Factors affecting quality of life of cervical cancer patients: A multivariate analysis

Objective: The aim of good management for cancer survivors should not be limited to only clinical care, but rather it should also include best quality of life (QOL). The objective of this study was to find out various factors affecting QOL in cervical cancer patients so that by modifying these factors, the best QOL can be provided to them. Materials and Methods: This was a prospective cohort study conducted in the Department of Obstetrics and Gynaecology and Department of Radiotherapy, King George's Medical University (KGMU), Lucknow, from May 2015 to July 2016. The cases were selected from patients visiting the outpatient department or who were admitted to the Department of Obstetrics and Gynaecology and Department of Radiotherapy, KGMU. The data information was collected in the form of face-to-face interview using European Organization for Research and Treatment of Cancer general cancer QOL Score 30 (EORTC QLQ C-30) and EORTC QOL questionnaire cervical cancer module (QLQ CX-24) questionnaire. Results: QOL was assessed in 85 patients. Health-related QOL was separately studied in terms of overall general QOL and cancer cervix-specific QOL, and various factors affecting QOL were studied by multivariate analysis. Conclusion: Education, tobacco use, degree of differentiation of tumor, and size of tumor were the independent factors found to have statistically significant effect on QOL of cervical cancer survivors

Acceptance for Human Papilloma virus vaccines, experience at tertiary care centre of northern india: a hospital-based survey

Background: Acceptance of HPV vaccine is varying widely worldwide in   range of 10-70%. For increasing the acceptability for HPV vaccine, finding the obstacles and catering them diligently is required. The aim of the study was to find out acceptability rate for HPV vaccine in northern India and various obstacles and facilitators affecting acceptance of HPV vaccine.Methods: A questionnaire based descriptive study was done in the Department of Obstetrics and Gynecology of King George Medical University, Lucknow, Uttar Pradesh, India from June 2016 to June 2017.  Questionnaire was filled by doctor after taking face to face interview of individuals. Ethical approval was obtained from the Institutional Ethical Committee of the KGMU, Lucknow, Uttar Pradesh, India. (1689/Ethics/R cell/17) acceptability rate and various facilitators and obstacles for HPV vaccine were studied. For continuous variables mean with standard deviation was used. For categorical variables frequencies and percentages were used. IBM SPSS statistics applied.Results: A total of 302 cases were face to face interviewed, amongst which, 70 cases (23%) showed acceptability and 232 did not accept the vaccine. The most common obstacles were lack of knowledge and high monetary cost being the cause of nonacceptance in 48.3% and   33.6% of cases respectively.Conclusions: Higher level of awareness and knowledge about HPV vaccine and inclusion in government immunization programmed may increase acceptability.

Effect of yoga nidra on physiological variables in patients of menstrual disturbances of reproductive age group.

Aim of this study was to see any effect on autonomic functions in menstrual disturbances patients after Yoga Nidra practice. The subjects for the study were 150 females with menstrual irregularities, 28.08±7.43 years of mean age, referred from department of Obstetrics and Gynecology CSMMU, UP, Lucknow. Subjects were divided randomly in to two groups’ intervention and in control groups -seventy five (75) in each group. Out of these, one hundred twenty six (126) completed the study protocol. The yogic intervention consisted of 35-40 minutes/day, five days in a week till six months. An autonomic function testing was done in both the groups at zero time and after six months. A significant positive effect was observed when yoga therapy was used as an adjunct in the patients of menstrual disturbances. There were significant improvements in the blood pressure, postural hypotension and sustained hand grip, heart rate expiration inspiration ratio and 30:15 beat ratios of the subjects after yogic practice.

Efficacy of misoprostol administration 24 hours after mifepristone for termination of early pregnancy.

Introduction: Mifepristone and misoprostol are the two drugs which are given at 36-48 h interval for medical abortion. This study was designed to study the efficacy of early administration of misoprostol (24 h after mifepristone) for medical termination of pregnancy less than 9 weeks and to compare this with standard protocol of mifepristone misoprostol combination at 48 h interval. Materials and Methods: Subjects for this single center prospective randomized case-control study were enrolled from the family planning outdoor patient department at our hospital with gestational age of less than 9 weeks. All subjects initially received 200 mg of oral mifepristone and then were randomly assigned to receive per vaginal 400 μg misoprostol at 24 h (study group) and 48 h (control group). They were then followed up after 14 days with transvaginal sonography to confirm completion of expulsion. Treatment was considered failed if surgical evacuation was needed for any indication. Primary outcome measure was success rate of the two treatment regimens. Results: Totally, 200 subjects were randomly allocated to each treatment arm (100 each). Complete expulsion was seen in 94% (94/100) in study group and 95% (95/100) in control group according to intention to treat analysis (P value ns). According to per protocol analysis success rate in study group was 93.6% and 94.3% in control group (P value ns). High failure rate after 7 weeks period of gestation in both the study and control group was found (26.3% and 30.0%; P value ns). Adverse effects were mostly similar in both the groups. Conclusion: Efficacy of mifepristone misoprostol combination at 24 h interval was similar to that at 48 h interval for medical abortion of pregnancy less than 9 weeks without compromising the safety (CTRI No. 2010/091/001422).

Oral contraceptive pills decrease pulmonary airway resistance in healthy north Indian women.

Objectives: Oral contraceptive pills (OCPs) are hormonal pills used by females to prevent conception; they are a combination of estrogen and progestin. There is, however, compelling evidence that throughout the reproductive life of a woman, her airways are subject to the influence of the cyclical variations in sex hormones which occur in relation to circadian rhythms. The present study has been designed to investigate the effects of OCPs on airway resistance in terms of spirometric parameters in OCP users and nonusers. Materials and Methods: A total of 100 women (age: 20-40 years) ware selected for the present study. The subjects were provided with a one-month supply of OCPs. The constituents per tablet of MALA-N used were levonorgestrel 0.15 mg and ethinylestradiol 0.03 mg. Peak expiratory flow rate (PEFR), forced expiratory flow in expiring 25-75% air (FEF 25-75), forced expiratory volume percentage in one second (FEV1% or FEV1/FVC), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were recorded. Results: In our study, the FEF 25-75and PEFR increased significantly in OCP users, showing that these hormone pills decrease the resistance offered by small bronchioles.

Lipid peroxidation and antioxidants in different stages of cervical cancer: Prognostic significance.

Background: Free radical Injury is associated with cancer, but how the extent of oxidative stress correlates with the FIGO (International Federation of Gynecology and Obstetrics) stage in Carcinoma Cervix (Ca Cx), and its significance as a prognostic marker, is not clear and needs an in-depth study. Aim: To correlate the blood levels of Lipid Peroxidation (LPO), Reduced Glutathione (GSH), Superoxide Dismutase (SOD), and Vitamin A and E levels with the clinical stage in Ca Cx. Settings and Design: This is a Prospective Case Control Study. Materials and Methods: LPO, SOD, reduced GSH were estimated by Bio Chemical Assays and Vitamins by High Performance Liquid Chromatography (HPLC). Statistical Analysis: The cases and controls were compared using One Way ANOVA and different stages over different time periods were individually compared by Repeated Measure Analysis of Variance. Results: The results indicated a statistically significant increase of LPO vis-a-vis the FIGO stage of Ca Cx and control, while the antioxidant status as depicted by GSH and SOD decreased. Vitamin A and E levels were significantly lower in cancer cases as compared to the control. Conclusion: Increased LPO and reduced antioxidant levels may be taken as associated predictive markers, thus suggesting that Ca Cx cases should get nutritive supplements to contain the blood LPO level and maintain a positive balance of antioxidants for a better outcome in terms of delayed recurrence and better Quality of Life (QOL).