bluuebunny/crossref_metadata_2025 huggingface dataset:
The results of efferent therapy by woman with HIV infection, with amniotic fluid outflow at 23 weeks with growth retardation syndrome of 2 fetus
Authors: Vetrov Vladimir V. , Ivanov Dmitry O. , Reznik Vitaly A. , Romanova Larisa A. , Melashenko Tat’yana V. , Shandrenko Ksenia A. , Krivolesova Tatiana A.
Published: January 2020

In the article presents data on the management of a 48-year-old patient with HIV infection, urogenital infection with pregnancy, which occurred as a result of IVF, with premature effusion of amniotic fluid at 23 weeks of pregnancy with the syndrome of growth retardation of 2 fetus in monochoric diamniotic twins. After the discharge of the amniotic fluid, the patient was treated for six days in an infectious hospital, then transferred to the perinatal center, where blood tests noted moderatemanifestations of endotoxicosis, increased levels of aminotransferases and an inflammatory reaction of the body. The course of treatment included detoxification methods (plasmapheresis, hemosorption, photomodification of blood with ultraviolet, laser rays), which contributed to the normalization of blood tests, prolongation of pregnancy for another three weeks in the absence of septic complications after operative childbirth in the mother and in newborn girls. At birth, 1 childs weight, body length and Apgar score were 750 g., 29 sm. and3/5points, respectively, in 2 children 590 g., 30 sm. and1/3points, respectively. The children required treatment from resuscitators, at the second stage of nursing, from rehabilitation specialists.
Imaging the Subsurface with Ambient Noise Autocorrelations
Authors: Clayton Robert W.
Published: January 2020

Autocorrelations created by stacks of near-offset traces from virtual source gathers are used to form an image of the deeper subsurface. We minimize the masking effects of the effective source time function by subtracting the survey-wide average autocorrelation from each trace. The result is a zero-offset reflection image of the subsurface generated by ambient noise correlation. The technique can be particularly useful for imaging the mid and lower crust, in which traditional seismic methods have penetration problems. We show examples from a one-component 3D survey and a three-component 2D profile. The 3D example shows the crust in the transition zone between the continent and the Inner Borderland in the Los Angeles, California, area, and for the first time, shows an image of the lower crust. The 2D profile provides both a P image and an S image of the basement interface in the San Bernardino basin in southern California.
The KHC Seismic Station: The Birthplace of Broadband Seismology
Authors: Kolář Petr
Published: January 2020

Nearly half a century has passed since the first broadband seismometer was installed by A. Plešinger and his team. The principles behind this instrument, as well as its features and new possibilities regarding broadband data mining, have been reported within the scientific literature. This text is intended as a commemoration of this pioneering work and also serves as a historical reminder of the social and political circumstances surrounding the time period of broadband seismometer introduction that are not mentioned in original works but that played an important role during broadband seismometer development.
Should it Stay or Should it Go? Smartphone Dependency
Authors: Foreman-Tran Kira , Schnurr Karina , Pardo Ana C. Ruiz , Minda John Paul
Published: January 2020

As smartphones grow in use and popularity, it is important to understand the possible effects that varying levels of smartphone use may have on human cognition. Although smartphones provide many advantages for daily activities, one must also recognize the potential disadvantages. For example, smartphone use may lead to nomophobia, which is defined as the modern fear of not being able to access your smartphone or the internet (Yildirim & Correia, 2015). The present study used a pilot and main study to examine the effects smartphones have on human cognition. The pilot study was conducted to measure nomophobia, mobile phone involvement, smartphone attachment and dependency, and general smartphone use. This portion was also used to determine the paradigm for the main study. Participants in the main study completed the 12 Cambridge Brain Science tasks, which measured different aspects of cognition' while leaving their smartphones in one of two locations: on their desk, or outside of the testing room. Additionally, participants completed the same four questionnaires from the pilot study. Results from both studies reveal the majority of individuals show moderate levels of nomophobia, dependency and attachment, and involvement. Subsequent data analysis focused on the double-trouble task, which is an attention-based task. Results found that there was no significant difference in performance on the double-trouble task between the two locations. Contrary to common belief, it seems that the mere presence of one’s smartphone does not affect performance on a cognitively demanding task.
A Study into the Demographics Having the Greatest Carbon Footprint
Authors: Xu Tony , Khalili Shayan
Published: January 2020

Our aim was to determine factors predicting greenhouse gas emissions per capita and to identify the demographics having the greatest carbon footprint. The relationship between socioeconomic trends and greenhouse gas emissions is controversial, given that many past studies evaluated only a single factor. We analyzed the relationship between global greenhouse gas emissions per capita and literacy rate, GDP per capita, urban population percentage, adolescent fertility rate, unemployment percentage, percent of agricultural land, research and development expenditure, renewable energy consumption, food production, population growth, mobile cellular subscriptions, air transport freight, and forest area. We gathered data from 217 countries spanning a period of 20 years; 1993 to 2012. We analyzed the data using multiple regression models. We concluded food production, renewable energy consumption, air transport, mobile cellular subscriptions, literacy rate, and population growth have the greatest impact on predicting greenhouse gas (GHG) emissions in our model, suggesting the demographic with the greatest carbon footprint are wealthy, educated people living in urban centers.
İlkokul Öğrencilerinin Gözünden Hayat Bilgisi Dersi
Authors: GÜNDOĞAN Aslı
Published: January 2020

Bu araştırmada ilkokul öğrencilerinin Hayat Bilgisi dersine yönelik görüşlerini belirlemek amaçlanmıştır. Araştırmada nitel araştırma yöntemi benimsenmiştir. Bu bağlamda fenomenolojik desenden yararlanılmıştır. Araştırmanın katılımcılarını Uşak ilindeki bir ilkokulda öğrenim gören 20 ilkokul üçüncü sınıf öğrencisi oluşturmuştur. Araştırma verileri yarı yapılandırılmış görüşmeler ile toplanmış; ses kayıt cihazı ile kayıt altına alnımıştır. Verilerin analizinde tematik analizden yararlanılmıştır. Araştırma sonuçlarına göre öğrenciler hayat bilgisi dersinin kapsamına yönelik gerçek yaşamla ilgili olduğunu, günlük sorunlarla başa çıkabilmede kimi bilgi ve beceriler kazandırdığını, temel değer ve düşünceleri barındırdığını ve onların eğlenme gereksinimlerini karşıladığını ifade etmişlerdir. Öğrenciler, öğretmen rolünü geleneksel özelliklerle ilişkilendirmişler; öğrencilerin pasif roller üstlendiği belirtmişlerdir. Bunun yanında öğrencilerin Hayat Bilgisi dersini ders dışı etkinliklerle işlemek istedikleri ancak bunu gerçekleştiremedikleri belirlenmiştir. Dersin değerlendirme boyutunda, öğretmenin sıklıkla test, soru-yanıt tekniklerini kullanmayı tercih ettiğini ortaya çıkmıştır. Son olarak araştırmada Hayat Bilgisi dersinin öğretmen ve öğrenciler tarafından her zaman olmasa bile kimi zamanlarda ihmal edilebildiği ve derse olduğundan daha fazla önem verilmesi gerektiği sonucuna ulaşılmıştır.
Yabancı Dil Öğretiminde Kültürlerarası İletişimin Temel Kavramları Konusunda Öğrenci Görüşleri
Authors: KÖŞKER Gizem
Published: January 2020

2000’li yıllardan itibaren yabancı dil öğretiminde benimsenen ve Avrupa Dilleri Ortak Çerçeve Programı’nda sistematik biçimde açıklanmış olan Görev Temelli Yaklaşım, yabancı dil kullanıcısını toplum içinde bir sosyal aktör olarak kabul etmektedir. Bireyin sadece dilsel ögelerle değil, toplum içindeki davranışları ile de farklı dil ve kültürden bireylerle iletişim kurduğu savunulan bu yaklaşımda, yabancı dil öğrenen bireyde, kültürel farklılıklara karşı hoşgörülü bir bakış açısı ve kendi kültürel kimliğine karşı da farkındalık geliştirmesi hedeflenir. Bu hedefi gerçekleştirmek için yabancı dil öğretiminde öğrencide, kültürlerarası iletişim yaklaşımında ön plana çıkan bazı kavramlarla ilgili farkındalık kazandırılması gerekmektedir. Bu çalışma Yabancı Diller Eğitimi Bölümü Fransızca Öğretmenliği Programı 4.sınıf öğrencilerinin kimlik, önyargı, klişe, ayrımcılık, etnik merkezcilik ve kültürlerarasılık kavramları ile ilgili görüşlerini belirlemek amacıyla gerçekleştirilmiştir. Durum çalışması olarak desenlenen bu nitel araştırmada, öğrencilerin sözü geçen kavramlarla ilgili görüşlerini detaylı biçimde belirleyebilmek için açık uçlu sorulardan oluşan görüşme formları aracılığıyla veri toplanmıştır. Verilerin analizi sürecinde içerik analizi yönteminden yararlanılmıştır. Çalışmaya katılan öğrencilerin, belirtilen kavramlarla ilgili görüşlerinden ulaşılan temalar yabancı dil öğretimi ile ilişkilendirilmiş ve raporlaştırılmıştır.
A randomized controlled trial on lactoferrin versus ferrous sulphate for the treatment of mild to moderate iron deficiency anaemia in pregnancy
Authors: Gawai Swati , Fonseca Michelle , Kapote Deepali
Published: January 2020

Background: One of the important factors associated with maternal and foetal complications during pregnancy is Anaemia. Various oral preparations of iron are available, and each has different bioavailability, efficacy and adverse effects. Lactoferrin is a naturally existing iron-binding multifunctional glycoprotein, and a member of a transferrin family, thus belonging to those proteins capable of binding and transferring iron. Lactoferrin has considerably less gastrointestinal side effects than ferrous sulfate and is very useful as well as promising alternative to ferrous sulphate.Methods: Prospective randomized controlled study. Total 100 females with 24 to 36 weeks of pregnancy with haemoglobin between 8 to 10 grams were included out of which 50 patients were given ferrous sulphate 200 mg BD and 50 patients were given lactoferrin 250 mg BD daily for 8 weeks. Various haematological parameters and the adverse effects of both the drugs were studied at registration, 4 weeks and 8 weeks and compared.Results: Thus, after this study authors can say that the rise in haemoglobin with lactoferrin was 1.58 g/dl while with ferrous sulphate it was 1.67 g/dl at 8 weeks. Adverse effects were much lesser in Group A taking lactoferrin compared to Group B.Conclusions: Thus, lactoferrin has the advantage over ferrous sulphate in having   less side effects and increasing the compliance and thus the efficacy of the drug compared to ferrous sulphate.
Evaluation of spot urinary albumin - creatinine ratio as a screening tool in the prediction of pre-eclampsia in early pregnancy: a pilot study
Authors: G. Rajeshwari , Dongare Akshaya Girish , Patil G. L. , Pujar Tejaswi
Published: January 2020

Background: Pre-eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in India. Objective of this study was to establish whether a spot urinary albumin/creatinine ratio (ACR) measured between 18-28 weeks of gestation can predict subsequent pre-eclampsia in asymptomatic pregnant women.Methods: A prospective observational study involving 50 registered antenatal cases visiting the obstetrics outpatient department between 18-28 weeks of singleton pregnancy with nil proteinuria upon dipstick measurement were included. ACR was determined from random single midstream urine sample. Statistical analysis was performed using Chi square test and Student’s t-test.Results: Of the study group, 10 patients had high ACR value, with 8(80%) developed pre-eclampsia and 2(20%) remained normotensive. ACR had a sensitivity of 80%, specificity 97.56%, positive predictive value of 88.89%, diagnostic accuracy of the test being 94.12%.Conclusions: The spot urinary protein creatinine ratio is a reliable predictor for pre-eclampsia in pregnancy.
Analytical study of Pap smear reports over a period of 1 year in a tertiary care centre
Authors: Reyaz Mehak , Nandi Nupur , Aggarwal Ritika
Published: January 2020

Background: Cervical cancer is the fourth most common cancer in women. In India and other developing countries cervical cancer is the leading cause of morbidity and mortality. Cancer cervix continues to be most common genital carcinoma in India accounting for 80% of all female genital malignancies. Pre-invase lesions can spontaneously regress to normal or remain stable for long period or progress to a higher degree of dysplasia. Cancer of cervix is preventable if diagnosed at the pre-invasive stage with regular intervals of cytological screening by Papanicolaou (Pap) smears. The aim of the study is to analyse the pap reports in terms of normal findings, infections, premalignant lesions and invasive cancers.Methods: All women attending the outpatient department gynaecology at TMMC and RC Moradabad, Uttar Pradesh over a period of 1 year from august 2017-18 presented of obstetrics and with white discharge per vagina were screened for cervical cancer using pap smear. All the smears were reported as per the 2014 Bethesda system.Results: Out of 1392 Pap smear reports ASCUS was reported in 27 cases (2%), LSIL in 27 cases (2%), HSIL in 15 cases (1%), malignant cells in 15 cases (1%) and normal including the infection is reported in 1308 cases (94%).Conclusions: Early cervical epithelial changes can be identified by a Pap smear test, which is the primary screening test for detection of precancerous cervical intraepithelial neoplasia and the early stage of invasive cervical cancer.
Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler
Authors: Modak Rupali , Pal Amitrajit , Pal Amitava , Ghosh Mrinal K.
Published: January 2020

Background: Preeclampsia (PE) is heterogeneous disorder. The aim of the study was to observe the role of a spot urinary protein - creatinine ratio (UPCR) and uterine artery doppler velocimetry measured between 20-24 weeks of gestation in prediction of preeclampsia.Methods: Prospective observational study conducted on 120 pregnant mothers with singleton pregnancy between 20-24 weeks of gestational age in two tertiary teaching hospitals in eastern India. A spot urinary protein creatinine ratio (UPCR) was determined in a mid- stream urine sample and estimation of protein was done by immunoturbidimetric micro albumin method and creatinine by modified Jaffe’s method. Doppler velocimetry was also determined at 20-24 weeks of gestation. A notch in uterine artery, unilateral or bilateral; or RI > 0.7 and PI of > 1.45 were considered to have an abnormal result. Women were followed-up and relationship between variables was assessed by Chi- square test.Results: Women who subsequently developed preeclampsia had significantly higher UPCR (median 44.8 mg/mmol) when compared with women of unaffected groups (median 26.6 mg/mmol). The optimum spot urinary UPCR to predict preeclampsia was 35.5 mg/mmol and the cut-off value >35.5 mg/mmol had a test sensitivity (80%), specificity (94.06%), PPV (66.76%) and NPV (96.94%).The area under curve (AUC) of spot UPCR in ROC curve was  0.949 (95% CI,0.891 - 1.000). For predicting preeclampsia, the mean uterine artery RI had to be >0.7 having sensitivity (60%), specificity (97.03%), PPV (75%) and NPV (94.23%). The area under curve (AUC) was 0.856 (95% CI, 0.742 - 0.971).Conclusions: Second trimester UA doppler is a useful screening test for prediction of preeclampsia. This test works best when combined with a spot UPCR and accuracy of both the methods for prediction of preeclampsia was 92.24%.
Perceptions about caesarean section among women and health care providers: a qualitative study in a rural maternity hospital in Karnataka, India
Authors: Attokaran Teny , Joseph Merlyn , B. Ramya , D’souza Caroline Pretista , . Soumya , Mathew Maria Mary , Kumari Rathna , Johnson Avita Rose
Published: January 2020

Background: Caesarean section is life-saving, but rising rates are a cause for concern. Perceptions surrounding caesarean delivery may play a significant role in the shared-decision making process. Objective of this study was to explore the perceptions of caesarean section among antenatal, postnatal women and healthcare providers in a rural maternity hospital in Ramanagara district, Karnataka.Methods: Qualitative research methodology was adopted to explore perceptions regarding preferred birthing mode, caesarean and its perceived complications. Focus group discussions and in-depth interviews were conducted with antenatal and postnatal women, their caregivers and health care providers. Inductive coding approach and thematic framework analysis was done.Results: Five major themes emerged regarding perceptions of caesarean section among women in a rural area of Karnataka: understanding, fears, decision making, after-care and prevention. Women had a strong preference for normal vaginal birth, but willing to accept doctor’s decision for caesarean as they believed that it would protect the life of unborn child. Women perceived that caesarean was profitable to the hospital. Common mentioned side effects following caesarean were backache and pain at the surgical site.Conclusions: The understanding regarding caesarean section was adequate. Women had fears linked to caesarean such as pain, inability to work, weight gain, prolonged recovery and caesarean deliveries in subsequent pregnancies. Husbands and other family members as well as the doctors were the important decision makers, while the women themselves had little say in the matter. Obstetricians need to focus on alleviating concerns among pregnant women and their family members regarding caesarean section.
Comparative study of intravenous hydralazine and labetalol in severe hypertensive disorders of pregnancy
Authors: Kumari Anupma , Rohatgi Renu , Singh Amrita , Kumar Raj
Published: January 2020

Background: Hypertensive disorders of pregnancy are among the most common medical complications of pregnancy and major cause of maternal, fetal and neonatal morbidity and mortality. The purpose of this study was to compare the efficacy and safety of intravenous hydralazine and labetalol for management of severe hypertensive disorders of pregnancy.Methods: This prospective study was conducted among 100 women admitted with SBP ≥ 160 or DBP ≥ 110 mmHg or both. Patients were divided into 2 groups randomly: labetalol and hydralazine group.Results: Majority of patients (38%) were in the age group of 21-25 years and primigravida (52%). There was more significant decrease in the systolic, diastolic and mean arterial blood pressure at the end of 15 and 30 minutes in labetalol group. Labetalol required fewer doses as compared to hydralazine to achieve the target blood pressure (average 1.95 versus 3.1). Total numbers of term deliveries were 19 (38%) in hydralazine group and 16 (32%) in labetalol group. Pre-term deliveries in hydralazine and labetalol group were 14 (28%) and 15 (30%) respectively. Headache was significantly more common in hydralazine treated patients than labetalol group.Conclusions: Both hydralazine and labetalol were effective and well-tolerated in the treatment of severe hypertensive disorders of pregnancy. Labetalol may be preferred because it was more effective in lowering the systolic blood pressure, diastolic blood pressure and mean arterial pressure to achieve target levels with less number of doses.
The tranexamic acid: as chemical tourniquet during Ward-Mayo’s operation
Authors: Mandal Sarbeswar , Mondal Sumanta Kumar , Pathak Pragati Awasthi , Agarwal Kavita
Published: January 2020

Background: The intra-operative blood loss which required transfusion is one of the complications in Ward-Mayo’s operation. The objective of this study was to evaluate its effectiveness to minimizes hemorrhage in Ward-Mayo’s operationMethods: It is a well-designed, Clinical, interventional, prospective, randomized control trial. In the department of obstetrics and gynecology, IPGMER-SSKM (PG) H, Kolkata, West Bengal, India. More than one-year study. After ethics approval, the total number of sixty-six cases will be selected with randomization for Ward-Mayo operation and allocated into two groups operated as - Gr-A (n = 33 cases) - by infiltrating locally tranexaminic acid, Gr-B (n = 33-controls) - application local conventional haemostatics.Results: The outcome informs of primary and secondary assessed, analyzed, tabulated and statistically significant showed accordingly as per graph pad software. In Table 1 and 2. The results of individual group (Gr. A and Gr. B) in forms of pry and Sec. outcomes showed that there are better outcomes in all aspects with zero mortality Tranexamic group than controls.Conclusions: This study concluded that the Tranexamic Acid can safely and effectively used by local infiltration during Ward-Mayo’ operation. Like other department, this technique can be utilized in other vaginal procedure (ex-Episiotomy).
Association of maternal physical status and pregnancy outcome
Authors: Tiwari Namrata , Mishra Vinay
Published: January 2020

Background: Lots of research both in India and abroad studying the effect of maternal physical markers on their infant’s birth weight is going on. The present study has been planned to evaluate the effects of maternal physical markers on their infant’s anthropometry and cord blood haemoglobin.Methods: Maternal background information, height, last known pre-pregnancy weight, gestational age and number of children was obtained and recorded in case proforma. 100 post-partum women and their newborns were studied. The study was carried in a post-natal ward of a tertiary care hospital. Maternal and neonatal data were recorded.Results: Maternal physical status (pre-pregnancy weight, height and BMI) significantly influences the pregnancy outcome (neonatal parameters) of the baby.Conclusions: There should be emphasis on improvement in nutrition of the girl child to improve the health of the upcoming generations. Maternal body mass index needs to be optimized to reduce perinatal complications to both mother and the baby.
Comparison between laparoscopy and laparotomy in the management of ectopic pregnancy: a retrospective study
Authors: Singh Suneeta , Sandhu Namrita , Singh Sanjay , Kumar Praveen , Aziz Atiya
Published: January 2020

Background: Ectopic pregnancy is one of the most important causes of maternal mortality and morbidity in the first trimester of pregnancy. Objective of this study was to compare the safety, feasibility and advantage of laparoscopic approach with that of laparotomy in management of ectopic pregnancy.Methods: A retrospective study was conducted at two tertiary hospitals over a period of two years i.e.; from Aug 2015 to July 2017. Seventy-five patients who had histopathology confirmed tubal ectopic pregnancy were divided into two groups; laparoscopy (Group I, no-39) and laparotomy (Group II no-36). The main outcome measures were operative time, blood loss, and requirement of blood transfusion, requirement of analgesia and duration of hospital stay.Results: Seventy-five patients of ectopic pregnancy who were managed surgically were studied. There were 39 cases in laparoscopy group and 36 cases in laparotomy group. The incidence of ectopic pregnancy was 1.56% (out of all deliveries over 2 years). Ampullary region was the commonest site of ectopic pregnancy (74.6%). No difference was found in the two groups regarding age, site of tubal pregnancy, pre op Hb status and haemoperitoneum. Mean operating time was significantly shorter in the laparoscopy group 39 min (range 30 - 52 min) versus 50 min (range 40-60 min) in the laparotomy group. There was no difference between the groups regarding the treatment with blood products and perioperative complications. Hospital stay was significantly longer in the laparotomy group (3.5 days) as compared to 2 days in laparoscopy group. The duration of post op analgesia requirement was also longer in laparotomy group (4 days) as compared to 2 days in laparoscopy group.Conclusions: Laparoscopic management of ectopic pregnancy is a safe, effective and beneficial option in the hands of an experienced laparoscopic surgeon even in cases of massive haemoperitoneum. It definitely offers the advantage of shorter duration of surgery, faster post op recovery, shorter duration of hospital stays and lesser requirement of post op analgesia.
Correlation of biomarkers and bone mineral density for osteoporosis in post-menopausal women
Authors: Hymavathi K. , Jakka Tejaswini , Paturi Bhaavya
Published: January 2020

Background: Osteoporosis is a metabolic bone disorder characterised by a low bone mass and microarchitectural deterioration of bone tissue followed by enhanced bone fragility and a consequent rise in fracture risk. Aim of the study is to correlate the biomarkers and bone mineral density in postmenopausal osteoporosis.Methods: This is a prospective study done in the department of obstetrics and gynaecology, Narayana medical College and Hospital, Nellore for a period of 2 years (October 2016-October 2018). This study was designed to assess the correlation between bone mineral density (BMD) and various biochemical markers.Results: The mean age of the present study is 60.51±9.35 years. There is a significant correlation found between age, serum phosphorus, urinary OHPr and bone mineral density. The mean BMI of the present study is 24.75±4.25 kg/m2. There is a significant correlation observed between BMI, serum ionized calcium, urinary OHPr and bone mineral density. There exists a significant correlation between BMD and urinary OHPr. It is found that in menopausal women spine and hip are the major sites affected by osteoporosis. The early changes are found in lumbar spine compared to hip. In the present study with increase in BMI there is increase in BMD signifying obesity is a protective factor for osteoporosis leaving aside all it’s ill effects. Urinary hydroxyproline a marker of resorption is found to have a negative correlation with BMD.Conclusions: BMD measurements using DEXA are not readily available in India. Biochemical markers of bone remodelling are useful tools in assessment of osteoporosis and are safe, inexpensive, easily performed. In the present study an attempt is made to correlate biochemical markers and BMD so as to detect osteoporosis even before the changes being evident on imaging studies.
Clinical profile and outcome of scar endometriosis in a tertiary care centre of Northern India
Authors: Juneja Sunil Kumar , Tandon Pooja , Sharma Anshu , Sharma Anjali
Published: January 2020

Background: Endometriosis is defined as the presence and proliferation of the endometrium outside the uterine cavity affecting an estimated 89 million women of reproductive age worldwide. Endometriosis occurs in 5% to 10% of all women, often resulting in debilitating pain and infertility, endometriosis at the scar site known as Scar endometriosis has also been described following obstetrical and gynecological surgery. Scar endometriosis has a much rarer incidence with an illusive presentation and is often misdiagnosed and definitive treatment gets delayed. Objectives of this study was to review the demographic profile, clinical presentation, treatment modalities and outcome in patients with scar endometriosis.Methods: The retrospective study of patients with scar endometriosis managed at DMCH during January 2014 to December 2018 was done.Results: Eight patients of scar endometrosis were diagnosed and operated in our institution over a period of five years. All patients (six with previous caesarean section scar site and two at episiotomy site) presented with tender nodules with pain which got exaggerated during menstruation.Conclusions: A high index of suspicion of scar endometriosis should be kept in patients presented with cyclical pain and tender mass getting exaggerated during menstruation.
A comparative study of non-descent vaginal hysterectomy and total laparoscopic hysterectomy
Authors: Kansara Vijay , Chaudhari Jaydeep , Desai Ajesh
Published: January 2020

Background: Hysterectomy is the second most common operation performed by the gynecologists, next only to caesarean section. Objective of the study was to compare fall in blood haemoglobin level, duration of operation, intra- and post-op complications between non-descent vaginal hysterectomy and total laparoscopic hysterectomy and establish the better method for hysterectomy in non-descent uterus.Methods: A retrospective comparative study of 90 hysterectomies was done from a period of May 2018 - April 2019 at GMERS Medical College and Hospital Sola, with 45 cases in group of non-descent vaginal hysterectomy (NDVH) and 45 in group of total laparoscopic hysterectomy (TLH). Demographic characteristics, co-morbid conditions, indications for surgery, operative time, intra- operative blood loss, post-operative analgesia requirements, post-operative hospital stay and post-operative complications were compared between both groups. Those patients having malignancy as diagnosed by Pap smear or by D and C were excluded from the studyResults: The most common age in both groups was 41-50 years. Adenomyotic uterus was the most common indication for surgery in both groups. The mean operative time in NDVH group was 45 min while it was 80 min in TLH group. p<0.001 suggested significant difference when operative time were compared between both groups. Both groups were similar in post-operative analgesia requirement and post-operative hospital stay. Post-operative complications were similar in both groups.Conclusions: In which way to approach the uterus shall depend upon skill of the surgeon, size and pathological nature of uterus, technology available in the hospital and preference of patient as well as surgeon.
Gynandroblastoma: a rare case report of ovarian sex cord tumour
Authors: Tanouti S. , Elamouri I. , Taheri H. , Saadi H. , Mimouni A.
Published: January 2020

Gynandroblastoma is an extremely rare ovarian sex cord tumor with malignant potential. An 61-year-old woman, menopausic, consulted for an abdominal pelvic mass. a latero-uterine mass measuring 27.8 cm in diameter showed a predominantly cystic pattern with a partial solid component. A unilateral adnexectomy was performed. A histopathological examination showed gynandroblastoma composed of juvenile granulosa and Sertoli-Leydig cells, chirurgical treatment was completed by total hysterectomy with right adnexectomy, omentectomy with no proof of malignant cells. We opted for a close observation without adjuvanted chemotherapy. two years after surgery, no signs of recurrence have been noted. The present findings can help clinicians make an accurate preoperative imaging diagnosis of gynandroblastoma with a juvenile granulosa cell component and plan an adequate treatment strategy for this rare, potentially malignant neoplasm.
Malignant transformation of ovarian mature teratoma: 04 cases report, review of the literature
Authors: Jamor Jihad , Conte Alpha Boubacar , Fdili Alaoui Fatima Zohra , Jayi Sofia , Chaara Hikmat , Melhouf Moulay Abdelilah
Published: January 2020

Mature ovarian teratomas or dermoid cysts are the most common ovarian germinal tumors and account for 20 to 25% of ovarian organ tumors. The malignant transformation of a mature teratoma is a rare event (1 to 3%), mainly found in the post-menopausal period. This is carcinomatous degeneration (80% of cases) or sarcomatous differentiated tissues of the dermoid cyst. The diagnosis of certainty is established by anatomopathological study of the surgical piece. Treatment of carcinoma teratomas is surgical and same to ovarian malignant epithelial tumors. We report four cases we managed in our health care center with a review of the literature.
Cardiac disease and pregnancy: hyper vigilance and extreme caution for optimal outcome
Authors: Dhawan Naresh , Kumar Rohin , Bhatt Reema Kumar
Published: January 2020

Cardiac disease in pregnancy is a leading cause of maternal death in more so high-income countries. The armamentarium for winning this difficult battle involves shared decision-making with communication across the clinical team and the patient. There is limited clinical evidence concerning effective approaches to managing such complex care and moreover involvement of different specialists makes coordinated care challenging. Bicuspid aortic valve (BAV) is the most common congenital cardiac malformation, occurring in 1-2% of the population whereas a single ventricle is a rare congenital heart disease that accounts for less than 1% of all congenital heart diseases. We had two cases of pregnancy with bicuspid aortic valve in one case and the other with single ventricle. The involvement of multidisciplinary team involving cardiologist, cardiothoracic anaesthetist and fetal maternal medicine specialist resulted in good maternal and fetal outcome in both the cases.
Monochorionic monoamniotic live twin ectopic pregnancy: a rarity
Authors: Dhama Vandana , Gupta Sonam
Published: January 2020

The incidence of unilateral live twin ectopic pregnancy is approximately 1:1,25,000 but increased in last few decades due to increased use of fertility drugs for ovulation induction, superovulation and assisted reproductive technology. It is also associated with increased incidence of pelvic inflammatory diseases. Patient was 30 years old G3P2L2 who presented to OPD of this LLRM medical college, Meerut with complain of amenorrhoea of two and half months. Pelvic examination revealed tenderness in lower abdomen, left adnexal fullness and tenderness without any bleeding. On USG, left adnexal monochorionic monoamniotic ectopic twins with normal cardiac activity. Exploratory laparotomy followed by left sided salpingectomy was done and patient was discharged with satisfactory condition. This is a very rare case and PID is also among risk factors and may also cause twin ectopic pregnancy.
Juvenile granulosa cell tumour in the third trimester of pregnancy
Authors: Gaughran Jonathan , Datta Argha , Hamilton Judith , Holland Tom , Sayasneh Ahmad
Published: January 2020

This case report describes the rare finding of a granulosa cell tumour in the third trimester of pregnancy. The presentation, investigation, management, histopathological findings and subsequent follow up are detailed. The difficulties associated with such diagnoses in pregnancy are explored.
An interesting case of Phocomelia
Authors: Lavanya C. , Devi T. Ramani , Gayathri D.
Published: January 2020

Authors present a very rare case of tetra-phocomelia evaluated by antenatal ultrasonography. It is a condition seen in 0.62 per 100,000 live births. This is a congenital chromosomal abnormality involving the musculoskeletal system. Primi gravida with spontaneous conception after a long period of infertility underwent early anomaly scan. Patient was not aware of the last menstrual period hence; NT scan was missed. Routine early anomaly scan done between 16-18 weeks of pregnancy diagnosed a fetus with Tetra-Phocomelia. Due to the lack of associated symptoms or significant history, our case did not fit into any specific syndrome and appears to be the result of a sporadic, non-hereditary limb deficiency involving all four limb buds.  Second opinion obtained from a fetal medicine consultant who confirmed the diagnosis. Hence, decided for mid trimester termination and fetus was expelled after 8 hours. Fetus was not sent for pathological analysis. Tetra-phocomelia is a rare congenital anomaly and it may be associated with other deformity also. 1st case of phocomelia was described after the intake of thalidomide. In this condition hands and feet are seen as small flippers of a seal. The differential diagnosis includes sporadic phocomelia, Holt-Oram syndrome, thrombocytopenia-absent radius syndrome (TAR syndrome), Robert’s syndrome, and thalidomide-induced phocomelia. Here authors are presenting a rare case of Phocomelia where there is no history of drug intake or family history. This has to differentiate from thrombocytopenia-absent radius syndrome (TAR syndrome), sporadic phocomelia, Holt-Oram syndrome, Robert’s syndrome, and thalidomide-induced phocomelia.
Establishment of diabetes association to enhance peer-education and self-management: perceptions of residents from Ogwashi-Uku and Ubulu-Unor communities in Delta state, Nigeria
Authors: Igumbor Eunice O. , Okoh Beatrice I. , Agofure Otovwe , Nwose Ezekiel U.
Published: January 2020

Background: Diabetes epidemic is an evolving phenomenon in Nigeria and sub-Saharan Africa. Most African governments are showing strong desire to reversing the current trend. However, information on the perception and readiness of rural and suburban community dwellers towards managing this disease need to be gathered.Methods: This was mixed methods including descriptive observational study and survey regarding establishment of a diabetic network in the rural and suburban localities. Quantitative screening data were collected to assess prevalence of diabetes or prediabetes, as well as investigate the perceptions of diabetic and non-diabetic residents. Establishment of diabetes register was initiated. 180 complete questionnaires were included for analysis, though 199 consented to participate. In the qualitative phase of the research, a convenience sampling questionnaire and focus group discussion on their perception about diabetes association or network. Their perceived response and opinions were then documented.Results: Among the participants, approximately 12% prevalence of diabetes and 10% prediabetes were observed. 19/25 cases of diabetes were entered in the register. Over 43% of the population never heard about diabetes association/network, but 72% of the diabetes cohort are willing to join diabetes network. A greater fraction of the suburban patients seems more aware, but willingness to accept diabetes is higher in the rural community.Conclusions: Most of the persons living with diabetes, and their relatives, are willingly to join diabetes network as well as encourage such organisation in their communities. Given the level of unawareness, there is need to establish diabetic association and advance the benefits.
Awareness of vaccine cold chain handlers about vaccine cold chain in district Etawah
Authors: Kumar Shishir , Singh Naresh Pal , Jain Pankaj Kumar , Kumar Sandip
Published: January 2020

Background: Vaccine potency can be lost when exposed to non-recommended temperatures. Hence for the proper running of the universal immunization programme (UIP) factors like vaccine cold chain and vaccine management wants great focus and attention skills and knowledge of the vaccine cold chain handlers so for good implementation of UIP vaccine cold chain handlers are important.Methods: This was an observational cross-sectional study. Study duration was carried out from October 2017 to March 2018. All the 16 cold chain handlers of district Etawah were interviewed.Results: All 16 (100.0%) were male and 1 (6.3%), 2 (12.5%), 8 (50.0%) and 5 (31.3%) of the respondents were high schools, intermediate, graduate, and post-graduate respectively. It had been observed that the hundred percent of the cold chain handlers with the knowledge of vaccine cold chain. It has been observed from the study that 15 (93.7%) cold chain handlers had knowledge of temperature range for vaccine storage.Conclusions: Quality of immunization program depends upon cold chain management at peripheral health institutions. In our study, we have found that most of the vaccine handlers were reported to have appropriate knowledge regarding the cold chain.
Malaria or typhoid co-infection in a tertiary care hospital of Bareilly, Uttar Pradesh, India
Authors: Katiyar Ghanshyam Dass , Agarwal Ajay Kumar , Khan Swati , Chaudhary Bharat Chand , Sharma Mahendra
Published: January 2020

Background: Malaria is a protozoal disease caused by infection with parasite of genus Plasmodium. Typhoid is common with malarial infection.Methods: A cross sectional study was done to find out co-infection of typhoid and malaria. Study was done in central pathological lab of department of pathology, RMCH, Bareilly. Blood samples were collected in EDTA vial and plain vial. Blood smear was examined for malaria parasite within RBCs. Malaria rapid test was done for detection of Plasmodium species and Widal test was done for typhoid.Results: In this study found co-infection of malaria with typhoid was 15.64%. In malarial cases 54.50% were males, while maximum cases (26.92%) were in 21-30 yrs age group.  Cases of P. vivax was maximum (86.28%) and maximum cases of P. vivax (29.42 %) was in 11-20 yrs age group while that of P. falciparum (22.22%) was in 11-20, 21-30, 41-50  yrs age group and maximum number (23.60%) of mixed malarial infection was in 31-40 yrs age group,  While co-infection of malaria with typhoid was maximum (24.59%) was in 11-20 yrs age group and maximum (53.28%) in females. Maximum (79.51%) cases of typhoid were of P. vivax. Conclusions: Malaria and typhoid co-infection still remain a major public health problem in many developing countries. Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic dilemma for the treating physician.
Assessment of the contributing risk factors in adult diabetic patients attending the diabetic clinic in Bankura Sammilani Medical College, Bankura
Authors: Padmey Indu , De Arindam , Gazi Eashin , Sarkar Aditya Prasad , Saren Asit Baran , Mahapatra Banamali Sinha
Published: January 2020

Background: Diabetes affects all segments of the population and is one of the leading causes of premature morbidity and mortality and requires life-long healthcare services. The National Rural Health Mission launched in 2005 and the new pilot National Programme for Prevention and Control of Diabetes, Cardiovascular diseases and Stroke offer opportunities for improving care for diabetes and other non-communicable diseases through service provision at the primary and secondary levels of care. This article describes the health services related factors and ascertains the physical status of adult diabetic patients.Methods: It is an institution based, cross-sectional, descriptive study. Complete enumeration of all patients attending diabetic clinic of Bankura Sammilani Medical College and hospital, Bankura, West Bengal was done. Eligible consenting adult patients, who were diagnosed as a case of diabetes and on treatment were interviewed with review of medical record. The study was preceded after obtaining ethical clearance. Data were entered in MS Excel spread sheet. Calculation was done with the help of software SPSS 22.0 free version.Results: Only 5.3% of study subjects had drug supply from hospital fully but rest of them had to buy from the shop. 79.3% of study subjects skipped the drug when it was finished. Diabetic complication was found to be more when distance of home from hospital was more.Conclusions: Antidiabetic drug were not regularly available in hospital so all most all had to purchase drug from the shop when not available at hospital.
A study of knowledge and practice of menstrual hygiene among adolescent school girls in rural and urban field practice area of RajaRajeswari Medical College and Hospital, Bangalore, India
Authors: Kailasraj Kanchanaganga Hassan , Basavaraju Vidya , Kumar Jayanth , Manjunatha Shashikala
Published: January 2020

Background: The word adolescent is derived from Latin word adolescence which means to grow into maturity. Adolescence is a period of transition from childhood to adulthood. WHO has defined adolescence as the age group 10-19 years. These are formative years when maximum amount of physical, psychological, developmental and behavioral changes take place. In India adolescent girls accounts for a little more than one- fifth of the population. The onset on menstruation is one of the most important changes occurring among the girls during the adolescent years. The event of menarche may be associated with taboos and myths existing in our traditional society which has a negative implication for women’s health, particularly their menstrual hygiene. Women having better knowledge regarding menstrual hygiene and safe practices are less vulnerable to reproductive tract infections.Methods: This was a cross-sectional descriptive study. The sample size of 184 is obtained in each group and rounded off to 190 (urban and rural schools). The duration of the study was for 5 months among adolescent high school girls in randomly selected schools.Results: The mean age of urban girls was 12.87±0.94 years whereas rural girls it was 12.85±0.86 years. Among 380 study subjects 43.4% were aware about menstruation before attaining menarche, 62.4% were aware that menstruation is a natural process. Majority of study subjects (58.9%) were using sanitary pads during menstruation and 46.8% of study subject’s changes absorbents twice a day. Conclusion: Knowledge and practice regarding menstrual hygiene among adolescent high school girls is better in rural area as compared to urban adolescent high school girls.
A study on awareness of human immunodeficiency virus among adolescent girls in urban and rural field practice areas of Osmania Medical College, Hyderabad, Telangana, India
Authors: Gurram Sudharani , Bollampalli Baburao
Published: January 2020

Background: Adolescents in India represent over 1/5th (22.3%) of total population. Though they constitute the healthiest section of population they are considered as vulnerable group. India having a large population with low literacy levels leading to a low level of awareness of HIV/AIDS, the disease is posing an alarming threat on the public health scenario. Globally, almost of a quarter of people living HIV are under the age of 25 years. In India, 35% of all reported AIDS cases are among the age group of 15-24 years, indicating the vulnerability of the younger population to the epidemic. This study aimed to assess knowledge regarding HIV/AIDS and to explore epidemiological determinants of awareness among them. Objectives of the study was to study the awareness of HIV/AIDS among adolescents of urban and rural field practice areas of OMC Hyderabad 2) to study the factors associated with knowledge and awareness among adolescents of urban and rural field practice areas of OMC, Hyderabad.Methods: A community based cross-sectional study is conducted in adolescents aged 10-19 years. A total of 760 adolescent girls (380 in each area) were interviewed and examined.Results: The study revealed that only 37.4 per cent of the sample subjects had known the expanded form of the abbreviation HIV/AIDS. Very few of the respondents (12.6%) knew that HIV/AIDS is preventable. 39% of them had the no knowledge with regard to the mode of transmission.Conclusions: This study strengthens the need of properly formulated awareness campaigns and programmes on HIV/AIDS.