Browsing by Author "Uma Pandey"

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A study of oxidative stress in cervical cancer- an institutional study
(Elsevier B.V., 2021) Kulsoom Zahra; Sandeep Patel; Tulika Dey; Uma Pandey; Surendra Pratap Mishra
Cervical cancer is the second most common cause of cancer-related death among women worldwide, especially in developing countries. Oxidative stress has been associated with cervical cancer. Many studies demonstrated that the low level of antioxidants induces the production of free radicals that cause lipid peroxidation, DNA, and protein damage leading to mutations that favors malignant transformation. This is a case-control institutional study conducted to evaluate the level of oxidative stress in cervical cancer patients and the age-matched healthy controls. We measured level of TBARS expressed as MDA, activity of SOD and GSH level by the spectrophotometric method, and level of 8-OHdG was estimated using a competitive sandwich ELISA assay. Our results showed a significant increase in the level of lipid peroxidation in group IV when compared to the control, group II and group III (p < 0.001). The activity of SOD was also significantly higher in group IV when compared to the control group (p < 0.001), group II (p < 0.001), and group III (p < 0.001). The level of GSH was also significantly lower in group IV when compared to the control group (p < 0.01), group II (p < 0.01), and group III (p < 0.01). The level of 8-OHdG was significantly higher in group IV than in the other groups (p < 0.01). The results suggest that oxidative stress is involved in the pathogenesis of cervical cancer, which is demonstrated by an increased level of lipid peroxidation and higher levels of 8-OHdG and an altered antioxidant defense system. © 2020
Anxiety, Depression and Behavioural Changes in Junior Doctors and Medical Students Associated with the Coronavirus Pandemic: A Cross-Sectional Survey
(Springer, 2021) Uma Pandey; Gillian Corbett; Suruchi Mohan; Shuja Reagu; Shubham Kumar; Thomas Farrell; Stephen Lindow
Introduction: Medical students are known to have high levels of depression, anxiety and stress from the high-pressure environments that they study and train in. The coronavirus pandemic presents source of stress and anxiety to large populations in general, and to healthcare professionals in particular. This study was undertaken to assess the psychological effects of this pandemic on the mental health of medical students and trainees. Materials and Methods: An online questionnaire was designed to capture information on the participant’s anxieties related to the pandemic and included a validated tool for the assessment of anxiety and depression symptoms (GAD-7 and PHQ-9, respectively). The questionnaire was prepared on Google Forms, and the link to the questionnaire was disseminated to 113 medical students and junior doctors on 19 April 2020, and the survey closed on 22 April 2020 midnight. Results: The survey was sent to 113 students, and 83 students participated. Of the participants, 47 (56.6%) were female and 36 (43.4%) were male, and 80 (96.4%) were aged less than 30 years old. Formal anxiety and depression scores using the GAD-7 and PHQ-9 tools indicated 15/82 (18.3%) had anxiety scores of 0 (lowest possible) and 21/82 (25.6%) had the lowest possible depression score of 0. However, 6/82 (7.3%) had scores that were classified as severe depression. Females had significantly higher median anxiety (5 v 2, p < 0.002) and depression scores (5 v 3, p = 0.025) than male participants. Direct patient care and care of patients with Covid-19 did not result in significant deterioration in anxiety and depression. Conclusion: Female students/junior doctors showed higher anxiety and depression scores than males. Direct patient care and care of patients with Covid-19 did not result in a measurable deterioration in anxiety and depression in this study. In this stressful pandemic situation, it is imperative to look after the mental health of healthcare workers as well as patients. © 2020, Federation of Obstetric & Gynecological Societies of India.
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.
Cholestasis of Pregnancy
(Springer Science+Business Media, 2025) Uma Pandey; Ruchi Birendra
Intrahepatic cholestasis of pregnancy (ICP) is the most common multifactorial hepatic disorder of pregnancy, which mainly manifests in the second or third trimester (after 30 weeks). About 1.5%–4% of otherwise healthy pregnancies are affected by intrahepatic cholestasis during pregnancy [1]. It is characterized by intense pruritus without any primary skin rash with elevated levels of bile acid and transaminases with or without increased serum bilirubin in the absence of any alternative cause, and the condition resolves 2–3 weeks after delivery [2]. The maternal outcome is good, but it is associated with very adverse fetal complications like preterm delivery, meconium staining of amniotic fluid, fetal bradycardia, fetal distress, and, most unfortunately, fetal demise, so timely diagnosis and treatment are needed. The deleterious effect on the fetus is directly proportional to the total bile acid (TBA) level with the risk of stillbirth above TBA serum concentration of 100 μmol/L or more. Meta-analysis suggests that most women with IHCP can probably be reassured that the risk of stillbirth is equivalent to that of pregnant women in the general population, as most women have bile acids below this threshold [3]. The therapy’s primary goal is to relieve pruritus, normalize maternal biochemistry, and prevent fetal complications. Ursodeoxycholic acid (UDCA) is used for medical management, but it is advisable to deliver around 37–38 weeks or even earlier if fetal compromise is detected. Pruritus Gravidarum is the term used for pruritus without skin rash occurring in the first trimester of pregnancy [4][[sup]].[[/sup]] © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
Coronavirus-The origin
(IP Innovative Publication Pvt. Ltd., 2020) Uma Pandey; Megha Garg
The world was apparently running smooth and was naïve about what was about to follow the mundane, up until December 2019 when a cluster of pneumonia cases first appeared in Wuhan, a city in Hubei province of China. The causative organism was identified as Novel Coronavirus. The Novel Coronavirus rapidly spread throughout China, causing an epidemic and later spread to different parts of the world, involving every continent and country (except Antarctica). Identifying the pandemic, WHO (World Health Organisation) in February 2020, designated the disease as COVID-19 (Coronavirus disease 2019). The virus causing this disease is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). © 2020 Innovative Publication, All rights reserved.
Correlative study of serum hepcidin levels and serum iron reserve parameters in preeclampsia and HELLP syndrome
(National Institute of Science Communication and Information Resources (NISCAIR), 2018) Tapan Kumar; Kulsoom Zahra; Tulika Dey; Anup Singh; Uma Pandey; S.P. Mishra
HELLP syndrome is described as a special group of severe preeclampsia characterized by haemolysis (H), elevated liver enzymes (EL) and low platelets (PL), whereas preeclampsia is a disease of unknown etiology characterized by hypertension and proteinuria after the 20th week of gestation. The objective of the study was to evaluate the level of hepcidin in the serum of the patient suffering from HELLP syndrome and preeclampsia. It was done by competitive sandwich ELISA which assesses the serum level of hepcidin in the forty patients suffering from preeclampsia and HELLP syndrome (as cases) and forty healthy individuals (as control). The results of our study showed that serum hepcidin levels were significantly increased among the cases (P =0.00171) in comparison to control (P <0.05) and transferrin saturation levels were significantly decreased (P <0.05) among the cases (P =0.001) in comparison to controls. The decrease in transferrin saturation indicates that there is low serum iron level among the cases. It was concluded that increased hepcidin level may be the cause of anemia among the cases. © 2018, National Institute of Science Communication and Information Resources (NISCAIR). All rights reserved.
Current Practices in Management of Placenta Accreta Spectrum in Low-resource Settings
(Jaypee Brothers Medical Publishers (P) Ltd, 2022) A.G. Radhika; Sruthi Bhaskaran; Shilpa Singh; Meena Samant; Archana Kumari; Pikee Saxena; Manisha Beck; Ruchi Srivastava; Rachna Chaudhary; Anita Singh; Uma Pandey
Background: Placenta accreta spectrum (PAS) is characterized by abnormal trophoblast invasion of part or entire placenta into the myometrium due to defects in the endometrial–myometrial interface following surgeries involving the uterine cavity, uterine curettage, or uterine infection. Cesarean section is an important risk factor for PAS. A global increase in Cesarean section has resulted in an exponential increase in the PAS. Objective: To examine the prevailing practices for the management of PAS in India and to formulate readily translatable practical management algorithms for low-resource settings. Materials and methods: This cross-sectional study was conducted from April 2019 to March 2020 across nine tertiary care centers in India. Ethics clearance was obtained for the study. Patient details were noted in predesigned pro forma. Risk factors, investigations for antenatal diagnosis and treatment options, and outcomes were recorded. Analysis data were analyzed using the statistical software Statistical Package for the Social Sciences (SPSS) version 16 (IBM, Armonk, New York, USA). The qualitative variables were reported as numbers and percentages. The association of surgery type (elective/emergency) and technique with qualitative variables and risk factors was analyzed using Chi-square/Fisher’s exact test. The quantitative variables are reported as the median and interquartile range and were tested with the Mann–Whitney U-test between the two groups. The Kruskal–Wallis test was applied to compare the quantitative variables among the three groups. A p-value less than 0.05 was considered significant. Result: The prevalence of PAS was 0.12%, and previous Cesarean scarring was the most important risk factor. There were almost 43% of women unbooked at the tertiary centers though they were being supervised by lower healthcare facilities during the antenatal period. Ultrasound (USG) diagnosis of PAS was established in 51.3% of cases only. Cesarean-hysterectomy and interval hysterectomy were undertaken in 84% and 8% women respectively. Intraoperative hemorrhage and urological injury were the most common complications. Based on the findings of the study, a simple, user-friendly algorithm for clinical practice and management was formulated. Conclusion: Identification of antenatal clinical factors for PAS risk stratification in low-resource settings is important to enable timely referral to tertiary care. The availability of USG and the necessary skills for detection of PAS are important factors for the diagnosis and management of PAS. Therefore, both radiologists and obstetricians should be adequately trained for the condition to prevent maternal morbidity and mortality. PAS-complicated Cesarean is best carried out at tertiary facilities with multidisciplinary planning and preparation. © The Author(s). 2022.
Diagnostic Dilemma in Peripartum Management of von Willebrand Disease: a Case Report
(Springer, 2021) Megha Garg; Uma Pandey; Lalit Prashant Meena
[No abstract available]
Exploring the Role of Augmented Reality and Virtual Reality in Digital Marketing for Developing Cultural-Educational Tourism in India
(IGI Global, 2025) Mandeep Bharti; Rohit Chauhan; Uma Pandey; Abhishek Kumar Maurya
Since technology is rapidly growing, new opportunities are emerging for enhancing cultural and educational tourism. Augmented Reality (AR) and Virtual Reality (VR) are some examples of immersive technologies that have the potential to revolutionize tourists' experiences with cultural heritage, especially in terms of more interaction and personalization. As India is a country rich in history, culture, and diversity, the introduction of AR and VR into tourism will provide an opportunity to preserve and promote extensive cultural heritage. This chapter investigates how cultural-educational tourism in India can incorporate AR and VR technologies. In this light, the chapter will start by examining AR and VR through an overview, including definitions and key concepts, and following their global applications. The chapter then delves into the benefits and challenges accruing to the implication of these technologies within the tourism sector, especially on how it will go on to help further the cultural-educational experiences of tourists in India. © 2025, IGI Global.
Heat-stable carbetocin versus oxytocin to prevent hemorrhage after vaginal birth
(Massachussetts Medical Society, 2018) Mariana Widmer; Gilda Piaggio; Thi M.H. Nguyen; Alfred Osoti; Olorunfemi O. Owa; Sujata Misra; Arri Coomarasamy; Hany Abdel-Aleem; Ashalata A. Mallapur; Zahida Qureshi; Pisake Lumbiganon; Archana B. Patel; Guillermo Carroli; Bu-Kola Fawole; Shivaprasad S. Goudar; Yeshita V. Pujar; James Neilson; G. Justus Hofmeyr; Lin L. Su; Jose Ferreira De Carvalho; Uma Pandey; Kidza Mugerwa; Shobha S. Shiragur; Josaphat Byamugisha; Daniel Giordano; A.M. Gülmezoglu
BACKGROUND Postpartum hemorrhage is the most common cause of maternal death. Oxytocin is the standard therapy for the prevention of postpartum hemorrhage, but it requires cold storage, which is not available in many countries. In a large trial, we compared a novel formulation of heat-stable carbetocin with oxytocin. METHODS We enrolled women across 23 sites in 10 countries in a randomized, double-blind, noninferiority trial comparing intramuscular injections of heat-stable carbetocin (at a dose of 100 μg) with oxytocin (at a dose of 10 IU) administered immediately after vaginal birth. Both drugs were kept in cold storage (2 to 8°C) to maintain double-blinding. There were two primary outcomes: the proportion of women with blood loss of at least 500 ml or the use of additional uterotonic agents, and the proportion of women with blood loss of at least 1000 ml. The noninferiority margins for the relative risks of these outcomes were 1.16 and 1.23, respectively. RESULTS A total of 29,645 women underwent randomization. The frequency of blood loss of at least 500 ml or the use of additional uterotonic agents was 14.5% in the carbetocin group and 14.4% in the oxytocin group (relative risk, 1.01; 95% confidence interval [CI], 0.95 to 1.06), a finding that was consistent with noninferiority. The frequency of blood loss of at least 1000 ml was 1.51% in the carbetocin group and 1.45% in the oxytocin group (relative risk, 1.04; 95% CI, 0.87 to 1.25), with the confidence interval crossing the margin of noninferiority. The use of additional uterotonic agents, interventions to stop bleeding, and adverse effects did not differ significantly between the two groups. CONCLUSIONS Heat-stable carbetocin was noninferior to oxytocin for the prevention of blood loss of at least 500 ml or the use of additional uterotonic agents. Noninferiority was not shown for the outcome of blood loss of at least 1000 ml; low event rates for this outcome reduced the power of the trial. Copyright © 2018 Massachusetts Medical Society.
Heat-Stable Carbetocin Versus Oxytocin to Prevent Hemorrhage after Vaginal Birth
(Lippincott Williams and Wilkins, 2018) Mariana Widmer; Gilda Piaggio; Thi M.H. Nguyen; Alfred Osoti; Olorunfemi O. Owa; Sujata Misra; Arri Coomarasamy; Hany Abdel-Aleem; Ashalata A. Mallapur; Zahida Qureshi; Pisake Lumbiganon; Archana B. Patel; Guillermo Carroli; Bukola Fawole; Shivaprasad S. Goudar; Yeshita V. Pujar; James Neilson; G. Justus Hofmeyr; Lin L. Su; Jose Ferreira De Carvalho; Uma Pandey; Kidza Mugerwa; Shobha S. Shiragur; Josaphat Byamugisha; Daniel Giordano; A. Metin Gülmezoglu
Postpartum hemorrhage is the most common cause of maternal death. Oxytocin is the standard therapy for the prevention of postpartum hemorrhage, but it requires cold storage,which is not available in many countries, and has unsatisfactory real-world efficacy as a result of heat sensitivity and quality issues such as insufficient active ingredient or impurities. Heat-stable carbetocin, an oxytocin analogue, does not require cold-chain transport and storage; it has been shown to maintain stability over a period of 36 months at 30°C and 75% relative humidity. Although there have been trials of carbetocin, most of the trials involved women undergoing cesarean delivery, were small, were of varied quality, and used an intravenous route of administration. The researchers conducted an international, randomized, double-blind, active-controlled noninferiority trial comparing the effects of heat-stable carbetocin with those of oxytocin on postpartum hemorrhage after vaginal birth at 23 hospitals (sites) in 10 countries between July 2015 and January 2018. Women who expected to give birth vaginally and who had a singleton pregnancy and cervical dilatation of 6 cm or less were eligible.Women were randomly assigned to receive a single intramuscular injection of either heat-stable carbetocin at a dose of 100 μg or oxytocin at a dose of 10 IU. Immediately after delivery, the drugwas administered and the management of the third stage of labor was conducted as recommended in theWorldHealth Organization guidelines. A total of 29,645 women underwent randomization. The frequency of blood loss of at least 500 mL or the use of additional uterotonic agents was 14.5% in the carbetocin group and 14.4% in the oxytocin group (relative risk, 1.01; 95% confidence interval [CI], 0.95-1.06), a finding that was consistent with noninferiority. The frequency of blood loss of at least 1000 mL was 1.51% in the carbetocin group and 1.45% in the oxytocin group (relative risk, 1.04; 95% CI, 0.87-1.25), with the CI crossing the margin of noninferiority. The use of additional uterotonic agents, interventions to stop bleeding, and adverse effects did not differ significantly between the 2 groups. Heat-stable carbetocinwas noninferior to oxytocin for the prevention of blood loss of at least 500 mL or the use of additional uterotonic agents. Low event rates for blood loss of at least 1000 mL limited the power of the trial to investigate that outcome. © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Indian National Association for the Study of the Liver—Federation of Obstetric and Gynaecological Societies of India Position Statement on Management of Liver Diseases in Pregnancy
(Elsevier B.V., 2019) Anil Arora; Ashish Kumar; Anil C. Anand; Pankaj Puri; Radha K. Dhiman; Subrat K. Acharya; K. Aggarwal; Neelam Aggarwal; Rakesh Aggarwal; Yogesh K. Chawla; Vinod K. Dixit; Ajay Duseja; Chundamannil E. Eapen; Bhabadev Goswami; Kanwal Gujral; A. Gupta; A. Jindal; Premashish Kar; Krishna Kumari; Kaushal Madan; Jaideep Malhotra; Narendra Malhotra; Gaurav Pandey; Uma Pandey; Ratna D. Puri; Ramesh R. Rai; Padaki N. Rao; Shiv K. Sarin; Aparna Sharma; Praveen Sharma; Koticherry T. Shenoy; Karam R. Singh; Shivaram P. Singh; Vanita Suri; Nirupama Trehanpati; M. Wadhawan
Liver diseases occurring during pregnancy can be serious and can progress rapidly, affecting outcomes for both the mother and fetus. They are a common cause of concern to an obstetrician and an important reason for referral to a hepatologist, gastroenterologist, or physician. Liver diseases during pregnancy can be divided into disorders unique to pregnancy, those coincidental with pregnancy, and preexisting liver diseases exacerbated by pregnancy. A rapid differential diagnosis between liver diseases related or unrelated to pregnancy is required so that specialist and urgent management of these conditions can be carried out. Specific Indian guidelines for the management of these patients are lacking. The Indian National Association for the Study of the Liver (INASL) in association with the Federation of Obstetric and Gynaecological Societies of India (FOGSI) had set up a taskforce for development of consensus guidelines for management of patients with liver diseases during pregnancy, relevant to India. For development of these guidelines, a two-day roundtable meeting was held on 26–27 May 2018 in New Delhi, to discuss, debate, and finalize the consensus statements. Only those statements that were unanimously approved by most members of the taskforce were accepted. The primary objective of this review is to present the consensus statements approved jointly by the INASL and FOGSI for diagnosing and managing pregnant women with liver diseases. This article provides an overview of liver diseases occurring in pregnancy, an update on the key mechanisms involved in its pathogenesis, and the recommended treatment options. © 2019
Intention to Vaccinate against SARS-CoV-2 amongst Healthcare Workers in India: A Multicenter Cross-sectional Study
(Jaypee Brothers Medical Publishers (P) Ltd, 2021) Divya Dwivedi; Uma Pandey; Sarah McDonell; Mark Hehir; Stephen W. Lindow
Aim and objective: The high fatality rate of the corona virus disease-19 (COVID-19) pandemic has led to the development of vaccines over a very short period of time. This is a study to assess the vaccine acceptability among Indian healthcare workers (HCWs) and to evaluate the knowledge, fears, and intentions among them regarding COVID-19 vaccination and to estimate the number of HCWs who will accept or refuse vaccination. Materials and methods: A multicenter cross-sectional study on COVID-19 vaccination was done in three tertiary hospitals by an anonymous online questionnaire. Doctors, nurses, students, and laboratory and administration staff were invited to take part. Results: A total of 314 HCWs participated voluntarily in the survey. Among the participants, 75.1% of them would definitely/probably accept the vaccination, and 24.8% would definitely/probably refuse if it were made available. Significant factors in the refusal were skepticism in the efficacy and safety of a vaccine. Conclusion: The majority of the respondents (75.1%) in our study were willing to receive and accept the vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus However, concerns about efficacy and safety of the vaccine need to be addressed to increase the uptake and ensuring coverage of large population in order to attain herd immunity against COVID-19. © The Author(s).
Lignocaine augments the in-vitro uterine contractions involving NO-guanylyl cyclase dependent mechanisms
(Elsevier Inc., 2017) Rashmi Raheja; Hemlata Gupta; Uma Pandey; Shripad B. Deshpande
Aims Lignocaine is used during intrapartum and postpartum period but there are conflicting reports regarding the effect of lignocaine on uterine contractility. Therefore, this study was undertaken to delineate the effect of lignocaine on uterine contractility and the underlying mechanisms. Main methods The in vitro contractions were recorded from the uterine segments obtained from adult rats (in estrous phase) and also from human myometrial tissue. Effect of lignocaine on spontaneous uterine contractions was recorded in the absence or presence of antagonists. Effect of sodium nitroprusside (SNP, NO donor) on uterine contractility was assessed. The NO2− was assayed (indicator of NO activity) from the supernatant after exposing the myometrial tissue to lignocaine in the absence or the presence of L-NAME or hemoglobin. Key findings Lignocaine (100 μM) increased the amplitude of uterine contractions by 75% with no alterations in frequency. Similar magnitude of increase was seen with human myometrial tissue also. The spontaneous activities were absent in Ca2 +-free or in nifedipine (10 μM) containing medium. Heparin (IP3 blocker, 10 IU/ml), but not the indomethacin (10 μM) blocked the lignocaine-induced augmentation. L-NAME (NOS inhibitor, 10 μM) or methylene blue (guanylyl cyclase inhibitor, 100 μM) partially blocked the lignocaine-induced augmentation. SNP (30 μM) increased the amplitude of spontaneous uterine contractions. Lignocaine increased the NO2− content (indicator of NO activity) of uterine tissue and the increase was blocked by L-NAME or hemoglobin. Significance Present observations indicate that lignocaine augments the amplitude of uterine contractions via Ca2 +-dependent mechanisms involving NO-G cyclase-dependent mechanisms. © 2017 Elsevier Inc.
Obstetric violence: Comparing medical student perceptions in India and the UK
(Elsevier Ireland Ltd, 2021) Thomas Gray; Suruchi Mohan; Stephen Lindow; Uma Pandey; Tom Farrell
Objective(s): Obstetric Violence refers to professional deficiencies in maternity care, which can occur in both low and high resource settings. Examples include non-dignified care, lack of respect when giving care, discrimination and abandonment of care. The objective of this study was to assess knowledge and attitudes towards obstetric violence in a cohort of medical students in India and the UK. Study design: An online survey was sent to 240 UK and 280 Indian medical students. This incorporated a video showing a dramatized scenario of obstetric violence. The survey assessed participant's demographics and prior knowledge of obstetric violence. Participants scored their perceptions of eight behaviours in the video on visual analogue scales. Participants were asked to reflect on their own practice and score this. Comparisons of survey responses between UK and Indian participants were made using chi squared/Student's t-test. Results: 62 Indian medical students and 58 UK medical students completed the survey. Indian medical students were significantly more likely to be male (p < 0.001). 26 % of UK participants had previously heard the term obstetric violence, compared to 34 % of Indian participants (p = 0.15). Both were able to correctly define obstetric violence at similar rates (32 % versus 34 %). Indian medical students were significantly less critical (p < 0.001) of all eight scored behaviours in the video of obstetric violence compared to their UK counterparts. UK medical students were significantly less likely to agree that the video had changed their perception on how teams should behave and act in this context (p < 0.001). 90 % of UK participants and 38 % of Indian participants had received training in professional behaviours. 14 % of UK participants had seen examples of obstetric violence in clinical practice compared to 49 % of Indian participants. Conclusions: UK and Indian medical students were able to identify behaviours associated with obstetric violence, although the majority were previously unaware of the term. Indian medical students in this study were less critical of obstetric violence in the video, which may be because of cultural reasons, greater numbers of male students, greater exposure to obstetric violence or less training on professional behaviours. Standardised training to prevent obstetric violence should be part of undergraduate medical training internationally. © 2021
Outcome of Diabetic Pregnancies in a Tertiary Referral Centre, Varanasi
(Federation of Obstetric and Gynecologycal Societies of India, 2016) Uma Pandey; Neeraj Kumar Agrawal; Shilpa Agrawal; Shuchita Batra
Aim: The study was done to determine the maternal and fetal outcome of pregnancies complicated by maternal diabetes either Gestational Diabetes Mellitus (GDM) or preexisting (type 1 or type 2) diabetes over a period from March 2011 to Feb 2013 in a tertiary care hospital, Varanasi. Methods: This is a retrospective audit of the maternal and fetal outcome of women who presented to the Sir Sundar Lal Hospital, Department of Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India from March 2011 to Feb 2013, with GDM or pre-existing type 1 or type 2 Diabetes with pregnancy. The audit group comprised 65 pregnancies (67 babies), of whom 27 had preexisting diabetes and 38 cases developed gestational diabetes. Pregnant women who were found to be diabetic preconceptionally or in the first trimester were classified as ‘pre-existing diabetes’. Results: There were total of 65 diabetic women in this retrospective study, 39 women were GDM (60 %) while 26 women (40 %) were having pre-existing diabetes (24 type 1 diabetes and 2 women were in type 2 diabetes group). There were 35 multigravid women (53.85 %) and 30 primigravid women (46.15 %). There were 39 (60 %) women on Insulin. There were 42 Lower Segment Caesarean Section (64.62 %) and 23 Spontaneous Vaginal Delivery (35.38 %). In fetal and neonatal complications, there were three still births, one case of intrapartum death, and one case of shoulder dystocia. Fetal anomalies were less frequent, one case of Gastroschisis with Hydrocephalus associated with Menigomyelocoele, there was one case of isolated Hydrocephalus, and there was also one case of Truncus arteriosus. Conclusions: The study analyses maternal and fetal complication in the GDM group and also preexisting diabetes group. In our centre, the 60 % women were GDM while 40 % were having pre-existing diabetes. Total rate of fetal/neonatal complication rate was 7.69 % and of congenital anomaly rate it was 9.23 %. Proportion of still birth, Intrauterine death, and congenital malformations was higher in the pre-existing diabetes group although the data are not large enough to draw a statistically significant conclusion. LSCS rate was little higher in the GDM group (69.23 %) in comparison to the preexisting diabetes group where it was 57.69 %. SVD (Spontaneous Vaginal Delivery) rate was 30.77 % in GDM and 42.31 % in the pre-existing diabetes group. HbA1c was within normal range 84.62 % of GDM group while in 15.38 % it was raised >6 %. In the pre-existing diabetes group, only 19.23 % of women had HbA1c within acceptable range and 80.77 % had it >6. The aim of St Vincent Declaration is to ‘achieve pregnancy outcome in the diabetic woman that is similar to that of the non-diabetic woman.’ But, so far we have not been able to achieve this. Our HbA1c level is remarkably high in the pre-existing diabetes group. Only 3 out of 65 patients’ women took Folic Acid periconceptionally. We need to work to achieve it our best. It is well known that insulin treatment during pregnancy results in reduction in the rate of macrosomia, fetal/neonatal, and maternal complications. Therefore, we need to use insulin judiciously and advocate its usage in the situations where it is needed. © 2015, Federation of Obstetric & Gynecological Societies of India.
Primary Unilateral Ovarian Lymphoma in a Young Girl: Case Report
(Springer, 2021) Shilpa Chowdary Peddappolla; Uma Pandey; Uday Pratap Shahi
[No abstract available]
Pyruvate Kinase M2 and Cancer: The Role of PKM2 in Promoting Tumorigenesis
(Frontiers Media S.A., 2020) Kulsoom Zahra; Tulika Dey; Ashish; Surendra Pratap Mishra; Uma Pandey
Pyruvate kinase plays a pivotal role in regulating cell metabolism. The final and rate-limiting step of glycolysis is the conversion of Phosphoenolpyruvate (PEP) to Pyruvate, which is catalyzed by Pyruvate Kinase. There are four isomeric, tissue-specific forms of Pyruvate Kinase found in mammals: PKL, PKR, PKM1, and PKM2. PKM1 and PKM2 are formed bya single mRNA transcript of the PKM gene by alternative splicing. The oligomers of PKM2 exist in high activity tetramer and low activity dimer forms. The dimer PKM2 regulates the rate-limiting step of glycolysis that shifts the glucose metabolism from the normal respiratory chain to lactate production in tumor cells. Besides its role as a metabolic regulator, it also acts as protein kinase, which contributes to tumorigenesis. This review is focused on the metabolic role of pyruvate kinase M2 in normal cells vs. cancerous cells and its regulation at the transcriptional level. The review also highlights the role of PKM2 as a potential diagnostic marker and as a therapeutic target in cancer treatment. © Copyright © 2020 Zahra, Dey, Ashish, Mishra and Pandey.
Role of anti mullerian hormone (AMH) in diagnosis of polycystic ovarian syndrome (PCOS) in Indian women
(IP Innovative Publication Pvt. Ltd., 2023) Uma Pandey; Neha Gupta; Shivi Jain; Surya Kumar Singh
Background: Transvaginal ultrasound is an important part of the Rotterdam criteria, which are commonly used to diagnose polycystic ovary syndrome (PCOS). Specifically, the presence of polycystic ovarian morphology (PCOM) is a key factor in the criteria. Another useful indicator of PCOM is the Anti-Mullerian hormone (AMH) level. Aim: The objective is to evaluate the diagnostic accuracy of serum Anti-Mullerian hormone (AMH) in identifying polycystic ovary syndrome (PCOS) and determine whether it can be used as a substitute for polycystic ovarian morphology (PCOM) in the Rotterdam criteria. Additionally, we aim to investigate the relationship between AMH levels and hyperandrogenism in PCOS patients. Materials and Methods: A study was out in SSH BHU various parameters will be used in diagnosis. Serum AMH Radiology: By Transvaginal Sonography single observer obtained dimensions for ovarian volume and the maximum number of follicles in one section. AMH levels will be estimated using commercially available Gen-II ELISA assay. Result: Biochemical evaluation will be done in the Department of Bio-Chemistry IMS BHU. The Anti-Mullerian hormone (AMH) serum levels will be measured using a commercially available ultra-sensitive Gen-II enzyme-linked immunosorbent assay (ELISA) kit from Beckman Coulter, CA. The ELISA has a lower limit of detectability (LoD) of 0.08 ng/ml, a lower limit of quantification (LoQ) of 0.17 mg/ml, and an intra-assay coefficient of variation of 5.8%. The unit of measurement is ng/mL (1ng/mL=7.14 pmol/L). Conclusion: The study showed that Anti-Mullerian hormone (AMH) levels were markedly higher in individuals with polycystic ovary syndrome (PCOS) than in controls. While AMH alone was not a reliable diagnostic marker for PCOS, the findings suggested that incorporating AMH levels as an additional factor in the existing Rotterdam criteria could improve the accuracy of PCOS diagnosis. Therefore, AMH levels have the potential as a useful adjunct marker for the diagnosis of PCOS. © 2023 Innovative Publication, All rights reserved.
Role of oxidative stress and low-grade inflammation in letrozole-induced polycystic ovary syndrome in the rat
(Elsevier B.V., 2016) Vivek Pandey; Anusha Singh; Ajit Singh; Amitabh Krishna; Uma Pandey; Yamini Bhusan Tripathi
The aims of the current study were to examine the effects of temporal changes in oxidative stress (OS) and low-grade inflammation in letrozole-treated rats and to correlate these changes with the development of polycystic ovary syndrome (PCOS)-like features. Rats were treated with letrozole for 7, 15 and 21 days to induce PCOS. On day 7 of the treatment, a significant increase in serum testosterone and high sensitive C-reactive protein (hsCRP), the low-grade inflammatory marker, was found in the letrozole treated rats compared to control rats. Moreover, a decreased immunoexpression of insulin receptor coincided with increased body weight. The strong correlation between the levels of hsCRP and lipid peroxidation (LPO) suggests simultaneous development of low-grade inflammation and OS in response to hyperandrogenism, and the role of OS in a formation of cystic follicles in the letrozole animal PCOS model. Therefore, the results of the present study suggest that OS and low-grade inflammation (hsCRP) are the major causes of PCOS induction in this model. © 2016 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn.