المؤلفون: Lakhbir Kaur Dhaliwal, Virendra Singh, Sunita Kumari, Kartar Singh, Sujata Siwatch

المصدر: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 42(5)

مصطلحات موضوعية: Infertility, Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, endocrine system diseases, digestive system, Gastroenterology, Non-alcoholic Fatty Liver Disease, Diabetes mellitus, Internal medicine, medicine, Humans, Risk factor, Transaminases, medicine.diagnostic_test, business.industry, Fatty liver, nutritional and metabolic diseases, Obstetrics and Gynecology, medicine.disease, female genital diseases and pregnancy complications, digestive system diseases, Liver biopsy, Female, Metabolic syndrome, Insulin Resistance, Transient elastography, business, Infertility, Female, Polycystic Ovary Syndrome

الوصف: Non-alcoholic fatty liver disease (NAFLD) is a frequent occurrence in polycystic ovarian syndrome (PCOS). We studied the frequencies and characteristics of NAFLD in PCOS women. We compared various methods of detection of advanced fibrosis/cirrhosis. One hundred and forty women with PCOS and seventy controls, matched for age, were evaluated for the presence of NAFLD. Anthropometric variables, serum levels of aminotransferases, glucose, lipids and transient elastography were done. Thirty-six percent of the NAFLD patients had abnormal aminotransferases. In women presenting to an infertility clinic, NAFLD was higher in both obese and non-obese PCOS women, being present in 117 (83.6%) of PCOS cases and 32 (45.7%) of non-PCOS controls (p< .001). Fibroscan is helpful in evaluating for liver fibrosis in patients with NAFLD.Impact StatementWhat is already known on this subject? Polycystic ovarian syndrome (PCOS) has been associated with many long-term health complications including endometrial cancer, diabetes, hypertension and metabolic syndrome. The association of PCOS with NAFLD has been suggested. NAFLD is recognised as a leading cause of liver dysfunction which can progress to long-term sequel of cirrhosis.What do the results of this study add? In this study, asymptomatic women seeking treatment of infertility were screened for presence of NAFLD. The study shows a high prevalence of NAFLD in young Indian women. The prevalence was significantly higher in women with PCOS than non-PCOS women.What are the implications of these findings for clinical practice and/or further research? The findings of the study suggest that all infertile women, especially those with PCOS, should be screened for NAFLD. This will help in early identification and management of this condition and to avoid long-term consequences of liver dysfunction and cirrhosis. PCOS is an independent risk factor for the development of NAFLD in obese women. Liver ultrasound, serum levels of transaminases clinch the diagnosis. Short of liver biopsy, non-invasive tests like Fibroscan and NAFLD fibrosis score are useful to assess the stage of fibrosis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::14586b810f18b20d6236cc72d538ab29Test
https://pubmed.ncbi.nlm.nih.gov/34689689Test

المؤلفون: Anupama Hari, Amita Jain, Neena Malhotra, Venkateswaran K. Iyer, S. P. Jaiswar, Lakhbir Kaur Dhaliwal, Urvashi B. Singh, Nomita Chandhiok, Aparna Srikantam, Aijaz Ahmad, Pankush Gupta, Shalini Gainder

المصدر: European journal of obstetrics, gynecology, and reproductive biology. 267

مصطلحات موضوعية: Pathology, medicine.medical_specialty, Tuberculosis, Biopsy, Antitubercular Agents, Endometrium, Immune system, medicine, Humans, Subclinical infection, CD20, medicine.diagnostic_test, biology, business.industry, Obstetrics and Gynecology, Mycobacterium tuberculosis, medicine.disease, Tuberculosis, Female Genital, medicine.anatomical_structure, Reproductive Medicine, Granuloma, biology.protein, Immunohistochemistry, Female, business, Infertility, Female, Endometrial biopsy

الوصف: Background Female Genital Tuberculosis (FGTB) causes infertility in a large number of females in developing countries. Presence of granuloma on histopathological examination of endometrial samples is diagnostic of FGTB. But immunohistochemical evaluation of endometrial aspirates has not been explored before. Aim To evaluate the immunohistochemical delineation of immune cells in FGTB. Methods 1515 infertile women from 20 to 35 years were enrolled and underwent endometrial aspiration (EA), which was subjected to microbiological and histopathological examination along with PCR. Patients positive for conventional tests like granulomas, acid fast bacilli, mycobacterial culture on LJ medium or liquid (MGIT) culture were started on antitubercular therapy. Conventional test negative but PCR positive patients were posted for laparoscopy. Immunohistochemistry (IHC) for LCA, CD68, CD3, CD4, CD8, CD 20, CD138, IFN gamma and IL10 were evaluated. Result 38/1515 (2.5%) subjects tested positive for conventional methods. PCR-TB was positive in 615/1515 samples (40.59%). On IHC, the number of CD45 (LCA) positive immune cells (p = 0.03) and IFN gamma (p = 0.002) and IL10 expression (p = 0.012) at 1 + level were higher in the PCR positive samples. Laparoscopy done in 418/463 patients and 89/418 (21.3%) showed definitive findings of tuberculosis. CD3, CD4, CD8, CD20, CD68 and CD138 showed no correlation with PCR and laparoscopy. Conclusion Increased IFN gamma and IL 10 expressing immune cells in PCR positive EA suggests subclinical early changes, and can be useful as a research tool but have no role in diagnosing FGTB.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4638c8ccf485a356819e3dce353437dbTest
https://pubmed.ncbi.nlm.nih.gov/34800826Test

المؤلفون: William Tarnow-Mordi, Bikramjit Das, Lakhbir Kaur Dhaliwal, Venkataseshan Sundaram, Praveen Kumar, Alpana Ghadge

المصدر: Journal of Perinatology. 38:496-504

مصطلحات موضوعية: Pregnancy, medicine.medical_specialty, Cord, business.industry, Obstetrics, Incidence (epidemiology), Obstetrics and Gynecology, Gestational age, medicine.disease, Umbilical cord, law.invention, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Randomized controlled trial, law, 030225 pediatrics, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, medicine, Gestation, 030212 general & internal medicine, business

الوصف: To compare effect of placental transfusion by delayed cord clamping (DCC) or cord milking (CM) with early cord clamping (ECC) on a composite of mortality or abnormal neurological status at 40 weeks’ post-menstrual age (PMA) and 24–30 months’ chronological age in neonates of 30–33 weeks’ gestation. Randomized, controlled trial. A composite of mortality or abnormal neurological status at 40 weeks PMA and survival free of neurodevelopmental abnormalities at 24–30 months’ chronological age. A total of 461 neonates were randomized to placental transfusion (n = 233) or to ECC (n = 228). Among those assigned to placental transfusion group, 173 underwent DCC while in the remaining 60, CM was done. Incidence of mortality or abnormal neurological status at 40 weeks PMA (43 (18%) vs 35 (15%), RR (95% CI) 1.2 (0.8, 1.8), p = 0.4) and survival free of neurodevelopmental impairment at 24–30 months of chronological age (99 (47%) vs. 100 (50%); RR (95% CI): 0.9 (0.8, 1.2); P = 0.9) was similar between the study groups. The placental transfusion group showed a trend towards lower incidence of necrotizing enterocolitis. In 30–33 weeks’ gestation preterm neonates, placental transfusion as compared to early cord clamping resulted in similar mortality or abnormal neurological status at 40 weeks PMA and at 24–30 months of chronological age.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::3b3d29d5875eeb6c65caef0345102f8fTest
https://doi.org/10.1038/s41372-018-0064-4Test

المؤلفون: Shalini Gainder, Sunil Sethi, Lakhbir Kaur Dhaliwal, Nidhi Jindal

المصدر: The Journal of Obstetrics and Gynecology of India. 68:123-128

مصطلحات موضوعية: 0301 basic medicine, Gynecology, Infertility, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, 030106 microbiology, Obstetrics and Gynecology, Diagnostic dilemma, Genital tuberculosis, medicine.disease, Secondary infertility, Diagnostic modalities, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Original Article, Mycobacteria growth indicator tube, Detection rate, business, Endometrial biopsy

الوصف: BACKGROUND: The purpose of this study was to assess the utility of Mycobacteria Growth Indicator Tube (MGIT) 960 culture medium for the diagnosis of genital tuberculosis (GTB) in women presenting with infertility. METHODS: The premenstrual endometrial biopsy samples in 300 women presenting with primary and secondary infertility were subjected to AFB smear method, histopathological examination and culture on LJ and MGIT 960 media. Detection rates were compared for diagnostic modalities and their combinations. RESULTS: In total, 30 cases were positive for genital tuberculosis by either of the four tests employed. The detection rates for AFB smear, MGIT culture, LJ culture and HPE were 50, 46.7, 3.3 and 33.3%, respectively. A combination of smear examination for AFB, MGIT 960 culture and histopathological examination was able to detect all the positive cases. A combination of MGIT and LJ media provided no added advantage over MGIT alone since the only case where LJ culture was positive had been detected by positive MGIT culture. In as many as five positive cases (16.7%), only MGIT culture was positive. CONCLUSION: The addition of MGIT 960 culture medium to routine battery of investigations in infertility patients significantly improves the diagnosis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::be1ba371d8935096b746390faa587468Test
https://doi.org/10.1007/s13224-017-1077-1Test

المؤلفون: Neelam Aggarwal, Vanita Suri, Lakhbir Kaur Dhaliwal, Rimpi Singla

المصدر: Bangladesh Journal of Obstetrics & Gynaecology. 30:25-29

مصطلحات موضوعية: medicine.medical_specialty, Pregnancy, Referral, business.industry, Obstetrics and Gynecology, Mean age, 030206 dentistry, Audit, North india, medicine.disease, Tertiary care, Health care delivery, 03 medical and health sciences, 0302 clinical medicine, Family medicine, Health care, Medicine, 030212 general & internal medicine, business

الوصف: Objective (s):The aim of the study was to find out the characteristics of emergency obstetric referrals, to evaluate the lapses in the existing referral system and to suggest the plausible solutions to improve the obstetric health care delivery system in India.Materials and methods: This prospective descriptive study was carried out in the Department of Obstertrics and Gynaecology PGIMER Chandigarh India from September 2012 to December 2012.All the obstetric emergency referrals to our institute, a tertiary care centre in North India were critically reviewed for reason for referral, adequacy of care provided before referral, lapses in management, factors behind suboptimal care and remedial measures are suggested.Results: There were 232 emergency referrals available for analysis. Of these 76% patients were referred directly to the institute, the highest level in referral chain in the region. Mean age was 26yrs, 28.6% of the patients were illiterate. In 75.5% of cases, the management of obstetric emergency before referral was suboptimal or poor. In 16% of cases patient failed to seek medical help timely despite emergency. In 40% of cases there was undue delay in referring or failure to provide even the basic care. Anticipated premature delivery and hypertensive disorders of pregnancy were the most common diagnosis at referral.Conclusion: Results from this pilot study shows that in spite of the most extensive health care infrastructure and so- called hierarchal referral system, there is gross inadequacy in referral system in India.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 25-29

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::a1e99fac4a030165c813c04bc7fe3ae4Test
https://doi.org/10.3329/bjog.v30i1.30504Test

المؤلفون: Kanya Mukhopadhyay, Lakhbir Kaur Dhaliwal, Dhaarani Jayaraman, Anil Kumar Bhalla

المصدر: Journal of human lactation : official journal of International Lactation Consultant Association. 33(3)

مصطلحات موضوعية: Male, medicine.medical_specialty, Pediatrics, Time Factors, Birth weight, Breastfeeding, Weight Gain, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, 030225 pediatrics, Lactation, medicine, Humans, 030212 general & internal medicine, Milk, Human, Obstetrics, business.industry, Incidence (epidemiology), Infant, Newborn, Obstetrics and Gynecology, Infant, Infant, Low Birth Weight, Kangaroo-Mother Care, Kangaroo-Mother Care Method, Low birth weight, medicine.anatomical_structure, Breast Feeding, Female, medicine.symptom, business, Breast feeding

الوصف: Background:Breastfeeding at discharge among sick low-birth-weight (LBW) infants is low despite counseling and intervention like kangaroo mother care (KMC).Research aim:The aim was to study the effects of early initiation of KMC on exclusive human milk feeding, growth, mortality, and morbidities in LBW neonates compared with late initiation of KMC during the hospital stay and postdischarge.Methods:A randomized controlled trial was conducted in level 2 and 3 areas of a tertiary care neonatal unit over 15 months. Inborn neonates weighing 1 to 1.8 kg and hemodynamically stable were randomized to receive either early KMC, initiated within the first 4 days of life, or late KMC (off respiratory support and intravenous fluids). Follow-up was until 1 month postdischarge. Outcomes were proportion of infants achieving exclusive human milk feeding and direct breastfeeding, growth, mortality and morbidities during hospital stay, and postdischarge feeding and KMC practices until 1 month.Results:The early KMC group ( n = 80) achieved significantly higher exclusive human milk feeding (86% vs. 45%, p < .001) and direct breastfeeding (49% vs. 30%, p = .021) in hospital and almost exclusive human milk feeding (73% vs. 36%, p < .001) until 1 month postdischarge than the late KMC group ( n = 80). The incidence of apnea (11.9% vs. 20%, p = .027) and recurrent apnea requiring ventilation (8.8% vs. 15%, p = .02) were significantly reduced in the early KMC group. There was no significant difference in mortality, morbidities, and growth during the hospital stay and postdischarge.Conclusion:Early KMC significantly increased exclusive human milk feeding and direct breastfeeding in LBW infants.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b6001654cc4db93a03dea7fd11c426d6Test
https://pubmed.ncbi.nlm.nih.gov/28152330Test

المؤلفون: Subhas Chandra Saha, Lakhbir Kaur Dhaliwal, Sameer Vyas, Anish Keepanasseril, Rashmi Bagga

المصدر: Gynecological Surgery. 8:161-164

مصطلحات موضوعية: congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Hysterectomy, medicine.diagnostic_test, business.industry, media_common.quotation_subject, medicine.medical_treatment, Reproductive medicine, Obstetrics and Gynecology, Interventional radiology, Fertility, Anastomosis, medicine.disease, Cervical agenesis, Surgery, Vaginal atresia, medicine.anatomical_structure, otorhinolaryngologic diseases, medicine, business, Cervix, media_common

الوصف: Congenital atresia of the cervix is a rare mullerian anomaly. Hysterectomy has been advocated as the management of choice in the early days as the reproductive performance is thought to be low despite successful neo-canal creation. In recent years, conservative surgery is being recommended more frequently in patients with congenital cervical atresia and with total or partial vaginal aplasia and is shown to have a better reproductive performance. The treatment strategy should be tailored to relieve retrograde menstrual symptoms and restore fertility. Here, we report a young girl with congenital cervical atresia with upper vaginal atresia managed with uterovaginal anastomosis and review the management options and reproductive performance in such cases.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::2dcd653d3bc4d121ff745c363983828eTest
https://doi.org/10.1007/s10397-010-0640-xTest

المؤلفون: Lakhbir Kaur Dhaliwal, Indu Gupta, Kamala Rani Khera

المصدر: Asia-Oceania Journal of Obstetrics and Gynaecology. 14:177-180

مصطلحات موضوعية: Adult, Male, Infertility, medicine.medical_specialty, Abortion, Septic, Abortion, Secondary infertility, Uterine abnormality, Sepsis, Pregnancy, Primary infertility, medicine, Humans, Prospective Studies, Hysterosalpingography, Fallopian Tubes, reproductive and urinary physiology, Gynecology, medicine.diagnostic_test, Obstetrics, business.industry, Age Factors, Obstetrics and Gynecology, medicine.disease, Infertility clinic, Female, business, Infertility, Female

الوصف: A total of 848 couples attended our infertility clinic over a period of 4 years. Two hundred forty-eight complained of secondary infertility of which 63.7% had an abnormal hysterosalpingographic finding. The abnormal hysterosalpingography (HSG) was seen to increase with an increase in age and duration of infertility. Of the subjects with previous viable delivery, 41.6% had normal HSG whereas 38.1% with previous spontaneous abortion and only 11.5% with previous induced abortion had a normal HSG. Uterine abnormality was 2 and a half times in the cases with spontaneous abortion than in cases who had previous viable delivery. Tubal blocks were detected more in secondary infertility group whereas congenital uterine abnormalities were more in primary infertility group. Bilateral tubal blocks were more common in cases who had an abortion followed by sepsis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::358951be944f0f850a65e73c542598f6Test
https://doi.org/10.1111/j.1447-0756.1988.tb00091.xTest

المؤلفون: Neelam Aggarwal, G. R. V. Prasad, V. Chopra, Rashmi Bagga, Subhas Chandra Saha, Lakhbir Kaur Dhaliwal

المصدر: Hypertension in Pregnancy. 26:139-149

مصطلحات موضوعية: Adult, Research design, medicine.medical_specialty, Referral, Pregnancy Complications, Cardiovascular, India, Gestational Age, Severity of Illness Index, Pregnancy, Severity of illness, Internal Medicine, Humans, Medicine, Adverse effect, Developing Countries, Retrospective Studies, Eclampsia, business.industry, Obstetrics, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, Retrospective cohort study, medicine.disease, Research Design, Chronic Disease, Hypertension, Female, business, Follow-Up Studies

الوصف: To assess pregnancy outcome in patients with severe chronic hypertension.A retrospective analysis of a 10-year period (1995-2004) in a referral hospital in northern India. The outcome was compared with those women with mild chronic hypertension who registered in the hypertensive disorders with pregnancy clinic immediately before and after each woman with severe chronic hypertension.Hospital data identified 25 such women. Superimposed preeclampsia (36.4% versus 8%), preterm delivery (86.4% versus 42%), and perinatal mortality (27.2% versus none) were increased in patients with severe chronic hypertension as compared to those with mild hypertension.The small number of cases reflects the lack of antenatal supervision in developing countries. A much larger number of women are referred in the third trimester with eclampsia or severe preeclampsia, at which time it is not possible to identify whether or not they had underlying hypertension. Adverse events were found to occur more often in patients with severe chronic hypertension compared with those with mild hypertension.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::34ed3b4531373e860fd1a41754185548Test
https://doi.org/10.1080/10641950701204588Test

المؤلفون: Shalini Gainder, Lakhbir Kaur Dhaliwal, Subhas Chandra Saha, Rashmi Bagga, Pranab Dey, Anish Keepanasseril

المصدر: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 35(3)

مصطلحات موضوعية: Gynecology, endocrine system, medicine.medical_specialty, Carcinoma, Transitional Cell, animal structures, urogenital system, business.industry, Obstetrics and Gynecology, Fallopian Tube Transitional Cell Carcinoma, Middle Aged, medicine.disease, Fever of Unknown Origin, female genital diseases and pregnancy complications, Abdominal Pain, medicine.anatomical_structure, Vaginal Discharge, Carcinoma, Medicine, Fallopian Tube Neoplasms, Humans, Female, Uterine Hemorrhage, business, Fallopian tube

الوصف: Carcinoma of the fallopian tube is one of the rarest gynaecological tumours accounting for only 0.18–1.6% of gynaecological malignancies (Nordin 1994). Preoperative diagnosis of fallopian tube carc...

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b1cd31be2ff6e3e2258c2b762ddff1f9Test
https://pubmed.ncbi.nlm.nih.gov/25162143Test