Journal of Obstetrics and Gynecology of India最新文献

{"title":"Call For Action: The Obstetrician's Role In Peripartum Mental Health.","authors":"Anahita R Chauhan, Arnav R Chauhan","doi":"10.1007/s13224-024-02076-3","DOIUrl":"10.1007/s13224-024-02076-3","url":null,"abstract":"<p><p>Peripartum mental health is an underdiagnosed and undertreated entity; obstetricians are in a dilemma when patients present with signs of any mental disturbance. The peripartum period is fraught with triggers that can cause, or exacerbate, mental illness, and obstetricians need to be aware of diagnoses and treatment of blues, depression, psychosis and other problems. Key strategies that can be adopted are discussed in this review, along with the scenario in India.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 5","pages":"386-390"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Role of HE4 in Diagnosis of Ovarian Tumors.","authors":"Satya Kumari, Pratibha Kumari, Sangeeta Pankaj, Jyotsna Rani, Kavya Abhilashi, Vijayanand Choudhary, Jaya Kumari","doi":"10.1007/s13224-023-01936-8","DOIUrl":"10.1007/s13224-023-01936-8","url":null,"abstract":"<p><strong>Background: </strong>Approximately 20% of women develop an ovarian cyst or pelvic mass at some point in their lives. Due to high false positivity of CA-125, women with various benign ovarian tumors simulating malignant masses undergo extensive debulking surgery resulting in increased morbidity. Serum HE4 is a useful test for better discrimination of benign or malignant nature of pelvic masses in preoperative period. Our study gives an update on the biological markers specifically CA-125 and a novel tumor marker HE4 and aims to reduce the debulking surgeries done for benign pathology.</p><p><strong>Materials and methods: </strong>The total study population (<i>n</i> = 302) included women who were operated with suspicious ovarian malignant mass (<i>n</i> = 238) with benign (<i>n</i> = 98), borderline (<i>n</i> = 6), and malignant (<i>n</i> = 134) ovarian tumors. Cutoff of CA-125 was 35 U/mL, and for HE4 140 pM for postmenopausal and 70 pM for premenopausal women were calculated at 86% and 81% accuracy, respectively. Statistical analysis was done using SPSS version 20.</p><p><strong>Results: </strong>The cutoff values of CA-125 were able to differentiate between benign, borderline, and malignant tumors with statistical significance (<i>p</i> < 0.05), whereas the cutoff values of HE4 significantly (<i>p</i> < 0.05) differentiated benign tumors from the malignant tumors, but not from the borderline tumors. Serum CA-125 has significantly higher sensitivity and NPV (95%, 72%, respectively) compared to HE4 (81%, 52%) and combined HE4 plus CA-125 (84%, 59%), whereas specificity, PPV, and AUC were higher for combined CA-125 plus HE4 (93%, 98%, 90%, respectively) compared to HE4 (83%, 95%, 88%) and CA-125 (48%, 88%, 87%).</p><p><strong>Conclusion: </strong>Measuring serum HE4 along with CA-125 in preoperative diagnosis helps in excluding benign ovarian tumors in which CA-125 was falsely raised, especially in center where frozen section is not available, thus potentially decreasing morbid debulking surgeries done for benign ovarian tumors.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 5","pages":"418-423"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"To Give or Not to Give\": Evolution of Recommendations on Administering Antenatal Corticosteroids in Late Preterm or Early Term.","authors":"Deepshikha, Japleen Kaur, Sahil Vikas","doi":"10.1007/s13224-024-01996-4","DOIUrl":"10.1007/s13224-024-01996-4","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 5","pages":"472-473"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Conundrum of Preterm Labour and Premature Births in Present Day Obstetrics.","authors":"Madhuri Patel","doi":"10.1007/s13224-024-02070-9","DOIUrl":"10.1007/s13224-024-02070-9","url":null,"abstract":"<p><p>Preterm Labour leading to premature births has remained one of the longest unresolved conundrums in medicine. This \"conundrum\" of issues surrounding preterm labour and birth appears to be complex. While we continue to accept that preterm birth is difficult to predict, we are being faced with an increasing trend in preterm births owing to the preponderance of the known risk factors in the present day Obstetric population. Health care providers should know that the challenges in handling preterm births and the role of Obstetricians in improving the overall health scenario in this context has to extend beyond mere individual patient care. Adequate sensitisation of both the perinatal care team, smooth referral pathways and providing realistic choices to the family are all important in reaching a rational outcome. Optimising perinatal care for preterm babies will go a long way in achieving the sustainable development goal of ending preventable neonatal deaths.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 5","pages":"383-385"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Modernizing Cervical Cytology Screening with Liquid-Based Methods at Community-Level Hospitals: A Much-Needed Breakthrough for India\".","authors":"Sunil E Tambvekar, Geetha Balsarkar","doi":"10.1007/s13224-024-02051-y","DOIUrl":"https://doi.org/10.1007/s13224-024-02051-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Cervical cancer still ranks highest causing cancer-related morbidity and mortality in women in India. It is prudent to emphasise and implement cervical cancer screening strategies in the population efficiently and with regular intervals. Conventionally, PAP smear cytology is obtained by wooden spatula-Ayre's spatula. To improve sensitivity and specificity of the procedure and detection rate, better techniques of cells retrieval are available mainly liquid-based cytology (LBC), with help of cyto-brush. Literature has consistently proven efficiency of the technique and also reduced the proportion of inadequate sampling. We conduct this study to compare both the techniques and efficiency in a community hospital from data over 6 years, to asses its role and benefits among Indian women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objectives: &lt;/strong&gt;To compare conventional PAP smear and liquid-based cytology techniques analysing detection rates of positive lesions (CIN and also includes ASCUS and malignant), incidence of inadequate sampling, efficiency and cost-effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is retrospective study at tertiary care obstetric hospital affiliated to government-run medical college in a metropolitan city of Mumbai. Data are retrieved from the Pathology Department, Medical Records Department, laboratory books and OPD registers. Pap's smear sampling was done mainly from OPD with all indications including routine tests as a part of gynaecological evaluation and screening, as well as for suspicious lesions on inspection. Group A consists women who had conventional PAP smear test for 3 years (Dec 2015-Nov 2018) and Group B had women who benefited by LBC method for 3 years (Dec 2018-Nov 2021). COVID-19 pandemic majorly affected the routine gynaecological OPD practice during 2021 as hospital was COVID facility hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Demographic parameters and presentations were comparable and similar. LBC methods have higher detection rate for positive reports, including ASCUS. But results were comparable in both groups and not statistically different. Importantly, incidences of inadequate sampling are reduced significantly with the LBC method. Unsatisfactory smears war high in Group A (7.752%) compared to Group B (3.712%) &lt;i&gt;p&lt;/i&gt;-value 0.005, stating the increased rate of requirement of sending repeat smears, which involves higher engagement of time, resources and active participation from healthcare personnel.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Good detection rates and significantly low rates of unsatisfactory smears make LBC rational and cost-effective. These are the times to switch to liquid-based cytology techniques, especially at the community level hospitals; in order to detect more women with cervical premalignant as well as malignant neoplastic lesions and to save lives. This can be made possible by emphasising the policy makers to incorporate these services through quality resource","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 4","pages":"371-377"},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staging of Cervical Cancer: What has Changed?","authors":"Pradnya Changede","doi":"10.1007/s13224-024-02054-9","DOIUrl":"https://doi.org/10.1007/s13224-024-02054-9","url":null,"abstract":"<p><p>In India, cervical cancer is the second most common cause of cancer-related fatalities and the fourth most common malignancy worldwide affecting women. India accounts for 25% of all cervical cancer-related deaths worldwide each year. The main drawbacks of clinical staging were the imprecise estimation of tumor size and the challenge of determining the involvement of pelvic and para-aortic lymph nodes with the few studies that FIGO allowed to be done for staging of cancer cervix. The use of 2009 staging approach showed that when many cases were operated based only on clinical findings, they subsequently required adjuvant therapy; hence, treatment-related morbidity was negatively impacted by these errors. Changes have been made to the staging of cervical cancer according to the 2018 revised International Federation of Gynecology and Obstetrics (FIGO) guidelines. Correction to cancer of the cervix staging was published recently in 2024. The horizontal extent (lateral extent) of the disease is not taken into consideration for staging in cases of microinvasive disease. Three subgroups have been identified based on the stratification of tumor size: IB1 ≤ 2 cm, IB2 > 2- ≤ 4 cm, and IB3 > 4 cm. Pathology and imaging modalities are added to clinical diagnosis for staging of cancer cervix. The involvement of lymph nodes (LNs) is now classified based on pathology (p) or imaging (r) which specifies that lymph node involvement is diagnosed using pathology (p) or imaging (r). Stage IIIC has been added [IIIC1 (involvement of pelvic nodes) and IIIC2 (involvement of para-aortic nodes)] is assigned to the case in the event of lymph node positive status. Pathological assessment takes precedence over radiological and clinical findings. The involvement of vascular/lymphatic spaces should not change the staging. The lower staging should be assigned when there is doubt about stage. Overall, the revised FIGO staging of cancer cervix (2024) has a number of advantages, including the inclusion of imaging and pathology, tumor size and LN-based categorization. More studies on staging of cancer cervix in different populations using revised staging of cancer cervix will help to prognosticate use of this staging.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 4","pages":"378-381"},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questionnaire-Based Study on the Knowledge of Cervical Cancer and Attitude and Perception Toward Self-Sampling Method of Screening, Among Women in Sikkim, India.","authors":"Pesona Grace Lucksom, Mingma Lhamu Sherpa, Anup Pradhan, Mingma Sherpa","doi":"10.1007/s13224-024-02049-6","DOIUrl":"https://doi.org/10.1007/s13224-024-02049-6","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer (CC) is the second most common cancer among women in India and in Sikkim. Screening helps in prevention and early detection of the disease; however, pelvic examination for smear collection is not preferred by many. Self-sampling method can be a good alternative for collection of smears, thus increasing screening uptake. Therefore, a study was conducted to evaluate perception about self-sampling method of screening among women in Sikkim.</p><p><strong>Methodology: </strong>A total of 210 women who consented for this study were screened for cervical cancer using Pap smear and HPV DNA. Women were taught to collect their self-sample for HPV DNA test. Questionnaires were used to assess their attitude toward self-sampling prior to collection of samples and perception, post-collection.</p><p><strong>Results: </strong>Seventy-percent women knew that CC is the most common cancer among women in Sikkim. 73% knew that it could be prevented, but only 57% had knowledge about screening facilities in Sikkim. 50% women knew about HPV vaccination program in Sikkim. 96% women had never done a self-sampling, while 67% had never heard about it. There was a significant change (<i>p</i> value < 0.00001) in perception toward self-sampling after the procedure. Comparative analysis showed that women found self-collection easier than expected. If they had a choice, they would prefer self-sampling over physician sampling; however, due to their trust in physicians they still believed physician collected sample would be better.</p><p><strong>Conclusion: </strong>Self-sampling is a socially acceptable screening technique and can increase compliance among socially shy community.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 4","pages":"364-370"},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transrectal Ultrasound in Cervical Cancer: A Systematic Review of its Current Application.","authors":"Vera Nevyta Tarigan, Dewi Lestari Rahmawati, Gilbert Sterling Octavius","doi":"10.1007/s13224-024-02047-8","DOIUrl":"https://doi.org/10.1007/s13224-024-02047-8","url":null,"abstract":"<p><strong>Introduction: </strong>The use of transrectal ultrasound (TRUS) is established in prostate cancer but remains limited in cervical cancer. This systematic review aims to aggregate and describe the current use and advancements of TRUS in cervical cancer to identify gaps in the literature.</p><p><strong>Methods: </strong>This study follows a protocol registered in the PROSPERO database (CRD42024520099). It includes cervical cancer patients confirmed by histopathological analysis, where TRUS was used for diagnosis or as an adjunct to therapeutic procedures. Cross-sectional, case-control, cohort, or randomized controlled trials published in any language were included. The risk of bias was assessed using the Newcastle Ottawa Scale (NOS).</p><p><strong>Results: </strong>From an initial pool of 3380 articles, 50 duplicates were removed, leaving 3330 unique articles. After screening titles and abstracts, 2932 articles were excluded, resulting in 31 studies included in the review. These studies involved 1635 women with cervical cancers, with a mean age of 52.9 years. Histopathologically, 81.2% were squamous cell carcinoma (SCC), and 39.6% were at FIGO stage IIB. Nineteen studies were prospective, five retrospective, and fourteen used consecutive sampling. Only 10 articles had a fair rating, while the rest received poor ratings. Complications from post-TRUS included pain (<i>N</i> = 106), haemorrhage (<i>N</i> = 59), and perforations (<i>N</i> = 10). TRUS was used in seven areas, including cancer extension and pre-operative assessment. It showed a strong correlation with MRI but had lower sensitivity. TRUS was useful in staging, diagnosis, and guiding brachytherapy, demonstrating comparable accuracy to MRI in several instances.</p><p><strong>Conclusion: </strong>The recommended use of TRUS in cervical cancer is still limited in formal guidelines, and clinical research remains insufficient.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13224-024-02047-8.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 4","pages":"303-310"},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Prevention in Cervical Cancer-Current Status and Way Forward.","authors":"Madhuri Patel","doi":"10.1007/s13224-024-02048-7","DOIUrl":"https://doi.org/10.1007/s13224-024-02048-7","url":null,"abstract":"<p><p>The effect of cancer in women has varied effects. Overall malignancies of the breast, cervix, and ovary account for over 43% of all cancer cases in India. Globally, cervical cancer is fourth cancer in terms of incidence among women, following breast, lung, and colorectal cancer. However, this illness primarily affects women in India, where it is the second most frequent malignancy after breast cancer. HPV-related cervical cancer is a serious public health issue that has a solution. In 2020, the World Health Organization (WHO) launched a global initiative to eliminate cervical cancer which set targets for three important strategies: HPV vaccination, cervical cancer screening, and treatment. The WHO's \"Best Buys\" recommendations for cancer sub-set place vaccination of females between the ages of 9 and 14 at the top of the list. In India, efforts are underway to increase the number of teenage girls receiving the human papillomavirus (HPV) vaccine. The nation granted licenses for bivalent and quadrivalent HPV vaccinations in 2008, and in 2018, a nonavalent vaccine was approved. It is important to keep in mind that the cervical carcinoma vaccination is not a quick fix; thus, screening for the disease should continue. Any nation can potentially significantly lower the incidence of cervical cancer by carefully combining economical, high-coverage vaccinations with well-organized screening programs. Since 9-14 years is the ideal age range before sexual debut in today's world, this is the key vaccine age range. Estimates of vaccine effectiveness for younger adolescents, those between the ages of 9 and 14 years, varied from roughly 74 to 93%. Let us envision an India of the future where girls grow up with one fewer cancer threatening their life and a place where cervical cancer has been eradicated.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 4","pages":"287-291"},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant Hysterectomy in Patients After Radiation for Locally Advanced Cervical Cancer: A Single-Center Prospective Longitudinal Study.","authors":"Sony Nanda, Bhagyalaxmi Nayak, S N Senapati, A K Padhy, Mamita Nayak, Jita Parija, Janmejaya Mohapatra, Manoranjan Mahapatra","doi":"10.1007/s13224-024-02053-w","DOIUrl":"https://doi.org/10.1007/s13224-024-02053-w","url":null,"abstract":"<p><strong>Introduction: </strong>Residual or recurrent cervical cancer post-CCRT is a challenging clinical issue, even though there has been much effort in recent decades to increase patient survival after radiation. There is a paucity of literature regarding the role of hysterectomy in recurrent/residual disease after radiation in LACC patients. Such a procedure is controversial and not routinely performed because of difficulties in obtaining tumor-free margins and the high rate of associated morbidity.</p><p><strong>Aims and objectives: </strong>Evaluate outcomes and morbidities in patients who had undergone hysterectomy for residual or recurrent disease after radiation in LACC patients.</p><p><strong>Material and methods: </strong>This is a prospective observational study on radiotherapy-treated LACC patients (IIB-III) with residual disease or recurrent disease who have undergone adjuvant hysterectomy. This study has been conducted at AHPGIC, Cuttack, with a sample size of 30 patients.</p><p><strong>Results: </strong>18/30 patients underwent extrafascial hysterectomy, and rest 12 patients had radical hysterectomy. No significant difference in complications, achieving tumor free margins or recurrences post adjuvant hysterectomy based on the radicality of surgery was observed. 5 cases of recurrences post-adjuvant hysterectomy were detected. Some of the factors which had significant association with recurrences post adjuvant hysterectomy were non squamous histology, no preoperative brachytherapy, deep stromal invasion and positive surgical margins. Median follow-up time was 14 months (12-27 months).</p><p><strong>Conclusion: </strong>This study shows that adjuvant hysterectomy is feasible with good outcome and acceptable morbidity after chemoradiotherapy in cervical cancer patients \"<i>If selection of patients for adjuvant hysterectomy is appropriate.\"</i></p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 4","pages":"357-363"},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}