scholarly journals The Role of Diagnostic Laparoscopy in the Unexplained Infertility Cases

2021 ◽  
Vol 2 (4) ◽  
pp. 57-63
Author(s):  
Ibrahim Arafa I. Hamed ◽  
Nahla Waer Shady ◽  
Abdu Saeed Ait-Allah
Keyword(s):  
Diagnostic Laparoscopy ◽  
Semen Analysis ◽  
Diagnostic Technique ◽  
Unexplained Infertility ◽  
University Hospital ◽  
Cross Sectional ◽  
Uterosacral Ligaments ◽  
Pelvic Ultrasonography ◽  
Infertility Patients

Purpose: The study examines how useful laparoscopy is in finalizing the diagnosis of unexplained infertility. Materials: The study included 50 women with 1 year or 2 years of infertility,  who had a regular marital life with unprotected intercourse for more than a year, normal husband's semen analysis, normal ovulation by folliculometry, normal hormonal profile, and normal hysterosalpingogram at the department of Obstetrics and Gynecology at Aswan University Hospital from January to December 2019. Methods: This is a cross-sectional observational study involving 50 women who underwent diagnostic laparoscopy after investigations and imaging failed to reveal the cause of infertility. During the procedure, the pelvis was inspected for any pathology, including the uterus, fallopian tubes, round ligaments, ureterovesical pouch, uterosacral ligaments, Douglas pouch, and ovarian fossae. Results: Diagnostic laparoscopy helped uncover abnormal pathologies such as endometriosis, adhesions, and tubal pathologies in 30 women (60%) of the 50 included in the study, whereas no abnormality was detected in the remaining 20 (40%). Conclusion: Laparoscopy is not only a crucial diagnostic technique in infertility patients, but it can also help with treatment selections. Conducting laparoscopy in cases of unexplained infertility is linked to both peritubular adhesions and pelvic endometriosis. These pelvic disorders might not be appropriately detected or treated without laparoscopy, and hysterosalpingography and basic imaging such as pelvic ultrasonography are frequently ignored.

scholarly journals Evaluation of role of laparoscopy in determining etiology of infertility

2017 ◽  
Vol 6 (12) ◽  
pp. 5322
Author(s):  
Hema K. R. ◽  
Lalitha H. S.
Keyword(s):  
Diagnostic Laparoscopy ◽  
Secondary Infertility ◽  
Peritoneal Disease ◽  
College Hospital ◽  
Medical College ◽  
Uterine Anomalies ◽  
Morphological Defects ◽  
Indispensable Tool ◽  
Infertility Patients

Background: Although population explosion is a major problem in India, infertility appears to be a problem in 5-15% of Indian population. All these patients require evaluation. Laparoscopy plays a valuable role in the diagnosis of infertility. After thorough clinical examination and specific investigations, diagnostic laparoscopy is performed to detect patency of tubes, morphological defects in uterus, ovaries and tuboperitoineal factors. This study was conducted to assess the role of diagnostic laparoscopy in the investigation of female infertility and to evaluate the various causes of infertility like endometriosis, PCOD tubal and peritoneal factors, uterine anomalies, tuberculosis etc. by using diagnostic laparoscopy.Methods: Study was carried out in 60 infertile patients attending outpatient department of hospitals attached to Sri Siddhartha Medical College Hospital, Tumkur.  Both primary and secondary infertility patients who were anxious to conceive and undergo diagnostic laparoscopy were evaluated. Those who were not willing and who were contraindicated for the procedure were excluded.Results: Diagnostic laparoscopy was performed in 72% of primary and 28% of secondary infertility patients. Majority of the patients of primary infertility were in age group 21-25 years and that of secondary were between 26-30 years. Majority of patients in both the groups had duration of 1-5 year of infertility. In our study tubal factors (50%) contributed to majority of the infertility causes. Complication rate was minimum and was comparable to other standard studies.Conclusions: Laparoscopic is the gold standard for diagnosing tubal and peritoneal disease, endometriosis and other pelvic pathology, because no other imaging technique gives the same degree of sensitivity or specificity. Hence diagnostic laparoscopy is an indispensable tool in the evaluation in the evaluation infertility.

scholarly journals The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization

2019 ◽  
Vol 8 (4) ◽  
pp. 548 ◽  
Author(s):  
Agni Pantou ◽  
Mara Simopoulou ◽  
Konstantinos Sfakianoudis ◽  
Polina Giannelou ◽  
Anna Rapani ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
In Vitro Fertilization ◽  
Primary Outcome ◽  
Unexplained Infertility ◽  
Vitro Fertilization ◽  
Natural Conception ◽  
Infertility Patients ◽  
Infertile Patients

The present study aims to explore the effectiveness of laparoscopic surgery on women presenting with infertility, of unidentified aetiology according to the standard infertility investigation, and recurrent failed In Vitro Fertilization (IVF) attempts. Identifying and correcting possible underlying pathologies by laparoscopy may subsequently enable natural conception in an effort to address infertility and avoid IVF overuse. One-hundred and seven (107) women with unidentified aetiology of infertility and recurrent failed IVF attempts met the inclusion criteria. Laparoscopic surgery was performed as the endpoint of the patients’ diagnostic journey, aiming to identify a possible underlying factor as the cause of infertility. Sixty-two (62) out of 107 patients (57.94%) that underwent laparoscopy were diagnosed with endometriosis, 25 out of the 107 patients (23.3%) were diagnosed with periadnixal and pelvic adhesions, and 20 cases (18.69%) presented with no pathology and remained unexplained. Following identification and correction of endometriosis and pelvic adhesions, patients were invited to conceive naturally. For the patients that laparoscopic investigation failed to reveal any pathology they were categorized as unexplained infertility and were subjected to a single IVF cycle. Natural conception success rate within the first postoperative year was the primary outcome. Within the first postoperative year, 30 out of 62 patients (48.38%) diagnosed with endometriosis following laparoscopic investigation achieved a natural conception, and 28 out of them (93.4%) reported live-births. Additionally, 11 out of 25 patients (44%) diagnosed with periadnixal and pelvic adhesions achieved natural conception within the first operative year. Regarding the group of unexplained infertility patients, only four out of the 20 patients (20%) achieved clinical pregnancy in the first post-operative IVF cycle. In conclusion, laparoscopy appears to be a promising approach, addressing infertility, providing significant diagnostic findings, while avoiding IVF overuse regarding patients of unidentified infertility presenting with recurrent failed IVF attempts.

Placebo use in clinical practice by nurses in an Iranian teaching hospital

2011 ◽  
Vol 18 (3) ◽  
pp. 364-373 ◽  
Author(s):  
Nayereh Baghcheghi ◽  
Hamid Reza Koohestani
Keyword(s):  
Clinical Practice ◽  
Teaching Hospital ◽  
Descriptive Study ◽  
Placebo Treatment ◽  
Self Report ◽  
University Hospital ◽  
Cross Sectional ◽  
The Past ◽  
Knowledge And Attitude

The present study was carried out to explore Iranian nurses’ use of placebos in clinical practice and their knowledge and attitude towards its use. A cross-sectional, descriptive study was conducted using self-report questionnaires. All nurses working in a university hospital in Arak (n = 342) were invited to participate in the study. Among 295 respondents, 221 (75%) reported that they had used at least one placebo within the past year and 179 (81%) told patients they were receiving actual medication. The most common reason and symptom for placebo use were after unjustified demand for medication and pain, respectively. Only 60 (20.33%) of the nurses believed that placebos should never be used. Results showed that most nurses in our study had used placebos and probably will continue to use them. Placebo use is viewed as ethically permissible among nurses. Some patients benefit from the placebos, but their use raises ethical questions. The role of placebo treatment, its mechanisms, and its ethics issues should be taught to nurses.

scholarly journals Effects of Self-Esteem on the Associations of Infertility-Related Stress With Psychological Distress Among Chinese Women With Infertility: A Cross-Sectional Study

2021 ◽  
Author(s):  
Chunying Cui ◽  
Yu Wang ◽  
Lie Wang ◽  
Xiaoxi Wang
Keyword(s):  
Psychological Distress ◽  
Chinese Women ◽  
Self Esteem ◽  
Female Infertility ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Related Stress ◽  
Infertility Patients

Abstract Background: Anxiety and depression are the most common occurring psychological distress in infertile patients. Our study aimed to evaluate the prevalence of depression and anxiety, and investigate the association of infertility-related stress with them among Chinese infertility patients. Meanwhile, the role of self-esteem in this association was explored as a positive psychological resource.Methods: The investigation was conducted between December 2017 to May 2018. Questionnaires that measured infertility-related stress, self-esteem, depression, and anxiety were distributed to 536 female infertility patients in Shenyang, China. Hierarchical linear regression analyses were used to examine the mediating and moderating role of self-esteem. Baron and Kenny’s technique, asymptotic, and resampling strategies were used to confirm the mediating role of self-esteem on the associations of infertility-related stress with depression and anxiety.Results: The prevalence of depression and anxiety was 27.9% and 42.2% among Chinese female infertility patients. Infertility-related stress was positively associated with depression and anxiety, whereas self-esteem was negatively associated with depression and anxiety. Besides, the effect of infertility-related stress on depression and anxiety gradually decreases with the increase of self-esteem. Meanwhile, self-esteem partially mediated the association of infertility-related stress with depression and anxiety.Conclusions: There was a high prevalence of psychological distress. Infertility-related stress and self-esteem were associated with psychological distress, which helped to explain why infertile women suffered higher prevalence of depression and anxiety. Besides, self-esteem mediated and moderated the effects of infertility-related stress on depression and anxiety. Interventions that focus on self-esteem may be effective and available resource to combat mental problems.

scholarly journals The role of PhD-prepared, hospital-based nurses: an inter-Nordic study

2019 ◽  
Vol 24 (7) ◽  
pp. 470-485
Author(s):  
Erik Elgaard Sørensen ◽  
Kathrine Hoffmann Kusk ◽  
Asa Muntlin Athlin ◽  
Kirsten Lode ◽  
Tone Rustøen ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Close Contact ◽  
Cross Sectional Study ◽  
Nordic Countries ◽  
University Hospital ◽  
University Hospitals ◽  
Cross Sectional ◽  
Research Activities ◽  
Evidence Based Care

Background Little is known about PhD-prepared nurses employed at Nordic university hospitals, how they are organised, what their practices look like or what career pathway they have chosen. Aims The purpose was to investigate and compare the prevalence of PhD-prepared nurses employed at university hospitals in the Nordic countries, to investigate what functions they fulfil and what research activities they undertake and to document how they describe their ideal work life. Methods A descriptive cross-sectional study. An electronic questionnaire was sent to 245 PhD-prepared nurses working at a university hospital in one of six Nordic countries and 166 responses were achieved (response rate 67%). Descriptive analyses were performed using SPSS Statistics. Results The study found notable differences among PhD-prepared nurses employed at university hospitals with respect to work function; organisational structure; satisfaction about time split between research and practice; and the mean scores of time spend on research, clinical practice and teaching, supervision and administration. Conclusions In order to succeed with capacity building among the nursing workforce, collaboration and networking with other researchers and close contact to clinical practice is important. The role of the hospital-based, PhD-prepared nurse needs to be better described and defined to ensure that evidence-based care is provided.

scholarly journals AB1072 ROLE OF ULTRASOUND IN DETECTION OF SHOULDER JOINT PATHOLOGIES IN ASYMPTOMATIC RHEUMATOID ARTHRITIS PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1825.2-1825
Author(s):  
M. G. Abdelzaher ◽  
S. Tharwat ◽  
A. Abdelkhalek ◽  
A. Abdelsalam
Keyword(s):  
Rheumatoid Arthritis ◽  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Joint Destruction ◽  
Chronic Inflammatory Disease ◽  
University Hospital ◽  
High Rate ◽  
Subscapularis Tendon ◽  
Cross Sectional

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease that results in progressive destruction of structural components of the joints1.It commonly affects the shoulder leading to pain, tenderness and decreased range of motion2.Increased shoulder pain has been found to correlate strongly with disease severity3, however there is little information available in the literature regarding shoulder pathologies in asymptomatic RA patients.Objectives:To determine the prevalence of pathologies in asymptomatic shoulders in rheumatoid arthritis patients and role of ultrasound to detect it.Methods:A cross-sectional study including two groups, first group included 36 RA patients, meeting the ACR/EULAR classification criteria for RA with no shoulder complaints. The second group included 36 healthy control subjects of similar age groups and sex, with no shoulder complaints. They were recruited from rheumatology outpatient clinic in Mansoura University Hospital. Only asymptomatic shoulders of both groups were examined clinically by inspection, palpation and special tests, then examined by ultrasound using Toshiba Xario 200 machine with 13 MHz superficial probe including biceps tendon, subscapularis tendon, supraspinatus tendon, subacromial subdeltoid (SASD) bursa, infraspinatus tendon, posterior glenohumeral joint for effusion or synovitis, acromioclavicular joint and humeral head for erosions. Findings of both groups were compared to each other.Results:Asymptomatic shoulders in RA patients showed significant number of pathologies in 72% of the examined patients in comparison with healthy subjects (17%). According to frequency, humeral erosions were detected in 12 patients (33%), acromioclavicular osteoarthritis in 8 patients (22%), biceps tenosynovitis, supraspinatus tendinopathy, glenohumeral effusion in 6 patients (17%), subscapularis tendinopathy in 4 patients (11.%), SASD bursitis in 2 patients (6%), Infraspinatus tendinopathy in 1 patient (3%).The healthy group showed less number of pathologies including supraspinatus tendinopathy 3 (8%), acromioclavicular osteoarthritis 2 (6%), humeral erosions 1 (3%).Conclusion:A significant high rate of different pathologies can be present in shoulders of RA patients despite negative history and normal physical examination. Ultrasound can be used for early detection and better management before irreversible joint destruction.References:[1]Weishaupt D, Schweitzer ME (2004) MR imaging of septic arthritis and rheumatoid arthritis of the shoulder. Magn Reson Imaging Clin N Am 12:111–124[2]Varache S, Cornec D, Morvan J, et al. Diagnostic accuracy of acr/eular 2010 criteria for rheumatoid arthritis in a 2-year cohort. The Journal of rheumatology. 2011; 38(7): 1250-1257.[3]Van de Sande MA, De Groot JH, Rozing PM. Clinical implications of rotator cuff degeneration in the rheumatic shoulder. Arthritis care & research. 2008; 59(3): 317-324.Disclosure of Interests:None declared

The role of diagnostic laparoscopy in couples treated for unexplained infertility in the fast track and standard treatment (FASTT) trial

2009 ◽  
Vol 92 (3) ◽  
pp. S32-S33 ◽  
Author(s):  
M.B. Goldman ◽  
T.A. MacKenzie ◽  
M.M. Regan ◽  
M.M. Alper ◽  
K.L. Thornton ◽  
...  
Keyword(s):  
Diagnostic Laparoscopy ◽  
Fast Track ◽  
Standard Treatment ◽  
Unexplained Infertility

scholarly journals Does Laparoscopy and Hysteroscopy Have a Place in the Diagnosis of Unexplained Infertility?

2020 ◽  
Vol 38 (01) ◽  
pp. 029-035
Author(s):  
Mohan S. Kamath ◽  
Judith F.W. Rikken ◽  
Jan Bosteels
Keyword(s):  
Intrauterine Insemination ◽  
Semen Analysis ◽  
Unexplained Infertility ◽  
Fertility Treatment ◽  
Future Research ◽  
Vitro Fertilization ◽  
Tubal Patency ◽  
The Impact

AbstractThe standard fertility workup includes assessment of ovulation, semen analysis, and evaluation of tubal patency. If the fertility workup is found to be normal, a diagnosis of unexplained infertility is made. The role of laparoscopy in fertility workup has been a matter of debate. The current review presents the evidence for and against laparoscopy and hysteroscopy during fertility workup and subsequently prior to fertility treatment. After appraising the literature, we found the role of diagnostic laparoscopy in fertility workup is limited and is dependent on factors like prevalence of pelvic infection, setting, and availability of expertise. Moreover, whenever a laparoscopy is planned as a part of the fertility workup, the preparation should include ability to carry out simultaneous therapeutic intervention to maximize the benefit. Similarly, the routine use of hysteroscopy in women with unexplained infertility cannot be recommended. There is a need to investigate the impact of choice of tubal test on chances of spontaneous conception and treatment outcomes in women with unexplained infertility. Our future research agenda should also include high-quality multicenter randomized trials assessing the cost-effectiveness of screening and operative hysteroscopy prior to intrauterine insemination or in vitro fertilization.

scholarly journals Role of Multi-Detector CT Angiography in Assesmente of Athrosclerotic Coronary Artery Disease

2020 ◽  
Vol 15 (2) ◽  
pp. 40-44
Author(s):  
Mustafa Adham Ismael
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Critical Role ◽  
Diagnostic Technique ◽  
Arterial Grafts ◽  
Cross Sectional ◽  
Venous Grafts ◽  
Artery Disease

Background:  Imaging has a critical role in the diagnosis and evaluation of cardiac diseases, beginning with chest radiography and fluoro-scopy and progressing to coronary angio-graphy, echocardiography, nuclear medicine and recently  multidetector computed tomo-graphy (MDCT) as well as magnetic resonance (MR) imaging Objective: To highlight the role of Multi-detector CT in the evaluation of coronary artery disease and its importance of being noninvasive diagnostic technique. Methods: A cross sectional study for 20 patients. Patients were asked to fast 6 hours prior to the examination and the patients with heart rates above 65 beats per minute were given cardio-selective beta-blocker and for heart rate above 75 (up to 85) beat/min, the best systole phase was used for reconstructing our images Results: for Evaluation of native coronary arteries, the CTCA showed significant lesions (occlusion or >60 % stenosis) in the native arteries of 13 patients and insignificant lesions in 7 patients.       Evaluation of CABG (8 arterial grafts); for (LIMA) graft, 83% were patented,   and 17% were narrowed and 100 % of (radial graft) were   patent. For Venous Grafts the study included 10 venous grafts; 70 % were patent, 20% were narrowed and 10 % were totally occluded. Conclusion: The multi-slice CTCA is now a clinically reliable noninvasive tool that allows the evaluation of the native coronary arteries, the bypass grafts, coronary stents.

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