Browsing by Author "Pandey, Uma"
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Publication A study of oxidative stress in cervical cancer- an institutional study(Elsevier B.V., 2021) Zahra, Kulsoom; Patel, Sandeep; Dey, Tulika; Pandey, Uma; Mishra, Surendra PratapCervical 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. � 2020Publication Anxiety, Depression and Behavioural Changes in Junior Doctors and Medical Students Associated with the Coronavirus Pandemic: A Cross-Sectional Survey(Springer, 2021) Pandey, Uma; Corbett, Gillian; Mohan, Suruchi; Reagu, Shuja; Kumar, Shubham; Farrell, Thomas; Lindow, StephenIntroduction: 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.Publication 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; Pandey, Uma; Singh, Kiran; Patel, Deepak SinghBackground: 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.Publication Current Practices in Management of Placenta Accreta Spectrum in Low-resource Settings(Jaypee Brothers Medical Publishers (P) Ltd, 2022) Radhika, A.G.; Bhaskaran, Sruthi; Singh, Shilpa; Samant, Meena; Kumari, Archana; Saxena, Pikee; Beck, Manisha; Srivastava, Ruchi; Chaudhary, Rachna; Singh, Anita; Pandey, UmaBackground: 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.Publication Diagnostic Dilemma in Peripartum Management of von Willebrand Disease: a Case Report(Springer, 2021) Garg, Megha; Pandey, Uma; Meena, Lalit Prashant[No abstract available]Publication Intention to Vaccinate against SARS-CoV-2 amongst Healthcare Workers in India: A Multicenter Cross-sectional Study(Jaypee Brothers Medical Publishers (P) Ltd, 2021) Dwivedi, Divya; Pandey, Uma; McDonell, Sarah; Hehir, Mark; Lindow, Stephen W.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).Publication Obstetric violence: Comparing medical student perceptions in India and the UK(Elsevier Ireland Ltd, 2021) Gray, Thomas; Mohan, Suruchi; Lindow, Stephen; Pandey, Uma; Farrell, TomObjective(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. � 2021Publication Primary Unilateral Ovarian Lymphoma in a Young Girl: Case Report(Springer, 2021) Peddappolla, Shilpa Chowdary; Pandey, Uma; Shahi, Uday Pratap[No abstract available]Publication Role of anti mullerian hormone (AMH) in diagnosis of polycystic ovarian syndrome (PCOS) in Indian women(IP Innovative Publication Pvt. Ltd., 2023) Pandey, Uma; Gupta, Neha; Jain, Shivi; Singh, Surya KumarBackground: 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.Publication Study of institute of medical sciences, BHU and Sir Sunder Lal Hospital staff regarding their attitudes and experiences of domestic violence(IP Innovative Publication Pvt. Ltd., 2023) Pandey, Uma; Narayan, Aditi; Lindow, S.W.Background: Domestic violence is a social evil prevalent across all cultures and societies. It refers to any form of physical or mental abuse suffered by a person from a relative or member of their domestic circle. The majority of the world is patriarchal and women are most affected. The present study was done to evaluate the attitudes and experiences of domestic violence amongst staff of SSH and IMS. Design: A total of 392 staff were questioned regarding their attitudes and experiences of Domestic Violence victims. The study was a cross observational study and questionnaires were distributed via Google Forms and were filled anonymously. The responses collected were categorized on the basis of the student and qualified staff members of SSH and IMS. The data obtained was subjected to statistical analysis using SPSS software. Results: Qualified healthcare professionals (53%) had more exposure to domestic violence victims than students (28%) and were aware (51%) that inquiring about DV was essential in their job. However, they were more concerned (33%) about potential impacts on patient relationships than students (32%). Both groups preferred seeking help from friends/family (48%) over the police (28%) for DV victims. Students were more proactive in reporting DV to the police. More qualified professionals (44%) believed government efforts to address DV were inadequate, while students (60%) saw room for improvement. COVID-19 worsened DV according to 61% of students and 42% of professionals. Both groups acknowledged DV inquiry as part of their job and supported hospital-based help, with students (35%) favoring dedicated services for IPV victims more than professionals (29%). Both groups lacked sufficient DV training in their curriculum (42%). Conclusion: Domestic violence persists as a social menace, often seen as a private matter despite available government and non-government efforts. The COVID-19 pandemic has exacerbated the situation for victims. Hospital support and healthcare professionals� training are lacking. Our study assesses the impact of DV training, urging authorities to address this critical issue. � 2023 Innovative Publication. All rights reserved.Publication Women�s health during Covid-19(IP Innovative Publication Pvt. Ltd., 2021) Garg, Megha; Pandey, Uma; Lindow, Stephen W.The world has been hit by the coronavirus (covid-19) pandemic starting in November 2019 and progressing in the following months of March-June 2020. The coronavirus pandemic has caused general disruption in healthcare systems and facilities in general. Resources are deviated towards treating coronavirus affected patients and also lockdowns and curfews are implemented to contain the spread of the virus. This has caused a negative impact on health of women of all age groups and suffering from diseases as accessing health facilities is now a challenge. The closure of outpatients, operation theatres and wards has caused a delay or cancellation in treatment for many women. This article emphasizes the condition of women during coronavirus pandemic and its impact on women�s health. � 2021 Innovative Publication, All rights reserved.
