bluuebunny/crossref_metadata_2025 huggingface dataset:
The Covid-19 pandemic and the implementation of telehealth in speech-language and hearing therapy for patients at home: an experience report
Authors: Dimer Nathalia Avila , Canto-Soares Natalia , Santos-Teixeira Larissa dos , Goulart Bárbara Niegia Garcia de
Published: May 2020

We present an experience report on the implementation of real-time telehealth in speech-language and hearing therapy for patients who were previously seen on an outpatient basis in a primary health care service. Twenty-five users were being monitored by the Speech-Language Therapy (SLT) team when the first cases of COVID-19 were notified in southern Brazil. Of these, it was judged that twelve patients required at least a monitoring call every two weeks. Teleconsultations were available in this first stage, on an emergency basis, during the implementation of the project in this format. The idea was to guarantee, due to the suspension of the SLT sessions, the maintenance of the care service for patients who could suffer worsening of their cases or even comorbidities. The appointments were carried out by video calls by SLT students, therapists of the extension project, and supervised by a speech-language therapist, synchronously. All conversations and orientations during the teleconsultation were conducted as calmly as possible and, in the case of infant patients, permeated by some playful activities. Telehealth has shown to be an efficient resource for the care of patients with SLT demands, enabling remote care with the same quality as face-to-face care. In addition, it has relevant potential, considering that there are a significant number of patients who need SLT assessment and live in regions where there is a shortage of qualified professionals.
Evidências de Validade da Escala de Orientação à Dominância Social no Brasil
Authors: Vilanova Felipe , Soares Damião , Duarte Michael de Quadros , Costa Angelo Brandelli
Published: May 2020

O presente estudo buscou adaptar a SDO7 para o contexto nacional, propor uma versão reduzida do instrumento, avaliar sua estrutura fatorial e evidências de validade entre grupos. Para tanto, realizou-se coleta de dados online em que participaram 1056 indivíduos de quatro diferentes amostras. Análises fatoriais confirmatórias indicaram os melhores índices de ajuste para a estrutura original de quatro fatores, sendo dois substanciais (Dominância e Anti-Igualitarismo) e dois de método (pró-traço e contra-traço). Os fatores substanciais, denominados “Dominância Social” e “Anti-Igualitarismo”, apresentaram alfa de Cronbach superior a 0,70 em todas as amostras. As versões longa e reduzida da escala apresentaram bons índices de validade de critério entre grupos com correlações altas entre os escores fatoriais dos fatores substanciais e a autocategorização política. Portanto, o instrumento apresentou evidências de validade e fidedignidade para o contexto nacional e podem ser utilizados em estudos futuros.
A Phase II Trial of Cabozantinib in Hormone Receptor-Positive Breast Cancer with Bone Metastases
Authors: Xu Jing , Higgins Michaela J. , Tolaney Sara M. , Come Steven E. , Smith Matthew R. , Fornier Monica , Mahmood Umar , Baselga Jose , Yeap Beow Y. , Chabner Bruce A. , Isakoff Steven J.
Published: May 2020

Background

We assessed the antitumor activity of cabozantinib, a potent multireceptor oral tyrosine kinase inhibitor, in patients with hormone receptor-positive breast cancer with bone metastases.

Patients and Methods

In this single-arm multicenter phase II study, patients received an initial starting dose of 100 mg, later reduced to 60 mg, per day. The primary endpoint was the bone scan response rate. Secondary endpoints included objective response rate by RECIST, progression-free survival (PFS), and overall survival (OS).

Results

Of 52 women enrolled, 20 (38%) experienced a partial response on bone scan and 6 (12%) had stable disease. Prior to the first repeat bone scan at 12 weeks, 19 (35%) patients discontinued study treatment because of early clinical progression or unacceptable toxicity. RECIST evaluation based on best overall response by computed tomography revealed stable disease in extraosseous tissues in 26 patients (50%) but no complete or partial responses. In 25 patients with disease control on bone scan at 12 weeks, only 3 (12%) patients developed extraosseous progression. The median PFS was 4.3 months, and median OS was 19.6 months. The most common grade 3 or 4 toxicities were hypertension (10%), anorexia (6%), diarrhea (6%), fatigue (4%), and hypophosphatemia (4%).

Conclusion

Bone scans improved in 38% of patients with metastatic hormone receptor-positive breast cancer and remained stable in an additional 12% for a minimum duration of 12 weeks on cabozantinib. Further investigations should assess the activity of cabozantinib in combination with other hormonal and other breast cancer therapies and determine whether bone scan responses correlate with meaningful antitumor effects. ClinicalTrials.gov  identifier. NCT01441947

Implications for Practice

Most patients with metastatic hormone receptor-positive (HR+) breast cancer have bone involvement, and many have bone-only disease, which is difficult to evaluate for response. This phase II single-arm study evaluated the clinical activity of the small molecule MET/RET/VEGFR2 inhibitor cabozantinib in patients with metastatic HR+ breast cancer with bone metastases. This study met its primary endpoint, and cabozantinib treatment resulted in a significant bone scan response rate correlating with improved survival. This is the first study to use bone scan response as a primary endpoint in breast cancer. The results support further study of cabozantinib in HR+ breast cancer.
O Exame de Suficiência na percepção dos alunos de Ciências Contábeis
Authors: Silva Joelson Viscovini da , Durigon Almir Rodrigues , Mattiello da Silva Juliana Vitória Vieira , Santos Rubens dos
Published: May 2020

O Exame de Suficiência é definido pelo Conselho Federal de Contabilidade (CFC) como prova de equalização destinada a comprovar a obtenção de conhecimentos médios, consoante aos conteúdos programáticos desenvolvidos nos cursos de bacharelado em Ciências Contábeis. Considerando esse contexto, este artigo objetiva identificar as percepções dos alunos sobre a realização do exame de suficiência. O estudo classifica-se em pesquisa exploratório-descritiva, dispondo de coleta de dados realizada por meio de um questionário aplicado pessoalmente pelos pesquisadores, contando com a participação de 188 alunos de graduação em Ciências Contábeis (cerca de 58,75% da população), de uma universidade pública do Estado de Mato Grosso, no ano de 2019. Os dados foram tratados com as seguintes técnicas estatísticas: estatística descritiva (média, mediana, frequência, máximo, mínimo e soma) e análise fatorial. Os resultados da pesquisa indicam que a importância e necessidade de aplicação do exame de suficiência para a profissão contábil é considerada a mais valorizada pelos discentes. Na análise fatorial, ficou evidente que valorização profissional tem maior peso nas percepções dos alunos (88,15%), seguido do ambiente acadêmico com 6,39%. Conclui-se que o Exame de Suficiência, na percepção dos alunos, é um instrumento que valoriza a profissão contábil, entretanto é necessário que os docentes discutam mais pontualmente sobre essa temática em sala de aula.
Correlação entre dois testes e a pontuação do Child Health Assessment Questionnaire em crianças com cardiopatia reumática
Authors: Gonçalves Fernanda Souza , Moreira de Almeida Suzana Souza , Santos Juliana Costa , Mendes Carlos Maurício Cardeal
Published: May 2020

INTRODUÇÃO: As crianças que evoluem para cardiopatia reumática passam a conviver com limitações, tornam-se comumente restritas no desempenho de atividade do cotidiano. OBJETIVO Verificar a existência de correlação entre o desempenho no teste de caminhada de seis minutos (TC6M) e do degrau de três minutos (TD3) e a pontuação do  child health assessment questionnaire (CHAQ) em criança com febre reumática. MÉTODOS: Estudo seccional sem grupo de comparação, descritivo e exploratório, realizado com 15 crianças. Foram avaliadas através dos testes submáximos, o TC6M e o TD3 e a avaliação da capacidade física sob a percepção do cuidador foi realizada por meio da aplicação do  CHAQ . RESULTADOS: A média de idade 13,7 anos, desvio padrão 1,9 anos. A maioria dos acompanhantes eram mães, 66,7%, e uma parcela considerável dos cuidadores apresentou baixo nível socioeconômico e de escolaridade. O valor obtido na distância percorrida através do TC6M demonstrou um baixo desempenho, mediana (intervalo interquartil) 420 (101) metros que também foi observado no teste do degrau de três minutos, mediana (intervalo interquartil) 68 (6,5) degraus. Em relação ao questionário CHAQ foi observado ausência de comprometimento da capacidade física diante da percepção dos responsáveis com escore final do questionário de 0,1. A correlação entre o questionário e o teste de caminhada de seis minutos (correlação de Sperman = - 0,21) e, entre o questionário e o teste do degrau de três minutos, (correlação de Sperman = - 0,39). CONCLUSÃO: Não foi encontrada correlação dos testes submáximos, em relação à capacidade física obtida através da percepção dos responsáveis avaliada através do questionário. Esse resultado chama a atenção para a importância do fisioterapeuta inserir na sua prática clínica, nesse perfil de pacientes os testes submáximos.
Respiratory Management of Myotonic Dystrophy
Authors: John R Bach , Giulio Chiarello , Somnath Gonapa
Published: May 2020

Patients with myotonic dystrophy can avoid episodes of respiratory failure by using up to continuous noninvasive ventilatory support (CNVS). Of 154 patients consecutively presenting to a neuromuscular disease clinic, 143 had types 1 or 2 and 11 had congenital myotonic dystrophy. Of the 76 who came multiple times, 41 were prescribed and used at least sleep NVS to relieve symptoms of fatigue and hypersomnolence. They had sleep and end-tidal (Pet) CO2 with highs over 50 mm Hg and many 4% or greater O2 desats per hour of sleep and all had mean sleep O2 sat levels less than 95% before beginning sleep NVS. Thirteen eventually had to extend NVS use into and eventually throughout daytime hours for CNVS. While using NVS during the day their arterial blood gases were within normal limits. When the 41 were using NVS only during sleep, 24 of the 41 also had normalization of diurnal SpO2 to ≥ 95% and decreased hypercapnia. The 41 patients have been using sleep NVS for 6.70±3.64 (range = 0.75 to 19) years per patient or for 274.7 patient-years. Seventy-two have died or been lost to follow-up. The 13 up to CNVS users have been doing so for 75.7 patient-years or a mean of 5.8±3.2 (range = 0.2 to 10) years per patient. The VC from first visit to most recent visit of all 71 decreased a mean 49.3±168.8 ml or about 1.5% per year. it decreased a mean 52±171 per year for the 41 NVS users over 274.7± 3.64 patient-years.
Does Changing Electoral Systems Affect (Corrupt) Particularistic Exchanges? Evidence from the Italian Case
Authors: Piattoni Simona , Giglioli Matteo Fabio Nels
Published: May 2020

The literature on forms of particularism explores the impact of institutional variables on what is denoted, alternatively, as constituency service, pork-barrel politics, or corruption. Attention has mostly been given to electoral systems, but other institutional provisions and political factors, such as party strength, are also relevant. The present contribution investigates the likely effects of electoral reforms on corruption control and seeks confirmation of the hypothesis that single member plurality (even within mixed member) systems are conducive to a type of particularism that might help fight corruption, taking Italy as a case. We test the impact of two electoral reforms and three electoral systems enacted in Italy between 1996 and 2016, whose primary aim was bolstering enfeebled party leaderships and facilitating the formation of durable governments, and we compare the effort at corruption control of the Italian governments born under these different electoral systems with those of other European democracies.
Features Results of ancient soils paleopedological studying near v. Troyanove on Kyrovogradschyna
Authors: Matviyishyna Zhanna , Parkhomenko Oleksandr
Published: May 2020

The old (Upper Pleistocene and modern soils inside of ancient settlement near v. Troyanove on Kyrovogradschyna (Ukraine) during complex archeological investigation with archeologist L.L. Zaliznyak. The paleopedological method with wide applying of geoarcheological approach was using for to set soil types, trends of development and changes of climate in time as result of comparing of ancient and modern soils. According to invitation of doctor of historic sincere archeologist prof. L.L. Zaliznyak authors studied Upper Paleolithic soils inside of ancient settlement near v. Troyanove on Kyrovogradschyna. The aim of studying were: to determined types of the buried soils; according possibility to reconstruct human habitation nature conditions of the last; to set trends of climatic changes in time. The publications which have attention to the trend of Holocene soils development; the profiles of ancient and inside of ancient v. Troyanove on Kyrovogradschyna. The aims studying were: to determined types of the buried soils; according possibility to reconstruct human habitation nature condition of the last; to set trends of climatic changes in time. The publications which have attention to the trend of Holocene soils development and profiles of ancient and modern soils were analyzed. The last were studied in the 3-th section, but only in the section 1 and 2 archeological artifacts were found out. In the section 1 siliceous material was laying lower of modern soil in Bug loess above vitachiv soil surface. In the section 2 modern chernozem had thickness 0,8-0,9 m and in lower part had erosion loud withBug loess where archeological material we concentrating in sediments. So, in the 1 section as well as in the 2-th section there were artifacts in the upper part of the Bug loess (about 24000 BP). Losses, that were keeping, according paleopedological (including micromorphological) data signs of formation in the cold or temperate-cold climate of steppe with spreading of rarely forest and bushes in the river valleys and gullies. May be there was the stage of sediments interraption between big loess and modern soil formation. In the section 3 background soil is represented by the Holocene chernozem about 0,9 m thick with clear Pk. Comparing modern and ancient soil (the last with siliceous material) allowed to conclude about grow warm conditions of climate for modern soil formation. In the modern time territory is disposing in the forest-steppe zone of temperate-warm climate, but in the Paleolyte conditions of temperate-cold or cold steppe climate were prevailed. More late investigations allowed to summary red data about nature conditions of habitant living in Kyrovogradschyna in the monography under redaction of L. L. Zaliznyak with coauthors Matviyishyna Zh. and S. Doroshkevich of 2013 “Ancient last of Novomyrgorodschina” (in Ukrainian).
Natural territorial folds of the upper reaches of the Lazeshche basin within the limits of Chornogora
Authors: Melnyk Anatolii , Karabiniuk Mykola , Kostiv L. , Senychak D. , Yaskiv B.
Published: May 2020

The article presents the results of the study of the landscape structure of the upper part of the Lazeshchyna basin within the limits of Chornogory. The tracts, streets and highlands were the objects of mapping. The research was carried out according to the methodology of Field Landscape Research by G. P. Miller (1974) with the wide use of literary sources, topographic maps and stock materials (geological, geomorphological maps, maps of Quaternary deposits), aerophotographic and cosmic images, and the ArcGis 10 software environment. Rich landscape features of the study area form six high altitudes: a mild convex denudation alpine-subalpine highlands with white-and-blueberries wilderness and meadow grass on mountain-meadow-brown and mountain-peat and brown soils; sharply concave long-glacial-erosional subalpine highlands with formations of deciduous and coniferous shrubs on mountain-peat and brown soils in a complex with rocky deposits and outcrops of indigenous rocks; mild convex denudation cold forested middle class with the domination of spruce forests on burozems; old-glacial-accumulative wooded middle mountains with the domination of spruce forests on brown soils; steep-eroded erosion-denudation forest of middle with domination of cyprinid and fir-beech- spruce-wood forests on brownfields; terraced bottom of river valleys with cold, humid climates and rivers of flood regime, with formation of fires, gray alder and secondary grass meadows on sod-brown soils and burozems. The morphological structure of highlands is expressed by twenty landscape streams and one hundred and thirty-two tracts. Established that the rough part of the main ridge of Chornogory between the peaks of Hoverla and Petros belongs to the high-altitude area of the miteconvex denudation forest middle middle with the domination of spruce forests on the brownfields, and not to the high-altitude area of the miteconvex denudation Alpine subalpine highlands with white-and-blueberries and wild mushrooms on mountain-meadow-brown-earth and mountain-t'orfyano-brown soils, as previously thought. For the first time, for the territory of the Ukrainian Carpathians, within the terraced bottoms of the river valleys with cool climate and rivers of flood regime, with the formation of feldspar, gray alder and secondary grass meadows on sod-brown soils and burozems, two new rows were discovered and encoded: the convex surfaces of low ridges composed of proluvial (muddy) deposits, represented by the depths, gravel and loam with crushed stone, with moisturite on rubbers; and the surfaces of the terraces are made in the water-glacial sediments represented by boulders, loams and sunsets and boulders and sand-pebble alluvium in the rivers of the year with the formation of fir and green alder on brown soils.
Six Degree-of-Freedom Broadband Ground-Motion Observations with Portable Sensors: Validation, Local Earthquakes, and Signal Processing
Authors: Yuan Shihao , Simonelli Andreino , Lin Chin-Jen , Bernauer Felix , Donner Stefanie , Braun Thomas , Wassermann Joachim , Igel Heiner
Published: May 2020

The additional observation of three components of rotational ground motions has benefits for tilt-seismometer coupling (e.g., ocean-bottom seismometry and volcano seismology), local site characterization, wavefield separation, source inversion, glacial and planetary seismology, as well as the monitoring of structural health. Field applications have been mostly hampered by the lack of portable sensors with appropriate broadband operation range and weak-motion sensitivity. Here, we present field observations of the first commercial portable broadband rotation sensor specifically designed for seismology. The sensor is a three-component fiber-optic gyro strictly sensitive to ground rotation only. The sensor field performance and records are validated by comparing it with both array-derived rotation measurements and a navigation-type gyro. We present observations of the 2018 Mw 5.4 Hualien earthquake and the 2016 central Italy earthquake sequence. Processing collocated rotation and classical translation records shows the potential in retrieving wave propagation direction and local structural velocity from point measurements comparable to small-scale arrays of seismic stations. We consider the availability of a portable, broadband, high sensitivity, and low self-noise rotation sensor to be a milestone in seismic instrumentation. Complete and accurate ground-motion observations (assuming a rigid base plate) are possible in the near, local, or regional field, opening up a wide range of seismological applications.
Um olhar sobre os percorridos históricos da educação ambiental em uma década de partilha no espaço lusófono e Galiza
Authors: Borges Aidil
Published: May 2020

Decorridos pouco mais que uma década da criação da Rede Lusófona e da realização regular dos encontros e Congressos lusos, sob o pano de fundo da Educação Ambiental nos oito territórios e regiões que compõe a comunidade lusófona, eis que aproveitamos deste momento para um olhar retrospetivo dos percorridos históricos dos congressos lusófonos, que aconteceu durante as II Xornadas Internacionais de Educación Ambiental do Centro de Extensión Universitaria e Divulgación Ambiental de Galicia - CEIDA, em abril de 2018, no Castelo de Santa Cruz em Liáns, Oleiros, A Coruña. Sobrevoando sobre essa década decorrida da realização do primeiro congresso de Santiago de Compostela, seguidos dos de, Cuiabá, Murtosa e ilha do Príncipe, bem como a institucionalização dos encontros lusófonos regulares, em vários palcos de territórios lusos, com algum distanciamento pelo tempo percorrido, podemos afirmar que estes encontros trouxeram à comunidade um momento único de partilha, pondo a tónica na importância do debate cultural e no fortalecimento da Educação Ambiental, no cruzamento de diálogos entre os diferentes atores, conceitos e métodos, conhecimento das inúmeras experiências, vivências e políticas públicas. Passou-se em revista nestes encontros, o Estado geral das Artes, fez-se uma radiografia das verdadeiras identidades que pulsam e sobrevivem nestes territórios lusófonos dando voz aos diferentes grupos sociais para a construção de uma política social inclusiva do ponto de vista ecológico. Na atual conjuntura, tendo em conta os novos desafios e questionamentos que a nossa sociedade enfrenta, urge agora traçar novos rumos para que de forma firme e determinado se possa posicionar e travar o status quo, com uma estratégia Glocal (contração do global e do local), fortalecida em uníssono como o único caminho para juntos, enfrentarmos e vencermos as atuais adversidades que a sociedade se nos interpela no atual cenário global.
Histomorphological analysis of placental changes of pre-eclampsia patients in a tertiary care hospital of Puducherry, India
Authors: Samal Rupal , K. Anandraj Vaithy , Sowmya S.
Published: May 2020

Background: Placenta is a dynamic tissue synthesized physiologically to serve as a nutrient source for developing fetus it is exposed to several changes in reaction to many toxemic conditions associated with pregnancies. Studies had proved that placental changes observed on histomorphology is directly proportional to reaction to hemodynamic compensatory mechanisms, thereby aiding the obstetricians to manage the sequelae of complications. Objective of this study was to study the placental histomorphology in pregnancies associated with pre-eclampsia and to quantitate the observed placental changes.Methods: The study comprised on 101 placental specimens obtained from department of obstetrics and gynecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry. Toxemia of pregnancies were divided into mild, severe preeclampsia and eclampsia based on blood pressure. The 101 cases were divided as 4 groups: Group 1 (control group); Group 2 (mild preeclampsia); Group 3 (severe preeclampsia); Group 4 (eclampsia).Results: Among the 101 cases, 38 placentas were from uncomplicated full-term deliveries which constitutes the control group. The rest 63 placenta were from toxemia of pregnancies which constitutes the study group.Conclusions: The incidence of toxemic pregnancies and pre-eclamptic cases are on higher margin than assumed. Histomorphology examination of placenta plays a vital role in assessing etiopathogenesis and mechanism of toxemic pregnancies. This aids the obstetrician to further manage subsequent sequelae and fix the complication to significant proportion.
The relation between of insulin like growth factor II and endometrial carcinoma
Authors: El Sokkary Hossam Hassan , Hashad Doaa Ibrahim , Sallam Ahmed Nooman , Azzam Amal Zaki , Koura Mohamed Ebied Abo
Published: May 2020

Background: Endometrial cancer is the most common gynecologic malignancy in the United States and the fourth most common cancer in women. The need of a soft marker that can be used with CA-125 tumor marker for early detection of endometrial cancer and to predict late stages and advanced histopathological grades and to specify the cases who will be managed by complete surgical staging including para aortic and pelvic lymphadenectomy is of great importance. The aim of the study was to evaluate the role of insulin like growth factor 2 in endometrial carcinoma and to correlate it with different histopathological grades of the disease.Methods: This study was applied on sixty patients with abnormal uterine bleeding and were divided into two groups, Group A included 30 cases of endometrial carcinoma, while Group B included 30 cases complaining of abnormal vaginal bleeding due to other causes as a control group. Serum samples were taken from all patients and estimation of IGF-2 serum levels using ElISA technique was done. Comparison of IGF-2 serum level between both groups and correlation of its levels with different histopathological grades of endometrial cancer group were done.Results: As regard comparison between both groups and ILGF2 serum level, study results demonstrated that ILGF2 levels ranged between 600.0-1440.0 ng/ml and 40.0-560.0 ng/ml with the mean of 781.33 ng/ml±196.45 and 336.0 ng/ml±212.86 for cases Group A and control Group B respectively. There was a statistically significant difference between the two studied groups regarding ILGF2 serum level (p<0.001). As regards correlation between histopathological grades and ILGF-2 serum level in cases Group A, the study revealed a strong positive correlation.Conclusions: ILGF-2 can be used as a serum marker for endometroid adenocarcinoma of the body of the uterus and to predict its higher histopathological grades.
Eclampsia: a comparative study in a tertiary hospital setting in South-South Region of Nigeria
Authors: Ikeanyi Eugene M. , Abasi Isaac J.
Published: May 2020

Background: Eclampsia remains a leading cause of maternal and perinatal morbidity and mortality often in settings of poor health seeking behaviour and services. Objective of this study was to determine the incidence, investigate the risk factors, obstetric outcomes and suggest ways of improving the impact of eclampsia.Methods: An analytical observational study on consecutive cases of eclampsia managed in a tertiary hospital setting from 2014 to 2019. For each case of eclampsia recruited the next gestational hypertensive and normotensive cases managed in the period were recruited to serve as controls. Computer statistical software, Chi square for test of associations were used for analysis with statistical significance set at p<0.05.Results: Among 3625 deliveries within the study period were 57 cases of eclampsia; an incidence of 1.57%. Most (74.4%) were antepartum eclampsia. Majority of the eclamptic mothers were unbooked (81.4%), of lower social class (86.0%), poorly educated (81.4%) and nulliparous (58.1%). Eclamptic mothers were more likely to be youth ≤24 years (39.5%), teenagers (25.6%), and unmarried. Twenty-four (55.8%) had abdominal delivery, anaemia (23.3%) and were transfused. Three women died from eclampsia; a case fatality of 6.98%. Twenty-four (55.8%) neonates were preterm, low birth weight (48.8%), intrauterine growth restriction (25.6%), special care baby unit admission (32.6%) and perinatal mortality 13 (30.2%).Conclusions: Eclampsia is still an un-mitigating malady in this study settings with increased maternal and perinatal complications. Nulliparity, low social status, young age and lack of prenatal care appeared significant risk factors. Quality prenatal care, early detection and management of pre-eclampsia will mitigate eclampsia occurrence and severity. Women empowerment is proffered.
A prospective study of demographic profile, risk factors and pregnancy outcome in Hepatitis B and Hepatitis C virus positive pregnant women in a tertiary care centre
Authors: Sharma Arti , Agarwal Shubhra , Bajpai Garima , Singh Anupriya , Agarwal Nikita , Mishra Shweta
Published: May 2020

Background: Viral hepatitis is the most common liver disease in pregnancy and is also the most common cause of jaundice in pregnancy in tropical countries. Risk factors for transmission are intravenous drug abuse, surgical and dental procedures done without adequate sterilization of instruments, sexual route etc. Early diagnosis and management can prevent maternal and fetal complications. This study was done to evaluate the frequency, risk factors and pregnancy outcome in hepatitis B virus (HBV) and hepatitis C virus (HCV) positive antenatal women.Methods: This case control study was conducted in Teerthankar Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India from January 2017 to June 2018 on total 2511 pregnant women. The serum samples were checked for presence of hepatitis B surface antigen (HBsAg) and presence of IgG antibodies to HCV. Analysis of sociodemographic profile, risk factors and pregnancy outcome were done in all HBV and HCV positive women.Results: Out of 2511 pregnant women, 292 were tested positive for hepatitis. Maximum number of women were in the age group of 21-30 years. Most of the seropositive women were multipara. Frequency of positivity was maximum for HCV (67.1%). The risk factors for transmission in study population were intravenous drug abuse, blood transfusion, history of surgery and tattooing.Conclusions: Hepatitis infection rate is increasing. Universal screening for HBV and HCV can be recommended in pregnant women in developing countries. Education and awareness of public and health care workers can reduce the risk of transmission.
Efficacy of betadine vaginal toileting before caesarean section in postoperative infections
Authors: Kaur Tarang Preet , Rathore Asmita M. , Sahu Latika
Published: May 2020

Background: The objective of the current study was to evaluate the efficacy of preoperative betadine vaginal toileting in reducing post caesarean infections (endometritis, febrile illness, wound sepsis).Methods: This prospective longitudinal study was conducted at Maulana Azad Medical College, New Delhi over 3 months among 200 women who underwent caesarean delivery. Inclusion criteria were defined as women undergoing caesarean section. Exclusion criteria included placenta previa, active genital herpes, cord prolapse, chorioamnionitis, allergy to iodine. After taking informed consent, subjects were divided into two groups by simple randomization method using computer generated random numbers- Group 1 (case) - subjects who underwent 5% povidone iodine sponge stick cleansing in all the fornices and walls of vagina for 30 seconds after foley’s catheter insertion and before abdominal scrubbing. Group 2 (control) - subjects who didn't receive betadine vaginal toileting before caesarean section Subjects were followed for 10 days postpartum (or till suture removal/ discharge from hospital, whichever was late). Demographic data, operative details and postoperative parameters were compared between the two groups.Results: Both groups were matched for baseline patients’ characteristics (age, BMI, gestational age, operative time). Women who received preoperative betadine vaginal toileting had markedly less incidence of endometritis (case-3%, control-10%, p<0.05), overall postoperative morbidity (case-13%, control-33%, p<0.001). Incidence of postoperative febrile illness (case-6%, control-12%, p>0.05) and wound sepsis (case-5%, control-12%, p>0.05) were found to be less but not significant between both groups.Conclusions: Preoperative vaginal cleansing helps in reducing postoperative morbidity by decreasing incidence of postoperative infection.
Comparative study of mifepristone versus balloon catheter for cervical ripening and induction of labour in previous caesarean section
Authors: Dahiya Krishna , Yadav Nisha , Dahiya Pushpa , Nandal Isha
Published: May 2020

Background: The objective of this present study was to compare the efficacy of oral mifepristone and balloon catheter for cervical ripening and induction of labour in women with previous caesarean section.Methods: This prospective study was conducted on 130 pregnant women with previous 1 caesarean section and term singleton pregnancy admitted for induction of labour. Sixty-five patients were induced with oral mifepristone (Group 1) and in another 65 transcervical balloon catheter (Group 2) was inserted for induction of labour. Both groups were than compared with respect to change in bishop score, induction to active phase interval, induction to delivery interval, dose of oxytocin in milliunits, mode of delivery, maternal complication and fetal outcomes.Results: Change in bishop score after induction was more in mifepristone group than balloon catheter group (p=0.002). Favorable bishop score was more in Group 1 (83.07%) than Group 2 (66%), p=0.05. There was significant difference in mode of delivery between two groups, 61.53% in Group 1, and 32.3% in Group 2 delivered vaginally (p<0.001).Conclusions: Present study showed that mifepristone is an alternative to balloon catheter for induction of labour in women with previous one caesarean section with poor bishop score.
Geriatric gynecology: need and spectrum
Authors: Singh Mridula , Chourasia Sudha
Published: May 2020

Background: Geriatric gynaecology deals with gynaecological pathologies essential in post-menopausal women aged 65 years and above. The spectrum of geriatric gynaecological disorders in India differs from those in developed countries as there are no effective screening program for early detection of cancer and the burden of ignorance and taboos. In this study we aim to find the spectrum of gynaecological disorders in geriatric women and establish the need of dedicated geriatric unit.Methods: A cross-sectional comparative study was conducted on menopausal women of age 45 years or above who attended gynecology OPD for general counselling about menopause or treatment of menopausal problems over the period of 6 months duration. All these menopausal women attending OPD during this interval were evaluated on the basis of pretested questionnaire.Results: Out of 234 post-menopausal women who entered the study, 29% women belong to geriatric group. Post-menopausal bleeding due to both malignant and benign causes and pelvic organ prolapse are the major problems in geriatric women whereas somatic complaints like flushing, night sweats are more common in younger menopausal women.Conclusions: Where the medical science has successfully increased the life expectancy, focused approach to geriatric gynecology around us is our responsibility, where female still hesitate to come out. The need for dedicated geriatric gynecology unit in India on urgent basis is emphasized by this study wherein cancers can be screened in early stage and severe lifestyle hampering conditions like pelvic organ prolapse can be treated timely.
Management and therapeutic implications of combined protein C and S deficiency in pregnancy: a case report
Authors: Agrawal Neha , Ghuman Navdeep , Singh Pratibha , Kathuria Priyanka
Published: May 2020

The pregnancy is an immunocompromised state. Thus, autoimmune diseases may affect pregnancy and get worsen during pregnancy. Here authors discuss a rare autoimmune thrombophilia disorder, protein C and S deficiency which may cause recurrent pregnancy losses by affecting haemostatic mechanisms in the body. This patient with recurrent pregnancy loss when evaluated extensively was found to have combined inherited protein C and S deficiency. It was successfully managed with thromboprophylaxis therapy, which resulted in the delivery of healthy baby. Long term anticoagulant prophylaxis should be considered weighing the risk of bleeding to thrombotic recurrence in such cases. In conclusion, combined protein C and S deficiency and that too presenting as recurrent pregnancy loss is very rare. Thrombophilia screening should be considered in cases of recurrent pregnancy losses. Adequate and appropriate thromboprophylaxis is an important part of the management of pregnant women with inherited thrombophilia.
Changing trends of indication of caesarean section
Authors: Goyal Neelam , Pandey Harshita
Published: May 2020

Background: Percentage of previous C-section undergoing repeat section is close to 90%-92%, morbidity associated with repeat surgery is bringing an altogether new set of challenges for the upcoming future obstetricians. Object of this study is to highlight high incidence of repeat section required and also growing new indications of C-section due to advanced availability of investigative tools.Methods: Retrospective study of 500 patients who underwent C-section and their indications from April 2019 to July 2019 in Govt Doon Medical college, Dehra Dun.Results: Out of total 500 C-sections carried from April 2019 to July 2019, patients with previous section were found to undergo a repeat C-section in 95% of the cases. Another common indication being oligohydramnios followed by cephalopelvic disproportion and failed induction.Conclusions: After assessing the results it is hereby concluded that the commonest indication of C-section in present time is having a previous C-section, which alarms us to take careful judicious decision in performing primi C-sections in order to prevent patients into entering a vicious cycle of repeat surgeries.
Significant perceived stressors in irritable bowel syndrome: a stress interventional module analysed
Authors: Gupta Sanjay , Singh Nitesh Kumar , Verma Vinod
Published: May 2020

Background: Psychological stress is an important factor for the development of irritable bowel syndrome (IBS). More and more clinical and experimental evidences are showing that IBS is a combination of irritable bowel and irritable brain. As IBS is a stress sensitive disorder, its treatment should focus on managing stress and stress-induced responses.Methods: This is a hospital based longitudinal study. 72 patients fulfilling the Rome IV criteria for irritable bowel syndrome were enrolled into the study. Perceived stress was assessed using student stress dimension questionnaire (SSDQ) while IBS severity was assessed using IBS severity scoring system (IBS-SSS). The stress interventional module (SIM) consist of specific domain targeted psychological interventions given to the patients weekly based on the stress domain mapping. The effectiveness of these interventions on reducing stress as well as IBS severity was assessed at baseline, and weeks 2, 4 and 6 follow-ups.Results: Of the studied IBS patients, most had SPS in multiple life domains while familial and interpersonal domains were affected in 78%. Also, total stress load in form of mean cumulative stress load at baseline was 451.1 which decreased significantly to 274.4 over 6 weeks. This SIM brought about a reduction in mean irritable bowel syndrome severity score from 27.5 to 20.6 in 6 weeks. This reduction in IBS severity score overtime was significant (p=0.001).Conclusions: Patients of irritable bowel syndrome show significant stress in multiple domains of life, which require proper assessment and management. Authors propose that individual-specific interventions aimed at reducing stress in all psychosocial life domains are efficacious and should be an integral part of managing IBS.
Factors associated with nutritional status of under five children among Satar Community of Bhadrapur Municipality, Jhapa, Nepal
Authors: Sangroula Raj Kumar , Uprety Srijana
Published: May 2020

Background: Adequate feeding is basic right of human being. According to NDHS 2016, prevalence of stunting, wasting and underweight are 36%, 10% and 27% respectively. The prevalence may be more in underprivileged community like Satar community who reside in eastern part of Nepal. This study was conducted to assess the factors associated with under nutrition of under five years children of Satar community in Bhadrapur Municipality.Methods: A community based cross sectional study was conducted in Bhadrapur Municipality of Jhapa district which were purposively selected. Four wards where Satar community reside were selected for collection of data. Verbal informed consent was taken from the mothers of the under five children and approval was taken from research committee of Central Institute of Science and Technology College. Bivariate analysis was performed to detect the factors associated with nutrition status of children.Results: In the study, prevalence of stunting, wasting and underweight were high as compared to national data i.e. 39.5%, 14.2% and 29.5% percent respectively. The study found that maternal education, paternal education, family income, exclusive breastfeeding and food frequency was significantly associated with under nutrition (stunting, wasting and underweight). Stunting was significantly associated with age of child and mother and religion. Underweight was associated with religion and weaning of children.Conclusions: High prevalence of stunting, wasting and underweight are due to socio demographic factors like religion, educational status of father and mother, family income and child feeding practice. Programs should be focused on socio demographic and economic factors and child feeding practice to reduce problem of malnutrition.
Dominant factors on selection of contraception toward new family planning acceptors in public health center area in Padang
Authors: Rahmatiqa Chamy , Patricia Helena
Published: May 2020

Background: The use of family planning or as known as KB in Indonesia from 1970 to 2017 has increased significantly. The most use of KB in non MKJP was injection 70% and pill 21%. The use of this method was very influential on the level of family planning continuity. Viewed from the 2012 SDKI, the dropout rate in the injection method was 40.7%. This phenomenon has contributed to the stagnation of the total fertility rate  and ultimately still impact to the high maternal mortality rate in Indonesia.Methods: This analytic study was conducted with a cross sectional approach. The populations in this study were all new family planning acceptors and samples of 114 people were taken by random sampling technique. The data collection was a questionnaire with data analysis using chi-square test.Results: More types of contraception were non MKJP (66.4%), more early adult age (60.8%), education level was more than half of low education (54.4%), and most of the mothers were unemployed (76.8). The parity were more than 1 and 2 children (52.8%), more contraceptive goals who did not want their children (60%), and the low support of their husbands was more than the high support of their husbands (55%). There was a relationship between age, education level, work status, parity, contraceptive goals, and husband support with the selection of contraceptive methods in new family planning acceptors.Conclusions: The dominant factor on selection of contraception toward new family planning acceptors was husband support.
An evaluational study: the perception of mother about routine immunization attending anganwadi centre in urban Hapur, Uttar Pradesh
Authors: Pathak Nitin K. , Kumar Pankaj
Published: May 2020

Background: Immunization is the most powerful, safe and cost-effective measures for prevention/control of a number of diseases. The historical success of eradicating the dreaded disease, Smallpox, prompted World Health Organization (WHO) to ask its member countries to launch immunization against six vaccine preventable diseases in its national immunization schedule because unequivocal knowledge and practices helps to develop positive attitude towards vaccination and thus their contribution to vaccination. It helps to reduce the burden of dreadful infectious diseases, which are best controlled by vaccination. Poor maternal knowledge likely to results in partial immunization coverage or nill immunization coverage in children.Methods: Total 256 mother with children of aged 12-60 months were interviewed during four months duration, for the study. During the survey, 256 mothers having children between 12-60 months were interviewed through a pre-tested semi-structured questionnaire.Results: 97.08 mothers knew that immunization is to be started at birth, 39% of mothers knew that OPV protects against polio. All the mothers had received T.T during pregnancy as per schedule (93%) and 99% had received 2 doses. Maximum mother reported that information was received by ASHA/AWW.Conclusions: According to source of information the IEC activities should be increased and to improve the level of knowledge among mother of under five children.
Evaluation of the factors related to dental anxiety in North Indian population: a questionnaire study
Authors: Singh Iqbal , Bhat Nitish , Kaur Robindera , Thakur Kalpna , Nandan Hemwati , Bhardwaj Nandini
Published: May 2020

Background: To evaluate the factors affecting dental anxiety level on the basis of a questionnaire in the North Indian Population.Methods: A questionnaire based on the various factors related to dental anxiety was formulated and distributed among the various regions of the north India. We got response from 250 people, the data was then analysed and results were formulated.Results: Out of 450 questionnaires which were distributed, a total of 400 questionnaires were received. Overall high prevalence of dental anxiety i.e. 85% was noted. More increased values for anxiety were seen for people younger than 30 years (70%), compare to that of elder people (30%). Females seem to have greater anxiety levels as compared to males (p value >0.000). Among 450 people 176 had visited clinics previously with 98 having bad experience (55.6%) and 78 people having a relatively good past dental experience (44.2%).Conclusions: Anxious patients are often more difficult to treat, therefore the questionnaire proved beneficial in estimating factors related to dental anxiety. Young people, women and those having negative dental experience had the highest anxiety levels.
A study on the health seeking behaviour among the geriatric population in the urban field practice area of JJM Medical College Davangere
Authors: Dhar Ruchi , Vidya G. S.
Published: May 2020

Background: According to census 2011 the elderly population aged 60 years and above account for 8% of total population and is projected to rise to 12.4% by the year 2026. Health status is an important factor that has a significant impact on quality of life. The elderly is one of the most vulnerable and high risk groups in terms of health status and their health seeking behaviour is crucial in any society.Methods: A community based cross sectional study was carried out for a period of 1 year for which a predesigned and semi-structured questionnaire was used and a total of 440 elderly were interviewed by house to house survey.Results: In our study it was found that the majority of the subjects (36.8%) were in the age group of 60-64 years, 52.5% were illiterate, 51.1% were unemployed and 49% belonged to class IV socio economic status. Any degree of formal schooling was found to be associated with better health seeking behavior. Majority of the subjects (58%) visited a government health facility in case of an illness and the main reason that was stated for not visiting a health facility was that they suffered from mild discomfort (44.4%) and did not consider it necessary to visit a health facility.Conclusions: It was observed that more number of males visited a health care facility in case of an illness, 241 (92.7%) whereas only 154 (85.6%) females visited a health facility in case of an illness. This difference was found to be statistically significant.