ABSTRACT
Background: Tuberculosis is an increasing health problem worldwide with around 9.6 billion new cases reported every year. Female genital tuberculosis (FGTB) has a varying incidence ranging from a very low of 0.69% in developed nations to as high as 19% in developing nations like India. The average incidence of infertility due to tuberculosis is 5-10% worldwide.Methods: The study was a hospital based prospective clinical study, from September 2014-2017 with sample size of 355 infertility cases. Endometrial sampling and diagnostic hystero-laparoscopy were used for diagnosis. Endometrial sample subjected for both the test CBNAAT and HPR was used for confirmation of positive patients. Inclusion criteria were, infertile patients diagnosed with genital tuberculosis who were then given treatment. Patients diagnosed to have infertility due to causes other than TB were excluded from the study. Highly suspected cases and those who were willing underwent diagnostic laparoscopy.Results: Out of 355 cases of infertility, 83 were because of genital TB, received treatment out of which 32 conceived. CBNAAT was very sensitive than histopathology or laparoscopy. The live birth rate and conception rate were 20.24% and 38.09 % respectively.Conclusions: CBNAAT is OPD based economical test (free by GOI), very sensitive and picked up more cases than histopathology or laparoscopy. The live birth rate and conception rate were found to be higher than other studies possible due to intervention at an earlier stage of the disease process. This test should be widely used by gynecologist for early detection of genital tuberculosis.
ABSTRACT
Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders seen in infertility clinic of Gynae OPD. It is basically is disease of metabolic disorder and requires ultrasound and hormonal assay for its diagnosis.Methods: The study was carried out in the GOPD of MGM medical College and M.Y. Hospital Indore (M.P.) India. It included 200 women in the age group 18-40 years diagnosed as PCOS and who were compared with 200 women of same age group without PCOS. The height, weight BMI and waist hip ratio were measured and analyzed statistically.Results: The present study shows that women with PCOS had higher incidence of acne hirsutism and irregular menses (p<0.0001), women with PCOS had higher mean ovarian volume measurement (11±1.4cc) compared to female controls who had lower volume of ovary with a range of (7.94±2.34cc. (p<0.0001) as calculated by USG by sonologist.Conclusions: The presence of central obesity, (waist hip ratio >0.87) is an indication for presence of PCOS. Thus, these patients may undergo further hormone evaluation and this simple measurement can help to screen out PCOS from general population. This prevents financial burden on low resource settings.
ABSTRACT
Background: PPH is responsible for quarter of maternal deaths occurring worldwide and its incidence is increasing in developed world. According to Confidential Enquiries into Maternal and Child Health (CEMACH) report obstetric hemorrhage occurs in around3.7 per 1000 births. The objective of the study is that it was a prospective randomized comparative study of misoprostol and balloon tamponade via condom catheter to prevent postpartum hemorrhage in normal delivered patients at MYH.Methods: A sample size of 200 normal delivered patients between age group 18 and 45 years is chosen with excessive bleeding after third stage of labour and after administration of oxytocics. These 200 patients are divided into two groups: First group receiving Misoprostol and applying condom catheter in other group. Both groups are evaluated for PPH.Results: It was found that CG balloon condom catheter was a much better and more effective alternative in controlling PPH than Misoprostol as the failure rate with CG balloon condom catheter were much less than that with misoprostol. Due to its cost effectiveness and being easily available at primary health center and due to absence of any drug reactions and easy technique of formation makes it a better modality in controlling PPH even at PHC.Conclusions: Patients with condom catheter in situ must show better result than patients receiving misoprostol.