Deciduosis in a cesarean scar

Endometriosis is the term used to describe the presence of endometrial tissue at sites other than the uterus. It may rarely arise from scar tissue due to previous abdominal surgery such as cesarean section or episiotomy and may present with some histological features of decidual change, fibrosis, hyperplasia, metaplasia and calcifications. Here we present a case report of a 34 years old gravida who had a nodular thickening of previous surgical scar and it was diagnosed as a case of deciduosis

Immunoglobulin therapy in recurrent pregnancy loss

Recurrent pregnancy loss is a global issue. This study was planned in order to evaluate the effects of high dose intravenous immunoglobulin [IVIg] in primary and secondary unexplained miscarriages in patients of recurrent pregnancy loss. Total 168 couples having history of primary or secondary recurrent pregnancy loss were included in the study. They were divided into IVIg group and control group. IVIg group was given 50 gm of IVIg on monthly basis. Control group was provided with normal saline drip at same intervals. Statistical package for social sciences 19 [SPSS 19] was used to analyze the data. Women receive IVIg treatment [primary + secondary recurrent pregnancy loss] shows significantly higher percentage of live birth as compare to control group [81%; p < 0.000]. Percentage of full term live birth is also significantly increased in IVIg group in comparison with control group [76.2%; p < 0.000]. In primary recurrent pregnancy loss total percentage of live births and full term live births were 85.3 and 79.4% in IVIg group while in control group it was 26.9% and 19.2% [p < 0.000]. In secondary recurrent pregnancy loss percentage of total number of live birth and full term live births in IVIg group is 78% and 74% in comparison with control group 32% and 26% respectively [p < 0.000]. High dose intravenous immunoglobulin has a beneficial role in patients of primary and secondary recurrent miscarriages

Uterine leiomyomata -unusual number managed with conservation of uterus

Uterine leiomyomata are the commonest neoplasms of female reproductive tract. On an average there are six to seven fibroids in the affected uterus. These neoplasms may lead to symptoms like menorrhagia, dysmenorrhea, pressure effects, urinary frequency, pelvic pain, infertility and pelvic mass. Here we present a case report of 34 years old nulliparous women having an unusual number [48] of fibroids. As she was nulliparous and wanted to conceive, her uterus was conserved and all the fibroids were surgically removed

Role of female age in determining causes of infertility and predicting outcome of in vitro fertilization

To look into various causes of infertility according to increasing age, differences in percentage of pregnancy rate after IVF in different age groups and role of various infertility parameters in determining pregnancy rate among these patients. A total of 206 infertile couples were selected and divided into two groups according to female age: Group I [<35 years, n=108] and Group II [>/= 35 years, n=98]. Diagnostic hysterosalpingography or laproscopy was done in order to rule out the tubal blockage and endometriosis. Ovarian dysfunction was excluded on the basis of hormonal analysis, IVF treatment following a long protocol for use of GnRH agonist was given to infertile couple. Analysis was done using SPSS 19 and MedCal software 12. Male causes were frequent in both groups without any significant difference [33%; p=0.882]. Tubal factor was significantly raised in older group [33%; p=0.000], whereas ovarian dysfunction was significantly higher in younger patients [33%; p=0.000]. Number of embryos transferred and pregnancy rate after IVF were significantly decreased in older couples [p

Endometrial histological findings in infertile women

Infertility is a global health problem and in Pakistan frequency of subfertility is 21.9%. The fact that cyclical histological changes in the endometrium correlate with fluctuating biorhythms of various hormone levels enables histological appearance of the endometrium to be a reliable parameter to evaluate the cause of infertility. To discern the histological patterns of endometrium in infertile women. This study was carried out at the clinic of one of the authors. The study included 120 consecutive cases of infertile women seeking Assisted Reproductive Treatment. D and C was performed to obtain the endometrial biopsy. The biopsy specimen was then fixed, processed and sectioned. Haematoxylin and Eosin staining was performed. Histological sections were examined under the microscope for evaluation of morphological features. The results were analyzed and percentages calculated. In the present study majority of patients [46.6%] belonged to 26-30 years age group. Amongst the morphological patterns observed, the percentage of cases in secretory phase was the maximum. There were 17 [14%] cases of cystic hyperplasia and the feature of intraluminal tufting was noted in 65 [54%] cases. Additionally, there were 4 [3.3%] cases of non specific endometritis and 1 [0.8%] case of tuberculous endometritis. In majority of the cases [46.7%] there was sporadic lymphocytic infiltration. Endometrial biopsy give information about hormone response of endometrium as well as the local factors of endometrium concerning non-specific and specific infections, tuberculous endometritis, hyperplasias and anovulatory cycle.

Leptin levels in infertile males

To determine the leptin levels in the serum of normal, subfertile and infertile men. Analytical study. Department of Animal Sciences Quaid-e-Azam University, Islamabad, National Institute of Health [NIH], Islamabad and Dr. Salma and Kafeel Medical Centre, Islamabad, from April to December 2009. Serum leptin levels hormonal concentrations [LH, FSH and testosterone] were determined by EIA in 154 males including 24 [15.58%] fertile, 19 [12.34%] polyzoospermic [PZs], 26 [16.88%] teratozoospermic [TZs], 27 [17.53%] astheno-teratozoospermic [ATZs], 18 [11.69%] oligozoospermic [OZs], 18 [11.69%] oligo-astheno-teratozoospermic [OATZs], 11 [7.14%] obstructive azoospermic [OBST-AZOOs] and 11 [7.14%] non-obstructive azoospermic [NON-OBST- AZOOs]. BMI was also determined, divided into groups of greater than 24. Hormonal concentrations were compared by ANOVA and correlation was performed by using Graph pad prism version 5. Significantly high levels of leptin concentrations were found in fertile [p < 0.001] as well as TZs, PZs, OZs, ATZs,[p < 0.001], OATZs [p < 0.01] and NON-OBST-AZOOs [p < 0.05] male subjects with BMI > 24 compared to fertile and infertile male patients with BMI < 24. Serum testosterone concentrations were significantly lower in PZs, OATZs, OZs, NON-OBST-AZOOs male patients with BMI < 24 compared to PZs [p < 0.05], OATZs, OZs [p < 0.01], OBST-AZOOs [p < 0.001] male patients with BMI > 24. Leptin showed a significant positive correlation with LH [p < 0.01] and FSH [p < 0.002] and a significant negative correlation with testosterone [p < 0.001]. Abnormal leptin level was significantly associated with fertility problems in males. Providing a link between leptin and reproduction factors contributing in control of testosterone and gonadotropins secretion in many aspects depending on fertility status in male subjects. BMI appears to have significant association with serum leptin levels

Pattern of benign breast diseases

This observational study was done on 234 patients at surgical unit-1 of Fauji Foundation Hospital, Rawalpindi to see the pattern of benign breast diseases in females. All patients presenting with breast lumps were evaluated clinically and subjected to FNAC or core needle biopsy. Fibrocystic disease was the commonest [26.92%] followed by fibroadenoma [23.50%]. fibrocystic disease was common in 5th decade [41.26%] and fibro adenoma in 2nd decade [42.27%] of life. Incidence of mastalgia [8.54%] was quite low with chronic granulomatous mastitis [5.98%] quite high in our study as compared to international literature

Incidence of malignancy in females presenting with breast lumps in OPD: a study of 277 cases

To find the incidence of malignancy in females presenting with breast lumps in surgical out patient and to find out the age related incidence of benign and malignant diseases in these patients. Study: A prospective study. Place and duration of study: The study was conducted from January 1999 to December 2000 at Fauji Foundation Hospital, Rawalpindi. Patients and All cases reporting to surgical outdoor with breast lumps were included and underwent investigation for the breast lumps to determine the histopathological diagnosis. A total of 277 cases were studied. 24.2% breast lumps were malignant and 75.8% were benign. The incidence of malignancy increases from 0% in 2nd decade to 38.9% in 5th and 100% in 9th decade of life. The probability of diagnosing a breast lump as a malignant is one in three in 4th decade, two in five in 5th decade and more then one in two there after. Fibrocystic disease [33.8%] and Fibro adenoma [27.1%] was the commonest finding among the benign lumps. Among malignant lumps infiltrating duct carcinoma [68.7%] is the commonest finding. There is a significantly high incidence of malignant breast lumps after the 3rd decade of life and it increases subsequently. It is recommended that the surgeon managing a case of breast lump in a patient above 30 years should be highly suspicious and cautious so that early detection and management of malignant lumps be carried out