Application of laparoscopy in current fertility practice

Background: The present study is carried out with the objective of establishing the role of diagnostic and operative laparoscopy as a simple, safe and accurate tool in the evaluation of infertility. The aims of current study were to study the application of laparoscopy in current fertility practice, to evaluate indications for diagnostic laparoscopy for infertility, to study findings of diagnostic laparoscopy and to study various operative procedures performed for correction of infertility.Methods: This is a prospective study of 50 women undergoing infertility workup in a private hospital from January 2011 to January 2012. All infertile women having primary or secondary infertility were included in the study. Couples having male factor infertility were excluded from the study. Data were collected and analyzed.Results: Our study is conducted in 50 cases of infertility patients out of which 74% were primary infertility and 26% were secondary infertility. Uterine factors were found in 16% of cases, tubal factors were found in 44% of cases, ovarian factors were implicated in 30% of cases out of which majority (12%) had PCOD. Among the peritoneal factors (18%) endometriosis and pelvic adhesions were found in 6% each. Inspite of thorough laparoscopic evaluation no cause (unexplained infertility) was found in 14% of cases and hence overall, the pelvic pathology was found in 86% of cases.Conclusions: Laparoscopy is the gold standard for diagnosing tubal and peritoneal disease, endometriosis, adhesions and other pelvic pathology, because no other imaging technique provides the same degree of sensitivity and specificity

Study of 50 cases of modern management of ectopic pregnancy

Background: In recent years, an increased incidence of ectopic gestation has been noted, which can be attributed to different reasons. Cases with ectopic gestation were studied and objectives were to study the incidence in various age groups, to study predisposing factors, to study different modes of clinical presentation, to study different sites of ectopic pregnancy and to study changing trends of modern management from radical surgical method to laparoscopic and medical management.Methods: A study of 50 cases of tubal ectopic pregnancy was carried out from May 2009 to June 2011 in tertiary health centre. Patients managed with following treatment modalities were selected for study. (1) Medical management (MTX), (2) Laparoscopic management: salpingostomy, salpingectomy, (3) Laparotomy management: salpingostomy, segmental resection, fimbrial expression, salpingectomy.Results: Lower abdominal pain was most common presenting symptom of ectopic pregnancy in 96% cases. The classical triad of symptoms (amenorrhea, abdominal pain and vaginal bleeding) was present in only 28% cases. PID contributed 24% cases and previous abortion contributed 28% cases indicating these two as the common risk factors. Ampulla was the commonest site for ectopic pregnancy, in 52% cases. Salpingostomy performed mainly at this site. In 6% cases ectopic pregnancy in infundibulum were treated with fimbrial expression and fimbriectomy. 22% patients were managed medically (methotraxte). These were the cases having unruptured ectopic pregnancy and ectopic mass <4 cm. Laparoscopy was done in 34% cases, in 2 cases it was converted to laparotomy. While open laparotomy was done in 40% cases.Conclusions: Ectopic pregnancy is a treatable problem. Ultrasonography plays central role in the diagnosis and management. Mode of therapy is determined by a combination of clinical symptoms, sonography findings and serum b-HCG values. Surgical management is still a cornerstone of management of ectopic pregnancy. But now scope of medical and laparoscopic management is also there. In recent years laparotomy has been replaced by laparoscopic surgery which is more conservative, minimally invasive and less time consuming which leads to quick recovery

Susceptibilities and speed of sound from PNJL model

We present the Taylor expansion coefficients of the pressure in quark number chemical potential $\mu_0=\mu_B / 3=\mu_u=\mu_d$, for the strongly interacting matter as described by the PNJL model for two light degenerate flavours of quarks u and d. The expansion has been done upto eighth order in $\mu_0$, and the results are consistent with recent estimates from Lattice. We have further obtained the specific heat $C_V$, squared speed of sound $v_s^2$ and the conformal measure \cC.Comment: 13 pages, 8 figures, References added, some discussions on Fig. 4 modified, one table added, results unchanged, version to appear in Phys. Rev.

Comparative cost of ART and conventional treatment within a dental school clinic

PKBACKGROUND: The changing oral health needs in South Africa require that both the teaching and clinical techniques of atraumatic restorative treatment (ART) form a part of the restorative undergraduate curriculum. OBJECTIVE: This study was undertaken to establish and compare the estimated costing of an amalgam, composite resin and ART restoration within the Board of Health Funders (BHF) recommended scale of benefits at the School of Oral Health Sciences Oral and Dental Hospital, University of the Witwatersrand (SOHS). METHODS: Fixed and variable costs were calculated by pricing items and equipment used in each procedure. The output values were established according to the recommended scale of benefits (BHF, 1999). This enabled the calculation of contribution margins and net income for each of the three restorations. RESULTS: The annual capital cost for the ART approach is approximately 50% of the other two options (e.g. per multiple surface restoration ART = R1.58; amalgam and composite resin restorative procedures: R3.12 and R3.10 respectively), despite the fact that ART restorations are rendered in a modern dental setting. CONCLUSIONS: Our study shows that implementation of the ART approach within the clinic setting of the SOHS can be accomplished without additional cost. Furthermore ART can be performed as an economically viable alternative to conventional treatment procedures within the clinic setting. The study represents a first step towards determining the cost efficiency of implementing ART as a pragmatic and cost-effective restorative option within the SOHS, University of the Witwatersrand

Complexes of Ga(III) with Thiomalic, Thiolactic, Thioglycollic, Malic Glycollic, Lactic & Aspartic Acids, & ɑ-Alanine & Glycine

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Herding in Quality Assessment: An Application to Organ Transplantation

There are many economic environments in which an object is offered sequentially to prospective buyers. It is often observed that once the object for sale is turned down by one or more agents, those that follow do the same. One explanation that has been p

Outpatient antibiotic prescription trends in the United States: A national cohort study

OBJECTIVETo characterize trends in outpatient antibiotic prescriptions in the United StatesDESIGNRetrospective ecological and temporal trend study evaluating outpatient antibiotic prescriptions from 2013 to 2015SETTINGNational administrative claims data from a pharmacy benefits manager PARTICIPANTS. Prescription pharmacy beneficiaries from Express Scripts Holding CompanyMEASUREMENTSAnnual and seasonal percent change in antibiotic prescriptionsRESULTSApproximately 98 million outpatient antibiotic prescriptions were filled by 39 million insurance beneficiaries during the 3-year study period. The most commonly prescribed antibiotics were azithromycin, amoxicillin, amoxicillin/clavulanate, ciprofloxacin, and cephalexin. No significant changes in individual or overall annual antibiotic prescribing rates were found during the study period. Significant seasonal variation was observed, with antibiotics being 42% more likely to be prescribed during February than September (peak-to-trough ratio [PTTR], 1.42; 95% confidence interval [CI], 1.39–1.61). Similar seasonal trends were found for azithromycin (PTTR, 2.46; 95% CI, 2.44–3.47), amoxicillin (PTTR, 1.52; 95% CI, 1.42–1.89), and amoxicillin/clavulanate (PTTR, 1.78; 95% CI, 1.68–2.29).CONCLUSIONSThis study demonstrates that annual national outpatient antibiotic prescribing practices remained unchanged during our study period. Furthermore, seasonal peaks in antibiotics generally used to treat viral upper respiratory tract infections remained unchanged during cold and influenza season. These results suggest that inappropriate prescribing of antibiotics remains widespread, despite the concurrent release of several guideline-based best practices intended to reduce inappropriate antibiotic consumption; however, further research linking national outpatient antibiotic prescriptions to associated medical conditions is needed to confirm these findings.Infect Control Hosp Epidemiol 2018;39:584–589</jats:sec

Defect tolerance in as-deposited selenium-alloyed cadmium telluride solar cells

The efficiency of cadmium telluride (CdTe) solar cells is limited primarily by voltage, which is known to depend on the carrier concentration and carrier lifetimes within the absorber layer of the cell. Here, cathodoluminescence measurements are made on an as-deposited CdSeTe/CdTe solar cell that show that selenium alloyed CdTe material luminesces much more strongly than non-alloyed CdTe. This reduction in non-radiative recombination in the CdSeTe suggests that the selenium gives it a certain defect tolerance. This has implications for carrier lifetimes and voltages in cadmium telluride solar cells

QGP Susceptibilities from PNJL Model

An improved version of the PNJL model is used to calculate various thermodynamical quantities, {\it viz.}, quark number susceptibility, isospin susceptibility, specific heat, speed of sound and conformal measure. Comparison with Lattice data is found to be encouraging.Comment: 4 pages, 2 figures, poster presented at Quark Matter'0

Characterisation of ATP-dependent Mur ligases involved in the biogenesis of cell wall peptidoglycan in Mycobacterium tuberculosis.

ATP-dependent Mur ligases (Mur synthetases) play essential roles in the biosynthesis of cell wall peptidoglycan (PG) as they catalyze the ligation of key amino acid residues to the stem peptide at the expense of ATP hydrolysis, thus representing potential targets for antibacterial drug discovery. In this study we characterized the division/cell wall (dcw) operon and identified a promoter driving the co-transcription of mur synthetases along with key cell division genes such as ftsQ and ftsW. Furthermore, we have extended our previous investigations of MurE to MurC, MurD and MurF synthetases from Mycobacterium tuberculosis. Functional analyses of the pure recombinant enzymes revealed that the presence of divalent cations is an absolute requirement for their activities. We also observed that higher concentrations of ATP and UDP-sugar substrates were inhibitory for the activities of all Mur synthetases suggesting stringent control of the cytoplasmic steps of the peptidoglycan biosynthetic pathway. In line with the previous findings on the regulation of mycobacterial MurD and corynebacterial MurC synthetases via phosphorylation, we found that all of the Mur synthetases interacted with the Ser/Thr protein kinases, PknA and PknB. In addition, we critically analyzed the interaction network of all of the Mur synthetases with proteins involved in cell division and cell wall PG biosynthesis to re-evaluate the importance of these key enzymes as novel therapeutic targets in anti-tubercular drug discovery