DefinePK

Research Objective

To determine the frequency of genital tuberculosis in patients undergoing diagnostic laparoscopy for infertility.

Methodology

A descriptive (cross-sectional) prospective study conducted over six months (February 12th, 2020 to August 12th, 2020) at the Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar. A sample size of 196 patients was calculated using WHO software based on a 47.1% proportion of genital tuberculosis in infertility, 95% confidence interval, and a 7% margin of error. Non-probability (consecutive) sampling was used. Inclusion criteria were women aged 18-40 presenting with primary or secondary infertility undergoing laparoscopy. Exclusion criteria included symptoms of pulmonary/extrapulmonary TB, endocrine problems, sexual disorders, autoimmune diseases, lung diseases, HIV co-infection, diabetes mellitus, malnourishment, hypertension, peritoneal adhesions from past surgeries, and ovulation abnormalities. Data was analyzed using SPSS version 17, with mean±SD for continuous variables and frequency/percentage for categorical variables. Chi-square test was used for post-stratification analysis with p<0.05 considered significant.

Methodology Flowchart

                        graph TD;
    A["Patient Presentation with Infertility"] --> B["Inclusion/Exclusion Criteria Check"];
    B -- Meets Criteria --> C["Informed Consent Obtained"];
    C --> D["Detailed History & Gynecological Examination"];
    D --> E["Blood Sample Collection for Lab Tests"];
    E --> F["Histopathological/PCR/Mantoux Tests"];
    D --> G["Diagnostic Laparoscopy Performed"];
    G --> H["Record Clinical, Lab, and Laparoscopic Findings"];
    H --> I["Data Analysis SPSS v17"];
    I --> J["Calculate Mean±SD, Frequency, Percentage"];
    I --> K["Perform Chi-Square Test for Stratification"];
    J --> L["Generate Tables and Results"];
    K --> L;
    L --> M["Formulate Conclusion"];                    

Discussion

The study found a 45% incidence of genital tuberculosis in infertile patients undergoing laparoscopy, aligning with other studies indicating GTB as a common cause of infertility, particularly in developing countries. The discussion highlights potential reasons for discrepancies in diagnostic findings, including prior antitubercular drug use, social stigma, and the possibility of other infections mimicking TB symptoms. The effectiveness of laparoscopy in identifying visual findings suggestive of GTB is emphasized.

Key Findings

The incidence of genital tuberculosis among patients undergoing laparoscopy for infertility was 45%. The mean age of patients was 30 years (SD+3.92). Fifty-seven percent of cases had primary infertility, and 43% had secondary infertility.

Conclusion

The study concludes that the incidence of genital tuberculosis in infertility in the observed setup was 45%.

Fact Check

- Study duration: February 12th, 2020 to August 12th, 2020. (Confirmed)
- Sample size: 196 patients. (Confirmed)
- Incidence of genital tuberculosis: 45%. (Confirmed)

Mind Map