Risk of incidental genital tract malignancies at the time of myomectomy and hysterectomy for benign conditions

( Garima Yadav ),( Meenakshi Rao ),( Shuchita Batra Goyal ),( Pratibha Singh ),( Priyanka Kathuria ),( Meenakshi Gothwal ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.2

Objective To determine the incidence of accidentally diagnosed genital malignancies in women undergoing gynecological surgeries for pathologies presumed to be benign. Methods Data of all women who underwent hysterectomy for benign indications were retrieved from hospital records. A total of 628 cases of hysterectomy and 35 cases of myomectomy were included. The final histopathology was accessed through the computer records, and the total number of genital tract malignancies was included. Results The incidence of occult uterine, ovarian, and cervical malignancies in women undergoing hysterectomy was 0.47%, 0.31%, and 0.15%, respectively. The incidence of uterine corpus malignancies in women undergoing myomectomy was 2.8%, and 3 cases of smooth muscle tumor of uncertain malignant potential (STUMP) were also identified. Endometrial stromal sarcomas were the most common pathology among uterine malignancies, followed by leiomyosarcoma and endometrial adenocarcinoma. Conclusion Postoperative diagnosis of malignancies in women undergoing surgery for benign indications poses great challenges to the treating surgeon. Occult malignancies must be ruled out by thorough preoperative assessment, especially in some subsets of women. Morcellation is an inevitable technique and complement to laparoscopic surgeries, although little chances of malignancy spread is related to its use. Nevertheless, thorough preoperative investigations and always ensuring contained morcellation can minimize these chances.

Detection of nerve fibers in the eutopic endometrium of women with endometriosis, uterine fibroids and adenomyosis

( Garima Yadav ),( Meenakshi Rao ),( Meenakshi Gothwal ),( Pratibha Singh ),( Priyanka Kathuria ),( Prem Prakash Sharma ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.5

Objective The primary objective of this study was to establish the presence of nerve fibers in the eutopic endometrium of women with endometriosis and to determine whether these nerve fibers are exclusive to endometriosis or are also found in other pelvic pathologies associated with dysmenorrhea. Methods Endometrial tissue was obtained by aspiration (Pipelle), endometrial curettage, or following hysterectomy in women with endometriosis confirmed through histopathological examination, leiomyomas, and adenomyosis. The eutopic endometrium was subjected to immunohistochemical staining to detect PGP 9.5, which is a highly specific pan-neuronal marker. The nerve fiber density was correlated with the patient’s pain score, as indicated by the Visual Analog Scale. A control group was formed by staining the endometrium of women presenting with dysmenorrhea but without the above-mentioned disorders. Results Nerve fibers were observed in sections of the endo-myometrium (in the deep endometrium) in 68% of patients with endometriosis who underwent hysterectomy or a deep endometrial biopsy. Nerve fibers were not observed in the aspirated endometrium of women with endometriosis. Only 13.7% of women with adenomyosis and 3.3% of women with fibroids had nerve fibers in their endometrium. Nerve fiber density was correlated with pain score in women with endometriosis. Conclusion Nerve fibers were found in the functional layer of eutopic endometrium in women with endometriosis; hence, we concluded that the presence of nerve fibers in the eutopic endometrium could diagnose endometriosis with a fairly good specificity of 92.7%. However, the absence of nerve fibers does not always exclude the disease.

Herbivore-responsive cotton phenolics and their impact on insect performance and biochemistry

Garima Dixit,Ashish Praveen,Tusha Tripathi,Vikash Kumar Yadav,Praveen C. Verma 한국응용곤충학회 2017 Journal of Asia-Pacific Entomology Vol.20 No.2

Insect damage to plants can have several impacts on plant biochemical composition and such changes may influence the insect performances. Here,we examined herbivore-responsive alterations in the phenolic profile of cotton plant using three cotton genotypes, Bc-68-2, Gcot-16 and Coker-312, belonging to G. hirsutumsp. during their infestation with two biting and chewing insects viz., Helicoverpa armigera and Spodoptera litura, separately for 96 h. Both insects had similar effects on phenolic induction in cotton plants (Gossypium sp.) at 96 h post infestation (hpi) however, the phenolic accumulationwas genotype specific.Wemeasured 13 phenolic compounds, out ofwhich four phenolic acids viz., gallic acid (GA), cinnamic acid (CA), p-coumaric acid (PA) and salicylic acid (SA) displayed higher accumulation in response to insect herbivory at 96 hpi. The subsequent impact of four herbivore- responsive phenolics on insect performance was evaluated through diet incorporation assay. Insect larvae displayed significant reduction in larvalweights and substantial mortality on 10th day in case of CA and PA incorporated diets at higher concentrations. Physiological examination of treated larvae on 5th and 10th day post feeding at CA and PA containing diets revealed oxidative stress, reduced lactate dehydrogenase enzyme activity, altered glucose and protein level and enhanced glutathione-S-transferase enzyme activity in larvae feeding on treatment diets as compared to controls.Our results suggest that the defensive chemistry of phenolics has important effect on the insect fitness and physiology and the flavonoids such as CA and PA can be utilized in pest control programmes.

De-novo Hybrid Protein Design for Biodegradation of Organophosphate Pesticides

Garima Awasthi,Ruchi Yadav,Prachi Srivastava 한국미생물·생명공학회 2019 한국미생물·생명공학회지 Vol.47 No.2

In the present investigation, we attempted to design a protocol to develop a hybrid protein with better bioremediation capacity. Using in silico approaches, a Hybrid Open Reading Frame (Hybrid ORF) is developed targeting the genes of microorganisms known for degradation of organophosphates. Out of 21 genes identified through BLAST search, 8 structurally similar genes (opdA, opd, opaA, pte RO, pdeA, parC, mpd and phnE) involved in biodegradation were screened. Gene conservational analysis categorizes these organophosphates degrading 8 genes into 4 super families i.e., Metallo-dependent hydrolases, Lactamase B, MPP and TM_PBP2 superfamily. Hybrid protein structure was modeled using multi-template homology modeling (3S07_A; 99%, 1P9E_A; 98%, 2ZO9_B; 33%, 2DXL_A; 33%) by Schrödinger software suit version 10.4.018. Structural verification of protein models was done using Ramachandran plot, it was showing 96.0% residue in the favored region, which was verified using RAMPAGE. The phosphotriesterase protein was showing the highest structural similarity with hybrid protein having raw score 984. The 5 binding sites of hybrid protein were identified through binding site prediction. The docking study shows that hybrid protein potentially interacts with 10 different organophosphates. The study results indicate that the hybrid protein designed has the capability of degrading a wide range of organophosphate compounds.

De-novo Hybrid Protein Design for Biodegradation of Organophosphate Pesticides

Awasthi, Garima,Yadav, Ruchi,Srivastava, Prachi The Korean Society for Microbiology and Biotechnol 2019 한국미생물·생명공학회지 Vol.47 No.2

In the present investigation, we attempted to design a protocol to develop a hybrid protein with better bioremediation capacity. Using in silico approaches, a Hybrid Open Reading Frame (Hybrid ORF) is developed targeting the genes of microorganisms known for degradation of organophosphates. Out of 21 genes identified through BLAST search, 8 structurally similar genes (opdA, opd, opaA, pte RO, pdeA, parC, mpd and phnE) involved in biodegradation were screened. Gene conservational analysis categorizes these organophosphates degrading 8 genes into 4 super families i.e., Metallo-dependent hydrolases, Lactamase B, MPP and TM_PBP2 superfamily. Hybrid protein structure was modeled using multi-template homology modeling (3S07_A; 99%, 1P9E_A; 98%, 2ZO9_B; 33%, 2DXL_A; 33%) by $Schr{\ddot{o}}dinger$ software suit version 10.4.018. Structural verification of protein models was done using Ramachandran plot, it was showing 96.0% residue in the favored region, which was verified using RAMPAGE. The phosphotriesterase protein was showing the highest structural similarity with hybrid protein having raw score 984. The 5 binding sites of hybrid protein were identified through binding site prediction. The docking study shows that hybrid protein potentially interacts with 10 different organophosphates. The study results indicate that the hybrid protein designed has the capability of degrading a wide range of organophosphate compounds.

Red cell alloimmunization in pregnancy: a study from a premier tertiary care centre of Western India

Meenakshi Gothwal,Pratibha Singh,Archana Bajpayee,Neha Agrawal,Garima Yadav,Charu Sharma 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.2

ObjectiveThe study was conducted to determine the frequency of alloimmunization to various blood group antibodies in pregnant women, and the risk of hemolytic disease in the fetus and newborn. MethodsAll antenatal women, irrespective of the period of gestation or obstetric history, were included, whereas those taking anti-D immune-prophylaxis or with a history of blood transfusion were excluded. Antibody screening and identification were performed using a Bio-Rad ID microtyping system. ResultsOf 2,084 antenatal females, 1,765 were D?antigen positive and 319 D?antigen negative. Sixty-five (3.119%) women alloimmunized. Out of 54 (2.591%) who had sensitized to D-antigen, 11 (0.527%) also sensitized to other antibodies. These 11 alloantibodies identified included: anti-M (n=6; 9.23%), anti-C (n=1; 3.076%), anti-E (n=1; 1.538%), anti-e (n=1; 1.538%), anti-Lewis (a) (n=1; 1.538%), and unspecified antibodies (n=1; 1.538%). Multiple antibodies were seen in four patients that combined: anti-D and anti-C (n=2; 3.076%), anti-e and anti-c (n=1; 1.538%), and anti-D and anti-G (n=1; 1.538%). ConclusionThe rate of alloimmunization in D-antigen-negative women was high. Apart from this, the alloimmunization rate in women with bad obstetric history was very high, at 8.1%. In developing countries such as India, universal antenatal antibody screening, though desirable, may not be justified at present, as the cost and infrastructure required would be immense because of the lower alloimmunization rates in RhD antigen-positive women. However, it is necessary to impose properly formulated protocols to screen pregnant women with bad obstetric history.

Pre-COVID and COVID experience of objective structured clinical examination as a learning tool for post-graduate residents in Obstetrics & Gynecology-a quality improvement study

Charu Sharma,Pratibha Singh,Shashank Shekhar,Abhishek Bhardwaj,Manisha Jhirwal,Navdeep Kaur Ghuman,Meenakshi Gothwal,Garima Yadav,Priyanka Kathuria,Vibha Mishra 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.4

Objective Due to its comprehensive, reliable, and valid format, the objective structured clinical examination (OSCE) is the gold standard for assessing the clinical competency of medical students. In the present study, we evaluated the importance of the OSCE as a learning tool for postgraduate (PG) residents assessing their junior undergraduate students. We further aimed to analyze quality improvement during the pre-coronavirus disease (COVID) and COVID periods. Methods This quality-improvement interventional study was conducted at the Department of Obstetrics and Gynecology. The PG residents were trained to conduct the OSCE. A formal feedback form was distributed to 22 participants, and their responses were analyzed using a five-point Likert scale. Fishbone analysis was performed, and the ‘plan-do-study-act’ (PDSA) cycle was implemented to improve the OSCE. Results Most of the residents (95%) believed that this examination system was extremely fair and covered a wide range of clinical skills and knowledge. Further, 4.5% believed it was more labor- and resource intensive and time-consuming. Eighteen (81.8%) residents stated that they had learned all three domains: communication skills, time management skills, and a stepwise approach to clinical scenarios. The PDSA cycle was run eight times, resulting in a dramatic improvement (from 30% to 70%) in the knowledge and clinical skills of PGs and the standard of OSCE. Conclusion The OSCE can be used as a learning tool for young assessors who are receptive to novel tools. The involvement of PGs in the OSCE improved their communication skills and helped overcome human resource limitations while manning various OSCE stations.