bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of postpartum intrauterine contraceptive devices
Authors: Shrigadhi Sandhya A. , Gawandi Prabhakar S. 
Published: April 2021

Background: PPIUCDs are the only postpartum family planning method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum in lactating women. The public health benefits from PPIUCDs stemmed from the women’s increased accessibility to PPIUCDs following facility births, as PPIUCDs could be offered at health facilities after childbirth. It is an attempt to reduce unmet family planning need. The specific aims of this study were to assess the acceptability, feasibility expulsion rate and complications of PPIUCD insertion among women delivering at term in our institute who were eligible and counselled for PPIUCD.Methods: Prospective study undertaken at Dr. Vaishampayan memorial government medical college, Solapur, Maharashtra conducted from September 2015 to August 2017. All women undergoing delivery at term in this institute and not having any contraindications for postpartum IUCD insertion were counseled for PPIUCD.Results: A total 3032 were eligible for PPIUCD insertion and were counseled for the same. 1.97% women accepted PPIUCD insertion while 98.03% of them declined insertion. 1124 underwent caesarean section while 1908 had vaginal delivery. Among vaginal delivery group rate of acceptance was 1.20% while that in caesarean section group was 3.29%.Conclusions: The present study concluded that overall acceptance of PPIUCD in our institute is 1.97 %. Considering fear of complications related to IUCD and partner refusal as major causes of refusal for PPIUCD in our study, emphasis on this aspect during counseling can improve acceptance.
Abortion and contraception practices in COVID-19 era
Authors: Maheshwari Bharti , Manchanda G. S. , Sharma Preeti , Setiya Taniya 
Published: April 2021

Background: To protect the gains made in sexual and reproductive health in over the past several decades, care for childbearing women and newborn infant’s needs to continue during the pandemic. The provision of safe abortion and contraceptive services remains critical. When staff and services are under extreme stress there is a real risk of increasing avoidable harm. Aim and objectives were to determine the effect of COVID-19 on accessibility and acceptance of contraception and safe abortion care services.Methods: Questionnaire survey was Done among 500 women in 6 months from April to September 2020, on availability and utilization of safe abortion and contraception services during lock down in covid time from patients getting treatment by Department of Obstetrics and Gynecology, Muzaffarnagar Medical College and health care workers (paramedics and others staff) of reproductive age group working in the institute.Results: Majority (56%) of women were in the age group of 20-30 years. 70% of women have access to contraception at present while it was reduced to 60% during lockdown. Most commonly used method was barrier method (70%) followed by OCP’s which they could avail maximum from pharmacy (40%). 65% of women had access to post delivery and post abortion contraception with most common method adopted being injectables, in 3% cases IUCD was inserted, 1% ligation with LSCS. Among them 42 cases were covid positive who underwent caesarean section and adopted contraception thereafter with tubal ligation in 2 cases. In this study 32% of women had unwanted pregnancy, among them 35% underwent surgical abortion 61% medical abortion and 4% continued pregnancy.Conclusions: The COVID-19 pandemic has impacted safe abortion and contraception services. Unwanted pregnancy increased to 32%. 62% subjects claimed for accessibility at government centre and door to door by health worker.
Interventions for gestational diabetes: impact of assisted reproduction
Authors: Ravi Preethi , Sundaram Lakshmi Shanmuga , Shankar Kundavi 
Published: April 2021

Background: This study was to assess whether assisted conception acts as a predictor for insulin therapy in gestational diabetes (GDM) treatment. The secondary aim of this study was to analyse the type of interventions that aided control of blood glucose. The role of ART as a risk factor that increases the risk of insulin therapy in GDM remains elusive. Many studies have established the increased association of GDM with ART conceptions. Factors like advanced maternal age, polycystic ovarian syndrome or obesity that increase GDM risk also contribute to subfertility. Increased level of Hb A1C, elevated FBS values are considered as risk factors for antenatal insulin therapy in women with GDM. This study was to assess if assisted reproduction is an independent variable associated with insulin therapy.Methods: In this retrospective study, GDM was diagnosed by fasting blood sugar and 2 hours postprandial or 75 gms OGTT based on IADPSG criteria with FBS >90, 2hr >140. Among the 121 GDM mothers, 42 women were ART conceptions and 79 were spontaneous conceptions. The entire study population (121) was divided into 3 groups based on the treatment required. Diet and lifestyle modifications only, diet and life style modifications with OHA and OHA with or without insulin therapy. The demographic, clinical, biochemical data were compared between groups. Details were obtained from case notes and entered in an excel sheet and SSPS software was used for statistical analysis. Inclusion criteria was all GDM pregnancies in the study period (4 years; January 2014 to December 2017) for whom case notes were available. Exclusion criteria was women with diabetes prior to pregnancy, those who moved elsewhere for delivery and multiple gestations.Results: There was no difference in the insulin requirement between ART conception and spontaneous conceptions. Out of 121 women, 34 women (28%) required diet and life style management, 38 women required OHA (31%), 49 women required insulin (40%). 73% of women who were managed with diet were spontaneous conceptions. Preterm labor was the commonest complication encountered (17%). ART women had more number of perinatal complications, in all treatment groups.Conclusions: ART was not a predictor for insulin therapy in this study group. The largest group of intervention for GDM was with insulin, 40%. Perinatal complications were seen more in ART mothers with GDM compared with spontaneous conceptions. Spontaneous conceptions women had more percentage of management with diet and life style modifications.
Partographic analysis of labour by modified WHO partograph in tertiary care centre
Authors: Jain Prekshi , Shah Akshay C. , Patel Babulal S. , Jani Shashwat K. 
Published: April 2021

Background: The partograph is a simple, inexpensive tool to provide a continuous pictorial overview of labor. The goal of this study is to use partograph to monitor labor, initiate uterine activity that is sufficient to produce cervical changes, fetal descent while avoiding uterine hyperstimulation, hypostimulation and fetal distress and provide timely surgical intervention where required. Methods: A hospital-based observational study involving prospective review of partographs for births that occurred in 2020 was conducted in 2 hospitals including SVP Hospital and V.S hospital Ahmedabad. A partographic analysis of labour was done in randomly selected 200 patients using modified WHO partogram. The study population was divided into Primigravida (96) and Multigravida (104) term patients. partograph recording were commenced at 4 cm dilatation. close maternal and fetal monitoring was done throughout the labour and partogram was plotted to detect any deviation from normal course.Results: Patients were grouped into primigravida and multigravida and based on partogram finding divided into mode of delivery. 22 of total 96 primigravida underwent caesarean section and 74 delivered vaginally. 8 of total 104 multigravida underwent caesarean section and 96 delivered vaginally. Out of 200 newborn only 11 had Apgar score <7 at 5 minutes.Conclusion: The WHO modified partograph is highly effective in reducing both maternal and neonatal morbidity. It aids in assessing the progress of labour and to identify when intervention is necessary. It is effective in preventing prolonged labour, obstructed labour, reducing operative intervention and improving neonatal outcome.
A five-year retrospective study of maternal mortality in a tertiary referral centre
Authors: Sarmalkar Meenal S. , Nayak Arun H. , Faisal Shameel , . Abhakumari 
Published: April 2021

Background: The objectives of this study were to calculate the maternal mortality ratio (MMR) and the causes of maternal deaths in an urban tertiary care institution.Methods: A retrospective study of 305 maternal deaths over the period from January 2014 to December 2018 was carried out. Data was analysed using frequency and percentage with the help of Microsoft Excel 2019.Results: The MMR during the study period was 666.75per 100,000 live births. Majority of maternal deaths (130, 42.62%) occurred in age group 21-25 years. Maximum number of women (288, 94.1%) came from urban area. Majority of maternal deaths occurred in referred cases (238, 78.03%) to our institution. Majority were registered cases (235, 77.0%). Maximum women (201, 62%) died in the postnatal period. Majority of maternal deaths (222, 72.79%) occurred within 7 days of admission. Direct and indirect causes contributed to 40% and 59.67% of maternal deaths. Among the direct causes of maternal deaths, haemorrhage (45, 14.75%)) was the leading causes for death followed by hypertensive disorders (42, 13.77%) and sepsis (11, 9.02%). Tuberculosis (34, 18.68%) was the most common indirect cause of maternal mortality in our study followed by hepatitis (30, 16.48%) and respiratory conditions (25, 9.02%).Conclusions: Adequate surveillance of tuberculosis in the antenatal period, health education of pregnant women, proper antenatal, intranatal and emergency obstetric care in the first referral unit with proper blood banking facilities and timely referral to the tertiary care institute will help to lower the high death rate.
Comparative study of pharmacological and combined pharmaco-mechanical method of induction of labour: a randomised study
Authors: Kumari Anshu , Chiniwar Mahantappa A. , Menasinkai Sharada B. 
Published: April 2021

Background: Comparative study of Pharmacological and Pharmaco- Mechanical method of induction of labour- A Randomised study. The objective of the study was to compare efficacy of pharmacological and combined pharmaco-mechanical method of induction of labour.Methods: A study was conducted in the department of Obstetrics and gynaecology, Adichunchanagiri Institute of Medical Sciences and Research Centre for a period of 18 months. 200 pregnant women requiring induction of labour were included in the study. In group 1 Dinoprostone 0.5 mg gel was inserted into cervical canal. In group 2 Foley’s catheter No 18 F was inserted within the cervix. The balloon of the catheter was filled with 30 ml normal saline and at the same time Dinoprostone 0.5 mg gel was inserted into posterior vaginal fornix. The Excel and SPSS (SPSS Inc, Chicago V 18.5) software packages were used for data entry and analysis. The results were averaged (mean ± Std Deviation) for each parameter for continuous data in tables.Results: Mean induction to active phase interval in group 1 was 8.43±4.11 hrs, in group 26.82±3.01 hrs (p =0.001). The rate of vaginal delivery in group 1 and group 2 was 55% and 66% respectively, difference was statistically significant (p=0.026).Conclusions: Synchronous use of intracervical Foley’s catheter and Dinoprostone 0.5 mg resulted in a shorter time for progress to active phase and also shortened induction to delivery interval as compared to Dinoprostone 0.5 mg alone. Higher risk of caesarean delivery was associated with single method as compared to combined methods.
Repeated ultrasound guided local infiltration of methotrexate in persistent gestational trophoblastic disease with myometrial invasion: case series and review of literature
Authors: Said Tamer H. , Elkerm Yasser 
Published: April 2021

Gestational trophoblastic disease is a group of rare tumors that involve abnormal growth of cells inside a woman's uterus. An invasive mole is a hydatidiform mole that has grown into the muscle layer of the uterus. Invasive vesicular moles can develop from either partial or complete moles, but complete moles become invasive much more often than do partial moles. Invasive moles develop in a little less than 20% of women who have had a complete mole evacuated. Treatment of invasive mole is classically by giving systemic chemotherapy. Objectives of current study were to evaluate the effect of repeated local methotrexate injection in treatment of invasive mole. Cases with invasive mole assigned for local injection of 50 mg methotrexate in 10 cm normal saline using local injection in the myometrium under transvaginal ultrasound guidance. Follow up weekly till negative results are obtained. All cases showed rapid decrease of the level of b-hCG level after local injection and showed negative hormone results within 6 weeks after injection. Local methotrexate intra-myometrial local injection therapy has successful results in cases with persistent invasive hydatidiform mole and should be tried before referring them for systemic therapy.
Assessment of physical and mental health status of doctors working in COVID-19 pandemic
Authors: Sahni Dimple , Kaur Rajwant , Sahni Girish , Bhagat Sanjeev , Kumar Pawan , Mittal Niraj 
Published: April 2021

<p class="abstract"><strong>Background:</strong> The objective of this study was to assess physical and mental health hazards among doctors working in COVID-19 pandemic.</p><p class="abstract"><strong>Methods:</strong> Online questionnaire sent to approximately 2500 doctors across India, 1214 responded back. Questionnaires comprised demographic variables, marital status, any associated comorbidities, educational level, geographic area according to red, green and orange zone; workplace characteristics (frontline or second-line), place of posting, change in appetite or sleep, whether sampled for COVID-19, and if positive kind of symptoms. Mental health was assessed using four scales like, 7 item insomnia severity index, 7 items generalized anxiety disorder, 9-item patient health questionnaire, and 22 items impact of event scale-revised, to evaluate severity of symptoms anxiety, depression, insomnia, and distress, respectively. Data analysed using IBM SPSS statistical software version 22. Four scale taken as interquartile and median. Kruskal-Wallis test and person chi square were used for comparison. Multinomial logistic regression model used.</p><p class="abstract"><strong>Results:</strong> 1214 respondents 25% had headache, 8% anosmia, 7% throat pain or cough, and skin allergy 5%, overall anxiety, depression, insomnia and distress found 38%, 36%, 27%, and 18% respectively.</p><p class="abstract"><strong>Conclusions:</strong> Study evaluated that doctors working in pandemic are under physical and mental stress. </p>
Auditory evoked potentials as yardstick for tinnitus
Authors: Banerjee Shrutinath , Paul Nilanjan , Chatterjee Indranil , Das Ishita , Das Rima , Debnath Sucheta 
Published: April 2021

<p class="abstract"><strong>Background:</strong> Aiming to evaluate the recent theoretical postulates on tinnitus underscoring the role of thalamocortical neural tracts, the present study: explores middle latency response (MLR) as a possible physiological measure of tinnitus: thus investigates the predicted exaggeration of P<sub>a</sub>-N<sub>a</sub>, N<sub>a</sub>-P<sub>b</sub> interpeak amplitudes in tinnitus patients and; explores middle latency response (MLR) as a prognostic indicator of tinnitus retraining therapy (TRT), thus evaluates possible decrease in P<sub>a</sub>-N<sub>a</sub> and N<sub>a</sub>-P<sub>b</sub> amplitude after 2 weeks exposure to tinnitus retraining therapy.</p><p class="abstract"><strong>Methods:</strong> An experimental group was constructed by randomly assigning 30 patients with mean age 38.5 years and complaining of debilitating tinnitus but with normal hearing for the study. MLR was administered on patients with normal auditory brainstem response (ABR) and otoacoustic emission (OAE) both pre- and post-tinnitus retraining therapy. </p><p class="abstract"><strong>Results:</strong> Results demonstrated no significant effect on P<sub>a</sub>, N<sub>a</sub> and N<sub>b</sub> absolute and interpeak latencies. However, significantly exaggerated P<sub>a</sub>-N<sub>a</sub> and N<sub>a</sub>-P<sub>b</sub> interpeak amplitudes between experimental and control groups as well as pre and post therapeutic groups were found.</p><p class="abstract"><strong>Conclusions:</strong> This proves that MLR may adequately reflect thalamocortical hyperactivity in cases with distressing tinnitus and demonstrable improvement post TRT warrants the use of MLR as its prognostic indicator.</p>
Mucormycosis coinfection associated with global COVID-19: a case series from India
Authors: Satish Deepthi , Joy Divya , Ross Anita , . Balasubramanya 
Published: April 2021

<p><strong> </strong></p><p class="abstract"><strong>Background: </strong>Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. There has been increasing number of mucormycosis cases during COVID-19 pandemic and also as post COVID-19 sequelae. Our study aimed at scrutinizing a possible coinfection of invasive mycoses and COVID-19 and also its management</p><p class="abstract"><strong>Methods: </strong>We did a retrospective case study of 25 patients presenting as invasive fungal infection from March -December 2020. Majority of patients were immunocompromised, since they presented during the pandemic, all patients were subjected to rapid antigen and RT -PCR testing for COVID-19.</p><p class="abstract"><strong>Results: </strong>11 patients tested COVID-19 positive out of 25. Diagnosis of mucormycosis was based on clinical features, culture, and histopathology from sinus biopsy. COVID-19 positive patients were managed in the high dependency units and COVID-19 wards. Severe COVID-19 positive patients were empirically started on IV Amphotericin based on clinical suspicion of mucormycosis and were taken up for debridement once stable. Negative patients underwent surgical debridement and were started on IV Amphotericin postoperatively.</p><p class="abstract"><strong>Conclusions: </strong>There have been lot of case reports from India showing COVID-19 recovered patients presenting with invasive fungal infections, this could be because of their immunocompromised status and long-term corticosteroid use. In our case series we had three patients with post COVID-19 mucormycosis. There was a surge in COVID-19 positive mucor cases during August and September which also coincided with the maximum peak of cases in India, thereafter, there has been a declining trend. There have been significant challenges in treatment modality and outcome due to the pandemic.</p>
Aplasia and agenesis of the frontal sinus in individual of southern region in Saudi Arabia
Authors: Shamakhi Radeif , Mubaraki Musleh , Dighriri Ramzi , Almarir Azza , Alyahya Alaa 
Published: April 2021

<p class="abstract"><strong>Background:</strong> The aim of this study was to demonstrate the prevalence of anatomic variations of frontal sinus in people of southern region in Saudi Arabia.</p><p class="abstract"><strong>Methods:</strong> This study used a retrospective radiological design to analyze computed tomography scans of 117 patients aged between 18 and 80 years of southern region in Saudi Arabia were used in this study. Patients with altered anatomy (iatrogenic or pathological) were excluded, CT scans were analyzed to demonstrate the incidence of anatomic variations of frontal sinus in people of southern region in Saudi Arabia.</p><p class="abstract"><strong>Results:</strong> The study included 117 patients, 75 of whom were males (64%) and 42 of whom were females (36%) with ages ranging from 18 to 80 years. The prevalence of bilateral frontal sinus aplasia is 5.9 % and 3.4% is in the unilateral frontal sinus.</p><p class="abstract"><strong>Conclusions:</strong> These figures on frontal sinus aplasia are critical in convincing surgeons to perform a preoperative CT scan of the paranasal sinuses and concentrate on the appearance of frontal sinuses on CT images to avoid unwanted complications during sinus surgeries.</p><p class="abstract"> </p>
Salivary gland tumours: a retrospective study at a tertiary care centre in South India
Authors: Swarnkar Neha , Venkataraman Srinivasan , Saravanam Prasanna Kumar 
Published: April 2021

<p><strong>Background:</strong> Salivary gland tumors are morphologically and histologically diverse group of lesions and their frequency varies in several parts of the world. Better understanding of these tumours will help in assessing the behaviour and outcomes of lesions of this region. The aim of this study was to analyse the charactertistics of different tumours occurring in the salivary gland in a tertiary care centre in South India.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted of salivary gland tumors diagnosed from the year 2015 to 2020. Patient age and gender, tumor site and frequency, histopathological diagnosis were evaluated and analysed.</p><p class="abstract"><strong>Results:</strong> A total of 36 salivary gland tumor cases was identified, 30 (87.3%) of which were classified as benign and 6 (12.7%) as malignant. Most tumors occurred in the parotid gland (81.3%). Pleomorphic adenoma was the most common tumor in 23 patients (63.8%), followed by warthins tumour. The tumors occurred more often in women than men.</p><p><strong>Conclusion: </strong>The results of the present study reinforce prevalence of salivary gland tumours. The parotid gland is the most common location and pleomorphic adenoma are the most frequent lesions. The malignant tumors also can occur in these glands and good clinical suspicion is necessary.</p><p class="abstract"> </p>
Audiological profile of pre-operative and post-operative results in mucosal diseases of the ear: a comparative study
Authors: M. Archana , Ahmed Ruman , Malashetti Santosh P. 
Published: April 2021

<p class="abstract"><strong>Background:</strong> The Objectives of the study were to study pre-operative audiological results in mucosal diseases of ear; to study post-operative audiological results in mucosal diseases of ear and to compare pre-operative and post-operative audiological results in mucosal diseases of ear.</p><p class="abstract"><strong>Methods:</strong> A prospective study was done on 60 patients presenting to out-patient department of Otorhinolaryngology and Head and Neck Surgery, S.Nijalingappa Medical College and H.S.K Hospital and Research Centre, Bagalkot from May 2018 to April 2020 with CSOM-mucosal disease. Audiological evaluation was done and compared using pure tone audiometry (Amplaid311TypeIEC645) before and after tympanoplasty with cortical mastoidectomy and mean air conduction (AC) threshold improvement and mean air-bone gap (AB gap) closure was analyzed. </p><p><strong>Results:</strong> Out of 60 patients, 27(45%) patients had medium sized central perforation. Mean pre-operative AC threshold was 44.5958±10.64639 dB HL which improved to 30.100±10.41056 dB HL at 1month and 21.8125±8.6928 dB HL at 3months post-operatively which was statistically significant with p&lt;0.001*. Mean AB gap closure at 1-month was 10.175±6.01098 dB HL and at 3-months was 11.0416±6.3458 dB HL.</p><p><strong>Conclusions:</strong> AC threshold gain and AB gap closure at 1month and 3 months post-tympanoplasty with cortical mastoidectomy for CSOM-mucosal disease are significant. Hence surgery is main basic tool which results in improvement of audiological results in mucosal diseases of ear.</p>