ABSTRACT
Background: One of the most important and underappreciated reproductive health problems in developing countries is that of infertility. Objective of this study was to evaluate HSC (hysteroscopy), HSG (hysterosalpingography) and ultrasonography in infertility.Methods: This study was conducted among 100 infertile patients over a period of two years. The patients were questioned for the detailed history including socioeconomic status, medical history and previous history of taking any medications and supplements. The recruited patients had to undergo.Results: Transvaginal sonography and clinical examination were done. Transvaginal sonography detected abnormality in 40% of women. 65 women had normal hysterosalpingography findings whereas the rest 35 women had abnormal hysterosalpingography findings. Thirty nine percent (39%) had normal hysteroscopic findings while sixty one percent (61%) had abnormal findings. The study depicts that hysteroscopy has sensitivity (95%) and negative predictive value NPV (92%) whereas that of TVS is 48.9% and 44.9% respectively. Hysterosalpingography has sensitivity 68.3% and NPV 40.3%. Specificity (100%) and positive predictive value PPV (100%) of all the three modalities are the same.Conclusions: The results of the present study showed that each modality provided useful information but no single modality provided complete information for evaluating infertile women. Thus, a combination of all three modalities- TVS (transvaginal sonography), HSG (hysterosalpingography) and hysteroscopy is necessary to evaluate infertile women.
ABSTRACT
Background: The objective of the present study was to observe the efficacy of LNG-IUS in the treatment of heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis.Methods: LNG-IUS was inserted in forty women between 20-50 years of age presenting with heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis diagnosed on transvaginal ultrasonography and followed up after 1 month, 3 months and 6 months of insertion. Subjective assessment of menstrual blood loss was done by pictorial blood loss assessment chart and dysmenorrhoea was assessed on the basis of universal pain assessment tool and side effects were noted at each visit.Results: Mean patients’ age was between 31-40 years (72.5%) and the follow up duration was 6 months. Significant improvements in dysmenorrhea, HMB and haemoglobin levels were observed. There was no significant change in the uterine volume. The most common side effect was prolonged vaginal spotting (n=26, 65%) and pain abdomen (n=13, 32.5%). LNG-IUS expulsion was observed in 1 patient (n=1, 2.5%). 3 patients underwent hysterectomy (n=3, 7.5%). The overall success rate of LNG-IUS was 82.5%.Conclusions: The LNG-IUS appears to be an effective method in alleviating dysmenorrhoea and heavy menstrual bleeding associated with adenomyosis during 6 months of study. It may be a valuable long-term alternative for the treatment of adenomyosis in young and perimenopausal women and it is a good strategy to reduce the number of hysterectomies in women with adenomyosis.
ABSTRACT
Various studies have reported the effect of different phases of normal menstrual cycle on the autonomic control over the cardiac activity using heart rate variability (HRV) analysis. However, information on cardiac autonomic activity in young females suffering from primary dysmenorrhea (PD) is scant. Hence, the aim of the present study was to assess the HRV and blood pressure (BP) in different phases of menstrual cycle in women with PD and to compare these findings with eumenorrheic females. Sixty healthy unmarried female subjects (30 females with PD and 30 control subjects), in the age group of 18-25 years, having regular 28-32 days menstrual cycle were recruited for the study. Anthropometric measurements such as height, weight, BMI and WHR were measured. Blood pressure was measured with automatic blood pressure monitor and lead II ECG recordings were done to obtain HRV, during menstrual, follicular and luteal phases of menstrual cycle in both groups. The data recorded were subjected to time and frequency domain analysis. The results showed that dysmenorrheic women had significantly high BMI (P<0.05). Analysis of HRV during the different phases of the menstrual cycle between two groups revealed significantly increased (P<0.01) mean HR and significantly reduced (P<0.01) mean RR and RMSSD in all the 3 examined phases, SDNN significantly less (P<0.05) and systolic BP significantly higher (P<0.001) during the luteal phase in study group compared to control. Also, we observed a statistically significant decrease in TP and LF ms2 (P<0.05), HF ms2 & nu (P<0.01) in menstrual phase, HF ms2 (P<0.05) and HF nu (P<0.01) in luteal phase, while LF nu and LF-HF ratio were found to be significantly higher (P<0.01) in menstrual and luteal phases in women with PD compared to control group. This study has shown decreased HRV in the form of increased sympathetic tone and decreased parasympathetic activity in dysmenorrheic women which may be considered an important cardiovascular risk factor.