Laparoscopic evaluation of female infertility

Sub-fertility is inability to ensure child bearing when it is wanted. Prevalence of sub-fertility in industrialised countries has been quoted as 20%, and seems to be on the rise. Traditional way to assess the uterine cavity, tubal structure and tubal patency was hysterosalpingography but it has now been largely superseded by laparoscopy and hysteroscopy. The objective of this study was to highlight the role of laparoscopy in establishing diagnosis of female infertility. This descriptive study was conducted in Gynaecology Unit of Liaquat University of Medical Health Sciences, Hyderabad, Pakistan from 28[th] August 2000 to 1[st] July 2001. Total 200 sub-fertile patients attended the gynaecology OPD. Out of these 30 patients were selected for laparoscopy and dye test who were suspected cases of endometriosis, abnormal HSG and unexplained infertility. Those patients who had medical disorders and contraindication for laparoscopy were excluded from study. Detailed history of every patient was recorded on a proforma and physical examination was performed. Laparoscopy was scheduled in proliferative phase of menstrual cycle. Data were analysed using SPSS 11. Frequency and percentages were calculated to describe the results. Out of 200 sub-fertile patients total 30 patients were selected for laparoscopy. Twenty [66%] patients were in primary infertility group while 10 [33%] patients were in secondary infertility group. Eleven [55%] patients of primary infertility belong to age group of 18-25 years while 6[60%] patients of secondary infertility belong to age group of 26-33 years [TABLE 1]. Mean duration of sub fertility at time of presentation in primary infertility group was 1.95 years while in secondary infertility was 2.70 years [Table 2]. In primary infertility group main associated symptoms were dysmenorrhoeal in 8 [40%], irregular cycles 5 [25%], and dyspareunia in 4 [20%]. In secondary infertility group 3 [30%] patients had dysmenorrhoeal and dyspareunia while 2 [20%] had irregular cycles. The commonest cause observed in patients with primary infertility was endometriosis spots which accounted for 11 [55%]. In secondary infertility tubal occlusion was more common which accounted for 3 [30%]. Laparoscopic procedures are less invasive, more convenient and more precise for diagnosis of sub-fertility in women

Attitudes towards menstruation among young women

To determine knowledge and different attitudes towards menstruation among young women. A descriptive study was carried out at Isra University Hyderabad and villages around the Isra University Hospital, from 1st April 2005 to 31st March 2006. Five hundred women from villages around Isra University Hospital and students of Isra University Hyderabad were selected by non-probability sampling who were of menstruating age irrespective of their marital and literacy status. Women with menstrual irregularities or any other gynecological or psychological problem were excluded. All information was recorded on a questionnaire Performa and analyzed on SPSS version 15.0. Out of 500 participants, 438 [87.6%] regarded menstruation as a natural process; whereas, 62 [12.4%] perceived it as a disease and curse from God. Out of 500, 415 [83%] of the participants responded that the menstruation process is good for health; however, 85 [17%] felt this process not healthy for themselves. Ignorance, false perceptions and unsafe practices regarding menstruation are not uncommon among young women, hence the importance of health education particularly of women living in rural areas. Then they will be better prepared emotionally to experience menstruation and will have less negative reactions

Silent uterine rupture at 24 weeks in twin gestation

Scar dehiscence is a preventable condition. If recognized earlier, the lives of the woman and child may be saved. We present a case of twin pregnancy with a previous lower segment caesarean section. The uterus ruptured at 24 weeks of gestation without uterine contraction

Asymptomatic bacteriuria in pregnancy

To determine the frequency and risk factors of asymptomatic bacteriuria during pregnancy. Descriptive study. In obstetric and gynecology outpatient department of Isra university hospital Hyderabad Sindh from 2 nd July to 10 th December 2007. Total 111 women were included in the study. Inclusion criteria were pregnant women with no clinical features suggestive of UTI. Symptomatic women, women with any medical or renal disease and those who had taken antibiotics in last 6 weeks were excluded from the study. Dipstick test was performed on MSU and urine was cultured incase of positive dipstick. Data was analyzed on SPSS version 11. Frequencies were runned and chi-square test was used as test of significance. A total of 111 women fulfilling the inclusion criteria were interviewed and tested for bateriuria. Out of them 10% [9%] had bacteriuria. Out of them 10% were below 20 years and 90% were between 20-30 years [p=0.17]. Regarding education 10% were literate and 90% were illiterate [p=<0.001]. Prevalence of bacteriuria was 100% in women who had past history of urinary tract infection [p=0.004]. 80% of women who were sexually active had bacteriuria while 20% had not [p=0.006]. No association of bacteriuria was found with anemia, age, parity and socioeconomic condition. Asymptomatic bacteriuria is a common infection during pregnancy, have strong association with education, past history of urinary tract infection and illiteracy