This document discusses genital tuberculosis (TB) and the authors' experience with diagnosing and treating it. Some key points:
- Genital TB is a significant cause of infertility in India, contributing to around 35-60% of infertility cases seen by the authors.
- Diagnosing latent or asymptomatic genital TB poses a major challenge as conventional tests only detect 15-20% of cases.
- The authors have found interferon gamma tests, MTBC tests, and TB PCR on endometrial biopsies and fluids to be helpful in diagnosing more cases.
- Laparoscopy and hysteroscopy also provide diagnostic information. The authors' laparoscopy findings have ranged from tub
tubal factor is almost 30% of all female infertility causes.Hence evaluation of tubes is usulally the first of the testings.
this presentation evaluates all the methods for evaluation of fallopian tubes
tubal factor is almost 30% of all female infertility causes.Hence evaluation of tubes is usulally the first of the testings.
this presentation evaluates all the methods for evaluation of fallopian tubes
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
OVERVIEW
Aim
Definition
Prerequisites
Individualisation of patient.
Ohss free IUI. Clinic
{Strict cancellation of cycle if OHSS is suspected}
Newer trends
Sucess Rates in IUI with COH
PROGNOTIC FACTORS to increase Pregnancy Rates..& discussion
Uterine prolapse (also called descensus or procidentia) means the uterus has descended from its normal position in the pelvis farther down into the vagina.Cervicopexy is fertility conserving surgical management of prolapse.
In cases of Nulliparous prolapse or even patients deserving child bearing uterus preserving surgeries are done.
Recently even for prolapse if women want to preserve uterus for variety of reasons ,with newer minimally invasive methods it is now gaining popularity.Larger studies and longer followup is required.
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)Sujoy Dasgupta
Dr Sujoy Dasgupta invited to deliver a lecture on "RPL- ESHRE Guideline" in the Annual Conference of RCOG (Royal College of Obstetricians and Gynaecologists) IRC (International Representative Committee) India East held on 20-21 May, 2023
Luteal phase insufficiency is one of the most important aspect of fertility treatment . But due to lack of proper understanding many unwanted medications are prescribed . This ppt will give an idea on the best evidence based luteal phase support for an ivf cycle.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
OVERVIEW
Aim
Definition
Prerequisites
Individualisation of patient.
Ohss free IUI. Clinic
{Strict cancellation of cycle if OHSS is suspected}
Newer trends
Sucess Rates in IUI with COH
PROGNOTIC FACTORS to increase Pregnancy Rates..& discussion
Uterine prolapse (also called descensus or procidentia) means the uterus has descended from its normal position in the pelvis farther down into the vagina.Cervicopexy is fertility conserving surgical management of prolapse.
In cases of Nulliparous prolapse or even patients deserving child bearing uterus preserving surgeries are done.
Recently even for prolapse if women want to preserve uterus for variety of reasons ,with newer minimally invasive methods it is now gaining popularity.Larger studies and longer followup is required.
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)Sujoy Dasgupta
Dr Sujoy Dasgupta invited to deliver a lecture on "RPL- ESHRE Guideline" in the Annual Conference of RCOG (Royal College of Obstetricians and Gynaecologists) IRC (International Representative Committee) India East held on 20-21 May, 2023
Luteal phase insufficiency is one of the most important aspect of fertility treatment . But due to lack of proper understanding many unwanted medications are prescribed . This ppt will give an idea on the best evidence based luteal phase support for an ivf cycle.
Slides for 3rd and 4th year medical students in Obstetrics and Gynecology- to not overlook the possibility as a diagnosis- still present. Slides highlighting diagnostic and management challenges
Diagnosis of tuberculosis by direct demonstration of the pathogen or by indirect demonstration of cell mediated immunity through activation of CD 4 and / or CD 8 T lymphocytes.
The Newer Concepts In Endometriosis Management : Dr Sharda JainLifecare Centre
The Newer Concepts In
Endometriosis Management
ENDOMETRIOSIS IS ENIGMA
DIAGNOSTIC DELEMMA
DEBILITATING DISEASE QOL
PROGRESSIVE DISEASE
RECURRENCE IS BIG PROBLEM
NO FINAL VERDICT ON CAUSE
NO PERMANENT CURE
The exact prevalence of endometriosis is unknown, but estimates 10% in the general female population in India but up to 50% in infertile women
The Newer Concepts forReduced Surgery to preserve fertility in Endometrios...Lifecare Centre
The Newer Concepts forReduced Surgery to preserve fertility in Endometriosis
ENDOMETRIOSIS IS ENIGMA
DIAGNOSTIC DILEMMA
DEBILITATING DISEASE QOL
PROGRESSIVE DISEASE
RECURRENCE IS BIG PROBLEM
NO FINAL VERDICT ON CAUSE
NO PERMANENT CURE
The exact prevalence of endometriosis is unknown, but estimates 10% in the general female population in India but up to 50% in infertile women
Anemia Free India Gynaecologist to focuss on *12gm Haemoglobin at Delivery I...Lifecare Centre
Important Highlights
Prophylactic Iron and Folic Acid Supplementation in all six target age groups.
Intensified year-round Behaviour Change Communication (BCC) Campaign for:(a) improving compliance to IFA and deworming, (b) enhancing appropriate infant and young child feeding practices, (c) encouraging increase in intake of iron-rich food through diet and/or fortified foods (d) ensuring delayed cord clamping .
Testing and treatment of anaemia, using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents.
Addressing non-nutritional causes of anaemia
in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis
Strategies for Improving Success Rates in ART PARTLifecare Centre
Strategies for Improving Success Rates in ART
Part - 2
Strategies for Improving Success Rates in ART
Tailoring Controlled Ovarian Stimulation
Strategies for Luteal Phase in ART cycles
Endometrial Receptivity Array
How to optimize success rates in ART? : Dr Sharda JainLifecare Centre
How to optimize success rates in ART? : Dr Sharda Jain
How to improve success rates in ART?
The big debate कार्य में आनंद
Evolution of In-vitro Fertilization (IVF)
Factors Influencing IVF Success Ist Part
Strategies for Improving Success Rates in ART Second Part
Innovations & Breakthroughs in IVF Part Three
OPEN DEBATE
SOCIALEGG FREEZING : Dr Poorva Bhargav and Dr Sharda JainLifecare Centre
SOCIALEGG FREEZING : Dr Poorva Bhargav and Dr Sharda Jain
Introduction
Social egg freezing (oocyte cryopreservation for non-medical reasons) has evolved as a proactive option for women looking to extend their reproductive possibilities past their peak childbearing years
It is the process of saving or protecting eggs, or reproductive tissues so that a person can use them to have biological children in future
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Genital TB in Infertility
History
Ancient Indian Text – 3000 BC by Charak
Morgagni 1744 - autopsy , 20 years with Genital TB
Ut + Tubes – filled with caseous material
Robert Koch 1882 - Discovered M. Tuberculosis
Sutherland 1949, Schaefer 1970
1/3 of words population is affected by TB
3. TB No. 1 cause of death of
women in India - Till 2012
2013 - it is 3rd
cause
Active 10% V/s latent 90%
India
4. Latent Genital TB
is Big Diagnostic Dilemma
Biggest Cause - Infertility, Rec. Miscarriage , AUB, PMB,
Pain in abdomen
• Due to lack of good tests in virtually symptomless
patients - Latent GTB - Remains undiagnosed
• No Case Definition
Grossly Under Reported
5. Genital Tuberculosis
INCIDENCE
- 2-10% infertility (western Data)
- 9-50% infertility (Indian Data)
ETIOLOGY
- Secondary to primary focus elsewhere (most common- lung)
MODE OF INFECTION
- Hematogenous spread – most common
- From adjacent structures – few cases
- Ascending structure – rare
- Age : 16-53 years (Max: 25-35 years)
6. Genital Tuberculosis
Pathology
Tube – Involved in 90% cases
Endosalpingitis
Patency may be present
Secondary infection with pyogenic organism
Exosalpingitis interstitial salpingitis
Uterus : Involves in 60-70% cases
Ovaries : Involves in 30% cases
Vulva / Vagina – ulcerative or hypertrophic growth
Cervix – very rare
8. Genital Tuberculosis
Clinical Picture
• Asymptomatic 10%
• Infertility 35 – 60%
• Menstrual Disorder 40-50%
Initial menorrhagia
Later oligo / amenorhoea
• Pain in lower abdomen -40%
• Lower grade fever, malaise, weight loss
mass, encysted ascites, doughy feel)
• Pelvic mass – usually non – tender , unless superadded
infection
• Post coital bleeding / irregular bleeding PV – local lesion
9. Diagnostic Challenges
• “GOLD STANDARD”-Conventional methods
– Histopathology (epitheloid granuloma)
– Microbiology (AFB, positive culture)
• Conventional detect only 15-20%
• Difficult, Dilemma when conventional negative
• Case definition for FGTB in absence of conventional?
Combination - bacteriology, histopathology,
molecular methods and laparoscopy/Hysteroscopy
10. Challenges in managing GTB
Diagnostic Dilemma
• When conventional tests are negative?
• How to diagnose Latent TB
• Is there a role of endoscopy?
Treatment Dilemma
– When only TB PCR / MTBC + ?
Tests after ATT
- AFB culture ? - HSG/ hysteroscopy
11. Our Current Practice of Investigations
for Genital Tuberculosis
• USG – TVS
• TLC, DLC
• ESR & Mantoux test
• Interferone gamma tes
• Pre- menstrual EB – Granulomas/ tuberculoma
MTBS/PCR
• HSG - rigid, lead – pipe appearance , bleeding of
tobacco pouch appearance – pyosalpinx
• Hysteroscopy Laparoscopy in selective cases
13. • ESR
• Rapid Culture for AFB
• HPE – for Koch's
• X-ray chest
Did not pick up TBIn our Experience
Mx Test
Did not Pick up TB
14. We know that
Conventional methods diagnose
only 15-23% cases
PAUCI-BACILLARY INFECTION
• AFB staining-1-3%
– At-least 10,000 bacilli/ml
• LJ culture 3-5%
– At-least 100 bacilli/ml
• HPE-Granuloma-3-20%
– Granuloma take up to 3 wks to develop
– Periodic shedding of endometrium
15. Interferon –γ release assay(IGRA)
• Immune based test indicate cellular response to recent or
remote sensitization to M.tuberculosis
• Quantiferon Gold, Quantiferon Gold – in tube and T-spot
test
• Alternative to TST/Mantoux
• Results unaffected y BCG vaccination status
• High specificity(96%) even in BCG vaccinated individuals
• Detection of latent TB
Widely Used Now
16. Radiometric culture BACTEC 460 :
– Based on generation of radioactive CO2 from palmitic acid
– Problem with disposal of radioactive compounds
MGIT(mycobacteria growth indicator tube system)
– Uses a fluorochrome marker
• Advantage
– higher sensitivity -80–90% (30-35% with LJ)
– Higher detection rate-7-10% (3-5% with LJ)
– quicker results -5–10 days (6weeks with LJ)
– Useful for drug susceptibility testing
• Disadvantage-Cost
Rapid culture methods
17. Now we have accepted
Molecular methods-PCR
• PCR-DNA
– Detection rates 22-44%
(Jindal UN, 2006, Rana T,
2011,Thangappah 2012)
– False positive-10-12% (Thangappah et
al, 2012)
– Positive even after full course ATT
• RT-PCR (m-RNA)
– Detection rates 2-8% (Rana T, 2011)
– Available in few labs
– Technically challenging
18. MTBC
HISTOCHEMISTRY BASED TEST
• Patented By Dr. Ghosh
• Potent is tagged to MTB complex
•Sensitively specificity for MTBC is very high
monoclonal TB
Used at
19. we have recently Associated that
Cell mediated immune markers i.e
• TNFa
•Interferon Gamma are raised in
patient of
Genital Koch’s
20. Laparoscopy-Why?
Tubal and peritoneal status
Peritoneal spillage avoided in latent/early disease
When PCR alone positive- Multiple samples-PW from
POD/biopsies
PCR positivity in PF-bacillary spill in peritoneum early in
disease even before fibrosis sets
Diagnostic Accuracy
– Lap diagnosis in 33-60%
(Sharma JB et al, 2008, Jindal U 2006)
– Lap findings in 59% vs 7.4% by HSG to diagnose FGTB
Kulshrestha. V et al. IJGO, 2011
25. 2005 - IVF Failure -13
7 Cases positive for MBTC (EB)
4 Cases Conceived on their own
3 required Lit Therapy
All had Threatened Abortion
26. Incidence of TB in Infertility
since 2005
June 2013 36%
(N- 1440)
Prior to 2005 - 11% only
Experience
Markedly ↑ since 2005
27. Detection of Latent Genital Koch’s
ESR
HPE
AFB culture
X-ray chest
TVS
Mx Test
MTBC Test
TB PCR
Interferon gamma Test
Prior < 2005 – 11%
x
After 2005 till June 2013 - 36%
Pick up Rate
28. Counseling
Genital Koch’s
Diagnosis
(TB gold /MTBC/TB- PCR)
------------------------------------------------------------------
Plays
Major Role
Immunology - ↑ TNF is invariably
associated
29. Association of
Cell mediated immune marker
TNFa
Interferone Gamma
Latent Genital
Koch’s
TH – type I cytokine production -
Causing infertility & Rec. Miscarriage
30. TH – Type I TH – Type II
Reproductive
Disaster
• Infertility
• Rec. Miscarriage
Successful
Pregnancy
35. • PID with no pain is
most important
symptom/ sign.
• It may present as -
• Fluid collection in
cul-de-sac
• Fluid collection in
endometrial cavity.
• Fluid collection inside
the tubes (if adhesions
at fimbrial end, fluid
shows a definite
oblong expansion
In TB
36. • T-O mass are seen as
unilocular or multilocular
thick walled mass with diffuse
internal echoes.
• Layering effect seen when
debri settles down.
• Outer margins poorly
delineated if adhesions present
• Restricted mobility (Frozen
pelvis)
In TB
37. Laparoscopic classification
• Definitive
– Tubercles, caseation, beaded tubes
• Probable
– Encysted fluid collection, dense pelvic and peri-tubal/peri-
ovarian adhesions, hydrosalpinx, TO masses, thick fibrosed
tubes, mid-tubal blocks, extravasation of dye on
chromopertubation
• Possible
– Mild/flimsy adhesions, dilated tortuous tubes, cornual/fimbrial
bloks, fimbrial agglutination/phimosis
• Incidental
– Fibroid, endometriosis, PCOS
• Normal findings
(Rattan A, Tub Lung Ds 1993, Bhanu NV et al. J Med microbiol, 2005)
38. LAPAROSCOPY – 250 cases
• No pathology - 28%
• Acitic Fluid POD – 16%
• One side block Tube 20%
• B/L block Tubes – 20%
- Pelvic Adhesions
- Peritoneal Tubercles
• TO-masses – 14%
- Caseous Tubes -3%
• Frozen pelvic 18%
• Endometriosis – 28%
--------------------------------------------------
In endometriosis TB + - 50%
Experience
All Cases of TB were not
subjected to hysterolaparoscopy
41. Insight at Hysteroscopy
• Pale endometrium
• Intra-uterine synechiae of varying grade
• Completely obliterated cavity (80%) by
adhesions
• Granulomas
• Poor distensibility
• Narrowing of Uterine cavity
There is no appearance which can be
described as diagnosed of tuberculosis
45. Genital Tuberculosis
Treatment
For next 4 monts – two drugs INH + nfampicine
Drugs Dose Side effects
INH 5mg/kg. 300mg max Hepatoxic
Peripheral neuritis
Rifampicin 10mg/kg. 600mg max Hepatoxic, fever, rash
Ethambutol 15mg/kg. 800-1000 mg
max
Ptic neuritis
Pyrizinamide 15-30 mg/kg
1.5-2 gm max
Hepatitis
hyperuricemia
1st
two months – 4 drugs
46. Tubercular Endometritis
in Infertility
Are we justified in starting ATT on the
basis of a positive molecular (PCR) test,
Histochemistry positive test (MTBC) with
no other obvious clinical features
?
51. Conclusion
• Latent Genital TB contributes significantly to
Infertility
• Suspicion raising Tests are Moutoux test,
TVS, Hysteroscopy Laparoscopy
• Latent Genital TB is diagnosed by TB PCR, MTBC
test, Interferon gamma test.
• TB if treated , gives very satisfying
success rates in infertility
• But Cure starts with Detection
52. Thanks to diagnosis of Latent Tuberculosis !
In infertility & Recurrent Miscarriages
We
Simply
must
Cure Starts with Detection
Diagnose
TB
Genital TB can be treated easily, it’s time for you to be
screened For TB in infertility & RM !
!