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Munshi H, Khan T, Khan S, DasMahapatra P, Balakrishnan S, Nirmala C, Das V, Kulkarni K, John BM, Majumdar A, Sowmini CV, Srivastava A, Khade K, Gajbhiye RK. Determinants of Conception and Adverse Pregnancy Outcomes in Women with Endometriosis: A Longitudinal Study. Reprod Sci 2024; 31:1757-1762. [PMID: 38653856 DOI: 10.1007/s43032-024-01569-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/18/2024] [Indexed: 04/25/2024]
Abstract
Endometriosis, affecting approximately 10% of reproductive-aged women globally, poses significant challenges, including chronic pelvic pain, dysmenorrhea, and infertility. In low- and middle-income countries like India, accessibility to affordable infertility care remains a concern. This multicenter prospective cohort study, conducted across six tertiary care hospitals in India from 2017 to 2022, aims to explore the natural progression of conception and pregnancy outcomes in women with endometriosis. Of the 257 participants, 19.1% conceived during the study, revealing significant geographic and income-based variations (p < 0.001, p = 0.01). Dysmenorrhea (p < 0.001) and dyspareunia (p=0.027) were correlated with conception, while no such associations were found with chronic pelvic pain or menstrual factors. Lesion type, number, and severity showed no conclusive link with conception. Natural conception occurred in 70% of cases, with an average post-surgery conception time of 282.1 days. Live birth rate was 85.7%, while complications included placenta previa (16.4%), preeclampsia (4.1%), and preterm births (4.1%). This study, one of the first in India on endometriosis-related fertility progression, emphasizes the need for comprehensive understanding and management of conception and pregnancy outcomes. Considering India's substantial endometriosis burden, the study recommends prioritizing larger multicenter investigations for a better understanding and effective strategies for infertility management.
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Affiliation(s)
- Hrishikesh Munshi
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Tabassum Khan
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Shagufta Khan
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | | | - Sheila Balakrishnan
- Department of Reproductive Medicine, Sree Avittam Thirunal (SAT) Hospital, Thiruvananthapuram, India
| | - Chelana Nirmala
- Department of Obstetrics and Gynecology, Sree Avittam Thirunal (SAT) Hospital, Thiruvananthapuram, India
| | - Vinita Das
- Department of Obstetrics and Gynecology, King George's Medical University (KGMU), Lucknow, India
| | | | - Bimal M John
- Minimally Invasive Surgery Unit, Credence Hospital - Multispecialty Women's Hospital and IVF Center, Thiruvananthapuram, India
| | - Amiya Majumdar
- Spectrum Clinic and Endoscopy Research Institute, Kolkata, India
| | - C V Sowmini
- Department of Obstetrics and Gynecology, Sree Avittam Thirunal (SAT) Hospital, Thiruvananthapuram, India
| | - Aarti Srivastava
- Department of Obstetrics and Gynecology, King George's Medical University (KGMU), Lucknow, India
| | - Komal Khade
- Molecular Endocrinology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Rahul K Gajbhiye
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India.
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Munshi H, Gajbhiye RK. Strengthening global snakebite data for WHO's goal for 2030. Lancet 2024; 403:907-908. [PMID: 38460982 DOI: 10.1016/s0140-6736(23)01698-7] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/11/2023] [Indexed: 03/11/2024]
Affiliation(s)
- Hrishikesh Munshi
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai 400012, India
| | - Rahul K Gajbhiye
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai 400012, India; Model Rural Health Research Unit, Vani, India.
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Munshi H, Gajbhiye RK. Prioritizing the Health and Well-Being of the Indigenous Communities in India. Asia Pac J Public Health 2024; 36:246-248. [PMID: 38294024 DOI: 10.1177/10105395231226298] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
The International Day of the World's Indigenous Peoples and the Tribal Pride Day hold significant importance in India, home to 106 million indigenous individuals. There are 705 recognized Scheduled Tribes (STs) in India that enrich the nation's cultural fabric but experience disproportionately high morbidity and mortality. Historical injustice, geographic isolation, and cultural diversity deeply influence ST health causing disparities between indigenous and non-indigenous health indicators. To meet Sustainable Development Goals, India established the Ministry of Tribal Affairs and implemented various health initiatives. However, climate change, deforestation, limited education and employment opportunities, poverty, and under-representation pose a challenge. Empowerment, inclusive policies, community-specific targets, resource allocation, technology utilization, and multi-sectoral collaboration are vital for indigenous health. Achieving health equity for indigenous communities is a global commitment and moral imperative. By addressing historical wrongs, and working holistically, we must ensure that indigenous communities in India and beyond enjoy improved health and well-being.
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Affiliation(s)
| | - Rahul K Gajbhiye
- Model Rural Health Research Unit (MRHRU), Vani, India
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
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Mahajan NN, Kesarwani S, Kumbhar P, Kuppusamy P, Pophalkar M, Thamke P, Asawa R, Sharan S, Mahale SD, Gajbhiye RK. Increased risk of early-onset preeclampsia in pregnant women with COVID-19. Hypertens Pregnancy 2023; 42:2187630. [PMID: 36891839 DOI: 10.1080/10641955.2023.2187630] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
OBJECTIVE To estimate incidence, risk of early and late-onset preeclampsia (PE) and understand their relationship with severity of COVID-19. METHODS Pregnant women with COVID-19 (n = 1929) were enrolled from 1 April 2020 to 24 February 2022. Primary outcome measure was incidence and risk of early onset PE in women with COVID-19. RESULTS The incidence of early and late-onset PE was 11.4% and 5.6%. Moderate to severe COVID-19 was associated with eight times higher risk of early onset PE [aOR = 8.13 (1.56-42.46), p = 0.0129] compared to asymptomatic group. CONCLUSIONS Risk of early onset PE was higher in pregnant women with symptomatic COVID-19 as compared to asymptomatic women.
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Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Shweta Kesarwani
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Padmaja Kumbhar
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Periyasamy Kuppusamy
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Madhura Pophalkar
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Pratiksha Thamke
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Ruchi Asawa
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Saumya Sharan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Smita D Mahale
- Emeritus Scientist, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Rahul K Gajbhiye
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
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Munshi H, Gajbhiye RK. Empowering Health care Systems and Communities for Snakebite Envenoming Control in India. Asia Pac J Public Health 2023; 35:535-537. [PMID: 37846023 DOI: 10.1177/10105395231206032] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Snakebite envenoming (SBE) is a global health challenge, predominantly affecting economically disadvantaged regions. India contributes significantly to global snakebite mortality. Since 2013, the Indian Council of Medical Research (ICMR) has spearheaded efforts to combat SBE. A multi-sectoral engagement in the snakebite research projects and inputs from communities, traditional healers, and the health system have led to the creation of an Information Education and Communication (IEC) material suite, including management flowchart, information booklets, posters, and brochures, all available in local languages. These resources were broadly disseminated in high-burden regions in Maharashtra and Odisha, resulting in an approximately 10% increase in case reporting within a year. This holistic approach, engaging diverse stakeholders and addressing multiple facets of SBE, offers promise for alleviating the snakebite burden, not only in India but also in other low- and middle-income countries across South Asia, Africa, and South America, holding potential for broader positive global impact.
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Affiliation(s)
- Hrishikesh Munshi
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
| | - Rahul K Gajbhiye
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
- Model Rural Health Research Unit (MRHRU), Vani, India
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Mahajan NN, Ansari M, Munshi H, More P, Gajbhiye RK. Different impact of COVID-19 on symptomatic pregnant and postpartum women in low-income countries and low- and middle-income countries. Int J Gynaecol Obstet 2023; 162:1110-1113. [PMID: 37337930 DOI: 10.1002/ijgo.14934] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/03/2023] [Accepted: 05/28/2023] [Indexed: 06/21/2023]
Abstract
SynopsisThe adverse outcomes of COVID‐19 among pregnant women have been pronounced in the low‐income countries compared with low‐ and middle‐income countries.
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Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Munira Ansari
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Hrishikesh Munshi
- Department of Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Pradnya More
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Rahul K Gajbhiye
- Department of Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
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Munshi H, Gajbhiye RK. Addressing disparities and challenges in global health from an LMIC perspective. Lancet 2023:S0140-6736(23)01171-6. [PMID: 37392745 DOI: 10.1016/s0140-6736(23)01171-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 07/03/2023]
Affiliation(s)
- Hrishikesh Munshi
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai 400012, India
| | - Rahul K Gajbhiye
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai 400012, India.
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Gajbhiye RK, Munshi H, Bawaskar HS. National programme for prevention & control of snakebite in India: Key challenges & recommendations. Indian J Med Res 2023; 157:271-275. [PMID: 36926753 PMCID: PMC10438420 DOI: 10.4103/ijmr.ijmr_2424_22] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Indexed: 03/17/2023] Open
Affiliation(s)
- Rahul K. Gajbhiye
- Department of Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai 400 012, Maharashtra, India
| | - Hrishikesh Munshi
- Department of Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai 400 012, Maharashtra, India
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Mahajan NN, Gajbhiye RK. Oxygen saturation in pregnant women with COVID-19: challenges in low-income and middle-income countries. Am J Obstet Gynecol 2023; 228:356-357. [PMID: 36306857 DOI: 10.1016/j.ajog.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/13/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, 4th Floor, College Bldg., Mumbai 400008, India.
| | - Rahul K Gajbhiye
- Indian Council of Medical Research-National Institute for Research in Reproductive and Child Health, Mumbai, India
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Subedi R, Rokade S, Surve S, Patil A, Kulkarni V, Gajbhiye RK, Madan T. Dysregulated serum and seminal plasma levels of surfactant protein D and MCP-1 in men with genital tract infection/inflammation. Am J Reprod Immunol 2023; 89:e13588. [PMID: 35771685 DOI: 10.1111/aji.13588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/08/2022] [Revised: 05/06/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
PROBLEM Surfactant protein D (SP-D), a multimeric collectin expressed by testicular mucosal epithelia and is positively regulated by testosterone. It exerts antimicrobial effects, modulates inflammation and rescued spermatogenesis in a murine model. Various cytokines and chemokines, including MCP-1, play a key role in regulating the inflammation in rat and human testis. The study aimed to investigate the role of SP-D and involvement of chemokines and cytokines in the male infertility associated with urogenital infections or inflammation. METHOD OF STUDY The cross-sectional study evaluated levels of SP-D, testosterone, estradiol and the cytokines/chemokines including MCP-1 in the serum and semen samples of fertile and infertile Indian men with and without urogenital infections/inflammation (n = 76). RESULTS Both fertile and infertile males with urogenital infection/inflammation had significantly lower levels of SP-D and higher levels of the chemokine, Monocyte chemoattractant protein 1 (MCP-1) in the serum and seminal plasma. Seminal plasma of these males exhibited significantly higher proportion of proteolytically degraded forms of SP-D. The serum SP-D levels positively correlated with testosterone/estradiol (TE) ratio. There was no significant correlation between the SP-D levels in seminal plasma and sperm count/motility. With a significant area under the Receiver Operating Characteristic curves, the serum and seminal plasma SP-D levels exhibited significant potential to predict infertility with high sensitivity and specificity in men with genital infections/inflammation. CONCLUSIONS The circulating and seminal plasma SP-D levels were decreased in men with urogenital infection and inflammation. This could be due to their engagement at the site of infection, dysregulated expression owing to the altered hormonal profile and increased proteolytic degradation.
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Affiliation(s)
- Rambhadur Subedi
- Department of Innate Immunity, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Sushama Rokade
- Department of Innate Immunity, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Suchitra Surve
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Anushree Patil
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Vijay Kulkarni
- Andrology Clinic, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Rahul K Gajbhiye
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India.,Andrology Clinic, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Taruna Madan
- Department of Innate Immunity, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
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Gajbhiye RK. Endometriosis and inflammatory immune responses: Indian experience. Am J Reprod Immunol 2023; 89:e13590. [PMID: 35751585 PMCID: PMC7615030 DOI: 10.1111/aji.13590] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/10/2022] [Accepted: 06/20/2022] [Indexed: 02/01/2023] Open
Abstract
Endometriosis is a public health disorder affecting ∼ 247 million women globally and ∼ 42 million women in India. Women with endometriosis suffer from dysmenorrhea, chronic pelvic pain, dyspareunia, dyschezia, fatigue, depression, and infertility leading to significant socioeconomic impact and morbidity. The etiology of endometriosis is not understood well even after 100 years of research. Currently, there is no permanent cure for endometriosis. The inflammatory immune response is one of the important features of etiopathogenesis of endometriosis and therefore understanding the inflammatory immune response would lead to a better understanding of this enigmatic disorder and may also lead to biomarker discovery for diagnosis of endometriosis. We investigated the autoimmune etiology of endometriosis in the Indian population. Using the proteomics approach, anti-endometrial antibodies (AEAs) were detected in Indian women with endometriosis [anti-endometrial antibodies - tropomyosin 3 (TPM3), stomatin-like protein2 (SLP-2), and tropomodulin 3 (TMOD3)]. The studies on AEAs provided a better understanding of autoimmune mechanisms in endometriosis. All three subtypes of endometriosis; superficial peritoneal, ovarian endometrioma, and deep infiltrating endometriosis were reported in Indian women. In this review, we discuss our experiences of the inflammatory immune response, autoimmunity, comorbidities, and clinical phenotypes in women with endometriosis in India.
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Affiliation(s)
- Rahul K Gajbhiye
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
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Mahajan NN, Kesarwani S, Salunke C, Kumbhar P, Yenkure P, Shaikh J, Shikhare S, Mahale SD, Sachdeva G, Gajbhiye RK. Clinical presentation, pregnancy complications, and outcomes of pregnant women with COVID-19 during the Omicron-dominant third wave in Mumbai, India. Int J Gynaecol Obstet 2022; 159:968-973. [PMID: 35861246 PMCID: PMC9349384 DOI: 10.1002/ijgo.14348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/07/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study clinical presentation, disease severity, pregnancy complications, and maternal outcomes in women affected with coronavirus disease 2019 (COVID-19) during the third wave compared with the first and second waves of COVID-19. METHODS A retrospective, observational cohort study was conducted among 2058 pregnant and postpartum women with COVID-19 admitted during three wave periods at a tertiary care COVID-19-dedicated hospital. RESULTS The number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -infected pregnant and postpartum women with symptoms of COVID-19 was four times higher during the third wave compared with the first (odds ratio [OR] 4.6, 95% confidence interval [CI] 3.5-6.0, P < 0.001). There was a significantly lower proportion of pregnant and postpartum women with moderate to severe COVID-19 during the third wave (0.6%, 2/318) compared with those during the first wave (2.4%, 27/1143, P < 0.001) and second wave (14.4%, 86/597, P < 0.001). The intensive care/high dependency unit admissions during the third wave were significantly lower (2.5%, 8/318) than during the second wave (14.7%, 88/597; OR 0.2, 95% CI 0.1-0.3, P < 0.001) but similar to the first wave (2.4%, 27/1143). CONCLUSIONS Decreased severity of COVID-19, reduced maternal mortality, and morbidity were reported in the third wave compared with the first wave and second wave of COVID-19 in the Mumbai Metropolitan Region, India. TRIAL REGISTRATION The study is registered with the Clinical Trial Registry of India (Registration no: CTRI/2020/05/025423).
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Affiliation(s)
- Niraj N. Mahajan
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Shweta Kesarwani
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Chetna Salunke
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Padmaja Kumbhar
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Piyusha Yenkure
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Juvairiya Shaikh
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Shrutika Shikhare
- Department of Obstetrics and GynecologyTopiwala National Medical College and BYL Nair Charitable HospitalMumbaiIndia
| | - Smita D. Mahale
- ICMR‐National Institute for Research in Reproductive and Child HealthMumbaiIndia
| | - Geetanjali Sachdeva
- ICMR‐National Institute for Research in Reproductive and Child HealthMumbaiIndia
| | - Rahul K. Gajbhiye
- ICMR‐National Institute for Research in Reproductive and Child HealthMumbaiIndia
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Bhurke AV, DasMahapatra P, Balakrishnan S, Khan SA, Mortlock S, Das V, Chellamma N, Vadakkathil SC, Srivastava A, Majumdar A, Pasi A, Sachdeva G, Montgomery GW, Gajbhiye RK. Clinical characteristics and surgical management of endometriosis-associated infertility: A multicenter prospective cohort study. Int J Gynaecol Obstet 2022; 159:86-96. [PMID: 35075631 PMCID: PMC7615031 DOI: 10.1002/ijgo.14115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/26/2021] [Accepted: 01/21/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To study clinical, surgical characteristics and the relationship between endometriosis lesion types and conception rate after surgery in infertile women with endometriosis. METHODS A prospective, multicenter cohort of 204 women (age 20-35 years) with endometriosis was followed up post-surgery between November 2017 and February 2020 at three tertiary-care hospitals. RESULTS Based on the severity of endometriosis lesion type, deep infiltrating endometriosis (DIE) (81/204, 39.7%) was the most common lesion; followed by ovarian endometriosis (OMA) (64/204, 31.4%), and superficial peritoneal endometriosis (SUP) (59/204, 28.9%). Endometriosis patients had a single lesion type (94/204, 46.1%), two lesion types (77/204, 37.7%), or three lesion types (33/204, 16.2%) with significant differences between regions (P < 0.001). Around 40% (37/95) of obese women had SUP (P = 0.003) whereas 78% (14/18) of underweight women had DIE (P < 0.001). Significant differences in mean Endometriosis Fertility Index scores between endometriosis lesion types and patients with one, two, and three types of lesions were observed (P < 0.001). The majority (22/32, 68.8%) of the women conceived naturally after the surgery. Half (16/32; 50%) of the women with a single lesion type conceived after the surgery; of which most (13/16, 81.2%) had SUP, followed by OMA (2/16, 12.5%), and DIE (1/16, 6.3%). CONCLUSION Women with SUP and only one type of endometriotic lesion were more likely to conceive post-surgery.
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Affiliation(s)
- Aishwarya V. Bhurke
- Clinical Research Laboratory, Indian Council of Medical Research–National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
| | | | - Sheila Balakrishnan
- Department of Reproductive Medicine, Government Medical College, Thiruvananthapuram, India
| | - Shagufta A. Khan
- Clinical Research Laboratory, Indian Council of Medical Research–National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
| | - Sally Mortlock
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland, Australia
| | - Vinita Das
- Department of Obstetrics and Gynecology, King George’s Medical University (KGMU), Lucknow, India
| | - Nirmala Chellamma
- Department of Obstetrics and Gynecology, Sree Avittam Thirunal Hospital, Government Medical College, Thiruvananthapuram, India
| | - Sowmini Cheruvara Vadakkathil
- Department of Obstetrics and Gynecology, Sree Avittam Thirunal Hospital, Government Medical College, Thiruvananthapuram, India
| | - Aarti Srivastava
- Department of Obstetrics and Gynecology, King George’s Medical University (KGMU), Lucknow, India
| | - Amiya Majumdar
- Spectrum Clinic & Endoscopy Research Institute, Kolkata, India
| | | | | | - Grant W. Montgomery
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland, Australia
| | - Rahul K. Gajbhiye
- Clinical Research Laboratory, Indian Council of Medical Research–National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
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Mahajan NN, Pednekar R, Gaikwad C, More P, Pophalkar M, Kesarwani S, Jnanananda B, Mahale SD, Gajbhiye RK. Increased spontaneous preterm births during the second wave of the coronavirus disease 2019 pandemic in India. Int J Gynaecol Obstet 2022; 157:115-120. [PMID: 34674259 PMCID: PMC9087695 DOI: 10.1002/ijgo.13991] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/20/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare spontaneous preterm birth (SPTB) and iatrogenic preterm birth (IPTB) rates during both waves of the coronavirus disease 2019 (COVID-19) pandemic. METHODS Retrospective analysis of the PregCovid registry of pregnant women with COVID-19 was performed at a dedicated COVID-19 hospital in Mumbai, India. The data of 1630 women were analyzed for this study between April 4, 2020 and July 4, 2021. Prepandemic data were analyzed and compared with pandemic data. Main outcome measure was spontaneous preterm birth rate. RESULTS Preterm deliveries were higher during the second wave (46/329; 14%) compared with the first wave (82/807; 10.2%) of the COVID-19 pandemic (P = 0.065). Higher SPTBs were reported during the second wave than the first wave (12.5% versus 8.3%) (P = 0.03) as well as the prepandemic period (12.5% versus 10.5%) (P = 0.286). IPTBs were significantly lower in the pandemic period than in the prepandemic period (1.8 versus 3.3) (P = 0.012). CONCLUSION In Mumbai, India, we found an unusual change in SPTBs during the 6 months of the second wave of COVID-19 compared with the previous 10 months of the first wave of pandemic and 1 year of prepandemic.
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Affiliation(s)
- Niraj N. Mahajan
- Department of Obstetrics and GynecologyTopiwala National Medical College & BYL Nair Charitable HospitalMumbaiIndia
| | - Rahi Pednekar
- Department of Obstetrics and GynecologyTopiwala National Medical College & BYL Nair Charitable HospitalMumbaiIndia
| | - Chaitanya Gaikwad
- Department of Obstetrics and GynecologyTopiwala National Medical College & BYL Nair Charitable HospitalMumbaiIndia
| | - Prajakta More
- Department of Obstetrics and GynecologyTopiwala National Medical College & BYL Nair Charitable HospitalMumbaiIndia
| | - Madhura Pophalkar
- Department of Obstetrics and GynecologyTopiwala National Medical College & BYL Nair Charitable HospitalMumbaiIndia
| | - Shweta Kesarwani
- Department of Obstetrics and GynecologyTopiwala National Medical College & BYL Nair Charitable HospitalMumbaiIndia
| | - Bhargavi Jnanananda
- Department of Obstetrics and GynecologyTopiwala National Medical College & BYL Nair Charitable HospitalMumbaiIndia
| | - Smita D Mahale
- ICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
| | - Rahul K Gajbhiye
- ICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
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15
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Gajbhiye RK, Mahajan NN, Waghmare R, Surve SV, Howal P, Bhurke A, Pious M, Modi DN, Mahale SD. Protocol for a prospective, hospital-based registry of pregnant women with SARS-CoV-2 infection in India: PregCovid Registry study. BMJ Open 2022; 12:e050039. [PMID: 35301200 PMCID: PMC8931796 DOI: 10.1136/bmjopen-2021-050039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Pregnant women are at increased risk of contracting COVID-19 due to several factors and therefore require special attention. However, the consequences of the COVID-19 pandemic on pregnant women and their newborns remain uncharted. The PregCovid registry aims to document the impact of SARS-CoV-2 infection on pregnant, postpartum women and their newborns. The aim of the registry is also to determine mother-to-child transmission of SARS-CoV-2 infection in India. METHODS AND ANALYSIS PregCovid is a hospital-based registry for capturing information of pregnant, postpartum women with COVID-19 and their newborns in India. Medical case records of pregnant and postpartum women with a laboratory-confirmed diagnosis of COVID-19 will be captured in real-time using an online electronic patient record software. The data analysis will be carried out for symptoms, the severity of COVID-19, pregnancy complications, maternal morbidity and mortality, neonatal complications, mother-to-child transmission, etc. Data analysis will be carried out for different waves of the COVID-19 pandemic for rapid response and developing strategies well in advance to manage pregnant women infected with SARS-CoV-2. The evidence generated from the registry will be regularly shared with the appropriate authorities for policy decisions. Thus, the registry data may be useful for planning the strategies for better management of pregnant women with COVID-19. ETHICS AND DISSEMINATION The study has been approved by the Institutional Ethics Committees of all the participating study sites under the Medical Education and Drugs Department, Government of Maharashtra, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai and ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India. The results from this study will be disseminated with local, state, and national health authorities, collaborators and the general population on the study website (https://pregcovid.com) as well as dissemination through scientific meetings and publications. TRIAL REGISTRATION NUMBER CTRI/2020/05/025423.
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Affiliation(s)
- Rahul K Gajbhiye
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Rakesh Waghmare
- Department of Community Medicine, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Suchitra V Surve
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Prashant Howal
- Department of Community Medicine, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Aishwarya Bhurke
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Merlin Pious
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Deepak N Modi
- Molecular and Cellular Biology Lab, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Smita D Mahale
- Emeritus Scientist, ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
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Malik S, Jain D, Bokade CM, Savaskar S, Deshmukh LS, Wade P, Madhura AD, Suryawanshi M, Bandichhode ST, Bodhgire SB, Zala S, Mahale SD, Modi DN, Waghmare R, Surve SV, Gajbhiye RK. Outcomes in neonates born to mothers with COVID-19 during the second wave in India. Eur J Pediatr 2022; 181:3537-3543. [PMID: 35802208 PMCID: PMC9263042 DOI: 10.1007/s00431-022-04546-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED COVID-19 pandemic has affected all age groups globally including pregnant women and their neonates. The aim of the study was to understand outcomes in neonates of mothers with COVID-19 during the first and second waves of COVID-19 pandemic. A retrospective analysis of 2524 neonates born to SARS-CoV-2-infected mothers was conducted during the first wave (n = 1782) and second wave (n = 742) of the COVID-19 pandemic at five study sites of the PregCovid registry in Maharashtra, India. A significant difference was noted in preterm birth, which was higher in the second wave (15.0%, 111/742) compared to the first wave (7.8%, 139/1782) (P < 0.001). The proportion of neonates requiring NICU admission was significantly higher in the second wave (19.0%, 141/742) as compared to that in the first wave (14.8%, 264/1782) (P < 0.05). On comparing regional differences, significantly higher neonatal complications were reported from Mumbai metropolitan region (P < 0.05). During the second wave of COVID-19, birth asphyxia and prematurity were 3.8- and 2.1-fold higher respectively (P < 0.001). Neonatal resuscitation at birth was significantly higher in second wave (3.4%, 25/742 vs 1.8%, 32/1782) (P < 0.05). The prevalence of SARS-CoV-2 infection in neonates was comparable (4.2% vs 4.6%) with no significant difference between the two waves. CONCLUSION Higher incidence of adverse outcomes in neonates born to SARS-CoV-2-infected mothers in the second wave of COVID-19 as compared to the first wave. TRIAL REGISTRATION PregCovid study is registered with the Clinical Trial Registry of India (CTRI/2020/05/025423, Registered on 28/05/2020). WHAT IS KNOWN • The second wave of COVID-19 was more lethal to pregnant women than the first wave. Newborns are at risk of developing complications. WHAT IS NEW • Birth asphyxia, prematurity, and neonatal resuscitation at birth were significantly higher in the second wave as compared to those in the first wave of the COVID-19 pandemic in India.
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Affiliation(s)
- Sushma Malik
- Department of Paediartrics, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra India
| | - Dipty Jain
- Department of Paediartrics, Government Medical College, Nagpur, Maharashtra India
| | - Chandrakant M. Bokade
- Department of Paediartrics, Indira Gandhi Government Medical College, Nagpur, Maharashtra India
| | - Shakira Savaskar
- Department of Paediartrics, Dr Vaishampayan Memorial Government Medical College, Solapur, Maharashtra India
| | - Laxmikant S. Deshmukh
- Department of Paediatrics, Government Medical College, Aurangabad, Maharashtra India
| | - Poonam Wade
- Department of Paediartrics, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra India
| | - Abhishek D. Madhura
- Department of Paediartrics, Government Medical College, Nagpur, Maharashtra India
| | - Milind Suryawanshi
- Department of Paediartrics, Indira Gandhi Government Medical College, Nagpur, Maharashtra India
| | - Sachin T. Bandichhode
- Department of Paediartrics, Dr Vaishampayan Memorial Government Medical College, Solapur, Maharashtra India
| | - Sachin B. Bodhgire
- Department of Paediatrics, Government Medical College, Aurangabad, Maharashtra India
| | - Sarika Zala
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, India
| | - Smita D. Mahale
- Emeritus Scientist, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai India
| | - Deepak N. Modi
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai India
| | - Rakesh Waghmare
- Medical Education and Drugs Department, Government of Maharashtra, Mumbai, India.
| | - Suchitra V. Surve
- Child Health Research Department, ICMR-National Institute for Research in Reproductive and Child Health, Maharashtra Parel, Mumbai, India
| | - Rahul K. Gajbhiye
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, India
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Sudhakar DVS, Shah R, Gajbhiye RK. Genetics of Male Infertility - Present and Future: A Narrative Review. J Hum Reprod Sci 2021; 14:217-227. [PMID: 34759610 PMCID: PMC8527069 DOI: 10.4103/jhrs.jhrs_115_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022] Open
Abstract
Infertility affects 8%–12% of couples worldwide with a male factor contributing to nearly 50% of couples either as a primary or contributing cause. Several genetic factors that include single-gene and multiple-gene defects associated with male infertility were reported in the past two decades. However, the etiology remains ambiguous in a majority of infertile men (~40%). The objective of this narrative review is to provide an update on the genetic factors associated with idiopathic male infertility and male reproductive system abnormalities identified in the last two decades. We performed a thorough literature search in online databases from January 2000 to July 2021. We observed a total of 13 genes associated with nonobstructive azoospermia due to maturation/meiotic arrest. Several studies that reported novel genes associated with multiple morphological abnormalities of the sperm flagella are also discussed in this review. ADGRG2, PANK2, SCNN1B, and CA12 genes are observed in non-CFTR-related vas aplasia. The genomic analysis should be quickly implemented in clinical practice as the detection of gene abnormalities in different male infertility phenotypes will facilitate genetic counseling.
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Affiliation(s)
- Digumarthi V S Sudhakar
- Department of Gamete Immunobiology, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Rupin Shah
- Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Rahul K Gajbhiye
- Clinical Research Lab and Andrology Clinic, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
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18
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Mahajan NN, Gaikwad C, Tayshete R, Saldanha C, Pednekar R, Mahale SD, Gajbhiye RK. Increased stillbirth rate during the second wave of COVID-19 pandemic in India. Eur J Obstet Gynecol Reprod Biol 2021; 266:191-192. [PMID: 34625338 PMCID: PMC7612909 DOI: 10.1016/j.ejogrb.2021.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Chaitanya Gaikwad
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Rajashri Tayshete
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Cara Saldanha
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Rahi Pednekar
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai 400012, India
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai 400012, India.
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19
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Mahajan NN, Pophalkar M, Patil S, Yewale B, Chaaithanya IK, Mahale SD, Gajbhiye RK. Pregnancy Outcomes and Maternal Complications During the Second Wave of Coronavirus Disease 2019 (COVID-19) in India. Obstet Gynecol 2021; 138:660-662. [PMID: 34233345 PMCID: PMC8454281 DOI: 10.1097/aog.0000000000004529] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/09/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022]
Abstract
Rates of severe coronavirus disease 2019 (COVID-19), intensive care unit admission, and maternal mortality increased among pregnant and postpartum women admitted for COVID-19 in the second wave compared with the first wave in India.
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Affiliation(s)
- Niraj N. Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, and the ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Madhura Pophalkar
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, and the ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Sarika Patil
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, and the ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Bhagyashree Yewale
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, and the ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Itta Krishna Chaaithanya
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, and the ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Smita D. Mahale
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, and the ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Rahul K. Gajbhiye
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, and the ICMR-National Institute for Research in Reproductive Health, Mumbai, India
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20
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Gajbhiye RK, Sawant MS, Kuppusamy P, Surve S, Pasi A, Prusty RK, Mahale SD, Modi DN. Differential impact of COVID-19 in pregnant women from high-income countries and low- to middle-income countries: A systematic review and meta-analysis. Int J Gynaecol Obstet 2021; 155:48-56. [PMID: 34160059 PMCID: PMC7612435 DOI: 10.1002/ijgo.13793] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/22/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND SARS-CoV-2 has infected a large number of pregnant women. OBJECTIVE To compare clinical, perinatal outcomes of women with COVID-19 from high-income countries (HICs) and low- to middle-income countries (LMICs). SEARCH STRATEGY Online databases were searched. SELECTION CRITERIA Original studies on pregnant women with COVID-19 were included. DATA COLLECTION AND ANALYSIS Information on clinical presentation, co-morbidities, pregnancy outcomes, neonatal outcomes, and SARS-CoV-2 infection in neonates was extracted. MAIN RESULTS The pooled estimate of SARS-CoV-2 positive neonates is 3.7%. Symptomatic presentations are less common in LMICs compared to HICs (odds ratio [OR] 0.38). Diabetes (OR 0.5), hypertension (OR 0.5), and asthma (OR 0.14) are commonly reported from HICs; hypothyroidism (OR 2.2), anemia (OR 3.2), and co-infections (OR 6.0) are commonly reported in LMICs. The overall risk of adverse pregnancy outcomes is higher in LMICs compared to HICs (OR 2.4). Abortion (OR 6.2), stillbirths (OR 2.0), and maternal death (OR 7.8) are more common in LMICs. Preterm births and premature rupture of membranes are comparable in both groups. Neonatal deaths (OR 3.7), pneumonia (OR 7.5), and neonatal SARS-CoV-2 infection (OR 1.8) are commonly reported in LMICs. CONCLUSIONS In LMICs, pregnant women and neonates are more vulnerable to adverse outcomes due to COVID-19. PROSPERO registration no: CRD42020198743.
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Affiliation(s)
- Rahul K. Gajbhiye
- Clinical Research LabICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
| | - Mamta S. Sawant
- Molecular and Cellular Biology LaboratoryICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
| | - Periyasamy Kuppusamy
- Clinical Research LabICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
| | - Suchitra Surve
- Department of Clinical ResearchICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
| | - Achhelal Pasi
- Airport Health OrganizationMinistry of Health and Family WelfareGovernment of IndiaMumbaiIndia
| | - Ranjan K. Prusty
- Department of BiostatisticsICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
| | - Smita D. Mahale
- Emeritus Scientist, ICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
| | - Deepak N. Modi
- Molecular and Cellular Biology LaboratoryICMR‐National Institute for Research in Reproductive HealthMumbaiIndia
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21
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Mahajan NN, Gajbhiye RK, Kuppusamy P, Bahirat S, Lokhande PD. Association of blood type A with increased risk of severe COVID-19 in healthcare workers. Ann Hematol 2021; 101:933-934. [PMID: 34420072 PMCID: PMC8380301 DOI: 10.1007/s00277-021-04641-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/16/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400008, India.
| | - Rahul K Gajbhiye
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive Health, Mumbai, 400012, India
| | - Periyasamy Kuppusamy
- Clinical Research Laboratory, ICMR-National Institute for Research in Reproductive Health, Mumbai, 400012, India
| | - Shubhada Bahirat
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400008, India
| | - Pradip D Lokhande
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400008, India
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22
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Waghmare R, Chaaithanya IK, Zala S, Deshmukh J, Uikey P, Wankhede S, Palve T, Sirsam S, Chavan R, Waikar M, Humane A, Khobragade A, Akare M, Sondawale RK, Sharma R, Nandre V, Howal P, Modi DN, Mahale SD, Gajbhiye RK. Outcomes of COVID-19 in Pregnant Women with Sickle Cell Disease in India: A Case Series. Indian J Hematol Blood Transfus 2021; 38:191-193. [PMID: 34421233 PMCID: PMC8370662 DOI: 10.1007/s12288-021-01482-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/06/2021] [Indexed: 02/07/2023] Open
Affiliation(s)
- Rakesh Waghmare
- Medical Education and Drugs Department, Government of Maharashtra, Mumbai, India
| | - Itta Krishna Chaaithanya
- Department of Molecular Immunology & Microbiology, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Sarika Zala
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Jitendra Deshmukh
- Departtment of Obstetrics & Gynecology, Government Medical College, Nagpur, India
| | - Prashant Uikey
- Department of Obstetrics & Gynecology, Indira Gandhi Government Medical College, Nagpur, India
| | - Sarika Wankhede
- Department of Obstetrics & Gynecology, Government Medical College, Chandrapur, India
| | | | | | - Rohidas Chavan
- Vasantrao Naik Government Medical College, Yavatmal, India
| | - Manjushri Waikar
- Departtment of Obstetrics & Gynecology, Government Medical College, Nagpur, India
| | - Anil Humane
- Departtment of Obstetrics & Gynecology, Government Medical College, Nagpur, India
| | | | - Monika Akare
- Department of Obstetrics & Gynecology, Indira Gandhi Government Medical College, Nagpur, India
| | - Ritesh K. Sondawale
- Department of Obstetrics & Gynecology, Government Medical College, Chandrapur, India
| | | | | | - Prashant Howal
- Medical Education and Drugs Department, Government of Maharashtra, Mumbai, India
| | - Deepak N. Modi
- Department of Molecular and Cellular Biology, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Smita D. Mahale
- Emeritus Scientist, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Rahul K. Gajbhiye
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
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23
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Gajbhiye RK, Montgomery G, Pai MV, Phukan P, Shekhar S, Padte K, DasMahapatra P, John BM, Shembekar C, Bhurke AV, Bagde N, Kulkarni K, Sardeshpande N, Humane A, Mahobia S, Shah M, Singh U, Srivastava A, Mishra G, Warty N, Chandra S, Mahale SD. Protocol for a case-control study investigating the clinical phenotypes and genetic regulation of endometriosis in Indian women: the ECGRI study. BMJ Open 2021; 11:e050844. [PMID: 34373312 PMCID: PMC8354274 DOI: 10.1136/bmjopen-2021-050844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Endometriosis is one of the common, gynaecological disorders associated with chronic pelvic pain and subfertility affecting ~10% of reproductive age women. The clinical presentation, etiopathogenesis of endometriosis subtypes and associated risk factors are largely unknown. Genome-Wide Association (GWA) Studies (GWAS) provide strong evidence for the role of genetic risk factors contributing to endometriosis. However, no studies have investigated the association of the GWAS-identified single-nucleotide polymorphism (SNPs) with endometriosis risk in the Indian population; therefore, one-sixth of the world's population is not represented in the global genome consortiums on endometriosis. The Endometriosis Clinical and Genetic Research in India (ECGRI) study aims to broaden our understanding of the clinical phenotypes and genetic risks associated with endometriosis. METHODS AND ANALYSIS ECGRI is a large-scale, multisite, case-control study of 2000 endometriosis cases and 2000 hospital controls to be recruited over 4 years at 15 collaborating study sites across India covering representative Indian population from east,north-east, north, central, west and southern geographical zones of India. We will use the World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project (WERF-EPHect) data collection instruments for capturing information on clinical, epidemiological, lifestyle, environmental and surgical factors. WERF-EPHect standard operating procedures will be followed for the collection, processing and storage of biological samples. The principal analyses will be for main outcome measures of the incidence of endometriosis, disease subtypes and disease severity determined from the clinical data. This will be followed by GWAS within and across ethnic groups. ETHICS AND DISSEMINATION The study is approved by the Institutional Ethics Committee of Indian Council of Medical Research-National Institute for Research in Reproductive Health and all participating study sites. The study is also approved by the Health Ministry Screening Committee of the Government of India. The results from this study will be actively disseminated through discussions with endometriosis patient groups, conference presentations and published manuscripts.
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Affiliation(s)
- Rahul K Gajbhiye
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Grant Montgomery
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
| | - Murlidhar V Pai
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India
| | - Pranay Phukan
- Department of Obstetrics and Gynaecology, Assam Medical College, Dibrugarh, Assam, India
| | - Shashank Shekhar
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kedar Padte
- Dr Kedar's Maternity, Infertility, Surgical Hospital, Endoscopy and IVF Center, Panji, Goa, India
| | | | - Bimal M John
- Minimally Invasive Surgery Unit, Credence Hospital, Thiruvananthapuram, Kerala, India
| | | | - Aishwarya V Bhurke
- Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Nilajkumar Bagde
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ketki Kulkarni
- Nowrosjee Wadia Maternity Hospital, Mumbai, Maharashtra, India
| | | | - Anil Humane
- Department of Obstetrics and Gynaecology, Government Medical College, Nagpur, Maharashtra, India
| | | | - Millind Shah
- Naval Maternity Endoscopy & Infertility Center, Solapur, Maharashtra, India
| | - Uma Singh
- Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Aarti Srivastava
- Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gita Mishra
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Neeta Warty
- Sanjeevani Gynaecological & Endoscopy Centre, Mumbai, Maharashtra, India
| | - Sunita Chandra
- Morpheus Lucknow Fertility Center, Lucknow, Uttar Pradesh, India
| | - Smita D Mahale
- Emeritus Scientist, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
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Mahajan NN, Srivastava S, Chakor R, More P, Mahale SD, Gajbhiye RK. Neurological complications of COVID-19 and spontaneous abortion in a pregnant woman - A case report. Eur J Obstet Gynecol Reprod Biol 2021; 263:278-279. [PMID: 34175157 PMCID: PMC8206547 DOI: 10.1016/j.ejogrb.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Shayla Srivastava
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Rahul Chakor
- Department of Neurology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Prajakta More
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai 400008, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai 400012, India
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai 400012, India.
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Malik S, Surve S, Wade P, Kondekar S, Sawant V, Shaikh M, Kuppusamy P, Bharmal R, Mahale SD, Modi DN, Gajbhiye RK. Clinical Characteristics, Management, and Short-Term Outcome of Neonates Born to Mothers with COVID-19 in a Tertiary Care Hospital in India. J Trop Pediatr 2021; 67:6296618. [PMID: 34114628 PMCID: PMC8411389 DOI: 10.1093/tropej/fmab054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION We describe the clinical characteristics, management, and short-term outcomes of SARS-CoV-2 neonates born to mothers with COVID-19 in a tertiary care hospital in Mumbai, India. METHODS The study is a retrospective analysis of 524 neonates born to mothers with COVID-19 admitted from 14th April 2020 to 31st July 2020. RESULTS SARS-CoV-2 infection was detected in 6.3% of the newborns of the mothers with COVID-19. No significant differences were observed between maturity at gestation, birth weight and sex of SARS-CoV-2 infected and noninfected newborns. The risk of sepsis was 4.09 [95% confidence interval (95% CI) 1.28-13.00] fold higher in the neonates with SARS-CoV-2 as compared to the noninfected group (p = 0.031). Poor feeding was significantly more common among SARS-CoV-2 infected neonates (12.1%) as compared to the noninfected neonates (2.7%) (p = 0.017). There was a total of 13 neonatal deaths, of which 3 deaths occurred in SARS-CoV-2 infected neonates (9%) while 10 (2.04%) in the SAR-CoV-2 negative group. The risk of neonatal death was higher in SARS-CoV-2 infected newborns [odds ratio (OR) 4.8; 95% CI 1.25-18.36]. CONCLUSION Neonatal SARS-CoV-2 infection is observed in almost 6% of neonates born to mothers with perinatal COVID-19. There is a higher risk of adverse outcomes such as neonatal sepsis and death in the SARS-CoV-2 infected as compared to the noninfected neonates.
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Affiliation(s)
- Sushma Malik
- Department of Paediatrics & Neonatology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India,Corresponding author Dr Sushma Malik, MD Professor and Head, Department of Paediatrics & Neonatology Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India, 400 008. Email : , Telephone + 919819065322
| | - Suchitra Surve
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Poonam Wade
- Department of Paediatrics & Neonatology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Santosh Kondekar
- Department of Paediatrics & Neonatology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Vishal Sawant
- Department of Paediatrics & Neonatology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Murtuja Shaikh
- Department of Paediatrics & Neonatology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | | | - Ramesh Bharmal
- Dean, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Deepak N Modi
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India,Dr Rahul K Gajbhiye, MBBS, PhD Scientist D & DBT Wellcome India Alliance Clinical & Public Health Intermediate Fellow, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, 400012, INDIA. Telephone: +91 22 24192036,
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Gajbhiye RK, Mahajan NN, Waghmare RB, Zala S, Chaaithanya IK, Kuppusamy P, Bhurke AV, Pious M, Surve S, Modi DN, Mahale SD. Clinical characteristics, outcomes, & mortality in pregnant women with COVID-19 in Maharashtra, India: Results from PregCovid registry. Indian J Med Res 2021; 153:629-636. [PMID: 34596595 PMCID: PMC8555584 DOI: 10.4103/ijmr.ijmr_1938_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background & objectives The PregCovid registry was established to document the clinical presentations, pregnancy outcomes and mortality of pregnant and post-partum women with COVID-19. Methods The PregCovid registry prospectively collects information in near-real time on pregnant and post-partum women with a laboratory-confirmed diagnosis of SARS-CoV-2 from 19 medical colleges across the State of Maharashtra, India. Data of 4203 pregnant women collected during the first wave of the COVID-19 pandemic (March 2020-January 2021) was analyzed. Results There were 3213 live births, 77 miscarriages and 834 undelivered pregnancies. The proportion of pregnancy/foetal loss including stillbirths was six per cent. Five hundred and thirty-four women (13%) were symptomatic, of which 382 (72%) had mild, 112 (21%) had moderate, and 40 (7.5%) had severe disease. The most common complication was preterm delivery (528, 16.3%) and hypertensive disorders in pregnancy (328, 10.1%). A total of 158 (3.8%) pregnant and post-partum women required intensive care, of which 152 (96%) were due to COVID-19 related complications. The overall case fatality rate (CFR) in pregnant and post-partum women with COVID-19 was 0.8 per cent (34/4203). Higher CFR was observed in Pune (9/853, 1.1%), Marathwada (4/351, 1.1%) regions as compared to Vidarbha (9/1155, 0.8%), Mumbai Metropolitan (11/1684, 0.7%), and Khandesh (1/160, 0.6%) regions. Comorbidities of anaemia, tuberculosis and diabetes mellitus were associated with maternal deaths. Interpretation & conclusions The study demonstrates the adverse outcomes including severe COVID-19 disease, pregnancy loss and maternal death in women with COVID-19 in Maharashtra, India.
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Affiliation(s)
- Rahul K. Gajbhiye
- Department of Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Niraj N. Mahajan
- Department of Obstetrics & Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Rakesh B. Waghmare
- Medical Education & Drugs Department, Government of Maharashtra, Mumbai, Maharashtra, India
| | - Sarika Zala
- Department of Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Itta Krishna Chaaithanya
- Department of Molecular Immunology & Microbiology, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Periyasamy Kuppusamy
- Department of Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Aishwarya V. Bhurke
- Department of Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Merlin Pious
- Department of Clinical Research Lab, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Suchitra Surve
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Deepak N. Modi
- Department of Molecular & Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Smita D. Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
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Gajbhiye RK, Mahajan NN, Kamath N, Bahirat S, Patokar G, Bhurke AV, Modi DN, Mahale SD. Clinical presentations, pregnancy complications, and maternal outcomes in pregnant women with COVID-19 and tuberculosis: A retrospective cohort study. Int J Gynaecol Obstet 2021; 153:176-179. [PMID: 33421126 PMCID: PMC7611277 DOI: 10.1002/ijgo.13588] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/12/2020] [Accepted: 01/07/2021] [Indexed: 11/24/2022]
Abstract
Pregnant women with symptomatic COVID‐19 should also be tested for TB in countries with a high burden of TB. The infrastructure of the TB Program can be utilized for the control of COVID‐19, and vice versa.
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Affiliation(s)
- Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Niraj N Mahajan
- Department of Obstetrics and Gynaecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Neha Kamath
- Department of Obstetrics and Gynaecology, Seth G S Medical College and KEM Hospital, Mumbai, India
| | - Shubhada Bahirat
- Department of Obstetrics and Gynaecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Gauri Patokar
- Department of Obstetrics and Gynaecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Aishwarya V Bhurke
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Deepak N Modi
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
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Tilve A, Mahajan NN, Pandey A, Jnanananda B, Gadekar S, Mahale SD, Gajbhiye RK. Impact of COVID-19 on pregnant women with Rheumatic heart disease or Peripartum cardiomyopathy. Eur J Obstet Gynecol Reprod Biol 2021; 258:459-461. [PMID: 33487485 PMCID: PMC7813491 DOI: 10.1016/j.ejogrb.2021.01.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/14/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Arundhati Tilve
- Department of Obstetrics and Gynaecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400008, India
| | - Niraj N Mahajan
- Department of Obstetrics and Gynaecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400008, India
| | - Ankita Pandey
- Department of Obstetrics and Gynaecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400008, India
| | - Bhargavi Jnanananda
- Department of Obstetrics and Gynaecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400008, India
| | - Sangram Gadekar
- Department of Obstetrics and Gynaecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400008, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai, 400012, India
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai, 400012, India.
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Mahajan NN, Gajbhiye RK, Bahirat S, Lokhande PD, Mathe A, Rathi S, Warty N, Mahajan KN, Srivastava V, Kuppusamy P, Mohite SC. Co-infection of malaria and early clearance of SARS-CoV-2 in healthcare workers. J Med Virol 2021; 93:2431-2438. [PMID: 33368412 DOI: 10.1002/jmv.26760] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 12/23/2022]
Abstract
Healthcare workers (HCWs) are at higher risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Information regarding co-infection of SARS-CoV-2 with vector-borne diseases (malaria and dengue) is crucial especially for the countries wherein malaria and dengue are endemic. The objective was to study the prevalence, demographic, clinical presentations among HCWs with coronavirus disease 2019 (COVID-19) and to compare the viral clearance in HCWs with COVID-19 and co-infection of malaria and dengue. This retrospective study was conducted at a dedicated COVID-19 hospital, BYL Nair Charitable Hospital (NH), Mumbai, India April 6th-October 31st 2020. The SARS-CoV-2 infection in HCWs was confirmed by reverse transcription-plymerase chain reaction. Out of 491 HCWs infected with SARS-CoV-2, analysis of viral clearance was carried out in 467 HCWs over seven month periods, The prevalence of SARS-CoV-2 infection in HCWs was 13% (491 out of 3711). Out of the HCWs with COVID-19, prevalence of SARS-CoV-2 infection was higher among security guards (25%) with 1% mortality. The co-infection of malaria or dengue was reported in 31 HCWs (6.3%). The mean duration of virus clearance was longer (12 days) in symptomatic HCWs as compared to asymptomatic (8 days, p < .005). The recovery of SARS-CoV-2 infection in HCWs was faster (mean 8 days) with co-infection of malaria than without malaria (p < .005). We recommend universal testing of HCWs, to optimize staffing levels during the current pandemic as HCWs are the most precious resource. There is a need to effectively implement standard protocols for prevention of vector-borne diseases, especially in the hospital settings.
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Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Rahul K Gajbhiye
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharastra, India
| | - Shubhada Bahirat
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Pradip D Lokhande
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Apeksha Mathe
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Surbhi Rathi
- Department of Pediatrics, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Neeta Warty
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Kshitija N Mahajan
- Department of Anesthesiology, LTMMC and General Hospital Sion, Mumbai, Maharastra, India
| | - Vartika Srivastava
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Periyasamy Kuppusamy
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharastra, India
| | - Shailesh C Mohite
- Department of FMT, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
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Mahajan NN, Gajbhiye RK, Pednekar RR, Pophalkar MP, Kesarwani SN, Bhurke AV, Mahale SD. Delirium in a pregnant woman with SARS-CoV-2 infection in India. Asian J Psychiatr 2021; 55:102513. [PMID: 33360706 PMCID: PMC7837259 DOI: 10.1016/j.ajp.2020.102513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/22/2020] [Accepted: 12/08/2020] [Indexed: 11/24/2022]
Abstract
• There is limited information on impact of COVID-19 on mental health of pregnant women. • Management of delirium in a 30-weeks pregnant woman with COVID-19 was challenging. • Training of obstetricians for managing the psychiatric emergencies is required especially in low resource settings.
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Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400 008, India.
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai, 400 012, India.
| | - Rahi R Pednekar
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400 008, India
| | - Madhura P Pophalkar
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400 008, India
| | - Shweta N Kesarwani
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400 008, India
| | - Aishwarya V Bhurke
- ICMR-National Institute for Research in Reproductive Health, Mumbai, 400 012, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai, 400 012, India
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Mahajan NN, Gajbhiye RK, Lokhande PD, Bahirat S, Modi D, Mathe AM, Bharmal R, Rathi S, Mohite SC, Tilve A. Clinical Presentation of Cases with SARS-CoV-2 Reinfection/ Reactivation. J Assoc Physicians India 2021; 69:16-18. [PMID: 34227769] [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: 06/13/2023]
Abstract
BACKGROUND Reinfection/reactivation of SARS-CoV-2 has been a matter of great interest from the immunological and vaccine perspective. However, little is known about the clinical presentation of such reinfection/reactivation. We report a case series of 9 COVID-19 patients having experienced two clinically- and/or virologically-confirmed episodes of COVID-19. METHODS Epidemiological and clinical characteristics of 9 healthcare workers (HCWs) with two episodes of SARS-CoV-2 are described. RESULTS The incidence of reinfection/reactivation amongst the HCWs was 2% (9 out of 491) with an average remission period of 66 days (range 43-78 days). Amongst the cases of reinfection 4/9 were asymptomatic in first episode were symptomatic in second episode. There is negative correlation between numbers of days the patients took to become SARS-CoV-2 negative by RT-CPR and/or clinically recover in the first episode and the second episode irrespective for the time spent in remission. CONCLUSION Shorter durations of SARS-COV-2 infection in the first episode are associated with longer time to recovery in the second episode in patients with re-infection/reactivation.
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Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai
| | - Pradip D Lokhande
- Department of Obstetrics and Gynecology Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra
| | - Shubhada Bahirat
- Department of Obstetrics and Gynecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra
| | - Deepak Modi
- ICMR-National Institute for Research in Reproductive Health, Mumbai
| | - Apeksha M Mathe
- Department of Obstetrics and Gynecology Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra
| | - Ramesh Bharmal
- Dean, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra
| | - Surbhi Rathi
- Department of Paediatrics, Department of FMT, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra
| | - Shailesh C Mohite
- Medical Superintendent, Department of FMT, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra
| | - Arundhati Tilve
- Department of Obstetrics and Gynecology Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra
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Mahajan NN, Ansari M, Gaikwad C, Jadhav P, Tirkey D, Pophalkar MP, Bhurke AV, Modi DN, Mahale SD, Gajbhiye RK. Impact of SARS-CoV-2 on multiple gestation pregnancy. Int J Gynaecol Obstet 2020; 152:220-225. [PMID: 33259652 PMCID: PMC7611278 DOI: 10.1002/ijgo.13508] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/06/2020] [Accepted: 11/27/2020] [Indexed: 11/30/2022]
Abstract
Objective To assess clinical presentations, pregnancy complications, and maternal and neonatal outcomes among women with multiple gestation pregnancy (MGP) and confirmed SARS‐CoV‐2 (COVID‐19) infection and to compare the data with a pre‐pandemic period. Methods A retrospective study at a dedicated COVID‐19 Hospital in Mumbai, India. Data were obtained from the PregCovid Registry of pregnant and postpartum women with PCR‐confirmed SARS‐CoV‐2 infection from April to September, 2020. Data were also compared with a cohort of women with MGP attending the hospital pre‐pandemic (n = 63). Results Data from 879 women (singleton pregnancy, n = 859; MGP, n = 20) with COVID‐19 were assessed. The twinning rate was 34.2 per 1000 births. As compared with singleton pregnancies, a higher proportion of women with MGP and Covid‐19 delivered preterm (P = 0.001). Spontaneous abortions were also higher in the MGP group than in the singleton group (P = 0.055). The incidence of pre‐eclampsia/eclampsia was higher in the COVID‐19 MGP group than in both the COVID‐19 singleton (41.6% vs. 7.9%) and pre‐pandemic MGP (50.0% vs. 12.7%) groups. Conclusion There was a higher risk of pre‐eclampsia among women with MGP and COVID‐19. Women with MGP and COVID‐19 infection should receive special attention with a multidisciplinary approach to both maternal and neonatal care during the pandemic. SARS‐CoV‐2 infection was found to be associated with increased risk of pre‐eclampsia and premature rapture of membranes among pregnant women with multiple gestation.
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Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, India
| | - Munira Ansari
- Department of Obstetrics and Gynecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, India
| | - Chaitanya Gaikwad
- Department of Obstetrics and Gynecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, India
| | - Priyanka Jadhav
- Department of Obstetrics and Gynecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, India
| | - Deepika Tirkey
- Department of Obstetrics and Gynecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, India
| | - Madhura P Pophalkar
- Department of Obstetrics and Gynecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, India
| | - Aishwarya V Bhurke
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Deepak N Modi
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
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Subramanyam AA, Nachane HB, Mahajan NN, Shinde S, D Mahale S, Gajbhiye RK. Postpartum psychosis in mothers with SARS-CoV-2 infection: A case series from India. Asian J Psychiatr 2020; 54:102406. [PMID: 33271702 PMCID: PMC7456193 DOI: 10.1016/j.ajp.2020.102406] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Alka A Subramanyam
- Department of Psychiatry, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400 008, India
| | - Hrishikesh B Nachane
- Department of Psychiatry, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400 008, India
| | - Niraj N Mahajan
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400 008, India.
| | - Snehal Shinde
- Department of Obstetrics and Gynecology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, 400 008, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai, 400 012, India
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai, 400 012, India.
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Mahajan NN, Kesarwani SN, Shinde SS, Nayak A, Modi DN, Mahale SD, Gajbhiye RK. Co-infection of malaria and dengue in pregnant women with SARS-CoV-2. Int J Gynaecol Obstet 2020; 151:459-462. [PMID: 33090458 PMCID: PMC7611276 DOI: 10.1002/ijgo.13415] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/06/2020] [Indexed: 01/23/2023]
Abstract
Physicians and obstetricians should be vigilant so that they can swiftly identify co‐infections of malaria and dengue in pregnant women with COVID‐19.
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Affiliation(s)
- Niraj N Mahajan
- Department of Obstetrics and Gynecology, TN Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Shweta N Kesarwani
- Department of Obstetrics and Gynecology, TN Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Snehal S Shinde
- Department of Obstetrics and Gynecology, TN Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Anurupa Nayak
- Department of Obstetrics and Gynecology, TN Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Deepak N Modi
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Smita D Mahale
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Rahul K Gajbhiye
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
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Khan SA, Jadhav SV, Suryawanshi AR, Bhonde GS, Gajbhiye RK, Khole VV. Evaluation of Contraceptive Potential of a Novel Epididymal Sperm Protein SFP2 in a Mouse Model. Am J Reprod Immunol 2011; 66:185-98. [DOI: 10.1111/j.1600-0897.2011.01030.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Suryawanshi AR, Khan SA, Gajbhiye RK, Gurav MY, Khole VV. Differential proteomics leads to identification of domain-specific epididymal sperm proteins. J Androl 2011; 32:240-259. [PMID: 20966424 DOI: 10.2164/jandrol.110.010967] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The alteration in the protein signatures of the testicular sperm during its epididymal sojourn makes it functionally competent for successful fertilization. The present study was undertaken to identify the proteins acquired on its 2 domains, that is, the head and the flagellum, during the epididymal transit using a differential proteomics approach. Testicular sperm proteome was compared with cauda epididymal sperm proteome in rat. The protein spots exclusively present in the cauda epididymal sperm proteome were searched in the cauda sperm head proteome and the cauda sperm flagella proteome, and a total of 335 spots were found by alignment and auto-matching of the gels, of which 140 could be identified by mass spectrometry. Database search revealed that of these 9 proteins were novels. Gene Ontology annotation revealed that the identified proteins were distributed across different cellular components and were primarily involved in metabolic processes. The study also provides information on the localization of these proteins on the sperm domains, which indirectly gives a clue about its putative function. Validation of 3 proteins, namely MMSDH, NDUFS1, and UQCRC2, using antibodies very elegantly demonstrates that the strategy has been very effective. This comprehensive data of domain-specific epididymal sperm proteins will be useful in development of newer targets for posttesticular contraception and diagnostic markers for infertility.
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Affiliation(s)
- Amol R Suryawanshi
- Department of Gamete Immunobiology, National Institute for Research in Reproductive Health (ICMR), Mumbai, India
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