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139 result(s) for "Shrivastava, Deepti"
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Psychological Problems Related to Infertility
Infertility is a problem of great significance among millions of couples. In our society, to have a child means living a fulfilled life. Thus, couples who cannot do so feel barren and incomplete. Therefore, infertility is more than just a medical problem. It affects all aspects of life, the most important being mental health. For many years, a person's mental health has been overlooked, but in the past few years, it has gained importance that mental health is as significant as physical health, which has also been stated in the WHO definition of health. This article discusses the mental toll that infertility takes on a person's life. A person may experience a myriad of psychological problems, of which stress for extended periods is one. Furthermore, it may cause feelings of guilt, emptiness, anxiety, and depression. The article mainly focuses on the need for counseling for couples dealing with infertility and under treatment because of the long waiting periods accompanying it. Although both men and women can contribute to infertility in India, women are exclusively held responsible, leading to more significant stress while undergoing treatment. The paper also provides an overview of infertility, the factors responsible, and the treatments currently available. Various studies have shown that delivering psychological support through psychiatric clinical specialists may accentuate the results of IVF (In-vitro fertilization) and ART (Assisted Reproductive Technology). This review sheds light on the effects of infertility on quality of life and how it can be prevented or reduced through psychotherapy.
Gingival Crevicular Fluid (GCF): A Diagnostic Tool for the Detection of Periodontal Health and Diseases
The methodologies applicable for the evaluation of periodontal associated diseases are constantly evolving to provide quick, realistic, and scientifically proven results. Trends in the past followed a clinical evaluation of periodontal tissues and radiographic-based reports that formed the foundation for detection of diseases involving the structures supporting the teeth. As the confines and limitations of conventional strategies became obvious over the passage of time, hand in hand variety of techniques have evolved and experimentally justified. These improvisations are based on an improved understanding of the periodontal-pathogenic cascade. Periodontal pathogenesis and a paradigm shift from disease understanding to disease prevention and treatment entail few prerequisites that demand the objectivity of diagnostics procedure that includes sensitivity and specificity along with an explanation of the intensity of the disease, Gingival crevicular fluid an oral bio-fluid resides in the close proximity with gingival tissues have been widely used to understand and differentiate the periodontal health and diseased status. The biomarkers present in the GCF can be a reliable tool to detect the minute changes seen in the disease processes. The GCF consists of various host and bacterial-derived products as well as biomarkers which in turn can be evaluated for the diagnosis, prognosis as well as management of the periodontal disease. Thus, the review aims at describing GCF as a potential oral biofluid helpful in differentiating periodontal health and disease status.
A Comprehensive Review of Screening Methods for Ovarian Masses: Towards Earlier Detection
Ovarian masses, ranging from benign cysts to malignant tumors, present complex diagnostic challenges in women's healthcare. Early detection of ovarian masses is paramount for improving patient outcomes, as delayed diagnoses often lead to advanced-stage disease with limited treatment options. This comprehensive review explores screening methods' current state, limitations, and emerging technologies to facilitate earlier detection. The limitations of existing screening methods, such as low sensitivity and specificity, underscore the need for improved early detection strategies. Imaging-based techniques, including transvaginal ultrasound, magnetic resonance imaging, and computed tomography, are vital in evaluating ovarian masses. However, the emergence of artificial intelligence (AI) and machine learning (ML) applications enhances the accuracy of image interpretation. Blood-based biomarkers, such as CA-125, have been the focus of research for ovarian mass detection. While CA-125 remains widely used, its limitations have prompted investigations into alternative serum biomarkers, including HE4 and miRNA, along with liquid biopsy and circulating tumor DNA. Ultrasound-based scoring systems, such as the risk of malignancy index (RMI), Ovarian-Adnexal Reporting and Data System (O-RADS), and guidelines from the International Ovarian Tumor Analysis (IOTA) group, provide structured approaches for classifying ovarian masses. These systems aid healthcare providers in clinical decision-making. Emerging technologies, such as liquid biopsy, AI, and proteomic/metabolomic approaches, offer promising avenues for enhancing early detection and risk assessment. Liquid biopsy provides noninvasive, real-time monitoring of ovarian masses, while AI and ML applications improve the accuracy of image interpretation. Proteomic and metabolomic studies reveal novel biomarkers and molecular insights. High-risk populations, often associated with genetic mutations such as BRCA1 and BRCA2, require specialized screening strategies. Current guidelines recommend screening modalities, risk-reduction strategies, and shared decision-making. Ongoing research focuses on refining risk assessment and personalized screening for high-risk individuals. This review underscores the importance of early detection in managing ovarian masses, emphasizing the need for improved screening methods, tailored approaches for high-risk populations, and ongoing research to further enhance diagnostic accuracy and patient outcomes.
Huntington's Disease: A Clinical Review
The Huntington's gene on chromosome 4 has a dominantly inherited CAG trinucleotide repeat expansion, ultimately resulting in Huntington's disease (HD), a completely penetrant neurological condition. The frequency is 10-100 times higher in the population descended from Europe than in East Asia. Through various processes, including impairment of proteostasis, transcription, and cell function, as well as direct toxicity of the mutant protein, mutated huntingtin triggers neuronal malfunction and loss at the cellular level. As the disease worsens, the brain becomes affected together with the striatum's initial macroscopic alterations. Since there are presently few medications that can change the course of the disease, palliative therapy, and symptom control are the cornerstone of treatment. Studying the cellular pathology and gross structural changes to the brain which occur as the illness advances have made enormous progress in recent years. There's been a substantial increase in medical studies and possible treatment options over the past ten years. The new treatments that aim to reduce amounts of mutant huntingtin are the most optimistic. However, one strategy is antisense oligonucleotide treatment, for which clinical trials are currently being conducted. These control trials might help us get another inch ahead of managing and perhaps even eliminating this nasty disease.
Maternal and Perinatal Outcomes in Placenta Previa: A Comprehensive Review of Evidence
Placenta previa poses significant risks to maternal and perinatal health, yet its management remains challenging. This comprehensive review synthesizes current evidence on maternal and perinatal outcomes in placenta previa, addressing its epidemiology, pathophysiology, diagnosis, and management strategies. Placenta previa complicates pregnancies, with increasing incidence linked to factors such as advanced maternal age and rising cesarean rates. Maternal complications, including hemorrhage and placenta accreta spectrum disorders, pose substantial risks. At the same time, perinatal outcomes are marked by increased rates of preterm birth, intrauterine growth restriction, and neonatal morbidity and mortality. Timely diagnosis and appropriate management, including antenatal corticosteroids and multidisciplinary care, are critical for optimizing outcomes. Future research should focus on improving diagnostic methods, evaluating novel interventions, and assessing long-term neurodevelopmental outcomes. This review underscores the importance of informed clinical practice and ongoing research efforts to enhance outcomes for women and infants affected by placenta previa.
Nutritional Deficiencies and Subfertility: A Comprehensive Review of Current Evidence
Subfertility, a condition marked by a reduced capacity to conceive naturally, affects a significant proportion of couples globally. Nutrition is a fundamental aspect of reproductive health, with various nutrients essential in maintaining optimal reproductive function. This comprehensive review explores the intricate relationship between nutritional deficiencies and subfertility. It examines key micronutrients such as vitamins D, E, C, and B12, as well as minerals such as zinc, iron, selenium, and magnesium, and their impacts on fertility. The review also considers macronutrients and the importance of a balanced diet in supporting reproductive health. Drawing on an extensive body of clinical evidence and studies, this review highlights how deficiencies in these nutrients can lead to hormonal imbalances, impaired gametogenesis, and suboptimal pregnancy outcomes. It discusses the efficacy of nutritional interventions, including dietary supplements and lifestyle modifications, in improving fertility. Furthermore, it addresses the emerging research on personalized nutrition and its potential to enhance reproductive outcomes. The review underscores the necessity for healthcare providers to assess and address the nutritional status of patients with subfertility. It provides practical recommendations for developing nutritional plans, counseling patients, and integrating nutritional interventions into fertility treatments. By offering a comprehensive synthesis of current evidence, this review aims to inform clinical practice and promote further research into the role of nutrition in enhancing fertility.
Craniofacial morphology in Apert syndrome: a systematic review and meta-analysis
This meta-analysis aims to compare Apert syndrome (AS) patients with non-AS populations (not clinically or genetically diagnosed) on craniofacial cephalometric characteristics (CCC) to combine publicly available scientific information while also improving the validity of primary study findings. A comprehensive search was performed in the following databases: PubMed, Google Scholar, Scopus, Medline, and Web of Science, an article published between 1st January 2000 to October 17th, 2021. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to carry out this systematic review. We used the PECO system to classify people with AS based on whether or not they had distinctive CCC compared to the non-AS population. Following are some examples of how PECO has been used: People with AS are labeled P; clinical or genetic diagnosis of AS is labeled E; individuals without AS are labeled C; CCC of AS are labeled O. Using the Newcastle–Ottawa Quality-Assessment-Scale, independent reviewers assessed the articles' methodological quality and extracted data. 13 studies were included in the systematic review. 8 out of 13 studies were score 7–8 in NOS scale, which indicated that most of the studies were medium to high qualities. Six case–control studies were analyzed for meta-analysis. Due to the wide range of variability in CCC, we were only able to include data from at least three previous studies. There was a statistically significant difference in N-S-PP ( I 2 : 76.56%; P  = 0.014; CI 1.27 to − 0.28) and Greater wing angle ( I 2 : 79.07%; P  = 0.008; CI 3.07–1.17) between AS and control subjects. Cleft palate, anterior open bite, crowding in the upper jaw, and hypodontia occurred more frequently among AS patients. Significant shortening of the mandibular width, height and length is the most reported feature in AS patients. CT scans can help patients with AS decide whether to pursue orthodontic treatment alone or to have their mouth surgically expanded. The role of well-informed orthodontic and maxillofacial practitioners is critical in preventing and rehabilitating oral health issues.
Effects of Variable Embryo Transfer on the Variable Window of Implantation and Analysis of Pregnancy Outcomes
Background A descriptive analysis of patients who underwent various embryo transfer methods to address the root cause of their infertility at a tertiary infertility care complex in Wardha, India, is presented herein. This analysis aims to evaluate the management of infertility and assess pregnancy outcomes. Methodology We conducted a retrospective cohort study on patients who underwent various embryo transfer methods to address the cause of their infertility, specifically focusing on a variable window of implantation (WOI) at a tertiary infertility clinic over a one-year period. The medical records of 11 patients in both the variable embryo transfer (VET) and control groups were reviewed and analyzed for this article. Results The examination of medical records revealed a significant improvement in the rate of implantation (p-value = 0.04) and clinical pregnancy outcomes (p-value = 0.03) among patients who underwent VET. Comparable statistical outcomes were observed for other variables of pregnancy outcome, including miscarriage rate, multiple pregnancy rate, and biochemical pregnancy rate. Conclusion This retrospective cohort study suggests that the utilization of VET could be a viable option for women experiencing recurrent implantation failure cycles, particularly when an adequate number of embryos are available. This is owing to the challenges in clinically diagnosing a variable WOI. Further studies with a significantly larger sample population are recommended to validate the results and integrate this approach into the standard operating procedures, aiming to enhance the likelihood of pregnancy in these populations.
Unveiling the Role of Endometrial CD-138: A Comprehensive Review on Its Significance in Infertility and Early Pregnancy
This review comprehensively examines the role of endometrial CD-138 (syndecan-1) in the context of infertility and early pregnancy. The endometrium, a dynamic tissue responsive to hormonal cues, plays a central role in fertility, and understanding the molecular intricacies governing its function is crucial. CD-138, a cell surface proteoglycan, emerges as a critical player expressed by various endometrial cell types. Our exploration encompasses a brief overview of the endometrium, introducing CD-138 as a significant molecular entity. The rationale for the review underscores the importance of elucidating endometrial factors in fertility and addresses existing knowledge gaps related to CD-138. Throughout the review, we unravel the multifaceted nature of CD-138 and its involvement in infertility, highlighting its potential as a diagnostic marker. Furthermore, insights into CD-138's role during early pregnancy, including trophoblast-endothelial interactions, are discussed. In conclusion, the findings underscore the clinical implications of CD-138, suggesting its utility in diagnostics and offering prospects for targeted therapeutic interventions. The identified knowledge gaps propel future research directions, promising to deepen our understanding of this enigmatic molecule and its transformative potential in reproductive medicine.
Regeneration Therapy: The Role of Platelet-Rich Plasma in Post-hysterectomy Wound Dehiscence Healing
A 58-year-old (para 2, living 2, abortion 0), overweight (BMI: 25 kg/m2), post-hysterectomy patient reported with wound dehiscence on day seven. She was a known case of hypertension and type 2 diabetes for the last five years. She presented with symptoms of abnormal uterine bleeding due to leiomyoma. The leiomyoma was refractory to medical management and thus she underwent a total abdominal hysterectomy. She underwent the procedure well after preoperative intensive diabetes and hypertension management. She was managed postoperatively with injectable antibiotics. On day seven postoperatively, the patient started experiencing wound discharge, after which she was treated with broad spectrum higher antibiotics and regular wound dressing with debridement of necrotic debris twice daily for five days. She was planned for alternative therapy in the form of rejuvenation therapy by platelet-rich plasma therapy, which thus helped further shorten her hospital stay and helped the wound to heal better.