bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaginal birth after cesarean
Authors: Gupta Shilpa , Ganatra Hina 
Published: June 2019

Background: A heightened awareness must be present among the clinicians while taking the decision to perform the first cesarean section, as it decides the future obstetric career of the women. Because of the rise in cesarean section rate in recent decades, the question of how to manage the subsequent deliveries becomes important. Vaginal birth after cesarean (VBAC) has long been proposed as an alternative measure to reduce repeat cesarean rate. Our present study aims to assess the predictive factors of successful VBAC and study the risks and benefits involved.Methods: A prospective observational study was conducted to assess the success of VBAC and its outcome in GMERS Medical College and Hospital, Ahmedabad. A total of 100 pregnant women with history of previous one cesarean section who fulfilled the criteria for vaginal delivery were recruited for study and the outcome was analyzed.Results: The success rate of VBAC was 58% while failed TOLAC which ended up in emergency repeat cesarean section was 42%. Vaginal delivery either before or after the history of previous cesarean section, neonatal birth weight between 2.5-3kg, and admission during active phase of labour were associated with successful VBAC. There were 2 cases of partial scar rupture diagnosed peroperatively. The commonest indication of repeat cesarean section was non progress of labour (45.2%) followed by fetal distress (16.7%). The neonatal morbidity rate was similar in both groups due to limited prolonged unsuccessful trial in our study. There was no maternal and neonatal mortality.Conclusions: To reduce the escalating rate of total cesarean section worldwide, VBAC is an alternative option which should be encouraged in carefully selected patients. However, it should be carried out in a well equipped institute with close fetal monitoring and availability of blood and trained personnel. Thus “once a cesarean section, always a hospital delivery” and not, “once a cesarean section, always a cesarean section”.
Studying prevention of parent to child transmission services, interventions, coverage and utilization
Authors: Patel Seema , Anand Nikhil 
Published: June 2019

Background: Human immunodeficiency virus (HIV) infection is increasing at an alarming rate globally. Apart from heterosexual route, mother to-child transmission is the next most important route of HIV transmission accounting for over 90% of infections in children. The present retrospective study is undertaken to evaluate the effectiveness of implementation of PPTCT programmed in GMERS Medical College, Sola, Ahmedabad, Gujarat, India.Methods: At ICTCs, registered ANCs are counseled and tested for HIV. HIV+ve ANCs are linked to services and followed-up for institutional delivery. Antiretroviral prophylaxis with nevirapine was given to seropositive mother-baby pairs during delivery and children testing. HIV+ve ANCs since 2014 to 2016 subsequently delivered till December 2018 and their exposed children followed up till 18 months for confirmation of their seropositivity status in PPTCT were study at GMERS medical college, sola, Ahmedabad, Gujarat, India.Results: 13595 ANCs registered, 100% were counseled pre-test, and 99.5% of them tested, 79.5% were counseled post-test. CD4 testing was carried out in all HIV+ve ANCs. 55 ANCs were detected HIV+ve inclusive of 37 new registered, 16 re-pregnancy and 2 unregistered cases. 55 pregnancy outcomes reported institutionally total 85.9% delivered at institute out of them 26.5% were caesarian sections and 62.4% delivered vaginally. Out of 48 live births, 47 sdNVP-MB-Pair were given. 48 children were traced till 18 months, 82.5% of live births were alive, and 68.75% of live births were tested. 1 was found HIV+ve with history of adherence to all prescribed PPTCT guidelines.Conclusions: PMTCT services - counseling and testing should be provided to all ANCs. EDD-based tracking, institutional deliveries, postnatal counseling to be encouraged along with complete MB pair coverage, capacity building of concerned staff regarding delivery of HIV+ve ANCs and exposed children tracking.
A rare case of Meckel Gruber syndrome
Authors: Chandra Rudrika , Singh Bhanu Pratap , Singh Sanjay 
Published: June 2019

Meckel Gruber syndrome (MGS) is a rare lethal autosomal recessive disorder. It is characterized by triad of features having occipital meningoencephalocele, polycystic kidneys and post-axial polydactyly. We report an antenatal patient detected with occipital meningoencephalocele in foetus on early anomaly scan at 15 weeks of gestation followed by foetal MRI which revealed the typical triad features strongly suggestive of MGS. The patient opted for medical termination of pregnancy and the abortus was autopsied, with the permission of the patient, for detailed evaluation of anomalies which were consistent with MGS. This case highlights the importance of a detailed foetal evaluation antenatally to detect anomalies which are incompatible with life and proper diagnosis as it has bearing on patient’s future obstetric outcome.
Medial versus lateral approache in laparscopic right hemicolectomy
Authors: Elsisi Alla Abd-Elazim , Rageh Tarek Mohey , Elmeligy Mohamed Hammed , Ibrahm Saad Soliman 
Published: June 2019

Background: Approach to right colon cancer is through open exploration but it has many complication, now laparoscopic right hemicolectomy is an advanced cancer surgery, laparoscopic right hemicolectomy can be done by medial or lateral or combined approach.Methods: This is prospective study carried out on 30 patients admitted to department of surgery in menufia university hospital from September 2016 to September 2018 and all cases have RT colon cancer; The patients are divided into three groups, 1- group A (n=10): underwent medial approach for laparscopic right hemicolectomy 2- group B (n=10): underwent lateral approach for laparscopic right hemicolectomy, 3- group C (n=10) : underwent combined laparscopic medial and lateral approach, Blood loss, operative time, operative and postoperative complication were assessed. The period of follow up is for 6 months.Results: Operative duration and blood loss were significantly lower in combined approach. Intra and post operative complications were low in combined and MA.Conclusions: Laparoscopic combined approach reduces the operative time and blood loss than MA and LA. Besides the oncologic advantages of an early vessel division and a "no-touch" dissection.
Thyroid autotransplantation following total thyroidectomy in benign thyroid disorders: a new technique to avoid postoperative hypothyroidism
Authors: Gamal Ahmed Mohamed , Elnaga Nagm Eldin Abu , Ayoub Mahmoud Thabet , Farghally Abdel Radi Abdel Salam 
Published: June 2019

Background: Although total thyroidectomy has become the operation of choice in treatment of BMNG, it leads to permanent hypothyroidism which lead the patient to take a lifelong exogenous hormone replacement therapy, which involves daily administration of levothyroxine at a dose that must be in close follow-up in terms of thyroid hormone levels. In addition, reaching euthyroid status using hormone replacement therapy can be affected in presence of other medical problems that interfere with absorption of the drug as mal-absorption syndrome. When all these are considered, there is a necessity of a novel method to avoid the occurrence of postoperative hypothyroidism.Methods: A case series prospective study carried out over 30 patients with benign thyroid disorders for whom total thyroidectomy is indicated to evaluate the capacity of auto-implanted thyroid tissue in achieving an euthyroid state without any need for life-long hormone replacement therapy. Postoperative Assessment consists of repeated thyroid function tests and thyroid scan with complementary SPECT/CT.Results: significant gradual increase in serum levels of T3 and T4 with corresponding decrease in TSH levels returning to normal levels 6-9 months postoperatively. Thyroid scan with complementary SPECT/CT was done for 15 patients to evaluate the functional capacity of the thyroid implant. Among the 15 patients, 13 patients have functioning thyroid implant (success percent: 6.6%). whereas 2 patients show non functioning thyroid implant (failure percent: 13.3%).Conclusions: Thyroid Auto-transplantation following total thyroidectomy in benign thyroid disorders is an effective method to prevent postoperative hypothyroidism.
Post-operative CT imaging of laparoscopic sleeve gastrectomy: our initial experience
Authors: Varaprasad Vemuri Naga , Venkatesh Manchikanti , Ravikanth Kongara 
Published: June 2019

Background: Laparoscopic sleeve gastrectomy (LSG) is a restrictive type of bariatric surgery. It is safe and effective with its many advantages like relative simplicity of the procedure, lack of malabsorption component and anastomoses and retaining the anatomical gastrointestinal continuity. Obesity, a chronic disease, with the significant rise of its comorbidities and mortality is attributing to the major financial and health burden globally. Methods: We conducted a prospective study of over 43 patients (male 32, female 11) over 5 years period i.e., from 2012 to 2017. These patients were assessed with contrast enhanced computerized tomography (CECT) for detection of post-operative complications.Results: The patients with the body mass index (BMI) >40 kg/m2 and or with a BMI >35 and <40 kg/m2 but with significant weight related comorbidities underwent Laparoscopic sleeve gastrectomy. Both intravenous (IV) and oral contrasts are used accordingly. With increasing number of surgeries and with associated co-morbidities complications following LSG are increasing, necessitating the need for a good understanding of clinical symptoms and post-operative complications of LSG. Post-operative imaging plays a crucial role in the early detection of complications resulting in reduced mortality rate.Conclusions: We suggest multidetector computed tomography (CT) with oral and IV contrast as an excellent tool for the patients having a nonspecific abdominal symptom post LSG.
Dynamic ultrasound in evaluating the spectrum of anterior abdominal wall lesions
Authors: Rana Priyanka , D’Souza John , Joshi Priscilla , Bandgar Amol , Mahajan Mangal , Kulthe Nikhil 
Published: June 2019

Background: Lesions in anterior abdominal wall are evident early and their clinical detection is easy. Ultrasonography is the first investigation for the patient clinically suspected to have an anterior abdominal wall lesion. This study evaluated the anterior abdominal wall pathologies using Dynamic ultrasound (USG) and compared the findings with surgical operative findings.Methods: There were 100 consecutive patients of all age groups with clinically suspected anterior abdominal wall pathologies referred for USG of the abdomen were selected for this study.Results: Our study showed a higher incidence of anterior abdominal wall pathologies in male patients (77 %) with an incidence of 41 % in the age group of >60 years. Hernias had an incidence of 93 % followed by undescended testis: 4 %, Divarication of recti: 2% and Rectus sheath hematoma: 1%. Inguinal hernia was the most common hernia with an incidence of 58%. The findings correlated with surgery and gave a sensitivity of 100 %.Conclusions: Ultrasonography including Dynamic USG is a safe, quick, cost-effective, accurate and non-invasive modality for assessing the anterior abdominal wall lesions with a high sensitivity. Dynamic USG also helped to accurately measure the diameter of the neck and content of the sac which aided the surgeon in managing the repair of the hernia.
Comparison between extra mucosal continuous prolene repair versus interrupted through and through silk repair in colonic anastomosis
Authors: Nayak Ashok Kumar , Nayak Malaya Krishna , Jha Dharbind Kumar , Kar Chinmaya , Maharana Debashree 
Published: June 2019

Background: The traditional double layered colonic anastomosis incorporates large amount of ischemic tissue in the suture line causing luminal narrowing and fistula formations. Single layered anastomosis may be done through continuous extramucosal suturing or by interrupted through and through technique using nonabsorbable materials. The single layer of suture has shown to be safe and causes fewer complications.Methods: The study was conducted in the Department of surgery, VIMSAR, Burla during the period from October 2016 to September 2018. All the patients of colonic anastomosis were included in the study. One group consists of extra mucosal continuous prolene repair and other interrupted though and through silk repair. Both groups were followed up and were compared taking different variables.Results: 146 cases of colonic anastomosis were performed, 110 with interrupted through and through silk repair (75.34%) and 36 with continuous extra mucosal prolene repair (24.66%).The mean time taken for silk repair was more (25.67 min) than prolene (15.5 min). The patients of prolene repair had shorter duration (9 days) of hospital stay than silk (12.4 days). The postoperative ileus was more in silk (16.36%) than prolene (5.56%). Anastomotic leak in prolene is less (2.78%) in comparison to silk (8.18%). The bowel movement appeared earlier with prolene (4.2 days) is less than ssilk (5.3 days).Conclusions: The present study shows single layer monofilament thin diameter prolene for different end to end colonic anastomosis has better prognostic panorama in relation to morbidity and mortality, and had an edge over conventional single or bilayere anastomosis.
Clinical and functional outcome comparison for platelet rich plasma with steroid injection in patients with isolated subacromial impingement syndrome
Authors: Mahajan Atul , Mehtani Anil 
Published: June 2019

Background: To compare the 6-weeks, 3 and 6 months outcome in 80 patients who received an injection of platelet-rich plasma (PRP) or steroid for sub-acromial impingement syndrome (SIS).Methods: There were 42 males and 38 females received a single-dose injection of PRP (n=40) or steroid (n=40) for SIS that had not responded to conservative treatment for more than 6 months. Both groups were put on physiotherapy protocol followed in our institution. The use of non-steroid anti-inflammatory drugs was prohibited. Patients were evaluated before and 6 weeks, 3 and 6 months after treatment using the constant score, visual analogue scale (VAS) for pain, and range of motion (ROM) of the shoulder.Results: No local or systemic complication occurred. Improvement in the constant score and VAS for pain at week 6, 3 and month 6 was clinically better following steroid than PRP injection. However, this difference was statistically insignificant. The 2 groups were comparable for improvement in ROM of the shoulder.Conclusions: PRP injection was not more effective than steroid injection for treatment of SIS in terms of at the end of 6 months. However, long term studies should be indicated to substantiate the findings.
Study of the Lichtenstein’s hernioplasty and its post-operative complications for different types of inguinal hernia
Authors: Nateson Anantha Kumar , Basavanayak Suresh Nayak , . Sudarsansrikanth 
Published: June 2019

Background: Lichtenstein’s hernioplasty is the commonly done surgery for inguinal hernias. The present study is aimed to study the Lichtenstein’s hernioplasty and its postoperative complications for different types of inguinal hernia.Methods: This prospective study was conducted at Department of General Surgery, MVJ Medical College and Research Hospital, Hoskote, Bangalore Rural, Karnataka. A total of 90 patients were selected for this study. Subjects with the age of 21 to 75 years with inguinal hernia are included in the study. A pre-designed proforma was used to collect their details. All selected cases were studied up to discharge regarding the type of hernia and followed up in OPD for 1 year regarding post-operative complications.Results: Immediate post-op complications like seroma/hematoma was observed in 10 (11.1%), wound infection was in 5 (5.5%) and orchitis was in 2 (2.2%). Post-operative complications like stiffness in lower abdomen was observed in 21 (23.3%) patients. Long term complications like forein body sensation was experienced by 22 (24.4) patients post-operatively at 1 month follow up, 8 (8.8%) patients at 3 months follow up and 3 (3.3) patients at 1 year follow up. Chronic pain was experienced by 17 (18.8%) patients at the end of 1 month follow up, at 3 month follow up, 13 (14.4%) patients and at the end of 1 year of follow up 4 (4.4%) patients at operated site. Recurrence was not observed in any of the patient.Conclusions: The study findings indicate that Lichtenstein’s hernioplasty was safe and reliable procedure for inguinal hernia repair.
Clinical profile and outcome of chest trauma: a four year retrospective analysis at a tertiary care centre
Authors: Khursheed Syed Quibtiya , Ashraf Waseem , Rather Ajaz Ahmad , . Shams-Ul-Bari 
Published: June 2019

Background: Chest trauma comprises about 10-15% of all traumas and 25% of all deaths from traumatic injury. Chest injuries are cause by blunt mechanisms such as road traffic accidents or penetrating mechanisms such as stab and missile injuries. Traumatic chest injuries are the most common cause of preventive mortality and morbidity.Methods: A retrospective study of all patients with chest injury presenting to Emergency Department of SKIMS Medical College, Srinagar was done. Records of all the patients were retrieved. A complete data regarding age, gender, mode/type of injury, extra thoracic injuries, mode of management and outcome was gathered.Results: A total number of 1429 trauma patients presented to AE of which 160 patients (11.2%) had chest trauma. Majority of the patients (51.87%, n=83) were of age group of 21-40 years. A male preponderance was observed. Road traffic accidents were major causes of blunt chest injury, while gunshot injury was the major causes of penetrating chest injuries. Head and neck injuries were the most common associated injuries. Tube thoracostomy was the commonest modality of management (65%) and (28%) patients were managed conservatively. Severity of chest trauma and associated injuries coupled with prompt diagnosis and treatment were important factors in efficient management of chest injuries.Conclusions: Chest trauma resulting from road traffic accidents remains the major mechanism of injury. Preventive measures aimed at educating the common masses about traffic rules and strictly implementing them is indispensable to reduce the incidence of chest injuries.
Hint Alt Kıtası’nda İlm-i Kelâm Çalışmaları (Bibliyografik Bir Deneme)
Authors: IŞIK Harun 
Published: June 2019

Hint alt kıtasında Müslümanlara ait dinî-ilmî eser geleneği, milâdî XII. yüzyıldan itibaren başlamış ve günümüze kadar gelmiştir. Özellikle Şeyh Ahmed Sirhindî, Şeyh Abdülhak Muhaddis Dihlevî, Şeyh Abdürrahim ve Şah Veliyyullah 18. yüzyıl ve sonrasına kaynaklık teşkil eden önemli şahsiyetlerdir. Sünnî geleneğe mensup İslâm düşünürlerinin kaleme aldığı Akâidve Kelam’a dair eserlerde benimsedikleri yöntem incelendiğinde, gelenekçiler, modernistler ve rasyonalistler olarak üç gruba ayrıldıkları görülmektedir. Şîa da Safevî Hânedanlığının yükselişinin ardından bölgedekendisini göstermeye başlamış, İsnâ Aşeriyye’ye ve İsmailî âlimler düşünce ve eserleriyle bölgede etkili olmuşlardır. Şiî âlimlerin bazısının gelenekçi bazısının da modernist olduğunu söyleyebiliriz. Kādiyânilik de Lahor kolu hariç, İslâmî gelenek içerisindeki heretik bir yapı olarak alt kıtanındüşünce tarihindeki yerini almıştır. Erciyes Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından 8217 nolu proje kapsamında elde edilen veriler ışığında hazırlanan bu çalışmanın amacı, İslâm düşüncesinin Hint alt kıtasındaki gelişimi bağlamında özellikle Şah Veliyullah sonrasına ait Akâid ve Kelam ilmi alanındaki çalışmaların bibliyografik açıdan tespit edilmesidir.
Sectarianism in The Middle East: Implications for the United States
Authors: KARTALOĞLU Habib 
Published: June 2019

Beş bölümden oluşan "Sectarianism in the Middle East: Implications
for the United States” başlıklı bu rapor, “Implications of a Religious
War in the Middle East for the U.S. Army” başlıklı bir projenin parçası
olarak yürütülen araştırma ve incelemeyi konu edinmektedir. United
States Army tarafından desteklenen bu projenin asıl amacı, son zamanlarda iç çatışmanın en
çok yaşandığı Irak ve Suriye ekseninde Ortadoğu’da mezhepçiliği ele almak ve
politika yapıcılara veriler sunmaktır.
Ontogenetik Varyabilitenin Labiatae Familyasına ait Bazı Bitkiler (Mentha spicata L., Origanum onites L., Melissa officinalis L., Lavandula angustifolia Mill.)’in Verimi Üzerine Etkileri
Authors: ÖZYAZICI Gülen , KEVSEROĞLU Kudret 
Published: June 2019

﻿Bu çalışmada,
Labiatae familyasına ait bazı bitkiler (Mentha
spicata L., Origanum onites L., Melissa officinalis L. ve Lavandula angustifolia Mill.)’de
ontogenetik varyabilitenin verim üzerine etkisinin araştırılması amaçlanmıştır.
Araştırma, Türkiye’nin Orta Karadeniz Bölgesi’nde yer alan Bafra Ovası
koşullarında iki yıl süre ile yürütülmüştür. Çalışmada, üç farklı hasat dönemi (Çiçeklenme
öncesi, % 50 çiçeklenme ve % 100
çiçeklenme) araştırma konusu olarak ele alınmıştır. Araştırma sonucuna göre
bitki boyu değerleri, M. spicata, O. onites, L. angustifolia ve M.
officinalis bitkilerinde sırasıyla 47.50-103.67 cm, 25.00-49.47 cm,
30.00-40.60 ve 56.90-96.60 cm arasında değişiklik göstermiş olup; M. spicata’da % 50, diğer bitkilerde ise
tam çiçeklenme devrelerinde en yüksek değerler ölçülmüştür. Hasat devreleri;
incelenen tüm bitkilerde taze herba, drog herba ve uçucu yağ verimini, M. spicata, O. onites ve M. officinalis türlerinde
drog yaprak verimini, L. angustifolia’da
drog çiçek verimini istatistiksel olarak anlamlı derecede etkilemiştir. Elde
edilen verilere göre; M. spicata ve M. officinalis bitkilerinin % 50
çiçeklenme döneminde, L. angustifolia
ve O. onites bitkilerinin de % 100
çiçeklenme döneminde hasat edilmesi önerilmektedir.
Sakız ve Siyah Kabak (Cucurbita pepo L.)’larda Ovül Kültüründe Spermidine ve Putrescine Uygulamalarının Haploid Bitki Elde Edilmesine Etkileri
Authors: KARA Begüm , SARI Nebahat 
Published: June 2019

Bu araştırmada, sakız ve siyah kabaklarda ovül kültüründe spermidine (Spd) ve putrescine (Put) uygulamalarının haploid bitki elde edilmesine etkileri araştırılmıştır. Araştırmada materyal olarak 3 farklı Sakız kabak çeşidi ile 3 farklı Siyah kabak çeşidi kullanılmıştır. Ovül kültürü uygulamalarında embriyo teşviki için 5 mg L-1 2.4-D ilave edilmiş MS besi ortamı kullanılmıştır. Araştırmada poliaminlerin etkisini görmek amacıyla Spd ve putrescine Put 40, 80 ve 160 μM L-1 dozda ayrı ayrı ve her ikisi birlikte 80, 160 ve 320 μM L-1 (1:1, v:v) dozlarında kullanılmıştır. Kontrol grubu sadece 5 mg L-1 2.4-D içermiştir. Elde edilen araştırma sonuçlarına göre, ovül gelişimi ve kallus oluşumunun her çeşide göre farklı seviyelerde olduğu tespit edilmiştir. Ovül gelişim sonuçlarına bakıldığında her çeşitte elde edilen ovül gelişim oranları genel olarak kontrol grubuna oranla daha başarılı bulunmuştur. Kallus oluşum sonucuna göre Elida Fı çeşidi sadece Put ve sadece Spd içeren ortamlarda, Roni Fı çeşidi Put+Spd içeren ortamlarda, Shakila Fı Spd ve Put+Spd içeren ortamlarda, Seyden Fı sadece Put içeren ortamlarda, Brillante Fı Put ve Put+Spd içeren ortamlarda ve Chivas Fı sadece Put içeren ortamlarda kontrol grubuna oranla daha iyi sonuçlar vermiş, genel olarak en iyi kallus gelişim oranı 40 μM L-1 Put içeren ortamda görülmüş, ancak bunlardan bitki elde edilememiştir. Haploid bitki elde edilebilmesi için poliaminlerin daha yüksek dozlarda kullanılması önerilmektedir.