energéticos producidos por las energías renovables y usarlos en momentos de déficit de producción, debido a la naturaleza intermitente de las FER. Por otra parte, como las microrredes renovables hibridadas con hidrógeno están compuestas por distintos elementos de producción y almacenamiento de diferentes características y dinámicas, es decir, tienen una naturaleza multicomponente, es imprescindible la implementación de sistemas de gestión energética (SGE), con el propósito de hallar los mejores servicios para cada elemento de la microrred, lo que permitirá conseguir conjuntamente un correcto funcionamiento de la misma. En ese sentido, la propuesta de este artículo es implementar un SGE basado en un controlador lógico borroso (CLB) multivariable y multietapa que haga frente a un problema multiobjetivo para mejorar el comportamiento de los elementos de la microrred en términos de tiempo de vida, eficiencia y costes de operación. Para lograr dicho objetivo, se considerará tanto el balance de potencia, el rendimiento y la degradación de los elementos de la microrred como los costes y beneficios de conexión de la microrred con la red eléctrica principal. En comparación con SGE tradicionales, como los basados en modelos o técnicas heurísticas, el SGE propuesto supone, de acuerdo a los resultados obtenidos, un mayor rendimiento y un mayor beneficio económico.
Armario para la formación en automatización y control de subestaciones eléctricas de tracción
Authors: Balboa Martín , Alonso Serafín , Fuertes Juan José , Morán Antonio , Prada Miguel Ángel , Pérez Daniel , Domínguez Manuel
Published: September 2022

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Introduciendo sostenibilidad y multidisciplinaridad en los grados de ingeniería
Authors: Calvo Isidro , Gil-García Jose Miguel , Carrascal Edorta , Armentia Aintzane , Barambones Óscar , Basogain Xabier , González Jose Manuel , Rico Teodoro , Escudero César , Tazo Inmaculada , Mesanza Amaia , García-Adeva Ángel J. , Apiñaniz Estibaliz
Published: September 2022

Este trabajo presenta el diseño de una experiencia docente en el ámbito de la sostenibilidad que se está llevando a cabo en el grado de Ingeniería en Electrónica Industrial y Automática, en la Escuela de Ingeniería de Vitoria-Gasteiz, UPV/EHU (EIVG). Se plantea un problema que experimenta directamente el alumnado, consistente en optimizar el grado de confort térmico en el edificio de la EIVG y al mismo tiempo reducir el gasto energético. Este problema se analizará en diferentes asignaturas del grado desde múltiples perspectivas y permitirá construir un hilo conductor para: (1) presentar los Objetivos de Desarrollo Sostenible (ODS), (2) concienciar de su importancia al alumnado y presentar acciones concretas, (3) analizar un problema de forma multidisciplinar y (4) visualizar cómo aplicar los conocimientos adquiridos en los futuros retos profesionales. La experiencia docente se realizará por medio de acciones que aplicarán metodologías activas en diferentes asignaturas, que cubren todos los cursos del grado, incluyendo opcionalmente los TFGs.
La contabilidad verde en lo blanco del algodón y su efecto en la agricultura. Una revisión documental.
Authors: Arellano Arellano Jesús Enmanuel
Published: September 2022

La agricultura, en especial la del algodón, es una actividad de numerosos beneficios económicos, pero también de cuidados especiales que pudiesen impactar negativamente al ambiente, pasando por alto el cuantificar o subsanar esos daños. La idea principal se centró en identificar el impacto ambiental, la forma de compensar parte del daño causado y la responsabilidad de la contabilidad en la sostenibilidad. Enmarcando la investigación en una postura crítico interpretativa, se encontraron elementos técnicos que ayudan a compensar al ecosistema por los daños atribuidos a la praxis agrícola, como técnicas orgánicas menos agresivas al ambiente, igualmente se evidenció, que la contabilidad como ciencia no es por si sola responsable del compromiso propio de las organizaciones de implementar acciones filántropas al ecosistema, esta solo registra e informa para la posterior toma de decisiones. Para que suceda la intención de sustentabilidad, se requiere de la participación de otras disciplinas y conductas éticas en las gerencias empresariales.
Revisión de literatura sobre logística internacional: Un análisis de red y tendencias.
Authors: Lazaro Guerrero Nancy Fabiola , Meza Vega Laura Juliana , Torres Villamizar Jonnatan Andrés
Published: September 2022

La logística internacional ha sido un tema de discusión muy interesante en los últimos años, dado a que la globalización ha encaminado a las naciones a un punto de intercambio comercial nunca antes visto, por lo que se hace necesario conocer el estado actual de la literatura al respecto, así como los autores más representativos, los temas específicos que se han desarrollado y los campos de la investigación que están emergiendo para que el mundo científico esté al tanto y pueda ayudar a llenar los posibles vacíos que se presenten. El artículo se caracteriza por un amplio espectro de búsqueda ya que distingue tanto los trabajos más citados e importantes para años anteriores como los más recientes alrededor del mundo. Siendo así, se utilizó una metodología basada en el análisis de red y el uso de clusters para condensar la información. Se llegó a la conclusión de que los temas son variados en cuanto a la aplicación de la logística internacional alrededor del mundo. Una muestra de ello es la localización de centros logísticos, los flujos de inversión y todo lo que conlleva la prestación del servicio como tal. Es de resaltar el surgimiento en la actualidad de temas como el desempeño de los puertos, es decir, como funcionan y el potencial con que cuentan los servicios logísticos, así como la aplicación de teorías y metodologías a contextos de países que no están tan involucrados en la dinámica mundial.
Estrategia de marketing para la comercialización del destino turístico Jama, Manabí
Authors: Carbache Mora Cesar Arturo , Bazurto Guerrero Jorge
Published: September 2022

La presente investigación tiene como finalidad, abordar las estrategias de marketing para la comercialización del destino turístico Jama en la provincia de Manabí, Ecuador. El diseño metodológico utilizado fue de tipo descriptivo, cuantitativo-cualitativo, ya que se aplicaron un cuestionario de escala de Likert y una entrevista al alcalde del Gobierno Autónomo Descentralizado. Los principales resultados encontrados son que el 47,9% manifestaron estar totalmente de acuerdo en que la oferta de los productos turísticos: sol y playa, arqueología, deportes, cultura, gastronomía; atraen a los visitantes. Por ello el 43,8% consideran que Jama debe ser un destino turístico con una imagen de marca ciudad.  Y para ello el 52,1% piensa que el uso de las plataformas digitales seria las herramientas adecuadas para comercializar este destino turístico. Queda establecido que los consumidores del destino Jama, por sus productos turísticos, pueden llegar a convertirse en una potencia turística luego del paso de la pandemia.
Posicionamiento competitivo y dinamismo comercial del Departamento de Santander en el año 2020
Authors: Ramírez Montañez Julio Cesar , Sarmiento Jaime Enrique , Valero Córdoba Gladys Mireya
Published: September 2022

El objetivo del presente artículo de investigación fue determinar el posicionamiento y la dinámica comercial del departamento de Santander en el año 2020 mediante la aplicación de los indicadores de concentración comercial al nivel de productos, proporciones en los intercambios comerciales mundiales, número de destinos / orígenes principales, índice de balanza comercial relativa (IBCR) y el índice de Balassa. Se emplea un método analítico y deductivo, en el que inicialmente se analiza el comportamiento exportador del departamento de Santander por capítulos del arancel de aduanas, para, con base en dicho comportamiento, seleccionar la oferta exportable. Luego, se toma como canasta exportable del departamento de Santander, los primeros 5 capítulos arancelarios, de acuerdo con la participación y a la dinámica exportadora en el año 2020. Dentro de los principales resultados destaca el alto nivel de concentración de las exportaciones de Santander en el año 2020, donde el petróleo y el café ocupan el 64% de las exportaciones totales del departamento. Las primeras partidas arancelarias de importación concentran el 51% del total de las importaciones de Santander en 2020, presentando una menor concentración en comparación con las exportaciones. Santander aportó el 0.002% de las exportaciones mundiales en el año 2020.  Los productos con mayor porcentaje de participación son el café con una participación del 0.29% de las exportaciones del grano a nivel mundial. El departamento de Santander aporta el 0.003% de las importaciones mundiales en el año 2020. Los productos que tienen un mayor porcentaje de participación de Santander en las importaciones mundiales el año 2020 son productos agrícolas con participaciones porcentuales de: Maíz (0.29%), leche concentrada (0.21%), residuos de aceite de soja (0.19%) y trigo (0.14%). Estados Unidos es el principal socio comercial de Santander, teniendo un mayor peso en las importaciones aportando el 49.6% de las compras internacionales del departamento.
Aplicación de las prácticas en gestión humana en las clínicas de Villavicencio - Colombia
Authors: Torres-Flórez Dagoberto , Marín-Acosta Dayana , Baquero-Bernal Camila
Published: September 2022

La importancia de comprender el aporte de las personas en el desarrollo de las organizaciones, en esto se analiza la situación actual de las prácticas de gestión humana en las Instituciones prestadoras de servicios de salud IPS de la ciudad de Villavicencio. Estudio descriptivo de enfoque cuantitativo, experimental e inferencial. Utilizando como instrumento de recolección de información el cuestionario Mp10 denominado Medición de procesos de gestión humana en PYMES aplicado a 175 colaboradores de las IPS de la ciudad de estudio, los datos fueron procesados a través del software IBM SPSS. La investigación arrojó un nivel de cumplimiento aceptable para cinco de un total de seis prácticas de gestión humana evaluadas, tan solo la categoría salud y seguridad que abarca los elementos del sistema de gestión de salud y seguridad en el trabajo, alcanzó un nivel de cumplimiento en alto grado. Los elementos que se relacionan con políticas de compensaciones e incentivos, para la motivación del personal representan debilidades dentro de estas instituciones, así como la utilización del sistema de evaluación del desempeño como estrategia de acceso a compensaciones para los colaboradores. Por el contrario, sus mayores fortalezas se evidencian respecto a la obtención de personas idóneas y generar un ambiente saludable para los mismos.
Signposts Signify Troubled Waters Ahead for Taiwan-U.S. Relations
Authors: Gipson Ronnie R.
Published: September 2022

The issue of Taiwan's independence and protection is reminiscent of Poland’s position in the late 1930s, facing unbridled aggression from Nazi Germany. Great Britain and France promised to declare war if Germany attacked Poland. However, after Germany attacked Poland on September 1, 1939, neither Great Britain nor France deployed troops to Polish soil to rebuff the attack and restore Poland’s sovereignty. The promise of assistance was an empty promise that the Polish people paid dearly. History teaches us that an ambiguous assistance policy will not stop naked aggression. A firmer stance and a more transparent approach are warranted from a diplomatic standpoint. This article is an essay that sets forth and supports the premise that the United States should clarify and strengthen its position of support for Taiwanese independence.

 

Preprint (November 18, 2021). Available at SSRN: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3939120
Development of biometric access control system
Authors: Буяков К.Е. , Елизаров Д.А. , Епифанцева М.Я. , Мызникова Т.А. , Шилер А.В.
Published: September 2022

Рассмотрены особенности современной архитектуры систем контроля и управления доступом, лучшие практики и тренды в области обеспечения безопасности посредством системы контроля и управления доступом, а также их основные характеристики. Доказана актуальность разработки программно-аппаратного комплекса контроля доступа с использованием биометрической системы аутентификации, основанной на распознавании отпечатков пальцев. Разработанная система обеспечивает гибкую интеграцию с корпоративными сервисами организации.

The article discusses the features of the modern architecture of access control systems, best practices and trends in the field of security, as well as the main characteristics. The relevance of the development of a software and hardware complex for access control using a biometric authentication system based on fingerprint recognition. The developed system provides flexible integration with corporate services of the organization.
Multi-agent system for scheduling at a university
Authors: Нагорных М.Э. , Быков А.Н. , Чернышев С.А.
Published: September 2022

Разработана мультиагентная система поддержки принятия решения для формирования расписания в вузе. Рассмотрены аналоги приложения, выявлены их сильные и слабые стороны. Применение мультиагентного подхода позволяет составлять расписание с учетом предпочтений относительно расписания каждой группы, что достигается за счет представления каждой группы как отдельного объекта системы, – так называемого агента. В статье представлены: стек технологий разработки, схемы взаимодействия модулей и акторов системы, а также результаты работы программы на реальном расписании университета.

The multi-agent decision support system for the formation of a schedule in the university was developed. During the development were considered analogs of the application, identified their strengths and weaknesses. The application of the multi-agent approach allows to create a schedule taking into account the schedule preferences of each group, this is achieved by representing each group as a separate object of the system, a so-called agent. The article contains: a stack of development technologies, schemes of interaction between modules and actors of the system, and also demonstrates the results of the program on a real university schedule.
Evaluación de Instrumentos de Gestión Ambiental Enfocados en la Problemática de Residuos Sólidos en el Humedal de Capellanía
Authors: Rodríguez Rincón Henry Alejandro , Zambrano Vargas Nathaly Julieth
Published: September 2022

Los Instrumentos de Gestión, son herramientas de características imparciales y neutras; son una opción de respuesta a problemas ambientales presentes en el Planeta. Pueden ser de regulación directa que se enfocan en sanciones, administrativos para la asignación de permisos y licencias, económicos o educativos para desarrollar conocimientos. La selección de uno o varios instrumentos de gestión dependerá del objetivo planteado como por ejemplo, la afectación de los ecosistemas tipo humedal a nivel global. El reconocimiento de la problemática de la degradación de cuerpos de agua que ofrecen múltiples servicios ecosistémicos de diferente tipo de índole ha llevado a que se efectúen medidas para frenar el avance de las problemáticas mencionadas anteriormente. Actualmente, en el país hay un total de doce sitios con sello RAMSAR y uno de ellos se encuentra el sistema de humedales de la ciudad de Bogotá, incluido el humedal objeto de estudio, humedal de Capellanía; siendo un humedal que se encuentra en un proceso retardado de recuperación por las múltiples afectaciones antrópicas que ha tenido, dentro de ellas están los residuos sólidos industriales, residenciales y escombros, además de conexiones erradas por diferentes sectores aledaños. Es por eso que, el objeto de estudio de este artículo será la evaluación de algunos instrumentos de gestión que involucran al humedal de Capellanía, desde los más grandes enfocados en las cuencas gestionadas por diferentes entidades, hasta aquellos que atienden específicamente la problemática de residuos sólidos efectuados por entidades locales; con el fin de detectar como ha sido su manejo y las falencias posibles en la gestión de esta problemática.
Cambios en el balance hídrico para la Cuenca del Rio Arzobispo con las series de precipitación y temperatura serie 1981-2000 y serie de 30 Años a 2015
Authors: Casas Sanabria Lady Laura
Published: September 2022

A partir de dos series de precipitación y temperatura (1981-2000 y 1985-2015), suministradas por las estaciones climáticas del Observatorio Meteorológico Nacional y Universidad Nacional de Colombia, se determinan los cambios en el balance hídrico de la cuenca del río Arzobispo. Se debe considerar que el recurso hídrico está siendo afectado por la presión humana, agravando cada vez más su disponibilidad (cantidad y calidad). Estos factores de presión son fundamentalmente la sobreexplotación de acuíferos, el vertimiento de sustancias contaminantes a los cuerpos de agua, los cambios en el uso del suelo tales como la deforestación, las prácticas agrícolas inadecuadas, el incremento de urbanizaciones en zonas de producción hídrica, entre otros. En ese sentido, es necesario determinar el estado actual de la oferta y disponibilidad del recurso hídrico, así como la presión por la demanda del mismo, teniendo en cuenta su distribución espacial y temporal, que permita establecer lineamientos a seguir para su protección, y que sirva de base a los usuarios del recurso y planificadores, para considerar su uso y disponibilidad en proyectos actuales y futuros [1]. Por tal razón el balance hídrico se considera una herramienta adecuada para la predicción espacial de las condiciones climáticas de un área definida, siempre que se tenga disponibles los datos requeridos como la precipitación, la temperatura, la ubicación del sitio, y las propiedades físicas del suelo.
A Plea for the Preservation of Early BASIC Game Programs
Authors: Gerrie Jim
Published: September 2022

Based on a consideration of the outlooks of the Social Construction of Technology (SCOT), Actor-Network Theory (ANT), as well as theories in the philosophy of technology, this critical essay is an argument for a greater recognition of the need to preserve significant early computer games written in BASIC and to provide improved public access to these programs. Although many of these programs have been preserved and presented to the public by hobbyists, there are significant gaps that have the potential to prevent recognition by future researchers of the pivotal role played by non-corporate actors in the early development of the video-game industry. Such informal efforts at curating these items so that they can be easily accessed are also limited by copyright laws.  Effectively addressing these issues requires increased support from museums and scholarly institutions.
Lifestyle and occupation risk factors for poor semen quality: a cross sectional study in Sri Lanka
Authors: Ranasinghe Chandana , Gamage Yehan , Perera Ominda , Karunarathna Chaminda , Galgamuwa Lahiru Sandaruwan , Batcha Milhan , Jayasekara Kithsiri
Published: September 2022

Background: Infertility is a major problem all around the world. According to WHO, the rate of infertility is approximately 15% worldwide and it differ from geographical location, ethnicity and social status. Lifestyle habits, environmental and occupational hazards, physical parameters can be recognized as major risk factors which may affect male infertility. The objective of this study was to determine factors associated with male infertility in Sri Lankan context.Methods: A cross-sectional study was conducted on 299 individuals participated for an infertility clinic at Castle Street Teaching Hospital, Colombo, Sri Lanka. Socio-demographic, occupational and environmental characteristics were collected using interviewer administered questionnaire. Semen samples were collected from each participant for laboratory investigations. Sperm concentration and motility were measured.Results: Out of total participants, 30.1% of participants had a sperm concentration of <15×10⁶ and the sperm motility was <32% in 34.7% participants.  Older age, tobacco smokers, using tight under wears and individuals exposed to either heat or chemical hazards were identified as risk groups with low sperm concentration and low semen volume. In addition, older age, individuals using tight under wears and individuals exposed to either heat or chemical hazards were significantly associated with low or abnormal sperm mortality. Individuals having diabetes showed a significantly higher non-motility rate of sperms. Alcohol usage, betel chewing, mumps, special radiation exposure, body mass index and waist circumference were not significantly associated with semen parameters in study population.Conclusions: Older age, tobacco smoking, wearing tight underwear, occupational exposures, and diabetes mellitus has shown a risk for the generation of poor semen parameters, which can lead to male infertility. Furthermore, it is very important to carry out extended studies regarding this problem to establish the effect of above factors.
A prospective randomised study comparing intermittent intramuscular regimen and intravenous infusion regimen of magnesium sulfate in the treatment of severe preclampsia and eclampsia
Authors: Dwivedi Joshita , Chakrabarti Shekhar
Published: September 2022

Background: Eclampsia and preeclampsia are important causes of mortality during childbirth and puerperium. Commonly used regimens of magnesium sulfate are i.m. Pritchard regimen and i.v. zuspan regimen. This study was done with aim to compare the efficacy of i.m. regimen with i.v. regimen for prevention and recurrence of seizures.Methods: This study was carried out in the department of obstetrics and gynaecology, in a medical college in north India. 88 patients presenting with pre-eclampsia and eclampsia were included. Duration of the study was 18 months (from 1st October 2017-31st March 2019). The patients enrolled were classified randomly into two groups, group A and group B. Our target was to include 50 patients in both groups but few patients left against medical advice and not all patients met inclusion criteria group A was given the following regimen- loading dose of magnesium sulfate 4 gm MgSO4 in 12 ml normal saline slow intravenous infusion in 10-15 minutes and 5 gm MgSO4 deep intramuscular route each buttock, then maintenance dose of magnesium sulfate 5 gm alternate buttock group B was given- loading dose of magnesium sulfate 4 gm MgSO4 in 12 ml normal saline slow i.v. infusion in 10-15 minutes then maintainence dose of magnesium sulfate i.v infusion 1 gm/hr.Results: There was no significant difference between serum Mg2+ levels measure at 0 hours (baseline), 2 hours, 4 hours, 6 hours and 8 hours after administration of loading dose in both groups.Conclusions: The intermittent i.m. regimen and i.v. infusion regimen are comparable in terms of recurrence and prevention of seizure, maternal and neonatal outcome.
A five-year retrospective study of cervical fibroids in a tertiary care centre
Authors: N. Sunanda , R. Sudha
Published: September 2022

Background: Cervical leiomyomas or fibroids are rare benign pelvic tumors. The symptoms vary from urinary retention, frequency, dyspareunia, intermenstrual bleeding, rarely mimicking procidentia or can cause uterine inversion. This study was conducted in a tertiary hospital to find out clinical presentation, prevalence of cervical fibroids.Methods: This study is a retrospective study where Women ranging from 20 to >60 years age attending gynecology OPD of Cheluvamba hospital tertiary care centre attached Mysuru medical college and research centre, Mysuru for abdominopelvic mass, pain, menstrual abnormalities over a period of 5 years (January 2012 to December 2016) were included the study. Socio-demographic profile, detailed menstrual history, reason for attending hospital and previous treatment taken prior to the hospital visit were recorded. Pregnant women with fibroids were excluded from the study. Parameters like type and size of cervical fibroid, mode of treatment, postoperative morbidities, histopathological reports were studied and interpreted in this study.Results: In this study total 20 women who presented with menorrhagia or with abdominopelvic mass had cervical fibroid. Of 20 patients 10 (50%) belonged to age group 31-40 years, 9 (45%) patients were of 41-50years age and 1 (5%) patient was >60 years age. The 16 (80%) patients presented with menorrhagia. Metrorrhagia was the commonest menstrual pattern seen in 15 (75%) women. Asymptomatic fibroids with abdominopelvic mass were seen in 4 (20%) women. The size was 12-28 weeks. Polypectomy was done in 1 (5%) woman and abdominal hysterectomy was done in 19 (95%) women. None of the patient had postoperative morbidity or mortality. histopathological reports in 17(85%) showed leiomyoma without degeneration while 3 (15%) cases showed degenerative changes.Conclusions: Further research is needed to find out biological factors causing fibroids including diet, stress, environmental and racial influences. Routine screening, early detection, increase awareness by early reporting to the hospital will reduces morbidity and improves quality of life socioeconomically.
Diagnostic accuracy of neutrophil to lymphocyte ratio in comparison with liver function tests for the diagnosis of intrahepatic cholestasis of pregnancy
Authors: Mansuri Taslim , Panwar Megha , Anand H. P. , Dabral Anjali
Published: September 2022

Background: In this study, we aimed to find diagnostic accuracy of neutrophil to lymphocyte ratio in comparison with liver function tests for the diagnosis of intrahepatic cholestasis of pregnancy and adverse fetal-maternal outcomes.Methods: NLR and aminotransferase (AST/ALT) levels in the blood samples of pregnant women with complaint of pruritus. 90 women with elevated transaminase were taken as cases and same number of women with normal aminotransferase levels taken as control. All were examined in this prospective case-control study.Results: Not only was the mean NLR elevated in the pregnant women with cholestasis when compared to the controls, but it also predicted the severity of the cholestasis. The correlation between transaminase levels and NLR was significant.Conclusions: Although TBA is still the diagnostic standard, NLR can be used as an initial screening tool due to its high specificity.
Ondansetron exposure during pregnancy is not associated with risk of congenital malformations: evidence from a meta-analysis
Authors: M. Sarada , Bakshi Rita , Vadgaonkar Devidas , Agarwal Mugdha , Shah Kiran , Dekate Jyoti , Tripathi Renuka
Published: September 2022

Ondansetron is widely used drug for treatment of morning sickness and hyperemesis gravidarum. However, whether exposure to ondansetron during pregnancy is associated with risk of congenital malformations or not remains debatable. The present meta-analysis was performed for published cohort/registry-based studies which evaluated the association between ondansetron exposure and risk of congenital malformations. Major congenital malformations were considered as the primary outcome measure. Specific abnormalities like cardiac malformation, septal defect, cleft lip/palate, hypospadias, and genitourinary abnormalities were considered as secondary outcome measures along with spontaneous abortion/miscarriage, stillbirth, preterm delivery, and low birth weight babies. Pooled analysis was done using the Mantle-Hanzle method, random effect model and were expressed as odds ratio (OR) with 95% CI. Fourteen studies were included in systematic review. There was no significant difference for major congenital malformations [n=12; OR: 1.12 (95% CI: 0.93-1.36), I2=96], septal defect [n=5; OR: 1.39 (95% CI: 1.01-1.91), I2=48%], cleft lip/palate [n=3; OR: 1.11 (95% CI: 0.80-1.53), I2=41%] between ondansetron exposed and control arms. However, a greater number of events were found in control arm than intervention arm for cardiac defect [n=7; OR: 1.26 (95% CI: 1.09-1.45), I2=71%; p=0.002]. We also observed a greater number of events for stillbirth and pre-term labour in control arm than in intervention arm with OR: 1.57 (95% CI: 1.24-1.97); p=0.0001 and OR: 1.33 (95% CI: 1.05-1.69); p=0.02, respectively. This meta-analysis concludes that ondansetron exposure during pregnancy is not associated with any increased risk of major congenital malformations, septal /cardiac defect, cleft lip/palate, spontaneous abortion/miscarriage, stillbirth, pre-term labour and low birth weight babies.
Surgical challenges in unusual fibroids - a case series
Authors: B. Sowjanya S. , Patil Vaibhav , Gusain Nisha , Sawant Tejashri
Published: September 2022

Uterine leiomyoma are benign monoclonal tumours arising from smooth muscle tissue. There are different types of fibroids depending on the location of fibroid. There are various operative challenges in long standing huge fibroids on abnormal location. Surgical difficulties associated with these cases are due to poor access to the operative field, distorted anatomy, difficulty in suturing the repairs, increased blood loss. It is an art and skill to surgically remove these difficult fibroids and do difficult hysterectomies. Here we present case series of 7 cases, we have described variety of fibroid at different ages, presentations, precautions and also surgical challenges and the steps to overcome them successfully. Case 1- cervical fibroid, case 2- submucosal fibroid polyp, case 3- Bulky uterus with fundal fibroid during vaginal hysterectomy, case 4- broad ligament fibroid, case 5- multiple fibroids, case 6- multiple subserosal fibroids during caesarean section, and case 7- giant fibroid. Different types of fibroids are tackled in different ways. So, fibroid mapping by imaging studies and also ureteric stenting preoperatively whenever needed, helps to prevent untoward injuries. Following principles of surgery in any difficult fibroids leads to successful management and also helps to prevent injuries to the urinary tract and avoiding intra operative blood loss.
Successful management of pregnancy with dual mechanical heart valves: a case report
Authors: Mishra Pallavi , Singh Neha
Published: September 2022

Incidence of cardiovascular diseases in pregnancy is increasing due to advanced maternal age at first conception and frequent association of comorbid chronic medical conditions. Rheumatic heart diseases comprise 56-89% of all CVDs in pregnancy in non-western countries. Management of pregnant women with mechanical valves is very challenging due to high risk of cardiac and non-cardiac complications either due to heart disease itself or changes in hemodynamics during pregnancy or due to anticoagulant therapy. We presented here a case of a 35-year-old pregnant woman with rheumatic heart disease with dual mechanical (aortic and mitral) valve replacement who was managed successfully by our team of expert clinicians with intensive antepartum surveillance with good obstetric outcome. It is very important for managing clinicians to have necessary information about high-risk cardiovascular diseases during pregnancy along with their management and treatment related feto-maternal complications in order to have optimal feto-maternal outcome.
Uterine arteriovenous malformation: a rare cause of abnormal uterine bleeding
Authors: Sina Mohim I. , Shakil Shariful I. , Rahman M. M. , Khan Mubarak H. , Rahman M. M. , Hoque M. E.
Published: September 2022

Uterine arteriovenous malformation (AVM) is a rare gynecological entity that usually presents with vaginal bleeding of variable spectrum. High level of suspicion aided by color Doppler ultrasound is needed to confirm the diagnosis. This case report describes a 52-year-old woman G7P6A1 who presented with irregular pervaginal bleeding for 5 years. Her symptom was recurrent, on and off and refractory to hormone therapy. She was diagnosed with uterine AVM on pelvic color Doppler ultrasound that revealed a dilated and hypervascular cystic mass of 6.2×4.1 cm located at right uterine wall where blood flow was bidirectional. As a definitive treatment, open abdominal hysterectomy was performed successfully. This report reminds gynecologists to consider uterine AVM as a rare differential diagnosis of abnormal uterine bleeding (AUB).
Twisted large cellular fibroma of the ovary with pelvic effusion-revisiting incomplete demons Meigs’ syndrome
Authors: T. Heera Shenoy , Antony Abhilash , Kailash Nishi , P. Shameema , P. Sathi P. , N. Fazna , Khader Reslin , R. Rajendran V. , K. Thara Thomas , Jayakumar Jayakrishnan
Published: September 2022

Fibromas of the ovary are benign tumours arising from the stromal component of the ovary. They represent 1% of ovarian neoplasms and are generally benign. The cellular subtype accounts for around 10% of these and is a tumour of uncertain malignant potential. Recurrence may occur or it could be associated with peritoneal implants. Usually these are solid tumours, sometimes with small areas of cystic degeneration. Occasionally, large fibromas may undergo torsion causing acute abdominal pain and generally tends to occur in post-menopausal women. The solid areas, ORADS and ascites simulated a malignant ovarian tumour on both MRI, USG and gross pathologic examination. Here we present a case of a postmenopausal woman presented with abdominal pain and postprandial vomiting with a large twisted ovarian fibroma leading to diagnostic and therapeutic challenges masquerading as a malignant ovarian neoplasm.
An interesting case of post hysterectomy vaginal bleeding
Authors: Banerjee Ramna , Rahman Farheen , Bajoria Sabita
Published: September 2022

Post hysterectomy vaginal bleeding is a very rare problem, particularly in women in whom the cervix has been removed with a reported incidence of 0.2-2%. It is very distressing for the women who has had hysterectomy in particular for abnormal uterine bleeding as she expects the bleeding problem to have been completely resolved after the procedure.We reported a case of a 34 year old women who underwent total abdominal hysterectomy and a left sided salpingo-oopherectomy for uterine fibroids and an ovarian cyst who presented with persistent vaginal spotting for 1 year following the surgery. During surgery it was found that the fimbrial end of the right fallopian tube was adherent to the vaginal vault that apparently periodically bled through a small rent in the vault. She was also found to have a small cyst in the right ovary.
Uterine lipo-leiomyoma in post-menopausal women: two interesting cases
Authors: Shenoy Heera Trivikrama , Kambalavan Shibin , Puthuprakkat Shameema , Singh Mary Nandini , Sasidharan Athira , Thomas Jomy Perumcheril
Published: September 2022

Lipo-leiomyomas (LL), incidentally found lipomatous variants of uterine leiomyomas do not require surgical intervention unless symptomatic. Large LL of the uterine body is very rare. Majority being benign, these could co-exist with other gynaecological malignancies, metabolic diseases and abnormal oestrogen statuses and do rarely transform to liposarcoma. Here, we presented two interesting cases of postmenopausal women with LL. Ultrasonography and MRI performed in the workup of both, incidentally demonstrated a fatty lesion arising from the uterine corpus, consistent with a lipo-leiomyoma. This case report stresses the need for greater awareness of these variants regarding histogenesis, diagnosis and treatment.
A rare case report of haemolytic uremic syndrome in post caesarean section
Authors: Gaikwad Priyanka , Deshmukh Jyotsna , Godbole Viraj , Pandey Shailja
Published: September 2022

Haemolytic uremic syndrome (HUS) is a clinical syndrome characterised by progressive kidney failure associated with microangiopathic haemolytic anemia and thrombocytopenia. Women may be genetically predisposed to develop HUS which gets aggravated by pregnancy. We presented a case of 25 year old G2p1l1 with h/o 9 months amenorrhoea was admitted in active labour, underwent emergency caesarean section for non-progression of labour. Postoperatively patient had decreased urine output with unexplained thrombocytopenia with deranged renal function tests and increased serum LDH with normal coagulation profile and no any evidence of foci of infection for which HUS was suspected. Patient was treated with hemodialysis, plasmapheresis and other supportive medical treatment.
Placental mesenchymal dysplasia: a diagnostic dilemma
Authors: Mittal Shivika , Sharma Chanderdeep , Dhatwalia Prashant
Published: September 2022

Placental mesenchymal dysplasia is a rare placental anomaly characterized by placental enlargement, dilatation and congestion of chorionic plate vessels, and villous edema without signs of trophoblastic proliferation. It is often confused with partial hydatidiform mole. It was first diagnosed in 1991 and the reported incidence is 0.02%. We hereby report a case of a 20 years PGR at a period of gestation 26 weeks 5 days with placental mesenchymal dysplasia. PMD is a rare entity that needs to be distinguished from molar pregnancy to prevent unnecessary termination of pregnancy. Once suspected, these patients should be treated as high-risk pregnancies as they are associated with intrauterine growth restriction (IUGR), intrauterine devices (IUD) and congenital anomalies.
Abdominal wall endometriosis in the caesarean section surgical scar- a case report
Authors: Trivikrama Heera Shenoy , . Shivakumar , Sajitha Ambichi Kuniyil , Chandni Sabarmathi , Geethanjali Remesh , Lavatt Deepak , Nidhi Naduvithiyil Thundikandi , Singh Mary Nandini , Shamla Padincharayil
Published: September 2022

Scar endometriosis is the presence of endometrial tissues with glands in the previous incision or scar. Its overall estimated incidence after post-caesarean and post-hysterectomy is 0.03-0.4% and 1.08-2%, respectively. The patient presents with non-specific symptoms such as cyclical abdominal pain at the site of a previous surgical incision and an abdominal lump with a cyclical increment in size, which is tender. The diagnosis is made only after the surgical excision with confirmation by histopathological analysis. We present the case of a 30-year-old P2 L2 complaining of cyclical abdominal pain and a lump on the right side of a Pfannenstiel incision. She had undergone two lower segment caesarean sections (LSCS); the last surgery was five years ago. She conceived and at 38.2 weeks an elective caesarean with concurrent sterilisation and excision of scar endometriosis with mesh repair was done. After the surgical excision, the sample was sent for histopathological examination, and scar endometriosis was confirmed.
Posterior reversible encephalopathy syndrome: a case report
Authors: Aafreen Asna , Pankaj Apoorv , Pankaj Aprajita
Published: September 2022

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic syndrome that is characterised by neurological symptoms and radiological features. The symptoms include vomiting, headache, seizures, variable loss of eyesight and loss of consciousness. Imaging studies show white mater abnormalities and edema. Management includes control of blood pressure and prevention of seizures along with timely delivery. Some patients might require ICU admission and a multidisciplinary team management. The condition has a good prognosis if timely management is instituted. Here we present a case report on PRES syndrome.
Ambiguous genitalia with positive reproductive outcome: a case report
Authors: Kapadia Lalit , Kapadia Rutul , Patel Manishkumar , Panchal Yagnik
Published: September 2022

Ambiguous genitalia are an uncommon phenotypic manifestation of the urogenital system that may indicate the presence of a life-threatening underlying disease. The development of normal male or female external genitalia is a consequence of a series of genetic and physiological processes beginning with sex determination and proceeding through internal and external reproductive structure differentiation following the genesis of a zygote. While the failure to progress normally through the stages of sex determination and differentiation is referred to as a disorder of sex development (DSD), not everyone with DSD has ambiguous genitalia. As a result, it is critical to ascertain the etiology as soon as feasible when uncertainty is noticed. The purpose of this case study is to highlight the favorable reproductive result associated with ambiguous genitalia.
Short-term outcomes after long inverted versus short standard biliopancreatic limb in Roux-en-Y gastric bypass
Authors: Morfin Vela Cuauhtemoc , Spaventa Ibarrola Antonio G. , Lopez Carlos Zerrweck , Rodriguez Gonzalez Arturo A. , Vargas Sahagun Cesar M. , Benavides Zavala Tomas E.
Published: September 2022

Background: Obesity is a public health issue that affects the entire world and it is rising. Roux-en-Y gastric bypass is one of the most common bariatric procedures and it can reach a significant and sustained excess weight loss and efficient comorbidity control. The main objective was to compare short-term outcomes between standard versus long biliopancreatic limb gastric bypass patients.Methods: it was a retrospective, comparative, descriptive, single-center study. We evaluated obese patients that underwent a laparoscopic Roux-en-Y gastric bypass with standard or long biliopancreatic limb in Centro Medico ABC, Mexico City, and compared general demographics, weight loss, excess weight loss, comorbidities and quality of life.Results: Of 50 patients analyzed, 24 were in the standard gastric bypass (S-GB) and 26 in the long biliopancreatic limb (LBPL-GB). Mean weight loss in the S-GB group was 33.1±12.1 kg and in the LBPL-GB was 40.2±12.6 kg with a difference of 7.1 kg. The percentage of excess weight loss (%EWL) was 72.5±14% in S-GB and 72.9±19% in LBPL-GB, with a difference of 0.4% in the 12 months of follow-up. There was a complete reduction of hypoglycemic drugs in 80% in the S-GB group and 100% in the LBPL-GB group.Conclusions: With this modification of the technique, we achieved important outcomes in regard of comorbidities, without affecting drastically weight loss or the EWL. This procedure is safe and feasible.
Ketogenic diet reduces oxidative stress in obese females in Port Harcourt, Nigeria
Authors: Edith Reuben , Tariah Fortune Amah-
Published: September 2022

Background: Sub-Saharan Africa is not insusceptible to the obesity epidemic, regardless of the continued problem of undernutrition. Increases in the rates of overweight and obesity are being identified in Sub-Saharan Africa, especially among women and people dwelling in urban populations. This study, therefore, is aimed at evaluating the effects of ketogenic diet on markers of oxidative stress (reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD), and malondialdehyde (MDA)) in obese female subjects on eight weeks ketogenic diet.Methods: A total of forty (40) participants, 10 overweight (25.0–29.9 kg/m2) and 30 obese (≥30 kg/m2) female subjects, were recruited and investigated via informed consent and approval obtained. The sera of the participants were collected by standard, sterile with a minimal invasive procedure for reduced glutathione, catalase, superoxide dismutase, malondialdehyde at weeks 0, 4, and 8 of ingestion of low carbohydrate ketogenic diet (LCKD).Results: There was a statistically significant increase in mean superoxide dismutase levels of participants at the 4th and 8th week after the introduction of low carbohydrate ketogenic diet (LCKD). There were also statistically insignificant changes in catalase and malondialdehyde levels in the participants between the baseline (week 0) and 4th and 8th weeks. Mean reduced glutathione was statistically significant at week 4 when compared with the baseline.Conclusions: Ketogenic diet reduces oxidative stress as evidenced by increased reduced glutathione and superoxide dismutase.