Introduction: Infertility is defined as incapability of a couple to achieve conception after a year of unprotected intercourse. Diagnostic laparoscopy is gold standard technique for evaluating such cases. The view obtained at laparoscopy is better than at the time of laparotomy. This is called "Panoramic view". Introducing only one port for entry of camera vis a vis one extra ancillary port for diagnostic purpose for manipulating abdomino-pelvic structures has been recommended by several authors but authentic studies are lacking Aims and Objectives: To compare single puncture with double puncture diagnostic laparoscopic technique and to evaluate benefits and side effects of a second puncture in infertile women. Materials and Methods: This study was a hospital based comparative type of interventional study conducted in the Department of Obstetrics & Gynaecology, S.M.S. Medical College, Jaipur from March 2016 to July 2017. All infertile women (both primary and secondary) admitted and posted for diagnostic laparoscopy by single and double puncture method in, of age between 20-40 years were enrolled in the study. Results: In majority of patients (80%) by single port, there was incomplete visualisation of both fallopian tubes, ovaries, pouch of douglas, spill of dyes. Full length of both tubes till fimbrial end, complete evaluation of both ovaries and their pathology was not possible even with proper technique, bowel preparation and Trendelenburg position. Using second port, it was possible to evaluate complete pelvic structures and their pathologies, bilateral or unilateral spill of dye, pouch of douglas by manipulation of intestinal loops and holding the tubes.
Conclusion:Approximately in 90% of the patients the operative surgeon could make out pathology and get a proper look at the structures along with therapeutic correction of pathologies in same setting without causing extra discomfort and postoperative pain and complication in comparison with single port technique.
Introduction:In pregnant women, lower level of both serum calcium and vitamin D cause serious impact on feto-maternal outcome. Purpose of the study is to use the opportunity of antenatal checkups to screen the screening of pregnant women for Vit D-3 and serum calcium levels and find out effect of clothes worn by them routinely as proper exposure to sunlight remain a key factor in Vit-D 3 level in burka and non burka clad. Methods and Material: This is an observational, randomized comparative study conducted in Department of obstetrics and Gynaecology at SMS Hospital, Jaipur, India from april, 2016 to july 2017. Total 200 of pregnant women who attended antenatal clinic were taken in the study, divided in burka clad and non burka clad and their blood samples sent for serum vitamin D3 and serum calcium level along with routine antenatal investigations. Results: In our study in both groups around 92-94% of the pregnant patients were found to be deficient as their serum vitamin -D levels were below 20 ng/ml. The calcium level in both groups were also below normal in around 70-72% patients. Conclusion: Serum vitamin D3 and serum calcium levels were very low in majority of pregnant women in both groups due to inadequate sun exposure, poor diet and supplement intake in their pre conceptional and antenatal period.
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