Utility of prophylactic cervical cerclage in intra-cytoplasmic sperm injection twins: a prospective study

Background: Several interventions have been used to reduce the rate of preterm birth and prolonging gestation in a twin pregnancy and routine usage of cervical cerclage in twin pregnancy conceived after intra-cytoplasmic sperm injection (ICSI) procedure has found to be beneficial.Methods: Prospective case series studies, series of expectant mothers with twin pregnancy conceived by ICSI were studied under tertiary care hospital setting. A total of 108 cases with twin pregnancy were included during a period of 2016 to 2019. Obstetric profile of all the cases was taken; cervical cerclage procedure was done at 14-16 weeks of gestation (McDonald method) after a normal nuchal translucency scan and a double marker test. Pregnancy outcome parameters like abortion, preterm labour/delivery, premature rupture of membranes (PROM), and mode of delivery, gestational age at delivery, birth weight and neonatal complications were assessed.Results: Mean age of the mothers was 30.61±4.45 years, rates of the pregnancy outcome parameters were abortion 0%, preterm labour 11.1%, premature rupture of membranes (PROM) 9.3%, mean gestational age at delivery was at 34.56±1.71 weeks. Neonatal outcome parameters were mean birth weight was at 2279±470 grams, 77.8% of the neonates had normal APGAR scores. The rates of NICU admission was 28%, RDS– 24.1%, 3.7% had sepsis and 92.6% of neonates survived and 7.4% died.Conclusions: In ICSI twin pregnancies with normal cervical measurements, prophylactic cervical cerclage is effective in prolonging pregnancy and preventing preterm delivery and thereby minimizing neonatal morbidity and mortality

IS discipline in the IT services land : an exploratory study of IS in India

Information Systems (IS) research is characterized by plurality of methodologies, perspectives and contexts giving rise to various communities within the discipline. Studies of IS communities in North America, Europe and Asia-Pacific highlight the cognitive diversity, institutional distribution and research themes based on geography. While regional variations have been acknowledged, the debate on the identity and status of IS is on-going. In this paper we conduct an exploratory study of the IS research paradigm in India and contribute to IS discipline studies by bringing in the India perspective. We analyse the &lsquo;cognitive&rsquo; and &lsquo;behavioural&rsquo; legitimacy of IS discipline in India based on interviews conducted with Indian business school professors from IS and non-IS disciplines. The focus of the study is to understand the current state of IS research community in India. We find a need to establish a &lsquo;collective identity&rsquo; of IS research in India, which will benefit both the Indian and larger IS community to work on unique research possibilities presented by the socioeconomic context of India.<br /

User Perceptions, Motivations and Implications on ERP Usage: An Indian Higher Education Context

Part 1: Full PapersInternational audienceGlobally ERP implementation in higher education (HE) sector has been increasing with universities under pressure to improve their performance and efficiency. Most of the studies related to ERP implementation in higher education are related to the factors which influence the success of ERP implementation or failures across various universities especially in the US and Australia. There is limited study of ERP implementation in HE institutes from a user perspective. Indian HE institutions have just started adopting ERP and there is no study available related to the Indian universities. In this paper we study the employee perceptions, motivations and use of ERP and the implications to the organization objectives. We study the ERP implementation in an Indian HE institute and provide a descriptive case study which can serve as a real life example for HE institutes in India and other developing countries planning to implement Enterprise Systems

Tuberculosis management practices by private practitioners in Andhra Pradesh, India.

SETTING: Private medical practitioners in Visakhapatnam district, Andhra Pradesh, India. OBJECTIVES: To evaluate self-reported TB diagnostic and treatment practices amongst private medical practitioners against benchmark practices articulated in the International Standards of Tuberculosis Care (ISTC), and factors associated with compliance with ISTC. DESIGN: Cross- sectional survey using semi-structured interviews. RESULTS: Of 296 randomly selected private practitioners, 201 (68%) were assessed for compliance to ISTC diagnostic and treatment standards in TB management. Only 11 (6%) followed a combination of 6 diagnostic standards together and only 1 followed a combination of all seven treatment standards together. There were 28 (14%) private practitioners who complied with a combination of three core ISTC (cough for tuberculosis suspects, sputum smear examination and use of standardized treatment). Higher ISTC compliance was associated with caring for more than 20 TB patients annually, prior sensitization to TB control guidelines, and practice of alternate systems of medicine. CONCLUSION: Few private practitioners in Visakhapatnam, India reported TB diagnostic and treatment practices that met ISTC. Better engagement of the private sector is urgently required to improve TB management practices and to prevent diagnostic delay and drug resistance

Private Practitioners adhering to ISTC^* diagnostic practices in Visakhapatnam, Andhra Pradesh.

<p><b>*(International Standards of TB Care).</b></p><p><b>TB = tuberculosis;</b></p><p><b>*Response to what antibiotic was used as trial antibiotic. 85 (53%) used non-fluoroquinolones.</b></p><p><b>**5 approaches included history, clinical examination, Tuberculin skin testing, bacteriological evaluation or relevant investigations to diagnose e.g. cervical lymph node TB.</b></p

Box 2- Decision aid for analysis.

<p>This is a decision aid for the purpose of analysis of data; the type of question asked in the questionnaire, subject of the question and the responses which should be considered as compliant against each diagnostic and treatment standard are summarized.</p

Characteristics of private practitioners in relation to compliance with 3 selected core ISTC^* in Visakhapatnam, AP.

<p><b>*(International Standards of TB Care).</b></p><p><b>Core ISTC Standards: Standard 1 = Using 2–3 weeks cough for identification of Pulmonary TB suspects; Standard 2 = Using sputum smear microscopy examination; and Standard 6 = Treatment with the standard 6-month regimen; TB = Tuberculosis; AYUSH = Ayurveda, Unani, Siddha, Homeopathy; RNTCP = Revised National TB Control Programme; RR = Relative Risk has been calculated for standard 1+2+8; CI = Confidence Interval.</b></p

Private Practitioners adhering to ISTC^* treatment practices in Visakhapatnam, Andhra Pradesh.

<p><b>*(International Standards of TB Care). H = INH, R = Rifampicin, Z = Pyrazinamide, E = Ethambutol, FDC = Fixed Drug Combinations, DOT- Directly observed treatment; TB = Tuberculosis; DR TB = Drug resistant TB.</b></p

Box 1- Diagnostic and treatment standards in International Standards of Tuberculosis Care.

<p>The principles of diagnostic and treatment standards in the International Standards of TB Care with their rationale and references are summarized.</p

Characteristics of responders and non-responders among private practitioners in Visakhapatnam, Andhra Pradesh.

<p><b>Responders = those who were administered the questionnaire, non responders = those who were not administered the questionnaire, AYUSH = Ayurveda, Unani, Siddha, Homeopathy, P value ≤0.05 = significant.</b></p