No abstract

Background: Any uterine bleeding outside the normal volume, duration, regularity or frequency is considered abnormal uterine bleeding. Objectives: This study was conducted to evaluate the efficacy of TAS/TVS and histopathological findings in AUB patients. Methods: A prospective study was done on 101 females of various age groups attending the Department of obstetrics and gynaecology over a period of 1 year with a clinical diagnosis of AUB. Each patient irrespective of the baseline investigations and sonography findings were subjected to premenstrual dilatation and curettage as well as hysteroscopy accordingly hence endometrial tissue obtained was subjected to histopathological examination. Result: In our present study the most recurring clinical uterine lesion noted was myoma in about 34.16%, followed by Adenomyosis in about 33.54%. Endometrial polyp was noted at 21.11% and endometrial carcinoma was in 8.69%. Cervical polyp and cervical carcinoma found in 1.24%. The sensitivity and specificity of sonography for Diagnosing Polyp as compared to HPE was 52.77% and 98.46% while positive predictive value and negative predictive value were 95.00 % and 79.01% respectively. Conclusion:Transabdominal or transvaginal ultrasound is low cost primary modality for screening and should include as a first line screening method. Though the investigation and management of AUB among the non-gravid women was confusing, histopathological diagnosis proved to be the gold standard.

Genital tract tuberculosis usually shows no symptoms and it is diagnosed as such incidentally during infertility investigations. In general, infertility is the most common clinical symptom of pelvic tuberculosis to the extent that it constitutes between 40 to 60 percent of the patients chief complaints. Female genital tuberculosis is still a major cause of infertility in India. This case highlights some of the well known facts about genital tuberculosis, that it is the relatively young female in the reproductive age group who are victim in female genital tuberculosis and infertility. In our case inspite of advanced genital tuberculosis, endometrial biopsy was negative for AFB and showed normal histopathology and diagnostic laparoscopy and biopsy from fallopian tubes revealed genital tuberculosis. Thus laparoscopy has definite place in the diagnosis of pelvic tuberculosis. Female genital tuberculosis is a major cause of infertility however diagnosis is sometime difficult and it becomes still more difficult when endometrial histopathology is normal therefore diagnostic laparoscopy is gold standard for confirmation of genital tuberculosis with its added advantages of complete evaluation of uterus, tubes, ovaries and operative intervention in the same sitting. [Int J Reprod Contracept Obstet Gynecol 2013; 2(1.000): 111-113

To evaluate the efficacy of intraoperative infusion of Levobupivacaine solution for the relief of pain after operative gynecologic laparoscopy. Design: Double-blind, randomized, controlled trial. Materials & method: Ninety females aged 18 to 60 years who underwent gynecologic laparoscopic surgery from October 2018 through October 2019. The patients were divided into three groups, Group A (n =30): Intraperitoneal infusion of a mixture of 10 ml of 0.5% Levobupivacaine (50 mg) with epinephrine (1:500) in 40 ml of Ringer's lactate solution postoperatively. Group B (n = 30): the same mixture solution infusion preoperatively and postoperatively (total 100 mg Levobupivacaine). Group C (n = 30): Control. Statistical analysis and results: Shoulder tip pain (STP), abdominal parietal pain (APP), and abdominal visceral pain (AVP) were recorded on a visual analog scale at 2, 4, 8, 16, and 24 hours postoperatively. A total of 79 patients fulfilled the study criteria. The overall incidence of STP was 61.5%. Abdominal visceral pain in group B was significantly less than in group C at 2 and 4 hours postoperatively (p =.011 and p = .010, respectively). Conclusion: Intraperitoneal Levobupivacaine administration both immediately after placement of trocars and at the end of surgery was found to be effective in reducing the intensity of AVP but not in reducing STP, APP, or postoperative analgesia consumption after gynecologic laparoscopic procedures.