Fetal Doppler for prediction of adverse perinatal outcome in preeclampsia in a low resource setting

Background: Diagnostic laparoscopy and hysteroscopy are considered the gold standard for diagnosing pelvic pathology in women among couples with infertility or subfertility. Knowledge of common pathologies in these patients would help plan investigations and deliver better care especially in resource limited settings. The current study was carried out to analyse the clinical-demographic profile and operative findings among women with subfertility undergoing diagnostic laparoscopy-hysteroscopy over a 4 years period.Methods: A retrospective record-based study conducted in the Department of Obstetrics and Gynaecology of People’s Hospital, PCMS and RC, Bhopal from 1st January 2013 to 31st December 2016 (4 years).Results: Sixty-two records of women with primary/ secondary infertility who underwent diagnostic laparoscopy-hysteroscopy during the study period satisfied the inclusion and exclusion criteria and were analyzed. Among these, 54 (87.09%) couples had primary infertility and 8 (12.9%) had secondary infertility. The mean age of women was 27.1 years (range 20-38 years; SD4.43). One third of women had more than 5 years duration of infertility. Eight (13%) had menstrual abnormalities. One or more tubal abnormality was found on diagnostic laparoscopy in 33.8% of all cases (31.4% of women with primary infertility and 50 % of women with secondary infertility). Pelvic adhesions (25.8%), endometriosis (24.2%) and evidence of acute or chronic pelvic inflammatory disease (19.3%) were the other leading abnormalities.Conclusions: While it is possible to suspect many abnormalities by a detailed history, a good examination and preliminary investigations such as the pelvic ultrasonography, a significant proportion of abnormalities such as the tubal abnormalities, endometriosis and pelvic adhesions can only be detected with certainty on laparoscopy. Hence it is recommended that diagnostic laparoscopy should be an early part of infertility work up.

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Laparoscopy as a diagnostic tool in evaluation of female factors in infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170469 ◽

2017 ◽

Vol 6 (3) ◽

pp. 864 ◽

Cited By ~ 1

Author(s):

Chaitra Krishna ◽

Prathima S. ◽

Savitha Chandraiah ◽

Anitha G. S.

Keyword(s):

Diagnostic Laparoscopy ◽

Polycystic Ovary ◽

Well Being ◽

Common Finding ◽

Infertile Couple ◽

Polycystic Ovaries ◽

Male Factor ◽

Secondary Infertility ◽

Infertile Women ◽

Primary Infertility

Background: Infertility leads to considerable personal suffering and disruption of family life. According to United Nations "Reproductive health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes". The objective of present study was to find out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility.Methods: It is a prospective study conducted on all infertile women and they underwent diagnostic laparoscopy for primary and secondary infertility during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analyzed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic findings regarding primary and secondary infertility.Results: Fifty infertile women underwent laparoscopy during the study period, 35 (70%) had primary infertility while 15 (30%) secondary infertility. 10 (28.5%) patients with primary and 3 (20%) patients with secondary infertility had no visible abnormality. The common finding was tubal blockage in 10 (28.5%) and 5 (33.3%) cases of primary and secondary infertility respectively. 9 (25.7%) cases of primary infertility were detected as polycystic ovaries (PCO) and 2 (13.3%) in cases of secondary infertility. Endometriosis was found in 1 case with primary infertility and 2 (13.3%) cases with secondary infertility. Fibroid was found in 3 (8.57%) and 1 (6.6%) cases of primary and secondary infertility respectively.Conclusions: Most common causes responsible for infertility were tubal occlusion and polycystic ovary. Infertile couple should be thoroughly investigated. Laparoscopy in infertility can be used for a definitive diagnosis.

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STUDY OF LAPAROSCOPIC EVALUATION OF FEMALE FACTORS IN INFERTILITY AT ANMMCH, GAYA, BIHAR

10.36106/ijsr/2733535 ◽

2021 ◽

pp. 60-62

Author(s):

Pankaj Kumar Chaudhary ◽

Anupam Chaurasia ◽

Lata Shukla Dwivedy ◽

Debarshi Jana

Keyword(s):

Diagnostic Laparoscopy ◽

Polycystic Ovaries ◽

Male Factor ◽

Secondary Infertility ◽

Infertile Women ◽

Medical College ◽

Primary Infertility ◽

Common Causes ◽

Tubal Blockage ◽

Laparoscopic Evaluation

Objective:To nd out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility. Study Design:Acase series. Place and Duration of Study: Department of Obstetrics and Gynaecology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, August 2018 to July 2019. Methodology:All infertile women underwent diagnostic laparoscopy for primary and secondary infertility during the study period were included. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analysed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic ndings regarding primary and secondary infertility. Results: Fifty infertile women underwent laparoscopy during the study period, 32 (64%) had primary infertility while 18 (36%) secondary infertility. Eight (25.0%) patients with primary and 2 (11.1%) patients with secondary infertility had no visible abnormality. The common nding was tubal blockage in 7 (21.9%) and 6 (33.3%) cases of primary and secondary infertility respectively. Five (15.6%) cases of primary infertility were detected as polycystic ovaries (PCO) which was not found in cases of secondary infertility. Endometriosis was found in 4 (12.5%) cases with primary infertility and 2 (11.1%) cases with secondary infertility. Pelvic inammatory disease (PID) was found in 1 (3.1%) and 2 (16.7%) cases of primary and secondary infertility respectively. Peritubal and periovarian adhesions were detected in 2 (6.3%) cases with primary infertility and 4 (22.2%) cases with secondary infertility. Fibriod was found in 2 (6.3%) and 1 (5.6%) cases of primary and secondary infertility respectively. Ovarian cyst detected in 2 (6.3%) cases with primary infertility while none was found in cases of secondary infertility. Conclusion: Most common causes responsible for infertility were tubal occlusion, endometriosis, peritubal and periovarian adhesions. Ovarian causes were seen in primary infertility only

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Evaluation of cases of infertility by diagnostic laparoscopy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170557 ◽

2017 ◽

Vol 6 (3) ◽

pp. 924

Author(s):

Sachin Wankhede ◽

Sarika Thakare ◽

Nivedita Goverdhan ◽

Santosh Shahane

Keyword(s):

Diagnostic Laparoscopy ◽

Male Factor Infertility ◽

Polycystic Ovaries ◽

Male Factor ◽

Secondary Infertility ◽

Primary Infertility ◽

Therapeutic Benefits ◽

Obstetrics And Gynaecology ◽

Uterine Anomalies ◽

Tubal Disease

Background: Infertility affects nearly 10-15% of couples and is an important part of clinical practice. Leading causes of infertility include tubal disease, ovulatory disorders, uterine or cervical factors, endometriosis and male factor infertility. The objective of the study was to find out different causes of female infertility with diagnostic laparoscopy.Methods: This was a descriptive study conducted from February 2012 to November 2013. 115 patients with infertility attending the infertility clinic in OPD of Obstetrics and Gynaecology were evaluated clinically with detailed history. The necessary investigations were carried out and the laparoscopic findings were documented.Results: There were 91 cases (79.13%) with primary infertility and 24 (20.87%) with secondary infertility. Laparoscopy revealed normal findings in 14 cases (15.38%) of primary infertility and 1 case (4.17%) of secondary infertility. Pelvic abnormality was found in 100 cases (86.95%). Tubal block was the most common pathology found in 36 cases (31.30%) followed by polycystic ovaries in 32 (27.83%) and adhesions in 24 (20.87%). Uterine anomalies were found in 3 cases (3.30%).Conclusions: Diagnostic laparoscopy is a valuable technique and a mandatory investigation, which, though invasive, is more convenient and more precise for the diagnosis of infertility. Because of its potential diagnostic as well as therapeutic benefits, all patients with infertility should undergo diagnostic laparoscopy as part of their primary workup of infertility.

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Is hysterolaparoscopy a real theranostic approach for anatomical barriers in female fertility? A future argument

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182362 ◽

2018 ◽

Vol 7 (6) ◽

pp. 2423

Author(s):

Namita Agrawal ◽

Poonam Yadav ◽

S. Fayyaz ◽

Brinderjeet Kaur

Keyword(s):

Real Time ◽

Female Fertility ◽

Therapeutic Interventions ◽

Secondary Infertility ◽

Female Patients ◽

Primary Infertility ◽

Diagnostic Work ◽

Infertility Patients ◽

Work Up ◽

Diagnostic Work Up

Background: Hysterolaparoscopy is a modality that provides the real time abdomino-pelvic view during diagnosis in infertile female patients and any pathology is noticed can be tackled at the same time. So we investigate the theranostic application of hysterolaparoscopy in structural causes of female infertility in present study.Methods: Authors prospectively evaluate 157 female patients (mean age 27.7 years) diagnosed as infertile, underwent hysterolaparoscopy during diagnostic work-up. All the enlisted patients fulfilled the criteria of infertility. The noticed anatomical abnormalities in the hysterolaparoscopy were tackled at the same time if possible.Results: Of the 157 infertile female patients, 93 (~59.2%) were of primary infertility and remaining 64 (~41.8%) were secondary infertility patients. Hysterolaparoscopy showed abnormalities in 125/157 (~85.0%) patients. The detected hysterolaparoscopic abnormalities were distributed in 77/93 (~82.8%) primary and 48/64 (~75.0%) secondary infertility patients. Of the 125 patients with abnormal hysterolaparoscopic findings, 121 (~96.8%) experienced for active therapeutic interventions. All of the 48 secondary infertility patients with hysterolaparoscopic abnormalities experienced for active hysterolaparoscopic interventions. Of 77 patients with hysterolaparoscopic abnormality in primary infertility group, 73 (~94.8%) experienced active intervention. Only four patients with streak ovaries and hypoplastic uterus, few tiny fibroids and adenomyosis did not undergo for active hysterolaparoscopic intervention.Conclusions: Authors concluded that hysterolaparoscopy has a better theranostic approach for the anatomical barriers of female fertility so it can be performed in the initial phases of the infertility diagnostic work-up.

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Tubal abnormalities on hysterosalphingography in primary and secondary infertility in Sokoto, Northwestern-Nigeria

Asian Journal of Medical Sciences ◽

10.3126/ajms.v6i2.10581 ◽

2014 ◽

Vol 6 (2) ◽

pp. 47-50 ◽

Cited By ~ 1

Author(s):

M. Danfulani ◽

G. H. Yunusa ◽

S. M. Ma'aji ◽

S. A. Sa'idu ◽

M. A. Musa

Keyword(s):

Medical Sciences ◽

Secondary Infertility ◽

Tubal Infertility ◽

Tubal Patency ◽

Resource Limited ◽

High Incidence ◽

Study Participants ◽

Work Up ◽

Tubal Pathology ◽

Treatment Of Infection

Background: Hysterosalphingography (HSG) remains a vital method of assessing tubal patency especially in a resource limited setting such as ours and tubal occlusion is the commonest cause of female infertility in the developing world. Objective: To review abnormal tubal pathological findings in hysterosalphingography (HSG) among women being investigated for primary and secondary infertility in Sokoto. Method: This is a retrospective review of HSG results of 317 women being investigated for both primary and secondary infertility was reviewed. The study was conducted from July 2009 to August 2012. Results: A total of 317 patients were studied. The age ranges of the study participants was from 17 - 48 years with a mean and standard deviation value of 32.5 ± 5.5. Out of the sample size, 139 (43.85%) showed normal HSG findings while 178 (56.15%) patients had abnormal HSG findings. Tubal abnormalities were found in 112 (35.33%) of the patients. The commonest tubal abnormality was tubal blockage.Conclusion: The high incidence of tubal pathology revealed in this study showed that HSG is still a very vital tool for infertility work-up. Early detection and prompt treatment of infection in our women should be encouraged as it is the major leading cause of tubal pathologies and consequently this would reduce the contribution of tubal infertility in this environment.DOI: http://dx.doi.org/10.3126/ajms.v6i2.10581Asian Journal of Medical Sciences Vol.6(2) 2015 48-51

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Carcinoma of the Breast in Low Resource Setting: A Surgical Case Series from Rural India

Christian Journal for Global Health ◽

10.15566/cjgh.v8i1.539 ◽

2021 ◽

Vol 8 (1) ◽

pp. 78-86

Author(s):

Royson Dsouza ◽

Anish Jacob Cherian ◽

Mrudula Rao ◽

Nandakumar Menon

Keyword(s):

Rural Women ◽

Tertiary Care ◽

Case Series ◽

Standard Of Care ◽

Comprehensive Management ◽

Common Cancer ◽

Resource Limited ◽

Resource Setting ◽

Low Resource Setting ◽

Tertiary Care Centers

The burden of breast cancer has been on the rise world over and has become the most common cancer among women in urban India and the second most common cancer in rural women after carcinoma cervix. There is a considerable delay in presentation associated with a lack of access to adequate and timely surgical intervention. Consequently, most patients present to tertiary care centers in advanced or inoperable stages. Many subsets of these patients can be managed adequately in resource-limited rural surgical centers. In this series of patients diagnosed with carcinoma breast, we have outlined comprehensive management that is possible in resource-constrained settings. The challenges in adhering to the standard of care and strategies to overcome these limitations have been discussed with a relevant review of the literature.

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Delayed death after hyena bite in a 3-year-old Tanzanian boy: the unique reality of neurosurgery in a resource-limited setting

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.12.peds19495 ◽

2020 ◽

Vol 25 (6) ◽

pp. 659-662

Author(s):

Denis Mkony ◽

Juma Magogo Mzimbiri ◽

Andreas Leidinger ◽

Christopher M. Bonfield ◽

Scott L. Zuckerman ◽

...

Keyword(s):

External Ventricular Drain ◽

Tissue Loss ◽

Current Case ◽

Resource Limited ◽

Resource Setting ◽

Low Resource Setting ◽

Irrigation And Debridement ◽

Lumbar Catheter ◽

Csf Diversion ◽

The Right

A 3-year-old boy presented after a hyena bite to the skull in Tanzania. A large degloving wound with herniating cerebrum was seen in the right parietotemporal region. A CT scan confirmed a large 8-cm skull defect. The patient was taken for irrigation and debridement, but due to significant tissue loss, the skin could not be closed. CSF leaked from the wound, and two additional operations for attempted closure were undertaken but failed. The plastic surgery team was consulted, but no closure was done because of the procedure’s complexity, lack of resources, and cost. CSF diversion could not be performed due to no available lumbar catheter or external ventricular drain. Meningitis developed, leading to severe hyponatremia and death. The current case highlights both the unique mechanism of a hyena bite requiring neurosurgical intervention and the realities of practicing neurosurgery in a low-resource setting.

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Social Stigma and Other Consequences of COVID-19 Pandemic in Low Resource Setting, in Eastern Africa: The Need to Increase Preventive Efforts and Addressing the Consequences, 2020

10.47363/jmcn/2020(1)107 ◽

2020 ◽

pp. 1-4

Author(s):

Shewangizaw Haile Mariam ◽

◽

Mengistu Abayneh ◽

Keyword(s):

Social Stigma ◽

Health Impact ◽

Social Consequences ◽

Eastern Africa ◽

Care Services ◽

Resource Limited ◽

Resource Setting ◽

Low Resource Setting ◽

Health Related ◽

And Control

Since the emergency of COVID-19 pandemics, many countries have been encountered a multitude of challenges. People have been facing health related and other social consequences throughout the world. It is too early to know the aggravated impact of COVID-19 on people living in resource-limited setting, like east Africa countries. In these countries, besides direct public health impact, the COVID-19 pandemic has provoked social stigma and discriminatory behaviors against people of certain ethnic backgrounds as well as anyone perceived to have been in contact with the virus. Social stigma can negatively affect those with the disease, as well as their caregivers, family, friends and communities. COVID-19 pandemics have also been provoked great impacts on daily social consumptions such as food and other food supplements. In addition, COVID-19 pandemic were overshadowed endemics diseases such as malaria, TB and HIV related care and antenatal care services as well as other non-communicable diseases prevention and control. Social stigma coupled with other consequences could result in more severe health problems, can undermine social cohesion and prompt possible social isolation of groups, which might contribute to a situation where the virus is more, not less, likely to spread and difficulties controlling a disease outbreak. Therefore, how we communicate about COVID-19 is critical in supporting people to take effective action to help combat the disease and to avoid fuelling fear and stigma. An environment needs to be created in which the disease and its impact can be discussed and addressed openly, honestly and effectively. This is a message for government, media and local organizations working on the COVID-19 infections.

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Observational study of HSG with laparoscopic correlation in infertility patients

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181926 ◽

2018 ◽

Vol 7 (5) ◽

pp. 1903

Author(s):

Avinash Dubbewar ◽

Saumen Kanti Nath

Keyword(s):

Predictive Value ◽

Pregnancy Loss ◽

Diagnostic Laparoscopy ◽

High Sensitivity ◽

Secondary Infertility ◽

Tubal Patency ◽

Primary Infertility ◽

Appropriate Therapy ◽

Infertility Patients ◽

Recurrent Early Pregnancy Loss

Background: Uterine abnormalities contribute to 10% of infertility cases and 50% of women with recurrent early pregnancy loss whereas fallopian tube abnormalities contribute to 20% of such cases.Methods: Total 61 patients of infertility and subfertility undergoing evaluation and treatment at our centre were selected for HSG. Total 25 patients from this group have undergone diagnostic laparoscopy, their findings were correlated with HSG findings retrospectively.Results: All the patients in the study group were either primary or secondary infertility patients. Of the 61 patients of infertility, 49 were in primary infertility group and 12 were in secondary infertility group. The age of patients was between 23 and 35 years. The average duration of primary infertility was 5 years and secondary infertility was 3.5years. Total 61 patients underwent HSG, 42(68.8%) patients had normal findings and 19(31.14%) patients had abnormal findings. In abnormal findings 4(6.55%) were Mullerian abnormalities and 15(24.59%) were either unilateral or bilateral tubal block. Total 25 patients underwent diagnostic laparoscopy out of 61 patients. The sensitivity of HSG was 90% and specificity was 60 % with positive predictive value of 60% and negative predictive value of 90% as compared to diagnostic laparoscopy. Tubal block was defined as any form of tubal occlusion detected at HSG and finally confirmed on laparoscopy. In our laparoscopy findings, peri-adnexal adhesions were found in 5 (20%) of the blocked tubes on laparoscopy. Endometriosis was detected in 1 (4%) of the blocked tubes and suspected intra-tubal block in 2 (8%).Pelvic inflammatory disease was found to contribute in 3 (12%).Conclusions: HSG demonstrates high sensitivity in our study. So, it should be used as the initial investigation for identifying uterine abnormality and tubal patency. As the specificity is less, we suggest that laparoscopy is necessary to recognize those cases of tubal block, which were unrecognized or wrongly recognized on HSG. In addition, the patients who were found to have tubal block on HSG, laparoscopy helps in finding the cause of infertility like existence of peritubal adhesions and endometriosis that can guide appropriate therapy.

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Congenital bicornuate unicollis uterus as a cause of secondary infertility: the role of imaging in the diagnosis in a low resource setting

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20164309 ◽

2016 ◽

Vol 2 (12) ◽

pp. 319

Author(s):

Mohammed Danfulani ◽

Abubakar Musa ◽

Sadisu M. Ma'aji ◽

Sule A. Saidu ◽

Muhammad A. Musa

Keyword(s):

Preterm Labor ◽

Intrauterine Growth Retardation ◽

Spontaneous Abortions ◽

Secondary Infertility ◽

Intrauterine Growth ◽

Resource Setting ◽

Low Resource Setting ◽

Uterine Anomalies ◽

Embryonic Life

Variety of congenital uterine anomalies occurs as a result of abnormal fusion of the mullerian duct during embryonic life. Bicornuate unicollis –one of such anomalies is associated with infertility, repeated spontaneous abortions, intrauterine growth retardation and preterm labor among others. We report a case of a 34-year old female para2+4 A1 with habitual abortion in secondary infertility due to bicornuate unicollis uterus that was diagnosed using hysterosalpingography (HSG) and ultrasonography. Uterine anomalies although rare are not uncommon. Imaging such as ultrasonography and HSG plays a pivotal role in the early detection of these anomalies.

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