ABSTRACT
Background: The inability to conceive is one of the most distressing conditions for a couple. It not only makes the female incomplete but also the social taboos attached are phenomenal. The problem of infertility as long as the recorded history of mankind. Fertility in our culture stands for reproductivity, growth and continuity. Reproduction is one of the basic essential for the survival of a species. Diagnostic laparoscopy & hysteroscopy have emerged as an accurate method of assessing, evaluating and treating infertility. Direct visualization of the abdominal and pelvic organs in laparohysteroscopy allows a definitive diagnosis to be made in many conditions where clinical examination and less invasive techniques such as ultrasound and hysterosalpingography fail to identify the problem.Methods: A prospective study was conducted in Department of Obstetrics and Gynaecology, AGMC& GBP Hospital Agartala. 50 infertile women suspected with pelvic (tubal, peritoneal, adnexal) and intrauterine (uterine polyp, septa, submucous fibroid, intrauterine adhesions) pathologies were included in the study for further evaluation and correlation of clinical findings with Laparohysteroscopy observations.Results: Out of 50 cases, 27 (54%) patients had primary infertility. While laparoscopy detected abnormalities in 60% of the cases, significant hysteroscopy findings were noted in 66% of cases. The most common laparoscopic abnormality was tubal (22%) ovarian and peritoneal (16%) in primary and secondary infertile patients respectively. On hysteroscopy, endometrial polyp (30%) was found as the commonest abnormality in both the groups.Conclusions: Laparoscopy and hysteroscopy are both diagnostic and therapeutic procedures. If pathology is discovered, it can often be treated simultaneously. Laparoscopy combined with hysteroscopy is the sole technique to have a direct view of the female reproductive tract and to find out the various causes of infertility.
ABSTRACT
OBJECTIVE: To ascertain the prevalence of active epilepsy, febrile seizures (FS), cerebral palsy (CP) and tic disorders (TD) in aged 19 years or less. METHODS: This was a cross-sectional observational study conducted as a two-stage door-to-door survey of a stratified randomly selected population in 2003-04. Trained field workers screened the population followed by case examination by the field neurologist. RESULTS: A total of 16979 (male 8898, female 8081) subjects aged <or= 19 years were surveyed. The prevalence rates per 100,000 population of active epilepsy, FS, CP and TD with 95% confidence intervals are 700.87 (580.60-838.68), 1113.14 (960.07-1283.59), 282.70 (CI 208.43-374.82) and 35.34 (12.96-76.92) respectively. Active epilepsy prevalence shows a rising trend and that of other disorders a declining trend with age. Of the epileptics who had brain CT scans, 23.4% showed single or multiple lesions suggestive of neurocysticercosis. Regarding treatment, 23.5% of the epileptics never received any antiepileptic drugs. Among those with history of FS, 9.5% developed epilepsy later on. The prevalence of FS among slum dwellers is lower than in the non-slum population. Among CP cases, 39.6% gave history of birth anoxia, 16.7% kernicterus and 31.3% epilepsy. Prevalence of CP is significantly associated with lower education status. CONCLUSION: The prevalence of CP and TD is lower than reported from western countries. CP prevalence is also comparatively lower than in many community studies from India. Compared to western nations, higher proportion of FS cases develops epilepsy. A third of the CP cases have seizures which is higher than in many Indian studies. Birth anoxia is a common cause of CP and educational underachievement is frequent.