Browsing by Author "Manjari Matah"

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Abdominal scar endometriosis after caesarean section: A rare entity
(Australasian Medical Journal Pty Ltd, 2011) Ruchi Sinha; Mohan Kumar; Manjari Matah
Scar endometriosis is an uncommon entity. It is often misdiagnosed leading to unnecessary referrals. Gynaecologists and general surgeons must be aware of this entity to avoid discomfort to the patient due to delay in diagnosis. We are presenting a case of scar endometriosis which was misdiagnosed initially. Detailed history of cyclic pain and swelling was the key point for the final diagnosis of scar endometriosis. Medical therapy was ineffective. Surgical excision of mass was the treatment for endometriotic lesion. This article is an attempt to create awareness of this condition among gynaecologists and general surgeons.
Comparative accuracy of magnetic resonance morphometry and sonography in assessment of post-cesarean uterine scar
(Wolters Kluwer Medknow Publications, 2018) Gayatri Satpathy; Ishan Kumar; Manjari Matah; Ashish Verma
Objective: To compare the diagnostic accuracy of magnetic resonance imaging (MRI) with that of ultrasonography (USG) for the measurement of lower segment cesarean scar during trial of labor after cesarean (TOLAC). Materials and Methods: This was a prospective case-control observational study conducted with a cohort of 30 participants being considered for TOLAC but eventually proceeding to lower segment cesarean section (LSCS) at a university-based teaching institute over a period of 2 years. Measurement of scar thicknesses were done by MRI and USG preoperatively and validated by surgical findings. Comparison of diagnostic accuracy as well as the cut-off values (to differentiate a normal scar from an abnormal scar) was done between the two modalities. Results: Insignificant systematic error between the measurements obtained by the two modalities was noted by a Bland-Altmann analysis. The diagnostic accuracy of USG for differentiating a normal from an abnormal uterine scar was 96.7% while that of MRI was at a slightly lower level of 90%. A strong level of agreement between the two modalities was observed. Conclusion: MRI offers no advantage in diagnostic accuracy for the measurement of LSCS scar thickness during consideration of TOLAC. Advances in Knowledge: Measurement of uterine scar by MRI has a good correlation with that done on USG in the setting of post-cesarean pregnancy. The results hold good both for normal (grades 1 and 2) and abnormal (grades 3) scars. MRI, however, does not offer any added advantage over sonographic scar thickness measurement for the differentiation of a normal (grades 1 and 2) from an abnormal (grade 3) scar. © 2018 Indian Journal of Radiology and Imaging | Published by Wolters Kluwer - Medknow.
Detection of HPV by PCR-A novel step in the prevention of cancer cervix
(2012) Manjari Matah; Sweta Sareen
Objectives (1) To compare the efficacy of Pap smear and HPV PCR for detection of CIN; and (2) To study the distribution of HPV genotypes. Methods One hundred women presenting at the female Outpatient Department with unhealthy cervices were subjected to a detailed history, clinical examination, Pap smear, HPV DNA PCR test, and colposcopic-directed biopsy (where indicated). Results This study has shown that there is a strong association of HPV infection with higher grades of CIN (100 % in patients with CIN 2, CIN 3, and CIS). The detection of CIN by HPV PCR was more accurate than by Pap smear. The most prevalent HPV genotype found in our study was HPV 16. Conclusion The advent ofHPVtesting has opened the doors for more accurate cervical cancer surveillance strategies than Pap smear. Early detection and treatment of CIN will considerably reduce the incidence of cervical cancer. © Federation of Obstetric & Gynecological Societies of India 2012.
Hospital based prospective longitudinal clinical and immunologic study of 179 patients of primary anti-phospholipid syndrome
(2013) Nand K. Singh; Dibya R. Behera; Ankit Agrawal; Mahendra Narayan Singh; Vikash Kumar; Manoj Godhra; Anurag Gupta; Devesh P. Yadav; Usha Singh; Lakshmi Kant Pandey; Manjari Matah
Aim: To study the clinical and immunological features of primary antiphospholipid syndrome (APS), and to analyze the differences between primary APS and APS associated with autoimmune rheumatic disease (ARD/APS). Methods: This prospective, longitudinal study, carried out from December 2004 to July 2011 included 179 patients with primary APS and 52 patients of ARD/APS diagnosed as per modified 2006 Sapporo's Criteria. Results: Out of 179 patients of primary APS, 12 were male and 167 were female. The mean age at the time of study entry was 27 ± 4.33 years. Venous thrombosis was noted in 33 (18.43%) patients. Seventeen patients had deep vein thrombosis and 11 (7.19%) had cortical vein and/or cortical sinus thrombosis. Arterial thrombosis was noted in 19 (10.61%) patients, out of which nine had intracranial arterial thrombosis. Thirty-two (17.85%) had recurrent early fetal losses (< 10 weeks) and 97 (54.18%) had late fetal loss (> 10 weeks). Immunoglobulin G (IgG) and IgM aCLA were present in 141 (78.77%) and 32 (17.87%) patients respectively, whereas lupus anticoagulant was present in 99 (55.3%) patients. In patients with bad obstetric outcome, lupus anticoagulant positivity was significantly more prevalent (P < 0.05) than aCLA positivity. Both venous and arterial thrombosis were significantly more common (P < 0.05) in ARD/APS. However, late fetal loss was significantly more prevalent (P < 0.001) in primary APS. Conclusion: Primary APS may lead to a variety of clinical manifestations due to venous and/or arterial thrombosis, which at times may be lethal. It is also an important cause of early and late pregnancy loss(es) and other pregnancy morbidities. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
Role of -460 C/T VEGF gene polymorphism in preeclampsia
(Elsevier (Singapore) Pte Ltd, 2013) Surbhi Roy; Manjari Matah; Deepika Jaiswal; Kiran Singh
Objective: To study association of VEGF-460C>T functional polymorphism with preeclampsia. Methods: The case-control study comprised of two groups: 40 pre-eclamsia patients and 45 healthy antenatal women. Genotyping for SNP-460 VEGF was done by ARMS-PCR method. For VEGF-460C>T functional polymorphism, allele and genotype distribution were evaluated using Chi-square test. Results: The prevalence of C allele was higher among cases compared to controls. The prevalence of CT and CC genotypes were also higher among cases compared to controls indicating that CT and CC genotypes and C allele to have a role in genetic susceptibility for preeclampsia. Conclusions: The carriage of VEGF-460C allele appears to be a risk factor for preeclampsia in present pilot study. © 2013 Hainan Medical College.
Utility of multiparametric MRI in Caesarean section scar characterization and preoperative prediction of scar dehiscence: A prospective study
(SAGE Publications Inc., 2017) Ishan Kumar; Ashish Verma; Manjari Matah; Gayatri Satpathy
Background Post-Caesarean uterine scar rupture during vaginal birth after Caesarean section (VBAC) is a potentially life-threatening complication. Prediction of scar dehiscence and scar rupture is vital in treatment planning and selecting candidates of trial of labor after a Caesarean section (CS). Purpose To assess the accuracy of magnetic resonance imaging (MRI) for evaluation of post-Caesarean uterine scar and to predict scar dehiscence during repeat CS. Material and Methods Thirty patients with a history of at least one previous CS underwent pelvic MRI for assessment of uterine scar during a subsequent gestation, all of whom underwent lower segment Caesarean section (LSCS) subsequently due to one of the established indications of CSs. Thickness, T1, T2 signal intensity ratio (SER), and apparent diffusion coefficient (ADC) value of scar site were charted. The lower uterine segment was assessed and graded intraoperatively and findings were correlated with MRI findings. Results A total of 30 participants were included in this study, of which nine were classified as having an abnormal scar (of various grades) based on surgical observations. T2 SER with a cutoff value of 0.935 showed the highest sensitivity of 100% and scar thickness value of 3.45 mm showed highest specificity of 91% in prediction of abnormal scar. On drawing a receiver operating characteristic (ROC) curve, T2 signal intensity ratio showed the highest area under the curve (AUC) closely followed by scar thickness values. Conclusion MRI derived parameters may be utilized for differentiation of an abnormal post-Caesarean uterine scar from a normal one. Both scar thickness and T2 SER measured on MRI can be used to predict scar dehiscence. However, T2 SER can serve as a more standardized and objective criterion. © 2017 The Foundation Acta Radiologica.