bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency obstetric care: measuring availability and monitoring progress
Authors: Nirupam S. , Yuster E.A. 
Published: December 2002

AbstractTo reduce maternal deaths substantially, the facilities for Emergency Obstetric Care (EOC) must exist, be accessible, be utilized by complicated cases and be successful. Accordingly, a new set of indicators, viz., number of functional EOC facilities, geographic bed distribution within a district, proportion of expected births and expected complications managed at these units, and case fatality rate for complicated cases, were assessed in ten districts drawn from ten major states of India. The paper discusses the findings and some of the problems of data collection and interpretation. In general, maldistribution of beds within the district, low levels of cesarean section rates and, sometimes, high case fatality point to a need for an improvement in availability, distribution and quality of EOC. Similarly, low institutional birth rate and much lower than expected number of complications reaching the facilities point to the need for encouraging families to use them. Changes in these indicators over time will help gauge improvements in provision and utilization of EOC. The study findings and methodology are serving as an important element for developing a monitoring system for EOC under Safe Motherhood in India.
Levels and determinants of maternal morbidity: results from a community‐based study in southern India
Authors: Bhatia J.C. 
Published: December 2002

AbstractThis analysis is based on detailed interviews with 3600 rural and urban women in southern India. They were younger than 35 and had at least one child less than 5 years of age. Each woman was questioned by a trained female interviewer and asked about problems she had encountered during the last pregnancy. Approximately two‐fifths (41%) reported at least one morbid condition associated with that event. About one‐fifth (18%) had had at least one problem during the antenatal period and delivery and another 23% indicated problems during the postpartum. Surgical interventions were made in 13.1% of all deliveries. However, if we consider only those taking place in hospital, more than one‐third (34.2%) were delivered surgically. The relationship between socioeconomic and demographic factors and reported maternal morbidity has been examined by using multivariate statistical techniques. The policy implications of the study are discussed.
An in vivo model of degenerative disc disease
Authors: Norcross Jason P. , Lester Gayle E. , Weinhold Paul , Dahners Laurence E. 
Published: December 2002

AbstractAlthough the precise etiology of low back pain is disputed, degeneration of the intervertebral disc is believed to play an important role. Many animal models have been described which reproduce the changes found in degenerative disc disease, but none allow for efficient, large‐scale testing of purported therapeutic agents. The purpose of this study was to develop a simple animal model resembling degenerative disc disease using the intervertebral discs found in the tails of rats. The proximal two intervertebral discs in the tails of 20 rats were injected with either chondroitinase ABC or control (phosphate buffered saline, PBS). The tails were harvested at 2 weeks, and measurements were made of intervertebral disc height (measured radiographically and histologically), biomechanics (stiffness, hysteresis, and residual deformation), and histologic appearance. Treatment with chondroitinase ABC resulted in a significant loss in intervertebral disc height (radiographic intervertebral disc height, p < 0.001; histologic intervertebral disc height, p < 0.001) and significant increases in all biomechanical parameters (stiffness, p < 0.001; hysteresis, p < 0.006; residual deformation, p < 0.004) compared to PBS controls. Intervertebral discs treated with chondroitinase ABC had significantly lower histologic grades for each grading category (nucleus pulposus (NP), annulus fibrosus, and proteoglycan staining) compared to controls. The results of injury with chondroitinase ABC were similar to the findings in degenerative disc disease: reduced intervertebral disc height, diminished proteoglycan content, loss of NP cells, and increased stiffness of the disc. Thus, the model appears to be a reasonable tool for the preliminary in vivo evaluation of proposed treatments for degenerative disc disease.© 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
Undersulfation of proteoglycans and proteins alter C6 glioma cells proliferation, adhesion and extracellular matrix organization
Authors: Mendes de Aguiar Claudia B.N. , Garcez Ricardo Castilho , Alvarez‐Silva Marcio , Trentin Andréa Gonçalves 
Published: December 2002

AbstractProteoglycans are considered to be important molecule in cell–microenvironment interactions. They are overexpressed in neoplastic cells modifying their growth and migration in hosts. In this work we verified that undersulfation of proteoglycans and other sulfated molecules, induced by sodium chlorate treatment, inhibited C6 glioma cells proliferation in a dose‐dependent way. This effect was restored by the addition of exogenous heparin. We could not detect significant cell mortality in our culture condition. The treatment also impaired in a dose‐dependent manner, C6 cell adhesion to extracellular matrix (ECM) proteins (collagen IV, laminin and fibronectin). In addition, sodium chlorate treatment altered C6 glioma cell morphology, from the fibroblast‐like to a more rounded one. This effect was accompanied by increased synthesis of fibronectin and alterations in its extracellular network organization. However, we could not observe modifications on laminin organization and synthesis. The results suggest an important connection between sulfation degree with important tumor functions, such as proliferation and adhesion. We suggest that proteoglycans may modulate the glioma microenvironment network during tumor cell progression and invasion.
Unmet need in family planning in South Asia Region
Authors: Kapoor I. 
Published: December 2002

AbstractToday's population in South Asia is estimated at 1.2 billion. With an average annual growth of 2%, it increases by more than 24 million people each year, the highest increment in the world. Despite recent improvements in the contraceptive prevalence rate, all countries in the region experience high levels of unmet need for contraception, Several of the region's characteristics have a bearing on the challenge of promoting and providing family planning services: women's status is particularly low; the persistence of son preference results in higher female than male mortality at all ages; the young age structure means an increasing number of people entering childbearing ages. Being predominantly rural, the region experiences shortages of trained health personnel as well as major problems of accessibility to basic health services.
Family planning in Sub‐Saharan Africa: present status and future strategies
Authors: Arkutu A. 
Published: December 2002

AbstractAfrica lags behind the rest of the developing world in most demographic, health and economic indicators of social development, but some progress has been made in contraceptive prevalence and fertility decline. Many challenges remain for governments on that continent to meet the basic reproductive health needs of their rapidly growing populations. With the sustained support of the international community, there is reason to be hopeful.
Severe anemia of pregnancy, recent experience
Authors: Sarin A.R. 
Published: December 2002

AbstractWe undertook this study to determine the current prevalence of anemia in pregnancy and its impact on maternal and perinatal mortality and morbidity, and to suggest ways to make the anemia prevention programs more effective. The incidence of pregnancy anemia was determined by a population‐based survey (1990–1994) of rural and urban areas using a cluster sample design. Mortality and morbidity data were gathered from our own hospital records (1982–1994). The survey data showed that 86.1% of pregnant women (n = 4752) were anemic (Hb < 11 g/dl); 56.0% had severe anemia (Hb < 7 g/dl); and 1.9% were decompensated (Hb < 4 g/dl). The hospital‐based analysis revealed that severe anemia contributed to 34.5% of all maternal deaths (case fatality ratio = 1769). Hypertensive disorders were found in 28.2% of severe anemia cases. The incidence of preterm labor was 31.2% in these cases and the birthweight 2.23 ± 1.13 kg (mean ± SD), while perinatal mortality was 65 compared to overall rates of 7.9%, 2.78 ± 1.32 kg and 46, respectively. We conclude that severe anemia of pregnancy is still rampant and its adverse consequences remain unabated. The risk‐care approach is advocated as an alternative strategy.
Antenatal risk screening and scoring: a new look
Authors: Fortney J.A. 
Published: December 2002

AbstractAt the individual level, risk assessment is fundamental to antenatal care. But at the program level, there are real difficulties associated with it, of which the most important is the false negatives — women with no (or few) risk factors who experience complications. This paper evaluates several commonly used indicators of risk in terms of both maternal (cephalopelvic disproportion) and fetal (low birthweight/prematurity) outcomes. The literature shows that obstetric history is a better measure of risk than so‐called demographic variables like age and parity. When assessing the utility of a risk factor, Us sensitivity must be evaluated against the likelihood of false negatives. If risk assessment is practiced effectively, it must include a means of ensuring prompt treatment for low risk women with (unexpected) complications.
Neonatal tetanus: review of progress
Authors: Gasse F. 
Published: December 2002

AbstractThe target set for elimination of neonatal tetanus (NT) is less than one case par 1000 live births in every district of the world. NT will then be considered to have been removed as a major public health problem and fewer than 150 000 cases are expected to occur annually worldwide if the achievements are maintained. It is estimated for 1993 that over 700 000 neonatal deaths due to tetanus were in fact prevented by maternal immunization and clean delivery practices. About 480 000 (70%) of them were averted in only three countries: India, Bangladesh and Indonesia. Meanwhile, 91 others already have an estimated NT rate below 1 per 1000 live births nationwide. Of these, 50 countries may already have achieved the target in each of their districts. According to 1993 estimates half a million newborn deaths due to tetanus are still occurring worldwide, 80% of them in 12 countries. Out of 14 others where NT remains a major public health problem, 12 are in the African Region. Together, these 26 countries contribute 90% of the global incidence of NT. By 1995, major strides towards the elimination of NT can be made by using the high risk approach and immunization, including organizing Days of Tranquility where necessary. But for this to be accomplished, there must be sufficient political commitment and financial support of some US$ 30 million to carry out the program in the 26 priority countries.
A 5‐year study of maternal mortality in Faisalabad City Pakistan
Authors: Bashir A. , Aleem M. , Mustansar M. 
Published: December 2002

AbstractA 5‐year study (1989–1993) of 215 maternal deaths in Faisalabad (third largest city of Pakistan) is presented. There were 276 717 live births recorded by the Municipal Corporation during that period, giving a maternal mortality of 0.77/1000 live births. These deaths included 88 (40.9%) in teaching hospitals, 70 (32.6%) at home and 57 (26.5%) in private hospitals. The main causes of maternal death were postpartum hemorrhage, 50 (23.3%), followed by pregnancy induced hypertension/eclampsia and non‐obstetric causes, 34 (15.8%) each. The study reveals that traditional birth attendant (TBA) training/refresher courses, intensive community education, antenatal checkup in local areas, free obstetric flying squad service, better linkage between formal and informal health services, home maternal death condolence camps and improvement of obstetric care in hospital, offered free for deserving cases have played major roles in reducing maternal mortality.
The Mother‐Baby Package: an approach to implementing safe motherhood
Authors: Mehta S. 
Published: December 2002

AbstractThe basic objectives of the Mother‐Baby Package are neither new nor controversial — they are considered the ‘four pillars’ of Safe Motherhood: (1) family planning — to ensure that individuals and couples have the information and services to plan and space pregnancies; (2) antenatal care — to ensure that complications of pregnancy are detected as early as possible and treated appropriately; (3) clean/safe delivery — to ensure that all birth attendants have the knowledge, siwills and equipment to perform a clean and safe delivery; (4) essential obstetric care — to ensure that essential care is made available to all women who need it. Complications during pregnancy and childbirth affect not only the women but their newborns as well. The woman and the fetus, the mother and the neonate, should be seen as a dyad — two units treated as one. Poorly managed pregnancies and/or deliveries and/or inadequate care of neonates during the first critical hours of life account for significant numbers of perinatal and neonatal deaths. Each intervention of the Package can be appropriately applied at community, health center and hospital levels. Only by providing this continuum of care from the community through to the referral hospital will significant impact on mortality be achieved. The goals of the Package are, by the year 2000, to reduce maternal mortality by half and neonatal and perinatal mortality by 30–40% of 1990 levels.
HIV, STD and their current impact on reproductive health: the need for control of sexually transmitted diseases
Authors: van Dam C.J. 
Published: December 2002

AbstractSTD and HIV are the second most important cause of Disability Adjusted Life Years lost in women in the developing world. Reasons for this are multiple, and include their higher vulnerability for STD and HIV, poor health care seeking behavior and lack of accessible and acceptable services. There is considerable synergism between family welfare services and STD programs: complications and sequelae of STD affect the reproductive tract and child health and survival; reproductive and child health and survival are the focus of family welfare programs. Family welfare services are thus well positioned to incorporate STD and HIV prevention and control measures. This is feasible, although practical and logistical problems need to be addressed. Where indicated, pilot integration projects can assess the cost‐effectiveness and outcome of such programs.
Maternal mortality: national versus hospital situation
Authors: Bhuiyan A.B. , Hussain F. 
Published: December 2002

AbstractA retrospective analysis of the causes of maternal mortality in two academic hospitals of Dhaka city over a 2‐year period was carried out and compared with national figures. These are the country's chief referral institutions, where only the critically ill are admitted. Currently, the national maternal mortality ratio (MMR) is 5.6/1000 live births, while in Dhaka Medical College Hospital the case fatality ratios (CFR) were 24.4 and 17.2 in 1992 and 1993, respectively. In Mitford Hospital the CFR was 11.1 and 5.4/1000 live births, during the same periods. The most common cause of maternal death at the national level was postpartum hemorrhage and at medical college hospitals it was eclampsia. If we can strengthen emergency obstetric care at all levels, we can reduce maternal mortality bolh at the national level and at the referral hospitals.
Natural sex selection for safe motherhood and as a solution for population control
Authors: Hingorani V. , Shroff G. 
Published: December 2002

AbstractFor Safe Motherhood wanted children should be of desired sex. As Y sperm have a shorter life span and migrate faster, if coitus occurs before ovulation, sperm must wait in the tube for the ovum to arrive. By the time the ovum arrives, Y sperm have died and X sperm fertilize the ovum, resulting in a baby girl. If coitus takes place after ovulation when the ovum is waiting in the tube, the faster migrating Y sperm fertilize the ovum resulting in a baby boy. Eighty women wishing to test this hypothesis by basal body temperature and ultrasound were recruited. Correct results have so far been obtained in 97%. This theory can be used for Safe Motherhood, for population control and to eliminate sex‐linked genetic disorders. It can also prevent both female feticide and infanticide in some cultures.
Rapid new bone tissue remodeling during distraction osteogenesis is associated with apoptosis
Authors: Li Gang , Dickson Glenn R. , Marsh David R. , Simpson Hamish 
Published: December 2002

AbstractDuring the process of distraction osteogenesis new bone forms and undergoes rapid remodeling. Apoptosis may be one of the regulatory mechanisms governing the removal of the redundant callus during distraction osteogenesis. A rabbit tibial lengthening model was used and lengthened at 0.7 mm/day for 3 weeks. The regenerating tissues from the distraction gap were examined for apoptotic changes by transmission electron microscopy (TEM) and the terminal deoxynucleotidyl transferase‐mediated dUTP‐biotin nick end‐labeling (TUNEL) method. Osteoclastic bone resorption activities were demonstrated by tartrate resistant acid phosphatase (TRAP) staining. The apoptotic cells were mainly present in the transitional regions between the fibrous tissue and the new bone in the mineralization front, and close to or on the new bone surfaces near the center of the regenerate. The TUNEL labeling was greatly reduced in the mature bone near the osteotomied bone ends. TEM examination confirmed the presence of cells with apoptotic changes at various regions of the regenerate. TRAP staining revealed that osteoclastic bone resorption activities in the regenerate were in a similar pattern of distribution to those of the TUNEL labeling. The localization of apoptotic cells at the different regions of the regenerate, accompanied by the osteoclast activities, suggest that apoptosis is closely related to bone formation and remodeling during distraction osteogenesis.© 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
Gliding properties of the long head of the biceps brachii
Authors: Heers G. , O'Driscoll S. W. , Halder A. M. , Zhao C. , Mura N. , Berglund L. J. , Zobitz M. E. , An K.‐N. 
Published: December 2002

AbstractTo elucidate the role of mechanical forces that resist motion of the long head of the biceps brachii, the gliding resistance of the tendon during abduction and adduction was measured. Nine human cadaveric glenohumeral joints were obtained (mean age 68 years, range 47–84). A testing device was developed to simulate glenohumeral abduction and adduction motion. Gliding resistance was calculated as the force differential on the proximal and distal ends of the biceps brachii at five glenohumeral angles (15°, 30°, 45°, 60° and 75°).The average gliding resistance in abduction at 15°, 30°, 45°, 60° and 75° for a 4.9 N load was 0.41, 0.40, 0.36, 0.32 and 0.28 N, respectively. At these same angles, but during adduction motion, the force on the proximal tendon end was either identical or less than the distal tendon end (p > 0.46) indicating a lack of resistance and even a phenomena of „negative”︁ resistance in which some other force overcame the friction. The difference in gliding resistance between abduction and adduction was significant (p < 0.05).The results indicate that forces opposing biceps tendon gliding are more complicated than simply due to friction. Tendon deformation inside the bicipital groove produces a direction‐dependent effect due to a mechanism of elastic recoil. Understanding forces that are absorbed by the tendon during active motion may provide insight into pathological changes that develop inside and around the tendon.© 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
Biomechanical effects of medial–lateral tibial tunnel placement in posterior cruciate ligament reconstruction
Authors: Markolf Keith L. , McAllister David R. , Young Charles R. , McWilliams Justin , Oakes Daniel A. 
Published: December 2002

AbstractWith most posterior cruciate (PCL) reconstruction techniques, the distal end of the graft is fixed within a tibial bone tunnel. Although a surgical goal is to locate this tunnel at the center of the PCL's tibial footprint, errors in medial–lateral tunnel placement of the tibial drill guide are possible because the position of the tip of the guide relative to the PCL's tibial footprint can be difficult to visualize from the standard arthroscopy portals. This study was designed to measure changes in knee laxity and graft forces resulting from mal‐position of the tibial tunnel medial and lateral to the center of the PCL's tibial insertion. Bone–patellar tendon–bone allografts were inserted into three separate tibial tunnels drilled into each of 10 fresh‐frozen knee specimens. Drilling the tibial tunnel 5 mm medial or lateral to the center of the PCL's tibial footprint had no significant effect on knee laxities: the graft pretension necessary to restore normal laxity at 90° of knee flexion (laxity match pretension) with the medial tunnel was 13.8 N (29%) greater than with the central tunnel. During passive knee flexion–extension, graft forces with the medial tibial tunnel were significantly higher than those with the central tunnel for flexion angles greater than 65° while graft forces with the central tibial tunnel were not significantly different than those with the lateral tibial tunnel. Graft forces with medial and lateral tunnels were not significantly different from those with a central tunnel for 100 N applied posterior tibial force, 5 N m applied varus and valgus moment, and 5 N m applied internal and external tibial torque. With the exception of slightly higher graft forces recorded with the medial tunnel beyond 65° of passive knee flexion, errors in medial–lateral placement of the tibial tunnel would not appear to have important effects on the biomechanical characteristics of the reconstructed knee.© 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.