J B Sharma

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

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Publications (177)211.09 Total impact

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    Full-text · Article · Jan 2016
  • Jai Bhagwan Sharma
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    ABSTRACT: Objective: Evaluation of anti-tubercular therapy on endometrium in Female Genital Tuberculosis Method: Total of 50 women having FGTB on endometrial aspirate (positive AFB, epitheloid granuloma, positive PCR, laparoscopy or hysteroscopy findings) were enrolled. Ultrasound was performed for endometrial thickness, mean resistive index and pulsatility index before and after anti-tuberculous therapy (ATT). Diagnostic hysteroscopy was performed for intra-uterine adhesions and look of cavity before and after ATT. Results: Menstrual cycle improved after anti-tubercular therapy (ATT). Endometrial aspirate findings improved with disappearance of AFB, epitheloid granuloma and decrease in PCR (94%vs 33%). After ATT, ultrasound examination of endometrial thickness improved from 7.01±1.48 mm to 7.51±1.48 mm while mean resistive index and pulsatility index decreased from 0.729±0.304 to 0.692±0.399 and 1.180 to 1.138. With ATT, improvement was seen in hysteroscopic findings with normal looking cavity increasing from 18(36%) to 34(72.1%) and pale looking cavity decreasing from 20(42.5%) to 8(16.8%). Before ATT, prevalence of intrauterine adhesions was 62% which decreased to 28.7% after ATT. Improvement was significant only in grade I adhesions from 34% to 2.1%, (p<0.001). There was no improvement in higher grade of intrauterine adhesions with ATT with grade II (6% vs 4.2%) and grade 2a (4% vs 2.1%), grade III being (2% vs2.1%), grade IV (4% vs4.2%), grade Va (4% vs4.2%) and grade Vb (8% vs10.6%) before and after ATT respectively. Conclusions: Early ATT improved menstrual cycle, endometrial thickness and reduced incidence of grade 1 adhesions. Advanced stages didn't show any improvement.
    No preview · Article · Dec 2015
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    ABSTRACT: Background: Human placental villous cytotrophoblasts exhibit relative externalization of negatively charged moieties to the outer leaflet of the plasma membrane during the time of syncytialization rendering their reactivity to positively charged cationic antimicrobial peptides (CAMPs) during the window of implantation and early placentation. Vaginal administration of a synthetic CAMP, Ala(8,13,18)-magainin II amide (AMA) inhibited blastocyst implantation and early placentation in monkeys. Furthermore, the administration of AMA resulted in significant inhibition of cell differentiation, enhancement in apoptosis and loss of viability in first trimester placental villous cytotrophoblasts in primary culture. The present study examines the effect of in vitro application of different doses (0, 1, 10, 100, 1000 ng/ml) of AMA on the secreted cytokine profiles of cytotrophoblasts obtained from placental villi samples (n = 13) collected during 8-9 weeks of gestation and grown on three-dimensional collagen matrix in vitro. Methods: A panel of forty-eight (48) cytokines in conditioned medium was analysed using multiplex immunoassays technique. Further, the steady state transcript levels of four cytokines (CCL4, CCL5, IL1B, IL6), the concentrations of which were affected by AMA in the isolated cytotrophoblasts, as well as, two cytokines (IL1A and TNF) which were not affected by AMA were estimated. Input list of cytokines secreted by cytotrophoblasts and showing differential secretion in response to AMA were used in enrichment analysis for the generation of biological networks. Results: Placental cytotrophoblasts secreted 27 cytokines, 13 of which are affected by AMA in vitro with significantly decreased secretion of CCLs-2, 3, 4, 5, CXCLs-1 and 8, FGF2 and MCSF and that of IL1B, IL6 and MIF, and increased secretion of IL16 and IL-2RA. Of the above cytokines showing differential secretion, only IL-2RA, IL16 and MIF showed significant correspondence in the steady state expression of their respective transcript levels. Post-hoc Enrichment analysis revealed Toll-like receptor (TLR) mediated pathways were the top-scored target pathways that were affected by AMA. Conclusions: Administration of a CAMP causes shift in the balance of immune-inflammatory responses involving downstream pathways of TLRs in cytotrophoblast function. Further verification of functions of placental trophoblasts on administration of CAMP with pregnancy outcome is necessary.
    Full-text · Article · Nov 2015 · Reproductive Biology and Endocrinology
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    ABSTRACT: Background: Female genital tuberculosis (FGTB) is an important cause of infertility in developing countries and causes significant findings in the peritoneal cavity and in the fallopian tube. Study objective: To study the effect of anti-tubercular treatment on the laparoscopic abdominopelvic and fallopian tube findings in female genital tuberculosis. Study design: Prospective cohort (Canadian Task force classification II2) All procedures were performed by one surgeon between June 2012 and May 2014. Setting: Tertiary referral centre in Northern India. Patients: Fifty women with infertility diagnosed with female genital TB on laparoscopy histopathology findings or on endometrial sampling (acid fast bacilli culture, granuloma on histopathology, positive polymerase chain reaction [PCR]. Interventions: Diagnostic laparoscopy in all women diagnosed with FGTB prior to and post 6 months course of ATT (2 months of rifampicin, isoniazid, pyrazinamide and ethambutol followed by 4 months course of rifampicin and isoniazid). Measurements and main results: The mean age of patients was 28.7 years, parity and BMI (body mass index) was 0.9 and 23.6kg/m2 respectively. Infertility was seen in all 50 women (66% primary infertility, 34% secondary infertility) with mean duration of infertility being 6.06years. Various abnormal laparoscopic findings of FGTB were tubercles on pelvic peritoneum, fallopian tube and ovary in 27(54%) women before ATT and in only women after ATT (p<.001) caseous nodules and encysted ascites were seen in 4 (8%) women before ATT but in none after ATT(p<.001) However, there was no change in the pelvic adhesions (42% vs 42.5%) and perihepatic adhesions(56% vs 58%) before and after ATT. Various laparoscopic findings in fallopian tube were hydrosalpinx (32%), pyosalpinx (4%), beaded tubes (12%), non visualization of tube(20%), tubal blockage on the right side (56%), on left side(50%)and on both sides (38%) before ATT. Hydrosalpinx, beaded tubes and nonvisualization of the tube were seen in 33.4%, 4.1% and 20.8% cases respectively after ATT. However, free spill increased to 52% on right side and 50% on left side after ATT. Conclusion: ATT improves laparoscopic findings in FGTB with infertility. However, advanced fibrotic lesions (pelvic and perihepatic adhesions and bilateral blocked tubes) don't improve with ATT.
    No preview · Article · Oct 2015 · Journal of Minimally Invasive Gynecology
  • Jai B. Sharma
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    ABSTRACT: Female genital tuberculosis (FGTB) is an important cause of significant morbidity, short- and long-term sequelae especially infertility whose incidence varies from 3 to 16 % cases in India. Mycobacterium tuberculosis is the etiological agent for tuberculosis. The fallopian tubes are involved in 90–100 % cases, endometrium is involved in 50–80 % cases, ovaries are involved in 20–30 % cases, and cervix is involved in 5–15 % cases of genital TB. Tuberculosis of vagina and vulva is rare (1–2 %). The diagnosis is made by detection of acid-fast bacilli on microscopy or culture on endometrial biopsy or on histopathological detection of epithelioid granuloma on biopsy. Polymerase chain reaction may be false positive and alone is not sufficient to make the diagnosis. Laparoscopy and hysteroscopy can diagnose genital tuberculosis by various findings. Treatment is by giving daily therapy of rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) for 2 months followed by daily 4 month therapy of rifampicin (R) and isoniazid (H). Alternatively 2 months intensive phase of RHZE can be daily followed by alternate day combination phase (RH) of 4 months. Three weekly dosing throughout therapy (RHZE thrice weekly for 2 months followed by RH thrice weekly for 4 months) can be given as directly observed treatment short-course. Surgery is rarely required only as drainage of abscesses. There is a role of in vitro fertilization and embryo transfer in women whose fallopian tubes are damaged but endometrium is healthy. Surrogacy or adoption is needed for women whose endometrium is also damaged. © 2015 Federation of Obstetric & Gynecological Societies of India
    No preview · Article · Oct 2015 · Journal of Obstetrics and Gynecology of India
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    ABSTRACT: Objectives: Large scale array based transcriptome analysis of autologous eutopic and ectopic endometrial tissues obtained from patients with ovarian endometriosis previously indicated possible differential expression of steady state transcripts between fertile and subfertile groups. In the present study, we have examined this notion using whole human genome transcriptome analysis of eutopic endometrium from fertile and sub-fertile patients having rASRM stage 4 ovarian endometriosis during proliferative and secretory phases of menstrual cycles. It was anticipated that this may yield an input list of molecules having high order of pathophysiological and clinical significance. Method: Endometrial eutopic samples were collected from fertile and sub-fertile (n=16/each) patients with stage 4 ovarian endometriosis. Total RNA was extracted and based on the quality and integrity (RIN >8.0) of extracted RNA, 24 samples were subjected to whole genome expression microarray. The selected images which passed the default quality control (n=23) were further subjected to exploratory analyses followed by differential display among groups using ANOVA with unequal variance and multiple comparison test with Benjamin-Hochberg correction using GeneSpring v13.0 software. The data was further subjected to enrichment analysis using GENEGO MetaCore Web portal. Results: Exploratory analyses identified expressional segregation between fertile and sub-fertile groups. The differential expression between fertile and sub-fertile groups identified 88 genes in the proliferative phase and 21 genes in the secretory phase. Functional genomics analysis revealed that the differentially expressed genes in fertile and sub-fertile patients with stage 4 ovarian endometriosis are associated with transcription regulation in terms of RNA editing, various other protease dependent G protein signaling cascades and receptor tyrosine kinase mediated signaling. Contrary to the fertile groups, the sub-fertile group with ovarian endometriosis appeared to display inadequacy in recycling of cellular materials in endometrial cells. Conclusions: Further molecular phenotyping of endometrium may identify differences between fertile and sub-fertile patients having ovarian endometriosis, which will reflect high order of pathophysiological and clinical leads towards better understanding and management of this complex gynecological disorder.
    No preview · Article · Oct 2015 · International Journal of Gynecology & Obstetrics
  • Murali Subbaiah · Sunesh Kumar · Kallol Kumar Roy · Jai Bhagwan Sharma · Neeta Singh
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    ABSTRACT: Background: Extrahepatic portal-vein obstruction (EHPVO) is a common cause of portal hypertension in developing countries. The main risk in pregnant women with this condition is variceal bleeding, which may be life-threatening. The objective of our study was to assess the outcome of pregnancy in women with EHPVO. Materials and methods: A retrospective analysis of 21 pregnancies in 12 women with EHPVO was carried out at a tertiary hospital in India. Results: The mean age of pregnant women with EHPVO was 25.3 years, and the mean duration of disease since diagnosis was 6.1 ± 1.2 years. All the patients had chronic EHPVO, and two patients were diagnosed in the index pregnancy. The incidence of abortion, preterm deliveries, and small for gestational age fetus was 23.8%, 18.7%, and 12.5%, respectively. Thrombocytopenia was found to complicate 61.9% of the pregnancies, while anemia was detected in 40% of the pregnancies. Variceal bleeding occurred in one woman, who was diagnosed during pregnancy and was managed successfully with endoscopic sclerotherapy. None of the patients who were diagnosed prenatally had variceal bleeding during pregnancy. The outcome in nine pregnancies, in which prenatal endoscopic variceal ligation was done, was compared with eight pregnancies, in which endoscopic sclerotherapy was done. No significant difference between the two groups in terms of pregnancy outcome and complications was found. There were no stillbirths or maternal mortality. Conclusion: Women with EHPVO who have been diagnosed and treated prenatally have a good pregnancy outcome. They should be managed in a tertiary care center with a multidisciplinary approach.
    No preview · Article · Sep 2015 · Taiwanese journal of obstetrics & gynecology
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    ABSTRACT: Indirect evidence suggests that eutopic endometrium of women suffering from endometriosis shows differential physiological characteristics as compared to normal endometrium in unaffected women. We have evaluated this issue by examining differential display using large scale gel-free 2D proteomic analysis followed by QTOF LC-MS system between endometrial proteins obtained from control endometrium from infertile women with no detectable endometriosis disease and that from infertile women with proven stage IV ovarian endometrioma. We identified several dysregulated endometrial proteins in women suffering from ovarian endometriosis, which included proteins involved in regulating cellular redox states, cellular signaling, cytoskeletal functions, stress response, apoptosis, salt-water and heme metabolism. Additionally, an overt indication of telomere maintenance and that of neoplastic potential of eutopic endometrium of infertile women with stage IV ovarian endometriosis was observed in post-hoc bioinformatics based analysis. This was further substantiated by consistent high immunopositive expression of four specific proteins (Annexin A2, HSP90, PDGFa and Tubulin-a) in endometrium of infertile patients with stage IV ovarian endometriosis, and these cellular proteins are known to be associated with several types of cancers.
    Full-text · Article · Jun 2015

  • No preview · Article · Jun 2015
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    ABSTRACT: To determine tumor marker concentrations during normal and high-risk pregnancies. The present cross-sectional study included women attending the gynecology outpatient department at All India Institute of Medical Sciences, New Delhi, India, between November 1, 2012 and March 31, 2013. Their serum was assayed for carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), and cancer antigen 15-3 (CA15-3). A total of 251 pregnant women and 31 nonpregnant women were included. Median CEA value was lower among pregnant women than among nonpregnant women (1.2μg/L vs 1.4μg/L; P=0.006), whereas that of CA15-3 was higher (16.7U/mL vs 12.3U/mL; P=0.03). CA19-9 concentration was higher among pregnant women aged 25-29years (7.0U/mL) or 30-34years (7.2U/mL) than among those aged 20-24years (4.2U/mL; P=0.01 for both). The CA15-3 level was increased during the second (13.0U/mL) and third (60.5U/mL) trimesters compared with the first trimester (9.5U/mL) (P≤0.01 for both comparisons). It was also raised in high-risk pregnancies (33.7U/mL), specifically pregnancies complicated by gestational diabetes mellitus (39.7U/mL), intrahepatic cholestasis of pregnancy (64.3U/mL), or heart disease (54.0U/mL) (P<0.05 for all). CA15-3 concentrations rise during pregnancy, but whether this increase can be attributed to physiological changes in breast tissue needs to be investigated further. Copyright © 2015. Published by Elsevier Ireland Ltd.
    Full-text · Article · Mar 2015 · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

  • No preview · Article · Jan 2015
  • J Sharma · Rinchen Zangmo · Sunesh Kumar · K Roy

    No preview · Article · Jan 2015
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    ABSTRACT: To compare the operation and reproductive outcome of hysteroscopic septal resection using unipolar resectoscope verses bipolar resectoscope. In this prospective randomized study, 70 women underwent hysteroscopic septal resection using either unipolar resectoscope or bipolar resectoscope. Intraoperative parameters (operation time, fluid deficit and complications) and pre- and postoperative serum sodium levels were compared between the two groups. A second-look hysteroscopy was performed after 6 weeks. All pregnancies occurring during the follow-up period were recorded. There was no statistically significant difference between the two groups in terms of operation parameters and second-look hysteroscopy findings. Six patients in the unipolar group were found to have hyponatremia in the postoperative period compared to none in the bipolar group (P = 0.025). Regarding reproductive outcome, the difference between the two groups was not significant. The use of bipolar resectoscope is associated with lesser risk of hyponatremia compared to unipolar resectoscope. Bipolar resectoscopy is a safe alternative to unipolar resectoscopy with similar reproductive outcome. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.
    No preview · Article · Dec 2014 · Journal of Obstetrics and Gynaecology Research
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    ABSTRACT: To assess the role of genital tuberculosis as an etiological factor for ectopic pregnancy. A total of eighteen women of ectopic pregnancy with concomitant female genital tuberculosis and a total of one hundred thirty six patients of ectopic pregnancy over a period of three years were enrolled. Mean age of patients with ectopic pregnancy and concomitant female genital tuberculosis was twenty-six and mean parity was 0.7. Most of these patients were in poor socio-economic group. Diagnosis of female genital tuberculosis was made by presence of granuloma in histopathological examination of endometrial aspirate or tubal specimen, positive acid fast bacilli in microscopy or culture, positive polymerase chain reaction in endometrial tissue and positive findings of genital tuberculosis during laparoscopy or laparotomy. Genital tuberculosis was responsible for 13.2% of all cases of ectopic pregnancy in the present study. Genital tuberculosis appears to be an important cause of ectopic pregnancy in India.
    No preview · Article · Oct 2014 · The Indian journal of tuberculosis
  • Debjyoti Karmakar · Jai B Sharma
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    ABSTRACT: Background: Female voiding dysfunction is a complex disorder, lacks definition, and is poorly understood and difficult to manage. Causes of Female Voiding Dysfunction: As there is no agreed classification of female voiding dysfunction, it is important to identify the several potential factors that might cause voiding dysfunction, namely anatomic, neurogenic, pharmacologic, endocrine, pharmacological and other causes. Presentation and Clinical Evaluation: Traditional and novel techniques are available and the importance and diagnostic dilemma related to these conditions need to be understood. We conclude by emphasizing the need to simplify the diagnosis and nomenclature of these conditions from a more clinical point of view as against an investigational perspective.
    No preview · Article · Jul 2014
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    ABSTRACT: A new bread wheat variety, HD3086 (Pusa Gautami) has been released and notified by the Central Sub- Committee on Crop Standards, Notification and Release of Varieties for Agricultural Crops, Government of India for commercial cultivation under timely sown irrigated conditions of North Western Plains Zone (NWPZ) of the country. HD 3086 has average yield of 5.46 t/ha with yield potential of 7.1 t/ha under timely sown irrigated conditions and showed superiority over checks. It is resistant to yellow rust and brown rust. It has shown superior quality parameters with protein content (12.5%), a sedimentation value (45 ml), best Glu-1 Score (10/10) and good extraction rate (70.5%) meeting all the criteria for superior bread making qualities. This variety has promise for timely sown irrigated planting areas and thus will contribute to increasing wheat production and will alleviate the socio-economic status of farmers of north-western plains in India.
    Full-text · Article · May 2014
  • K K Roy · M Subbaiah · S Kumar · J B Sharma · N Singh
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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.
    No preview · Article · May 2014 · Journal of Obstetrics and Gynaecology
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    ABSTRACT: A new bread wheat variety, HD3090 (Pusa Amulya) has been released and notifed by the Central Sub- Committee on Crop Standards, Notifcation and Release of Varieties for Agricultural Crops, Government of India vide S. O. 224 E dated 24th January 2014, for commercial cultivation under late sown irrigated conditions of Peninsular Zone (PZ) of the country. HD 3090, a semi-dwarf (80 cm), rust resistant and early maturing (101 days) wheat variety has average yield of 4.21 t/ha with yield potential of 6.31 t/ha under late sown irrigated conditions and showed superiority over checks (HD2932, Raj4083 and NIAW34). HD3090 being resistant to leaf and stem rust would help in disease management by minimizing the incidence of rust diseases. High protein content (13.3%), high (79.4 kg/hl) hectolitre weight and good grain appearance of this wheat would have better farmer acceptance. This being an early maturing,rust resistant varieties has promise for late sown irrigated planting areas under various cropping systems in the peninsular zone and thus will contribute to increasing wheat production and contribute in alleviating the socio- economic status of farmers in this region.
    No preview · Article · Apr 2014
  • Raksha Arora · J B Sharma

    No preview · Article · Apr 2014 · The Indian journal of tuberculosis
  • Subodh Kumar Regmi · Urvashi B. Singh · Jai Bhagwan Sharma · Rajeev Kumar
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    ABSTRACT: Objective: Male partners of infertile women with genital tuberculosis (TB) are often screened for genital TB. We aimed to evaluate the clinical significance of a positive screening semen polymerase chain reaction (PCR) for Mycobacterium tuberculosis test (TB-PCR) in asymptomatic men undergoing infertility evaluation and determine the need for a detailed investigation and treatment for TB. Materials and methods: Between March 2012 and January 2013, male partners of 15 infertile women with a diagnosis of genitourinary TB (GUTB) as the cause of infertility, tested positive either on semen PCR for TB (13 cases), or Mycobacterium Growth Indicator Tube-960 test (2 cases). These asymptomatic men underwent infertility evaluation along with evaluation for GUTB. Diagnosis of GUTB was based on standard clinical criteria, which included a high index of suspicion along with clinical, laboratory, and/or radiological evidence of GUTB. Men who had no clinical evidence of GUTB were followed up with clinical evaluation, semen analysis, and repeat semen PCR for TB after 6 months. Results: Fourteen subjects consented for inclusion in the study. One had a history of pulmonary TB 20 years earlier. Another patient was found to have mediastinal lymphadenopathy (tubercular). All except one had a normal semen analysis. None of the patients met the standard clinical criteria for GUTB diagnosis. 8 patients followed up at 6 months with repeat semen analysis, which was similar to the baseline values and no clinical evidence of TB. Interpretation and conclusions: Asymptomatic men with positive screening semen PCR for TB do not have clinical evidence of TB. Male partners of women with infertility and GUTB should not be screened if they have no symptoms.
    No preview · Article · Mar 2014 · Journal of Men s Health

Publication Stats

2k Citations
211.09 Total Impact Points


  • 2006-2015
    • 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
  • 2009-2012
    • Christ Church College, Kanpur
      Cawnpore, Uttar Pradesh, India
  • 2007-2012
    • Rajiv Gandhi Cancer Institute
      New Dilli, NCT, India
  • 2008-2009
    • Rajiv Gandhi Cancer Institute & Research Centre
      New Dilli, NCT, India
  • 2000-2006
    • Lok Nayak Hospital
      New Dilli, NCT, India
  • 2001-2005
    • Maulana Azad Medical College
      • Department of Obstetrics & Gynaecology
      New Dilli, NCT, India