The relationship between hysterosalpingography findings and female infertility in a Nigerian population

Purpose: This study aims to explore the relationships between abnormal hysterosalpingography (HSG) findings and all types of infertility. Material and methods: This retrospective study was carried out at a private radiodiagnostic centre in Lagos, Nigeria. The radiologist reports of all consecutive patients who had HSG evaluation from 2016 to 2018 were analysed. Biodemographic information and indications for HSG evaluation were also documented. Logistic regression was used to test correlations between the explanatory and outcome variables. P ≤ 0.05 represented a statistically significant result. Results: A total of 450 patients were involved in this study, with ages ranging from 21 to 51 years and a mean age of 34.6 ± 5.56 years. The age group 31-35 years had the highest frequency of infertility. There were 299 patients referred for infertility. Secondary infertility was seen in 211 patients (46.9%), primary infertility was seen in 79 patients (17.6%), and subfertility was seen in nine patients (2%). There were 49 patients (10.9%) with cornual tubal blockage, while 57 patients (12.7%) had perifimbrial adhesion and/or blockage. There were 56 patients (12.4%) with hydrosalpinx and nine patients (2.0%) with tubal occlusion. Multivariate logistic regression analysis showed women with hydrosalpinx were 2.11 times more likely to be infertile than those without hydrosalpinx (95% CI: 1.02-4.36, p = 0.042). Conclusions: The presence of hydrosalpinx was a significant risk factor in developing all types of infertility. Understanding the HSG patterns and their correlations with infertility will help physicians across the world when evaluating infertility in patients of similar background to our patient population

Engaging patients and parents to improve mental health intervention for youth with rheumatological disease

Abstract Background Mental health disorders are common in youth with rheumatological disease yet optimal intervention strategies are understudied in this population. We examined patient and parent perspectives on mental health intervention for youth with rheumatological disease. Methods We conducted a mixed methods cross-sectional study, via anonymous online survey, developed by researchers together with patient/parent partners, to quantitatively and qualitatively examine youth experiences with mental health services and resources in North America. Patients ages 14–24 years with juvenile idiopathic arthritis, juvenile dermatomyositis, or systemic lupus erythematous, and parents of patients ages 8–24 with these diseases were eligible (not required to participate in pairs). Participants self-reported mental health problems (categorized into clinician-diagnosed disorders vs self-diagnosed symptoms) and treatments (e.g. therapy, medications) received for the youth. Multivariate linear regression models compared patient and parent mean Likert ratings for level of: i) comfort with mental health providers, and ii) barriers to seeking mental health services, adjusting for potential confounders (patient age, gender, disease duration, and patient/parent visual analog score for disease-related health). Participants indicated usefulness of mental health resources; text responses describing these experiences were analyzed by qualitative description. Results Participants included 123 patients and 324 parents. Patients reported clinician-diagnosed anxiety (39%) and depression (35%); another 27 and 18% endorsed self-diagnosed symptoms of these disorders, respectively. 80% of patients with clinician-diagnosed disorders reported receiving treatment, while 11% of those with self-diagnosed symptoms reported any treatment. Patients were less comfortable than parents with all mental health providers. The top two barriers to treatment for patients and parents were concerns about mental health providers not understanding the rheumatological disease, and inadequate insurance coverage. Over 60% had used patient mental health resources, and over 60% of these participants found them to be helpful, although text responses identified a desire for resources tailored to patients with rheumatological disease. Conclusion Self-reported mental health problems are prevalent for youth in this sample with rheumatological disease, and obstacles to mental health treatment include disease-related and logistic factors. Strategies are needed to improve acceptance and accessibility of mental health intervention, including routine mental health screening and availability of disease-specific mental health resources