Comparative evaluation of tubal patency by hysterosalpingography and laparoscopic chromopertubation

Background: Infertility is defined as one year of unprotected intercourse without pregnancy, primary in which no previous pregnancies have occurred and secondary in which a prior pregnancy not necessarily a live birth has occurred. The objective of the study was to compare the relative efficacy of hysterosalpingography (HSG) and laparoscopy with chromopertubation in the diagnosis of tubal factors in infertile women.Methods: 90 infertile women attending the infertility clinic at Dharmapuri Medical College and Hospital were selected for this study. The study period was from April 2016 to July 2017 these patients were initially counseled along with their partners and a thorough history of both the partners was obtained followed by a general and pelvic examination of female partners.Results: HSG results indicated that 48 patients had tubal pathology and 11 patients had uterine pathology. Of those 11 patients with uterine pathology, 6 patients with synechiae had both tubal and uterine pathology. The remaining 5 had only uterine pathology and tubes were patent in them. The site of tubal occlusion in all those blocked tubes shows that more number of the tubal blockage was seen in mid segment of the tube (24 cases) followed by the fimbrial block in 16 cases. Diagnostic laparoscopy with chromopertubation was performed in all 90 patients and the findings were recorded.Conclusions: HSG has reasonably good sensitivity and specificity in diagnosing tubal pathology of infertile women. But given the high rate of false-positive diagnosis of tubal pathology (29%) in HSG, a follow-up laparoscopy is warranted.

Uterine artery Doppler in first trimester in prediction of adverse pregnancy outcome in Dharmapuri district of Tamil Nadu

Background: Pregnancies are complicated by hypertensive disorders of about 5-10% and hemorrhage, sepsis, and fetal growth restriction constitute a triad contributing to maternal morbidity and mortality. Hypertensive disorders in pregnancy vary from mildly elevated blood pressure to severe hypertension with multi-organ dysfunction. The study aims to evaluate the first-trimester uterine artery Doppler in the prediction of the development of adverse pregnancy outcomes.Methods: This prospective longitudinal observational was done in Dharmapuri Medical College and Hospital were selected for this study. Totally 150 pregnant women were included in the study. 75 were controls and 75 cases. The study period was from June 2018 to February 2019. Evaluating the optimal definition of abnormal first trimester.Results: Previous obstetric history in the study population. In the study group 3% of bad obstetric history (BOH) present. In the case group, 5% has BOH due to 2 neonatal death and 2 term intrauterine device (IUD), uterine artery Doppler parameters to predict adverse pregnancy outcomes, and association of gestational hypertension in the study groups. In the control group, 1%, and the case group 5% of them had gestational hypertension. Out of 4, 3 had an average uterine artery Doppler more than 2.3 (maximum of 2.7) and 1 had single uterine artery Doppler abnormality.Conclusions: The study showed that first-trimester uterine artery Doppler with single and average uterine artery pulsatility index (PI) >95th centile (2.3) has a better screening value in my population. The overall performance of the first-trimester uterine artery Doppler in the prediction of adverse pregnancy outcomes is valuable

Shear Strength Characteristics of Coir Fibre Stabilised Stone Matrix Asphalt Mixtures

The triaxial test measures the mix stability in the form of shear strength and gave better information for the prediction of field performance. The stresses acting on the laboratory specimen during the test simulate the state of stresses existing in the pavement. The Stone Matrix Asphalt mixtures (SMA)were investigated using triaxial shear strength testing at 50.8 mm/min ram rate loading at 60°C to investigate the effect of additive, coir fibre on the strength properties by varying  the percentages of fibre. SMA without fibre  is taken as the control mixture. The test was conducted at 0, 50, 75 and 100kPa confinements. The Mohr-Coulomb failure theory was used to analyze the test data and the analysis shows that the SMA stabilized mixtures had highest cohesion and shear strength as compared to the control mixture, but almost similar angle of internal friction value. The higher values of cohesion and shear strength can be associated to a fibre content of 0.3% and the percentage increase in cohesion is about 53% with respect to the control mixture. This shows that the mixture has greater resistance to shearing stresses than the control mixture. There is a trend that the strain at failure increases with increasing confinement pressure, indicating their stress dependent behaviour. The stress-strain curves indicate that the peak stress developed and the time of its occurrence is higher in stabilized mixtures when compared to those of the control mixture. For stabilized mixtures, it is observed that the shape change of the stress-strain curves is more gradual with increase in fibre content and brittle type failure does not seem to occur as in the case of control mixture.&nbsp