scholarly journals Comparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility

2017 ◽  
Vol 13 (4) ◽  
pp. 281-285 ◽  
Author(s):  
A. Nigam ◽  
P. Saxena ◽  
A. Mishra
Keyword(s):  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Uterine Cavity ◽  
Cervical Canal ◽  
Diagnostic Modality ◽  
Infertile Patient ◽  
Infertile Women ◽  
Intrauterine Abnormalities

Background Hysterosalpingography (HSG) is a useful screening test for the evaluation of female infertility. Laparoscopy has proven role in routine infertility work up but role of hysteroscopy in an infertile patient with normal HSG for additional information is a subject of debate. Hysteroscopy permits direct visualization of the cervical canal and the uterine cavity and thereby helping in the evaluation of shape, and cavitary lesion.Objective To detect uterine abnormalities in infertile women by various approaches i.e. HSG and hysteroscopy and evaluating the role of combining hysteroscopy with laparoscopy for the evaluation of tubo-uterine factor for primary infertility.Method One twenty eight infertile women were evaluated and HSG was performed as a basic test for evaluation of tubes and uterine cavity. Women were subjected to combined laparoscopic and hysteroscopic examination on evidence of HSG abnormalities. In absence of any HSG abnormality, women were subjected to ovulation induction for three to six months and if they did not conceive during this period they were undertaken for combined laparo-hysteroscopic evaluation.Result The positive predictive value of HSG for detecting the intrauterine abnormalities was 70% among 126 patients where the hysteroscopy could be performed successfully. The diagnostic accuracy of HSG for intrauterine abnormalities revealed false negative rate of 12.96%. The most frequent pathologies encountered by laparoscopy were tubal and/or peritoneal and were found in 68% (87/128) of women. Total 64.06% infertile women had some abnormality on laparoscopy. This detection rate has been increased from 64.06% to 71.86% on including the concomitant hysteroscopy.Conclusion HSG is a good diagnostic modality to detect uterine as well as tubal abnormalities in infertile patient. HSG and hysteroscopy are complementary to each other and whenever the patient is undertaken for diagnostic laparoscopy for the infertility, hysteroscopy should be combined to improve the detection rate of abnormalities especially in communities where there is enormous risk of pelvic infection.

scholarly journals Sentinel Lymph Node Biopsy in Early Breast Cancer Using the Indocyanine Green Fluorescence Technique: A Validation Study

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Loh Soon Khang ◽  
Suraya Baharudin ◽  
Juliana Abdul Latiff ◽  
Siti Aishah Mahamad Dom ◽  
Shahrun Niza Suhaimi
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Breast Cancer ◽  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Node Biopsy

INTRODUCTION: Introduction: Sentinel lymph node biopsy (SLNB) is now recognized as the standard of care for early breast cancer patients with negative axillary lymph nodes. Various approaches for Sentinel Lymph Node (SLN) identification using either the blue dye method or scintigraphy alone or their combination have been proposed. However, this method is costly and may not be applicable in certain developing countries. SLNB involving the use of indocyanine green (ICG) offers several advantages, and it is valid and safe when in direct comparison with the blue dye method and scintigraphy. Hence, we performed SLNB using this method in early breast cancer as the first center that involves the use of ICG in Malaysia. We performed validation study on this method with the aims to determine its sensitivity and safety profile. MATERIALS AND METHODS: This is a validation and non-randomised prospective observational study involving 20 patients underwent SLNB wherein ICG is used for localisation. The patients were recruited according to the recommendations stipulated in the Malaysia Clinical Practice Guideline. RESULT: The average number of SLNs removed per patient was 4.0 (range, 3–6) with sentinel lymph nodes detection rate at 98.75% (79/80). The false negative rate is at 5%. No adverse events were observed in all cases. CONCLUSION: The ICG fluorescence method is simple, reliable and safe. Moreover, it demonstrates a high SLN detection rate with a low false-negative rate, and it does not require a special instrument for radioisotope use.

What is the role of routine hysteroscopy in the evaluation of uterine cavity in infertile women?

2004 ◽  
Vol 1271 ◽  
pp. 259-262 ◽  
Author(s):  
Adriana Pedro ◽  
Mônica Jorge ◽  
Edson Fonseca ◽  
Lucia Costa-Paiva ◽  
José R. Gabiatti ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Infertile Women

scholarly journals Investigating Hysteroscopy Implementation in Infertile Women Candidate With a Normal Uterine Cavity for Laparoscopy in Hysterosalpingography

2018 ◽  
Vol 7 (1) ◽  
pp. 79-84
Author(s):  
Maliheh Amirian ◽  
Anis Darvish Mohammadabad ◽  
Negar Morovatdar ◽  
Leili Hafizi
Keyword(s):  
Diagnostic Laparoscopy ◽  
False Negative ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Endometrial Polyps ◽  
Infertile Women ◽  
Submucous Myoma ◽  
Age Range

Objectives: Endometrial pathologies inside the cavity can occur simultaneously with gestational unpleasant consequences but are not always capable of being diagnosed by the hysterosalpingography (HSG). This study aimed to examine the value of performing diagnostic hysteroscopy beside diagnostic laparoscopy among infertile women with normal uterine cavities in HSG. Materials and Methods: A total of 103 infertile women with normal uterine cavities in the HSG and within the age range of 18-40 who referred to Imam Reza hospital for laparoscopy during 2016-2017 were included in this cross-sectional study. Hysteroscopy was performed simultaneously with diagnostic laparoscopy. Then, the existence of uterine pathologies like endometrial polyps, submucous myoma, and uterine endometrial adhesions and their relationship with the patient’s age, infertility type and duration, and cycle time were evaluated. A P value less than 0.05 was considered statistically significant. Results: Overall, 64 patients (63.1 %) had a normal uterine cavity in the hysteroscopy while 39 of them had an abnormal uterine cavity, the HSG false negative cases of whom were reported 37.9%. The pathologies found in the hysteroscopy were endometrial polyp (16 cases), submucous myoma (1 case), uterine septum (6 cases), asherman syndrome (7 cases), bicornuate uterus (4 cases), polyp + asherman (3 cases), polyp + submucous myoma (1 case), and septum + submucous myoma (1 case). Patients’ age, type of infertility, and menstruation time during performing hysteroscopy made no particular difference in diagnosing pathologies of the uterine cavity in the hysteroscopy. Conclusions: Based on the findings, conducting hysteroscopy in infertile women who are candidates of laparoscopy and have normal uterine cavities in HSG can result in recognizing some cases of uterine pathologies which influence the outcomes of future pregnancies is not dependent upon the patient’s age, menstruation time, type and duration of infertility, and result of laparoscopy.

Sentinel node mapping in the prostate cancer

2011 ◽  
Vol 50 (03) ◽  
pp. 107-115 ◽  
Author(s):  
K.T Tabasi ◽  
S. M. M Bazaz ◽  
V. R. D Kakhki ◽  
A. F Massoom ◽  
H Gholami ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sentinel Node ◽  
Cancer Patients ◽  
Detection Rate ◽  
Meta Analysis ◽  
Standard Procedure ◽  
False Negative ◽  
False Negative Rate ◽  
Q Value ◽  
High Detection Rate

SummaryAim: Sentinel node (SN) biopsy is becoming a standard procedure in the management of several malignancies. Several groups have evaluated the feasibility and value of this procedure in prostate cancer patients. In the current meta-analysis, we comprehensively and quantitatively summarized the results of these studies. Methods: Several databases including Medline, SCOPUS, Google Scholar, Ovid, Springer, and Science direct were systematically searched for the relevant studies regarding SL biopsy in the prostate cancer (“prostate” AND “sentinel” as search keywords). The outcomes of interest were sensitivity and detection rate of the procedure. Results: For detection rate and sensitivity 21 and 16 studies met the criteria of inclusion respectively. Pooled detection rate was 93.8% (95% CI 89–96.6%). Cochrane Q value was 216.077 (I2 = 89.81% and p < 0.001). Pooled sensitivity was 94% (95% CI 91–96%). Cochrane Q value was 14.12 (I2 = 0.0 and p = 0.516). Conclusion: SL biopsy can prevent unnecessary pelvic lymph node dissection in prostate cancer patients. This procedure is feasible with low false negative rate and high detection rate.

scholarly journals Hysterosalpingography Findings and Jimah Ratio of the Uterine Cavity in Women with Infertility in Central Region, Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bashiru Babatunde Jimah ◽  
Philip Gorleku ◽  
Anthony Baffour Appiah
Keyword(s):  
Central Region ◽  
Acute Infection ◽  
Significant Proportion ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Cape Coast ◽  
Secondary Infertility ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Infertile Women

Background. Infertility affects from 1.3% to 25.7% of couples worldwide and, especially, from 14.5% to 16.4% in Africa. Hysterosalpingography (HSG) is a diagnostic modality that is considered both common and efficient. It is used to investigate abnormalities of the uterine cavity and fallopian tubes. This study assessed the spectrum of findings on HSG among women with infertility in the Central Region (Ghana). Methods. We conducted a prospective cross-sectional study to examine 203 infertile women undergoing HSG work-up at the Cape Coast Teaching Hospital. The exclusion criteria were acute infection of the vagina or cervix and active vaginal bleeding or pregnancy. Data were entered with Microsoft Excel and analyzed using SPSS version 21. Results. A total of 203 women were enrolled, and eighty-five (41.87%) of the women had at least one or more abnormalities. The mean age was 32.9 years with majority of the women within 30–39 years (61.08%). More than half (50.74%) of the women presented with secondary infertility, while age of women ( p = 0.004 ) and duration of infertility (0.034) were found to be in association with the type of infertility. Uterine findings were predominantly capacious uterine cavity (45.1%) and uterine fibroids (33.3%), while fallopian tube findings included bilateral blockage (24.2%), right unilateral proximal blockage (17.7%), loculated spillage (16.1%), and left unilateral proximal blockage (16.1%). The range of normal uterine cavity size, measured as ratio (Jimah ratio) of intercornual diameter to interiliac diameter was 0.2–0.45, with a mean of 0.36. Conclusion. Secondary infertility was the commonest indication for HSG in the study, and a significant proportion of infertile women had abnormalities. Abnormalities were higher in the fallopian tubes than the uterus, while capacious uterine cavity, uterine fibroid, and bilaterally blocked tubes were the top three abnormalities found.

HYSTEROSCOPY FOR DIAGNOSIS OF FEMALE GENITAL TUBERCULOSIS IN INFERTILE WOMEN: AN ESSENTIAL TOOL IN MINIMALLY INVASIVE ERA.

2021 ◽  
pp. 73-76
Author(s):  
Vinita Sarbhai ◽  
Aafreen Naaz ◽  
Vikram Sarbhai
Keyword(s):  
Prospective Observational Study ◽  
Uterine Cavity ◽  
Endometrial Biopsy ◽  
Genital Tuberculosis ◽  
Infertile Women ◽  
Female Genital Tuberculosis ◽  
The Common ◽  
Basic Evaluation ◽  
Female Genital

INTRODUCTION: Female genital tuberculosis (FGTB) is difcult to diagnose due to asymptomatic presentation and paucity of denitive investigations. Hysteroscopy can be utilized for the diagnosis of genital tuberculosis in infertile women. This study was done to study the role of hysteroscopy in the diagnosis of genital tuberculosis. METHODS: Prospective observational study was performed on 50 infertile women after basic evaluation of infertility. The women with tubal factors for infertility or unexplained infertility were selected for the study. Premenstrual endometrial biopsy (EB) was done for mycobacteria (AFB) detection. Hysteroscopy was performed in the next cycle if no AFB was detected on EB. ATT was given if genital TB was diagnosed on EB, and hysteroscopy was performed after completion of ATT. Hysteroscopic observations were compared with endometrial biopsy results. RESULTS: A total of 4 (8%) cases were diagnosed as bacteriologically positive for genital tuberculosis in endometrial samples. They were given anti-tubercular treatment. On hysteroscopy, pale endometrium (16%), Intrauterine adhesions (46%), and osteal obliteration (18%) were the common abnormal observations. 12 patients had mild adhesions, 6 had moderate and 5 patients had severe adhesions. Overall, 26 (52%) patients had features of intrauterine brosis, like intra-uterine adhesions or ostial obliteration, which could be suggestive of chronic infection like tuberculosis. Hysteroscopic adhesiolysis was performed in 46% and the cavity was restored. CONCLUSION: Endometrial Biopsy and Hysteroscopy are complementary procedures that together can help in the diagnosis of FGTB. Hysteroscopy is not only the gold standard for diagnosing uterine adhesions, distortion of the uterine cavity and tubal ostia, but it can also be a prognostic and therapeutic tool.

scholarly journals Potential Diagnostic Properties of Chest Ultrasound in Thoracic Tuberculosis—A Systematic Review

2018 ◽  
Vol 15 (10) ◽  
pp. 2235 ◽  
Author(s):  
Francesco Di Gennaro ◽  
Luigi Pisani ◽  
Nicola Veronese ◽  
Damiano Pizzol ◽  
Valeria Lippolis ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Needle Biopsy ◽  
False Negative ◽  
False Negative Rate ◽  
Mediastinal Lymph Nodes ◽  
Ultrasound Guided ◽  
Pleural Thickening ◽  
Chest Ultrasound ◽  
Thoracic Tuberculosis

Background: Chest ultrasound (CUS) has been shown to be a sensitive and specific imaging modality for pneumothorax, pneumonia, and pleural effusions. However, the role of chest ultrasound in the diagnosis of thoracic tuberculosis (TB) is uncertain. We performed a systematic search in the medical literature to better define the potential role and value of chest ultrasound in diagnosing thoracic tuberculosis. Aim: To describe existing literature with regard to the diagnostic value of chest ultrasound in thoracic tuberculosis. Methods: MEDLINE, EMBASE, and Scopus databases were searched for relevant articles. We included studies that used chest ultrasound for the diagnosis or management of any form of thoracic tuberculosis, including pulmonary, pleural, mediastinal, and military forms. Results: We identified five main fields of chest ultrasound application: (1) Detection, characterization, and quantification of TB; (2) detection of residual pleural thickening after evacuation; (3) chest ultrasound-guided needle biopsy; (4) identification of pathologic mediastinal lymph nodes in children; and (5) identification of parenchymal ultrasound patterns. Effusion was also detected, in early stages, with signs of organization in 24–100% of patients. A low to moderate (10–23%), false negative rate was reported for chest ultrasound-guided needle biopsy. CUS was able to identify mediastinal lymph nodes in as many as 67% of patients with negative chest radiography. Conclusions: Very few studies with important methodological limitations analyze the role of chest ultrasound in the diagnosis of TB. The scarce available data suggests potential targets of future diagnostic or feasibility trials, such as the detection of tuberculosis–related pleural effusion, residual pleural thickening, lymphadenopathy, TB parenchymal patterns, or the use of CUS in biopsy guidance.

scholarly journals Role of Hysterosalpingography for Evaluation of Infertility

1970 ◽  
Vol 39 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Shahara Haque
Keyword(s):  
Medical Journal ◽  
Diagnostic Tool ◽  
False Positive ◽  
False Negative ◽  
Uterine Cavity ◽  
Age Group ◽  
Fallopian Tubes ◽  
Potential Accuracy ◽  
Tubal Pathology

The patients investigated under this study have complaints of inability to conception and they were not responding to treatment. Patients with infertility were studied, the peak incidence of infertility was found in between 26-29 years of age group. Hysterosalpingography examination detected tubal and uterine pathology correctly in 26 cases (81.25%) out of 29 cases of complaining of infertility. Of 18 negative cases, 12 cases (80%) are diagnosed correctly as normal by Hysterosalpingography. After laparoscopic examination it was established that three (20%) were false positive and 6 cases were false negative. If a longer series are analyzed, these findings may vary slightly but still it is very useful diagnostic tool for detection of infertility. Hysterosalpingography will give utmost benefit to the patients of our country. In our study we found that Hysterosalpingography is still the best technique for intrauterine and tubal pathology. This study has established the fact that Hysterosalpingography should be the first approach in the diagnosis of infertility which gives valuable information about both uterine cavity and fallopian tubes at low risk and minimal hazards. As a result of our findings, it is our investigation of female infertility due to its potential accuracy and easy performance Keywords: Hysterosalpingography; Infertility. DOI: 10.3329/bmj.v39i1.6228 Bangladesh Medical Journal 2010; 39(1): 16-23

Intraoperative SEP monitoring in neurosurgery around the brain stem and cervical spinal cord: differential recording of subcortical components

1994 ◽  
Vol 81 (2) ◽  
pp. 213-220 ◽  
Author(s):  
Wolfgang Wagner ◽  
Lydia Peghini-Halbig ◽  
Johannes C. Mäurer ◽  
Axel Perneczky
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Cervical Spinal Cord ◽  
False Negative ◽  
False Negative Rate ◽  
Content Type ◽  
Negative Rate ◽  
Neurosurgical Patients ◽  
The Brain

✓ The results of intraoperative monitoring of median nerve somatosensory evoked potentials (SEP's) were evaluated in 75 neurosurgical patients in order to assess the role of differential derivation of brain stem (P14) and spinal cord (N13) wave activity. These components were compared with the conventionally recorded neck potential (“N13”) that reflects overlap of P14 and N13. The spinal cord N13 wave was recorded from the posterior to anterior lower aspect of the neck and the brain stem P14 wave from the midfrontal scalp to the nasopharynx; both derivations enabled isolated low-artifact recording of these components. In 18.7% of patients, moderate to major latency and/or amplitude shifts of N13 or P14 were found that were masked in conventional neck-scalp recordings of “N13”. There was a 6.7% false-negative rate in this series. Using a neck-scalp derivation alone, a 14.7% false-negative rate would have resulted and an isolated worsening of the P14 component (with stable neck potential) in six cases would have been overlooked. It is concluded that the proposed SEP recording technique allows independent assessment of spinal cord and brain stem activity. It is, therefore, superior to the conventional neck-scalp derivation technique, in which important information may be concealed or even lost due to the overlap of the brain stem P14 and spinal cord N13 potentials.

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