ABSTRACT
Introduction: Infertility is defined as ‘the failure to achievea clinical pregnancy after 12 months or more of regularunprotected sexual intercourse’ by WHO. The WHO estimatesthe overall prevalence of primary infertility in India to bebetween 3.9% and 16.8%. The study was done to assess therole of diagnostic laparoscopy in infertile patients in a ruraltertiary care hospital, in southern India.Materail and method: This is a retrospective study conductedin tertiary care hospital for a period of one year. All patientswith complaints of infertility (primary and secondary) whowere admitted and evaluated for infertility in OBG departmentof MVJ medical college, Hoskote for a period of one yearwere included in the study.60 patients underwent diagnosticlaparoscopy .The prevalence of abnormalities were note.Results: Sixty patients underwent diagnostic laparoscopywith chromopertubation for infertility during period of oneyear. Among 60 patients, 45 (76.66%) patients had primaryinfertility and 15(23.34%) patients had secondary infertility.The patient’s age distribution was between 18 – 38 yrs.Maximum number of patients were between 20- 30 years.Among 60 patients , 26 (43.33%) patients had abnormallaparoscopic findings.Multiple abnormalities were foundin most of the patients .18(30%) patients had PID and itssqueal of peritubal adhesions , 11(18.3%) patients had PCOD, 4(6.66%) patients had endometriosis, 1(2.77%)patient hadhypoplastic uterus, 7(11.66%) patients had uterine fibroids,10(16.66%0 patients had tubal block on chromopertubation .Conclusion: Diagnostic laparoscopy provides an unobstructedmagnified view of the pelvic reproductive organs. Ovarian,tubal and peritoneal surface pathology can be easily identifiedwhich are missed on routine infertility work up Hencediagnostic laparoscopy is an essential investigation in theevaluation of female infertility and also helps in decisionmaking, patient selection for IUI , IVF or natural conceptionand in treating infertile couples.
ABSTRACT
INTRODUCTION: The study aimed to investigate the interplay between Monte Carlo Variance (MCV) and fluence smoothing factor (FSF) in volumetric modulated arc therapy treatment planning by using a sample set of complex treatment planning cases and a X‑ray Voxel Monte Carlo–based treatment planning system equipped with tools to tune fluence smoothness as well as MCV. MATERIALS AND METHODS: The dosimetric (dose to tumor volume, and organ at risk) and physical characteristic (treatment time, number of segments, and so on) of a set 45 treatment plans for all combinations of 1%, 3%, 5% MCV and 1, 3, 5 FSF were evaluated for five carcinoma esophagus cases under the study. RESULT: Increase in FSF reduce the treatment time. Variation of MCV and FSF gives a highest planning target volume (PTV), heart and lung dose variation of 3.6%, 12.8% and 4.3%, respectively. The heart dose variation was highest among all organs at risk. Highest variation of spinal cord dose was 0.6 Gy. CONCLUSION: Variation of MCV and FSF influences the organ at risk (OAR) doses significantly but not PTV coverage and dose homogeneity. Variation in FSF causes difference in dosimetric and physical parameters for the treatment plans but variation of MCV does not. MCV 3% or less do not improve the plan quality significantly (physical and clinical) compared with MCV greater than 3%. The use of MCV between 3% and 5% gives similar results as 1% with lesser calculation time. Minimally detected differences in plan quality suggest that the optimum FSF can be set between 3 and 5.
ABSTRACT
Background: Tamoxifen is given in women with breast cancer who underwent surgery and is receptor positive. As Tamoxifen increases the risk of endometrial carcinoma to 2% a screening technique such as transvaginal sonography is essential to identify women at risk of endometrial cancer. Aim: To identify endometrial pathology in women using tamoxifen after surgery for breast cancer Material and methods: Fifty women on tamoxifen for breast cancer attending the department of radiotherapy were screened once in six months by history taking, clinical examination and measuring endometrial thickness with TVS. Endometrial biopsy for histology was performed in women with endometrial thickness more than 11 mm Observation: Endometrial biopsy was performed in ten women who were found to have endometrial thickness > 11 mm. Out of ten, four had normal endometrium, three had simple hyperplasia one was found to have complex endometrial hyperplasia without atypia and two were reported to have inadequate endometrium. Conclusion: Routine screening with TVS is not a cost effective measure as tamoxifen induces subepithelial stromal hypertrophy resulting in minimal tissue yield on endometrial biopsy. Therefore bleeding should remain the primary trigger for investigation of women on tamoxifen.
ABSTRACT
Several antibiotics are in use to treat different diseases caused by human pathogenic microorganisms. It is being observed that the invented medicines are not much effective in treatment, as the infection causing microbes are becoming resistant and modifying themselves into multidrug resistant strains. To fight against these human pathogens there is a need of introduction of new antibiotics. The synthetic derivatives or synthetic antibiotics are effective but unsafe for use and the results are not satisfactory due the resistance building capacity of the microbes. At the same time, the side effects and adverse reactions caused by these multispectrum antibiotics are not ignorable. Due to these reasons plant derived compounds or phytomedicines having antimicrobial action are needed to be evaluated, introduced and implemented through clinical and biological trials. Here we present the information about some plants which are reported to be antimicrobial in nature and act against human pathogens. The efficacy of their antimicrobial action needs to be evaluated for their biological functions. To be concise, our review is limited to the plants showing antimicrobial efficacy against Klebsiella pnuemoniae. For the present work we have focused on essential oil yielding plants which are known to be more useful to fight against this pathogen. A total of 90 plants species are reviewed, among them 14 are essential oil yielding plants. The plants which are able to inhibit the growth of the K. pneumoniae are enlisted and their details of the study such as family it belongs, parts used, microbial strain number used in the study, extractant and the standard antibiotic used to compare the effect are tabulated in detail to have a complete analysis of the information from the recent work. The essential yielding plants are tabulated separately.
ABSTRACT
Seventy-one adult skulls (58 dentulous skulls: 56 bilateral and 2 unilateral, 13 edentulous: 11 bilateral and 2 unilateral) of unknown sex were examined for the variations of the location of the greater palatine foramen. The location of greater palatine foramen (GPF) was noted with relation to mid sagittal suture (MSS), posterior palatal border (PPB), and maxillary molars by measuring the distances using a sliding caliper to the nearest millimeter. Difference in the distance of the foramen from MSS and PPG in both the skull types was found to be statistically insignificant. Commonest location of the foramen was found to be opposite to third molar tooth (85.95%), followed by the interval between second and third molar teeth (13.15%), and opposite to the second molar tooth (only one case - 0.88%). Well-formed bony canals were found along the groove for the palatine nerves and vessels unilaterally in the right side in two skulls. These observation may be of help to the dental surgeon during the peripheral block of maxillary nerve for the maxillo-facial surgery.