Hysteroscopic salpingosonography: a novel technique for infertile patients

Background: Infertility is akin to curse in our country. Patients of infertility run from pillar to post to get relief. Government Hospitals in India lie at the tail end of window-shopping of infertility centres by the patients having exhausted all their resources. Patients report without any detailed records, lost reports, coming after long hiatus of having stopped treatment in desperation, making one wonder how to proceed. At the other end are patients who have undergone laparotomy for various reasons like intestinal obstruction, tubercular abdomen, adnexal masses and their tubal status is not very clear on HSG. So, repeat laparoscopy in the former group and performing ab initio in the latter, involves putting the patients to the risk of general anesthesia, injury to internal organs due to anticipated adhesions. Although Hassan’s technique of open trocar entry is well accepted the first port entry, whatever be the mode, is an entry open to risks.Methods: In a selected group of infertile women, a baseline TVS was done on 2/3 day of menses and on the 7/8 day of menstrual cycle hysteroscopy was done which was immediately followed by another transvaginal ultrasound. The descriptive statistics is presented in the form of percentages and appropriate graphs.Results: Among the 54 patients who underwent this procedure, 65% had normal uterine cavity. 18% were referred for IVF. 9.2% conceived post procedure.Conclusions: Successive use of transvaginal ultrasound after hysteroscopy i.e Hysteroscopic sonosalpingography is a useful procedure in a select group of infertile patients. 

Secular Trend in Stature and Age at Menarche Among Punjabi Aroras Residing in New Delhi, India

The study was conducted on Punjabi Arora girls (n=159) and their mothers to see the phenomenon of secular trend in stature and age at menarche. An increase in stature and decrease in age at menarche was reported when the data of daughters was compared with that of their mothers thereby indicating secular trend in these two parameters. Better living conditions, improved nutrition and medical facilities, changes in environmental and socio-economic factors may account for increase in stature and early biological maturation

Association of subchondral bone texture on magnetic resonance imaging with radiographic knee osteoarthritis progression: data from the Osteoarthritis Initiative Bone Ancillary Study.

OBJECTIVES: To assess whether initial or 12-18-month change in magnetic resonance imaging (MRI) subchondral bone texture is predictive of radiographic knee osteoarthritis (OA) progression over 36 months. METHODS: This was a nested case-control study including 122 knees/122 participants in the Osteoarthritis Initiative (OAI) Bone Ancillary Study, who underwent MRI optimised for subchondral bone assessment at either the 30- or 36-month and 48-month OAI visits. Case knees (n = 61) had radiographic OA progression between the 36- and 72-month OAI visits, defined as ≥ 0.7 mm minimum medial tibiofemoral radiographic joint space (minJSW) loss. Control knees (n = 61) without radiographic OA progression were matched (1:1) to cases for age, sex, body mass index and initial medial minJSW. Texture analysis was performed on the medial femoral and tibial subchondral bone. We assessed the association of texture features with radiographic progression by creating a composite texture score using penalised logistic regression and calculating odds ratios. We evaluated the predictive performance of texture features for predicting radiographic progression using c-statistics. RESULTS: Initial (odds ratio [95% confidence interval] = 2.13 [1.41-3.40]) and 12- 18-month change (3.76 [2.04-7.82]) texture scores were significantly associated with radiographic OA progression. Combinations of texture features were significant predictors of radiographic progression using initial (c-statistic [95% confidence interval] = 0.65 [0.64-0.65], p = 0.003) and 12-18-month change (0.68 [0.68-0.68], p < 0.001) data. CONCLUSIONS: Initial and 12-18-month changes in MRI subchondral bone texture score were significantly associated with radiographic progression at 36 months, with better predictive performance for 12-18-month change in texture. These results suggest that texture analysis may be a useful biomarker of subchondral bone in OA. KEY POINTS: • Subchondral bone MRI texture analysis is a promising knee osteoarthritis imaging biomarker. • In this study, subchondral bone texture was associated with knee osteoarthritis progression. • This demonstrates predictive and concurrent validity of MRI subchondral bone texture analysis. • This method may be useful in clinical trials with interventions targeting bone

Secular Trend in Stature and Age at Menarche Among Punjabi Aroras Residing in New Delhi, India

The study was conducted on Punjabi Arora girls (n=159) and their mothers to see the phenomenon of secular trend in stature and age at menarche. An increase in stature and decrease in age at menarche was reported when the data of daughters was compared with that of their mothers thereby indicating secular trend in these two parameters. Better living conditions, improved nutrition and medical facilities, changes in environmental and socio-economic factors may account for increase in stature and early biological maturation

Evaluation of efficacy of dexmedetomidine versus propofol for sedation in children undergoing magnetic resonance imaging

Background: A deep level of sedation is required for magnetic resonance imaging (MRI) in children to ensure optimum image quality. The present study was conducted to evaluate the efficacy and safety of dexmedetomidine versus propofol for sedation in children undergoing MRI. Materials and Methods: A total of sixty children aged 2–10 years, having physical status 1 or 2 according to the American Society of Anesthesiologists, undergoing MRI were included in the study. Group D: (n = 30) received injection dexmedetomidine 2 μg/kg for 10 min followed by continuous infusion of 1.0 μg/kg/h. Group P (n = 30) received injection propofol 1 mg/kg bolus followed by continuous infusion of 100 μg/kg/min. Results: The mean time for onset of sedation in Group D was much longer than in Group P (P = 0.000). Mean duration of sedation was comparable in the two groups. The number of patients requiring increased infusion of study drug was significantly higher in Group D (30%) as compared to Group P (16.7%) (P < 0.05). The average recovery time in Group D was much longer than in Group P (P < 0.001). Conclusion: Propofol had an advantage of providing rapid onset of sedation and quicker recovery time. Dexmedetomidine resulted in a better preservation of respiratory rate and oxygen saturation, so it may be more suitable in children who are prone to respiratory depression. Hence, both the drugs could achieve required sedation in children posted for MRI

Effect of high index buffer layer in PbSe clad waveguide to design a visible range polarizer

Polarization properties of PbSe clad optical waveguide are exploited theoretically, in the visible range at λ = 0.6328 μm. Due to semiconducting nature, lead selenide (PbSe) supports lossy modes and showed oscillatory behavior in generated attenuation curves. It is observed that at different PbSe thicknesses, TM or TE guided modes may be selectively attenuated. High attenuation in waveguide modes mainly occurred due to the phase matching between lossy modes supported by PbSe cladding and lossless waveguide modes. It is proposed that by placing a high index buffer layer between PbSe cladding and waveguide, phase matching can be improved further. This property can be utilized to design highly efficient polarizers. Significant results are presented to show the effect of different buffer indices (1.55, 1.88 and 2.67). At the buffer index value  1.88, TE and TM pass polarizers can be designed with extinction ratios 501 dB and 316 dB respectively. Also, an extensively high attenuation loss of 243299 dBcm-1 can be achieved with buffer index 2.67 for TM mode polarization. Obtained results are well supported by generated field plots for the proposed polarizing structures