bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized controlled trial of intravenous paracetamol and intravenous tramadol for labour analgesia
Authors: Mandrelle Kavita , Marwah Meghna , Liddle Dootika 
Published: August 2023

Labour pain is among the most excruciating pain experienced by women. Pain relief during labour is expected to reduce maternal stress, improve maternal and perinatal outcome. Paracetamol and tramadol are easily available, inexpensive and easy administeration. The present study compared the efficacy of intravenous paracetamol and intravenous tramadol for labour analgesia. : A randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology, Christian Medical College, Ludhiana including 130 patients divided into two groups. Group A received 1000 mg of intravenous paracetamol and Group B received 100 mg of intravenous tramadol hydrochloride for labour analgesia in active phase of labour (&#62;/= 4 cm cervical dilatation). Pain intensity was assessed by Visual Analogue scale (VAS) before; after 1 and 3 hours of drug administration. Duration of labour, mode of delivery, drug-delivery interval, maternal side effects and neonatal outcomes were also assessed.Total 130 patients with 65 in each group were included. Pain intensity was assessed and it was observed that Mean VAS score was significantly lower after 1 and 3 hours of drug administration in Group A than Group B. Mean duration of 1 stage of labour (210.79+-70.49 minutes) and mean drug delivery interval (4.34 hours) was significantly lower in Group A than Group B (246.95+/-76.09 minutes; 5.17 hours). Maternal side-effects were observed more with tramadol than paracetamol.Intravenous paracetamol is more effective labour analgesic with lesser VAS score, shorter duration of labour, drug delivery interval and with few maternal side-effects.
Critical analysis of misoprostol versus mifepristone with misoprostol in medical termination of pregnancy
Authors: Nipanal Hanumant V , Doddiah Swetha , Talawar Soubhagya R 
Published: August 2023

Termination of pregnancy by any method before the viable period is called abortion. Medical methods can avoid complications of surgical method of abortion which has many disadvantages like perforation of uterus, hemorrhage, sepsis and increased morbidity. The WHO has approved mifepristone and misoprostol combination for medical abortion. 1. To compare the efficacy of Misoprostol versus combination of mifepristone with Misoprostol. 2. To asses the side effects of Misoprostol and combinationion of Mifepristone and Misoprostol.It is prospective observational study consisting of two groups with each 61 subjects of MTP patients. Group A (Misoprostol alone): Receive tablet misoprostol 600 microgram start placed per vaginally followed by 400 microgram misoprostol tablet placed per vaginally every 4 hourly up to maximum five doses. In case of first trimester cases 800 microgram tablet misoprostol placed per vaginally followed by 400 microgram misoprostol tablet placed per vaginally every 4 hourly up to maximum four doses. Group B (Mifepristone and Misoprostol): Receive tablet mifepristone 200mg orally on empty stomach. After 24 hours will receive tablet misoprostol as mentioned in group A. Misoprostol alone has success rate of 78.69% whereas combination with Mifepristone success was 93.44%. The mean Induction - abortion interval in misoprostol alone group was 11.803 hours and with mifepristone combination it was B5.623 hours. Medical termination of pregnancy by sequential administration of mifepristone with misoprostol has less induction abortion interval compared to using misoprostol alone. This combination has more success rate and also has lesser side effects.
Efficacy of different doses of mifepristone in the management of uterine leiomyoma in a tertiary care centre
Authors: Gopalan Ushadevi , Marimuthu Sangeetha 
Published: August 2023

Leiomyoma or uterine fibroid are benign tumours that arise from the smooth muscles of the uterus. The leiomyomas are common gynaecological problem encountered among reproductive age group women. Mifepristone is the commonly used drug in the management of uterine leiomyoma. The objective of the study were to study the efficacy and safety of 10mg and 25mg of Mifepristone in the management of uterine fibroid. This is a randomized controlled Trial conducted in tertiary care centre. Hundred women with the diagnosis of uterine fibroid were taken up for the study. Group-A (n=50) were given Mifepristone 10mg and Group-B (n=50) were given Mifepristone 25mg daily for a period of 3 months. Reduction in the size of fibroid were assessed at the end of 3 months. At the end of 3months there was a significant reduction in both menstrual blood loss and fibroid volume in both the groups (p&#60;0.001). There was a also significant improvement in haemoglobin levels in both the groups. When compared to Group –A (10mg Mifepristone) more side effects were noted in Group-B (25mg Mifepristone). Nausea and vomiting developed in 90% and 60% of patients in group A and B.Gastrointestinal discomfort developed in 80% and 50% of patients in group A and B. Both Mifepristone 10mg and 25mg had similar clinical outcomes but 10mg had better compliance and lower side effects. Hence, 10mg can be preferred over 25mg in order to bring about effective management of uterine fibroid.
Prevalence of polycystic ovary syndromes (PCOS) in adolescent girls and young women: A questionnaire-based study
Authors: Tiwari Aman , Mathur Aayushi 
Published: August 2023

One of the most prevalent metabolic disorders among women of reproductive age is polycystic ovarian syndrome (PCOS).Menstrual dysfunction and androgen excess symptoms, such as hirsutism and acne, are common in women with PCOS. Additionally, there may be an increased risk of other morbidities such as obesity, insulin resistance, type 2 diabetes mellitus, cardiovascular diseases, infertility, cancer, and psychological disorders.This study is an attempt to summarise the prevalence of polycystic ovarian syndrome(PCOS) in adolescent girls and young women residing in the National Capital Region belonging to the age group of 11-30 years.The study was questionnaire-based and carried out for a duration of 6 months with 267 participants. The BMI of the participants was calculated using the formula: BMI= weight in kgs/ height in m2. PCOS was diagnosed using a questionnaire with Rotterdam’s criteria.The prevalence of PCOS was found to be 77.1%. The mean age group at which maximum number of participants were diagnosed with PCOS was 18-20 years. The BMI (BMI=kg/m2) of all the participants was calculated and 8% participants came under the obese category. 90% of the participants were aware of PCOS, 79.2% participants agreed PCOS is increasing rapidly while 19.3% participants had no idea about PCOS.The study concludes that respondents were less aware of the actual prevalence of PCOS and also associate the disorder’s manifestation with lifestyle variations. Even at this young age adolescent girls and women are at a high risk of metabolic syndrome because of the increased prevalence of sedentary lifestyles and lack of physical activity. A good diet, regular exercise, early diagnosis, and treatment modalities available are all critical components of raising awareness about PCOS and the risk factors associated with it.
Is USG-assisted Caudal Block Adequate for Postoperative Analgesia in the Early Phase of Circumcision? Is Rescue Analgesia Necessary?
Authors: Coskun Ilker , Yalcin Onur 
Published: August 2023

Introduction and Objective: Caudal block has been used in children for many years and is considered the gold standard for multimodal analgesia in the pediatric age group. Caudal block belongs to the category of central neuraxial blocks, which can provide both visceral and somatic analgesia. With the introduction of ultrasound into the clinical practice of anaesthesia, the caudal block is now performed under USG guidance. In our study, we aimed to compare the efficacy of a single caudal block in postoperative acute pain management, the need for additional analgesics, the incidence of side effects, the timing of initial analgesic administration, and the need for rescue analgesic administration (paracetamol 10 mg/kg) in circumcision surgery.
Materials and Methods: 120 patients undergoing circumcision surgery were divided into 3 groups. The caudal block was performed in all cases under USG guidance. Only the caudal block was applied for cases in the Caudal group (Group C). The Caudal + paracetamol group (Group CP) received paracetamol 10 mg/kg intravenously (i.v.) and the caudal block. Patients in the Caudal + meperidine group (Group CM) received 1 mg/kg meperidine intravenously. The caudal block was performed in each case with a 0.5 ml/kg volume of 0.125% bupivacaine.
Results: As a result of our study, it was found that the least postoperative pain occurred in 12.50% of the CM group (p=0.011). Significant results were obtained when weight and age variables were analyzed according to the groups (p-values p=0.011 and p=0.003, respectively). Significant differences were found between the input pulse values, 5-minute pulse values, 15-minute pulse values, and input SpO2 values (p values p &lt; 0.001, p &lt; 0.001, p=0.011, p=0.037, respectively). Only Wong-Baker pain scores at the 24th hour differed significantly from the periods measured after the groups (p &lt; 0.001). There was no significant difference between the FLACC and Wong-Baker pain scores in the other periods. There was no difference between the groups regarding the time when postoperative analgesics were administered and the total amount of analgesics administered (rescue analgesic 10 mg/kg oral paracetamol) (p=0.408, p=0.238).

Conclusion: Caudal block can be safely applied during circumcision. Ultrasound guidance increases the chances of success and reduces the complication rate. Caudal block can be safely used in pediatric surgery since it does not cause serious complications, has low postoperative pain scores, and reduces the number of postoperative analgesics.
Efficacy of activated PMS/PDS by different methods in inactivating E.coli and P.aeroginosa
Authors: Eleren Sevil Çalışkan , Yavaş Ebru 
Published: August 2023

Abstract
The aim of the present study was to evaluate to efficacy of peroxydisulfate(PDS)/peroxymonosulfate(PMS) activated by different methods in inactivating E.coli and P.aeruginosa. The UV-A, UV-A/PDS or PMS and NaOH/PDS processes were used to inactivate E.coli and P.aeruginosa. Three different sulfate salts (K2S2O8, Na2S2O8 and Oxone) were used to activate with UV-A radiation and the inactivation effects were determined. During 30 minutes of UV A radiation, the addition of 3 mM K2S2O8, Na2S2O8, and Oxone increased the removal efficiency of E. coli by 1.76, 1.51, and 2.47 log, respectively. For P. aeruginosa, there was an increase of 1.44, 1.62, and 2.55 logs, respectively. The highest removal efficiency was obtained with oxone + UV-A on E.coli and P.aeroginosa. In order to examine the inactivation effect of alkaline (NaOH) activated peroxydisulfate on microorganisms, studies were carried out using two different doses of K2S2O8 (2 and 3 mmol/L). With the increase of PDS concentration, the removal efficiency for both bacteria increased. Higher removal efficiency was obtained at high base/PDS ratios. When the PDS concentration is increased from 2mM to 3mM at the same NaOH/PDS (0.25) ratio, the time required for 4 log bacteria removal is reduced by 33% for E.coli, while there is a decrease of more than 44.2% for P.aeroginosa.
Analysis of the first inpatient expenditure for cervical cancer patients before and during the COVID-19 pandemic in a provincial maternal and children care hospital in China
Authors: Xiong Lili , Wen Bin , Mengjun Zeng , Xie Zhiqun , Xie Donghua , Kong Fanjuan 
Published: August 2023

Abstract
Background
COVID-19 has led to economic difficulties for many cancer patients. This study aimed to identify the trend and the major cost items of inpatient expenditure for the admittance to hospital for cervical cancer patients in Hunan Province Maternal and Children Care Hospital from 2017 to 2021.
Methods
This study assessed the composition of inpatient expenditure using the gray correlation method and the variation in the hospitalization expense structure using the degree of structural variation. χ2 testing were applied to compare the basic information for inpatients among different years.
Results
A total of 909 patients were identified. The median age of the patients was 49±10.25 years. Insurance payments for cancer patients accounted for 33.51% before the COVID-19 pandemic (2017–2019) but increased to 80.29% during the pandemic (2020–2021). Diagnosis costs accounted for the largest proportion of medical expenditure every year and showed an increasing trend during the study period, with the highest percentage (35.16%) in 2021. Diagnosis costs had the highest gray correlation, with a value of 1.00. Although the consumables cost accounted for the lowest proportion of total costs each year, they showed a fluctuating growth trend with an average annual growth rate of 23.54%, which was the only fluctuation cost of the six constituents. Drug cost had the only positive value for the structural variation of total medical expenditure over the five years and the proportion of structural variation contribution gradually increased from 29.94% (2019–2020) to 47.83% during COVID-19 pandemic (2020–2021).
Conclusions
The proportion of hospitalization expenses paid by insurance after COVID-19 is higher than that paid before COVID-19. Attention should be paid to the rising costs of drugs after the COVID-19 pandemic and reasonable control should be maintained for the diagnosis costs to reduce the total expenditure on cervical cancer patients after COVID-19.
Soil Degradation around Orji Municipal Solid Waste Dumpsite: A Spatial Assessment
Authors: Nwawuike Nnawugwu , Nwawuike Ifeoma Monica 
Published: August 2023

Abstract
The present study assessed the impact of municipal solid waste dump on the degradation of soil around Orji dumpsite. The major municipal open solid waste dump was used for this study. A total of fifteen soil samples were collected. Three control samples were randomly obtained from IMSU research farm while twelve soil samples were collected from the base (0 m) of the dumpsite, 10 m and 20 m away from the dumpsite. The samples were collected to the east, west, north and south of the dumpsite. The samples were air dried, crushed and sieved before laboratory analyses. The results obtained indicate that the concentration of the parameters analyzed ranged from 82–91% (sand), 3–9% (silt), 7–9%(clay), 5.30–7.70 (pH), 2–9 dS m− 1 (EC), 0.0013–0.0058 mg kg− 1 (salinity), 1.24–5.71% (OM), 23.20-46.40Cmol kg− 1 (CEC), 2.36–16.20 Cmol kg− 1 (Ca) and 0.34–4.39 Cmol kg− 1 (Mg). These concentrations indicate substantial enrichment. Correlation analysis was applied to establish the relationship between selected chemical parameters. It was found that EC and salinity majorly determined the availability of most of the other analyzed parameters. The extent of soil degradation around the dumpsite was analyzed using the SDI. It showed that the dumpsite soil degradation index varied from 4,863% (0 m), 3,598% (10 m) and 3,353% (20 m). Thus, distance affected the rate of soil degradation in all directions away from the dumpsite.
Novel Exploration of Topological Degree Method for Non-Instantaneous Impulsive Fractional Integro-Differential Equation through Application of Filtering System
Authors: Muthuselvan K. , Vadivoo B Sundara , MUNJAM SHANKAR RAO , Nisar K S 
Published: August 2023

Abstract
This paper explores the execution of the topological degree method (TDM) on initial conditions
for a non-instantaneous impulsive fractional integro-di erential equation (NIFrIDE). The Laplace
transform technique (LTT) is used to obtain the solution representation of the given system. The
fundamental objective of this work is to acquire the existence and uniqueness results for a nite-
dimensional case of a given dynamical system using the topological degree method and Gronwall's
inequality, respectively. We examine two numerical computations for a given non-instantaneous
impulsive fractional integro-di erential equation. In addition to discussing the application of a
given problem through the ltering system.
Performance Characteristics of an Ultrasonic Homogenizer by Analytical, Numerical and Experimental Methods
Authors: Jahromi Mohammad Saber , Abedini Rezvan , Fartashvand Vahid 
Published: August 2023

Abstract
The following paper discusses the modeling of an ultrasonic homogenizer, and the characteristics obtained from the modeling and the results of experimental tests are examined and compared. Analytical solution method, electromechanical equivalent circuit, and finite element simulation can be used in designing and modeling an ultrasonic tool. This paper aims to compare three modeling methods to obtain the advantages and applications of each one. Experimental tests such as measuring the amplitude of the vibration using the inductive gap sensor and impedance test to calculate the impedance value in a frequency range have also been carried out. Finally, the data obtained from the experimental tests have been compared with the modeling results. A comparison of the results shows that for the design of an ultrasonic tool, design parameters such as resonance frequency and amplitude output of the tool can be obtained with good accuracy using modeling. The finite element method is a powerful tool for designing and modeling the ultrasonic system and determining its modal and harmonic characteristics.
Relationship Between NDEL1 Anomaly, Lissencephaly, and Developmental Delay: A Case Report
Authors: CHEN Chun-yu , SUN Shu-Fen , TUAN Sheng-Hui , HUANG Wan-Yun , CHANG Shin-Tsu , *LIOU I-Hsiu 
Published: August 2023

Abstract
Background: Nuclear-distribution element-like 1 (NDEL1) anomaly is a rare genetic condition associated with neurodevelopmental disorders, such as brain malformations, seizures, lissencephaly, and cognitive impairment. However, the clinical features and long-term outcomes of NDEL1 anomaly remain poorly understood.
Case Presentation: A 7-month-old male infant initially presented with nodding of the head and limb extension, along with seizures and developmental delay. The patient was diagnosed with West syndrome based on generalized tonic seizures, hypsarrhythmia on sleep electroencephalogram, and delayed myelination on brain magnetic resonance imaging (MRI). At the age of 3 years, the patient was further diagnosed with NDEL1 anomaly, confirmed by genetic testing. Follow-up examinations at 18 months and 4 years revealed severe developmental delay, speech and language deficits, poor motor function, and lissencephaly on brain MRI.
Conclusion: This is the first reported case of lissencephaly, developmental delay, and NDEL1 anomaly. Knowledge regarding the pathophysiology, clinical presentation, treatment options, and prognosis of the disease remains limited.
Significant improvement after sensory tricks and trunk strength training for Parkinson’s disease with Antecollis and Camptocormia: a case report and literature review
Authors: WANG JIAREN , HU YUE 
Published: August 2023

Abstract
Objective: To investigate whether central and peripheral interventions can alleviate symptoms in a patient with Parkinson's disease (PD) with Antecollis (AC) and Camptocormia (CC) as the primary manifestations. To the best of our knowledge, this case is the first reported case of rehabilitation method for AC.
Methods: We present the case of a 65-year-old female PD patient with AC and CC. The course of the disease was 5 years. She was treated with rehabilitation strategies such as sensory tricks and trunk strength training. In the inpatient period, we compared and analyzed this patient's gait analysis, rehabilitation assessment scale, and angles of her trunk abnormal posture in the first, third, and fifth weeks.
Results: The patient's stride length increased, indicating that the patient's walking ability was improved. The patient could simulate shopping on the street under supervision and needed minimal assistance to go up and down stairs. The Unified Parkinson's Disease ScalePart Three score and Camptocormia severity score decreased. Furthermore, the Modified Barthel Index score, Lawton's Scale of Instrumental Activities of Daily Living score, and Berg Balance Scale score increased. In addition, the patient showed significant improvements in the angles of AC, Upper CC, and Lower CC.
Conclusion: The present case suggests that sensory tricks and trunk strength training are beneficial and safe for patients with AC and CC. Further studies are required to confirm the effectiveness of therapeutic interventions.
Impact of different fludarabine doses in the fludarabine-based conditioning regimen for unrelated bone marrow transplantation
Authors: Kuriyama Kodai , Fuji Shigeo , Ito Ayumu , Doki Noriko , Katayama Yuta , Ohigashi Hiroyuki , Nishida Tetsuya , Serizawa Kentaro , Eto Tetsuya , Uchida Naoyuki , Kanda Yoshinobu , Tanaka Masatsugu , Matsuoka Ken-ichi , Nakazawa Hideyuki , Kanda Junya , Fukuda Takahiro , Atsuta Yoshiko , Ogata Masao 
Published: August 2023

Abstract
To compare the effect of fludarabine (Flu) dose, the clinical outcomes of patients who received Flu and busulfan (FB; n = 1647) or melphalan (Flu with melphalan (FM); n = 1162) conditioning for unrelated bone marrow transplantation were retrospectively analyzed using Japanese nationwide registry data. In the FB group, high-dose Flu (180 mg/m2; HFB) and low-dose Flu (150/125 mg/m2; LFB) were given to 1334 and 313 patients, respectively. The three-year overall survival (OS) rates were significantly higher in the HFB group than in the LFB group (49.5% vs. 39.2%, p < 0.001). In the HFB and LFB groups, the cumulative incidences were 30.4% and 36.6% (p = 0.058) for three-year relapse. In the multivariate analysis for OS and relapse, Flu dose was identified as an independent prognostic factor (hazard ratio: 0.83, p = 0.03; hazard ratio: 0.80, p = 0.043). In the FM group, high-dose Flu (180 mg/m2; HFM) and low-dose Flu (150/125 mg/m2; LFM) were given to 118 and 1044 patients, respectively. The OS and relapse did not differ significantly between the HFM and LFM groups. These findings suggest that high-dose Flu was associated with favorable outcomes in the FB group but not in the FM group.