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Papers by Lola Ramachandran
Andrologia, Jul 30, 2019
The SRY gene is considered as the key player in the male sexual differentiation and developmental... more The SRY gene is considered as the key player in the male sexual differentiation and developmental pathway. SRY gene mutations account for ~15% of 46,XY disorders of sexual development patients, and majority of them resides within the HMG domain of the protein. In this study, we report a novel missense mutation within the HMG domain of SRY gene, and an A‐to‐T transition causes E89V amino acid substitution in a 15‐year‐old female patient with 46,XY karyotype and complete gonadal dysgenesis. Moreover, three‐dimensional analysis of protein–DNA complex showed that the replacement of highly hydrophilic glutamic acid residue with a hydrophobic residue like valine would have an impact on the structure of protein. In conclusion, we identified a novel SRY mutation in a 46,XY female patient with complete gonadal dysgenesis, and based on the protein modelling, we propose that the identified mutation could impair normal function of the SRY protein.
Kerala Journal of Ophthalmology
Indian Journal of Obstetrics and Gynecology Research, 2019
Introduction: Diabetes is the most common medical complication of pregnancy. Ultrasound has a maj... more Introduction: Diabetes is the most common medical complication of pregnancy. Ultrasound has a major role antenatally in predicting fetal weight by using subcutaneous tissue thickness. Hence the major complication macrosomia can be tackled ideally. Materials and Methods: 100 patients found to have diabetes mellitus, were send for antenatal scan between 30 to 35 weeks and umbilical cord thickness (UC), fetal abdominal subcutaneous tissue thickness (ASTT) and subscapular subcutaneous tissue thickness (SSTT) are measured. They were followed up to delivery and the baby birth weight was recorded to correlate with the sonographic measurements. Results: SSTT and ASTT measurement had statistically significant correlation with birth weight with a 'p value' of <0.001. Conclusion: Soft tissue thickness specially SSTT and ASTT can be used to predict macrosomia; hence complications due to that can be properly tackled.
Introduction: There is an increasing prevalence of obesity among fertile women in our country whi... more Introduction: There is an increasing prevalence of obesity among fertile women in our country which is now a growing public health concern. Women with BMI more than 30 are considered as obese and are at greater risk of adverse perinatal outcome. This study will provide over view of complications related to high BMI. To identify and assess the association of maternal obesity during pregnancy with the perinatal outcome Material and Methods: This was the Analytical study and included 100 patients who were randomly selected from Out Patient Department of Gynaecology Department, Jubilee Mission Medical College,who matched inclusion criteria, their BMI checked during their first antenatal visit. Then patients were followed for any complications. Results: The present study has showed that PIH has been developed to 21% of patients, gestational diabetes mellitus to 32%, pre-eclampsia to 21%, PPH to 7%, Threatened miscarriage occurred to 31%, wound infection developed to 5%, and 11% babies ad...
OBJECTIVE : To look for evidence of HCA in spontaneous preterm labour by histopathological examin... more OBJECTIVE : To look for evidence of HCA in spontaneous preterm labour by histopathological examination of the placenta and correlate early neonatal mortality with severity to HCA. METHODOLOGY :The study consists of all women who are admitted with spontaneous preterm labour pain and after delivery placental examination was done. RESULTS: 60 cases were studied,33 were late preterm (55%),15 were moderate(25%),8 very preterm(13%)and 4 extreme preterm(7%).Percentage of HCA in each group was 15,80,75&100 respectively.Mean gestational age and mean birth weight of HCA group(n=27)was 31.40±1.13 and 1706.40± 227.58 and without HCA(n=33)was 34.51±0.54 and 2245.90 ±162.47 respectively.The maternal total leucocyte count was significantly high in HCA group.maternal CRP was raised in 26 patients of which 22 had HCA.Neonatal mortality was 3 amongst 60, 3 of the babies had HCA. CONCLUSION : In our study,we found that HCA is significantly correlated with lower gestational age,lower birth weight,highe...
Indian Journal of Obstetrics and Gynecology Research, 2016
Preterm labor is the major cause of preterm birth that affects 12–18% of all births in India. Cer... more Preterm labor is the major cause of preterm birth that affects 12–18% of all births in India. Cervical shortening or effacement is one of the first steps in the parturition process. In the present study the mean cervical length at 11-14weeks for the term delivered group is 4.04+-0.35cms and the mean cervical length for the preterm delivered group 3.85±0.33 cms. The cervical length at 18-22 weeks was significantly shorter in the group that had preterm deliveries (2.77 cms) than in those who had term deliveries (3.74 cms) (P < 0.001). The cervical length at 18-22 weeks in the group that delivered preterm was significantly shorter than in those who had delivered at term. The mean cervical length showed a gradual decrease from the first to the second scan and an increased risk for preterm delivery was seen in those cases which demonstrated a rapid shortening in cervical length. Introduction Preterm birth, defined as birth at less than 37 weeks of gestation, is the most important single determinant of adverse infant outcome in terms of both survival and quality of life. Preterm deliveries present a problem, because of the several neonatal complications and the long term sequelae which includes cerebral palsy, developmental delay, chronic lung diseases, visual loss and hearing loss. Preterm labour is the major cause of preterm birth that affects 12 –18% of all births in India 1,2. Cervical length is considered as one of the key predictors of preterm delivery 3. Cervical length assessment by ultrasound is now routinely used during obstetric scan. Transvaginal scan (TVS) of the cervix is now considered as an important screening tool for preterm delivery. When cervical length (CL) on TVS is less than 15 mm, 40‐47% of these women will deliver within 7 days, irrespective of any interventions or use of tocolysis 4. In contrast, a CL ≥15mm is reassuring since less than 1‐2% will deliver within 7 days. In asymptomatic women, TVS of the cervix is most beneficial for the identification of women at low risk for preterm delivery 5. However, a short cervix detected by ultrasound around mid trimester increases the risk of preterm delivery in this group. Transvaginal cervical length
Recent Advances in Adolescent Health, 2011
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Tubal problems associated with infertility can be due to blocked tubes, adhesion and ... more Background: Tubal problems associated with infertility can be due to blocked tubes, adhesion and scarring of the tubes and distal block leading to Hydrosalpinx. The objective of this study is to evaluate the accuracy and efficiency of Sonosalpingography in the assessment of tubal patency, in comparison to the gold standard method of laparoscopic Chromopertubation and to determine its value as a basic non-invasive screening procedure in infertile women. Methods: A prospective study involving a series of 50 women including both primary and secondary infertility registered in the infertility clinic, Obstetrics and Gynaecology department, at Jubilee Mission Hospital for 1 year (June 2011 to June 2012). These patients after initial evaluation were subjected to sonosalpingography on one of the days between 5th and 10th days of the menstrual cycle for assessment of tubal patency. This was followed by laparoscopy with chromopertubation on the same day or next day. The results of the two tests were compared to determine the accuracy of these SSG. Results: Mean duration of infertility 6-12 years of standard deviation (SD) from mean of 3.72 years. SE<0.4769 and 95% CI was 5.6 to 7.079 yrs. Sensitively for tubal patency with SSG compared to Laparoscopic chromotubation was 93.30% with 95% CI between 84.77 and 96.85. Conclusions: If SSG is performed as a base line test, laparoscopy can be reserved for those women who have unexplained infertility or whose SSG is abnormal or whose medical history and physical examination reveal pelvic pathology.
IP innovative publication pvt. ltd, 2019
Introduction: Diabetes is the most common medical complication of pregnancy. Ultrasound has a maj... more Introduction: Diabetes is the most common medical complication of pregnancy. Ultrasound has a major role antenatally in predicting fetal weight by using subcutaneous tissue thickness. Hence the major complication macrosomia can be tackled ideally.
Materials and Methods: 100 patients found to have diabetes mellitus, were send for antenatal scan between 30 to 35 weeks and umbilical cord thickness (UC), fetal abdominal subcutaneous tissue thickness (ASTT) and subscapular subcutaneous tissue thickness (SSTT) are measured. They were followed up to delivery and the baby birth weight was recorded to correlate with the sonographic measurements.
Results: SSTT and ASTT measurement had statistically significant correlation with birth weight with a ‘p value’ of <0.001.
Conclusion: Soft tissue thickness specially SSTT and ASTT can be used to predict macrosomia; hence complications due to that can be properly tackled.
Andrologia, Jul 30, 2019
The SRY gene is considered as the key player in the male sexual differentiation and developmental... more The SRY gene is considered as the key player in the male sexual differentiation and developmental pathway. SRY gene mutations account for ~15% of 46,XY disorders of sexual development patients, and majority of them resides within the HMG domain of the protein. In this study, we report a novel missense mutation within the HMG domain of SRY gene, and an A‐to‐T transition causes E89V amino acid substitution in a 15‐year‐old female patient with 46,XY karyotype and complete gonadal dysgenesis. Moreover, three‐dimensional analysis of protein–DNA complex showed that the replacement of highly hydrophilic glutamic acid residue with a hydrophobic residue like valine would have an impact on the structure of protein. In conclusion, we identified a novel SRY mutation in a 46,XY female patient with complete gonadal dysgenesis, and based on the protein modelling, we propose that the identified mutation could impair normal function of the SRY protein.
Kerala Journal of Ophthalmology
Indian Journal of Obstetrics and Gynecology Research, 2019
Introduction: Diabetes is the most common medical complication of pregnancy. Ultrasound has a maj... more Introduction: Diabetes is the most common medical complication of pregnancy. Ultrasound has a major role antenatally in predicting fetal weight by using subcutaneous tissue thickness. Hence the major complication macrosomia can be tackled ideally. Materials and Methods: 100 patients found to have diabetes mellitus, were send for antenatal scan between 30 to 35 weeks and umbilical cord thickness (UC), fetal abdominal subcutaneous tissue thickness (ASTT) and subscapular subcutaneous tissue thickness (SSTT) are measured. They were followed up to delivery and the baby birth weight was recorded to correlate with the sonographic measurements. Results: SSTT and ASTT measurement had statistically significant correlation with birth weight with a 'p value' of <0.001. Conclusion: Soft tissue thickness specially SSTT and ASTT can be used to predict macrosomia; hence complications due to that can be properly tackled.
Introduction: There is an increasing prevalence of obesity among fertile women in our country whi... more Introduction: There is an increasing prevalence of obesity among fertile women in our country which is now a growing public health concern. Women with BMI more than 30 are considered as obese and are at greater risk of adverse perinatal outcome. This study will provide over view of complications related to high BMI. To identify and assess the association of maternal obesity during pregnancy with the perinatal outcome Material and Methods: This was the Analytical study and included 100 patients who were randomly selected from Out Patient Department of Gynaecology Department, Jubilee Mission Medical College,who matched inclusion criteria, their BMI checked during their first antenatal visit. Then patients were followed for any complications. Results: The present study has showed that PIH has been developed to 21% of patients, gestational diabetes mellitus to 32%, pre-eclampsia to 21%, PPH to 7%, Threatened miscarriage occurred to 31%, wound infection developed to 5%, and 11% babies ad...
OBJECTIVE : To look for evidence of HCA in spontaneous preterm labour by histopathological examin... more OBJECTIVE : To look for evidence of HCA in spontaneous preterm labour by histopathological examination of the placenta and correlate early neonatal mortality with severity to HCA. METHODOLOGY :The study consists of all women who are admitted with spontaneous preterm labour pain and after delivery placental examination was done. RESULTS: 60 cases were studied,33 were late preterm (55%),15 were moderate(25%),8 very preterm(13%)and 4 extreme preterm(7%).Percentage of HCA in each group was 15,80,75&100 respectively.Mean gestational age and mean birth weight of HCA group(n=27)was 31.40±1.13 and 1706.40± 227.58 and without HCA(n=33)was 34.51±0.54 and 2245.90 ±162.47 respectively.The maternal total leucocyte count was significantly high in HCA group.maternal CRP was raised in 26 patients of which 22 had HCA.Neonatal mortality was 3 amongst 60, 3 of the babies had HCA. CONCLUSION : In our study,we found that HCA is significantly correlated with lower gestational age,lower birth weight,highe...
Indian Journal of Obstetrics and Gynecology Research, 2016
Preterm labor is the major cause of preterm birth that affects 12–18% of all births in India. Cer... more Preterm labor is the major cause of preterm birth that affects 12–18% of all births in India. Cervical shortening or effacement is one of the first steps in the parturition process. In the present study the mean cervical length at 11-14weeks for the term delivered group is 4.04+-0.35cms and the mean cervical length for the preterm delivered group 3.85±0.33 cms. The cervical length at 18-22 weeks was significantly shorter in the group that had preterm deliveries (2.77 cms) than in those who had term deliveries (3.74 cms) (P < 0.001). The cervical length at 18-22 weeks in the group that delivered preterm was significantly shorter than in those who had delivered at term. The mean cervical length showed a gradual decrease from the first to the second scan and an increased risk for preterm delivery was seen in those cases which demonstrated a rapid shortening in cervical length. Introduction Preterm birth, defined as birth at less than 37 weeks of gestation, is the most important single determinant of adverse infant outcome in terms of both survival and quality of life. Preterm deliveries present a problem, because of the several neonatal complications and the long term sequelae which includes cerebral palsy, developmental delay, chronic lung diseases, visual loss and hearing loss. Preterm labour is the major cause of preterm birth that affects 12 –18% of all births in India 1,2. Cervical length is considered as one of the key predictors of preterm delivery 3. Cervical length assessment by ultrasound is now routinely used during obstetric scan. Transvaginal scan (TVS) of the cervix is now considered as an important screening tool for preterm delivery. When cervical length (CL) on TVS is less than 15 mm, 40‐47% of these women will deliver within 7 days, irrespective of any interventions or use of tocolysis 4. In contrast, a CL ≥15mm is reassuring since less than 1‐2% will deliver within 7 days. In asymptomatic women, TVS of the cervix is most beneficial for the identification of women at low risk for preterm delivery 5. However, a short cervix detected by ultrasound around mid trimester increases the risk of preterm delivery in this group. Transvaginal cervical length
Recent Advances in Adolescent Health, 2011
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Tubal problems associated with infertility can be due to blocked tubes, adhesion and ... more Background: Tubal problems associated with infertility can be due to blocked tubes, adhesion and scarring of the tubes and distal block leading to Hydrosalpinx. The objective of this study is to evaluate the accuracy and efficiency of Sonosalpingography in the assessment of tubal patency, in comparison to the gold standard method of laparoscopic Chromopertubation and to determine its value as a basic non-invasive screening procedure in infertile women. Methods: A prospective study involving a series of 50 women including both primary and secondary infertility registered in the infertility clinic, Obstetrics and Gynaecology department, at Jubilee Mission Hospital for 1 year (June 2011 to June 2012). These patients after initial evaluation were subjected to sonosalpingography on one of the days between 5th and 10th days of the menstrual cycle for assessment of tubal patency. This was followed by laparoscopy with chromopertubation on the same day or next day. The results of the two tests were compared to determine the accuracy of these SSG. Results: Mean duration of infertility 6-12 years of standard deviation (SD) from mean of 3.72 years. SE<0.4769 and 95% CI was 5.6 to 7.079 yrs. Sensitively for tubal patency with SSG compared to Laparoscopic chromotubation was 93.30% with 95% CI between 84.77 and 96.85. Conclusions: If SSG is performed as a base line test, laparoscopy can be reserved for those women who have unexplained infertility or whose SSG is abnormal or whose medical history and physical examination reveal pelvic pathology.
IP innovative publication pvt. ltd, 2019
Introduction: Diabetes is the most common medical complication of pregnancy. Ultrasound has a maj... more Introduction: Diabetes is the most common medical complication of pregnancy. Ultrasound has a major role antenatally in predicting fetal weight by using subcutaneous tissue thickness. Hence the major complication macrosomia can be tackled ideally.
Materials and Methods: 100 patients found to have diabetes mellitus, were send for antenatal scan between 30 to 35 weeks and umbilical cord thickness (UC), fetal abdominal subcutaneous tissue thickness (ASTT) and subscapular subcutaneous tissue thickness (SSTT) are measured. They were followed up to delivery and the baby birth weight was recorded to correlate with the sonographic measurements.
Results: SSTT and ASTT measurement had statistically significant correlation with birth weight with a ‘p value’ of <0.001.
Conclusion: Soft tissue thickness specially SSTT and ASTT can be used to predict macrosomia; hence complications due to that can be properly tackled.