Role of laparoscopy in infertility in a rural setup hospital

Background: Infertility is a major health issue with multifactorial etiology. None of the laboratory findings alone is conclusive in diagnosing infertility. A minimally invasive method such as laparoscopy has come into play in finding the etiology and planning the further management of infertility. This study is intended to focus the role of laparoscopy in finding the causes of infertility in a rural set up area.Methods: 100 cases of primary and secondary infertility were subjected to laparoscopy after taking informed consent. Causes of infertility were found out. The present study was conducted at Acharya Vinoba Bhave Rural Hospital, Wardha from 2011-2013.Results: There were 75 cases (75%) of primary infertility as against 25 cases (25%) of secondary infertility. A maximum of 40 cases (40%) were in the age group of 20 - 25 years. Uterine causes contributed about 14 cases (14%), tubal causes contributed about 34 (34%), ovarian factors accounted for 27 cases (27%), peritoneal causes contributed for 7 cases (7%), unexplained infertility accounted for 18 cases (18%).Conclusions: Laparoscopy is a gold standard for tubal, ovarian cases, in cases of endometriosis and in adhesions till date. Laparoscopy can be used for evaluation of almost all the cases of infertility. Because of its potential diagnostic and therapeutic benefits, all the patients with infertility should undergo laparoscopy prior to any advance procedure in infertility management. Diagnostic laparoscopy has become so important in the evaluation of infertility that it has now been considered as a basic skill which should be learnt by every gynaecologist in the advanced scientific era

How To Control Text Simplification? An Empirical Study of Control Tokens for Meaning Preserving Controlled Simplification

Text simplification rewrites text to be more readable for a specific audience, while preserving its meaning. However, determining what makes a text easy to read depends on who are the intended readers. Recent work has introduced a wealth of techniques to control output simplicity, ranging from specifying the desired reading grade level to providing control tokens that directly encode low-level simplification edit operations. However, it remains unclear how to set the input parameters that control simplification in practice. Existing approaches set them at the corpus level, disregarding the complexity of individual source text, and do not directly evaluate them at the instance level. In this work, we conduct an empirical study to understand how different control mechanisms impact the adequacy and simplicity of model outputs. Based on these insights, we introduce a simple method for predicting control tokens at the sentence level to enhance the quality of the simplified text. Predicting control token values using features extracted from the original complex text and a user-specified degree of complexity improves the quality of the simplified outputs over corpus-level search-based heuristics.Comment: work in progres

Prevalence of hyperprolactinemia in infertile cases and its correlation with TSH in a rural set up hospital

Background: Hyperprolactinemia is a common endocrine disorder of hypothalamic-pituitary ovarian axis affecting the reproductive functions. Despite the significant role of hyperprolactinemia in infertility, serum prolactin estimation is still not universally done as a part of evaluation of infertility. This study intended to find out the incidence of hyperprolactinemia in infertility, highlight the importance of assessment of serum TSH level in hyperprolactinemia.Methods: 200 cases of primary and secondary infertility were investigated for serum prolactin levels at Acharya Vinoba Bhave Rural Hospital, Wardha from 2011-2013.Results: There were 130 (65%) cases of primary infertility as against 70 (35%) cases of secondary infertility. A maximum of 106 (53%) cases were in the age group of 26 - 30 years, with the mean age as 27.50±3.76years. There were 11.5% cases of hyperprolactinemia out of 200 cases of infertility. 21.73% cases of hyperprolactinemia had hypothyroidism.Conclusion: The high prevalence of hyperprolactinemia with infertility stresses the fact that all the cases of infertility should be subjected for serum prolactin estimation. Prolactin estimation should be done at early stages of infertility check up rather than straight away going for more costly tests or invasive procedures. There is high crude prevalence of hypothyroidism in hyperprolactinemia. All the cases of hyperprolactinemia should have TSH estimation.

Does climate information matter? A proposed monitoring and evaluation framework for participatory assessment of the impact of climate services for male and female farmers

This report summarizes a new contextual and gender-responsive monitoring and evaluation framework (M&E) to assess the added value of climate information and advisory services for smallholder farming communities across the developing world. The proposed M&E is based on three primary goals for conducting an evaluation of climate services for farmers: 1) to inform design of a new climate service project; 2) to identify gaps in climate service delivery, and improve project effectiveness and service delivery quality; and 3) to assess impact of provided services for farmers, hypothesized to benefit from the climate service. In order to meet these goals, we developed a multi-step process for climate service impact evaluation, including a pre-assessment (PA) toolkit of ethnographic and evaluative tools, followed by guidelines for baseline data collection, monitoring, and evaluation of climate service projects. The PA serves to build understanding of background contextual issues that constrain or enable the usefulness of climate information services in any given community, such as information about farmer’s decision- making, socio-economic and cultural constraints behind behavioral changes, and gender roles and norms within a given community. These elements may have impacts on information use and changes in practices, skills and abilities that aid farmers’ adaptation to a changing climate, and uptake of information to make decisions under uncertainty. Once such understanding of farmers’ decision-making context is determined, evaluators will be better equipped to define a contextualized impact pathway of climate information for rural farmers. The PA is the first step in a larger process of developing a targeted, locally-specific and gender-responsive M&E framework. This M&E framework will enable project teams to evaluate the relevance of climate services to support smallholder farmer decision-making under an uncertain climate and improve local management of climate related risks at the farm-level

Study of uterine artery embolization: a newer modality in secondary PPH

Background: Postpartum hemorrhage remains a major cause of both maternal mortality and morbidity worldwide. This study reflects the clinical outcomes including clinical effectiveness, and safety of uterine artery embolization (UAE) for the treatment of obstetrical uterine hemorrhage at a tertiary-care hospital, in terms of secondary PPH.Methods: The data were collected as a retrospective study from SAMC and PGI obstetric and gynecology department 12 women with secondary pph were included in the study.Results: With the use of uterine artery embolization 12 women were successfully treated amongst them maximum patients were in 26-35 yrs of age and mean age of women were 32.4yrs and gravidity of patients presenting with pph is 3 or more.Conclusions: Selective UAE is a safe and effective method to control obstetric hemorrhage. Blood product requirements after UAE were low, and the surgical risks and absolute loss of fertility associated with hysterectomy were avoided

Primary mucinuous adenocarcinoma of the ovary: a case report

Ovarian neoplasms are common tumours in females comprising 23% of all gynecologic tumours and are the most common gynecologic malignancy. Ovarian cancer is primarily a disease of postmenopausal women, the highest number of cases being concentrated in the age group from 50 to 70 years. They are the 5th leading cause of cancer related deaths in women. Primary Mucinuous cystadenocarcinoma of ovary is very rare. Our reported case was 50 years old woman which came in our OPD of Sri Aurobindo Institute of Medical Sciences with vague symptoms of lower abdominal pain and swelling. The data were collected by history-taking, clinical examination, laboratory investigations, ultrasonographic examination, CECT abdomen, CA 125, and by histo-pathological study of the excised surgical specimen. The case was reported as a rare ovarian mucinous cystadenocarcinoma. New and improved screening modalities are required for early diagnosis. And proper diagnostic criteria should be made for better prognosis

Assessment of perimenopausal bleeding

Background: Abnormal uterine bleeding (AUB) is one of the most common presenting complaints encountered in a Gynecologist's office and accounts for almost 10% consultations in any busy out-patient clinic. Perimenopause is defined as the time around menopause during which menstrual cycle and endocrine changes are occurring but 12 months of amenorrhea has not yet occurred. Patients usually present first to their family physicians, who can do most of the diagnostic workup and management.Methods: 200 women of perimenopausal age group with AUB presenting to gynecology OPD and wards of Department of Obstetrics and Gynecology, SAMC & PGI, Indore. The study was conducted from May 2013 to April 2014.Results: In our present study majority (57%) of the women in our study were in the age group 40-45 years and rest were having age more than 46 years. In our present study 52% of the women presented with menorrhagia, 16.5% presented with polymenorrhagia, 11.5% presented with metropathia haemorrhagica, 9% presented with polymenorrhoea, 4.5% presented with metrorrhagia.Conclusions: There are various menstrual irregularities during perimenopausal period, some due to variation in hormones which are physiological some due to pathological changes. Every case of perimenopausal bleeding needs evaluation. Base line investigations should be offered to all the patients. Public awareness programme in the community and yearly physical checkup should be advised to all the patients

The effects of target contrast on Drosophila courtship

Many animals use visual cues such as object shape, color and motion to detect and pursue conspecific mates. Contrast is another possibly informative visual cue, but has not been studied in great detail. In this study, we presented male Drosophila melanogaster with small, fly-sized, moving objects painted either black, white or gray to test whether they use contrast cues to identify mates. We found that males frequently chased gray objects and rarely chased white or black objects. Although males started chasing black objects as often as gray objects, the resulting chases were much shorter. To test whether the attraction to gray objects was mediated via contrast, we fabricated black and gray behavioral chambers. However, wild-type males almost never chased any objects in these darkly colored chambers. To circumvent this limitation, we increased baseline levels of chasing by thermogenetically activating P1 neurons to promote courtship. Males with thermogenetically activated P1 neurons maintained a similar preference for gray objects despite elevated levels of courtship behavior. When placed in a black chamber, males with activated P1 neurons switched their preference and chased black objects more than gray objects. We also tested whether males use contrast cues to orient to particular parts of the female's body during courtship. When presented with moving objects painted two colors, males positioned themselves next to the gray half regardless of whether the other half was painted black or white. These results suggest that males can use contrast to recognize potential mates and to position themselves during courtship