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.

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.

Comparison of healing assessments of periapical endodontic surgery using conventional radiography and cone-beam computed tomography: A systematic review

Sharma Garima,Abraham Dax,Gupta Alpa,Aggarwal Vivek,Mehta Namrata,Jala Sucheta,Chauhan Parul,Singh Arundeep 대한영상치의학회 2022 Imaging Science in Dentistry Vol.52 No.1

Purpose: This systematic review aimed to compare assessments of the healing of periapical endodontic surgery using conventional radiography and cone-beam computed tomography (CBCT). Materials and Methods: This review of clinical studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All articles published from 1990 to March 2020 pertaining to clinical and radiographic healing assessments after endodontic surgery using conventional radiography and CBCT were included. The question was “healing assessment of endodontic surgery using cone-beam computed tomography.” The review was conducted by manual searching, as well as undertaking a review of electronic literature databases, including PubMed and Scopus. The studies included compared radiographic and CBCT assessments of periapical healing after periapical endodontic surgery. Results: The initial search retrieved 372 articles. The titles and abstracts of these articles were read, leading to the selection of 73 articles for full-text analysis. After the eligibility criteria were applied, 11 articles were selected for data extraction and qualitative analysis. The majority of studies found that CBCT enabled better assessments of healing than conventional radiography, suggesting higher efficacy of CBCT for correct diagnosis and treatment planning. A risk of bias assessment was done for 10 studies, which fell into the low to moderate risk categories. Conclusion: Three-dimensional radiography provides an overall better assessment of healing, which is imperative for correct diagnosis and treatment planning.

Cervical xanthogranuloma in a case of postmenopausal pyometra

( Alpana Singh ),( Garima Vats ),( A G Radhika ),( Pragati Meena ),( Gita Radhakrisnan ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.5

Xanthogranuloma is a non-neoplastic presentation of chronic inflammation commonly seen in gallbladder, kidney and rarely seen in genital organs. Only one case has been reported in cervix. Here, we report a case of 60-yearold postmenopausal lady who presented with history of fever and purulent discharge per-vaginum. On speculum examination, cervix had an ulcer extending from 3 to 5 o’clock position. Uterus was bulky. On probing the ulcer, a 1-cm deep sinus was identified. Ultrasound showed enlarged uterus and fluid collection suggestive of pyometra. Pyometra was drained and cervical biopsy was taken from the ulcerated lesion; histopathology revealed granulomatous inflammation with predominantly xanthous cells suggestive of tuberculosis. High index of clinical suspicion needs to be maintained in abnormal cervix. It is a perplexing and rare entity for a clinician and also a diagnosis of exclusion; only histopathology can help for diagnosis. It mimics like malignancy and chronic infections.

Comparison of healing assessments of periapical endodontic surgery using conventional radiography and cone-beam computed tomography: A systematic review

Sharma, Garima,Abraham, Dax,Gupta, Alpa,Aggarwal, Vivek,Mehta, Namrata,Jala, Sucheta,Chauhan, Parul,Singh, Arundeep Korean Academy of Oral and Maxillofacial Radiology 2021 Imaging Science in Dentistry Vol.51 No.-

Purpose: This systematic review aimed to compare assessments of the healing of periapical endodontic surgery using conventional radiography and cone-beam computed tomography (CBCT). Materials and Methods: This review of clinical studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All articles published from 1990 to March 2020 pertaining to clinical and radiographic healing assessments after endodontic surgery using conventional radiography and CBCT were included. The question was "healing assessment of endodontic surgery using cone-beam computed tomography." The review was conducted by manual searching, as well as undertaking a review of electronic literature databases, including PubMed and Scopus. The studies included compared radiographic and CBCT assessments of periapical healing after periapical endodontic surgery. Results: The initial search retrieved 372 articles. The titles and abstracts of these articles were read, leading to the selection of 73 articles for full-text analysis. After the eligibility criteria were applied, 11 articles were selected for data extraction and qualitative analysis. The majority of studies found that CBCT enabled better assessments of healing than conventional radiography, suggesting higher efficacy of CBCT for correct diagnosis and treatment planning. A risk of bias assessment was done for 10 studies, which fell into the low to moderate risk categories. Conclusion: Three-dimensional radiography provides an overall better assessment of healing, which is imperative for correct diagnosis and treatment planning.

New face in the row of bioactive compounds and toxin-antitoxin modules: Xenorhabdus nematophila

Shobhi Chaudhary,Singh Garima,Gupta Nomita,Ghosh Chaitali,Rathore Jitendra Singh 한국응용곤충학회 2023 Journal of Asia-Pacific Entomology Vol.26 No.4

Mutualistic symbiosis exists in the natural world between the Enterobacteriaceae genus Xenorhabdus and the entomopathogenic nematode genus Steinernema. Despite the fact that the bulk of the relationships are speciesspecific, a single Xenorhabdus sp. may infect more than one Steinernema sp. During the complex and stressful life cycle inside the gut of insect as well as in soil, Xenorhabdus nematophila produces various bioactive com pounds. These bioactive compounds are responsible for killing of infected insect larvae. It also ensures the reproduction and proliferation of the bacteria and nematodes. In this review, we have discussed various bioactive compounds produced by Xenorhabdus nematophila, proving it extremely critical for novel antibiotic discovery in the era of current antibiotic resistance crisis. The wide range of bioactive compounds produced by X. nematophila have antibacterial as well as antifungal properties. However, some of the bioactive compounds are effective against insects, nematodes, protozoa, and has anti-cancer potential too. Further, we have also discussed the increased production and gene regulation of several antimicrobial compounds. In the end, we have also discussed the presence of Toxin-Antitoxin (TA) systems and their involvement in adaptation to multiple adverse envi ronments for the bacteria.

Efficacy of fecal microbiota therapy in steroid dependent ulcerative colitis: a real world intention-to-treat analysis

( Ajit Sood ),( Ramit Mahajan ),( Garima Juyal ),( Vandana Midha ),( Charanpreet Singh Grewal ),( Varun Mehta ),( Arshdeep Singh ),( Mohan C Joshi ),( Vikram Narang ),( Kirandeep Kaur ),( Hasrat Sidhu 대한장연구학회 2019 Intestinal Research Vol.17 No.1

Background/Aims: Four high-quality randomized controlled trials have proven the efficacy of fecal microbiota transplantation (FMT) in active ulcerative colitis (UC). We assessed the efficacy of FMT in a real-world setting involving steroid-dependent patients with UC. Methods: This was a single-center prospective analysis of data from steroid-dependent patients with UC treated with FMT from September 2015 to September 2017 at the Dayanand Medical College, a tertiary care center in India. Fecal samples from random unrelated donors were administered through colonoscopy at weeks 0, 2, 6, 10, 14, 18, and 22. The primary outcome was achievement of steroid-free clinical remission, and the secondary outcomes were clinical response and endoscopic remission at 24 weeks. Modified intention-to-treat analysis was performed, which included subjects who underwent at least 1 FMT. Results: Of 345 patients with UC treated during the study period, 49 (14.2%) had steroid-dependent UC. Of these 49 patients, 41 underwent FMT: 33 completed 7 sessions over 22 weeks according to the protocol, and 8 discontinued treatment (non-response, 5; lost to follow-up, 2; and fear of adverse effects, 1). At week 24, steroid-free clinical remission was achieved in 19 out of 41 (46.3%) patients, whereas clinical response and endoscopic remission were achieved in 31 out of 41 (75.6%) and 26 out of 41 (63.4%) patients, respectively. All patients with clinical response were able to withdraw steroids. There were no serious adverse events necessitating discontinuation. Conclusions: A multisession FMT via the colonoscopic route is a promising therapeutic option for patients with steroid-dependent UC, as it can induce clinical remission and aid in steroid withdrawal. (Intest Res 2019;17:78-86)

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.

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.

EXISTENCE OF SOLUTION FOR SYSTEM OF INTEGRAL EQUATIONS AND FUNCTIONAL EQUATIONS THROUGH NON-NEGATIVE FUNCTION WITH PROPERTY OF ONENESS

Om Prakash Chauhan,Deepak Singh,Vishal Joshi,Garima Singh,Rajendra Kumar Sharma 경남대학교 기초과학연구소 2018 Nonlinear Functional Analysis and Applications Vol.23 No.4

In this article, we define the notion of a non-negative function satisfying property of oneness. Utilizing this concept, certain unified fixed point results are established. Furthermore generalized φ-contractions mapping and some fixed point results in the framework of symmetric space are also presented. Some well-known results from the existence literature are obtained through our introduced setting. Results are substantiated by some innovative examples with the aid of visualization of surfaces. Moreover applications of obtained theory for the existence for the system of integral equations as well as for the system of functional equations occurred in dynamic programming are also presented.