Browsing by Author "Deepak Singh Patel"

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Case-control Association Study of TLR4 (rs 1927914) Polymorphism with the Risk of Low Birth Weight and Fetal Growth Restriction in North Indian Women
(Jaypee Brothers Medical Publishers (P) Ltd, 2022) Anupama; Uma Pandey; Kiran Singh; Deepak Singh Patel
Background: Compared to newborns of normal birth weight at term gestation, the mortality and morbidity rates for low birth weight (LBW) and fetal growth restriction (FGR) babies are absurdly high. This is because these babies are more vulnerable to infections. Aims and objectives: To study the association of toll-like receptor (TLR) 4 gene T>C (rs 1927914) polymorphism with the risk of LBW and FGR at term gestation in north Indian women. Materials and methods: One hundred and eighty-two pregnant women (50 LBW and 32 FGR cases and 100 controls), 18–45 years of age, who attended the antenatal clinic or labor room were studied. We studied different maternal factors like maternal height, body mass index, number of antenatal visits, pre-pregnancy weight, and weight gain during pregnancy. In newborns, parameters like birth weight, gender, Apgar score after 1 and 5 minutes, NICU admission, and different anthropometric data were assessed. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was studied to analyze the single-nucleotide polymorphism of TLR4 (rs1927914) T>C. Results: There was no significant association between TLR4 (rs 1927914) T>C polymorphism and risk of LBW and FGR. Genotype, TC, and CC of TLR4 T>C polymorphism showed a slight increase in the risk of LBW (p = 0.38). Conclusions: The present study suggests that several inter-related factors increase the risk of LBW and FGR. The complex interplay and co-existence of many maternal and fetal factors are the leading cause of the increased risk of LBW and intrauterine growth restriction. Early prediction, identification of these risk factors, and proper management may prevent infant morbidities. © The Author(s). 2022.
Prediction of response to radiotherapy in locally advanced carcinoma cervix using multiparametric MRI: A prospective, single-center, longitudinal study
(John Wiley and Sons Inc, 2023) Ashish Verma; Ishan Kumar; Deepak Singh Patel; Ritika Ranjan; Munendra Singh; Satyajeet Pradhan; Ram Chandra Shukla
Purpose: To evaluate the possible role of a multiparametric magnetic resonance imaging (MRI) and semiquantitative fusion map for the prediction of response to radiotherapy in carcinoma cervix. Methods: This was a prospective, single-center, longitudinal observational study performed on patients with locally advanced carcinoma cervix. Relative blood flow (rBF), relative blood volume (rBV), and apparent diffusion coefficient (ADC) values were obtained before and after the onset of radiotherapy. rBV, rBF, and ADC values were used to generate a semiquantitative pharmacokinetic model map to identify any hypoxic component of the tumor. The subjects were retrospectively classified as responders and nonresponders based on response to treatment. Prospective prediction of response status was done using pretreatment multiparametric MRI parameters (rBF, rBV, and ADC) and semiquantitative parametric map. Results: In 32 patients (29 with parametrial involvement and 15 with lymphadenopathy), pretreatment ADC of the primary tumor was the most accurate measure for predicting response to treatment as well as for treatment-induced fractional volume reduction. Although rBV and rBF were insignificant metrics in isolation for predicting response status, a combination with ADC in the form of parametric map had a sensitivity of 86.4% and 77.2%, specificity of 70% and 70%, positive predictive value of 86.4% and 85%, and negative predictive value 70% and 59% respectively by two independent observers. Conclusion: ADC is the most accurate measure for predicting the response to treatment. A manual parametric map generated by an off-line fusion of the above map with those generated by pharmacokinetic modeling of perfusion-weighted MRI may be a useful tool for the prediction of response to radiotherapy. © 2022 John Wiley & Sons Australia, Ltd.