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Biomedical subjects

V L Bhargava

Publications and source records attributed to V L Bhargava.

At least 19 recordsLinked to original sources
PubMed1998

Correlation of radiological and pathological assessment of tumour volume with lymph node involvement in cancer cervix.

The present study was carried out in 18 patients with carcinoma cervix stage IB through early IIB-Preoperative computerised tomography (C.T.) was done within seven days before surgery. Volume of tumour was determined from the C. T. films. Radical hysterectomy Type-III was performed in all 18 patients and specimens of cervix, parametrium and lymph nodes subjected to histopathological examination. Each specimen of cervix was cut into 4 to 12 equal sections depending on the size of the tumour mass. Cervical tumour volume was measured. Correlation of radiological with pathological tumour volume and of tumour volume with lymph node involvement was done. C. T. Scan was able to detect tumour mass accurately only four patients (Sensitivity 40%, Specificity 28.5%). In the Indian setting the conventional surgical approach appears to be the more appropriate.

Adult↗
PubMed1998

Histologic chorioamnionitis & its association with prematurity in a hospital-based study.

This prospective study was undertaken to study the occurrence of histologic chorioamnionitis and determine its association with prematurity; and to assess whether colonization of the genital tract of pregnant women by genital mycoplasmas or Chlamydia trachomatis is a risk factor for histologic chorioamnionitis. A total of 268 women with singleton pregnancies of over 26 weeks gestation were subjected to high vaginal cultures of genital mycoplasmas and endocervical specimens for chlamydia antigen. Placental histopathology was performed on multiple sections. Histologic chorioamnionitis was documented in 22.4 per cent (60/208) placentae. Genital tract colonization with Ureaplasma urealyticum or C. trachomatis was not a risk factor for histologic chorioamnionitis. Neonates born in association with histologic chorioamnionitis had a mean birth weight 111 g lower than those born without this lesion (2626.9 +/- 702 g vs 2737.8 +/- 500 g, NS). The relative risk (95% confidence interval) of prematurity in the presence of histologic chorioamnionitis was 1.49 (0.87-2.53). Analysis of linear trend in proportions for prevalence of histologic chorioamnionitis with decreasing gestation showed a significant association (P = 0.047, 1-tail). These results taken together suggest that histologic chorioamnionitis may be a risk factor of prematurity, but of only a modest magnitude.

Chorioamnionitis↗
PubMed1996

Effect of antiprogestin RU 486 on the proliferation and metabolic activity of stromal cells separated from human endometrium.

The effects of RU 486 on the proliferation and metabolic activity of human endometrial stromal cells in culture were studied. RU 486 at 10(-7) M/well significantly stimulated (P < 0.001) the growth as well as metabolic activity in the culture system. Interestingly, RU 486 at 10(-6) M/well did not stimulate metabolic activity in the culture. Progesterone, in combination with RU 486 at 10(-7) M/well, caused a significant increase in proliferation (assessed by thymidine incorporation) (P < 0.001) over control and P4 alone, but not significantly different from RU 486 at 10(-7) M/well alone. The same pattern was observed for metabolic functions (assessed by uridine incorporation) when RU 486 at 10(-7) M/well, along with P4, was added to the culture. Interestingly, RU 486 at 10(-6) M/well with P4 had no effect on RNA synthesis in the culture. The relevance of these findings is discussed.

Cell Division↗
PubMed1996

Effect of hormones and antihormones on phospholipase A2 activity in human endometrial stromal cells.

Phospholipase A2 activity was studied in isolated human endometrial predecidual cells, and in human endometrium collected from day 19-23 of the menstrual cycle, by performing a radiochemical assay. Phospholipase A2 activity on day 20 was significantly higher than other days (P < 0.001), and the activity was found to gradually decrease after day 20 of the menstrual cycle. The effects of the hormones estradiol and progesterone, and antihormones tamoxifen and RU 486, were studied on the phospholipase A2 activity in isolated predecidual stromal cells. Estradiol produced a significant stimulatory effect (P < 0.001) on phospholipase A2 activity in predecidual cells, and this effect was antagonized by tamoxifen. The combination of estradiol and tamoxifen was significantly different from estradiol alone (P < 0.001), but not from tamoxifen alone. RU 486 alone significantly increased (P < 0.001) phospholipase A2 activity in predecidual stromal cells. However, progesterone had no effect on phospholipase A2 activity in predecidual stromal cells.

Analysis of Variance↗
PubMed1996

Clinical and DNA studies on 46, XY females with gonadal dysgenesis. A report of six cases.

BACKGROUND: Understanding the process of sex determination has been aided by the molecular analysis of individuals whose karyotype does not correspond to their phenotype, 46, XX males and 46, XY females. CASES: We studied the clinical and molecular data on six 46, XY females of Indian ethnic origin. In each subject, cytogenetic analysis indicated a 46, XY karyotype without mosaicism. In four of the cases DNA studies were performed on the sex-determining region, Y chromosome gene. A de novo point mutation was identified in one subject. CONCLUSION: Our data provide additional evidence for genetic heterogeneity in the etiology of 46, XY gonadal dysgenesis.

Adolescent↗
PubMed1995

Tamoxifen increases the proliferation of human endometrial stromal cells in in vitro. A model for evaluation of endometrial hyperplasia.

Tamoxifen given for breast cancer therapy, has a complex and an unclear action on the endometrium. A large number of literatures has attributed the proliferous changes in the endometrium caused by tamoxifen (Tam). No report has appeared on the endometrial cellular changes induced by Tam. The present study shows a significant (P < 0.001) increase in the proliferative activity due to Tam in endometrial stromal cells over control and estradiol (E2). This in vitro model is useful for the study of the hyperplasic effect of Tam at the cellular level.

Cell Division↗
PubMed1994

Maternal and perinatal outcome in thyrotoxicosis complicating pregnancy.

In this report we describe 32 pregnancies complicated by hyperthyroidism cared for over a 7-year period at AIIMS, New Delhi. In 6 cases hyperthyroidism was diagnosed during pregnancy; others were diagnosed before conception and were on antithyroid therapy during pregnancy. For control of thyrotoxicosis thiourea derivatives, carbimazole (CMZ) and propylthiouracil (PTU), were both used. The dosage of antithyroid drugs could be decreased or stopped in the third trimester in only 28% cases, while 50% cases did not require any change in the dosage during gestation and 21% required an increase in dosage with advancing gestation to control thyrotoxicosis. Maternal and fetal complications included preterm labour (25%), PIH (22%), thyroid crisis (9%) and intrauterine growth retardation (13%). Thyroid status of neonates was found abnormal in 9% cases, including 1 case (3%) of neonatal thyrotoxicosis with goitre and 2 (6%) cases of neonatal hypothyroidism. One maternal death occurred due to thyroid storm. No case of stillbirth or perinatal death occurred in the present study. In our experience of 32 cases maternal and fetal complications are reported with increased frequency, requiring close surveillance of thyroid status to maintain euthyroidism and intensive fetal monitoring during pregnancy to achieve good maternal and perinatal outcome.

Adult↗
PubMed1994

Pregnancy with idiopathic thrombocytopenic purpura.

The management of ITP in pregnancy remains controversial, particularly with reference to labour management. Thirteen pregnancies in 9 women with ITP are analysed with respect to maternal and neonatal outcome. One pregnancy culminated in spontaneous abortion. Ten infants were born by vaginal delivery and two by Caesarean section. There were no maternal or perinatal deaths. Maternal morbidity was not increased significantly due to ITP and none of the infants had purpuric manifestations even with low platelet counts. It is concluded that the obstetric management of these patients should be individualised and should not be based on platelet count alone.

Adult↗
PubMed1993

A hospital-based study on the use of paramedical personnel for clinical downstaging of cancer cervix.

Two auxiliary nurse midwives (ANMs) were recruited and trained to recognize normal and different types of abnormal cervices. A total of 2102 women were examined by a gynaecologist and ANM independently and their findings were noted. Comparison of their findings showed an overall agreement of 89.6 per cent (Kappa 0.84 with standard error of 0.015 and a significantly large Z value of 55.6). Gross examination of 4679 women attending the Gynaecology OPD revealed normal cervix in 49.6 per cent and suspected lesions or malignant cervix in 3.4 per cent of women. Cytology smears were taken in 3608 women. Adequacy of smears was 97 per cent. Comparing the group clinically diagnosed as highly suspected or malignant to the cytologically diagnosed suspected group (atypical and malignant), clinical examination had a sensitivity of 81.7 per cent and specificity of 97.3 per cent; while comparison of the group clinically diagnosed as abnormal cervix to abnormal cytology (all grades of dysplasia, atypical and malignant cells), the clinical examination had a sensitivity of 92.5 per cent and specificity of 37.4 per cent. It was concluded that paramedical staff (ANMs) can be relied upon to do speculum examination in women in the community and take cytology smears in selected cases.

Allied Health Personnel↗
PubMed1992

Bone metastasis in ovarian cancer.

Bone involvement in carcinoma of ovary occurs rarely. In a review of 103 patients over last 3 years we have seen 4 such patients (serous-2, mucinous-1, mixed germ cell tumour-1). Patients presented with severe localized bone pain, bony swelling and difficulty in walking. The common sites of involvement were vertebrae, pelvic bones and skull. Radiologically the osteolytic lesions were commonest. Bone lesions were associated with abdomino-pelvic disease in 3 patients. Cisplatinum based chemotherapy in addition to local radiation resulted in significant response in 2 patients; one complete and one partial response. The median survival was 7.5 months (range 6-39 months) after bone metastasis. We conclude bone involvement in cancer ovary is associated with poor prognosis.

Adenocarcinoma, Mucinous↗
PubMed1992

Hypothyroidism complicating pregnancy.

In this report we describe 26 pregnancies complicated by hypothyroidism cared for over 6.5 years at AIIMS, New Delhi. In 2 women hypothyroidism was diagnosed during pregnancy; others were diagnosed before pregnancy and continued to receive thyroxine replacement therapy throughout pregnancy. The thyroxine treatment needed readjustment in 7 (26.9%) pregnancies to maintain euthyroidism. Maternal complications included anaemia (23.0%), pregnancy induced hypertension (26.9%), postpartum haemorrhage (7.7%), intrauterine growth retardation (15.4%), postdatism (30.8%), and deficient lactation (19.2%). Perinatal mortality was 3.9%. No case of stillbirth occurred probably because of intensive fetal monitoring and timely termination of pregnancies on evidence of intrauterine fetal compromise. One neonatal death occurred due to fetal thyrotoxicosis. In these cases close surveillance during pregnancy is needed to maintain optimum thyroid hormone concentration, and intensive fetal monitoring is required to achieve a good perinatal outcome.

Adult↗
PubMed1992

Management of malignant germ cell tumours of ovary.

Ten patients of the advanced malignant germ cell tumours of the ovary were treated by cisplatin based combination chemotherapy after initial conservation surgery. Eight patients completed course containing cisplatinum, vinblastine and bleomycin. Five patients (62.5%) achieved CR while 2 (25%) attained PR. One patient died due to tumour lysis and respiratory infection. Rest two patients did not turn up in follow up. Long term follow up indicates above regimen to be highly effective. However poor performance status, advanced stage of disease and post operative gross residual disease were poor prognostic factors in our patients.

Adolescent↗
PubMed1991

Chemotherapy in recurrent and advanced cervical cancer.

Twenty-five patients, ranging from 21 to 61 years of age (median = 45 years), with histologically proven recurrent and advanced cervical cancer were treated with chemotherapy using a combination of bleomycin, ifosfamide, and cis-platinum (BIP). Twenty-one patients were evaluable for response. Ninety percent of patients achieved a subjective response. An objective response was noted in 14 of 21 (66.6%) patients: complete in 4 (19%) and partial in 10 (47.6%). Side effects were mainly nausea/vomiting, alopecia, myelosuppression, reversible encephalopathy, and impaired renal function. One patient died from the toxic effects of chemotherapy. These results indicate that BIP is an active combination in recurrent cervical cancer with acceptable toxicity.

Adult↗
PubMed1991

Chlamydia trachomatis in pelvic inflammatory disease.

C. trachomatis seems to be an important causative organism of pelvic inflammatory disease (PID) as C. trachomatis antigen and/or antibody was found in 234 (69.85%) of 335 patients clinically diagnosed to have PID. Antigen was detected in the lower genital tract of 118 (35.22%) patients whereas IgG antibody was present in 188 (56.11%), of whom 89 (47.34%) had a high titre. Repeat testing of sera of 37 patients showed a rise in antibody titre in 18 (40%). As the success rate of therapy for PID with doxycycline was found to be 80 per cent, early diagnosis and treatment may be recommended to prevent further complications of PID.

Adult↗
PubMed1987

Synthetic antiprogestins stimulate human granulosa cell estradiol production in vitro.

The effect of synthetic antiprogestins, RMI 14156 and STS 557, on gonadotrophin stimulated estradiol (E2) production in human ovarian granulosa cells (GC) has been tested in vitro, to see if by virtue of their antiprogestational activity these compounds would promote the production of E2, and thereby follicular growth. Granulosa cells from human ovaries were cultured in modified minimum essential medium with or without luteinising hormone (LH, 10 ng/ml), follicle stimulating hormone (FSH, 100 ng/ml), androstenedione (A, 10(-7) M), RMI 14156 (10(-9) M-10(-5) M) and STS 557 (10(-9) M-10(-5) M), in a humidified 95% air 5% CO2 atmosphere at 37 degrees C for 48 hours. RMI 14156 and STS 557 were found to stimulate the production of E2 by cultured human GC in a dose dependent manner, the stimulation being significant (P less than 0.001-P less than 0.05) at higher doses (10(-6) M, 10(-5) M). The two antiprogestins used also stimulated the gonadotrophin induced E2 production significantly. Results demonstrated that these synthetic antiprogestins, having an 'estra' type of basic structure RMI 14156 17 beta hydroxy-7 alpha-methyl-5-estra-en-3-one); STS 557 (17 alpha-cyanomethyl-17 beta-hydroxy-estra-4,9(10)diene-3-one) can directly promote E2 production from human ovarian GC in vitro.

Adult↗