Clinical utility of Shabda and Sparsha Pareeksha in evaluation of Prakruta and Vaikruta Garbhavastha

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Priyanka T K ◽  
V.N. K. Usha ◽  
Sucheta Kumari M
Keyword(s):  
Clinical Study ◽  
Clinical Utility ◽  
Neonatal Outcome ◽  
Predictive Accuracy ◽  
Cost Effective ◽  
Well Being ◽  
Prospective Clinical Study ◽  
Clinical Tool ◽  
Accuracy Rate ◽  
Fetal Pathology

Garbha is a conglomeration of biological mass with different strata including consciousness, needs an innovative clinical tool to evaluate its well being, which proves safe, potent, cost-effective and noninvasive. The idea of taking up this study was to sensitively predict the Prakrutavastha or well being w.r.t Garbha-pushti and ongoing Fetal Pathology, Vaikrutavastha w.s.r Garbhavyapads for a sharp interference to get a possible best neonatal outcome. The objective of this study was to calculate the predictive accuracy of evaluation of Garbhaspandanam on external Shabda and Sparsha Pareeksha. A Prospective Clinical study of Garbhaspandanam (FHS and FM) with external Shabda and Sparsha stimulation on maternal abdomen, from 24th week onwards was conducted in a cohort of 30 Singleton Pregnant women at Dept. of Prasuti Tantra and Stri Roga, S.D.M.C.A. Hospital, Udupi. Among the 9 cases in abnormal category, 2 cases had gone for IUD and one case though placed in abnormal category had responded relatively well to Shabda and Sparsha Pareeksha which may be due to the proper antenatal care and intervention given along with the patient’s Vatakara Nidana Parivarjana. Predictive Accuracy Rate on Shabda and Sparsha Pareeksha showed, FHS 70%, FM 76.7%; FHS 73.3%, FM 66.7% respectively. Shabda and Sparshapareeksha can be utilized as the Garbha - chetana - dyodakalakshana and can be performed as a routine antenatal bedside procedure, which can fairly detect the Prakruta and Vaikrutavastha of Garbha w.r.t Pushti. However larger prospective studies are required.

scholarly journals Clinical Utility of Temporal Subtraction Images in Successive Whole-Body Bone Scans: Evaluation in a Prospective Clinical Study

2010 ◽  
Vol 24 (4) ◽  
pp. 680-687 ◽  
Author(s):  
Junji Shiraishi ◽  
Daniel Appelbaum ◽  
Yonglin Pu ◽  
Roger Engelmann ◽  
Qiang Li ◽  
...  
Keyword(s):  
Clinical Study ◽  
Clinical Utility ◽  
Whole Body ◽  
Prospective Clinical Study ◽  
Temporal Subtraction ◽  
Bone Scans ◽  
Body Bone

scholarly journals Analysis of the Evolving MDS/AML Clones to Identify Resistance Mechanisms and Predict New Therapy Options at Relapse Using Computational Biology Modeling: Case-Studies from iCare1 Clinical Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3086-3086
Author(s):  
Shireen Vali ◽  
Taher Abbasi ◽  
Neeraj Kumar Singh ◽  
Shahabuddin Usmani ◽  
Deepak Anil Lala ◽  
...  
Keyword(s):  
Clinical Study ◽  
Computational Biology ◽  
Clinical Response ◽  
Clinical Outcomes ◽  
Predictive Accuracy ◽  
Committee Member ◽  
Treatment Options ◽  
Induction Treatment ◽  
Prospective Clinical Study ◽  
New Therapy

Abstract Background : Relapse is a major challenge in treating patients with MDS and AML. In this study we used a genomics-informed computational biology modeling (CBM) technique to understand the mechanisms of relapse after chemotherapy treatment and to postulate new re-induction treatment options. Methods : 120 patients with AML or MDS were recruited in the iCare1 prospective clinical study (NCT02435550), designed to assess predictive accuracy of CBM prediction by comparing computer predictions of treatment response to actual clinical outcomes. WES, CNV, and cytogenetics were obtained for 96 patients (Table). Genomic profiling was conducted by conventional cytogenetics, whole exome sequencing (SureSelectXT Clinical Research Exome, Agilent), and array CGH (Agilent). Somatic genomic mutations were inputted into CBM technology to create disease-specific protein network maps for each patient. A digital drug library of FDA-approved drugs was created for CBM by programming each agent's mechanism of action determined from published literature. Digital drug simulations of the patient's choice of therapy were tested at varying doses and predicted efficacy of the drugs were measured as a function of a disease inhibition score (DIS), defined as the degree to which disease pathways and phenotypes (cell proliferation and viability) were returned to a mutation-free state. Treating physicians were masked to the results of CBM predictions and the clinical outcomes were prospectively recorded. Clinical response for MDS patients was defined as CR+PR+HI (IWG 2006). Clinical response for AML patients was defined as CR+PR by IWG 2003 criteria. Results: 50 patients were eligible for evaluation based on length of follow-up. In 50 patients, 61 treatments were administered. CBM maps of relapsed samples from iCare 1 patients accurately matched the patient's nonresponse of treatment at relapse in 90% of patients and identified mechanisms for chemoresistance in these patients (Table 1). An example case-study is presented (CASE I: UFH-00012): AML patient, relapsed after 7+3 induction therapy. CBM predicted response to azacitidine (AZA) at first relapse and clinically was evaluated to be a responder with a blast reduction to 2%, normal CBC, and normal cytogenetics. After 9 months of AZA, the disease relapsed and was genetically profiled. CBM analysis and digital drug simulation of the relapsed disease genomics confirmed a non-response to AZA. A GOF mutation in EZH2 present in pre-AZA was a key driver of response while this was missing in the AZA-refractory sample. ASXL1 mutation was present in both samples and without the EZH2 mutation in after-AZA sample is posited as the mechanism for AZA resistance. Digital drug screening identified the combination of AZA with venetoclax as a possibly effective drug combination due to upregulation of BCL2 in this patient's disease network. Simplistic network schematics derived from the CBM analysis for pre and post AZA samples are illustrated in Figs 1 & Fig 2. Conclusions : Genomics-informed CBM accurately predicted response to standard of care in MDS and AML and identified mechanisms for induction failure. Loss of EZH2 mutation was identified as a possible mechanism for AZA-resistance in the face of ASXL1 mutation. CBM analysis of the refractory disease predicted a new therapy option for this patient based on the evolved disease characteristics. Disclosures Vali: Cell Works Group Inc.: Employment. Abbasi:Cell Works Group Inc.: Employment. Singh:Cellworks Research India Private Limited: Employment. Usmani:Cellworks Research India Private Limited: Employment. Lala:Cellworks Research India Private Limited: Employment. G:Cellworks Research India Private Limited: Employment. Radhakrishnan:Cellworks Research India Private Limited: Employment. Birajdar:Cellworks Research India Private Limited: Employment. Naga:Cellworks Research India Private Limited: Employment. Cogle:Celgene: Other: Steering Committee Member of Connect MDS/AML Registry.

scholarly journals Intrapartum Vibroacoustic Stimulation Test and Cardiotocography for the Prediction of Neonatal Outcome

2012 ◽  
Vol 4 (3) ◽  
pp. 141-143
Author(s):  
Imam Bano ◽  
Nasreen Noor ◽  
C Kavitha
Keyword(s):  
Developing Countries ◽  
South Asian ◽  
Neonatal Outcome ◽  
Well Being ◽  
Fetal Outcome ◽  
Stimulation Test ◽  
Clinical Tool ◽  
Fetal Scalp ◽  
Fetal Scalp Blood Sampling

ABSTRACT Objectives To evaluate the role of intrapartum vibroacoustic stimulation (VAST) and cardiotocography (CTG) for the prediction of neonatal outcome. Materials and methods One hundred and twenty-five patients in labor with cephalic presentation were selected and subjected to CTG and VAST was done further to find out whether fetus is reactive or nonreactive and findings were correlated with the fetal outcome. Results VAST is a good predictor of fetal well being. It is less time consuming, inexpensive and technically easy to perform. In developing countries, where fetal scalp blood sampling is not available in all institutions, VAST can effectively be used as a clinical tool to compliment abnormal CTG traces for better prediction of fetal outcome. How to cite this article Kavitha C, Bano I, Noor N. Intrapartum Vibroacoustic Stimulation Test and Cardiotocography for the Prediction of Neonatal Outcome. J South Asian Feder Obst Gynae 2012;4(3):141-143.

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