Browsing by Author "Jain, Shuchi"

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    Diagnosis of Genital Tuberculosis in Infertile Women by Using the Composite Reference Standard
    (Hindawi Limited, 2022) Saxena, Riden; Shrinet, Kriti; Rai, Sachchida Nand; Singh, Kamal; Jain, Shivi; Jain, Shuchi; Singh, Deeksha; Anupurba, Shampa; Jain, Madhu
    Female genital tuberculosis (FGTB) can be asymptomatic or even masquerade as other gynecological conditions. Conventional methods of FGTB diagnosis include various imaging, bacteriological, molecular, and pathological techniques that are only positive in a small percentage of patients, leaving many cases with undiagnosed condition. In the absence of a perfect diagnostic method, composite reference standards (CRSs) have been advocated in this diagnostic study. This study assesses the agreement between traditional diagnostic modalities using CRS and prevalent TB groups among different fallopian tube infertility manifestations. A total of 86 women with primary and secondary infertility were included in the study and subjected to bacteriological, pathological, and radiological examination for the diagnosis of FGTB. Results were evaluated statistically for concordance of the diagnostic tests to the CRS by sensitivity and specificity, while PPV and NPV were calculated for the performance of diagnostic tests of FGTB. We observed that 11.2% of women were found to be true positives by means of CRS. The positive findings by CRS were as follows: ultrasonography (13.9%), laparoscopy (14%), hysteroscopy (12%), GeneXpert (4.8%), culture (4.8%), polymerase chain reaction (4.8%), and histopathology (6.4%). GeneXpert and culture were found to have a perfect agreement with CRS. Hysterosalpingography, laparoscopy, and hysteroscopy have a fair agreement with CRS. Out of 43 women with tubal factor infertility, 6 women were found in the definitive TB group with mixed conditions of tubal manifestations. This study evaluates and demonstrates the reliability of the collective assessment of various diagnostic methods with CRS findings that help in identifying different TB groups of genital tuberculosis patients from all infertile patients by applying the criteria of CRS. � 2022 Riden Saxena et al.
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    Platelet function disorder in women with heavy menstrual bleeding in Eastern Uttar Pradesh
    (Regional Institute of Medical Sciences, 2021) Jain, Shuchi; Agrawal, Nisha Rani; Tilak, Vijai; Mohammad, Ekhlak; Dash, D.; Jain, Madhu
    Background: Platelet function disorder (PFD) is turning out to be a major cause of heavy menstrual bleeding (HMB) in women. One should suspect for this entity and should look for it in all girls who have this issue since menarche to impart proper management. Objectives: This study was carried out to find the incidence of PFD in Patients with HMB referred to our tertiary care teaching hospital. Materials and Methods: Platelet aggregation in response to ristocetin-induced platelet aggregation (RIPA), Adrenaline, adenosine diphosphate, and Collagen was studied in 50 women with HMB and in the equal number of age-matched healthy women. Bleeding time and Platelet count were also measured. Results: Glanzmann�s thrombasthenia (GT) was detected in 5 and Bernard Soulier Syndrome (BSS) in 2 women with HMB. Macrothrombocytopenia was observed in BSS. RIPA was also significantly reduced in BSS but normal in GT. Coagulopathies should always be doubted in the presence of significant anemia. One should carry out the Platelet function studies when screening parameters like prothrombin time, partial thromboplastin time, von Willebrand factor, and factor VIII activity level are normal. Normal platelet count and morphology in addition suggest functional defects in platelets which can be detected by various aggregation studies, electron microscopy, flow cytometry, and thromboelastography. Conclusion: The clinicians treating women with HMB should be aware of PFD as an important etiology and the platelet function should be studied in all women with HMB in a phase-wise manner in order not to miss the diagnosis and also to make it more cost-effective. � 2021 Journal of Medical Society | Published by Wolters Kluwer-Medknow.
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    Prevalence of von Willebrand Disease in Patients with Heavy Menstrual Bleeding: An Indian Perspective
    (Jaypee Brothers Medical Publishers (P) Ltd, 2021) Jain, Shuchi; Agrawal, Nisha R.; Tilak, Vijai; Jain, Madhu; Singh, Tej B.; Piplani, Krishna S.
    Aim: The von Willebrand disease (vWD) is said to be the most common hemostatic disorder among the nonstructural causes of heavy menstrual bleeding (HMB). This study was carried out to find prevalence of vWD and its subtypes in patients with HMB referred to a tertiary healthcare center. Materials and methods: Two hundred patients with HMB and equal number of age-matched control were subjected to laboratory tests such as complete blood count, bleeding time, and clotting time. Prothrombin time (PT), activated partial thromboplastin time (APTT), and factor VIII (FVIII):C assay were done manually. von Willebrand factor (vWF:Ag) antigen assay and vWF:Ag collagen binding (CB) were done by enzyme-linked immunosorbent assay (ELISA). Platelet aggregation study with ristocetin was done to find the different subtypes of vWD. Results: vWD and its subtypes were diagnosed in 25 out of 200 women with HMB with a prevalence of 12.5%. Type III vWD was the commonest (15/25, 60%), followed by type II (7/25, 28%) and type I (3/25, 12%). Among the various subcategories of type II, type IIB was conspicuously absent and type IIN was the most frequent (5/7, 71%). Conclusion: vWD should always be considered as one of the possible bleeding disorders in patients with HMB particularly in those referred to a tertiary care center. It was detected in 12.5% of such women, and type III was the most frequent type encountered among its various subtypes. Clinical significance: Detection of vWD and its various subtypes at the earliest opportunity would help the treating physician to plan out a definite line of management and save many women from unwarranted hysterectomies and also improve their quality of life and reproductive potential. � The Author(s).