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Article ; Online: Correlation of cardiotocography abnormalities with position and attitude of the fetal head in labor.

Sridharan, Shylabirami / Guruvare, Shyamala / Rao, Chythra R

AJOG global reports

2022 Volume 2, Issue 4, Page(s) 100112

Abstract: Background: Fetal distress indicated as the cause for cesarean delivery based on cardiotocography findings most often does not reflect in the newborn assessment. Cardiotocography findings are just the decision indicators for cesarean delivery, in the ... ...

Abstract	Background: Fetal distress indicated as the cause for cesarean delivery based on cardiotocography findings most often does not reflect in the newborn assessment. Cardiotocography findings are just the decision indicators for cesarean delivery, in the background of labor abnormalities owing to deflexed head or occipitoposterior position. Objective: This study aimed to investigate the association between cardiotocography findings and the attitude of fetal head and occiput position. Study design: We conducted a prospective observational study in a tertiary hospital in South India, including 304 women in labor with vertex presentation. Fetal attitude, the position of the head, labor abnormalities, and cardiotocography findings were noted. The chi-square test was applied using MedCalc software (version 19) to investigate the association of cardiotocography findings with the attitude of fetal head and occiput position. Results: Cardiotocography findings had significant association with occipitoposterior position (relative risk, 1.70; 95% confidence interval, 1.32-2.19) and deflexed attitude of the fetal head (relative risk, 1.44; 95% confidence interval, 1.11-1.87). Among cases with occipitoposterior position, 10 of 42 (24%) had pathologic cardiotocography, and 19 of 42 (45%) had suspicious cardiotocography, whereas among cases with deflexed head position, these proportions were 12 of 61 (20%) and 24 of 61 (40%), respectively. Conclusion: Pathologic and suspicious cardiotocography tracings were more frequent in women with fetal occipitoposterior and deflexed head position. However, the association was not specific to any cardiotocography pattern.
Language	English
Publishing date	2022-09-23
Publishing country	United States
Document type	Journal Article
ISSN	2666-5778
ISSN (online)	2666-5778
DOI	10.1016/j.xagr.2022.100112
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Article ; Online: Sertoli-Leydig cell ovarian tumour: a rare cause of virilisation and androgenic alopecia.

Mudraje, Sriram / Shetty, Sahana / Guruvare, Shyamala / Kudva, Ranjini

BMJ case reports

2022 Volume 15, Issue 8

Abstract: Sertoli-Leydig cell tumours (SLCTs) represent a rare cause of hyperandrogenic state. SLCTs are sex cord ovarian neoplasms, accounting for <0.2% of all ovarian tumours. Most of the sex cord-stromal tumours have a benign clinical course, with 10%-20% of ... ...

Abstract	Sertoli-Leydig cell tumours (SLCTs) represent a rare cause of hyperandrogenic state. SLCTs are sex cord ovarian neoplasms, accounting for <0.2% of all ovarian tumours. Most of the sex cord-stromal tumours have a benign clinical course, with 10%-20% of them at risk of aggressive course. We report a case of a woman in her 30s who presented with androgenic alopecia, virilisation and secondary amenorrhoea. The evaluation revealed an extremely high testosterone level. Imaging for the localisation of source of excess testosterone with contrast-enhanced CT of the abdomen revealed a right ovarian mass. Hence, a diagnosis of testosterone-secreting ovarian tumour was considered. The patient underwent right salphingo-oophorectomy, and histopathology was reported as Sertoli cell tumour. Postoperatively, there was normalisation of serum testosterone levels with decrease in virilisation and resumption of spontaneous menstrual cycles. The patient conceived spontaneously after 2 months of surgery.
MeSH term(s)	Alopecia/complications ; Female ; Humans ; Leydig Cells/pathology ; Male ; Ovarian Neoplasms/complications ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/surgery ; Sertoli-Leydig Cell Tumor/complications ; Sertoli-Leydig Cell Tumor/diagnosis ; Sertoli-Leydig Cell Tumor/surgery ; Sex Cord-Gonadal Stromal Tumors/complications ; Sex Cord-Gonadal Stromal Tumors/diagnosis ; Sex Cord-Gonadal Stromal Tumors/surgery ; Testosterone ; Virilism/complications
Chemical Substances	Testosterone (3XMK78S47O)
Language	English
Publishing date	2022-08-25
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-249324
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Article ; Online: Accuracy of 3-D Surface Rendering of 2-D Ultrasound Images of the Uterus Using a Novel Software in Mapping Uterine Fibroids.

Guruvare, Shyamala / Hebbar, Shripad / Bai, Lakshmi / Jaiprakash, Padmapriya / Reddy, Deepa / Hc, Deepa

Ultrasound in medicine & biology

2023 Volume 50, Issue 1, Page(s) 128–133

Abstract: Objective: Three-dimensional surface rendering of 2-D ultrasound images of the uterus in mapping uterine fibroids is a fast-evolving imaging technique that holds great potential for gynecology. The purpose of this study was to assess the accuracy of 3-D ...

Abstract	Objective: Three-dimensional surface rendering of 2-D ultrasound images of the uterus in mapping uterine fibroids is a fast-evolving imaging technique that holds great potential for gynecology. The purpose of this study was to assess the accuracy of 3-D surface rendering of 2-D ultrasound images of the uterus using a new Fibroid Mapping Reviewer Application (FMRA) software for mapping uterine fibroids as compared with the pathological evaluation of uterine fibroids in pre-menopausal women undergoing hysterectomy. Methods: We enrolled women aged 35-55 y scheduled for hysterectomy for symptomatic fibroids at a tertiary care hospital from 2019 to 2021. Per pre-set guidelines, we recorded 2-D images and videos of the uterus with fibroids during the transvaginal ultrasound. The recordings were transferred through USB, loaded in the FMRA software and post-processed to generate a 3-D rendered uterus model. An experienced pathologist assessed and documented the gross examination details per a set protocol. We compared the pre-specified dimensions related to the size (L1, L2) and location (X, Y) of fibroids between the 3-D model and the pathologist's assessment of the hysterectomy specimen. Results: A total of 25 fibroids in 25 women, the single largest per woman, were considered for analysis. The two methods had good correlation with respect to size (for L1, R² = 0.9723, and for L2, R² = 0.9784) and location (for X, R² = 0.9618, and for Y, R² = 0.9753). Inter-observer analysis revealed that measurements from two sonologists were reproducible (Cronbach's α = 0.9 for the L1, L2 and L3 dimensions of fibroids from the 3-D model). Conclusion: The FMRA is a novel tool for mapping fibroids. With its proven accuracy, it will be helpful in planning surgeries and during guided procedures for managing uterine fibroids.
MeSH term(s)	Female ; Humans ; Uterine Neoplasms/diagnostic imaging ; Uterine Neoplasms/surgery ; Uterus/diagnostic imaging ; Uterus/surgery ; Leiomyoma/diagnostic imaging ; Leiomyoma/surgery ; Hysterectomy ; Ultrasonography ; Treatment Outcome
Language	English
Publishing date	2023-10-10
Publishing country	England
Document type	Journal Article
ZDB-ID	186150-5
ISSN	1879-291X ; 0301-5629
ISSN (online)	1879-291X
ISSN	0301-5629
DOI	10.1016/j.ultrasmedbio.2023.09.013
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Article: Prevalence and Associated Risk Factors of Antenatal Depression among Pregnant Women Attending Tertiary Care Hospitals in South India.

Prabhu, Savitha / Guruvare, Shyamala / George, Linu Sara / Nayak, Baby S / Mayya, Shreemathi

Depression research and treatment

2022 Volume 2022, Page(s) 9127358

Abstract: Background: Antenatal depression (AND) is a common mood disorder that affects both the mother and the child.: Objective: The current study is aimed at identifying the prevalence of antenatal depression and the risk factors associated with it in South ...

Abstract	Background: Antenatal depression (AND) is a common mood disorder that affects both the mother and the child. Objective: The current study is aimed at identifying the prevalence of antenatal depression and the risk factors associated with it in South Indian pregnant women. Materials and methods: The current study was carried out in a tertiary care teaching hospital where pregnancy and postnatal care are offered. In the study, 314 pregnant women who visited the antenatal clinic for their prenatal checkups were included. To diagnose possible depression, Edinburgh Postnatal Depression Scale (EPDS) was used. The chi-square test was applied to determine the association between antenatal depression and various socioeconomic, obstetric, and medical factors. A logistic regression analysis was performed to identify significant confounding variables. Results: Of the total 314 women, 69 (21.98%) were suffering from possible depression with the mean EPDS score being 10.61 ± 7.48. Women of younger age had greater risks for depression than older women (AOR = 2.01; 95% CI: 0.56-7.20). Maternal age ( Conclusions: Clinical efforts should focus on screening antenatal depression, early identification, and effective care, thus preventing progression to postpartum depression and its detrimental effects.
Language	English
Publishing date	2022-11-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573947-5
ISSN	2090-133X ; 2090-1321
ISSN (online)	2090-133X
ISSN	2090-1321
DOI	10.1155/2022/9127358
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Article ; Online: Hybrid Transfer Learning for Classification of Uterine Cervix Images for Cervical Cancer Screening.

Kudva, Vidya / Prasad, Keerthana / Guruvare, Shyamala

Journal of digital imaging

2019 Volume 33, Issue 3, Page(s) 619–631

Abstract: Transfer learning using deep pre-trained convolutional neural networks is increasingly used to solve a large number of problems in the medical field. In spite of being trained using images with entirely different domain, these networks are flexible to ... ...

Abstract	Transfer learning using deep pre-trained convolutional neural networks is increasingly used to solve a large number of problems in the medical field. In spite of being trained using images with entirely different domain, these networks are flexible to adapt to solve a problem in a different domain too. Transfer learning involves fine-tuning a pre-trained network with optimal values of hyperparameters such as learning rate, batch size, and number of training epochs. The process of training the network identifies the relevant features for solving a specific problem. Adapting the pre-trained network to solve a different problem requires fine-tuning until relevant features are obtained. This is facilitated through the use of large number of filters present in the convolutional layers of pre-trained network. A very few features out of these features are useful for solving the problem in a different domain, while others are irrelevant, use of which may only reduce the efficacy of the network. However, by minimizing the number of filters required to solve the problem, the efficiency of the training the network can be improved. In this study, we consider identification of relevant filters using the pre-trained networks namely AlexNet and VGG-16 net to detect cervical cancer from cervix images. This paper presents a novel hybrid transfer learning technique, in which a CNN is built and trained from scratch, with initial weights of only those filters which were identified as relevant using AlexNet and VGG-16 net. This study used 2198 cervix images with 1090 belonging to negative class and 1108 to positive class. Our experiment using hybrid transfer learning achieved an accuracy of 91.46%.
MeSH term(s)	Early Detection of Cancer ; Female ; Humans ; Machine Learning ; Neural Networks, Computer ; Uterine Cervical Neoplasms/diagnostic imaging
Language	English
Publishing date	2019-12-14
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1033897-4
ISSN	1618-727X ; 0897-1889
ISSN (online)	1618-727X
ISSN	0897-1889
DOI	10.1007/s10278-019-00269-1
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Zs.A 2941: Show issues

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Article ; Online: Automation of Detection of Cervical Cancer Using Convolutional Neural Networks.

Kudva, Vidya / Prasad, Keerthana / Guruvare, Shyamala

Critical reviews in biomedical engineering

2018 Volume 46, Issue 2, Page(s) 135–145

Abstract: Classification of digital cervical images acquired during visual inspection with acetic acid (VIA) is an important step in automated image-based cervical cancer detection. Many algorithms have been developed for classification of cervical images based on ...

Abstract	Classification of digital cervical images acquired during visual inspection with acetic acid (VIA) is an important step in automated image-based cervical cancer detection. Many algorithms have been developed for classification of cervical images based on extracting mathematical features and classifying these images. Deciding the suitability of a feature and learning the algorithm is a complex task. On the other hand, convolutional neural networks (CNNs) self-learn most suitable hierarchical features from the raw input image. In this paper, we demonstrate the feasibility of using a shallow layer CNN for classification of image patches of cervical images as cancerous or not cancerous. We used cervix images acquired after the application of 3%-5% acetic acid using an Android device in 102 women. Of these, 42 cervix images belonged in the VIA-positive category (pathologic) and 60 in the VIA-negative category (healthy controls). A total of 275 image patches of 15 × 15 pixels were manually extracted from VIA-positive areas, and we considered these patches as positive examples. Similarly, 409 image patches were extracted from VIA-negative areas and were labeled as VIA negative. These image patches were classified using a shallow layer CNN composed of a layer each of convolutional, rectified linear unit, pooling, and two fully connected layers. A classification accuracy of 100% is achieved using shallow CNN.
MeSH term(s)	Algorithms ; Automation ; Cervix Uteri/cytology ; Cervix Uteri/pathology ; Early Detection of Cancer/instrumentation ; Early Detection of Cancer/methods ; Feasibility Studies ; Female ; Humans ; Image Processing, Computer-Assisted/instrumentation ; Image Processing, Computer-Assisted/methods ; Machine Learning ; Neural Networks (Computer) ; Predictive Value of Tests ; Reproducibility of Results ; Sensitivity and Specificity ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/pathology
Language	English
Publishing date	2018-07-05
Publishing country	United States
Document type	Evaluation Studies ; Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1411103-2
ISSN	1943-619X ; 0278-940X
ISSN (online)	1943-619X
ISSN	0278-940X
DOI	10.1615/CritRevBiomedEng.2018026019
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Article ; Online: Ovarian borderline mucinous tumor with squamous overgrowth: An unusual finding with review of literature.

Vasudevan, Geetha / Jaiprakash, Padmapriya / Guruvare, Shyamala / Samanta, Nivedita

Indian journal of pathology & microbiology

2018 Volume 61, Issue 2, Page(s) 261–263

Abstract: Borderline mucinous tumor (BMT) is often associated with other entities such as dermoid cyst, Brenner tumor, and endometriosis. Squamous areas are often associated which may be a part of BMT or its associated conditions. Here, we describe squamous ... ...

Abstract	Borderline mucinous tumor (BMT) is often associated with other entities such as dermoid cyst, Brenner tumor, and endometriosis. Squamous areas are often associated which may be a part of BMT or its associated conditions. Here, we describe squamous overgrowth in a case of intestinal type of mucinous borderline tumor in a 29-year-old uniparous female and discuss the diagnostic difficulties.
MeSH term(s)	Adult ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/surgery ; Cystadenoma, Mucinous/pathology ; Cystadenoma, Mucinous/surgery ; Female ; Humans ; Hysterectomy ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Ovary/pathology ; Uterus/pathology
Language	English
Publishing date	2018-04-20
Publishing country	India
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	197621-7
ISSN	0974-5130 ; 0377-4929
ISSN (online)	0974-5130
ISSN	0377-4929
DOI	10.4103/IJPM.IJPM_30_17
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Article ; Online: Andriod Device-Based Cervical Cancer Screening for Resource-Poor Settings.

Kudva, Vidya / Prasad, Keerthana / Guruvare, Shyamala

Journal of digital imaging

2018 Volume 31, Issue 5, Page(s) 646–654

Abstract: Visual inspection with acetic acid (VIA) is an effective, affordable and simple test for cervical cancer screening in resource-poor settings. But considerable expertise is needed to differentiate cancerous lesions from normal lesions, which is lacking in ...

Abstract	Visual inspection with acetic acid (VIA) is an effective, affordable and simple test for cervical cancer screening in resource-poor settings. But considerable expertise is needed to differentiate cancerous lesions from normal lesions, which is lacking in developing countries. Many studies have attempted automation of cervical cancer detection from cervix images acquired during the VIA process. These studies used images acquired through colposcopy or cervicography. However, colposcopy is expensive and hence is not feasible as a screening tool in resource-poor settings. Cervicography uses a digital camera to acquire cervix images which are subsequently sent to experts for evaluation. Hence, cervicography does not provide a real-time decision of whether the cervix is normal or not, during the VIA examination. In case the cervix is found to be abnormal, the patient may be referred to a hospital for further evaluation using Pap smear and/or biopsy. An android device with an inbuilt app to acquire images and provide instant results would be an obvious choice in resource-poor settings. In this paper, we propose an algorithm for analysis of cervix images acquired using an android device, which can be used for the development of decision support system to provide instant decision during cervical cancer screening. This algorithm offers an accuracy of 97.94%, a sensitivity of 99.05% and specificity of 97.16%.
MeSH term(s)	Acetic Acid ; Algorithms ; Cervix Uteri/diagnostic imaging ; Decision Support Systems, Clinical ; Developing Countries ; Female ; Humans ; Mobile Applications ; Photography ; Poverty ; Reproducibility of Results ; Sensitivity and Specificity ; Telemedicine/instrumentation ; Telemedicine/methods ; Uterine Cervical Neoplasms/diagnostic imaging
Chemical Substances	Acetic Acid (Q40Q9N063P)
Language	English
Publishing date	2018-05-18
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1033897-4
ISSN	1618-727X ; 0897-1889
ISSN (online)	1618-727X
ISSN	0897-1889
DOI	10.1007/s10278-018-0083-x
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Article ; Online: Utility of three dimensional (3-D) ultrasound and power Doppler in identification of high risk endometrial cancer at a tertiary care hospital in southern India: A preliminary study.

Pandey, Harshitha / Guruvare, Shyamala / Kadavigere, Rajagopal / Rao, Chythra R

Taiwanese journal of obstetrics & gynecology

2018 Volume 57, Issue 4, Page(s) 522–527

Abstract: Objective: The study was conducted to find the utility of three dimensional (3-D) ultrasound and Doppler sonography in differentiating benign and malignant endometrial lesions and to ascertain the association of sonology parameters with type, grade and ... ...

Abstract	Objective: The study was conducted to find the utility of three dimensional (3-D) ultrasound and Doppler sonography in differentiating benign and malignant endometrial lesions and to ascertain the association of sonology parameters with type, grade and stage of endometrial cancer. Materials and methods: Women attending the gynaecology department of a tertiary care hospital, with a provisional diagnosis of carcinoma endometrium were subjected to three dimensional power Doppler ultrasound evaluation and assessment of vascular patterns. VOCAL (Virtual Organ Computer-aided Analysis) software was used to assess volume, Vascularisation Index (VI), Flow Index (FI) and Vascularisation Flow Index (VFI). Ultrasound parameters were compared with histologic diagnosis to evaluate the diagnostic performance using Receiver Operating Characteristic (ROC) Curve. Results: Sixty-four women were included in the study, 33 with benign and 31 with malignant endometrial lesions. Larger endometrial volume and higher Doppler indices correlated with malignant lesions. The variables with good discriminatory potential between benign and malignant status were VI and VFI, having a sensitivity of 90.3% and specificity of around 80%. VFI (adjusted odds ratio of 40.4; (95% CI - 8.46-192.88), p value < 0.001) was the only significant variable identified by multivariate logistic regression, when adjusted for age and post-menopausal status. Multiple global and focal vessel pattern was seen predominantly in malignant cases (specificity 93.9%), although the sensitivity was low (61.2%). Higher stages and grades of tumour and non-endometrioid types had higher Doppler indices, and requires further evaluation. Conclusions: 3-D ultrasound has good discrimination potential between benign and malignant endometrial lesions and could be useful as a screening tool. However, utility of 3-D tool for differentiation between tumour characteristics needs further validation.
MeSH term(s)	Endometrial Neoplasms/blood supply ; Endometrial Neoplasms/diagnostic imaging ; Endometrial Neoplasms/pathology ; Endometrium/blood supply ; Endometrium/diagnostic imaging ; Endometrium/pathology ; Female ; Humans ; Imaging, Three-Dimensional/methods ; India ; Neoplasm Staging ; Neovascularization, Pathologic/diagnostic imaging ; ROC Curve ; Risk Factors ; Sensitivity and Specificity ; Tertiary Care Centers ; Ultrasonography/methods ; Ultrasonography, Doppler/methods
Language	English
Publishing date	2018-08-16
Publishing country	China (Republic : 1949- )
Document type	Journal Article
ISSN	1875-6263
ISSN (online)	1875-6263
DOI	10.1016/j.tjog.2018.06.007
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Article ; Online: Sigmoido-uterine fistula: An uncommon communication!

Rodrigues, Gabriel / Reddy Janumpalli, Krishna Kalyan / Guruvare, Shyamala / Arjun, Suresh / Khan, Afroz / Jayasankar, Balaji

European journal of obstetrics, gynecology, and reproductive biology

2019 Volume 239, Page(s) 74–76

MeSH term(s)	Aged ; Colonoscopy ; Female ; Fistula/diagnosis ; Fistula/surgery ; Humans ; Intestinal Fistula/diagnosis ; Intestinal Fistula/surgery ; Magnetic Resonance Imaging ; Sigmoid Diseases/diagnosis ; Sigmoid Diseases/surgery ; Uterine Diseases/diagnosis ; Uterine Diseases/surgery
Language	English
Publishing date	2019-06-03
Publishing country	Ireland
Document type	Case Reports ; Letter
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2019.06.002
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