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Patel M G, Borah N, Kumar B, Rai R, Singh V, Maji C. MEDITERRANEAN DIET AND ITS IMPACT ON THE ILLNESS CHARACTERISTIC OF YOUTH WITH IRRITABLE BOWEL CONDITION. Georgian Med News 2023:62-66. [PMID: 38325300] [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: 02/09/2024]
Abstract
Irritable Bowel Disorder (IBD) is a prevalent digestive illness that frequently affects young people and drastically decreases the Quality of Life (QoL). Adults with IBD indications may find relief from their symptoms through nutritional changes like the Mediterranean-style diet. Concerning the seriousness of symptoms, QoL, and additional pertinent results in young people with IBD, this investigation seeks to determine the impact of the Mediterranean-style diet. 200 individuals with IBD who met the Rome-IV criterion and were between the ages of 13 and 19 were enrolled in the present research. A Mediterranean-style diet was provided to the Study Group (SG), which consisted of 100 individuals, while the Control Group (CG), which consisted of 100 patients, followed the usual diet. Various laboratory and clinical characteristics were also assessed at the beginning and end of the study, in addition to IBD values. The Mediterranean-style diet has been demonstrated to be effective and tolerated well in kids and teenagers with IBD. The IBD -SSS (from 148±42.3 to 224±71) IBD -QoL (from 76.7±8.1 to 61.3±9.8), and cumulative IBD rating (from 29.3±11.7 to 32.6±12.1) all showed notable increases in individuals who followed well to this diet. The CG, in comparison, did not show any significant enhancements in these factors. This indicates that a Mediterranean-style diet might provide therapeutic advantages for IBD individuals, especially those who keep adherent to it, concerning symptom severity and QoL. The Mediterranean-style diet proved to be both secure and associated with notable improvements in IBD rates in young and adolescents with IBD.
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Affiliation(s)
- G Patel M
- 1Department of Community Medicine, Parul University, PO Limda, Tal. Waghodia, District Vadodara, Gujarat, India
| | - N Borah
- 2Department of Life Sciences, School of Sciences, JAIN (Deemed-to-be University), Karnataka, India
| | - B Kumar
- 3School of Pharmacy & Research, Dev Bhoomi Uttarakhand University, Dehradun, India
| | - R Rai
- 4Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, India
| | - V Singh
- 5Department of General Medicine, TMMC&RC, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Ch Maji
- 6Department of Pharmacy, Noida Institute of Engineering and Technology (Pharmacy Institute), Uttar Pradesh, India
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Rai R, Sehgal R, Singhal S, Suri V, Shivkumar P, Balasubramani L, Rajaram S, Shamsunder S, Bagga R, Vashist S, Meena J, Mishra A, Chawla L, Kumari S, Mani K, Bhatla N. Cervical Cancer Screening Coverage at Tertiary Care Institutes Across India. Asian Pac J Cancer Prev 2023; 24:4269-4275. [PMID: 38156863 PMCID: PMC10909083 DOI: 10.31557/apjcp.2023.24.12.4269] [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: 08/13/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES The 70% screening coverage target proposed in the global cervical cancer elimination strategy is not achieved even at tertiary centres in India. A situational analysis was done to assess the currently existing facilities and barriers in tertiary care institutes. METHODS This cross sectional multicentric study was conducted from August to September 2021 in six tertiary care institutes across India. Women aged 30-49 years attending outpatient services (OPD) were invited for cervical screening. Women and health care professionals (HCPs) were administered structured questionnaires to assess knowledge, attitude and practices regarding cervical cancer screening services. RESULTS Out of 6709 eligible women who attended OPD, 1666 (24.8%; range:19-57%) received screening. Availability of screening kits was limited to 10-25 Pap/HPV tests per day. Visual inspection with acetic acid (VIA) and HPV testing were offered only at certain centres. Colposcopy and treatment facilities were optimal at all centres. Knowledge, attitude and practices were analysed for 1800 women: 45.7% had heard of cervical cancer, 78.0% did not know that it is preventable, 75.8% never heard about screening. Common symptoms correctly identified included postmenopausal bleeding (4.8%), postcoital bleeding (5.7%), intermenstrual bleeding (5.8%) and vaginal discharge (12.4%). Risk factors were identified by minority: poor menstrual hygiene (6.6%), oral contraceptive pill use (6.4%), multiparity (4.4%), and HPV infection (3.0%). Out of 21, mean total knowledge score (MTKS) was 2.07± 2.67. Out of 317 HCPs, 96.5% knew that cervical cancer is caused by HPV infection, is preceded by premalignant stage, and that it is preventable by screening and treatment (80.1%). Knowledge about screening modalities was present in 87.4% for cytology, 75.1% for VIA, 68.8% for HPV test. MTKS of HCPs was 20.88±6.61 out of 32. CONCLUSION Even at tertiary centres, limited availability of HPV tests, reluctance to implement VIA and lack of awareness among women remain the major barriers.
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Affiliation(s)
- Rakhi Rai
- Department of Obstetrics and Gynaecology, WHO CC AIIMS, New Delhi, India.
| | - Rohini Sehgal
- Department of Obstetrics and Gynaecology, WHO CC AIIMS, New Delhi, India.
| | - Seema Singhal
- Department of Obstetrics and Gynaecology, WHO CC AIIMS, New Delhi, India.
| | - Vanita Suri
- Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
| | | | - Latha Balasubramani
- Department of Gynaecology Oncology, VN Cancer Centre, GKNM Hospital, Coimbatore, India.
| | - Shalini Rajaram
- Department of Obstetrics and Gynaecology AIIMS, Rishikesh, India.
| | - Saritha Shamsunder
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India.
| | - Rashmi Bagga
- Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
| | - Shachi Vashist
- Department of Obstetrics and Gynaecology, WHO CC AIIMS, New Delhi, India.
| | - Jyoti Meena
- Department of Obstetrics and Gynaecology, WHO CC AIIMS, New Delhi, India.
| | - Archana Mishra
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India.
| | - Latika Chawla
- Department of Obstetrics and Gynaecology AIIMS, Rishikesh, India.
| | - Sarita Kumari
- Department of Obstetrics and Gynaecology, WHO CC AIIMS, New Delhi, India.
| | | | - Neerja Bhatla
- Department of Obstetrics and Gynaecology, WHO CC AIIMS, New Delhi, India.
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Rai R, Bhatla N. Early detection and treatment of postpartum haemorrhage: A game-changing strategy. Natl Med J India 2023; 36:316-317. [PMID: 38759984 DOI: 10.25259/nmji_580_2023] [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] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Affiliation(s)
- Rakhi Rai
- Department of Obstetrics and Gynaecology All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Department of Obstetrics and Gynaecology All India Institute of Medical Sciences, New Delhi, India
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Rai R, Roy KK, Zangmo R, Nair V, Jain A. Ovarian Ligament Plication as a Treatment for Patient with Elongated Ovarian Ligament with Recurrent Abdominal Pain in the Absence of Ovarian Torsion. Gynecol Minim Invasive Ther 2022; 11:250-252. [PMID: 36660328 PMCID: PMC9844036 DOI: 10.4103/gmit.gmit_78_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/09/2021] [Accepted: 03/17/2022] [Indexed: 11/09/2022] Open
Abstract
Elongated ovarian ligament can lead to adnexal torsion. Several cases of ovarian torsion have been reported where the ovarian ligament was elongated, and ovarian detorsion and ovarian ligament plication were done. In our case, a young girl presented with recurrent left lower abdominal pain, especially after exercise, with normal ovaries found on ultrasound. Laparoscopy was performed given recurrent pelvic pain and found elongated left ovarian ligament with normal ovaries. Considering the possibility of recurrent torsion and detorsion of the ovary due to elongated left ovarian ligament, left ovarian ligament plication was done. The patient remained pain-free till 1 year of follow-up. No such case has been reported in the literature where the ovarian ligament plication was performed without torsion. Hence, elongated ovarian ligament could cause recurrent pelvic pain due to possible torsion, and a simple, easy procedure of ovarian ligament plication can help relieve pain.
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Affiliation(s)
- Rakhi Rai
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India,Address for correspondence: Dr. Rakhi Rai, Teaching Block, 3rd Floor, Department of Obstetrics and Gynecology, AIIMS, New Delhi, India. E-mail:
| | - Kallol Kumar Roy
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Rinchen Zangmo
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Vinod Nair
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Aayush Jain
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
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Farahani L, Mowla S, Tharakan T, Lee Y, Kundu S, Khanjani S, Sindi E, Rai R, Regan L, Ramsay J, Bennett P, Dhillo W, Minhas S, Jayasena C, MacIntyre D. O-252 Next generation sequencing analysis of the seminal microbiome in male partners of women with idiopathic recurrent pregnancy loss: results of a prospective cohort study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac106.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is there an association between the semen microbiome, seminal reactive oxygen species (ROS) and DNA fragmentation in men with recurrent pregnancy loss (RPL)?
Summary answer
This pilot study outlines the subtle role that microbiota play in influencing ROS and sperm DNA damage for male partners of women with RPL
What is known already
RPL is defined as the loss of two or more consecutive pregnancies. This devastating condition impacts approximately 1% of couples. Paternal causes are not routinely screened for and an underlying cause is not found in up to 50% of cases. Recent studies have reported an association between elevated seminal ROS and sperm DNA fragmentation in the male partner, and RPL. We hypothesised that seminal microbiota contribute to increased ROS and sperm DNA damage. To test this, we investigated the relationship between seminal bacterial composition and ROS levels in men with proven fertility versus men with a history of RPL.
Study design, size, duration
We conducted a prospective, case-control study and recruited participants between November 2018 and March 2020 at Imperial College Healthcare NHS Trust. A total of 109 men participated in the study; 46 men with RPL and 63 men with proven fertility and no history of RPL. Each participant attended for a single study visit which consisted of a full medical history, assessment of testicular volume, height, weight, blood samples and production of a semen sample.
Participants/materials, setting, methods
Routine semen analysis (WHO) and endocrine and lipid profiles were performed for all patients. Semen ROS and DNA fragmentation were performed (luminol and TUNEL methodologies, respectively). ROS were classified as high (>3.77 RLU/s) or low (<3.77 RLU/s). Metataxonomic profiling of samples was performed using Illumina Miseq-based sequencing of the V1-V2 hypervariable regions of bacterial 16S rRNA gene amplicons. Multivariate and univariate modelling was performed to explore associations between metataxonomic profiles, ROS levels and clinical metadata.
Main results and the role of chance
Men with RPL had higher mean semen volume (p = 0.02) and increased prevalence of high ROS (p = 0.02, Fisher's exact) compared with controls; but other clinical characteristics were similar between groups. A total of 3,700,136 high quality sequence reads were generated for the dataset with an average of 33,946 reads/sample. Hierarchical clustering of bacterial genera relative abundances identified 4 distinct microbial signatures characterised by high relative abundance of 1. Streptococcus, 2. Lactobacillus and Gardnerella, 3. polymicrobial (including Prevotella), and 4. Corynebacterium and Finegoldia. Prevalences of these groups were similar in control and RPL groups (p = 0.11). Additionally, no association between the bacterial genera groups and elevated ROS, DNA fragmentation, or clinical factors such as age, ethnicity, or semen volume were observed (chi-square tests). At species taxonomy level relative abundance of L. crispatus was higher in controls compared to RPL, but did not withstand false discovery rate correction for multiple testing (p = 0.006, q = 0.67). Higher relative abundance of Microbacterium was detected in semen samples with high DNA fragmentation (p = 8.7E-4, q = 0.08). This relationship was even stronger within the RPL cohort (p = 2.8E-5, q = 0.002). No significant enrichment of specific taxa was observed between high or low ROS samples however, low ROS was associated with Corynebacterium relative abundance >20%.
Limitations, reasons for caution
More patients are required to enhance statistical power. Duplicate sample collection may establish the robustness of seminal compositions observed. Time since last sexual intercourse samples may affect the analysis. Concomitant analysis of the vaginal microbiome of female partners may improve our understanding of how partners may affect each other’s fertility.
Wider implications of the findings
Our data suggests interactions between microbiota composition, ROS and sperm DNA damage which may be implicated in the pathogenesis of recurrent miscarriage. Further studies are needed to determine if seminal microbiota play causal roles in RPL, and whether interventions modifying the seminal microbiome may modify pregnancy outcomes in affected couples
Trial registration number
not applicable
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Affiliation(s)
- L Farahani
- Imperial College Healthcare NHS Trust, Obstetrics & Gynaecology , London, United Kingdom
| | - S Mowla
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
| | - T Tharakan
- Charing Cross Hospital , Urology, London, United Kingdom
| | - Y Lee
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
| | - S Kundu
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
| | - S Khanjani
- University College London Hospital , Gynaecology, London, United Kingdom
| | - E Sindi
- Imperial College, Section of Investigative Medicine , London, United Kingdom
| | - R Rai
- Imperial College Healthcare NHS Trust, Obstetrics & Gynaecology , London, United Kingdom
| | - L Regan
- Imperial College Healthcare NHS Trust, Obstetrics & Gynaecology , London, United Kingdom
| | - J Ramsay
- Hammersmith Hospital , Andrology, London, United Kingdom
| | - P Bennett
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
| | - W Dhillo
- Imperial College, Section of Investigative Medicine , London, United Kingdom
| | - S Minhas
- Charing Cross Hospital , Urology, London, United Kingdom
| | - C Jayasena
- Imperial College, Section of Investigative Medicine , London, United Kingdom
| | - D MacIntyre
- Imperial College, Institute of Reproductive Developmental Biology , London, United Kingdom
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Zangmo R, Sarkar A, Rai R, Kulshreshtha A. Re: Obstetric anal sphincter injury by maternal origin and length of residence. BJOG 2022; 129:1175-1176. [PMID: 34989112 DOI: 10.1111/1471-0528.17070] [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: 11/07/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Rinchen Zangmo
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Avir Sarkar
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Rakhi Rai
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Anshul Kulshreshtha
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
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7
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Prameela M, Prabhu LV, Murlimanju B, Pai MM, Rai R, Ganesh Kumar C. Morphological Variants of the Abductor Pollicis Longus and Extensor Pollicis Brevis Tendons. A Cadaveric Study. Muscles Ligaments Tendons J 2022. [DOI: 10.32098/mltj.01.2022.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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8
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Sharma S, Roy K, Rai R, Zangmo R, Malhotra N, Das A. Assessment of pain at different steps of diagnostic hysteroscopy using room temperature normal saline versus warmed normal saline solution as distension medium: A randomized controlled trial. Gynecol Minim Invasive Ther 2022; 11:41-46. [PMID: 35310129 PMCID: PMC8926041 DOI: 10.4103/gmit.gmit_5_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/19/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives: Compare pain intensity at entry into the cervical os, during uterine distension and 15 min after the procedure, in patients undergoing diagnostic hysteroscopy with room temperature normal saline versus that with saline warmed to 38–40°C, using visual analog scale (VAS) score. Furthermore, compare the time taken and failed procedures between them. Materials and Methods: This was a randomized controlled, prospective study conducted at a Tertiary Care Center on 100 patients planned for diagnostic hysteroscopy with a 4 mm 30° hysteroscope using vaginoscopy technique. They were divided into two groups of 50 each, with control undergoing the procedure using normal saline at room temperature and the test with saline warmed to 38–40°C as distension medium. Primary outcomes were VAS at the point of entry into the internal os (T0), 1 min later (T1), and 15 min after the procedure (T15). Secondary outcomes were procedural acceptance, time taken, and failed procedures. Results: The mean VAS in the control group at T0, T1, T15 was 3.31 (1.461;‒0.870–0.245), 2.46 (1.398;‒0.539–0.498), 0.75 (0.911;‒0.379–0.338), respectively, as compared to the test group of 3.62 (1.282;‒0.870–0.245), 2.48 (1.148;‒0.540–0.498), 0.77 (0.911;‒0.379–0.379), respectively. About 73.5% of controls and 68.8% in the test group were willing to undergo the procedure again. About 93.9% of controls would recommend it further as against 93.8% among the test controls. The time taken and number of failed procedures showed no statistical difference. Conclusion: No significant difference was noted in terms of outcomes measured by warming the distension medium.
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9
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Saha SC, Rai R, Bagga R, Jain A, Mukhopadhyay K, Kumar P. Pregnancy Outcome of Rh D Alloimmunized Pregnancies: A Tertiary Care Institute Experience of a Developing Country. J Obstet Gynaecol India 2021; 71:583-590. [PMID: 34898895 DOI: 10.1007/s13224-021-01455-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022] Open
Abstract
Aim To determine the socio-demographic characteristics and pregnancy outcome of Rh D alloimmunized women monitored with MCA PSV (middle cerebral artery peak systolic velocity). Materials and Methods In total, 363 Rh D alloimmunized women attended antenatal clinic or obstetric emergency between January 2006 and December 2014. MCA PSV was the screening method for detection of fetal anemia. Intrauterine blood transfusion (IUT) was given when MCA PSV was > 1.5 MOM. Totally, 162 women (164 fetuses) received 492 transfusions. Forty-eight women had fetal hydrops at presentation. Five women (three received IUT) were lost to follow-up. Pregnancy outcome of 358 women and socio-demographic characteristics of 363 women were analyzed. Results The perinatal mortality was 421, 66 and 87 per 1000 live births in hydrops group, non-hydrops IUT group and non-IUT group, respectively. Conclusion Rh alloimmunization is still a major cause of perinatal morbidity and mortality. The higher gravidity, previous history of pregnancy wastage, still births and hydrops increase the requirement of intrauterine transfusion. MCA PSV is an excellent tool for monitoring of Rh alloimmunized pregnancies to detect fetal anemia. Early detection and monitoring by MCA PSV improve its outcome.
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Affiliation(s)
- Subhas Chandra Saha
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Rakhi Rai
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
- Present Address: Department of Obstetrics & Gynecology, AIIMS, 3rd Floor, Teaching Block, New Delhi, India
| | - Rashmi Bagga
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Ashish Jain
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Kanya Mukhopadhyay
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Praveen Kumar
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Falk GL, Phillips S, Rai R, Corke P. Comment on: Multimodal analgesia with thoracic epidural after transthoracic oesophagectomy: Do we need more evidence? Br J Surg 2021; 108:e387. [PMID: 34418050 DOI: 10.1093/bjs/znab269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/30/2021] [Indexed: 11/14/2022]
Abstract
This article is a response to the publication ‘Comparison of multimodal analgesia with thoracic epidural after transthoracic oesophagectomy’. It discuss the differing outcomes from using this technique in other publications.
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Affiliation(s)
- G L Falk
- Department of Upper Gastro -Intestinal Surgery, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - S Phillips
- University of Sydney, Sydney Adventist Hospital Wahroonga, Sydney, NSW, Australia
| | - R Rai
- Department of Anaesthesia, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - P Corke
- Acute Pain Service, Concord Repatriation General Hospital, Sydney, NSW, Australia
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Noor N, Das A, Roy KK, Bharti J, Nair VG, Rai R. Extraperitoneal Laparoscopy in Severe Intra-abdominal Adhesions: A Safe Alternative to Laparotomy. Gynecol Minim Invasive Ther 2021; 10:181-183. [PMID: 34485066 PMCID: PMC8384020 DOI: 10.4103/gmit.gmit_54_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/09/2020] [Accepted: 10/29/2020] [Indexed: 11/10/2022] Open
Abstract
Surgery in a frozen abdomen can be difficult and dangerous with a significant risk of visceral injuries. We report a case of a 26-year-old lady with chronic pelvic pain diagnosed to have large bilateral adnexal cysts on magnetic resonance imaging with normal tumor markers. She had previous two laparotomies for benign conditions. Laparoscopy was planned, but pneumoperitoneum could not be created due to dense intraperitoneal adhesions. Direct entry was done into the preperitoneal space followed by insufflation of gas in this space. Blunt and sharp dissection of this space was done without breaching the peritoneum to reach the adnexa. The adnexal cyst was found to be encysted collection due to adhesions from previous surgeries. Deroofing was done followed by the visualization of pelvic structures intraperitoneally. Extraperitoneal laparoscopy may be used as a safe alternative to laparotomy in patients with dense intra-abdominal adhesions with the advantage of faster postoperative recovery.
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Affiliation(s)
- Nilofar Noor
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Anamika Das
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Kallol Kumar Roy
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Juhi Bharti
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod G Nair
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Rakhi Rai
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
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Rai R, Patel F, Melana S, Feld J, Navada S, Odchimar-Reissig R, Demakos E, Reddy E, Silverman L. Topic: AS04-MDS Biology and Pathogenesis/AS04f-Gene expression profiling. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106681.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Balfoussia D, Salim R, Rai R. P–635 Standard versus mild ovarian stimulation in women with polycystic ovaries (PCO): Impact on outcomes in subsequent frozen embryo treatment cycles (FET). Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does mild ovarian stimulation in women with PCO result in higher live birth rates during subsequent FET cycles?
Summary answer
Mild ovarian stimulation with FSH doses <150IU did not result in higher clinical pregnancy or livebirth rates in subsequent FET.
What is known already
Ovarian stimulation during IVF in women with PCO is associated with an exaggerated response, ovarian hyperstimulation syndrome, poor egg to follicle ratio, low fertilisation rates and poor blastocyst conversion. Mild ovarian stimulation, often referred to as protocols with FSH doses under 150IU, is often employed to overcome these challenges. One of the perceived benefits of this approach is improved oocyte and embryo quality reflected in lower aneuploidy rates.
Study design, size, duration
This was a retrospective observational study looking at 99 FET between January 2011 and Jan 2021 that followed a fresh cycle in women with a pre-treatment antral follicle count of 12 + 12 or greater. Patients were identified through the antral follicle count at the pre-treatment investigation ultrasound scan. Ultrasound findings, treatment cycle details and clinical outcomes were entered prospectively into a dedicated clinic database. Data was retrieved and analysed using SPSS V25.
Participants/materials, setting, methods
The study was conducted in a large IVF centre. Data on women with an AFC of 12 + 12 or above, undergoing an autologous FET cycle following a fresh cycle were collected. Women were split into those receiving <150IU of FSH (Group1, n = 51) and those receiving FSH ³150 IU (Group 2, n = 48). Binary logistic regression analysis was performed to control for confounders. Live birth was the primary outcome, with biochemical and clinical pregnancy being secondary outcomes.
Main results and the role of chance
Women in Group 1 were younger (30.8±3.6 v 33.8±3.65, p < 0.005) but had a similar antral follicle count (38.2±11.7 v 34.2±9.1, p = 0.07). The total number of eggs collected (24.1±13.8 v 25.9±8.8, p = 0.45) and fertilisation rate (0.59±0.2 v 0.58±0.18, p = 0.77) during their fresh cycle were comparable. Women in Group 2 had a larger number of embryos suitable for cryopreservation (7.36±4.2 v 4.8±3.5, p = 0.001)
In the subsequent frozen embryo replacement cycle, there was no difference in the number or quality of embryos transferred with most women having a single embryo transfer (63% v 48%, p = 0.14) and at least one top quality embryo transferred (68.6% v 81%, p = 0.15). There was a higher biochemical pregnancy rate in Group 1 (84% v 66%, p = 0.035) but with no difference in clinical pregnancy rate (53% v 44%, p = 0.37) or live birth rate (49% v 42%, p = 0.76). Live birth rates remained comparable even after controlling for age, and number and quality of embryos transferred (OR: 1.21 (95% CI 0.50–2.94).
Limitations, reasons for caution
This was a retrospective analysis raising the risk of allocation bias. This study was also at risk of information bias as it relied on accurate documentation of the AFC at the pre-treatment scan.
Wider implications of the findings: Patients can be reassured that both stimulation protocols result in similar live birth rates in subsequent frozen embryo replacement cycles.
Prospective trials using PGT-A are required to assess whether aneuploidy could account for the discrepancy in biochemical pregnancy rates in the two groups considering the subsequent comparable clinical pregnancy rates.
Trial registration number
Not applicable
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Affiliation(s)
- D Balfoussia
- Imperial College Healthcare NHS Trust, Obstetrics and Gynaecology- St Mary’s Hospital, London, United Kingdom
| | - R Salim
- Imperial College Healthcare NHS Trust, Wolfson Fertility Centre, London, United Kingdom
| | - R Rai
- Imperial College Healthcare NHS Trust, Wolfson Fertility Centre, London, United Kingdom
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Roy KK, Gajapathy SR, Rai R, Zangmo R, Das A, Singhal S. Assessment of Tubal Patency with Selective Chromopertubation at Office Hysteroscopy versus Modified Minilaparoscopy in Infertile Women. Gynecol Minim Invasive Ther 2021; 10:159-165. [PMID: 34485060 PMCID: PMC8384029 DOI: 10.4103/gmit.gmit_95_20] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/12/2020] [Accepted: 01/27/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Tubal factor is the leading cause of female infertility. Diagnostic hysterolaparoscopy with chromopertubation plays a pivotal role in its evaluation. Office hysteroscopy (OH) has gained popularity as the outpatient procedure for diagnostic purposes. OH being a less invasive approach, the current study was undertaken to compare the accuracy of assessment of tubal patency with chromopertubation at OH with modified minilaparoscopy in infertile patients. MATERIALS AND METHODS The present study was a pilot study conducted from March 2017 to August 2018. Eighty patients were recruited. OH was done without anesthesia. Diluted methylene blue dye was injected. The eddy current of blue dye, "Visualizable flow" at ostium, and disappearance of blue dye from the uterine cavity through ostium was documented as evidence of patent tubal ostium. In case of tubal occlusion, uterine cavity became blue due to backflow of dye. After OH, minilaparoscopy with chromopertubation was performed under general anesthesia. Both tubes were assessed separately for tubal patency. RESULTS All patients underwent OH followed by minilaparoscopy in the same sitting. OH was 87.5% sensitive with positive predictive value of 95.2%. Compared to minilaparoscopy, OH is 85.6% accurate in predicting tubal patency. The area under receiver operating curve was 0.96 (SE is 0.15 with 95% confidence interval of 0.93-0.99, P < 0.001). It implies that, OH should correctly identify all laparoscopic cases with probability of 0.96. CONCLUSION OH chromopertubation can be used as an alternative to laparoscopy for assessing tubal patency with added advantages of lack of requirement of anesthesia, minimal cost, and better patient acceptance. Moreover, the procedure is less time-consuming and less invasive with high sensitivity and moderate specificity.
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Affiliation(s)
- Kallol Kumar Roy
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | | | - Rakhi Rai
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Rinchen Zangmo
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Anamika Das
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Seema Singhal
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
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Roy KK, Anusha SM, Rai R, Das A, Zangmo R, Singhal S. A Prospective Randomized Comparative Clinical trial of Hysteroscopic Septal Resection Using Conventional Resectoscope Versus Mini-resectoscope. J Hum Reprod Sci 2021; 14:61-67. [PMID: 34083994 PMCID: PMC8057140 DOI: 10.4103/jhrs.jhrs_12_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/04/2020] [Accepted: 01/14/2021] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Hysteroscopic metroplasty (HM) is the gold standard treatment for women with septate uterus with recurrent pregnancy loss. Miniresectoscope requires less cervical dilatation as compared to conventional resectoscope. Very few studies are available in the literature on use of miniresectoscope for operative purpose. AIM OF THE STUDY This study aimed to compare operative and postoperative outcome parameters using conventional versus mini resectoscope (MR) for hysteroscopic septal resection (HSR). STUDY SETTINGS AND DESIGN This was a prospective randomized controlled trial conducted in the Department of Obstetrics and Gynaecology from July 2017 to May 2019. MATERIALS AND METHODS Forty patients fulfilling the inclusion criteria were recruited and randomized into two groups. In Group A (20 patients), HSR was done using conventional resectoscope (CR) and in Group B (20 patients), MR was used. The various parameters recorded were cervical dilatation time, operating time, intraoperative complications, postoperative pain, and hospital stay and reproductive outcome post surgery in both groups. RESULTS Data analysis was carried out using SPSS IBM software version 20.0. The mean operating time was comparable but cervical dilatation time was significantly more in Group A. The duration of hospital stay was significantly less in Group B. There were no differences in adequacy of vision in both the groups but area of field was less in MR group. Four out of nine patients with infertility conceived after surgery. 65% in Group A and 70% in Group B conceived during follow up. CONCLUSION Our study showed that hysteroscopic metroplasty with MR, has comparable efficacy to CR in terms of good vision and septal resectability with added advantages of shorter cervical dilatation time, ease of entry of resectoscope, shorter operative time and significantly reduced postoperative morbidity in terms of less pain. However, the field of vision is less and resection time is more, hence more expertise is required. Further larger randomized trials are required.
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Affiliation(s)
- Kallol Kumar Roy
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - S. M. Anusha
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Rakhi Rai
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Anamika Das
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Rinchen Zangmo
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Seema Singhal
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
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Buckley JG, Dowling JA, Sidhom M, Liney GP, Rai R, Metcalfe PE, Holloway LC, Keall PJ. Pelvic organ motion and dosimetric implications during horizontal patient rotation for prostate radiation therapy. Med Phys 2020; 48:397-413. [PMID: 33151543 DOI: 10.1002/mp.14579] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Gantry-free radiation therapy systems utilizing patient rotation would be simpler and more cost effective than the conventional gantry-based systems. Such a system could enable the expansion of radiation therapy to meet global demand and reduce capital costs. Recent advances in adaptive radiation therapy could potentially be applied to correct for gravitational deformation during horizontal patient rotation. This study aims to quantify the pelvic organ motion and the dosimetric implications of horizontal rotation for prostate intensity-modulated radiation therapy (IMRT) treatments. METHODS Eight human participants who previously received prostate radiation therapy were imaged in a clinical magnetic resonance imaging (MRI) scanner using a bespoke patient rotation system (PRS). The patients were imaged every 45 degrees during a full roll rotation (0-360 degrees). Whole pelvic bone, prostate, rectum, and bladder motion were compared to the supine position using dice similarity coefficient (DSC) and mean absolute surface distance (MASD). Prostate centroid motion was compared in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) direction prior to and following pelvic bone-guided rigid registration. Seven-field prostate IMRT treatment plans were generated for each patient rotation angles under three adaption scenarios: No plan adaption, rigid planning target volume (PTV)-guided alignment to the prostate, and plan re-optimization. Prostate, rectum, and bladder doses were compared for each adaption scenario. RESULTS Pelvic bone motion within the PRS of up to 53 mm relative to the supine position was observed for some participants. Internal organ motion was greatest at the 180-degree PRS couch angle (prone), with prostate centroid motion range < 2 mm LR, 0 mm to 14 mm SI, and -11 mm to 4 mm AP. Rotation with no adaption of the treatment plan resulted in an underdose to the PTV -- in some instances up to 75% (D95%: 78 ± 0.3 Gy at supine to 20 ± 15.0 Gy at the 225-degree PRS couch angle). Bladder dose was reduced during the rotation by up to 98% (V60 Gy: 15.0 ± 9.4% supine to 0.3 ± 0.5% at the 225-degree PRS couch angle). In some instances, the rectum dose increased during rotation (V60Gy: 20.0 ± 4.5% supine to 25.0 ± 15.0% at the 135-degree PRS couch angle). Rigid PTV-guided alignment resulted in PTV coverage which, though statistically lower (P < 0.05 for all D95% values), was within 1 Gy of the supine plans. Plan re-optimization resulted in a statistically equivalent PTV coverage compared to the supine plans (P > 0.05 for all D95% metrics and all within ±0.4 Gy). For both rigid PTV-guided alignment and plan re-optimization, rectum dose volume metrics were reduced compared to the supine position between the 90- and 225-degree PRS couch angles (P < 0.05). Bladder dose volume metrics were not impacted by rotation. CONCLUSION Pelvic bone and internal organ motion are present during patient rotation. Rigid PTV-guided alignment to the prostate will be a requirement if prostate IMRT is to be safely delivered using patient rotation. Plan re-optimization for each PRS couch angle to account for anatomical deformations further improves the PTV coverage.
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Affiliation(s)
- J G Buckley
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - J A Dowling
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- CSIRO Australian eHealth Research Centre, Herston, QLD, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - M Sidhom
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
- Liverpool and Macarthur Cancer Therapy Centre, Sydney, NSW, Australia
| | - G P Liney
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
- Liverpool and Macarthur Cancer Therapy Centre, Sydney, NSW, Australia
| | - R Rai
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Liverpool and Macarthur Cancer Therapy Centre, Sydney, NSW, Australia
| | - P E Metcalfe
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - L C Holloway
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
- Liverpool and Macarthur Cancer Therapy Centre, Sydney, NSW, Australia
- Institute of Medical Physics, University of Sydney, Sydney, NSW, Australia
| | - P J Keall
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- ACRF Image-X Institute, School of Health Sciences, University of Sydney, Sydney, Australia
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Jiji P, Joy T, Murlimanju B, Pai M, Prabhu L, Rai R. An Anatomical Perspective of Ulnar Collateral Nerve with Reference to Nerve and Muscle Transfer Surgery. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.03.2020.23] [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] [Indexed: 11/05/2022]
Affiliation(s)
- P.J. Jiji
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - T. Joy
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - B.V. Murlimanju
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - M.M. Pai
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - L.V. Prabhu
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - R. Rai
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Nair VG, Roy KK, Rai R, Das A, Bharti J, Zangmo R. Effectiveness of Misoprostol in Office Hysteroscopy in Premenopausal Nulliparous Women: A Prospective Randomized Double-Blind Placebo-Controlled Trial. J Hum Reprod Sci 2020; 13:104-109. [PMID: 32792757 PMCID: PMC7394087 DOI: 10.4103/jhrs.jhrs_149_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/19/2020] [Accepted: 04/12/2020] [Indexed: 12/02/2022] Open
Abstract
Study Objective: The objective of this was to evaluate the effectiveness of misoprostol in premenopausal nulliparous women with 200-mcg single vaginal dose 4 h before the procedure. Design: This was a prospective randomized double-blind placebo-controlled trial. Setting: This study was conducted in a tertiary care and academic research center. Patients: One hundred patients were included in the study: 50 in misoprostol group and 50 in placebo. Interventions: Patients underwent office hysteroscopy 4 h after vaginal application of misoprostol or placebo. Measurements and Main Results: Ease of doing hysteroscopy was significantly better in the misoprostol group (difficulty score: 2.74 ± 1.20) as compared to placebo (difficulty score: 4.20 ± 1.10), P = 0.001. The time taken for negotiating the internal os (cervical passage time) was found to be significantly shorter in the misoprostol group (6.20 ± 5.21 s) as compared to placebo (14.78 ± 11.84 s), P = 0.001. The overall Visual Analog Scale (VAS) score was significantly lower in the intervention group (2.64 ± 1.62) as compared to placebo (4.90 ± 1.90), P = 0.001. Moreover, the VAS score at the point of passing internal os was significantly lower in the misoprostol group (2.82 ± 1.39) as compared to placebo (4.94 ± 1.96), P = 0.001. Misoprostol had a significant positive effect on satisfaction level of patients; 76% (n = 38) of women in the misoprostol group expressed their willingness to undergo the procedure again if required versus 18% (n = 9) in placebo, P = 0.001. Furthermore, 78% (n = 39) of women in the misoprostol group would recommend the procedure to their friends and relatives versus 36% (n = 18) in placebo, P = 0.001. Conclusion: Preoperative cervical preparation with 200 mcg of misoprostol vaginal application 4 h before office hysteroscopy in premenopausal nulliparous women significantly reduces the difficulty encountered in negotiating the cervical canal. Further, it significantly reduces the pain experienced by the patient at the point of passage through internal os as well as throughout the entire procedure.
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Affiliation(s)
- Vinod G Nair
- Department of Obstetrics and Gynaecology, Division of Minimally Invasive Gynaecological Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kallol Kumar Roy
- Department of Obstetrics and Gynaecology, Division of Minimally Invasive Gynaecological Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Rakhi Rai
- Department of Obstetrics and Gynaecology, Division of Minimally Invasive Gynaecological Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Anamika Das
- Department of Obstetrics and Gynaecology, Division of Minimally Invasive Gynaecological Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Juhi Bharti
- Department of Obstetrics and Gynaecology, Division of Minimally Invasive Gynaecological Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Rinchen Zangmo
- Department of Obstetrics and Gynaecology, Division of Minimally Invasive Gynaecological Surgery, All India Institute of Medical Sciences, New Delhi, India
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Essel K, Benbrook D, Rai R, Chandra V. Sulforaphane as a Potential Therapeutic for Endometrial Cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rai R, Tonse M, Rai A, Dass P, Janardhanan J. A study on perforating peroneal artery. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.01.2020.15] [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] [Indexed: 11/05/2022]
Affiliation(s)
- R. Rai
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - M. Tonse
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - A.R. Rai
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - P.M. Dass
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - J.P. Janardhanan
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
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Jameson M, Martin P, Aly F, Koh E, Rai R, Estall V, Liney G, Metcalfe P, Holloway L. OC-024: Changes in brain tumour perfusion and diffusion characteristic during treatment. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(20)30430-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rai R, Bansal N. Correlation between Vitamin D and Carotid Artery Intima Media Thickness in Patients with Ischemic Stroke. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Buckley JG, Rai R, Liney GP, Dowling JA, Holloway LC, Metcalfe PE, Keall PJ. Anatomical deformation due to horizontal rotation: towards gantry-free radiation therapy. ACTA ACUST UNITED AC 2019; 64:175014. [DOI: 10.1088/1361-6560/ab324c] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Tang S, Koh E, Rai R, Otton J, Tran D, Delaney G, Holloway L, Schmitt B, Liney G. EP-1333 Myocardial changes detected using Cardiac MRI in left breast patients treated with Radiation. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31753-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Femia G, Pender P, Tang S, Koh E, Delaney G, Thomas L, Holloway L, Rai R, Liney G, Otton J. Effects of Breast Radiotherapy on Right Ventricular Systolic Function. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tang S, Otton J, Koh E, Rai R, Delaney G, Tran D, Thomas L, Holloway L, Liney G. Longitudinal Results of Cardiac MRI Left Ventricular Mapping Following Tangential Left Breast Radiotherapy. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thapa BD, Regmi MC, Rai R. Risk Factors for Adverse Outcome in Pregnant Women with Obstructed Labor. Nepal j obstet gynaecol 2018. [DOI: 10.3126/njog.v13i1.21614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: The aim of the study was to assess the risk factors for adverse outcomes in pregnancy with obstructed labor.Methods: It was a prospective descriptive study conducted at BP Koirala Institute of Health sciences (BPKIHS).The patients with obstructed labour were managed and followed up until delivery and six weeks postpartum from Jan to Dec 2012.Results: There were 57 (0.6%) cases of obstructed labour out of 9500 deliveries. The main cause was cephalopelvic disproportion in 36 (63.2%). The majority of the cases were from rural areas, low socioeconomic status, non salaried and illiterate. Risk for maternal mortality, peripartum hysterectomy and perinatal mortality as adverse outcomes was significantly associated with low socioeconomic status (AOR 12.5, P=0.02) and literacy status (AOR 21.9, P=0.001). If only the risk of perinatal mortality is taken as an adverse outcome, it is significantly associated with booking status (AOR 7, P=0.001), low socioeconomic status (AOR 9.62, P=0.037) and literacy of the patient (AOR 15, P=0.001). Perinatal mortality rate was 100 per 1000 live births in women with obstructed labour. The case fatality rate was 1.2%.
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Tang S, Koh E, Rai R, Otton J, Herschtal A, Tran D, Delaney G, Holloway L, Thomas L, Schmitt B, Liney G, Ananthapadmanachan S. Changes in Cardiac MRI Derived Left Ventricular Segmental Strain in Left Sided Breast Cancer Patients Treated with Tangential Radioation Therapy Alone Correlated with Dose. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pant A, Kumar R, Wani NA, Verma S, Sharma R, Pande V, Saxena AK, Dixit R, Rai R, Pandey KC. Allosteric Site Inhibitor Disrupting Auto-Processing of Malarial Cysteine Proteases. Sci Rep 2018; 8:16193. [PMID: 30385827 PMCID: PMC6212536 DOI: 10.1038/s41598-018-34564-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 10/16/2018] [Indexed: 02/08/2023] Open
Abstract
Falcipains are major haemoglobinases of Plasmodium falciparum required for parasite growth and development. They consist of pro- and mature domains that interact via 'hot-spot' interactions and maintain the structural integrity of enzyme in zymogen state. Upon sensing the acidic environment, these interactions dissociate and active enzyme is released. For inhibiting falcipains, several active site inhibitors exist, however, compounds that target via allosteric mechanism remains uncharacterized. Therefore, we designed and synthesized six azapeptide compounds, among which, NA-01 & NA-03 arrested parasite growth by specifically blocking the auto-processing of falcipains. Inhibitors showed high affinity for enzymes in presence of the prodomain without affecting the secondary structure. Binding of NA-03 at the interface induced rigidity in the prodomain preventing structural reorganization. We further reported a histidine-dependent activation of falcipain. Collectively, for the first time we provide a framework for blocking the allosteric site of crucial haemoglobinases of the human malaria parasite. Targeting the allosteric site could provide high selectivity and less vulnerable to drug resistance.
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Affiliation(s)
- A Pant
- ICMR-National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
- Department of Biotechnology, Kumaun University, Nainital, Uttarakhand, India
| | - R Kumar
- Integrated Science Lab, Umeå University, Umeå, Sweden
| | - N A Wani
- Medicinal Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - S Verma
- ICMR-National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
- Department of Biotechnology, Kumaun University, Nainital, Uttarakhand, India
| | - R Sharma
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - V Pande
- Department of Biotechnology, Kumaun University, Nainital, Uttarakhand, India
| | - A K Saxena
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - R Dixit
- ICMR-National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - R Rai
- Medicinal Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India
| | - K C Pandey
- ICMR-National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India.
- Department of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, MP - 462001, India.
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Liney GP, Dong B, Weber E, Rai R, Destruel A, Garcia-Alvarez R, Manton DJ, Jelen U, Zhang K, Barton M, Keall P, Crozier S. Imaging performance of a dedicated radiation transparent RF coil on a 1.0 Tesla inline MRI-linac. ACTA ACUST UNITED AC 2018; 63:135005. [DOI: 10.1088/1361-6560/aac813] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Oar A, Rai R, Jameson M, Deshpande S, Liney G, Juresic E, Veneran J, Dinsdale G, Elwadia D, Kumar S, Lee M. OC-0295: The feasibility of volumetric 4DMRI in upper abdominal radiation therapy treatment planning. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30605-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bhatta RD, Rijal P, Pradhan T, Chhetri S, Rai R, Uprety DK. A Profile of Patients with Molar Pregnancy. Nepal j obstet gynaecol 2017. [DOI: 10.3126/njog.v11i2.17461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: This study was done to determine the incidence, modes of presentation and prognosis of molar pregnancy at B. P. Koirala Institute of Health Sciences.Methods: This was a prospective study done among patients with molar pregnancy admitted at BPKIHS from January 2010 to January 2011. The study was conducted after ethical clearance from Institutional Ethical Review Board of BPKIHS. Written informed consent was taken for enrollment in the study. Baseline information like age, address, race and patient’s presenting complaints, period of gestation and serial serum beta human chorionic gonadotropin (βhCG) were collected and analyzed after entering in excel sheet.Results: Total 48 cases of molar pregnancy were diagnosed during the study period. The incidence of molar pregnancy was found to be 5.58 per 1000 deliveries. The most common mode of presentation was per vaginal bleeding i.e. in 64.58% of cases. Majority of the patients were in the age group of 20-34 years (62.5%). Mean time for normalization of βhCG after suction evacuation was 10.19 weeks.Conclusions: Molar pregnancy is a pregnancy related problem which most commonly presents with per vaginal bleeding during first and second trimester. Most of the patients are treated with suction and evacuation but some develop persistent gestational trophoblastic disease.
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Nguyen K, Min M, Holloway L, Jameson M, Rumley C, Fowler A, Lee M, Forstner D, Rai R, Liney G. PO-0615: Can diffusion-weighted MRI predict for xerostomia and QoL in head and neck patients receiving RT? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31052-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Liney GP, Dong B, Begg J, Vial P, Zhang K, Lee F, Walker A, Rai R, Causer T, Alnaghy SJ, Oborn BM, Holloway L, Metcalfe P, Barton M, Crozier S, Keall P. Technical Note: Experimental results from a prototype high-field inline MRI-linac. Med Phys 2017; 43:5188. [PMID: 27587049 DOI: 10.1118/1.4961395] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The pursuit of real-time image guided radiotherapy using optimal tissue contrast has seen the development of several hybrid magnetic resonance imaging (MRI)-treatment systems, high field and low field, and inline and perpendicular configurations. As part of a new MRI-linac program, an MRI scanner was integrated with a linear accelerator to enable investigations of a coupled inline MRI-linac system. This work describes results from a prototype experimental system to demonstrate the feasibility of a high field inline MR-linac. METHODS The magnet is a 1.5 T MRI system (Sonata, Siemens Healthcare) was located in a purpose built radiofrequency (RF) cage enabling shielding from and close proximity to a linear accelerator with inline (and future perpendicular) orientation. A portable linear accelerator (Linatron, Varian) was installed together with a multileaf collimator (Millennium, Varian) to provide dynamic field collimation and the whole assembly built onto a stainless-steel rail system. A series of MRI-linac experiments was performed to investigate (1) image quality with beam on measured using a macropodine (kangaroo) ex vivo phantom; (2) the noise as a function of beam state measured using a 6-channel surface coil array; and (3) electron contamination effects measured using Gafchromic film and an electronic portal imaging device (EPID). RESULTS (1) Image quality was unaffected by the radiation beam with the macropodine phantom image with the beam on being almost identical to the image with the beam off. (2) Noise measured with a surface RF coil produced a 25% elevation of background intensity when the radiation beam was on. (3) Film and EPID measurements demonstrated electron focusing occurring along the centerline of the magnet axis. CONCLUSIONS A proof-of-concept high-field MRI-linac has been built and experimentally characterized. This system has allowed us to establish the efficacy of a high field inline MRI-linac and study a number of the technical challenges and solutions.
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Affiliation(s)
- G P Liney
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia; Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia; School of Medicine, University of New South Wales, Sydney NSW 2170, Australia; and Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia
| | - B Dong
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia
| | - J Begg
- Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia
| | - P Vial
- Radiation Physics & Liverpool Cancer Therapy Centre, Liverpool, NSW 2170, Australia and Radiation Physics Laboratory, Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - K Zhang
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia
| | - F Lee
- Radiation Physics Laboratory, Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - A Walker
- Medical Physics, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia and Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia
| | - R Rai
- Medical Physics, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia and Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia
| | - T Causer
- Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia
| | - S J Alnaghy
- Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia
| | - B M Oborn
- Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia and Illawarra Cancer Care Centre, Wollongong Hospital, NSW 2500, Australia
| | - L Holloway
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia; Radiation Physics, Liverpool Cancer Therapy Centre, Liverpool NSW 2170, Australia; School of Medicine, University of New South Wales, Sydney NSW 2170, Australia; Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia; and Radiation Physics Laboratory, Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - P Metcalfe
- Centre for Medical Radiation Physics, University of Wollongong, NSW 2522, Australia
| | - M Barton
- Department of Medical Physics, Ingham Institute for Applied Medical Research, Liverpool NSW 2170, Australia and School of Medicine, University of New South Wales, Sydney NSW 2170, Australia
| | - S Crozier
- School of Information Technology & Electrical Engineering, University of Queensland, Brisbane, QLD 4072, Australia
| | - P Keall
- Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney NSW 2170, Australia
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Bagga R, Rai R, Kalra J, Saha PK, Singh T. An Unusual Cause of Postabortal Fever Requiring Prompt Surgical Intervention: A Pyomyoma and its Imaging Features. Oman Med J 2017; 32:73-76. [PMID: 28042408 PMCID: PMC5187398 DOI: 10.5001/omj.2017.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 08/25/2015] [Accepted: 03/02/2016] [Indexed: 11/03/2022] Open
Abstract
Pyomyoma is an unusual complication of leiomyoma, occurring most commonly in the postpartum, postabortal, and post-menopausal periods. It develops due to infection in necrotic foci within leiomyoma, which is more common during pregnancy due to rapid growth, and in postmenopausal women due to vascular insufficiency. Other contributing factors are curettage, gynecological surgery, cervical stenosis, immunodeficiency, and recently, uterine artery embolization. It presents with a typical triad of sepsis, leiomyoma, and absence of any apparent source of infection. We report a case of persistent postabortal fever in a 26-year-old female due to a pyomyoma, which resolved after a myomectomy. Pyomyoma may become life threatening in the event of intraperitoneal rupture resulting in pyoperitoneum and septic shock. Hence, gynecologists should consider this diagnosis in women with a leiomyoma and sepsis in the absence of any apparent source of infection.
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Affiliation(s)
- Rashmi Bagga
- Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakhi Rai
- Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jasvinder Kalra
- Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pradip K Saha
- Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tulika Singh
- Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Rijal P, Pradhan T, Agrawal A, Rai R, Bhatta R, Chhetri S. Assessment of Risk Factors, Feasibility and Acceptability of VIA for Cervical Cancer Screening and Prevention. Nepal j obstet gynaecol 2016. [DOI: 10.3126/njog.v11i1.16289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims – To assess feasibility of visual inspection with acetic acid and treatment with cryotherapy for cervical cancer screening and prevention and assess risk factors for cervical cancer in the screened population.Methods – A prospective analysis of all patients enrolled for cervical cancer screening by visual inspection, meeting the eligibility criteria for screening and treatment as per national guidelines 2011 was analyzed form March 2012 to April 2013.Results – A total of 4138 met the eligibility criteria and were counseled for screening, 33 rejected for screening. Out of 4105 screened 241 were visual inspection with acetic acid positive, 211 were treated with cryotherapy, 25 treated with LEEP, 5 rejected to treatment. Mean age of patient in year’s ± SD 41.48 ± 9.72. The visual inspection with acetic acidpositivity rate was 5.9 %Conclusion – Single visit approach is a feasible and acceptable form of cervical cancer screening strategy in our population.
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Guest J, Rai R, Cartwright E. Do coinfection patients with HIV/HCV respond differently to new hepatitis C treatments than HCV monoinfected patients? Data from HAVACS and the Atlanta Veterans Affairs Medical Center. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tallawi M, Dippold D, Rai R, D'Atri D, Roether J, Schubert D, Rosellini E, Engel F, Boccaccini A. Novel PGS/PCL electrospun fiber mats with patterned topographical features for cardiac patch applications. Materials Science and Engineering: C 2016; 69:569-76. [DOI: 10.1016/j.msec.2016.06.083] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/24/2016] [Accepted: 06/25/2016] [Indexed: 10/21/2022]
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39
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Ipsen S, Blanck O, Lowther NJ, Liney GP, Rai R, Bode F, Dunst J, Schweikard A, Keall PJ. Towards real-time MRI-guided 3D localization of deforming targets for non-invasive cardiac radiosurgery. Phys Med Biol 2016; 61:7848-7863. [DOI: 10.1088/0031-9155/61/22/7848] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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40
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Park J, Parakh S, Mendis S, Rai R, Lo S, Haydon A, Andrews M, Cebon J, Guminski A, Kefford R, Long G, Menzies A, Klein O, Carlino M. Efficacy of anti-PD-1 therapy in patients with melanoma brain metastases. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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42
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Keall P, Dong B, Vial P, Walker A, Zhang K, Begg J, Rai R, Holloway L, Barton M, Crozier S, Liney G. TH-AB-BRA-12: Experimental Results From the First High-Field Inline MRI-Linac. Med Phys 2016. [DOI: 10.1118/1.4958064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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43
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Ganesan B, Prakasarao A, Palraj T, Rai R, Singaravelu G. SU-F-T-473: Evaluation of Off-Axis And Peripheral Dose Using Different Detectors. Med Phys 2016. [DOI: 10.1118/1.4956658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ganesan B, Prakasarao A, Palraj T, Rai R, Singaravelu G. SU-F-T-474: Evaluation of Dose Perturbation, Temperature and Sensitivity Variation With Accumulated Dose of MOSFET Detector. Med Phys 2016. [DOI: 10.1118/1.4956659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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45
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De Leon J, Rivest-Henault D, Keats S, Jameson M, Rai R, Arumugam S, Wilton L, Ngo D, Martin J, Sidhom M, Holloway L. PV-0328: Rectal immobilisation device in stereotactic prostate treatment: intrafraction motion and dosimetry. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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46
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Rai R, Saha SC, Jain A, Bagga R, Kumar P, Marwaha N. Anti-M Alloimmunization in Pregnancy: An Unusual Cause of Bad Obstetric History. J Obstet Gynaecol India 2016; 66:607-609. [PMID: 27803521 DOI: 10.1007/s13224-015-0822-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/23/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Rakhi Rai
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Subhas Chandra Saha
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashish Jain
- Department of Blood Transfusion, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rashmi Bagga
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Praveen Kumar
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Neelam Marwaha
- Department of Blood Transfusion, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Rohilla M, Rai R, Yanamandra U, Chaudhary N, Malhotra P, Varma N, Jain V, Prasad GRV, Kalra J, Varma SC. Obstetric Complications and Management in Chronic Myeloid Leukemia. Indian J Hematol Blood Transfus 2016; 32:62-6. [PMID: 26855508 PMCID: PMC4733674 DOI: 10.1007/s12288-015-0519-0] [Citation(s) in RCA: 8] [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: 01/23/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022] Open
Abstract
Chronic myeloid leukaemia (CML) is amongst the most common haematological malignancies encountered in adults. The younger age of onset and increased incidence of CML in Indians leads to higher chances of encountering it in pregnancy. Pregnancy in CML is a complex situation as first line therapy with tyrosine kinase inhibitors (TKI), is fraught with multiple fetal safety issues. The fetal aspects have been elucidated in literature, but there is scarcity of information on the obstetric outcome per se in presence of CML, excluding the influence of TKI. Obstetric outcomes of 5 pregnancies in four patients with CML are being reported. Literature on interplay of CML and bleeding or thrombotic manifestations is reviewed. The major complications encountered were antepartum (APH) and postpartum haemorrhage (PPH), preterm labour, intrauterine growth retardation and intrauterine fetal death. Patients in the reproductive age group with diagnosis of CML should be carefully counseled regarding the effect of disease and TKI on the maternal-fetal health. Bleeding complications, particularly APH and PPH may be encountered in CML patients. Close coordination of the obstetrician, haematologist, and neonatologist is required in managing these cases successfully. The need for absolute contraception till the remission of disease needs to be emphasized for further pregnancies.
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Affiliation(s)
- Minakshi Rohilla
- />Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - Rakhi Rai
- />Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - Uday Yanamandra
- />Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - Neelam Chaudhary
- />Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - Pankaj Malhotra
- />Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - Neelam Varma
- />Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - Vanita Jain
- />Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - G. R. V. Prasad
- />Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - Jasvinder Kalra
- />Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
| | - Subhash C. Varma
- />Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh (U.T.), India
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Rai R, Zhang F, Colavita K, Leu NA, Kurosaka S, Kumar A, Birnbaum MD, Győrffy B, Dong DW, Shtutman M, Kashina A. Arginyltransferase suppresses cell tumorigenic potential and inversely correlates with metastases in human cancers. Oncogene 2015; 35:4058-68. [PMID: 26686093 PMCID: PMC4916053 DOI: 10.1038/onc.2015.473] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 11/09/2015] [Accepted: 11/14/2015] [Indexed: 02/07/2023]
Abstract
Arginylation is an emerging post-translational modification mediated by arginyltransferase (ATE1) that is essential for mammalian embryogenesis and regulation of the cytoskeleton. Here, we discovered that Ate1-knockout (KO) embryonic fibroblasts exhibit tumorigenic properties, including abnormally rapid contact-independent growth, reduced ability to form cell-cell contacts and chromosomal aberrations. Ate1-KO fibroblasts can form large colonies in Matrigel and exhibit invasive behavior, unlike wild-type fibroblasts. Furthermore, Ate1-KO cells form tumors in subcutaneous xenograft assays in immunocompromised mice. Abnormal growth in these cells can be partially rescued by reintroduction of stably expressed specific Ate1 isoforms, which also reduce the ability of these cells to form tumors. Tumor array studies and bioinformatics analysis show that Ate1 is downregulated in several types of human cancer samples at the protein level, and that its transcription level inversely correlates with metastatic progression and patient survival. We conclude that Ate1-KO results in carcinogenic transformation of cultured fibroblasts, suggesting that in addition to its previously known activities Ate1 gene is essential for tumor suppression and also likely participates in suppression of metastatic growth.
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Affiliation(s)
- R Rai
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - F Zhang
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Molecular & Cellular Pharmacology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - K Colavita
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - N A Leu
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - S Kurosaka
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - A Kumar
- Department of Molecular & Cellular Pharmacology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M D Birnbaum
- Department of Molecular & Cellular Pharmacology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - B Győrffy
- MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary.,Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - D W Dong
- Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M Shtutman
- University of South Carolina, Columbia, SC, USA
| | - A Kashina
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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49
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Rai R, Sikka P, Aggarwal N, Shankaregowda SA. Gangrenous Cystitis in A Woman Following Vaginal Delivery: An Uncommon Occurrence - A Case Report. J Clin Diagn Res 2015; 9:QD13-4. [PMID: 26676158 DOI: 10.7860/jcdr/2015/12676.6822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 08/07/2015] [Indexed: 11/24/2022]
Abstract
Gangrenous cystitis is now a rare condition with the advent of antibiotics and better obstetric services. It has a multifactorial causation manifesting as urosepsis or peritonitis. We report a case of 24-year-old lady who presented at day 12 postpartum with abdominal distension and vomitings. History of prolonged labour was present. Peritoneal tap was suggestive of pyoperitoneum. Hence she was taken up for emergency laparotomy and incidentally found to have bladder necrosis. Partial cystectomy was done and patient was discharged in a satisfactory condition after 2 weeks.
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Affiliation(s)
- Rakhi Rai
- Research Officer, Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research , Chandigarh, India
| | - Pooja Sikka
- Assistant Professor, Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research , Chandigarh, India
| | - Neelam Aggarwal
- Associate Professor, Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research , Chandigarh, India
| | - Sriharsha Ajjur Shankaregowda
- Senior Resident, Department of Urology, Postgraduate Institute of Medical Education and Research , Chandigarh, India
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50
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Madeddu D, Falco A, Frati C, Graiani G, Gervasi A, Lorusso B, Rosellini E, Rai R, Boccaccini A, Lagrasta C, Quaini F. Assessment of cardiac patches suitability for tissue engineering. Vascul Pharmacol 2015. [DOI: 10.1016/j.vph.2015.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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