Introduction: The success of any in vitro fertilization (IVF) program depends upon a number of factors, including the ovarian stimulation protocol, quality and quantity of gametes obtained, and the embryo transfer (ET) procedure itself. ET procedure is a crucial step in the success of any IVF or intracytoplasmic sperm injection cycle and has to be mastered and meticulously performed. Ultrasound, being a noninvasive procedure, is used extensively in assisted reproduction and has an important role in ET procedure. Hormonal stimulation of the ovaries causes their enlargement, thereby resulting in variation of the uterine position. There is a paucity of literature documenting this change in uterine position, especially in the Indian population. Therefore, this study was undertaken to find any variation in the uterine position and its impact on pregnancy rates. Methadology: In vitro fertilization was done after ovarian stimulation and ET was done on day 3 at 8 cell stage. Biochemical Pregnancy Rates and clinical pregnancy rates were determined for all the ET procedures. Results: The anteverted uterus was present in 102 cases, amounting to 77.2%, whereas the remaining 30 cases had retroverted uterus, amounting to 22.8%. The ET procedure in anteverted cases was performed with ease in the majority of the cases. However, three cases had difficult ET. In comparison, the six difficult ETs were reported out of a total of 30 retroverted uterus, amounting to 20% of cases. Conclusion: The superiority of ultrasound-guided ET has been proved beyond any doubt as compared to the clinical touch method and it remains the mainstay of ET procedure.

Background: Pregnancy is characterized by various endocrinological and physiological changes affecting different organs including ear, nose and throat. Otorhinolaryngological manifestations in pregnant women are mainly due to changes in levels of sex hormones such as estrogen and progesterone. While majority of these conditions are benign and reverse after parturition, some do not. The study was conducted with an objective to find the incidence of various otorhinolaryngological manifestations among pregnant women and to create awareness among the medical professionals to diagnose these conditions. Methods: This is a hospital based cross sectional study of 240 pregnant women who presented to the department of otorhinolaryngology with ENT symptoms. Detailed history, general physical examination and complete ENT examination was done on all subjects. Results: 47.9% of the study cases had otological manifestations among which otitis media was the main finding. 16.7 % of the cases had nasal symptoms among which rhinits was the main condition predominantly observed in the 3rd trimester. 19.6% of the cases had oral cavity lesions with stomatitis being the most commonly found cause. 15.8% of the cases had throat complaints, among which gastroesophageal reflux disease (GERD) was the most common cause found during 2nd and 3rd trimester. Conclusions: Recognition and understanding of pregnancy related ear, nose throat complaints will allow otolaryngologist to reassure and manage these patients, improving their experience of the gestational period.

ABSTRACT Infertility remains one of the health problems in India like anywhere else in the world. Infertility affects about 15% of the population. After the advent of the first in vitro fertilization (IVF) in 1978, there remains a ray of hope for infertile couples to have their own biological child. Over the past decade, there has been a mushrooming of assisted reproductive technology (ART) clinics in all the major cities of India. The number of IVF cycles performed annually in these clinics has been steadily increasing. There is a lack of data on the number of IVF cycles performed annually as there is no central or nodal agency that collects analyzes and maintains the IVF database of these clinics. Our study has worked out the infertility profile of infertile married couples in a retrospective manner. Our study showed that blocked fallopian tubes remain the single most common cause of infertility in India. How to cite this article Jamwal VDS, Subhash B, Karunakaran S, et al. Retrospective Study on the Infertility Profile of Patients Reporting for In Vitro Fertilization and Embryo Transfer in a Tertiary Care Hospital in India. J Med Acad 2020;3(2):50–53.

Introduction: The last century has witnessed rapid growth of the health-care institutions in both the public and the private sector as per the demand from the growing population. This has resulted in substantial amount of the biomedical waste (BMW) is generated which presents a health hazard. Objectives: The objective is to study the BMW management (BMWM) practices of the secondary care government hospital and to suggest measures for improvement of the current BMW practices for evolving a better and more efficient system of BMWM. Materials and Methods: The study design was a descriptive study in which various stakeholders and facets of BMWM system in government hospitals were taken into consideration. Samples drawn were purposive, with the objective of studying BMWM in a secondary care hospital. The observations, interviews, and focus group discussions were used for data collection. Results: The various categories of waste generated in a 345 bedded secondary care government hospital and the quantity on a monthly average basis was calculated. Total BMW collected and treated by health-care facility in kg/day is 12 kg, and the same amount is disposed of in a day. Conclusion: There is a dire need for making appropriate technologies, imparting professional training, and allocating adequate financial resources for effective and safe BMW disposal. Public-private partnership and total commitment of the top management will help in proper handling and disposal of BMW.

Introduction: Infertility has been declared as a public health concern by the World Health Organization. Infertility affects approximately 10%–15% of couples worldwide. Male factors contribute significantly to infertility approximately 35% of couples. Assessment of the integrity of sperm DNA is important in male infertility. Semen cryopreservation techniques as a measure of fertility preservation have been shown to increase DNA fragmentation. The main objective is to study the effects of cryopreservation on sperm DNA fragmentation in ejaculated spermatozoa. Material and Methods: The study was conducted in a tertiary care referral hospital for infertility during the period of January 01, 2013–March 31, 2014. A total of one hundred patients who met the inclusion criteria were included in the study. Sperm DNA fragmentation was done prefreeze and postthaw by sperm chromatin dispersion test. Results: Mean sperm count prefreeze was 56.6 million/ml (standard deviation [SD] = 22.5 million) of semen. Lowest concentration of spermatozoa in the study population was 25 million/ml of semen and highest concentration of spermatozoa in the study population was 120 million/ml of semen. Postfreeze concentration had mean of 66.1 million (SD = 22.4 million). DNA fragmentation in prefreeze was 3.5% (0.3%) and in postfreeze 3.6% (0.3%). There was statistically significant difference between prefreeze and postfreeze values both in sperm count and DNA fragmentation. There was a statistically significant correlation between age and postthaw DNA fragmentation. Discussion and Conclusion: Although cryopreservation increases the DNA fragmentation level of washed sperm significantly, this does not prevent us from utilization of cryopreservation facility because benefits far outweigh the adverse effects of cryopreservation.

BACKGROUNDFemale sterilisation has been widely accepted in India especially after the availability of endoscopic ligations and even the couples with low parity have started opting for it.As per ministry of health records, 46 lakh tubectomies were performed as against 1.79 lakh vasectomies between 2011 and 2012.Success of national sterilisation programme is possible only with universal availability of reversal procedures in the fast changing present day social scenario.The aim of the study was to find an easy and practical approach for reversal after laparoscopic sterilisation and to devise an easy and universally available reversal procedure for the providers of sterilisation services. MATERIALS AND METHODSTwenty-five females presenting in OPD for reversal of laparoscopic sterilisation were counselled and operated abdominally using 4x magnification with a simple technique after ruling out infection under regional anaesthesia, i.e. combined spinal and epidural technique.The tissues were continuously irrigated with heparinised ringer lactate. RESULTSThe common reason for reversal was death of one or more children in twenty cases.Other reasons for reversal were sickness of living children in two cases and remarriage in three cases.Patency was observed in all twenty-five cases at the time of operation.16 (64%) females conceived within 1-4 years.Out of these 14 (56%) were term pregnancies and 2 (8%) ended in abortions.4 (16%) did not conceive, whereas 2 (8%) were lost to followup.The result of 3 (12%) is still awaited.The type of anastomosis performed was isthmo-isthmic in 16 (64%) with 9 term pregnancies and 1 abortion.4 (16%) were isthmo-ampullary with 2 term pregnancies and 2 with isthmo-interstitial cases had 2 term pregnancies.Combination of cornual implantation and isthmo-isthmic anastomosis in 1 case had a term pregnancy and 2 with combination of isthmo-isthmic and isthmo-ampullary anastomosis had 1 abortion. CONCLUSIONThe simplicity of the procedure, acceptable pregnancy rates and cost effectiveness as compared to IVF can contribute to benefit the masses especially located in remote areas and without the facility of latest techniques.

Aim: To find out the most effective dose of beta adrenoreceptor blocker esmolol for attenuation of pressor response. Settings and Design: Prospective, hospital-based. Subjects and Methods: A total of 100 patients randomly divided into four groups of 25 each were included who were ASA-I i.e.18 years old and above, of both sexes. Group I, II, III and IV received 0, 1, 2 and 3 mg/kg of esmolol hydrochloride diluted in 10 ml of dextrose 5% slowly injected over a period of 15-20 seconds. Baseline parameters i.e. heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) mean arterial pressure (MAP), oxygen saturation (SpO2) and electrocardiography (ECG) were recorded. These parameters were again recorded at 30 seconds after administration of propofol, at 1 and 2 minutes after esmolol administration and at 1, 3, 5 and 10 minutes after intubation. Results: Values of baseline parameters and at 30 seconds after giving propofol were comparable. Oxygen saturation (SpO2) in all the four groups did not show any variation at all intervals i.e. baseline, 30 seconds after propofol, 1 and 2 minutes after administration of the study drug, 1, 3, 5 and 10 minutes after intubation. A decrease in HR, SBP, DBP and MAP was observed in Groups II, III and IV when compared to their individual baseline values which started at 1 minute after the administration of the study drug. However, there was an increase in mean HR, SBP, DBP and MAP seen immediately 1 minute after intubation in Groups I and II when compared with their individual baseline values. Whereas, in Group III and IV the mean values for the various parameters were comparable to the baseline. No rhythm disturbance was seen in the ECG in any of the groups. Conclusion: Intravenous esmolol in a dose of 1 mg/kg body weight is ineffective in blunting the haemodynamic responses to laryngoscopy and intubation, but esmolol in a dose of 2 mg/kg body weight given 3 minutes before laryngoscopy and endotracheal intubation is effective in attenuating the haemodynamic responses, without any deleterious effects.

Introduction: Carotidynia is a radiating neck pain syndrome associated with tenderness over the carotid bifurcation, without apparent structured abnormality of the carotid artery itself.Due to its controversial aspects, the Headache Classification Subcommittee of the International Headache Society agreed to remove carotidynia as a distinct entity in the 2 nd Edition of Classification of Headache Disorders, 2004.Material and methods: 10 out-patients suffering from idiopathic carotidynia with clinically elicitable "Fay sign" were enrolled and after a detailed clinical examination, their biochemical and radiological investigations were carried out.Results: A combination of NSAID, oral steroids and antacid therapy showed positive results in five patients out of enrolled ten within one week.The rest five patients, became symptom free with the addition of pregabalin.Two patients had a relapse after 3 months and were managed with a combination of NSAIDs and pregabalin.Conclusion: Idiopathic carotidynia responds to symptomatic treatment involving NSAIDs, oral steroids and pregabalin.Patients need to be investigated to exclude any neurological and/or vascular cause.