Study of the obstetrics and perinatal outcome of in vitro fertilization pregnancies at tertiary care centre

Background: Assisted reproductive techniques (ART) has been a boon to the unfortunate. However, the outcomes aren’t the same to all. The study has observed the outcomes in IVF conceived patients. The pregnant women were followed-up throughout their antenatal and post-natal (7 days) period and an appropriate meta-analysis was made.Methods: This is an Observational Prospective study. It was conducted at an IVF center of tertiary hospital. With valid written informed consents 96 patients were recruited and observed for18 months. Data collected by Universal sampling method, analyzed and interpreted.Results: A total 65.6% belonged above 30 years, 67.7% were primigravida and 7.3% had history of previous ectopic pregnancy. In 23.75% multifetal pregnancy was significant and 20.63% had OS tightening done. Most common reason for opting IVF was multiple failed IUI (71.6%). More than 40% were delivered by caesarean section. 91.1% of babies cried immediately after birth and 50.4% babies required NICU admission.13.4% babies had neonatal death and 3.1% were IUFD. 58.30% pregnancies were singleton. Mean birth weight was 1.87 Kg and 72.6% children were born low birth weight. Statistical significance (p<0.001) was found in between no. of foetuses delivered and preterm delivery. 56.3% birth were preterm birth. PIH and GDM complication is most common in multiple gestations observed in 10.7% of pregnancies.Conclusions: Assisted Reproductive technologies has helped the infertile couples. Outcomes could be unfruitful in few, while others may have a complicated antenatal period. Preterm deliveries are more common in multiple gestation thus complementing the lower birth weights. Comorbidities significantly affected obstetric outcome

Reproductive potential in a case of Mosaic Turners syndrome with 46XY karyotype

This article describes a case of 18year-old-female who presented with primary amenorrhea, phenotypic features of Turners syndrome, which was confirmed later by Karyotype to have mosaic 45XO(8)/46XY(22). She had delayed puberty and proved (hormonally) to have ovarian failure, with absent Mullerian structures (radiologically and laparoscopy)

Case Report - Isolated Tuberculous Hepatic Abscess in a Non-Immunocompromised Patient

A 38 years old female presented with pain in the epigastrium, jaundice and fever since one and half month. The computerised tomographic scan of the abdomen revealed a multiloculated abscess of the left lobe of liver. The pus drained from the liver abscess at laparotomy showed acid-fast bacilli on microscopy. A detailed search failed to identify any other focus of tuberculous infection. The case has been reported for the rarity of isolated hepatic tuberculous abscess and its presentation with jaundice, a rare feature, and to highlight the importance of microscopic or culture diagnosis in a suspected case of pyaemic abscess

Isolated tuberculous hepatic abscess in a non-immunocompromised patient

A 38 years old female presented with pain in the epigastrium, jaundice and fever since one and half month. The computerised tomographic scan of the abdomen revealed a multiloculated abscess of the left lobe of liver. The pus drained from the liver abscess at laparotomy showed acid-fast bacilli on microscopy. A detailed search failed to identify any other focus of tuberculous infection. The case has been reported for the rarity of isolated hepatic tuberculous abscess and its presentation with jaundice, a rare feature, and to highlight the importance of microscopic or culture diagnosis in a suspected case of pyaemic abscess

Isolated tuberculous hepatic abscess in a non-immunocompromised patient.

A 38 years old female presented with pain in the epigastrium, jaundice and fever since one and half month. The computerised tomographic scan of the abdomen revealed a multiloculated abscess of the left lobe of liver. The pus drained from the liver abscess at laparotomy showed acid fast bacilli on microscopy. A detailed search failed to identify any other focus of tuberculous infection. The case has been reported for the rarity of isolated hepatic tuberculous abscess and its presentation with jaundice, a rare feature, and to highlight the importance of microscopic or culture diagnosis in a suspected case of pyaemic abscess

Loose cell clusters with vascular coats: Zellballen pattern of paraganglioma on cytology

Paragangliomas are uncommon tumors arising in paraganglion tissue, which is well represented in the head and neck. A correct pre-operative cytological diagnosis helps in planning early and optimal surgery. Cytologic features in carotid body tumor and extra adrenal paragangliomas have been well described and documented. In addition to the acinar and discrete arrangement of cells, smears also showed a few large loose clusters of cells enveloped by thin vascular channels-the so-called zellballen pattern, a diagnostic feature on histopathology. Zellballen pattern of paraganglioma on cytology is not a common finding and hence is being reported

Tuberculosis of pubic dymphysis presenting with hypogastric mass

A 28-year-old male patient presented with a swelling in the hypogastrium since one and a half months associated with a history of chronic cough, anorexia and weight loss. There was no history of tuberculosis in self or contact with patient with tuberculosis. On examination there was a 5 x 5 cms soft, intrapariet al swelling in the hypogastrium. A clinical diagnosis of haemangioma of the pariet al wall of the hypogastrium was made. X-ray of the pubic bones showed bony erosion of the public symphysis (Figure 1). Ultrasonography showed a 5 x 4 cms intrapariet al swelling in the hypograstric region. Computerised tomographic (CT) scan of the abdomen showed a 5 x 5 cms intrapariet al swelling in the hypograstrium with erosion of the public symphysis (Figure 2). CT guided needle aspiration of pus showed presence of acid fast bacilli. Fluid adenosine deaminase level was 284 U/L (normal of 0.1-22 U/L). Patient was started on antituberculous drugs and he showed good response. The hypogastric mass disappeared three months after treatment

Estimation of plasma levels of bisphenol-A & phthalates in fertile & infertile women by gas chromatography-mass spectrometry

Background & objectives: Bisphenol-A (BPA) and phthalates are utilized widely in consumer products. Due to their ubiquitous presence in the environment, a concern is expressed worldwide about their possible effect on human reproductive health. This study was conducted to compare the internal exposure of BPA and phthalates (using their metabolites as biomarkers) in plasma samples of infertile and fertile women. Methods: A sensitive gas chromatographic-mass spectrometric (GC-MS) method was developed to simultaneously quantify BPA and four phthalate monoester metabolites [namely mono-methyl phthalate (MMP), mono-benzyl phthalate (MBzP), mono-2-ethylhexyl phthalate (MEHP) and mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP)] in human plasma. The method was validated using charcoal-stripped human plasma. Activated charcoal was also utilized to reduce contamination from reagents. The method was designed to account for and/or eliminate background contamination from all sources. Results: The limit of quantification for the method was 5 ng/ml for MMP and MBzP, while 1 ng/ml for BPA, MEHP and MEHHP, respectively. The precision and accuracy were well within the acceptable range. BPA was detectable in 77 per cent of plasma samples of infertile women and 29 per cent of fertile women. All the four phthalate metabolites were detected in plasma samples of both fertile and infertile women. Interpretation & conclusions: A GC-MS was developed and validated to estimate the BPA and four phthalate monoester metabolites in human plasma. It was utilised to analyse the plasma samples from fertile and infertile women. The infertile women showed significantly higher plasma concentrations of MBzP, BPA and MEHHP as compared to fertile women. The levels of MMP and MEHP were not significantly different between the two groups. Further studies need to be done to confirm these preliminary findings