Safdarjang Hospital Research Articles

The Department of Pediatrics, Safdarjang Hospital, New Delhi, 1950–2020

The paper attempts to capture the development of the Department of Pediatrics, Safdarjang Hospital, New Delhi, from a historical perspective in its founding years in late 1950s, showing the progress from its nascent state as a part of adult medicine to a full-fledged independent department with state-of-the-art advances in the 2020s. From an ordinary Pediatrics Department, it was reorganized radically to expand clinical facilities as well as education and research by innovative methods, developing subspecialties including an upgradation of the neonatology division, simultaneously establishing linkages with community level centres. The pioneering workshops for training obstetricians and pediatricians paved the way for initiation of multiple such national workshops across the country, by the Government of India, for establishment of neonatal care units countrywide. It was instrumental in the formulation of 'Essential New-born Care' as the first national newborn care program and later a new concept of 'Mother and Neonatal Care Unit (M-NICU)' for perinatal care, apart from many other contributions for shaping national policies.

Clinical Pearls in Interventional Pain Management

The sad demise of Dr. M Sri Ram is a profound grief for whole of the Indian anesthesia community. I was personally connected with him with effect from mid 1960’s when I was a medicine resident at Safdarjang Hospital and Dr. Shriram was pursuing his postgraduation under Dr. G. C. Tendon at All India Institute of Medical Sciences (AIIMS) New Delhi. Dr. Shriram had the destiny to return to Andhra Pradesh (AP) state and I joined King Edward (VII) Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai. Thus, the fond memories of more than six decades spent with him overwhelm my feelings.

Covid-19 and Cancer: A Scientometric Assessment of India's Publications During 2020–21

The article examines and evaluates India's research output on the theme ‘Covid-19 and Cancer’ using bibliometric methods. A total of 520 India's publications were identified on the topic of ‘Covid-19 and Cancer’ in Scopus database, that were cited 2713 times with an average of 5.22 citations per paper. About 12.11% of these publications received external funding support and registered 8.25 citations per paper. The largest number of India's publictaions (88.46%) were published in Medicine journals and adults constitutes the largest population age group (15.38%) studied among India's total publications. Lung cancer research constitutes the largest publications share (9.42%) among different types of cancers and surgery reported the largest publication share among treatment methods studies in India's total publications on this topic. The maximum number of publications emerged from USA, Italy and U.K. (2641, 1357 and 1153 publications), and publications from China (24.56, Spain (14.52) and Italy (13.12) received the highest citation per paper. The organisations that produced the highest number of publications were Tata Memorial Hospital, Mumbai (75 papers), All India Institute of Medical Sciences, New Delhi (63 papers), Homi Bhabha National Institute, Mumbai (59 papers) and Postgraduate Institute of Medical Education & Research, Chandigarh (35 papers). The organisations with highest citation impact per paper and relative citation index were Tata Medical Center, Kolkata (13.0 and 2.49), BHU-Varanasi (12.70 and 2.43), VMMC and Safdarjang Hospital, New Delhi (5.0 and 0.96) and Tata Memorial Hospital, Mumbai (4.73 and 0.91). The authors that produced the highest number of publications were B. Biswas (12 papers), S. Bhatnagar (11 papers) and A. Batra (9 papers). The authors who had the highest citation impact per paper and relative citation index were P. Chaturvedi (13.25 and 2.54), C.S. Pramesh (12.29 and 2.35) and S. Gupta (4.0 and 0.77). The journals that produced the highest number of publications were Indian Journal of Medical and Paediatric Oncology (with 28 papers), Indian Journal of Surgical Oncology (19 papers) and Journal of Surgical Oncology (18 papers) and the most impactful journals were Clinical Oncology (19.17), JCO Global Oncology (19.09) and Indian Pediatrics (17.80). The most studied subfields as reflected in keyword frequency were Covid-19, Pandemic (332), Neoplasms (175), Cancer Patients (112), Malignant Neoplasm (100), Cancer Surgery (79) and Cancer Chemotherapy (66).

Role of Placental laterality as a Predictive Tool for Preeclampsia

Objective: To study role of Ultrasound determined placental laterality as a predictor of preeclampsia Methods: This prospective study was conducted in the Department of Obstetrics and Gynaecology, VMMC & Safdarjang Hospital, New Delhi from Feb 2019 to July 2019. Three hundred pregnant women attending antenatal clinic both OPD and IPD between 16 to 20 weeks of gestation without any high risk factor were subjected to ultrasound examination as a part of routine antenatal examination and placental location was determined. These cases were followed up for the development of preeclampsia. Results :Out of the 300 women studied 241 had central placenta (Group A) and 59 had laterally located placenta (group B).Out of 59 women with lateral placenta, 29 (49.2%) developed preeclampsia while out of the 241 women with central placenta only 19 (7.88%) developed preeclampsia. This was statistically significant (p value<0.0001). The sensitivity, specificity, positive predictive value and negative predictive value of placental laterality as a predictor for preeclampsia was 64.18%, 83.19%, 53.16% and 88.64% respectively. Conclusion: Placental laterality by ultrasound d at 16-20 weeks; is a simple, cheap and effective method ,establishing its role as early predictor of pre-eclampsia.

To Study the Coagulation Profile Derangements in Metabolic Syndrome

Introduction: The metabolic syndrome is a complex disorder characterized by the presence of a clustering of metabolic risk factors usually in a single individual associated with the presence of central obesity and a strong association with diabetes and cardiovascular disease morbidity and mortality. It is a fast spreading global pandemic & emerging as a public health problem with poor outcome and Quality of life thus more predilection is towards preventive than curative treatment. According to WHO Clinical Criteria, Metabolic syndrome is defined as insulin resistance, identified by 1 of the following, Type 2 diabetes, fasting blood glucose more than 110 mg/dl plus any 2 of the following: antihypertensive medication and /or high blood pressure > 140 mm systolic or >90 mm diastolic, plasma triglyceride (TG) level more than 150 mg/dl (1.7 mmol/L), high-density lipoprotein (HDL) cholesterol level less than 35 mg/dl (0.9 mmol/L) in men or less than 39 (1.0 mmol/L)in women , BMI >30 kg/m2 and/or waist:hip ratio >0.9 in men, > 0.85 in women, Urinary albumen excretion rate > 20 mcg/min or albumin:creatinine ratio>30mg/g Aims & Objectives: To investigate the coagulation profile derangements in metabolic syndrome. To study the relationship of various components of metabolic syndrome with coagulation parameters. Material & Methods: This was a prospective cross-sectional study carried out in Haematology & Medicine Deptt of SafdarJang Hospital, New Delhi. After taking consent from the Hospital Ethics Committee, a total of 50 cases of metabolic syndrome presenting as outpatient or inpatient were included in the study. 50 age & sex matched controls were selected which did not satisfy the criteria for metabolic syndrome. Observation & Results: In our study we found that the cases with metabolic syndrome have significantly increased levels of Fibrinogen, Factor VIII and Plasminogen Activator Inhibitor1 (PAI1). PT & APTT were shorter in cases with metabolic syndrome. The mean value of fibrinogen in cases was 402.24 ± 66.92 mg/dl while that in control was 261.5 ± 41.95 mg/dl with a P value of <.0001 which was statistically significant. The mean value of Factor VIII in cases was 152.66 ± 7.54 IU/dl while that in control was 131.44 ± 6.24 IU/dl with a P value of <.0001 which was statistically significant. The mean value of Plasminogen Activator Inhibitor1 (PAI1) in cases was 49.99 ± 5.34 ng/ml while that in control was 36.75 ± 3.35 ng/ml with a P value of <.0001 which was statistically significant. Prothrombin Time (PT) values in cases were 9.79 ± 0.74 seconds and in controls were 12.04 ± 0.7 seconds & this difference was statistically significant (p<.0001). Activated partial Thromboplastin Time (APTT) values in cases were 28.96 ± 0.92 seconds and in controls were 32.6 ± 1.34 seconds & this difference was statistically significant (p<.0001). Conclusions: The coagulation parameters studied correlated significantly with the components of metabolic syndrome. The values varied significantly with increased number of features of metabolic syndrome. Thus we can conclude that metabolic syndrome is a hypercoagulable state and further studies are required for further evaluation of the consequences of this hypercoagulable state.. Disclosures No relevant conflicts of interest to declare.

Clinico-hematological profile of anaemia in adolescent girls in a tertiary care hospital of North India

Background: Anaemia in adolescent girls leads to foetal morbidity and mortality in future. The current study was done with the aim to study the clinico-haematological profile of anaemia in adolescent girls in a tertiary care hospital of North India.Methods: An observational study was conducted among 50 adolescent girls with anaemia (Hb <12 g/dl) in the Department of Medicine in collaboration with Department of Pediatrics and Department of Haematology at VMMC and Safdar-jang Hospital, New Delhi. Detailed previous history of the patients was collected. Blood samples were collected from all the patients and analysed for hematological parameters. Data were analysed statistically and p values less than 0.05 was considered significant.Results: The prevalence of anaemia was common in the patients of age group of 15-19 years (58%). The common symp-tom observed was fatigue (82%). Pallor was the common sign noticed in 66% patients. Majority of the patients with anaemia belongs to upper lower class (52%). Mean value of haemoglobin was high (7.80±1.22) in microcytic hypo-chromic anaemia compared to other types of anaemia. Serum iron levels were low in both microcytic and dimor-phic group but the difference was statistically not significant (p=0.43). Serum vitamin B12 levels were low in mac-rocytic and dimorphic anaemia and the difference was statistically significant (p=0.001).Conclusions: This study showed that nutritional deficiency anaemia was more prevalent in adolescent girls of age group between 15-19 years of upper lower socioeconomic status. Nonspecific symptoms like fatigue and weakness should not be ignored in the adolescent girls as they could be important indicators towards incidence of anaemia in these patients.

Changing Trends in Clinical Profile of Cerebral Palsy

Abstract Background There may be change in clinical spectrum of cerebral palsy (CP) due to improvement in maternal and child care health service. The clinical profi le, aetiological factors and comorbidities of children with CP attending Department of PMR, VMMC & Safdarjang Hospital during the years 1981- 1989 and 2008 - 2012 were therefore compared and analysis done. Methods Four hundred and ten (group B) children with CP registered in last 4 years (2008 - 2012) at PMR Department of VMMC & Safdarjang Hospital were compared with previous study of 544 (group A) children during year 1981 - 1989 from same centre. Results Spastic CP remained most common in both the groups. Diplegia is commonest type of CP (38.78%) as compared to previous group where quadriplegia (34.9%) was most common. The mixed type showed a statistical signifi cant increase in percentage (group A: 0.18 % versus group B: 3.7 %). In aetiology, there is decrease in prenatal and postnatal causes and increase in natal causes which were statistically signifi cant. Birth asphyxia (50.3 %) remains the main aetiological factor as earlier (24.5%). Speech problems (59.7%), mental retardation (31.7%) and seizures (26.8%) are common comorbidities as compared to previous studies where mental retardation (47.2 %) was found to be most common followed by speech impairment (37%), visual impairment (9%) and seizures (8.8%). Conclusions Clinical profile of CP has evolved with an increase in diplegic and a decrease in quadriplegic CP.

Prophylactic Low Molecular Weight Heparin Improving Perinatal Outcome in Non-thrombophilic Placental-Mediated Complications.

To study the role of low molecular weight heparin (LMWH) in perinatal outcome. A randomized, case control study was conducted at Safdarjang hospital, New Delhi. Patients were recruited from Sept. 2011 to May 2013 and were followed up till delivery. Thirty cases and controls were enrolled which comprised non-thrombophilic patients with previous history of preeclampsia, fetal growth restriction, abruption, and stillbirth (>20weeks). Study group received daily single dose of LMWH depending upon the weight, subcutaneously; it was started before 15weeks of gestation and continued up to 36weeks. Nursery/NICU admission, APGAR score at 0 and 5min, birth weight, gestational age at delivery, mode of delivery were observed among the interventional and control groups. There was substantial reduction (80%) in nursery/NICU admission. The mean gestational age and birth weight of the cases were observed to be higher as compared to those of control (38.05±2.02 vs. 37.58±2.06weeks and 2770±400 vs. 2530±0.533g). Prophylactic LMWH before 15weeks of gestation improved the perinatal outcome in non-thrombophilic pregnant women.

Antifungal Resistance Patterns, Virulence Attributes and Spectrum of Oral Candida Species in Patients with Periodontal Disease

Aims: To observe the antifungal resistance pattern, virulence attributes and spectrum of Candida species in oral cavities of patients with periodontal diseases and healthy individuals. Study Design: A total number of 52 patients with periodontal disease and 100 healthy subjects were included in the study. Place and Duration: The study was carried out in the Apex Regional STD Teaching, Training and Research Centre, VMMC and Safdarjang Hospital and Department of Biosciences, Jamia Millia Islamia, New Delhi. Duration of the study was from December 2011 to June 2013. Methodology: Oral swabs were collected from the patients and control group. The specimens Original Research Article Kumar et al.; BMRJ, 5(1): 68-75, 2015; Article no. BMRJ.2015.008 69 were cultured for Candida and the species identified, according to standard protocols. Antifungal susceptibility testing and virulence tests were performed. Results: Out of 52 patients screened 11 yielded (21%) different Candida species, with Candida albicans (83%) being the commonest and non Candida albicans Candida (NCAC) species accounting for 17 %. Among 100 healthy controls, 23 were colonized by various Candida species, with Candida albicans again as the predominant species. A significant difference (P =.002) was observed in the secretion of proteinase enzyme between the isolates from cases and controls. However, in the distribution of Candida species, antifungal resistance patterns, phospholipase secretion and biofilm formation there was no such significant difference. Conclusion: Our results reveal that there is no significant difference in the distribution of Candida species among healthy subjects and patients with periodontal diseases. Antifungal resistance patterns and expression of some of the important virulence attributes also revealed no differences between the isolates from patients and control populations.

Clinical profile and treatment status of subjects with cleft lip and palate anomaly in India: Preliminary report of a three-center study

Context: Treatment of patients with cleft lip and palate (CLP) anomaly requires a multidisciplinary approach from birth until adulthood. Many children with cleft anomaly are born in rural areas where resources for treatment and awareness on cleft care are limited. Consequently, many patients may receive limited or suboptimal care due to multitudes of reasons. Aims: The current study was aimed to record the baseline data on the spectrum of clinical profile of cleft patients, treatment protocols, quality of treatment and the residual treatment needs of patients with CLP anomaly visiting three major hospitals across Delhi and National Capital Region (NCR). The experience gained from the three-center study would be used to lay a framework to conduct a nationwide multicenter study in terms of logistics, feasibility and difficulties. Materials and Methods: The study titled CLP anomaly in India: Clinical profile Risk factors and current status of treatment: A hospital based study was started in 2010 as a Task Force project of Indian Council of Medical Research. The Pilot phase, which started in 2012, encompassed three cleft centers across Delhi and NCR, namely, All India Institute of Medical Sciences, Safdarjang Hospital and Medanta - The Medicity. Data for 126 non-syndromic CLP subjects was recorded on a specially designed performa. Each case was evaluated by a team of specialists comprising of a Plastic Surgeon, an Orthodontist, ENT Surgeon, Dental Surgeon, Speech therapist and an Audiologist. Clinical records included profile and intraoral photos, dental study models, audiometric and speech evaluation data. The current paper attempts to highlights a few of relevant observations of the pooled data from three centers. Results and Conclusions: The results indicate a lack of uniform protocol followed in providing care to cleft patients. A great variation was found in the quality of treatment received by many of the patients.

Deformities and Bony Changes in Leprosy

Abstract India has eradicated leprosy as per WHO norms but the cases with residual deformities will persist for long. With this idea, a study was undertaken on consecutive 70 patients coming to the outpatient section of Physical Medicine and Rehabilitation Department of Safdarjang Hospital, New Delhi to study various deformities and bony changes. All the patients were leprosy cured but attending hospital for their deformities only. Specific bony changes were seen in multibacillary patients, while the non-specific and osteoporotic changes were seen in all types of patients. Patients appeared more willing to get the deformities treated than hiding the same from the society.

The clinical presentations of penile tuberculosis

International Journal of DermatologyVolume 52, Issue 6 p. 759-761 Commentary The clinical presentations of penile tuberculosis V. Ramesh MD, Corresponding Author V. Ramesh MD Departments of Dermatology & STD, Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical Sciences, New Delhi, India Correspondence Dr. V. Ramesh, md Departments of Dermatology & STD Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical SciencesNew DelhiIndia E-mail: weramesh@hotmail.comSearch for more papers by this authorM. Ramam MD, M. Ramam MD Departments of Dermatology & STD, Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this authorPooja Pahwa MD, DNB, Pooja Pahwa MD, DNB Departments of Dermatology & STD, Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this authorShalini Malhotra DNB, Shalini Malhotra DNB Departments of Dermatology & STD, Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this author V. Ramesh MD, Corresponding Author V. Ramesh MD Departments of Dermatology & STD, Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical Sciences, New Delhi, India Correspondence Dr. V. Ramesh, md Departments of Dermatology & STD Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical SciencesNew DelhiIndia E-mail: weramesh@hotmail.comSearch for more papers by this authorM. Ramam MD, M. Ramam MD Departments of Dermatology & STD, Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this authorPooja Pahwa MD, DNB, Pooja Pahwa MD, DNB Departments of Dermatology & STD, Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this authorShalini Malhotra DNB, Shalini Malhotra DNB Departments of Dermatology & STD, Vardhman Mahavir Medical College & Safdarjang Hospital and All India Institute of Medical Sciences, New Delhi, IndiaSearch for more papers by this author First published: 17 May 2013 https://doi.org/10.1111/j.1365-4632.2012.05797.xCitations: 6 Conflicts of interest: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume52, Issue6June 2013Pages 759-761 RelatedInformation

Delhi Rape Case

A twenty-three years old female medical student was gang raped on December 16, 2012 in a public bus in Delhi, India. The woman, whose name was not revealed due to Indian laws, was taken to the Safdarjang Hospital where she had gone through multiple surgeries and was placed on ventilation. She was sent to Elizabeth Hospital, Singapore on December 26 for the transplantation of her damaged organs but unfortunately she was died while undergoing emergency treatment on December 29.

Effect of literacy on family planning practices among married women in rural south India

International Journal of Medicine and Public Health,2012,2,4,27.DOI:10.5530/ijmedph.2.4.5Published:Oct 2012Type:Original ArticleEffect of literacy on family planning practices among married women in rural south IndiaRizwan S A, Ankita Kankaria, Ronald K. Roy, Ravi P. Upadhyay, Palanivel C, Vinoth Gnana Chellaiyan, and Surendra Babu D Rizwan S A.1, Ankita Kankaria1, Ronald K. Roy2, Ravi P. Upadhyay3, Palanivel C.4, Vinoth Gnana Chellaiyan3 and Surendra Babu D.1 1MBBS. Resident, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India 2MBBS. Resident, Madurai Medical College, Madurai, Tamilnadu, India 3MD. Resident, Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi, India 4MD. Assistant Professor, Indira Gandhi Medical College and Research Institute, Puducherry, India Abstract:Background and Aim: Few studies in India have tried to examine the role of female literacy on contraception usage. This study aimed to determine family planning related knowledge and practices and their association with female literacy. Materials and methods: Facility based cross-sectional study was done among married women aged 15–45 years attending outpatient department of three primary health centres in rural Tamilnadu. Data were collected using pretested semistructured questionnaire by a convenience sampling technique. To assess family planning related knowledge, a composite score was calculated and final score was categorised into satisfactory and unsatisfactory. Results: A total of 100 women participated. Fifty nine percent had satisfactory Family Planning related Knowledge and practices (FPK). Contraception prevalence rate for modern methods was 60%. Eighty percent had ever undergone abortions and among them, one fifth had undergone uncertified abortions.With increase in the literacy status, proportion having satisfactory family planning related knowledge increased (p < 0.001) and the parity decreased (p < 0.001). More literate women were using contraception, had undergone sterilization, had undergone certified abortions and had less male child preference compared to illiterate women. Conclusion: This study offers evidence that promotion of female literacy could be considered a strategy for promoting contraceptive usage and addressing population growth in India. Keywords:Contraception, Facility based study, Family Planning, Female literacy, IndiaView:PDF (324.8 KB)

A pilot study for diagnosis of genital Chlamydia trachomatis infections by polymerase chain reaction among symptomatic Indian women

Chlamydia trachomatis is the most common bacterial etiology of sexually transmitted infection. A pilot study was designed using PCR for amplification and detection of a specific 517 bp sequence of the common endogenous plasmid of C. trachomatis from clinical swab specimens obtained from symptomatic female patients attending STD clinics of AIIMS and Regional STD Teaching, Training & Research Center, Safdarjang Hospital, New Delhi. 97 patients were recruited in the study, and endocervical swabs were collected following standard procedures. The samples were analyzed by PCR and direct fluorescence antibody (DFA) for detection of C. trachomatis, and the sensitivity, specificity, PPV and NPV of PCR were calculated taking DFA as gold standard. Out of 97 samples tested, 9 were positive for C. trachomatis by PCR. 1 PCR positive patient was negative by DFA although a total of 11 patients were positive by DFA. The sensitivity, specificity, PPV and NPV of PCR with reference to DFA was 72.73%, 98.84%, 88.89% and 96.59%, respectively. This PCR had high specificity and NPV for detection of C.trachomatis. In light of the introduction of enhanced syndromic approach, which involves the use of laboratory techniques (wherever possible) to confirm clinical diagnosis, a diagnostic PCR with high specificity and NPV is particularly valuable for determination of etiological diagnosis and hence contribute to judicious use of antimicrobials in the community.

Assessment of psychological status and quality of life in patients with facial burn scars

Introduction : This study was carried out in the Department of Burns, Plastic and Maxillofacial Surgery, Safdarjang Hospital, New Delhi. Aim : The aim of this study was to assess the psychological status of patients with facial burn scars and to assess the quality of life (QOL) of these patients. Materials and Methods : The study was performed on 20 patients who were interviewed to assess depression (psychological status) and QOL. The assessment of depression was carried out using Beck's depression inventory, which has been translated into Hindi for use. The depression based on this questionnaire was graded into present or absent and further into mild, moderate and severe if present. QOL was assessed using the World Health Organization (WHO) QOL index questionnaire. The QOL was assessed to determine the environmental well being, adjustment to social relations, psychological well being and physical health and level of independence. The assessment of the patients was compared with the general population of similar socioeconomic strata. Results : The study showed presence of depression in all the studied subjects, with more females in the moderate and severe group of depression and more males in the mild group of depression. QOL assessment revealed significant derangement of psychological well being and social interaction in all subjects, but the physical abilities and environmental interaction were comparable to the normal subjects. Further, it is concluded to carry out larger and well-designed studies in burn and trauma patients to establish a protocol for assessment and management of post-traumatic stress disorders.

Diagnostic implications of 16S ribosomal assay for gonorrhoea

ObjectivesIn the absence of a single nucleic acid amplification test (NAAT) that is both highly specific and sensitive for gonorrhoea, many have put forward the 16S-based assay as a confirmatory...

Seroprevalence of antibodies against Chlamydia trachomatis inclusion membrane proteins B and C in infected symptomatic women

Proteins in the inclusion membrane of Chlamydia trachomatis (CT) have been anticipated to play pivotal roles in the molecular and cellular interactions between the pathogen and host. However, there is lack of data on host immunity with respect to antibody responses against chlamydial inclusion proteins. We used full-length fusion proteins for CT inclusion membrane proteins B and C (IncB and IncC respectively), two early-infection phase proteins, to study their role in antibody generation during human infection. Three hundred and fifty-five women (aged 22-36 years) attending the Gynaecology outpatient department, Safdarjang Hospital, New Delhi, India were enrolled in this hospital ethical committee approved study. Out of these, 108 were diagnosed to be cervical CT-positive. Of these 108 patients, 67 (62.03%) showed ELISA positivity for IncB IgG, and 64 (59.25%) for IncC IgG. There was a positive correlation between antibody titres against IncB and IncC and with antibodies against CT major outer membrane protein (MOMP) in CT-positive sera. Our data also showed a positive association between antibody titres against IncB and IncC in patients with cervicitis and pelvic inflammatory disease (PID). Significantly high antibody titres were detected in cervicitis cases compared with PID. There were significantly higher levels of serum cytokines (TNF-alpha, IFN-gamma and IL-12) in Inc-positive cervicitis cases than in PID cases. In addition, our study also showed higher IncB and IncC IgG(2) titres in comparison to respective IgG1, IgG3 and IgG4 titres in CT-positive sera. Our data suggested that antibodies against CT IncB and IncC were prevalent in CT-positive women diagnosed with cervicitis or PID.

Epidemiology of sleep disorders in pregnant subjects: A questionnaire based survey

Introduction There are several changes which occur during the pregnant state that can impact directly or indirectly on breathing. A questionnaire based survey of sleep disorders amongst pregnant subjects attending a tertiary care hospital in New Delhi. Material & Methods The study was based on a questionnaire. It contained, besides personal identification of the subject, a set of 35 questions. In addition it also had the Epworth Sleep Questionnaire. A validated questionnaire for anxiety and depression was also used. Details of present pregnancy (parity, gravida, last menstrual period, expected date of delivery and period of gestation) was also recorded. The total number of pregnant subjects interviewed was 325. They were selected randomly from those attending the ante-natal clinic of Safdarjang Hospital & Vardhman Mahavir Medical College, New Delhi. Observations The overall prevalence of snoring was 13.5%. It correlated positively with depression (p<0.075) and gestation period (p<0.016). The overall prevalence of SDB was 9.5%. It correlated positively with gestation period (p<0.042) BMI (p<0.05) and disorders of initiation & maintenance of sleep (DIMS) (p<0.005) and depression (p<0.021). The overall prevalence of DIMS was 47.6%. The prevalence of DIMS was maximum in the third trimester; and it showed a positive correlation with rising gestation period. The overall prevalence of Restless Leg Syndrome (RLS) was 15.7%. It was most prevalent in age group 21-25 years (p<0.045). It showed rising trend with increase in gestation period (p<0.049), increasing parity (p<0.071) and decreasing hemoglobin concentration (p<0.047). The overall prevalence of depression was 11.4%. It correlated positively with increasing parity (p<0.045). The overall prevalence of anxiety was 18.1%. It correlated negatively with increasing age (p<0.057) & BMI (p<0.067) and positively with increasing gestation period (p<0.099). The overall prevalence of excessive daytime sleepiness (EDS) was 30.5%. It correlated negatively, with

Soluble and membranous vascular endothelial growth factor receptor-1 in pregnancies complicated by pre-eclampsia

Vascular endothelial growth factor receptor-1 (VEGFR-1) is essential for the normal development and function of the placenta. Defective placental vasculogenesis and trophoblast function may lead to pre-eclampsia, a pregnancy-specific syndrome of hypertension and proteinuria. In order to study the association of VEGFR-1 with the development of pre-eclampsia, a cross-sectional study was carried out to evaluate the concentration of soluble VEGFR-1 (sVEGFR-1) in 360 serum samples and to analyze the expression of membranous VEGFR-1 in 40 placental samples of normal and pre-eclamptic pregnant women. Serum and placental samples at different gestational ages were collected from the Department of Obstetrics and Gynaecology, VMMC and Safdarjang Hospital, New Delhi. The serum levels of sVEGFR-1 and the expression of membranous VEGFR-1 were estimated by enzyme-linked immunosorbent assay and immunohistochemistry, respectively. The serum levels of sVEGFR-1 were seen to be positively increased (p=0.0001) in patients with pre-eclampsia at different gestational intervals as compared to the healthy pregnant women they were matched with. However, receiver operating characteristic (ROC) curve analysis showed a higher sensitivity (89.17%) and specificity (90.0%) in early onset (< or =34 weeks) in contrast with the late-onset (>34 weeks) pre-eclamptic group. Also, significant up-regulation of membranous VEGFR-1 immunoreactivity was observed in all placental cells (syncytiotrophoblast, cytotrophoblast, endothelial cells and Hofbauer cells) of pre-eclamptic groups in both < or =34 weeks (p=0.0001) and >34 weeks (p=0.0001) as compared to the normal group. Elevated sVEGFR-1 serum levels and up-regulated membranous VEGFR-1 expression in placenta denote abnormality in VEGF-mediated function in all placental cells, and thus may contribute to etiopathogenesis of pre-eclampsia. Nevertheless, this study also shows the possible diagnostic utility of sVEGFR-1 as a sensitive and specific biomarker for the early onset (< or =34 weeks) of pre-eclampsia.