bluuebunny/crossref_metadata_2025 huggingface dataset:
Adıyaman İli Ticari Badem Bahçelerinde Badem İçkurdu (Eurytoma amygdali End.)’nun Pupa Gelişiminin ve Ergin Çıkış Zamanın Belirlenmesi
Authors: ÇAĞLAR Öznur , ISIKBER Ali Arda
Published: March 2021

Bu çalışmada; Adıyaman ilinde Besni (Merkez) ve Kahta (Tuğlu köyü ve Hacıyusuf köyü) ilçelerinde bulunan badem bahçesinde Badem İçkurdu (Eurytoma amygdali End.)’nun ergin çıkış zamanın belirlenmesi amaçlanmıştır. Badem İçkurdu’nun pupa gelişimini ve ergin çıkışlarını takip etmek amacıyla her bir badem bahçesinin farklı bölgelerinden badem ağaçları seçilmiş ve her bir ağacın güney, kuzey ve güney-batı yönlerinde bulunan dallara şifon dal kafesler yerleştirilerek içerine E. amygdali ile bulaşık mumyalaşmış badem meyveleri konulmuştur. Çalışma sonucunda, ağacın farklı yönlerine (güneybatı, kuzey ve güney) yerleştirilen E. amygdali ile bulaşık mumyalaşmış badem meyvelerinde diyapoz larva, pupa gelişimine ve ergin oluşuma önemli etkiye sahip olmadığını göstermiştir. Üç farklı lokasyondaki badem ağaçlarına yerleştirilen kafesler içerisinde bulanan E. amygdali ile bulaşık mumyalaşmış badem meyveleri içerisindeki diyapoz larvaların ilk beyaz pupa ve ilk ergin çıkış tarihleri ve pupa ile ergin çıkış süreleri arasında önemli farklığın olmadığı görülmüştür. İlk beyaz pupa oluşumu Kahta ilçesi 1. bahçede (Tuğlu köyü), Kahta 2. bahçede (Hacıyusuf köyü) ve Besni’deki bahçede sırasıyla 26, 28 ve 26 Şubat’ta gerçekleşirken badem ağacı pembe çiçek tomurcuğu döneminde olduğu görülmüştür. İlk ergin çıkışı Kahta ilçesi 1., 2. bahçede ve Besni’deki bahçede sırasıyla 27, 27 ve 24 Mart’ta gerçekleşirken badem ağaçları çağla mercimek iriliği döneminde olduğu görülmüştür. Ergin çıkış süresi Kahta ilçesi 1., 2. bahçede ve Besni’deki bahçede sırasıyla 15, 15 ve 17 gün sürmüştür. Pupa süresi Kahta ilçesi 1., 2. bahçede ve Besni’deki bahçede sırasıyla 34, 33 ve 31 gün olarak belirlenmiştir.
Video Oyunların Eğitim Araştırmalarında Kullanımı: Bir Sistematik Tarama
Authors: ALTINPULLUK Hakan
Published: March 2021

Bu araştırmada video oyunların eğitim araştırmalarındaki mevcut durumunun incelenmesi ve araştırma eğilimlerinin belirlenmesi amaçlanmıştır. 2007-2019 yılları arasında yayınlanan ve başlığında “video oyunları” anahtar sözcükleri olan, Web of Science veritabanında Social Sciences Citation Index (SSCI) indeksli 67 makalenin sistematik tarama yöntemiyle incelenmesiyle araştırma gerçekleştirilmiştir. Araştırma sonucunda, 2017 ve 2019 yıllarında yayın sayılarının en üst noktaya ulaştığı, en fazla Fen Bilimleri alanında video oyunlar araştırmalarının yapıldığı, en çok duyuşsal ve motivasyonel öğrenme çıktılarının elde edildiği ve oyunların en çok video oyun konsollarında oynandığı bulgusuna ulaşılmıştır. Kullanılan araştırma yöntemine ilişkin bulgular incelendiğinde, en çok nicel yöntemin tercih edildiği, veri toplama aracı olarak en çok testlerin kullanıldığı, örneklem grubu olarak ilköğretim öğrencilerinin seçildiği bulgusuna ulaşılmıştır. Kuramsal yaklaşımlara ilişkin ise oyun tabanlı öğrenme yaklaşımının en fazla tercih edilen öğrenme yaklaşımı olduğu belirlenmiştir. Ayrıca, araştırma bulgularına dayalı olarak bazı önerilerde bulunulmuştur.
Maliyetli Sinyalizasyon Teorisi Bağlamında Pazarlama İletişimi Kampanyaları ve Kitle İletişim Araçları
Authors: ÖZDEMİR Şebnem
Published: March 2021

Aslen 1975 yılında Zahavi tarafından ortaya konulan “Handikap İlkesi”ne dayanan “Maliyetli Sinyalizasyon Teorisi” günümüzde gerek hayvan davranışını gerekse insan davranışını açıklamakta yararlanılan bir teoridir. İletişim disiplini altında incelendiğinde Maliyetli Sinyalizasyon Teorisi, temelinde, iletişimsel eylem içerisinde olan oyuncunun karşı tarafa dürüst sinyaller göndermesinin yarattığı maliyete odaklanır. Maliyetli sinyalizasyon, çoğu zaman (özellikle sinyal veren taraf açısından) bir kayba yol açsa da zaman zaman söz konusu maliyete sebep olan dürüst sinyallerin, sinyali alan tarafta güven oluşturması sebebi ile bir kazanç da yaratabilir. Dürüst sinyaller sayesinde tesis edilen güvenin yaratacağı kazanç ile zayıflığın ortaya çıkması sebebi ile oluşan kayıp Oyun Teorisi kapsamında da çalışılmaktadır. Türkçe alanyazında Maliyetli Sinyalizasyon Teorisi ile ilgili ciddi bir boşluk bulunduğu görülmektedir. Bu derleme çalışmasında Maliyetli Sinyalizasyon Teorisi irdelenmiş ve bu teori doğrultusunda, teoriye örnek teşkil edebilecek pazarlama iletişimi kampanyaları ve kitle iletişim araçları incelenmiştir. Çalışma dahilinde verilen kampanyaların seçiminde herhangi bir kriter kullanılmamış, teoriye örnek teşkil edebilecek tartışmalı pazarlama iletişimi kampanyaları incelenmiştir. Çalışmada ayrıca kampanyaların yer aldığı mecraların sinyalizasyon gücü de ele alınmıştır. Derleme mahiyetinde hazırlanan bu çalışmanın Maliyetli Sinyalizasyon Teorisi ile ilgili Türkçe alanyazına katkıda bulunması umulmaktadır. Çalışmanın, bu konuda ileride yapılacak nitel / nicel çalışmalara altyapı oluşturması amaçlanmıştır.
Prevalence and cesarean rates of immigrant adolescent pregnancies
Authors: Birge Özer , Serin Aliye Nigar , Kayar İlkan
Published: March 2021

Background: aim of this study was to compare Syrian migrant adolescent pregnancies and Turkish adolescent pregnancies, who gave birth in Osmaniye State Hospital.Methods: 22,724 women who gave birth at the Osmaniye State Hospital obstetrics and gynecology department between January 2013 and January 2020 were screened retrospectively. 868 Turkish adolescent pregnant women and 522 Syrian migrant adolescent pregnant women were compared. Whether the differences between Turkish and Syrian adolescents were noteworthy (95% confidence interval) was determined using the independent samples t test and Pearson Chi-Square test with statistical software Minitab (version 16.0, USA).Results: A total of 22,724 births, including 15,883 Turkish and 6841 Syrian immigrants, were analyzed. The number of Turkish adolescent pregnant women was 868 (5.5%), the number of Syrian adolescent pregnant women was 522 (7.6%), the rate of Syrian adolescent pregnancy was higher. The cesarean rate was observed 36.7% in Turkish adolescent pregnancies and 20.1% in Syrian adolescent pregnants, cesarean rates were significantly higher in Turkish adolescent pregnants (p<0.001). When the total of 1390 (6.1%) adolescent pregnancies were evaluated in Osmaniye, where there were intense migrants and Syrian camp, the cesarean rate was found to be 30.5%, and the birth rate of low birth weight below 2500 gm was 11.1%.Conclusions: Maternal and fetal complications increase in adolescent pregnancies. War and migration are associated with poor obstetric outcomes in pregnancies. With Syrian immigration, an increase in adolescent pregnancy rate, cesarean rate, and low birth weight rate was observed in the region. For these reasons, studies should be done to prevent Syrian adolescent pregnancies. Social and education support, regular follow-up should be done to improve pregnancy outcomes. Adolescent pregnant women are more likely to have vaginal delivery. Therefore, normal vaginal delivery should be followed unless there is an emergency cesarean indication.
A prospective study on comparison of cervical length measured transvaginally and bishop score in predicting successful labour induction
Authors: Balaji T. E. , S. Vijaya
Published: March 2021

Background: Induction of labour is one of the common interventions in obstetric practice. Cervical assessment has been used as a prediction of the successful vaginal delivery. This study is designed to investigate transvaginal ultrasonographic cervical measurement as a predictor of duration of labour and successful induction resulting in vaginal delivery and compare the performance of ultrasonographic cervical measurement with that of the Bishop score in predicting the outcome of labour induction.Methods: It is a prospective observational study. In this study, for the 100 primigravida women with gestational age of 37-42 weeks of gestation admitted for induction of labour, the cervical length was measured by transvaginal ultrasound and then Bishop Score was assessed by digital examination. Predictive values for successful labour induction were detected and compared.Results: Using Spearman’s rho correlation both TVS cervical length and Bishop score have significant correlation in predicting the success of induction of labour. Cervical length is the better predictor of the likelihood of delivering vaginally within 24hrs.  In the receiver operating characteristic curves, the best cut-off points for the prediction of successful induction was 26mm for cervical length and 4 for the Bishop Score. However, TVS cervical length appears to be a better predictor than the Bishop Score, with a sensitivity of 58.1% and a specificity of 100% compared to 70.3% and 45.5% respectively.Conclusions: Transvaginal sonographic measurement of cervical length is a better predictor of the likelihood of successful induction of labour within 24hrs of induction and increased vaginal deliveries within 48 hours of induction when compared to Bishop Score.
An experience with COVID-19 positive pregnant patients at a tertiary care center
Authors: Baser Anshu , Gupta Akriti , Sharma Sunil , Kumar Sushil
Published: March 2021

Background: The Covid-19 pandemic is a global phenomenon. The lockdown imposed by the central and state governments, has also led to restriction of movement of patients thus reducing their access to antenatal care. Our hospital was officially declared as a Covid-19 centre as per government directives. The hospital has been managing Covid-19 positive patients as per guidelines. We here present the data of management of COVID-19 positive pregnant patients.Methods: A retrospective study. All COVID positive patients admitted to the obstetric unit of the hospital from 23 March 2020 to November 2020 were analysed. A total of 96 COVID positive patients were analysed. The patients were analysed for antenatal complications, complications during delivery, mode of delivery and neonatal complications.Results: There was only one patient with major complications associated with COVID. Most of the patients were either asymptomatic or had mild symptoms. There was only one maternal mortality. 23 out of the 89 antenatal cases required emergency caesarean section. The caesarean section rate was higher in COVID positive patients though the caesarean sections were done for obstetric indications only. Three neonates tested positive for the virus. 2 of the neonate required NICU admission.Conclusions: COVID-19 is a completely unprecedented situation. The aim of this study was to demonstrate that the effect of COVID-19 on pregnant women is minimal. There were only 2 patients with major complications. The COVID positive pregnant patients can be managed effectively with proper personal protective equipment and adherence to guidelines.
An evaluation of the prevalence, cause and risk factors associated with leucorrhoea in reproductive age group women
Authors: Arthy A. Priya , Sen Sangeeta , Kumar A. Ganesh , Rajaram R. , Archunan G.
Published: March 2021

Background: The community based study was carried out in women of reproductive age group with a specific aim to evaluate the prevalence and risk factors of leucorrhoea.Methods: In this investigation, a total of 191 women who presented with gynaecological complaint of white discharge and seeking medical assistance was taken as a study sample for PAP smear. The basic details like socio demographic, past obstetric history and menstrual history were included prior to the smear study.Results: High prevalence of vaginal discharge was observed in the age group of 30-39, those who had two parity, previous obstetric history of normal vaginal delivery and usage of Copper T as a method of contraception. The binary logistics model explains the risk factors levels of abnormal vaginal discharge with 95% confident interval. Based on the data analysed, the age group of 30-39 and 40-49 are more likely to have a risk of 3.22 and 2.68 folds respectively. Likewise, the participants with the history of diabetes had a 2.08 folds increased risk of leucorrhoea rather than other complications and 2.21 folds of risk to those who used barrier methods like condom as a contraceptive method.Conclusions: The results concluded that the occurrence of vaginal discharge in women is age dependent and the most common risk factors for causing the vaginal discharge in the reproductive age group i.e. 30-49 years of age, are previous normal vaginal delivery, diabetes and usage of contraceptive methods like intra uterine contraceptive device and barrier methods.
Comparison of intravenous paracetamol vs. intramuscular diclofenac for postoperative pain control in abdominal hysterectomy
Authors: Bisht Poonam , Jain Geeta
Published: March 2021

Background: Abdominal hysterectomy is one of the most common gynaecological surgery conducted worldwide. It is commonly associated with post operative pain. The aim of this study was Comparison of intravenous Paracetamol versus intramuscular Diclofenac for postoperative pain control in abdominal hysterectomy. Objectives of this study were to compare the effectiveness of intravenous Paracetamol and intramuscular Diclofenac when used for post-operative pain control in abdominal hysterectomy patients and to compare the need for rescue analgesia in both the groups.Methods: It’s a prospective observational and clinically randomized study conducted in Department of Obstetrics and Gynaecology, Government Medical College Haldwani and associated Dr. Shushila Tiwari Government Hospital, Haldwani consisting of 120 patients undergoing abdominal hysterectomy. 60 patients in group A received Paracetamol 1000 mg (100ml infusion) intravenous followed by subsequent doses of 1000 mg every 8 hourly for 48 hrs and another 60 patients in group B received injection Diclofenac 75 mg intramuscular every 8 hourly for 48hrs. Pain intensity of patients was noted 2 hourly for 6 hours after giving the first dose of the drug and then at every 8 hour for next 48 hours, using VAS scoring. Patient’s hemodynamics in form of respiratory rate, heart rate, mean arterial pressure (MAP), oxygen saturation (sPO2) were monitored as per pain monitoring protocol.Results: Post-op mean VAS score at different point of time among the two treatment groups was lower for Paracetamol group as compared to Diclofenac group. The difference was found to be statistically significant at all point of time post op. Adverse effect like nausea, vomiting and dizziness was seen more among Diclofenac group as compared to Paracetamol group.Conclusions: Intravenous Paracetamol use was found to be associated with better postoperative pain relief and reduced need for rescue analgesia consumption in the postoperative period.
Palm-coein classification of abnormal uterine bleeding and clinicohistopathological correlation
Authors: Vasava Vimal H. , Airao Bhavesh B. , Shingala Milan R.
Published: March 2021

Background: The aim was to categorize women with AUB as per the PALM-COEIN classification system as this is a step towards cause based diagnosis and focused management of patients. The acronym PALM-COEIN comes from arranging basic categories of the classification system. The PALM group comprises the structural entities, which can be measured visually or by using imaging techniques and histopathology. The COEIN group comprises the non- organic types which cannot be defined by imaging or histopathology.Methods: The study comprised 350 women of reproductive age with AUB for minimum 3 month time span. It describes and observes AUB in amount, interval and frequency for women attending out-patient Gynaecology department of C. U. Shah Medical College and Hospital, Surendranagar (Gujrat) over a period of 1year from November 17 to October 18. They were assessed on the basis of structured history, physical examination, local pelvis examination, investigations, USG findings and endometrial histopathological report. Cause of AUB was determined and treatment was given to the patient as appropriated by categorization done in agreement with the PALM-COEIN classification.Results: The most prevalent cause of AUB was ovulatory dysfunction (n=99, 28.2%). Next common cause was leiomyoma (n=90, 25.7%), followed by endometrial causes (n=52, 14.5%), adenomyosis (n=30, 8.5%) not yet classified (n=32, 9.7%), malignancy and hyperplasia (n=28, 8.1%), polyp (n=9, 2.5%), iatrogenic (n=7, 2.2%) and coagulopathy (n=1, 0.3%).Conclusions: The PALM-COEIN classification helps to practically as certain because of AUB, and there by effectively adopt the correct treatment for AUB patients.
Role of neutrophil-lymphocyte ratio in determining the outcomes of preterm premature rupture of membranes
Authors: Lakshmi M. P. A. Sai , Sravani V. Lakshmi
Published: March 2021

Background: Premature Rupture of Membranes (PROM) is a significant obstetric problem. Evaluation of neutorphil-lymphocyte ratio (NLR) is expected to throw light on the potential scope of early prediction of PPROM. With this background, the present study was carried out to compare the NLR among preterm PROM and healthy controls to evaluate the predictive role of NLR and platelet-lymphocyte ratio (PLR).Methods: This case control study was carried out among 101 pregnant women 44 pregnant women diagnosed with Preterm PROM and 55 term gestation matched healthy controls. Laboratory parameters (including complete blood count were measured. PLR was calculated as the number of platelets divided by the lymphocyte count, and NLR was calculated by dividing the neutrophil Count by the lymphocyte count, both of which were obtained from the same blood samples.Results: All the inflammatory markers including total count, neutrophil count, NLR and PLR ratios were elevated among PPROM group compared to the controls. The observed differences in the mean levels of these parameters were statistically significant (p<0.05).Conclusions: It may be considered that monitoring of NLR during second and early third trimesters as a routine practice among high risk mothers can significantly help in early prediction of PPROM and help in minimizing adverse maternal and neonatal outcomes.
Prophylactic use of tranexamic acid for reducing postpartum hemorrhage in vaginal delivery
Authors: Ginjupalli Anusha , S. N. Anuradha , D. Joshi Suyajna
Published: March 2021

Background: The use of anti-fibrinolytic therapy has potential to reduce obstetric blood loss due to profound changes that take place in the fibrinolytic system during normal childbirth. Objective was to evaluate the efficacy of tranexamic acid in reducing postpartum hemorrhage (PPH) during normal labour.Methods: Patients who planned for normal delivery and fulfilling the inclusion criteria were recruited for the study. The pre-delivery parameters -pulse rate, blood pressure, Hb gm% and PCV% were measured for each patient. The study group received injection oxytocin (10 IU) and injection tranexamic acid (500 mg) slow intravenous route. The control group received injection oxytocin (10 IU) and placebo injection. Immediately after delivery of the anterior shoulder of the baby, when all the liquor was drained, Brasse-V drape is placed under the patient. Then the patient was given pre-weighed pads, which were weighed 2 hours post-partum. Final blood loss was calculated by combining amount of blood collected in the drape and blood absorbed by the pads.Results: The total number of patients studied was 300- equally distributed in both the groups. There was a significant increase in the pulse rate and decrease in blood pressure in the control group compared to the study group. The post-delivery haemoglobin and haematocrit were significantly reduced in the control group. The blood loss was significantly low in the study group. The need for other uterotonics, blood transfusion, and duration of hospital stay, were significantly low in study group.Conclusions: Tranexamic acid, when given prophylactically to the women with vaginal delivery who received prophylactic oxytocin, appears to reduce the blood loss effectively compared to placebo alone.
Association and correlation of thyroid dysfunction with anemia types in pregnant women of northern Andhra Pradesh, India
Authors: V. Prabhavathi , V. Prasad D. K. , K. Sravani
Published: March 2021

Background: Thyroid dysfunction is a common disorder in pregnancy along with anemia. But no study has evaluated the association between them. To estimate the prevalence of thyroid dysfunction and its association with anemia types in pregnant women during 1st trimester.Methods: Three hundred and eighty pregnant women with <12 weeks of gestational age were selected for the study with no history of thyroid dysfunction and anemia. All the pregnant women were classified into A, euthyroid and B, thyroid dysfunction groups. The B group was again subdivided into hypothyroid, subclinical hypothyroid (SCH), hyperthyroid according to nature of dysfunction. 5 ml of blood sample was collected from all subjects to analyse thyroid hormones and erythrocyte indices.Results: Out of 380 subjects, euthyroid was found to be 77.9%, and rest 22.1% were with thyroid dysfunction. Out of 84 thyroid dysfunction, hypothyroid was found to be 7.9%, SCH 13.9% and hyperthyroid was 0.3%. Out of 296 euthyroid women, anemia was identified in 97 pregnant women (32.8%) whereas in thyroid dysfunction women it was 43 women out of 84 (51.2%) which is a statistically significant. Significantly higher frequency of microcytic hypochromic anemia and normocytic normochromic anemia types were also found in thyroid dysfunction groups compared to euthyroid group (p<0.05). However, no significance between the thyroid dysfunction groups, Statistically significant difference was observed in the Hb concentration, RBC count, MCV, MCH and PCV between euthyroid and different thyroid dysfunction conditions (p<0.05). A statistically significant positive correlation was found between fT4 and erythrocyte indices.Conclusions: As fT4 and TSH correlated with erythrocyte indices, it is advisable to screen for thyroid dysfunction and vice versa so as to prevent the complications associated with anemia and thyroid dysfunction.
Diverse presentation of connective tissue disorders in pregnancy
Authors: Bedi Mini , Kaur Sandeep , Patil Prashant , Kaur Kamaljeet , Kaur Harbhajan , Kaur Harkiran
Published: March 2021

Connective tissue disorders (CTD) include a variety of chronic multisystem disorders including autoimmune conditions. Many of these conditions affect women of childbearing age and therefore pregnancy poses an important challenge for the caregivers. The precise knowledge of therapeutic safety and the effect of disease on pregnancy and vice versa are important to achieve best outcome. Hence, it is imperative to have a vast knowledge of disease with proper preconception counselling. We report series of cases of connective tissue disorders in pregnancy: tuberous sclerosis (TS), systemic lupus erythmatosis (SLE) and neurofibromatosis (NF) type 1. The first case with tuberous sclerosis was associated with obstetric complications. In both cases of SLE, we observed preterm delivery and IUGR. However, the course of SLE remained the same in both the cases. The case with NF 1 taught us that a normal obstetric outcome could be expected in pregnant women.
Wombstone-massive calcified fibroid: a case report
Authors: Ananthula Shruthi , Gopalan Ushadevi
Published: March 2021

We report a case of a calcified submucous leiomyoma in 50 years women with lower abdominal discomfort. She had no previous history of surgery. Work up confirmed a calcified leiomyoma. The diagnosis was made by radiological findings. Total abdominal hysterectomy with bilateral salpingo-oophorectomy is the surgery of choice for these cases. Histopathological examination confirmed a calcified leiomyoma. A calcified leiomyoma in a post-menopausal woman is rare.
Transmigration of copper T presenting as abdominal wall mass: a case report
Authors: Devi T. Ramani , Banu S. Shameema , Harini T. , Kanimozhi P.
Published: March 2021

Copper T is one of the widely used intra uterine contraceptive devices due to its safe, effective and reversible nature. It has also been widely used as it is cost effective too. Copper T is usually inserted immediate post-partum, post abortal, during the proliferative phase of any menstrual cycle or 6 to 8 weeks following post-partum. Complications associated with use of Copper T include heavy menstrual bleeding, pelvic inflammatory disease, uterine perforation, displacement and rarely, transmigration. Post-insertion of copper T, women need to have regular follow up visits to prevent such complications. Patients should be advised to check for the presence of threads periodically. Considerable number of patients with transmigration of copper T has been reported in literature. Sites into which transmigration has been reported include broad ligament, ovarian fossa, urinary bladder, sigmoid colon, rectum, peritoneum, omentum, pouch of douglas, retro peritoneal space, iliac veins, ovaries, appendix and rarely in the abdominal wall. Transmigrated copper T may be diagnosed with ultrasonogram, X-ray and CT scan. Copper containing intra-uterine devices are known to provoke inflammatory reactions and symptoms depending upon the sites to which they have been transmigrated. Hence, we should resort to early intervention and remove the misplaced copper IUCD at the earliest. Here, we are reporting a rare case of transmigration of copper T into the anterior abdominal wall elaborating on various facets of copper T including its advent, incidence of use, efficient diagnosis and well-planned retrieval.
Glycosylated hemoglobin as an efficacious tool for early prediction of gestational diabetes mellitus
Authors: Shendre Sneha D. , Palaniswamy Vijayalakshmi , Rewatkar Swanand S.
Published: March 2021

The incidence and prevalence of GDM is on the rise worldwide and, more so in developing countries including India. GDM is associated with maternal, fetal and neonatal morbidities. Current guidelines recommend GDM screening only at 24-28 weeks of gestation. Diagnosis of GDM in later half of pregnancy leads to fetal and maternal morbidities in spite of good glycemic control. This necessitates the use of a simpler, convenient, accurate, and reliable test, which can predict GDM in early gestation. Our article reviews the scope of using HbA1c for GDM and its efficacy in screening GDM.
Effect of asymptomatic bacteriuria on pregnancy outcome: a review
Authors: Neelima Nalam , Gopalan Ushadevi
Published: March 2021

Asymptomatic bacteriuria is more common in pregnancy and if left untreated it may progress to upper urinary tract infection. Early detection and treatment of asymptomatic bacteriuria prevents further progression of the infection and thereby preventing undesirable complications to the mother and fetus. It is advisable to do Urine culture and sensitivity in all antenatal women irrespective of the gestational age and symptoms.
Tympanometry and computed tomography measurement of middle ear volumes in patients with unilateral chronic otitis media
Authors: Shukla Anuj Kumar , Kanaujia S. K. , Kaushik Sandeep , Saxena Nishant Saurabh
Published: March 2021

Background: Tympanometry and computed tomography (CT) measurement of middle ear volume in patients with unilateral chronic otitis media.

Methods: The prospective study was conducted on 50 patients of diagnosed unilateral chronic otitis media showing clinical symptoms which affect quality of life. Patients who were fulfilling inclusion criteria after screening were selected for study. We studied patients who had a unilateral tympanic membrane (TM) perforation and a normal TM in the contralateral ear which act as control group to estimate the ME volume in the lesioned ear. Further we have compared pre and postoperative middle ear volume (measured by CT and tympanometry) in control & diseased ear to correlate middle ear volume results obtained by CT and Tympanometry.

Results: The mean value of MEV measured by tympanometry and CT were (1.343±0.580) and (1.106±0.380) respectively (Figure 1). Volume measurement by tympanometry is higher as compared to volume measured by CT in lesioned ear, hence tympanometry measured volume in diseased ear were higher that measured by CT which is closer to normal values in both normal and Diseased ears. Also hearing shows improvement in diseased ear after surgery due to restoration of middle ear volume closer to normal.

Conclusions: It was concluded in our study that CT is more reliable investigation for middle ear volume measurement as compared to Tympanometry in diseased as well as normal ears.
Remote access endoscopic parathyroidectomy: a study of 17 cases from Central India
Authors: Gajbhiye Raj Narendra , Deshpande Gayatri Amit , Tirpude Bhupesh , Bhanarkar Hemant , Akulwar Vikrant , Kodape Girish
Published: March 2021

Background: It has been debated that "remote access endoscopic parathyroidectomy" requires extensive dissection, thereby, increasing the risk of complications. Hence, the aim of this study is to assess the feasibility and safety of remote access endoscopic parathyroidectomy via the unilateral axilla-breast approach (ABA) and transoral vestibular approach (TOEPVA).  

Method: The study includes 17 patients with primary hyperparathyroidism undergoing endoscopic parathyroidectomy from January 2016 to December 2020. Of these, 11 patients underwent parathyroidectomy via unilateral ABA and 6 had TOEPVA. Preoperatively, ultrasonography of neck, sestamibi scan and CT scan neck were done to localise the diseased gland. Post operatively, Serum calcium and parathyroid hormone levels were monitored.

Results: The mean age of patients was 35.6±10.5 years. Except one, all the patients were females. The mean operative time of the unilateral ABA and TOEPVA group was 93.67±28.64 minutes and 138.6±31 minutes respectively. Except for three patients, in all the patients, the parathormone levels normalised. One patient had hungry bone syndrome postoperatively. The mean hospital stay of the unilateral ABA and TOEPVA group was 3±1.5 days and 4±3.09 days respectively. One patient had post-operative transient recurrent laryngeal nerve paresis. Seroma and surgical emphysema were seen in two patients each. 

Conclusions: Remote Access Endoscopic parathyroidectomy may be considered safe in treatment of parathyroid tumours. Precise preoperative localisation is mandatory. In addition to a magnified view and a better illumination, the potential advantages of endoscopic techniques are better cosmetic results, decreased hospital stay and better patient comfort.
Management of benign paediatric thyroid nodules: experience from paediatric ENT services of a tertiary care hospital
Authors: Chakravarti Arunabha , Chandrasekhar Sneha
Published: March 2021

Thyroid nodules are a common occurrence in adults but are rarely seen in children. We present here four cases of paediatric thyroid nodules. Patients were subjected to a thorough clinical evaluation, blood thyroid level testing, ultrasonography (USG) and fine needle aspiration cytology (FNAC). The size of the nodules ranged from 2 cm to 7.5 cm. All four nodules were reported as “benign” on FNAC, of which three under-went total thyroidectomy owing to the bi-laterality and large size of the nodules. None of the cases had post-operative complications of hypocalcemia or recurrent laryngeal nerve paralysis. Of the 3 patients taken up for surgery one patient was found to have papillary thyroid carcinoma. Subsequent radiological investigation showed no residual disease. All three operated cases were followed-up in the ENT outpatient department for at least 2 years and showed no signs of recurrence. One patient with a small thyroid nodule (2 cm) was managed non – surgically and has been kept on follow up since 12 months. In our experience, total thyroidectomy, even in a benign disease, in expert hands, is a safe procedure and the best management option in children with large goiter, to avoid recurrence and thereby a redo surgery.  
Juvenile ossifying fibroma of the orbit: a rare location
Authors: Clarós Pedro , Polainas Sofia , Fortuny Marta , Clarós Andres
Published: March 2021

Osseous tumors in the craniofacial skeleton of young patients are not very frequent, and tumors involving the walls of the orbital cavity are even more infrequent. Despite being usually slow-growing, even small neoformations can have a local aggressive behavior, displacing and compressing vital structures, and so it is important to perform an early diagnosis in order to avoid the tumor to pose problems on the optic nerve and threaten vision. The case that we are presenting shows an ossifying fibroma in a 19-year-old male from Ethiopia, a benign lesion whose progressive growth caused proptosis and downward displacement of the left eye. Following an adequate radiological diagnosis, we were able to delimit the fibroma existence and location. The surgery was conducted in a conservative form, allowing the patient not to suffer from post-surgery malformations. Histopathological diagnosis was compatible with juvenile ossifying fibroma, psammomatoid variant, arising from an uncommon location – the roof of the orbit.  
Mucormycosis complicating diabetes mellitus and COVID-19: a diagnostic and therapeutic threat
Authors: Amalanathan Sophia , Colbert Kumaran Ramesh , Chockalingam Satish Kumar , Sinhasan Sankappa Pundalikappa , Jadhav Chaitra
Published: March 2021

COVID-19 infections is known to have a multitude of clinical presentations, and newer clinical complications continue to be reported from all over the world. It is now widely known that the diabetic patients with poor glycemic control are associated with a higher risk of developing severe COVID-19 infection. They are also at a high risk for developing secondary bacterial or fungal, co infections because of the complex interplay of multiple risk factors , necessitating an intensive medical care and monitoring in them. We are presenting a case of mucormycosis in a diabetic patient with moderate COVID pneumonia that presented to us as orbital cellulitis and the events that followed. There have been very few documented cases of mucormycosis in COVID infected diabetic patients so far during this pandemic and we also present a literature review of the same.
A rare case of aggressive invasive fungal sinusitis with multidrug resistant Pseudomonas aeruginosa co-infection in immunocompromised: a therapeutic challenge
Authors: Basu Debaditya , Kumar Abhijit , Gupta Ajay , Baruah Binayak , Kumar Alok , Mishra Nibedita
Published: March 2021

Mucormycosis is known to be rapidly progressing and fulminant fungal infection which has the ability to cause significant morbidity and mortality, especially in immunocompromised patients. Pseudomonas aeruginosa commonly co-isolated bacterial species from chronic wounds are likely to interact and compete with Mucorales spores.We report a 70 years old female who presented to us initially with left facial swelling with a cheek ulcer. She had initially denied the necessary investigations but later presented to us with flared up symptoms. She was a known case of type 2 diabetes mellitus, hypothyroidism and dilated cardiomyopathy on medication with permanent pacemaker implant. She was found to have left maxillary mucormycosis with left sided cheek wound having superinfection with Pseudomonas aeruginosa. Patient was started on injection Amphotericin B (lipophilic) and injection colistin with surgical debridement of the wound. Left Caldwell-Luc surgery with left inferior meatal antrostomy was performed for clearing fungal debris in left maxillary sinus. The purpose behind this paper is to highlight the need of early detection and aggressive management for successful management of mucormycosis.
Hurthle cell adenoma and papillary microcarcinoma: a rare case of thyroid collision tumor
Authors: Palo Seetu , Deshpande Archana H. , Gargade Citrawati B.
Published: March 2021

Collision tumors of the thyroid gland are histologically distinct tumors coexisting within the gland. Here, we depict a case of a 36-year-old woman who presented with anterior neck swelling of one-year duration. Local examination revealed a 3×2 cm, firm, right solitary thyroid nodule. Fine needle aspiration cytology was suggestive of Hurthle cell neoplasm. Patient underwent a right hemi-thyroidectomy. Histopathological examination showed co-existence of Hurthle cell adenoma and papillary thyroid microcarcinoma. The patient was asymptomatic during six months follow up. It is important that the surgeons and pathologists are aware of these collision tumors so that optimal therapeutic interventions can be carried out.   
Bem-Estar Social e o Conceito de Eficiência
Authors: Gico Junior Ivo Teixeira
Published: March 2021

Desde a Constituição Federal (art. 37) até o Código de Processo Civil (art. 8º) há dezenas de diplomas legais comandando a busca pela eficiência, mas não existe uma definição jurídica do que seja eficiência. O presente artigo demonstra como os conceitos econômicos de eficiência produtiva, alocativa e dinâmica podem ser utilizados para dar conteúdo aos referidos comandos jurídicos. Os critérios de Pareto e de Kaldor-Hicks são apresentados como mecanismos de aferição de eficiência e a Análise Custo-Benefício e a Análise de Impacto Regulatório são meras aplicações dos referidos critérios. Por fim, demonstra-se como os conceitos tradicionais de eficácia, eficiência e efetividade da Administração podem ser integrados nesse arcabouço teórico, em uma abordagem sistemática e coerente.
A constituição equatoriana de 2008 e a proteção a povos indígenas: avanços jurídicos e desafios de uma realidade discriminatória
Authors: Sanson Alexandre , Chiarello de Souza Pinto Felipe , Asato Junqueira Michelle
Published: March 2021

Incluído no movimento do “novo constitucionalismo latino-americano”, o cenário jurídico-normativo do Equador aponta para a tentativa da interação entre os movimentos indígenas e as instituições políticas daquele país desde a Constituição de 2008. Contudo, o diálogo intercultural ainda não se apresenta efetivo, ensejando críticas profundas quanto ao tratamento conferido às populações vulneráveis, nos termos já analisados, inclusive, pela Corte Interamericana de Direitos Humanos. O método de análise é o indutivo, utilizando-se de pesquisa bibliográfica documental e de estudos de caso.
Análise de alguns cenários de tributação de serviços públicos
Authors: Durán Alba Juan Fernando , Knoerr Fernando Gustavo , Monteschio Horácio
Published: March 2021

A Constituição protege a livre iniciativa justamente para que se viabilize o desenvolvimento nacional esperado, como almeja o artigo terceiro da Carta Maior. Para tanto, é necessário que a economia do país possua trilhos próprios, bem estabelecidos, firmes, seguros e que tenham como rumo o crescimento continuo e responsável. Com essas metas em vista, o papel do Estado é de regulação, não de invasor ou de agente ativo desse cenário. Não se pode ser maestro, músico e plateia ao mesmo tempo. Assim, o Estado pode agir em ambientes onde se procura o lucro, com objetivo de autodesenvolvimento, apenas quando precisar de tal prestação para alcançar o seu desiderato público. Ou seja, sua atividade fora do âmbito restrito de ente público - com todas as prerrogativas e sujeições inerentes a essa condição - é excepcional e assim devem ser tratadas e exercidas conformes os limites constitucionais dessa excepcionalidade. O presente trabalho não pretende trazer respostas definitivas, mas apenas levantar inquietações e lembrar o fato cada vez mais presente de que a responsabilidade demandada pela prestação de atividades e serviços públicos faz com que se torne imprescindível a existência e aplicação de instrumentos jurídicos com viabilizem esse exercício, bem como se proteja a ordem econômica dos reflexos negativos que eventualmente tenham que suportar, de igual maneira, a plena realização dos direitos fundamentais.
Multichannel information-measuring system on an unmanned aircraft for measuring the total induction vector of the Earth's magnetic field
Authors: Zlygostev I. N. , Epov M. I. , Savluk A. V. , Glinskikh V. N.
Published: March 2021

A prototype of a multichannel information-measuring system for measuring the vector of induction of the Earth's magnetic field (EMF) was developed, manufactured and successfully passed a complex of preliminary tests, which is applicable for the further development of technology for airborne geophysical reconnaissance at different altitudes from an unmanned aerial vehicle (UAV) and a software product that allows with the measurement of the value of the induction modulus of the EMF, determine the values of its components.
The effect of carbon monoxide on the oxidation of propane over a glass fiber based platinum catalyst
Authors: Kovalyov E. V. , Sadovskaya E. M. , Aver’yanova V. V. , Bal’zhinimaev B. S.
Published: March 2021

Deep oxidation of hydrocarbons over platinum catalysts underlies the majority of processes for purification of industrial waste gases. Since waste gases usually contain carbon monoxide, it is important to investigate its effect on the oxidation kinetics of hydrocarbons. This paper considers results of the study on the oxidation kinetics of propane over a glass fiber platinum catalyst in the presence or absence of CO in the reaction mixture. It was found that at low temperatures the presence of CO strongly hinders the oxidation of propane, whereas upon temperature elevation this detrimental effect is replaced by the beneficial effect of CO. As shown by numerical modeling, this bidirectional effect can be attributed to the competitive adsorption of oxygen, propane and CO on the catalyst active sites.
The Effect of Physical Activity on Diabetes Mellitus Patients with Hypertension
Authors: Dieni Utami Nisa , Safitri Dyan Kusumaningrum Niken
Published: March 2021

Physical activity plays an important role in controlling blood glucose levels and reducing the risk of cardiovascular disorders in patients with diabetes mellitus (DM). DM patients should follow the principle of FITT (frequency, intensity, type and time) while doing a physical activity, which has a direct effect on their health condition. However, the identification of physical activity in DM patients with hypertension is still limited. Therefore, this study aimed to describe the effect of physical activity on DM patients with hypertension. Accordingly, this cross-sectional study included patients with hypertension, aged 18–65 years, able to communicate verbally, and visiting a public healthcare centre in Semarang between February and March 2020. The Baecke Physical Activity Questionnaire (BPAQ) was used to identify the physical activities done by the participants. Quantitative data analysis revealed the distribution of frequency, percentage, mean, and standard deviation. A total of 150 respondents participated in the study, mostly in late adulthood (54.7%), women (68%), and having DM with hypertension for one–five years. The results showed that 40.7% of the respondents had a low level of physical activity, of which 46% did not play any sport and 92.7% had low occupational physical activity. The average leisure time index was 2.31 ± 0.6, which means that most of them did a few physical activities during leisure time. It is concluded that since many DM patients with hypertensions were categorized as having low level of physical activity, this may affect their blood glucose level and blood pressure.
Keywords: blood glucose, blood pressure, diabetes mellitus, hypertension, physical activity
Effect of Patient's Knowledge and OHI-S on Periodontal Disease Among Age Group 19–64 Years in the Dental Clinic at the Community Health Centre, Bareng, Malang
Authors: Andari Astuti Indrian , Yunus Moch , Warih Gayatri Rara
Published: March 2021

Periodontal disease, also known as gum disease, is a combination of several inflammatory conditions accumulated from supporting tissues in the teeth that result from bacterial infections. Periodontal disease develop gradually and become increasingly severe, so maintaining good periodontal health is important. The patient’s level of knowledge about periodontal disease can directly affect their periodontal health. It is generally caused by poor oral hygiene. Nevertheless, dental and oral hygiene values can be measured by the Simplified Oral Hygiene Index (OHI-S). This cross-sectional study included patients visiting the Dental Care and Orthodontic Health Clinic at the Community Health Centre in Bareng, Malang, aged between 19 and 64 years. The research instrument used was a questionnaire and patients’ medical records.. The results showed a significant relationship between the level of knowledge and the OHI-S with periodontal disease using the contingency coefficient test, with p-value = 0.026 on the variable level of knowledge and p-value = 0.045 on the OHI-S variable. A significant relationship was also seen between the level of knowledge and periodontal disease (p = 0.026) and between OHI-S and periodontal disease (p = 0.045). Further study of the stronger effect between the two is needed.
Keywords: the level of knowledge, Oral Hygiene Index Simplified (OHI-S), periodontal disease
Early Detection of Periodontitis in Public Health Centres in Malang: An Overview
Authors: Nurma Azuro Hanum , Yunus Moch , Warih Gayatri Rara
Published: March 2021

Based on the Basic Health Research (Riskesdas) 2018, the incidence of periodontitis in Indonesia was reported at 74.1%, which makes it one of the most common oral health problems in the country. Overall, 2,759 patients, aged 19–64 years underwent periodontal examinations at the Public Health Centres in Malang between January and September 2019. The present study aimed to determine the description of periodontitis patients at the Public Health Centres, Malang, by conducting an early detection of periodontitis against the risk of the disease. This study used a cross-sectional design and a proportional random sampling technique. In total, 277 respondents visited the Public Health Centres in Malang during the study period. The early detection result is based on the number of questionnaire scores on signs, symptoms, and exposures to risk factors for periodontitis, which are divided into three categories: high, moderate, and low risks. The instrument used in this study is a modification of the previous research instrument by Renatus. The result showed that 58 respondents had moderate (21%), 4 (1.4%) had high, and 215 (77.6%) had low risks of periodontitis. Respondents who had a lower risk of periodontitis were more than the respondents who had high and moderate risks of periodontitis.
Keywords: periodontitis, history of gingivitis, heredity (family history), oral hygiene, history of tobacco use
Functional Status and Incidence of Loss to Follow-up after Antiretroviral Therapy Initiation
Authors: Dewi Ambarwati Rosita , Eko Wardani Hartati , Dwi Tama Tika
Published: March 2021

Taking medication for lifetime puts Human Immunodeficiency Virus (HIV)-infected patients in challenging situations. The loss to follow-up (LTFU) is a major problem arising from their non-compliance. Information about functional status as a predictor of LTFU is limited. Therefore, this study was aimed to identify the association between the functional status and the incidence of LTFU among HIV patients at Saiful Anwar General Hospital, Indonesia. A retrospective cohort study was conducted in the tropical diseases and infections division of the Saiful Anwar General Hospital by observing 148 HIV patients who were diagnosed in 2015. Data were collected based on existing data in medical records. The log-rank test was used to compare the time of LTFU between groups. Cox proportional hazard was used to determine the effect of functional status after being controlled by other variables. This study found that 65.9% of HIV patients were able to retain on antiretroviral therapy for 39 months. Functional status had a significant association with the time LTFU occurred. Ambulatory patients had a higher risk of experiencing LTFU than working functional status (AHR = 2.289; 95% CI 1.106–4.738; p-value = 0.026). Identifying the patient’s characteristic that has a higher risk of LTFU helps to determine the right strategy to ensure treatment adherence.
Keywords: antiretroviral therapy (ART), functional status, HIV, loss to follow-up (LTFU), Indonesia