scholarly journals Role of diagnostic hystero-laparoscopy in the evaluation of female infertility

2019 ◽  
Vol 8 (8) ◽  
pp. 3156
Author(s):  
Deepa Shanmugham ◽  
Nambala Divya Sahitya ◽  
Sindhu Natarajan ◽  
Deepak Kannan Saravanany
Keyword(s):  
Tertiary Care ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Tertiary Care Centre ◽  
Male Factor ◽  
Acute Pelvic Inflammatory Disease ◽  
Tubal Factor ◽  
The Mean ◽  
A Prospective Study

Background: Infertility affects about 10-15% of reproductive age couples. The main causes of infertility include male factor, ovulatory disorders, tubal factor and endometriosis. This study was conducted to determine the role of Diagnostic hystero-laparoscopy (DHL) in the evaluation of female infertility.Methods: This study was a prospective study done in a tertiary care centre over a period of 1 year on all infertile couples. The exclusion criteria: male factor infertility, hypothyroidism, hyperprolactinemia, acute pelvic inflammatory disease. Diagnostic hysterolaparoscopy was performed in all study patients in pre ovulatory phase, under general anaesthesia. The findings were then documented and analysed.Results: A total number of 90 patients were recruited for the study. The mean age of the patients was 28±3 years. The mean BMI of the study patients was 25±4 kg/m2. The mean duration of infertility was 5.4 years. On laparoscopy, 28 patients had polycystic ovaries (31.1%), 4 patients had pelvic adhesions (4.4%), 2 patients had endometriosis (2.2%) and tubal block was identified in 10 patients (11.11%). 10 patients had abnormal findings on hysteroscopy.Conclusions: Hystero laparoscopy is an effective diagnostic tool in the evaluation of infertility and has to be included in basic diagnostic workup.

scholarly journals Role of hysterolaparoscopy in the diagnosis and management of infertility

2020 ◽  
Vol 9 (4) ◽  
pp. 1585
Author(s):  
Saumya P. Agrawal ◽  
Nupoor Kedia ◽  
Shashwat K. Jani ◽  
Siddharth P. Agrawal
Keyword(s):  
Tertiary Care ◽  
Care Centre ◽  
Polycystic Ovaries ◽  
Tertiary Care Centre ◽  
Unprotected Sexual Intercourse ◽  
Therapeutic Measure ◽  
Centre Hospital ◽  
A Prospective Study ◽  
Laparoscopic Finding

Background: Infertility is defined by WHO and ICMART as a disease of the reproductive system by the failure to achieve a clinical pregnancy after 12 months or more regular unprotected sexual intercourse. Objective of this study were to assess the role of hysteroscopy and laparoscopy in the evaluation of female infertility. To assess the therapeutic role of these endoscopic modalities in cases of infertility.Methods: A prospective study of 112 women coming with the complain of infertility to a tertiary care centre hospital in Ahmedabad over a period of 30 months from January 2017 to June 2019.Results: Of the 112 cases, 69.7% had primary infertility and 30.3% had secondary infertility. Septum was the most common hysteroscopic finding (7.1%) followed by polyps (5.4%) and synechiae (3.6%). Adhesions was the most common laparoscopic finding (23.2%) followed by tubal blocks (19.7%) and fibroid (17.9%). Polycystic ovaries were seen in 12.5% patients followed by endometriosis in 10.7% women. Myomectomy was most common therapeutic procedure (17.9%) followed by adhesiolysis in 14.3% women and PCO drilling in 8.9% women.Conclusions: Hysterolaparoscopy is useful as a diagnostic and therapeutic measure for women having infertility.

scholarly journals ROLE OF TLC NLR & SERUM CREATININE IN DIAGNOSING ACUTE APPENDICITIS: A PROSPECTIVE STUDY IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 1-3
Author(s):  
Madhu B S ◽  
Shraddha Shenoy
Keyword(s):  
Acute Appendicitis ◽  
Serum Creatinine ◽  
Prospective Study ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cutoff Value ◽  
A Prospective Study ◽  
Complicated Acute Appendicitis

Aim- To assess the role of TLC and NLR and serum creatinine in diagnosing acute appendicitis. Background-Acute appendicitis being the most common surgical emergency globally can lead to varied consequences if not detected and treated accurately. Early and precise biochemical detectors affect the severity of acute appendicitis. Materials and methodology- A prospective study was conducted in K R Hospital, Mysore from 2019-2020. All cases of acute appendicitis during this period were assessed for severity. TLC, NLR and serum creatinine were assessed and correlated with severity of acute appendicitis. Results- A total of 96 patients were included in the study, 72 patients had SAA and 24 had CAA. This was classified in accordance to the cut off values. TC cut off point was 15,050 cells/cumm ,Sn 91.7 %, Sp 74.6%. The NLR cutoff value was 4.56, Sn of 83.3%, Sp of 66.2%. The cutoff value for neutrophil count was 77.6%, Sn 91.7% , Sp 71.18%. The cutoff value for lymphocyte count was 18.2%, Sn was 91.7%, Sp 65.8%. The cutoff value of creatinine was 0.73, Sn of 83.3%, Sp 80.03%. Conclusion- TC, TLC, NLR and Serum creatinine combinedly help distinguishing between the simple acute appendicitis and complicated acute appendicitis and is a very economical measure for the prediction

scholarly journals Role of Mifepristone in treatment of uterine fibroid: an experience from tertiary care centre in South India

2019 ◽  
Vol 8 (3) ◽  
pp. 974
Author(s):  
S. V. Nachiketha ◽  
Veena Hadi
Keyword(s):  
Side Effects ◽  
Uterine Fibroid ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Tertiary Care Centre ◽  
Common Benign Tumour ◽  
Fibroid Volume ◽  
Reproductive Age Group

Background: Uterine fibroid are the most common benign tumour of the uterus and is seen in 20% of women in their reproductive age group. The aim of the study was to evaluate effect of Mifepristone on uterine fibroid with reference to reduction in size of fibroid and change in symptomatic profile.Methods: It is a hospital based interventional study conducted at KIMS Hubli hospital. 98 patients with symptomatic fibroid uterus were given 50mg of Mifepristone on alternate day for 3 months.Results: Mifepristone treatment significantly reduced mean PBAC score from baseline score of 212.61 to 20.39 at the end of 3rd month of therapy. Mean fibroid volume also reduced significantly from baseline value of 237.95cm3 to 30.45cm3 after 3 months of treatment. At the end of therapy hemoglobin was raised from 9.57g/dl at baseline to 10.42g/dl after 3 months of treatment. No major side effects were observed, and 7% patients had hysterectomy.Conclusions: Mifepristone is very useful option in perimenopausal women with symptomatic fibroid. It reduces fibroid size and its symptoms without any major side effects. However, future long term RCTs are needed to assess the safety and efficacy of Mifepristone.

The role of Papanicolaou smear in the diagnosis of pathological flora in reproductive age group patients in tertiary care centre

2019 ◽  
Vol 9 (2) ◽  
pp. 72-75
Author(s):  
Megalamane Supreetha ◽  
◽  
Preeti Ashok Utnal ◽  
Anantharamaiah Hemalatha ◽  
◽  
...  
Keyword(s):  
Tertiary Care ◽  
Reproductive Age ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Papanicolaou Smear ◽  
Reproductive Age Group

scholarly journals A PROSPECTIVE STUDY OF THE PATTERN OF USE OF ANTIMICROBIAL AGENTS IN SURGICAL PROPHYLAXIS IN A TERTIARY CARE CENTRE

2016 ◽  
Vol 9 (1) ◽  
pp. 283
Author(s):  
C. S. Brethis ◽  
S. Thamizharasan ◽  
S. A. Sridevi ◽  
B. Kalaiselvi ◽  
M. Balaji Singh ◽  
...  
Keyword(s):  
Antimicrobial Agent ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Cost Effective ◽  
Surgical Prophylaxis ◽  
Tertiary Care Centre ◽  
Medical College ◽  
The Mean ◽  
A Prospective Study ◽  
Induction Of Anaesthesia

<p><strong>Objective: </strong>To evaluate the most common class of antimicrobial agents used in surgical prophylaxis.<strong> </strong>To evaluate the timing, dosage, route and duration of use of antimicrobial agents in surgical prophylaxis.<strong></strong></p><p><strong>Methods: </strong>The study subjects were 214 patients who underwent general surgical procedures at Vinayaka Missions Kirupananda Variyar Medical College from July 2013 to June 2014. The use of antimicrobial agents was noted from the first dose of antibiotic given before the induction of anaesthesia. After surgery was completed the duration of antibiotic in the post-operative ward was noted. <strong></strong></p><p><strong>Results: </strong>Majority of the patients were males of age group 50-60 y and the most common surgical procedure was hernioplasty. Combination therapy with two antimicrobial agents was more preferred regimen 126 (58.9%). Among the antimicrobial agent's cefotaxime 114 (24.8%) was the most commonly prescribed drug and it was followed by metronidazole 121 (21.9%). ceftriaxone 60 (13.1%) was the third most commonly prescribed antimicrobial agent. The mean duration of prescription of antimicrobial agents in the present study was 4.78 d and the mean cost of drug treatment was 787.54 rupees. The cost-effective regimen was that of aminoglycosides and imidazole.</p><p><strong>Conclusion: </strong>The choice of antimicrobial agent was based on the local prevalence pattern of microorganisms. The intravenous administration of antibiotic prophylaxis immediately before or after the induction of anaesthesia is the most reliable method for ensuring effective serum concentration at the time of surgery. The antimicrobial agent chosen must cover all the most likely contaminating organisms.</p>

scholarly journals Analysis of causes and clinical pattern of infertility in couples coming to a tertiary care centre in Bihar, India

2017 ◽  
Vol 6 (6) ◽  
pp. 2279
Author(s):  
Kalpana Singh ◽  
Rekha Kumari ◽  
Alok Ranjan ◽  
Geetam Bharti
Keyword(s):  
Laboratory Tests ◽  
Semen Analysis ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Tertiary Care Centre ◽  
Male Factor ◽  
Secondary Infertility ◽  
Unprotected Sexual Intercourse ◽  
Clinical Pattern ◽  
High Level

Background: Infertility is one of the major health problems and a socially destabilizing condition for couples often causing marital disharmony. Infertility is defined as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, its prevalence is approximately 8-12%.There are numerous factors such as anatomical, physiological and genetic factors that cause infertility. Many environmental and acquired factors also lead to inability to conceive. Objective of the present study was to determine the causes and clinical pattern of infertility in infertile couples.Methods: It was a hospital based observational study carried out on 750 women in reproductive age group attending out-patient clinic of Reproductive Biology Department of Indira Gandhi Institute of Medical Sciences (IGIMS) at Patna during April 2013 to March 2017. All the cases of primary and secondary infertility diagnosed after full examinations and laboratory tests were included and cases lacking of full examinations and laboratory tests were excluded. All the data of infertile couples were recorded in a semi-structured Case Information Performa.Results: Out of 750 women 454 women had all the data and they participated in the study Nearly 68% women had primary infertility and rest had secondary infertility. Male factor was responsible in 37.39%, female factor in 20.48%, unexplained in 22.46% while a combination of both factor was seen in 8.37% cases in our study .135 women had irregular menstrual cycles in which 64(47%) had oligomenohhrea. 79% women had normal ultrasonography and nearly 11% of women had evidence of PCOD. 24% women had hypothyroidism (TSH more than 4.5 IU/L) and 59(13%) were found to have high level of prolactin i.e. >25 ng/ml. Nearly 8% of women had high level of FSH i.e. more than 10 IU/L which is an indicator of ovarian resistance. In nearly 16% women one fallopian tube was found blocked and 8% had both tubes blocked in hysterosalpingography. Husband semen analysis was done to assess male factor. Nearly 14% of their male partners suffered from azoospermia and 23% had at least one abnormal parameter in semen analysis.Conclusions: Etiological pattern of infertility varies in different parts of World. Male and female factors both are responsible for infertility. So, both the partners should be counselled and investigated properly.

scholarly journals Safety and feasibility of video assisted thoracoscopic thymectomy for myasthenia gravis: a single centre experience

2019 ◽  
Vol 6 (6) ◽  
pp. 2159
Author(s):  
Raj N. Gajbhiye ◽  
Hemant Bhanarkar ◽  
Vikrant V. Akulwar ◽  
Bhupesh Tirpude ◽  
Niketan Jambhulkar ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Tertiary Care ◽  
Operating Time ◽  
Neurological Outcomes ◽  
Video Assisted ◽  
Single Centre Experience ◽  
The Mean ◽  
A Prospective Study ◽  
Vats Thymectomy

Background: Myasthenia gravis (MG) is an autoimmune disease affecting acetylcholine postsynaptic receptor of voluntary muscles. Thymectomy is a mainstay in the treatment for myasthenia gravis with or without thymoma. For many years transsternal and transcervical thymectomy had been the most common approaches used, video assisted thoracoscopic thymectomy is still not accepted as approach of choice. We intend to study the role of Video assisted thoracoscopic thymectomy for myasthenia gravis in central Indian population.Methods: Study was conducted in single tertiary care institute from January 2015 to November 2018. It is a prospective study. Aims of the study were to evaluate the safety and feasibility of video assisted thoracoscopic thymectomy for patients of myasthenia gravis. All patients of myasthenia gravis who underwent underwent video assisted thoracoscopic thymectomy (VATS) were included in the study. Intraoperative and postoperative details were studied to assess the safety and feasibility of VATS for treatment of myasthenia gravis.Results: 16 patients including 7 men and 9 women with the mean age of 35.5 years were investigated. All patients had myasthenia gravis, 12 pts had thymoma while remaining 4 pts had normal thymus. Mean operating time was 104 mins, Mean intraoperative blood loss was 45 ml (range 20 to 60 ml). There was no major intraoperative or postoperative complication or mortality. Mean ICU stay and hospital stay was 33 hrs and 4.25 days respectively.Conclusions: VATS thymectomy is safe and effective approach for the treatment of MG with or without thymoma. MG treated by VATS resulted in comparable neurological outcomes to those associated with the transsternal approach.

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