European Journal of Molecular & Clinical Medicine

Background: Low backache (LBA) in females is a major public health problem world-wide and treating this condition is also challenging due to its vast differential diagnosis. Pelvic inflammatory disease (PID) is the most frequently encountered condition in females for LBA and if diagnosed and treated early can lead to significant improvement in symptoms of LBA.       Aim: The present study is conducted to determine the incidence of Pelvic inflammatory disease (PID) and its associated risk factors in women with complaints of low back pain (LBP).      Material and Methods: A prospective epidemiological study was done in the department of orthopedics in GRMC Gwalior, M.P. 400 female patients attending OPD with the presenting complaint of LBP were enrolled in our study. Detailed history was taken and thorough examination was done.      Results: Out of 400 patients with LBA, PID was found in 324 (81%) patients. Maximum number (32%) of patients was from the age group of 41- 50 years. Majority of patients (60.7%) were of low socio-economic status, 51.7% females were illiterate, 69% females were overweight  31.8% of patients complained of vaginal discharge were age group of 41-50 years. 37.4% women used oral contraceptive pills and 58.1% females had an intrauterine contraceptive device inserted. Majority of the PID patients (53.4%) showed inflammatory cell on Pap smear
Conclusion: The present study suggests that PID is a major contributing factor in LBP in middle age females.

Background:Infertility is not merely a health problem, it is also a social injustice and inequality. Infertility have a serious impact on both the psychological wellbeing and the social status of the women in the developing world. Objectives: to find out clinic-demographic characteristics of patients with infertility attending Obstetrics and Gynaecology OPD of RMCH Bareilly.
Materials and Methods: This was a one-year hospital based cross-sectional comparative study carried out in Department of Obstetrics and Gynaecology, Rohilkhand Medical College and Hospital, Bareilly, a tertiary care and teaching hospital in western Uttar Pradesh from 1^st November 2019 to 31^st October 2020 in women with age group 18-45 years presented with indications of primary and secondary infertility and the estimated sample size was 50.
Results: Highest percentage of cases (48%) have been reported for 21-30 age group, followed by 31-40 (38%), above 40 (12%) and below 20 age group (2%). The mean + SD value has been calculated as 31.96 + 7.77. Incidence among patients in high school is highest (34%), followed by primary school (32%), illiterate (22%), post high school (8%) and patients with graduate level education have reported lowest cases (4%).  Homemaker profession has the highest percentage of cases (72%), followed by daily wage worker (14%), other professions (8%) and working women (6%). Class III SES represents the highest percentage (48%), followed by Class IV (40%), Class V (6%), Class II (4%) and Class I represents the least percentage (2%). Most common symptom is menstrual dysfunction (40%), followed by abnormal vaginal discharge (28%), pelvic pain (16%), Fever/Malaise/loss of weight (8%) and very few have been asymptomatic (4%).
Conclusion: There is urgent need of regular health checkups and appropriate preventive, promotive and therapeutic interventions.

Background:Infertility is not merely a health problem, it is also a social injustice and inequality. Infertility have a serious impact on both the psychological wellbeing and the social status of the women in the developing world. Objectives: to find out clinic-demographic characteristics of patients with infertility attending Obstetrics and Gynaecology OPD of RMCH Bareilly.
Materials and Methods: This was a one-year hospital based cross-sectional comparative study carried out in Department of Obstetrics and Gynaecology, Rohilkhand Medical College and Hospital, Bareilly, a tertiary care and teaching hospital in western Uttar Pradesh from 1^st November 2019 to 31^st October 2020 in women with age group 18-45 years presented with indications of primary and secondary infertility and the estimated sample size was 50.
Results: Highest percentage of cases (48%) have been reported for 21-30 age group, followed by 31-40 (38%), above 40 (12%) and below 20 age group (2%). The mean + SD value has been calculated as 31.96 + 7.77. Incidence among patients in high school is highest (34%), followed by primary school (32%), illiterate (22%), post high school (8%) and patients with graduate level education have reported lowest cases (4%).  Homemaker profession has the highest percentage of cases (72%), followed by daily wage worker (14%), other professions (8%) and working women (6%). Class III SES represents the highest percentage (48%), followed by Class IV (40%), Class V (6%), Class II (4%) and Class I represents the least percentage (2%). Most common symptom is menstrual dysfunction (40%), followed by abnormal vaginal discharge (28%), pelvic pain (16%), Fever/Malaise/loss of weight (8%) and very few have been asymptomatic (4%).
Conclusion: There is urgent need of regular health checkups and appropriate preventive, promotive and therapeutic interventions.

Background: Female infertility is quite prevalent these days and with development of newer treatment options, Magnetic Resonance Imaging (MRI) is frequently performed where diagnosis is arduous. The aim of our research was to study the indications of MRI pelvis and its accuracy with respect to hysteroscopy/laparoscopy in evaluation of female infertility and to aid in determination of cases requiring interventional or surgical correction.
A retrospective cross sectional study was carried out for two years eight months between March2019 and November 2021. Amongst 183 infertile women(with primary and secondary infertility) of age group 19-40 years were evaluated, 82 patients who were not conclusively diagnosed by Ultrasonography (USG) or Hysterosalpingography (HSG) were referred for MRI.The MRI findings were compared with hysteroscopic/laparoscopic findings which were considered final. Data was analyzed for indications of MRI and its diagnostic accuracy in female infertility.
Results: On MRI, we found 27 cases of Mullerian anomalies, 16 cases of leiomyoma(Multiple/submucosal), 12 cases of adenomyosis , 11 cases of infective etiology [pelvic inflammatory disease (PID) / pyosalpinx/ hydrosalpinx],  9 cases of endometriosis, 3 cases of endometrial polyp, 3 cases of uterine synechiae. MRI was able to correctly diagnose 78 out of 82 cases. Our MRI findings were confirmed with hysteroscopy or laparoscopy. In majority of cases, MRI findings were same as the surgical findings. Only in few(n=3)cases, findings onMRI were discordant with final surgical diagnosis.
Conclusion: Our study shows that MR imaging is highly accurate noninvasive method of choice for diagnosis of uterovaginal & tubo-ovarian lesions associated with female infertility, especially where the diagnosis is controversial on USG and HSG. Its diagnostic accuracy approaches that of hysteroscopic/ laparoscopic findings in 96.2% of the cases. The superior soft tissue resolution and multiplanar capability of MRI helps in better delineation of the morphology and orientation of pelvic structures. Hence MRI plays a decisive role in management of female infertility and can come to rescue in complex cases.

Background:Living as an involuntarily childless woman is challenging for feminity and female roles in society. Infertility affects about 10-15% of reproductive age couples. WHO estimates that 60-80 million couples worldwide currently suffer from infertility. The causes of female infertility are multifactorial and necessitate comprehensive evaluation. Laparoscopy with chromopertubation is viewed as the “gold standard” test for tubal assessment. Adding Hysteroscopy to the procedure allows for concomitant evaluation of intrauterine cavity. With this preview, my study aims at evaluating the role of diagnostic hystero-laparoscopy as a safe & cost- effective tool for assessment of unexplained female infertility.
Materials and Methods: An observational hospital based study on 260 patients was carried out in a tertiary care centerDr. PSIMS &RF, Vijayawada, Andhra Pradesh, India -over a period of 2.5 years from October 2019 to April 2022. Women aged 18-40yr with normal hormone profile without male factor infertility were included.
Results: Out of 260 cases, 60.93% patients had primary infertility. PCOS was found to be the most commonly associated with primary infertility. Whereas the most common causes of secondary infertility were found to be PID, endometriosis and endometrial polyps each respectively. Hysterolaparoscopy revealed intrauterine lesions and therapeutic measures like ovarian drilling, lysis of intrauterineadhesions, cystectomy, polypectomy and septal resection were carried out.
Conclusion: Hysterolaparoscopy is an effective diagnostic tool for evaluation of correctable tuboperitoneal pathologies like endometriosis, polycystic ovaries, adnexal pathologies and subseptate uterus which are usually missed by other imaging modalities. When done by a trained and experienced investigator and with proper selection of patients, hysterolaparoscopy proves to be a definitive investigative procedure for evaluation of female infertility. It also helps in formulation of a treatment modality.