|Status of Maternal Serum Vitamin D Levels in Rural India
||Monika K. Kotpalliwar
||Saunitra A. Inamdar
Abstract: Background: The role of Vitamin D during pregnancy and its effect on maternal and fetal health is just
beginning to be understood. What is clear, however, is that Vitamin D deficiency during pregnancy is rampant throughout
the world. Vitamin D deficiency is prevalent in India, a finding that is unexpected in a tropical country with abundant
sunshine. Various studies have shown an intrinsic relation between various parameters of maternal and fetal wellbeing
with maternal Vitamin D status during pregnancy.
Aim: To determine the status of Vitamin D levels in pregnancy among rural mothers.
Methods: A total of 60 pregnant females, aged 20-35 years were studied during the third trimester of pregnancy. Serum
Vitamin D was measured by chemiluminescent immunoassay.
Results: 65% subjects were found to have Vitamin D deficiency and 26.67% were found to have Vitamin D insufficiency
whereas 8.33% had normal Vitamin D levels. Mean maternal serum Vitamin D level was 15.97±9.216 ng/mL.
Conclusions: We observed a high prevalence of physiologically significant hypovitaminosis D among pregnant women
attending rural hospital. As mentioned in literature, Vitamin D deficiency is associated with adverse fetomaternal
outcome, the magnitude of hypovitaminosis D in antenatal period warrants public health intervention.
|Increasing Cesarean Births, Cause for Concern
Abstract: Introduction: Relationship between increasing Caesarean section rates (CSRs), maternal-perinatal outcome
continues to be controversial but CSRs, have risen high, regardless of age, babies number etc, higher than necessary
for optimal maternal neonatal outcome with geographic variations. WHO advocates that CSRs should remain 5 - 10%
and with rates higher than 15%, risks increase. Studies reveal higher perinatal mortality with increasing CSRs. There are
many harmful effects on mother too.
Objective: To look into status of CSRs, causes of high CSRs, possibilities of reduction in CSRs.
Material & methods: Literature search with available search engines was done adding personal experiences and
Results: It was revealed that CSRs are increasing globally. Leading factors quoted are genuine needs, more women
asking for CS, liability pressure, continuous electronic fetal monitoring, private care, health problems, race/ethnicity and
other characteristics but none accounts for high CSRs. Upward trends in Caesarean births (CBs) are neither explained
by maternal characteristics nor pregnancy complications. Babies are more likely to have breathing problems, diabetes,
allergies, asthma, exhibit differences in composition of intestinal flora, long-term obesity, immune, endocrine dysfunction
independent of intestinal microbiota, prematurity, respiratory distress syndrome, neonatal intensive care unit admission.
All these lead to high perinatal mortality. CSs done without medical indication represent drain on resources, negative
health equity. Possible interventions to lower CSRs may be partography, vacuum / forceps births, evidence-based
protocols for evaluating fetal status, dysfunctional labour, second opinion for CS decision, auditing indications.
Conclusions: CSRs are increasing with their sequelae. Health authorities, professional associations, institutions, public,
media should work together to reduce maternal sufferings, social, financial burden due to over roofing CSRs.
|An Interesting Solid Mass in the Posterior Maxilla of a Pregnant Woman
||Can Engin Durmaz
Abstract: We report a case of a 22 year-old pregnant woman who was considered in the differential diagnosis included
an erupted odontoma and an exposed necrotic bone of the maxilla at the time of the third trimester. During the 4th week
of the postpartum period, an orthopantomography was taken and radiopaque mass and ill-defined impacted molar teeth
were observed. After the surgical operation, the final diagnosis of ossifying fibroma was rendered. Ossifying fibromas
behave like benign bone neoplasms and are often considered to be a type of fibro-osseous lesions. They can affect both
the mandible and the maxilla, particularly the mandible. Fibroosseous lesions with unusual clinical and radiological
presentations might disquieten both the dental practicioner and the patient.
|A Rare Pathology, Vulval Leiomyoma: Case Report and Literature Review
||Rachael Ann Read
Abstract: This is a case of a vulval leiomyoma in a 50-year-old parous patient. There are fewer than a hundred and
twenty cases of vulval smooth muscle tumour reported in literature. This case offers more evidence for this rarely
reported condition, and as a learning point to avoid misdiagnosis.
|The Role of Fetal MRI in the Diagnosis of Agenesis of Corpus Callosum (ACC) and other Associated Cerebral Anomalies
Abstract: The corpus callosum is the main transverse tract of fibers that connects the two cerebral hemispheres. In rare
conditions an absence of fusion of the main commissural pathway connecting the cerebral hemispheres is observed.
This malformation develops in utero and is classified as partial and complete agenesis or hypoplasia of corpus callosum.
The condition is found in 3 to 7: 1000 live births. Fetal ultrasound (US) is first-line modality in evaluating corpus callosum
by 18-20 weeks of gestation. Fetal magnetic resonance imaging (MRI) is useful for exact assessment of the degree of
malformation as well as for detecting frequently associated anomalies. This pictorial review aims to present the role of
fetal MRI as a valuable adjunct to US in various abnormalities of corpus callosum in fetuses, which is an important issue
for prognostic counseling.
|Rural Community Based Caesarean Section Ratesin A Resource Poor Region
Abstract: Background: Tremendous increase in caesarean section rates (CSR) is reported with controversial
relationship between CSR and maternal-perinatal outcome.
Objective: was to know rural community based CSR, spill over effects of institutional practices and maternal, perinatal
outcome in low resource region.
Material Methods: Nurse Midwives based at institute visit each village, five times a year, provide home based prenatal
care, advocacy for intranatal, postnatal care, create awareness in women, communities about emergencies in high, low
risk, action needed. Records of pregnancy outcome, collected on regular basis were analysed irrespective of place,
Results: CSR was 4.8% between1987- 1990,( base information), 11.6% between 2008 - 2011, in villages within 25-35
kms from institute, being served since 26 years (old), 1.2% between 1996 - 1999, 5.4% between 2008 - 2011 in villages
75-85 kms from institute, being served since 1996 (new). Perinatal mortality rates (PMR) have decreased, 62 between
1987 - 1990, 26 between 2008 - 2011 (2.38 times reduction) in old villages, 42 between 1996 - 1999 and 23 between
2008 - 2011 (1.82 times reduction) in new villages, with no maternal death due to pregnancy, labour specific disorders,
one death each due to sickle cell disease, murder, suicide in 15 years in this small population. There was
disproportionate increase in CSR midway, parallel to institute's CSR.
While nurse midwives can do a lot for maternal care in community, facility’s everyday practices affect community’s CSR.
Periodic audit is essential at health facility, community for possibilities of improving maternal perinatal outcome, curtailing
|Henoch Schönlein Purpura in Pregnancy: a Case with Uncomplicated Maternal and Neonatal Outcome
Abstract: Introduction: Henoch-Schönlein Purpura (HSP) is a systemic IgA-mediated small-vessel vasculitis. It is
primarily a childhood disease, rarely described in pregnancy. Pregnant women with HSP are at risk for hypertensive and
hemorrhagic complications. Due to the rarity of the condition during pregnancy, there is no consensus about the
preferred course of treatment but concerns regarding optimal management are ongoing.
Case presentation: We report the case of an 18 year-old primigravida, with a 3-year history of HSP, who had an
uneventful pregnancy and term delivery with epidural anesthesia.
Conclusion: Due to the systemic nature of HSP, multidisciplinary management of pregnant HSP patients should be
warranted to prevent complications.
||Abdel Karim M. El Hemaly
||Laila A. S. E. Mousa
Abstract: Continence is self-restraint and self- control especially temperance, sexual behavior and the body excreta
(ability to control one’s bowel and bladder).
Continence is an acquired behavior gained by learning and training. Continence is a nerve-muscle action. An alert
healthy nervous system (NS) and intact reactive muscles are the tools for expressing continence.
To gain continence, is how to control and train your sympathetic nervous system (NS). Most sympathetic nerve endings
secrete nor-epinephrine (NE). NE excites most of the visceral structures. The sympathetic NS mobilizes the body’s
systems during confronting a situation “Fight or flight.”
We gain progressively rising up sympathetic tone from everyday life stress, teaching, and experience. Stimulation of the
sympathetic NS, leads to rise in blood pressure. It dilates the pupil of the eye. It excites the liver to release glucose, and
increases the rate of metabolism of essentially all the cells of the body “fight or flight”. The integrative centers of the brain
can acquire by learning, and training how to master, synchronize, and harmonize different responses according to social
circumstances. Therefore, it is how to control the sympathetic NS is the way to gain continence.
After learning, sympathetic stimulation leads to: holding back (continence) or fight or flight”. If the situation is over –
whelming, the result is sympathetic failure and subsequent incontinence.
Incontinence results from fault in the sympathetic NS, CNS and/or the target organ.
Therefore, correcting the pathology of body’s excreta incontinence is by correcting the sympathetic nerves and their
neurotransmitters medically or treating the target organs (IUS & IAS) surgically.
|Systematic Documentation of Fetal Heart Rate (FHR) Patterns and the Correlation with pH Computed in the Umbilical Artery
Abstract: Introduction: A new computer program was written to analyze FHR-tracings of 601 fetuses from the
Frauenklinik Detmold in Germany. This program is demonstrated in this paper using data of one fetus only.
Material and methods: During a time period of eleven years 601 FHR-tracings were recorded electronically and further
analyzed. To demonstrate the program only one fetal case was further analyzed: 1.) In this case we measured the fetal
heart frequency (FHF) and one broad deceleration, 2.) the micro-fluctuation (micro) of this fetus and the micro during the
large deceleration, 3.) the oscillation amplitude (OZA) during the whole CTG and the OZA during this broad deceleration.
In addition the weighted WAS-score (reference 14) was determined and the actual pH-value was computed (not
measured) for umbilical blood. All these parameters are available in each case of these 601 fetuses.
Results: Besides the electronic CTG-analysis it is new to determine the actual pH-values in umbilical blood using only
the FHF: Both variables are not identical but belong closely together. The FHR helps to determine fetal well being and it
helps to compute the pH-values in umbilical fetal blood. Therefore, micro-blood sampling (MBU) according to E. Saling
seems to be no more necessary. These results are preliminary because our number of MBU’s is still small. The new
program is able to analyze FHR-tracings thoroughly and to determine the pH-values in umbilical blood
continuously.However, FHR-monitoring with a small computer seems to be necessary.
Conclusions: The fetus in utero can be monitored seriously using his FHR together with other parameters. In hypoxic
danger, the foetus can be monitored sufficiently without intermittent control of his actual pH-values in peripheral blood.
Fetal pH-values can be determined approximately and continuously using only the FHR.
|Perinatal Outcome in Pregnant Women with Heart Disease Attending a Combined Obstetric and Cardiology Clinic in a Resource Limited Country
Abstract: Previously published literature has shown a clear relationship between adverse perinatal outcome and the
presence of maternal heart disease even when demographic and obstetric risk factors have been taken into account.
Prospective studies from South Africa or Africa describing pregnancy outcome in mothers with heart disease, where
there is a high prevalence of acquired rheumatic heart disease as well as cardiomyopathies and congenital heart lesions,
are limited. Perinatal data were collected to describe the perinatal outcome in patients with heart disease.
Objectives: The purpose of this study was to describe the perinatal outcome of pregnancies in women with heart disease
attending a multidisciplinary clinic and to compare the perinatal mortality rate with the perinatal mortality rate for the
background population. To determine whether there are any other associated adverse outcomes in babies born to
mothers with heart disease.
Methods: The first eighty-two consecutive pregnant patients with heart disease attending the weekly combined
cardiology and obstetric clinic were studied over eighteen months. Neonatal outcome was recorded. Adverse neonatal
outcome was defined as perinatal mortality, the need for delivery room resuscitation and admission to neonatal intensive
care unit (NICU).
Results: Perinatal mortality was 12.1 per 1000 live births. Only one stillbirth was documented. Adverse neonatal outcome
was 9.7%. Caesarean section rate was 40% with 29% of infants delivered preterm.
Conclusion: Perinatal mortality rate in this cohort was excellent - possibly due to a high level of joint care - but was linked
to a high rate of obstetric intervention.
|Impact of Gestational Age at Delivery on Fetal Heart Rate Monitoring During the Second Stage of Labor
Abstract: Objective: To clarify whether gestational age at delivery affects the interpretation level of fetal heart rate (FHR)
tracings in the second stage of labor in primiparous and singleton pregnancies.
Methods: The database at one tertiary hospital in Japan was retrospectively reviewed for women with singleton fetuses
in cephalic presentation and vaginal labor at 37+0 gestational weeks between June 1, 2011, and March 31, 2013.
Continuous FHR tracings in the second stage of labor were subdivided into 10-minute intervals, each of which we called
a window, from the beginning through delivery, and were assessed according to the five-tier classification proposed by
the Japan Society of Obstetrics and Gynecology, in which level 1 is normal, level 2 is subnormal, and levels 3-5 are
abnormal patterns. Subjects were divided into two groups, including early term (37 0/7 to 38 6/7 weeks) and full term (39
0/7 to 41 6/7 weeks), according to the delivery age.
Results: In total, 914 parturient women were eligible for the study protocol, including 228 and 686 women in early and full
term, respectively. Vacuum extraction was more often observed in full term than in early term (P=0.007). Although the
maximal level, number of level-5 windows, number of level-4 windows, and number of level-3 and level-4 windows were
similar between the groups, the summation of level-4 windows 3 was significantly higher in full term than in early term
Conclusion: Full term delivery has a higher risk than does early term delivery from the standpoint of FHR monitoring.
|A Comparison of Two Methods for Estimating Censored Linear Regression Models
This paper presents two basic methods called as weighted least squares (WLS) and synthetic data transformations (SDT). The key idea of the paper is to estimate the parameters of the linear regression model with randomly right-censored data by using these two methods. Recently, the mentioned methods have received considerable attention in the literature. Studies on this subject show that both methods work well for linear regression model with censored data. A particular focus of our paper is to compare the performance of the WLS and SDT methods and to reveal the strong and weak aspects of them. In this context, we made a simulation study and a real data example.
|Silver Ion-Eluting Dressings for Prevention of Post-Cesarean Wound Infection: A Randomized, Controlled Trial
||William J. Kellett
Abstract: Objective: To test the null hypothesis that administering silver ion-eluting wound dressing or paper cloth
adhesive wound dressing to women undergoing cesarean section will result in no difference in the incidence of surgical
Materials And Methods: 514 women met inclusion criteria and were randomly assigned to receive one of two surgical
dressing regimens: standard soft paper cloth or silver ion-eluting dressings. Patients were evaluated for signs of infection
during their hospitalization, and again at 1-week postpartum. Sample size was calculated to allow a two-tailed alpha of
0.05 and power of 80%. Data were analyzed on intent-to-treat basis using parametic and nonparametic statistics.
Categorical data were presented as frequencies; P-values were calculated using Pearson’s chi-square test. Logistic
regression was performed to control for the effect of maternal BMI.
Results: Analysis involved 236 women in the cloth dressing group and 239 in the silver ion-eluting dressing group.
Nineteen of 236 patients (8%) randomized to the cloth dressing group met clinical criteria for surgical site infection
infection compared to 25 of 239 (10%) in the silver ion-eluting dressing group. No statistically significant difference in
infection rate was detected, p=0.36, RR = 1.3, CI = 0.7-2.5. A multivariable model adjusted for BMI confirmed no
evidence of an association between dressing type and infection rate. Cost analysis for the cloth dressing used in this
study was $1.30 per dressing ($306.80 group total), compared to $46.36 per dressing ($11,080.04 group total) in the
silver ion-eluting dressing group.
Conclusion: There was no statistically significant difference in the incidence of post-cesarean section surgical site
infection rates when comparing paper cloth to silver ion-eluting dressings in an obstetrical population.
|Fetal and Perinatal Lymhangiomas - A Spectrum of MR and CT Findings
Abstract: Lympahgiomas are uncomon benign congenital multiloculated cystic malformations of lympahtics with the
potential to infiltrate surrounding structures. They are discovered mainly by US, as first method of choice in fetal
examination. However, fetal MR imaging is suitable to confirm or reject ultrasogographic findings, provides detailed
anatomical orientation and is appropriate to evaluate the extent and character of lymphangiomas. This complementary
technique contributes to the accurate diagnosis of lymphatic anomalies and benefits of excellent tissue resolution, large
field-of-view and relative operator independency. This article present three cases of lymphangioma of different
localizations, describes prenatal and perinatal magnetic resonance (MR) and computed tomography (CT) imaging
findings, and discusses the advantages of those supplementary to ultrasound (US) methods in regard to patient
counseling, management and delivery decisions /continuation or termination of pregnancy/.
|Gestational Weight and Nutrition: A Qualitative Study
Abstract: Background: Excessive gestational weight gain and maternal obesity are well recognized as risk factors for
maternal and foetal complications. Little is known regarding the beliefs and attitudes of Irish pregnant women with a
medical card attending a rural General Practice on weight and nutrition.
Aim: To identify knowledge and attitudes among Irish pregnant women in a rural General Practice regarding gestational
nutrition and weight.
Methods: Ten women took part in individual audio-taped interviews in this qualitative descriptive study. The method of
qualitative description was used in data analysis to identify recurring themes and provide a comprehensive summary of
Results: Five main themes were identified: (i) Fear of postnatal weight retention, (ii) The legacy effect of the first
pregnancy on weight (iii) Little awareness of link between gestational weight gain and infants' health risks (iv) Aceptance
of the doctor's advice and (v) Barriers to physical activity in pregnancy.
Conclusions: Women considered weight mainly in the context of their own health. There was a lack of awareness on the
effect of excess gestational weight on their baby's in utero, birth and future weight. In contrast, mothers to-be appeared
to be concerned to protect their newborn's health through adequate pre-natal nutrition.
|Ovarian Sclerosing Stromal Tumour Presenting with Pseudo- Meigs' Syndrome
Abstract: Sclerosing stromal tumour (SST) is an uncommon ovarian sex-cord stromal neoplasm that has distinctive
clinical, pathological and radiological features. Unlike other stromal tumours, which commonly present in the fifth and
sixth decades, it occurs predominantly in the second and third decades, typically in the early 20s . As SST is rare,
reports of unusual presentations might assist diagnosis.
|Modelling and Simulation of Self Heating in GaN Based High Electron Mobility Transistors (HEMTs)
Abstract: In this paper we present the numerical simulation and characterization of GaN based high electron mobility
transistors (HEMTs) using commercial device simulation software ATLAS from Silvaco international. Device has been
characterized in terms of its electrical and thermal behavior by simulating its transfer and output characteristics without
self-heating and with self-heating. Also we simulated the distribution of lattice temperature inside the device for thermal
characterization of the device. For electrical characterization the fundamental equations responsible for charge transport
of charge carriers have been solved using finite element method. For thermal characterization fundamental equations of
charge transport and heat flow equations have been solved self consistently.
|Band Sequence - Past, Present and Future
||Gopagondanahalli Krishna Revanna
Abstract: Amniotic band sequence (ABS) is a constellation of congenital malformations involving mostly distal
extremities, less often craniofacial and visceral defects. It is often characterized by the asymmetry of the organ
involvement and can manifest with varying severity. Amniotic band sequence lacks a precise definition and pathogenic
mechanism, with the extrinsic theory of “Early amnion rupture sequence” being the most widely accepted hypothesis.
Using 3-dimension (3D) or 4-dimension (4D) ultrasound scans, ABS related fetal diagnoses can be made early in
pregnancy facilitating fetal interventions. Today with minimally invasive fetal surgery, the amniotic bands can be released
to save a limb or to avoid a fetal death due to amniotic band constriction of the umbilical cord. To date, no definite
genetic basis has been known for the defects seen in ABS. Published articles; monographs and personal experience in
fetal and neonatal diagnosis of ABS have contributed extensively to this review article.
|Do BMI or Waıst-to-Hıp Ratıo Interfere wıth The Number of Oocytes Retrıeved ın IVF Cycles?
||Ayse Nur Cakir Gungor
Abstract: The effect of obesity on ovarian response to ovulation induction and on in vitro fertilization (IVF) outcome is
controversial. This controversy might stem from the fact that almost all studies on the subject use body mass index (BMI)
for obesity measurement. We aimed to determine which obesity measure predicts the possible effect of obesity on
ovarian response in IVF patients. In this retrospective study, patients who presented for IVF and underwent an
antagonist protocol were included. Their histories and cycle properties were recorded, as well as their BMI and waist-tohip
(W/H) ratios. A total of 35 patients were included. While normal BMI significantly lowered the gonadotropin dose,
normal W/H ratio increased the antral follicle count (AFC). Both BMI and W/H ratio did not significantly affect either the
number of oocytes retrieved or the metaphase II oocytes. Ovulation induction during IVF cycles can overcome the
adverse effects of obesity on ovarian reserve. Large-sample-sized, well-designed studies must be performed to clarify
the best obesity measurement method for infertility treatment and to determine the real effect of obesity on IVF success.
|First Trimester Screening
Abstract: Screening for aneuploidies in the first and second trimester of pregnancy is an important aspect of prenatal
testing. The overall prevalence of aneuploidy is around 1 in 228 (0.4%). First trimester screening has proved effective in
identifying aneuploid fetuses, the definitive diagnostic test for aneuploidy available in first trimester is chorion villous
|Adverse Effects of Diclofenac after Cesarean Section: A Case Report
Abstract: A 27-year-old nullipara, 38 weeks pregnant, was admitted for elective cesarean section under spinal
anesthesia. Past medical history was unremarkable. Spinal anesthesia was performed with 10mg of 0.5% heavy
bupivacaine. Ephedrine 10 mg was added to Ringer solution for prevention of hypotension. Hemodynamic parameters
were normal and stable during surgery. Several hours later, the patient asked for analgesic drug and two 100mg
diclofenac suppositories were administered. Three hours later, the patient suffered from an extensive and cramping
abdominal pain. The pain was located in the right upper quadrant and radiated to the right infrascapular region.
Electrocardiogram obtained was normal. Intravenous pantoprazole and oral anti-acid were administered, but no decease
in pain was seen after fifteen minutes. Subsequently, a sublingual nitoglycerine perle was administered and the intensity
of pain was decreased significantly. The diagnosis of Oddi spasm was assumed.
|Congenital Lobar Emphysema- Exploring the Myth!
||Iyer Harohalli Venkatesh
Abstract: A case of congenital lobar emphysema is reported in an infant who was otherwise diagnosed to have viral
bronchiolitis in the immediate admission.
|Incidence of Incidental Finding of Mullerian Anomalies at Successful Term Pregnancies: A Three-Year Study in India
||Vijay Lakshmi Adapala
Abstract: Introduction: Mullerian Anomalies are known to disturb the reproductive life of women immensely and
adversely affect their obstetric outcomes too. Therefore, they get identified either during pubertal, early reproductive or
antenatal period. Ultrasound diagnosis in pregnancy after first trimester is also very difficult Very few anomalies get
diagnosed after a successful term pregnancy incidentally during delivery. Their actual incidence varies from 1-10% but
little is known about incidence of unidentified cases in successful term pregnancies Aim: To determine the incidence of
incidental finding of Mullerian Anomalies in successful term pregnancies
Methods: Over 3 year study period at a tertiary care centre we observed all women who delivered both by vaginal route
and cesarean section for any Mullerian Anomaly. Results: Of the total 5124 women who delivered at our institute at term
gestation, 3 women were excluded, as they were known cases of Mullerian anomalies on regular follow up at our
institute. 11 women were identified with Mullerian Anomalies incidentally during delivery at term.9 of them were referral
cases. 5 cases of Arcuate Uterus, 2 cases of septate uterus, 2 cases of Unicornuate uterus, 1 case of bicornuate uterus
and 1case of agenesis of fallopian tube were found.
Conclusion: Mullerian Anomalies are seen occasionally incidentally in successful term pregnancies during delivery. They
can be asymptomatic, silent and can have positive pregnancy outcomes. These incidences are crucial for counseling of
patients and their families. Also, we must be on a look out for these diagnoses not only to identify co existing urological
disturbances but also to help us improve their subsequent obstetric performances.
|Transvaginal Bilateral Uterine Artery Occlusion for Treatment of Symptomatic Uterine Myomas: An Effective Modality in Low Resource Settings
||Adel Saad Helal
||Hossam M. Gouda
Abstract: Objective: To study the effectiveness and safety of bilateral uterine artery occlusion through the vaginal
approach as an alternative treatment modality for symptomatic uterine myomas.
Methods: Sixty-nine premenopausal women with symptomatic uterine leiomyomata were studied. None of them desired
further pregnancy underwent bilateral vaginal uterine arteries occlusion. The primary outcome measures were patient
satisfaction as regards menstrual blood loss compared with pre treatment loss and operative duration. Secondary
outcome measures included postoperative pain, complications, secondary interventions, and failures.
Results: Sixty-three women were completed follow up till 24 months after the procedure. The primary outcomes were
encouraging as regards patient satisfaction for post treatment blood loss (90.7 %) and mean operative duration ( 35 ±9.5
minutes). After 6 months of follow-up, 6 patients resumed heavy periods and interventions needs secondary.
Conclusion: Trans-vaginal occlusion of uterine arteries improved clinical symptoms in the majority of patients.
|Is BMI Sufficient to Evaluate the Association between Obesity and Ovarian Reserves?
||Ayse Nur Cakir Gungor
Abstract: Body fat content and distribution might have an effect on ovarian reserves. Here, we studied the effects of
body fat distribution on the antral follicle count (AFC) of women who consulted for infertility. In this two-center study, the
ovarian reserves of patients who came to the hospital for infertility treatment was evaluated based on their AFC and
early follicular phase follicle-stimulating hormone (FSH) levels. In addition, adiposity was evaluated using their body
mass index (BMI) and waist-to-hip ratios (WHRs), the subcutaneous tissue thickness of the bicipital and tricipital regions,
and the body adiposity index (BAI). Body fat distribution was evaluated using bioelectrical impedance analysis (BIA). We
evaluated 58 patients in this study. While we failed to show a relationship between BMI and WHR based on the AFC,
there was a significant relationship between body fat percentage and the AFC. The AFC in patients with < 35% body fat
and 35% body fat was 11.54 ± 4.27 and 9.00 ± 3.95, respectively (p = 0.029). There was no significant relationship
between the AFC and the WHR, BAI, and bicipital and tricipital subcutaneous tissue thickness. BMI may not reflect the
adiposity of every patient. When evaluating the ovarian reserves of patients, we must consider other measures of obesity
that reflect body fatness. Further large studies must be conducted to investigate the relationship between body fat and
|Subdermal Contraceptive Implants: Profile of Acceptors in a Tertiary Hospital in Southern Nigeria
||Aniekan M. Abasiattai
||Ntiense M. Utuk
Abstract: Background: Subdermal contraceptive implants provide safe, effective, convenient, long term reversible
fertility regulation, and because of their numerous non-contraceptive benefits are particularly suitable for women in
developing countries. This study determines the socio-demographic characteristics of acceptors of subdermal implants,
the timing of their use and their complications at the University of Uyo Teaching Hospital, Uyo.
Materials and Methods: The record cards of all clients that accepted subdermal contraceptive implants over a four year
period were reviewed.
Results: There were a total of 1057 new contraceptive acceptors out of which 197 (18.6%) accepted contraceptive
implants. The modal age group of the clients was 30-34 years (38.0%). One hundred and fifty six patients (79.2%) were
mulitparous, 97.5% of the patients had attained secondary level of education while 92.4% were Christians. About 56.9%
of the clients preferred to use implants to space child births, most of the implants were inserted during the first week of
the menstrual period, and majority (78.2%) of the clients obtained their information concerning implants from clinic
personnel. The most common complication was abnormal vaginal bleeding.
Conclusion: contraceptive implants are very effective contraceptive methods that are mostly accepted and used by
young, educated parous women who mostly preferred to space births. There is also a high continuation rate among
acceptors so increasing availability of implants in family planning units nationwide could increase the number of women
who utilize this method of contraception.
|Spontaneous Vaginal Evisceration with Small Bowel Infarction
||Antonio J. Ramirez
Abstract: We report a case of a 72 year old woman who presented with small bowel infarction following a spontaneous
vaginal evisceration and vaginal vault prolapse.
The bowel infarction was managed by small bowel resection and anastomosis, and the vaginal evisceration was repaired
|Do Polyps Matter?
Abstract: Introduction: Endometrial polyps (EP) are common within the gynaecological practice. The aims of this study
are to evaluate the risk of premalignant and malignant changes in EP and to determine the predictors of histological
outcomes of these lesions.
Methods: This is a retrospective study conducted over a 12-year period between January 2000 and 2012. Data were
retrieved from patients’ and theatre records. The histopathology reports of all cases were retrieved. All cases with
confirmed EP at hysteroscopy were identified.
Results: There were a total of 397 cases. Age range was between 24 and 89 years, median age at presentation was 54
years. Histology outcomes were classified into benign, premalignant (hyperplasia with atypia) and malignant. Age
greater 60 years was strongly associated with abnormal histology i.e. premalignant and malignant changes in polyps
(OR 2.174 [CI 1.645-2.874], p<0.001) Menopausal status showed a strong link with abnormal histology (OR 1.599 [CI
1.388- 1.842], p<0.001). These patients were about one and a half times more likely to have abnormal histology in the
event of a polyp. The results are similar with premalignant histology (OR 1.610 [CI 1.394- 1.860], p<0.001).
Results for patients presenting with postmenopausal bleeding were also positive. They were more likely to have
abnormal histology compared to patients with other symptoms (OR1.776 [CI 1.516-2.079], p<0.001). Postmenopausal
bleeding is also strongly associated with premalignancy (OR 1.782 [CI 1.515- 2.096], p<0.001). The use of hormone
replacement therapy (HRT) or tamoxifen was not associated with abnormal histology (p= 0.114 and p=0.668
respectively) or premalignancy (p= 0.138 and p= 0.764 respectively).
Polyps greater than 15mm were not associated with abnormal histology (OR 1.313 [CI 0.932-1.850], p= 0.143) or
premalignancy (OR 1.292 [CI 0.896-1.864], p= 0.196).
Conclusion: There is a strong link between patients’ age and menopausal status with abnormal or premalignant
histology. Postmenopausal bleeding is also an important predictor of abnormal or premalignant changes at histology.
|Reducing Risk of Campylobacteriosis from Poultry: A Mini Review
Abstract: The worldwide annual cost of campylobacteriosis is at least several billion dollars. Risk analysis is being used
to reduce the magnitude of the problem and to support regulations and voluntary actions that are successful in that the
number of cases of illness is decreasing. The new regulations in the U.S. have resulted in commercial products with
fewer Campylobacter. During the last 16 years there has been significant progress in New Zealand because of new
regulations that have resulted in reduced numbers of Campylobacter on marketed products. While some progress has
been made in reducing cross contamination, it remains an important issue. Food safety education on the general
principles of food hygiene and food handling as well as applications of hazard analysis and critical control point (HACCP)
principles in food safety management are recommended to address the challenges associated with cross contamination.
Economic analysis of campylobacteriosis and the poultry meat industry shows that there are significant benefits of
addressing the challenges associated with Campylobacter in poultry products. Freezing has been shown to be an
excellent cost-effective method to reduce the number of viable Campylobacter and the number of cases of
|Comparison of Antioxidant Activity of Rosemary Extract in Peanut Oil and Flaxseed Oil in Relation to their Fatty Acids Compositions
||Dandan Tao, Ling Pan
Abstract: In this investigation, the antioxidant activity of rosemary extract in peanut oil (PO) and flaxseed oil (FO) during
accelerated storage has been studied and compared. Rosemary extracts were prepared in two forms, i.e. powdery
rosemary extract (PRE) and oily rosemary extract (ORE). The changes of fatty acids composition during 24 days of
storage were measured, and the correlations between unsaturated fatty acids (18: 3, 18: 2 and 18:1) and parameters of
oil oxidation (PV, p-AV and TBARS) were analyzed, respectively. PRE was more effective than ORE in stabilization of
both PO and FO samples. PO samples showed significantly higher oxidative stability than FO samples during 24 days of
storage. Negative correlations were found in 18:3 vs. peroxide value in PO and FO samples. Positive correlations were
found in 18:1 vs. p-AV and TBARS in PO and FO samples, and in 18:2 vs. p-AV and TBARS only in FO samples. Hence
FO samples were more susceptible to oxidation than PO samples because of its significantly higher content of 18:3.
Moreover, rosemary extract effectively inhibited the oil oxidation potentially by retarding the decomposition of 18:1 for PO
samples, while by retarding the decomposition of 18:2 and 18:1 for FO samples.
Practical applications: Oxidation of unsaturated fatty acids is one of the major concerns in oil consumption and storage.
The addition of natural antioxidants is a potential way to retard the oxidation of oils and thus to extend the shelf life of oil
products. Rosemary extract has been reported to show good antioxidant activity and could act as a good resource to
inhibit oil oxidation. The results in this study not only confirmed the effectiveness of rosemary extract in stabilizing oil
during storage, but also suggested different anti-oxidative pathways in different oil system in relation to their different
fatty acid compositions. Therefore, rosemary extract may have great market potential as food antioxidant in edible oils.
|A Dynamical Study of Risk Factors in Intracerebral Hemorrhage using Multivariate Approach
||Afaq Ahmed Siddiqui
||Junaid S. Siddiqui
Abstract: The purpose of this study is to investigate the effects of clinical covariates to the outcome of Intracerebral
Hemorrhage (ICH) patients in terms of best fitted and excellent discriminate model of binary response variable.
Clinical data of 985 patients with ICH have collected using the International classification of diseases, Ninth revision
codes. The diagnosis of ICH was confirmed by neuro-imaging in all patients.
Univariate analysis revealed that out of 88 covariates 46 were found to be significant (p<0.05). The multivariable analysis
using multiple logistic regressions, exhibited a significant negative relationship between ICH and hypertension. The
improvement among ICH patients having hypertension was 0.5 (p=0.001, ARR=0.5, 95% C.I. 0.3 – 0.8). The
improvement among ICH patients using antihypertensive medicine was 1.3 (p = 0.016, ARR=1.3, 95% C.I. 1.1 – 1.5).
Thus present study showed that ICH has strong relationship with use of antihypertensive medicine. The improvement of
patients who were using antihypertensive medicine at the time of discharge was 3.0 times (p < 0.0001, ARR=3.0, 95%
C.I. 2.7 – 3.2) as compared to those who did not use antihypertensive medicine. The change in ARR from 1.3 to 3.0
times shows that the use of antihypertensive medicine and ICH outcome variable are positively associated. The change
in ARR of hypertensive range of SBP also indicates that the blood pressure range and ICH outcome variable are
negatively associated. The neurological symptomatology, slurred speech and double vision are important factors of
proposed statistical models. Moreover, a clear decrease was found in mental status from normal to coma in applicable
Surgery is an important part of recovery, and estimated that the improvement among the ICH patients, who were treated
with surgery, was 1.4 times with significant p-value in best fitted models. The complication of pneumonia during
treatment of ICH subjects has highly significant negative association with outcome variable.
Present Model has 0.892 area under the curve with sensitivity (0.852), specificity (0.793) and p-value (0.204). This
indicates that the model gives the impression to fit quite well for predictive performance of the ICH outcome variable and
the model is excellent model.
|Evaluation of Rheological, Textural and Thermal Properties of Quinoa (Chenopodium Quinoa Willd) Based Breakfast Puree
||Olusola Samuel Jolayemi
Abstract: This study was conducted to determine the rheological, thermal, textural and color properties of quinoa based
breakfast puree possessing high nutritional value and composed of mainly non-dairy milk (soy milk) which could be an
alternative to conventional gluten-containing dairy breakfast meals. The rheological properties were evaluated under
steady and dynamic shear conditions. The steady shear test was carried out at 27 oC using a rotational type of
viscometer. Quinoa puree showed pseudo plastic non-Newtonian and time-independent flow behavior. Rheological data
was modeled by using Power and Herschel Buckley Models (R2>0.99). Dynamic shear properties were determined by
applying sweep test using a rheometer. G'
(elastic modulus) was reported to be greater than G" (viscous modulus)
exhibiting elastic behavior. Specific Heat (Cp) of quinoa puree was determined endothermically using Differential
Scanning Calorimeter (DSC). The sample thermogram showed no glass transition point. But the melting point appeared
at elevated temperature (above 120 oC). Textural properties of the puree in terms of consistency, cohesiveness and
firmness confirmed its viscoelastic nature. Water activity was about 0.97 and the color was reasonably light and
|Evaluation of Antibacterial Activity and Phenolic Contents of Four Nigerian Medicinal Plants
Abstract: In this study, phenolic compounds and antimicrobial properties of four medicinal plants from Nigeria was
investigated. The antibacterial properties and minimum inhibition concentration of Microdesmis puberula, Hypoestis
verticillaris, Icacina tricantha, and Enterolobium cyclocarpum against 21 different bacteria was carried out using the disc
diffusion assay. These plant extract were subjected to phytochemical screening by reverse phase HPLC (high pressure
liquid chromatography) coupled with diode array detection and GC-MS (gas chromatography- mass spectrum). H.
verticillaris had the most significant activity and showed inhibitory activity against most of the Gram-positive bacteria.
However, M. puberula was only effective against the growth of Staphylococcus aureus and Enterobacter sakkai with
inhibition zone of 8 mm. Furthermore, both I. tricantha and E. cyclocarpum only had antimicrobial effect on S. warneri
with the inhibition zone of 12 and 13 mm, respectively. The results showed that M. puberula mostly contained 0.46
mg100 g-1 dry sample quarcetin and H. verticillaris contained approximately 0.7 mg 100 g-1 dry sample mangiferin and
quarcetin. Moreover, both I. tricantha and E. cyclocarpum contain mostly quarcetin and rutin. According to GC-MS
results, M. puberula contained thymol and methyl cinnamic acid and H. verticillaris contained methyl cinnamic acid and
gallic acid. These plant extracts can be considered to be used in the cosmetic and food industries or even as a safe
alternative to synthetic antimicrobial drugs.
|Synergistic Antioxidant Activity of Capsicum Oleoresin, Lecithin and Curcuminoids in Sunflower Oil
||Sameera A. Rege
||Shamim A. Momin
Abstract: Essential fatty acids (EFAs) have the tendency to undergo autoxidation. Hence, the addition of antioxidants
becomes a key step during their storage. Synthetic antioxidants are found to be toxic in nature. Recently, many
investigations were carried out where EFAs were stabilized by natural antioxidants those can even replace synthetic
antioxidant totally. In the present study, capsicum oleoresin, soy lecithin and curcuminoids were used to stabilize EFAs
in refined sunflower oil. The study showed that the synergism of these natural antioxidants in proper proportion
increased the shelf life of sunflower oil. Consequently, the nutritive value of EFAs was restored because of their effective
stabilization and the natural antioxidants added for their stabilization provided the medicinal benefits.
|Automatic Identification of Relevant Colors in Non-Destructive Quality Evaluation of Fresh Salad Vegetables
||Dario Pietro Cavallo
Abstract: Quality loss during storage is often associated to changes in relevant product colors and/or to the appearance
of new pigments. Computer Vision System (CVS) for non-destructive quality evaluation often relies on human knowledge
provided by operators to identify these relevant colors and their features. The approach described in this paper
automatically identifies the most significant colors in unevenly colored products to evaluate their quality level. Its
performance was compared with results obtained by exploiting human training. The new method improved quality
evaluation and reduced the subjectivity and the inconsistency potentially induced by operators.
|Growth of Asaia spp. in Flavored Mineral Water - Evaluation of the Volumetric “Bottle Effect”
Abstract: This study evaluates the growth of acetic acid bacteria Asaia spp. in fruit flavored mineral water in both plastic
and glass bottles with different volumes. Two strains of bacteria A. bogorensis and A. lannensis were isolated from
spoiled soft drinks. Bacterial growth was analyzed using the plate count method and light microscopy. The results
indicate that the tested strains of Asaia spp. exhibit the better growth in the polytereftalate bottles with small volumes:
0.33 L and 0.5 L. The microscopic observations documented that these bacteria are able to form visible cell coaggregates
after 2-week period storage at 25oC. Using glass as packaging material allows for the slower growth of Asaia
spp. and contributes to improving the microbiological stability of fruit-flavored mineral waters.
|Effect of Raw Material Quality on Quality and Yield of Dried Fish Products
||Bangalore A. Shamasundar
Abstract: Dried fish products were prepared from siganid (Siganus sutor) and anchovy (Stolephorus sp.) using solar
drying and from flounder (Paralichthys patagonicus) using atmospheric freeze-drying. Very good correlations were
obtained between raw material quality and dried fish quality, in a dimensionless scale. A lower slope was obtained for
= 0.971) when comparing with siganid and anchovy (R
= 0.892), indicating that raw material quality
influences the quality of final products, being higher in fatty than in lean fish. This information is useful to reject
unsuitable raw material before processing. A correlation between quality of raw material and process yield is presented.
|Modeling and Simulation of Thermal Sterilization of Conduction Heat Canned Foods Using Heat Transfer Coefficients Boundary Conditions
||Ibrahim O. Mohamed
Abstract: A generalized computer simulation model for thermal sterilization of conduction-heated canned food was
developed. The model is based on expressing the boundary conditions in term of heat transfer coefficients to allow for
handling all possible types of boundary conditions in addition of updating the boundary conditions during thermal
processing. The developed computer program was based on an alternating direction implicit (ADI) finite difference
method using Crank-Nicolson scheme of discretization. The computer simulation model was validated using published
experimental time-temperature data collected at the geometric center for 5 % (w/w) canned bentonite in cylindrical can
with 9 % headspace. An excellent prediction for the can center temperature during both heating and cooling cycle
compared to experimental data was obtained. The program was used successfully in tracing the location of the cold spot
by examining the solution of the temperature profiles along the central axial direction at a given time confirming that cold
spot for the can size and headspace level used is at the geometric center. The developed computer program will be a
valuable tool in thermal process design, scheduling and optimization because it is based on realistic thermal processing
conditions that take into consideration actual thermal resistance at the can boundary surfaces and at the headspace
|Influence of Tasting Spots on Texture of Chicken Breast Fillets
||HyoJin Chloe Cho
||Jessica M. MacMartin
Abstract: Despite the fact that a chicken breast is a single part, the fillet possesses different texture characteristics in
different “tasting spots” within the fillet. The objective of this study was to identify differences in tasting spots on chicken
breast fillets of large birds (4.0 – 5.5 kilogram) in their texture and sensory attributes. Researchers divided raw chicken
fillets into two pieces, head and tail, and measured hardness using a texture analyzer. Non-trained participants rated
sensory characteristics (appearance, initial taste, aroma, flavor, color, after taste, texture, overall quality, overall liking) of
the cooked chicken breast fillets. Texture analyzer data showed that there was a significant difference in hardness
between two different parts of the raw chicken breast fillet (head and tail). Also, analysis of the sensory attributes
indicated a significant difference in liking of appearance and texture of the cooked fillet.
|Comparison of the Volatile Components in Chinese Traditional Xiaoqu Liquor
Abstract: Volatile components in Sichuan Xiaoqu liquor of Chongqing Jiangjin District, Chongqing Yongchuan District,
Sichuan Kaijiang County, Sichuan Zigong were studied by the method of combining headspace solid-phase
microextraction (HS-SPME) with gas chromatography coupled with mass spectrometry (GC-MS). Results showed that
29, 31, 44, 45 kinds of aromatic components were identified from the Xiaoqu liquor of Jiangjin, Chongqing Yongchuan,
Kaijiang and Zigong respectively. Esters, alcohols as well as aldehydes and ketones are the main substances. According
to peak area relative percentage contents, content of ethyl acetate, isoamyl alcohol and ethyl caprate in the 4 kinds of
Xiaoqu liquor is relatively high.