J B Sharma

All India Institute of Medical Sciences, New Dilli, NCT, India

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Publications (147)176.21 Total impact

  • Debjyoti Karmakar, Jai B Sharma
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    ABSTRACT: Female voiding dysfunction is a complex disorder, lacks definition, and is poorly understood and difficult to manage.
    Journal of mid-life health. 07/2014; 5(3):104-10.
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    ABSTRACT: A retrospective analysis of 11 pregnancies complicated by isolated fetal congenital complete heart block (CCHB) in anti-SSA/Ro antibody positive women was carried out at a tertiary hospital in India to study the perinatal outcome. The mean gestational age at the time of detection of fetal CCHB was 24.5 ± 3.1weeks. Six mothers were asymptomatic; two had Sjögren's syndrome and three had systemic lupus erythematosus. Oral dexamethasone was given to all the patients after the diagnosis was made. There was one case of intrauterine death. Seven (63.6%) neonates needed a permanent pacemaker. There was no significant difference in the perinatal outcome in asymptomatic women with fetal CCHB and in women with connective tissue disorder and fetal CCHB. To conclude, fetal CCHB is associated with high morbidity but the presence of underlying connective disorder in the mother does not worsen the prognosis of the affected neonate.
    Journal of Obstetrics and Gynaecology 05/2014; · 0.55 Impact Factor
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    ABSTRACT: The aim of this prospective randomized study was to evaluate the efficacy of estrogen in preventing intrauterine adhesions following hysteroscopic septal resection and to investigate its effect on reproductive outcome. After hysteroscopic septal resection, 90 women received either estrogen or placebo (n = 45 per group) for 30 days. A second-look hysteroscopy was performed after 2 months. All pregnancies occurring during the study period were recorded. Adhesions developed in three of 43 (6.9%) patients in the control group compared to none in the estrogen group. This difference was not statistically significant (P = 0.24). Regarding reproductive outcome, the differences between the two groups were also not significant. Estrogen treatment was not found to prevent intrauterine adhesions or improve reproductive outcome after hysteroscopic septal resection.
    Journal of Obstetrics and Gynaecology Research 02/2014; · 0.84 Impact Factor
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  • International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 10/2013; · 1.41 Impact Factor
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    ABSTRACT: Abstract Aim: The aim of this study was to evaluate the role of dehydroepiandrosterone (DHEA) supplementation on the ovarian reserve markers in infertile patients who were poor responders in previous in vitro fertilization (IVF) cycles. Study design: A prospective clinical trial was conducted on 30 patients with history of poor response in previous IVF cycles. These patients were treated with DHEA, (Tab Eema-D, Corona Remedies Pvt Ltd., Ahmedabad, Gujurat, India) 25 mg thrice a day for four months. Ovarian stimulation was done using the previous protocol. Clinical parameters were measured before and treatment with DHEA. Results were analysed using Student's "t" paired test. Results: DHEA resulted in a significant increase (p < 0.05) in the serum Antimullerian hormone in all age groups (35, 36-38 and >38 years). Peak estradiol level on the day of human chorionic gonadotrophin administration also increased significantly (p < 0.05). A significant decrease (p < 0.05) was noted in Day 2 follicle-stimulating hormone (FSH) in all age groups. There was no statistically significant difference in the antral follicle count (AFC). Pregnancy rate was 16.7% after treatment. Thus, DHEA has a significant effect in improving the ovarian reserve in poor responders with previously failed IVF cycles. It can help in enhancing clinical pregnancy rate in these patients.
    Gynecological Endocrinology 09/2013; · 1.30 Impact Factor
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    ABSTRACT: To evaluate the efficacy of intraperitoneal bupivacaine to reduce post operative pain after diagnostic minilaparoscopy in patients with infertility. A prospective randomized study was performed. The study group consisted of 104 women with infertility undergoing diagnostic minilaparoscopy. At the end of the procedure, the treatment group (Group A) was given 10 mL of intraperitoneal 0.25 % bupivacaine (100 mg) and the control group (Group B) given 10 mL of intraperitoneal saline. Post operative pain was recorded with the use of a visual analog scale with scores ranging from 1 to 10 at 2, 4, 6 and 8 h intervals after the surgery. Additional analgesics given to the patients in the post operative period and any other side effects were noted. The treatment group had significantly lower pain scores at 2, 4, 6 and 8 h after the procedure (P < 0.05). The need for post operative analgesics also was significantly lower in the treatment group (P = 0.007). Post operative intraperitoneal bupivacaine administration is beneficial for patients undergoing diagnostic minilaparoscopy. It can significantly decrease post operative pain for up to 8 h and reduce the need for additional analgesics.
    Archives of Gynecology 08/2013; · 0.91 Impact Factor
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    ABSTRACT: To study the outcome of pregnancy in women with idiopathic thrombocytopenic purpura. A retrospective analysis of 30 pregnancies in 26 women with idiopathic thrombocytopenic purpura was carried out at a tertiary hospital in India. The courses of the disease, maternal and perinatal outcome in these pregnancies were studied. Mean age of pregnant women with idiopathic thrombocytopenic purpura was 27.3 years and 61.5 % was primigravidae. Out of 26 patients with idiopathic thrombocytopenic purpura, 16 were already diagnosed while the other 10 were diagnosed during pregnancy. The incidence of bleeding episodes in antenatal period, severe thrombocytopenia and hemorrhagic complications at the time of delivery was 30, 37 and 11.1 %, respectively. Oral steroids were required in 40 % of pregnancies. Two patients received intravenous immunoglobulin therapy. Severe thrombocytopenia at the time of delivery was more commonly seen in women in whom ITP was diagnosed during pregnancy as compared to those in whom ITP was diagnosed prior to pregnancy (P = 0.04). Severe thrombocytopenia was seen in 18.5 % of neonates and intracranial hemorrhage was detected in 1 neonate. There were no still births or maternal mortality. Pregnancy outcome in patients with idiopathic thrombocytopenic purpura is generally good.
    Archives of Gynecology 07/2013; · 0.91 Impact Factor
  • Jai Bhagwan Sharma, Moumita Naha, Sunesh Kumar
    Indian journal of endocrinology and metabolism. 05/2013; 17(3):540-1.
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    ABSTRACT: BACKGROUND: A retrospective analysis of the records of all the patients of pulmonary arterial hypertension with pregnancy at AIIMS, New Delhi, India, to study maternal and perinatal outcome and to compare outcome between severe and mild pulmonary arterial hypertension. MATERIALS AND METHODS: A retrospective analysis was carried out of 30 pregnancies in women with pulmonary arterial hypertension (PAH) who delivered at ≥28 weeks of gestation from July 2006 through July 2012 at a tertiary care center in India. Pulmonary artery blood pressure (PABP) during the first trimester of pregnancy or before pregnancy was considered to define PABP as severe or mild, with severe cases having systolic PABP >50 mmHg on echocardiography. RESULTS: Out of 30 patients, 14 patients had severe PAH and 16 patients had mild PAH. Women with severe PAH had a significantly higher incidence of preterm delivery (11 vs. 3, P < 0.05), small for gestational age infants (10 vs. 2, P < 0.05) and cardiac complications (6 vs. 1, P < 0.05) compared to women with mild PAH. There was maternal mortality in a patient with Eisenmenger syndrome. In women with severe PAH and mild PAH, PABP increased in later pregnancy from 63.14 ± 7.6 to 71.57 ± 7.9 mmHg (P < 0.05) and from 40.37 ± 3.6 to 41.69 ± 4.1 mmHg (P < 0.05), respectively. CONCLUSIONS: Pregnancy in women with severe PAH is associated with higher maternal morbidity and adverse fetal outcome compared to pregnancy in women with mild PAH.
    Archives of Gynecology 02/2013; · 0.91 Impact Factor
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    ABSTRACT: BACKGROUND: A retrospective analysis of the records of all the patients of heart disease with pregnancy at AIIMS, New Delhi, India, to find out the maternal and fetal outcome. MATERIALS AND METHODS: A retrospective analysis was carried out of 100 pregnancies in women with heart disease who delivered at ≥28 weeks of gestation from July 2009 through August 2012. RESULTS: Cardiac disease was found to complicate 3.8 % of pregnancies. Rheumatic heart disease (n = 64, 64 %) was the predominant cardiac disease. Congenital heart disease was found to complicate 36 pregnancies (n = 36, 36 %).Cardiac complications were seen in 32 (32 %) and fetal complications in 18 (18 %) pregnancies. Fewer cardiac and postpartum complications were present in NYHA class I/II patients compared to NYHA III/IV patients (P < 0.05). Pregnancy outcome was better in rheumatic heart disease patients who had undergone cardiac intervention prior to pregnancy (n = 29, 45.2 %) compared to those whose heart disease remained uncorrected (n = 35, 54.8 %) but the difference was not statistically significant. There was one maternal mortality in a patient with Eisenmenger syndrome. Two of the newborns of the 17 women who had received anticoagulants had features of warfarin embryopathy. CONCLUSION: Pregnancy in women in NYHA class III/IV is associated with significantly higher maternal morbidity and cardiac interventions before pregnancy, when indicated may improve pregnancy outcome.
    Archives of Gynecology 02/2013; · 0.91 Impact Factor
  • Jai Bhagwan Sharma, Manisha Yadav
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    ABSTRACT: There is considerable worldwide confusion in the use of terminologies and definitions around the symptom of abnormal uterine bleeding (AUB), and these are increasingly leading to difficulties in setting up multinational clinical trials and in interpreting the results of studies undertaken in single centers. In November 2010, the International Federation of Gynecology and Obstetrics formally accepted a new classification system for causes of AUB in the reproductive years. The system, based on the acronym polyps, adenomyosis, leiomyoma, malignancy and hyperplasia - coagulopathy, ovulatory disorders, endometrial causes, iatrogenic, not classified was developed in response to concerns about the design and interpretation of basic science and clinical investigation that relates to the problem of AUB.
    Journal of mid-life health. 01/2013; 4(1):42-5.
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    ABSTRACT: Export Date: 18 October 2014
    International Journal of Gynecology and Obstetrics. 01/2013; 121(1):96.
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    ABSTRACT: Pelvic floor dysfunction and prolapse affect 50 % of women past middle age. Failure to recognize the complex set of pelvic floor defects in individuals leads to most post-surgical failures. Imaging has so far not had an established role in the investigation of prolapse. The present study is an attempt to define the role of magnetic resonance imaging in POP. Thirty patients with clinically graded stage III/IV prolapse underwent routine physical examination and grading of POP in the Department of Obstetrics and Gynaecology, AIIMS. Dynamic MR evaluation with TRUFISP configuration was done and organ prolapse was measured through the hiatal line (HMO classification). The agreement of MRI, physical examination and intra-operative examination was analyzed using kappa as the test of agreement. Twenty-eight subjects with grade III and 2 subjects with grade IV prolapse were enrolled. The mean age was 52.8 and the mean parity was 3.63. On MRI, 19 patients were found to have grade III prolapse, 4 had grade IV prolapse and the rest had grade I and II prolapse. There was poor agreement of MRI with clinical examination in anterior and middle compartments (k 0.161, k 0.144). The agreement between MRI and Intra-operative findings was 0.369, 0.422 for anterior and posterior compartments. Kappa was 0.085 for rectocele and 0.710 for enteroceles. The agreement was better for posterior compartment and enterocele. MRI detected 5 out of 8 enteroceles intra-operatively. The study demonstrates that while dynamic MRI does not confer any additional advantage in the diagnosis of anterior and middle compartment defects, the diagnosis of enteroceles, which may be missed clinically, is efficiently made on dynamic MRI imaging. Additionally, MRI can differentiate enterocele from a high rectocele which can further classify the surgery needed. There is also a need to standardize the protocol and the role of MR imaging in POP.
    Archives of Gynecology 06/2012; 286(4):953-8. · 0.91 Impact Factor
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    ABSTRACT: To compare findings with 2-deoxy-2-((18)F)fluoro-D-glucose positron emission tomography combined with computed tomography ((18)F-FDG-PET/CT) with findings obtained using ultrasound (US), magnetic resonance imaging (MRI), and CT in patients with proven tubercular tubo-ovarian masses. Seventeen patients with proven tubercular tubo-ovarian masses underwent (18)F-FDG-PET/CT imaging and the findings were compared with US (for all patients), MRI (for 9 patients), CT (for 4 patients), and laparotomy or laparoscopic findings (for 14 patients). Eleven patients (64.7%) had unilateral tubo-ovarian masses, with activity in 6 masses (35.3%); 4 patients (23.5%) had bilateral tubo-ovarian masses, with activity in all masses; and 2 patients (11.76%) had unilateral space-occupying lesions, with activity in 1 lesion. The detection rates of tubo-ovarian masses with (18)F-FDG-PET/CT were similar to, but the characterization of adnexal masses was less than, those obtained with CT or MRI. Finally, (18)F-FDG-PET/CT was equally accurate as laparoscopy or laparotomy in detecting the presence, laterality, and activity of tubo-ovarian masses. Imaging with (18)F-FDG-PET/CT is noninvasive and appears to be clinically useful for the diagnosis of tubercular tubo-ovarian masses.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 05/2012; 118(2):123-8. · 1.41 Impact Factor
  • J. Sharma, S. Kumar
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    ABSTRACT: The effect of additives (Sb and Ag) on a.c. conductivity and dielectric properties of Se70Te30 glassy alloy at temperature range 300–350 K and frequency range 1 kHz–5 MHz has been studied. Experimental results indicate that a.c. conductivity and dielectric parameters depend on temperature, frequency and the impurity incorporated in Se–Te glassy system. The a.c. conductivity in the aforesaid frequency range is found to obey the ωs law. A strong dependence of a.c. conductivity and exponent s in the entire temperature and frequency range contradicts quantum-mechanical tunneling (QMT) model and can be interpreted in terms of the correlated barrier hopping (CBH) model. The temperature and frequency dependence of the dielectric parameters are also studied and it is found that the results agrees by the theory of hopping of charge carriers over potential barrier as suggested by Elliott in chalcogenide glasses. The change in the dielectric parameters with the opposite influence of the replacement of Te by Sb on the one hand, and by Ag, on the other hand is being correlated by the nature of covalent character of the studied composition and with the change in density of defect states.
    Physica B Condensed Matter 02/2012; 407(3):457–463. · 1.28 Impact Factor
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    ABSTRACT: To assess ovarian reserve in infertile women with genital tuberculosis planning to undergo in vitro fertilization and in women of proven fertility, and compare the findings. A cross-sectional study was conducted at an outpatient gynecology unit with 104 women with genital tuberculosis and 104 healthy controls. In each group, ovarian reserve tests consisted in estimating serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and inhibin B on day 3 of a natural menstrual cycle. On the same day ovarian volume, number of antral follicles, and ovarian stromal blood flow were also estimated. The mean FSH and LH levels were significantly higher, and the mean inhibin B levels were significantly lower, among the participants with genital tuberculosis than among the controls. Conversely, the mean ovarian volume and the mean number of antral follicles were significantly lower among the participants with genital tuberculosis, as were the mean peak systolic velocity and pulsatility index for each ovary. There is no single absolute predictor of ovarian reserve, but combining the current assessment methods provides a close estimation of a woman's reproductive capability. Values for the studied markers showed that ovarian reserve was compromised in women with genital tuberculosis.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 01/2012; 117(1):40-4. · 1.41 Impact Factor
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    ABSTRACT: Gemcitabine, an anti-metabolite, has some activity in hepatocellular carcinoma (HCC) in terms of responses and median survival. To analyze our experience with the use of gemcitabine in combination with cisplatin in HCC with respect to response, toxicity and survival. We studied the records of patients of HCC treated from January 2000 to December 2005 with gemcitabine and cisplatin, and found 24 of them to be evaluable for response, toxicity and survival. Of 24 patients receiving three or more cycles of chemotherapy, six (25%) had a partial response and an additional 12 (50%) had stable disease. The median overall survival (OS) was 7.5 months (95% confidence interval, 4.5-10.5 months) and 1-year survival was 18%. Grade 3 and 4 anemia, thrombocytopenia and neutropenia were observed in, respectively, 17, 17 and 33% patients. The most frequent non-hematologic toxicities were nausea and vomiting and peripheral neuropathy. We report a partial response rate of 25% with stable disease in an additional 50% to three or more cycles of chemotherapy with gemcitabine and cisplatin, with a median OS of 7.5 months (95% confidence interval, 4.5-10.5) and acceptable toxicity profile from our single-center retrospective study of 24 patients of HCC. We trust that, in HCC, gemcitabine is a good drug to be the foundation to build the chemotherapeutic or targeted agents' combinations on.
    Indian journal of medical and paediatric oncology 01/2012; 33(1):42-7.
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    ABSTRACT: To compare the efficacy of letrozole and clomiphene citrate (CC) in patients of anovulatory polycystic ovarian syndrome (PCOS) with infertility. This prospective randomized clinical trial included 204 patients of PCOS. 98 patients (294 cycles) received 2.5-5 mg of letrozole; 106 patients (318 cycles) received 50-100 mg of CC (both orally from Days 3-7 of menstrual cycle). The treatment continued for three cycles in both the groups. ovulation rate, endometrial thickness, and pregnancy rate. Statistical analysis was done using SPSS 13 software. P value less than 0.05 was considered significant. The mean number of dominant follicles in letrozole groups and CC groups was 1.86±0.26 and 1.92±0.17, respectively (P=0.126). Number of ovulatory cycle in letrozole group was 196 (66.6%) versus 216 (67.9%) in CC group (P=0.712). The mean mid-cycle endometrial thickness was 9.1±0.3 mm in letrozole group and 6.3±1.1 in CC group, which was statistically significant (P=0.014). The mean Estradiol [E2] level in clomiphene citrate group was significantly higher in CC group (364.2±71.4 pg/mL) than letrozole group (248.2± 42.2 pg/mL). 43 patients from the letrozole group (43.8%) and 28 patients from the CC group (26.4%) became pregnant. Letrozole and CC have comparable ovulation rate. The effect of letrozole showed a better endometrial response and pregnancy rate compared with CC.
    Journal of human reproductive sciences. 01/2012; 5(1):20-5.
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    ABSTRACT: This study was undertaken to report the results of weekly combination chemotherapy with cetuximab in recurrent/metastatic head and neck squamous cell carcinoma (R/M SCCHN). Retrospective analysis of 35 R/M SCCHN patients who received cetuximab with weekly paclitaxel and platin (cisplatin/carboplatin) from SCCHN August 2006 to October 2008 at our Institute was performed. Thirty-five patients (33 [94.3%] males and 2 [5.7%] females) received the planned weekly chemotherapy protocol. Median age of these patients was 52 years. Of the SCCHN 32 evaluable patients, 25 patients showed symptomatic improvement and 7 showed no improvement. Radiological responses using RECIST criteria reported CR in 1 patient (3.1%), PR in 17 patients (53.1%), and SD in 6 patients (18.8%). The remaining six patients demonstrated disease progression while two could not be assessed. Median overall survival (OS) was 8.016 months (95% CI; 6.572--9.461) and median PFS was 5.782 months (95% CI; 4.521--7.044). The major chemotherapy-related grades 2 and 3 toxicity recorded was cetuximab-induced rash reported in 24 patients. No treatment-related death within 30 days was observed. Cetuximab with weekly combination chemotherapy (Paclitaxel + Platinum compound) has shown promise, demonstrating comparable response and outcomes with acceptable toxicity in R/M SCCHN patients.
    Indian Journal of Cancer 01/2012; 49(1):1-5. · 1.13 Impact Factor

Publication Stats

935 Citations
176.21 Total Impact Points

Institutions

  • 2005–2014
    • All India Institute of Medical Sciences
      • Department of Obstetrics and Gynaecology
      New Dilli, NCT, India
  • 2008–2013
    • AIIMS Bhopal All India Institute of Medical Sciences
      Bhopal, Madhya Pradesh, India
    • Rajiv Gandhi Cancer Institute & Research Centre
      New Dilli, NCT, India
  • 2010–2012
    • Christ Church College, Kanpur
      Cawnpore, Uttar Pradesh, India
  • 2004–2006
    • Lok Nayak Hospital
      New Dilli, NCT, India
  • 2000–2004
    • Maulana Azad Medical College
      • Department of Obstetrics & Gynaecology
      New Delhi, NCT, India