OBJECTIVE: Infertility continues to be a common medical problem with significant societal repercussions and psychological and economic effects on families' lives. Hysterosalpingography (HSG) is the preferred method in clinical practice for evaluating the uterine cavity and tubal patency. Our study aims to present a comprehensive perspective on the importance of the HSG procedure in the evaluation of infertile patients, starting with the recommendation of the HSG procedure to the patient, the application of the procedure, and the evaluation of the patient's post-procedure process. PATIENTS AND METHODS: This is a prospective evaluation of 323 women who underwent HSG at Kafkas University between 2021-2022. The type and duration of infertility in patients, the source from which the patient received the recommendation for HSG, visual pain score for evaluating pain during the HSG procedure, HSG results, patients' perspectives on the procedure's contribution to the treatment processes, their immediate post-procedure pain, and their pregnancy status within 6 months after the procedure were evaluated. RESULTS: 72.1% of patients had primary, and 27.8% had secondary infertility. 82% of HSG results were reported as normal. Among primary infertility, uterine pathologies were detected in 62.5%. In secondary infertile patients, tubal pathology was detected in 88.4%. There is a statistically significant difference between the infertility types of patients with normal HSG results and those without (p=0.001). There was also a difference between the results of HSG and follow-up types (p<0.001). A statistical difference was also found between the HSG result and the patients' conception status within 6 months after the procedure (p<0.001). CONCLUSIONS: When it comes to the cost of the HSG procedure for infertility, as well as potential pain, radiation exposure, and rare allergic reactions to the contrast material, it is important to choose the appropriate circumstances for this procedure. In order to avoid unnecessary interventional procedures, it would be beneficial to discuss the recommendation of HSG for primary infertile patients under 28.5 years of age. Further research is required in this regard. Since tubal factors are most common among secondary infertile women, this group of patients is more likely to benefit from HSG in the evaluation.
Hysterosalpingography , Infertility, Female , Humans , Female , Pregnancy , Uterus , Contrast Media , Pain
The Theory of Mind deficit due to cognitive-affective disintegration is a poorly understood cognitive consequence of cortical and subcortical disruption in right temporal lobe epilepsy. Following Marr's trilevel approach, we used the material-specific processing model to understand the Theory of Mind deficit in drug-resistant epilepsy (N = 30). We examined pre- and post-surgery changes in first-order (somatic-affective, non-verbal component) and second-order Theory of Mind (cognitive-verbal component) in three groups formed using: (i) seizure side (right versus left), (ii) right temporal epilepsy (right temporal lobe epilepsy versus non-right temporal lobe epilepsy), and (iii) right temporal lobe epilepsy with amygdalohippocampectomy (right temporal lobe epilepsy versus left temporal lobe epilepsy amygdalohippocampectomy versus non-amygdalohippocampectomy). We observed a marked deficit in the first-order Theory of Mind in the right temporal lobe amygdalohippocampectomy group; we mapped this deficit to decline in the non-verbal component of Theory of Mind (somatic-affective component). Preliminary results support using a material-specific processing model to understand the Theory of Mind deficits in right temporal lobe epilepsy amygdalohippocampectomy. Malleability of verbal processing in presence of deterioration of non-verbal processing might have clinical relevance for post-surgery recovery in right temporal lobe epilepsy amygdalohippocampectomy. Documenting the material-specific nature of deficits (verbal versus non-verbal) in non-western, linguistically, and socioeconomically diverse country enables us to understand the problem of heterogeneity in post-surgery cognitive consequences in the right amygdalohippocampectomy.
