Female genital tuberculosis (FGTB) has a crucial role in many gynaecological complaint and delay in diagnosis can cause irreversible damages. The new diagnostic technique GeneXpert system is accurate and rapid test can make paradigm shift in FGTB treatment. The aim of the study to estimate efficacy of different tests i.e. AFB BACTEC culture, molecular assay (TB-PCR) and histopathology in comparison to GeneXpert system to detect FGTB. The prospective observational study was conducted in between January, 2018 and June, 2019. Randomly selected total 62 patients were put under all four diagnostic tests from endometrial sampling. The positivity of genital TB and efficacy of the tests were compared with test result of GeneXpert assay.In our study, out of 62 patients, most commonly 33.9% were each from age group of 21-30 and 31-40 years i.e. reproductive ages, 45.2% were overweight, primary infertility of 48.4% patients were predominant symptomatology. Overall positivity by GeneXpert test was 21% (3/62), histopathology 8.1% (5/62), AFB BACTEC culture 12.9% (8/62) and 24.2% (15/62%) by molecular assay (TB-PCR). On evaluating against our diagnostic tests, specificity of histopathology, AFB BACTEC Culture and TB-PCR was 97.96%, 95.92% and 75.51%. The diagnostic tests were analysed by Kappa measure agreement in comparison to GeneXpert assay. The histopathology and AFB BACTEC Culture showed fair and moderate agreement respectively, but on the contrary TB-PCR have not showed any agreement with GeneXpert assay.High degree of suspicion and battery of tests needed for diagnosis of genital TB. Rapid diagnosis by GeneXpert assay may play a crucial role in TB control programme. Female genital tuberculosis (FGTB) has a crucial role in many gynaecological complaint and delay in diagnosis can cause irreversible damages. The new diagnostic technique GeneXpert system is accurate and rapid test can make paradigm shift in FGTB treatment.
Heavy menstrual bleeding (HMB), is one of the most frequently encountered problem in the gynaecology OPD. It can significantly affect women’s quality of life and overburden health-care systems. The Levonorgestrel Releasing Intrauterine System (LNG-IUS) is a highly effective long-acting reversal contraceptive, also useful for controlling HMB and promoted by National Institute for Health and Care Excellence (NICE). This prospective interventional study conducted upon 30 women, with heavy menstrual bleeding, of 30-50 years’ age, reporting in the outpatient department of a tertiary health care facility unit “between” January 2018 to June 2019. Women, who met inclusion and exclusion criteria were our study population. Data was collected during follow up at 1, 3 and 6 month and all the association were tested by mean, proportion and percentages. Chi-square test was used for comparing categorical result and p-value of less than 0.05 was considered as statistically significant. Calculation was made by using IBM SPSS 26 version of statistical software. Majority of women were from 40-45 years’ age group. Pictorial Blood Loss Assessment Chart (PBAC) score was calculated in 30 women who underwent LNG IUS insertion.There was significant reduction (p<0.05) in the mean PBAC score at 3and 6month compared to their initial value after LNG-IUS insertion. LNG IUS is effective and can be used as first line measure for treatment of HMB.
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