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Das S, Shastry S, Rai L, Baliga PB. Frequency and clinical significance of red cell antibodies in pregnancy - A prospective study from India. INDIAN J PATHOL MICR 2021; 63:241-246. [PMID: 32317523 DOI: 10.4103/ijpm.ijpm_737_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background For appropriate management of hemolytic disease of the fetus and newborn (HDFN), it is important to detect irregular red cell antibody in the antenatal period. Though it is a simple one-step method, it is not part of routine antenatal screening in many developing countries. To reiterate the importance of antenatal antibody screening, we have assessed the frequency and clinical significance of irregular red cell antibodies in our patient population. Materials and Methods A prospective study was carried out from October 2013 to May 2015 at a tertiary care center from south India. All antenatal samples received by the laboratory for red cell antibody screening were screened using a commercial three-cell screening panel. Antibody identification along with further Immunohematological techniques as required were performed for cases with positive screening results. Neonates of the alloimmunized cases were followed up to determine the clinical significance of the antibody. Results A total of 2336 antenatal mothers were screened for red cell antibodies. The overall rate of alloimmunization in the study group was 2.27%. Alloimmunization rate among RhD-negative pregnancies was 6.9%. Other than anti-D (49%), we identified anti-D + anti-C (5%), anti-G (5%), anti-c (5%), anti-E (2%), anti-e (2%), anti-H (Bombay phenotype) (7%), anti-M (2%), anti-Lea (2%), anti-Leb (12%), and autoantibodies (9%) in the maternal serum. Anti-D, anti-D + anti-C, anti-G, anti-c, and anti-H were found to be clinically significant in this study. Conclusion This study showed that 1 in 125 RhD-positive pregnancies can develop red cell alloantibodies. Hence, implementing routine antenatal antibody screening irrespective of RhD status is essential.
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Affiliation(s)
- Soumya Das
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shamee Shastry
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Lavanya Rai
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Poornima B Baliga
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Abstract
Background: Thrombocytopenia, defined as a platelet count less than 150 million/mm3, affects 6% to 10% of all pregnant women and other than anemia is the most common hematologic disorder in pregnancy.Methods: We studied all patients with thrombocytopenia in pregnancy from June 2012 to May 2013. There were 86 patients recruited into the study. Pregnant women with preeclampsia and suspected connective tissue disorder were also screened for thrombocytopenia. All women with platelet count of <1.50,000/µl during the study period were included.Results: Patients were grouped in to mild thrombocytopenia (platelet 100,000-149,999/µl), moderate thrombocytopenia (platelet 50,000-99,999/µl) and severe thrombocytopenia (platelet <49,999/µl. Pregnancy specific cause of thrombocytopenia was in 63 (73.2%) women and non-pregnancy specific were in 23(26.7%) patients.Conclusions: Preeclampsia and HELLP syndrome is more common cause of thrombocytopenia in pregnancy. Abruption can occur in patients with severe thrombocytopenia. Though platelet count is not routinely done in pregnancy it is advisable to do so as it may help in detecting gestational thrombocytopenia or other immune related condition.
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Hebbar S, Rai L, Ali Z. Critical Evaluation of various Sonologic Parameters of Early Foetal Growth Discrepancies in Predicting Adverse Pregnancy Outcomes. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/34657.11428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vellamkondu A, Vasudeva A, Bhat RG, Kamath A, Amin SV, Rai L, Kumar P. Risk Assessment at 11-14-Week Antenatal Visit: A Tertiary Referral Center Experience from South India. J Obstet Gynaecol India 2017; 67:421-427. [PMID: 29162956 DOI: 10.1007/s13224-017-0985-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 03/27/2017] [Indexed: 12/16/2022] Open
Abstract
Background Present study carried out in a tertiary referral hospital in South India attempts to determine the predictive value of integrated screening at 11-14-week antenatal visit. Objectives To determine the detection rate of fetal abnormalities at 11-14 weeks and also to predict the placental dysfunction disorders based on early integrated evaluation. Method Integrated screening performed on 440 women between 11 and 14 weeks, including detailed maternal history [medical history, bad obstetric history (BOH)], body mass index (BMI), mean arterial pressure (MAP), detailed ultrasound and maternal serum biochemistry as part of combined first-trimester screening for aneuploidy. Results There were two proven Down's syndrome foetuses; both detected with combined screening test. There were 12 fetuses with major anomalies, out of whom 7 (58.3%) detected in 11-14-week scan. Among 440, 114 pregnancies (25.9%) developed complications in pregnancy, including 33 (7.5%) gestational hypertension, 8 (1.8%) pre-eclampsia, 41 (9.38%) SGA, 13 (2.9%) abortions, 22 (5%) indicated and 9 (2.04%) spontaneous preterm deliveries, 38 (8.63%) GDM and 3 (0.6%) stillbirth/IUD. Among the risk factors, age >35 years, BMI >23 kg/m2, BOH, MAP >105 mmHg and PAPP-A <0.5 MoM correlated well with adverse outcome. Using early integrated screening, 78.9% of obstetric complications could be predicted although 306 (69.5%) were labeled high risk, among whom 90 (29.4%) developed adverse pregnancy outcomes. Conclusions Majority of fetal abnormalities can be detected, and majority adverse pregnancy outcomes can be predicted at 11-14-week antenatal visit, although this study shows high screen positivity and low specificity in a tertiary referral unit.
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Affiliation(s)
- Anusha Vellamkondu
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104 India
| | - Akhila Vasudeva
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104 India
| | - Rajeshwari G Bhat
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104 India
| | - Asha Kamath
- Department of Community Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104 India
| | - Sapna V Amin
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104 India
| | - Lavanya Rai
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104 India
| | - Pratap Kumar
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104 India
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Abstract
INTRODUCTION Neurological disorders in pregnancy can be pregnancy related or can be caused by exacerbation of a pre-existing neurological condition or sometimes may even be detected for the first time during pregnancy in which it might be an incidental finding. The diagnosis and management of the neurological disorders in pregnancy is always a challenging task due to varied symptomatology and risks to the fetus. The evaluation and management should be performed in a stepwise fashion and requires multidisciplinary approach. AIM The present study was conducted with the aim to study the influence of neurological disorders on outcome of pregnancy. MATERIAL AND METHODS This was a prospective observational study conduted over a period of 1 year (2013-2014) including 54 pregnant women with neurological manifestations. The spectrum of neurological manifestations was divided into-pregnancy specific, incidental and pre-existing neurological disorders for analysis. Five unusual cases with varied manifestations were studied in detail. Any pregnant woman presenting with neurological manifestation, irrespective of gestational age were included in the present study. The neurological manifestation and the obstetric outcome were analysed in the present study. RESULTS There were 54 women with varied neurological manifestations, majority (74%) of them being primigravida. Seizure was the most common (63%) manifestation. The incidence of pregnancy specific disorder (eclampsia), pre-existing disease (epilepsy) and incidental causes were 40.8%, 37% and 22.2% respectively. Of the 22 women with eclampsia, 15(68%) had seizure during antepartum period and 7(32%) in the postpartum period. Three patients out of 22 who had eclampsia had intrauterine fetal demise on arrival itself, whereas the perinatal outcome was good in the other 19 patients who had live born babies. The most common incidental cause in the present study was tubercular meningitis (44%). There was however a maternal and perinatal mortality in woman with structural malformation who had massive intra-ventricular haemorrhage, secondary to ruptured cerebral cavernoma. Here we have described in detail 5 patients with varied clinical manifestation causing diagnostic dilemma. They are spinal arterio-venous malformation, disseminated toxoplasmosis, massive intra-ventricular haemorrhage (ruptured cerebral cavernoma), tubercular meningitis with cortical venous thrombosis, suspected Bartter syndrome presenting as coma. CONCLUSION Neurological manifestation during pregnancy may not always be a primary neurological disorder, instead may be manifestation secondary to any systemic illness. Hence, a wide index of suspicion and neuroimaging aids in arriving at the diagnosis certainly improves the pregnancy outcome.
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Affiliation(s)
- Sandya Renukesh
- Senior Resident, Department of Obstetrics and Gynaecology, St John’s Medical College, Bangalore, India
| | - Lavanya Rai
- Professor and Head of Department, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Udupi, India
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Patil A, Bhat S, Pai KM, Rai L, Kartha VB, Chidangil S. Ultra-sensitive high performance liquid chromatography-laser-induced fluorescence based proteomics for clinical applications. J Proteomics 2015; 127:202-10. [PMID: 25979166 DOI: 10.1016/j.jprot.2015.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/18/2015] [Accepted: 05/06/2015] [Indexed: 11/20/2022]
Abstract
UNLABELLED An ultra-sensitive high performance liquid chromatography-laser induced fluorescence (HPLC-LIF) based technique has been developed by our group at Manipal, for screening, early detection, and staging for various cancers, using protein profiling of clinical samples like, body fluids, cellular specimens, and biopsy-tissue. More than 300 protein profiles of different clinical samples (serum, saliva, cellular samples and tissue homogenates) from volunteers (normal, and different pre-malignant/malignant conditions) were recorded using this set-up. The protein profiles were analyzed using principal component analysis (PCA) to achieve objective detection and classification of malignant, premalignant and healthy conditions with high sensitivity and specificity. The HPLC-LIF protein profiling combined with PCA, as a routine method for screening, diagnosis, and staging of cervical cancer and oral cancer, is discussed in this paper. BIOLOGICAL SIGNIFICANCE In recent years, proteomics techniques have advanced tremendously in life sciences and medical sciences for the detection and identification of proteins in body fluids, tissue homogenates and cellular samples to understand biochemical mechanisms leading to different diseases. Some of the methods include techniques like high performance liquid chromatography, 2D-gel electrophoresis, MALDI-TOF-MS, SELDI-TOF-MS, CE-MS and LC-MS techniques. We have developed an ultra-sensitive high performance liquid chromatography-laser induced fluorescence (HPLC-LIF) based technique, for screening, early detection, and staging for various cancers, using protein profiling of clinical samples like, body fluids, cellular specimens, and biopsy-tissue. More than 300 protein profiles of different clinical samples (serum, saliva, cellular samples and tissue homogenates) from healthy and volunteers with different malignant conditions were recorded by using this set-up. The protein profile data were analyzed using principal component analysis (PCA) for objective classification and detection of malignant, premalignant and healthy conditions. The method is extremely sensitive to detect proteins with limit of detection of the order of femto-moles. The HPLC-LIF combined with PCA as a potential proteomic method for the diagnosis of oral cancer and cervical cancer has been discussed in this paper. This article is part of a Special Issue entitled: Proteomics in India.
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Affiliation(s)
- Ajeetkumar Patil
- Dept. of Atomic and Molecular Physics, Manipal University, Manipal, Karnataka, India
| | - Sujatha Bhat
- Dept. of Microbiology, Melaka Manipal Medical College, Manipal University, Manipal, India
| | - Keerthilatha M Pai
- Dept. of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, India
| | - Lavanya Rai
- Dept. of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, India
| | - V B Kartha
- 21, Udayagiri, Sion, Trombay, Mumbai, India
| | - Santhosh Chidangil
- Dept. of Atomic and Molecular Physics, Manipal University, Manipal, Karnataka, India.
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Bajpai N, Bhakta R, Kumar P, Rai L, Hebbar S. Manipal Cervical Scoring System by Transvaginal Ultrasound in Predicting Successful Labour Induction. J Clin Diagn Res 2015; 9:QC04-9. [PMID: 26155521 DOI: 10.7860/jcdr/2015/12315.5970] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/05/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Induction of labour (IOL) nowadays is a common procedure in obstetric practice. The success of IOL largely depends upon "favourability" or "readiness" cervix which is traditionally assessed by manual examination and Scored as Bishop Score. However, this method is limited by subjectivity and reproducibility and though done in all the patients prior to IOL, several studies have demonstrated poor correlation between Bishop Score and outcome of labour. OBJECTIVE To evaluate the role of preinduction transvaginal ultrasonographic (TVS) cervical assessment in predicting labour outcome and to compare its performance against Bishop Score in patients undergoing induction of labour (IOL). SETTING A tertiary medical college hospital in Southern India. DESIGN Prospective observational and investigational study. MATERIALS AND METHODS Transvaginal ultrasound was performed in 131 patients who underwent labour induction at term with intact membranes and live fetus. Bishop Score was assessed by pervaginal examination and was compared with preinduction TVS cervical Score (parameters being cervical length, funneling, position of cervix and distance of presenting part from external os). Labour was induced within one hour of cervical assessment. The labour induction was considered successful if patient could get into active labour i.e., onset of regular uterine contractions (at interval of 2-3 minutes) and cervical dilatation of 4 cm or greater within 24 hours of induction. RESULTS Labour induction was successful in 86.9% of patients. At cut off Scores of ≥ 4, TVS cervical Score performed better than Bishop Score (Sensitivity 77% vs. 65%, Specificity 93% vs. 86%). ROC analysis indicated that Area Under Curve (AUC) was more for TVS Score (0.90, 95% CI 0.84 - 0.95), compared to Bishop Score. It was found that an increase in cervical length and distance from the os by 1 mm from their means were associated with an increase in odds for failure of induction and there by caesarean delivery by 6.5% and 11% respectively. CONCLUSION In women experiencing labour induction, transvaginal ultrasound score comprising of five different parameters indicated success of induction better than Bishop Score. Further, two of its components (longer cervical length and increased distance of presenting part from external os) demonstrated significant and independent prediction of the likelihood of failure of induction and risk of operative delivery.
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Affiliation(s)
- Neha Bajpai
- Assistant Professor, Department of Obstetrics and Gynaecology, KMC Manipal , Manipal University, India
| | - Rajesh Bhakta
- Associate Professor, Department of Obstetrics and Gynaecology, KMC Manipal , Manipal University, India
| | - Pratap Kumar
- Professor, Department of Obstetrics and Gynaecology, KMC Manipal , Manipal University, India
| | - Lavanya Rai
- Professor and Unit Head, Department of Obstetrics and Gynaecology, KMC Manipal , Manipal University, India
| | - Shripad Hebbar
- Additional Professor, Department of Obstetrics and Gynaecology, KMC Manipal , Manipal University, India
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Abstract
INTRODUCTION: Many women face problems related to infertility in various aspects of their life. Also, it is not comfortable to discuss on this issue. Because of this, the feelings and distress faced by women may not come out and the pent up emotions may lead to different stress related problems. MATERIAL AND METHODS : A descriptive research design was adopted to assess the stress and coping mechanism of infertile women attending infertility clinic in Kathmandu Nepal. The study was conducted from October 2011 to January 2013. Purposive sampling technique was used and sample size was 100. Data was collected through semi- structured interview using; 'Perceived Stress Scale'(PSS) and 'Coping Check List' (CCL). RESULTS: Regarding stress level of respondents, 40% were at very high level of stress and 35% with high level of stress. High level stress was found among the age group of 21-30 years. In relation to level of stress and coping strategies, 54.17% respondents with high stress used religious coping strategies, 50% of the respondents with very high stress also used religious coping, followed by 40% emotional coping and 37.5% problem focused coping and seeking social support strategies to overcome the stress. CONCLUSION: It can be concluded that the almost more than half of the respondents were under high level of stress and mostly were those who are under treatment for more than 1-3 yrs of duration. The study also concluded that the higher the age the respondents were more stressed due to the infertility. It was also found that most of the respondents used religious coping as well as emotional focused coping during the stressful period.DOI: http://dx.doi.org/10.3126/jucms.v2i4.12039Journal of Universal College of Medical Sciences (2014) Vol.02 No.04 Issue 08Page: 24-28
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Gulavani N, Rodrigues G, Prabhu R, Kamath G, Rai L, Rao L. Non-functioning Aortocaval Paraganglioma Masquerading as Celiac Lymphnodal Metastasis. Eurasian J Med 2015; 46:53-6. [PMID: 25610296 DOI: 10.5152/eajm.2014.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 06/11/2013] [Indexed: 11/22/2022] Open
Abstract
An extra-adrenal paraganglioma is a rare tumour derived from chromaffin cells of sympathetic ganglia. This report documents a rare case of a non-functional aortocaval paraganglioma in a 24-year-old woman with persistent abdominal pain. Computed tomography revealed a solid mass, measuring 2.5x3cms, localized between the celiac trunk and superior mesenteric artery in aortocaval location along with right ovarian cystic mass. A clinical diagnosis of malignant ovarian tumour with celiac nodal metastasis was made. Excision and pathological analysis of both revealed an aortocaval extra-adrenal paraganglioma and benign ovarian cyst. On serial follow-up the patient was in a good health, asymptomatic and without evidence of tumour recurrence. This case emphasizes the necessity of including extra-adrenal paraganglioma in the differential diagnosis and management of retroperitoneal tumours, despite its rarity.
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Affiliation(s)
- Nikhil Gulavani
- Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, India
| | - Gabriel Rodrigues
- Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, India
| | - Raghunath Prabhu
- Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, India
| | - Ganesh Kamath
- Department of Cardiothoracic and Vascular Surgery, Kasturba Medical College, Manipal University, Manipal, India
| | - Lavanya Rai
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, India
| | - Lakshmi Rao
- Department of Pathology, Kasturba Medical College, Manipal University, Manipal, India
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Mundkur A, Rai L, Hebbar S, Guruvare S, Adiga P. Fallopian tube choriocarcinoma presenting as ovarian tumour: a case report. J Clin Diagn Res 2015; 9:QD01-2. [PMID: 25738040 DOI: 10.7860/jcdr/2015/9018.5359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 10/30/2014] [Indexed: 11/24/2022]
Abstract
Choriocarcinoma of the fallopian tube is a rare form of gestational trophoblastic disease. It can be gestational or non gestational choriocarcinoma, based on the origin. Fallopian tube choriocarcinoma has been reported commonly after ectopic pregnancy. Choriocarcinomas are germ cell tumours formed by trophoblastic elements. A 26-year-old lady presented with pain and mass abdomen of 15 days duration. Clinical examination revealed a ovarian tumour with elevated beta HCG. The working diagnosis was ovarian choriocarcinoma. Patient was also found to be having pulmonary artery hypertension due to the metastasis to lungs. Staging laparotomy was done. Histopathology revealed it to be metastatic gestational choriocarcinoma of fallopian tube with vascular emboli. The stage was stage III and WHO scoring of 15. She received Etoposide, Methotrexate, Actinomicin, Cyclophosphamide and Oncovin therapy. Following treatment there was a significant drop in the beta HCG. Patient tolerated the chemotherapy well. This is a rare presentation of choriocarcinoma with good prognosis.
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Affiliation(s)
- Anjali Mundkur
- Assistant Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
| | - Lavanya Rai
- Professor and HOD, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
| | - Shripad Hebbar
- Additional Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
| | - Shyamala Guruvare
- Associate Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
| | - Prashanth Adiga
- Associate Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
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Abstract
Background: Cut-off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. Aim: To study the various factors influencing the ET in postmenopausal women. Subjects and Methods: This was a prospective observational study. A total of 110 postmenopausal women underwent detailed history taking, clinical examination, and transvaginal scan for uterine volume and ovarian volume. The volumes were calculated by using ellipsoid formula: Width × thickness × height × 0.523. The variation in ET with respect to the influencing factors such as age, duration of menopause, parity, body mass index (BMI), medical illness like diabetes/hypertension, drugs like tamoxifen, presence of myoma, uterine volume, ovarian volume, and serum estradiol (in selected patients) were measured. Descriptive analysis was performed using SPSS software (version 16, Chicago II, USA) to obtain mean, standard deviation (SD), 95% confidence intervals (CIs) and inter quartile ranges. Comparison of means was carried out using analysis of variance. Results: The mean (SD) age of the patients was 55.4 (6.91) years (95% CI, 54.1, 56.7). The mean (SD) age at menopause was 47.95 (3.90) years (95% CI, 47.2, 48.7) and the mean (SD) duration of menopause was 7.27 (6.65) years (95% CI, 6.01, 8.53). The mean (SD) ET was 3.8 (2.3) mm (95% CI, 3.36, 4.23). Medical illness like diabetes and hypertension did not alter the ET. ET increased as BMI increased and it was statistically significant. The presence of myoma increased uterine volume significantly and was associated with thick endometrial stripe. Similarly, whenever the ovaries were visualized and as the ovarian volume increased, there was an increase in ET. When ET was > 4 mm (n = 37), they were offered endocel, of which 16 agreed to undergo the procedure. None were found to have endometrial cancer. Conclusion: This study suggests that parity, BMI, presence of myoma, tamoxifen usage, uterine volume, ovarian volume and serum estradiol influence the ET in postmenopausal women.
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Affiliation(s)
- S Hebbar
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - V Chaya
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - L Rai
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - A Ramachandran
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
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Kumaran A, Guruvare S, Sharan K, Rai L, Hebbar S. Chemoradiation Related Acute Morbidity in Carcinoma Cervix and Correlation with Hematologic Toxicity: A South Indian Prospective Study. Asian Pac J Cancer Prev 2014; 15:4483-6. [DOI: 10.7314/apjcp.2014.15.11.4483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bhat S, Kartha VB, Rai L, Chidangil S. A Comparison of Protein Profiles of Cervical Tissue Homogenate, Exfoliated Cells from Cervix and Serum in Normal and Cervical Malignancy Conditions. J Chromatogr Sci 2014; 53:167-76. [DOI: 10.1093/chromsci/bmu039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Shripad H, Rai L, Mohan A. Comparison of Blood Loss in Induced vs. Spontaneous Vaginal Delivery Using Specialized Blood Collection Bag. J Clin Diagn Res 2014; 8:OC01-4. [PMID: 24959480 PMCID: PMC4064887 DOI: 10.7860/jcdr/2014/7417.4208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 01/17/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare third stage blood loss in induced vs. spontaneous vaginal deliveries and to correlate the amount of blood loss with the decrease in haemoglobin following deliveries. SETTING Department of Obstetrics and Gynaecology, Kasturba Hospital Manipal, Karnataka, India. MATERIALS AND METHODS Blood loss following placental deliveries was measured by using special collection bags in 150 pregnant ladies who delivered vaginally by labour induction and it was compared with that of another 50 women who had spontaneous vaginal deliveries. Haemoglobin values were recorded for each patient prior to labour and after delivery of child. RESULTS The mean blood loss in induced group was 30 mL more than that in spontaneous group (202 ± 117 mL vs. 172 ± 114 mL), but this was not statistically significant (p=0.12). However, when different methods of induction were compared, oxytocin group was found to have significantly higher blood loss (327 ± 140 mL) as compared to that in other types of labour inductions as well as spontaneous deliveries. Labour induction using prostaglandins did not produce more blood loss as compared that produced by spontaneous deliveries. Both induced and spontaneous delivery groups showed statistically significant drops in post-delivery haemoglobin values, but the drop was relatively more in induced group as compared to that in spontaneous vaginal delivery group (0.96gm/dL vs. 0.56gm/dL), which appeared to be statistically significant (p=0.002). CONCLUSION Labour induction using prostaglandins is safe as compared to oxytocin usage. Accurate estimation of blood loss is important in all types of deliveries, in order to detect postpartum haemorrhage early, so that appropriate measures can be undertaken.
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Affiliation(s)
- Hebbar Shripad
- Additional Professor, Department of Obstetrics and Gynaecology, KMC Manipal, Manipal University, Karnataka, India
| | - Lavanya Rai
- Professor, Department of Obstetrics and Gynaecology, KMC Manipal, Manipal University, Karnataka, India
| | - Akshara Mohan
- Junior Resident, Department of Obstetrics and Gynaecology, KMC Manipal, Manipal University, Karnataka, India
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Kabekkodu SP, Bhat S, Radhakrishnan R, Aithal A, Mascarenhas R, Pandey D, Rai L, Kushtagi P, Mundyat GP, Satyamoorthy K. DNA promoter methylation-dependent transcription of the double C2-like domain β (DOC2B) gene regulates tumor growth in human cervical cancer. J Biol Chem 2014; 289:10637-10649. [PMID: 24570007 DOI: 10.1074/jbc.m113.491506] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Double C2-like domain β (DOC2B) gene encodes for a calcium-binding protein, which is involved in neurotransmitter release, sorting, and exocytosis. We have identified the promoter region of the DOC2B gene as hypermethylated in pre-malignant, malignant cervical tissues, and cervical cancer cell lines by methylation-sensitive dimethyl sulfoxide-polymerase chain reaction and bisulfite genome sequencing; whereas, it was unmethylated in normal cervical tissues (p < 0.05). The promoter hypermethylation was inversely associated with mRNA expression in SiHa, CaSki, and HeLa cells and treatment with demethylating agent 5-aza-2-deoxycytidine restored DOC2B expression. The region -630 to +25 bp of the DOC2B gene showed robust promoter activity by a luciferase reporter assay and was inhibited by in vitro artificial methylation with Sss1 methylase prior to transient transfections. Overexpression of the DOC2B gene in SiHa cells when compared with controls showed significantly reduced colony formation, cell proliferation, induced cell cycle arrest, and repressed cell migration and invasion (p < 0.05). Ectopic expression of DOC2B resulted in anoikis-mediated cell death and repressed tumor growth in a nude mice xenograft model (p < 0.05). DOC2B expressing cells showed a significant increase in intracellular calcium level (p < 0.05), impaired AKT1 and ERK1/2 signaling, and induced actin cytoskeleton remodeling. Our results show that promoter hypermethylation and silencing of the DOC2B gene is an early and frequent event during cervical carcinogenesis and whose reduced expression due to DNA promoter methylation may lead to selective cervical tumor growth.
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Affiliation(s)
- Shama Prasada Kabekkodu
- Division of Biotechnology, Manipal Life Sciences Centre, Manipal University, Manipal 576104, India
| | - Samatha Bhat
- Division of Biotechnology, Manipal Life Sciences Centre, Manipal University, Manipal 576104, India
| | - Raghu Radhakrishnan
- Division of Biotechnology, Manipal Life Sciences Centre, Manipal University, Manipal 576104, India
| | - Abhijit Aithal
- Division of Biotechnology, Manipal Life Sciences Centre, Manipal University, Manipal 576104, India
| | - Roshan Mascarenhas
- Division of Biotechnology, Manipal Life Sciences Centre, Manipal University, Manipal 576104, India
| | - Deeksha Pandey
- Department of OBGYN, Kasturba Medical College, Manipal University, Manipal 576104, India
| | - Lavanya Rai
- Department of OBGYN, Kasturba Medical College, Manipal University, Manipal 576104, India
| | - Pralhad Kushtagi
- Department of OBGYN, Kasturba Medical College, Manipal University, Mangalore 575001, India
| | - Gopinath Puthiya Mundyat
- Division of Biotechnology, Manipal Life Sciences Centre, Manipal University, Manipal 576104, India
| | - Kapaettu Satyamoorthy
- Division of Biotechnology, Manipal Life Sciences Centre, Manipal University, Manipal 576104, India.
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Ch U, Guruvare S, Bhat SS, Rai L, Rao S. Evaluation of placenta in foetal demise and foetal growth restriction. J Clin Diagn Res 2014; 7:2530-3. [PMID: 24392392 DOI: 10.7860/jcdr/2013/6204.3601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 07/28/2013] [Indexed: 11/24/2022]
Abstract
AIM The study objective was to evaluate the pathological changes of the placenta in foetal death and foetal growth restriction and to find correlation of the findings with clinical causes. SETTING AND DESIGN Prospective study at a tertiary care hospital. MATERIAL AND METHODS Gross and histopathological examinations of the placentae were carried out in pregnancies with foetal demise (IUD) and Foetal Growth Restriction (FGR). STATISTICAL ANALYSIS SPSS, version 11.5. RESULTS Placentae of twenty seven women with foetal demise and of equal number of women with foetal growth restriction were studied. Placental weight was less than 10(th) percentile in 61.5% women in IUD group and in 93% women in the FGR group. Gross examination of placentae showed abnormalities in 12 (44%) women of IUD group and in 16 (59%) women of FGR group. Histopathological abnormalities were observed in 74.1% women of the IUD group and in 66.7% women of FGR group. Placental histopathology correlated with clinical risk factors in 60% women of IUD group and in 40% women of FGR group. Among the women with no clinically explainable cause for IUD and FGR, 86% and 57% had placental histopathological abnormalities respectively. CONCLUSION The histopathological abnormalities of the placenta can be used to document the clinical causes of foetal demise and growth restriction; it may explain the causes in cases of clinically unexplained foetal demise and foetal growth restriction.
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Affiliation(s)
- Ujwala Ch
- Resident, Department of Obstetrics and Gynaecology, Kasturba Medical College , Manipal, 576104, India
| | - Shyamala Guruvare
- Associate Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College , Manipal, 576104, India
| | - Sudha S Bhat
- Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College , Manipal, 576104, India
| | - Lavanya Rai
- Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College , Manipal, 576104, India
| | - Sugandhi Rao
- Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College , Manipal, 576104, India
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Hebbar S, Rai L, Adiga P. Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy. Med J DY Patil Univ 2014. [DOI: 10.4103/0975-2870.135255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Background: Iron deficiency anemia (IDA) is the most common medical problem in pregnancy. Parenteral iron is a useful treatment, although iron dextran use decreased due to anaphylaxis. Iron sucrose is a newer agent that has overcome the shortcomings of iron dextran. Objective: The aim of this study was to compare the efficacy and tolerance of intravenous iron sucrose (IVIS) therapy with oral iron (OI) therapy in pregnant women with IDA and to study the factors influencing treatment. Materials and Methods: This prospective, randomized clinical trial included pregnant women between 14 and 36 weeks with established IDA who were treated with IVIS or OI (ferrous fumarate). All patients were monitored for laboratory response and adverse effects. Independent sample-t test, Chi square test and ANOVA were used for statistical analysis. P < 0.05 was considered significant. Results: Although hemoglobin increased in both the groups, increase in the reticulocyte count and percentage increase in hemoglobin was significantly higher in the IVIS group than in the OI group (23.62% vs. 14.11%). Serum ferritin was significantly higher in the IVIS group than in the OI group (P = 0.000). The IVIS group had no major side-effects. Compliance was good with OI, although 23% had gastrointestinal side-effects. Patient weight, gestation at diagnosis, initial hemoglobin and ferritin levels did not influence the response to treatment. Conclusion: IVIS is safe and effective in the treatment of IDA during pregnancy. Iron stores increased better with IVIS compared with OI.
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Affiliation(s)
- Syal Neeru
- Department of Obstetrics and Gynecology, KMC Hospital, Manipal University Manipal, Karnataka, India
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Mundkur A, Rai L. Prepare and prevent rather than repair and repent: Study of maternal mortality in tertiary care hospital. ACTA ACUST UNITED AC 2013. [DOI: 10.4103/2230-8598.118962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rai L, Shripad H, Guruvayare S, Prashant A, Sunil A. Recurrent familial hydatidiform mole - a rare clinical problem. J Turk Ger Gynecol Assoc 2012; 13:284-6. [PMID: 24592059 DOI: 10.5152/jtgga.2012.48] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 04/14/2012] [Indexed: 11/22/2022] Open
Abstract
Familial recurrent hydatidiform mole is a rare event; here we report an unusual case of a gravida 5 aged 29 years, with five recurrent hydatidiform moles and no normal pregnancy. After the fourth molar pregnancy, she developed persistent trophoblastic disease that required 7 cycles of single agent chemotherapy. Two years after the treatment, she presented with her fifth molar pregnancy. Her elder sister had seven hydatidiform moles from two different unrelated male partners. As this is familial, and recurrent, with no viable conceptions in both the sisters, it is likely to be biparental in origin. Unlike androgenetic moles, biparental moles arise due to a global inherited failure of maternal imprinting. It is an autosomal recessive defect in the female germ line. Genetic analysis is essential, although it is not available in all centers. Donor Oocyte IVF is the only option for women with biparental moles to have normal offspring.
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Affiliation(s)
- Lavanya Rai
- Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India
| | - Hebbar Shripad
- Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India
| | - Shyamala Guruvayare
- Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India
| | - Adiga Prashant
- Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India
| | - Anjali Sunil
- Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India
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Rai L. M534 LATENT IRON DEFICIENCY ANEMIA IN PREGNANCY AND IRON SUPPLEMENTATION. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bhat S, Patil A, Rai L, Kartha VB, Chidangil S. Application of HPLC combined with laser induced fluorescence for protein profile analysis of tissue homogenates in cervical cancer. ScientificWorldJournal 2012; 2012:976421. [PMID: 22645492 PMCID: PMC3356758 DOI: 10.1100/2012/976421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 01/02/2012] [Indexed: 11/17/2022] Open
Abstract
A highly objective method, High Performance Liquid Chromatography with Laser Induced Fluorescence (HPLC-LIF) technique was used to study the protein profiles of normal and cervical cancer tissue homogenates. A total of 44 samples including normal cervical biopsy samples from the hysterectomy patients and the patients suffering from different stages of the cervical cancer were recorded by HPLC-LIF and analysed by Principle Component Analysis (PCA) to get statistical information on different tissue components. Discrimination of different stages of the samples was carried out by considering three parameters--scores of factor, spectral residual, and Mahalanobis Distance. Diagnostic accuracy of the method was evaluated using Receiver Operating Characteristic (ROC) analysis, and Youden's index (J) plots. The PCA results showed high sensitivity and specificity (~100) for cervical cancer diagnosis. ROC and Youden's index curves for both normal and malignant standard sets show good diagnostic accuracy with high AUC values. The statistical analysis has shown that the differences in protein profiles can be used to diagnose biochemical changes in the tissue, and thus can be readily applied for the detection of cervical cancer, even in situations where a histopathology examination is not easy because of nonavailability of experienced pathologists.
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Affiliation(s)
- Sujatha Bhat
- KMC International Center, Manipal University, Manipal 576104, India
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Herth FJF, Sterman DH, Silvestri GA, Keast T, Rai L, Gibbs J, Wibowo H, Eberhardt R. Trans-Parenchymal Nodule Access (TPNA) – Ein neues Verfahren in der Diagnostik kleiner Lungenrundherde. Pneumologie 2012. [DOI: 10.1055/s-0032-1302709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nayak SS, Adiga PK, Rai L, Girisha KM. Severe rhizomelic chondrodysplasia punctata in a fetus due to maternal mixed connective tissue disorder. Genet Couns 2012; 23:487-491. [PMID: 23431749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Maternal systemic lupus erythematosus and autoimmune diseases have been extremely rarely reported to cause rhizomelic chondrodysplasia punctata. We report on a fetus aborted spontaneously at 21 weeks of gestation due to complications of maternal mixed connective tissue disorder. The fetus had micrognathia, a depressed nasal bridge, flat nose, long philtrum, short columella and rhizomelia. Radiographic study showed stippling of carpal and tarsal bones, short humeri and coronal clefts in the vertebrae. Ossification centers were present at the lower end of the femora and upper end of the tibiae.
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Affiliation(s)
- S S Nayak
- Division of Medical Genetics, Department of Pediatrics, Kasturba Medical College, Manipal University, Manipal, India
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Affiliation(s)
- Joseph Thomas
- Department of Urology, Kasturba Medical College, Manipal, India
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Bhat S, Patil A, Rai L, Kartha V, Santhosh C. Protein profile analysis of cellular samples from the cervix for the objective diagnosis of cervical cancer using HPLC-LIF. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878:3225-30. [DOI: 10.1016/j.jchromb.2010.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 09/02/2010] [Accepted: 09/24/2010] [Indexed: 11/25/2022]
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Girisha KM, Bhat P, Adiga PK, Pai AH, Rai L. Unusual facial cleft in Fryns syndrome: defect of stomodeum? Genet Couns 2010; 21:233-236. [PMID: 20681225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Unusual facial cleft in Fryns syndrome: defect of stomodeum?: We report on a fetus with Fryns syndrome. The facial cleft was unusual. There was bilateral cleft lip with cleft palate. The intermaxillary segment was connected through the base of a mound in the midline to the lower lip. We believe this is an atypical facial cleft in Fryns syndrome and likely represents a defective stomodeum.
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Affiliation(s)
- K M Girisha
- Genetics Clinic, Department of Pediatrics, Kasturba Medical College, Manipal University, Manipal, India.
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Sonkusare S, Rai L, Naik P. Preterm birth: mode of delivery and neonatal outcome. Med J Malaysia 2009; 64:303-306. [PMID: 20954555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
To evaluate the perinatal outcome of premature babies according to the mode of delivery. A total of 113 pregnant women and 124 neonates who delivered from 30 to 35 weeks of gestation were enrolled and outcomes of 70 neonates born vaginally were compared to 54 neonates born by caesarean. Neonatal mortality rate was 20 percent for infants in caesarean group as compared to 10 percent for vaginal group. There was no significant difference in the neonatal morbidity among both the groups. Caesarean delivery cannot be routinely recommended, unless there are obstetric indications.
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Affiliation(s)
- S Sonkusare
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal - 576104, Karnataka, India.
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Rai L, Meenakshi D, Kamath A. Metformin--a convenient alternative to insulin for Indian women with diabetes in pregnancy. Indian J Med Sci 2009; 63:491-497. [PMID: 20075550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To compare the use of metformin with that of insulin for the treatment of gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) unresponsive to diet therapy. MATERIALS AND METHODS In this prospective observational study, maternal glycemic control and perinatal outcome in diabetic pregnancies were compared between 2 obstetric units, one using insulin therapy and the other using metformin therapy. Baseline pretreatment glycemic profile was done and then repeated weekly throughout pregnancy. The outcome measures studied were glycemic control, maternal complications and perinatal outcome. RESULTS Sixty women with gestational and type 2 diabetes were enrolled, 30 each for metformin and insulin. Both groups were comparable with respect to age, body mass index (BMI), parity and pretreatment plasma glucose levels. Glycemic control was better with metformin after 1 week of therapy and also throughout gestation (P = 0.03-0.007). There were no major complications or perinatal deaths in this study. Mean gestational age and birth weight (2.9 +/- 0.4 kg versus 3.1 +/- 0.4 kg, P = 0.30) were comparable. However, there was a significant increase in neonatal intensive care unit (NICU) admission and stay for babies born in the insulin group. The cost of treatment was tenfold higher in thethe insulin group. CONCLUSION Metformin is clinically effective, cheap and a safe alternative to insulin therapy in pregnant diabetic women.
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Affiliation(s)
- Lavanya Rai
- Department of Obstetrics and Gynecology, Kasturba Medical College Hospital, Manipal, Karnataka, India.
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Rai L, Meenakshi D, Kamath A. Metformin - A convenient alternative to insulin for Indian women with diabetes in pregnancy. ACTA ACUST UNITED AC 2009. [DOI: 10.4103/0019-5359.58878] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rai L, Kumar P, Mahato KK, Kartha VB, Santhosh C. Serum protein profile study of normal and cervical cancer subjects by high performance liquid chromatography with laser-induced fluorescence. J Biomed Opt 2008; 13:054062. [PMID: 19149028 DOI: 10.1117/1.2992166] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
High performance liquid chromatography with high sensitivity laser-induced fluorescence detection is used to study the protein profiles of serum samples from healthy volunteers and cervical cancer subjects. The protein profiles are subjected to principal component analysis (PCA). PCA shows that the large number of chromatograms of a given class of serum samples--say normal/malignant--can be expressed in terms of a small number of factors (principal components). Three parameters--scores of the factors, squared residuals, and Mahalanobis distance--are derived from PCA. The parameters are observed to have a narrow range for protein profiles of standard calibration sets formed from groups of clinically confirmed normal/malignant classes. Limit tests using match/no match of the parameters of any test sample with parameters derived for the standard calibration sets give very good discrimination between malignant and normal samples with high sensitivity (approximately 100%) aand specificity (approximately 94%).
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Dey P, Gupta P, Acharya NK, Rao SN, Ray S, Chakrabarty S, Ramprasad S, Kurian TA, Mawroh A, Kundu A, Bhaktha G, Joseph CP, Kumar P, Rai L, Rao A. Antioxidants and lipid peroxidation in gestational diabetes--a preliminary study. Indian J Physiol Pharmacol 2008; 52:149-156. [PMID: 19130858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Increased free radical activity in gestational diabetes (GDM) can lead to a host of damaging and degenerative maternal and fetal complications. Hence antioxidant levels in blood of GDM mothers and cord blood were estimated. Erythrocyte glutathione (GSH), superoxide dismutase (SOD) and thiobarbituric acid reactive substances (TBARS), plasma vitamins C and E and serum total glutathione-S-transferase (GST), protein thiols and ceruloplasmin (Cp) were estimated spectrophotometrically in maternal blood of age matched controls and mothers with GDM and also in cord blood samples of the above. There was a significant increase in the erythrocytic GSH, serum total GST and protein thiols in GDM maternal blood when compared to controls whereas erythrocytic SOD exhibited a marked decrease in GDM cases. The changes in plasma vitamins C and E, Cp and erythrocytic TBARS in GDM were not significantly different from controls. Cord blood levels of protein thiols were also significantly increased in GDM. No significant changes were observed in the serum Cp and GST levels of the same. Hence, elevated glucose levels can induce oxidative stress in GDM mothers.
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Affiliation(s)
- Prasenjit Dey
- Department of Biochemistry, Kasturba Medical College and Hospital, Manipal 576 104
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Affiliation(s)
- U Kamath
- Department of Biochemistry, Katsturba Medical College, Manipal, Karnataka, India
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Kalra A, Nair S, Rai L. Association of obesity and insulin resistance with dyslipidemia in Indian women with polycystic ovarian syndrome. Indian J Med Sci 2006; 60:447-53. [PMID: 17090865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Dyslipidemia, diabetes and obesity are all potent cardiovascular risk factors that tend to cluster in women with polycystic ovary syndrome (PCOS). Metabolic disorders in patients with PCOS cannot be explained solely by the presence of obesity. OBJECTIVE To study the correlation between insulin resistance and serum lipid profile in Indian women with PCOS. SETTING Gynecology clinic of a tertiary care hospital. MATERIALS AND METHODS In this prospective study done from April 2004 to December 2004, 65 women with PCOS had their body mass index (BMI) and waist hip ratio calculated. Fasting glucose, insulin and lipid profiles were also estimated in each case. Insulin resistance was defined by fasting glucose-to-insulin ratio <or=4.5. The association of obesity markers and insulin resistance with lipid parameters was then studied. Statistical analysis using student 't' and Mann Whitney U tests was done as indicated. RESULTS Insulin resistance was seen in 50 of the 65 PCOS women. There was no correlation seen between markers of obesity such as BMI and waist/hip ratio with various lipid parameters. But in PCOS women with insulin resistance, the lipid profile was significantly different [high triglycerides, total cholesterol and lower high-density lipoprotein (HDL)] compared to insulin-sensitive women. The difference between the two groups for total cholesterol (P = 0.002), triglycerides (P =or<0.001) and HDL (P <or=0.001) was statistically significant but that for low-density lipoprotein (LDL) (P <or=0.07) was not statistically significant. CONCLUSION Insulin resistance is associated with dyslipidemia in women with PCOS, independent of obesity.
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Affiliation(s)
- Anuradha Kalra
- Department of Obstetrics and Gynecology, Kasturba Medical College Hospital, Manipal, Karnataka, India
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Abstract
In the present work, we examine normal and malignant stage IIIB cervical tissue by laser induced fluorescence, with 2 different objectives. (i) Development of the fluorescence spectroscopy technique as a standard optical method for discrimination of normal and malignant tissue samples and, (ii) Optimization of the technique by the method of matching of a sample spectrum with calibration sets of spectra of pathologically certified samples. Laser-induced fluorescence spectra were measured using samples from 62 subjects at different excitation wavelengths. Principal component analysis (PCA) of spectra and intensity ratios of curve-resolved fluorescence peaks were tested for discrimination. It was found that PCA of total fluorescence at 325 nm excitation gives specificity and sensitivity over 95%. Use of calibration sets of spectra of histo-pathologically certified samples combined with PCA for matching and pass/fail classification of test samples is shown to have high sensitivity/specificity for routine diagnostic purposes as well as for possible staging of the disease. Further, the multi-component origin of the fluorescence spectra is illustrated by curve resolution and fluorescence spectra of separated proteins of tissue homogenates.
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Affiliation(s)
- Siddappa M Chidananda
- Center for Molecular and Cellular Biology, Manipal Academy of Higher Education, Science Center, Manipal, Karnataka, India
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Rai L, Kalra A, Nair S. Association of obesity and insulin resistance with dyslipidemia in Indian women with polycystic ovarian syndrome. ACTA ACUST UNITED AC 2006. [DOI: 10.4103/0019-5359.27971] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- Lavanya Rai
- Department of Obstetrics, Kasturba Medical College Hospital, Manipal, India.
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Affiliation(s)
- L Rai
- Department of Obstetrics, KMC Hospital, Manipal, Karnataka, India
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Abstract
Foetuses born to mothers with gestational diabetes are at increased risk of developing respiratory distress, foetal macrosomia, foetal anomalies and platelet hyperaggregability. High blood glucose level induces oxidative stress and decreases antioxidant defences. The present study discusses the possibility of lipid peroxidation and protein oxidation in both maternal and foetal erythrocytes as an indicator of oxygen radical activity. The level of lipid peroxidation and protein oxidation in erythrocytes was estimated in 20 mothers with gestational diabetes and their newborns. The maternal age varied between 19 and 42 y and foetal age ranged between 34 and 39 weeks. The proteolytic activities in the erythrocyte lysates obtained from mothers with gestational diabetes and their newborns were significantly greater [(mean +/- SD) 24.41 +/- 9.05 and 16.70 +/- 3.36 microM of amino groups/g haemoglobin, n = 20, respectively] than those from control group (10.18 +/- 4.84 and 14.64 +/- 6.21 microM amino groups/g haemoglobin, n = 15, respectively; p < 0.05 in both cases). Similarly erythrocyte malondialdehyde levels were significantly elevated in babies born to mothers with gestational diabetes (10.11 +/- 2.21 nM/g haemoglobin) when compared to controls (6.8 +/- 3.75 nM/g haemoglobin) (p < 0.05). In the erythrocytes of mothers with gestational diabetes, malondialdehyde levels correlated significantly with glycated haemoglobin levels (p < 0.01). The results of this study indicate that the oxidative stress induced by gestational diabetes manifests as increased lipid peroxidation and protein oxidative damage in the erythrocytes of both mothers with gestational diabetes and their newborn infants.
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Affiliation(s)
- U Kamath
- Department of Biochemistry, Katsturba Medical College, Manipal, Karnataka, India
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Chung F, Rai L. Importance of conventional units. Phys Ther 1997; 77:561, 563. [PMID: 9149765 DOI: 10.1093/ptj/77.5.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Rai L, Kurien L, Kumar P. Symphysis fundal height curve--a simple method for foetal growth assessment. J Postgrad Med 1995; 41:93-4. [PMID: 10707727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
In this prospective study, symphisis fundal height (SFH) was measured in centimeters at different weeks of gestation from 20th week onwards in 100 healthy women with uncomplicated pregnancies. A curve was plotted based on the mean SFH measurements with standard deviation. Readings were also arranged on the basis of 10th, 50th and 90th percentiles. Percentile curve was similar to the curve based on mean with standard deviation. The rate of growth was 1 cm per week between 20-32 weeks. Thereafter, there was a slight fall in the rate of growth. SFH measurement is a simple method of foetal growth assessment which can be utilized even by paramedical workers to screen for small for gestational age babies. It is better to have a standard curve derived from the population as there is regional variation.
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Affiliation(s)
- L Rai
- Department of Obstetrics and Gynaecology, KMC Hospital, Manipal DK, Karnataka
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Rai L, Ram K, Kant U, Madan SK, Sharma SK. Energy expenditure and ventilatory responses during Siddhasana--a yogic seated posture. Indian J Physiol Pharmacol 1994; 38:29-33. [PMID: 8132240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Reports of energy expenditure and ventilatory responses to yogic seated posture of Siddhasana are lacking in literature. Various cardio-ventilatory responses were studied in states of the horizontal supine, chair-sitting and Siddhasana. It was observed that sitting in Siddhasana posture was characterised by greater minute ventilation, larger tidal volume, higher oxygen consumption, greater CO2 elimination, higher heart frequency greater oxygen pulse and lesser as compared with other two postures. These observations suggest that Siddhasana is a mild type of exercise and may have its application in conditions of low cardio-respiratory reserves especially in individuals in whom heavy exercises are contra-indicated.
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Affiliation(s)
- L Rai
- Central Research Institute for Yoga, New Delhi
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Rai L, Ram K. Energy expenditure and ventilatory responses during Virasana--a yogic standing posture. Indian J Physiol Pharmacol 1993; 37:45-50. [PMID: 8449544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Energy expenditure and ventilatory responses to yogic standing posture of Virasana were studied on 10 healthy men (25-37 years of age). The results of various responses respectively to the horizontal supine, Chair-sitting and Virasana were: Minute Ventilation (VE) 7.64, 8.61 and 18.67 L/min; Respiratory Frequency (FR) 15.71, 15.70 and 21.45 Breath/min; Tidal Volume (VT) 0.496, 0.544 and 0.827 L/min; Oxygen consumption (VO2) 0.127, 0.234 and 0.573 L/min; Carbondioxide Elimination (VCO2) 0.127, 0.134 and 0.420 L/min; Respiratory Exchange Ratio (RER) 0.58, 0.57 and 0.69; Heart Frequency (FH) 65.2, 74.5 and 104.4 beats/min; Oxygen Pulse (O2P) 3.32, 3.17 and 5.45 ml/beat; Ventilatory Equivalent (VE-EQ) 36.78, 37.12 and 33.85; Multiple of Resting VO2 (METS) 0.96, 1.05 and 2.53 and Metabolic Cost (MC) 1.04, 1.13 and 2.76 Cal/min. Virasana posture was characterised by higher VE, FR, VT, VO2, VCO2, FH and O2P with lesser VE-EQ. The observations suggest that Virasana induces temporarily a hypermetabolic state characterised by enhanced sympathetic nervous system activity which gets inhibited during the adoption of resting supine shavasana posture.
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Affiliation(s)
- L Rai
- Department of Physiology, Central Research Institute for Yoga, New Delhi
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Abstract
Forty six young asthmatics with a history of childhood asthma were admitted for yoga training. Effects of training on resting pulmonary functions, exercise capacity, and exercise-induced bronchial lability index were measured. Yoga training resulted in a significant increase in pulmonary function and exercise capacity. A follow-up study spanning two years showed a good response with reduced symptom score and drug requirements in these subjects. It is concluded that yoga training is beneficial for young asthmatics.
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Affiliation(s)
- S C Jain
- Laboratory Division, Central Research Institute for Yoga, New Delhi, India
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Rai L, Venugopal N, Kapadia RD, Nalini V. Struma ovarii. J Indian Med Assoc 1990; 88:227-9. [PMID: 2262705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- L Rai
- Kasturba Medical College, Manipal
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Abstract
The management of abruptio placentae remains a problem, despite advances in medical science. This study analyses severity of abruption, resultant morbidity, and maternal and fetal mortality in 105 cases. Among the contributory factors, hypertension (44%) and grand multiparity (24%) were common. There was no maternal death among these cases, mainly because of liberal use of blood transfusion, prompt delivery, and careful fetal monitoring, but perinatal mortality remained high (73%). Factors responsible for this high perinatal mortality and its prevention are discussed.
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Affiliation(s)
- L Rai
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, India
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Srivastava KN, Gupta PR, Kumar I, Jain BS, Rai L, Manchanda RC. Solitary eosinophilic granuloma of orbit. Eye Ear Nose Throat Mon 1968; 47:639-42. [PMID: 5726540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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