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Background: The prevalence of infertility ranges from 3.5% to 16.7% in more developed nations and from 6.9% to 9.3% in less developed nations, with an estimated overall median prevalence of 9%. The present study was aimed to evaluate the role of hysterolaparoscopy in the study of primary and secondary infertility, to identify the various pathological conditions in female reproductive tract leading to primary/ secondary infertility, to develop a plan for therapy and management at the same time.Methods: This is a one-year prospective study conducted in obstetrics and gynecology department at D. Y. Patil hospital, Navi Mumbai, Maharashtra, India. All infertility patients seen in outpatient department, who were medically fit, willing for surgery and willing to get enrolled for study were included in this study.Results: Out of total 120 cases for infertility evaluated, tubal factor is the most common cause (28.3%) in both primary (23.3%) and secondary (43.3%) infertility group as seen on laparoscopy. Followed by ovarian factors (28.3%), peritoneal (11.6%) and uterine factors (10.8%). In 27 cases (22%), there were no detectable pathology at laparoscopy. In this study, hysteroscopy findings show 5.8% cases to have submucous fibroid uterus, 3.3% submucous polyp, 1.6% subseptate uterus, 0.8% septate uterus, 0.8% intrauterine adhesions, 0.8% bicornuate uterus and cervical stenosis 1.6% of patients.Conclusions: From this study, it is concluded that the diagnostic hysteroscopy and laparoscopy is an effective and safe tool in evaluation of female infertility. It provides direct and magnified view of all pelvic organs.
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Background: There has been a rising incidence of preterm labour in India. Preterm labour poses greater risks of morbidity and mortality of the preterm neonates. Various factors contribute towards risk of preterm labour and its outcome. Addressing these factors appropriately improves the outcome in pregnant women.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology from the period of July 2017 to July 2018.Results: The present study was in 98 patients admitted in our hospital with preterm labour. Clinical profile of those patients was studied. Statistically significant association was found between administration of antibiotics and tocolysis in prolongation of pregnancy (p value=0.00). There was an association found between gestational age at birth and immediate neonatal outcome (p value=0.00). Preterm labour was more common in multigravidae (62.4%) and women with cervical length less than 3 cm (85.17%).Conclusions: Preterm labour can be expected more commonly in multigravidae, pregnant women with cervical length less than 3 cm and in presence of high-risk factors. Anticipation of preterm labour, judicious use of antibiotics, tocolytics can improve the outcome of preterm labour.
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Background: Adolescence is an intermediary phase from childhood to adulthood and is a very delicate phase of life. WHO has defined Adolescence as the period between 10-19 years of life. Among adolescents, girls constitute a more vulnerable group, particularly in developing countries, where they are traditionally married at an early age and are exposed to greater risk of reproductive morbidity and mortality. Nutritional deficiency disorders (stunting, wasting), menstrual disorders, mental health problems etc. appear as serious problem during this stage. The study was done with objective to assess the morbidity pattern in school going adolescent girls in Urban and Rural Prayagraj.Methods: A school based cross-sectional study was carried out in Prayagraj district. Study participants were 800 adolescent girls, 400 urban and 400 rural of age groups 10–19 years studying in class 6th to 12th. The data was collected by using predesigned, pretested, semi structured questionnaire and analyzed by using SPSS 21.0 version.Results: It was observed that most prevalent morbidity in rural and urban school going adolescent girls were dysmenorrhoea 381 (47.6%), pallor 296 (37%), psychological problems 325 (40.6%) and ocular diseases 191 (23.8%). Other morbidities were hypertension, dental problems, overweight/obesity, skin diseases, ear diseases, respiratory diseases, gastrointestinal diseases and injury.Conclusions: Out of 800 study participants, 275 adolescent girls were having morbidity. Significant difference in proportion of morbidities was found among rural and urban adolescent girls with ear diseases, eye diseases, pallor, dysmenorrhoea, overweight/obesity and hypertension.
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Background: Palliative care aims to relieve suffering in all stages of disease. We studied the effect of introducing palliative care early at diagnosis on patient reported outcome among patients of carcinoma cervix. Methodology: We assigned patients with advanced stage of carcinoma cervix to receive either early palliative care integration or standard oncologic care alone. Quality of life and overall health were assessed at baseline, 12 weeks and at 20 weeks with use of European Organisation for Research & Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C-30 scale and EORTC QLQ Cx-24 scale. We studied the secondary outcomes related to emergency hospital visits, compliance to treatment and End of life interventions. Results: The difference in score of EORTC C-30 and EORTC QLQ Cx-24 scales amongst groups was statistically significant at 12 weeks (P<0.05). Group P patients had 100% compliance for treatment, as compared to patients from Group C, as 6 patients left treatment before conclusion. The difference in scores of Group P and Group C, for all EORTC C-30 and EORTC QLQ Cx-24 questions at 20 weeks were not statistically significant (P>0.05). Conclusion: Among patients with advanced stage of carcinoma cervix, early palliative care led to significant improvement in quality of life, overall health, emergency hospital visits, and admission at end of life.
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Background: The aim of study was to to assess respiratory indices in underweight and overweight young group (subcategory) and compare the same with normal weight controls (in the age group of 18 to 30 years). Methods: In the present study 210 subjects were included, aged between 18 yrs-30 yrs after applying inclusion and exclusion criteria. The groups (n=210, case= 132 and control= 78) are divided into group A, B, C, D, E and F respectively each having 21, 78, 40. 35, 29 and 7 subjects on the basis Of international classification of BMI. Results: In our study mean predicted value of FEV1/FVC ratio in group A 84.02±31.24(underweight), group C 86.83±29.46(pre-obese), group D 92.10±13.31(obese class 1),group 93.72±9.49 ( obese class 2) and group F191.02±22.24( obese class 3), when compared to control group B 87.95±26.77 was found to be decreased in group A and increased in other obese group , but it was within normal range in all groups and no statistical difference found between different groups (P value>0.05). Conclusion: After analyzing the data, we did not observe any statistically significant difference in FEV1/FVC between the control and underweight and overweight group.
ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune disorder affecting multiple organ systems. It is characterized by the presence of autoantibodies reactive against various self-antigens. Susceptibility to SLE is found to be associated with many major histocompatibility complex (MHC) and non-MHC genes, one of which is APO-1/Fas gene, which is present on chromosome 10 in humans. The APO-1/Fas promoter contains consensus sequences for binding of several transcription factors that affect the intensity of Fas expression in cells. The mutations in the APO-1/Fas promoter are associated with risk and severity in various autoimmune diseases and other malignancies. The APO-1/Fas receptor is expressed by many cell types. Two forms of APO-1/Fas protein that are involved in regulation of apoptosis have been identified. Fas receptor-mediated apoptosis plays a physiological and pathological role in killing of infected cell targets. In this review, we have focused on APO-1/Fas gene structure, promoter variants and its association with SLE and other autoimmune diseases. Functional aspects of Fas receptor in apoptosis are also discussed.