bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study to evaluate serum 25-hydroxy vitamin D3 and calcium levels in maternal and cord blood and their effect on pregnancy outcome
Authors: B. P. Thangappah Radha , Sampson Ursula , Azad Amrin , Arumugam Rathna , Anand Smriti , Karunakaran Ponnalagan 
Published: March 2019

Background: To determine the prevalence of vitamin D deficiency among pregnant mothers and their neonates and to study the effect of vitamin D deficiency on maternal and perinatal outcome.Methods: This prospective cohort study conducted in a teaching hospital included 223 pregnant mothers and their offspring born in 2017. Detailed history was taken to ascertain the causes of vitamin D deficiency. vitamin D3 and calcium levels were estimated in maternal and cord blood samples. To study the association between the vitamin D status and the various maternal and neonatal parameters.Results: 91.9 % of women were house wives involved in indoor activities. Pre-eclampsia and GDM were seen in 4.5% of cases each. 5.41% were obese and 84% were of medium complexion, and 8% were dark. 93.7% were non- vegetarians, and fish, egg and milk consumption was adequate in 61.3% , 64% and 71% respectively. Only 5.40% of women had adequate exposure to sunlight. The mean birth weight was 3.08± 0.36 Kg. and 14 babies were admitted to NICU for neonatal asphyxia.77.40% had deficient levels of vitamin D <20 ng/ml. Only four pregnant mothers (1.8%) had sufficient levels vitamin D. There was no statistically significant association between vitamin D deficiency and various maternal and neonatal parameters.Conclusions: This study has shown that the prevalence of vitamin D deficiency among south Indian pregnant mothers and their newborn is very high and the ways to improve the vitamin D status among pregnant mothers should be looked at.
Obstetric outcome in elderly gravida
Authors: Gaikwad Supriya S. , Chaudhari Kamlesh R. , Batheja Karuna 
Published: March 2019

Background: Maternal age is an important determinant of the outcome of pregnancy. Advanced maternal age generally signify age after 35 years at the time of delivery. It is associated with decreased fertility and increased risk. Elderly gravida is associated with many complications during pregnancy, labour and also for the baby. In recent times women has changed their lifestyles such as pursuit of higher education and entry into work forces and career advancement outside the home.Methods: This was a retrospective study done in 57 elderly pregnant women more than 33 years age, over a period of 18 months, conducted in a multi-specialty hospital.Results: 57 elderly pregnant women were selected for the study. 47% were in age group of 33-35 years and 42% were in age group of 36-40 years. 61.40% patients were housewives and 38.59% were employed. 50.8% of patients had history of previous abortions and 35% were conceived after treatment for sterility. 64.9% of patients conceived spontaneously and 35% by assisted reproductive technology. Majority of patients (33.3%) required Invitro-fertilization. Multiple pregnancy was high- 21.05%. Hypertension was observed in 26.3% of patients, Antepartum haemorrhage in 4.34%, Preterm delivery 49.1%, Induction of labour in 10.52%, Normal vaginal delivery only in14%. Majority of patients (80.7%) were delivered by caesarean section.Conclusions: Elderly pregnant patients have higher risks of specific pregnancy complications which contribute to a higher frequency of maternal morbidity and greater health care costs. The risks are due to Hypertension, diabetes, multiple pregnancy, preterm labour, antepartum haemorrhage, PROM, malpresentation, prolonged labour, increased caesarean section rate and postpartum haemorrhage.
Chemo-resistant gestational trophoblastic neoplasia: a review of cases at a tertiary cancer centre
Authors: R. Mirji Sharayu , M. Patel Shilpa , S. Arora Ruchi , D. Desai Ava , H. Mankad Meeta , K. Sangeetha , P. Panchal Harsha 
Published: March 2019

Background: Gestational trophoblastic neoplasia (GTN) was earlier a dreaded malignancy with high mortality rates. GTN is now considered to be one of the most curable solid tumours in women with cure rates greater than 90% even in the presence of metastases. Despite the high chemo sensitivity, treatment failure or drug resistance has been described in both groups.Methods: In this study, available records of GTN cases over 6 years were reviewed with emphasis on those who were resistant to the first line of chemotherapy. Of these, 37(34.58%) were resistant to the first line of chemotherapy. These cases were studied with respect to age, parity, antecedent pregnancy, interval from antecedent pregnancy, pretreatment β hCG, risk score and presence of metastases. The data was analyzed in order to find any risk factors associated with chemo-resistance.Results: Total number of cases of GTN was 107. Out of these 107 cases, 63 (58.88%) were low risk and 44 (41.12%) were high risk according to FIGO scoring system. Complete response was achieved with first line chemotherapy in 70 (65.42%) patients. The remaining 37 (34.57%) were resistant to first line chemotherapy. In the low risk group, 30 (47.62%) cases, and in the high-risk group, 7(15.91%) were resistant to first line of chemotherapy.Conclusions: Despite the high chemo sensitivity of GTN, resistance to first line chemotherapy may be encountered in up to 40% of cases. It is important to identify the patients who are at risk to develop resistance, early identification of resistance and change of chemotherapy so as to minimize the exposure of these patients to ineffective chemotherapy.
Association of hyperlipidaemia in preterm delivery
Authors: Kundoor Ruthvika , Sandhya Rani Burri 
Published: March 2019

Background: Premature infant is the most important outcome of preterm delivery and is also the cause for infant mortality after congenital abnormality. Around the world, there are 3.6 million per year neonatal deaths, of which in developing countries, 99% deaths are observed. This study was conducted to evaluate the elevated triglycerides and cholesterol relationship on preterm labor risk.Methods: 350 healthy pregnant women were included in the study group in the age group of 18-36 years, their gestational age was confirmed either by last menstrual period or by ultrasound. This study was conducted in Department of Obstetrics and Gynaecology at Osmania University, Hyderabad, Telangana India.Results: The good outcomes were observed in mothers with normal cholesterol values and preterm deliveries were observed in 32.14% of mothers with abnormal cholesterol values. 0.3% of mothers with normal triglyceride values and 75% of mothers with abnormal values had preterm delivery. P value difference was statistically significant (P<0.05).Conclusions: By measuring serum total cholesterol and triglycerides, along with serum screening of α-fetoprotein and inhibin A, it can be used to predict the preterm labour.
Association of first trimester serum level of placental growth factor (PlGF) and cervical length with onset of preterm labour
Authors: Sahoo Ipsita , Dey Madhusudan , A. Jayamol 
Published: March 2019

Background: Preterm labour (PTL) or premature labour is defined as one where labour starts before the 37th completed week. The incidence of preterm birth is around 5-10% and it is the leading cause of perinatal morbidity and mortality. Diagnosis and treatment of PTL is challenging. However, owing to the availability of effective strategies for prevention of preterm birth, risk identification and early prediction is even more essential. This may provide opportunity for intervention and better obstetric care. Various biochemical markers were studied for prediction of preterm labour, but the sensitivity and specificity were found to be low. This study focuses on determining whether serum level of PlGF and ultrasound measure of cervical length at 10 – 14 weeks period of gestation can be used for early prediction of preterm labour.Methods: 296 antenatal women participated in this prospective observational study carried out from Dec 2015 to Sep 2017 at a tertiary care hospital. Serum level of PlGF was determined at 10-14 weeks. In the same sitting, cervical length was measured by transvaginal sonography. All these patients were followed up in antenatal OPD for monitoring the onset of preterm labour.Results: Incidence of preterm labour was 6.76 %. Maternal characteristics and obstetric factors were comparable in cases and controls. Serum PlGF level and cervical length values were lower in preterm labour group than term deliveries. But this result was not statistically significant.Conclusions: Lower levels of PlGF and cervical length were seen in preterm labour group, although it was not found to be statistically significant.
Ruptured ovarian cyst hemorrhage: the swing between conservative and surgical management
Authors: Al-Shukri Maryam 
Published: March 2019

Ruptured ovarian cyst hemorrhage is one of the causes of acute abdomen in women of reproductive age group that can be life threatening.1 There have been persistent interest in the discussion of managing ruptured ovarian cyst with or without ovulation.1–4 The dilemma of surgical versus conservative/non-surgical management always exist in such cases. It is more of a conundrum when the patient has abnormal coagulation due to either hematological disorders or as a result of anticoagulants.1,5 Commonly, indications for surgical interventions are variable and includes: if the source of the bleeding is not confirmed, if patient is hemodynamically unstable, or if there are evidence of ongoing bleeding not settling despite conservative measures in a reasonable time.1
Acute bilirubin encephalopathy in term neonates: a hospital-based study
Authors: Iqbal Javaid , Sharma Sunil Dutt , Jamwal Ashu , Saini Ghanshyam 
Published: March 2019

Background: Acute Bilirubin Encephalopathy and kernicterus is an important cause of cerebral palsy, developmental delay and hearing impairment in low-middle income countries. Interventions such as universal screening for neonatal jaundice, Rhesus immunoglobulins, intensive phototherapy and exchange transfusion have made kernicterus rare in high income countries, but in our set up such cases continue to be reported. Methods: Retrospective observational study where case records of term neonates brought to the neonatal ICU with signs and symptoms of acute bilirubin encephalopathy during the years 2016 and 2017 were sought and analysed.Results: A total of ten term babies reported to the neonatal unit with severe hyperbilirubinemia along with signs and symptoms of bilirubin encephalopathy of which 60% were females. 90% had a birth weight of more than 2.5 kg and mean birth weight was 2.7±0.25 kgs. All the babies were out born. A 4 babies were born at home of which 3 pregnancies were completely unsupervised during the antenatal period. 90% of the babies were from the rural areas, 6 of the cases were from the districts Rajouri, Poonch and Reasi where the terrain is hilly, 2 from rural areas of Jammu and 1 from Kathua. Only 1 was from the Jammu city. The age at admission ranged from 3-9 days and serum bilirubin from 24 to 43.3 mg %. A 5 babies had ABO incompatibility, 1 Rh incompatibility, 1 sepsis, while no cause could be found in 3.Conclusions: Neonatal jaundice is often not easily appreciated by mothers and caregivers in the home setting until it becomes severe enough, at which point neurological damage may have already occurred. There is an urgent need to train the primary health care personnel in assessment and early identification of risk factors for severe neonatal hyperbilirubinemia. They can help the families to seek prompt treatment for this preventable cause of cerebral palsy and mental retardation.
Role of colonoscopy in haemorrhoids with other colorectal disorders
Authors: Mala Tariq Ahmed , Ahmad Syeed Rayees , Malla Shahid Amin 
Published: March 2019

Background: Haemorrhoids are the enlargement or engorgement of the normal fibrovascular anal cushions. These fibrovascular cushions lose their attachment to the underlying rectal wall and lead to prolapse with repeated straining over time, thinning of rectal mucosa and subsequent bleeding. The objective of the present endeavour was to study the prevalence of associated colorectal lesions like colonic carcinoma, diverticular disease, inflammatory bowel disease which present the rectal bleeding and role of colonoscopy in these lesionsMethods: This study was conducted in hundred fifty patients presenting with bleeding and haemorrhoids were analyzed. All patients were examined locally and endoscopically. All significant endoscopic findings (diverticuli, polyps, cancer, angiodysplasia and varices or colitis) were recorded.Results: Majority of patients were males (102), accounting for (68 percent). The main symptom at the time of presentation was rectal bleeding (90 percent). The digital rectal examination was normal in 114 patients. The commonest finding on proctoscopy examination was haemorrhoids. Colonoscopy showed haemorrhoids in maximum patients (147 percent). The associate lesions with altered bowel habits were growth in 12, worm in 6, solitary rectal ulcer in 3, pancolitis in 3.Conclusions: It can be concluded that in the present study colonoscopy revealed a high proportion of colorectal pathologies with haemorrhoids presenting with bleeding per rectum. Colonoscopy thus proved to be very useful procedure in patients with haemorrhoids especially in elderly.
Association of non-alcoholic fatty liver disease with chronic kidney disease in type 2 diabetes mellitus
Authors: Rajender Akash , Bhargava Rajat , Choudhary Priyanka , N. Sheetal , Upadhyay Shalini , Singh Gopal , Nepalia Subhash , Rijhwani Puneet 
Published: March 2019

Background: Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. NAFLD is considered a disease of no consequence. Data on the effect of NAFLD on renal dysfunction in T2DM is sparse. Author aimed to study the association of NAFLD with CKD in Indian T2DM subjects.Methods: In an observational cross-sectional study at Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India from February 2017 to March 2018. 197 out of 268 randomly selected type 2 diabetes mellitus (T2DM) subjects were selected for the study after considering the inclusion and exclusion criteria. CKD was defined as estimated GFR <60 ml/min per 1.73 m2 and/or albumin to creatinine ratio ≥30 mg/g. NAFLD was diagnosed using ultrasonography. The association between NAFLD and CKD was analyzed using SPSS (version 24.0).Results: On ultrasonography 133 (67.5%) T2DM subjects had NAFLD. Diabetic with NAFLD (133, 67.51%) had significantly more history of hypertension (p 0.006), higher systolic (p 0.03) and diastolic BP (p 0.009), higher BMI (p <0.001), waist circumference (p <0.001), fasting glucose (p 0.03), triglyceride (p<0.001) and higher urinary albumin-to-creatinine ratio (p <0.001). Diabetics with CKD (61, 30.96%), were older (p 0.03), hypertensive (p <0.001) and had higher fasting glucose (p 0.003). Subjects with CKD had a higher prevalence of underlying NAFLD (78.69% vs 62.5%, p 0.03) as compared with diabetics with no CKD. T2DM subjects with NAFLD had more than two times (OR 2.88 (1.1-6.78), p 0.03) the risk of developing CKD after multivariate analysis as compared to subjects without NAFLD.Conclusions: NAFLD is a risk factor for development of CKD in patients of type 2 diabetes mellitus. Screening and early preventive measures may go long way in reducing morbidity.
The Conceptual World of the Ghadarites
Authors: D'Souza Radha 
Published: March 2019

The Ghadar movement is framed by scholars variously as socialist or proto-communist, anarchist, secular or religious nationalist. These theoretical frames developed in the European historical contexts to oppose liberalism and modernism. Framing historical experiences of colonialism and resistance to it by using theories developed in radically different conditions of European capitalism and Enlightenment, disrupts history-writing and the historical consciousness of people in the Third World. This paper examines the historical consciousness that guided Ghadar resistance to colonial rule. How are we to understand the distinction between system and ‘lifeworld’ that Jurgen Habermas makes in a context where the ‘system’ is capitalist /imperialist/ modernist and the ‘lifeworld’ is South Asian/ Indian Enlightenment/ colonial? What was the ‘lifeworld’ of the Ghadar leaders that informed their understanding of nationalism and state, secularism and religion, liberation and justice? Theories contribute to creating historical consciousness and identity by showing us a view of the world that we can identify with, by providing a sense of continuity with the past. Disruption of South Asia’s historical consciousness has had profound consequences for the people of the subcontinent. This paper locates the Ghadar movement in the structural transformations of South Asia after the end of the First War of Independence in 1857 known as the Great Ghadar. The paper takes common theoretical lenses used to analyse the Ghadar movement in academic scholarship: secular and ethno-religious nationalism, anarchism and socialism as its point of departure to sketch the theoretical and philosophical routes through which Ghadar leaders arrived at comparable values and political positions. It shows how they could be secular, religious, anarchist and socialist simultaneously. The Ghadar movement is important because it is the last major resistance movement that saw South Asia through South Asian lenses and attempted to address problems of colonialism and national independence in ways that was consistent with Indian historical consciousness and cultural and intellectual traditions.
John Atkinson Grimshaw
Authors: Tejedor Estupiñan Ricardo Alonso 
Published: March 2019

Fue el tercero de seis hijos del policía David Grimshaw y su esposa Mary Atkinson. Nació en la ciudad de Leeds, la cual fue en sus albores un sitio comercial especializado en lanas. Las líneas del ferrocarril llegaron a esta ciudad en 1848, por lo cual empezaría a modernizarse rápidamente, para pronto convertirse en una de las más importantes en la segunda etapa de la revolución industrial inglesa, siendo actualmente, después de Londres y Manchester la tercera más grande en población, en donde su producto se destaca por los servicios de negocios, financieros y legales.
Muy poco se conoce de su vida personal, lo que ha dificultado hacer una semblanza del artista. Se cree que fue autodidacta y, según las fechas de sus obras y dibujos, se estima que inició a pintar hacia 1850, en plena época victoriana.
Monitoring of conductive hearing loss due to because of eustachian tube dysfunction preservative treated with the Otovent pneumotherapy method.
Authors: Nowak Małgorzata , Wolnowska Beata , Sekula Alicja 
Published: March 2019

INTRODUCTION. A conductive hearing loss is a very common problem in childhood. It is possible to indicate many reasons for the problem, but most of the times it is caused by the infectious process, as well as the typical adenoid hypertrophy in children. Very often this disease is associated with obstruction of the eustachian tube.OBJECTIVE. In this study, the authors present the results of the hearing tests of patients who underwent the treatment of the eustachian tube obstruction by pneumotherapy with otovent. The aim of the work was to monitor the effectiveness of this method of OME treatment.RESEARCH GROUP AND METHODOLOGY. The research group consisted of 54 children aged 4 to 15 years, including 23 girls and 31 boys. The control group consisted of 16 children. Pure tone audiometry and impedance audiometry were performed before and after the therapy, for all of the participants.RESULTS. Obtained results of the study showed improvement in hearing in children correctly using the Otovent set. Hearing improvement was recorded both in the results of pure tone audiometry and impedance audiometry.CONCLUSIONS. The obtained results showed the effectiveness of the pneumotherapy method. In the case of the research group, 81.4% of children achieved the auditory norm (44 people). In the case of the control group, after a fixed period of application of the Otovent set, this value was 0%. The intergroup comparative analysis clearly shows that the research group obtained significantly better results within all of the parameters assessed, than the control group.
Acid steatocrit in the first 2 years of life: diagnostic accuracy and reference limits
Authors: Wieczorek-Filipiak Mirosława , Drzymała-Czyż Sławomira , Walkowiak Dariusz , Szydłowski Jarosław , Miśkiewicz-Chotnicka Anna , Szajstek Zuzanna , Moczko Jerzy , Walkowiak Jarosław 
Published: March 2019

Introduction. The measurement of acid steatocrit (AS) is an established method to assess faecal fat balance. However, data regarding AS in healthy infants and toddlers are sparse. Aim. This study aimed to determine the range of normal values for AS in the first two years of life and evaluate the correlations with other faecal fat balance tests.Material and Methods. AS (%) was assessed by 72-hour stool collection in 160 children aged 1–24 months (8 groups of 20: aged 1–3, 4–6 months, etc.).Results. AS was higher in infants < 6 months than in those aged 7–12, 13–18 and 19–24 months (p < 0.05, p < 0.001 and p < 0.001, respectively). The correlations between AS and age and faecal fat concentration (FFC) were statistically significant, but moderate or weak (r = -0.48, p < 0.0001; r = 0.28, p < 0.001, respectively). A 90th/95th percentile nomogram of AS was created based on these results, with values ranging from 23.6/23.9% at 1 month to 12.1/12.9% at 24 months. Conclusions. Healthy infants have a significantly higher AS than older children. For this reason, we propose an upper limits nomogram, providing detailed reference values for infants and children in their first two years of life. However, it should be noted that AS does not reflect adequately FFE and FFC in this population.
Spirometry in selected clinical situations
Authors: Szczechowiak Piotr , Piorunek Tomasz 
Published: March 2019

Spirometry is the most frequently performed functional test of the respiratory system. In pulmonological practice it is a basic tool used to diagnose ventilation disorders and to monitor treatment. The results obtained during the test are compared to predicted values, that is, assumed parameter values, computed on the basis of anthropometrical data such as: age, gender and height, with the use of complex equations. The use of additional variables including, e.g. an ethnic group or a race as well as corrective factors, enables a more exact determination of their values. Spirometry can be conducted in a sitting or standing position; however, for the subject safety reasons it is usually performed in a sitting position. It allows to eliminate the risk of fall as a result of syncope or impaired balance. Spirometry in a standing position should be considered in measurably obese patients or in patients with a wide abdominal circumference caused by other reasons. Patients with normal body weight obtain equivalent or slightly higher spirometric values in a standing position. In the selected clinical situations some problems with the measurement of the actual hight of patients in a standard way (measurement without shoes, feet together, upright position, eyes straight ahead) and with correct calculation of predicted values occur. They are, among others, silhouette-disturbing disorders or diseases causing changes in body proportions, from the less often occurring, like Marfan syndrome or achondroplasia, to more frequent posture defects and mobility impairments. These diseases influence the change of the predictive functional parameter values which are used to compare with the obtained results. The aim of the study is to demonstrate the methods of height and predicted values determination on the basis of measurements of ranges between different body points with the use of simple and complex equations in a group of patients in whom the application of standard measurement methods is impossible.