Kallol Kumar Roy

A prospective randomized trial comparing the efficacy of Letrozole and Clomiphene citrate in induction of ovulation in polycystic ovarian syndrome

OBJECTIVES: To compare the efficacy of letrozole and clomiphene citrate (CC) in patients of anovulatory polycystic ovarian syndrome (PCOS) with infertility. MATERIALS AND METHODS: This prospective randomized clinical trial included 204 patients of PCOS. 98 patients (294 cycles) received 2.5–5 mg of letrozole; 106 patients (318 cycles) received 50–100 mg of CC (both orally from Days 3–7 of menstrual cycle). The treatment continued for three cycles in both the groups. Main outcome measures: ovulation rate, endometrial thickness, and pregnancy rate. Statistical analysis was done using SPSS 13 software. P value less than 0.05 was considered significant. RESULTS: The mean number of dominant follicles in letrozole groups and CC groups was 1.86±0.26 and 1.92±0.17, respectively (P=0.126). Number of ovulatory cycle in letrozole group was 196 (66.6%) versus 216 (67.9%) in CC group (P=0.712). The mean mid-cycle endometrial thickness was 9.1±0.3 mm in letrozole group and 6.3±1.1 in CC group, which was statistically significant (P=0.014). The mean Estradiol [E2] level in clomiphene citrate group was significantly higher in CC group (364.2±71.4 pg/mL) than letrozole group (248.2± 42.2 pg/mL). 43 patients from the letrozole group (43.8%) and 28 patients from the CC group (26.4%) became pregnant. CONCLUSION: Letrozole and CC have comparable ovulation rate. The effect of letrozole showed a better endometrial response and pregnancy rate compared with CC.

The role of magnetic resonance imaging in fetal renal anomalies

To evaluate the role of magnetic resonance imaging (MRI) in fetuses with suspected renal anomalies after ultrasonography.

Pregnancy associated aplastic anemia: maternal and fetal outcome.

Aim:  To study the maternal and fetal outcome in cases of aplastic anemia associated with pregnancy.

Hysteroscopic findings in women with primary and secondary infertility due to genital tuberculosis

To evaluate hysteroscopic findings of infertile women with genital tuberculosis.

Hysterosalpingographic findings in infertile women with genital tuberculosis

To evaluate the hysterosalpingographic findings from infertile women who were subsequently diagnosed with genital tuberculosis.

COMPARISON OF EFFICACY OF ORAL DROTAVERINE PLUS MEFENAMIC ACID WITH PARACERVICAL BLOCK AND WITH INTRAVENOUS SEDATION FOR PAIN RELIEF DURING HYSTEROSCOPY AND ENDOMETRIAL BIOPSY

BACKGROUND Office hysteroscopy with endometrial biopsy is usually the first investigation for abnormal uterine bleeding and other uterine diseases. AIMS To evaluate the effect of oral drotaverine with mefenamic acid on pain perception during hysteroscopy and endometrial biopsy and to compare it with that of paracervical block using 1% lignocaine and with that of intravenous sedation using diazepam with pentazocine. SETTINGS AND DESIGN Outpatient gynecological department and open randomized trial. MATERIALS AND METHODS One hundred twenty women undergoing hysteroscopy and endometrial biopsy were randomized into 3 groups. Group I received tablet containing drotaverine hydrochloride (80 mg)+mefenamic acid (250 mg), group II received lignocaine paracervically and group III received intravenous diazepam. The intensity of pain during the procedure, 30 and 60 minutes later on visual analog scale (VAS) was assessed. STATISTICAL ANALYSIS Statistical analysis was performed using Kruskal-Wallis test, with the Bonferroni correction, the t test, and the chi2 test. RESULTS Groups were similar in age, parity, vaginal birth or relevant medical history. A statistically significant difference in pain scores was noted among the 3 groups during the procedure (group I, 4.13+/-1.28; group II, 5.93+/-1.26; group III, 5.58+/-1.51), (P<0.001); as well as 30 minutes later (group I, 1.78+/-0.89; group II, 2.53+/-0.81; group III, 2.23+/-0.94), (P<0.001) and 60 minutes later (group I, 1.2+/-0.46; group II, 1.98+/-0.83; group III, 1.68+/-0.75), (P<0.001). VAS at different time intervals among the groups was also statistically significant. No adverse effects were observed. CONCLUSIONS Oral drotaverine with mefenamic acid is effective in women undergoing hysteroscopy and endometrial biopsy.

Increased complication rates associated with laparoscopic surgery among patients with genital tuberculosis

To compare the complications and surgical difficulties encountered during laparoscopy between women diagnosed with and without genital tuberculosis (TB).

Comparison of perinatal outcome of growth-restricted fetuses with normal and abnormal umbilical artery Doppler waveforms.

AIMS To evaluate the role of umbilical artery Doppler in growth- restricted fetuses. MATERIALS AND METHODS In a prospective observational study, 70 pregnant women with growth-restricted fetuses confirmed by ultrasound, were followed up with Doppler studies of the umbilical artery. The study group consisted of 35 women, where the Doppler waveform in the umbilical artery was compromised (either absent end diastolic flow [AEDF] or reversed end diastolic flow [REDF]). These were compared with an equal number of controls, where growth- restricted fetuses had normal doppler waveforms. Outcome measures were evaluated in both groups and analyzed. RESULTS The periods of gestation at delivery were 27.2 +/- 3.5 weeks in group 1 and 37 +/- 3.3 weeks in-group II, respectively. Perinatal morbidity and mortality was significantly increased in the group with compromised umbilical artery blood group. Birth weight in group I was 742 +/- 126 grams and in group II was 1680 +/- 259 grams. This difference was statistically significant (P=0.0001). In comparison to AEDF, REDF fetuses had more morbidities. Perinatal mortality was also significantly increased in this group (P=0.001). CONCLUSION Umbilical artery Doppler should be used in the management of growth-restricted fetuses. In those fetuses in normal Doppler, pregnancy can be prolonged. REDF is an indication for termination of pregnancy.

Sexual trauma—an unusual cause of a vesicovaginal fistula

A 20-year-old nullipara presented with a post-coital vesicovaginal fistula in the trigone of the bladder. She had normal genital development and no other cause was found. The fistula was repaired by vaginal route.

Effectiveness of estrogen in the prevention of intrauterine adhesions after hysteroscopic septal resection: A prospective, randomized study

The aim of this prospective randomized study was to evaluate the efficacy of estrogen in preventing intrauterine adhesions following hysteroscopic septal resection and to investigate its effect on reproductive outcome.