bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eclampsia in Janakpur Zonal Hospital, Nepal: Favourable outcome with Magnesium sulphate
Authors: Jha Rani , Verma Sheela , Jha Shailesh K 
Published: November 2008

Aim: To determine the demographic characters of patients of eclampsia and the effectiveness of Magnesium Sulphate in terms of maternal and perinatal outcome. Methods: A prospective study of the eclamptic patients was conducted from 18th Aug - 17th Oct 2006 (1 Bhadra 2063 to 30 Ashwin 2063) attending the Obstetric Department of Janakpur Zonal Hospital (JZH). Results: Of the 50 eclamptic women [antepartum 80%, intrapartum 6 % and postpartum 14%] with overall improvement in 92% although 2 cases had to be referred to center with ICU facility and 2 cases died. The demographic characteristics were young primiparous population of low socioeconomic condtion. Caesarean was done for 48 %. Pretermaurity was seen in 50% and 76% were live birth. Conclusions: Nepal has a high maternal mortality rate and eclampsia is a big contributing factor, which could be reduced by using magnesium sulphate widely in all parts of Nepal taking, ours as one of the peripheral hospital as an example. Key words: Eclampsia, magnesium sulphate, maternal mortality doi:10.3126/njog.v2i1.1470 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 17 - 19 May -June 2007
Home based obstetric care: How much safer?
Authors: Joshi Manohar 
Published: November 2008

Objective: To find out the obstetric care management and the consequences of home based delivery assisted by skilled birth attendants or quacks from registered delivery of referral cases in Bhim Hospital, Siddharthnagar, Rupandehi district, Nepal. Methods: This is a retrospective and descriptive study of the clients who were referred to and from Bhim Hospital, Siddharthnagar for obstetric conditions during the past four years (2058-2061). Results: A total number of 3174 women were cared during these 4 years (2058-2061). A decreasing tendency in hospital deliveries were noted during the same period of four years (2058-2061). The numbers of cases being referred from the community were seen to increase every year from 4.6% in the first years to 19.8% in the fourth year. Out of the 380 cases referred 188 were complicated obstetric cases. Among them 48 women were delivered by ventouse while 140 women had to be re-referred for operative delivery to district hospital having caesarean facility. This was shear wastage of time. Holding back the laboring women in villages for the benefit of incentive; provided by Government to promote home based delivery care was speculated to be one of the reasons why women were brought so late. Conclusion. In view of women's benefit and to limit unnecessary dilly-dallying in between, it is rather better to refer difficult obstetric case from the community directly to the district hospitals, equipped with extended comprehensive emergency obstetric care (CEOC) services, escaping various ladders of referral thus saving time. Instead a concept of birthing center to be emphasized more than home based delivery. Keywords: Birthing center, extended CEOC services, ventouse delivery in the community. doi:10.3126/njog.v2i1.1471 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 20 - 22 May -June 2007
Oral: Vaginal Misoprostol: Which route for induction of term labor?
Authors: Khatri (Adhikari) Ratna , Sharma Jyoti , Amatya Archana 
Published: November 2008

Aim: To compare the effectiveness of oral misoprostol with vaginal misoprostol for induction of labour at or more than 40 weeks of pregnancy. Method: Study design: Prospective comparative study. Duration: March 2005 to February 2006 (12 months)in the Dept of Obs/Gyn, TU Teaching Hospital, Kathmandu. Methods: Hundred nullipara (primi or gravida 2 with 1 spontaneous or induced abortion < 12 gestational weeks) in a singleton pregnancy > 40 but with Bishop's score < 4 were induced equally with either oral (100 mgm) Group A or vaginal (25mcg) Group B: were administered 4 hourly up to maximum of 6 doses. Primary outcome measures: duration of induction to active stage of labour or delivery, spontaneous rupture of membrane (SROM), meconium stained liquor (MSL), caesarean and neonatal morbidity with respect to Apgar score were assessed. Results: In vaginal 33 oral 17 had SROM with higher incidence of MSL (60% versus 12%) and higher caesarean 15%: 4%. Even there was > fetal distress 11/15: 2/7 group B/, which was statistically significant. No significant difference was noted in the pre induction cervical score, number of doses, induction to active stage of labour, induction to delivery time, use of oxytocin, failed induction and Apgar scores. Conclusion: Oral misoprostol found to be associated with less SROM, meconium stained liquor and vaginal birth and comparatively less neonatal care unit admissions outweighs its advantages over the vaginal misopristol, although either route were equally proven to be effective for inducing labour in women with unfavourable cervix (Bishop's score < 4) at term pregnancy. doi:10.3126/njog.v2i1.1472 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 23 - 28 May -June 2007
Malignancies of the female genital tract from general gynecological services: Five years review at BPKIHS
Authors: Pokharel Hanoon P , Basnet Nibedita , Uprety Dhruba , Bannerjee Basudeb , Sinha Aravind , Pokharel Paras K 
Published: November 2008

Aim: To observe the trend of malignant diseases of the female genital tract, and to assess pattern amongst the diagnosed cases and its management at BPKIHS. Methods: All the diagnosed cases of female genital malignancies were followed. Cases in advance stages were referred to Oncology Centers. Some patients opted to undergo treatment at BPKIHS. Those case sheets and histopathology reports were analyzed to see the trend and pattern of diseases and its optimum management. Referred cases who came for further follow up in the general gynecology department after consultation and treatment are also included in the study. Setting: Department of obstetrics & Gynecology and Pathology, BPKIHS. Results: Cervical cancer was the commonest malignant disease 216 (67.3%) followed by the ovary (17%), endometrium (10%), choriocarcinoma (3.4%) and vulva and vagina (2.8%). The mean (years in) age of the patients varied with the type of cancer as follows - cervix (30.9), ovary (40.4), endometrium (54.8), choriocarcinoma (25.6) and Vagina & vulva (42.2). Out of the total 216 patients Carcinoma Cervix only 20 patients were admitted for Radical surgery and treatment. 196 patients belonged to the group of advanced carcinoma cervix and were referred to the cancer hospital for radiotherapy and chemotherapy. Conclusion: Cancer cervix is the most common and manageable disease if diagnosed early provided mandatory selective screening program are implemented. The missed opportunity to diagnose the disease in time should be utilized by creating national or regional community - based cervical cancer screening program. General gynecological service provider can also contribute a lot to reduce the burden of disease. Keywords: Female genital malignancies, carcinoma cervix, radiotherapy and chemotherapy. doi:10.3126/njog.v2i1.1474 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 35 - 38 May -June 2007
Pre-operative hemoglobin level: Correlation with hemoperitoneum in ectopic pregnancy
Authors: Gurung Geeta , Rana Ashma 
Published: November 2008

Aim: To find out the incidence and correlation of preoperative hemoglobin level (Hb %) with hemoperitoneum in cases of ectopic pregnancy (EP). Methods: This was a prospective study carried out in Tribhuvan University Teaching Hospital (TUTH), Nepal during the period of 5 years; 15 April 2002-14 April 2007 (Baisakh 2059 - Chaitra 2063). All the cases of hemoperitoneum from rupture of EP confirmed at laparotomy were analyzed. Unruptured ectopic EP undergoing medical management or ruptured organized EP forming tubo-ovarian mass and ruptured rudimentary horn pregnancy without hemoperitoneum were all excluded. Datas were collected from patient's interview, reviewing the operation record and record file. Result: Of the total 167 EP constituting 0.963 % of all deliveries, managed during the five years period, 150 (90%) cases with hemoperitoneum were analyzed. Further excluding five cases not mentioning the amount of hemoperitoneum 145 [ < 1500ml (98) or >1500ml ->3000ml (47)] was categorized to have different degrees of anaemia was ascertained in 90 (62.1%): Severe (13), moderate (55) and mild (22). Results depicted a negative (inverse) correlation between pre operative Hb level and hemoperitoneum. Conclusion: In conclusion there is negative (inverse) correlation between pre-operative Hb percentage and hemoperitoneum which is statistically significant. Keywords: Ruptured ectopic, hemoperitoneum, hemoglobin level doi:10.3126/njog.v2i1.1475 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 39 - 43 May -June 2007
Safe abortion service and post abortion care: Understanding complications
Authors: Thapa Sudha , Satyal Indira , Malla Kasturi 
Published: November 2008

Aim: To see if unsafe abortions are getting lesser after the establishment of comprehensive abortion care (CAC) Unit since March 2004. Methods: Retrospective study of women admitted with complication of abortions [induced (medically/criminal) or spontaneous] during the entire ten years period after the inception of post abortion care (PAC) Unit 2095 May -2007 April; the last 3 years overlapping the service years of CAC Unit establishment. Result: CAC and PAC units both are using manual vacuum aspiration (MVA) to procure uterine evacuation. CAC clients in the last 3 years have reached to a little less than 10,000. This is close to MVA services provided in the PAC Unit in the last 10 years amounting to 11,519. But the number (n=3958) of service provided by the PAC Unit for a complete period of three years 2058-2060 (April 2001 - April 2004) showed a slight increase to (n=4323) as the CAC Unit became functional during the 2061-2063 (15th April 2004- 2007). The complications observed in PAC unit while providing MVA are much more than CAC unit (5.75%: 2%). But the nature of complication is much more serious in CAC Unit, 10 of them needing laparotomy for 20(0.02%) cases of uterine perforation. The induced abortion rate within the hospital, three years before and during CAC services is almost similar (4.07%: 4.34%). Seriousness of the problem has definitely reduced during recent 3 year's period (Baisakh 2061-2063 Chaitra) i.e. 52: 34 except for an unfortunate rise in uterine perforation from 8 to 29 cases, 10 being from the CAC Unit. Conclusion: Though the number of complicated cases of induced abortion seeking hospitalization has not changed much after inception of CAC services in the recent three years, there is definitely a decline in the admission of more serious complicated cases of induced abortion in the recent years with unfortunate rise in number of cases of uterine perforation. doi:10.3126/njog.v2i1.1476 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 44 - 49 May -June 2007
Vaginal hysterectomy in Primary Health Center, Darchula: A remote area of rural Nepal
Authors: Pant Padam R , Joshi Bhoj R , Yogi Karbir N , Mishra Shyam S , Tinkari Bhim S 
Published: November 2008

Aim: To make situational analysis of getting organized with vaginal hysterectomy and pelvic floor repair for uterine prolapse in Primary Health Center in remote area. Method: This is a prospective descriptive study conducted in a three bedded Primary Health Center ‘Gokuleswar' of Darchula district in far western region of Nepal. The vaginal hysterectomy camp was funded by Ministry of health. Women with second and third degree prolapse or complete procidentia were screened for operation. Patient were investigated for urine routine and microscopic examination, blood grouping, haemoglobin, total and differential count, bleeding time clotting time, blood sugar random, HIV, HBsAg. Result: 72 patients were operated. Majority of the patients were 40-50 years of age. Two patients (2.7%) were below 30 years of age. Parity ranged from 2-13. Among the operated patients, 49 (68 %) had complete procidentia. More than half of the patient 37(51.38%) had prolonged bleeding time, one patient (1.38%) needed laprotomy for uncontrolled bleeding and required right sided internal artery ligation for haemostasis. Conclusion: Providing surgical service in rural setting at their own door step to the Nepalese women who have no time to travel to different hospital at their own cost is divine. Such an out reach programme is a major health benefit. Key words: Uterovaginal prolapse, vaginal hysterectomy, rural gynecological problem. doi:10.3126/njog.v2i1.1477 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 50 - 3 May -June 2007
Peritoneal fetus and tubal placentation: A case report of an abdominal pregnancy
Authors: Singh Alka , Sharma Paban 
Published: November 2008

Reported here is a silent case of an abdominal pregnancy with fetal demise at twenty one weeks gestation, extracted from the peritoneal cavity at laparotomy along with the removal of placenta contained in fallopian tube by salphingectomy without any effort. Key words: intra-uterine fetal demise, abdominal fetus, placenta doi:10.3126/njog.v2i1.1479 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 56 - 58 May -June 2007
Fallopian tube carcinoma: Energy lost in diagnosing without the total benefit of chemotherapy
Authors: Pradhan Neelam , Ghimire Sita , Bist Kesang D , Manandhar Reeta 
Published: November 2008

A post menopausal lady presented with vague symptoms of swelling in lower abdomen giving an impression of left adnexal mass clinically, with detection of similar finding on USG and CT scan, and an additional feature suggestive of liver metastases. On laparotomy this looked like a fallopian tube carcinoma and it was confirmed histologically, which showed infiltration of both the ovaries, left broad ligament, and cervix. FNAC of lymph node depicted metastatic adenocarcinoma, although the tumour markers and Pap test were negative. Patient's refusal to undergo chemotherapy turned down all the efforts made in making the diagnosis of this advanced malignancy. Key words: Adnexal mass, fallopian tube carcinoma, tumour markers doi:10.3126/njog.v2i1.1481 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 63 - 66 May -June 2007
Lipoleiomyosarcoma an extremely unusual sarcoma of uterus: A case report
Authors: Jha Abhimanyu , Sayami Gita , Adhikari Deepti 
Published: November 2008

Uterine lipoleiomyosarcoma is a heterologous sarcoma composed of variable proportions of malignant lipoblasts histologically corresponding to well differentiated liposarcoma and malignant smooth muscle cells corresponding to leiomyosarcoma. Finding of benign lipomatous component in a typical leiomyoma (lipoleiomyoma) is not an uncommon, however, lipoleiomyosarcoma is an extremely rare malignant tumor and only very few cases have been reported so far. We report a case of lipoleiomyosarcoma of uterine corpus in a postmenopausal woman presenting with lower abdominal pain and abdominal mass. Diagnosis of lipoleiomyosarcoma was confirmed by histopathological examination of hysterectomy specimen. This is the first case of lipoleiomyosarcoma of uterus reported from Nepal. Keywords: Lipoleiomyosarcoma, uterus, histopathology, unusual case. doi:10.3126/njog.v2i1.1482 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 67 - 70 May -June 2007
Malignant mixed mullerian tumour: A brief communication
Authors: Malla Dibya S , Vaidya Achala , Kumar Prabhaker 
Published: November 2008

Carcinosarcoma is a Malignant mixed mullerian tumor (MMT) originating from the mesothelium and mesenchyme of embryonic mesoderm, now better established by electron microscopy and immuno-peroxidase techniques. The most interesting aspects in the histogenesis of this biphasic tumour mostly monoclonal in origin are briefly communicated in this paper. Unfortunately, no adjuvant chemo or radiotherapy for either persistent or recurrent malignant diseases has ever resulted in cure of this aggressive tumour, usually seen in menopausal women. Key words: Malignant mixed mullerian tumor (MMT), carcinosarcoma, menopause. doi:10.3126/njog.v2i1.1484 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 74 - 78 May -June 2007
Mesoporous Silica with Multiple Catalytic Functionalities
Authors: Zhang Fang , Liu Guohua , He Wenhan , Yin Hong , Yang Xushi , Li Hui , Zhu Jian , Li Hexing , Lu Yunfeng 
Published: November 2008

AbstractMesoporous silica containing multiple organometallic active sites is synthesized using a traditional post‐synthesis complexation technique and a surfactant‐directed assembly approach. Systematic spectroscopic studies and structure analysis indicate that catalytic mesoporous silica with controlled composition and pore structure can be readily synthesized. Catalytic performance examined by an aqueous medium two‐step cascade reaction indicates that these materials possess excellent catalytic activity, reusability, and an interesting synergic effect. This work provides novel synthesis platforms towards multifunctional catalysts for more efficient chemical transformations.
Up to 96% Enantioselectivities in the Hydrogenation of Fluorine Substituted (E)‐2,3‐Diphenylpropenoic Acids over Cinchonidine‐Modified Palladium Catalyst
Authors: Szőllősi György , Hermán Beáta , Felföldi Károly , Fülöp Ferenc , Bartók Mihály 
Published: November 2008

AbstractThe enantioselective hydrogenation of methoxy‐ and fluorine‐substituted (E)‐2,3‐diphenylpropenoic acid derivatives was studied over cinchonidine‐modified, supported palladium catalysts in the absence and presence of benzylamine as additive. The fluorine substituent in the appropriate position was even more efficient than the methoxy group in increasing the optical purity of the saturated product. High enantioselectivities, up to 96%, were obtained in the hydrogenation of some disubstituted derivatives, unprecedented in the hydrogenation of prochiral unsaturated carboxylic acids over modified heterogeneous catalyst. The best optical purities were reached in the hydrogenation of derivates bearing a para‐substituent on the β phenyl and an ortho‐substituent on the α phenyl ring, respectively. The influence of the substituent on the β phenyl ring was attributed to the increase in the efficiency of the modifier‐substrate interaction by electronic effects or to a decrease in the adsorption strength of the substituted acid over modified surface sites. The beneficial effect of the ortho‐substituent on the α phenyl ring was assumed to be due to the additional interaction of this substituent with the modifier on the surface, its steric hindrance contributing only in a small part to the observed effect. These suggestions were supported by results obtained in the hydrogenations of some methyl‐substituted derivatives.
Efficient Syntheses of (Thio)phosphonylated Isobenzofurans by Tandem Nucleophilic Addition and Regioselective 5‐exo‐dig Addition to Carbon‐Carbon Triple Bond: Cooperative Effect to 1,8‐Diazabicyclo[5.4.0]undec‐7‐ene (DBU)
Authors: Wang Fei , Wang Yadan , Cai Lingchao , Miao Zhiwei , Chen Ruyu 
Published: November 2008

AbstractThe tandem nucleophilic addition‐cyclization reaction of o‐alkynylbenzaldehydes or o‐alkynylacetophenones 2 with dialkyl phosphites or dialkyl phosphonothioates 1 took place very smoothly in the presence of 1,8‐diazabicyclo[5.4.0]undec‐7‐ene (DBU) in THF at room temperature. In all cases, the reaction proceeded in a regioselective manner leading to the 5‐exo‐dig products 3 in excellent yields. The phenomenon of a 1,5‐sigmatropic hydrogen shift or a 1,5‐sigmatropic methyl shift was observed in this reaction depending on the different substituent groups such as R3 in the o‐alkynylbenzaldehyde or o‐alkynylacetophenone 2 substrates.
Activation of Elemental Sulfur by Electrogenerated Cyanomethyl Anion: Synthesis of Substituted 2‐Aminothiophenes by the Gewald Reaction
Authors: Feroci Marta , Chiarotto Isabella , Rossi Leucio , Inesi Achille 
Published: November 2008

AbstractThe activation of elemental sulfur (S8) has been achieved by means of electrogenerated cyanomethyl anion [easily obtained by galvanostatic reduction from acetonitrile/tetraethylammonium hexafluorophosphate (MeCN‐Et4NPF6)]. The “activated” sulfur reacted with ylidenemalononitriles to give substituted 2‐aminothiophenes in very high yields. This variation of the Gewald reaction has been carried out using only catalytic amounts of electricity and supporting electrolyte. A proposed mechanism for the interaction between S8 and cyanomethyl anion is described.
A Practical and Effective Ruthenium Trichloride‐Based Protocol for the Regio‐ and Stereoselective Catalytic Hydroamidation of Terminal Alkynes
Authors: Gooßen Lukas J. , Arndt Matthias , Blanchot Mathieu , Rudolphi Felix , Menges Fabian , Niedner‐Schatteburg Gereon 
Published: November 2008

AbstractA rational catalyst development based on mechanistic and spectroscopic investigations led to the discovery of a new protocol for catalytic hydroamidation reactions that draws on easily available ruthenium trichloride trihydrate (RuCl3⋅3 H2O) as the catalyst precursor instead of the previously employed, expensive bis(2‐methylallyl)(1,5‐cyclooctadiene)ruthenium(II). This practical and easy‐to‐use protocol dramatically improves the synthetic applicability of Ru‐catalyzed hydroamidations. The catalyst, generated in situ from ruthenium(III) chloride hydrate, tri‐n‐butylphosphine, 4‐(dimethylamino)pyridine and potassium carbonate, effectively promotes the addition of secondary amides, lactams and carbamates to terminal alkynes under formation of (E)‐anti‐Markovnikov enamides. The scope of the new protocol is demonstrated by the synthesis of 24 functionalized enamide derivatives, among them valuable intermediates for organic synthesis.
Asymmetric Desymmetrization of the Diallyl Acetals of Alkynals by the Enantioselective Pauson–Khand‐Type Reaction Catalysts
Authors: Kim Dong Eun , Lee Bo Hyung , Rajagopalasarma Mudigonda , Genêt Jean‐Pierre , Ratovelomanana‐Vidal Virginie , Jeong Nakcheol 
Published: November 2008

AbstractAsymmetric desymmetrization of the diallyl acetals of alkynal (1) by an enantioselective Pauson–Khand‐type reaction catalyst was studied. The corresponding 5‐oxabicyclo[3.3.0]octenones (2) were obtained as a mixture of diastereomers (2a and 2b), which were hydrolyzed to afford a single enantiomer (3), in high yields (up to 88%) as well as excellent enantioselectivities (up to 97%).
Blood exposure incidence rates from the North Carolina study of home Care and hospice nurses
Authors: Leiss Jack K. , Lyden Jennifer T. , Mathews Rahel , Sitzman Kathleen L. , Vanderpuije Abenah , Mav Deepak , Kendra Mary Agnes , Klein Cynthia , Humphrey Carolyn J. 
Published: November 2008

AbstractBackgroundHome care/hospice nurses may be at elevated risk of blood exposure because of the nature of their work and work environment. However, little is known about the incidence of blood exposure in this population.MethodsA mail survey (n = 1,473) was conducted among home care/hospice nurses in North Carolina in 2006.ResultsThe adjusted response rate was 69%. Nine percent of nurses had at least one exposure/year. Overall incidence was 27.4 (95% confidence interval: 20.2, 34.6)/100,000 visits. Nurses who had worked in home care ≤5 years had higher exposure rates than other nurses—seven times higher for needlesticks and 3.5 times higher for non‐intact skin exposures. Nurses who worked part time/contract had higher exposure rates than nurses who worked full time—seven times higher for needlesticks and 1.5 times higher for non‐intact skin exposures. The rates for part‐time/contract nurses with ≤5 years experience were extremely high. Sensitivity analysis showed that it is unlikely that response bias had an important impact on these results.ConclusionsApproximately 150 North Carolina home care/hospice nurses are exposed to blood annually. If these results are representative of other states, then approximately 12,000 home care/hospice nurses are exposed each year nationwide. Improved prevention efforts are needed to reduce blood exposure in home care/hospice nurses. Am. J. Ind. Med. 52:99–104, 2009. © 2008 Wiley‐Liss, Inc.