ROLE OF GENITAL TUBERCULOSIS IN SUB-FERTILE WOMEN

OBJECTIVE: To evaluate role of Acid fast bacilli culture (AFB) in sub-fertile women undergoing laparoscopy and dye test with endometrial biopsy. METHODS:  This cross-sectional study was conducted from 1st January 2020 to 30th April 2021, on 108 cases of subfertility, enrolled through non-probability consecutive sampling technique, for diagnostic laparoscopy & dye test with endometrial biopsy for AFB culture. We included all women of reproductive age with ≥2 years of subfertility, normal menstrual history, hormonal assay and normal male-factor. All women with comorbidities, women having contraindications for anaesthesia & couple with male-factor subfertility were excluded. Data analysis was done by SPSS version-20.      RESULTS: Seventy-two (66.7%) women had primary and 36 (33.3%) had secondary subfertility. Duration of subfertility was >5 years in 63 (58.3%) cases. Ninety-seven (89.8%) patients had bilateral patent tubes. Majority of patients (n=46/108; 42.6%) were aging 32-38 years. Endometrial biopsy of 22 (20.4%) cases were positive for AFB culture. Out of AFB-positive cases, 17 (77.3%) had primary and 5 (22.7%) had secondary sub-fertility. All AFB-positive cases had patent tubes (unilateral n=5/22; bilateral n=17/22). Common laparoscopic findings were tortuous tubes (n=30; 27.8%) and clumped end fimbrial (n=24, 22.2%). CONCLUSION: In our study, endometrial sampling of 20.4% cases were positive for AFB culture. Although female genital tuberculosis constitutes a small proportion of extra-pulmonary tuberculosis, but it has an immense effect on fertility. Thus without challenging the superiority of laparoscopy, AFB culture could be considered a judicious part of subfertility workup in low resource countries carrying high burden of disease

5-Chloro-2-hy­droxy­benzoic acid

The asymmetric unit of the title compound, C7H5ClO3, contains two mol­ecules; both feature an intra­molecular O—H⋯O hydrogen bond, which generates an S(6) ring. In the crystal, both mol­ecules form inversion dimers linked by pairs of O—H⋯O hydrogen bonds with R 2 2(8) ring motifs. The dimers are inter­linked by C—H⋯O inter­actions

N-(4-Chloro­phen­yl)-2-hy­droxy­benzamide

In the title compound, C13H10ClNO2, the dihedral angle between the aromatic rings is 20.02 (6)° and intra­molecular N—H⋯O and C—H⋯O hydrogen bonds both generate S(6) rings. In the crystal, mol­ecules are linked by O—H⋯O hydrogen bonds into C(6) chains propagating in [010]

Abdominal Hysterectomy for Benign Gynecological Diseases

OBJECTIVES This study aims to assess the Pap smear screening method’s accuracy in detecting precancerous lesions. METHODOLOGY After fulfilling the inclusion criteria patients were selected, the patient’s bladder was emptied and put in a dorsal position, and Cusco’s speculum was introduced after lubrication followed by insertion of Ayer’s spatula, applied on the transformational zone, and rotated in 360 degrees. Specimen smeared on glass slides and sent to the laboratory with fulfilled lab pre-requisite form. Patients were requested to follow up with a histopathology report. RESULTS Mean age of the patient was 38.111+9.461 years. Among the 77 patients whose samples were taken 15.4% were asymptomatic, 32.1% with vaginal discharge, 17.9% vaginal discharge,17.0% with intermenstrual bleeding and 16.7% were having lower abdominal pain with p value=0.087. Histopathology reports were interpreted upon follow-up visit among those 1.3% came out to be positive for malignancy, 76.6% negative for malignancy while 22.1% had an inadequate sample. CONCLUSION The most common method for screening for cervical cancer is the Pap smear, but its efficacy in detecting early precancerous lesions is very low, possibly due to laboratory error or false technique to a gynecologist of sample technique in our tertiary care hospital. Other screening methods should be used instead of conventional Pap smear

Study of Postdatism with Respect to Fetomaternal Outcome at A Tertiary Care Hospital

OBJECTIVES This study aims to know our setup’s fetomaternal pregnancy complications that extend beyond 40 weeks of gestation. METHODOLOGY This is a prospective cross-sectional study of 390 patients with uncomplicated postdated pregnancies fulfilling the inclusion and exclusion criteria admitted to the department of Obstetrics and Gynecology (both in spontaneous labour and induced patient) at Hayatabad Medical Complex, a tertiary care hospital in Peshawar, KPK from July 2020 to June 2021.RESULTS Out of 390 patients, a majority (72.30 %) were in the age group of 20 – 35 years. Most of them (50.51%) presented at gestation 40+1 – 40+6 weeks. The majority (57.69%) were multigravida, and most (93.07%) were un-booked. Most delivered vaginally (80.51%), and 19.48% had C/section (including both emergency and elective). The most common indication for C/section was fetal distress (44.73%), followed by C/section on demand (18.42%). The majority>90% had Apgar score greater than seven at 5 minutes which was gestation dependent. Overall perinatal mortality was 4.07% which was also gestation dependent ranging from 0.5% at 40+1 – 40+6 weeks to 2.30% at and beyond 42 weeks of gestation. Neonatal morbidity in the form of Birth asphyxia, Meconium Aspiration Syndrome (MAS), Shoulder Dystocia and NICU admission also showed an increasing tendency with increasing gestation beyond 40 weeks. Maternal morbidity in the form of PPH, perineal tears 3°/4° and endometritis also showed a similar increasing trend with increasing gestation beyond 40 weeks. CONCLUSION Pregnancy continuing beyond 40 weeks has a definite risk to the fetus.

2-Hy­droxy-N-(4-methyl­phen­yl)benzamide

In the crystal structure of the title compound, C14H13NO2, the mol­ecules are approximately planar, the r.m.s. deviation for all non-H atoms being 0.0435 Å; the dihedral angle between the two rings is 3.45 (12)°. The planarity is accounted for in terms of the presence of intra­molecular N—H⋯O and C—H⋯O hydrogen bonding, each of which completes an S(6) ring motif. The mol­ecules are stabilized in the form of supra­molecular chains extending along the crystallographic c axis due to inter­molecular O—H⋯O and C—H⋯O hydrogen bonding; each type leads to an R 2 1(6) ring motif

2-Hy­droxy-5-nitro-N-phenyl­benzamide

The mol­ecule of the title compound, C13H10N2O4, is almost planar with a dihedral angle between the benzene rings of 1.99 (13)°. The nitro group and its parent benzene ring are oriented at a dihedral angle of 7.6 (3)°. Intra­molecular C—H⋯O and N—H⋯O hydrogen bonds form two planar S(6) motifs. Inter­molecular O—H⋯O=C hydrogen bonds join mol­ecules into chains extending along the c axis

4-Chloro-2-hy­droxy-N-(4-methyl­phen­yl)benzamide

In the title compound, C14H12ClNO2, the dihedral angle between the aromatic rings is 14.87 (11)° and an intra­molecular N—H⋯O hydrogen bond generates an S(6) ring. In the crystal, mol­ecules are linked by O—H⋯O hydrogen bonds, generating C(6) chains propagating along the c-axis direction

2-Hy­droxy-N-(3-nitro­phen­yl)benzamide

In the crystal structure of title compound, C13H10N2O4, as expected, the nitro- and hy­droxy-substituted benzene rings are planar with r. m. s. deviations of 0.0037 and 0.0014 Å, respectively, but are twisted slightly relative to each other, making a dihedral angle of 12.23 (7)°. The nitro group is only slightly twisted [by 2.71 (16)°] with respect to its parent ring. An intra­molecular N—H⋯O hydrogen bond forms an S(6) ring motif. Inter­molecular N—H⋯O and O—H⋯O hydrogen bonds build up sheets parallel to the ab plane. Futhermore, weak π–π inter­actions [centroid–centroid distances = 3.7150 (8) 3.7342 (6) and 3.9421 (8) Å] between the rings yield a three-dimensional network

2-Hydr­oxy-3-nitro­benzamide

The asymmetric unit of title compound, C7H6N2O4, contains two mol­ecules, one of which has a disordered nitro group with an occupancy ratio of 0.517 (9):0.483 (9) for the O atoms. Both mol­ecules contain an intra­molecular O—H⋯O hydrogen bond. In the crystal, both mol­ecules form inversion dimers linked by pairs of N—H⋯O hydrogen bonds, resulting in R 2 2(8) ring motifs. The dimers are connected by further N—H⋯O links and weak C—H⋯O inter­actions, resulting in a layered motif