Papers by hemangi chaudhari
Journal of Medical Virology
Journal of Medical Virology, 2022
Cancer of the cervix uteri is the fourth most common cancer worldwide with a high mortality rate.... more Cancer of the cervix uteri is the fourth most common cancer worldwide with a high mortality rate. Due to the limitations of existing methods, alternative methods for triage are needed for early detection of cervical cancer precursors before progression to high grade disease.The aim of this study was to evaluate HPV E6/E7 oncogene expression as markers for early identification of cervical cancer risk in women with minor cytological abnormalities and in those with negative cytology. The detection of HPV was done using PCR and confirmed by southern hybridization. The high risk (HR) and low risk (LR) HPV types were identified by HPV typing. HPV DNA positive patients were further tested for markers of oncogene expression by real time PCR. Out of the women screened, 54/512 (10.54%) women tested positive for HPV infection. HR HPV DNA was found in 32/485 (6.60%) in women with normal cytology (Pap negative) and 22/27 (81.5%) ASCUS/LSIL cases. High-risk HPV E6/E7 oncogene transcripts were detected in 36/512 (7.03%) of these patients. The positivity rate of E6/E7 mRNA was 2.48% (12/485) in the normal cervical cytology group and 88.9% (24/27) in abnormal cervical cytology group. The HPV E6/E7mRNA test sensitivity was found to be 88.89% and specificity was 97.53%. In comparison the sensitivity of HPV DNA test was found to be 81.48% and specificity was 93.40%. In conclusion, E6 and E7 transcripts could provide a sensitive, early predictor of cervical cancer risk in women with normal cytology and minor cytological alterations. This article is protected by copyright. All rights reserved.
Indian Journal of Medical Research, 2021
Background & objectives: Aetiology of cervical cancer (CaCx) is multifactorial. Besides human... more Background & objectives: Aetiology of cervical cancer (CaCx) is multifactorial. Besides human papillomavirus (HPV) infection, many immunogenetic factors are involved in this complex process. The present study was carried out to investigate one such factor, interleukin-6 (IL-6), a central pro-inflammatory cytokine and a polymorphism at its promoter region -174 G/C (rs1800795) with CaCx. Methods: HPV-infected women with or without CaCx were enrolled in group I and II, respectively. Another group of uninfected healthy women was also included as group III for comparison. Polymorphism in IL-6-174 G/C and IL-6 levels were analyzed by sequence-specific primer PCR (PCR-SSP) and ELISA, respectively. Results: Groups I (n=111) and II (n=87) had significantly higher frequency of IL-6-174 GG genotype [odds ratios (OR)=3.9; P<0.001 and OR=3.2; P<0.001, respectively] as compared to group III (n=163). Furthermore, individuals with GG or GC genotypes had high IL-6 levels than those with CC genotypes. IL-6 levels were significantly (P<0.001) elevated in group I. This was also significantly high in untreated cases as compared to treated (P<0.05) ones. IL-6 levels of treated group were comparable with groups II and III. Interpretation & conclusions: Our results suggested a possible association of IL-6-174 GG with CaCx, which was also associated with high IL-6 levels. Decreased levels of IL-6 following treatment indicate its possible prognostic use in CaCx cases.
Indian Journal of Medical Microbiology, 2019
Original Article introduction Cervical cancer is the major cause of cancer mortality in Indian wo... more Original Article introduction Cervical cancer is the major cause of cancer mortality in Indian women, 60,078 die every year, with an incidence of 14.9/100,000. [1] High-risk human papillomavirus (HR-HPV) types are associated with cervical cancer. HPV infection is transient and persists only in a minority, leading to high-grade cervical intraepithelial neoplasia and invasive cancer. According to their oncogenic potential, HPV types are classified into low-risk (LR)
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: The World Health Organization has described obesity as one of today's most neglec... more Background: The World Health Organization has described obesity as one of today's most neglected public health problems, affecting every region of the globe. The objective of the present study was to compare obstetric outcome in overweight and obese pregnant women.Methods: A prospective observational study was conducted in obstetrics and gynecology department in KEM hospital, Mumbai between 2014- 2015 to study the effects of maternal BMI on maternal and perinatal outcome and to compare the obstetric outcome (maternal and perinatal) between overweight and obese mother. All antenatal patients fulfilling inclusion criteria were divided in two groups, overweight and obese based on BMI <30 kg/m2 and >30 kg/m2 respectively. Distribution of maternal risk factors like gestational hypertension and preeclampsia, gestational diabetes mellitus, unfavourable obstetric history specially in previous pregnancy like miscarriages, and instances of fetal demise, history of previous caesarean...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: The objective of this study was to study maternal and fetal outcome in connective tis... more Background: The objective of this study was to study maternal and fetal outcome in connective tissue disorders in pregnancy.Methods: This was a retrospective type of observational study done in department of obstetrics and gynecology and department of rheumatology at a King Edward Memorial hospital over a period of 1.5 years. 48 women were included in this study after informed consent. All these women presented with collagen disorders to ANC outpatient department or to rheumatology outpatient department or in emergency. All postpartum patients having connective tissue disorders not recruited during ANC were also included in this study after taking their written, informed and valid consent.Results: Connective tissue disorders are associated with multiple voluntary and involuntary abortions as well as intrauterine fetal deaths. Even in those women having live births, many undergo cesarean sections due to various indications like fetal distress, poor biophysical profile, non-reassuring...
Journal of SAFOG with DVD, 2017
A 30-year-old, third gravid with two previous abortions, with in vitro fertilization conception w... more A 30-year-old, third gravid with two previous abortions, with in vitro fertilization conception with 11 weeks and 6 days of gestation, came with complaints of mild bleeding per vaginum. Ultrasonography revealed a live pregnancy in the cervical canal corresponding to 12 weeks of gestation. Single dose of intramuscular methotrexate 1 mg/kg was given. Three days postmedical management, transvaginal ultrasound-guided intracardiac instillation of potassium chloride 1.5 mL was carried out. Injection methotrexate, 4 mL, was instilled in the amniotic cavity. On day 5 postprocedure, patient had a bout of severe vaginal bleeding for which emergency vaginal exploration was carried out. Products of conception were suctioned out and placenta was removed. Hemostatic cervical vascular sutures were taken on either side to occlude the descending branch of cervical artery. A Foley catheter (18F) was inserted in the cervical canal and distended with 60 mL of normal saline, thereby compressing the placental bed from within the cervical canal. Hemostasis was achieved and maintained.
The Journal of Obstetrics and Gynecology of India, 2016
Objectives The aim of the study was to identify the risk factors predisposing to morbidly adheren... more Objectives The aim of the study was to identify the risk factors predisposing to morbidly adherent placenta and to study the different modes of management and the obstetric and neonatal outcome of these patients. Methods This was a retrospective cum prospective observational study conducted in the Department of Obstetrics and Gynaecology in a tertiary care referral hospital in Mumbai from January 2012 to November 2014. Results The incidence of morbidly adherent placenta was 1.32 per 1000 pregnancies with patient profile comprising second gravida in the age group 26-28 years; 90 % of the patients in this study had previous Caesarean section and co-existing placenta praevia was diagnosed in 63 %. Fiftythree per cent of the women delivered between 35 and 38 weeks and 40 % had elective deliveries. Caesarean section was the mode of delivery in 90 % of the patients.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
A 35 year old female patient, married since 8 years, G6P1L1SA4 was registered with our unit since... more A 35 year old female patient, married since 8 years, G6P1L1SA4 was registered with our unit since 8 th week of gestation. She was a known case of protein C and protein S deficiency diagnosed 7 years ago (thrombotic profileprotein C: 70% normal: 70-100%, protein S: 55% normal: 70/140%, AT-III: 116% normal 70/140%, factor V leiden: no mutation detected) which was detected on evaluation for her bad obstetric history. ACLA was also positive. She was started on injection low molecular weight heparin 0.6 mg s/c OD, in addition to continuing Tb. Aspirin 75 mg which had been started when the pregnancy was registered. Foleys induction was done at 39 weeks of gestation in view of previous LSCS with pre-eclampsia. Emergency LSCS was done in view of previous LSCS with non-progress of labour. Male child weighing 2.4 kg was born which is doing well. A patient having combined deficiency of both factors protein C and protein S is very rare. Anticoagulation therapy is the cornerstone in the management of patients with inherited coagulation defects.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: The purpose of the study was to analyze maternal and perinatal outcome according to m... more Background: The purpose of the study was to analyze maternal and perinatal outcome according to mode of delivery in singleton breech presentation retrospectively in a tertiary care center. Methods: This was a retrospective observational study done in KEM Hospital, during 2012 to 2013. Maternal and perinatal outcome was studied retrospectively. The data was collected from the mother's medical records. The neonatology records were also examined. Primary outcomes included neonatal mortality, morbidity and maternal morbidity. Results: Out of 100 selected patients; 27 delivered vaginally and 73 underwent lower segment caesarean section (LSCS). Perinatal mortality was 3%. Two out of 3 were delivered vaginally and 1 underwent LSCS. Perinatal morbidity was 1% in vaginal delivery. Maternal morbidity was 2%, both patients underwent emergency LSCS. There was no maternal mortality in the study. Conclusions: Delivery of breech fetus when labor and delivery is supervised and or conducted by experienced obstetrician lowers maternal morbidity, neonatal morbidity and mortality.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: To evaluate pregnancy outcome in women with elevated serum thyroid stimulating hormon... more Background: To evaluate pregnancy outcome in women with elevated serum thyroid stimulating hormone (TSH) values as compared to those in whom hypothyroidism was treated. Methods: A prospective interventional comparative study was conducted in the department of obstetrics and gynaecology in King Edward Memorial Hospital, Mumbai, India from 2014 to 2015. A cohort of 60 hypothyroid patients was divided into two groups of 30 each. Group 1, euthyroid (treated hypothyroid) and group 2, hypothyroid at the time of labor and pregnancy outcomes were compared. Results: All patients in group 1 delivered at term; whereas in group 2, 9 (30%) patients had preterm deliveries and 21 (70%) delivered at term, amongst which 5 patients delivered babies with severe intrauterine growth restriction (IUGR). Neonatal intensive-care unit (NICU) admission were required for 3 neonates in group 1 and 11 (36.67%) neonates in group 2. Group 1 delivered 5 (16.67%) low birth weight babies (weight <2.5 kg) whereas 16 (53.34%) babies had low birth weight in group 2. Conclusions: Treatment of patients diagnosed with hypothyroidism during pregnancy significantly (p value <0.05) reduced the risk of preterm labor, low birth weight, need for NICU admission.
Immunobiology, 2016
Dysregulation of immune response at the feto-maternal interface during first trimester of pregnan... more Dysregulation of immune response at the feto-maternal interface during first trimester of pregnancy is one of the leading causes of spontaneous abortion. Previously, we reported differential expression of collectins, soluble pattern recognition molecules involved in immunoregulation, in placental and decidual tissues during spontaneous labor. In the present pilot study, the expression of collectins was analyzed in the inflamed human gestational tissues of spontaneous abortion ('SA') and in 13.5 dpc placental tissues from resorption survived embryos of murine model (CBA/J X DBA/2J). Transcripts of SP-A were significantly down-regulated and SP-D were significantly up-regulated in placental and decidual tissues of 'SA' group compared to that of 'normal' group. Immunostaining for SP-D and MBL proteins was positive in placental and decidual tissues. However, levels of SP-D and MBL proteins were not significantly altered in placental as well as in decidual tissues ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Degeneration in a fibroid is seen when the blood supply falls inadequate to support the center of... more Degeneration in a fibroid is seen when the blood supply falls inadequate to support the center of fibroid. Usually degeneration in a fibroid requires a symptomatic medical management. This is a case report of a degenerating fibroid that uncommonly presented in postpartum period as a retroperitoneal abscess requiring exploratory laparotomy.
The Indian journal of medical research, 2014
Human papillomavirus (HPV) is the main causative agent for cervical cancer. Variability in host i... more Human papillomavirus (HPV) is the main causative agent for cervical cancer. Variability in host immunogenetic factors is important in determining the overall cellular immune response to the HPV infection. This study was carried out to confirm the association between human leukocyte antigen (HLA) class II alleles and cervical cancer in HPV infected women. b0 oth low and high resolution methods were used to genotype HLA class II (DRB1 and DQB1) alleles in 75 women with cervical cancer (cases) and 75 HPV positive women and 100 HPV negative women with healthy cervix (controls). odds ratio and 95% confidence interval were calculated. Co-occurring HLA alleles (haplotype) across cases and controls were also studied. Significant association was found for HLA-DRB1FNx0103(FNx0113:01) and - DQB1FNx0102(FNx0102:01) with increased risk for cervical cancer. Also, HLA-DRB1FNx0113(FNx0113:01); -DQB1FNx0106 and -DQB1FNx0103:02 were significantly associated with decreased risk for cervical cancer. Ha...
PLoS ONE, 2014
Collectins, collagen-containing Ca 2+ dependent C-type lectins and a class of secretory proteins ... more Collectins, collagen-containing Ca 2+ dependent C-type lectins and a class of secretory proteins including SPA , SP-D and MBL, are integral to immunomodulation and innate immune defense. In the present study, we aimed to investigate their placental transcript synthesis, labor associated differential expression and localization at feto-maternal interface, and their functional implication in spontaneous labor. The study involved using feto-maternal interface (placental/decidual tissues) from two groups of healthy pregnant women at term ($37 weeks of gestation), undergoing either elective C-section with no labor ('NLc' group, n = 5), or normal vaginal delivery with spontaneous labor ('SLv' group, n = 5). The immune function of SP-D, on term placental explants, was analyzed for cytokine profile using multiplexed cytokine array. SPA , SP-D and MBL transcripts were observed in the term placenta. The 'SLv' group showed significant up-regulation of SP-D (p = 0.001), and down-regulation of SPA (p = 0.005), transcripts and protein compared to the 'NLc' group. Significant increase in 43 kDa and 50 kDa SP-D forms in placental and decidual tissues was associated with the spontaneous labor (p,0.05). In addition, the MMP-9-cleaved form of SP-D (25 kDa) was significantly higher in the placentae of 'SLv' group compared to the 'NLc' group (p = 0.002). Labor associated cytokines IL-1a, IL-1b, IL-6, IL-8, IL-10, TNF-a and MCP-1 showed significant increase (p,0.05) in a dose dependent manner in the placental explants treated with nSP-D and rhSP-D. In conclusion, the study emphasizes that SPA and SP-D proteins associate with the spontaneous labor and SP-D plausibly contributes to the pro-inflammatory immune milieu of feto-maternal tissues.
Immunogenetics, 2014
We studied the relationship between human leukocyte antigen (HLA) class I alleles and cervical ca... more We studied the relationship between human leukocyte antigen (HLA) class I alleles and cervical cancer among Indian women. Seventy-five cervical cancer cases were compared with 175 noncancer controls. Cervical biopsy tissue specimen from cancer cases and cervical swab specimen from controls were collected for HPV detection and typing. Blood was taken for HLA typing by PCR-SSOP method. The impact of HLA class I alleles on cervical cancer risk was evaluated using StatCalc program (Epi Info version 6.0.4. CDC Atlanta, GA, USA), and confirmed with Bonferroni correction. Results revealed HLA-B*37, HLA-B*58 were associated significantly with increased risk while HLA-B*40 with decreased risk for cervical cancer. At high-resolution analysis after Bonferroni correction, HLA-B*37:01 allele was associated with increased risk, whereas HLA-B*40:06 was with decreased risk for cervical cancer. HLA-B*37:01 and HLA-B*40:06 belong to the same superfamily of HLA-B44. In silico analysis revealed differe...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: This study is carried out on 382 cases of maternal deaths from July 2010 to June 2016... more Background: This study is carried out on 382 cases of maternal deaths from July 2010 to June 2016 at the department of obstetrics and gynaecology of tertiary centre to evaluate causes and risk factor associated with maternal deaths.Methods: Retrospective analysis of all maternal deaths occurred in department of obstetrics and gynaecology of tertiary care hospital from July 2010 to June 2016.Results: The MMR in the study period was 915/100000 live births. Maximum no. of maternal death 42.7% were in age group of 21-25 years, majority of them residing in urban area. 117 patients referred from sub-district/district hospital. 76.4% patients were registered. 60% maternal deaths were seen in postnatal period. In present study majority of maternal deaths 60% were due to indirect cause while 40% patients died due to direct cause. Major causes of maternal deaths were hypertensive disorder 12%, obstetric haemorrhage 11% tuberculosis 11%, hepatitis E 8% and pregnancy related infections 5.6%.Con...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: Vaginal birth after caesarean section (VBAC) has become an integral part of modern ob... more Background: Vaginal birth after caesarean section (VBAC) has become an integral part of modern obstetrics with more than 1lakh VBACs achieved each year nationwide. Several studies have reported perinatal risks associated with failed trial of labour and uterine rupture in women attempting VBAC, due to concerns about these complications, the rate of VBAC deliveries has continued to fall in developed countries, with an inverse increase in Caesarean Sections (CS). To better assess the risk of uterine rupture, many authors have proposed sonographic measurement of scar or lower uterine segment (LUS) thickness near term, assuming that there is an inverse correlation between LUS thickness and the risk of uterine scar defect. Therefore, this assessment for the management of women with prior CS has increased safety by selecting women with the lowest risk of uterine rupture.Methods: Present study was a prospective observational study which assessed the obstetric outcome in women with previous ...
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Papers by hemangi chaudhari