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L Seshadri

Publications and source records attributed to L Seshadri.

At least 37 records · Page 2Linked to original sources
PubMed1995

Changes in the physical state and expression of human papillomavirus type 16 in the progression of cervical intraepithelial neoplasia lesions analysed by PCR.

Using a PCR strategy which detects disruptions in the E2 reading frame we have analysed the progression of human papillomavirus type 16 (HPV-16)-positive cervical lesions. From a total of 192 samples analysed, we detected HPV-16 in 74. In samples from the spectrum of inflammatory states and cervical intraepithelial neoplasia (CIN) grade I lesions we detected episomal forms of the virus. In invasive tumours and in samples from CIN III lesions there were no episomes detected, suggesting that lesions with integrated HPV-16 precede the invasive stage. The RT-PCR analysis demonstrated the presence of E6 transcripts at all stages and E2 transcripts in all early lesions. The E2 transcripts were not detected in 26 out of 29 CIN III lesions and tumours in which there was a disruption in the E2 gene. In tumours with E2 gene disruptions, we used single-primer PCR to demonstrate the presence of E2 gene sequences.

DNA Primers↗
PubMed1994

Endocrine profile of women with amenorrhea and oligomenorrhea.

OBJECTIVES: To find out the common causes of amenorrhea and oligomenorrhea in south Indian women and to draw up a protocol for evaluation of women with these problems. METHODS: A retrospective study of 426 women with amenorrhea and oligomenorrhea was carried out. RESULTS: Forty-one patients had primary amenorrhea, 132 had secondary amenorrhea and 289 women presented with oligomenorrhea. Hypergonadotropic amenorrhea and congenital absence of the uterus and vagina accounted for 60% of primary amenorrhea. Chronic anovulatory disorders and premature ovarian failure were found in 72% of women with secondary amenorrhea but weight loss related amenorrhea was uncommon. CONCLUSIONS: On the basis of the observations made, a protocol for evaluation and management of women with amenorrhea and oligomenorrhea was evolved.

Adult↗
PubMed1994

Use of the Foley catheter as a cervical ripening agent prior to induction of labor.

OBJECTIVE: To study the effect of the extraamniotic Foley catheter as a cervical ripening agent prior to induction of labor. METHOD: A descriptive study was carried out on 187 patients who had labor induced following cervical ripening with the extraamniotic Foley catheter. There were 99 nulliparas and 88 multiparas whose labor outcomes were analyzed separately. RESULTS: The mean change in the modified Bishop score was 3.7 for nulliparas and 3.3 for multiparas. The induction-delivery interval was 8.7 h for nulliparas and 5.5 h for multiparas. CONCLUSION: The Foley catheter was found to be an effective agent for cervical ripening in both primiparas and multiparas and its use was not associated with any complications.

Adult↗
PubMed1994

Management of patients with mildly dysplastic cervical smears.

The management of patients with mild dysplasia on cervical smears remains controversial. Recent studies have shown that many harbor high grade squamous intraepithelial lesions (HSIL) and human papillomavirus (HPV) and warrant further evaluation rather than follow-up. This prospective study dealt with the evaluation of patients with mild dysplastic smears using colposcopy and directed biopsies with view to identifying HSIL/HPV and treating them. Among 100 cases studied, 61% revealed HSIL/HPV; of them, 10% had high grades. Hence, patients with mildly dysplastic lesions should be evaluated further and managed with histopathologic examination of the biopsy specimen. This protocol may be cost effective for evaluating women with mildly dysplastic smears in a referral center, though it may not be so when compared to a policy of treating the infection, repeating the smears and performing colposcopy and biopsy on all those with persistent abnormality.

Biopsy↗
PubMed1993

Cervical ripening induces labour through interleukin 1 beta.

In order to study the Interleukin 1 beta (IL-1 beta) levels in mechanical cervical ripening with Foley catheter, IL-1 beta levels in amniotic fluid of 12 women before and after cervical ripening were compared with those in 23 women in spontaneous active labour. IL-1 beta was present in 81.8% of patients after cervical ripening and in none prior to it. In women with spontaneous labour 69.6% had immunodetectable IL-1 beta. Women with spontaneous labour and those sampled after cervical ripening had similar IL-1 beta levels in the amniotic fluid. Cervical ripening with Foley catheter is associated with high levels of IL-1 beta and this probably induces labour.

Amniotic Fluid↗
PubMed1993

Large solitary luteinized follicle cyst of pregnancy and puerperium.

A case of large solitary luteinized follicle cyst of pregnancy and the puerperium, arising in a 22 year old primipara, three months post partum, is presented with clinical and pathological details. This is a rare type of follicle cyst and has to be differentiated from a cystic neoplasm.

Adult↗
PubMed1993

Prevalence of HIV infection in pregnant women in Vellore region.

All pregnant women attending the antenatal clinic of a large hospital in Vellore, India (Christian Medical College Hospital) were screened for HIV infection between October 1987 and June 1992. A total of 36,953 blood samples were thus screened and 20 infected women were identified. Among these 18 women had acquired HIV infection from their husbands, who were also detected to be HIV infected. While these 18 women were monogamous, all the husbands had multiple sex partners. Two of the 20 women in this series were commercial sex workers. Among the 20, 17 (85%) women belonged to low socio-economic status, while three were from well-to-do families, with the husbands being businessmen or teachers. As the overall prevalence (0.054%) of HIV infection among pregnant women was relatively high and equal to or higher than many States in the USA and in areas outside London in the UK, the authors recommend that strict universal precautions be instituted in all obstetric practice in India.

Adult↗
PubMed1991

Cervical intraepithelial neoplasia and human papilloma virus infection.

Evidence of human papilloma virus (HPV) infection was sought in 50 patients with cervical intraepithelial neoplasia (CIN) and 50 controls. Cytologic, colposcopic and histopathological examinations were carried out in each one of them. Cytological evidence of HPV infection was found in 13 cases and two controls. Colposcopic evidence was found in 33 (66%) cases and 17 (34%) controls and histopathological evidence in 35 (70%) patients and 14 (28%) controls. These differences were statistically significant. Colposcopy proved to be a good method of diagnosing HPV infection with a sensitivity of 86% and specificity of 80% compared to histopathologic diagnosis.

Colposcopy↗
PubMed1990

Colposcopy in the diagnosis of cervical neoplasia.

Two hundred and ninety one women were evaluated for cervical cancer by cytology and colposcopy. Of these, 152 patients underwent colposcopically directed biopsy for histological evaluation. Colposcopy and cytology were in agreement in 88 per cent of cases whereas colposcopy and histopathology were in agreement in 79 per cent of cases. Cytology underestimated the severity of the lesion in nine per cent while colposcopy underestimated the lesion in 7.2 per cent (False negative rate). In 13.8 per cent of cases colposcopy overestimated the lesion (False positive rate). The cone biopsy rate in this series was 30 per cent. We conclude that since colposcopy shows excellent correlation with histopathology, it will be a useful tool to reduce cone biopsy rates, particularly in younger women in the child-bearing age group.

Adult↗
PubMed1985

The diagnosis, treatment and complications of cervical intraepithelial neoplasia--experience at the Royal Hospital for Women, Sydney, during the years 1972-1982.

During the 11 years 1972-1982, 770 patients with cervical intraepithelial neoplasia III (carcinoma in situ/severe dysplasia) were treated at The Royal Hospital for Women, Sydney. Of these, 592 had primary conization (Group I) and 153 had colposcopically directed biopsy and diathermy (Group II). Carcinoma in situ was diagnosed in the remaining 25 following hysterectomy for other gynaecological indications. The recurrence rates were similar in the 2 groups, but the conization group had a complication rate of 9.6% while none of the patients in group II had any significant complications. The presenting symptoms, gravidity, cytology and histopathological diagnosis were similar in the 2 groups. The conization and subsequent hysterectomy rates have decreased over the years. However, 50% of patients are still treated in this institution by cone biopsy. More conservative treatment (biopsy and diathermy) is being performed in increasing numbers of younger patients.

Adult↗
PubMedDate not supplied

Management of prolonged pregnancy: a randomized trial of induction of labour and antepartum foetal monitoring.

BACKGROUND: The two methods of management of prolonged pregnancy, induction of labour and expectant management with foetal surveillance, have pros and cons. Therefore, we compared the induction of labour with serial antenatal foetal monitoring in the management of post-term pregnancy. METHODS: Seventy-four women with uncomplicated pregnancy at 41 weeks (287 days) of gestation were randomly assigned to undergo either induction of labour or serial antenatal foetal monitoring. Labour was induced in the latter group whenever there was evidence of foetal compromise. Antenatal monitoring consisted of the foetal kick count, non-stress test and biophysical profile. RESULTS: Fifty-seven per cent of women went into spontaneous labour by 41 weeks and 4 days (291 days) of gestation and only 14% developed foetal compromise before that. However, when the gestational age was more than 41 weeks and 4 days (291 days), the incidence of meconium staining of amniotic fluid and evidence of uteroplacental insufficiency increased significantly. The rate of caesarean section, instrumental delivery, foetal distress and duration of labour did not differ significantly between the two groups. CONCLUSION: The policy of inducing labour at 41 weeks and 4 days (291 days of gestation) in uncomplicated pregnancies is justified in our population. However, foetal monitoring should begin at 41 weeks of gestation.

Adult↗