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European journal of obstetrics, gynecology, and reproductive biology 01/2011; 156(1):118-9. · 1.97 Impact Factor
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Australian and New Zealand Journal of Obstetrics and Gynaecology 07/2009; 49(3):333-4. · 1.24 Impact Factor
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ABSTRACT: To evaluate the efficacy and complications of uterine artery embolization (UAE) versus laparoscopic occlusion of uterine vessels (LOUV) in the management of symptomatic fibroids.
A pilot randomized clinical trial in which 20 patients with symptomatic fibroids were randomly allocated into two groups. Ten women underwent UAE, and 10 women underwent LOUV. Symptomatic improvement in menorrhagia and reduction in the volumes of the uterus and the fibroid were assessed at 3 and 6 months.
The patients were comparable with regard to age and parity. At 6 months, there was no significant difference in the mean reduction in menstrual blood loss, uterine volume, and volume of the dominant fibroid between the two groups (P=0.436, P=0.796, P=1.00, respectively). However, higher pain scores were recorded on day 1 in the UAE group compared with the LOUV group (P=0.0002).
The effects of UAE and LOUV in the management of symptomatic fibroids are comparable. The main advantage of LOUV is less postoperative pain compared with UAE.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 03/2009; 105(2):162-5. · 1.41 Impact Factor
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ABSTRACT: To compare the efficacy and side effects of 0.2 mg methyl-ergometrine IM, 400 microg misoprostol sublingual and 125 microg 15 methyl PGF2alpha IM in active management of third stage of labor.
Two hundred low risk pregnant women with induced or spontaneous labor were randomized to receive either 400 microg misoprostol sublingually or 0.2 mg methyl-ergometrine intramuscularly or 125 microg 15-methyl PGF2alpha intramuscularly, after the delivery of anterior shoulder of baby. The main outcome measures were: blood loss more than 500 ml, need for additional oxytoxic drug, change in hemoglobin level and side effects due to drugs.
The median estimated blood loss, blood loss more than 500 ml, need for additional oxytocic drug and change in hemoglobin levels were similar in all three groups. The significant side effects in the misoprostol group were shivering, pyrexia (temperature > 38 degrees C) and vomiting, which were self-limiting. Diarrhea was significantly more in the 15 methyl PGF2alpha group. Three women in methyl-ergometrine group underwent manual removal of placenta. One woman in misoprostol group received blood transfusion.
Sublingual misoprostol appears to be as effective as intramuscular methyl-ergometrine and intramuscular 15-methyl PGF2alpha in the prevention of postpartum hemorrhage. It can be a good alternative in resource poor setting.
Archives of Gynecology 03/2009; 280(6):893-7. · 0.91 Impact Factor
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European Journal of Obstetrics & Gynecology and Reproductive Biology 06/2008; 138(1):120-1. · 1.97 Impact Factor
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Archives of Gynecology and Obstetrics 01/2008; 276(6):641-3. · 1.28 Impact Factor
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Archives of Gynecology and Obstetrics 12/2007; 276(5):563-4. · 1.28 Impact Factor
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ABSTRACT: Gastrointestinal stromal tumors are CD117 (C Kit) positive mesenchymal neoplasms, that may arise anywhere in the gastrointestinal tract. Their current therapy is imatinib mesylate before or after surgery.
We describe a case of 17-year-old female with metastasis to the cervix uteri of a primary mesenteric gastrointestinal tumor.
Surgery remains the mainstay of known curative treatment. The manifestations of GIST are not restricted to the typical locations within the bowel; may have very unusual metastatic sites or infiltrations per continuitatem.
World Journal of Surgical Oncology 02/2007; 5:137. · 1.12 Impact Factor
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European Journal of Obstetrics & Gynecology and Reproductive Biology 12/2006; 129(1):92-4. · 1.97 Impact Factor
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ABSTRACT: Menopause is a pro-atherogenic state with a sharp rise in the incidence of coronary artery disease. This pilot study was designed as an equivalence randomized clinical trial to explore the potential of LycoRed (containing 2000 microg lycopene) as an alternative to hormone replacement therapy (HRT) for the prevention of coronary artery disease in postmenopausal women.
Forty-one healthy postmenopausal women were randomly allocated to receive either continuous combined HRT (n = 21) or LycoRed (n = 20) for six months. Serum lipid profile, marker of lipid peroxidation (malondialdehyde), and the level of endogenous antioxidant (glutathione) were measured at the baseline, and 3 and 6 months after the intervention in both groups.
At 6 months, HRT resulted in a significant decrease in total cholesterol (TC) level by 23.5%, low-density lipoproteins (LDL) by 19.6%, and an increase in high-density lipoproteins (HDL) by 38.9%. The LycoRed group showed similar changes in TC (-24.2%), LDL (-14.9%) and HDL (+26.1%). Triglyceride levels showed a smaller though significant increase at 6 months, but not at 3 months, in both groups. There was no significant change in the very LDL (VLDL) level in either group. Malondialdehyde levels decreased significantly by 16.3% and 13.3%, whereas glutathione levels increased significantly by 5.9% and 12.5% in HRT and LycoRed groups, respectively.
Both HRT and LycoRed had a favorable effect on serum lipids and oxidative stress markers which were comparable. LycoRed can be used as an alternative to HRT to reduce the risk of atherosclerosis in postmenopausal women.
Journal of Obstetrics and Gynaecology Research 07/2006; 32(3):299-304. · 0.94 Impact Factor
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ABSTRACT: We retrospectively reviewed six cases of post-operative rectus sheath haematoma (RSH) managed atour institute during last six years. Out of 6 patients (mean age 27 years) who presented with RSH, fourpreceded caesarean section and two abdominal hysterectomy. They presented clinically as pain abdomen(n-6), shock (n-3), DIC (n-2) and fever (n-1). Haemoperitoneum was observed in 3 patients with shockand the diagnosis was confirmed at surgery. Three clinically stable patients with an infraumbilical abdominalmass were managed conservatively. One required US guided aspiration of the infected haematoma.Massive RSH is an unusual potentially life threatening condition. The diagnosis should be considered in allpatients with acute post-operative pain and free fluid in the abdomen.
JK Science : Journal of Medical Education & Research. 01/2006;
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ABSTRACT: To compare the efficacy of glyceryl trinitrate (GTN), dinoprostone and misoprostol for preinduction cervical ripening in primigravida at term.
Sixty-five term primigravida, each with an unfavorable cervix (Bishop score </=5), were randomized to receive GTN (0.5 mg perivaginally, n = 21), dinoprostone gel (0.5 mg intracervically, n = 21) and misoprostol (50 microg perivaginally, n = 23) for a maximum of two doses, 6 h apart. Statistical analysis included paired t-tests to compare pre- and post-treatment Bishop scores, one-way analysis of variance (anova) tests to compare quantitative variables and chi-squared tests to compare the proportion of subjects achieving favorable Bishop scores.
Baseline Bishop scores were similar in the GTN (3.4 +/- 0.9), dinoprostone (3.4 +/- 1.0) and misoprostol groups (3.2 +/- 1.2). The final outcome was favorable (Bishop score >6) in a greater proportion of subjects in the misoprostol (n = 18, 81.8%) and dinoprostone (n = 14, 66.7%) groups compared with the GTN group (n = 11, 55%). In subjects with a severely unfavorable cervix (Bishop score </=3), treatment with misoprostol led to a favorable response in 61.6% of patients compared with 45.6% in the misoprostol group and 33.3% in the GTN group. A significant improvement was noted in the Bishop score of all three groups (P < 0.001) but the increase in Bishop score was greater in misoprostol (3.5 +/- 2.1) and dinoprostone groups (2.8 +/- 1.5), compared with the GTN group (2.0 +/- 1.0, ANOVA F = 4.8, P = 0.01). Hyperstimulation and tachysystole were observed only in the misoprostol (9% and 4.3%) and dinoprostone groups (4.7% and 16.2%). The most common adverse effect in the GTN group was headache, which was observed in 47.6% of this group's subjects.
The findings of the present study suggest that GTN is safer, but less efficacious, compared with prostaglandins for preinduction cervical ripening at term.
Journal of Obstetrics and Gynaecology Research 07/2005; 31(3):210-5. · 0.94 Impact Factor
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ABSTRACT: To evaluate the feasibility and tolerability of the vaginoscopic approach for office hysteroscopy.
Prospective observational study.
Tertiary care hospital.
Unselected, consecutive 100 patients scheduled for diagnostic hysteroscopy.
Hysteroscopy with a vaginoscopic approach using a 5-mm rigid hysteroscope with single inflow channel, and normal saline for distension.
Successful hysteroscopy by the vaginoscopic approach; operative time; and degree of pain experienced.
The vaginoscopic technique was successful in 79% of the patients. The median operative time was 120 seconds in successful cases and 360 seconds in those in which the vaginoscopic approach was unsuccessful and had to be performed by the conventional technique with or without dilatation, the difference being statistically significant (P < 0.001). The procedure took < or = 2 minutes in 91.1% (72/79) of the successful cases. No pain or mild pain was experienced by 97.5% (77/79) of patients in whom vaginohysteroscopy was successful.
Hysteroscopy with the vaginoscopic approach is the ideal method for outpatient hysteroscopy. It is feasible, quick, and very well tolerated, obviating the need for any analgesia or local anesthesia.
Journal of Laparoendoscopic & Advanced Surgical Techniques 06/2005; 15(3):290-3. · 1.40 Impact Factor
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ABSTRACT: Large chorioangiomas are rare and associated with significant fetal and maternal risks. A case ofchorioangioma syndrome is presented with polyhydramnios, pre-eclampsia, preterm labor and fetomaternalhemorrhage. Antenatal diagnosis is possible with ultrasound, and the prognosis for pregnancyoutcome can be predicted by evaluating the vascularity of the tumor on color doppler sonography.
JK Science : Journal of Medical Education & Research. 01/2005;
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ABSTRACT: A rare case of vesicocervical fistula following repair of a vesicovaginal fistula is presented. The patient complained of cyclical menouria since the first repair done 15years ago and gradually worsening urinary incontinence. A laparoscopic assisted repair of the fistula was performed and the patient is fully continent at 12-months follow up.
International Urogynecology Journal 09/2004; 15(5):358-359. · 1.83 Impact Factor
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ABSTRACT: We report an unusual case of invasive mole metastasized to the urinary bladder. The patient presented with hematuria one month after evacuation of a molar pregnancy. The serum chorionic gonadotropin levels regressed spontaneously following transurethral cystoscopic resection of the tumour. Metastasis of an invasive mole to the urinary bladder has not been previously reported.
Indian Journal of Cancer 39(3):116-8.
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ABSTRACT: A rare case of vesicocervical fistula following repair of a vesicovaginal fistula is presented. The patient complained of cyclical menouria since the first repair done 15 years ago and gradually worsening urinary incontinence. A laparoscopic assisted repair of the fistula was performed and the patient is fully continent at 12-months follow up.
International Urogynecology Journal 15(5):358-9. · 1.83 Impact Factor
