Identification of Factors Contributing to Primary Female Subfertility by Diagnostic Hystero-Laparoscopy: An Experience of Private Hospital

Background: Management of subfertility is influenced by the diagnosis of its causative factor. Combined diagnostic hystero-laparoscopy has emerged as an effective procedure in identifying causative factors of female subfertility. Objectives: This study aimed to identify contributory factors to primary female subfertility by diagnostic hystero-laparoscopy. Methods: This descriptive study was conducted at the Department of Obstetrics and Gynecology of Hameed Latif hospital, Lahore, Pakistan from December 2021 to May 2022. Data was collected from 344 women with female primary subfertility, undergoing combined diagnostic hystero-laparascopy. All the demographic data along with identified causative factors (tubal blockade, cervical Os stenosis, endometrial polyp, uterine septum, uterine fibroid, endometriosis, peri tubal adhesions and polycystic ovaries) during the procedure were recorded in predesigned study proforma. Data were analyzed through SPSS software 23. Results: Mean age of the patients was 25±5.0 years and the mean duration of subfertility was 3.8+0.55 years. Two hundred and eighty-four (82.56%) patients had abnormal findings, while sixty (17.44%) had normal findings. Out of 284 patients, 94(34%) had one identified factor, while 190 (66%) patients had two or more identified factors for primary subfertility. Polycystic ovaries were seen in 128(37.21%) patients, followed by tubal blockade in 81(23.54%), peri tubal adhesions/hydrosalpinx in 58(16.86%) patients. Conclusions: Diagnostic hystero-laparoscopy is an effective diagnostic procedure for the evaluation of female factor subfertility and may be helpful to gynecologists in devising further management plans.

The Dark Side of the Universe - Some Suggestions

Only about 4% of the Universe’s composition is known and understood, while the remaining 96% is the unknown and mysterious. Ever since the concrete discovery of the dark matter (≈ 26% of the total Universe) by Vera Rubin (mainly)1 in 1970s (otherwise known as the constant rotational velocity curves profiles) and of dark energy (≈ 70% of the total Universe’s energy density) by Adam Riess, Brian Schmidt, Saul Perlmutter and others in 1997, there have been many proposals for the both. The dark matter models contain quantum fields (mainly); scalar, vector and tensor; while other proposals rely on the modified gravity. The dark energy models could be categorized into two groups as: (1) the vacuum energy (non-dynamical); (2) the dynamical models. In the work presented in this thesis we do two things: (I) We explain the constant rotational velocity curves of the spiral galaxy in f(R) gravity. We showed that we can get the rotational velocity curves in f(R) gravity, in vacuum and in different 1Others include W. Kent Ford, Jr. and N. Thonnard. matter distribution scenarios of the galactic environment. We also used the Brans-Dicke theory to get information about the dark matter (particle nature) and its behavior in the galactic environment. (II) We describe the dark energy to be a combination of both non-dynamical vacuum energy and dynamical energy. The non-dynamical vacuum energy comes from the minimum energy of the scalar Higgs potential while the dynamical part comes from the evolving Higgs fields. We argue that all the dark energy models must have some prior connection with Particle Physics no matter which category they fall in. For this reason, we take the extension of the standard model of the Particle Physics by including two Higgs doublets in two different scenarios and the extension of the two Higgs doublet model with different vacuua to show that we can get the accelerated expansion of the Universe from scalar fields already present in Particle Physics in the quintessential regime while satisfying all Particle Physics constrains.