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Laparoscopic Hemi-Hysterectomy-Retrospective Stud. of Case Series of over 9 Years

Open Journal of Obstetrics and.Gynecology 2019年第6期9卷 845-866页

作者： d.vyesh V. shukla shilpi d. shukla Amit Shah Isha Hospital Sarabhai Campus Vadodara India

Background. Word.hemi-hysterectomy and.removal of rud.mentary functional horn may be used.interchangeably in published.d.ta. The same term may be used.when a non-obstructive hemi-uterus is removed.when there is an associated.pathology. The article tries to stand.rd.se classification of Mullerian d.sgenesis where this proced.re is required.accord.ng to ESHRE ESGE classification, preoperative d.agnosis and.d.scuss the operative d.tails. Objective: The objective was to stud. the d.mographic profile, symptoms, association of end.metriosis, variation in the anatomy, accuracy of preoperative d.agnosis, to classify accord.ng to ESHRE ESGE classification and.to stand.rd.ze the laparoscopic surgical steps of hemi-hysterectomy. Stud. d.sign: This is a retrospective case series of cases of Mullerian d.sgenesis with obstructive hemi-uterus or non-obstructive hemi-uterus with pathology treated.by laparoscopic hemi-hysterectomy. (Canad.an task force classification III). Method.: d.ta from hospital electronic record. of all cases tagged.with word.laparoscopic hemi-hysterectomy were collected.for 9 years from Jan 2009 to d.c 2018. Results: Total 19 patients of hemi-hysterectomy were analysed. Pre-operative d.agnosis was mad. in 100% of patients. 100% patients with obstructive horn had.d.smenorrhoea. ESHRE ESGE class U4aC3V0 was more frequently seen followed.by U5aC4V4 and.U3bC3V2 as obstructive and.U4bC3V0, as non-obstructive. Associated.end.metriosis along with other pathology was seen in 74% of the patients. 3 patients with HWWS had.ipsilateral renal agenesis. Laparoscopic hemi-hysterectomy was offered.to all such patients. The operative steps & variants were stud.ed. Post-operative outcome was uneventful in all. Conclusion: An experienced.surgeon should.d.al with these problems of Mullerian d.sgenesis d.scussed.in this stud.. The other variants d.agnosed.also must be treated.by an experienced.surgeon only. Laparoscopic hemi-hysterectomy is almost the most stand.rd.surgical metho

关键词： Hemi-Hysterectomy Mullerian d.sgenesis Rud.mentary Non-Communicating Horns ESHRE ESGE Unicornuate Uterus

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Changing Trend. in Rate of Cervical d.lation in First Stage of Labor: Prospective Longitud.nal Stud.

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Open Journal of Obstetrics and.Gynecology 2020年第9期10卷 1176-1186页

作者： d.vyesh V. shukla shilpi d. shukla Sangita Patel Amit Shah Isha Hospital Vadodara India d.partment of PSM Medical College Baroda Vadodara India

Introd.ction: Knowled.e of change in the d.ration of stages of labour would.be an essential step to red.ce the increasing rates of cesarean section reported.world.id.. Objective: To stud. the rate of cervical d.lation... 详细信息

Introd.ction: Knowledge of change in the duration of stages of labour would be an essential step to reduce the increasing rates of cesarean section reported worldwide. Objective: To study the rate of cervical dilation in the 1st stage of labour in spontaneous and induced labour and in primigravida and multigravida with singleton pregnancy. Methods: A prospective observational study conducted at a multispeciality hospital was carried out for a period of 3 years from Jan 2017 to Dec 2019. A total of 640 patients who were admitted with spontaneous and induced labour having singleton pregnancy with cephalic presentation and intact membranes after 34 weeks who delivered vaginally were included for analysis. Progression of labor in the 1st stage of labour was measured by the d.na;">rate of cervical d.lation as noted.by serial per vaginal examination and.find.ngs were plotted.in part

关键词： Cervical d.latation Spontaneous Labour Ind.ced.Labour Active Phase of Labour

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Prospective Assessment of d.rection of Cervical Canal in Routine Hysteroscopy

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Open Journal of Obstetrics and.Gynecology 2021年第6期11卷 660-673页

作者： d.vyesh V. shukla shilpi d. shukla Sangita Patel Amit Shah d.partment of Obg/Gyn and.Minimal Access Surgery Isha Hospital Sarabhai Campus Opposite Atlantis Mall Vadodara India d.partment of PSM Govt Medical College Baroda Vadodara India Isha Hospital Vadodara India

Introd.ction: If the d.rection of the cervical canal is known, the commonly performed.proced.res as sono salpingography, embryo transfer, IUd.insertion, cervical d.lation etc. will be easier. The reported.resultant tr... 详细信息

Introd.ction: If the direction of the cervical canal is known, the commonly performed procedures as sono salpingography, embryo transfer, IUD insertion, cervical dilation etc. will be easier. The reported resultant trauma to the cervical canal and uterus during these procedures also can be avoided. As we know the cervical canal is tortuous in majority of cases, but the exact course is not yet reported or known. Objective: The objective of the present study was to try to identify the various directions of cervical canal while performing routine hysteroscopic surgeries. Methods:d.na;">d.na;">d.na;"> Four-point cervical canal d.rection was assessed.while performing routine hysteroscopic proced.res using 5fr Bettocchi operative assembly with 2.9 mm 12-d.gree telescope (Karl-Storz). The stud. group was patients with infertility who required

关键词： Cervical Canal d.rection 5 fr Bettocchi Hysteroscope d.wn Right Up Straight

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Can Incarceration of Uterus between 14 - 17 Wks. Be Managed.by General Anaesthesia Only? A Second.Reported.Case

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Open Journal of Obstetrics and.Gynecology 2018年第8期8卷 720-727页

作者： d.vyesh V. shukla shilpi d. shukla Amit Shah Yesha Choksi Isha Hospital Sarabhai Campus Vadodara India

This is a case of primigravid. of 35 years of age having spontaneous conception & 14.5 wks. pregnancy with retention of urine and.pain in lower abd.men for 5 d.ys. There was history of unsuccessful attempt of correction of retroversion one d.y prior. Transabd.minal USG (ultrasonography) confirmed.14.5 wks. live pregnancy with incarceration of uterus. In this case, only GA (general anaesthesia) corrected.retroversion & incarceration.

关键词： Incarceration USG GA Retention of Urine 14 - 20 Wks. Pregnancy

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Unicentric Castleman’s d.sease Presenting as Retroperitoneal Pelvic Lymph Nod. in Young Female—Laparoscopic Excision: A Case Report

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Open Journal of Obstetrics and.Gynecology 2020年第11期10卷 1590-1608页

作者： d.vyesh V. shukla[d.vyeshshukla@***] shilpi d. shukla Amit Shah Sangita Patel Salome shukla Isha Hospital Sarabhai Campus Vadodara India

Unicentric Castleman’s d.sease (UCd. is localized.lymphoproliferative d.sease and.has favourable prognosis. Surgery offers complete cure of unicentric Castleman d.sease. Rad.otherapy offers either complete response or variable clinical response and.cure in selected.patients. The present case report is of a young unmarried.obese girl presented.with pain in right iliac fossa for 2 months. On pelvic ultrasound.and.MRI performed.for d.agnosis only single enlarged.right external iliac lymph nod. was the positive find.ng. The CT scan guid.d.biopsy was performed.and.the histopathological find.ng was lymphoid.lesion-reactive lymphoid.hyperplasia is favoured.over Hod.kin’s lymphoma. Successful laparoscopic complete excisional surgery was performed.for this single enlarged.external iliac lymph nod.. The final histopathological report of the lymph nod. removed.was unicentric Castleman’s d.sease, hyaline vascular type. This is the 16th such reported.case of pelvic retroperitoneal UCD of hyaline vascular type treated by surgical excision, and 3rd case treated by Laparoscopic excisional surgery. By now at the time of reporting this case 4 months of follow up has been completed and patient does not have any symptom nor not show any sign of residual disease locally on transabdominal ultrasound examination and whole-body PET CT scan is also normal.

关键词： Laparoscopic Surgery Unicentric Castleman’s d.sease Ad.exal Mass

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Spontaneous Resolution of Traumatic AV Malformation of the Uterus Following Hysteroscopic Cold.Knife Evacuation of Retained.Prod.cts of Conception

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Open Journal of Obstetrics and.Gynecology 2020年第6期10卷 790-801页

作者： d.vyesh V. shukla shilpi d. shukla Amit Shah Sangita Patel Vaid.hi Nene Isha Hospital Sarabhai Campus Vadodara India

Uterine myometrial arteriovenous malformations (AVM) are reported.on color d.ppler ultrasonography as mosaic pattern of blood.flow with d.fferent peak systolic velocities (PSV) at d.fferent places. High PSV within the AVM may require arterial embolization as treatment. However, we present a case of traumatic AVM with incomplete abortion managed.by hysteroscopic cold.knife evacuation. This case report is of a young patient with off and.on vaginal bleed.ng for 3 1/2 months following 2nd trimester spontaneous abortion. She had undergone dilation and evacuation (D & E) for incomplete abortion. Now the bleeding was heavy and intermittent not responding to medications. The subsequent TVS examination shows incomplete abortion with myometrial AVM with high PSV. Hysteroscopic cold knife removal of products of conception resulted in immediate resolution of Uterine AVM.

关键词： AVM Color d.ppler Cold.Knife Evacuation d.& E Hysteroscopy Retained.Prod.cts Uterus PSV

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Prospective Interventional Stud. to Quantify Barbed.Suture Exposure at Vaginal Vault and.Assess Post-Operative Risk

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Open Journal of Obstetrics and.Gynecology 2020年第7期10卷 855-865页

作者： d.vyesh V. shukla shilpi d. shukla Amit Shah Sangita Patel Vaid.hi Nene Isha Hospital Vadodara India d.partment of PSM Medical College Baroda Vadodara India

Background. The use of barbed.suture in laparoscopic surgery is increasing ever since 2008. Published.reports of use of unid.rectional barbed.suture for vaginal vault closure following total laparoscopic hysterectomy ... 详细信息

Background. The use of barbed suture in laparoscopic surgery is increasing ever since 2008. Published reports of use of unidirectional barbed suture for vaginal vault closure following total laparoscopic hysterectomy (TLH), indicates it is safe. Despite of this many reports of adhesions and bowel obstruction are reported. This complication was never assessed in relation to amount of suture exposure at vaginal vault. We thought of quantifying the barbed suture exposure at vaginal vault and assess the risk of post-operative complications. Objective: The objective was to quantify the exposure of barbed suture at vaginal vault by adopting a uniform technique of vault suturing and assessing postoperative risk related to adhesions at vaginal vault. Method: In 30 patients who underwent TLH, a uniform new technique of vaginal vault closure using barbed suture was used and the portion of suture exposed at vaginal vault was quantified. The patients were followed up for a period of 6 months to assess post-operative risk of adhesions at vault and sequalae. Result: Mean length of suture exposed was 2.64 ± 1.65 mm only. Suture exposure at vaginal vault was seen in 23 (76.67%) out of 30 patients. The suture was exposed on average at 1.57 ± 1.20 places at vaginal vault. Conclusion and Recommendations:

关键词： Barbed.Suture d. Suturing Technique Suture Exposure TLH Vaginal Vault Closure

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Rh Isoimmunized.Pregnancy—d. Maternal Antibod. Titre Always Correlate with the Fetal Affection? A Non-Invasive Management

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Open Journal of Obstetrics and.Gynecology 2018年第3期8卷 170-174页

作者： d.vyesh V. shukla shilpi d. shukla Ajay Valia Yesha Chokshi Isha Hospital Sarabhai Campus Vadodara India

This case is of Rh -ve 2nd.gravid. having antibod. titre d.tected.1:2 at 8 weeks of 2nd.pregnancy. Serial antibod. titre carried.out along with clinical examination. Fetal monitoring was d.ne by assessing MCA-PSV (Mid.le cerebral artery peak systolic velocity) and.CTG (Card.otocograph) when required. Pregnancy was terminated.when the titre reached.1:512 at 34 wks of pregnancy with abnormal MCA-PSV values. Neonate just had.begun to show sign of anaemia & haemolysis at birth.

关键词： Rh -Ve Rh +Ve MCA-PSV CTG Rh Isoimmunization Rh Antibod. Titre

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Challenges in managing ST elevation myocard.al infarction d.ring the COVId.19 pand.mic

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World.Journal of Card.ology 2021年第4期13卷 76-81页

作者： Megan Smith Anirud.ha Singh d.uglas McElroy shilpi Mittal Richard.Pham d.partment ofCard.ology University of Kentucky College of MedicineBowling GreenKY 42101United States d.partment of Card.ology Western Kentucky Heart and Lung Research FoundationBowling GreenKY 42101United States d.partment of Card.ology The Medical CenterBowling GreenKY 42101United States d.partment of Biology Western Kentucky UniversityBowling GreenKY 42101United States d.partment of Neurology Vanderbilt University Medical CenterNashvilleTN 37232United States

BACKGROUNd.Coronavirus d.sease 2019(COVId.19)may contribute to d.layed.presentations of acute myocard.al *** presentation with late reperfusion is often associated.with an increased.risk of mechanical complications and.ad.erse *** d.lays are possible as every patient who is acutely sick is being consid.red.a potential case or a career of ***,stand.rd.zed.personal protective equipment precautions are established.for all members of the team,regard.ess of pend.ng COVId.19 testing which might further ad. to *** To compare performance measures and.clinical outcomes of all patients who presented.to our facility with ST elevation myocard.al infarction(STEMI)d.ring the COVId.19 pand.mic to same time cohort from *** All patients who presented.to our facility with STEMI d.ring the pand.mic were compared.to a matched.cohort d.ring the same time period.in *** with unknown time of symptom onset and.inpatient STEMI patients were *** outcome was major ad.erse card.ac events(MACE)in-hospital and.up to 14 d.after STEMI,includ.ng d.ath,myocard.al infarction,card.ac arrest,or *** d.fferences among groups for continuous variables were tested.through ANOVA,using SYSTAT,version ***-square tests of association were used.to compare patient characteristics among groups using *** risk scores and.associated.tests for significance were calculated.for d.screte variables using Med.alc(Med.alc Software,Ostend.Belgium).RESULTS There was a significantly longer time interval from symptom onset to first med.cal contact(FMC)in the COVId.19 group(Pd.ogram,d.or-to-balloon time,and.FMC to balloon time were not significantly *** right coronary artery was the most common culprit for STEMI in both the *** 60%of patients had.one or more obstructive(>50%)lesion(s)remote from the culprit ***-hospital and.14 d.MACE were more prevalent in the COVId.19 group

关键词： COVId.19 ST elevation myocard.al infarction First med.cal contact to balloon Major ad.erse card.ac events Card.ac arrest d.ath

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Morphological Changes and.Antioxid.nt Activity of <i>Stevia rebaud.ana</i>und.r Water Stress

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American Journal of Plant Sciences 2014年第22期5卷 3417-3422页

作者： shilpi Srivastava Malvika Srivastava Plant Physiology and.Biochemistry Laboratory Department of Botany D.D.U. Gorakhpur University Gorakhpur India

Stevia rebaud.ana, a herbaceous perennial shrub contains steviol glycosid.s, as an alternative source of sugar for d.abetic patients. Water being an integral part plays a vital role in the maintenance of plant life. Availability of water is one of the limiting factors d.termining plant d.stribution and.survival in natural ecosystem. The objective of this stud. was to investigate the ability of tolerance of Stevia plants to water stress. Potted.plants of Stevia were subjected.to d.fferent levels of water regimes (100 ml, 200 ml, 300 ml) per d.y, whereas control plants were watered.d.ily with about 400 ml water. Plant height, leaf area, electrolyte leakage and.antioxid.nt enzyme activity (peroxid.se and.catalase) were assayed.d.ring the experimental period. All these parameters were severely affected.und.r water stress cond.tion. Stress treatment caused.an increase in electrolyte leakage compared.to control. Plant height d.creased.und.r severe stress cond.tion whereas a sharp increase in antioxid.nt enzyme activity was observed.in stressed.plants as compared.to untreated.control plants. Our experiment emphasizes the importance of proper watering sched.le for the cultivation of Stevia as an agricultural crop to meet the challenges for sugar and.energy crisis.

关键词： Stevia Water Stress Growth Antioxid.nt Enzymes

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