Browsing by Author "Singh, Tej B."
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Publication A Correlation between Antral Follicle Count and Anti-M�llerian Hormone in Healthy Indian Women of Reproductive Age(Jaypee Brothers Medical Publishers (P) Ltd, 2022) Jain, Shivi; Shukla, Ram C.; Jain, Madhu; Singh, Usha; Singh, Tej B.Aim: To determine which of the two parameters between antral follicle count (AFC) and anti-M�llerian 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.Publication Clinico.epidemiological profile and treatment outcome in adolescents and young patients of rectal cancer attending a tertiary cancer center(Wolters Kluwer Medknow Publications, 2023) Mishra, Ritusha; Pandey, Ankita; Mishra, Himanshu; Singh, Tej B.; Mandal, Abhijit; Asthana, Anupam K.Introduction: The incidence of colorectal cancer in young adults is on an increasing trend. It is observed that this subgroup of patients has an aggressive disease and carries a poorer prognosis compared to its older counterpart. This study aimed to analyze the incidence, treatment outcome, and prognostic factors in adolescents and young adults with rectal cancer attending a tertiary cancer center in North India. Materials and Methods: We retrospectively analyzed 50 patients of histologically proven rectal cancer, aged up to 30 years, treated at our center between 2015 and 2019. The clinical, demographic, and pathological parameters were studied in all these patients. Kaplan-Meier survival analysis was used to find out survival. Univariate analysis was performed to assess prognostic factors. Results: The incidence was 26.4% at our center with a median age of 28 years. Bleeding per rectum was the commonest complaint. Most of them had signet ring cell histology (26%). The median overall survival was 16 months. Survival was significantly better in patients having bleeding per rectum as an initial complaint (P = 0.009), absence of lymphovascular invasion (LVI) (P = 0.005), and perineural invasion (PNI) (P = 0.002), who received complete planned treatment compared to patients who could not receive either of the modality (P < 0.001). Patients who did not receive radiotherapy (RT) had the worst outcomes compared to those who received RT in any form. RT dose of 50.4 Gy was found to be superior as compared to other schedules. There was no significant difference in survival with gender, tumor stage, grade, type of surgery, or chemotherapy regimen. Conclusion: The majority of patients presented in an advanced stage. Therefore, bleeding per rectum should be properly and timely investigated in all these young patients. Early detection and complete treatment are paramount to improving the outcome. � 2023 Copyright:Publication Evaluation of survival outcomes and prognostic factors of carcinoma anal canal at a tertiary cancer center(Wolters Kluwer Medknow Publications, 2023) Mishra, Himanshu; Mishra, Ritusha; Singh, Ankita; Mandal, Abhijit; Singh, Tej B.; Asthana, Anupam K.Context: Concurrent chemoradiotherapy is considered a standard of care for patients with carcinoma anal canal. Being an unusual malignancy, there is limited Indian data regarding survival outcomes and prognostic factors. Aim: To evaluate survival outcomes and associated prognostic factors in patients with carcinoma anal canal treated with radical intent. Methods and Material: Patients with squamous cell carcinoma of the anal canal, treated with radical intent between 2015 and 2019 were included in the study. Data regarding the baseline characteristics of the patients and treatment outcomes were collected and analyzed. Survival rates were estimated using Kaplan-Meier method. To determine survival difference between the groups, log-rank test was used. Multivariate analyses were performed with Cox proportional hazard models and P value < 0.05 was considered significant. Results: Forty-two patients were identified after applying suitable eligibility criteria. The median age was 55 years (range: 26-80 years).The median follow-up duration was 23.5 months (range: 1.9-51.9 months). The 3-year overall survival (OS), disease-free survival (DFS), and locoregional (LRC) were 78.5%, 53.1%, and 66.4%, respectively. On multivariate analysis, inferior DFS was significantly affected by lack of concurrent chemotherapy (CT) (hazard ratio [HR], 11.50; 95% confidence interval [CI], 1.92-68.78; P = 0.007) and radiotherapy (RT) dose of 45 Gy or less (HR, 35.96; 95% CI, 6.32-204.56; P = 0.000). Conclusion: For patients of carcinoma anal canal, concurrent CT and RT dose are independent prognostic factors influencing DFS. � 2023 Copyright:Publication 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).
