Browsing by Author "Bajarang Bahadur"

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Comparative analysis of simultaneous integrated boost and sequential boost radiotherapy in node-positive cervical cancer: dosimetric and radiobiological considerations
(Springer Science and Business Media Deutschland GmbH, 2024) Ritusha Mishra; Shreya Singh; Ganesh Patel; Abhijit Mandal; Himanshu Mishra; Ankita Pandey; Bajarang Bahadur; Pramod Kumar Singh; Shikha Sachan; Mallika Tewari
For locally advanced cervical cancer, the standard therapeutic approach involves concomitant chemoradiation therapy, supplemented by a brachytherapy boost. Moreover, an external beam radiotherapy (RT) boost should be considered for treating gross lymph node (LN) volumes. Two boost approaches exist with Volumetric Intensity Modulated Arc Therapy (VMAT): Sequential (SEQ) and Simultaneous Integrated Boost (SIB). This study undertakes a comprehensive dosimetric and radiobiological comparison between these two boost strategies. The study encompassed ten patients who underwent RT for cervical cancer with node-positive disease. Two sets of treatment plans were generated for each patient: SIB-VMAT and SEQ-VMAT. Dosimetric as well as radiobiological parameters including tumour control probability (TCP) and normal tissue complication probability (NTCP) were compared. Both techniques were analyzed for two different levels of LN involvement – only pelvic LNs and pelvic with para-aortic LNs. Statistical analysis was performed using SPSS software version 25.0. SIB-VMAT exhibited superior target coverage, yielding improved doses to the planning target volume (PTV) and gross tumour volume (GTV). Notably, SIB-VMAT plans displayed markedly superior dose conformity. While SEQ-VMAT displayed favorable organ sparing for femoral heads, SIB-VMAT appeared as the more efficient approach for mitigating bladder and bowel doses. TCP was significantly higher with SIB-VMAT, suggesting a higher likelihood of successful tumour control. Conversely, no statistically significant difference in NTCP was observed between the two techniques. This study’s findings underscore the advantages of SIB-VMAT over SEQ-VMAT in terms of improved target coverage, dose conformity, and tumour control probability. In particular, SIB-VMAT demonstrated potential benefits for cases involving para-aortic nodes. It is concluded that SIB-VMAT should be the preferred approach in all cases of locally advanced cervical cancer. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
Epidemiology of disability and access to disability support and rehabilitation services in India: A secondary data analysis of the National Sample Survey (2018)
(BMJ Publishing Group, 2025) Moonis Mirza; Vandana Esht; Madhur Verma; Bajarang Bahadur; Ajit Kumar Jaiswal; Manoj Alagarajan; Rajesh Kakkar
Objective The aim of this study was to examine the epidemiology of disability in India and assess access to disability support and rehabilitation services by people with disability (PWD). Design This study is a secondary analysis of data from the 76th round of the National Sample Survey (2018), focusing on disability in India. Setting The survey employed a stratified two-stage sampling design based on Census 2011, covering all states and union territories of India. Villages and urban blocks were selected in the first stage, while households were chosen in the second stage across rural and urban areas. Participants The survey included data from a population of 576 796 individuals residing in 118 152 households from 8992 village/urban blocks (5378 rural villages and 3614 urban blocks). The analysis focused on 107 125 individuals (61 707 male and 45 305 female) who reported at least one disability. Outcome measures The primary outcome was € any disability'. Secondary outcomes included access to disability support and rehabilitation services, which assessed difficulties in accessing public buildings and transport, loss of employment after disability, availability of government support, enrolment in special schools, and possession of a disability certificate. Results The overall weighted disability prevalence was 2.2%, with significant disparities across sociodemographic characteristics. Among PWD, 45.9% of those who acquired disability after birth were aged between 15 years and 59 years, and 20.8% received no government aid. About 40% of PWD struggled to use public transport, and 57.7% had difficulties accessing public buildings. Additionally, 60.7% reported job loss due to disability, and 69.6% lacked a disability certificate. Conclusion This study highlights disparities faced by PWD in accessing disability support and rehabilitation services. There is an urgent need for concerted efforts to minimise such experiences. This will help us enhance the well-being and participation of PWD and empower them to contribute to society with their true potential. © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
Psychological distress in women with primary and secondary infertility: a comparative analysis of depression, anxiety, and stress
(Frontiers Media SA, 2025) Shraddha Chaurasiya; Royana Singh; Bajarang Bahadur; Surbhi Singh; Varsha Maurya; Sangeeta Rai
Background: Polycystic Ovary Syndrome (PCOS) and Recurrent Pregnancy Loss (RPL) are reproductive disorders frequently linked to psychological distress. This study compared the severity of depression, anxiety, and stress levels between women with PCOS and RPL and assessed their association with years of marriage. Materials and methods: A cross-sectional study conducted a random sampling method on 157 women (PCOS: 70; RPL: 87) attending the Obstetrics and Gynecology OPD at IMS BHU, Varanasi. Psychological status was assessed using the DASS-21 scale, a reliable tool widely used in reproductive health research. Chi-square test and independent sample t-tests were used for statistical analysis. Results: Mean scores were significantly higher in RPL than in PCOS: depression (10.7 ± 3.5 vs. 8.8 ± 4.3, p = 0.003), anxiety (13.3 ± 3.8 vs. 10.7 ± 5.5, p = 0.001), and stress (12.3 ± 4.4 vs. 10.3 ± 6.1, p = 0.007). Marriage duration was significantly longer among women with severe depression (RPL: 8.4 ± 5.2 yrs.; PCOS: 6.3 ± 3.1 yrs), anxiety (RPL: 8.6 ± 5.1 yrs.; PCOS: 7.1 ± 3.3 yrs), and stress (RPL: 9.0 ± 5.2 yrs.; PCOS: 6.3 ± 3.1 yrs), all p < 0.05. Age was higher in RPL patients (p = 0.024); LH was higher in PCOS (p = 0.000). No significant differences were observed in AMH or BMI. Psychological symptoms were more severe among women with RPL, and a longer duration of marriage was associated with greater symptom severity. Marriage duration was significantly higher in women classified with severe depression, anxiety, and stress based on DASS-21 scores, indicating a correlational rather than causal relationship. Conclusion: Routine psychological assessment is recommended for women with PCOS and RPL. Early identification of psychological distress may help improve overall reproductive and emotional health outcomes in these patients. © © 2025 Chaurasiya, Singh, Bahadur, Singh, Maurya and Rai.
Spatial heterogeneity study of early child marriages before and after implementation of prohibition of Child Marriage Act (2006) in India: Evidence from NFHS
(Universidade Federal de Lavras -Departamento de Estatistica, 2025) Bajarang Bahadur; Anuj Singh; Jagriti Gupta
Despite numerous laws, rights, and well-known health concerns, child marriage remains to be prevalent in developing countries such as India. This practice is fueled by a complex interaction of social and normative attitudes and values that are understated in national and even state-level assessments of child marriage drivers. This study aims to assess the spatial pattern and associated factors of early-marriage before and after Prohibition of Child Marriage Act in Indian districts among reproductive aged women. Univariate and Bivariate analysis, Multiple logistic regression, Moran’s I Statistics and Regression analysis (OLS and Spatial Error/Lag Model) were carried out for the analysis of data in our study. The data came from the fourth round of the National Family Health Survey (2015-16).This study finds wide inter districts heterogeneity in levels of child marriage, one decade before and after prohibition of child marriage across India. The prevalence of child marriage has substantially declined (nearly 21%) after implementation of prohibition of child marriage act. Bivariate Moran’s I value for rural was found to be highest 0.76 and 0.72 before and after implemented act respectively suggesting high spatial auto-correlation of early-marriages in the rural-districts of India. The findings of this study show that the prevalence of child marriage has substantially declined after implementation of child marriage act but this declining trend of child marriage has been accompanied by many factors apart from enforcement of laws against child marriage practice. Furthermore, future child marriage programs and policies should take into account improving economic status, enhancing female sovereignty and marital decision-making in the home, as well as the geographic, social, and normative aspects of the local community. © Brazilian Journal of Biometrics.