bluuebunny/crossref_metadata_2025 huggingface dataset:
EL TESORO FENICIO DE ALISEDA
Authors: ORTI BELMONTE Miguel Ángel
Published: January 2022

Este trabajo fue redactado por M. Ángel Orti Belmonte (1891-1973) en los meses inmediatos al descubrimiento del Tesoro de Aliseda (Cáceres), ocurrido el 29 de febrero de 1920. Desde entonces ha permanecido inédito. Su original junto a una primera versión y otros documentos de interés para su contextualización se encuentran en la Fundación “Lucio Gil de Fagoaga” (Requena, Valencia)i. Su publicación cien años después en este Dossier enriquece la historiografía de este célebre hallazgo y sus confusas circunstancias. Asimismo, su análisis complementario ofrece una nueva lectura sobre el conflicto que mantuvieron Orti Belmonte y J. Ramón Mélida por la publicación en primicia de las joyas.
MELILLA Y LA LEY DE EXTRANJERÍA DE 1985. TRASCENDENCIA INTERNACIONAL DE UN CONFLICTO LOCAL. ANÁLISIS DE TRES PERIÓDICOS
Authors: RUBIANO SEGOVIA Sonia
Published: January 2022

La ley de Extranjería de 1985 no había tenido en cuenta a las miles de personas que habían nacido o vivían en Melilla desde hacía varias generaciones, pero que no tenían ningún derecho como ciudadanos. Bajo el liderazgo de Aomar Mohamedi Duddú, el colectivo musulmán de Melilla se movilizó para reclamar su derecho a obtener la nacionalidad española. El objetivo de este artículo es analizar la imbricación de este conflicto, que se desarrolló entre 1985 y 1987, y que era a priori local, con las reclamaciones territoriales de Marruecos, y la dimensión internacional que alcanzó, a través del análisis de lo que al respecto publicaron tres periódicos de tirada nacional: ABC, El País y La Vanguardia a lo largo de esos años.
A Survival Analysis based Volatility and Sparsity Modeling Network for Student Dropout Prediction v1
Authors: Pan Feng , Huang Bingyao , Zhang Chunhong , Zhu Xinning , Wu Zhenyu , Zhang Moyu , Ji Yang , Ma Zhanfei , Li Zhengchen
Published: January 2022

Student Dropout Prediction (SDP) is of pivotal significance in mitigating withdrawals in Massive Open Online Courses. Research in these areas are usually carried out using deep learning to detect complex nonlinear patterns in students' learning sequences. However, the volatility and sparsity of data always weaken the performance of deep neural networks. Prevailing approaches always required an additional data smoothing or interpolation step independent of the prediction model, which may lose valuable information or introduce inauthentic data. Besides, when modeling the SDP problem as a binary classification task, previous works often required to specify an observation window, which may lead to inconsistent prediction results with different settings. To address these issues in an end-to-end learning framework, we propose a Survival Analysis based Volatility and Sparsity Modeling Network (SAVSNet). Particularly, SAVSNet smooths the volatile time series by convolution network while preserving the original data information using Long-Short Term Memory Network (LSTM). Furthermore, we propose a Time-Missing-Aware LSTM unit to mitigate the impact of data sparsity by integrating informative missingness patterns into the model. To achieve consistent predictions along time, a survival analysis loss fuction is adopted for parameter estimation and the model outputs monotonically decreasing survival probabilities. In the experiments, we compare the proposed method with state-of-the-art methods in two real-world MOOC datasets and the experiment results show the effectiveness of our proposed model.
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Mental distress and demographic, behavioral, obstetric characteristics, and health condition in pregnant women
Authors: Harmel Betina , Höfelmann Doroteia Aparecida
Published: January 2022

Introduction. Mental distress can have consequences for the health of women and children. Objective. To estimate the prevalence of mental distress and to identify its association with socioeconomic, demographic, health-related behaviors, obstetrics, and health status in pregnant women. Method. Cross-sectional study carried out with women undergoing prenatal care at the Unified Health System in Colombo-Paraná. The prevalence of mental distress was investigated using the Self-Reporting Questionnaire. Results. Among pregnant women (n = 605), the prevalence of mental distress was 47.9% (95% CI [44.0, 51.9]). After an adjusted analysis, the following was associated with the outcome: living without a partner (PR 1.27; 95% CI [1.06, 1.52]), having up to seven years of schooling (PR 1.30; 95% CI [1.04, 1.63]), performing moderate or intense physical activity (PR 1.47; 95% CI [1.02, 2.12]), consuming alcohol in the last 12 months (PR 1.29; 95% CI [1.08, 1.54]), being in the third pregnancy (PR 1.33; 95% CI [1.06, 1.67]), in the last trimester of pregnancy (PR 1.43; 95% CI [1.06, 1.94]), and the presence of a common pregnancy symptom (PR 1.56; 95% CI [1.15, 2.11]). Discussion and conclusion. Comprehensive mental health care during pregnancy is necessary especially for women in social vulnerability, at the end of pregnancy, and with worse health.
Processo de Homogeneização de Carne Bovina: Características Microbiológicas
Authors: Palermo Mendes Janaína , Prudente Serafim Flávia , Valentim Jean Kaique , Freitas Silva Ariadne
Published: January 2022

A carne moída bovina é um produto de alto valor nutricional e em função do problema de conservação que favorece a oxidação, além de temperaturas inadequadas e falhas nas condições de higiene, proporciona um ambiente de proliferação de bactérias, tornando-se um produto nocivo à saúde.  Este trabalho tem como intuito, por meio de uma revisão de literatura atualizada, identificar o grau de importância de informações diretamente relacionadas à qualidade e particularidades no processamento da carne bovina homogeneizada. Por se tratar de um produto alimentício de fácil preparo e aquisição, a biosseguridade deve ser procedida através de uma abordagem integrada em que se considere toda a cadeia de produção. A excessiva manipulação do produto e as condições de temperatura são um dos principais problemas da carne moída, já que este produto cárneo passa por oxidação lipídica, à medida que a temperatura vai se elevando após o processo de homogeneização, há um acelerado aumento das reações químicas e enzimáticas na musculatura, favorecendo o crescimento de micro-organismos como as bactérias gram-negativas como Enterobacteriaceae Pseudomonas e por Gram-positivas: Enterococcus, Lactobacillus e Staphylococcus propiciam o aparecimento de bactérias patogênicas como Clostridium perfringens, S. aureus, Salmonella sp.,  e também alguns sorotipos de Escherichia coli e, ocasionalmente, Yersinia enterocolitica, Clostridium botulinum e Bacillus cereus.
 
Palavras-chave: Carne Moída. Processamento. Qualidade. Segurança Alimentar.
 
Abstract
Ground  beef is a product of high nutritional value and due to the conservation problem that favors oxidation in addition to inadequate temperatures and flaws in hygiene conditions, it provides an environment for the bacteria proliferation , making it a harmful product to health. This work aims to, through an updated literature review, identify the degree of importance of information directly related to the quality and particularities in the homogenized beef processing. Because it is a food product that is easy to prepare and purchase, biosecurity must be pursued through an integrated approach that considers the entire production chain. The excessive product handling and the temperature conditions is one of the main problems of ground beef, since this meat product undergoes lipid oxidation and as the temperature rises after the homogenization process, there is an accelerated increase in chemical and enzymatic reactions in the musculature, favoring the growth of microorganisms such as gram-negative bacteria namely: Enterobacteriaceae Pseudomonas and by Gram-positive: Enterococcus, Lactobacillus and Staphylococcus, propitiate the appearance of pathogenic bacteria such as Clostridium perfringens, S. aureus, Salmonella sp., and also some Escherichia coli serotypes and, occasionally, Yersinia enterocolitica, Clostridium botulinum and Bacillus cereus.
 
Keywords: Food Security. Ground Beef. Processing, Quality.
Water Hyacinth: a Possible Indicator of Lead in Water Bodies
Authors: S. Marcondes Jaéli , V. Almeida Bruno , B. L. de Freitas Guilherme , Q. Mariani Filipe , José de Almeida Durinézio , C. G. de Lima Patricia
Published: January 2022

Nos últimos anos, uma grande ênfase se concentrou no desenvolvimento de biomarcadores sensíveis como uma ferramenta útil para estudos ambientais. Estudos documentaram que vários contaminantes, compostos metálicos e orgânicos, são capazes de induzir alterações específicas em certas enzimas envolvidas na replicação e geração de células perceptíveis em microscopia óptica. Estes marcadores devem ser de fácil manejo e a técnica de avaliação deve ser barata e rápida. É preferível que os marcadores possam ser usados diretamente no corpo hídrico e que possa ser mantido por um longo período no sistema. Este trabalho verificou a hipótese de que o Echornia crassipes possa ser usado como biomarcador para flutuações de chumbo em corpos hídricos. O E. crassipes foi cultivado em seis concentrações diferentes de chumbo (0,03; 0,05; 0,10; 0,20; 0,25 e 0,30 mg/L-1 Pb) e após cultivo por 30 dias, a coifa e o meristema primário da raiz foram analisados quanto as anormalidades cromossômicas e estruturais. Foram levantadas e testadas duas hipóteses para a correlação observada entre o oxalato e a concentração do metal. Obteve-se uma correlação positiva entre as anormalidades observadas e a flutuação na concentração do metal. Obteve-se ainda um aumento na concentração de ráfides de oxalato de cálcio, apresentando correlação positiva com a concentração de chumbo.
 
Palavras-chave: Bioindicador. Metais Pesados. Poluição.
 
Abstract
During recent years, a great emphasis has focused on developing sensitive biomarkers as a useful tool for environmental studies. Studies have documented that several contaminants, both metal and organic compounds, are able to induce specific alterations in certain enzymes which are involved in cellular replication and generation perceptible in optical microscopy. These markers must be easy to handle and the evaluation technique must be cheap and quick. It is preferable that the markers can be used directly in the water body and that it can be maintained for a long time in the system. This work verified the hypothesis that Echornia crassipes could be used as a biomarker for lead fluctuations in water bodies. E. crassipes was grown in six different concentrations of lead (0.03; 0.05; 0.10; 0.20; 0.25 and 0.30 mg/L-1 Pb) and after 30 days' cultivation, the coif and the root’s primary meristem were analyzed for chromosomal and structural abnormalities. Two hypotheses were raised and tested for the observed correlation between oxalate and metal concentration. A positive correlation was obtained between the abnormalities observed and the fluctuation in the metal concentration. An increase in the concentration of calcium oxalate raphids was also obtained, showing a positive correlation with the concentration of lead.
 
Keywords: Bioindicator. Heavy Metals. Pollution.
Avaliação da Toxicidade do Lodo de Curtume em Plantas de Girassol
Authors: De Araujo Bitencourt Gislayne , Guidorissi Natália da Silva , Rosa Artur Guerra , Brandão Pedro Henrique Lande , Rockenbach Roanita Iara , Laura Valdemir Antônio
Published: January 2022

Um subproduto da pecuária bovina bastante representativo no Brasil é a produção de couro do tipo wet-blue. No entanto, o processo de beneficiamento gera grande quantidade de resíduos na forma de lodo, que se apresenta o cromo em sua constituição, sendo considerado um resíduo nocivo ao meio ambiente. O objetivo com este trabalho foi avaliar os efeitos de toxicidade da aplicação do lodo de curtume em diferentes dosagens no crescimento de girassol (Helianthus annuus L.), a fim de verificar a possibilidade de utilização desse resíduo sem comprometer a performance das plantas. O experimento foi realizado em casa de vegetação, os vasos foram preenchidos com 5 kg de solo e o lodo foi aplicado nas doses: 0,1; 1; 10; 100 e 250 g.kg-1 de lodo/solo. Foram semeadas três sementes de girassol, em cada vaso, cultivados por 30 dias. O delineamento experimental utilizado foi inteiramente casualizado com cinco repetições. As variáveis avaliadas foram: porcentagem de germinação, comprimento de raiz e parte aérea das plantas, diâmetro de caule, número de folhas e produção de matéria seca de raiz e de parte aérea. Os dados foram submetidos a análise de variância (teste F) e teste de Tukey. A dose de 100 g.kg-1 ocasionou efeitos de toxicidade nas plantas. Diferente da dose de 250 g.kg-1, que inibiu a germinação das sementes. Com base nos resultados, recomenda-se a utilização de até 10 g.kg-1 de lodo de curtume no crescimento de girassol.
 
Palavras-chave: Composto Orgânico. Helianthus annuus. Resíduo. Tratamento de Couro.
 
Abstract  
The representative by-product of cattle ranching in Brazil is the production of wet-blue leather. However, the beneficiation process generates a large amount of waste in the form of sludge, that presents chromium in its constitution, considered a waste harmful to the environment. The aim of this work was to evaluate the toxicity effects of applying tannery sludge at different dosages on sunflower (Helianthus annuus L.) growth in order to verify the possibility of using this residue without compromising the plants’ performance. The experiment was carried out in a greenhouse, the pots were filled with 5 kg of soil and the sludge was applied in doses: 0.1; 1; 10; 100 and 250 g.kg-1 of sludge/soil. Three sunflower seeds were sown in each pot, grown for 30 days. The experimental design used was completely randomized with five replications. The evaluated variables were: germination percentage, root length and plants’ aerial part, stem diameter, number of leaves and dry root production and aerial part. The data were submitted to analysis of variance (F test) and Tukey test. The dose of 100 g.kg-1 caused toxicity effects on plants. Different from the 250 g.kg-1 dose that inhibited seed germination. Based on the results, it is recommended to use up to 10 g.kg-1 of tannery sludge in sunflower growth.
 
Keywords: Organic compound. Helianthus annuus. Residue. Leather Treatment.
A Garantia do Duplo Grau de Jurisdição e a Supressão de Instância no Novo Código de Processo Civil
Authors: Alves Mickael Ferreira
Published: January 2022

ResumoO duplo grau de jurisdição é um princípio constitucional que garante à parte o direito de reexame de uma decisão acaso desfavorável e o Novo Código de Processo Civil, sancionado no dia 16 de março de 2015, prevê, em seu artigo 1.013, §3º, I que se a causa estiver em condições de imediato julgamento, o tribunal deve decidir desde logo o mérito quando: a) reformar sentença fundada em julgamento sem resolução do mérito; b) decretar a nulidade da sentença por não ser ela congruente com os limites do pedido ou da causa de pedir; c) constatar a omissão no exame de um dos pedidos; d) decretar a nulidade de sentença por falta de fundamentação. Dessa forma veremos na presente obra que as expressões empregadas pela leitura do novo dispositivo processual civil gera inconstrovérsias em que poderiam estar elencadas supressões de instâncias podendo configurar, a partir daí, uma colisão entre direitos e garantias fundamentais.
Palavras-chave: Jurisdição. Reformar. Colisão. Supressões.
AbstractThe double degree of jurisdiction is a constitutional principle that guarantees the party the right to review a decision that is unfavorable and the New Code of Civil Procedure, sanctioned on March 16, 2015, provides, in its article 1.013, paragraph 3, I that if the case is in conditions of immediate judgment, the court must decide immediately on the merits when: a) it reforms a sentence based on judgment without resolution of the merits; b) decree the nullity of the sentence because it is not congruent with the limits of the request or the cause of request; c) verifying the omission in the examination of one of the requests; d) decree the nullity of the sentence for lack of reasoning. Thus, we will see in this work that the expressions used by the reading of the new civil procedural device generate inconsistencies in which the suppression of instances could be listed, which could configure, from that point on, a collision between fundamental rights and guarantees.
Keywords: Jurisdiction. Reform. Collision. Deletions.
Motivação e Fundamentação das Decisões Judiciais à Luz do Novo Código de Processo Civil
Authors: Alves Mickael Ferreira
Published: January 2022

ResumoNa Constituição Federal de 1988 o princípio da motivação das decisões judiciais está expresso no art. 93, IX, em que todos os julgamentos dos órgãos do Poder Judiciário serão públicos, e fundamentadas todas as decisões, sob pena de nulidade, podendo a lei limitar a presença, em determinados atos, às próprias partes e a seus advogados, ou somente a estes, em casos nos quais a preservação do direito à intimidade do interessado no sigilo não prejudique o interesse público à informação. É com base nesse princípio constitucional que a referida obra vai abordar as grandes evoluções trazidas pelo Novo Código de Processo Civil, principalmente em considerar não-fundamentada a decisão que não enfrentar todos os argumentos deduzidos no processo capazes de, em tese, infirmar a conclusão adotada pelo julgador.
Palavras-chave: Motivação. Decisões. Fundamentada.
AbstractIn the Federal Constitution of 1988, the principle of motivation of judicial decisions is expressed in art. 93, IX, in which all judgments of the bodies of the Judiciary will be public, and all decisions will be substantiated, under penalty of nullity, and the law may limit the presence, in certain acts, to the parties themselves and their lawyers, or only to these, in cases in which the preservation of the right to privacy of the person interested in secrecy does not harm the public interest in information. It is based on this constitutional principle that the aforementioned work will address the major developments brought about by the New Code of Civil Procedure, mainly in considering unfounded the decision that does not face all the arguments deduced in the process capable of, in theory, invalidating the adopted conclusion by the judge.
Keywords: Motivation. Decisions. Grounded
O Termo de Ajustamento de Conduta (TAC) e sua Abrangência e Eficácia Territorial
Authors: Sampaio Ricardo Marfori , Pscheidt Kristian Rodrigo
Published: January 2022

ResumoNão há expressa disposição legal que determine a extensão ou não dos efeitos de um TAC para além da região onde foi firmado. Os efeitos e abrangência do TAC decorrem da expectativa do dano e direitos questionados pelo Ministério Público, que deverá, por rigor legal, declarar seu alcance em decisão que o homologar, proferida pelo respectivo Conselho Superior. A compreensão de que os efeitos do TAC abrangem tão somente a competência territorial que o projetou – por decorrência de interpretação extensiva da diretriz do art. 16 da Lei da ACP – encontra forte resistência pela doutrina e jurisprudência que tendem a reconhecer como mais segura a leitura do art. 103 do CDC, assim como também por prestígio ao princípio constitucional da igualdade, embora o Supremo Tribunal Federal tenha reconhecido previamente repercussão geral do tema e está prestas a enfrentar sua constitucionalidade.
Palavras-chave: Termo de Ajustamento de Conduta. Ministério Público. Eficácia. Lei 7.347/85
AbstractThere is no express legal provision that determines the extent or not of the effects of a TAC beyond the region where it was signed. The effects and scope of the TAC result from the expectation of damage and rights questioned by the Public Ministry, which must, by legal rigor, declare its scope in a decision that ratifies it, issued by the respective Superior Council. The understanding that the effects of the TAC only cover the territorial competence that designed it - due to the extensive interpretation of the guideline of art. 16 of the ACP Law - finds strong resistance by the doctrine and jurisprudence that tend to recognize the reading of art. 103 of the CDC, as well as for prestige to the constitutional principle of equality, although the Federal Supreme Court has previously recognized the general repercussion of the topic and is ready to face its constitutionality.
Keywords: Conduct Adjustment Term. Public Ministry. Efficiency. Law 7.347/85
Responsabilidade Civil do Fornecedor: e o Direito à Efetiva Reparação de Danos
Authors: Bezerra Fernanda Volpi , Carnevalle Moacir Junior
Published: January 2022

ResumoO presente artigo tem o objetivo de elucidar sobre a responsabilidade civil inerente ao fornecedor no que tange a respeito da reparação de danos diante dos vícios que são constatados em produtos e serviços fornecidos e prestados na relação de consumo. Se faz necessária a explanação a respeito da responsabilidade civil disposta no Código de Defesa do Consumidor para que fique claro sua devida aplicação e a importância de sua caracterização para que aconteça a devida reparação. Diante disso, deve-se apresentar a relação de consumo juntamente com os elementos que a compõem, é de suma importância ter a concepção de qual o papel de cada parte presente na relação de consumo, com o intuito de buscar sempre a igualdade entre as partes nessa relação. Por fim, não menos importante, deve-se elucidar sobre a responsabilidade civil do fornecedor e o direito que o consumidor possui em decorrência da sua vulnerabilidade presente na relação de consumo, nota-se que o legislador buscou dar igualdade, proteção e segurança à parte mais frágil na relação consumerista, ou seja, demonstra-se o consumidor ser essa parte. Para tanto, optou-se pelo desenvolvimento de uma pesquisa bibliográfica, ressaltando-se o entendimento doutrinário acerca do assunto apresentado e a legislação vigente acerca dos direitos consumeristas.
Palavras-chave: Responsabilidade. Fornecedor. Reparação de Danos. Relação de Consumo.
AbstractThis article aims to elucidate on the civil liability inherent to the supplier regarding the repair of damage in the face of defects that are found in products and services supplied and provided in the consumer relationship. It is necessary to explain the civil liability set forth in the Consumer Defense Code in order to make clear its proper application and the importance of its characterization so that the proper reparation can be made. In light of this, the consumer relationship must be presented along with the elements that compose it, it is of utmost importance to have the conception of what the role of each party present in the consumer relationship is, in order to always seek equality between the parties in this relationship. Last but not least, it is important to elucidate the civil liability of the supplier and the rights that the consumer has as a result of his vulnerability in the consumer relation. To this end, we chose to develop a bibliographic research, highlighting the doctrinaire understanding about the subject presented and the current legislation about consumer rights.
Keywords: Responsibility. Supplier. Damage Repair. Consumption Relationship.
Prevalence and phenotypic features of polycystic ovary syndrome among patients attending gynaecology clinic in two referral hospitals in Yaoundé, Cameroon
Authors: Kemfang Jean Dupont Ngowa , Omgba Jacques Yann Omgba , Ngo Esther Um , Chebu Cyrille Armel Nono , Fouogue Jovanny Tsuala , Kingsley Ombaku , Eugène Sobngwi
Published: January 2022

Background: Polycystic ovary syndrome (PCOS) is a common gynaecological endocrine disease in women at reproductive age. This study aimed to determine the prevalence and phenotypes of PCOS among women attending gynecology clinic at the two referral hospitals in Yaoundé.Methods: It was a cross sectional retrospective study involving women attending the gynecology clinic of two referral hospitals in Yaoundé, Cameroon from January 2016 to March 2018. The socio-demographic information, clinical and laboratory characteristics of each patient were collected from the medical files.Results: A total of 143 patients diagnosed with PCOS were included. The prevalence of PCOS was estimated at 3.5%. The mean age of patients was 29.18±4.5 years with a range of 17 to 41 years. Most patients were either overweight (31.7%) or obese (43%) and 0.7% patients were underweight. The most frequent presentations of PCOS patients were infertility (74.1%), oligomenorrhea/amenorrhea (68.5%), hirsutism (62,9%) and acne (20.3%). The different phenotypes represented were classical phenotype A: 69% (99/143), phenotype B: 17% (24/143), phenotype C: 09% (13/143) and phenotype D: 05% (07/143). Medical treatment (76.9%) and general measures (23.1%) were the most frequent therapeutic options among PCOS patients. In vitro fertilization (08.4%) and surgical drilling (07%) was also used.Conclusions: Prevalence of PCOS in our setting is 3.5%. The classical phenotype A is the most common. It is important to think about PCOS in women attending gynecology clinic.
Médical interruption of pregnancy in the 2nd and 3rd trimester of pregnancy: about 42 cases collged ať the Tunis Maternity and Neonatology Center “Service A”
Authors: Djiguemde Nebnomyidboumbou Norbert Wences , Millogo Traore Timongo Francoise Danielle , Lankoande Jean , Chanouffi Cheli Dalenda , Sfar Ezzidine
Published: January 2022

Background: Study IMGs in the 2nd or 3rd trimester of pregnancy in department “A” of the CMNT.Methods: Descriptive and analytical cross-sectional study in the “A” obstetrics gynecology department of the CMNT from January to June 2012. The variables studied related to sociodemographic characteristics, diagnosis, management and prognosis. Undiagnosed fetal abnormalities in the 1st trimester, serious maternal pathologies are the inclusion criteria. IMGs for embryofetopathies and MFIUs were not included in the study.Results: The average age was 32 years with an average term of 27 weeks of amenorrhea and 01 day. The indication was 97.6% fetal. Fetal malformations were divided into 54.8% neurological abnormalities, 4.8% renal abnormalities, 4.8% digestive abnormalities, 4.8% bone abnormalities, 2.4% pulmonary abnormalities and 2.4% cardiac abnormalities. The foeto-pathological examination was carried out 64.3% confirming the antenatal diagnosis with an ultrasound sensitivity of 67.6% in the 2nd trimester and 83.3% in the 3rd trimester. The overall expulsion time was 30.6 hours (<28 SA) and 43.9 hours (>28 SA), an overall success rate at 24 hours of 97.6% with one uterine rupture, 3 uterine retentions and hemorrhage. No cases of maternal death or infection were observed.Conclusions: The delay in the diagnosis of fetal pathologies makes it difficult to decide on abortion for practitioners and parents. Antenatal ultrasound and fetal karyotype represented the means that made it possible to pose or suspect the diagnosis of fetal abnormality.
Umbilical and middle cerebral arteries Doppler velocimetry in early and late onset pre-eclampsia
Authors: Sulaiman Bilal , Isah Aliyu Y. , Abdullahi Habiba I. , Adewole Nathaniel , Opadiran Oluwatunmobi R. , Suleiman Usman , Ibrahim Rukayya , Ekele Bisallah A.
Published: January 2022

Background: Pre-eclampsia (PE) is a multisytemic disorder originating from the placenta with a high prevalence in sub-Saharan Africa. Early (<34 weeks) and late (>34 weeks) – onset PE have different maternal and perinatal outcomes with overlapping clinical features. Differences in Doppler velocimetry pattern in these subgroups appears unsettled.Methods: In a prospective cohort study, 110 pregnant women with singleton pregnancy diagnosed with PE were recruited and had umbilical and middle cerebral arteries (MCA) Doppler velocimetry done. The pregnancies were followed up to delivery and outcome recorded and analysed using Microsoft excel 2013. Student t-test and Chi-squared test were used for continuous and categorical variables respectively. Level of significance was set at less than 0.05.Results: There were 53 (49.1%) women with early – onset preeclampsia and 55 (50.9%) with late-onset PE. The mean age of women was 30.30±5.2 years. The mean umbilical artery, middle cerebral artery pulsatility indices (PI) and cerebroplacental ratio (CPR) were 1.3±0.5, 1.1±0.5 and 1.1±1.2 respectively. There was statistical significant difference between the umbilical artery PI (p˂0.001), middle cerebral artery PI (p˂0.05) and CPR (p˂0.001) between early onset and late onset preeclamptic women. The resistance index and systolic diastolic ratio of both the umbilical and middle cerebral arteries were similar between the two groups (p>0.05).Conclusions: This study showed that umbilical and middle cerebral artery PI and CPR may be the most important Doppler parameters to watch-out for in monitoring women with PE.
Predictive value of serum uric acid levels for adverse perinatal outcomes in preeclampsia
Authors: Bhagavan Veena , Rao Aadhishree , Sharma Ritu
Published: January 2022

Background: Hypertensive disorders of pregnancy affect 6-8% of all pregnancies and along-with haemorrhage and infection, they form a complex triad, contributing immensely to maternal morbidity and mortality. Although exact aetio-pathogenesis of pre-eclampsia is unknown, multiple factors have been implicated to have a role in it; the factors being abnormal placental implantation, endothelial dysfunction, maternal immunological tolerance, cardiovascular, genetic, nutritional and environmental factors. Increased uric acid concentration is one of the most pronounced clinical findings in preeclampsia. Hyperuricemia in preeclamptic women is primarily due to a reduction in glomerular filtration rate due to endothelial dysfunction. In this study we look to explore the relationship between elevated serum uric acid and the perinatal outcomes, especially the ability to predict adverse perinatal outcomes.Methods: This was a hospital based retrospective study, conducted in A J institute of medical sciences and research centre, from January 2020 to December 2020. 75 study participants >20 weeks with diagnosed preeclampsia were chosen and their perinatal outcomes were measured. Chi square test and Fisher exact test was used to calculate p>0.05 was considered statistically significant. Results: Mean gestational age at delivery for elevated serum uric acid was 36.8 with SD=2.57 and those with normal uric acid levels is 38.43 with SD=0.89. FGR was seen in 5 patients, among which 4 (80%) had increased serum uric acid levels and 1 (20%) had normal serum uric acid levels. Total number of neonates who had APGAR score <7 was 3, among whom 2 neonates (66.66%) were born to increased uric acid level mothers. Out of 74 neonates, total number of neonates who had NICU admission were 20, among whom 9 neonates (45%) were born to mothers with increased serum uric acid levels.Conclusions: The study concluded that elevated serum uric acid is significantly associated with adverse perinatal outcomes, like FGR, low birthweight, low APGAR score and increased NICU admissions, there was no significant association between elevated serum uric acid level and mode of delivery.
Prevalence of thyroid disorders in antenatal patients and its feto-maternal outcome
Authors: Airao Bhavesh B. , Patel Nisiben N. , Dholariya Avni B.
Published: January 2022

Background: Thyroid disorders are common in pregnancy and most common disorder is subclinical hypothyroidism. Due to the complex hormonal changes during pregnancy, it is important to remember that thyroxine requirements are higher in pregnancy. Maternal hypothyroidism is an easily treatable condition that has been associated with increased risk of low birth weight, fetal distress and impaired neuropsychological development. Hyperthyroidism in pregnancy is less common as conception is a problem. Majority of them are due to Graves’ disease, though gestational hyperthyroidism is to be excluded. Early and effective treatment of thyroid disorder ensures a safe pregnancy with minimal maternal and neonatal complications.Methods: One hundred pregnant women attending antenatal clinic in first trimester were registered. Apart from routine basic and obstetrical investigations, TSH, FT3 and FT4 level estimation was done. L-thyroxine was given for hypothyroidism, this dosing was based on a study by Abalovich et al according to the body weight to maintain serum TSH near normal. For hyperthyroidism, given carbimazole if serum TSH level <1 MIU/l. Serum TSH estimation was repeated at regular interval. All the patients followed till the end of pregnancy. The normal patients served as controls. Pregnancy outcome studied statistically.Results: Around 68.8% of the inadequately treated patients developed complications like GDM, pre-eclampsia, oligohydramnios and preterm deliveries. Whereas only 32% of the control group developed these mentioned complications, this implied a significant association between inadequately treated thyroid disorders and poor pregnancy outcomes as evidenced by the p value of 0.002 which was very significant.Conclusions: Adequate treatment of thyroid disorders in pregnancy significantly reduces complications like miscarriages, pre-eclampsia, IUGR, oligohydramnios, glucose intolerance, preterm labour, low birth weight babies, abruptio placentae and stillbirth.
Study of maternal near miss and mortality in obstetrics in a tertiary care hospital
Authors: Ninama Pallavi G. , Karnavat Ronak D. , Siddhpura Shivani T. , Karia Jil P.
Published: January 2022

Background: Maternal health is an important aspect for the development of any country in terms of increasing equity and reducing poverty. In 2009, WHO came up with clinical, laboratory and management criteria for identification of the maternal near miss cases. Aim of the current study was to determine the level of near-miss maternal morbidity and mortality due to severe obstetrical complications or maternal disease in a tertiary care hospital. Objectives of the study were to compare the relation of near miss events with that of maternal mortality and to see the trend of near miss events.Methods: Cases were defined based on WHO criteria 2009. Study was conducted at GMERS Medical College and Hospital, Sola, Ahmedabad from 2020 to 2021. The study population were near miss cases and maternal deaths.Results: During the period of audit there were a total of 6776 deliveries, 6434 live birth, 145 near miss and 36 maternal deaths.Conclusions: Haemorrhage and hypertension are the leading cause of maternal near miss and maternal mortality in our hospital. As near miss indices represent quality of health care it should be represented in the national indices.
Endometrial histopathology patterns in women with abnormal uterine bleeding
Authors: Choudhary Anjali , Agarwal Shikha , Kohli Swati , Mishra Shweta , Singh Parul
Published: January 2022

Background: Abnormal uterine bleeding is the most common gynaecological condition for which many women seek medical opinion. Evaluation of these women requires careful investigation into the cause and nature of bleeding with a main focus to exclude organic pathology, especially genital malignancies. Endometrial biopsy is one such intervention which is of immense value in categorizing the conditions. Aims and objectives of current study were to analyse endometrial histology patterns in women with AUB.Methods: This was a retrospective study conducted on women with AUB who presented in the gynae OPD during the study period of one year and had endometrial biopsy as part of evaluation. Women between with AUB were included in the study after excluding pregnancy related bleeding. Detailed clinical history, examination findings, investigations and endometrial histopathology was noted.Results: A total of 97 women with AUB who had undergone dilatation and curettage with endometrial biopsy were studied. Majority of women were in age group of 40-45 years and heavy menstrual bleeding was the commonest complaint, AUB (P) 17% and AUB (L) 39%, accounted for most of the clinical presentations. Endometrial histology showed varied patterns 27 % had secretory endometrium, 11% proliferative endometrium. There were 7 cases of endometrial hyperplasia without atypia and three cases of endometrial malignancy. Conclusions: Histopathological evaluation of endometrium is the cornerstone of management of abnormal uterine bleeding. Endometrial patterns obtained can be useful in ruling out malignancy and help in formulating further management.
Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid
Authors: Gupta Pooja , Singh Santosh Kumar
Published: January 2022

Background: Meconium stained amniotic fluid is the movement of meconium in the uterus by the fetus during the ANC period or through labor. It has been speculated during the intrapartum and postpartum period as a factor affecting fetal wellbeing and considered as the hallmark symptom of imminent asphyxia. Aim and objectives of current study were to correlate the presence of meconium-stained amniotic fluid with the mode of delivery and perinatal outcome.Methods: A total of 100 women were taken in the study in which meconium stained amniotic fluid and its relation with mode of delivery and neonatal outcome were observed for 2 years.Results: A total of hundred cases were studied. Incidence of types of meconium found to be thin (25%), moderate (34%) and thick (41%). 76% of patients with thin meconium were delivered vaginally without any assistance with instruments, while 64.7% and 68.3% of cases with moderate to thick meconium respectively were delivered by LSCS. In the group of patients with APGAR score more than 7 at five minutes, there is more percentage of patients with thin MSL while in the group of patients with APGAR score less than 7, there is more percentage of patients with thick meconium. No cases of meconium aspiration syndrome were foundConclusions: The types of meconium affect the mode of delivery and fetal outcome. There is no association between having a low birth weight and passage of meconium during labor. The severity of the type of meconium associated with APGAR might be due to severe hypoxia and severe form of nervous system depression leading to cardiovascular and respiratory depression and activation of the parasympathetic nervous system causing anal sphincter relaxation and passage of meconium.
Safety and effectiveness of tranexamic acid in reduction of post-partum hemorrhage in patients undergoing caesarean section in tertiary care hospital of Southern India
Authors: L. Girish B. , S. G. Shraddha , L. Dwarakanath
Published: January 2022

Background: Obstetric haemorrhage is a leading cause of premature maternal mortality, accounting for at least 100,000 deaths each year worldwide. Tranexamic acid has been shown to reduce uterine blood loss in non-surgical aspect. The aim of the study is to evaluate the safety and effectiveness of TXA in prevention of post-partum hemorrhage in patients undergoing caesarean delivery and to compare the secondary clinical outcomes.Methods: In this prospective observational cross-sectional study, 50 pregnant women undergoing CD were selected in random pattern and divided into control and study group of 25 patients each, in the department of obstetrics and gynaecology in Sri. Siddhartha medical college, Tumakuru from November 2019 to October 2021. The study group were given 1 g of TXA intravenously and the control group did not receive TXA. All the pregnant women received 20 units of oxytocin following delivery.Results: Mean of the total blood loss in the study group was 67 % less than the control group. Secondary clinical outcomes such as need for blood transfusion, other surgical measures to stop bleeding were comparatively less in study group compared to control groups. To note, no significant difference in duration of hospital stay was found between two groups.Conclusions: Our study suggests that, a safe dose of 1g IV tranexamic acid prior to caesarean section has an effective role in reducing blood loss and significantly improved blood loss–related secondary clinical outcomes with fewer side effects.
Maternal and perinatal outcomes in pregnancy associated with placenta previa
Authors: Gupta Jyoti , Hak Jyoti , . Anuradha , . Harleen , Mehta Lakshay
Published: January 2022

Background: Placenta previa is associated with increased maternal and perinatal complications like malpresentation, premature labor, higher rates of caesarean section, peripartum hysterectomies, postpartum hemorrhage, sepsis, shock and retained placenta and even death. Antepartum haemorrhage may frequently result in low birth weight babies, preterm labour or repeated small events of haemorrhage causing chronic placental insufficiency and foetal growth retardation or intrauterine fetal death.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, SMGS, hospital, Jammu over a period of 1 year. All admitted cases of placenta previa were included in the study.Results: The total numbers of deliveries in one our hospital were 18567 during the study period. 364 patients admitted with antepartum heamorrhage so the incidence of APH in our hospital was 1.96%. 157 cases out of 346 were of placenta previa. It was observed that placenta previa cases were highest in the maternal age group of 26-30 yrs, i.e. 55.42%, 71.97% were multigravidae and those with prior caesarean section. 15.92 % had undergone peripartum hysterectomy due to massive PPH. The percentage of perinatal death was 18.23% and the main cause was prematurity.Conclusions: Based upon observation made during this study, it is concluded that placenta previa is a serious condition with significant maternal and perinatal morbidity and mortality. Improvements in management of placenta previa have helped in improving neonatal survival and reduce maternal morbidity and mortality.
A prospective study of maternal and fetal outcome in patients with hypertensive disorders of pregnancy and COVID-19 infection in a tertiary care center
Authors: Chavan Niranjan , Simpatwar Sonam , Kapote Deepali , Deshmukh Prasad , Sakhalkar Ashwini
Published: January 2022

Background: During the current COVID-19 epidemic, managing pregnant patients is an issue. Pregnant women with coronavirus infection have an increased risk of miscarriage, preclampsia, caesarean delivery, and neonatal mortality. The additive effect of COVID-19 infection and preclampsia in pregnancy may affect the fetal and maternal outcome in a more complicated way. There have been only a few studies till now to observe the combined effect of both in pregnancy. Our study aims to observe and analyse the maternal and fetal outcomes in pregnancy complicated by preclampsia and COVID-19 infection.Methods: This is a prospective study at a tertiary referral facility. This research included women with hypertension who were hospitalized for delivery and screened for SARS-RTPCR using a nasopharyngeal swab from April 2020 to September 30, 2021. The maternal and neonatal outcomes were studied and analyzed.Results: In our study of 65 women with COVID-19 infection and hypertensive disorders in pregnancy, about 6 (9.2%) had eclampsia, 6 (9.2%) had abruptio placenta, 5 (7.6%) had DIC, 3 (4.6%) had HELLP, 2 (3.07%) had acute kidney injury, 2 (3.07%) had ARDS, and 1 (1.5%) had PRESS. 4 (6.1%) had chronic hypertension. Further, 12 (18.4%) of patients needed ICU admission with ventilatory support; about 5 (7.6%) was the rate of maternal deaths in our study. 43 (65%) of neonates were appropriate for gestational age, while 20 (32%) were low birth weight and 2 (3%) were extremely low birth weight. 45% of women with preclampsia develop complications.Conclusions: Our study concluded that complications from preclampsia are more common in women with COVID-19 infection, but a larger sample size is necessary for statistical significance.
Rare case of heterotopic pregnancy: a case report
Authors: Khanam Rosy , Choudhury Shabir A.
Published: January 2022

Heterotopic pregnancy refers to condition where two pregnancies are present simultaneously at different implantation sites mostly manifested as intrauterine and ectopic pregnancies. First heterotopic pregnancy after in vitro fertilization was reported in 1972. Mostly it is a sporadic condition. The most common ectopic site is the fallopian tube, both in spontaneous and assisted reproductive technology (ART) heterotopic pregnancies. Almost 60-70% of heterotopic cases result in live childbirth with outcomes similar to that of singleton pregnancies. Spontaneous heterotopic pregnancy is a rare and potentially dangerous condition in which intrauterine (IU) and extrauterine pregnancies occur at the same time. It can be a life-threatening condition and can be missed, with the diagnosis being overlooked. A high suspicion is needed in women with risk factors for an ectopic pregnancy and in low-risk women with an intrauterine gestation who have free fluid with or without an adnexal mass or in those presenting acute abdominal pain and shock. The ectopic component is usually treated surgically and the intrauterine one is expected to continue normally.
Саse reроrt оf fetal liver cirrhosis due to gestational alloimmune liver disease in а primigravida femаle, in north east region of India
Authors: Gupta Priya , Maheshwari Sandip
Published: January 2022

Fetal liver failure is a major cause of neonatal morbidity and mortality, presenting as acute liver failure and/or congenital cirrhosis. There are several causes of fetal liver failure and early diagnosis is mandatory to elucidate the etiology and determine a specific treatment or the best management strategy. Gestational alloimmune liver disease associated with neonatal hemochromatosis (GALD-NH) is a rare cause of fetal liver failure. It should be considered in any neonate with fetal signs of liver failure with no other identifiable causes. GALD-NH is often diagnosed late and patients are therefore referred late to specialized centers, delaying treatment. This case highlighted the consequences of late diagnosis and treatment of GALD-NH and emphasizes the importance of a high grade of suspicion of this disease in order to refer the patient to a specialized center soon enough to perform the appropriate treatment.