Jai Bhagwan Sharma

Leptin, IL‐10 and Inflammatory Markers (TNF‐α, IL‐6 and IL‐8) in Pre‐Eclamptic, Normotensive Pregnant and Healthy Non‐Pregnant Women

Despite progress in immunobiology, pre‐eclampsia (PE) remains one of the most common reasons for women to die during pregnancy. The widespread pathophysiological mechanisms are endothelial dysfunction, oxidative stress and inflammation. The aim of this study was to assess the alteration in the levels of leptin, interleukin (IL)‐10 and inflammatory cytokines [tumour necrosis factor (TNF)‐α, IL‐6 & IL‐8] in pre‐eclamptic (severe and mild), healthy pregnant and non‐pregnant women and correlate these parameters with disease severity.

Oxidative stress markers and antioxidant levels in normal pregnancy and pre‐eclampsia

Objective: To compare the levels of 3 oxidative stress markers (glutathione peroxidase [GPX], superoxide dismutase [SOD], and malondialdehyde [MDA]) and 2 antioxidants (vitamin C and lycopene) in healthy and pre‐eclamptic pregnant women.

Role of FDG PET-CT in detecting recurrence in patients with uterine sarcoma: comparison with conventional imaging.

PurposeThe purpose of the present study was to evaluate the role of 18F-fluorodeoxyglucose (FDG) PET-CT in detecting recurrent disease in posttherapy patients of uterine sarcoma and compare the same with conventional imaging (CI). MethodsA total of 15 FDG PET-CT studies were acquired in 12 posttherapy uterine sarcoma patients. The images were evaluated by two experienced nuclear medicine physicians in consensus. Clinical/imaging follow-up (minimum 6 months) and histopathology were taken as the reference standard. All the patients had also undergone CI (CT or MRI or ultrasonography) of the chest, abdomen, and pelvis. The diagnostic accuracy of FDG PET-CT was calculated and compared with that of CI. ResultsThe median age of the patients was 51.5 years (interquartile range: 47.5–53). Histopathology was leiomyosarcoma in six, carcinosarcoma in five, and endometrial stromal sarcoma in one patient. Six FDG PET-CT studies were carried out for suspected recurrence and nine for posttherapy surveillance. Six FDG PET-CTs were positive and nine were negative for recurrence. The sensitivity, specificity, and accuracy of FDG PET-CT were 85.7, 100, and 93.3%, respectively, on per study-based analysis, and 80, 100, and 83.3% on per lesion-based analysis. PET-CT showed higher sensitivity and specificity compared with CI for both study-based and lesion-based analysis. However, no significant difference was found between FDG PET-CT and CI either in the study-based or in the lesion-based analysis (P not significant). ConclusionFDG PET-CT is a highly sensitive and specific modality for detecting recurrence in posttherapy patients with uterine sarcoma. However, it provides no significant advantage over CI for this purpose.

Effect of dietary habits on prevalence of anemia in pregnant women of Delhi.

Aim:  To see the effect of various dietary habits, such as a vegetarian diet or various types of meat, on the prevalence of anemia in pregnant women.

A prospective randomized trial comparing the efficacy of Letrozole and Clomiphene citrate in induction of ovulation in polycystic ovarian syndrome

OBJECTIVES: To compare the efficacy of letrozole and clomiphene citrate (CC) in patients of anovulatory polycystic ovarian syndrome (PCOS) with infertility. MATERIALS AND METHODS: This prospective randomized clinical trial included 204 patients of PCOS. 98 patients (294 cycles) received 2.5–5 mg of letrozole; 106 patients (318 cycles) received 50–100 mg of CC (both orally from Days 3–7 of menstrual cycle). The treatment continued for three cycles in both the groups. Main outcome measures: ovulation rate, endometrial thickness, and pregnancy rate. Statistical analysis was done using SPSS 13 software. P value less than 0.05 was considered significant. RESULTS: The mean number of dominant follicles in letrozole groups and CC groups was 1.86±0.26 and 1.92±0.17, respectively (P=0.126). Number of ovulatory cycle in letrozole group was 196 (66.6%) versus 216 (67.9%) in CC group (P=0.712). The mean mid-cycle endometrial thickness was 9.1±0.3 mm in letrozole group and 6.3±1.1 in CC group, which was statistically significant (P=0.014). The mean Estradiol [E2] level in clomiphene citrate group was significantly higher in CC group (364.2±71.4 pg/mL) than letrozole group (248.2± 42.2 pg/mL). 43 patients from the letrozole group (43.8%) and 28 patients from the CC group (26.4%) became pregnant. CONCLUSION: Letrozole and CC have comparable ovulation rate. The effect of letrozole showed a better endometrial response and pregnancy rate compared with CC.

The role of magnetic resonance imaging in fetal renal anomalies

To evaluate the role of magnetic resonance imaging (MRI) in fetuses with suspected renal anomalies after ultrasonography.

Hysteroscopic findings in women with primary and secondary infertility due to genital tuberculosis

To evaluate hysteroscopic findings of infertile women with genital tuberculosis.

Hysterosalpingographic findings in infertile women with genital tuberculosis

To evaluate the hysterosalpingographic findings from infertile women who were subsequently diagnosed with genital tuberculosis.

Increased complication rates associated with laparoscopic surgery among patients with genital tuberculosis

To compare the complications and surgical difficulties encountered during laparoscopy between women diagnosed with and without genital tuberculosis (TB).

Comparison of perinatal outcome of growth-restricted fetuses with normal and abnormal umbilical artery Doppler waveforms.

AIMS To evaluate the role of umbilical artery Doppler in growth- restricted fetuses. MATERIALS AND METHODS In a prospective observational study, 70 pregnant women with growth-restricted fetuses confirmed by ultrasound, were followed up with Doppler studies of the umbilical artery. The study group consisted of 35 women, where the Doppler waveform in the umbilical artery was compromised (either absent end diastolic flow [AEDF] or reversed end diastolic flow [REDF]). These were compared with an equal number of controls, where growth- restricted fetuses had normal doppler waveforms. Outcome measures were evaluated in both groups and analyzed. RESULTS The periods of gestation at delivery were 27.2 +/- 3.5 weeks in group 1 and 37 +/- 3.3 weeks in-group II, respectively. Perinatal morbidity and mortality was significantly increased in the group with compromised umbilical artery blood group. Birth weight in group I was 742 +/- 126 grams and in group II was 1680 +/- 259 grams. This difference was statistically significant (P=0.0001). In comparison to AEDF, REDF fetuses had more morbidities. Perinatal mortality was also significantly increased in this group (P=0.001). CONCLUSION Umbilical artery Doppler should be used in the management of growth-restricted fetuses. In those fetuses in normal Doppler, pregnancy can be prolonged. REDF is an indication for termination of pregnancy.