Browsing by Author "Usha Singh"

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A Correlation between Antral Follicle Count and Anti-Müllerian Hormone in Healthy Indian Women of Reproductive Age
(Jaypee Brothers Medical Publishers (P) Ltd, 2022) Shivi Jain; Ram C. Shukla; Madhu Jain; Usha Singh; Tej B. Singh
Aim: To determine which of the two parameters between antral follicle count (AFC) and anti-Müllerian hormone (AMH) had better correlation with age in healthy females, and also to estimate the strength of correlation between AMH and AFC. Materials and methods: This was a prospective, cross-sectional study comprising 1,181 fertile women of age 20–40 years, who were divided into four age groups, i.e., group I (20–24 years), group II (25–29 years), group III (30–34 years), and group IV (35–40 years). AFC and AMH were measured on third day of menstrual cycle. Pearson correlation and linear regression analysis were used. Statistical Package for Social Sciences, trial version 20, was used for the statistical analysis. A p-value of <0.05 was considered statistically significant. Results: The correlation coefficients between AFC and age, AMH and age, AMH and AFC were r = −0.403, r = −0.824 and r = 0.328; p <0.001, respectively. A strong positive correlation (r = 0.986, p <0.001) was noted between AMH and age in group I, while strong negative correlations (p <0.001) were noted in other groups. The correlations between AFC and age (r = −0.177) and AMH and AFC (r = 0.175) were significant (p <0.05) only in group IV. Age accounted for 16.3% variation in AFC and 67.8% variation in AMH. Conclusion: AMH correlated better with age than AFC. There was a weak correlation between AMH and AFC. Clinical significance: The counselling of a woman about her reproductive potential should be based on both AFC and AMH taken together, apart from chronological age, to avoid false sense of security or unnecessary alarm. © The Author(s). 2022.
A study of drainage characteristics of Punpun River basin - A tributary of the Ganga River
(2007) Usha Singh
The Punpun river basin presents some unique drainage characteristics which the present study tries to analyse using quantitative methods. After describing the overall particularity of this drainage basin between the Son in the west and the Phalgu river in the east, the study looks at the drainage network of the tributaries. Some anomalies in the course of the Morar are discussed. It then examines both the drainage frequency and the drainage density which both show regional differences form south to north. The paper further describes the drainage pattern observed within the Punpun basin.
Acute kidney injury in pregnancy with special reference to pregnancy-specific disorders: a hospital based study (2014–2016)
(Springer International Publishing, 2018) Jai Prakash; Vivek C. Ganiger; Suraj Prakash; Mohammad Iqbal; Deba Prasad Kar; Usha Singh; Ashish Verma
Introduction: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. Method: All pregnant women attending the department of Obstetrics and Gynecology from November 2014 to July 2016 were screened for AKI based on: (1) sudden elevation of serum creatinine ≥ 1 mg/dl; (2) oligoanuria for > 12 h; and (3) need for dialysis. The detailed clinical profile of AKI in patients with preeclampsia/eclampsia (PE/E), hemolysis/elevated liver enzymes/low platelet count (HELLP) syndrome, acute fatty liver of pregnancy (AFLP), and pregnancy-associated thrombotic microangiopathy (P-TMA) was analyzed. Laboratory investigations included: complete blood count, renal function tests, urinalysis, coagulation profile (platelet count, INR, prothrombin time and activated partial thromboplastin time), and immunological assay (C3, C4, ANA, anti-dsDNA antibody, antiphospholipid antibody). Contrast-enhanced CT scan of kidney ureter and bladder (KUB) and renal biopsy were performed in selected cases. Maternal and fetal outcome were analyzed individually. The patients were followed for 3 months or longer to determine the recovery of renal function or progression to chronic kidney disease (CKD). Results: Overall, 4741 pregnant women (mean age 26.8 ± 4.8 years) were evaluated for AKI. P-AKI was found in 132/4741 (2.78%) patients. In the majority (91.6%), AKI developed in the late 3rd trimester and post-partum period. P-AKI was related to obstetric complications (in 61.4%), pregnancy-specific disorders (in 57.5%) and miscellaneous factors (7.5%). Puerperal sepsis, ante-partum and post-partum hemorrhage were contributing factors for P-AKI in 34 (25.8%), 11 (8.3%) and 28 (21.2%) patients, respectively. P-AKI due to pregnancy-specific disorders developed in 76/4741 patients, i.e. in 1:62 pregnancies. PE/E was the cause of P-AKI in 62 patients (46.9%) followed by HELLP syndrome in 9 (6.8%) and AFLP in 05 (3.8%). P-TMA causing AKI was not observed. Complete recovery of renal function occurred in 89.4% of patients while 6 (4.6%) progressed to CKD (ESRD: 3 and CKD stage IV: 3). Maternal mortality was 6%. Puerperal sepsis was the sole cause of patchy cortical necrosis in 5 (3.7%) cases. Premature delivery occurred in 40.9% patients and full-term delivery in 35.6%. Perinatal mortality was 23.5%, mainly due to intrauterine death (17.5%) and prematurity (6%). Conclusion: PE/E was the commonest cause of P-AKI in our study, similar to the situation in developed countries. Post-partum hemorrhage was the second-most common (21.5%) cause. Puerperal sepsis contributed to AKI in one-fourth of pregnant women. P-TMA was not recorded in this study and AFLP was an uncommon cause of P-AKI in our country. Renal function returned to normal in all patients with P-AKI due to pregnancy-specific disorders. However, perinatal mortality was high despite the good prognosis of P-AKI. © 2018, Italian Society of Nephrology.
Anti-stress effect of alcoholic extracts of some ayurvedic plants in immobilized stressed charles foaster rats strains
(2009) Alok Kumar Verma; Arti Upadhayaya; S.R. Pathak; Usha Singh
The present investigation is a comprehensive study of extract on pattern of serum immunoglobulins . Present study was undertaken to evaluate the immunomodulatory activity of 70% ethanolic extracts of Nymphaea stellafa(Nymphaeceae), Sida cardifolia (Malvaceae),Ipomea digitata (Convolvulaceae) and Hippophae rhamnoides (Elaegnaceae) on humoral response in chales foaster rats strain against immobilization stress induced immune suppression. © Global Science Publications.
Anticyclic citrullinated peptide autoantibodies in systemic lupus erythematosus
(2011) Usha Singh; Sangeeta Singh; Nand K. Singh; Pramod K. Verma; Suman Singh
Systemic lupus erythematosus is an autoimmune disease with protean manifestation. Arthritis is one of the most common manifestations seen in SLE. Anti-CCP Ab is a recently described autoantibody that has been claimed as a most sensitive and specific marker for the diagnosis of RA. Study was performed to see whether anti-CCP2 Ab is positive in lupus arthritis or not. Anti-CCP Ab, ANA, ds DNA, and APLA were estimated by ELISA. Anti-CCP2 Ab was positive in 22 cases (37.93%) of SLE. Mean value of anti-CCP (18.08 ± 16.95 U/ml) was statistically significant (P < 0.001) when compared to control (5.07 ± U/ml). A total of 44 (75.86%) patients with SLE had arthritis. In 29 (50.00%) cases, arthritis resembled RA along with classical features of SLE, while 15 cases (25.86%) had nonspecific lupus arthritis. In 13 cases (44.82%) of RA type lupus arthritis, anti-CCP2 Ab was positive, while only three (20%) nonspecific lupus arthritis cases had elevated anti-CCP. In 14 (24.13) patients with SLE, there was no arthritis, but in this group also (6/14) 42.85% cases had elevated anti-CCP. A total of 11 (50%) patients with duration less than 1 year had more anti-CCP 2 positivity when compared to disease duration between 1 and 3 years (27.27%) and disease duration more than 3 years (22.72%), but specifically, it was not significant. Our study concludes that anti-CCP2 is not a specific antibody for RA, but it is present in autoimmune diseases. © 2010 Springer-Verlag.
Assessment of predictive markers of response to neoadjuvant chemotherapy in breast cancer
(2010) Mallika Tewari; Satyajit Pradhan; Usha Singh; Taj Bali Singh; Hari Shankar Shukla
OBJECTIVE: To identify the predictive markers associated with chemotherapy sensitivity, especially those producing pathological complete response (pCR) following neoadjuvant chemotherapy (NACT) in patients with locally advanced breast cancer. METHODS: Core needle biopsy of 50 locally advanced breast cancer patients was analysed for histopathology, grade, oestrogen receptor, progesterone receptor, HER2, Ki-67, p53, Bcl-2, and BAX before starting NACT. This was correlated with response to NACT using Response Evaluation Criteria in Solid Tumours criteria. RESULTS: The mean tumour reduction rate per chemotherapy cycle was significantly higher in BAXpositive (p = 0.01) and Bcl-2-negative (p = 0.04) tumours. BAX expression significantly (p = 0.043) correlated with a response of an at least 30% reduction in tumour size post-NACT on multivariate analysis. A significant relationship was seen between loss of Bcl-2 expression and pCR on univariate (p = 0.048) analysis. Overall, all of the above 12 parameters had 30.4% and 28.5% success in predicting clinical complete response and pCR, respectively, by the Cox and Snell formula. CONCLUSION: Of all parameters examined, only the apoptosis-related genes (Bcl-2 and BAX) seemed to exert some influence on the response to NACT, and neither by itself was sufficient to predict pCR; however, 50 patients is not sufficient to simultaneously analyse several predictive markers. © 2010 Asian Surgical Association.
Association of various inflammatory diseases with human leukocyte antigens B27, B7, Bw4 and Bw6 in patients with SSA
(2009) Sangeeta Singh; Gyanendra K. Sonkar; Usha Singh
Seronegative spondyloarthropathies (SSA) are a group of inflammatory disorders, which clinically involve the axial skeleton and the sacroiliiac and shoulder joints. The aim of the present study was to study the association of HLA B27, B7, Bw4 and Bw6 with some inflammatory diseases, in SSA patients in our area. A total of 220 SSA patients were studied and HLA typing for these antigens were done by the complement-mediated microcytotoxicity method. The total positivity of B27 was found to be 68.64% in SSA patients. Tubercular infection (χ2 = 8.06) and acute anterior uveitis (χ2 = 6.19) were found to be statistically significant (P < 0.05) in B27-positive SSA patients. Tuberculosis was also found to be significantly (χ2 = 6.40) associated with Bw4. In SSA urinary tract infection, gastrointestinal infection and streptococcal infection were not significantly associated with B27, B7, Bw4 or Bw6 antigens. Our study concludes that microbial infections do have some pathogenic role in causing SSA. © 2009 Springer-Verlag.
CA 125: A potential tumor marker for gallbladder cancer
(2006) Amita Chaube; Mallika Tewari; Usha Singh; H.S. Shukla
Background: CA 125 is a glycoprotein and a commonly used tumor marker in ovarian carcinoma. Its use in gallbladder carcinoma (GBC) has not yet been reported. We have henceforth examined for the first time the diagnostic utility of CA 125 in patients with gallbladder diseases. Patients and Methods: Serum CA 125 was measured in 64 patients with GBC, 47 Gallstone disease (GSD) and 23 healthy volunteers by ELISA. CA 125 level was compared between different cohorts by non-parametric test (Kruskal Wallis and Mann-Whitney test). Receiver operating characteristic curve (ROC) was constructed to see the diagnostic utility of CA 125. Its level was also correlated with age, sex and clinico-pathological parameters of the patients included in the study. Results: Mean value of CA 125 in patients with GBC, GSD and healthy volunteers was 77.44 ± 141.31 U/ml, 7.85 ± 5.40 U/ml, and 8.08 ± 3.26 U/ml respectively and showed a statistically significant difference (P < 0.001). CA 125 at cut off value of 11 U/ml yielded 64% sensitivity and 90% specificity in differentiating benign from malignant gallbladder disease. CA 125 level increased with stage and grade of the GBC though this was not statistically significant. A higher level of CA 125 was found in presence of gallbladder mass, weight loss, ascites and loss of appetite compared to patients with GSD. No association of CA 125 was apparent with either age or sex of the patients. Conclusion: CA 125 has a diagnostic potential for GBC and can differentiate GBC from GSD in light of other clinical details. © 2006 Wiley-Liss, Inc.
Coexistence of Ankylosing Spondylitis and Systemic Lupus Erythematosus
(2010) Sangeeta Singh; Gyanendra Kumar Sonkar; Usha Singh
Coexistence of ankylosing spondylitis with connective tissue diseases is uncommon. We describe here the coexistence of ankylosing spondylitis and systemic lupus erythematosus in a 35-year-old man. He presented with a 4-year history of pain in the hip joint and lower spine, and he later developed a malar rash and discoid rash. Immunological tests revealed that antinuclear antibody and double stranded DNA antibody were positive. The human leukocyte antigen B27 antigen was also found to be positive. We propose that development of systemic lupus erythematosus in this case may have been due to low grade chronic inflammation. © 2010 Elsevier.
Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and procalcitonin in predicting severity, organ failure, pancreatic necrosis, and mortality in acute pancreatitis
(2013) Ajay K. Khanna; Susanta Meher; Shashi Prakash; Satyendra Kumar Tiwary; Usha Singh; Arvind Srivastava; V.K. Dixit
Background. Multifactorial scorings, radiological scores, and biochemical markers may help in early prediction of severity, pancreatic necrosis, and mortality in patients with acute pancreatitis (AP). Methods. BISAP, APACHE-II, MOSS, and SIRS scores were calculated using data within 24 hrs of admission, whereas Ranson and Glasgow scores after 48 hrs of admission; CTSI was calculated on day 4 whereas IL-6 and CRP values at end of study. Predictive accuracy of scoring systems, sensitivity, specificity, and positive and negative predictive values of various markers in prediction of severe acute pancreatitis, organ failure, pancreatic necrosis, admission to intensive care units and mortality were calculated. Results. Of 72 patients, 31 patients had organ failure and local complication classified as severe acute pancreatitis, 17 had pancreatic necrosis, and 9 died (12.5%). Area under curves for Ranson, Glasgow, MOSS, SIRS, APACHE-II, BISAP, CTSI, IL-6, and CRP in predicting SAP were 0.85, 0.75, 0.73, 0.73, 0.88, 0.80, 0.90, and 0.91, respectively, for pancreatic necrosis 0.70, 0.64, 0.61, 0.61, 0.68, 0.61, 0.75, 0.86, and 0.90, respectively, and for mortality 0.84, 0.83, 0.77, 0.76, 0.86, 0.83, 0.57, 0.80, and 0.75, respectively. Conclusion. CRP and IL-6 have shown a promising result in early detection of severity and pancreatic necrosis whereas APACHE-II and Ranson score in predicting AP related mortality in this study. © 2013 Ajay K. Khanna et al.
Correlation between antral follicle count and anti-Mullerian hormone in infertile Indian women
(Regional Institute of Medical Sciences, 2021) Shivi Jain; Ram Chandra Shukla; Madhu Jain; Usha Singh; Tej Bali Singh
Background: Antral follicle count (AFC) and anti-Mullerian hormone (AMH) have been used as indicators of ovarian reserve in infertile women. There still exists a debate about the association between the two parameters. Objective: The objective of the study was to find out the relationship between AFC and AMH in infertile women. Methods: This was a prospective, hospital-based, cross-sectional study, in which 1083 infertile women (aged 20– 40 years) with primary infertility were included. They were divided into four age groups, i.e., Group I (20–24 years), Group II (25–29 years), Group III (30–34 years), and Group IV (35–40 years). AMH and AFC were measured on 3rd day of menstrual cycle. Pearson correlation and linear regression analysis were done to find out the relationship between age, AFC, and AMH. Statistical analysis was done using IBM SPSS Statistics for Windows, version 20 (IBM Corp., Armonk, N.Y., USA). A P < 0.05 was considered statistically significant. Results: There was modest negative correlation of AFC with age (r = −0.476, P < 0.001). AMH showed strong negative correlation with age (r = −0.844, P < 0.001) and modest positive correlation with AFC (r = 0.400, P < 0.001). For separate age groups also, statistically significant correlations (P < 0.05–P < 0.001) were noted between age, AFC, and AMH. Age explained 22.7% variation in AFC and 71.2% variation in AMH. Conclusion: There was a significant correlation between AMH and AFC in infertile women. AFC showed a continuous decline with increasing age. However, AMH increased with age till third decade of life and showed negative correlation with AFC. Thereafter, AMH started decreasing with age and showed positive correlation with AFC. © The Authors.
CTLA4 gene polymorphism and its association with disease occurrence, clinical manifestations, serum markers and cytokine levels in SLE patients from North India
(Wolters Kluwer Medknow Publications, 2022) Vikas Kailashiya; Usha Singh; Jyotsna Kailashiya
Background: Cytotoxic T lymphocyte-Associated protein-4 (CTLA-4) or CD152 is an inhibitory receptor expressed constitutively on CD4+CD25+ T regulatory lymphocytes (Treg) and transiently on activated CD4+ and CD8+ T lymphocytes. Association of CTLA4 gene polymorphisms with Systemic Lupus Erythematosus (SLE) has been reported in south Indians, but not in north Indians. This study aims to investigate CTLA4 gene polymorphism and its association with the occurrence of SLE, its clinical manifestation and serological markers in north Indians. Methods: This cross sectional study was done in a tertiary health care centre in north India. Patients reporting to the hospital and diagnosed with systemic lupus erythematosus were included in study. +49 A/G (snp-rs231775) CTLA4 gene polymorphism was analysed in 41 SLE patients and 21 matched healthy controls by real time PCR method. ANA (Antinuclear Antibody), anti dsDNA, Interferon-γ (IFN-γ), TGF-β, IL-10 were measured by ELISA kits. Complement (C3 and C4) and immunoglobulins (IgA, IgG, IgM) estimation were done with the turbidometry method. Chi-square test was used for comparison between groups and odds ratio with 95% confidence interval was calculated to estimate the associated risk. Results: A/A genotype was most common (51.2%) followed by the A/G genotype (46.3%) and G/G genotype (2.4%, detected in only 1 patient). The frequency of A allele was 74.4%, while of G allele was only 25.6%. A/G genotype SLE patients showed a higher risk (odds ratio 37.5, 95% CI-6.048-232.51) of developing edema compared to A/A genotype patients. There was no statistically significant association of various CTLA4 genotypes with the occurrence of SLE and serum markers. Conclusions: A/A was the most common CTLA4 genotype in both SLE patients and healthy controls of north India. Contrary to the previous report in south Indians, there was no statistically significant association between CTLA4 genotype and occurrence of SLE in north Indians. Only the presence of generalised edema was found significantly associated with the A/G genotype. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Estrogen and progesterone receptor status in breast cancer: Effect of oral contraceptive pills and hormone replacement therapy
(Churchill Livingstone, 2007) Mallika Tewari; S. Pradhan; Usha Singh; Hari S. Shukla
Background: Higher incidence of hormone receptor positive breast cancer (BC) in White women compared to Blacks and Asians is attributed to different inherent biology. Many of our patients have estrogen receptor (ER) and progesterone receptor (PR) negative tumors. We tried to explore if this is related to low frequency of oral contraceptive pills (OCP) and hormone replacement therapy (HRT) intake. Setting: Breast Unit, Department of Surgical Oncology, Tertiary Care Hospital, India. Methods: Records of female BC patients classified as 'Users' of OCP/HRT for minimum of 1 year and age, stage, histopathology matched 'Non-users' were reviewed retrospectively from January 1990 to October 2006. Results: Analysis of 150 evaluable 'Users' (58/122 premenopausal, 92/178 postmenopausal) and 150 matched 'Non-users' revealed 128 (42.67%) patients had ER and PR-negative, 157 (52.33%) ER and PR-positive, 12(4%) ER-positive/PR-negative, 3(1%) ER-negative/PR-positive tumor. Significantly more ER-positive tumor was found in both premenopausal [62.07% versus 39.06%, p=0.0184, odd's ratio (OR) 2.5527 and 95% confidence interval (CI) 1.2297-5.2993] and postmenopausal (63.04% versus 40.7%, p=0.0046, OR 2.4857 and 95% CI 1.3593-4.5455) 'Users' compared to 'Non-users', respectively. Grade III tumors were significantly less in premenopausal (p=0.0041) and postmenopausal (p=0.0012) 'Users'. Conclusions: These observations suggest that a low incidence of hormone receptor positivity in our patients could be partly due to low prevalence of OCP/HRT intake. © 2007 Elsevier Ltd. All rights reserved.
Etiopathological study of crescentic glomerulonephritis and its outcome: A retrospective analysis
(Journal of Association of Physicians of India, 2019) Jai Prakash; Prem Shankar Patel; Suraj Prakash; Mohd Iqbal; Shiv Shankar Sharma; Shivendra Singh; Usha Singh
Introduction: Crescentic Glomerulonephritis (CGN) is most aggressive structural phenotype and accounts for 2%-7% of renal biopsy in most series. The aim of study was to assess the clinical feature and outcome of CGN at our centre. Material and Methods: The renal biopsy performed during the period of January 2015 to January 2018 was studied and patients showing crescentic glomerulonephritis on histology were selected for this study. The clinical presentation, immunological assay, biochemical and haematological investigations, treatment protocol and final outcome at three month of these patients were analysed in the present study. Results: Of 380 biopsy, 26 (male=17, female=9) patients had histological evidence of CGN (6.8%). The age of patients ranged between 13-75 (mean=43) years. Fibro cellular and cellular crescent was noted in 84.61% and 15.38% of patients respectively. Small vessels vasculitis and granuloma was observed in 5 (19.23%) cases. Based on immunohistopathology, we observed type I (n=3), type II (n=8), type III (n=5), type IV (n=3), and type V (n=7) crescentic GN in 11.53%, 30.76%, 19.23%, 11.53% and 26.92% of patients respectively. Haemodialysis was given to 22(84.61%) and 4(15.38%) patients were treated with immunosuppressive therapy. Plasmapheresis was used in two double positive (ANCA + Anti GBM Ab) patients. Remaining 21(80.76%) has progressed to ESRD over a period of 2-3 months. Conclusion: Type II (immune complex) CGN was most common type followed by type V (immune negative) and type III (pauci-immune) CGN. The crescentic GN had worse prognosis with >80% of patients progressed to ESRD within 3 month of time from onset of illness. Early diagnosis and treatment is associated with favourable outcome. © 2019 Journal of Association of Physicians of India. All rights reserved.
Evaluation of serum interleukin 6 and tumour necrosis factor alpha levels, and their association with various non-immunological parameters in renal transplant recipients
(2013) Gyanendra Kumar Sonkar; Sangeeta Singh; Satyendra Kumar Sonkar; Usha Singh; Rana Gopal Singh
Introduction Renal transplant rejection involves both immunological and non-immunological factors. The objective of the present study was to investigate the association between immunological factors, such as serum interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α), and non-immunological parameters, such as age, serum creatinine (SCr), creatinine clearance (CrCl) and dyslipidaemia, in renal transplant recipients (RTRs). Methods This study included 90 RTRs and 90 healthy controls. Biochemical parameters, including serum IL-6 and TNF-α, were estimated using standard protocols. CrCl was calculated using the Cockroft-Gault equation, and the type of rejection was confirmed on biopsy. Student's t-test and univariate and multivariate analyses were performed using the Statistical Package for the Social Sciences for Windows version 15. Results The mean levels of serum IL-6 and TNF-α were significantly higher in RTRs than in the control group (p < 0.001). These parameters were also found to be significantly different between the transplant rejection (TR) and transplant stable (TS) groups (p < 0.001). CrCl was significantly decreased in the TR group when compared to the TS group (p < 0.001). The two cytokines, IL-6 and TNF-α, correlated significantly with all metabolic parameters, such as SCr, CrCl and dyslipidaemia. Multiple regression analysis showed that TNF-α and CrCl were the strongest predictors of IL-6. Conclusion We conclude that immunological factors, as well as non-immunological factors such as CrCl, SCr and dyslipidaemia, play important roles in the pathogenesis of graft rejection and renal graft dysfunction.
Global Retinoblastoma Presentation and Analysis by National Income Level
(American Medical Association, 2020) Ido Didi Fabian; Elhassan Abdallah; Shehu U. Abdullahi; Rula A. Abdulqader; Sahadatou Adamou Boubacar; Dupe S. Ademola-Popoola; Adedayo Adio; Armin R. Afshar; Priyanka Aggarwal; Ada E. Aghaji; Alia Ahmad; Marliyanti N. R. Akib; Lamis Al Harby; Mouroge H. Al Ani; Aygun Alakbarova; Silvia Alarcón Portabella; Safaa A. F. Al-Badri; Ana Patricia A. Alcasabas; Saad A. Al-Dahmash; Amanda Alejos; Ernesto Alemany-Rubio; Amadou I. Alfa Bio; Yvania Alfonso Carreras; Christiane Al-Haddad; Hamoud H. Y. Al-Hussaini; Amany M. Ali; Donjeta B. Alia; Mazin F. Al-Jadiry; Usama Al-Jumaly; Hind M. Alkatan; Charlotta All-Eriksson; Ali A. R. M. Al-Mafrachi; Argentino A. Almeida; Khalifa M. Alsawidi; Athar A. S. M. Al-Shaheen; Entissar H. Al-Shammary; Primawita O. Amiruddin; Romanzo Antonino; Nicholas J. Astbury; Hatice T. Atalay; La-Ongsri Atchaneeyasakul; Rose Atsiaya; Taweevat Attaseth; Than H. Aung; Silvia Ayala; Baglan Baizakova; Julia Balaguer; Ruhengiz Balayeva; Walentyna Balwierz; Honorio Barranco; Covadonga Bascaran; Maja Beck Popovic; Raquel Benavides; Sarra Benmiloud; Nissrine Bennani Guebessi; Rokia C. Berete; Jesse L. Berry; Anirban Bhaduri; Sunil Bhat; Shelley J. Biddulph; Eva M. Biewald; Nadia Bobrova; Marianna Boehme; H.C. Boldt; Maria Teresa B. C. Bonanomi; Norbert Bornfeld; Gabrielle C. Bouda; Hédi Bouguila; Amaria Boumedane; Rachel C. Brennan; Bénédicte G. Brichard; Jassada Buaboonnam; Patricia Calderón-Sotelo; Doris A. Calle Jara; Jayne E. Camuglia; Miriam R. Cano; Michael Capra; Nathalie Cassoux; Guilherme Castela; Luis Castillo; Jaume Català-Mora; Guillermo L. Chantada; Shabana Chaudhry; Sonal S. Chaugule; Argudit Chauhan; Bhavna Chawla; Violeta S. Chernodrinska; Faraja S. Chiwanga; Tsengelmaa Chuluunbat; Krzysztof Cieslik; Ruellyn L. Cockcroft; Codruta Comsa; Zelia M. Correa; Maria G. Correa Llano; Timothy W. Corson; Kristin E. Cowan-Lyn; Monika Csóka; Xuehao Cui; Isac V. Da Gama; Wantanee Dangboon; Anirban Das; Sima Das; Jacquelyn M. Davanzo; Alan Davidson; Patrick De Potter; Karina Q. Delgado; Hakan Demirci; Laurence Desjardins; Rosdali Y. Diaz Coronado; Helen Dimaras; Andrew J. Dodgshun; Craig Donaldson; Carla R. Donato Macedo; Monica D. Dragomir; Yi Du; Magritha Du Bruyn; Kemala S. Edison; I. Wayan Eka Sutyawan; Asmaa El Kettani; Amal M. Elbahi; James E. Elder; Dina Elgalaly; Alaa M. Elhaddad; Moawia M. Ali Elhassan; Mahmoud M. Elzembely; Vera A. Essuman; Ted Grimbert A. Evina; Zehra Fadoo; Adriana C. Fandiño; Mohammad Faranoush; Oluyemi Fasina; Delia D. P. G. Fernández; Ana Fernández-Teijeiro; Allen Foster; Shahar Frenkel; Ligia D. Fu; Soad L. Fuentes-Alabi; Brenda L. Gallie; Moira Gandiwa; Juan L. Garcia; David García Aldana; Pascale Y. Gassant; Jennifer A. Geel; Fariba Ghassemi; Ana V. Girón; Zelalem Gizachew; Marco A. Goenz; Aaron S. Gold; Maya Goldberg-Lavid; Glen A. Gole; Nir Gomel; Efren Gonzalez; Graciela Gonzalez Perez; Liudmira González-Rodríguez; Henry N. Garcia Pacheco; Jaime Graells; Liz Green; Pernille A. Gregersen; Nathalia D. A. K. Grigorovski; Koffi M. Guedenon; D. Sanjeeva Gunasekera; Ahmet K. Gündüz; Himika Gupta; Sanjiv Gupta; Theodora Hadjistilianou; Patrick Hamel; Syed A. Hamid; Norhafizah Hamzah; Eric D. Hansen; J. William Harbour; M. Elizabeth Hartnett; Murat Hasanreisoglu; Sadiq Hassan; Shadab Hassan; Stanislava Hederova; Jose Hernandez; Lorelay Marie Carcamo Hernandez; Laila Hessissen; Diriba F. Hordofa; Laura C. Huang; G.B. Hubbard; Marlies Hummlen; Kristina Husakova; Allawi N. Hussein Al-Janabi; Russo Ida; Vesna R. Ilic; Vivekaraj Jairaj; Irfan Jeeva; Helen Jenkinson; Xunda Ji; Dong Hyun Jo; Kenneth P. Johnson; William J. Johnson; Michael M. Jones; Theophile B. Amani Kabesha; Rolande L. Kabore; Swathi Kaliki; Abubakar Kalinaki; Mehmet Kantar; Ling-Yuh Kao; Tamar Kardava; Rejin Kebudi; Tomas Kepak; Naama Keren-Froim; Zohora J. Khan; Hussain A. Khaqan; Phara Khauv; Wajiha J. Kheir; Vikas Khetan; Alireza Khodabande; Zaza Khotenashvili; Jonathan W. Kim; Jeong Hun Kim; Hayyam Kiratli; Tero T. Kivelä; Artur Klett; Jess Elio Kosh Komba Palet; Dalia Krivaitiene; Mariana Kruger; Kittisak Kulvichit; Mayasari W. Kuntorini; Alice Kyara; Eva S. Lachmann; Carol P. S. Lam; Geoffrey C. Lam; Scott A. Larson; Slobodanka Latinović; Kelly D. Laurenti; Bao Han A. Le; Karin Lecuona; Amy A. Leverant; Cairui Li; Ben Limbu; Quah Boon Long; Juan P. López; Robert M. Lukamba; Livia Lumbroso; Sandra Luna-Fineman; Delfitri Lutfi; Lesia Lysytsia; George N. Magrath; Amita Mahajan; Abdul Rahim Majeed; Erika Maka; Mayuri Makan; Emil K. Makimbetov; Chatonda Manda; Nieves Martín Begue; Lauren Mason; John O. Mason; Ibrahim O. Matende; Miguel Materin; Clarissa C. D. S. Mattosinho; Marchelo Matua; Ismail Mayet; Freddy B. Mbumba; John D. McKenzie; Aurora Medina-Sanson; Azim Mehrvar; Aemero A. Mengesha; Vikas Menon; Gary John V. D. Mercado; Marilyn B. Mets; Edoardo Midena; Divyansh K. C. Mishra; Furahini G. Mndeme; Ahmed A. Mohamedani; Mona T. Mohammad; Annette C. Moll; Margarita M. Montero; Rosa A. Morales; Claude Moreira; Prithvi Mruthyunjaya; McHikirwa S. Msina; Gerald Msukwa; Sangeeta S. Mudaliar; Kangwa I. Muma; Francis L. Munier; Gabriela Murgoi; Timothy G. Murray; Kareem O. Musa; Asma Mushtaq; Hamzah Mustak; Okwen M. Muyen; Gita Naidu; Akshay Gopinathan Nair; Larisa Naumenko; Paule Aïda Ndoye Roth; Yetty M. Nency; Vladimir Neroev; Hang Ngo; Rosa M. Nieves; Marina Nikitovic; Elizabeth D. Nkanga; Henry Nkumbe; Murtuza Nuruddin; Mutale Nyaywa; Ghislaine Obono-Obiang; Ngozi C. Oguego; Andrzej Olechowski; Scott C. N. Oliver; Peter Osei-Bonsu; Diego Ossandon; Manuel A. Paez-Escamilla; Halimah Pagarra; Sally L Painter; Vivian Paintsil; Luisa Paiva; Bikramjit P. Pal; Mahesh Shanmugam Palanivelu; Ruzanna Papyan; Raffaele Parrozzani; Manoj Parulekar; Claudia R. Pascual Morales; Katherine E. Paton; Katarzyna Pawinska-Wasikowska; Jacob Pe'Er; Armando Peña; Sanja Perić; Chau T. M. Pham; Remezo Philbert; David A. Plager; Pavel Pochop; Rodrigo A. Polania; Vladimir G. Polyakov; Manca T. Pompe; Jonathan J. Pons; Daphna Prat; Vireak Prom; Ignatius Purwanto; Ali O. Qadir; Seema Qayyum; Jiang Qian; Ardizal Rahman; Salman Rahman; Jamalia Rahmat; Purnima Rajkarnikar; Rajesh Ramanjulu; Aparna Ramasubramanian; Marco A. Ramirez-Ortiz; Léa Raobela; Riffat Rashid; M. Ashwin Reddy; Ehud Reich; Lorna A. Renner; David Reynders; Dahiru Ribadu; Mussagy M. Riheia; Petra Ritter-Sovinz; Duangnate Rojanaporn; Livia Romero; Soma R. Roy; Raya H. Saab; Svetlana Saakyan; Ahmed H Sabhan; Mandeep S. Sagoo; Azza M. A. Said; Rohit Saiju; Beatriz Salas; Sonsoles San Román Pacheco; Gissela L. Sánchez; Phayvanh Sayalith; Trish A. Scanlan; Amy C. Schefler; Judy Schoeman; Ahad Sedaghat; Stefan Seregard; Rachna Seth; Ankoor S. Shah; Shawkat A. Shakoor; Manoj K. Sharma; Sadik T. Sherief; Nandan G. Shetye; Carol L. Shields; Sorath Noorani Siddiqui; Sidi Sidi Cheikh; Sónia Silva; Arun D. Singh; Niharika Singh; Usha Singh; Penny Singha; Rita S. Sitorus; Alison H. Skalet; Hendrian D. Soebagjo; Tetyana Sorochynska; Grace Ssali; Andrew W. Stacey; Sandra E. Staffieri; Erin D. Stahl; Christina Stathopoulos; Branka Stirn Kranjc; David K. Stones; Caron Strahlendorf; Maria Estela Coleoni Suarez; Sadia Sultana; Xiantao Sun; Meryl Sundy; Rosanne Superstein; Eddy Supriyadi; Supawan Surukrattanaskul; Shigenobu Suzuki; Karel Svojgr; Fatoumata Sylla; Gevorg Tamamyan; Deborah Tan; Alketa Tandili; Fanny F. Tarrillo Leiva; Maryam Tashvighi; Bekim Tateshi; Edi S. Tehuteru; Luiz F. Teixeira; Kok Hoi Teh; Tuyisabe Theophile; Helen Toledano; Doan L. Trang; Fousseyni Traoré; Sumalin Trichaiyaporn; Samuray Tuncer; Harba Tyau-Tyau; Ali B. Umar; Emel Unal; Ogul E. Uner; Steen F. Urbak; Tatiana L. Ushakova; Rustam H. Usmanov; Sandra Valeina; Milo Van Hoefen Wijsard; Adisai Varadisai; Liliana Vasquez; Leon O. Vaughan; Nevyana V. Veleva-Krasteva; Nishant Verma; Andi A. Victor; Maris Viksnins; Edwin G. Villacís Chafla; Vicktoria Vishnevskia-Dai; Tushar Vora; Antonio E. Wachtel; Werner Wackernagel; Keith Waddell; Patricia D. Wade; Amina H. Wali; Yi-Zhuo Wang; Avery Weiss; Matthew W. Wilson; Amelia D. C. Wime; Atchareeya Wiwatwongwana; Damrong Wiwatwongwana; Charlotte Wolley Dod; Phanthipha Wongwai; Daoman Xiang; Yishuang Xiao; Jason C. Yam; Huasheng Yang; Jenny M. Yanga; Muhammad A Yaqub; Vera A. Yarovaya; Andrey A. Yarovoy; Huijing Ye; Yacoub A. Yousef; Putu Yuliawati; Arturo M. Zapata López; Ekhtelbenina Zein; Chengyue Zhang; Yi Zhang; Junyang Zhao; Xiaoyu Zheng; Katsiaryna Zhilyaeva; Nida Zia; Othman A. O. Ziko; Marcia Zondervan; Richard Bowman
Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved.
Ground water assessment and its utilization in Chitrakoot district, U.P
(2011) Swati Yadav; Usha Singh
The present paper attempts to study the ground water resources of Chitrakoot district (U.P.) and its uses in agricultural, domestic and industrial sectors. In the assessment of ground water the present study includes the condition of water table, recharge of ground water by rainfall, canal seepage and return seepage by irrigated fields, quality of ground water and its utilization in different sectors .This study reveals that the rate of recharge is higher than the rate of draft of ground water in the district as a whole at present. So it falls in the safe category for future development. It is also observed that the quality of ground water is suitable for both the domestic and irrigational purposes. Present study is based on the data collected from Central Ground Water Board (Lucknow), Office of Ex. Engineer, Irrigation Division ,Karwi (Chitrakoot), Office of Assistant Engineer Minor Irrigation Division(Banda) & chemical analysis of water samples from different observation wells of the Chitrakoot District personally collected in the last week of May 2008.
Histological Spectrum of Clinical Kidney Disease in Type 2 Diabetes Mellitus Patients with special Reference to nonalbuminuric Diabetic Nephropathy: A Kidney Biopsy-based Study
(Journal of Association of Physicians of India, 2022) Jai Prakash; Prem Shankar Patel; Mohd Iqbal; Shiv Shankar Sharma; Shivendra Singh; Neeraj K. Agrawal; Usha Singh
Background: Diabetic nephropathy (DN) is an important and catastrophic complication of diabetes mellitus (DM). Kidney disease has heterogeneity in histology in diabetes patients and includes both diabetic kidney disease (DKD) (albuminuric or nonalbuminuric) and nondiabetic kidney disease (NDKD) either in isolation or in coexistence with DN. Diabetic nephropathy is hard to overturn. While NDKD is treatable and reversible. Materials and methods: We enrolled a total of 50 type 2 diabetes mellitus (T2DM) patients with clinical kidney disease, of both genders and age >18 years, who underwent kidney biopsy from October 2016 to October 2018. Patients with proteinuria <30 mg per day were excluded from the study. The indications of the renal biopsy were nephrotic syndrome (NS), active urinary sediment, rapid decline in renal function, asymptomatic proteinuria, and hematuria. Result: A total of 50 (males: 42 and females: eight) patients with T2DM who underwent kidney biopsy were enrolled. The clinical presentation was: NS 26 (52%), chronic kidney disease (CKD) 11 (22%), asymptomatic proteinuria and hematuria six (12%), acute kidney injury (AKI) four (8%), and acute nephritic syndrome (ANS) three (6%). Diabetic retinopathy (DR) was noted in 19 (38%) cases. Kidney biopsy revealed isolated DN, isolated NDKD, and NDKD superimposed on DN in 26 (52%), 14 (28%), and 10 (20%) cases, respectively. Idiopathic membranous nephropathy (MN) (4) and amyloidosis (2) were the most common forms of NDKD, whereas diffuse proliferative glomerulonephritis (DPGN) was the main form of NDKD superimposed on DN. Diabetic nephropathy was observed in 15 (79%) cases in presence of DR and also in 11 (35.5%) cases even in absence of DR. Of eight patients with microalbuminuria four (50%) cases have biopsy-proven DN. Conclusion: About 48% of patients had NDKD either in isolation or in coexistence with DN. Diabetic nephropathy was found in absence of DR and in patients with a low level of proteinuria. The level of proteinuria and presence of DR does not help to distinguish DN vs NDKD. Hence, renal biopsy may be useful in selected T2DM patients with clinical kidney disease to diagnose NDKD. © The Author(s).
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.
Human leukocyte antigen in patients with psoriasis
(2011) Sangeeta Singh; Usha Singh; Sanjay Singh
[No abstract available]