bluuebunny/crossref_metadata_2025 huggingface dataset:
TEACHERS’ PROBLEMS IN TEACHING MATHEMATICS USING MOTHER TONGUE IN A DISTRICT OF THE PHILIPPINES
Authors:   Jose Rizal Memorial State University, Baquiller GE , Abellon Jr. W ,   Depament of Education, Philippines
Published: September 2021

The transition of teaching Mathematics from English language to Mother tongue-based in primary grades has brought challenges and problems to teachers concerned. This paper attempts to determine those problems encountered by these teachers teaching Mathematics using Mother Tongue and the possible recourses they employed to address those problems. The study employed the descriptive- survey method of research using a questionnaire, purposively distributed to seven principals and thirty-three teachers who are identified respondents. Weighted mean and ranking system were utilized as measures to find out the prevalent problem, its recourses and how frequent they used the recourses. Based on the data gathered and analyzed, it was found out that language is the most prevalent problem in teaching Mathematics using mother tongue of which, insufficient translation from English term to mother tongue ranks on top. Whereas, in the area of instruction, content delivery using MT as medium for instruction is the major problem, while for teaching materials, the incomplete or delayed arrival of instructional material prevailed the most. The result further revealed that the identified problems in terms of language, teaching instruction and teaching material are mostly described as serious problem. To address the problem with regards to language; the teachers used other MT terms that fits the unfamiliar MT term, allowing pupils to use their own preferred term and remain to use English translation/ term. While for instruction; teachers use translation, drills, code switching, and pictures, whereas for teaching materials, teachers used school funds for material production, utilize local magazines as supplement, share resources to other grade level and borrow materials from other schools. All these recourses were all oftentimes applied/used. From the results, it is recommended that becoming teachers should be equipped with knowledge on teaching MTB-MLE and newly-hired teachers should attend seminars and trainings regarding such implementation. Principals or school heads should find measures for speedy delivery of learning materials Keywords: Teaching Mathematics, Problems on Language, Materials and Instruction, Recourses for Teaching MTB-MLE
DEVELOPMENT OF DIVERSITY COMPETENCY IN HEALTH PROFESSIONALS: PRELIMINARY INVESTIGATION
Authors:   Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico, Valencia J , Turrubiates M ,   Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico, Olivares S ,   Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico
Published: September 2021

Migratory displacements, the multiplicity of ethnic groups, and tremendous cultural diversity in today's society (culture, sex, religion, language, education, sexual orientation) worldwide have made it necessary for health professionals to address the immediate demands and needs of society. The objective of this study was to identify the development of diversity competency through educational innovations. The methodology was quantitative, descriptive, and cross-sectional. The tool was a questionnaire used as a pre-test and post-test to measure the value perceived by the students participating in our university's Tec Week activities. It was applied to the total number of students enrolled in the Tec Week activities. The questionnaire was answered by 21 students participating in the activities "Me, You, Others, Us" and "Diversity in a Globalized World." Focus groups validated the questionnaire; for statistical analysis, the Wilcoxon test was used and Cronbach's Alpha (0.97). The results of the Tec Week activities "Me, You, Others, Us" and "Diversity in a Globalized World" showed the dimension in which students feel more confident in their self-reflection. For the diversity competency, it was "Strengthen my Support for Gender Equality." However, the activity in which the students did not feel confident in both the pre and post-tests was "Participate in Inclusion Initiatives with Vulnerable Groups." The development of diversity competency contributes high value to the training of health professionals. It is based on human rights and individuality and considers the patient's characteristics, expressing openness, interest, and disposition towards the diversity surrounding them. Keywords: Generic competencies, diversity competency, health professionals, higher education, educational innovation
EDUCATION 4.0 FRAMEWORK: ENRICHING ACTIVE LEARNING WITH VIRTUAL AND TECHNOLOGICAL TOOLS
Authors:   School of Engineering, Tecnologico de Monterrey, Mexico, Caratozzolo P , Alvarez-Delgado A ,   School of Humanities and Education, Tecnologico de Monterrey, Mexico
Published: September 2021

At the beginning of 2020, many educators were still unclear what exactly it meant to design teaching-learning processes in the Fourth Industrial Revolution, “Education 4.0”. Despite this, and due to the Corona crisis, all institutions were dizzyingly pushed into partially known digital and technological environments, dragging teachers and students with them. In the field of higher education, the situation was doubly challenging: there were still deep misunderstandings about how to improve the cognitive abilities of Generation Z students, and serious confusion about the fact that technological tools -even advanced- can hardly replace an entire cognitive theory. The present work is a study on the effectiveness of the Active Learning approach in STEAM (Science, Technology, Engineering, Art and Mathematics); the didactic use of technological tools (including screencasting and podcasting) and, the design of innovative strategies to enhance the development of the skills declared in the Education 4.0 Framework: global citizenship, innovation and creativity, digital literacy and interpersonal awareness. The methodology used was quantitative-experimental with a 4-group Solomon design, involved more than 250 students and was developed over three years, including the two semesters of 2020 (fully online environments). The use of VALUE rubrics (Valid Assessment of Learning in Undergraduate Education) allowed the obtaining of conclusive results: (i) the importance of a correct diagnosis of the development of digital literacy skills to promote the formation of metacognitive awareness; (ii) the impact of the design and implementation of adequate cognitive tools in the quality of the learning outcomes; and (iii) the relevance of the dosed use of technological tools in each stage of a 2D learning taxonomy (cognitive process dimension / orthogonal knowledge dimension). Keywords: Critical Thinking, Creativity, Higher Education, Educational Innovation
Effect of donor and host factors on corneal graft transparency
Authors:   Assistant Professor, Department of ophthalmology, S.B.KS. M.I and R.C., Dhiraj General Hospital, Sumandeep Vidhyapeeth, Piparia, Gujrat, India, Jain Dr. Amisha , Joshi Dr. Hema ,   Cataract, Cornea and Ocular surface, H V Desai Eye Hospital, Pune, Maharastra, India, Jain Dr. Nimish ,   Assistant Professor, Department of Cardiac Anaesthesia, S.B.KS. M.I and R.C., Dhiraj General Hospital, Sumandeep Vidhyapeeth, Piparia, Gujrat, India
Published: September 2021

Objective: To study the correlation between donor factors and recipients' factors on graft clarity.Materials and methods: The study comprised 30 cases of Keratoplasty surgery with a follow up of6 months. All donor corneas were evaluated by Konan specular microscope for endothelial cellcount; details of the donor like age, cause of death were noted. The patients were divided into twogroups, Group 1 had graft failure, and Group 2 had clear corneas. Observation and Result: Therewere 12 patients in group 1 and 18 patients in group 2 with six months of follow up. The meanendothelial cell count in group 1 was 1942.3/mm2, and group 2 was 2334.8/mm2. There is asignificant difference in the mean endothelial cell count between the two groups. On analysing theindication for Keratoplasty in two groups, the outcome was best for the corneal opacity group duringworst for the graft failure group. Conclusion: Donor endothelial cell count significantly influencedgraft outcome; rest donor factors (age, death enucleation interval, enucleation surgery interval)don't affect graft survival. Indication for Keratoplasty is a significant predictor of graft survival.
Del vacío a la re-creación: vivencias de infidelidad y recuperación
Authors: Builes Coorea Maria Victoria , Ramírez Zapata Alexandra María , Arango Beatriz , Anderson María Teresa
Published: September 2021

Objetivo: indagar acerca de las vivencias que tienen las parejas que se han recuperado luego de un evento de infidelidad. Método: el enfoque fue cualitativo y el método fue biográfico narrativo. Se realizaron entrevistas semiestructuradas con 8 parejas y uno de los miembros de otras 2, y un grupo de discusión con cuatro terapeutas. Resultados: las personas infidelizadas transitaron por las vivencias del vacío, de la falacia del control y de la vuelta en sí, para finalmente arribar de vuelta a la relación. Por su parte, las personas infieles en su vivencia recorren el camino que va de ser ‘pillados’: la muerte simbólica tras el descubrimiento, al peso de la culpa y a la labor parresiástica, para culminar en la recreación de sí y de la relación. Conclusión: los participantes, además del dolor, se conocieron más a ellos y a sus parejas, y se re-crearon mediante la reflexión, para finalizar morando desde un lugar más estético su relación.
FINITE CONVERGENCE OF TWO-STAGE ALGORITHMS FOR SOLVING OF EQUILIBRIUM PROBLEMS
Authors: Vedel Ya. I. , Golubeva E. N. , Semenov V. V.
Published: September 2021

A two iterative two-stage proximal algorithms for the approximate solution of the equilibrium problem in a Hilbert space is considered. In this article we proved the convergence of algorithms in a finite number of iterations when the condition of sharpness is fulfilled.
Shovels Used by Russians in 17th–18th Century Siberia
Authors:   Institute of Archaeology and Ethnography, Siberian Branch, Russian Academy of Sciences, Tataurov S. F. , Tikhonov S. S. ,   Institute of Archaeology and Ethnography, Siberian Branch, Russian Academy of Sciences
Published: September 2021

Статья посвящена одному из самых востребованных и многофункциональных инструментов в системе жизнеобеспечения русского населения Сибири XVII-XVIII вв. — лопате. Ее основой являются более чем 20 целых и фрагментов изделий — материалы 13-летних раскопок г. Тары на территории Омской обл. В работе подробно рассматриваются лопаты, найденные на памятниках Западной Сибири, определяются место и значимость этих орудий в хозяйстве первых русских сибиряков. Опираясь на результаты анализа изобразительных материалов по лопатам Западной Сибири, приведенных в летописи С. У. Ремезова, данные о раскопках Тарской крепости, городов Мангазея и Надым, исследователи делают вывод о наличии у русского населения Сибири в указанный период специализированных инструментов для различных работ в разные времена года. Имелись лопаты для выборки грунта при строительстве оборонительных сооружений, жилых и хозяйственных построек, копки могил, сельскохозяйственной обработки земли. Описываются лопаты, использовавшиеся для уборки снега, работы с сыпучими материалами, при выпечке хлеба, а также лопатки, которыми играли дети. Приведены данные о форме изделий и породах деревьев, из которых сибиряки делали лопаты.
Possibilities of antenatal pathology diagnostics in women after assisted reproductive technologies
Authors: Kamaeva Tat’yana A.
Published: September 2021

PURPOSE: improving the efficiency of diagnosis of placental insufficiency using modern diagnostic methods.

MATERIALS AND METHODS: The analysis of individual cards, analysis of the gynecological history and somatic morbidity of 426 pregnant women who did not have somatic pathologies and underwent screenings in accordance with the current regulations were performed. The main group of them consisted of 290 women, who showed signs of chronic placental insufficiency at different stages of pregnancy. The control group consisted of 136 women who had no signs of placental insufficiency throughout their pregnancy.

RESULTS: It was revealed that the main reasons for the development of chronic placental insufficiency of the main group are preeclampsia (68.4%), the threat of termination of pregnancy (34.7%), burdened obstetric and gynecological history (32.5%), isoserological incompatibility (25.6%), pyelonephritis during pregnancy (14.2%) and anemia of pregnant women (13.2%). It was revealed that visualization of the fetoplacental complex and measurement of peripheral resistance in the umbilical artery during the second trimester of pregnancy are not very informative. To reduce the negative impact of fetoplacental insufficiency and its timely diagnosis, it is necessary to use radiation methods for examining the motherplacentafetus system.

CONCLUSIONS: For timely diagnosis of fetoplacental insufficiency and reduction of its negative impact, it is necessary to use radiation methods of studying the mother-placenta-fetus system.
The role of the shear mach number in earthquake source dynamics
Authors: Ben-Menahem Ari
Published: September 2021

abstract

The effect of the rupture velocity upon the spatial and temporal dependence of earthquake source functions is investigated. To this end a model is suggested in which the fault zone is realized as a flexible membrane under the action of a moving force with additional stiffness forces provided by the surrounding medium. The motion of each particle of the membrane is impeded by a displacement-dependent friction and radiation damping.

The particle motion along the fault is found to obey an inhomogeneous Klein-Gordon equation whose solutions are derived in closed form. In the time domain, the solutions yield a particle-motion function that has frequently been derived by analysis of earthquake seismograms. The physical parameters in the theoretical source function are found to depend strongly on the Mach number, as already predicted by the theoretical directivity function.

The theory excludes the possibility of supersonic rupture and asserts a transonic rupture for major shallow earthquakes and subsonic rupture for seismic events with low and intermediate magnitudes. It predicts new functional relations between the initial particle velocity at the fault's tip, D˙0, the Mach number, M = ν/β, the rise time τ, the stress drop σ∞ and the fault length L.
Mode conversion of Love waves at a continental margin
Authors: Gregersen S. , Alsop L. E.
Published: September 2021

abstract

Lateral inhomogeneities in the Earth's crust and upper mantle have a large effect on the amplitudes of seismic surface waves. Numerical calculations have been made for Love waves propagating from a continental structure into an oceanic structure, and vice versa. The results of these calculations are compared with observations at the seismic stations BKS, lying on a continental structure, and OBS, lying on an oceanic structure. Calculated, as well as observed, ratios of Love-wave amplitudes at the continental surface and at the ocean bottom show two prominent trends: There is almost no dependence on angle of incidence; and the amplitude ratios increase with decreasing period in the period interval 60 to 20 sec. For periods shorter than 25 sec, mode conversion between fundamental and first-higher modes is significant. This is due to differences in the amplitudes of the particle motions as a function of depth for the fundamental and first-higher modes in the oceanic and continental structure. When the path of the Love wave from the source to the receiver is across one or more continental margins, the dispersed Love-wave train is distorted by this mode conversion. Since the group velocities in the continental structure for the fundamental and first-higher modes are different, the two modes will be separated in time, when they pass through a continental structure. As a consequence, the energy of the periods between 20 and 25 sec is spread out in time, when the continental part of the path is long and a number of continental margins are encountered. Since mode conversion is insignificant for periods longer than 30 sec, these periods become dominant in the Love-wave train.
Seismic characteristics of southeast Missouri as indicated by a regional telemetered microearthquake array
Authors: Stauder William , Kramer Mark , Fischer Gerard , Schaefer Stephen , Morrissey Sean T.
Published: September 2021

abstract

A regional microearthquake network has been established in the New Madrid seismic zone to study better the seismic characteristics of this region. The network consists of 16 stations distributed on the borders of and within the head of the Mississippi embayment. The network has a location sensitivity for all earthquakes of mb ≧ 1 occurring within the network. A total of 330 earthquakes has been located within a 1.5° by 1.5° area inside the array during the first 21 months of operation. The spatial distribution of these hypocenters has identified for the first time in this region the existence of linear seismically active zones, corresponding presumably to seismically active faults. Several of these trend N40°E, parallel to the axis of the embayment. Others trend NW; these latter are parallel to and possibly are related to the crest of the Pascola arch which joins the Ozark uplift to the Nashville dome. The linear dimensions of the features identified thus far vary in length from about 25 km to about 100 km. The b value as determined by the number of earthquakes located thus far is about 0.8.
Development of the Early Support System for Young Children in Ukraine: The Periods of System Formation
Authors: Khomenko Svitlana
Published: September 2021

The article examines the formation of the early support system for young children as an integral part of Ukraine’s state policy in the field of education and children’s rights, the international and national legislation that defines this system, and the stages of its formation. Early support is understood as an interdisciplinary family-centred comprehensive support system for young children with developmental disabilities or biological or social risks. The aim of this system is to improve children’s development and their families’ quality of life with the help of special institutions, organisations and their subdivisions of different subordination: the Ministry of Education, the Ministry of Health and Social Protection of Ukraine. The main provisions declared in international and national legal documents concerning early support for children with special educational needs at different age periods are analysed and the stages of system formation are defined. The practices of early support for children with special educational needs at each formation stage are described.
The Impacts of Machine Learning in Financial Crisis Prediction
Authors:   Xandr, Vadlamudi Siddhartha
Published: September 2021

The most complicated and expected issue to be handled in corporate firms, small-scale businesses, and investors’ even governments are financial crisis prediction. To this effect, it was of interest to us to investigate the current impact of the newly employed technique that is machine learning (ML) to handle this menace in all spheres of business both private and public. The study uses systematic literature assessment to study the impact of ML in financial crisis prediction. From the selected works of literature, we have been able to establish the important role play by this method in the prediction of bankruptcy and creditworthiness that was not handled appropriately by others method. Also, machine learning helps in data handling, data privacy, and confidentiality. This study presents a leading approach to achieving financial growth and plasticity in corporate organizations. We, therefore, recommend a real-time study to investigate the impact of ML in FCP.
Enabling Trustworthiness in Artificial Intelligence - A Detailed Discussion
Authors:   Vintech Solutions, Vadlamudi Siddhartha
Published: September 2021

Artificial intelligence (AI) delivers numerous chances to add to the prosperity of people and the stability of economies and society, yet besides, it adds up a variety of novel moral, legal, social, and innovative difficulties. Trustworthy AI (TAI) bases on the possibility that trust builds the establishment of various societies, economies, and sustainable turn of events, and that people, organizations, and societies can along these lines just at any point understand the maximum capacity of AI, if trust can be set up in its development, deployment, and use. The risks of unintended and negative outcomes related to AI are proportionately high, particularly at scale. Most AI is really artificial narrow intelligence, intended to achieve a specific task on previously curated information from a certain source. Since most AI models expand on correlations, predictions could fail to sum up to various populations or settings and might fuel existing disparities and biases. As the AI industry is amazingly imbalanced, and experts are as of now overpowered by other digital devices, there could be a little capacity to catch blunders. With this article, we aim to present the idea of TAI and its five essential standards (1) usefulness, (2) non-maleficence, (3) autonomy, (4) justice, and (5) logic. We further draw on these five standards to build up a data-driven analysis for TAI and present its application by portraying productive paths for future research, especially as to the distributed ledger technology-based acknowledgment of TAI.
Clinical characterisation and management outcomes of COVID-19 infection in pregnancy in a Nigerian tertiary hospital
Authors: Ijarotimi Omotade A. , Ubom Akaninyene E. , Awowole Ibraheem O. , Ayegbusi Ekundayo O. , Kuti Oluwafemi
Published: September 2021

Background: Literature on the antenatal and perinatal management and outcomes of COVID-19 infection in pregnancy in Nigeria and sub-Saharan Africa is gradually emerging but sparse. There is an urgent need to build up the knowledge base of COVID-19 infection in Nigerian pregnant women. The objective of the current study was to determine the clinical characteristics and management outcomes of COVID-19 infection in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.Methods: A one-year retrospective review of all cases of COVID-19 infection in pregnancy managed at the OAUTHC. Relevant data were extracted from the case records of all cases managed using a purpose-designed proforma. Data collected was analysed using IBM-SPSS, version 24. Associations between categorical variables were assessed using chi square, with level of significance set at <0.05.Results: A total of 22 cases were managed. Majority (15, 68.2%) of the women were either asymptomatic or had mild symptoms. The commonest symptom was cough (8, 36.4%). The mean duration of admission was 6.6±4.2 days. The most common maternal and perinatal complication was preterm delivery/birth (3, 13.6%). There was no maternal mortality. The mean birth weight of the babies was 3226g±597g, with mean 1- and 5- minutes Apgar scores of 8.0±1.3 and 9.5±0.6 respectively.Conclusions: Although COVID-19 infection in pregnancy is an asymptomatic or mild infection in the majority of cases in Ile-Ife, Nigeria, it is associated with adverse maternal and perinatal outcomes. Further studies are recommended to determine transplacental transmission of COVID-19 infection and antibodies.
Prevalence of self-reported reproductive tract infections/sexually transmitted infections symptoms and treatment seeking behavior among the married tribal women in Udaipur, Rajasthan
Authors: Verma Anjana , Patyal Ashish , Mathur Medha , Mathur Navgeet , Hirani Jitendra
Published: September 2021

Background: Indian tribes are culturally distinct communities, with unique traditions and practices. Lack of awareness and “culture of silence” about reproductive health issues among women in rural areas contributes to high burden of reproductive tract infections/sexually tract infections. Rural tribal women also suffer from ignorance, poverty and lack of access to quality health care, which makes them more vulnerable to RTIs/STIs.Methods: It was a community based cross sectional study conducted among 200 tribal women living in rural Udaipur, Rajasthan. The study was conducted from May 2019 to November 2019. A predesigned, pretested and structured questionnaire was used to take the interview of eligible women. Questionnaire included questions about sociodemographic profile, questions to assess the knowledge regarding RTIs and history of occurrence of any RTI symptom in the past six months and; questions to assess the treatment seeking behaviour for RTI symptoms.Results: Most of the participants were 26-35 years old.About 37% gave the history of experiencing RTI symptoms, vaginal discharge being the most common (46%) symptom. Regarding the treatment, most (34%) of the females took treatment from government hospital, followed by 26% of women who bought the medicines direct from pharmacy (over the counter), about 16% consulted a private practitioner. Prevalence was found to be significantly higher in less educated, belonging to lower socioeconomic status and among non-users of contraceptive methods.Conclusions: Health education and active participation of stakeholders in the reproductive health programs is essential to strengthen the ongoing schemes about improving reproductive health of tribal women.
First trimester uterine artery Doppler screening in the prediction of adverse pregnancy outcomes
Authors: Jayson Jacqueline A. , Mandrelle Kavita , Dhar Tapasya , Singla Subhash
Published: September 2021

Background: Uterine artery Doppler waveform has been extensively studied as a predictive marker for the later development of preeclampsia and fetal growth restriction. Therefore, uterine artery doppler has emerged as a good test for the prediction of preeclampsia, being simple to perform, reproducible and non-invasive. The present study was done to evaluate the first trimester uterine artery Doppler in the prediction of adverse pregnancy outcome.Methods: This was a prospective cohort study for all pregnant women attending antenatal clinic during 11-14 weeks of gestation at Christian medical college and hospital, Ludhiana, during a period of 18 months. Study population of (n~270) was taken. A pre-designed case record was filled at the time of registration. After taking informed consent, these women underwent ultrasound for uterine artery Doppler pulsatility index along with nuchal translucency & nasal bone scan by transabdominal ultrasound. Patients were followed up throughout the gestation to find out the development of any adverse pregnancy outcomes (early onset preeclampsia, early onset fetal growth restriction, late onset preeclampsia, late onset fetal growth restriction, oligohydramnios, placental abruption and stillbirth).Results: In our study, about 75% of antenatal women were found to have normal first trimester uterine artery pulsatility index and the rest 25% had abnormal pulsatility index. About 40% of women with abnormal dopplers developed complications associated to hypertensive disorders and adverse pregnancy outcomes, while 60% went on to have a normal pregnancy. It was observed that 13.2% developed gestational hypertension, 10.29% developed pulmonary embolism, 1.47% developed eclampsia, 22.05% developed oligohydramnios, 42.64% developed fetal growth restriction, 4.41 % developed placental abruption and 5.88% delivered stillbirth neonates.Conclusions: As hypertensive disorders of pregnancy pose a great risk of maternal and fetal morbidity and mortality, an evolution of Doppler studies have proven to be beneficial. Doppler ultrasound was found to be a valuable modality in the evaluation of fetal and placental circulation as well as in the prediction of pregnancy outcomes. According to the receiver operating characteristic curve obtained in our study, sensitivity and specificity of first trimester uterine artery pulsatility index was predictive for pregnancy complications and adverse outcomes.
Posterior reversible encephalopathy syndrome and pregnancy: a Moroccan retrospective study of a patient’s oligo series
Authors: Benjilany Aboubakr , Kouach Jaouad
Published: September 2021

Posterior reversible encephalopathy syndrome (PRES) is an entity combining reversible central nervous system damages with characteristic magnetic resonance imaging (MRI) brain imaging, it can occur in peripartum regardless of any preexisting pathology. PRES in peripartum is a poorly understood phenomenon. Early diagnosis and management are essential to prevent irreversible neurological sequelae. We report 6 cases series of PRES, collected at obstetrics and gynecology department of the military hospital Mohamed V in Rabat, between 2000 and 2019, in order to describe and analyze epidemiological, clinical, paraclinical and therapeutic aspects. Average age was 27 years old. Found symptoms were: high blood pressure, seizures, headaches, visual disturbances, consciousness disorders, vivid osteotendinous reflexes, vertigo, nausea and vomiting. Associated complications were status epilepticus, eclampsia, haemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome and acute lung edema. Radiologically, found lesions are suggestive of PRES. After management, evolution was favorable in all patients.
Septicaemia in pregnancy: a case report
Authors: Jain Amrita , Sathyamurthy Kaavya
Published: September 2021

Necrotizing fasciitis (NF) is a rare, life-threatening surgical infection in pregnancy with high rates of morbidity and mortality. It is a severe, potentially fatal infectious disease which rapidly extends from the subcutaneous tissue along the superficial and deep fascia causing vascular occlusion, ischemia, and necrosis of tissues. A 30-year-old gravida 2 para1 living 1 woman, at 32 weeks of gestation with previous caesarean section and recently diagnosed diabetes, hypertension was admitted to our hospital with signs and symptoms of severe sepsis with pruritic black lesions over abdomen and perineum. Patient was in a morbid state in our hospital. During clinical examination, fetal heart sound was not localised suggestive of intrauterine fetal demise (IUFD), with ulcerative lesions over abdomen and vulva. Patient was immediately taken for surgical intervention and was suggestive of ruptured uterus with extrusion of fetus in abdominal cavity with cellulitis of abdominal and vulva. During initial laboratory examinations, diabetes mellitus was diagnosed. Patient was kept on ventilatory support and was vitals were stabilised. Multidisciplinary therapy with immediate aggressive surgical debridement of necrotic tissues, multiple antibiotics, and intensive care monitoring was performed successfully. The patient’s postoperative course was uncomplicated and skin defect healed by second intention of healing. The following case emphasized the potential immunosuppressive role of pregnancy state in conjunction with diabetes mellitus in the development of severe necrotizing soft tissue infections.
Caesarean section in second stage of labour: a commentary on principles and techniques
Authors: Archibong Michael S. , Adenikinju Wilson S. , Olayemi Olaniyi J. , Amuda Mariam
Published: September 2021

Caesarean section done at full cervical dilatation (second stage of labour) has been on the rise globally and comes with its own unique challenges and complications. This commentary highlights the peculiar challenges associated with caesarean section in second stage of labour and gives an overview on various principles to be followed and techniques to employ to reduce fetal and maternal morbidity.
Prevalence and predictors of institutional delivery in Lumjung, Tanahun and Gorkha district of Nepal: a community-based cross-sectional study
Authors: Khanal Gayatri , Shrestha Niki , Dhungana Govinda , Priyani Suneel
Published: September 2021

Background: The Maternal mortality rate (MMR) in Nepal had dropped from 444 per 1, 00,000 live births in 2005 to 239 per 1, 00,000 live births in 2016. However, the MMR of Nepal is still highest in the South Asian countries except Afghanistan. Although maternal mortality has declined noticeably in Nepal, there still persists a low proportion of institutional deliveries. The aim of the study was to assess the factors influencing the utilization rate of institutional delivery.Methods: A cross-sectional study was conducted in selected village development committee of Lamjung, Tanahun and Gorkha district using semi-structured interview schedule. A random sample of 1410 married women who gave birth in the last two years were included in the study. Multiple logistic regression analysis was carried out to identify the factors associated with institutional delivery.  Results: The prevalence of institutional delivery in three districts was 73.1%, highest in Lamjung (78.8%) and lowest in Gorkha (67.8%).  Employed women (aoR=1.7, CI=1.05-2.80), seeking antenatal check-up (aoR=5.8, CI=3.00-11.16), secondary (SLC) or above education (aoR= 3.3, CI=1.93-5.54), more than 20 years of age at marriage (aoR=1.5, CI=1.02-2.04), Kshetri by cast (aoR=1.7, CI=1.11-2.64) were statistically significant and associated with an increased rate of institutional delivery.Conclusions: Occupation, education, antenatal check-up, age at marriage, and ethnicity/cast are major factors for determining institutional delivery. The concerned authorities have to consider the predictors of institutional delivery in formulating the policy and plan for implementing safe motherhood delivery.
Impact of introduction of the anti-female genital mutilation law on the practice of female genital mutilation in Garissa County, Kenya
Authors: Derowa Yasmin H. , Gitonga Eliphas , Otieno George , Yoos Alison , Jisuvei Clayton S.
Published: September 2021

Background: Female genital mutilation (FGM), is a social traditional practice performed by cutting parts of the external female genitalia. Garissa county in north eastern Kenya has the highest prevalence of FGM in Kenya at 94%.  This practise was illegalised in Kenya in 2011. The aim of the study was to assess the successes of anti-FGM programs in Garissa County.Methods: This was a cross sectional study involving 108 participants of both genders and different age groups. Questionnaires were used in data collection. Obtained data was analyzed using SPSS version 25. Chi square was used to compare characteristics between female participants who had undergone FGM and participants not circumcised.  Results: Of the 108 participants, 53.7% were females. The median age of participants was 23 years [Interquartile range (IQR])15-40]. The prevalence of FGM was 62% with the mean age at circumcision being 8.34 years (SD=2.69 years). Being of Muslim faith was associated with practice of FGM (p<0.001). There was high level of awareness of the anti-FGM law among youths at 84%. Two thirds of participants did not support FGM. Excision was the main type of FGM practiced. Among those circumcised, 14.7% were circumcised by trained nurses.Conclusions: Introduction of the anti-FGM law, and its advocacy by NGOs has led to a reduction in the practice of FGM in Garissa county. There is an increase in the medicalization of FGM in Garissa with evidence of the practice going underground. This study recommends NGOs to have a clearer focus on the method chosen for use in advocating for the abandonment of FGM.
The rule of health education on the prospective grooms’ and brides’ awareness in Tarakan city
Authors: Aris M. , . Harris , J. Hadi Anto
Published: September 2021

Background: This study was intended to assess the influence of the exclusive breastfeeding module on the awareness of prospective brides in Tarakan city.Methods: The quantitative approach with pretest and posttest was chosen as research method. The research subjects were prospective brides who were undergoing prenuptial guidance at the Ministry of Religion office in Tarakan city with a sample size of respondents (n=100). Before the module was developed, a survey was conducted as a research draft. The module is created in narrative form and is corrected by experts prior to testing. The exclusive breastfeeding module was spread after the pretest was carried out to measure the awareness of the prospective brides on exclusive breastfeeding. Data analysis was done with t test.Results: Characteristics of the male respondents in the reading exclusive breastfeeding module group were generally aged 25-30 years (52%) and the group listening to the lectures were generally aged 20-24 years and 25-30 years (32% and 32%). Meanwhile, the female respondents in the reading module group and the listening group were generally 25-29 years (40%) and 20-24 years (56%). Male respondents in the reading exclusive breastfeeding module group and the listening to lectures group were generally self-employed (76% and 88%). The male respondents’ awareness in the reading module group and listening to lectures group was statistically all significant with a p<0.05.Conclusions: Basically, all female respondents’ awareness in the reading module and lecture group was statistically significant with a p<0.05. Health education through reading exclusive breastfeeding modules and listening to lectures can increase the brides’ and grooms’ awareness of exclusive breastfeeding.
Severity and clinical causes of chronic kidney disease among outpatients from selected hospitals in Nairobi County, Kenya
Authors: Mbithi Annastacia N. , Kimani Harun M. , Orago Alloys S. S.
Published: September 2021

Background: Chronic kidney disease (CKD) is a worldwide public health issue with high prevalence (8% and 16%) among adults. The severity of CKD and associated clinical features are less characterized in Kenya. We set to determine severity and clinical features of CKD among outpatient attendees in selected hospitals in Nairobi county.Methods: In this hospital based analytical cross-sectional study design, we collected data from Kenyatta National Hospital (KNH), Aga Khan University Hospital (AKUHN) and Mater Misericordiae Hospital. We recruited 336 adult CKD outpatients aged 18 years and above attending nephrology clinics between January and July, 2020 using a simple random sampling. A self-administered questionnaire was used to collect social-demographic data while data on severity and clinical features were retrieved from patient’s files of those who had given an informed consent. Descriptive and inferential statistics were performed using statistical package of social science version 26.0.Results: Majority of CKD patients (61.9%) had severe disease. Among patients with CKD, the following clinical features were statistically significant with severe disease; diabetic nephropathy (OR 3.43, 95% CI; 1.72, 5.67), glomerulonephritis (OR 2.52, 95% CI; 2.07, 4.05), hypertensive nephrosclerosis (OR 1.95, 95% CI; 1.87, 3.11), polycystic kidney disease (OR 1.26, 95% CI; 1.12, 2.61) and systemic lupus erythematosus (OR 1.16, 95% CI; 1.06, 1.39).Conclusions: Among outpatient attendees in Nairobi county, severe CKD is likely to be found in patients with diabetic nephropathy, glomerulonephritis, hypertensive nephrosclerosis, polycystic kidney disease and systemic lupus erythematosus. Therefore, the patients with these features need proper follow up and treatment to slow down progression of CKD to severe stages. However, more studies are need to be done to ascertain that the clinical features are responsible for severe CKD.
A novel approach to assess the effectiveness of medical technological intervention in the management of diabetes mellitus
Authors: Doddaiah Sunil Kumar , Shwetha G. , Gopi Arun , Murthy M. R. Narayana , S. Bilimale Anil
Published: September 2021

Background: Diabetes mellitus is one of the leading diseases in the current scenario due to lifestyle changes it causes premature illness and death across the world. Hence, the current study aimed at studying the effectiveness of medical technological education intervention in the management of diabetes mellitus.Methods: A quasi-experimental study of 138 diabetes mellitus patients at an urban health Centre, Mysuru was conducted from 1st November 2019 to 31st May 2020, information regarding socio-demographic characteristics was collected in a pre-tested proforma by interview technique and HbA1C levels was collected after taking consent from the study participants. The assessment of the effectiveness of medical technological education intervention was done by considering the improvement in mean HbA1C levels.Results: The comparison of HbA1C of group A, B and C before and after the educational intervention showed a reduction of mean HbA1C from 7.60% to 6.84% in group A which was significant statistically and in group B it has reduced from 7.30% to 7.14%, however in group C it has increased from 7.71%  to 8.50%.Conclusions: The medical technological education intervention using the smartphone application is effective when compared to traditional methods. It plays an important role in the management of diabetes mellitus.
Indian diabetes risk profile of employees in a tertiary care facility in north Maharashtra: a cross sectional study
Authors: Ashtekar Shyam V. , Singh Aryaman , Padhyegurjar Manasi S. , Shaikh Sidrah M. , Kapse Abhimanyu R. , Thorat Devendra R. , Bele Rahul R. , Dhatare Pushpak D. , Sharif Ashhar Ahmed , Rajput Abhimanyu
Published: September 2021

Background: The rising prevalence of type 2 diabetes (T2D) in India calls for screening of at-risk adults. Objectives were to assess IDRS (Indian diabetes risk score) of T2D in staff in tertiary care hospital, and to assess covariates random blood sugar (RBS), BMI, skinfold thickness (SFT), pre-existing T2D in the employees.Methods: In this cross sectional study, IDRS was used to assess all staff in a tertiary care institute. Anthropometric measurements, BP and RBS were done. Information on parental T2D, cereal intake and weekly physical activity (PA) was obtained in interview.Results: 370 subjects (F-117, M-273) with mean age 30.81 (7.99), BMI 22.89 (14.13) years were screened. Subjects in moderate and sedentary work were 185 each, 15% women and 39% men had higher waist size. Total 5.4% subjects had T2D including known diabetics. RBS in women and men was 113.1 (27.87), 114.7 (27.66), with IDRS score high in 29 (7.84%) and moderate in 144 (38.92%). Parental T2D was present in 19.5% subjects. IDRS risk was strongly associated with type of work (Chi-square 79.0283, df=4, p=0.00). Multiple logistic regression for IDRS risk outcome showed association of age (OR 1.4), BMI (OR1.3), parental T2D (OR 9.6) with highly significant p values. Multiple linear regression for RBS outcome was associated with age (OR 1.3) and BMI (OR 1.4) but the results were statistically not significant.Conclusions: Pooled IDRS risk was present in 47% subjects despite younger age of study population. Improvements in physical activity and reduction in waist size is the need of the hour.
Clinical profile and outcome of traumatic brain injury in children: record-based descriptive study
Authors: Rathod Lekha Bhupendra , Shidam Umakant G. , Kesaria Ruchir , Mohata Sanket , Lakhe Prashant , Prabhudesai Sanket , Jha Mala
Published: September 2021

Background: Paediatric head injury is considered to be a major public health problem and is often associated with significant morbidity and mortality in severe cases. The present study aimed to explore the demographics, mechanism of injury and clinical aspects of injury in children in a peripheral hospital attached to tertiary care centre.Methods: Electronic medical records of all paediatric patients aged ≤12 years with traumatic brain injury admitted during one-year period from January to December 2018 were reviewed. Epidemiological and clinical data of paediatric patients with traumatic brain injury (TBI) were analysed using SPSS version 20.Results: The medical records of 203 paediatric patients with TBI were analysed. The majority of the injury occurred in patients belonging to age-group 1-6 years. The number of male children outnumbered (58.1%) that of female children (41.9%). Fall from height was the most common mode of injury, followed by fall from a staircase. As per the Glasgow coma scale, 4% patients had severe head injury. Vomiting and headache was the most common symptom at admission (50.2%), a subdural hematoma was the most common lesion seen on computed tomography scans; frontal bone was the most common site of skull bone injury. Cutaneous injuries associated with contused lacerated wounds were the most common external injuries, 92.1% completely recovered with conservative management.Conclusions: Increasing incidence of paediatric trauma suggests the need for supervision during play and identification of environmental risk factors for such injuries. Parental advice and supervision is recommended to prevent accidental falls.
Burden and treatment seeking behaviour in chronic kidney disease patients: a cross-sectional descriptive study
Authors: Dhania Bindiya , Kumar Ashok , Kalal Nipin , Bajpai Nitin Kumar
Published: September 2021

Background: CKD is a debilitating condition accountable for high morbidity and an overall burden on society and Government. The study objectives were to assess the burden and treatment seeking behaviour of CKD patients and to determine the association of demographic variables with burden and treatment seeking behaviour in CKD patients.Methods: A Descriptive survey research design was conducted on CKD Patients. 220 CKD patients were selected and a self-structured burden rating scale was used to assess the level of burden and treatment seeking behaviour checklist was used to find out the level of treatment seeking behaviour in CKD patients. Data were collected through face to face or telephonic interview by using non-probability convenient sampling technique.Results: Among 220 patients, majority of CKD patients had hypertension as comorbidity. More than half of CKD patients had moderate level of burden. CKD patients had highest burden in emotional domain. Majority of CKD patients ‘feel muscle cramps’ in level of burden. More than half of CKD patients had fair level of treatment seeking behaviour. CKD patients had highest treatment seeking behaviour in personal domain. There was significant association of burden and treatment seeking behaviour with demographic variables.Conclusions: Majority of CKD Patients had moderate level of Burden and fair level of treatment seeking behaviour. It was found that there was a significant association of burden and treatment seeking behaviour with demographic variables. The health care seeking behaviour of CKD patients drive them to come for treatment.