bluuebunny/crossref_metadata_2025 huggingface dataset:
E-Governance and Public Services in Local Governments: Study of The Taspen Smart Card Programfor Pension Fund Services in Makassar City and Pinrang Regency
Authors: Saputra Lukman Nul Hakim Amran , Khaerah Nur , Abdillah Abdillah , Mustari Nuryanti
Published: July 2023

This study aims to analyze the implementation of e-Government through Taspen Smart Card Program in pension fund services of State Civil Service. This study used a combination method of concurrent triangulation design (a balanced mix of quantitative and qualitative). The major instrument used was questionnaire and interview. There were participants of the Taspen Smart Card Program that involved as samples and informants in this study.  The number of samples was 40 and 2 people as informants. The samples taken using probability sampling techniques. The data were analyzed using regression analysis technique. The results of this study indicated that the implementation of e- Government through Taspen Smart Card Program in pension fund services of State Civil Service in Pinrang and Makassar Regency is running very well. This is based on the average score obtained was 139.6 or 87.25% which indicates that the implementation of Taspen Smart Card fall into very good category. Furthermore, the study also shows that the implementation of Taspen Smart Card Program has a positive and significant effect in pension fund services of State Civil Service in Pinrang and Makassar Regency by 33.3% and the remaining 66.7% due to the existence of other programs issued by the government.
An Exploratory Study of the Effectiveness of Unconditional EducationalAssistance Program as a Programmatic Electoral Strategy in the Philippines: The Case of Makati City’s Project FREE
Authors: Ayson Miguel Enrico Gutierrez , Calvo Esther Marylerma
Published: July 2023

This exploratory study deviated from the influential theoretical lens of clientelism in examining voter-politician ties in Philippine political studies. Drawing on Kitschelt and Wilkinson’s (2007) conceptualization of programmatic politics as an alternative electoral strategy, we investigated how a programmatic linkage between a local political leader and its electoral constituency is facilitated through the non-contingent and regular distribution of school-related materials for public school children. This local programmatic policy has gained popularity among various local government units (LGUs) in the Philippines. We focused on the Makati City government’s Project FREE (Free Relevant and Excellent Education) due to its reputation for arguably being the most innovative and comprehensive educational assistance program ever implemented at the country’s local scale. We employed a purposive sampling technique to obtain our participants – the project’s parent beneficiaries. Through in-depth interviews, we investigated the attitudes and perceptions of Project FREE’s parent beneficiaries towards the mayor’s programmatic commitment to them. By using thematic analysis, five themes emerged from the interview data: (1) financial relief, (2) educational security, (3) unique source of local citizen satisfaction, (4) personally dispensed patronage of a benefactor politician, and (5) invaluable benefits and project continuity: influencing vote preference. Beyond the particularistic and contingency-based patronage exchange prevalent in the Philippine local political setting, this study’s findings also offer in-depth explanations for what motivates voters to reciprocate their local political leader with electoral support for its education-based programmatic inducements.
How Poor Leadership Skills Elicit Unethical Behavior: Evidence from Public Organizations
Authors: Benlahcene Abderrahmane , Meddour Houcine
Published: July 2023

Global political and financial entities have witnessed many scandals linked to leaders’ unethical behavior. Previous research suggests that the susceptibility of leaders to act in an unethical way is rooted in various individual, organizational, and social factors. However, unethical leadership is scarcely examined in the context of African countries. This study explores the role of poor leadership skills and qualities in eliciting unethical leadership behavior in Algerian public organizations. Using an exploratory qualitative approach, 15 leaders and managers were included in series of in-depth interviews. The results of the data analysis revealed that poor leadership skills and competencies are critical antecedents of unethical leadership behavior within Algerian public organizations. This study contributes to the ongoing research efforts that seek to identify and minimize the causes of unethical behaviors of leaders across sectors and disciplines. This study provides insights into the construct of unethical leadership and how individual, organizational, and social factors predict leaders’ unethical behavior. While there are many studies on the issue of unethical leadership, research on the potential role of poor leadership skills in eliciting unethical behavior is scarce, especially in Algeria. This study found that there is a strong link between skills and competencies of leaders and their ethical behavior within organizational settings.
Jokowi’s Loyal Opposition: Analysis of the Model of the Possibility of the Prosper Justice Party to the GovernMent (2014- 2021)
Authors: MUSTOFA IN’AMUL , PURWANINGSIH TITIN , AL HAMDI RIDHO
Published: July 2023

After the 2014 general election and through 2021, the Prosperous Justice Party (PKS) decided to become the executive power’s loyal opposition under President Joko Widodo. PKS’s decision to join an opposition party resulted in a substantial increase in its vote total, from 6.79% in the 2014 election to 8.21% in the 2019 election. There are hints that PKS intends to replicate the strategy employed by the Indonesian Democratic Party of Struggle (PDIP), which be- came President Susilo Bambang Yudhoyono’s opposition during his two terms in office and won the 2014 election. Using secondary data and qualitative descriptive analysis, this study examines the model and pattern of PKS opposition to the Jokowi administration between 2014 and 2021. This study’s findings indicate that the relationship model between PKS and the government is cooperative rather than antagonistic. As an opposition party under a presidential system, PKS works as a balancer and controller of power through selective rather than universal criticism of government policies and performance.
The Culture of Organizational Performance Impact of Remote Working: The Case of Yeme Architect
Authors: STERJO ALKESTID
Published: July 2023

The Covid-19 pandemic has dramatically changed how organisations oper- ate, receiving attention by many. Remote working entails new norms, which subsequently transform organisational culture that is central to organisational performance. This research explores how this change shapes organisational values that underpins organisational culture, and its effect on employees’ performance. Using a case study of a SME architectural firm in Bradford, UK, qualitative data was gathered through interviews and secondary data, where data was analysed using thematic analysis method. Synthesis suggests, to preserve the existing values, employers should seek to constantly engage with employees through frequent communications, demonstrate actions in favour of the values and reenforce them through reward and recognition. However, new mechanisms to implement this should be identified, given the new working environment (virtual) and different factors affecting employees’ motivation.
Changing trends of prevalence and presentation of ectopic pregnancy cases admitted in DMCH
Authors: Fatema Bushra , Begum Mahmuda , Zaman Faria , Aktar Shahida
Published: July 2023

Background: An ectopic pregnancy occurs outside the uterus and is a relatively common condition among women of childbearing age. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death. The aim of the study was to evaluate the changing trends of prevalence and presentation of ectopic pregnancy cases admitted in DMCH.
Methods: This study was undertaken among the patients admitted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital during the period from October 2012 to March 2013. Clinical evaluation of cases of ectopic pregnancy in terms of sociodemographic factors, presentations, risk factors, examination findings, per operative findings and management offered to the patients. The period from Data was entered in MS Excel and Statistical analysis was done using SPSS-24.
Results: Most of the patients were 20-30 years age group and mean age was 28.08±4.24 years. The frequency of ectopic pregnancy was 7.60%.  High incidence was found among 0-1 parity (48%) and from a lower socioeconomic status. Commonest presentation was lower abdominal pain (94%), amenorrhoea (100%), P/V bleeding (38%) and syncopal attack (48%). Most of the cases was without contraceptic coverage (60%). Previous history of abortion/MR (50%), history of pelvic infection (30%) and history of D&C (16%) constitute the main bulk of risk factors. Most of the patients managed by laparotomy followed by salpingectomy which is still the standard treatment in many cases.
Conclusions: Study has found that previous abortions are major etiological factor for ectopic pregnancy than previous pelvic infection. Most of the patients were managed by laparotomy. The general public should be made aware the sign and symptoms of ectopic pregnancy. Proper and modern diagnostic tools and training program for these should be made available in all tertiary level hospital.
Fetomaternal outcome among elderly gravida and normal age group mothers
Authors: Deeksha Deepa M. , Alagesan Sujatha M.
Published: July 2023

Background: Advanced maternal age is defined as 35 years or more at estimated date of delivery is considered to have higher incidence of obstetric complications and adverse pregnancy outcome than younger women. Maternal age plays a vital role in pregnancy outcome. This study is instituted with the idea of identifying the association of advanced maternal age and adverse pregnancy outcome. Objective was to compare demographic characteristics and maternal outcome in elderly pregnancy in comparison with normal age group pregnancy. To compare perinatal outcome of elderly pregnancy with normal age group pregnancy.
Methods: This was comparative case control study conducted at department of obstetrics and gynecology, Tirunelveli medical college hospital in 100 patients, about 50 in each of the 2 groups with maternal age > 35years and < 35 years. A group 1 (study group) was pregnant women of age >35 years and group 2 was pregnant women of age >18 years and<35 years. Pregnant women of age< 18 years and pregnant women having major medical disorders before pregnancy were excluded from study.
Results: Among the study group incidence of artificial conception; spontaneous abortion; overt diabetes; chronic hypertension; preeclampsia; gestational hypertension ; fetal complications like FGR; shoulder dystocia were statistically significant.
Conclusions: This study concludes that there is raised maternal morbidity and operative interventions needed with increasing age. Close monitoring for any complications is vital as early diagnosis and intervention will bring an excellent maternal and fetal outcome.
Ultrasonographic evaluation of pelvic pain in first trimester of pregnancy: a prospective study
Authors: Samanta Riya , Anand Rama , Solanki Ravi S. , Yadav Reena
Published: July 2023

Background: Early and accurate diagnosis of the cause of pelvic pain in first trimester of pregnancy is essential for appropriate clinical decision making thereby enabling correct and timely management. The aim of the study was to evaluate the role of ultrasonography in evaluation various causes of pelvic pain in the first trimester of pregnancy and correlate the imaging findings with clinical/per-operative findings.
Methods: This was a prospective observational study approved by the Institutional Review Board and conducted from November 2016 to March 2018. 67 patients with pelvic pain in their first trimester, attending the antenatal clinic or OBG emergency underwent pelvic ultrasonography and the findings were correlated with clinical/per-operative findings.
Results: Ectopic pregnancies formed the largest individual group comprising of 45 (67.2%) cases of the total study population followed by spontaneous abortion 5(7.5%). Other causes included subchorionic haemorrhage, ovarian torsion, uterine fibroid, simple/haemorrhagic/dermoid cyst of ovary and acute appendicitis. 4 (6%) patients had normal intrauterine pregnancy.
Conclusions: Ultrasonography has high diagnostic accuracy of 94% and 100% sensitivity for detecting the cause of first trimester pelvic pain.
Evaluation of non-stress test as predictor of perinatal outcome in high risk and low risk pregnancy: a prospective study
Authors: Amin Hardik , Dashora Sanchita , Sharma Rajrani , Joshi Ruchi
Published: July 2023

Background: NST is simple, cheap, non-harmful, easily repeated, and cost effective with low maintenance profile. NST is a very effective method to investigating the intrauterine growth retardation (IUGR), late pregnancy, premature birth, multiple pregnancy, Rh sensitivity, diabetes, liver disease, decreased bowel movements, oligohydramnios etc. Objectives were to evaluate the efficacy and role of antenatal NST in improving perinatal outcome in high-risk pregnancies.
Methods: This prospective study was done among 100 pregnant women (group A: high risk pregnancy, n=50, group B: low risk pregnancy, n=50). Nonstress test was done for 20 minutes if the test was inconclusive or nonreactive. It was continued for another 20 minutes extended CTG. Fetal stimulation was also done. The NST done before onset of labour was used as reference. Interpretation if NST tracings was done according to ACOG guideline.
Results: Around 58% participants of high-risk group and 82% of low-risk group had ‘reactive’ and NST tracings respectively. Almost 36% participants of high-risk group and 16% of low-risk group were delivered baby by LSCS method. Around 24% participants of high-risk group and 10% of low-risk group had meconium-stained amniotic fluid. Around 66% babies of participants of high-risk group and 24% of low-risk group were admitted in NICU. The mean birth weight of babies of high-risk group participants was 2.52 kg and of low-risk group participants was 2.85 kg.
Conclusions: Present study reveals significant difference between reactive and nonreactive NST in terms of Apgar scores and NICU admissions in both the groups. Hence judicious use of NST will certainly help in timely identification of at-risk fetuses thereby avoiding unnecessary delay in intervention.
Study of comparison of transvaginal cervical length and Bishop score in predicting successful labour induction- a prospective study from a tertiary care hospital of Rajasthan
Authors: Monika  , Jakhar Balveer , Choudhary Neeraj , Khoiwal Susheela
Published: July 2023

Background: Labor induction is one of the common interventions in obstetric practice. Assessment of cervix has been used as a predictor of the successful vaginal delivery. The traditional method of predicting whether an induced labour will result in successful vaginal delivery is based on the pre induction favourability of cervix as assessed by the Bishop score. Now we used transvaginal sonography (TVS) as an objective method of assessment of cervical length to evaluate the role of the pre-induction transvaginal ultrasonographic (TVS) cervical length in predicting labour outcome and comparing it to the Bishop score in patients undergoing induction of labour.
Methods: This observational prospective study included 100 pregnant women in which induction of labour was performed at 37-42 weeks of gestation. Cervical length on transvaginal ultrasound and bishop score by digital examination is assessed prior to induction in cases according to standard protocol.
Results: In our study though the sensitivity of the Bishop score in predicting the successful labour induction was higher (75.6%) compared with that of cervical length measured trans vaginally (69.35%). The specificity and positive predictive value for the cervical length (2.7 cm) was 77.78% and 91.49% compared with the Bishop score (4) 55.55% and 81.82% respectively.
Conclusions: Bishop score and transvaginal cervical length both are good predictors of successful induction of labour. Transvaginal cervical length provides a better prediction of the likelihood of vaginal delivery within 24 hours of induction.
Exploring the role of serum β-HCG levels in predicting hypertensive disorders of pregnancy: a prospective observational study
Authors: Yadav Ritu , Manisha  , Shaheen Rizwana
Published: July 2023

Background: Hypertensive disorders of pregnancy pose significant risks to maternal and fetal health, contributing to global morbidity and mortality. Despite extensive research, these disorders remain a public health concern, necessitating the identification and prediction of associated risks for effective prevention and management.
Methods: A prospective observational study was conducted in a hospital setting, involving 200 antenatal women visiting the Department of Obstetrics and Gynecology for routine checkups over a six-month period. Sample size calculation was based on expected sensitivity and prevalence rates. Inclusion criteria were defined, and clinical examinations were performed on the participants.
Results: Higher serum β-HCG levels were significantly associated with hypertensive disorders of pregnancy. Low levels correlated with 12 out of 122 cases, while high levels correlated with 59 out of 78 cases. Two deaths were linked to hypertensive disorders. Age did not show a significant association, but variations were observed among religious groups.
Conclusions: This study concludes that higher serum β-HCG levels are significantly associated with the development of hypertensive disorders of pregnancy. Age did not show a significant association with these disorders, suggesting the involvement of other contributing factors. The findings provide valuable insights for clinical management and further research in this field, contributing to a better understanding of the etiology and predictors of hypertensive disorders of pregnancy.
Association of volume of first trimester subchorionic hemorrhage with pregnancy outcome
Authors: Bairwa Pooja , Hooja Nupur , Sharma Pooja , Mehta Mili , Kumari Shilpa , Choudhary Sunil
Published: July 2023

Background: Vaginal bleeding during the first trimester of pregnancy may or may not be associated with subchorionic hemorrhage (SCH). The volume of SCH may affect foetal growth or development. The aim of the study was to determine the impact of first trimester pregnancy SCH on pregnancy outcome.
Methods: 151 women each in two groups (with and without SCH), all with first trimester bleeding were enrolled, monitored throughout pregnancy and outcome noted.
Results: 72.8% women with SCH and 78.1% women without SCH gave birth to a live neonate. The relative risk of pregnancy wastage (spontaneous abortion, antepartum or intrapartum stillbirth) for the women with SCH was 1.22 (95% CI 0.81-1.82; p value =0.33) as compared to those with no SCH. 97% of women with SCH>10 ml had pregnancy wastage (mostly aborted before 20 weeks), 40% of women with SCH>5-10 ml had pregnancy wastage (p<0.001).
Conclusions: The mere presence of SCH did not increase the risk of adverse pregnancy outcomes. However, a large volume of SCH significantly increased the risk of pregnancy wastage in comparison to a smaller SCH.
Assess the acceptance and compliance of injectable contraceptive depot medroxyprogestrone acetate
Authors: Nigam Neha , Mishra Jyoti , Rathod Ishwar
Published: July 2023

Background: The use of safe and effective contraception is the need of the hour in India, with one of the world’s largest and fastest growing population. Assessing the acceptance and compliance of women for temporary contraception DMPA. Acceptance shall be compared between different reproductive age group, different parity and among lactating/non lactating female.
Methods: In this study, 100 women have been taken, those were appropriate within the inclusion criteria for the period of one year. Injection DMPA 150 mg injected intramuscularly every 3 months and used questionnaire method for assessing the acceptance and compliance of women for temporary contraception DMPA.
Results: Injectable contraceptive DMPA is safe, convenient, efficacious and effective long term contraceptive. It is acceptable to women when offered with quality counselling and follow up care. Acceptance of DMPA, was found that there is no need of daily administration of DMPA in 51% of women, 10% women found it’s easy to administer via intramuscular injection, lactating female can breast feed also as it possess no changes in breast milk.
Conclusions: DMPA is highly efficacious, safe and effective method of contraception requiring less frequent dosing and can be used in lactating female. Women who received information on DMPA safety, efficacy and side effects are more likely to continue DMPA use.
Fertility-sparing surgery for symptomatic uterine fibroid in young women: a case report
Authors: Arvindar  , Sen Sangeeta
Published: July 2023

Uterine leiomyoma is very common tumor in women of reproductive age. Clinical manifestation ranges from asymptomatic to very heavy bothersome menstrual bleeding or dysmenorrhoea. Considering the patient age, severity of symptoms and child bearing medical or conservative surgical or hysterectomy is decided. Herer we are presenting a case of A 27 years old Para2 housewife coming from middle socioeconomic status was admitted with history of chronic lower abdominal pain since last 5 years and heavy menstrual bleeding since last 6months. Her period was regular but associated with pain and heavy bleeding. She was normotensive and pulse was 78/min. mild pallor present clinically. On abdominal examination-there is lower abdominal swelling situated in midline almost globular, firm to hard in consistency margins are well defined except lower margins which could not be reached, surface smooth and dull on percussion. Vaginal examination revealed vulva normal, vagina and cervix looks healthy on speculum examination. Bimanual examination shows pelvi-abdominal large mass seem to be arisen from uterus. Both fornices are free. After complete routine and ultrasound evaluation a diagnosis of anterior intramural fibroid was made. As patient wants her fertility to be preserved so decision of open myomectomy was taken. Myoma was removed completely with capsule and without interfering the uterine cavity. Uterine incision was closed. Patient stood well with procedure and discharged form hospital.
Tobacco addiction and infertility in India: an overview
Authors: Patel Garima , Kashyap Aryan
Published: July 2023

Tobacco addiction is one of the oldest known addictions with annual death toll of three million. And India is the second largest consumer of tobacco in the world because of easy availability of variety of smoking and smokeless tobacco products in the market.  This has made the situating very complex in India, as the same tobacco generating billions of revenues for India is also a financial burden over the health care sector. Tobacco is a risk factor for approximately 50 serious health care diseases including infertility. But it is surprising that only 22% of the general population are familiar with the reproductive risks associated with smoking. This shear ignorance has led to increase in smoking among women too. Tobacco use not only decrease fecundity and reproductive potential of the individual, but also causes relationship disharmony among the already emotional wrecked infertile couple. Though this stress might be the contributory factor towards tobacco abuse but ironically this tobacco use further escalates the financial ‘stress’ in these couples. Multiple attempts may be required during the process of quitting and the likelihood of success increases with each attempt. The ultimate key is counselling, education, and encouragement at each clinical visit.
Comparison between minimal stitch hernioplasty and continuous suturing of mesh in inguinal hernia repair: a randomised controlled trial
Authors: S. Vidhya Sree , Palit Sandhya , Giridharan Bhanumati , M. Dinesh , A. Balasubramanian
Published: July 2023

Background: Inguinal hernia repair is the most commonly done surgery of all general surgical procedures. Hence in an attempt to decrease the pain and increase the patient’s comfort, various techniques have been considered to fix the mesh. The aim of this study was to compare the differences between the two techniques of mesh fixation namely the minimal stitch method and the continuous suturing in terms of various parameters.
Methods: This study was conducted selecting 126 patients who attended the general surgery OPD at ESIC MC and PGIMSR and randomly allocating them to the two study groups; the patients were followed up till 6 months post-operatively. The parameters taken into account were: the operative time, the duration of hospital stay, the pain scores at various time intervals (POD 1, 3, 7, 30, 60, 90, 180) and the incidence of complications if any.
Results: Among the 126 male patients enrolled in the study, the highest % belonged to the age group 51-60. 90% of them had unilateral hernias. The pain scores were significantly low in the minimal stitch group from the first postoperative day up to 1 month. The operative time and duration of hospital stay was also significantly decreased in the minimal stitch group.
Conclusions: Hence, the minimal stitch technique used for inguinal hernia repair in our study proved to be comparable to the conventional suturing, better than the latter in terms of patients’ subjective satisfactory factors such as less operative time and less hospital stay while having no significant difference in terms of occurrence of chronic inguinodynia or any other postoperative complications.
A ligament to identify the inferior limit of dissection in minimally invasive surgery for inguinal hernia
Authors: Philip Sujith , Iype Geethu Rachel , Muralee Meera
Published: July 2023

Background: Minimally invasive surgery has recently become the approach of choice for surgeons for inguinal hernia repair. Subsequent to excellent visualisation of the preperitoneal space by high definition and 4K systems during laparoscopy and robotic surgery, as well as increasing use of multi detector CT scans to visualise abdomen, our knowledge of the anatomy of the posterior view of inguinal region has been enhanced. However, recurrence after surgery for groin hernia continues to be an issue during its learning curve especially for laparoscopic repair. One cause for recurrence is the infolding of the mesh after its placement in the preperitoneal space. A reason for this is inadequate dissection of the peritoneal fold especially inferomedially. The peritoneum has to be dissected inferomedially till the point where the vas deferens turns medially. During the course of a randomised study done to compare Transabdominal preperitoneal mesh repair with Totally extraperitoneal mesh repair for Inguinal hernia, a structure was seen passing from the medial aspect of the vas deferens where it turned medially
Methods: Prospective analysis of 106 consecutive patients who underwent laparoscopic inguinal hernia was done to identify the presence of such a ligament.
Results: This study demonstrates the existence of a ligamentous structure from the vas deferens to the posterior lamina of subparietal layer of peritoneal space at the site where the vas turns medially.
Conclusions: Identification and division of this ligament will help to ensure complete dissection of the peritoneum inferiorly as well as creaseless placement of mesh thus preventing recurrence.
A study to assess the quality of life among patients with high grade non-muscle invasive carcinoma urinary bladder receiving immunotherapy
Authors: Kumar Manish , Bhangu Gurpreet Singh , Bansal Darpan
Published: July 2023

Background: Urinary bladder lesions are a great health concern as it lies among the top ten most common cancers in the world. These range from benign, harmless lesions that do not recur to life-threatening tumors. The present study was undertaken to assess the quality of life among patients with high-grade non-muscle invasive carcinoma of the urinary bladder receiving immunotherapy.
Methods: A hospital-based experimental study was conducted in the Department of General Surgery of Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar from April 2021 to July 2022. To examine the Quality of Life of 60 patients before and after immunotherapy, the WHOQOL-BREF tool was employed. The participants were followed for a total of six months, with two follow-ups carried out at intervals of three months each.
Results: The pre-test physical scores (20.70±8.66) were substantially lower than the other domains. At three and six months, the psychological scores were 21.93±8.51 and 49.37±12.27 respectively, while social scores were 23.93±12.16 and 49.15±24.09 correspondingly. Environment scores (p=0.45) showed no significant difference between groups after BCG treatment.
Conclusions: It was vivid that the negative effects of NMIBC on QOL are most pronounced in the physical realm. Quality of life for those with high-grade NMIBC who had BCG treatment improved significantly across all dimensions except the environment. The quality of life of high-grade NMIBC patients was not affected by any of the socio-demographic characteristics except for education and occupational status.
Study of options and procedures in reconstruction of post mastectomy breast defects in a regional cancer centre
Authors: Palukuri Lakshmi , Kathi Srinath , Pawde Sanujit , Srinivas Shreedharala , Madhulika D.
Published: July 2023

Background: Post mastectomy autologous breast reconstruction is challenging and involves restoring the patients lost structure and prepping the patient for adjuvant therapy and also psychosocial benefits that comes with early breast reconstruction. We analysed latissimus dorsi flap, transverse rectus abdomenis flap, deep inferior epigastric perforator flap and thoracoabdominal flap. Aim was to reconstruct post mastectomy defect using various methods, to enable the patient to receive early adjuvant therapy. Objectives were to study the various procedures used for post mastectomy defect autologous breast reconstruction. To evaluate the reliability of various flaps used. To evaluate the complications of flaps and their management. To assess the advantages and disadvantages of each flap.
Methods: 42 post mastectomy defect patients reconstructed with 4 flaps over 24 months, included in the study and results analysed.
Results: In 42 cases, latissimus dorsi flap was done in 11 cases, transverse rectus abdominis flap was done in 6 cases, deep inferior epigastric perforator flap was done in 3 cases and thoracoabdominal flap was done in 22 cases. Total flap loss in 1 case and partial flap loss in 6 cases was seen.
Conclusions: Immediate autologous breast reconstruction is helpful in making the patient ready for upcoming adjuvant therapy along with psychosocial benefits. We have analysed 4 different types of flaps and compared their advantages and disadvantages. We found that thoracoabdominal flap is a good option of immediate coverage in low socioeconomic class patients and ones with terminal disease.
Evaluation of role of peri portal infiltration of ropivacaine in post laparoscopic cholecystectomy pain management: a randomized controlled double-blind study
Authors: Nayal Deepankar , Bijalwan Anurag , Singhal Pradeep , Kumar Ajay
Published: July 2023

Background: Laparoscopic cholecystectomy is considered as the treatment of choice for symptomatic cholelithiasis. The present study was conducted to assess the role of peri-portal infiltration of ropivacaine in post laparoscopic cholecystectomy pain management.
Methods: A total of 100 eligible cases undergoing laparoscopic cholecystectomy were randomly allocated in two groups: group A (received infiltration of total 20 ml of 0.5% ropivacaine, 5 ml in each port site after removal of trocar, and group B (received placebo i.e., 20 ml normal saline). Postoperative pain was assessed using Wong Baker facial pain scale at 6, 12 and 18 hours and use of rescue analgesics were noted.
Results: Group I comprised of 27 males and 23 females and group II had 25 males and 25 females. The mean heart rate in group I was 85.4 and in group II was 86.2. Respiratory rate was 14.2 cycles/minute in group I and 15.2 cycles/minute in group II. The mean blood pressure was 134.2/74.6 mmHg in group I and 136.4/75.2 mmHg in group II and oxygen saturation was 99.2% in group I and in group II was 99.5%. The mean VAS scores were significantly lower in group A cases as compared to group B, throughout the study follow up (p<0.01). 70% in group A and 90% in group B required 1 dose and 10% in group II required 2 doses. Duration of rescue analgesia was 21.49 minutes in group A and 17.3 minutes in group B.
Conclusions: Peri-portal infiltration of ropivacaine is effective in reducing post laparoscopic cholecystectomy pain. Mean duration of analgesia was significantly more and requirement of rescue analgesics were significantly less in cases managed by peri-portal infiltration of ropivacaine as compared to control group (using NSAIDs).
Exstrophy epispadias complex with adenocarcinoma in adults: a case series and repair technique
Authors: Ranjan Amit , Sarma Debanga , Barua Sasanka Kumar , Phukan Mandeep , Bagchi Puskal Kumar
Published: July 2023

The exstrophy-epispadias-complex (EEC) is a rare congenital malformation with a spectrum of abdominal-pelvic fusion abnormalities, with an incidence of 1/46,000 LB. Recurrence is 1 in100 & the male-to-female ratio is 2.3:1. Patients rarely may present in adulthood due to a lack of knowledge or financial constraints; it increases the risk of bladder carcinoma mostly adenocarcinoma or squamous carcinoma, due to chronic inflammation, infection, and metaplasia. It has a significant physical, functional, social, sexual, and psychological burden. Three patients have been operated on in our institute. A 37-year-old male, A 19-year-old male, and A 23- year-old female patient. The operation planned was a radical cystectomy with an ileal conduit and an expanded local lymphadenectomy in all three patients. The pelvis and abdominal wall defects were repaired differently post-radical cystectomy in all 3 patients using different techniques. The first patient went through primary tension closure, in the second patient bilateral rectus muscle was used as a flap and reinforced with mesh, and in the third patient, we used a rotation skin flap. All three patients were followed for 1 year. The first patient developed wound dehiscence followed by fecal fistula during follow-up and succumb due to sepsis, the second patient recovered well with a muscle flap in the postoperative period, unfortunately, developed recurrence locally and succumb due to multiple metastases, and the third patient develops flap necrosis at the tip postoperative on day 5, however, recover well after dressing, no recurrence seen on 1 year of regular follow up. As a result, the bilateral rectus flap with mesh recovers better than the rotation skin flap, which is better than primary tension closure.
Intraoperative diagnosis of left-sided appendicitis in a patient with partial situs inversus and levocardia: a rare case report
Authors: Talreja Deep P. , Talreja Rani Bai , Elsayed Ahmed M. , Albatanony Ayman A.
Published: July 2023

Acute appendicitis is common surgical conditions, requiring an emergency operation and accounting for 4% to 8% of all emergency department visits. The diagnosis depends on clinical manifestation, radiological findings, and surgeon experience. Appendicitis causing pain in the left lower quadrant is rare and can occur with congenital abnormalities that include a true left-sided appendix or as an atypical presentation of a right-sided, but long appendix, which projects into the left lower quadrant. Left-sided acute appendicitis develops in association with two types of congenital anomalies: situs in versus and mid-gut malrotation. Here we are reporting a case of right-side lower quadrant pain presentation of left appendicitis with partial situs inversus. A 28-year-old male presented to the emergency department with a one-day history of right lower quadrant (RLQ) abdominal pain associated with nausea and vomiting. Physical examination revealed RLQ abdominal tenderness with localized guarding. Laboratory tests revealed raised levels of C-reactive protein and neutrophilic leukocytosis. Abdominal ultrasound report came as non-visualized appendix. Patient was taken for laparoscopic appendicectomy where the appendix was not found on the right iliac fossa. Laparoscopic exploration was done and revealed a swollen inflamed left-sided appendix attached to a healthy mobile left sided caecum. Laparoscopic appendicectomy was carried out and the postoperative period was uneventful and the patient was discharged within 24 hours. Postoperative chest and abdominal contrast-enhanced computed tomography showed a situs inversus with levocardia. Left-sided appendicitis is a rare condition characterized by the anatomical variation of the appendix with atypical presentation and is therefore easy to misdiagnose. Preoperative clinical diagnosis of left sided acute appendicitis is difficult and imaging may help determine the correct diagnosis. Laparoscopic appendicectomy is far more superior to the open method in these cases as it saves the patient a formal open surgical exploration.
Assessment of knowledge and attitude towards menstrual cup usage among adolescent girls
Authors: George Manju , Marath Usha , Rajan Eline , Shaju Jesna , George Jismol , Poulose Sandra , Jolly Tinku
Published: July 2023

A woman is the essence of whole universe. If there would be no women, the human race is surely going to end. Women deserves more care and attention especially during the reproductive phase. Menstruation is a unique phenomenon of females of reproductive age group. Cultural, religious and traditional beliefs can lead to different restrictions that women face during their menstrual period. Menstrual cup is a device for menstrual flow management and is claimed to be a healthy and environmentally friendly alternative to the conventional menstrual sanitary protections.

Even though menstrual cup is highly efficient it requires fair amount of self-confidence and assurance to insert into one’s own body. And the prevailing myths on breakage of hymen make the confusion of adolescents even worse. This study was aimed at assessing knowledge and attitude towards menstrual cup usage among adolescent girls.

Descriptive survey design was used. A total of 100 adolescent girls were selected using convenient quota sampling methods. Data was collected using structured knowledge questionnaire to assess knowledge and an attitude rating scale to assess attitude towards menstrual cup usage.

The study results revealed that 50 % students had good knowledge, 35 % students had satisfactory knowledge, 8 % students had excellent knowledge, 6 % students had poor knowledge and one percent students had very poor knowledge about menstrual cup usage. Majority (81%) had a positive attitude towards menstrual cup usage, 19% had neutral attitude and none had negative attitude. Hence majority of the subjects had a good attitude towards menstrual cup usage. There was no relation between knowledge and attitude of adolescent girls towards menstrual cup usage.

Women have lots of concerns about managing menstrual flow. Fear of spotting, stains, squishy, messy, smelling and annoying nature of sanitary pads is still a major dilemma. Other alternative measure to sanitary napkins is menstrual cup. Adolescent girls achieve their knowledge on menstrual cup through the social media.

In a developing world, menstrual management is not only difficult but also may have serious adverse impact on the lives of women. Even when taboos are not a major problem, convenient or inexpensive menstrual collection materials are not available. Efforts to produce inexpensive materials are solely lacking. Women use clothes, absorbent pads or tampons to manage menstrual flow. Washing the clothes or disposing the pads hygienically is a challenge for most of the females. By interacting with other teens, investigators understood that women have lots of concerns about using sanitary pads. Other alternative measure to sanitary napkins is menstrual cup but females require self-confidence and assurance to insert it to one’s own body.
THE OTTOMAN PHILIPPINES RELATIONS DURING THE AMERICAN CONTROL OF THE PHILIPPINES (1898-1916)
Authors: ÖZKAN Selim Hilmi
Published: August 2023

The present study attempts to investigate the resistance of Philippine people against Spanish rule in 1521 and American rule in 1898, along with their resistance against the colonialists in the Philippines, island country of Southeast Asia. Additionally, the attitude of the Ottoman Empire towards these controlled and Ottoman-Philippine relations will also be analyzed. The Philippines remained under Spanish rule for several centuries until the Americans arrived. Given that the geographical location of the Philippine islands is on one of the historically important trade route networks stretching from Europe to the Far East and the China Sea, these relations have become more crucial. During this period Captain John P. Finley, the U.S. governor of Zamboanga in the Philippines made a visit to Istanbul and tried to persuade the Ottoman administration that Muslims should not resist the American occupation by using the influence of the caliph on Muslims. The main resources of our research are based on the documents in the Presidential Ottoman Archives and their background. National and international research on the Philippines have also guided us through our research.
KADİM TARTIŞMANIN ARDINDAN; OSMANLI’DA KİMYASAL SİLAH ÜRETİMİ VAR MIYDI?
Authors: SABANCI Zeynep
Published: August 2023

Modern dönemde değişen savaşım (warfare) olgusunu yönetmek, devletlerin birincil uğraşı olmuştur. Dolayısıyla tüm kurumları ile bilimsel çalışmalara adanan kişisel hayatlar da bu sürece eklemlenmekte gecikmemiştir. Düşmanı etkisizleştirmede başlıca silahların yetersizliği Birinci Dünya Savaşı’nın hemen başında kendini göstermişti. Öyle ki, değişen savaş stratejileri, çatışmaların cephe ile sınırlı kalmaması ve harbin beklenenden daha uzun sürmesiyle ortaya çıkan çaresizlik durumu şiddet unsurlarını yeniden gündeme almayı gerektirdi. Çeşitli kimyasalların, gaz ve boğucu etki yapan maddelerin silahlarda kullanılması ile ilgili çalışmalar savaş öncesi dönemlerde başlamış olmasına rağmen bunların etkin bir şekilde kullanımı Birinci Dünya Savaşı’na denk gelmiştir. Çalışmamızda, kimyasal silahların savaş sırasındaki genel kullanım alanları ortaya konulmuştur. Özellikle Alman girişiminin öncülüğünde İstanbul’da kurulan askeri nitelikli gaz dolum fabrikaları mercek altına alınmıştır. Öte yandan, bunların kullanımı ile ilgili sürecin siper savaşına ve yıpratma stratejilerine yaptığı öngörülmeyen olağanüstü sonuçları tartışılmış, bunun Osmanlı’daki yansımaları analiz edilmiştir.
GEDİZ NEHRİ’NDE TAŞKINLAR, ISLAH ÇALIŞMALARI VE AFET YÖNETİMİ (1860-1901)
Authors: SATILMIŞ Selahattin , ACAR KAPLAN Kezban
Published: August 2023

Akarsular, doğa olaylarına karşı alınan tedbirlerin çok daha kısıtlı olduğu eski zamanlarda, günümüze nispeten daha sık taşarak etraflarına önemli miktarda zararlar vermekteydiler. 19. yüzyılda sık bir şekilde taşan nehirlerden birisi de Kütahya’ya bağlı Gediz kasabasının doğusundaki dağlardan kaynağını alan ve 275 km yol aldıktan sonra Ege Denizi’ne dökülen Gediz Nehri idi. 1860-1901 yılları arasında Gediz’in on altı defa taştığı tespit edilebilmiştir. Yaşanan taşkınların sel afetlerine yol açması neticesinde insanlar, hayvanlar, yerleşim birimleri, tarım, ticaret, ulaşım, iletişim, işletmeler ve İzmir Limanı önemli derecede zarar görmüş, büyük miktarda ekonomik kayıplar yaşanmıştır. Merkezi ve yerel hükümetler Gediz Nehri taşkınlarını ve yol açtığı zararları en aza indirmek amacıyla birtakım tedbirler aldıkları gibi taşkınlar sonrasında yardıma muhtaç durumda kalan selzedelerin yaralarını sarmak amacıyla da bazı önemli girişimlerde bulunmuşlardır. Arşiv belgeleri ve dönemin gazeteleri esas alınarak hazırlanan bu çalışma ile Osmanlı doğal afet tarihine ve kısmen de olsa Gediz Havzası’nda bulunan yerleşim birimlerinin tarihine katkı sağlanması hedeflenmiştir.
SOCIALIZATION OF THE PERSONALITY IN THE PROCESS OF EDUCATION AND REALIZATION OF THE INDIVIDUAL
Authors: TERZIEV Venelın
Published: July 2023

Socialising and education are processes related to overall personal development. Through them, the individual is prepared to contribute to different aspects of society, assimilating into any societal culture. The role education plays as a social and societal activity aiming to prepare those growing up to take the rightful place as full-fledged members of society is looked at in detail. The review is on education approaches which encourage learners to realise their individual potential with qualities and opportunities. An accent is placed on contemporary trends allowing learners to gain knowledge aiding critical thinking and necessary for future employment
A review of the study of environmental modeling tools to understand the real impact of cosmetic products on environmental safety
Authors: Inácio Bianchi Caroline , Berardo Gonçalves Maia Campos Patrícia Maria
Published: July 2023

In contrast to human health risk assessment, there are no definitive guidelines for environmental risk assessment of cosmetic products. The objective of this study was to perform an in-depth analysis of ten modeling environmental tools and to establish the best rationale to assess the impact on environmental safety considering the recent global pandemic scenario and the evolution of the consumer mindset. A literature analysis was performed for the ten modeling environmental tools, and when possible, each was downloaded for comparison. Chesar was the tool that proved to be the easiest to enter data, and it has the more straightforward and direct application steps; thus, it was chosen for the initial assessment of ingredients that demonstrate potential environmental hazards. For high-level tools, it was not possible to establish a comparison for choice, as the models are private and have little data in the literature. Even so, for a more detailed assessment after the first initial assessment via Chesar, iSTREEM could be used. This study delivers important knowledge about the modeling tools and how to establish a rationale for environmental risk assessment. Keywords: environmental modeling tools, environmental risk assessment, cosmetic products, environmental impact, formulation