Does type of intervention affects the endoscopic procedure outcome in female infertile patients? an experience at a single tertiary care centre

Background: To compare the types of hysterolaparoscopic interventions in female infertile patients and evaluate the outcome in terms of achieving pregnancy at follow up of 12 months.Methods: We prospectively evaluated 157 female-infertile-patients (age range 19-35 years; mean age 27.75 years). During their workup, all underwent hysterolaparoscopy. The detected anatomical abnormalities on hysterolaparoscopy were also tackled at same time if possible. After hysterolaparoscopy, Patients were advised for regular sexual activity. Follow-up of all recruited patients was done for 12 months or till achievement of fetal cardiac activity.Results: Of the 157 female-infertile-patients, 93 (59.2%) were of primary infertility and remaining 64 (41.74%) were secondary infertility patients. Hysterolaparoscopy revealed abnormalities in 125/157 patients. Of the 125 patients with abnormal hysterolaparoscopic findings, 121 underwent active therapeutic interventions. Out of 121 underwent active intervention and 43 patients conceived during next 12 months. Of 121 patients, 81 (66.9%) experienced single type intervention and remaining 40 (33.1%) experienced multiple type of the intervention. Among 81 patients with single type intervention, 28 conceived while 33 patients with multiple type of intervention 15 conceived. There was no statistically significant difference in pregnancy outcome in both groups. When we analyzed independently in primary and secondary infertility patients, similarly there was no significant difference in the pregnancy outcome.Conclusions: We concluded the conception rate was not significantly difference in infertile female patients, who underwent either single or multiple type hysterolaparoscopic intervention. So hysterolaparoscopy interventions should be performed in infertile female patients irrespective of type and extent of pelvic pathologies

Is hysterolaparoscopy a real theranostic approach for anatomical barriers in female fertility? A future argument

Background: Hysterolaparoscopy is a modality that provides the real time abdomino-pelvic view during diagnosis in infertile female patients and any pathology is noticed can be tackled at the same time. So we investigate the theranostic application of hysterolaparoscopy in structural causes of female infertility in present study.Methods: Authors prospectively evaluate 157 female patients (mean age 27.7 years) diagnosed as infertile, underwent hysterolaparoscopy during diagnostic work-up.  All the enlisted patients fulfilled the criteria of infertility. The noticed anatomical abnormalities in the hysterolaparoscopy were tackled at the same time if possible.Results: Of the 157 infertile female patients, 93 (~59.2%) were of primary infertility and remaining 64 (~41.8%) were secondary infertility patients. Hysterolaparoscopy showed abnormalities in 125/157 (~85.0%) patients. The detected hysterolaparoscopic abnormalities were distributed in 77/93 (~82.8%) primary and 48/64 (~75.0%) secondary infertility patients. Of the 125 patients with abnormal hysterolaparoscopic findings, 121 (~96.8%) experienced for active therapeutic interventions. All of the 48 secondary infertility patients with hysterolaparoscopic abnormalities experienced for active hysterolaparoscopic interventions. Of 77 patients with hysterolaparoscopic abnormality in primary infertility group, 73 (~94.8%) experienced active intervention. Only four patients with streak ovaries and hypoplastic uterus, few tiny fibroids and adenomyosis did not undergo for active hysterolaparoscopic intervention.Conclusions: Authors concluded that hysterolaparoscopy has a better theranostic approach for the anatomical barriers of female fertility so it can be performed in the initial phases of the infertility diagnostic work-up

The Inflammasome: First Line of the Immune Response to Cell Stress

The NALP3-inflammasome is a protein complex that stimulates caspase-1 activation to promote the processing and secretion of proinflammatory cytokines. Recent work indicates that the NALP3-inflammasome can be activated by endogenous “danger signals” as well as compounds associated with pathogens (Kanneganti et al., 2006; Mariathasan et al., 2006; Martinon et al., 2006; Sutterwala et al., 2006). Here, we discuss new insights into the regulation of caspase-1 activity in the inflammatory response

Chocolate cyst became ovarian abscess following IVF: a serious surgical emergency

We are reporting a rare case of ovarian abscess in an endometrioma following ultrasound guided oocyte retrieval during in vitro fertilization technique. Ovarian abscess within an endometrioma is a rare gynaecological problem. We are presenting a case of a giant abscess formation in an endometrioma following in vitro fertilization in a 36-year-old woman in view of secondary infertility. She presented with high grade fever with chills and rigor for more than 2 months associated with pain in abdomen with a progressively increasing lower abdominal mass. Patient was treated at a tertiary care hospital with multidisciplinary approach. Laparotomy was performed, and two litres of the foul-smelling pus was drained, followed by bilateral salpingooophorectomy. Uterus was left in situ to preserve her future fertility potential. Histology of the specimen confirmed endometriotic nature of the cyst. Pus on culture sensitivity was sterile. Patient had an uneventful recovery and was discharged on the 7th post-operative day. In our case endometrioma presented as failure of in vitro fertilization technique followed by a medical illness. This case highlights that endometrioma became not only a cause of failure of in vitro fertilization technique but also presented as a medical illness and should be dealt as one

Comparison of Bond Failure and Accuracy of Two Indirect Bonding Techniques and Materials: An In-Vivo Study

The purpose of this study was to compare and evaluate the clinical bond failure rate and accuracy of bracket placement of two indirect bonding materials and transfer trays. A split mouth technique was used in this study in which twenty patients were randomly divided into four groups: Group A – Polyvinyl siloxane / Sondhi™ Rapid-Set (3M unitek), Group B - Polyvinyl siloxane / custom IQ (Reliance orthodontics), Group C - Thermal glue / Sondhi™ Rapid-Set (3M unitek) & Group D - Thermal glue / custom IQ ( Reliance orthodontics). A total of 326 brackets were bonded and bond failure of brackets involved only first time failures during the tray removal, initial arch wire placement and thereafter three consecutive appointments (30,60 and 90 days). Accuracy of bracket placement was measured with modified digital/vernier caliper. Vertical and horizontal measurements were taken both on the models and intraorally in the patients and were evaluated for accuracy. CONCLUSION: The findings of the study showed Polyvinyl Siloxane / Sondhi Rapid Set had maximum bond failure rate (25.4%) when compared with other groups. The bond failure rate was higher during the transfer tray removal (7.6%) which gradually declined in consecutive appointments. Thermal glue transfer tray and Custom IQ (Reliance orthodontics) resin proved to be superior with minimum bond failure. Mandibular second premolars (22.2%) and lower incisors (17.7%) showed increased bond failure rates. Indirect bonding was accurate in vertical dimension and fourth quadrant showed least accuracy. Thermal glue / Sondhi Rapid set (3M unitek) group was efficient in accurate transfer of the brackets. Thermal Glue found to be an inexpensive and a better transfer tray material when compared to Polyvinyl Siloxane. Thermal Glue tray reinforced with 19 gauge wire proved to be more effective. In case of malocclusions it was recommended to section the tray to minimize bond failure. Modified Digital vernier caliper can be a reproducible and convenient method for measuring bracket placement accuracy. These findings need to be confirmed in future studies with larger samples over a longer period of time

Multimodal Sleep Apnea Detection with Missing or Noisy Modalities

Polysomnography (PSG) is a type of sleep study that records multimodal physiological signals and is widely used for purposes such as sleep staging and respiratory event detection. Conventional machine learning methods assume that each sleep study is associated with a fixed set of observed modalities and that all modalities are available for each sample. However, noisy and missing modalities are a common issue in real-world clinical settings. In this study, we propose a comprehensive pipeline aiming to compensate for the missing or noisy modalities when performing sleep apnea detection. Unlike other existing studies, our proposed model works with any combination of available modalities. Our experiments show that the proposed model outperforms other state-of-the-art approaches in sleep apnea detection using various subsets of available data and different levels of noise, and maintains its high performance (AUROC>0.9) even in the presence of high levels of noise or missingness. This is especially relevant in settings where the level of noise and missingness is high (such as pediatric or outside-of-clinic scenarios)

An unusual presentation of huge paraovarian cyst as papillary serous cyst adenofibroma: a rare case report

Paraovarian cysts constitute 10-20% of all adnexal masses and are usually less than two centimeter in diameter. Authors reported a 20-year-old unmarried female with vague abdominal discomfort since 1 year. On examination abdomen was uniformly distended with central position of umbilicus. Ultrasonography showed a large cystic mass extending from pelvis to pancreas likely of ovarian origin. Biochemical evaluation was not suggestive of malignant nature of this cystic mass. So, with due care of cosmesis, surgery was planned. After the midline vertical incision, peritoneal washings were collected for oicytological analysis to further exclude malignancy. Then 5mm cannula with trocar was inserted into the cyst to suck out the fluid then shrunken cystic wall was exteriorised. Right ovary was absolutely healthy. Enucleation of the cyst was done with preservation of ovary. Histopathology reported as a papillary serous cyst adenofibroma. Follow up period was uneventful.

Quantifying flood model accuracy under varying surface complexities

This is the final version. Available on open access from Elsevier via the DOI in this recordData availability: Data will be made available on request.Open Access experimental datasets used in this paper are available at https://zenodo.org/communities/floodinteract/Floods in urban areas which feature interactions between piped and surface networks are hydraulically complex. Further, obtaining in situ calibration data, although necessary for robust simulations, can be very challenging. The aim of this research is to evaluate the performance of a commonly used deterministic 1D-2D flood model, calibrated using low resolution data, against a higher resolution dataset containing flows, depths and velocity fields; which are replicated from an experimental scale model water facility. Calibration of the numerical model was conducted using a lower resolution dataset, which consisted of a simple rectangular profile. The model was then evaluated against a dataset that was higher in spatial resolution and more complex in geometry (a street profile containing parking spaces). The findings show that when the model increased in scenario complexity model performance was reduced, though most of the simulation error was < 10% (NRMSE). Similarly, there was more error in the validated model that was higher in spatial resolution than lower. This was due to calibration not being stringent enough when conducted in a lower spatial resolution. However, overall the work shows the potential for the use of low-resolution datasets for model calibration.Engineering and Physical Sciences Research Council (EPSRC