bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphological study of fly-ash block under angular impact of 9 mm projectile
Authors: Singh Malika , Rohatgi Dr. Richa , Kumar Saurabh , Gupta Dr Sanjay
Published: September 2023

BACKGROUND: Concrete structures utilized in protective buildings such as ammunition depots and bunkers are susceptible to missile impacts, necessitating a comprehensive ballistic assessment involving penetration and perforation mechanics. Most of the empirical and analytical models for projectile penetration in concrete primarily focus on determining the penetration depth, scabbing, and perforation thicknesses. Concrete structures subjected to firearm attacks exhibit distinct fracture modes that can aid in identifying the firearm used and potential firing locations.
AIM: This study aims to comprehend the effects of the angular firing of a 9 mm full metal jacketed projectile on aerated concrete blocks, fired from a 5 m range. The goal is to generate hypotheses and conclusions based solely on the observable damage resulting from bullet impacts. A meticulous analysis of the incurred damages can unveil a range of possibilities.
MATERIALS AND METHODS: The sample comprised 12 aerated concrete blocks, each subject to 919 mm bullets fired from four different angles: 0, 15, 30, and 45. The relationship between impact angle and entry hole dimensions was established using the best-fit ellipse method.
RESULTS: Examination of the fracture pattern revealed significant damage at both entry and exit holes for a 0 impact angle. As the impact angle increased, the exit hole diameter progressively decreased, culminating in no perforation at a 45 angle. This trend correlated with fracture patterns near entry and exit holes, along with energy dissipation at the impact site corresponding to the impact angle.
CONCLUSION: A trend was observed between projectile energy loss upon impact and resultant damage to aerated concrete block surfaces. Analysis of aerated concrete block components deposited on the bullets, including rifling details, can help link them to the gunshot openings and firearms recovered at crime scenes.
The role of polymorphisms in the genes of the hemostasis system and the folate-methionine cycle in the development of recurrent pregnancy loss
Authors: Belotserkovtseva Larisa D. , Kovalenko Lyudmila V. , Mordovina Inna I. , Donnikov Maksim Yu. , Babaeva Aisel E.
Published: September 2023

BACKGROUND:Recurrent pregnancy loss is a serious clinical problem that complicates about 2% of pregnancies. There is evidence that thrombophilia and disorders of folate-methionine metabolism may cause recurrent pregnancy loss.
AIM:The aim of this study was to evaluate the contribution of polymorphic variants of the genes of the hemostasis system and the folate-methionine cycle in women with recurrent pregnancy loss.
MATERIALS AND METHODS:Clinical examination of 406 pregnant women divided into two study groups was carried out. The main study group consisted of 206 women with two or more pregnancy losses known up to 12 weeks of pregnancy; the control group included 200 apparently healthy women with a known history of two or more live births, no spontaneous or induced abortions, infertility, or endometriosis. All patients underwent a molecular genetic study of 12 single nucleotide polymorphisms in the genes of the hemostasis system and the folate-methionine cycle performed by real-time polymerase chain reaction.
RESULTS:We studied single nucleotide polymorphisms in eight genes involved in the hemostasis system and in four genes of the folate-methionine cycle. An association of presence of alternative variants such as 1565C (rs5918) of theITGB3integrin beta-3 gene and A66G (rs1801394) of theMTRRmethionine synthase reductase gene with the development of recurrent pregnancy loss was found. The frequency of their occurrence was 29.1 and 77.7% in the recurrent pregnancy loss group vs. 12.0 and 49.0% in the control group, respectively (p 0.01). The combined carriage of the alternative variants 1565C (rs5918) of theITGB3gene and A66G (rs1801394) of theMTRRgene in the recurrent pregnancy loss group was diagnosed more often than in the control group and amounted to 47 (22.8%) vs. 12 (6.0%) cases ( = 5.047;p 0.01; odds ratio 3.631; 95% confidence interval 2.3749.034). We have thus developed a three-locus model of the synergetic action of allelic variants of the above genes in the development of recurrent pregnancy loss in early pregnancy [10976 GA (rs6046) of theF7, 455 GA (rs1800790) of theFGB, 1565 TC (rs5918) of theITGB3] with reproducibility of 8/10, sensitivity of 65.6%, and specificity of 68.8% ( = 15.7415,p 0.0001; odds ratio 3.341, 95% confidence interval 1.8246.118).
CONCLUSIONS:This study allows for confirming the hypothesis that the status of genetic variants of theITGB3andMTRRgenes and the association of three single nucleotide polymorphisms: rs6046 of theF7, rs1800790 of theFGB, and rs5918 of theITGB3may be used as predictors of recurrent pregnancy loss development.
Efficacy of using progesterone as an immunosuppressant for the prevention of preeclampsia in pregnant women with iron-deficiency anemia
Authors: Djabbarova Yulduz K. , Ismoilova Shoira  T. , Ziyaeva Shakhida T. , Mirzaahmedova Kamola T.
Published: September 2023

BACKGROUND:In previous studies, our data on the activation of pro-inflammatory cytokines at the systemic and local levels indicated an inadequate maternal immune response to fetal egg antigens against the backdrop of endocrine system restructuring and iron-deficiency anemia, which is a fundamental mechanism underlying the pathogenesis of preeclampsia. The above was the basis for the use of immunotherapy at a high risk of developing preeclampsia in pregnant women.
AIM:The aim of this study was to evaluate the use of micronized progesterone as an immunosuppressant for the prevention of preeclampsia in pregnant women with iron-deficiency anemia.
MATERIALS AND METHODS:We examined 44 pregnant women with iron-deficiency anemia in dynamics by trimesters of pregnancy: patients before and after taking micronized progesterone (main group,n= 25) and untreated pregnant women (comparison group,n= 19). We used general clinical and laboratory methods, assessing serum progesterone levels at 46, 2528 and 3236 weeks of pregnancy before and after the treatment, as well as statistical methods using evidence-based medicine approaches.
RESULTS:Taking micronized progesterone in pregnant women with iron-deficiency anemia from early gestation increased blood progesterone level by 1.5 times by 28 weeks of pregnancy (p 0.05) and by 2.5 times by 3234 weeks of pregnancy (p 0.05) compared to that in women who did not take the hormonal drug. In case of progesterone deficiency in pregnant women with iron-deficiency anemia and mild preeclampsia, the administration of micronized progesterone elevated its blood level by 2.4 times (p 0.05), but in severe preeclampsia in untreated women, the hormone concentrations were reduced. In women with iron-deficiency anemia, due to the inclusion of progestogen in standard antianemic therapy from early stages and throughout pregnancy, the incidence of severe preeclampsia and preterm birth was decreased in 93.3% of cases, which led to a live birth in most cases.
CONCLUSIONS:Micronized progesterone in pregnant women may be used to correct progesterone deficiency conditions, one of which is iron-deficiency anemia, and, as an immunosuppressant, to protect the fetus from an aggressive maternal immune response, manifested by the development of preeclampsia and other complications. The use of the gestagen therapy from early pregnancy is a promising tool for the prevention of preeclampsia in pregnant women with iron-deficiency anemia. Undoubtedly, further and more extensive research is needed to better understand this issue.
The role of serotonin in prenatal ontogenesis
Authors: Evsyukova Inna I.
Published: September 2023

This review article summarizes current ideas about the role of serotonin in prenatal ontogenesis. We herein present the results of experimental and clinical studies that reveal the mechanisms of serotonin involvement in the establishment and development of the single mother-placenta-fetus system. The article highlights the key role of maternal serotonin in the genetic program for the morphological and functional development of fetal organs from the earliest stages of prenatal ontogenesis, in both normal and complicated pregnancy. We also discuss gestational factors that affect the production of maternal, placental, and fetal serotonin, as its deficiency or excess during pregnancy determines perinatal and long-term pathology programming in the offspring. The article substantiates the prospects for using serotonin as a biochemical marker of brain damage in a newborn for the timely application of neuroprotection and the prevention of adverse consequences.
Dictionary Learning for Single-Channel Passive Seismic Denoising
Authors: Chen Yangkang , Savvaidis Alexandros , Fomel Sergey
Published: September 2023

Passive seismic denoising is mostly performed using a simple band-pass filter, which can be problematic when signal and noise share the same frequency band. More advanced passive seismic denoising methods take advantage of fixed-basis transforms, for example, the wavelet, to remove noise. Here, we present an open-source package for data-driven denoising based on adaptively learning sparse transform. Contrary to the fixed-basis transforms, the proposed method belongs to the adaptive-basis transforms. We learn the 1D features embedded in the passive seismic data from all the available waveform data sets without requiring spatial coherency in a data-driven way. Thus, the new method is flexible to apply in any passive seismic monitoring project because of its data-driven and single-channel nature when implemented. Considering the computationally expensive K-singular-value-decomposition (KSVD) in the traditional dictionary learning framework, we suggest applying a fast SVD-free dictionary learning method that can be readily applicable to process massive seismic data during passive seismic monitoring. The proposed method is applied to two synthetic data examples and three real passive seismic data sets to demonstrate its effectiveness in improving the signal-to-noise ratio, and its potential in applications like arrival picking. The open-source reproducible package can be found in the Data and Resources section.
Nurse Entrepreneurship in the Emerging Healthcare Industry: A Systematic Review
Authors: SENEL TEKİN Perihan , GURLAŞ Fevziye
Published: September 2023

Entrepreneurship is encouraged in every sector in the twenty-first century. In the field of health, nurse entrepreneurship emerges as an important issue in providing health services and improving public health. In this research, the development of entrepreneurial behavior in nursing in the world and a systematic examination of this development within the framework of academic knowledge are aimed. For this purpose, the types of entrepreneurship discussed in the last 10 years of research in the field of entrepreneurship in nursing and the methods, findings and results of these studies were examined. As a result of the search made in databases with high international recognition, 78.761 publications on nurse entrepreneurship were reached in the last ten years, and 30 articles were included in the final review. Classical, social, collective and intrapreneurship were discussed in these studies, which were examined in terms of entrepreneurship typology. As a result of the review, it was seen that the studies in the literature mostly focused on the opportunities and obstacles in front of entrepreneurial nurses. While collective entrepreneurship was included for the first time in the literature, it was found that eco-entrepreneurship and digital entrepreneurship have not yet been the subject of research on nurse entrepreneurship. However, it has been found that more research is needed on the relations between entrepreneurial nurses and non-governmental organizations, the incentives for increasing entrepreneurship and role modeling in entrepreneurship.
Investigation of Online Education Readiness of Teachers Involved in eTwinning Quality Processes in the Context of Various Variables (Example of Eskişehir Province)
Authors: ÖZEN Emin , ÇIRAY ÖZKARA Funda
Published: September 2023

In this research, it is aimed to examine the readiness for online education of teachers who are members of the eTwinning platform (eTwinner) and who take part in the project processes that present a quality label as a result, in the context of demographic and technology usage variables and to develop suggestions in this direction. The research, based on the cross-sectional survey model, was carried out with 384 teachers working in Eskişehir and registered on the eTwinning portal in the 2022-2023 academic year. The K–12 Teachers’ Online Teaching Readiness Scale was applied. In the analysis of the data, a t-test was used for variables with two sublevels, and one-way ANOVA was used for the variables with more than two sublevels. In case of a difference in the ANOVA test, post-hoc tests were used to determine the pairwise differences. The results showed that the average level of readiness for online education of eTwinner teachers working in Eskişehir is high and the group with the highest readiness for online education is teachers with a service period of 1-10 years. Among the factors of educational technology proficiency, learner readiness, and relative usefulness, male teachers were more than female. On the other hand, it is a remarkable result in the research that female teachers have higher proficiency in pedagogical and ethical competency than male teachers, and that postgraduate teachers in technical and pedagogical, and ethical competence have higher proficiency than those with undergraduate degrees.
Türkiye İmalat Sanayinde Yurtiçi Satışlar ve İhracat İlişkisi: BİST Sınai Endeksinde Yer Alan İmalat Sanayi İşletmeleri Üzerine Bir Uygulama (2010-2020)
Authors: ÖZDEMİR Dilan , ÜZÜMCÜ Adem
Published: September 2023

Bu çalışmada Türkiye ihracatında stratejik öneme sahip olan imalat sanayinin yurtiçi satışları ve ihracatı arasındaki ilişki 2010-2020 yılları için incelenmektedir. Çalışmanın veri setini Borsa İstanbul (BIST)’da işlem gören, BIST Sınai Endeksi içinde yer alan ve 2010 yılı itibarıyla itibariyle aktif büyüklüğü 100 Milyon TL’nin üzerinde olan imalat sanayi işletmeleri oluşturmaktadır. Çalışmada panel veri analizi çerçevesinde panel eş bütünleşme testleri uygulanmıştır. Modelin uzun dönem regresyon katsayıları incelenmiş ve model tahmini için Panel Düzeltilmiş Standart Hataları tahmincisi (Panel Corrected Standart Errors- PCSE) kullanılmıştır. Ayrıca ihracat ve yurt içi satışlar değişkenleri arasındaki nedensellik ilişkisinin incelenmesi için panel nedensellik testi uygulanmıştır. 2010-2020 dönemi itibarıyla BIST Sınai Endeksinde yer alan 68 sanayi işletmesinin yurtiçi satışları ile ihracatları arasında eşbütünleşme ilişkisi bulunduğu sonucuna ulaşılmıştır. Bu iki değişken arasında ilgili literatür çerçevesinde iktisadi anlamda tamamlayıcılık ilişkisi olduğu da tespit edilmiştir. Ampirik analiz sonuçlarına göre BİST Sınai Endeksinde yer alan imalat sanayi işletmelerinin yurtiçi satışlarında meydana gelen %1 düzeyindeki artışın bu işletmelerin ihracatlarını %0,77 oranında artırdığı, bu işletmelerin ihracatlarının %1 düzeyinde artmasının ise yurtiçi satışlarını %0,17 oranında artırdığı bulgusuna ulaşılmıştır.
Algılanan Yönetici Desteğinin Prososyal Hizmet Davranışları Üzerindeki Etkisi: Algılanan İçsellik Statüsünün Aracı Rolü
Authors: METE Bilgen
Published: September 2023

Çalışan-örgüt ilişkisi, çalışanların örgütleri ile kurdukları ilişkiyi inceleyen bir yapıdır. Bu yapı, sosyal değişim teorisini temel alır ve çalışanların, örgütten aldıkları faydaya olumlu şekilde karşılık vereceğini öngörür. Bu araştırmanın amacı, sosyal değişim teorisi temelinde otel işletmeleri çalışanlarının yöneticilerinden aldıkları desteğin karşılığını prososyal davranış göstererek verip vermeyeceklerinin belirlenmesidir. Bu süreçte bu ilişkiye, algılanan içsellik statüsünün aracılık edeceği öne sürülmüştür. Özellikle hizmet kalitesinin algılanmasında büyük öneme sahip olan prososyal hizmet davranışlarının öncüllerinin belirlenmesi açısından, araştırma sonuçlarının önem taşıdığı düşünülmektedir. Araştırma yöntemi olarak ilişkisel analiz yaklaşımı seçilmiş ve veriler, Rize ilinde hizmet veren otel işletmelerinde görev yapan 138 çalışandan elde edilmiştir. Veri toplama aracı olarak; Eisenberger ve diğerleri (1986), Bettencourt ve Brown (1997) ve Stamper ve Masterson (2002) tarafından geliştirilen ölçeklerden yararlanılarak oluşturulan anket kullanılmıştır. Algılanan yönetici desteğinin ve algılanan içsellik statüsünün, prososyal hizmet davranışı üzerindeki direkt etkileri ve algılanan içsellik statüsünün aracılık etkisi Process makrosu ile analiz edilmiştir. Elde edilen bulgular, algılanan yönetici desteğinin ve algılanan içsellik statüsünün prososyal hizmet davranışını artırdığını ve algılanan içsellik statüsünün aracılık etkisini kanıtlamıştır.
Luck in the Just Society -Sociology of Individual’s Choices and a Justification for Egalitarian Social Policies-
Authors: ARUN M. Onur
Published: September 2023

To what extent can individuals be kept responsible for the disadvantages they experience? This is undoubtedly one of the most fundamental questions that have led to a historical cleavage between egalitarian perspectives that underline roles of structural inequalities leading to disadvantages and anti-egalitarian/libertarian perspectives that tend to keep individuals themselves responsible for their own living conditions. Taking a mediating position between these perspectives, a relatively new normative framework, viz. luck egalitarianism, has recently provided an analytical answer to this question. Building upon an authentic conceptual framework in which two distinct forms of luck are defined, it claims that individuals cannot be kept responsible for their disadvantaged conditions so long as these conditions have appeared as consequences of factors that are beyond their own control, such as luck, which inescapably brings forth a normative idea that individuals should take responsibility of disadvantages that are consequences of their own choices/decisions. This paper discusses that evaluative aspects of individuals’ choices/decisions within the given configuration of luck egalitarianism’s analytical framework are excessively ambiguous, which can easily lead it to turn into a perspective morally justifying quite a number of disadvantages. Drawing on various hypothetical cases and empirical findings, it suggests that luck egalitarianism should recognize sociological formation of individuals’ choices/decisions in modern stratified societies to overcome such jeopardy. Following this, it addresses two positive implications of such recognition as (1) saving luck egalitarianism from being a means of right-wing exclusionary political positions and (2) opening up a space to incorporate egalitarian social policies.
Kıt Kaynakların Paylaştırılması: Talepler Problemi Literatürü Üzerine Bir İnceleme
Authors: AYGÜN Orhan , ERTEMEL Sinan , DOĞAN Burak
Published: September 2023

Bu makale, literatürde “talepler problemi” olarak bilinen, hak sahiplerinin taleplerini karşılamada yetersiz bir kaynağın, kaynak üzerindeki mülkiyet iddiaları gözetilerek paylaştırılması modelini inceler. Bu modelin miras dağıtımından tayınlamaya, iflas eden şirketin mallarının alacaklılara tahsisinden vergilendirmeye kadar birçok farklı uygulaması bulunur. Makalede, aksiyomatik bir yaklaşım benimsenerek talepler problemine çözüm sunan dağıtım kurallarının matematiksel aksiyom olarak ifade edilen özellikleri irdelenir. Ayrıca, literatürde öne çıkan orantılı kural ve eşitlikçi kurallar gibi dağıtım kuralları aksiyomatik karakterizasyonları ile incelenir. Son olarak, bu çalışma, yetersiz kaynağın, kaynak üzerinde birbiriyle çelişen iddiaları bulunan talep sahipleri arasında adil ve hakça dağıtılması konusunda kapsamlı bir çerçeve sunar.
Çıplak İstatistik’e Bakış
Authors: SEZER Zeynep Afra
Published: September 2023

Çıplak İstatistik (Kitap incelemesi)

Dartmouth College'daki Rockefeller Center'da öğretim görevlisi ve politika uzmanı Charles Wheelan’ın kaleme aldığı ve 2012 yılında yayınladığı ‘Çıplak İstatistik’ kitabı Buzdağı Yayınevi tarafından Ali Atav çevirisiyle 2018’de Türkiye’de yayınlandı. Çıplak İstatistik; ortalama, medyan, standart sapma, olasılık, korelasyon, merkezi limit teoremi ve regresyon analizi gibi konularda pek çok istatistiksel aracın gerçekte ne olduğunu ve hayatımızda neye karşılık geldiğini formüllere boğulmadan anlaşılır bir dille anlatıyor. Bu değerlendirme yazısında; yazarın kitapta ele aldığı konu başlıklarını bir istatistik öğrencisinin anlatımıyla tek tek ele alıp değerlendirmesi yapılacaktır.
Una lección sobre la renovación liberal de F. A. Hayek
Authors: Martínez de Pisón Cavero José María
Published: September 2023

Tras la Segunda Guerra Mundial, y en plena época de triunfo del keynesianismo y del Estado social, F. A. von Hayek llevó a cabo una renovación del pensamiento liberal recurriendo a sus bases teóricas más clásicas. De esta manera, el pensamiento de Hayek se ha convertido con el tiempo en el inspirador de la teoría y práctica neoliberal.
Obstetric outcomes of vaginal birth after caesarean section in Bingham University Teaching Hospital, Jos, Nigeria
Authors: Edugbe Adikpe E. , Bitus James , Nnawike Okeke C. , John Onyeji , Mikah Samaila
Published: September 2023

Background: Objective of the study was to review the obstetric outcomes of vaginal birth after caesarean section (VBAC) in Bingham University Teaching Hospital (BhUTH).
Methods: A retrospective review of women planned for VBAC at BhUTH from January, 2020 to December 2021. Variables measured included gestational age at time of delivery, inter-delivery interval, and vaginal delivery before or after primary caesarean section (CS), outcome of labor, indications for repeat CS, neonatal and maternal outcomes.
Results: During the study period there were 1535 deliveries and 94 were planned VBAC. Of the 94, 55.3% had a repeat emergency CS while 44.7% had a successful VBAC. Successful VBAC rate was 52.4% in multipara compared to 47.6% in primipara. Repeat CS rate was 34.6% in multips and 65.4% in primaparas. The commonest indication for the repeat CS was failure to progress due to cephalopelvic disproportion, 26.9%, mal-positioning, 25.0%, fetal distress and poor uterine contractions accounted for 13.5% each. Prior vaginal delivery especially a prior VBAC was associated with a higher rate of successful VBAC, 40.5% compared to VBAC rate of 21.4% in those who had a vaginal delivery before the caesarean section. The successful VBAC rate was highest among those weighing 2.5<3.5 kg, 66.7% compared to fetal weight of <2.5 kg and ≥3.5 kg birth weight.
Conclusions: The VBAC rate observed is higher than what is obtainable in other centers in our country but is far less than what is obtainable in the developed societies. The maternal and perinatal morbidity and mortality are however comparable with the developed societies despite our limited facilities.
Study of chronic pelvic pain by laparoscopy in tertiary care hospital
Authors: Bendale Rucha D. , Palve Tushar T. , Narvekar Rutuja M. , Parasnis Ketki , Miskin Sneha
Published: September 2023

Background: Laproscopy in chronic pelvic pain can revel findings that cannot be detected clinically, by ultrsonography, so it can be treated and diagnosed at the same sitting. This study was undertaken to evaluate role of laproscopy in chronic pelvic pain.
Methods: Study design is a prospective study conducted in JJ hospital and Cama and Albless Hospital. A total of ‘44’ women presenting in OPD with chronic pelvic pain for more than 6 months duration were taken for the study.
Results: Out of 44 patients who presented with pelvic pain 1 (2.27%) patient had no detectable pelvic pathology by laparoscopy. Prior ultrasound done in these 44 patients revealed that 14 (31%) had normal pelvic scan. Hence, ultrasound underdiagnosed 13 patients who actually had pelvic pathology on laparoscopy. Out of 44 patients 3 (6%) had normal clinical diagnosis, hence clinical examination under-diagnosed 2 other patients who on laparoscopy did not have any pelvic pathology.
Conclusions: Laparoscopy is valuable in definitive diagnosis of pelvic pain. Use of laparoscopy for diagnostic and therapeutic purposes helps in avoiding laparotomy in majority of patients and morbidity and mortality associated with it.
The prevalence of thyroid disorder in pregnancy
Authors: Shah Neelima , Shah Prashant , Namala Vyshnavi , Chowdhary Deepannita Roy , Shah Rachana
Published: September 2023

Background: The development of maternal thyroid disorders during early pregnancy can influence the pregnancy outcome and fetal development. The present study was conducted to know the prevalence of thyroid disorders in the Indian pregnant population and the obstetric outcomes of those women suffering from thyroid disorders.
Methods: The present study was conducted on 100 women who came for an antenatal check-up in the first trimester, with Singleton Pregnancy. A detailed history was taken followed by a thorough general physical examination. Patients were sent for TSH (Thyroid Stimulating Hormone) testing. Patients were sent for TSH (Thyroid Stimulating Hormone) testing. If TSH (Thyroid Stimulating Hormone) was deranged, then FT3 and FT4 levels were checked. Depending upon the FT3 and FT4 values they are grouped as subclinical/overt hypothyroidism or hyperthyroidism.
Results: Most of the patients in the present study were from the age group 21 to 30 years. The prevalence of thyroid disorders in the present study was 38%, including hypo and hyperthyroidism. 28% of patients were found to be hypothyroid; 10% of patients were hyperthyroid.
Conclusions: The prevalence of thyroid disorders, especially hypothyroidism (28%) was high. Further studies are needed to assess adverse effects on maternal and fetal outcomes. Routine antenatal thyroid screening should be done.
Awareness and practices regarding post-partum diet among post-natal mothers
Authors: Paliwal Haribala , Zachariah Jisha , Nagda Sanjay , Paliwal Chetna , Chaturvedi Dharmesh
Published: September 2023

Background: Postnatal mothers need about 500 extra calories each day, as well as plenty of protein, calcium and fluids to stay healthy and produce nutritious breast milk. Balanced diet during puerperal period must include lean meats, high-fiber foods, low-fat dairy products and plenty of fresh fruits and vegetables. Therefore, present study aims to assess the knowledge and dietary practices among the women during their puerperal period.
Method: Quantitative descriptive research design was utilized to carry out the study. A sample of women during their puerperal period admitted in district hospital, Tumkur, Karnataka, selected for the study using non probability convenient sampling technique.
Results: Study found that 87% participants had average and poor knowledge while 82% participants had average and poor practices regarding post-partum diet during their puerperal period. Age, educational status, occupational status, monthly income, type of family, obstetrical score, source of information from T.V., book and newspaper were significantly associated with knowledge score. Religion, educational status, occupational status, monthly income, place of residence, source of information from T.V., book, newspaper, friends and relatives were significantly associated with the practice score of the participants. There was significant correlation (r=0.304) found between knowledge and practice score regarding post-partum diet among participants.
Conclusions: Study concluded that there was less knowledge and poor practice among majority of the postnatal mothers regarding post-partum diet. Hence, proper awareness regarding importance of balanced post-partum diet must be given to the post-natal mothers.
Enhancing women's knowledge and awareness of preconception care: promoting optimal reproductive health outcomes
Authors: Jaiswal Sangeeta , Sahu Savita , Sharma N. R. , . Ankita
Published: September 2023

Background: Preconception care (PCC) is crucial to mother and child health. Many women don't realise how PCC might affect pregnancy and labour. Hence, we aimed to assess women's current knowledge and awareness levels regarding PCC, enhance knowledge, and empower women to prioritize proactive healthcare before conception.
Methods: This cross-sectional study consisted of 200 reproductive-age women. Infertility therapy (n=50), poor obstetrics history (n=50), and term delivery (n=100) were the three groups. Family, gynaecological, and demographic data were obtained. Preconception care and medical issues that affect pregnancy outcomes were taught to all study participants to identify risk factors.
Results: Most participants were aged between 18 and 25 (48%). Primary infertility was present in 52% of women. The main causes of infertility were pelvic inflammatory disease (40%) and genital tuberculosis (20%), treated with antibiotics and anti-tubercular medicines, respectively. Only 1 woman had both preconception and antenatal checkups, while 30 had neither. Maternal morbidity occurred in 52% of normal deliveries, with anaemia being the most prevalent. Caesarean sections were mostly due to prior 1 lower segment caesarean section (LSCS) (32%). Conception and healthy births were achieved in 10% and 6% of BOH patients and 18% and 10% of infertile patients, respectively.
Conclusions: There is a need to provide women with accurate and detailed information on PCC and to establish functional clinics with evidence-based guidelines to enhance uptake and pregnancy outcomes.
Feto maternal outcomes of fibroid in pregnancy: a retrospective observational study
Authors: Handa Nishtha , Anjali
Published: September 2023

Background: Uterine fibroid is one of the most common intrauterine masses among females at the reproductive age. Although most of the uterine fibroids are asymptomatic during pregnancy, serious complications may occur. Aim of this study was to assess the obstetric outcome (maternal and fetal) in pregnancy with fibroid.
Methods: A retrospective observational study was performed at Obstetrics and Gynecology Department in ABVIMS and RML hospital. 50 pregnant patients with >2 cm size fibroids were taken in the study. Maternal age, parity, size of the fibroid, complications during pregnancy, and mode of delivery were noted.
Results: The 20% of pregnancies ended up in spontaneous abortions. 60% of them had to undergo caesarean section out of which, 10% was for non-progress of labor (NPOL), 5% for outlet obstruction, 5% with malpresentation, 16% patients with APH, 4% patients had elective LSCS for placenta previa and 10% with previous cesarean who were not willing for vaginal delivery. Other complications; placenta previa 16% and low lying placenta 10% patients, pre-eclampsia 20%, malpresentation 20%. Post-partum hemorrhage (PPH) was seen in 24% of the cases. 4% cases had red degeneration which were managed conservatively. Neonatal outcomes included 30% of babies born preterm, 40% being small for gestational age, 10% having low 1-minute APGAR score and 4% with low APGAR at 5 and 10 min.  30% had NICU admission for varied reasons.
Conclusions: Fibroids in pregnancy may be associated with complications affecting the course of pregnancy and labor. So, pregnancy must be cautiously monitored in the antenatal period, through regular follow-up.
Amniotic fluid index as indicator for pregnancy outcome in late third trimester
Authors: Majumdar Anamika , Mallick Kallol , Majumdar Ritwika , Patel Priyanka
Published: September 2023

Background: Amniotic fluid index is one of the major predictors of pregnancy outcome. Less AFI indicate growth restriction and renal anomalies of fetus, whereas more may indicate fetal GI anomalies, maternal diabetes mellitus, and so forth. Objectives were to establish reference standards for AFI for local population after 34 weeks of pregnancy and to decide an optimal scan interval for AFI estimation in third trimester in low-risk antenatal women.
Methods: A prospective estimation of AFI was done in 83 healthy low risk pregnant women from 34 to 40 weeks at weekly intervals. The trend of amniotic fluid volume was studied with advancing gestational age. Statistical analysis was done using SPSS software (Version 16, Chicago, IL). Percentile curves (5th, 50th, and 95th centiles) were constructed for comparison with other studies. Cohen’s d coefficient was used to examine the magnitude of change at different time intervals.
Results: Starting from 34 weeks till 40 weeks, 83 ultrasound measurements were available. The mean (standard deviation) of AFI values (in cms) were 34W:14.59(1.79), 35W: 14.25 (1.57), 36W: 13.17 (1.56), 37W: 12.48 (1.52), 38W: 12.2 (1.7), and 39W: 11.37 (1.71). The5th percentile cut-off was 8.7 cm at 40 weeks. There was a gradual decline of AFI values as the gestational age approached term. Significant drop in AFI was noted at two-week intervals.
Conclusions: Appreciable changes occurred in AFI values as gestation advanced by two weeks. Hence, it is recommended to follow up low risk antenatal women every two weeks after 34 weeks of pregnancy.
Maternal and perinatal outcome in placenta previa in atertiary care centre: a record based retrospective case series study
Authors: Doddamani Mayakka , G. M. Vidyashree , Pujari L. L. , Mallapur Ashalatha
Published: September 2023

Background: Placenta previa occurs when the placenta is situated wholly or partially in the lower uterine segment. It is one of the leading causes for maternal and perinatal morbidity and mortality. It occurs in 4 to 5 cases out of 1000 pregnancies and remains a significant cause for maternal and perinatal morbidity and mortality. Objective of this study is to know the maternal and perinatal outcome in placenta previa.
Methods: It is a retrospective case series study. Data of 51 pregnant women diagnosed with placenta previa managed at SNMC and HSK hospital between January 21 to December 22 were retrieved and analyzed.
Results: Incidence of placenta previa was found to be 1.6% of 3135 deliveries at the given time. Among 51 cases of placenta previa, 7.84% delivered vaginally, 92.16% underwent caesarean section. 45.10% were early preterm, 29.41% had late preterm delivery, 25.49% had term deliver, 49.02% had h/o previous LSCS, 7.8% had history of d and e, 17.65% had h/o abortion, 11.76 % still born. Blood transfusion was done for 27.45% of women, post-partum haemorrhage was documented in 21.56%, 7.84% needed ICU admission and there were no documented peri-partum hysterectomy upon any of these women.
Conclusions: The availability of advanced emergency obstetric care across greater number of referral hospitals has been responsible to decrease the morbidity and mortality associated with many complicated obstetric conditions. However the challenge is that as this condition is confirmed by ultrasound, women should take regular antenatal check-ups, should be counselled and made aware of the complications associated with this condition so that adequate and appropriate management can be planned and executed for better maternal and perinatal outcome also with on time referral to tertiary care centre where there is required multidisciplinary team, adequate availability of blood and blood products, NICU and ICU facilities where these high risk caesarean be managed efficiently the potential to limit maternal and perinatal mortality and morbidity caused due to placenta previa can be greatly reduced.
An unusual presentation of vulvar cavernous hemangioma in a 10-year-old premenarchal girl: a rare entity
Authors: Verma Aruna , Sharma Garima , Srivastava Neelu , Verma Nidhi
Published: September 2023

Vascular tumors of the female genitalia are unusual. Hemangiomas are benign tumors of the blood vessels. Usually they are asymptomatic but may present as discomfort, pain and other symptoms. However, vulvar cavernous hemangioma can be seen in newborns and infants, but rarely occur in children and adult women. A 10-year old premenarchal girl presented with a painless swelling on her right labia majora since birth which was increasing gradually. On examination, a well-defined, soft, mobile and non-tender multicystic swelling was observed involving right labia majora and minora of approximately 5×6 cm in size. An ultrasound of the lesion showed a well-circumscribed, hypo echoic mass with multicystic lesion of size 40×14×44 mm arising from right labia majora with vascularity on color Doppler and venous flow on spectral pattern, suggestive of vascular malformation. Surgical excision of lesion was performed with the utmost care to preserve the surrounding healthy tissue and vulvar anatomy. Histopathological examination (HPE) report confirmed the diagnosis of a cavernous hemangioma with no evidence of malignancy. Vulvar cavernous hemangioma is an uncommon vascular tumor that can be rarely seen in pediatric patients. Imaging studies, such as ultrasound and magnetic resonance imaging (MRI), play a crucial role in confirming the diagnosis and guiding the management. Surgical excision with preservation of healthy tissue is the treatment of choice. Long-term follow-up is essential to monitor for any signs of recurrence and ensure the patient's well-being.
Inverted flap lip plasty, Abbe's method, in the reconstruction of bilateral complete cleft lip sequelae: report of a case
Authors: Miranda Juan G. L. , Rodriguez Mario D. G. , Chavez Obed H. G. , Almeida Eros R. R. , Berrones Arianna R.
Published: September 2023

This study presents the case of a female patient treated between the ages of 19 and 24 years, with sequelae of complete bilateral cleft lip and palate. Sequelae treated include upper lip incompetence due to low lip volume and length, absence of premaxilla (due to unknown cause), conditioning a large naso alveolar and naso palatal fistula in the region of the primary and secondary palate junction (Pittsburgh V), and finally, dental malocclusion due to prognathism condition. Aforementioned sequelae were treated through upper labial plasty at the expense of translocation of pedicled lower labial flap in the lower labial artery, using Abbe's method; upper anterior removable partial anterior dental prosthesis, with sealing of the nasal cavity, and finally, Intraoral bilateral sagittal split osteotomies of mandibular ascending ramus, in order to reduce prognathism.
Effect of technique of surfactant administration (MIST vs. InSurE) on morbidity and mortality profile of preterm neonates treated for RDS: a randomized control trial
Authors: G. M. Jeevan , Asif Mohammed , Talikoti Shivprasad , Kachhwaha Ritika
Published: September 2023

Background: Neonatal respiratory distress syndrome is a disease affecting preterm neonates caused by insufficient pulmonary surfactant in alveoli. The reported case fatality rate is 57 to 89% in low- and middle-income countries. As there is very scanty data regarding the studies on MIST technique in India, we have generated data in our institution to compare the morbidity and mortality profile in preterm babies with RDS treated with MIST and InSurE technique. Objective was to evaluate effect of technique of surfactant administration (MIST vs. InSurE) on morbidity and mortality profile of preterm neonates treated for RDS.
Methods: A Randomised controlled trial, was done on preterm neonates <34 weeks of gestation with RDS admitted in NICU between January 2020 to January 2021 who required surfactant administration. All the neonates who were fulfilling inclusion criteria after taking informed consent were randomized by colour coded chits and allotted into two groups namely Group A (MIST) & Group B (Conventional- InSurE technique).
Results: A total of 100 newborns with RDS were included in the study. Among them 50 were treated with MIST and 50 with InSurE. In the present study, there is no statistically significant differences in morbity among both the study groups but there is a statistically significant difference in the incidence of mortality between two groups that is more among InSurE group.
Conclusions: MIST technique is having similar morbidity profile in comparison to InSurE technique, but mortality rate is less in MIST than InSurE group.
Congenital hypothyroidism screening by umbilical cord blood thyroid stimulating hormone: a cross sectional study
Authors: R. N. Karthik , S. Udayakumar , K. Pratibha , K. Pushpalatha
Published: September 2023

Background: Congenital hypothyroidism is one of the most important and common preventable cause of intellectual disability. The objective of the study is to determine the proportion of congenital hypothyroidism among newborn babies delivered at ESIC-MC and PGIMSR Hospital, Bangalore.
Methods: Present study was a cross sectional study conducted in the Department of Paediatrics, ESICMC and PGIMSR over a period of 18 months from march 2021 to august 2022. All babies wherein the cord blood TSH was found to be over 20 mIU/l will be intimated within 24 hrs of the test. The babies were advised to give fresh samples TSH on day 3.
Results: In the present study, of the 1900 deliveries, cord blood was available for 1669 newborns. Of the 1669 newborns, 3.1% (N=51) newborns had cord blood TSH more than 20 mIU/l and remaining 96.9%(n=1618) had cord blood TSH levels of less than 20 mIU/l. Out of 51 newborn who were screened positive for congenital hypothyroidism were subjected to futher testing by serum TSH on day 3. Serum TSH on day 3 levels was high (>20 mIU/l) 11.7% (N=6) neonates and serum TSH (<20 mIU/l) 88.2% (N=46) neonates. In this study, the proportion of congenital hypothyroidism was 0.4% (N=6) which was 1 in 278 babies delivered.
Conclusions: The present study adds emphasis on the need for continuing screening for congenital hypothyroidisn, one of the preventable cause for intellectual disability. In developing countries, incidence is very high, the need for screening programs is the need of the hour.
Impact of educational intervention on breastfeeding practices of mother undergoing institutional delivery
Authors: Rai Rajesh , Khatun Reshma , Inamdar Prithi , Patil Rohan
Published: September 2023

Background: Existing literature shows that education and supportive interventions, both for breast-feeding mothers as well as for healthcare professionals, can increase the proportion of women that use exclusive breast-feeding. Healthy nursing practise can be encouraged by offering mothers the proper guidance from medical professionals and by designing educational programmes that explicitly target women with low levels of education and few resources. Aims was to study the effect of structured educational intervention for improving appropriate breastfeeding practices at 6-8 weeks of birth and to evaluate the factors causing deviation from recommended breastfeeding norms.
Methods: An interventional study was done to assess breastfeeding knowledge, attitude and practices of mother undergoing institutional delivery in the Department of Paediatrics, D. Y. Patil University School of Medicine, Nerul, Navi Mumbai. Continuous Data was presented as mean, median, and standard deviation. Categorical data were presented as frequency and percentages. Statistical analysis was carried out with the help of statistical test such as Chi-square test to know the significant relationship and software used was SPSS 26. The level of significance was set at 5%. All p values less than 0.05 was treated as significant.
Results: We found that additional educational intervention over and above to routine counselling significantly improved knowledge of not using pre-lacteal feeds in intervention group (p=0.0003), the understanding of importance of colostrum (p=0.001). Most importantly, Group 1 had exclusive breastfeeding rate of 74.5% (149/200) as compared to group 2 with additional intervention; who had exclusive breastfeeding rate of 93.5% (187/200) (p<0.0001).
Conclusions: We could conclude that educational interventions in a structured format in the postnatal period can increase the exclusive breastfeeding rates and sustain it further lowering the mortality significantly.
Malaria: a masquerader of cytopenias in leukemia
Authors: Mohan Madhulika , Nagarajan Priyathersini , Karunanidhi Prathibha , Sudagar Sivaranjini , Sneha Latha M.
Published: September 2023

In developing countries where the prevalence of malaria and cancer are high it can be expected to occur together.  6-year-old male child, a known case of B cell acute lymphoblastic leukemia, on maintenance phase of chemotherapy presented to us with fever. His initial investigations showed no identifiable focus or significant abnormalities. He continued to have high grade fever spikes in spite of stepping up antibiotics. A week after admission he was found to have cytopenias and mild splenomegaly. Peripheral smear and bone marrow aspiration study showed enlarged RBCs infested by Plasmodium vivax. We report this case to make the clinicians aware that malaria can be cause of fever in patients on cancer treatment.
Complications after therapeutic plasma exchange within 24 hours
Authors: Bharti Jyoti , Chandra Tulika , Solanki Archana , Singh Ashutosh , Reedy D. Himanshu , Agarwal Mallika
Published: September 2023

Background: By therapeutic apheresis is to remove a pathologic element from blood or to modulate cellular function. By this study we observed, complications after the therapeutic plasma exchange (TPE) within 24 hours with respect to patient’s demographic profiles and procedural variations.
Methods: One-year prospective observational study conducted by the Department of Transfusion Medicine in collaboration with the Medicine Department, King George’s Medical University, Lucknow India.
Results: In our study total of 60 cases and total of 150 TPE cycles were performed. Maximum mean age (36±4) was observed for cough and vomiting both and maximum mean BMI was observed followed for Infection at phlebotomy site (36.34±5.09). Maximum mean variation of hemoglobin was observed for vomiting (2.28±0.00), followed by internal bleeding. Maximum mean variation of activated partial thromboplastin time (aPTT) was observed for cough (22.05±0.34), followed by vomiting. Maximum mean variation of prothrombin time (PT) was observed for hypothermia (13.16±10.47), followed by internal bleeding. Maximum mean variation of S. creatinine was observed for abdominal discomfort (0.23±1.54), followed by vomiting. Maximum mean variation of systolic blood pressure (SBP) was observed for cough (7.00±5.20), followed by bipedal edema. Maximum mean variation of SpO2 was observed for death.
Conclusions: Complication within 24 hours after the procedure was abdominal discomfort mainly in males with a correlation with body mass index (BMI). We observed significant positive association with complication versus APTT, PT, S. urea, S. creatinine, pulse, SBP, SpO2 and BMI. This emphasizes the decreasing trend of the complications with the increase in number of cycles.