Study on Comparative Diagnostic Efficacy of HSG & Laparoscopy in Infertility.

Tubal occlusion is one of the most frequent causes of infertility in women. The evaluation of the fallopian tube is necessary in female infertility. The two most important diagnostic procedures for evaluation of tubal patency are hysterosalpingography (HSG) and laparoscopy. We wanted to compare the diagnostic efficacy of HSG & diagnostic laparoscopy in evaluation of tubal patency in infertility.METHODSA hospital OPD based prospective study was conducted among fifty patients fulfilling the inclusion and exclusion criteria who attended the OPD for treatment of infertility in the Department of Obstetrics and Gynaecology, Medical College and Hospital, Kolkata from 1st January 2016 - 31st December 2017. After taking proper history, thorough examination and basic investigations for infertility work-up, HSG and Laparoscopy were performed.RESULTSAnalysis showed that most of the patients were in the age group of 30 to 35 years. Incidence of primary and secondary infertility was 64% and 36% respectively. Right proximal and distal blockage in HSG, and DL were 56% and 40% in HSG and 48% and 28% in DL respectively. p=0.0001. Left proximal and distal blockage in HSG and DL were 32% and 56 % in HSG and 40% and 28 % in DL. Right and left hydrosalpinx on HSG and DL were 32% and 12% in HSG and 40% and 16 % in DL. p<0.005. Right and left peri-tubal adhesions on HSG and DL were 36% and 20% at HSG and 52% and 28 % in DL. p<0.005. Thus, laparoscopy is superior in detection of hydrosalpinx and peritubal adhesions than HSG. In this analysis, the incidence of submucosal, intramural and subserous fibroids was 16%, 12% and 8 % respectively. Incidence of septate, unicornuate, bicornuate & arcuate uterus was 8%, 6%, 6%, 2% respectively. Intrauterine adhesions were detected in 12% and endometrial polyp in 4% of patients.CONCLUSIONSHSG is considered to have a high sensitivity and specificity to detect tubal block. HSG and laparoscopy are not alternative, but are complementary in the evaluation of tubal block.

Correlation of anthropometric parameters with QTc interval in malnourished children.

Various studies have reported the effect of severe malnutrition on electrolyte levels and electrocardiographic parameters. However, only a few have reported these findings in mild and moderate grades of malnutrition in children. Therefore, the objective of this study was to assess the effect of malnutrition (mainly mild and moderate grades) on corrected QT interval (QTc) and QT dispersion (QTcd) and electrolyte changes. A total of 20 malnourished children in the age group of 2-11 yrs were enrolled in the study group and 20 age and sex matched healthy children were taken as controls. Anthropometry, serum levels of albumin & electrolytes were determined. QTc and QTcd (difference between maximum & minimum corrected QT interval) were measured with the help of RMS Polyrite D. Our results have shown that body weight, height, body mass index (BMI), serum levels of albumin, potassium & calcium were lower (P<0.01) in malnourished children. QTc (P<0.01) & QTcd (P<0.01) were significantly greater in malnourished children than controls. We concluded that increase in QTc and QTcd intervals is associated with electrolyte disturbances in malnourished children. Electrolyte disturbance correction and appropriate nutrition therapy followed by further cardiac evaluation must be taken into account in the management of these patients.

Clinically unsuspected Hodgkin's lymphoma diagnosed primarily from bone marrow trephine biopsy: report of six cases.

Bone marrow may be the initial or rarely the only site of involvement in Hodgkin's lymphoma. A high index of suspicion is required to pick up the histopathological changes of Hodgkin's lesions in the bone marrow like necrosis, presence of Reed-Sternberg cell or its variant in a polymorphic background infiltrate, focal fibrosis and myxoid change especially in the absence of classical clinical picture. Bone marrow with immunohistochemistry has a valuable role in the staging and in the diagnosis of primary medullary Hodgkin's lymphoma. B-symptoms may easily masquerade as an infectious process as in all our cases the patients had fever as a presenting feature, in four of them tuberculosis was suspected clinically and two had received antitubercular therapy elsewhere. We report six human immunodeficiency virus-negative patients diagnosed over a period of 5 years in which the initial diagnosis of Hodgkin's lymphoma was suggested from bone marrow histology.