ABSTRACT
To evaluate laparoscopically the causes of chronic pelvic pain in our set-up, so that appropriate treatment could be offered to these patients and unnecessary hospital visits and repeated use of antibiotics are avoided. A descriptive study. Obstetrics and gynecology outpatient department [OPD] of Liaquat University Hospital Hyderabad, Sindh - Pakistan from 1[st] October 2006 to 31[st] March 2007. This study was based on sample of convenience and conducted on women who attended OPD. A total of 4301 patients attended the OPD. Among them, 271 patients attended the OPD because of chronic pelvic pain. They were thoroughly interviewed and investigated. Those patients who did not respond to symptomatic treatment were advised laparoscopy. Thirty-three patients who fulfilled the inclusion criteria and gave consent were selected for laparoscopy. Informed consent was taken and detailed history, thorough examination and necessary investigations were carried out. Patients with serious heart or lung disease, peritonitis, intestinal obstruction, abdominal operations and malignancy were excluded. Diagnostic laparoscopy was carried out under general anesthesia and operative findings were noted on a proforma. Data were analyzed through software programme SPSS version 11.0. Of these 33 patients, majority 17[51.52%] belonged to 31-41 years of age group and were multiparous patients [57.58%]. Seventeen [51.52%] patients had dull, deep pelvic pain with occasional sharp episodes. Only 03[9.1%] patients with acute pain required hospitalization. Eleven [33.33%] patients complained of subfertility, 7[21.21%] had dysmenorrhea while 05[15.15%] had dysfunctional bleeding. Only 04[12.12%] patients complained of backache low down in the lumbosacral region. No any sign was present in 7[21.21%] patients. Uterus was bulky in 11[33.33%]patients. Adnexal masses were felt in 06[18.18%] patients while 05[15.15%] had nodularity in pouch of Douglas. Regarding laparoscopic findings, 11[33.33%] patients had chronic pelvic inflammatory disease. Varying degree of endometriosis was seen in 09[27.27%] patients. In 04[12.12%] patients, no abnormality was detected. This study emphasizes the importance of laparoscopy in evaluating the cause of chronic pelvic pain. This procedure shall be considered an essential investigation in the management of such patients so that repeated and unnecessary use of antibiotics and other drugs could be avoided
Subject(s)
Humans , Female , Adult , Pelvic Pain/etiology , LaparoscopyABSTRACT
The seeds of Nigella sativa plant have been used to promote health and fight disease for centuries especially in the Middle East and Southeast Asia. This plant has been a great focus of research. This clinical study was undertaken to determine the adjuvant effect of Nigella sativa oil on various clinical and biochemical parameters of the metabolic syndrome This prospective study was conducted at a tertiary health care centre in North India. After final diagnosis and considering inclusion and exclusion criteria, sixty patients were enrolled in this study. Informed and written consent was taken from all the patients enrolled. Approval from institutional ethical committee was obtained. Patients were divided into two groups of thirty. In group I [standard group] patients were given tablet Atorvastatin 10 mg once a day and tablet Metformin 500 mg twice a day for a period of six weeks. In group II [Nigella sativa] group, patients were given tablet Atorvastatin 10 mg once a day, tablet Metformin 500 mg twice a day and Nigella sativa oil 2.5 ml twice daily for a period of six weeks. Blood sugar, both fasting and postprandial, fasting lipid profile, body mass index, body weight and waist circumference were recorded before and after completion of therapy. The above mentioned methodology was followed and it was found that the difference in percentage improvement in group II was significant with reference to total cholesterol, low density lipoprotein [LDL] and fasting blood glucose [p < 0.05]. Nigella sativa oil is effective as an add-on therapy in patients with metabolic syndrome. Nigella sativa oil has a significant therapeutic activity in diabetic and dyslipidemic patients