Browsing by Author "Sakshi Agarwal"

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A Comparison Between Intravesical Gemcitabine Plus Docetaxel and Intravesical Bacillus Calmette-Guérin in the Treatment of Nonmuscle Invasive Naive Urinary Bladder Cancer: A Systematic Review and Meta-analysis of Oncological Outcomes
(2025) Rachana Tripathy; Lalit Kumar; Sakshi Agarwal; Anuja Thakur; Mahesh R. Khairnar; Sameer Trivedi; Satya Narayan Sankhwar
This study evaluated the efficacy, recurrence rates, and safety of intravesical gemcitabine plus docetaxel compared to standard Bacillus Calmette-Guérin (BCG) therapy for treating naïve non-muscle-invasive bladder cancer (NMIBC), with a focus on reducing recurrence and progression concerns associated with transurethral resection (TURBT). A systematic review and meta-analysis of three original studies were conducted, assessing recurrence rates and safety profiles. The meta-analysis revealed no heterogeneity in recurrence rates between the gemcitabine plus docetaxel and BCG groups, with an overall Odds Ratio for recurrence of 0.72 (95% CI: 0.36-1.47). Although the clinical recurrence rate was slightly lower in the gemcitabine plus docetaxel group, the difference was not statistically significant (Z = 0.89, P = 0.37). The gemcitabine plus docetaxel group experienced fewer severe side effects compared to the BCG group. Due to the limited number of studies available, further randomized trials are necessary to confirm the role of intravesical gemcitabine plus docetaxel in NMIBC management. © © 2025 Elsevier Inc. All rights reserved.
A Comparison Between Intravesical Gemcitabine Plus Docetaxel and Intravesical Bacillus Calmette-Guérin in the Treatment of Nonmuscle Invasive Naive Urinary Bladder Cancer: A Systematic Review and Meta-analysis of Oncological Outcomes
(Elsevier Inc., 2025) Rachana Tripathy; Lalit Kumar; Sakshi Agarwal; Anuja Thakur; Mahesh R. Khairnar; Sameer Trivedi; Satya Narayan Sankhwar
This study evaluated the efficacy, recurrence rates, and safety of intravesical gemcitabine plus docetaxel compared to standard Bacillus Calmette-Guérin (BCG) therapy for treating naïve non-muscle-invasive bladder cancer (NMIBC), with a focus on reducing recurrence and progression concerns associated with transurethral resection (TURBT). A systematic review and meta-analysis of three original studies were conducted, assessing recurrence rates and safety profiles. The meta-analysis revealed no heterogeneity in recurrence rates between the gemcitabine plus docetaxel and BCG groups, with an overall Odds Ratio for recurrence of 0.72 (95% CI: 0.36–1.47). Although the clinical recurrence rate was slightly lower in the gemcitabine plus docetaxel group, the difference was not statistically significant (Z = 0.89, P = 0.37). The gemcitabine plus docetaxel group experienced fewer severe side effects compared to the BCG group. Due to the limited number of studies available, further randomized trials are necessary to confirm the role of intravesical gemcitabine plus docetaxel in NMIBC management. © 2025 Elsevier Inc.
Assessing the clinical efficacy of neoadjuvant intravesical Mitomycin C in naïve non-muscle invasive urinary bladder cancer: A systematic review and meta-analysis
(Elsevier Inc., 2025) Anuja Thakur; Lalit Kumar; Sakshi Agarwal; Rachana Tripathy; Yashasvi Singh; Sameer Trivedi; Ujwal Kumar
Background and Objective: Naïve non-muscle invasive bladder cancer (NMIBC) is commonly treated with transurethral resection (TURBT), but recurrence and progression remain concerns. This meta-analysis, the first we have conducted on this topic, compared recurrence and progression rates between patients treated with neoadjuvant Mitomycin C (MMC) and the control group (TURBT alone). Methods: Relevant articles were identified and appraised through a structured literature assessment. Databases searched included PubMed, Medline, Scopus, and Science Direct. Duplicate publications, book sections, conference papers, encyclopedias, case reports, magazine articles, presentations, theses, protocols, systematic reviews, and meta-analyses were excluded. Heterogeneity was assessed using the I2. Key findings and limitations: The meta-analysis evaluated recurrence rates, progression rates, and adverse events. No heterogeneity was observed (I2=0 %). The pooled odd ratio (OR) for recurrence was 2.554 (95 % CI: 1.637-3.986), indicating a significant decrease in recurrence for the MMC group (P < 0.001). For progression rates, the overall pooled OR was 1.508 (95 % CI: 0.832-2.734), suggesting that the MMC group showed a lower progression rate. However, this difference was not statistically significant (P = 0.176).Adverse events varied, with the MMC group showing fewer cases of hematuria (8.4 % vs. 34 %) but more irritative bladder symptoms. Conclusions and Clinical Implications: The meta-analysis suggests lower recurrence and progression rates in the neoadjuvant MMC group compared to the control group. Both groups experienced a comparable range of adverse events, suggesting that both treatment approaches exhibit a similar safety profile. Larger and more randomized controlled trials (RCT) are needed to confirm MMC's effectiveness in NIMBC treatment and establish its role in clinical practice. © 2025 Elsevier Inc.
Association of intronic variants (Apal and Bsml) of vitamin D receptor gene with uterine leiomyoma among North Indian women
(Elsevier B.V., 2025) Sonal Tiwari; Rakesh Kumar Gupta; Sakshi Agarwal; Amita Diwakar; Arun K. Bind; Pawan Kumar Dubey
Background: Understanding the genetic factors involved in the Uterine Leiomyoma (UL) development is crucial for exploring the complexities of UL disorders. This study aimed to examine genetic association between UL incidence and intronic polymorphisms of vitamin D receptor gene in north Indian population. Methodology: Total 200 subjects (100 healthy women and 100 with uterine leiomyomas) of age- and gender-matched control subjects, were genotyped for BsmI (rs1544410) and ApaI (rs7975232) polymorphisms in the VDR gene using TETRA ARMS PCR, followed by Sanger sequencing validation. Levels of VDR mRNA and vitamin D were also assessed through quantitative real-time PCR and ELISA respectively. The association of these variants with leiomyomas was analyzed, along with clinico-pathological (obesity) association. Results: ApaI revealed a significant association with UL, especially for the TG genotype (OR = 2.38; 95 % CI, 1.26–––4.51; p = 0.003). In a similar manner, ApaI is associated with an increased risk for UL with all three genetic models. Comparing VDR ApaI polymorphism between obese and non-obese patients revealed that AC genotype was significantly (OR = 3.71; 95 % CI, 1.53––9.11; p = 0.002) associated with a reduced risk of UL in non-obese patients. The expression of VDR mRNA was two times lower in patients with UL (p < 0.001), along with decreased serum vitamin D levels (p < 0.001). A significant association was also observed between VDR ApaI variant with reduced mRNA expression, vitamin D level and obesity. However, no associations were observed among Bsm1 VDR genotypes and ULs. Conclusion: This study found significant association between the VDR intronic ApaI polymorphism (rs7975232) and the incidence of UL. This VDR variant showed significant association with reduced VDR mRNA expression and serum vitamin D levels in UL patients. However, no significant association was observed between BsmI VDR polymorphism (rs1544410) and UL in North Indian women. © 2025 Elsevier B.V.
Buccal versus Vaginal Graft Urethroplasty in Female Urethral Stricture: A Systematic Review and Meta-Analysis
(Springer Nature, 2025) Lalit Kumar; Anuja Thakur; Sakshi Agarwal; Mahesh R. Khairnar; Sameer Trivedi; Satya Narain Shankhwar
Introduction and Hypothesis: This study is aimed at comparing success rate, maximum flow rate (Qmax), and post-void residual volume (PVR) between the buccal mucosal graft (BMG) and vaginal wall graft (VWG) through a meta-analysis of studies commonly performed by urogynecologists. Methods: A systematic review was performed in April 2024, including retrospective, prospective, and comparative studies excluding duplicates, review, editorial comments, case reports, systematic reviews, meta-analyses, and therapeutic indications. Heterogeneity in the meta-analysis was assessed using I2 statistics. Results: The meta-analysis incorporated a quantitative assessment of 18 original articles. The studies in meta-analysis evaluated various parameters, including Qmax, PVR, and success rates of surgical outcomes. The I2 statistics indicated no heterogeneity in Qmax and success rates between BMG and VWG, both with I2 = 0% and high heterogeneity for PVR values (I2 > 50%). According to the results, Qmax values were 23.266 for BMG and 24.945 for VWG, PVR values were 14.651 for BMG and 23.009 for VWG, and success rates were 86.2% for BMG and 89.8% for VWG. A definition of success across the studies was established by achieving Qmax > 15 ml/s at 3 months, a PVR < 30 ml, and an improvement in the American Urological Association symptom scores. Conclusions: Meta-analysis indicates no significant differences between VWG and BMG regarding Qmax, PVR, and the overall success rate of surgical outcomes. Both BMG and VWG graft options demonstrate effectiveness in female urethroplasty. Graft choice should be based on graft availability and feasibility, patient characteristics, and the surgeon’s preference and expertise. © The Author(s), under exclusive license to International Urogynecological Association 2025.
Comparative evaluation of conventional and socket-shield techniques on maxillary esthetics following immediate implant placement in fresh extraction sockets: A randomized controlled trial
(Wolters Kluwer Medknow Publications, 2024) Farhan Durrani; Aishwarya Pandey; Shweta Ahlawat; Ekta Kumari; S. U. Gokila Vani; Sakshi Agarwal; P. G. Naveen Kumar
Background: Dental implants in fresh extraction sockets of the maxillary esthetic area are technique-sensitive procedures where retaining a buccal root segment can enhance periodontium preservation and esthetics. This study aims to compare marginal bone levels and esthetic outcomes between conventional immediate implant placement and the socket-shield technique in fresh maxillary extraction sockets. Materials and Methods: Twenty-four patients with type 1 extraction sockets were included in this randomized trial and assigned to either conventional immediate implant placement or the socket-shield technique. Implant survival, crestal bone levels, and pink esthetic scores (PES) were evaluated at 8 months (temporary prosthesis), 12 months, and 36 months (final crowns). Results: All implant-supported restorations were successful within the study's observation period. The socket-shield technique showed significantly lower marginal bone loss (e.g. 1.40 ± 0.29 mm vs. 1.70 ± 0.36 mm at 36 months; P = 0.040) and superior PES (e.g., 10.50 ± 0.90 vs. 9.36 ± 0.98 at 36 months; P = 0.008) compared to the conventional technique. However, the technique's complexity underscores the need for expertise and careful execution to optimize tissue preservation in the maxillary esthetic zone. Conclusion: The socket-shield technique better preserves hard and soft tissues around implant-retained prostheses than conventional implant placement in maxillary esthetic regions. Further studies with larger sample sizes and longer follow-up are required to validate these findings. © 2025 Indian Society of Periodontology.
COMPARING THE EFFICACY OF OSSEODENSIFICATION OVER CONVENTIONAL DRILLING TECHNIQUE ON IMPLANT STABILITY AND BONE DENSITY IN LOW BONE DENSITY SITES: A SYSTEMATIC REVIEW AND META-ANALYSIS
(Elsevier Inc., 2025) Shraddha Shilpi; Monika Bansal; Mahesh R. Khairnar; Gokila Vani Su; Zainab Akram; Rashika M; Sakshi Agarwal
Purpose of the research: To assess the efficacy of osseodensification (OD) over conventional drilling technique (CD) on implant stability and bone density in low bone density sites. Materials and methods: An electronic and manual search were conducted to analyze the effect of OD over CD technique on implant stability and bone density in human-based randomized controlled trials (RCTs) and nonrandomized controlled trials (NRCTs). The risk of bias was assessed using (RoB 2.0) and (ROBINS-I) tools for RCTs and NRCTs respectively. The meta-analysis was applied with RevMan 5.4, using the random-fixed effects model. Heterogeneity was assessed by a Q test and quantified with I2 statistics. Results: Our literature search identified 1454 publications, of which only 6 met all the inclusion criteria. The meta-analysis of the included studies showed that the implant stability quotient (ISQ) was greater in OD than in the CD group without being statistically significant both immediately and at the follow-up period after implant placement, with a standardized mean difference of 2.13 [95%CI = −0.08, 4.35] with P = .06 and 1.81 [95%CI = −0.41, 4.03] with P = .11 respectively. The difference in bone density in the OD compared to the CD group was statistically significant, immediately after implant placement with a standardized mean difference of 2.14 [95%CI = 0.68, 3.59] with P = .004 and nonsignificant at 3 to 7 months with a standardized mean difference of 1.54 [95%CI = −0.34, 3.43] with P = .11. Conclusion: The findings of the present review and meta-analysis show that dental implants placed using the OD technique reveal greater implant stability and improved bone density in areas with low bone density compared to the CD technique. However, more clinical studies are needed to validate the findings. © 2025 Elsevier Inc.
Comparison of intravaginal and interstitial brachytherapy in cervical cancer after inadvertent hysterectomy: a retrospective study
(Nature Research, 2025) Sunil Choudhary; Ankita Pandey; Ankita Singh; Ankur Mourya; Neha Gupta; Syed Mohamed Shajid; Gogul Priean Venkatachalam; Sangita Rai; Sakshi Agarwal; P. Venkatraman; Lalit Mohan Mohan Aggarwal
The purpose of this study was to compare intravaginal brachytherapy (IVBT) with interstitial brachytherapy (ISBT) in patients presenting with residual or recurrent disease after inadvertent hysterectomy for cervical cancer. Records of consecutive patients with cervical cancer, registered in the Radiotherapy Outpatient Department (RTOPD) between March 2018 and March 2021, who had inadvertent hysterectomy followed by external beam radiotherapy (EBRT) and IVBT (n = 15) or ISBT (n = 15) were analyzed retrospectively. All the patients received a dose of 45–50 Gy/25 fractions in 5 weeks by EBRT with concurrent cisplatin. A dose of 6 Gy/fraction/week for two consecutive weeks was prescribed at 5 mm from the surface of the vaginal cylinder in the IVBT arm. Patients in the ISBT arm were treated with 6 Gy/fraction for four fractions over two days with Martinez Universal Perineal Interstitial Template (MUPIT). Overall survival (OS) and disease-free survival (DFS) were the primary endpoints. Acute and late toxicities were the secondary endpoints. Median follow-up (FU) was 24.3 months and 32.8 months in the IVBT and ISBT arms respectively. Most of the patients failed within 12–18 months after brachytherapy. The 3-year OS for IVBT and ISBT arms were 54% and 93% respectively (p = 0.011). The 3-year DFS for IVBT and ISBT arms were 42% and 93% respectively(p = 0.023). Both the arms had similar acute & late toxicities. ISBT had significantly better survival outcomes in terms of OS, and DFS with similar toxicity as compared to IVBT in patients with residual or recurrent disease after inadvertent hysterectomy for cervical cancer. © The Author(s) 2025.
Deciphering the landscape of triple negative breast cancer from microenvironment dynamics and molecular insights to biomarker analysis and therapeutic modalities
(John Wiley and Sons Inc, 2024) Harshita Tiwari; Swati Singh; Sonal Sharma; Priyamvada Gupta; Ashish Verma; Amrit Chattopadhaya; Brijesh Kumar; Sakshi Agarwal; Rajiv Kumar; Sanjeev Kumar Gupta; Vibhav Gautam
Triple negative breast cancer (TNBC) displays a notable challenge in clinical oncology due to its invasive nature which is attributed to the absence of progesterone receptor (PR), estrogen receptor (ER), and human epidermal growth factor receptor (HER-2). The heterogenous tumor microenvironment (TME) of TNBC is composed of diverse constituents that intricately interact to evade immune response and facilitate cancer progression and metastasis. Based on molecular gene expression, TNBC is classified into four molecular subtypes: basal-like (BL1 and BL2), luminal androgen receptor (LAR), immunomodulatory (IM), and mesenchymal. TNBC is an aggressive histological variant with adverse prognosis and poor therapeutic response. The lack of response in most of the TNBC patients could be attributed to the heterogeneity of the disease, highlighting the need for more effective treatments and reliable prognostic biomarkers. Targeting certain signaling pathways and their components has emerged as a promising therapeutic strategy for improving patient outcomes. In this review, we have summarized the interactions among various components of the dynamic TME in TNBC and discussed the classification of its molecular subtypes. Moreover, the purpose of this review is to compile and provide an overview of the most recent data about recently discovered novel TNBC biomarkers and targeted therapeutics that have proven successful in treating metastatic TNBC. The emergence of novel therapeutic strategies such as chemoimmunotherapy, chimeric antigen receptor (CAR)-T cells-based immunotherapy, phytometabolites-mediated natural therapy, photodynamic and photothermal approaches have made a significant positive impact and have paved the way for more effective interventions. © 2024 Wiley Periodicals LLC.
Deciphering the landscape of triple negative breast cancer from microenvironment dynamics and molecular insights to biomarker analysis and therapeutic modalities
(John Wiley and Sons Inc, 2025) Harshita Tiwari; Swati Singh; Sonal Sharma; Priyamvada K. Gupta; Ashish Verma; Amrit Chattopadhaya; Brijesh Kumar; Sakshi Agarwal; Rajiv Kumar; Sanjeev Kumar Gupta; Vibhav Gautam
Triple negative breast cancer (TNBC) displays a notable challenge in clinical oncology due to its invasive nature which is attributed to the absence of progesterone receptor (PR), estrogen receptor (ER), and human epidermal growth factor receptor (HER-2). The heterogenous tumor microenvironment (TME) of TNBC is composed of diverse constituents that intricately interact to evade immune response and facilitate cancer progression and metastasis. Based on molecular gene expression, TNBC is classified into four molecular subtypes: basal-like (BL1 and BL2), luminal androgen receptor (LAR), immunomodulatory (IM), and mesenchymal. TNBC is an aggressive histological variant with adverse prognosis and poor therapeutic response. The lack of response in most of the TNBC patients could be attributed to the heterogeneity of the disease, highlighting the need for more effective treatments and reliable prognostic biomarkers. Targeting certain signaling pathways and their components has emerged as a promising therapeutic strategy for improving patient outcomes. In this review, we have summarized the interactions among various components of the dynamic TME in TNBC and discussed the classification of its molecular subtypes. Moreover, the purpose of this review is to compile and provide an overview of the most recent data about recently discovered novel TNBC biomarkers and targeted therapeutics that have proven successful in treating metastatic TNBC. The emergence of novel therapeutic strategies such as chemoimmunotherapy, chimeric antigen receptor (CAR)-T cells-based immunotherapy, phytometabolites-mediated natural therapy, photodynamic and photothermal approaches have made a significant positive impact and have paved the way for more effective interventions. © 2024 Wiley Periodicals LLC.
Effects of endometriosis, fibroids, and other pathological conditions on muscular contractions in the human fallopian tube
(Oxford University Press, 2025) Richa S. Singh; Sakshi Agarwal; Parul Sharma; Sanjeev Kumar Mahto
Background: Ectopic pregnancy and tubal endometriosis directly affect the fallopian tube structure and function, while ovarian cysts and uterine fibroids may indirectly influence tubal physiology. These conditions are associated with infertility, but their impact on fallopian tube mechanical contractions remains unclear. This study aimed to assess the effects of these pathologies on fallopian tube contractility. Method: Ampulla samples were obtained from women undergoing salpingectomy for benign causes. Based on the menstrual phases, samples were divided into two groups: proliferative (normal proliferative, tubal endometriosis, ovarian cysts, and uterine fibroids) and secretory (normal secretory and ectopic pregnancy). Normal proliferative considered control for the proliferative group, while normal secretory for the ectopic pregnancy. Contractile parameters, maximum contractile force, basal tone, frequency, and amplitude were measured using an isometric force transducer, while in another set of experiments; the oxytocin doses (1 and 10 μM) response was assessed. Smooth muscle organization and structural changes were analyzed through hematoxylin and eosin staining. Result: Compared to the normal proliferative, the tubal endometriosis and ovarian cysts groups showed significantly lower maximum contractile force, basal tone, frequency, and amplitude, along with damaged smooth muscle layers, while uterine fibroids showed decreased frequency and amplitude, with organized muscle structure. Ectopic pregnancy showed higher maximum contractile force and basal tone than normal secretory, with increased frequency and amplitude and disorganized smooth muscle. Oxytocin increased contractility at 1 μM and reduced it at 10 μM in most groups. Conclusion: This study demonstrated that fallopian tube contractions and tissue structure were differentially affected across groups, with increased contractility observed in the ectopic pregnancy group and reduced contractility in the uterine fibroids, ovarian cysts, and tubal endometriosis groups. © The Author(s) 2025. Published by Oxford University Press on behalf of the Society for the Study of Reproduction. All rights reserved.
Genetic association of vitamin D receptor polymorphisms (ApaI, BsmI, and FokI) with gestational diabetes mellitus in North Indian women: a case–control study
(BioMed Central Ltd, 2025) Rakesh Kumar Gupta; Sonal Tiwari; Sakshi Agarwal; Amita Diwakar; Pawan Kumar Dubey
Background: Gestational diabetes mellitus (GDM) affects nearly 14% of pregnancies and imposes an increased risk of adverse outcomes for both pregnant women and their developing babies. This study examined the genetic association of vitamin D receptor (VDR) variants (ApaI, BsmI, and FokI) with GDM in the North Indian population. Methods: Tetra-ARMS PCR was used for genotyping of VDR variants followed by Sanger sequencing validation. The genotypes of VDR variants, Odds ratio (OR) and confidence interval (CI) were further analyzed in GDM and determined by different genetic models. Results: The C allele of ApaI (rs7975232) genotype significantly associated with increased risk of GDM compared to the TT genotype carrying pregnant women. The A allele of BsmI, and A allele of FokI genotypes was found as a risk factor for GDM. Sanger sequencing confirmed the changes in ApaI (T/C), BsmI (A/G), and FokI (A/G) gene sequence which linked to GDM. The circulatory vitamin D3 levels were significantly lower in GDM patients whereas, homozygous genotypes of ApaΙ (CC, P < 0.0884), BsmI (GG, P < 0.8192) and FokI (GG, P < 0.0303) was associated with vitamin D deficiency. On other hand, mother age, blood glucose and glycated haemoglobin (HbA1c) were significantly higher in the GDM group vs. the control group. Conclusion: VDR ApaI (rs7975232) and FokI (rs2228570) polymorphisms, HbA1c level, and vitamin D are associated with the risk of GDM in the north Indian population. Considering the impact of vitamin D3 level, it is suggested that pregnant Indian women must consider vitamin D supplementation during pregnancy. © The Author(s) 2025.
Genetic variants related to insulin metabolism are associated with gestational diabetes mellitus
(Elsevier B.V., 2024) Ravi Bhushan; Shafiul Haque; Rakesh Kumar Gupta; Anjali Rani; Amita Diwakar; Sakshi Agarwal; Anima Tripathi; Pawan K. Dubey
The current study sought to investigate the associations of common genetic risk variants with gestational diabetes mellitus (GDM) risk in the north Indian population and to evaluate their utility in identifying GDM cases. A case-control study, including 300 pregnant women, was included, and clinical and pathological information was collected. The amplification-refractory mutation system (ARMS) was used for genotyping four single nucleotide polymorphisms (SNPs), namely FTO (rs9939609), PPARG2 (rs1801282), SLC30A8 (rs13266634), and TCF7L2 (rs12255372). The odds ratio and confidence interval were determined for each SNP in different genetic models. Further, attributable risk, population penetrance, and relative risk were also calculated. The risk allele A of FTO (rs9939609) poses a two times higher risk of GDM (p = 0.02, OR = 2.5). The CG and GG genotypes of PPARG2 (rs1801282) have half a lower risk of GDM. In SLC30A8 (rs13266634), the recessive model analysis showed a two times higher risk of having GDM, while the recessive model (TT vs. GG + GT) analysis in TCF7L2 (rs12255372) indicates a lower risk of GDM. Finally, the relative risk, population penetrance, and attributable risk for risk allele in all four variants was higher in GDM mothers. All four polymorphisms were found to be significantly associated with BMI, HbA1c, and insulin. Our study first time confirmed a significant association with GDM for four variants, FTO, PPARG2, SLC30A8, and TCF7L2, in the North Indian population. © 2024 Elsevier B.V.
Oviduct contractility in non-pregnant rats: changes in estrous cycle and effects of estrogen and progesterone antagonists
(BioScientifica Ltd., 2025) Richa S. Singh; Parul Sharma; Shristi Modanwal; Himanshu Ranjan; Amaresh Kumar Singh; Sakshi Agarwal; Sanjeev Kumar Mahto
This study aimed to systematically characterize oviduct contractility across the estrous cycle and to examine the regulatory roles of estradiol and progesterone using receptor antagonists and molecular docking to explore both receptor-mediated and ion channel pathways. Female Wistar rats (n = 48) were used for this purpose. Oviducts were collected during proestrus, estrus, metestrus, and diestrus, and spontaneous contractions were recorded using an isometric force transducer. Serum levels of estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, and prolactin were measured through enzyme-linked immunosorbent assay (ELISA). To understand hormonal regulation, tamoxifen (10 mg/kg) was administered during proestrus, and mifepristone (5 mg/kg) was administered during metestrus. Immunofluorescence (IF) study was performed to evaluate expression of the estrogen, progesterone, and glucocorticoid receptors (ER, PR, and GR). Molecular docking analysis assessed interactions of the antagonists with estrogen and progesterone receptors and ion channels. Oviduct contractility was observed noticeably highest during proestrus (high estradiol) and lowest in metestrus and diestrus phases (high progesterone). Tamoxifen significantly reduced contraction parameters (P < 0.001) and estradiol levels, while mifepristone notably increased contraction force (P < 0.01), elevated estradiol levels (P < 0.001), and decreased the proportion of progesterone hormone. The IF study indicated suppression of ER, PR, and GR expression following treatment with mifepristone. Docking analysis revealed that tamoxifen interacted with potassium channels and ERβ, while mifepristone showed high affinity for PR, GR, and calcium channels. These findings highlight that oviduct contractility is dynamically regulated across the estrous cycle through both receptor-mediated and potential non-receptor and non-genomic pathways involving ion channels. © 2025 the author(s)
Peri-Implant Esthetics in Focus: Comparing Anodized Titanium and Zirconium Dioxide Abutments in a Randomized Clinical Trial
(John Wiley and Sons Inc, 2025) Sakshi Agarwal; Farhan Durrani; Aishwarya Pandey; M. Rashika; Shraddha Shilpi; Dhanraj Meena
Objective: Achieving optimal esthetics remains challenging due to limited comparative evidence between pink-anodized titanium and zirconium dioxide abutments. The objective of this clinical study was to evaluate the optical outcomes of pink-anodized titanium and zirconium dioxide abutments in the esthetic region. Methods: Twenty-two subjects with an edentulous site in the maxillary esthetic region with a tooth present mesially and distally were selected for implant surgery along with hard and soft tissue augmentation. Group A received a pink-anodized titanium abutment with a layered lithium disilicate single crown. Group B received a zirconium dioxide abutment with the same prosthesis material. The contralateral natural tooth served as the control group. Optical outcomes were assessed using a spectrophotometer. The CIELAB color coordinates (Commission Internationale de l'Eclairage) were recorded to calculate ΔE values. Vernier calipers, along with an endodontic file, were used to measure the peri-implant soft tissue thickness. The Pink Esthetic Score (PES) was evaluated using digital images of 22 single-tooth implant crowns to assess the surrounding soft tissue esthetics. Results: Zirconia abutments (Group A) demonstrated superior optical outcomes compared to pink-anodized titanium abutments (Group B). The ΔE values for Group A at the peri-implant soft tissue, coronal, and midfacial crown levels were significantly lower compared to Group B. Soft tissue thickness (STT) increased over time in both groups, with a slight increase in Group B. The Pink Esthetic Score (PES) also improved with recall visits at each evaluation. Conclusion: Zirconia abutments provided superior esthetic outcomes compared to pink-anodized titanium abutments, with significantly lower color differences (ΔE) and higher Pink Esthetic Scores (PES). Although pink-anodized titanium abutments showed increased soft tissue thickening with time, zirconia abutments remained the more favorable option for esthetically demanding cases. Clinical Trials Registry: (CTRI No. CTRI/2024/03/064442). © 2025 Wiley Periodicals LLC.
Periodontal and prosthetic perspective of implant-supported full-arch prostheses with monolithic zirconia and porcelain fused metal restorative materials: A three-year retrospective case series
(Wolters Kluwer Medknow Publications, 2025) Farhan Durrani; Aishwarya Pandey; Rashika Muralisekar; Sakshi Agarwal; Shraddha Shilpi; Kajol Kumari Rajak
Full-mouth implant-supported prosthetic rehabilitation for failing dentition is a complex, multifactorial process influenced by prosthetic materials and peri-implant periodontal health. Traditionally, porcelain-fused-to-metal (PFM) frameworks have ensured functional stability and acceptable esthetics; however, the advent of monolithic zirconia layered with porcelain has introduced enhanced mechanical strength and esthetic appeal. This retrospective case series evaluated the 3-year clinical outcomes of full-arch implant-supported prostheses fabricated using either monolithic zirconia or PFM in edentulous patients, focusing on peri-implant soft-tissue health, marginal bone loss, and prosthetic complications. Ten edentulous patients rehabilitated with full-arch implant-supported prostheses were included and assessed clinically and radiographically for peri-implant tissue health, plaque accumulation, probing depth, bleeding on probing, marginal bone levels, and technical complications over a 3-year follow-up. Both prosthetic materials demonstrated stable peri-implant tissue health and 100% implant survival at the 3-year mark. Monolithic zirconia restorations exhibited reduced plaque accumulation, stable bone levels, and absence of prosthetic complications, whereas the PFM group showed minor technical issues such as porcelain chipping and screw loosening. Within the limitations of this study, both materials proved clinically viable for full-arch implant rehabilitation; however, monolithic zirconia showed a trend toward superior biological and mechanical outcomes. Larger, prospective studies are warranted to validate these preliminary findings. © 2025 Indian Society of Periodontology.
Platelet-Neutrophil Interactions and Thrombo-inflammatory Complications in Type 2 Diabetes Mellitus
(Springer, 2022) Nishith M. Shrimali; Sakshi Agarwal; Arundhati Tiwari; Prasenjit Guchhait
Purpose of the Review: This review recapitulates the complex pathophysiology of type 2 diabetes mellitus associated with a prothrombotic and proinflammatory phenotype. It focuses on the roles played by platelets and neutrophils in these pathologies and then focuses on recent advances in therapeutic interventions. Recent Findings: Platelets, fundamental to the process of hemostasis (and thrombosis), have been increasingly implicated with inflammatory responses. Similarly, neutrophils, the first line of defense against pathogen invasions, forming a crucial role in body’s inflammatory immune responses, have been progressively associated with coagulation and thrombotic reactions. Interestingly, these two cells also interact with each other in their microenvironment, forming platelet-neutrophil complexes, to achieve full functionality. The incidence of these complexes is found to be higher in patients with diabetes mellitus, promoting associated complications. Summary: This review attempts to understand the interplay of these cells in a diabetic, hyperglycemic milieu, concluding with a look back at the available therapeutic interventions to address the complications. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Prospective Assessment of VI-RADS with Muscle Invasion in Urinary Bladder Cancer and Its Implication on Re-Resection/Restaging TURBT Patients
(Springer Science and Business Media Deutschland GmbH, 2025) Sukhad Kural; Abhay Kumar Pathak; Shweta K. Singh; Garima Jain; Mahima L. Yadav; Sakshi Agarwal; Ishan Kumar; Manjari Gupta; Yashasvi Singh; Ujwal Kumar; Sameer Trivedi; Satya Narayan Sankhwar; Parimal Das; Lalit Kumar
Background: Bladder cancer (BCa) diagnosis relies on distinguishing muscle-invasive bladder cancer (MIBC) from non-muscle-invasive bladder cancer (NMIBC) forms. Transurethral resection of the bladder tumor (TURBT) is a standard procedure for initial staging and treatment. The Vesical Imaging-Reporting and Data System (VI-RADS) enhances diagnostic accuracy for muscle invasiveness through advanced imaging techniques, potentially reducing reliance on repeat TURBT and improving patient management. Objective: We aimed to evaluate the role of VI-RADS in predicting muscle invasiveness in BCa and its potential to predict adverse pathology in high-risk NMIBC to avoid unnecessary repeat TURBT procedures. Methods: In this prospective study, we included 62 patients over the age of 18 years who underwent TURBT. In a secondary phase, patients selected for restaging TURBT (re-TURBT) were included, but those with T2 tumors or low-risk NMIBC were excluded. Multiparametric magnetic resonance imaging (MRI) examinations were scored by a radiologist using the VI-RADS 5 method, while a pathologist analyzed TURBT and re-TURBT samples for accurate staging. Statistical analysis evaluated the role of VI-RADS in BCa staging. Results: The VI-RADS score was the only predictive factor for muscle invasion in multivariate analysis. Setting the VI-RADS score at >3 resulted in the highest sensitivity, specificity, and diagnostic accuracy, with values of 67.0%, 89.0%, and 78%, respectively. The receiver operating characteristic area under the curve score for VI-RADS for muscle invasion was 85% for stage Ta, 61% for stage T1, and 88% for stage T2, which shows the utility of VI-RADS in the predictiveness of MIBC/NMIBC. Conclusion: VI-RADS is effective in stratifying BCa patients by predicting muscle invasiveness and identifying NMIBC cases that may not need repeat TURBT. © Society of Surgical Oncology 2024.
Skin Adhesive 3D-Printable BSA-Amyloid/Cellulose Hybrid Hydrogel Film for Rapid Wound Healing and Skin Regeneration with Enhanced Antioxidant and Anti-Inflammatory Properties
(American Chemical Society, 2025) Saurabh Kumar Srivastava; Shikha Tripathi; Sakshi Agarwal; Rahul Ranjan; Somesh Agrawal; Prodyut Dhar; Eugene B. Postnikov; Shilpi Chaudhary; Vinod N. Tiwari; Avanish Singh Parmar
Natural polymer-based hydrogels closely mimic the extracellular matrix, making them ideal for supporting cell growth and tissue regeneration. Recent advancements in tuning their porosity, morphology, and size have helped overcome key challenges in tissue engineering, such as vascularization and multicellular integration. However, their clinical use is often limited by drawbacks, such as low mechanical strength, structural instability, high production costs, and limited reproducibility. In this work, we present a skin-adhesive, 3D-printable/injectable hybrid hydrogel composed of natural protein and cellulose. This hybrid hydrogel overcomes the limitations of conventional systems by enhancing mechanical strength, scaffold stability, reproducibility, cost-effectiveness, and adhesive properties while preserving high biocompatibility and biodegradability. Using the same formulation, a wound dressing material is fabricated and applied at the wound site either by suturing or as an adhesive film. Furthermore, the hydrogel exhibits inherent antibacterial, antioxidant (60% of radical scavenging), anti-inflammatory, cell viability (up to 90%), and cell migration properties that significantly promote wound healing. This multifunctional hybrid hydrogel offers a promising solution for next-generation wound dressing applications and contributes to the advancement of bioactive and customizable materials in regenerative medicine. © 2025 American Chemical Society
Urinary extracellular vesicles-encapsulated miRNA signatures: A new paradigm for urinary bladder cancer diagnosis and classification
(Elsevier Inc., 2024) Sukhad Kural; Garima Jain; Sakshi Agarwal; Parimal Das; Lalit Kumar
Bladder cancer (BCa) stands as prevalent malignancy of the urinary system globally, especially among men. The clinical classification of BCa into non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) is crucial for prognosis and treatment decisions. However, challenges persist in current diagnostic methods like Urine cytopathology that shows poor sensitivity therefore compromising on accurately diagnosing and monitoring BCa. In recent years, research has emphasized the importance of identifying urine and blood-based specific biomarkers for BCa that can enable early and precise diagnosis, effective tumor classification, and monitoring. The convenient proximity of urine with the urinary bladder epithelium makes urine a good source of noninvasive biomarkers, in particular urinary EVs because of the packaged existence of tumor-associated molecules. Therefore, the review assesses the potential of urinary extracellular vesicles (uEVs) as noninvasive biomarkers for BCa. We have elaborately reviewed and discussed the research that delves into the role of urinary EVs in the context of BCa diagnosis and classification. Extensive research has been dedicated to investigating differential microRNA (miRNA) expressions, with the goal of establishing distinct, noninvasive biomarkers for BCa. The identification of such biomarkers has the potential to revolutionize early detection, risk stratification, therapeutic interventions, and ultimately, the long-term prognosis of BCa patients. Despite notable advancements, inconsistencies persist in the biomarkers identified, methodologies employed, and study populations. This review meticulously compiles reported miRNA biomarkers, critically assessing the variability and discrepancies observed in existing research. By synthesizing these findings, the article aims to direct future studies toward a more cohesive and dependable approach in BCa biomarker identification, fostering progress in patient care and management. © 2024 Elsevier Inc.