Role of hysterolaparoscopy in the evaluation of female infertility in a tertiary care centre

Background: Infertility is one of the most important and underappreciated reproductive health problems in developing countries. Inability to conceive bears a social stigma which causes societal repercussion and personal suffering. The advent of hysterolaparoscopy have redefined the evaluation and treatment of infertile women. Study aimed to assess the role of hysterolaparoscopy in the evaluation of female infertility.Methods: This prospective observational study was done in the department of obstetrics and gynaecology, Gandhi Medical College, Sultania Zanana Hospital, Bhopal, during the period between 1st December 2016 to 30th November 2017. 104 infertile patients either with primary or secondary infertility were included after thorough evaluation.Results: Out of 104 infertile patients, 82(78.8%) women had primary infertility and rest 22(21.1%) women had secondary infertility. In primary infertility group, most common laparoscopic finding was PCOD in 24(29%) women and in secondary infertility group, tubal blockage was seen in 9(40%) women. The most common pathology seen in hysteroscopy was submucous fibroid in 6(7.3%) women with primary infertility, whereas in secondary infertility group, synechiae was found in 2(9%) patients and septum was seen in 1(4.5%) patient. Out of 104 patients, 33 (31.7%) patients underwent various interventions. The most common intervention was ovarian drilling for PCOS in 21(63.3%) patients followed by hysteroscopic cannulation in 5(15.5%) patients.Conclusions: Hysterolaparoscopy is a very useful tool that can detect various structural abnormalities in multiple sites like uterus, tubes, ovaries and peritoneal cavity in the same sitting. When done by experienced hands and proper selection of patients, hysterolaparoscopy can be considered as a definitive investigative procedure for evaluation of female infertility.

Quantitative Assessment of Hand Dysfunction in Patients with Early Parkinson's Disease and Focal Hand Dystonia

OBJECTIVE: Motor impairments related to hand function are common symptoms in patients with movement disorders, such as Parkinson’s disease (PD) and focal hand dystonia (FHD). However, hand dysfunction has not been quantitatively assessed as a clinical tool for screening patient groups from healthy controls (HCs). The aim of our study was 1) to quantitatively assess hand dysfunction in patients with PD and FHD and its usefulness as a screening tool 2) to grade disease severity in PD and FHD based on hand dysfunction. METHODS: The current case-control study included HCs (n = 50) and patients with known history of PD (n = 25) or FHD (n = 16). Hand function was assessed by a precision grip task while participants lifted objects of 1.3 N and 1.7 N under dry skin conditions, followed by very wet skin conditions (VWSCs). Receiver operating characteristic and summative scoring analyses were performed. RESULTS: In PD, the combination of loading phase duration and lifting phase duration at quantitative cutoffs of 0.36 and 0.74 seconds identified 21/25 patients as diseased and 49/50 subjects as HCs with 1.7 N under VWSCs. In PD, 5/21 was graded as “mild” and 16/21 as “moderate cases.” In FHD, slip force at a cutoff of 1.2 N identified 13/16 patients as diseased and 41/50 subjects as HC with 1.7 N under VWSCs, but disease severity could not be graded. CONCLUSION: Our results demonstrate the use of precision grip task as an important clinical tool in assessment of hand dysfunction in movement disorder patients. Use of quantitative cutoffs may improve diagnostic accuracy and serve as a valuable adjunct to existing clinical assessment methods.

Substance abuse amongst the medical graduate students in a developing country.

Background & objectives: Substance abuse is found worldwide including among students. We carried out this study to estimate the prevalence of substance abuse among medical student studying in a medical college in north India. Methods: Using a validated questionnaire a cross-sectional survey was conducted among 230 undergraduate and postgraduate medical students in a private medical college. Results: The prevalence of substance abuse was 20.43 per cent (47/230) among medical students. An increase in substance abuse was observed in the latter years of medical education. A total of 43 of 47 (91.7%) students using these substances were aware of the ill effects. The most common reasons for substance use were relief from psychological stress (34/47, 72.4%) and occasional celebration (34/47, 72.4%). Of the 47 substance users, 28 (59.6%) made past attempts to quit the substance abuse. Interpretation & conclusions: Nearly one-fifth of medical students abuse at least one substance despite knowing the ill effects with the main predisposing factor being the psychological stress.

Impact of Total Contact Plaster Boot via off Loading Practice in Trophic Ulcers of the Feet: Case Series

Trophic ulcers have emerged as one of the major complications following diabetes mellitus (DM) and Hansen’s diseases (HD). In this case series, the study attempted total contact plaster boot using a readily available plaster of Paris to treat trophic ulcer for 10 subjects. A total of five subjects with DM and five subjects with HD were included based on the study criteria. Pre and post test measure of wound measurement size following total contact plaster boot were taken as an outcome measure. All ten subjects showed decrease in size of wound following fifteen days of treatment. No adverse effects were associated with this type of treatment. Subjects with trophic ulcer may benefit from the application of total contact plaster boot.

Prosthetic Rehabilitation of Cleft Palate Patient : A Case Report.

Cleft palate is a commonly observed congenital maxillofacial defect. Numerous methods of prosthodontic rehabilitation have been advocated ranging from simple removable prosthesis to implant supported restorations. The final choice mainly depends upon the existing clinical condition and patient’s acceptance towards treatment. This clinical report describes a conservative and cost effective method of rehabilitation of a cleft palate patient using a removable partial denture made from heat polymerizing acrylic resin.