Dengue fever is a mosquito borne arboviral infection which is a major health problem worldwide. Complications vary widely and become critical mostly during defervescence period. Dengue fever in pregnant women can cause variety of obstetric and neonatal complications. Sheehan's syndrome (SS) is a parturitionrelated pituitary disease resulting from severe postpartum haemorrhage and can present with varying degrees of pituitary insufficiency. Emergency anaesthetic management of a dengue parturient and SS which developed subsequently, secondary to profuse intrapartum bleeding is discussed.
Background: Intra uterine insemination is a treatment modality of Assisted Reproductive technology for unexplained infertile couples before going to more invasive and expensive procedures. According to Ayurveda, the major pathogenesis of Vandhyatva (Infertility) is vata vitiation and it is already said that yoni never be vitiated without Vata dosha. Uttar basti (Intra uterine Instillation of medicine) is a unique local treatment procedure in gynecological disorders. Aims and Objectives: The aim of the study was to evaluate the role of Uttar basti (Intra uterine Instillation of medicine) on Intra Uterine insemination in unexplained infertility couples. Materials and Methods: After obtaining CTRI registration, total 20 cases of Unexplained infertility were registered and treated with Dhanwantar taila uttar basti followed with pre-ovulatory and post ovulatory Intra Uterine Insemination. Results: The result was assessed using the 'Proportion t test'. After 3 cycle treatment, significant results were observed in terms of clinical pregnancy. Conclusion: Uttar basti (Intra uterine Instillation of medicine) was found effective to enhance Intra Uterine insemination success rate and also increasing size of follicle & endometrium thickness.
Oral poster abstracts increased availability of highly sensitive quantitative b-HCG testing and improvement in trans-vaginal USS technology. Objective: To determine whether laparoscopy is still the gold standard for the diagnosis of ectopic pregnancy. Materials and Method: A retrospective analysis of the adnexal findings, serum b-HCG and progesterone levels in 84 cases of surgically confirmed EP. Results: Mean age = 29.7 yrs, range = 17-41 yrs. Adnexal masses: A pelvic mass was ultimately found in all the patients. 75/84 (89.3%) had an adnexal mass on the initial scan, while 9/84 (10.7%) were managed as pregnancy of unknown location until a subsequent USS elucidated a pelvic mass in these patients. A live EP was found in 18/84 (21.4%) of cases while a further 8/84 (9.5%) had a gestational sac with a yolk sac or fetal pole. The side of the pelvic mass could not be determined in 8/84 (9.5%) of cases because of it's central location. 9.5% of cases were cornual pregnancies. Serum b-HCG: 14/84 patients (16.7%) had b-HCG levels of < 1000 i.u., 26.2% had levels of 1,001-4000 i.u., 35.7% had levels of 4,001-10,000 i.u. 14.3% had levels > 25, 000 i.u. Serum progesterone: Five patients did not have serum progesterone results. Of the remaining 79, 38% had serum progesterone of 20 or less, 48.1% had a serum progesterone level of 21-60, while 13.9% had levels of 61-100. Conclusion:Since an adnexal mass was demonstrated virtually in all cases, it may be safe to conclude that in combination with quantitative b-HCG assays, laparoscopy now has very limited or no role in diagnosis, but rather for treatment of ectopic pregnancy. OP15.05Surgical intervention for diagnosis of ectopic pregnancy: are we doing the right thing? N. Dixit, S. Tahseen, S. Das Luton and Dunstable Hospital, United KingdomObjective: Ectopic pregnancy is a diagnostic dilemma. Patient's clinical presentation, prior knowledge of risk factors like serial βhcg (human chorionic gonadotropin hormone) and ultrasound are diagnostic tools. Single bhcg level as a discriminatory level is not specific. As the natural history of βhcg in early pregnancy is known the use of serial samples is justifiable. Laparoscopy is not the 'gold standard' diagnostic test as a 3-4% false negative and 5% false positive rate has been reported. Laparoscopy should only be performed when surgical intervention is indicated as not only it exposes the patient to unnecessary surgical intervention and its risks but also costs the NHS £1000 per procedure. We did an audit to find out the negative laparoscopy rate for suspected ectopic pregnancy in our hospital and to explore reasons for negative laparoscopy in individual cases to reflect on our clinical practice. Method: Retrospective review over a period of six months. Data was collected for age parity risk factors, diagnostic procedures, symptoms serial βhcg, and time interval for diagnosis and for surgery from first visit. Results: Conclusion:Results of the diagnostic test as serial βhcg and ultrasound should be awaited for whenever possible and ...
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