bluuebunny/crossref_metadata_2025 huggingface dataset:
The Issues of Fashion Brand Equity in a Circular Economy
Authors: Bieńkowska Jolanta
Published: May 2023

Theoretical background: The worldwide fashion business has confronted the demand to transit from a linear to a circular business model that involves a series of fundamental alterations to the hitherto highly efficient strategies. As a consequence, a conceptual issue concerning fashion brand value creation has emerged. This applies notably to luxury, premium and fast fashion brands. Satisfying the expectations of customers and stakeholders should cease to be simply a matter of manufacturing a varied and impressive product line, since it has to be both sustainable and sensitive to the emergent requirements of the natural and social environment. Along with the aforementioned challenges, the key messages conveyed by brands through the marketing communication are also undergoing a transformation. Purpose of the article: To present the perspectives on building fashion brand equity in a circular economy, including risks and opportunities. Research methods: A review of scientific and specialised studies, selected using specific keywords, was undertaken. Data sources included academic resources: books, articles, market data (e.g. McKinsey & Company) and statistics published on the Statista platform, as well as specialised resources: expert articles, reports from organisations approaching the issue under research (e.g. EU, UN, Fashion Revolution, the Ellen MacArthur Foundation, etc.). The search area was composed of electronic resources: licensed, open access websites and topic-related websites. The aim of the data analysis was to systematise background knowledge through an inductive method. Main findings: 1. The fashion business needs a change of mission, vision and strategy along with cooperation and coopetition among brands of the luxury goods, mass goods and organic MSMEs markets within its ecosystems in order to achieve the expected brand value. 2. The implementation of circular economy model in the fashion business implies the necessity to restrict overproduction and overconsumption of clothes and accessories at the same time as utilising sustainable raw materials and production technologies. Furthermore, it requires the dissemination of the slow fashion model, which incorporates the reuse of clothes by other users (rental of clothes, second hand, upcycling). 3. Change of consumer behaviour, popularisation of research findings and expertise from independent organizations is a factor stimulating fashion brands to act towards a circular economy in order to maintain high brand value.
Designing the Competitive Intelligence Model for Organization
Authors: Bartuś Kamila
Published: May 2023

Theoretical background: These studies are motivated by three reasons: (1) the Competitive Intelligence (CI) approach is a critical factor in increasing the organization’s ability to monitor and strengthen competitive advantage; (2) too little research has been done on the use of new management theories in the CI approach and (3) there is no research devoted to computer-assisted CI. Purpose of the article: This study proposes a comprehensive framework for extending the CI’s potential in the organization’s activities and its computer-assisted support. The purpose of this article is to develop a new CI construction theory and propose a holistic, conceptual CI model, as well as carry out its initial verification. Research methods: The comprehensive CI model is based on the following theories: (1) Resource-Based View (RBV), Industrial Organization (IO) and Business Model Canvas, which were used for CI design, (2) theories for measuring and validating CI implementation, i.e.: Competitive Profile Matrix (CPM), Industrial Critical Success Factors (ICSF) and (3) theories for integrated computer-assisted CI. The validation of the proposed comprehensive CI model was based on data on the opinions of SUV class users. Main findings: The results obtained during the validation of the CI model show great importance for a comprehensive look at the topic of computer-assisted CI. This contribution is significant because in the literature there are no such studies and conclusions obtained from them. The results obtained and conclusions should be useful for all organizations that need to analyze competitiveness using a comprehensive CI model.
Health as a Value from the Viewpoint of Patients After Completing Their Treatment of a Neoplastic Disease
Authors: Antoszewska Beata , Tobota-Różańska Aleksandra
Published: May 2023

Introduction: Health is attributed with different meanings, both semantic and axiological, depending on our current life situation. Apparently, when we are free of any ailment, we do not think much about health and our actions are aimed at performing social tasks and roles. It is only when we fall ill or recover from an illness that we realise what health means to us. Research Aim: The objective of this study has been to determine the value of health in the opinion of patients who have completed their treatment of a neoplastic illness in relation to the duration of the treatment and socio-demographic circumstances. Method: The study involved a group of 51 persons aged 15 to 49 years, who had gone through the process of treatment of neoplastic disease. The study was carried out using a standardised research tool called the Health Criteria List, developed by Juczyński, which defines health in five aspects: condition, outcome, process, property and goal. Results: For the respondents, health understood as ‘condition’, ‘goal’ and ‘result’ proved to be the most important, while health seen as ‘property’ or ‘process’ mattered less, and consequently these aspects scored lower in the hierarchy of importance. Conclusion: Encouraging one to reflect on one’s health and take care of it is important for the current condition and future health, which will certainly allow one to achieve the set life goals better.
The Importance of Families of Minors in the Rehabilitation Work of Educators – an Interactive Perspective
Authors: Dobińska Gabriela Zuzanna , Miśkiewicz Katarzyna Anna
Published: May 2023

Introduction: The paper focuses on the work of pedagogues (educators of youth educational centers and family probation officers), who work with families of minors. Research Aim: The aim of the article is to describe the types of social rehabilitation educators and the significance that pedagogues attribute to their relations with the families of minors as part of strengthening social rehabilitation activities. Method: The collected empirical material comes from interviews and observations of the everyday professional lives of educators from educational centers and family probation officers. The procedures of grounded methodology determined the method of analyzing the collected data, creating conditions for the generation of patterns which shaped the activities performed by the educators. The theoretical framework is determined by the assumptions of symbolic interactionism. Results: We will present a typology of educators and strategies used by them in contacts with families of minors in an open and closed environment. We have highlighted the extreme strategies applied by educators in their work with families of juveniles, i.e. active and passive strategies, and within this framework we selected the tactics used by the respondents. Conclusions: We managed to find out that despite the variety of environments in which educators of youth educational centers and family probation officers work, they reached for similar activities aimed at establishing and managing a relationship with the families of minors. Furthermore, we compared our analyses with the proposed characteristics of models of working with families. Finally, we took note of the fact that while the respondents implemented all work models, the professional-directed and family-allied models dominated.
Sistema de uso doméstico para monitorear el consumo energético combinando el uso de las plataformas Arduino y Android
Authors: Benítez-Pina Israel Francisco
Published: May 2023

Los sistemas domóticos se presentan como una estrategia importante para monitorear el consumo eléctrico doméstico para una gestión energética adecuada que permita reducir el consumo en los hogares. En este estudio se desarrolló un sistema domótico económico para medir el consumo eléctrico en tiempo real en hogares cubanos. El sistema está basado en las plataformas Arduino y Android, usando diferentes sensores. Adicionalmente, se desarrolló una App compatible con Android para conectarla con el sistema, permitiendo la interacción entre el usuario y el sistema. Comparado con las mediciones del metro-contador eléctrico de la vivienda, el sistema obtienes resultados con 0.36% de error. Por consiguiente, el sistema es adecuado para medir el consumo eléctrico residencial. Dada sus características, este dispositivo y la aplicación pueden mejorarse para su uso en instalaciones del sector terciario.
The evaluation between vitamin D level and pelvic organ prolapse in post-menopausal women
Authors: Rani Paul Zhuma , Khanam Nurun Nahar , Chandra Barai Shyamal , Parvin Mst. Nargis , Talukder Plabony , Siddiqua Masrura , Nahar Nurun , Sultana Nigar , Rahman Nasima , Haque Dona Georgia , Jahan Samanta , Koly Homyera
Published: May 2023

Background: Vitamin D is important for skeletal integrity and optimal muscle function. The high incidence and prevalence of vitamin D deficiency and pelvic organ prolapse have been found in postmenopausal women, raising the question of whether the entities are related. The aim of the study was to evaluation between vitamin D level and pelvic organ prolapse in post-menopausal women.
Methods: This case control study has been designed and conducted in the Department of Obstetrics and Gynecology, BSMMU to investigate the level of vitamin D in patients with and without pelvic organ prolapse to explore the association of vitamin D with pelvic organ prolapse. After taking informed written consent the serum vitamin D level of all participants was measured by CMIA technology with flexible assay protocols at Biochemistry and Molecular Biology department of the same institute. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-24).
Results: The study population was divided into two groups, a case group (n=74) consisting of patients with pelvic organ prolapse and a control group (n=74) comprising of women without pelvic organ prolapse. A total 148 participants of 52 years or older attending the out or inpatient department were enrolled in the study. Mean±SD level of Vitamin D in the case group was 13.96±5.18 ng/ml and in the control, group was 21.08±5.77 ng/ml respectively. The difference was statistically significant (p<0.05). Moreover, the vitamin D levels were inversely proportionate with the severity of pelvic organ prolapse.
Conclusions: Vitamin D deficiency may be an important systemic factor associated with pelvic organ prolapse. Measuring vitamin D levels in postmenopausal women and replenishing deficiencies may also be important for the pelvic floor.
Impact of respectful maternity care and its outcome in a childbearing woman
Authors: K. Shwetha , Yadav Anjalee , Jeetu
Published: May 2023

Background: Respectful maternity care (RMC) is an individualised approach which emphasises on moral values and respect for human rights, and encourages behaviours that take into account women's preferences and the needs of both pregnant women and new mothers. The Indian Government has recently undertaken RMC under LaQshya to give respectable attention and care to the pregnant patients at medical facilities.
Methods: It is a cross sectional study conducted in the department of obstetrics and gynaecology at a tertiary care hospital in Bhopal. Pregnant women who came for labour and delivery services were included in the study and all pregnant female–healthcare provider interactions during childbirth were taken for assessment.
Results: Patient satisfaction survey of labour room done consecutively for 3 months revealed PSS score of 4.55, 4.51 and 4.51 in month 1, 2 and 3. Similarly, patient satisfaction survey of maternity operation theatre (OT) done consecutively for 3 months revealed PSS score of 4.59, 4.56 and 4.50 in month 1, 2 and 3.
Conclusions: The study's results show that respectful maternity care is still in its budding stage despite the fact that women are noticing and reporting positive changes in maternity care practises. In order to improve maternal health outcomes for all women, there is a need for increased action, discussion, research, and advocacy on this crucial public health and human rights problem.
Predictive value of admission and intrapartum cardiotocography in normal and high risk antenatal women
Authors: Nagpal Anuradha , Tyagi Mamta , Gupta Smriti , Manvi Gupta
Published: May 2023

Background: Cardiotocography is the most common method for assessing fetal health and reveals brain oxygenation. This study is done for admission and intrapartum cardiotocography in high- and low-risk pregnancies and its correlation with neonatal outcome.
Methods: All high-risk and normal antenatal women with more than 34 weeks of pregnancy and vertex presentation who came to the labor room were included in the study. 200 cases were taken, 100 were in the "high risk group," and the remaining 100 were in the "low risk group." On admission CTG and intrapartum CTG tracing were taken after written and informed consent, neonatal outcomes were observed, and adverse neonatal outcomes were noted.
Results: Admission CTG results were unsatisfactory for 9% of women in the high-risk group and none in the low-risk group. Intrapartum NST was non reassuring in 51% of high-risk women and 6% of the low-risk group. Of the total number of neonates admitted to the NICU, 14 were from the low-risk group, while 50 were from the high-risk group.
Conclusions: On admission NST in both low and high-risk women, the absence of category III NST predicted the absence of an adverse neonatal outcome most accurately. Even during labor in both high-risk and low-risk women, the absence of category III reassured the fetal well-being most precisely.
Association of breast feeding in ovarian malignancy: is breastfeeding a boon? a single institutional experience
Authors: Shanmugam Subbiah , Balakrishnan Sathiyaseelan
Published: May 2023

Background: There are many risk factors which can attribute to ovarian cancer. Oral contraceptive pill (OCP) usage, salpingo-oophorectomy, and high parity are considered as protective factors for ovarian cancer. Lactation (breastfeeding), incomplete pregnancies, and sterilization may offer a weak protection against ovarian cancer. There are only few modifiable risk factors beyond oral contraceptive use exist. Hence identifying additional modifiable factors is needed to tailor prevention strategies.
Methods: In our institution, we analyzed 250 patients who underwent treatment for various malignancies from 2020 to 2022. Among those patients, 128 patients were treated for ovarian malignancy who were compared with 122 control patients (patients with malignancy other than ovarian cancer). We collected data of these patients from medical records. We analyzed the association of breast feeding, and the duration of breast feeding with ovarian malignancy.
Results: A total of 128 women with ovarian malignancy; mean (SD) age, 53.3 (7.7) years and 122 controls; mean (SD) age, 51.6 (8.0) years were included. Breastfeeding was associated with a 26.4% lower risk of invasive ovarian cancer in patients who breastfed their children for cumulative period of more than one year.
Conclusions: Breast feeding is associated with significant reduction in ovarian malignancy when the duration of breast feeding exceeds more than one year. Thus, encouraging breast feeding and increasing the duration of breast feeding may help in reducing the incidence of ovarian malignancy.
Induction of labour using transcervical Foley's catheter with extra amniotic saline infusion versus intracervical prostaglandin E2 gel at term gestation: a comparative study
Authors: Priya Madana Jyotsna , Kumar S. Vasantha , S. Nandini
Published: May 2023

Background: The intentional commencement of cervical ripening and uterine contraction for the purpose of achieving delivery prior to the onset of spontaneous parturition is known as induction of labour. When the benefits to the mother or the foetus surpass the benefits of extending the pregnancy, it is indicated. The purpose of this study was to assess the efficacy of a transcervical foley's catheter with extra amniotic saline infusion against intra cervical prostaglandin E2 gel for inducing labour in term pregnant women.
Methods: From January 2020 to June 2021, a comparative study was undertaken at R.L. Jalappa Hospital and Research Centre. The study enrolled a total of 72 individuals. After obtaining informed consent from the patients who were admitted, and meeting the inclusion criteria, detailed history was collected, baseline investigations were done.  After clinical examination of the patient, by using the simple lottery method, patients were divided into group A (Extra amniotic saline infusion group with Foley’s catheter) and group B (Dinoprostone (PGE2 gel) group).
Results: Prolonged gestational age, hypertensive disorders in pregnancy, and oligohydramnios were the most frequent causes for induction in the EASI group, accounting for 38.89%, 38.89%, and 22.22%, respectively. The dinoprostone group has 36.11%, 33.33%, and 25%, respectively. After induction, the majority of patients in the EASI group had a modified Bishop's score of 2.
Conclusions: Our research found that PGE2 and EASI were equally effective in inducing labour.
Significance of maternal hemogram parameters as new inflammatory markers for prediction of threatened preterm labor and preterm premature rupture of membranes
Authors: Rani Anupam , Karya Urmila , Nehra Sakshi
Published: May 2023

Background: Non-invasive, inexpensive and easily available simple markers are needed for timely prediction of preterm labor and preterm premature rupture of membranes (PPROM) in women at risk. Aims and objectives of current study was to study the significance of maternal hemogram parameters i.e., NLR, PLR, MPV, PDW and plateletcrit in TPL, PPROM.
Methods: A total number of 150 pregnant women, 50 with PPROM (group 1), 50 with TPL (group 2) and 50 gestation matched healthy controls (group 3) attending antenatal clinic and labor room in SVBP Hospital and associated LLRM Medical College, Meerut were recruited in study. Complete blood count was done from blood sample collected in EDTA vials using 5-part automated cell analyzer device. Hematological parameters like NLR, PLR, MPV, PDW and plateletcrit were measured from CBC.
Results: Patients with PPROM had increased NLR, PLR, MPV, PWD and plateletcrit than patients with threatened preterm labor group and healthy control group.
Conclusions: NLR, PLR, MPV, PDW, and Plateletcrit were significantly increased in both PPROM group and TPL group compared to healthy control group and have a predictive value in PPROM and TPL. Monitoring of these parameters can be promising and cost-effective methods in prediction of TPL and PPROM.
Frequency of gestational diabetes mellitus and associated risk factors amongst women attending antenatal clinic at a tertiary care hospital of West Bengal, India
Authors: Rabi Tousif , Bandyopadhyay Kausik , Adak Shiuli Roy
Published: May 2023

Background: Women with gestational diabetes are associated with adverse pregnancy outcomes. This study was conducted to evaluate prevalence of gestational diabetes mellitus and associated risk factors amongst women attending antenatal clinic of a tertiary care hospital of west Bengal, India.
Methods: Universal screening for gestational diabetes mellitus was done in 215 women with estimated gestational age between 24 weeks to 28 weeks. They were requested to drink 75 gram of glucose dissolved 300 ml of water irrespective of their last meal. Gestational diabetes mellitus was diagnosed if 2 hour plasma glucose value was ≥ 140 mg/dl. Relevant history was taken and associations with risk factors like age, parity, pregnancy body-mass index, bad obstetric history, family history of diabetes and history of previous macrosomia were analysed statistically.
Results: This study found that prevalence of gestational diabetes mellitus was 14.9%.Statistically significant association was found between glucose tolerance in pregnancy and maternal age, pregnancy body-mass-index, bad obstetric history, family history of diabetes and history of previous macrosomia.
Conclusions: Prevalence of gestational diabetes mellitus was 14.9% which can be considered alarming and its associations with risk factors were statistically significant.
KAP study on emergency contraception among women of reproductive age group attending JNUIMSRC OPD, Jaipur, India
Authors: Meena Pragati , Meena Seema , Choudhary Richa , Sharma Bharti
Published: May 2023

Background: Unintended pregnancy, unplanned birth and unsafe abortion have been a major challenge to the reproductive health of women worldwide. Despite the availability of highly efficient contraceptive technologies, there are still many undesired pregnancies that put women at a higher risk of mortality, frequently as a result of unsafe abortion. Emergency contraceptive pills can be used to prevent these unwanted pregnancies. Aim of this study was to assess the knowledge, attitude and practice of use of emergency contraception among women of reproductive age group attending JNUIMSRC OPD, Jaipur, India.
Methods: Institution based cross-sectional study was conducted among 100 females of reproductive age group attending JNUIMSRC OPD, Jaipur, India. Data was collected using pretested semi-structured questionnaire after written informed consent. Descriptive and inferential statistics were used to analyse the data generated.
Results: Among respondents who were aware of ECPs, 64% had good knowledge of it, 90% had positive attitude towards ECPs and 63% have used earlier. A significant association was found between age, residence, educational level and occupational status with awareness of ECPs.
Conclusions: Awareness and utilization of emergency contraceptive pills is low among females of reproductive age group attending OPD at JNUIMSRC. Thus awareness should be enhanced through formal education, communication from healthcare professionals and media that can offer trustworthy and accurate information on ECPs.
Hypertensive disorders of pregnancy: a manifestation of insulin resistance
Authors: Marandi Satyabhama , D. Surya , Chanania Kabita , Pati Tapasi , Nayak Sibananda , Jacob Anju Mariam , Kumar R. Praveen
Published: May 2023

Background: Pregnancy is a unique physiological diabetogenic state characterised by increased insulin resistance that ensures adequate supply of nutrients to the developing fetus. The insulin sensitivity falls to upto 50 percent in the late pregnancy. Thus insulin resistance and the resultant hyperinsulinemia are the characteristics features that are evident in the normal pregnancy during third trimester. In Hypertensive disorders of pregnancy (HDP), there is exacerbation of the physiological insulin resistance that occurs in normal pregnancy resulting in increased fasting serum insulin level.
Methods: This is a case control study conducted on 90 antenatal women, during the study period of one and half years (from December 2020 to June 2022) in IMS and SUM Hospital, Bhubaneswar. With informed written consent and after fulfilling the criterias, 60 normotensive patients were chosen as controls and 30 pregnant patients with hypertensive disorders of pregnancy were chosen as cases. After 8 hours of overnight fasting, 2ml of blood is drawn and processed by CMIA technology to detect fasting serum insulin levels. The mean fasting serum insulin levels were compared between the cases and the controls.
Results: The mean fasting serum insulin level of controls was found to be 9.27 and the mean fasting serum insulin level of cases was found to be 15.01 which was higher than controls. This was found to be statistically significant with a P value of 0.000.
Conclusions: Increased fasting serum insulin level is observed in women with HDP than normotensive pregnant women.
The trends of isolation and antimicrobial susceptibility of group B Streptococcus in urine culture: a 7-years cross sectional study
Authors: Kannambath Rachana , Vasanthaiah Shruthi , Jamir Imola , Sagili Haritha , Mandal Jharna
Published: May 2023

Background: Group B Streptococcus (GBS)/Streptococcus agalactiae (S. agalactiae) is a common rectovaginal colonizer, thereby a potential agent of neonatal and maternal infection. This study estimates the trends of isolation of GBS, its antimicrobial profile in urine culture and the demographic characteristics of these patients over a 7-year period.
Methods: A record-based study was conducted, which included all the urine culture reports of GBS/S. agalactiae from January 2014 to December 2020. The trend of occurrence of GBS bacteriuria, demographic characteristics and antimicrobial susceptibility pattern were analyzed.
Results: Out of 137 urine samples which grew GBS/S. agalactiae, 55(40.15%) were from antenatal women. Most of the isolates were from females (72.26%), with a male preponderance noted among the elderly population (age>60 years). The predominant age group affected were adults between 20 to 59 years. The majority of the isolates (60.58%) were susceptible to all the four tested antibiotics, namely, ciprofloxacin, nitrofurantoin, ampicillin and vancomycin. Ciprofloxacin resistance was observed in 32.85% (45/137) isolates, 5.84% (8/137) isolates were resistant to ampicillin and 2.92% (4/137) were resistant to nitrofurantoin.
Conclusions: All the isolates were susceptible to vancomycin. GBS/S. agalactiae is an important agent of bacteriuria in antenatal women as well as in non-pregnant population, especially the elderly males. Emerging resistance to various group of antibiotics warrants routine susceptibility testing.
A prospective study of risk factors and feto-maternal outcome of preterm labor in OG department of tertiary care centre of South Gujarat
Authors: Prajapati Neha V. , Bhatia Saral
Published: May 2023

Background: Every year globally, an estimated 15 million babies are born preterm and this number is rising over major parts of the world. Severe morbidity is common in neonates born before 32-34 weeks of gestation. Management of prematurity is a team approach by the obstetrician and the pediatrician.
Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology, NCH, Surat from October 2019 to October 2020. 120 consenting consecutive subjects fulfilling inclusion criteria were enrolled.
Results: The most common risk factor for preterm labor in my study was PPROM (premature rupture of membranes). 27% subjects were diagnosed with threatened preterm labor. 22% subjects delivered preterm due to advanced labor. Labor arrest with tocolytic drug nifedipine was attempted in 30 subjects without any complications, which was successful in 19 subjects. The most common maternal complication in preterm labor was postpartum hemorrhage. All neonates were admitted to NICU, amongst them 45 developed complications. The most common complication in preterm neonates was respiratory distress. The rate of early neonatal death was 6.6%.
Conclusions: Inspite of advances in antenatal care and neonatal services, preterm birth remains a burden to families. Strengthening of referral systems to make sure that high risk patients are managed at tertiary care centers with NICU facilities will improve the neonatal outcome.
Histological spectrum and diagnostic challenges in endometrial carcinoma of the uterus
Authors: Chandwani Teena V. , Bhat Dharitri M. , Deshpande Archana H.
Published: May 2023

Background: Endometrial carcinoma is the most common type of malignancy of the uterine corpus accounting for 95% of all primary malignancies. Epidemiological studies have proved the role of unopposed estrogen as an important factor in pathogenesis of endometrial carcinoma. Pathologists play an important role not only in the histological confirmation of the diagnosis, but in subtyping, grading and staging of the tumor. Current study is undertaken to study the histological spectrum in endometrial carcinomas.
Methods: Present study includes histologically confirmed cases of endometrial carcinoma of uterine corpus over a period of 24 months (July2020 to June 2022) in a tertiary health care center in central India. After gross examination, and standard sectioning, all these tumors were subtyped on histology and grading, staging was done as per WHO and FIGO recommendations. In cases with diagnostic dispute and overlapping features, IHC markers were applied.
Results: Amongst total 30 confirmed cases of endometrial carcinoma, endometrioid type was most common (25) followed by villoglandular and serous type of adenocarcinoma. Architectural and nuclear grading was done in all cases. Staging could be done in hysterectomy specimens only. Difficulties encountered while grading and staging are discussed.
Conclusions: Endometrial carcinoma was the most common type of malignancy. Other types were villoglandular and serous adenocarcinoma. Various additional histological features were also observed. Grade I tumors were commonly seen. Depth of myometrial invasion was measured in hysterectomy specimens. Various diagnostic challenges encountered are discussed.
Obstetric hysterectomy in a tertiary centre: a 3-year retrospective study
Authors: More Mayuri V. , Purandare Nandan S. , Kaundinya Aditi P. , Poojari Deeksha S. , Gandi Sudharani , Patil Aloukika P. , Gopal Sriram
Published: May 2023

Background: Obstetric hysterectomy (OH) is a life-saving procedure and involves removal of uterus in cases of intractable hemorrhage. This study includes 21 cases of OH in a period of 3 years at a tertiary centre. We sought to understand the prevalence, indications and outcomes of emergency obstetric hysterectomy.
Methods: This is a retrospective, observational study, conducted with the means of hospital delivery records in a tertiary care centre in Navi Mumbai. We included all patients who underwent obstetric hysterectomy in a span of 3 years between 1st April 2020 to 31st March 2023, in Dr. D.Y. Patil Hospital, Navi Mumbai, India.
Results: Twenty- one OH were done in the period of study. The incidence of obstetric hysterectomy was 0.45% (452 OH per 100,000 deliveries). It was more prevalent in patients with caesarean section compared to vaginal delivery. Women between the age 25-35 years group comprised of 57.15% cases. Out of the 21 women in the study 7 women were primigravida (33.33%). Most common cause for OH was observed to be uterine atony (42.85%) followed by adherent placenta (28.57%). Maternal morbidity like admission to intensive care unit and need for blood and blood product transfusion was noted in most patients, mortality was observed in only 1 case. Neonatal mortality was nil in this study but, admission to neonatal intensive care unit was required in 7 patients.
Conclusions: Although, obstetric hysterectomy kills the future reproductive prospect for a woman, it is life saving for her. Timely decision for OH can not only prevent mortality but, also morbidity for the woman. Previous caesarean section and multigravida have higher incidence of OH. Atonicity is the predominant cause for obstetric hysterectomy in this study.
Early diagnosis, a step towards reducing mortality in placenta accreta spectrum: a case series
Authors: Sai Rashmi Sura  , Gakhar Aashima , Patnaik Manasi , Pattnaik Lipipuspa , Manoghna Gorantla , Konakanchi Asha
Published: May 2023

The worldwide incidence of placenta accrete spectrum (PAS) is increasing day by day, mostly due to the increasing trends in caesarean section (CS) rates. PAS is accountable for high maternal morbidity and mortality as it is associated with extensive haemorrhage, which often requires hysterectomy, multiple blood and blood product transfusions, ureteric and bladder injuries and prolonged ICU stay. The aim of this case series is to highlight the importance of early diagnosis and high degree of suspicion of PAS for a planned management in decreasing maternal morbidity and mortality. Antenatal patients who were associated with PAS and managed in obstetrics and gynaecology department, Kalinga institute of medical sciences, Bhubaneswar during the time period of 2 years were critically reviewed and are being presented as case series. High degree of suspicion, pre operative radiological diagnosis, well preparedness and multidisciplinary approach help us in reducing the maternal mortality and morbidity significantly. Conservative management of PAS can preserve future fertility but should only be done in hospitals with 24 hour emergency care and enough expertise as it carries high chances of maternal complications.
A rare case of acute non puerperal complete uterine inversion in nulliparous virgin female
Authors: Bhangale Saurabh V. , Kumar Ashok , Sharma Mamta , Arora Naina
Published: May 2023

Non-puerperal uterine inversion (NPUI) is extremely rare and accounts for 17% of all uterine inversion cases. A few more than 150 cases have been reported amongst which 10-15 have been reported in nulliparous females and 3-4 have been reported in virgin females from 1914 till date. A 40 years unmarried nulliparous female denying sexual activity presented to our hospital with acute non puerperal complete uterine inversion with something coming out per vaginum of sudden onset while straining at defecation, lower abdominal pain and minimal bleeding per vaginum with history of uterine fibroid and chronic constipation. Diagnosis was confirmed with ultrasonography and examination under anaesthesia after written informed valid consent. After detailed counselling and obtaining written informed valid consent, the patient underwent exploration with a combined abdominal-vaginal approach. Following vaginal myomectomy, the uterus was repositioned using Haultain procedure after a failed attempt of Huntington procedure. Total abdominal hysterectomy with bilateral salpingectomy with vaginal vault suspension was done sparing bilateral ovaries. Diagnosis requires a high index of suspicion and their management is a challenge to gynaecologists due to its rare occurrence, distorted pelvic anatomy and associated pelvic organ injuries during surgery. Good anatomical and clinical knowledge along with surgical skills is of utmost importance for successful outcomes.
Uterosacral ligament fibroid: a rare occurrence yet a major diagnostic challenge
Authors: Mishra Tejasa , Jain Madhu , Jain Shivi
Published: May 2023

Fibroid is a common benign neoplasm more often located in the uterus and less commonly seen in the adnexa and other supporting structures of uterus like broad and uterosacral ligament. The incidence of extra uterine leiomyomas is <1%. A 48-year-old female para one live one presented with chief complaints of mass per abdomen for 2 years and prolonged heavy bleeding for 15 days. Based on the clinical and radiological findings, a diagnosis of tubo-ovarian mass was made. The patient underwent staging laparotomy. However, intraoperatively, she was diagnosed with uterosacral ligament fibroid of size approximately 40×45 cm. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. There was no associated complication. Histopathology confirmed the mass to be leiomyoma. Uterosacral ligament fibroid is encountered very rarely. Our case report intends to bring to light the necessity of keeping the various possible locations of leiomyoma in mind and in considering adnexal mass as an important differential diagnosis of leiomyoma and vice-versa before operating. Leiomyoma is often confused with ovarian mass or neoplasm posing a diagnostic difficulty to a gynaecologist as well as radiologist thereby posing a challenge to the operating surgeon while performing surgery.
Predictors of invasive mechanical ventilation in children with severe COVID-19
Authors: Sodani Ravitanaya , Gupta Shalu , Sharma Ankita Goel , Maheshwari Anu , Singh Preeti , Kumar Virendra
Published: May 2023

Background: To compare the demographic characteristics, clinical symptoms, laboratory findings, and comorbidities of hospitalized children with the Coronavirus disease (COVID-19) who required invasive mechanical ventilation (IMV) and analyse them to find out potential predictors for requirement of mechanical ventilation.
Methods: Study design was of single centre, retrospective record review. Settings were tertiary care hospital in New Delhi, India, between April, 2020 to October, 2020
Results: 100-laboratory confirmed COVID-19 cases were admitted during the study period. Thirty-five patients required IMV. Median age of ventilated patients was 65 (10.5, 126) months and median weight was 15 (8.5, 23.3) kg. Forty-three percent (43%) of patients were underweight (p=0.46) while 40% had chronic co-morbidity (p=0.015). Gastrointestinal symptoms (p<0.05), altered sensorium at presentation (p<0.001) and hypoxia at admission (p<0.00) were significantly greater in those who required ventilation. A statistically significant difference was also noted in inflammatory markers between ventilated and non-ventilated patients. Acute kidney injury (p=0.003) and transaminitis (p=0.05) at admission were 26 and 32% respectively in ventilated patients. The most common indicators for ventilation need were primary respiratory disease (35%) followed by shock (31%) and low Glasgow coma scale (23%). Nearly 70% of these were intubated within 48 hours of hospital admission. Multivariate analysis highlighted that presence of low SpO2 at admission (adjusted OR, 6.9; 95% CI, 1.3-36.6) was significantly associated with need of IMV.
Conclusions: Study highlights important characteristics of paediatric population from developing country with COVID-19 who required IMV. Presence of low oxygen saturation at admission significantly associated with need of IMV.
A study of etiopathogenesis, clinical and laboratory profile evaluation of typhoid fever in paediatric age group in Bijapur
Authors: Malagi Naushad Ali , Moheet Mohammed Abdul , Thobbi A. N.
Published: May 2023

Background: Salmonella typhi causes typhoid illness. In India, it is a huge public health issue. Several impoverished nations have endemic typhoid fever. The wide range of clinical symptoms of typhoid fever makes diagnosis difficult. The purpose of this study was to better understand the vast range of clinical symptoms, comorbidities, and drug sensitivity patterns associated with typhoid fever in children.
Methods: From March 2021 to October 2022, 100 children hospitalised to the paediatric unit at Al-Ameen Medical College and Hospital in Bijapur with proven typhoid fever were included in the study. Age, gender, presenting complaint, laboratory tests, and antibiotic sensitivity pattern are all gathered and analysed in each patient.
Results: There were 58 men (58%) and 42 females (42%) among the 100 cases. The most typical age range was 5 to 15 years. Fever was the most prevalent symptom, occurring in 100% of patients, headache (80%), coated tongue (100%), vomiting (45%), and abdominal pain (70%). In 68% of cases, the most prevalent indication was a toxic look, and hepatomegaly in 44%. In 28% of instances, leukocytopenia was discovered. In every case, the blood culture proved positive. The length of hospital stay ranged from 3 to 10 days. There was no recorded death.
Conclusions: Unhygienic habits and consuming meals from the outside are the main causes of typhoid fever. By raising people's understanding of disease transmission and its many preventative methods, this serious public health issue can be resolved.
Clinical profile, cardiac involvement and outcome of children admitted with multisystem inflammatory syndrome in PICU at GB Pant children hospital Srinagar
Authors: Jan Muzafar , Kasana Sarafraz Ahmad , Khan Younus Ramzan , Bashir Amber
Published: May 2023

Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe hyper inflammatory post infectious complication of acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, which typically occurs 2-6 weeks after exposure to SARS-CoV-2. Aim was to determine the clinical profile, cardiac involvement and outcome of children admitted with multisystem inflammatory syndrome in pediatric intensive care unit.
Methods: This prospective observational study was conducted in pediatric intensive care unit over period of two years. After informed consent from parents, all those patients meeting inclusion criteria were subjected to complete history, general and systemic physical examination. Routine baseline investigations included CBC, LFT, KFT, ABG, serum calcium and phosphorous, and other investigations like echocardiography, COVID-19 RAT and RTPCR and various inflammatory markers like serum ferritin, pro-calcitonin, CRP and ESR whenever required were done.
Results: In our study out of 77 MIS-C patients 40 were males and 37 were females with a male female ratio of 1.1:1. The mean average age was 7.4 years. Out of them 47 (61%) patients had a history of COVID-19 infection/contact with positive COVID-19 cases 3 to 4 weeks before presentation. In our study gastrointestinal, respiratory, and cardiac systems were mostly involved. Rash and conjunctival congestion was seen in 81% of MIS-C patients. On echocardiography out of 77 MIS-C patients, 15 (19.5%) had pericardial effusion, 25 (32.5%) had coronary artery dilatations and 32 patients (41.5%) had left ventricular systolic dysfunction with LVEF <55%.
Conclusions: Pediatric multisystem inflammatory syndrome is a serious and life-threatening illnesses having a significant impact on morbidity and mortality.
ABO/Rh incompatibility in neonatal jaundice: a tertiary hospital based cross sectional study
Authors: Khiangte Lalrinkimi , Joseph Dibin
Published: May 2023

Background: Neonatal hyperbilirubinemia, defined as a total serum bilirubin level above 5 mg/dl (86 μmol/l). Haemolytic disease of the newborn due to blood group incompatibilities between mother and foetus is one of the commonest cause of hyperbilirubinemia in the newborn.
Methods: A Hospital based cross sectional study was conducted among newborns admitted with jaundice.
Results: In our study 51 cases of neonatal jaundice were due to ABO incompatibility and among them 24 were having O-A incompatibility and 27 were having O-B incompatibility. The mean serum bilirubin in patients with ABO incompatibility were higher (24.8) than those without ABO incompatibility.
Conclusions: In the present study, one third of newborns with neonatal jaundice were having ABO incompatibility.  The mean serum bilirubin in patients with ABO incompatibility were higher than those without ABO incompatibility. This highlights the importance of recognizing ABO Rh incompatibility in neonatal jaundice.
Mobile phones and children: exposure and pattern of usage of mobile phones among children - a descriptive cross-sectional study
Authors: Reddy Duvvur Preethika , Earan Sujay Kumar , Thambiprabagarane Kalaimani  , Arulkumaran Arunagirinathan
Published: May 2023

Background: Mobile phone as an invention of the modern world has managed to penetrate not only the most distant parts of the world but also various age groups in a person’s life. There is a need to evaluate the children’ interactions with these modern devices as they might have a significant effect on their behavior, sleep patterns, and psychological addiction. Objectives of the research were: to study the socio demographic characteristics of children using mobile phones, to determine the average time duration of exposure to mobile phones, and to determine the age of initial exposure to mobile phones.
Methods: It was a descriptive cross sectional observational study. The study was conducted at Sri Manakula Vinayagar Medical College and Hospital. All the children between the age group of 0-12 years visiting the pediatric outpatient department fulfilling the inclusion criteria were enrolled in the study.
Results: Of the 248 children enrolled in the study mobile phone exposure was found in 143 (57.66%) boys and 105 (42.34%) girls. 67.74% of the parents agreed that the mobile phones were being used by their children just for fun without any intended or specific use. 26% of the times it was used to engage the children when the parents were busy. 30.24% of the kids had a screen time of less than 30 minutes on a daily basis. 23.39% of the children were used to the screen for more than 2 hours in a day, on a cumulative basis. It was noted that more than 50% of children were exposed to mobile phones within 1 year of age. The earliest age of exposure to mobile phone was 2 months of age.
Conclusions: Regardless of the socioeconomic status the accessibility and the owning of the mobile phones is same across the socioeconomic strata. The need of the hour is to raise awareness among the parents regarding the excessive use of mobile phones among children and their possible adverse impacts on physical and psychosocial health.
An online mindfulness-based intervention influences the health-related quality of life of Indian children and adolescent during COVID-19 pandemic: a randomized controlled trial
Authors: Pal Anirban , Mukhopadhyay Purnava , Pal Nidhi Dawar
Published: May 2023

Background: COVID-19 pandemic is endangering the psychosocial health of Indian children and adolescent. The psychosocial morbidity can get manifested as psychiatric diseases if not addressed properly. This study aims to see the effects of an online Mindfulness-based intervention on the health-related quality of life (HRQoL) of apparently healthy but ‘vulnerable’ children in Indian community, during the COVID-19 pandemic.
Methods: A randomized controlled trial with 43 children and one of their interactive parents as participants from the community. An online eight-week Mindfulness program was selected as the psychosocial intervention. 22 participants in group M attended the Mindfulness program (parents in group PM) while 21 participants in group C attended placebo sessions (parents in group PC). The quantitative measure was the HRQoL, measured by the KIDSCREEN10 questionnaire. Qualitative data was in form of a response to a question “Which aspect of the mindfulness program appealed to you the most from your child’s perspective?” The post-program parent responses were analyzed on basis of some emergent themes. The statistical analyses used were independent samples t-test, Chi-square test and one-way analysis of variance (ANOVA) for the outcome variables.
Results: The KIDSCREEN10 score significantly improved (p value <0.0001) in the cases (group M and PM), compared to the control groups. ‘Calm’ and ‘focus’ were the prominent emergent themes, reported by the parents post-program.
Conclusions: The online mindfulness-based intervention positively impacts the health-related quality of life of Indian children and adolescents during the COVID-19 pandemic. The results need to be substantiated by further studies.