Ketamine Use in Hysterosalpingography (the Jimah Procedure): A Follow-Up of Bilateral Tubal Evaluation of 27 Infertile Women at a Teaching Hospital, Ghana

Background. Pain, anxiety, and distress are common in radiological investigations including hysterosalpingogram (HSG). Studies suggest that sedation allows patients to better tolerate diagnostic imaging and image-guided procedures by relieving anxiety, discomfort, and pain. This study aimed at assessing the safety and effectiveness of ketamine use in HSG and the proportion of true positive bilateral tubal blockage during HSG using the Jimah Procedure. Methods. We performed repeated HSG workup under IV ketamine (20–40 mg/mL) sedation for 27 infertile women at the Cape Coast Teaching Hospital. The exclusion criteria included unilateral tubular blockage, acute infection of the vagina or cervix, active vaginal bleeding, glaucoma, and high blood pressure at the time of the study. Data were entered with Microsoft Excel and analyzed using SPSS version 21. Results. A total of 27 patients (age range: 25–48 years) previously diagnosed of bilateral tubal blockage or spasm were enrolled for the repeat HSG procedure. The median age was 34 years (IQR: 32–37), while secondary infertility (20) (74.1%) was the commonest indication. None of the patients reported of pain or distress during or after the procedure. Two (7.4%) women vomited after HSG. Twelve patients (44.4%) had bilateral tubal blockage (true positive), while tubal patency was seen in 15 (55.6%) patients on HSG under ketamine sedation. Conclusion. This study found IV ketamine sedation produces profound anesthesia and analgesia and eliminates tubal spasm. We recommend that radiologists in developing countries should consider sedating patients during HSG and documenting observations and patients’ feedback to help assess safety and effectiveness in local settings.

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Hysterosalpingography Findings and Jimah Ratio of the Uterine Cavity in Women with Infertility in Central Region, Ghana

Radiology Research and Practice ◽

10.1155/2020/6697653 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Bashiru Babatunde Jimah ◽

Philip Gorleku ◽

Anthony Baffour Appiah

Keyword(s):

Central Region ◽

Acute Infection ◽

Significant Proportion ◽

Uterine Cavity ◽

Fallopian Tubes ◽

Cape Coast ◽

Secondary Infertility ◽

Diagnostic Modality ◽

Cross Sectional ◽

Infertile Women

Background. Infertility affects from 1.3% to 25.7% of couples worldwide and, especially, from 14.5% to 16.4% in Africa. Hysterosalpingography (HSG) is a diagnostic modality that is considered both common and efficient. It is used to investigate abnormalities of the uterine cavity and fallopian tubes. This study assessed the spectrum of findings on HSG among women with infertility in the Central Region (Ghana). Methods. We conducted a prospective cross-sectional study to examine 203 infertile women undergoing HSG work-up at the Cape Coast Teaching Hospital. The exclusion criteria were acute infection of the vagina or cervix and active vaginal bleeding or pregnancy. Data were entered with Microsoft Excel and analyzed using SPSS version 21. Results. A total of 203 women were enrolled, and eighty-five (41.87%) of the women had at least one or more abnormalities. The mean age was 32.9 years with majority of the women within 30–39 years (61.08%). More than half (50.74%) of the women presented with secondary infertility, while age of women ( p = 0.004 ) and duration of infertility (0.034) were found to be in association with the type of infertility. Uterine findings were predominantly capacious uterine cavity (45.1%) and uterine fibroids (33.3%), while fallopian tube findings included bilateral blockage (24.2%), right unilateral proximal blockage (17.7%), loculated spillage (16.1%), and left unilateral proximal blockage (16.1%). The range of normal uterine cavity size, measured as ratio (Jimah ratio) of intercornual diameter to interiliac diameter was 0.2–0.45, with a mean of 0.36. Conclusion. Secondary infertility was the commonest indication for HSG in the study, and a significant proportion of infertile women had abnormalities. Abnormalities were higher in the fallopian tubes than the uterus, while capacious uterine cavity, uterine fibroid, and bilaterally blocked tubes were the top three abnormalities found.

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Patterns Of Hysterosalpingographic Findings In Infertile Patients Presenting In A Tertiary Care Hospital Of Quetta

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2018087 ◽

2019 ◽

Vol 09 (04) ◽

pp. 299-302

Author(s):

Pari Gul ◽

Shama Jogezai ◽

Fahmida Naheed ◽

Palwasha Gul

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Secondary Data ◽

Radiology Department ◽

Care Hospital ◽

Age Group ◽

Infertile Women ◽

Tubal Blockage ◽

Age Range ◽

Infertile Patients

Objective: To study the different patterns of Hysterosalpingographic findings in women evaluated for infertility in a tertiary care hospital of Quetta. Setting and design: A crossectional study conducted at the Radiology Department of Bolan medical complex hospital, Quetta Methodology: A two year secondary data based study of hysterosalpingographic films were assessed, data of 338 infertile women investigated for infertility from July’ 2016 till June’ 2018. Hysterosalpingography examination was done in the preovulatory phase of the menstrual cycle. Results: Infertility was the main indication for all the hysterosalpingographic examinations with primary infertility the predominant infertility accounting for 186(55%) of all cases while secondary infertility constituted 152(45%) cases. Majority of the patients n=146(43%) were in the age group of 28-33 years as this is the peak age of reproduction. Out of the total 338 patients reviewed, normal hysterosalpingography finding with free peritoneal spill of contrast were seen in n=212(62%) cases. The most common abnormality revealed was tubal blockage among n=81 (24.2%) patients followed by hydrosalpinx n=23(6.5) %. Other abnormalities included loculated contrast spill, fibroids, Asherman syndrome and adenomyosis. Congenital anomalies were also seen of which arcuate uterus was seen commonly followed by bicornuate uterus. Conclusion: It was concluded that most of the HSG findings were normal, followed by tubal abnormalities in the age range from 28 to 33 years. Tubal occlusion and hydrosalpinx were the most common abnormal findings in this study.

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Comparative evaluation of tubal patency by hysterosalpingography and laparoscopic chromopertubation

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204007 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3994

Author(s):

Bindu S.

Keyword(s):

High Rate ◽

Tubal Patency ◽

Infertile Women ◽

Medical College ◽

False Positive Diagnosis ◽

Tubal Blockage ◽

History Of ◽

One Year ◽

Tubal Pathology

Background: Infertility is defined as one year of unprotected intercourse without pregnancy, primary in which no previous pregnancies have occurred and secondary in which a prior pregnancy not necessarily a live birth has occurred. The objective of the study was to compare the relative efficacy of hysterosalpingography (HSG) and laparoscopy with chromopertubation in the diagnosis of tubal factors in infertile women.Methods: 90 infertile women attending the infertility clinic at Dharmapuri Medical College and Hospital were selected for this study. The study period was from April 2016 to July 2017 these patients were initially counseled along with their partners and a thorough history of both the partners was obtained followed by a general and pelvic examination of female partners.Results: HSG results indicated that 48 patients had tubal pathology and 11 patients had uterine pathology. Of those 11 patients with uterine pathology, 6 patients with synechiae had both tubal and uterine pathology. The remaining 5 had only uterine pathology and tubes were patent in them. The site of tubal occlusion in all those blocked tubes shows that more number of the tubal blockage was seen in mid segment of the tube (24 cases) followed by the fimbrial block in 16 cases. Diagnostic laparoscopy with chromopertubation was performed in all 90 patients and the findings were recorded.Conclusions: HSG has reasonably good sensitivity and specificity in diagnosing tubal pathology of infertile women. But given the high rate of false-positive diagnosis of tubal pathology (29%) in HSG, a follow-up laparoscopy is warranted.

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Profil Pasien Katarak Senilis Pada Usia 40 Tahun Keatas di RSI Siti Rahmah Tahun 2017

Health & Medical Journal ◽

10.33854/heme.v1i1.214 ◽

2019 ◽

Vol 1 (1) ◽

pp. 15-21

Author(s):

Rada Puspita ◽

Haves Ashan ◽

Fidiariani Sjaaf

Keyword(s):

High School ◽

Secondary Data ◽

Study Data ◽

Vision Impairment ◽

High School Education ◽

Frequency Data ◽

Private Companies ◽

The World ◽

Age Range ◽

Cataract Patients

Vision impairment is estimated to affect 285 million people in the world, where 16-20% experience blindness, from the number of blindness suffered at the age of 40-50 years. Cataract seninis is all lens opacities that are found in old age that is above 40 years. The purpose of identifying and collecting frequency data Profile of Senilis cataract patients at the age of 40 years and above at RSI Siti Rahmah Padang in 2017. The research method is descriptive type of research, this study data taken is secondary data, In this study data was taken from the Medical Record at RSI Siti Rahmah Padang. When the study was conducted in February-August 2018, the population of this study were all cataract patients at the age of 40 years and above at RSI Siti Rahmah Padang in 2017 with 80 samples. Data analysis is univariate presented in the form of a frequency distribution table. Results From 80 respondents as many as 40 people (50%) were in the age range of 60-69 years, as many as 42 people (52.5%) patients were male, as many as 31 people (38.8%) patients with high school education and 35 people (43.8%) patients work as private companies. Conclusion In general, most patients are at the age of 60-69 years, the most sex is men, the highest education is high school and most patients are private.

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A novel use of vaginoscopic office hysteroscopy for prediction of tubal patency and peristalsis among infertile women: a preliminary study

Gynecological Surgery ◽

10.1007/s10397-016-0944-6 ◽

2016 ◽

Vol 13 (3) ◽

pp. 187-192 ◽

Cited By ~ 1

Author(s):

Atef M. Darwish ◽

Ahmad I. Hassanin ◽

Mahmoud A. Abdel Aleem ◽

Islam H. Aboushama ◽

Ibraheem I. Mohammad

Keyword(s):

Office Hysteroscopy ◽

Tubal Patency ◽

Infertile Women ◽

Preliminary Study

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Synergism of Hypothyroidism and Hyperprolactinemia to impact on efficiency of menstrual cycle and ovulatory status

Journal of Education College Wasit University ◽

10.31185/eduj.vol1.iss28.32 ◽

2017 ◽

Vol 1 (28) ◽

pp. 661-670

Author(s):

NASSER NAFAA ABRAHEM ◽

SAAD HASSAN DREIJ ◽

Mahdi Saber Al-Deresawi

Keyword(s):

Thyroid Hormone ◽

Menstrual Cycle ◽

Teaching Hospital ◽

Infertile Women ◽

Menstrual Disturbance ◽

Menstrual Irregularities ◽

Relationship Of ◽

The Relationship ◽

Hormonal Assay

This study aimed to determine the relationship of thyroid hormone disturbance and prolactin over production to impact on the menstrual irregularities anovulation .This study were carried out in Al-Karama teaching hospital and included (47) primary infertile women, (30 ) of them were with hypothyroidism , the patients aged between (18-40). This study extended from February to June 2017. The hormonal assay of TSH, FT3, FT4 ,FSH , LH and PRL that revealed :- There were high significantly (p < 0.01) increased in TSH concentrations , significantly (p < 0.05) decreased in levels of FT3 and FT4.Gonadotropins hormones recorded significantly ( p <0.05) decreased in levels of FSH and non significantly increased in levels of LH. Prolactin concentrations that obtained revealed to significantly (p < 0.05) increased in patients with hypothyroidism . This study reported there were (70%) of hypothyroidism patients with menstrual disturbance. We concluded , that hypothyroidism and Hyperprolactinemia commonly related and synergized to menstrual irregularities and ovulatory failure.

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A study on factors associated with clomifene resistance in infertile women with WHO group II anovulation at a teaching hospital in Sri Lanka

Sri Lanka Journal of Obstetrics and Gynaecology ◽

10.4038/sljog.v36i3.7715 ◽

2014 ◽

Vol 36 (3) ◽

pp. 71

Author(s):

T S Palihawadana ◽

D M A B Dissanayake ◽

P S Wijesinghe ◽

H R Seneviratne

Keyword(s):

Sri Lanka ◽

Teaching Hospital ◽

Infertile Women ◽

Factors Associated ◽

Group Ii ◽

Who Group Ii Anovulation

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Management of the lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH), with terazosin

Annals of King Edward Medical University ◽

10.21649/akemu.v11i4.1111 ◽

2016 ◽

Vol 11 (4) ◽

Author(s):

Muhammad Mubeen ◽

Ahmad N ◽

Muhammad Shahzad ◽

Nawaz M ◽

Akbar M

Keyword(s):

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Study Data ◽

Prostatic Hyperplasia ◽

Urinary Tract Symptoms ◽

Study Results ◽

Age Range ◽

Lower Urinary

Objective: This study was designed to assess the efficacy, safety and compliance of terazosin in the management of lower urinary tract symptoms due to benign prostatic hyperplasia. Patients and methods: Study was conducted in the department of urology, DHQ Hospital Vehari, in about 1-year i-e from July 2004 to June 2005. Sixty patients with an age range of 45-85 years were included in the study. Data was collected prospectively. Patients were assessed according to the international prostate symptom score (I-PSS) at the start of study, during follow up and at the end of study. Results: Out of sixty patients, fifty-two were able to complete the study. It was observed that most of the patients obtained a significant decrease in the prostate symptoms score and improvement in QoL score, with only a few side effects. Conclusion: Terazosin is a safe and effective treatment for BPH with good compliance.

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Vitamin E Level In Friedreich’s Ataxic Phenotype Patients In Four Major Hospitals In Baghdad

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v13i1.143 ◽

2019 ◽

Vol 13 (1) ◽

pp. 132-136

Author(s):

Ahmed Hasan Ahmed

Keyword(s):

Vitamin E ◽

Teaching Hospital ◽

Friedreich Ataxia ◽

Control Group ◽

Female Patients ◽

Radical Trapping ◽

Male Patients ◽

The Difference ◽

Classic Form ◽

Age Range

Background: Friedreich ataxia (FRDA) is the most common form of inherited ataxia, comprising one-half of all hereditary ataxias with a carrier rate between 1 in 60 to 1 in 90 and with a disease prevalence of 1 per 29,000. It can occur in two forms the classic form or in association with a vitamin E dependent ataxia. The precise role of Vitamin E in the nervous system is unknown; An Oxidative attack is suspected to play a role in Ataxia with Vitamin E deficiency, as well as in Friedreich ataxia. Vitamin E is the major free-radical-trapping antioxidant. Objective: Theobjectives of the study is to asses vitamin E level in patients with Friedreichs ataxia phenotype in Iraqi patients. Type of the study:Cross-sectional study. Method: This study was conducted at the neuroscience hospital and Baghdad teaching hospital during the period from the 1st of November 2013 through November 2014. Forty patients with friedreich's ataxia attended in neuroscience hospital and Baghdad teaching hospital during this period; there was12 male, 20 female patients and their age range between (4-50) years. Results: Regarding the level of vitamin E in patients in the present study, The study revealed that mean level of vitamin E for Friedreich ataxia patients was (10.92 μg/ml) ranging from (8-18 μg/ml),while in the control group the mean was (28.06μg/ml) ranging from (22-36μg/ml), the difference in mean level was found to be statistically significant (p=0.0001.) Thirty percents of (FRDA) patients was (8-9.9μg/ml), while half of patients (50%) were within (10-11.9 μg/ml),and low percentage (15 %)of patients were within (12-13.9 μg/ml ). The rest (5%) were had vitamin E level equal or more than 14 μg/ml. these finding revealed that majority of Friedreich ataxia patients were found with low level of vitamin E (32 patients(80%)), and low percentage with normal level (8 patients(20%.)) Patients with Friedreich ataxia were found to have a comparable level 10.47±1.79(8.4-13.5),11.48±2.61(9.4-18) and 10.66±1.26(9-12.5) for those with less than 10 years, 10-19 years , equal or more than 20 years of age respectively (p=0.382), while it was found to have a significantly decreasing level with advance in the age for the control group, 30.57±4.61(24.5-36), 27.46±3.16(23.7-33.5), 25.50±3.03 (22.9-29) for those less than 10 years, 10-19 years, 20 years or more respectively (p=0.006.) Vitamin E level in relation to Gender showed that Friedriech ataxia male patients had significantly higher vitamin E level compared to females [12.05±2.66 (9.0-18.0) compared to 10.17±1.07 (8.4-12.0)] (p=0.003), while relation to gender in the control group was not of significant value statistically [27.08±2.90 (22.9-30.0) for male compared to 29.04±4.97 (23.7-36) for females] , p=0.136. Conclusion: In the light of the results of the present study, the following conclusions were made: The level of vitamin E in friedreichs ataxic phenotype patients was subnormal than normal range representing 80% of the sample selected for the test. The level of vitamin E in male patients of freidriechs ataxic phenotype patients was higher than female patients.

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