bluuebunny/crossref_metadata_2025 huggingface dataset:
Perfil epidemiológico de gestantes de alto risco com parto prematuro em um hospital de referência
Authors: Menetrier Jacqueline Vergutz , Almeida Gleidaiane de
Published: March 2017

O estudo objetivou identificar o perfil epidemiológico das gestantes classificadas como sendo de alto-risco internadas em um hospital de referência no Sudoeste do Paraná que tiveram parto prematuro durante o ano de 2015. Trata-se de uma pesquisa de campo de caráter retrospectivo e documental, com abordagem quantitativa, cujas informações foram coletadas dos prontuários das pacientes que constituíram a amostra. Durante o período estudado, foram registrados 820 partos na instituição, desses, 153 ocorreram prematuramente. Assim, a taxa de prematuridade na instituição, durante o período estudado foi de 18,6%. Quanto aos dados sociodemográficos, foram encontrados em maior frequência idades entre 17 e 25 anos (41,5%), com ensino médio completo e com companheiro. Em relação às características da assistência, prevaleceram as mulheres que realizaram mais de 6 consultas de pré-natal (64,6%), tendo iniciado ainda no primeiro trimestre (76,2%), sendo que o parto ocorreu entre 33 e 36 semanas de gestação em 81,5% dos casos e através de cesárea. Faz-se necessário adotar medidas que possibilitem a identificação precoce de possíveis fatores desfavoráveis para a evolução da gestação, tratando de forma adequada cada situação, viabilizando uma gestação sem maiores complicações para a saúde da mãe e do bebê.
Prevalência de quedas em idosos na comunidade
Authors: Guerra Heloísa Silva , Sousa Renata Alves e , Bernardes Daniela Cristina Ferreira , Santana Juliana Alves , Barreira Luana Marchese
Published: March 2017

A ocorrência de quedas constitui uma das principais causas de morbidade e mortalidade na população idosa, tendo se tornado um problema importante de saúde pública devido aos altos custos sociais e financeiros que acarreta. O objetivo deste estudo foi determinar a prevalência de quedas em idosos vinculados a uma unidade básica de saúde. Trata-se de estudo descritivo transversal com a avaliação de idosos a partir de dois instrumentos: um relacionado aos dados sóciodemográficos e outro sobre a ocorrência de quedas nos últimos 12 meses. Os dados foram processados e analisados por meio do SPSS® versão 20.0 para Windows. No total, 97 idosos com média de idade de 70,5 anos (+ 8 anos) participaram do estudo 32 idosos referiram ter caído pelo menos uma vez nos últimos 12 meses, estimando prevalência de 33% (32/97; IC 95%: 24,2% - 42,8%) de quedas entre os participantes. O número de quedas variou de uma a 10 vezes no último ano, com média de duas quedas por idoso (+ 2 quedas). A queda da própria altura (87,5%) e ocorrida fora do domicílio (31,3%), foi a mais referida. O medo de cair novamente foi a consequência permanente da queda mais apontada pelos idosos. A prevalência de quedas neste estudo apresentou índices importantes, trazendo repercussões negativas para a saúde dos indivíduos.
Análise qualitativa do aleitamento materno com o uso do software IRAMUTEQ
Authors: Moimaz Suzely Adas Saliba , Amaral Marcelo Augusto , Miotto Aline Maria Malachini , Costa Iris do Céu Clara , Garbin Cléa Adas Saliba
Published: March 2017

Objetivou-se analisar a fala de gestantes sobre o aleitamento materno e aprofundar os fatores envolvidos no desmame precoce. Trata-se de uma pesquisa qualitativa realizada com uma amostra de 22 gestantes de 18 a 40 anos e período gestacional de 12 a 36 semanas. Foram realizados três grupos focais com a participação de moderador, observador e seis a nove gestantes, empregando-se um roteiro com questões norteadoras. Os discursos foram gravados, transcritos e os conteúdos textuais processados no software IRAMUTEQ e analisados pelas técnicas de Classificação Hierárquica Descendente, Análise de Conteúdo, Análise de Similitude e Nuvem de Palavras. Foram observadas 10.587 ocorrências de palavras, sendo 1.583 formas distintas. Destas, foram encontradas 289 palavras equiparadas por meio de Classificações Hierárquicas Descendentes e que resultaram em cinco categorias: causa do desmame, ansiedade e medo, conflito, enfrentamento e intenção de amamentar. Conclui-se que há intencionalidade por parte das gestantes para a prática do aleitamento materno, contudo, as análises lexicográficas do corpus textual demonstraram negação ao ato de amamentar e as possíveis causas para desmame precoce.
Reflexões sobre as disfunções sacroilíaca e sexual
Authors: Thomaz Tatiane , Nunes Erica Feio Carneiro , Latorre Gustavo Fernando
Published: March 2017

O objetivo deste estudo foi abordar a estudar relação entre disfunções sacroilíacas (DSI) e disfunção sexual (DS). Buscou-se nas bases de dados SciELO e PUBMED por artigos de 2006 a 2012 nas línguas portuguesa e inglesa, com as palavras-chave articulação sacroilíaca e disfunção sexual feminina, resultando em sete artigos. Os resultados mostraram que fraturas da cintura pélvica estão relacionadas à DS feminina. Apesar de as bases teóricas apontarem clara relação entre outras DSI que não fraturas e a DS, esta relação não teve respaldo na literatura. Conclui-se que se necessitam de estudos explorando as alterações anatômicas e biomecânicas da articulação sacroilíaca, especialmente as que gerem fraqueza ou tensão da musculatura do assoalho pélvico como possíveis fatores etiológicos da DS.
A clinical audit and confidential enquiry of caesarean section indications at rural tertiary health care centre
Authors: Thool Ketki N. , Jain Shuchi M. , Shivkumar Poonam V. , Jain Manish A. , Podder Manjiri R.
Published: March 2017

Background: Worldwide CSR has been steadily increasing beyond recommended level of 15 %by WHO. High CSR have been reported in developed and developing countries. Reasons for increase in CSR are not obvious and somewhat complex. Thus, present study was undertaken to analyze various indications for CS performed at rural tertiary health care centre Sewagram, M.S.Methods: This was prospective study included all women who underwent CS from 1st January 2015 till 30th June 2016. Data was entered in MS excel sheet analyzed with percentage and chi square test using SPSS ver.17.Results: CSR was 36 .88% in present study. As per NICE guidelines CS were classified in four categories based on urgency, women were distributed in each category. Category I had 22.62%, category II -38.61%, category III - 28.37% and Category IV - 10.40% women. In CAT I common indication was foetal bradycardia (71.53%). In CAT II CS, common indication was non reassuring foetal status (38.82%).  Breech presentation (14.74%) and previous scar with doubtfull scar integrity (14.33) were next common indications. In CAT III (43.43%), IV (41.13%) previous LSCS with inadequate pelvis was the common indication. Confidential enquiry revealed that 26.17% (28/107), 20.3% (40/197), 23.17%, (35/151) and 8.3 % (5/60) of CAT I, II, III and IV CS had questionable indications.Conclusions: In this study, CSR was higher than WHO standard. Common indications in primipara was foetal distress while in multiparas primary indication previous LSCS
Microbiological profile of asymptomatic bacteriuria in pregnancy
Authors: Bose Anu Mary , K. Sreekumary P. , Pulikkottil Sobha Kurian
Published: March 2017

Background: Asymptomatic bacteriuria is the presence of actively multiplying bacteria within the urinary tract in the absence of any symptoms. Anatomical and physiological changes make women more susceptible to UTI in pregnancy. The objective of present study was to determine the percentage of pregnant women with asymptomatic bacteriuria and its microbiological profile.Methods: A total of 555 antenatal women who had no clinical features of urinary tract infection were recruited for this study over a period of one year. Clean catch mid-stream urine sample was collected and semi quantitatively cultured immediately. Significant bacteriuria was identified and antibiotic sensitivity found out by conventional methods.Results: Significant growth was observed in 26 samples. There was no association between age, parity, gravidity, period of gestation and asymptomatic bacteriuria. Gram stain was found to be the best screening test. Escherichia coli were the commonest organism isolated. Escherichia coli and Staphylococcus saprophyticus were the most resistant organisms.Conclusions: Escherichia coli, the most common organism isolated, was resistant to most of the commonly used antibiotics. Wet film examination, the most commonly used screening test in our set up, was less sensitive and specific. So culture has to be done in all antenatal cases for screening asymptomatic bacteriuria of pregnancy.
Role of uterine artery Doppler in prediction of FGR in high risk pregnancies in 20-24 weeks
Authors: Dave Anupama , Joshi Ruchi , Sooruthiya Shweta , Dave Atisha
Published: March 2017

Background: Accurate prediction of fetal growth retardation (FGR) is a long-sought goal of perinatology as it contributes significantly to perinatal mortality and morbidity. It generally manifest later in pregnancy, their underlying pathophysiology is largely established early in pregnancy. Early detection will help in decreasing the associated morbidity.Methods: The study was carried out on 100 pregnant women of 20-24 weeks gestation in the Department of Obstetrics and Gynecology, MGM Medical College and MY Hospital, Indore from March 2015 to February 2016.Presence of diastolic notch in uterine artery waveform was taken as screen positive.Results: Total Diastolic notch positive cases 20/100 out of which 60% developed FGR and 80/100 Diastolic notch negative cases out of which only 4 cases (5%) will developed FGR. The sensitivity of the test was 75% while the specificity was 90.47%. The positive predictive value was 60% while the negative predictive value was 89.74%. 50% of screen positive belonged to 30-39 year age group and 68.75% FGR was seen in primiparous.Conclusions: Study of uterine artery flow velocity waveform seems to be a modern technique which can be used for ruling out the probability of FGR. Presences of diastolic notch in uterine vessels in 2nd trimester are of prognostic value for maternal complications and fetal jeopardy and therefore need of further critical assessment and management.
Study of occult stress urinary incontinence in pelvic organ prolapse
Authors: Reddy Nemakallu Sarala , Ghose Seetesh
Published: March 2017

Background: Pelvic organ prolapse and stress urinary incontinence are two common health-related conditions. If a woman with pelvic organ prolapse leaks only when the prolapse is reduced, it is called occult stress urinary incontinence (OSUI). The prevalence of OSUI in women with severe genitourinary prolapse varies from 27-68% in literature. In this study we want to find out the relationship between OSUI and stress urinary incontinence (SUI) following corrective surgery.The objectives of the study are to determine the number of women with urinary leak following reduction of prolapse before surgery; to determine the number women with occult stress urinary incontinence developing stress urinary incontinence following surgery and to determine the risk of developing stress urinary incontinence after vaginal hysterectomy and pelvic floor repair in these women.Methods: This is a longitudinal observational study. All women with pelvic organ prolapse (POP) of grade II or higher requiring corrective surgery were initially evaluated for OSUI using vaginal pack and followed up post operatively at 6 weeks and 12 weeks using QUID to look for post-operative stress urinary incontinence (POSUI).Results: The overall incidence of OSUI in our study was 7.5%. OSUI was significantly associated with factors like older age, higher BMI, high parity, short inter pregnancy interval and higher grade of prolapse and not significantly associated with factors like place of delivery, delivery events and mode of delivery.Conclusions: It is important to test all women with POP for OSUI and patients with OSUI need long term follow up to detect POSUI
Analysis of relationship between memory functions and blood indices across parturition in primigravidae
Authors: Venkataraman Srinivasan , Meerasa Semmal Syed
Published: March 2017

Background: Psychoneuroendocrinology is a nascent and vibrant field of endocrinology, revealing the unexplored paths of the diversifying field relating to cognitive functions and blood indices which is an interesting learning arena. This work, establishes the relationship of cognitive status and blood indices across parturition among the same subjects.Methods: The experimental design aimed at administration of cognitive assessment function tests as per Wechsler’s memory scale to pregnant subjects and getting specific blood parameters analysed across parturition. The statistical analysis included regression analysis to eliminate the effect of age on the parameters considered and a paired T test to establish relationship across parturition among the same subjects.Results: Cognitive assessment of the subjects clearly revealed that the following aspects of cognitive functions during conception are significantly impaired post parturition general memory, mental control 1, 2, 3, immediate recall memory. (Mental control 4 and 5). Symbolic memory (observations). Whereas the following cognitive functions of the same subjects during conception, are NOT significantly impaired post parturition, orientation, digit cognition (mental control 6 and 7). In the case of blood indices, as per the results obtained, it is quite clearly evident that the following blood parameters of the same subjects showed statistically significant difference during conception compared to post parturition. Mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), mean corpuscular volume (MCV). Whereas the following blood parameters of the same subjects showed NO statistically significant difference during conception compared to post parturition, haemoglobin (Hb), total count (TC), platelet count (PC)Conclusions: The domain of cognition related to immediate and recent memory functions, Mean corpuscular blood indices have shown significant variation during pregnancy compared to post parturition. Therefore, the parameters considered in this study indirectly reflects upon the hormonal influence on cognition and blood indices, further studies will help venture more into this newer field of psycho endoneuroimmunology.
A comparative study of metformin and glyburide in gestational diabetes mellitus
Authors: Pujara Prashant , Singh Vinita , Murmu Sunita , Kumari Suman , Prajapati Dhara
Published: March 2017

Background: Incidence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM provides a window of opportunity for the primary prevention of the type 2 diabetes by preventing transgeneration transmission to fetus. Insulin in management of GDM has many drawbacks, so use of OHAs has been increased worldwide.Methods: Randomized control trial was performed in patients with GDM who required medical management. Subjects were randomized into two groups and treated with Metformin and Glyburide, results were compared.Results: While comparing efficacy of metformin and glyburide in this study for maternal variables; the failure rate of metformin was found to be 9.39 times higher compared to glyburide. Glyburide was associated with 9.5 times more risk to develop hypoglycemia in mother compared to metformin. While comparing neonatal variables nursery admission was found to be more and statistically significant in neonates whose mother has received glyburide compared to metformin (p=0.03, RR=2.26). Though statistically insignificant, LGA fetuses and neonatal hypoglycemia were 2.1 times more in glyburide group compared to metformin.Conclusions: Though glyburide can be effective alternative to metformin and insulin for GDM, it is associated with higher risk of maternal hypoglycemia, neonatal hypoglycemia, LGA fetuses and higher rate of nursery admissions compared to metformin. Higher adverse neonatal outcomes with glyburide use question the widespread use of glyburide as first line management modality in GDM and also as an alternative to insulin as advised by many groups.
Evaluation of post sterilization ectopic gestations
Authors: Sarella Lavanya K.
Published: March 2017

Background: Tubal sterilization is considered a permanent method of contraception. The risk of failure of tubectomy is only 0.1-0.3%. Most often the pregnancy following tubal sterilization is ectopic gestation.Methods: 35 cases of post sterilization ectopic gestation were evaluated during a period of January 2014 to December 2015 at Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh, India.Results: Number of post sterilization ectopic gestation were (n=35) 33%, in 105 ectopic gestations during this period. 93% were in the age group of 20-30years with a mean age of 30.5years. 82% were gravida three who underwent sterilization with two living children. 62% of women presented with 4-6 weeks of amenorrhoea. 97.14% underwent minilaparotomy and out of which 74% were performed in Government hospitals. Puerperal sterilizations constituted 85%. In all cases ectopic gestation occurred within 10years of undergoing sterilization and all cases presented with hemoperitoneum. Site of rupture is ampulla in 31.4% of cases. Length of remaining tube is 7-8cm in 60% of cases.Conclusions: History of tubal sterilization does not rule out the possibility of ectopic gestation even when many years after the tubectomy. Adopting correct technique can reduce the failure rates. Woman should be counselled about the possibility of intra and extra uterine gestation at the time of performing tubectomy.
Knowledge attitude practice and acceptance of postpartum intrauterine devices among postpartal women in a tertiary care center
Authors: Yadav Sumitra , Joshi Ruchi , Solanki Monica
Published: March 2017

Background: PPIUCDs are the only method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum phase. World Health Organization (WHO) medical eligibility criteria state that it is generally safe for postpartum lactating women to use a PPIUCD, with the advantages outweighing the disadvantages. PPIUCDs are cost-effective and they are low-cost intervention that reduces maternal, infant, and under-five Child mortality.Methods: After approval from the ethical committee and consent from the patients, the study was performed on 1000 postpartum women within 10 min. of delivery and up to 6 weeks of delivery at Labour Room of, M.Y. Hospital, Indore.Results: Majority of acceptor (72.5%) belong to age group of 18-25 years and 53% belonged to urban area. Acceptance was more in those who completed their secondary school level education (33%). Working women (55.5%) accepted PPIUCD more than the non-working. Out of 1000 women counselled only 10% agreed for PPIUVD insertion. During the study of 1 year duration (3.5%) of non-acceptors become pregnant and none of the acceptors conceived. Most common reason stated for accepting PPIUCD among acceptors, was that it is a reversible method (66%). Most common reason for not accepting PPIUCD among non-acceptors, because they are interested in Other Method of Family Planning (60%).Conclusions: Verbal acceptance is more than actual insertion of PPIUCD because of adoption of other method of family planning, family pressure, nonacceptance by partner, lack of awareness, fear of complication. Proper counselling can help to generate awareness and compliance for PPIUCD use in postpartum mother who have institutional delivery. Inserting CuT 380A within 10 min after placental delivery is safe and effective, has high retention rate. The expulsion rate was not high, and further can be reduced with practice could not be predicted.
A comparative study of 25µg versus 50µg vaginal misoprostol for induction of labour at term premature rupture of membrane
Authors: Sinha Renu K. , Gupta Santoshi
Published: March 2017

Background: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients.Methods: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients.Results: PROM to delivery interval was significantly shorter with 50mcg vaginal misoprostol as compared to 25 mcg vaginal misoprostol (15.71±3.29 hours vs. 18.23±3.23 hours, (p value = 0.0023) Number of doses required was less with 50mcg vaginal misoprostol group as compared to 25mcg vaginal misoprostol (1.22±0.42 vs. 1.91±0.80, p value <0.05). 83.6% women in group A and 69.09% women in group B underwent spontaneous vaginal delivery within 24 hours. 3.64% women in group A and 7.27% in group B had instrumental delivery. Caesarean section was performed in 12.27% cases in group A and 23.64% cases in group B. The complication rate was comparable.Conclusions: 50mcg vaginal misoprostol is more effective and safe for induction of labour at term PROM as compared to 25 mcg vaginal misoprostol
Case series of Foley’s induction in patients with previous caesarean
Authors: R. Hemalatha K. , D. Swetha
Published: March 2017

Background: The objective of this study was to study the efficacy of intracervical Foley’s catheter induction in women with previous history of caesarean section and to evaluate the maternal and fetal outcome of these pregnancies.Methods: It is a prospective analysis of 30 patients whose labour was induced by intracervical Foley’s bulb for VBAC delivery. This study was conducted in KIMS, Hubli. Age, parity, indication of previous caesarean, inter-pregnancy interval and outcome of index pregnancy were studied in detail and analysed.Results: 30 women with previous history of caesarean were included into the study. Various indications of induction during index pregnancies were- post-datism, IUGR, intra-uterine foetal demise and severe pre-eclampsia and eclampsia. Out of 30 women, 18 (60%) had successful VBAC delivery, 12 (40%) underwent repeat LSCS. 19 cases needed augmentation of labour. Indications for caesarean section were failed induction in 5 (16.6%) women, threatened scar rupture in 3 (10%), non-progress of labour in 2 (6.6%) and meconium stained amniotic fluid in 2 (6.6%). No cases of uterine rupture or maternal mortality was noted in the study.Conclusions: In our study the rate of vaginal birth was 60% without major maternal complications. Hence intracervical Foley’s catheter is an effective, safe and acceptable for labour induction in women with previous caesarean.
Comparative study of ropivacaine (0.5%) plain versus levobupivacaine (0.5%) plain in gynecological surgeries
Authors: Jain Sunita , Bendwal Hari Prasad , Deodhar Pooja , Bhambani Pawan , Romday Rakesh , Jain Preeti
Published: March 2017

Background: Regional anesthesia increasingly used for gynecological surgeries, has advantage of decreased stress response to surgery, decreased cardiorespiratory depression, with improved postoperative analgesia.Methods: This randomized, prospective, double blind study was conducted at Amaltas Institute of Medical Sciences, Banger Dewas in Department of Anesthesia between June 2016-December 2016. Sixty patients who were posted for gynecological surgeries were enrolled and randomly divided into two groups: Group R received 3.5 ml (17.5 mg) 0.5% ropivacaine plain and Group L received 3.5 ml (17.5 mg) 0.5% levobupivacaine plain. The onset and duration of sensory and motor block and any undesirable side effects were noted.Results: Demographic parameters were comparable between the two groups (P >0.05). Onset of sensory and motor block was significantly faster in Group L, duration of motor and sensory block was significantly less in Group R. Patients in group R were hemodynamically stable (P = 0.032) compared to group L.Conclusions: Both ropivacaine and levobupivacaine have the desirable blocking property and can be used in gynecological surgeries. Ropivacaine showed shorter duration of sensory and motor block allowed early mobilization and early recovery of patients.
Meshplasty treatment for stress urinary: a prospective clinical trial
Authors: Yadav Pramila , Rajendrasaraogi . , Chavan Komal N.
Published: March 2017

Background: Stress urinary incontinence is when there is involuntary loss of urine due to increase intra-abdominal and intravesical pressure.Methods: This is a prospective clinical trial which was conducted at a Municipal General Hospital in Mumbai in the Department of Obstetrics and Gynecology for a period of 10 years from January 2005 to December 2015.The study group consisted of 518 cases with clinically demonstrable SUI with or without pelvic floor defects. Meshplasty was performed as a choice of surgery for SUI correction.Results: The study group was divided based on age(25-40,41-55,>55),parity(I,II-III,>IV), symptoms (SUI, Dysfunctional uterine bleeding, prolapse), type of anaesthesia (local, general/spinal anaesthesia), surgery performed (meshplasty alone, meshplasty with cystorectocele repair, meshplasty with vaginal hysterectomy (VH), meshplasty with VH with cystorectocele repair, meshplasty with VH with cystorectocele repair with sacrospinous fixation), complications (mesh rejection, urine retention).Conclusions: Meshplasty is a simple inexpensive procedure with short learning curve. This has a 94% success rate.
Differential diagnosis of bilateral ovarian masses during pregnancy, and their hormonal effect
Authors: Masuda Tatsuo , Matsuzaki Shinya , Takiuchi Tsuyoshi , Endo Masayuki , Tomimatsu Takuji , Kimura Tadashi
Published: March 2017

Rapidly enlarging bilateral ovarian cystic masses can be confused with malignant entities. When this happens during pregnancy, benign transient reactivity can present a similar clinical course. Here we describe a 33-year-old woman with hyperreactio luteinalis or multiple gestational theca lutein cysts whose ovaries drastically changed in size peripartum, with concordant changes in human chorionic gonadotropin, thyroid function, and testosterone levels. Management was conservative and the cystic masses spontaneously remitted postpartum. Present work suggested that evaluating the character of the cysts by magnetic resonance imaging and serial assessments of their size and the patient’s hormonal levels may assist in diagnosis. Conservative management could be successfully applied in a carefully chosen subset of patients to avoid unnecessary invasive procedures.
Primary ovarian pregnancy: histopathology remains the key to confirming diagnosis setting
Authors: Anand Priyanka , Nargotra Namrata
Published: March 2017

Ectopic pregnancy occurs in 2% of all pregnancies. Primary ovarian pregnancy is a rare entity and accounts for only 0.15-3% of all ectopic gestations. It usually ends with rupture before the end of first trimester. The diagnosis is often made intraoperatively and confirmed histopathologically. A 23 year old female presented with severe hypogastric abdominal pain with no history of amenorrhea. She underwent a laprotomy and a right sided salpingo-oopherectomy and the excised material was sent for histopathological examination. Chorionic villi were seen within the ovarian stroma suggesting the likely possibility of an ovarian pregnancy. Ovarian pregnancy is rare; although awareness of this condition is important for reducing its associated morbidity and mortality. This highlights the importance of histopathology for the accurate diagnosis of this condition.
An unusual presentation of choriocarcinoma
Authors: Rao Amishrita Lakku , Devi Rama Sarala
Published: March 2017

Choriocarcinoma is the most malignant growth arising from the uterine body. Incidence of choriocarcinoma following vesicular mole is 29-83%. Diagnosis of choriocarcinoma is by histopathology only. In the present case 22year old woman with history of vesicular mole evacuation 8 months back suddenly landed in shock. During her irregular follow up, misleading ultrasonographic findings and clinical features delayed the diagnosis of advanced choriocarcinoma till it perforated through the uterus and patient landed in shock due to massive hemoperitoneum.We report this case because of its unusual presentation which led to diagnostic dilemma and mismanagement.
Unilateral minimal ovarian cancer with peritoneal implant and an intraepithelial carcinoma in the contralateral fallopian tube
Authors: Terada Hiroyuki , Honda Ken-ichi , Nakagawa Tomoko , Takase Aki , Kurihara Yasushi , Ando Tetsuji , Tendo Masashige , Hori Takeshi , Miyamoto Keiko , Inaba Mayumi , Ohsaw Masahiko
Published: March 2017

Here we present postoperative pathology of an 82-year-old woman who presented with massive ascites, and an implant-like adenocarcinoma on her intrapelvic peritoneum, which revealed a minimal (<5mm) serous adenocarcinoma on her left ovary and an intraepithelial carcinoma on inner surface of her right Fallopian tube.  The left ovarian serous adenocarcinoma may have originated as an intraepithelial carcinoma on contralateral Fallopian tube.
Spontaneous rupture of pregnancy luteoma
Authors: Bahat Pınar Yalçın , Çetin Berna Aslan , Turan Gökçe
Published: March 2017

Luteoma is a rare condition in pregnancy. In this article, we aimed to present a rare case of pregnancy luteoma detected during cesarean section and pathologically in the context of literature information.
ETHICS IN CHILD AND YOUTH CARE PRACTICE WITH TRANSGENDER YOUTH
Authors: Clark Beth A.
Published: March 2017

Issues that arise in child and youth care practice with transgender (trans) youth and their families can be complex and ethically challenging. While many trans youth are thriving and have strong family and social supports, others face family conflict and experience negative health outcomes linked to societal stigma. The purpose of this paper is to explore how four ethical approaches — bioethics, rights-based ethics, relational ethics, and justice-doing — may be applied to practice situations involving trans youth and their families. This paper is grounded in the gender affirmative model of care and integrates empirical evidence, critical thinking, and explicit argumentation in ethical analysis. Following a brief overview of evidence related to trans youth care, case vignettes are analyzed using diverse ethical approaches. These approaches draw on a variety of philosophical and disciplinary traditions. However, the analyses consistently lead to three imperatives: providing support and affirmation for trans youth; supporting families to support their youth; and fighting injustice where it impedes these goals.
Polityka względem odnawialnych źródeł energii w Polsce i Japonii - analiza porównawcza
Authors: Kowalska Anna
Published: March 2017

W dobie globalizacji i coraz większej świadomości konsumentów dotyczącej troski o środowisko naturalne ważnym czynnikiem jest wdrażanie proekologicznych i zrównoważonych instalacji w celu ograniczenia negatywnego wpływu działalność ludzkiej na środowisko. Punktem zwrotnym troski o „czystą planetę” jest wykorzystywanie odnawialnych źródeł energii i zwiększenie ich udziału w całkowitym zużyciu energii elektrycznej. Celem artykułu jest analiza porównawcza uwarunkowań rozwoju energetyki odnawialnej w Polsce i Japonii. Pomimo deklarowanego zainteresowania energią odnawialną, w obu krajach praktyczne jej wykorzystanie pozostaje poniżej możliwości.
Enseñar en cuerpo y alma: la teoría de la enseñanza y el saber en la pulsión
Authors: Behares Luis Ernesto
Published: March 2017

En este trabajo intentamos aportar, en el marco de referencia de la Teoría del Acontecimiento Didáctico (TAcDi), al tratamiento del cuerpo como presencia-ausencia en la enseñanza, en torno al saber que allí es posible producir. Exploramos para ello la noción de “pulsión” y sus variaciones en la obra de Freud, a partir de lo cual incorporamos una visión triádica: representación consciente (Imaginario), desplazamiento inconsciente (Simbólico) y angustia (Real). Esta visión triádica abre interesantes perspectivas para trabajar en una teoría de la enseñanza que enfatice la cuestión del saber sin establecerse en términos cognitivistas.
O professor intérprete de língua de sinais em sala de aula: ponto de partida para se repensar a relação ensino, sujeito e linguagem
Authors: Souza Regina Maria de
Published: March 2017

O presente trabalho discute a necessária participação educativa do intérprete de língua de sinais em sala de aula. A partir da teoria do Acontecimento Didático sobre o ensino e das idéias de Derrida sobre o ato interpretativo, defende a tese de que tentar estabelecer limites para a atuação do intérprete educacional - na tentativa de fazer com que não se confunda com a figura do/a professor/a em sala de aula - é submeter-se a uma formação discursiva de ensino que o reduz ou ao currículo, ou ao método (técnicas) ou a intervenções que consideram tão somente a “capacidade” cognitiva do sujeito.
Evolução setorial do emprego nas regiões chilenas no período de 2007-2009
Authors: Cardozo Daniela Peres , Oliveira Gilson Batista de
Published: March 2017

Este artigo tem como objetivo analisar a variação setorial e regional do emprego chileno entre os anos de 2007 e 2009. Para tanto, utilizou-se a metodologia shift-share (estrutural-diferencial), uma ferramenta de dados estatísticos que possibilita identificar os distintos fatores relacionado à variação do emprego, variação essa atribuída a  aspectos estruturais e diferenciais. Setorialmente, os resultados apresentados indicam que os setores exportadores foram os que tiveram os piores desempenhos, sendo o componente estrutural explicativo para o fato. Em relação às regiões, Tarapacá, Coquimbo, Valparaíso, Maule, Araucanía, Aysen, Magallanes y la Antártica Chilena e a Região Metropolitana apresentaram as maiores taxa de crescimento na criação de emprego, enquanto as demais ficaram abaixo da média nacional. Desse modo, o presente trabalho ressalta a importância da aplicação e leitura da análise regional para avaliar, bem como para estabelecer uma agenda de políticas regionais e nacional após diagnosticar suas deficiências setoriais.
O efeito do Programa Territorial nas relações sociais dos agricultores familiares do Território da Cidadania do Vale do Rio Vermelho, em Goiás, Brasil
Authors: Camargo Ricardo de Siqueira , Medina Gabriel
Published: March 2017

Este artigo avalia os efeitos do programa territorial PROINF nas relações sociais de agricultoresfamiliares e também entre os membros do Conselho Municipal de Desenvolvimento Rural Sustentável(CMDRS). Os resultados mostram que os investimentos ocorridos em benefício direto dos agricultoresresultaram em maior desenvolvimento local do que aqueles voltados às esferas intermediárias de mediaçãoda política territorial.
O Português Centro Histórico de São Francisco do Sul (BR): um atributo para o turismo cultural
Authors: Rossini Diva de Mello , Tricárico Luciano Torres , Tomelin Carlos Alberto
Published: March 2017

Este artigo divulga a importância da preservação da memória e da identidade por meio da conservação do patrimônio histórico construído, o qual pode se tornar um atributo para o desenvolvimento do turismo cultural. Os locais de realização do estudo foram a Baixa Pombalina em Lisboa (PO) e o centro histórico de São ‘Francisco do Sul (BR). O método aplicado foi de Rossini (2014), cujas categorias de analise da paisagem foram hierarquizadas por análise de redes sociais.
Risk Factors of Neonatal Sepsis: A Preliminary Study in Dr. Soetomo Hospital
Authors: Utomo Martono Tri
Published: March 2017

The risk factors of developing neonatal sepsis could be caused by maternal and neonatal risk factors. Objective to determine the characteristics and risk factors for neonatal sepsis. Study design was case control study. The data of neonates were taken from the medical record. Neonates who were admitted in neonatal care unit of Dr. Soetomo hospital were included at January 2010 to February 2010, and divided into 2 groups, one group was sepsis cases and other group was non sepsis cases as a control. The risk factors that associated with sepsis were studied. Chi square and logistic regression analysis were used to analyze the data. 97 patients were includedand 31were sepsis cases and non sepsis case were 66. The risk factors that significantly cause sepsis are low birth weight (p=0.001 OR 2.75, 95% CI 1.454–5.200) , prematurity (p=0.000, OR 4.073, 95% CI 2.180–7.609), meconeal amniotic fluid (p=0.029, OR 2.535,95% CI 1.225–5.245) and C-section (p=0.032, OR 1.895, 95% CI 1.087–3.303). The significant risk factors of the neonatal sepsis arelow birth weight, prematurity, meconeal amniotic fluid, and caesarian section
Correlation between soluble urokinase plasminogen activator receptor with CD4 T lymphocyte and WHO clinical staging of HIV infection
Authors: Wardhani Shinta Oktya , Burhan Niniek , Ismanoe Gatoet , Yudani Tri
Published: March 2017

The urokinase-type plasminogen activator (uPA) and its receptor play a key role in pericellular proteolysis, cell migration and signal transduction. Previous study showed that suPAR could be used as an independent prognostic marker of disease progression in HIV-1 patients.1,17 Immune status of HIV patient and progressivity of disease are important parameters used as clinical concideration before initiating anti retroviral treatment and for monitoring treatment effectivity. Recently immune status of HIV patients is determined by CD4 T lymphocyte counting which represents the remaining healthy lymphocyte T expressing CD4 that very expensive and need special laboratory equipment. Destruction and shedding of T lymphocyte, macrophage and natural killer cell will deliver soluble urokinase plasminogen activator receptor, a surface protein which is expressed by those cells and can be measured by ELISA8,9,11. This study objective is to determine correlation between suPAR plasma concentration and CD4 T lymphocyte and WHO clinical stagging of HIV infection. Study subjects. Fifty four naieve HIV-1-infected patients (32 males, and 22 females) are participant in a cross sectional study enrolled on 22 November 2007 until 31 july 2008 at the department of infectious disease Saiful Anwar Hospital, Malang, Indonesia. Blood sampling. Two blood samples were drawn before treatment, CD4 counts were measured with an Epics XL-MCL Coulter flowcytometer. EDTA plasma for suPAR measurement was stored at -80°C. Data are presented as mean±standart deviation. P<0.05 is considered significant. Statistical calculations were done using SSPS 15. Patients (n = 54) enrolled and clustered according to WHO clinical stage ( I - IV) at inclusion. All HIV-infected patients had measurable levels of plasma suPAR with a median value of 8,9 ng/mL(range 1,65-29,7 ng/mL). Pearson correlation demonstrated a weak but significant negative between suPAR and CD4 T lymphocyte count (p=-0.634, p<.0005). suPAR level positively correlated with the WHO-defined clinical stages (P< .0005, spearman correlation test, r=0,87). There were significant difference between each stage i.e I(1,6± o,61ng/mL), II(3.04±1.03 ng/mL), III (10.53±7.1ng/mL) and IV (20.42±10.81ng/mL) (P< .0005, Spearman test). In addition pearson correlation demonstrated a weak but significant negative correlation between suPAR and CD4 count (p=-0.66; P<.0005). There were negative significant correlatio between CD4 count and suPAR level, suggested that suPAR could provide as a complementary biological marker for HIV-1 although it can not replace the CD4 count. SuPAR plasma concentration and clinical stage give significantly correlation with WHO clinical staging of HIV infection.
THE EFFECTS OF NICOTINE ON THE PERIODONTAL TISSUE
Authors: Herawati Herawati , Sunariani Jenny
Published: March 2017

Tobacco contains thousands of chemical substances which known to be harmful to periodontal tissues. Nicotine was considered as the most toxic substances to periodontal tissues. The datas in this review indicate that smoking may have a significant role in the initiation and progression of periodontal destruction. The conclusion of this and the other studies indicate that smokers have a less favorable response to periodontal therapy than non smoker. Nicotine is potentially toxic substances that have a detrimental effect on periodontal tissue, by altering the host response or directly damage the cells of normal periodontium.
RECCURENT LARYNGEAL PAPILLOMA
Authors: Purnami Nyilo , Fathoni Rizka
Published: March 2017

A case of respiratory papillomatosis was reported. The patient suffered from the disease since eight months old with chief complaint progressive hoarseness and dyspnea. It was diagnosed with respiratory papillomatosis and scheduled for performing tracheotomy and continued with the first microlaryngeal surgery (MLS). Decanulation was taken after 2nd surgery of removing papillomas. Finally was reported she got serial of surgery for 22 times during 18 years of age. It was costly and deteriorating quality of life. The problem remains persisted because of frequent recurrences and need for repetitive surgeries. Specimen biopsy for histologic examination was shown the signs of HPV infection, papilomatic coated squamous epithel with mild dysplasia and coilocytosis. The threatening of upper airway obstruction is the main important reason for patient's coming. The patency of airway assessed by Direct Laryngoscopy then the next treatment was decided with schedule of Micro Laryngeal Surgery (MLS). Finally the MLS treatment is just only for temporarilyrecovery. A further research to define the proper treatment in the future is required, especially for prevention of the diseases related to the viral causes of infection.
THE PRELIMINARY STUDY OF ANTIOXIDANT ACTIVITY FROM XYLO-OLIGOSACCHARIDE OF CORNCOB (ZEA MAYS) HYDROLYSIS PRODUCT WITH ENDO-β-XYLANASE ENZYME
Authors: Yamani Laura Navika , Kristanti Alfinda Novi , Puspaningsih Ni Nyoman
Published: March 2017

Xylo-oligosaccharide derived from corncob hemicellulose has been reported to possess antioxidant activity. In order to assess the effective scavenging of xylo-oligosaccharide, we conducted in vitro studies based on self-made xylo-oligosaccharide with DPPH (2,2diphenyl-1-picrilhydrazil) method. Xylo-oligosaccharide was prepared with enzymatic hydrolysis. The enzyme used for hemicellulose hydrolysis was endo-β-xylanase enzyme from PC-01 isolated bactrerium. PC-01 isolated bacterium used in this study was Pacet hot spring which was isolated from East Java. Endo-β-xylanase enzyme is an extracelluler enzyme. There was about 0.199 U/mL after purification and dialysis process. Hydrolisis product of hemicellulose A and B from corncob were analyzed with TLC (Thin Layer Chromatography) and HPLC (High Performance Liquid Chromatography). This analysis showed that hydrolysis product of hemicellulose B had a lot of xylo-oligosaccharide hydrolysis product of hemicellulose than Xylo-oligosaccharide hydrolysis product of hemicelluloses A. Xylo-olygosaccharide was analyzed as on antioxidant activity. Xylo-oligosaccharide hydrolysis product ofhemicellulose B (IC = 48.96) has higher antioxidant activity than Xylo-oligosaccharide hydrolysis product of hemicellulose A (IC 50 50 = 92.302). The toxicity of xylo-oligosaccharide can be calculated by the value of LC 50 (Lethality concentration). LC of xylooligosaccharide derived from corncob hemicellulose was 400 ppm so that xylo-oligosaccharide has anti tumor activity because xylooligosaccharide has LC 50 < 1000 ppm.
PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS?
Authors: Hadi Usman , Kuntaman Kuntaman , Qiptiyah Mariyatul , Paraton Hari
Published: March 2017

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.
Closed Expressions of the Fibonacci Polynomials in Terms of Tridiagonal Determinants
Authors: Qi Feng , Wang Jing-Lin , Guo Bai-Ni
Published: March 2017

In the paper, the authors nd a new closed expression for the Fibonacci polynomials and, consequently, for the Fibonacci numbers, in terms of a tridiagonal determinant.
Identities of the Chebyshev Polynomials, the Inverse of a Triangular Matrix, and Identities of the Catalan Numbers
Authors: Qi Feng , Guo Bai-Ni
Published: March 2017

In the paper, the authors establish two identities to express the generating function of the Chebyshev polynomials of the second kind and its higher order derivatives in terms of the generating function and its derivatives each other, deduce an explicit formula and an identities for the Chebyshev polynomials of the second kind, derive the inverse of an integer, unit, and lower triangular matrix, present several identities of the Catalan numbers, and give some remarks on the closely related results including connections of the Catalan numbers respectively with the Chebyshev polynomials, the central Delannoy numbers, and the Fibonacci polynomials.
An Effective Supervision Model of a Standard Clause for Consumer Protection in the Business Transactions
Authors: Syamsudin M. , Anto M. Bekti Hendrie , Kurniyanto M. Nur Laili Dwi , Puspitasari Intan
Published: March 2017

This research aims to form an effective supervision model of a standard clause to protect consumer’s rights and interests. This study answers the questions the effectiveness of a standard clause supervision carried out by Otoritas Jasa Keuangan [Financial Services Authority (OJK)] and Badan Penyelesaian Sengketa Konsumen [Consumer Dispute Settlement Agency (BPSK)]; effective supervision model of a standard clause which can protect the rights and interest of the consumer. The object of this study are OJK and BPSK as a supervision of a standard clause. The result of this research shows that the supervision of standard clause done by those institutions has not been effective yet, this caused by several factors to wit the weakness of implementing regulation in terms of supervision, unclear supervision mechanism, the weakness of socialization related to the rules of standard clause towards business actors, and other weakness and obstacles faced by both institutions. The effective supervision model of standard clause is being formed that based on five points, namely: (1) the needs of institution/agency reformation who authorize to do supervision of standard clause; (2) the needs to determine the scope of duty and authority of standard clause supervision institution; (3) the needs of determination of material range about standard clause subjected to supervision which comprises: the content, the form, the position and the expression; (4) the needs of precise mechanism of standard clause supervision conducted by supervision institution; (5) the needs of following up the supervision results, especially to the business actors who break the standard clause rules.