bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy-Associated Breast Cancer
Authors: Kulshrestha Meeta 
Published: June 2011

ABSTRACT
The incidence of pregnancy associated with breast cancer can be expected to increase as maternal age at the time of pregnancy continues to increase. Women diagnosed with breast cancer during pregnancy have similar disease characteristics to age-matched controls. Surgical treatment may be performed as for the nonpregnant women. Radiotherapy and endocrine or antibody treatment should be postponed until after delivery. A multidisciplinary approach is recommended for optimal clinical decision-making. But physicians should be aggressive in the work-up of breast symptoms in the pregnant population to expedite diagnosis. It is generally agreed that therapeutic radiation, if necessary, should be delayed until completion of pregnancy.
Comparative Study of Nonstress Test and Fetal Acoustic Stimulation Test in Assessment of Fetal Well-being
Authors: Arshad Zakia , Bano Imam , Noor Nasreen , Motwani Lata 
Published: June 2011

ABSTRACT

Objectives
To compare and evaluate the role of nonstress test and acoustic stimulation test on the perinatal outcome.

Materials and methods
Around 100 patients above 34 weeks of gestation were selected and subjected to nonstress test (NST) and acoustic stimulation test (AST) on weekly basis to find whether fetus is reactive or nonreactive, and followed till delivery to find out the perinatal outcome.

Results
When comparison of reactive NST and reactive AST was done, the incidence of meconium staining was 8 (9%) and 9 (9.6%), clinical fetal distress 16 (18.8%) and 18 (19.3%), operative interference for fetal distress 17 (19.3%) and 20 (21.5%), low Apgar score at 5 minutes 1 (1.1%) and 1 (1%), neonatal deaths 3 (3.3%) and 3 (3.2%), low birth weight 27 (30.6%) and 29 (31.1%), and NICU admission 13 (14.7%) and 13 (13.9%) respectively. While the incidence of meconium staining was 4 (33.3%) and 3 (42.8%), clincal fetal distress 8 (66.6%) and 6 (85.7%), operative interference 6 (50%) and 3 (42.8%), low Apgar score at 5 minutes 3 (25%) and 3 (42.8%), neonatal death 4 (33.3%) and 4 (57.1%), low birth weight 7 (58.3%) and 5 (71.4%) respectively in nonreactive NST and nonreactive AST groups.
Hysteroscopy—A Mode of Screening Women with Postmenopausal Bleeding: Our Experience
Authors: Naik Sejal , Lodha Pooja , Tandulwadkar Sunita , Agarwal Bhavana , Deshmukh Prashant 
Published: June 2011

ABSTRACTStudy Objective1. To study the etiology of postmenopausal bleeding.2. To study the significance of hysteroscopy in evaluation of the etiopathogenic factors.3. Correlating the diagnosis after transvaginal sonography (TVS), hysteroscopy and histopathology.4. Feasibility of conservative management with hysteroscopy in postmenopausal bleeding.DesignProspective study from January 2009 to June 2010.SettingDepartment of Obstetrics and Gynecology of Ruby Hall Clinic, Pune, Maharashtra, India.Sample sizeSixty postmenopausal women with complaint of bleeding per vaginum.InterventionsClinical and sonographic evaluation followed by diagnostic and/or therapeutic hysteroscopy and guided biopsy. Hysteroscopic images were analyzed and compared with histopathological results.Measurements and main resultsOn hysteroscopy, endometrium is classified as suggestive of normal, atrophic, endometrial hyperplasia or endometrial carcinoma. Histopathological diagnosis was taken as a gold standard to determine the efficacy of hysteroscopy in diagnosing endometrial pathologies. The sensitivity and specificity of hysteroscopy in diagnosing endometrial pathologies was assessed.ConclusionsIn women with postmenopausal bleeding, hysteroscopy is a valuable tool that allows precise diagnosis of various endouterine pathologies. In our study, the sensitivity of hysteroscopy was 97% and the specificity was 98.66%. Hence, we can conclude that it is highly accurate for evaluating endometrial pathologies. For obvious benign lesions, it also provides treatment in the same sitting, therefore avoiding an extensive, morbid, and expensive procedure like hysterectomy.
Screening of Peri- and Postmenopausal Women for Hypothyroidism
Authors: Jain Sheela , Joshi Sulabha Avinash , Vaidya Madhuri , Sherawat Nidhi 
Published: June 2011

ABSTRACT

Objectives
1. To study the prevalence of hypothyroidism in peri- and postmenopausal women
2. To study the correlation of menopausal symptoms with hypothyroidism.

Methods
Hospital based cross-sectional study carried out at Lata Mangeshkar Hospital, 200 women relatives of indoor patients in obstetrics and gynecology ward were included in study. Subjects included in study were in peri- and postmenopausal age group between 40 to 55 years, provided they fulfilled inclusion and exclusion criteria. History was noted, menopause rating scale (MRS) score was obtained and height and weight was measured and serum TSH estimation was done. Results were noted and analyzed.

Results
Out of 200 women 25 women had raised TSH levels. Three women had overt hypothyroidism (TSH high, free T4 low), and 22 women had subclinical hypothyroidism (TSH high, free T4 normal). It was observed that out of 94 women who had MRS score, more than 8, 16 (16.6%) women had hypothyroidism and out of 106 women with lower MRS score (1 to 8), nine (8.49%) women had hypothyroidism.

Conclusions
Prevalence of hypothyroidism is high in peri- and postmenopausal age group (12.5%). Though women with high score are more likely to suffer from hypothyroidism, low score does not preclude the possibility of hypothyroidism. Screening should be done in this age group to prevent complications of hypothyroidism.
Maternal and Perinatal Outcome of Pregnancy with Hepatitis E Infection
Authors: Singh Asha , Shrestha Nira Singh , Shrestha Sanjaya Kumar , Malla Kasturi , Thapa Laxmi Bikram 
Published: June 2011

ABSTRACT

Objective
To see the prevalence of HEV infection in the cases of acute hepatitis among pregnant women, and maternal and perinatal outcome of pregnancy complicated by HEV infection.

Methods
This was a descriptive study done at two tertiary care hospital in Kathmandu, Nepal between July 2006 and June 2007. Women presenting with acute hepatitis were tested for HEV using commercial rapid HEV test kit (assure HEV IgM Rapid test by MP diagnostics). Pregnant women, who tested positive for HEV, were enrolled as study group. Maternal and perinatal outcome of these women were analyzed.

Results
Ninety-three pregnant women with acute hepatitis due to HEV were admitted during the study period. Of these 93 cases, acute liver failure occurred in 24 (25.8%), acute renal failure in eight (8.6%) and maternal mortality occurred in 18 (19.35 %). Five women (5.4%) had miscarriage and 79 delivered (53 preterm and 26 term). Pregnancy continued in nine. Perinatal mortality occurred in 16 (20.2%) of which nine were still birth and seven neonatal deaths.

Conclusion
Hepatitis E virus infection is a major cause of acute hepatitis in pregnant women with adverse maternal and perinatal outcome.
Ormeloxifene versus Medroxyprogesterone Acetate (MPA) in the Treatment of Dysfunctional Uterine Bleeding: A Double-Blind Randomized Controlled Trial
Authors: Bellad MB , Mekhala D , Shravage Jyotsna , Ganachari MS , Dhumale HA 
Published: June 2011

ABSTRACTObjectiveTo find the effectiveness of ormeloxifene vs medroxyprogesterone acetate (MPA) to reduce blood loss in dysfunctional uterine bleeding (DUB).Materials and methods:Design—A double blind randomized controlled trial.Data source—The women attending gynecology OPD in teaching hospital attached to Jawaharlal Nehru Medical College, Belgaum, India for menorrhagia, meeting the selection criteria were enrolled into the study.Randomization—Computer-generated randomization, with block size of two, was done into two groups.Intervention—One group (group A) received capsule ormeloxifene 60 mg to be taken two days a week at an interval of 3 days, and a placebo form of medroxyprogesterone acetate for 21 days starting from day 2 to 5 of the menstrual cycle for three consecutive cycles. Other group (group B) received medroxyprogesterone acetate (MPA) 10 mg for 21 days starting from day 2 to 5 of the menstrual cycle, and a placebo form of ormeloxifene for 2 days a week with an interval of 3 days for three consecutive cycles. The drug and its placebo were in similar capsular form. All the participants were ensured to use the similar type of sanitary napkins, and transvaginal ultrasonography was done to note the endometrial thickness (ET) before and after the drug therapy.Blinding—The department of clinical pharmacy prepared the drug packets and kept the randomization code till the data was analyzed, thus ensuring the double blinding.OutcomeParticipants were interviewed during subsequent cycle. Pictorial blood assessment chart (PBAC) score was used to calculate blood loss during menses at the first and subsequent three months.Data analysisThe mean PBAC scores and endometrial thickness were compared in two groups.ResultsThe mean pretreatment PBAC scores in group A and group B were 262.26 and 238.71 ml respectively. The mean PBAC scores at the end of the study period were 73 and 108 in group A and B respectively, reporting an overall reduction in mean blood loss by 85.7 and 54.76% (p = 0.0205) in group A and B respectively. Thus, there was a significant reduction in blood loss in the group receiving ormeloxifene. The reduction in the mean endometrial thickness was more in ormeloxifene group. However, this was not statistically significant (p = 0.0942).ConclusionOrmeloxifene is more effective as compared to MPA in reducing the blood loss in the treatment of DUB.
Safety and Efficacy of Intravenous Iron Therapy in Postnatal Patients with Iron Deficiency Anemia
Authors: Kouser Shahnaz , Kouser Shaheen , Malik Mariam , Malik Ahmad 
Published: June 2011

ABSTRACT

Objective
This prospective study was conducted to establish safety and efficacy of intravenous iron therapy in postnatal anemic patients.

Results
Around 217 anemic women were included in the study. Most of these patients (82.2%) were of 21 to 30 years of age having parity of 2 to 4 (53.9%). Almost 71% of patients had moderate anemia with Hb of 7 to 9 gm/dl. Around 208 patients (95.86%) required two to four injections of intravenous iron to build up Hb to optimum acceptable level. Only seven patients (3.22%) suffered from minor complications of local rash, while three (1.38%) had more severe allergic reactions but were managed successfully.

Conclusion
Intravenous iron is a safe and effective alternative in postnatal patients as it ensures iron therapy in low resource and noncompliant patients.
Progressive Muscle Relaxation in Hyperemesis Gravidarum
Authors: Vaidya Madhuri , Gawande Sushil , Tadke Rahul , Kirpekar Vivek , Bhave Sudhir 
Published: June 2011

ABSTRACT

Aims
To assess the role of progressive muscle relaxation in the management of hyperemesis gravidarum.

Methods
This is a prospective, randomized, observer blind and comparative study. Around 30 pregnant women admitted for the treatment of hyperemesis gravidarum were enrolled and randomized into experimental and control groups. Each group was of 15 patients. Experimental group patients received pharmacotherapy with daily progressive muscle relaxation for 2 weeks, while patients in control group received only pharmacotherapy.

Results
(1) Significantly high number of patients required three or more drugs in control group as compared to experimental group, (2) experimental group patients achieved complete response within 2.73 days ± SD, while control group patients achieved complete response within 4 days ± SD, (3) none of the patients in experimental group had recurrence within 2 weeks of observation period, while 13% patients in control group had recurrence after complete response, (4) on clinical global improvement scale, patients in experimental group achieved better improvement.

Conclusions
Progressive muscle relaxation is effective in hyperemesis gravidarum and when combined with antiemetics, it reduces the number of antiemetics required to treat hyperemesis gravidarum. Patients also show early response to treatment, less recurrence and better improvement when combined with antiemetics.
A Rare Case of Recurrent Vaginal Wall Abscess in Communicating Bicornuate Uterus with Renal Agenesis
Authors: Bhute Sindhu , Shrivastava Deepti , Mukherjee Satarupa , Rani Deepika 
Published: June 2011

ABSTRACT
Clinical presentation of müllerian anomalies vary widely. We are reporting here a case of müllerian anomaly, had suffered from secondary infertility and purulent vaginal discharge for last two years. After thorough clinical examination and systematic investigations, her proper diagnosis of communicating bicornuate uterus (H shaped) with partial agenesis of left cervix and total agenesis of right cervix and right kidney was made and patency of right tube was restored, so that not only her symptoms were resolved but she had successful pregnancy too.
Primary Adenocarcinoma of the Fallopian Tube
Authors: Udaya Kumar M , Narayana Swamy M , Manjunath RL , Kalyani R , Patil Avinash , Jain Shobithe 
Published: June 2011

ABSTRACT
Carcinoma of the fallopian tube is not one of the commonest cancer encountered in the clinical practice. Nevertheless, it is vital to have clear knowledge about this disease, since it often presents with various common disorders and when missed, it lends poor prognosis to the patient.
A Rare Case of Invasion of LSCS Scar by Partial Mole
Authors: Singh Amreen , Bhute Sindhu , Shrivastava Deepti , Mukherjee Satarupa 
Published: June 2011

ABSTRACTInvasive mole can mimic in presentation to inevitable, incomplete and missed abortion, and sometimes obstetric emergencies like intraperitoneal hemorrhage with heavy vaginal bleeding. Although rare, but with increasing incidence of LSCS, isolated invasion at LSCS (lower segment cesarian section) scar by partial mole may be seen, as in this case.To exclude pregnancy before Copper-T (Cu-T) insertion is important, even in a lady with irregular period presenting at 5th day of menses because bleeding may be related to pregnancy.
Dengue Fever in Pregnancy Mimicking Obstetric Hemorrhage
Authors: Mehta Meghana Narendrabhai , Shah Jitesh Mafatlal , Vachhani Ashvin Dayalal , Desai Archish Ishvarbhai 
Published: June 2011

ABSTRACT
Dengue is a major public health problem in the tropical and subtropical area. Dengue fever is caused by one of the four dengue virus serotypes of the genus Flavivirus, family flaviviridae, RNA virus.1-3 Dengue is transmitted to humans by the mosquito Aedes aegypti. The principal maternal complications are abortion, premature labor, retroplacental hematoma leading to antepartum hemorrhage and hemorrhage during and after delivery. Fetal complications are prematurity, intrauterine fetal death (IUFD), acute fetal distress in labor, maternal-fetal (vertical) transmission and neonatal death. Management of dengue fever is conservative with intravenous fluid replacement and close observation of vital signs and bleeding.
Postcesarean Colonic Obstruction due to Sigmoid Volvulus
Authors: Kokila MS , Dwivedi Akhilesh Dutta , Tejeswini K , Arava Srinivas 
Published: June 2011

ABSTRACT
Sigmoid volvulus causing intestinal obstruction in immediate postcesarean period is extremely rare, commonest being adhesions and adynamic ileus. The presenting features of this complication are mistaken for usual postoperative signs and symptoms causing delayed diagnosis. Thus, a case of intestinal obstruction due to sigmoid volvulus in immediate postcesarean period is presented. Detorsion of sigmoid and decompression of bowel was done. Intestines were viable because of early detection and prompt intervention. Therefore, high index of suspicion and prompt surgical interventions are required to minimize maternal morbidity and mortality.
A Rare Case of Autosomal Dominant Polycystic Kidney Disease Presenting in utero
Authors: Dhumale Hema , Pujar Yeshita , Sherigar Bhavana , Desai Babasaheb Raosaheb , Durdi Geeta , Dalal Anita 
Published: June 2011

ABSTRACT
Autosomal dominant polycystic kidney disease (ADPKD) is the most widespread cause of genetic nephropathy. Only 25% of patients are symptomatic.1 One in 1,000 people carries the autosomal dominant polycystic kidney disease mutant gene. Autosomal dominant polycystic kidney disease is usually asymptomatic until the third or fourth decade of life, although histological evidence of the disease is likely to be present from intrauterine life. Rarely, however, kidneys that are anatomically similar may cause death in infancy or early childhood, and the condition has been designated as “adult variety occurring in infancy”.2 In ADPKD, cysts develop only later in adulthood yet exceptionally cysts may be encountered in utero.
We report a rare case of ADPKD, which was diagnosed by ultrasonography in utero as infantile polycystic kidney disease due to the presence of bilateral enlarged hyperechogenic kidneys with oligohydramnios. Pregnancy was terminated and autopsy revealed it to be an adult polycystic kidney disease. This case is reported due to its rare presentation in utero.
A Rare Case of Acardiac Twin
Authors: Damani Manisha 
Published: June 2011

ABSTRACT
This is a very rare condition happening on average once in every 35000 pregnancies. One twin is usually normal. The other is body like tissue often with malformed legs and lower body but no upper body or heart. Abnormal blood vessels on the placental surface allow the normal twin (pump twin) to pump blood through the tissues of abnormal twin. Because the pump twin heart has to pump for two, there is high risk of going into heart failure and death of normal twin. In our cases nature miraculously interrupted the blood circulation to acardiac twin which resulted in normal growth of normal twin. I present here this interesting case diagnosed and followed up and delivered at our institution.
Comparison of Radiant Warmer Care and Kangaroo Mother Care Shortly after Birth on the Neurobehavioral Responses of the Newborn
Authors: John Renjana Rebecca , Nayak Sabitha , Paul Shiney 
Published: June 2011

ABSTRACT

Background of the study
In 1978, kangaroo mother care (KMC) was proposed as a caring alternative for low birth weight infants. The method of skin to skin contact has shown physiologic, cognitive and emotional gains for preterm infant, however, kangaroo mother care has not been studied adequately in term newborns. The present study reporting early outcomes of comparing the kangaroo mother care to radiant warmer care.
Objectives of the study:
• To assess the neurobehavioral response of the newborn during radiant warmer care (RWC) and kangaroo mother care
• The effect of radiant warmer care and kangaroo mother care on neurobehavioral response of the newborn.

Methods
A quasi-experimental post-test design was used in this study to compare the effect of kangaroo mother care and radiant warmer care on neurobehavioral response of term newborn. A total of 40 subjects who met the inclusion criteria were randomized—20 to KMC and 20 to RWC by simple random sampling technique. The data was collected by using the following tools:
1. Observational check list
2. Modified Brazelton Behavioral Assessment Scale.

Results
Both study groups were similar regarding all physiologic state variables. There is a slight difference in the behavioral state, the mean behavioral response scores of the RWC and KMC were 5.6500 and 5.9500 respectively, and the mean difference was 0.300. Interpretation and conclusion: The findings of the study showed that kangaroo mother care seems to influence state organization and physiologic state regulation of the newborn infant shortly after birth.
Reappraisal of Endometrial Stromal Sarcoma: Report of Four Cases with Review of Literature
Authors: Gayathri BN , Rao Kadam Satyanarayan , Chatura KR 
Published: June 2011

ABSTRACT
Endometrial stromal sarcomas (ESSs) are morphologically heterogenous and diagnosed by light microscopy in most instances. The distinction between smooth muscle neoplasms, such as cellular leiomyoma and low-grade ESS can be problematic. The diagnoses of ESS on the basis of systematic assessment of gross and histological parameters are highlighted.
Hysterectomy from four patients for a clinical diagnosis of leiomyoma was studied. Grossly, three had polypoidal lesion and in one myometrial widening with obvious permeation was noted. Microscopy showed features of ESS in three cases. Other case was diagnosed as cellular leiomyoma thought to be endometrial polyp. Reticulin stain was employed to highlight the characteristic spiral arterioles in ESS and thick-walled vessels in cellular leiomyoma.
Complications during Vaginal Hysterectomy: How to get over Them?
Authors: Joshi Sulabha , Ghike Sunita , Bhalerao Anuja , Kawthalkar Anjali 
Published: June 2011

ABSTRACT
Today vaginal hysterectomy is the most commonly performed gynecological surgery for prolapsed uteri and for other conditions, like fibroid, dysfunctional uterine bleeding, cervical intraepithelial neoplasia, etc.
Vaginal hysterectomy has least incidence of complications. Complications like hemorrhage, infection, bladder injury, etc. are known.
This prospective study was carried out at a tertiary hospital to analyze the complications and find measures to prevent or decrease complications.
Primary hemorrhage was the most common complication, followed by bladder injury and infection. Thus proper selection of cases, preoperatively prepare for any eventuality and intraoperative proficiency can decrease vaginal hysterectomy complications.
Evaluation of Downstaging, Visual Inspection with Acetic Acid and Lugol's Iodine in Screening of Cervical Cancer
Authors: Durdi Geeta , Patil Kamal , Lumb Lakshita 
Published: June 2011

ABSTRACT

Objectives
To detect and compare the sensitivity and specificity of downstaging and visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI).

Methods
Screening with downstaging, VIA and VILI were done on 680 women who fulfilled the inclusion criteria at a primary health center attached to the university hospital, over a period of one year. Those who had abnormal results in downstaging, VIA and VILI were biopsied and sensitivity, specificity, negative predictive value and positive predictive value were calculated.

Results
The sensitivities of downstaging, VIA and VILI were 54.55, 63.64 and 90.91% and specificities were 93.42, 95.07 and 97.46% respectively. The positive predictive value of downstaging, VIA and VILI were 12.01, 17.5 and 35.7% and negative predictive values were 99.2, 99.37 and 98.85% respectively.

Conclusion
VIA and VILI are suitable primary screening procedures as compared to downstaging because of high sensitivity and specificity. The negative predictive value of downstaging, VIA and VILI is better than the positive predictive value. Downstaging can be used in rural areas where acetic acid and Lugol's iodine are not available.