bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi‐camera traffic scene mosaic based on camera calibration
Authors: Wu Feifan , Song Huansheng , Dai Zhe , Wang Wei , Li Junyan
Published: February 2021

Recently, the traffic application based on vision in the single traffic‐monitoring scene has been widely studied and developed. However, cross‐regional research is still in its infancy. In order to help solve the application of cross‐regional traffic surveillance scenarios, this paper proposes a more reliable and accurate road scene mosaic method under multi‐camera surveillance. The mosaic road panorama contains physical information, which can be used to achieve a cross‐regional measurement. It also lays the foundation for vehicle spatial location, vehicle speed and traffic incident detection across regions. First, the mapping relationship between the three‐dimensional sub‐world coordinates and their corresponding two‐dimensional image coordinates is established by camera calibration. Second, the projection transformation relationship between two cameras is established by two sub‐world coordinate systems and their common information. Finally, we use the proposed inverse projection idea and translation vector relationship to complete the mosaic of two traffic‐monitoring road scenes. The experimental results show that the camera calibration accuracy can reach more than 97% in a single scene. The measurement accuracy of the mosaic block is over 95%. The experimental results show that the proposed method has a higher accuracy, which has great value in related theoretical research and practical applications.
Solving 1D non‐linear magneto quasi‐static Maxwell's equations using neural networks
Authors: Baldan Marco , Baldan Giacomo , Nacke Bernard
Published: February 2021

Electromagnetics (EM) can be described, together with the constitutive laws, by four PDEs, called Maxwell's equations. “Quasi‐static” approximations emerge from neglecting particular couplings of electric and magnetic field related quantities. In case of slowly time varying fields, if inductive and resistive effects have to be considered, whereas capacitive effects can be neglected, the magneto quasi‐static (MQS) approximation applies. The solution of the MQS Maxwell's equations, traditionally obtained with finite differences and elements methods, is crucial in modelling EM devices. In this paper, the applicability of an unsupervised deep learning model is studied in order to solve MQS Maxwell's equations, in both frequency and time domain. In this framework, a straightforward way to model hysteretic and anhysteretic non‐linearity is shown. The introduced technique is used for the field analysis in the place of the classical finite elements in two applications: on the one hand, the B–H curve inverse determination of AISI 4140, on the other, the simulation of an induction heating process. Finally, since many of the commercial FEM packages do not allow modelling hysteresis, it is shown how the present approach could be further adopted for the inverse magnetic properties identification of new magnetic flux concentrators for induction applications.
Aquarium trade and fish farms as a source of non-native freshwater fish introductions in French Guiana
Authors: Brosse Sébastien , Baglan Antoine , Covain Raphael , Lalagüe Hadrien , Le Bail Pierre-Yves , Vigouroux Régis , Quartarollo Grégory
Published: February 2021

Rivers of French Guiana are still little invaded by non-native fish, but several fish introductions were recently recorded through the development of aquarium fish trade and fish farms. Here we report records of 11 non-native fish species. Among them, four (Cichla monoculus,Heros efasciatus,Mesonauta guyanaeandPoecilia reticulata) are established and one of them (Heros efasciatus) is rapidly increasing its spatial range. Two species (Hyphessobrycon equesandPterophyllum scalare) were not retrieved in recent records and are probably extinct from French Guiana. The establishment status of the five other species (Arapaima gigas,Colossoma macropomum,Cyprinus carpio,Oreochromis mossambicusandOsteoglossum bicirrhosum) is uncertain and only a few specimens were observed in the wild. Nevertheless, these species, intensively reared in nearby countries, belong to highly invasive species able to cause detrimental impacts on recipient ecosystems. Those first occurrences of invasive fish species in French Guiana should therefore act as an early warning for both researchers and environmental managers.
Research on Promoting the Construction of Online Government Service Platform with Standardization
Authors: Xu Xiao Wen , Ying Li
Published: February 2021

The standardization of the online government service platform is of great significance to simplify the procedures and improve the efficiency of administrative licensing agencies. In this paper, the definition of online government service platform, from the law, policy background, the practice level, carry out the work of government services online analysis summarizes the necessity, the role of online government service platform and the existing problems, and analysis the reasons from the dimension of standardization, standardization can be targeted to summarize proposed online government service platform construction of three aspects of the role.
Development of a vocational and pedagogic position reflection of a doctor as part of continuing medical education program
Authors: Bogatyrev Andrei Anatoljevich , Vanchakova Nina Pavlovna , Chernyavskaya Anna Pavlovna , Krasilnikova Natalia Valerjevna , Elizaveta  , Vatskel Aleksandrovna , Babina Anna Artemjevna
Published: February 2021

The article considers vocational and pedagogic position reflection as an important component of medical vocational continuing education of doctors. According to the general hypothesis of the study, a special program for training vocational and pedagogic position reflection can contribute positively to medical caregivers’ vocational performance in treating patients, who experience troubles with medical compliance and adaptation to the disease. The key methods of the study include a literature survey and theoretical elaboration of the concept of the vocational and pedagogic position of a doctor reflection, meanwhile, the empirical research is based on formative pilot experiment, preceded and followed by testing medical learners’ personal reflexivity readinesses (by using Karpov’s questionnaire). The medical caregiver’s ‘reflective ability’ (Bogin) was considered as a source of doctors’ professionalization. Reflexivity was regarded as a key component of doctors’ preparedness to show empathy and to provide proper pedagogic support for hemodialysis patients, receiving audio-therapy. The results of the study show significant positive dynamics in learners’ cognitive sphere and critical thinking development, a high level of performance in role-played solving educational training healthcare cases, meanwhile personal reflexivity measurements have shown no statistically significant differences after training (according to Student’s t-test). The latter experimentation result testifies the personal nature of the reflexivity feature.
Identification of T- and B-cell epitopes in HPV-16 E7 gene isolated from cervical cancer patients
Authors: Kumar Anoop , Yadav Inderjit Singh , Sekhon Rupinder , Bharadwaj Dwaipayan , Bharadwaj Mausumi
Published: February 2021

Introduction: In India, cervical cancer is the most common cancer among females. Persistence infection with high risk human papillomaviruses (HR-HPV) is an etiological agent for cervical cancer development, especially HPV-16 is found to be exclusively high in cervical cancer cases in Indian population. The continuous expression and transforming ability of HPV E7 helps in progression of cervical cancer and other HPV related disease, which make E7 as a suitable targets for the development of therapeutic vaccines.

Objectives: Identification of T-& B-cell epitopes HPV-16 E7 gene isolated from in cervical cancer patients.

Materials and Methods: A total of 80 cervical cancer tissue biopsies were collected and processed for DNA extraction, HPV diagnosis and genotyping. E7 gene of HPV-16 positive samples were amplified and sequenced. Epitopes in E7 gene sequence were predicted by online freely available tools.

Results: In the present study we got 72 samples (90%) were positive for HPV and out of which 68 samples (94.4%) were positive for the HPV-16. HPV-16 positive samples were sequenced and translated. IEDB server was used for epitope analysis; 12 potent epitopes for the MHC-I alleles were identified in isolated E7 gene of HPV-16. The most potent epitopes were MHGDTPTLHEYM for HLA-C*07:01; LLMGTLGIVCPI for HLA-A*02:01 and MHGDTPTLHEYML for HLA-C*07:01; having percentile rank 0.2 for all three and antigencity score of 0.20011, 0.15358 and 0.10735, respectively.

Conclusion: This is an effective strategy to design immuno-therapeutics and therapeutic vaccine against HPV using E7 as target. These findings will be helpful in the development of effective vaccine for particular geographical region.
Pattern of distant metastases in treated cases of carcinoma cervix : An analysis
Authors: Chauhan Ashok K. , Kaur Paramjeet , Khurana Anil , Verma Yashpal , Bansal Nupur
Published: February 2021

Aims: To analyze pattern of distant failure, site of metastases, number of metastases and duration in patient with carcinoma of cervix treated with concomitant chemoradiation.

Materials and Methods: From May 2011 to December 2015, 73 patients of carcinoma cervix who treated with radical treatment (concomitant chemoradiation followed by 3 session of HDR brachytherapy) with distant metastases presented at Department of Radiotherapy-II, Pt BDS PGIMS, Rohtak were evaluated retrospectively.

Results: Most of the female with metastases were in age group of 50-59 years (82%), 12% were in age group >60 and 6% were in < 50 year age group. Initial stage of presentation was 40% (29/73), 48% (35/73) and 12% (9/73) in stage II, III and IVA respectively. Out of which 93% had squamous cell carcinoma histology and 7% were having adenocarcinoma at time of presentation. Among them 49/73 (67%) had solitary metastases, 19/73 (26%) had two metastatic sites and 5/73 (7%) had multiple metastatic sites. Commonest site of distant metastases was paraaortic lymphnodes in 40% of cases, followed by liver, lungs, brains, cervical lymph nodes and one case of cutaneous metastases was also seen. Paraaortic lymphnodes, liver and lung metastases present in maximum number of patient with multiple metastases. Salvage chemotherapy given in 51 cases, palliative radiotherapy (30 Gy or 20 Gy) in 37 cases whereas in 5% of cases single session with 8 Gy was given.

Conclusion: A regular and long term follow up of patients with carcinoma of cervix is necessary to detect distant metastases. With early and proper diagnosis and treatment a better outcome could be achieved.
Evaluation of biomarkers p16ink4a/ki-67 in cervical cytology for diagnosis of cervical intraepithelial neoplasia
Authors: Sathija P. K. , Rajaram S. , Arora V. K. , Gupta B. , Goel N.
Published: February 2021

Background: Novel biomarkers, P16INK4a/Ki-67 are disease specific and identify risk of progression to cervical cancer.

Aim: To test the clinical utility of biomarkers p16INK4a/Ki-67 in cervical intraepithelial neoplasia.

Methodology: Experimental study was conducted over an 18 month period at a tertiary care hospital. 3500 sexually active women between 30-55 years were screened by VIA/VILI, Pap test & HPV-DNA PCR. All screen positive women (n=280) underwent colposcopy and biopsy if required. At the time of colposcopy repeat cervical smear were taken for evaluation of p16INK4a/Ki-67. Immunocytochemistry for p16INK4A and Ki-67 was done by partitioning one slide into two parts for each biomarker. For p16INK4A positivity, nuclear +/- cytoplasmic scoring and intensity score was calculated and final score obtained. For Ki-67 staining was exclusively nuclear. Staining patterns were categorized as negative, intermediate or strongly positive.

Results: 86 women with abnormal cytology were evaluated with p16INK4A/Ki-67 immunocytochemistry and 20.9% (n=18) and 18.6% (n=16) were positive for each biomarker. For ASCUS (n=42) and LSIL (n=23) smears, specificity and NPV were 100% with a likelihood ratio (LR+) of 27 and 25 respectively suggesting good diagnostic accuracy. The combined sensitivity and specificity of p16INK4a/Ki-67 in detecting CIN-2+ lesion was 76.9% and 95.8% respectively with LR+ of 18.72 in high grade smears.

Conclusions: p16INK4A/Ki-67 evaluation in cervical cytology are valuable biomarkers in ruling out or detecting CIN2+ in ASCUS and LSIL smears. Unnecessary intervention in large number of low grade smears can be avoided by applying these biomarkers. In high grade smears detection rate of biomarkers p16INK4A/Ki-67 was high and had a good diagnostic accuracy.
Comparison of Keyes punch biopsy instrument with cervical punch biopsy forceps for diagnosing cervical lesions
Authors: Tyagi Natasha , Suneja Amita , Mishra Kiran , Jain Sandhya , Vaid Neelam B. , Guleria Kiran
Published: February 2021

Aims: To assess the feasibility and efficacy of Keyes punch biopsy instrument (KP) in diagnosing cervical lesions and compare it with cervical punch biopsy forceps (CP).

Methods: 75 women having adequate colposcopy with abnormal transformation zone were included and paired colposcopic directed biopsies were taken using KP followed by CP from the same target area. The outcome parameters were compared using paired t-test, Wilcoxon signed rank test and McNemar test.

Results: It was feasible in all cases to take cervical biopsy with KP and CP. Volume of gross specimen obtained by KP was less than CP (0.076±0.097 vs 0.101±0.156 cm3, p=0.061), however on microscopic examination, mean length and depth of tissue in KP was greater than CP by 0.06 mm (p=0.810) and 0.14 mm (p=0.634) respectively. There was an exact agreement with final surgical specimen in 42% of cases in both forceps. Agreement within 1 degree was found in 25% of cases with KP and in 17% of cases with CP. Both the forceps equally missed microinvasive lesions but KP was inferior to CP for invasive cancer.

Conclusion: KP is almost at par with CP for diagnosing preinvasive cervical lesions and is a useful adjunct to the existing armamentarium of biopsy forceps.
Evaluation of different methods to assess homologous recombination status and sensitivity to PARP inhibitors in ovarian cancer
Authors: Mukhopadhyay Asima , Curtin Nicola , Edmondson Richard
Published: February 2021

Methods: Matched samples of ascites and tumor tissue were taken from patients undergoing surgery for epithelial ovarian cancer. Tumor samples were formalin fixed and paraffin embedded (FFPE); ascites samples were used to generate primary cultures (PC). HR status was determined in PCs as previously described.[1] IC50 for the PARP inhibitor Rucaparib was estimated using SRB assays. DNA was extracted from the FFPE tissue. The following techniques were evaluated in PCs or paired FFPE samples: DR-GFP reporter assay, PARP activity assay, BRCA1 expression on immunohistochemistry, BRCA1 methylation status and BRCA1/2 mutation analysis. A next generation sequencing based assay was used to detect mutations and other genomic alterations in a large panel of cancer-associated genes, including BRCA1/2.

Results: Paired samples were collected from 64 patients and characterized for HR function. 47/64 (76%) were high grade serous. 44% (28/64)) were HR defective (HRD) by Rad51 assay and correlated with Rucaparib sensitivity (PPV-92%, NPV-100%). Molecular analysis revealed that all mutations and other genomic alterations detected in ascites derived PCs were also found in matched FFPE tumor tissues. All tumors with serous histology contained p53 mutations, whilst the remaining tumors without p53 mutations were non-serous in histology. DR-GFP assay was unreliable in PC due to poor transfection. In a subset of 50 cancers there was reduced BRCA1 expression in the HRD vs. HRC tumours (34.8% vs. 22.7%, ns) whilst in a further subset of 30 cases there was no difference in endogenous or stimulated PARP activity between HRD and HRC tumours. Deleterious BRCA2 mutations were identified in 7 tumors, 6 of which were HRD. Only 1 deleterious BRCA1 mutation was detected but methylation of BRCA1 was identified in 13 of 64 (20%) tumors, 7 of which were HRD. Mutation of BRCA2 was mutually exclusive to methylation of BRCA1. HRD vs. HRC tumours showed BRCA1 methylation (25% vs. 17%) and BRCA1/2 mutation (21% vs. 0.3%). 14/28 (50%) HR defective tumors do not have BRCA1/2 mutations or BRCA1 methylation, suggesting other mechanisms can also result in a HR defective phenotype. 28/64 (43%) of samples demonstrated the HR defective phenotype. In all cases HR status correlated with sensitivity to Rucaparib.

Conclusion: As expected, deleterious BRCA2 mutations conferred a HRD phenotype in cells but methylation of BRCA1 was not universally associated with HRD. This may be as a result of only partial silencing of the gene by methylation and further work is required to identify thresholds of methylation which may predict HR status. The use of BRCA1/2 mutation testing alone is unlikely to identify the majority of HR defective ovarian tumors. Assessment of functional status of HRD is the preferred option and further technologies should be developed to simplify the Rad51 assay.
Evaluation of supragastric lesser sac using a laparoscope during cytoreductive surgery in epithelial ovarian carcinoma: A site for occult metastasis
Authors: Mukhopadhyay Asima , Basu Kaustav , Helm William
Published: February 2021

Background: The supragastric lesser sac (SGLS) is a site of metastasis from epithelial ovarian cancer (EOC). Since this region is difficult to access and represents a confluence of critical structures, it may be a barrier to complete cytoreductive surgery (CRS).

Methods: The SGLS was explored in consecutive patients undergoing CRS with EOC. After a xipho-pubic laparotomy incision, the SGLS was examined; visualisation and treatment was aided by using a laparoscope. Resectable disease was cleared using the following methods alone or in combination: direct tumor excision, argon beam coagulation, plasma jet or electrocautery.

Results: 30 patients were evaluated between November 2013 and August 2014 in NGOC, Gateshead. SGLSM was present in 21/30 (70%) of EOCs, 19/25 (76%) high grade serous disease, 21/26 (81%) stage ≥3 disease, 18/20 (90%) with PCI score ≥15, 12/15 (80%) with ascites ≥500 ml, 13/18 (72%) at primary surgery and 8/10 (80%) at interval surgery. Sites included: lesser omentum (11), caudate lobe (10), groove of ligamentum venosum (6), floor (20), upper recess (7), subpyloric space (6), FOW (13), coeliac axis (5), porta hepatis (6), anterior surface of pancreas (2) retro-pancreatic (2). Size of metastases: <2.5mm = 3, <1 cm = 8, ≥1 cm = 7. Pre-operative CT scan identified 4/22 (18%) cases. In 18/21 patients SGLSM was completely resected or ablated; there were no complications. End Result: Optimal 27/30 (90%) including no visible disease = 18, <2.5 mm = 5; 17/21 (81%) cases would have been ≥2.5 mm residual disease if SGLS was not evaluated/treated. In a further cohort of 30 patients evaluated at Tata Medical Center, Kolkata, SGLSM was present in 18 (60%) of patients. CC1 resection was obtained in >90% cases.

Conclusion: EOC frequently metastasizes to the SGLS and is often resectable. Lack of meticulous examination may result in incomplete resection; evaluation should be performed at least in stage ≥3 disease when the surgical intent is total clearance of disease.
Diagnostic accuracy of intraoperative frozen section in ovarian neoplasms: Experience in a tertiary oncology centre
Authors: Bajracharya Anu , Sekhon Rupinder , Giri Shweta , Rawal Sudhir
Published: February 2021

Aims and Objectives: This study is done to assess the accuracy of intraoperative frozen section in the diagnosis of various categories of ovarian neoplasm conducted in RGCI.

Materials and Methods: Introperative frozen sections for suspected ovarian neoplasm that underwent surgery as primary line of therapy at this institution were analyzed retrospectively from Jan. 2014 - Dec. 2015. The results of frozen section were compared with the final histopathologic diagnosis on paraffin sections and the overall accuracy, sensitivity, specificity, positive and negative predictive values were determined.

Results: The study included 159 cases and the mean age of patients was 44.72 ± 14.28 years (Range 19-75 years). The mean size of tumor was 12.5 ± 5.9 cm. Sensitivity of frozen section for benign, borderline and malignant tumors was 98.53%, 73.33% and 94.74% respectively. And the related specificities were 95.60%, 96.53% and 100% respectively. There were 150 concordant cases and 9 discordant cases. Overall diagnostic accuracy of frozen section was 94.33%.

Conclusion: Intraoperative frozen section diagnosis appears to be an accurate and comparable technique for the histopathology diagnosis of ovarian tumours. It is a valuable tool to guide the surgical management of these patients.
Clinico-pathological characterstics of epithelial ovarian malignancy in young female
Authors: Ghuge Dhananjay , Tiwari Alok , Singh Subraharsh , Kaur Satinder
Published: February 2021

Background and Objective: Epithelial ovarian cancer mostly appears in aged women, but rarely in young women. Little is known about the clinical characteristics and prognosis of epithelial ovarian cancer in women aged below 40 years. This study was to evaluate the clinical and histopathological characteristics of young patients with epithelial ovarian cancer.

Methods: A total of 31 patients with confirmed epithelial ovarian cancer under the age of 40 years between 2007 to 2015 were retrospectively analyzed.

Results: Mean age of the patient is 32 years. The common symptoms included abdominal pain (21 patient 67%), self detected pelvic mass (9 patient 29%) and 1 patient with bleeding per vaginum. The average maximum diameter of tumour is 10.7 cm. Family history positive in 8 patient (5 ca.breast and 3 ca.ovary). Mean level of CA. 125 is 883.36 u/ml. CA 125 level lowest is of 6 u/ml and highest is of 7557 u/ml. Tumour located bilaterally in 14 patient (45%). Ascitis present in 18 patient (58%). Pleural effusion seen in 6 patient (19%). Twenty six cases underwent optimal cytoreduction out of them 7 taken NACT. Two patient underwent fertility preservation surgery. Three patient underwent palliative chemotherapy due to unwillingness. Eleven patient classified as stage III and stage IV each (35% of each), six patient is of stage I (19%) and three patient of stage II (9.6%). Serous adenocarcinoma (80.6%) and mucinous adenocarcinoma (19%) are the common histopathological findings. Thirteen patient (41.9%) has well differentiated tumour, eight (25.8%) has moderately differentiated and ten (32.25%) has poorely differentiated tumour. Twenty eight patient received platinum and paclitaxel-based chemotherapy before or after operation.

Conclusion: Young women with epithelial ovarian cancer under the age of 40 years mostly have serous adenocarcinoma; well differentiated and tumors are normally bilateral. The ovarian function can be preserved (fertility preservation) in part of stage Ia and Grade I patients.
Association of organochlorine pesticides and risk of epithelial ovarian cancer: A case control study
Authors: Mazumdar Darshana
Published: February 2021

Background: Organochlorine pesticides (OCPs) belongs to the class of hydrocarbons characterized by its cyclic structure. Due to their persistent nature OCP gets accumulated in the food chain and cause possible adverse health effects specifically various hormone mediated disorders. Ovarian cancer is also one of the hormone dependant cancer and begins with the transformation of cells that comprises the ovaries including surface epithelial, germ cells, etc. It has been suggested that endocrine disruption, exposure to xenobiotic and subsequent oxidative stress may antedate ovarian cancer and contribute to its pathogenesis. However, no report regarding any association of OCP level with etiology of epithelial ovarian cancer is so far available among North Indian population.

Methods: A total of 120 subjects were included in this case control study, consisting of 60 histological proven cases of epithelial ovarian cancer and 60 controls subjects. Quantification of OCP levels was done by Perkin Elmer Gas Chromatograph (GC) equipped with 63Ni selective Electron Capture Detector.

Results: Levels of b-HCH, endosulfan I, p’p’-DDT, p’p’-DDE and heptachlor were found significantly high in cases of epithelial ovarian cancer as compared to control. A significant association was also observed between higher levels of b-HCH and heptachlor and EOC with odds ratio of 2.76 and 2.97 respectively.

Conclusion: Results indicate the plausible role of OCPs with the pathogenesis of epithelial ovarian cancer among North Indian population. Moreover, it is one of the first report suggesting significant level of heptachlor among north Indian women population with epithelial ovarian cancer.
Outcome of bowel resection in women with advanced ovarian carcinoma
Authors: Sebastian Ajit , Thomas Dhanya Susan , Thomas Anitha , Chandy Rachel , Peedicayil Abraham
Published: February 2021

Aim: To evaluate the mortality and morbidity related to bowel resection in women with advanced ovarian carcinoma.

Methods: Retrospective case series of 47 women with stage III and IV carcinoma ovary who underwent bowel resection, over the period of 5 years from Jan 2011 to Dec 2015. The disease free survival was assessed and the prognostic factors for disease free survival was also analysed by bivariate analysis.

Results: In this cohort 64% (30/47) had primary debulking, 21% (10/47) had interval debulking and 15% (7/47) had secondary debulking. The mean period of follow up was 23 months (1 – 45 month). The mortality was 15% (7/47), while major morbidity like anastomotic leak were nil. The three variables considered for mortality were relaparotomy, paralytic ileus and surgical site infection. 6% (3/47) had relaparotomy, 21% (10/47) had paralytic iileus and 15% (7/47) had surgical site infection. The overall morbidity was 42.5% (20/47). A total 34% (16/47) of patients had stoma. 79% (37/47) patients had optimal debulking.

Conclusion: Bowel resection in optimally selected cases of advanced carcinoma ovary is a good option with limited mortality and morbidity. Often, bowel resection is the only way to achieve optimal debulking.
Role of cancer antigen 19-9 in complex ovarian tumors
Authors: Thomas Dhanya S. , Sebastian Ajit , Thomas Vinotha , Thomas Anitha , Chandy Rachel , Peedicayil Abraham
Published: February 2021

Background: Cancer antigen 19-9 (CA 19-9) is a tumor-associated mucin glycoprotein antigen that may be elevated in healthy individuals as well as in patients with benign and malignant tumors. It is useful in the management of pancreatic and other gastrointestinal tumors. CA 19-9 is also elevated in benign and malignant ovarian tumors.

Aim: To study the pattern of serum CA 19-9 in complex ovarian tumors.

Methods: The study design was descriptive, based on data collected from medical records. Patients with a complex ovarian mass, who were investigated with CA 19-9 and had undergone surgery, were included in the study. The study duration was 2 years from January 2014 to December 2015. A total of 273 patients (119 benign and 154 malignant) with complex ovarian mass and elevated CA 19-9 underwent surgery during the study period.

Results: CA 19-9 was elevated in 55 patients (20%). Of these, 23 patients had benign tumors while 32 had malignant tumors. Among patients with benign tumors, 21 had dermoid, 23 had mucinous tumors and 75 had other types of tumors. CA 19-9 was elevated in 10 (47.6%) of the dermoids, 7 (30.4%) of the mucinous tumors and 6 (8%) of the other benign tumors. Among patients with malignant tumors, 138 were epithelial and 16 were non epithelial tumors. Of the epithelial tumors, 31 were mucinous and 107 were nonmucinous types. Overall, 29 (21%) had elevated CA 19-9. Of the epithelial tumors, 22.6% of the mucinous type and 20.6% of the non mucinous type had elevated CA 19-9. Among the non-epithelial tumors, 3 (18.8%) had elevated CA19-9.

Conclusion: CA 19-9 is elevated in several conditions but most likely to be raised in dermoid cysts and mucinous tumours. CA19-9 levels need to be interpreted along with clinical and radiological findings.
Unusually high serum Ca 19-9 in a benign ovarian tumor
Authors: Pandey Divya , Pruthi Neha , Salhan Sudha
Published: February 2021

Introduction: Ovarian tumors have a varied spectrum of presentation. Tumors which look malignant clinico-biochemically can ultimately turn out to be benign. Tumor markers help in diagnosing various malignancies. Carbohydrate antigen 19-9 is one such marker seen to be elevated in some ovarian tumors.

Case: A 55 year old, lean and thin postmenopausal female presented to Gynae OPD with abdominal mass, anorexia and weight loss developing over last 6 months. During workup, she was found to have unusually high Ca 19-9 along with MRI findings suggestive of ovarian tumor. Staging laparotomy followed by total abdominal hysterectomy with bilateral salpingoophorectomy was performed. Per operative findings were suggestive of benign nature of ovarian tumor of size 18× 20 cm. Patient was kept under follow up. Histopathology report showed benign mucinous cystadenoma. The serum levels of Ca19-9 returned to normal 8 weeks following surgery. This case report shows a rare and significant elevation of Ca19-9 levels with benign mucinous cystadenoma of the ovary, thus showing that women with unusually elevated tumor markers and even symptoms suggesting malignancy may actually harbour a benign disease.

Conclusion: Unusually high Ca 19-9 may be associated with benign mucinous cystadenoma but thorough workup to rule out malignancy is a must in every case.
Inguinal lymphadenopathy as a presentation for ovarian cancer
Authors: Shah Swati , Giri Shveta , Sekhon Rupinder , Rawal Sudhir
Published: February 2021

Ovarian carcinoma usually presents at an advanced stage with diffuse intra abdominal manifestations. Inguinal lymph node metastasis is rare event in ovarian cancer. We report 7 cases who presented with inguinal lymphadenopathy as the initial manifestation between January 2014 to January 2016. All patients underwent tru-cut biopsy from inguinal area. Morphology and IHC were suggestive of ovarian origin or female genital Tract origin. Two patients underwent primary debulking surgery while four patients were managed by neo-adjuvant chemotherapy followed by interval cytoreductive surgery owing to relatively poor performance status at presentation. One patient underwent secondary debulking in which inguinal Lymph node was positive for metastatic deposits.
Poster Abstract
Authors: Madan Shikha
Published: February 2021

Primary pure ovarian leiomyosarcomas constitute a malignant subgroup of ovarian smooth muscle tumors which comprise only 1% of ovarian tumors. Their origin, etiology, histologic features, clinical behavior, and optimal treatment are still obscure. We report a case of leiomyosarcoma of ovary, diagnosed on histopathology in a 30 year old female.
Comparison of MRI findings with actual HPE findings in case of carcinoma endometrium
Authors: Gupta Shaveta
Published: February 2021

Objectives: The objectives of this study is to investigate the correlation of magnetic resonance imaging (MRI) in predicting the depth of myometrial invasion, cervical involvement and lymph node involvement and actual histopathological findings in the women with endometrial cancer.

Methods: This is a reterospective study of the patients of endometrial cancer from Nov 2011 to Jan 2016 who underwent Surgery (Total abdominal Hystrectomy with B/l salpingoophorectomy with peritoneal washings with b/l pelvic lymphadenectomy with or without para aortic lymphadenectomy) at our centre Max Superspeciality Hospital. CE MRI Pelvis has been done pre operatively in every patient. After the surgery Histopathological reports of the specimen checked and compared with MRI findings of that case. The purpose of the study is to evaluate the validity of MRI findings of endometrial cancer in comparison to final histopathological findings.

Results: For the detection of myometrial invasion, overall sensitivity of MRI is 93.9%, specificity is 66.6%, for cervical involvement Senstivity is 60% and specificity 1s 93.75% and for detection of lymph node involvement sensitivity is 66.6% and specificity is 93.5%. Most common Finding on MRI is thickened endometrium with disruption of Junction jone.

Conclusions: Preoperative pelvic MRI is a sensitive method of identifying invasion to the myometrium in endometrial cancer. MRI Is a sensitive noninvasive modality in predicting locoregional spread in ca endometrium. Senstivity in detecting Myometrial invasion is high but sensitivity is less in detecting cervical involvement and lymph node involvement is less.
Vulvar cancer: Patterns of recurrence and clinicopathological prognostic factors involved in recurrent cases
Authors:   Kanika
Published: February 2021

Objective: Vulvar cancer is a rare disease, with an incidence of 0.6% of all female malignancies. With the advances in management of carcinoma vulva to individualisation of treatment to reduce the psychosexual impact an aggressive treatment can have, it is imperative to understand the patterns of recurrence and the common prognostic factors involved. The aim of this study was to determine prognostic variables for recurrence and survival and to identify patterns of recurrence in patients with vulvar cancer.

Materials and Methods: All patients (n=87) with primary vulvar cancer treated at the Rajiv Gandhi Cancer Institute between January, 2006 to January, 2015 who underwent surgery were retrospectively analysed regarding the prognostic relevance of different clinicopathological variables. Recurrences were evaluated with regard to their characteristics and localisation and the variables associated with them were analyzed.

Results: Age, stage of tumor, size of tumor, location of tumor (central or lateral), lymph node metastasis, depth of invasion and involvement of resection margins, associated intraepithelial abnormality predicted disease-free and overall survival. In multivariate analysis, lymph node status and positive margin status was the most important independent prognostic factor (p = 0.002). Irrespective of the initial nodal involvement, recurrences occurred primarily in the vulvar region.

Conclusion: Inguinofemoral lymph node status and adequate margins at initial diagnosis is of critical prognostic importance for patients with vulvar cancer. Further tumour biological characteristics need to be identified to stratify patients with nodal involvement for adjuvant radiotherapy of the vulva to prevent local recurrences.
Oral Abstract
Authors: Hematbhai Satodiya Mohit
Published: February 2021

Objective: To compare the incidence, maternal and fetal outcomes of gestational diabetes mellitus using one step vs. two step as a screening procedure.

Methodology: A prospective randomized trial involving screening of 1000 pregnant women for gestational diabetes mellitus was conducted. Women were divided in two groups (500 each). Group A comprised of patients screened with two step approach (ACOG recommendation), Group B comprised of women screened by one step method (IADPSG criteria). Women diagnosed with ‘gestational diabetes’ were followed in antenatal clinic and incidence of GDM, maternal and fetal outcome between two groups were analyzed using SPSS.

Results: The incidence of GDM was almost double using one step approach versus two step which was 19.2% and 11.8%respectively. Maternal outcomes were comparable in both the groups except the risk of preterm delivery which was 2.5 times more in group A than group B (odds ratio = 2.43 95% CI = 1.01-5.79). Further fetal outcomes were also comparable except neonatal hypoglycemia which was seen in 29.31% in group A vs. 7.4% in group B. In the group B 15 patients (15.8%) patients with GDM (based on FBS ≥ 92 mg/dl at 1st ANC visit) showed clinical symptoms and blood sugars in hypoglycemic range on MNT requiring resumption of normal diet.

Conclusion: The incidence of GDM using IADPSG criteria was almost double versus ACOG criteria. Maternal and fetal outcomes were comparable except in 15.8% women diagnosed as GDM (using FBS ≥ 92 mg/dl at 1st ANC visit as per IADPSG) suffered from hypoglycemia. A large trial is being proposed before these criteria are adopted.
Prevalence of abnormal PAP smears in antenatal women in a tertiary hospital in India
Authors: Shamsunder Saritha , Gautam Akriti , Khanna Geetika , Malik Sunita
Published: February 2021

Background: Pregnancy provides a good time for opportunistic screening of our women who rarely attend for cervical screening. The prevalence of abnormal PAP smear in pregnant women in developed countries was 5-6%, however, no literature was available from India.

Aim: To determine the prevalence of abnormal PAP smears in antenatal women presenting to our antenatal clinic.

Methods: Women attending the antenatal clinic with gestation of <28 weeks were recruited after an informed consent and had a PAP smear by Ayre spatula and cytobrush or a broom type of cytobrush. The comfort level during smear taking & any problems noted were recorded using a pain score. The smears were stained using the PAP stain, were categorized as adequate or inadequate & classified as per Bethesda classification.

Results: We had 150 women participating, the mean age was 24.2 yrs, the mean period of gestation was 17 weeks; 43.9% were nulliparous. Smear adequacy rate was 71.5% overall. Pain during procedure was reported in 2.9% of women, 18.3% had minor discomfort; 78.6% were comfortable. Minor bleeding during smear taking was noted in 15%; this was more with the cytobrush & broom than the Ayre spatula alone. Abnormal smears were seen in three women; two had AGC & one had LSIL.

Conclusions: Opportunistic cervical screening during pregnancy is safe and well tolerated. Abnormal Cervical smears were seen in 2% of our pregnant women.
Poster Abstract
Authors: Bajaj Kanika
Published: February 2021

Tuberous sclerosis (TS) is a genetic disorder that is inherited in an autosomal dominant fashion with variable clinical manifestations including seizures, mental retardation, renal failure and pneumothorax. The literature on TS in pregnancy is largely based upon case reports which have shown a 43% complication rate including oligohydramnios, polyhydramnios, IUGR, hemorrhage from ruptured renal tumors, PPROM, renal failure, placental abruption and perinatal demise. We reporting a case of 33 yr old female with gravida 3 para 2 and live 2 with period of gestation 9 months with tuberous sclerosis, with severe oligohydramnios with fetal cardiomegaly and mild pericardial effusion and pleural effusion. She had facial angiofibromas along with bilateral renal angiomyolipomas. The previous fetal outcomes were normal, with facial angiofibroma. We report such a unique case having all clinically diagnostic physical sings of tuberous sclerosis with good fetal outcomes.
Massive peripheral giant cell granuloma associated with pregnancy
Authors: Jain Vikas
Published: February 2021

Peripheral giant cell granuloma (PGCG) is a relatively Common reactive exophytic lesion of the oral cavity. The influence of hormones has been suggested as contributory factor in PGCG development and predominance of these lesions in young females as well as some previously reported pregnancy related cases support this belief. It has been observed that majority of lesions present in the 4th decade of life, when hormonal changes are more pronounced. Cailluette and Mattar in their study found that peripheral giant cell granuloma are under the influence of the ovarian hormones. However Chambers and Spector suggested peripheral giant cell granuloma to be enhanced by pregnancy rather than being pregnancy dependent. The responsiveness of gingiva to these hormones along with the immunosuppressive actions of the hormones contributes to the growth of the lesion. Clinically, PGCGs may present as polypoid or nodular lesions, predominantly bluish red with a smooth shiny or mamillated surface.

This poster will review the literature available on the association of Massive Peripheral Giant Cell Granuloma With Pregnancy with focus on possible causes of PGCG during pregnancy.
Synchronous malignancy of ovary and cervix
Authors: Malhotra Vani , Nanda Smiti , Chauhan Meenakshi , Bhuria Vandana
Published: February 2021

Background: Synchronous primary malignancies of the female genital tract constitute 1.7% of all genital malignancies.

Case: A 45-year-old para 5 woman presented with loss of appetite and abdominal distention. Provisional diagnosis of ovarian malignancy was made. Final histopathology of the specimen revealed ovarian papillary serous cystadenocacinoma with cervical leiomyosarcoma. She received chemotherapy.

Results: Patient is on regular follow-up.

Conclusion: The coexistence of primary neoplasms in the ovary and cervix are rare. A normal appearing organ may have a hidden malignancy. So, every surgical specimen should be subjected to detailed histopathological examination. Also, the possibility of synchronous malignancy elsewhere in body should be kept in mind while working on a genital malignancy.
Distant pedicled musculocutaneous/fasciocutaneous flaps; a novel approach for reconstruction of large vulvar defects
Authors: Mishra Kripa Shanker
Published: February 2021

Introduction: Postablative reconstruction of vulvar defects is a difficult challenge. Local flaps carry a high incidence of delayed wound healing as local flaps may redistribute but not eliminate local wound tension. Repair of defect with distant pedicled flaps may avert local complications by minimising tension to the skin and increasing the initial biomechanical strength of wound. The aim of this study was to determine the clinical outcome of distant musculocutaneous & fasciocutaneous flaps used for postablative reconstruction of large vulvar defects.

Methods: Between January 2015 to December 2015 total three patients underwent vulvectomy and immediate reconstruction with distant pedicled flaps for vulvar carcinoma. Postoperative complications were recorded and clinical outcomes were evaluated.

Results: Two of the three flaps healed primarily. One flap was complicated by minor wound dehiscence, which healed with conservative treatment. Hospital stay and clinical course was shorter in comparison to local flaps and split skin graft.

Conclusions: Distant musculocutaneous and fasciocutaneous flaps provide excellent design flexibility and can be tailored to reconstruct postablative vulvar defects with good outcomes and minimal morbidity.
An acute cardiac complication of HIPEC
Authors: Pathak Soumi
Published: February 2021

Recently, cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) has been described for both treatment and prevention of locoregional cancer of various origin. As this procedure involves large amount of blood and fluid loss during the CRS phase, and haemodynamic, metabolic, and coagulation changes during the HIPEC phase, thus thorough study and evaluation is needed to reduce the morbidity and mortality associated with this newer modality in treatment of cancer patients. We hereby describe a case report where a patient developed acute cardiac dysfunction in the immediate postoperative period following CRS with HIPEC. A 65 years old patient weighing 62 kg had undergone CRS with HIPEC for ovarian carcinoma. She had a blood loss of 1.5 L and ascetic fluid drainage of 1.5 L. Intraoperatively fluid was given according to stroke volume variation and two pack cell was transfused to maintain haemoglobin above 10 g. Two hours postoperatively she suddenly developed severe hypotension and an echocardiography done revealed a global left ventricular dysfunction with a 28% ejection fraction. She was intubated and put on inotropic support. Utrasound abdomen revealed fluids and features suggestive of intestinal perforation. So she was reopened on the 3rd postoperative day and primary closure of the intestinal perforation was done. Thereafter she became haemodynamically stable and we were able to extubate her on the fourth post operative day. Thus we conclude that goal directed fluid therapy with advanced monitoring, thorough evaluation, skeptical vigilance and preemtive thinking is required to deal with the challenges posed by CRS with HIPEC.
To compare the effects of dexmedetomidine versus propofol infusion on various parameters intraoperatively and their effects on the recovery profile postoperatively in patients undergoing laparoscopic assisted robotic pelvic surgeries
Authors: Jaggi Tejinder Singh
Published: February 2021

Methods: 80 ASA physical status I-II patients, 30-65 years, BMI ≤30 undergoing surgery for 120-180 minutes. Computer randomisation, 40 each, in dexmedetomidine group D and in propofol group P. Induction with fentanyl 1.5 mcg mkg−1 and propofol 2 mg kg−1. Maintained with desflurane 3-5% with air 50% and O2 50%. In D group (bolus 0.5 mcg mkg−1 for 10 minutes then maintenance 0.2-0.5 mcg mkg−1 hr−1) and in P group (propofol @ 50-150 mcg kg−1 min−1) started. At docking of robotic arms single dose morphine @ 0.075 mg kg−1 in both groups is given. Hemodynamic stability (MAP and HR) is adjusted within 20% of base line values.

Results: Early and intermediate recovery was fast in D group and total fentanyl requirement intraoperatively was less in D group.

Discussion: Dexmedetomidine is known to decrease sympathetic outflow and circulating catecholamine’s levels therefore has caused decrease in both MAP and HR similar to propofol. Dexmedetomidine has analgesia sparing effect hence less total fentanyl dose both intraoperatively. Patients with dexmedetomidine are early aroused, so early and intermediate recoveries were faster with dexmedetomidine than propofol. Thus dexmedetomidine may prove to be useful adjuvant for robotic surgeries.

Conclusion: Dexmedetomidine more effective for both intraoperative and postoperative analgesia. Recoveries both early and intermediate are faster in dexmedetomidine group.
A rare case report of incidental solitary uterine metastasis in primary invasive lobular carcinoma of breast
Authors: Gupta Vivek , Mishra Amita , Kalra Namit , Narula Bhawna
Published: February 2021

Introduction: Infiltrating Lobular carcinoma (ILC) of the breast is second most common cancer of breast next only to Infiltrating ductal carcinoma (IDC). It has a different metastatic pattern as compared to the IDC. Breast cancer is the most frequent primary site which spreads to gynaecologic organs.

Case Presentation: A 40 yrs old Iraqi lady presented as a diagnosed case of lobular carcinoma of left breast. She had already undergone a lumpectomy at Iraq a month back and now had come for completion of treatment. On metastatic workup with PETCT scan, we found a multicentric residual disease in the left breast along with some ipsilateral axillary LN with significant uptake. The concurrent CECT done showed a uterine leiomyomam also. As she was strongly hormone receptor positive, had completed her family and was having mennorhagia probably attributable to uterine fibroids. She was offered hysterectomy with B/L salpingo-oophorectomy. She was keen for breast preservation but in view of her multicentricity of disease on the left breast she was counselled for mastectomy with upfront whole breast reconstruction with TRAM flap. She underwent left modified radical mastectomy with hysterectomy with BSO and TRAM flap reconstruction. The histopathological examination revealed a multicentric, multifocal ILC, grade II with heavy nodal involvement including extracapsular extension. The leiomyoma of uterus also showed tumor deposits from lobular carcinoma breast.

Conclusion: We report a very rare case of metastatic pattern of carcinoma of breast. On literature review we found that it is common for the lobular carcinomas of breast to metastasise to gynaecologic organs. Uterine corpus is a very rare site of metastasis for extragenital cancers including breast. All the patients of primary lobular carcinoma of breast should be screened for gynaecologic secondaries in the preoperative workup with high degree of suspicion.