Kumar Suneet

Bio: Kumar Suneet is an academic researcher. The author has contributed to research in topics: Endometrial hyperplasia & Lipiduria. The author has an hindex of 1, co-authored 2 publications receiving 4 citations.

Clinicopathological Study of Abnormal Uterine Bleeding in North Indian Patients

Abstract: Abnormal uterine bleeding is the common presenting complains in the Gynaecology outpatient department in all age groups. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. The study is planned to evaluate the pathological conditions in endometrium of the patients having abnormal uterine bleeding and its correlation with clinical condition. The 50 women’s having age from 20-60 history of abnormal uterine bleeding was studied. Endometrial tissue collected by sampling procedure such as Dilatation and Curettage (D&C),endometrial biopsies had been sent to the pathology lab for evaluation. The histopathological study of the endometrium showed Proliferative Endometrium as prominent histopathological pattern in 18 patients. Secretory Phase was seen in 12 womens, Endometrial Hyperplasia is seen in 8, Menstrual Phase observed in 3 patients. Atrophic Endometrium was followed in 7 patients followed by Endometrial Metaplasia in 2 patients.

Clinicopathological Study of Nephrotic Syndrome in North Indian Patients

Abstract: Nephrotic syndrome is commonest renal diseases in developing country. The nephrotic syndrome is a clinical syndrome complex characterized by a number of renal and extra renal features, the most prominent of which are proteinuria >3.5g/1.73m3/24 h (in practice >3.0-3.5 g/24 h), hyperlipidemia, lipiduria, and hyper coaguability. The present study was planned in North Indian Hospital. The total 20 patients referred to Out-Patient Department (OPD) and in-patient department (IPD). All the patients were subjected to renal biopsy. The Swelling of feet and puffiness of face is found in about 8 patients out of 20. Weakness, loss of appetite, and generalized bodyache is seen in 4 patients. Distension of abdomen and difficulty in breathing is observed in 3 patients. Pallor and dizziness is seen in 2 cases and Decreased urinary volume is observed in 3 patients. The most common primary glomerular diseases causing nephrotic syndrome in children and adults are minimal change diseases and membranous glomerulonephritis, respectively.

Dysfunctional uterine bleeding.

Abstract: Dysfunctional uterine bleeding is most commonly associated with chronic anovulation. Early diagnosis of anovulation is important; the induction of regular withdrawal periods using a progestin such as Provera prevents the development of endometrial hyperplasia with the subsequent inevitable occurrence of a heavy, frightening vaginal bleed. The etiology of dysfunctional uterine bleeding occurring during ovulatory cycles is unknown and all medical therapies at present are necessarily experimental. Hysterectomy is probably the treatment of choice for women who have finished their childbearing career and in whom persisting menorrhagia during ovulatory cycles results in anemia.

Etiological factors of abnormal uterine bleeding according to PALM- COEIN classification in perimenopausal women in a tertiary care centre

Abstract: Background: Perimenopause is described as years prior to menopause that encompasses the change from normal ovulatory cycle to cessation of menses, ending 12 months after the last menses. International federation of gynaecology and obstetrics (FIGO) developed a new classification PALM-COEIN in order to standardize the factors associated with AUB. It classifies AUB as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia (PALM) structural abnormalities Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified (COEIN) unrelated to structural abnormalities. Objectives of this study were to categorise the causes of AUB in perimenopausal women in context to PALM COEIN classification system. Correlation of co-morbities (diabetes, hypertension and thyroid disorders) with AUB in perimenopausal age group. Methods: This is a retrospective study from the month of May 2019 to October 2019, considering 100 patients of perimenopausal age group (40 to 55 years of age group) in J. K. Hospital Bhopal, Madhya Pradesh with complaints of abnormal uterine bleeding, admitted in gynae ward. Results: Most of the patients in the current study were between 45-50 years of age i.e. 44%. Menorrhagia was the commonest menstrual disorder encountered in 52% of patients. As per FIGO; AUB-L constituted 42% AUB-O constituted 12%, AUB-P constituted 11%, AUB-A 10%, AUB-M constituted 8% AUB-E constituted 8%, not yet classified constituted 4% of total cases. Conclusions: AUB (PALM-COEIN) for causes of abnormal uterine bleeding classification was very useful in categorizing cases of AUB. It suggests that etiology of AUB and also gives place for presence of multiple factors as a cause of AUB in a particular case.

Abnormal uterine bleeding in peri-menopausal age: An observational study

Abstract: Introduction: Abnormal Uterine Bleeding (AUB) is a term which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynecological complaint accounting one third of outpatient visits to gynecologist. It is caused by wide variety of organic or non-organic causes. The aim of this study was to find out incidence of abnormal uterine bleeding with respect to aetiopathology, age, parity, marital status, treatment options and other medical disorders. Materials and Methods: This study included prospective study of randomly selected 180 cases of abnormal uterine bleeding between 40–55 years of age during April 2015 to July 2016, in the Dept. of Obstetric & Gynaecology, NMCH, Patna. Details of each patient’s were recorded and analysed with respect to aetiopathology, age, parity, marital status, socioeconomic status, treatment options and other medical disorders. Patients were evaluated with menstrual history, physical examination, laboratory tests, imaging studies and histological examinations. Patients were followed up from 3 to 8 months with an average of about 4.5 months. Results: Most common age group presenting with AUB was 40–45 years (65.55%) and mostly (68.33%) belonged to low socioeconomic status. Most of the women were multiparous and menorrhagia was most common presentation. In 51.66% cases, cause was non-organic (dysfunctional uterine bleeding) and among organic causes fibroid (28.88%) uterus was most common. Bulky uterus was found in 41.11% of cases and 43.33% had proliferative endometrium. Majority of patients had mild anemia. Maximum number of patients (70.55%) were treated surgically and 27.77% got medical treatment. Conclusion: Abnormal uterine bleeding (AUB) is a common gynecological complaint associated with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, l

Clinicopathological correlation in primary nephrotic syndrome

Abstract: Objective: To study the clinicopathological correlation in patients suffering from primary/idiopathic nephrotic syndrome. Materials and Methods: A total of 34 cases of idiopathic nephrotic syndrome were included in the present study. All patients had undergone renals biopsy for histological diagnosis. Results: The patients were subjected to renal biopsy and on the basis of light microscopic findings they were divided into two broad groups. Group A included 25 patients whose renal biopsy showed histological picture of minimal change disease. Group B included nine patients whose renal biopsy showed features other than those seen in minimal change disease. Most patients presented in the 2 nd and 3 rd decade (range was found from 14 to 80 years). Increased serum creatinine (<1.6 mg%) wasfound in two (8%) in group A and four (44%) in group B. Thus, the number of patients having high serum creatinine was significantly higher in group B. Nine patients (33%) in group A and three (33%) in group B had low glomerular filtration rate (GFR;i.e.,<90m1/min). Low serum protein (i.e.,<6 g%) was seen in 18(72%) in group A and five (55.5%) in group B and low serum albumin (i.e.,< 3.2 g%) was found in 21 (84%) in group A and six (66%) in group B. The mean serum cholesterol was 426.76 ΁ 77.11 mg% and mean triglyceride was 269.80 ΁ 148.11 mg% in group A, while in group B the mean cholesterol was 357.33 ΁ 116.19 mg% and mean serum triglyceride was 231.55 ΁ 73.85 mg%. Conclusion: Most patients of nephrotic syndrome presented in the 2 nd and 3 rd decades. All patients in both the groups had high serum triglycerides. Seventy-three percent of nephrotic syndrome cases had histopathological diagnosis of minimal change disease, 8.8% had membranoproliferative glomerulonephritis. Membranous glomerulonephritis, focal segmented glomerulosclerosis, and diffuse proliferative glomerulonephritis accounted for 6% cases each.

Vitamin D status and serum vitamin D binding protein levels in Nigerian children with nephrotic syndrome

Abstract: Introduction: Nephrotic syndrome is a chronic relapsing condition associated with urinary loss of albumin and other proteins such as vitamin D binding protein (DBP). We determined vitamin D status and serum DBP levels in children with nephrotic syndrome and compared them to healthy controls. Methods: A cross-sectional study was performed over a six-month period in children less than 18 years of age. The children with nephrotic syndrome were categorised by disease status as either newly diagnosed, in remission, resistant to therapy, or in relapse. Vitamin D levels were regarded as sufficient if ≥75 nmol/L, insufficient if <75 nmol/L but ≥50 nmol/L, deficient if <50 nmol/L, and severely deficient if <25 nmol/L. Serum DBP was also measured. Results: Fifty-five children with nephrotic syndrome and 24 controls were included in the study. There was no significant difference between the median ages of the cases (72.0 months, interquartile range (IQR) 48.0–120.0 months) and the controls (84.0 months, IQR 39.0–129.0 months). Severe vitamin D deficiency, deficiency and insufficient levels were documented in 54.5%, 41.8% and 3.6% of cases, respectively, significantly lower than the controls (P = 0.003). Vitamin D levels were higher in children with nephrotic syndrome in remission than in those who were not (30.3 ± 15.2 nmol/L vs 19.6 ± 11.0 nmol/L, P = 0.004). In the groups who were in remission, newly diagnosed, relapsing, and resistant, the median vitamin D levels were 30.3 nmol/L, 20.1 nmol/L, 19.2 nmol/L and 9.4 nmol/L, respectively (P = 0.031). Conclusions: Hypovitaminosis D occurs frequently in Nigerian children with nephrotic syndrome as well as in apparently healthy controls. Routine supplementation of vitamin D should be considered in children with nephrotic syndrome irrespective of whether the disease is in remission or not, or whether it is steroid-sensitive or not. Keywords: nephrotic syndrome, vitamin D deficiency, vitamin D binding protein