1.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
2.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
3.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
4.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
5.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
6.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
7.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
8.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
9.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
10.Role of D-dimer in Prognostication of Head Injury Patients: A Systematic Literature Review
Vaishali WALKE ; Suresh Kumar THANNEERU ; Manisha SHRIVASTAVA ; Shweta MISHRA ; Md YUNUS ; Oday ATALLAH ; Amit AGRAWAL
Journal of Neurointensive Care 2025;8(2):29-46
Studies have suggested that patients with severe head injury, in addition to Glasgow Coma Scale (GCS), reveal high D-dimer levels which are independently associated with increased mortality. In the present review, we analyzed the literature where studies have reported the role of D-dimers as a potential biomarker in stratification and early identification of patients with TBI who are at risk of clinical deterioration, where early intervention can improve overall outcomes. After scrutinizing 246 articles, which were narrowed down to 38 (16 prospective, 9 retrospective, 2 RCTs, 2 case-control, 1 cross-sectional study). All these studies included 7,589 patients, in whom D-dimer was measured at different timings and in different ways. Most studies demonstrated significant changes that could be utilized for prognostication. However, we also observed instances where no significant changes were found. Unfortunately, direct comparisons were hindered by variations in the methods used to measure D-dimer across different outcomes. Limitations included the lack of a substantial number of RCTs, heterogeneity of available data, and the difficulty in summarization of specific cutoff points for D-dimer. Future studies, especially RCTs, should measure D-dimer levels at different times from injury for an accurate assessment of its correlation with outcomes.

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