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Biomedical subjects

K Arumugam

Publications and source records attributed to K Arumugam.

At least 19 recordsLinked to original sources
PubMed1997

Emergency cervical circlage for cervical incompetence.

Twelve patients had emergency cervical circlage for inevitable middle trimester abortion due to cervical incompetence. The mean gestation was 23 weeks (range 15-28 weeks). The median cervical dilatation was 3 cm. In three patients, the cervical dilatation was more than 5 cm. The median prolongation of pregnancy was 3.3 weeks (range 4 days to 10 weeks). Eight of the 14 babies survived. All babies that survived were more than 1000 g. Based on our experience, we advocate an active approach to inevitable middle trimester abortions due to cervical incompetence.

Journal Article↗
PubMed1997

Menstrual characteristics associated with endometriosis.

This case-controlled study investigates whether the presence of menstrual characteristics, which may increase the exposure of the peritoneal cavity to retrograde menstruation, increases the risk of developing endometriosis. The menstrual characteristics considered were 1. age at menarche of less than 12 years, 2. duration of menstrual flow greater than five days and 3. menstrual cycle lengths of < 28 days. The frequency with which these menstrual characteristics occurred in 305 women with proven endometriosis was compared with their frequency in 305 age-matched women without endometriosis. Adjusting for the confounding factors of parity, age at first childbirth and social class, the only menstrual characteristic that was significantly associated with endometriosis was menstrual cycle lengths of less than 28 days (odds ratio 1.83; 95% confidence intervals 1.60-2.55). There was insufficient evidence to conclude that the presence of menstrual characteristics which may increase the exposure of the peritoneal cavity to retrograde menstruation, increase a women's risk of developing endometriosis. The association of short menstrual cycle lengths with endometriosis may have been consequential rather than causal.

Adult↗
PubMed1995

Endometriosis and infertility: the role of exogenous lipid peroxides in the peritoneal fluid.

OBJECTIVE: To determine if lipid peroxides were raised in the pelvic peritoneal fluid of patients with endometriosis. DESIGN: Control study involving patients with and without endometriosis. METHODS: The lipid peroxide (malondialdehyde) levels in the pelvic PF of 12 patients with moderate-to severe endometriosis, 15 patients with minimal-mild endometriosis and 13 patients with normal pelvises were compared. RESULTS: The level of lipid peroxides were not affected by the presence nor the severity of endometriosis. CONCLUSION: Accelerated lipid peroxidation does not appear to play a role in the causal relationship between endometriosis and infertility.

Ascitic Fluid↗
PubMed1995

De novo formation of adhesions in endometriosis: the role of iron and free radical reactions.

OBJECTIVE: To show that raised iron levels in the peritoneal fluid (PF) of patients with endometriosis catalyze free radical reactions that results in the tissue destruction and fibrosis seen in these patients. DESIGN: A case-controlled study of the iron levels (microgram/mL) in the pelvic PF of 12 patients with moderate-to-severe disease, 15 patients with minimal-to-mild disease and in 17 women with normal pelvises were compared. As an index of free radical reactions through lipid peroxidation, the levels of malondialdehyde levels (ng/mL) were assessed simultaneously in the same specimens. RESULTS: Controlling for the phase of the menstrual cycle, significantly higher levels of iron were seen in patients with endometriosis, the levels being correlated with the severity of the disease. However no such corresponding relationship was seen in the malondialdehyde levels in the PF. CONCLUSIONS: These results suggest that raised iron levels in the PF do not play a role in catalyzing free radical reactions as judged by the degree of lipid peroxidation.

Ascitic Fluid↗
PubMed1994

Endometriosis and infertility: raised iron concentration in the peritoneal fluid and its effect on the acrosome reaction.

Endometriosis and infertility are commonly associated. This study investigated the role of accelerated lipid peroxidation of spermatozoa by the peritoneal fluid of patients with endometriosis as a cause for this association. It proposes that the increased iron concentration present in the fluid of these patients acts as a catalyst for the process. Peritoneal fluid from 25 patients with endometriosis and 25 matched controls was obtained at laparoscopy. Spermatozoa were incubated in the fluid from both groups and the subsequent acrosome reaction rates analysed. The relationship between these results and iron concentration in the fluid was examined. A significant decrease in the acrosome reaction rate was seen in the endometriotic group (P = 0.034). Overall, a decrease in the acrosome reaction rate was associated with an increased iron concentration in the fluid (18 of the 25 pairs). In mild disease, (six of 11 pairs), the relationship was not as marked as that in severe disease (12 of 14 pairs). These results suggest that the peritoneal fluid in patients with endometriosis has a detrimental action on the acrosome reaction of spermatozoa in vitro.

Acrosome↗
PubMed1993

Endometriosis and social class: an Asian experience.

The social class distribution in 147 patients confirmed to have endometriosis at laparoscopy was done to see if the disease was associated with affluence. Two hundred and eighty-one patients confirmed not to have endometriosis was used as controls. The patients were derived from a background population for which the social class characteristics was known. Endometriosis was significantly (p < 0.001) associated with social class 1 and 2. However there was no association between social class distribution and the severity of the disease developed.

Adult↗
PubMed1993

Sperm dysfunction in partners of infertile patients with minimal or mild endometriosis.

A review of the literature does not show that minimal or mild endometriosis unquestionably causes infertility although its association is known; the cause only becomes apparent as the disease progresses. In these patients therefore, prolonged infertility for other reasons may have exacerbated or predisposed a tendency in them to develop the disease. Sperm dysfunction in their partners may have been one factor. Sperm penetration assays using mid-cycle (estrus) bovine cervical mucus were studied in 22 men whose wives were confirmed to have minimal or mild endometriosis. All men had normal semen analyses. For controls, 16 men of proved fertility were used. Whilst all but one (94%) of the fertile men showed adequate penetration (> 30 mm), only 59% of the men in the study group achieved this penetration (p < 0.05). These findings provide evidence that minimal or mild endometriosis may not be the primary cause of infertility in patients in whom the diagnosis is made.

Adult↗
PubMed1992

The use of the semen analysis in predicting fertility outcome.

The study investigates the use of the various parameters of the semen analysis in predicting the fertility outcome in 82 infertile couples. The sperm density, % progressive motility, % normal morphology were divided into 'normal' and 'abnormal' based on the criteria proposed by WHO. The subsequent cumulative pregnancy rates were then calculated according to this criteria. A life-table method of analysis was used. All female related fertility factors were excluded. With the exception of a sperm density of less than 20 x 10(6) per ml the other parameters showed no significant correlation with the cumulative pregnancy rates at 12 months or 24 months respectively. We concluded that the semen analysis does not predict the probable outcome of the subsequent rates even when female fertility related factors were excluded apart from a sperm density less than 20 x 10(6) per ml.

Female↗
PubMed1992

Endometriosis and race.

The pelvic findings of 202 infertile women undergoing diagnostic laparoscopy in Kuala Lumpur, Malaysia were compared to that of 464 infertile women undergoing diagnostic laparoscopy in Aberdeen, United Kingdom. Endometriosis was significantly more common in the women from Kuala Lumpur (51% against 22%, p less than 0.001). There was however no significant difference seen in the severity of the disease (AFS Classification, 1985). These findings confirm our clinical impression that endometriosis is more common in Asian women when compared to Caucasian women.

Adult↗
PubMed1991

Uterine leiomyomata in pregnancy.

Sixty cases with uterine leiomyomata in pregnancy are presented. The incidence was 1 in 1033 deliveries. The median age of the patients was 33.4 years. The majority were primigravidae (60%). A significant number of patients gave a history of infertility (43%) and spontaneous abortions (25%). The commonest antenatal complication was malpresentation and in all these patients the myomata were larger than 6 cm. Typical features of red degeneration occurred in 10% of cases. The cesarean section rate was 73%, the commonest indication being obstructed labor. Severe hemorrhage was encountered at cesarean section in 10 patients, 3 of whom needed hysterectomy. There were no perinatal deaths.

Adult↗
PubMed1991

Oocyte and follicular fluid characteristics in women with mild endometriosis.

The follicular development, fertilization and cleavage rates and follicular fluid endocrinology were assessed in 20 women with mild endometriosis during a spontaneous menstrual cycle. Diagnostic laparoscopy was performed 32 h after the onset of the endogenous luteinizing hormone (LH) surge in the 20 women with laparoscopically confirmed mild endometriosis and in a control group of ten women with tubal infertility. There was no significant difference in oocyte maturity or fertilization and cleavage rates between the women with mild endometriosis and those in the control group. The endocrine milieu of the pre-ovulatory oocyte at the time of aspiration was similar in the two groups.

Adult↗
PubMed1991

Efficacy of laparoscopic electrocoagulation in infertile patients with minimal or mild endometriosis.

The cumulative pregnancy rates in 17 infertile patients with minimal or mild endometriosis who underwent laparoscopic electrocoagulation were compared with those of 20 similar patients who underwent only diagnostic laparoscopy. A life-table method of analysis was used. No significant differences in pregnancy rates was evident at either 6 months (p greater than 0.5) or 12 months (p greater than 0.5) of follow-up. These results question the use of laparoscopic electrocoagulation for the treatment of infertile patients with minimal or mild endometriosis.

Adult↗
PubMed1991

Serum prolactin levels in infertile patients with endometriosis.

Raised prolactin levels have been implicated as a cause for infertility in patients with endometriosis. This study was done to investigate if serum prolactin levels were significantly raised in infertile patients with endometriosis. Serum prolactin levels were studied in 43 infertile patients with endometriosis. For controls, 36 infertile patients with normal pelvic findings were used. For standardization, blood samples were drawn on day 21 of the menstrual cycle. Analysis was done by radioimmunoassay using reagent kits. The mean prolactin level in the endometriotic group was 372 mIU/l (range 187-752) while that in the controls was 333 mIU/l.(range 124-767). There was no statistical difference (t = 1.12). Furthermore the accepted normal level for serum prolactin in our population is less than 540 mIU/l. These results show that there is no evidence to implicate raised prolactin levels as a cause for infertility in patients with endometriosis.

Adult↗
PubMed1991

Combined pregnancy--a case report.

A case of combined intra- and extra-uterine pregnancy is reported. Awareness of this condition, a high index of suspicion, the proper interpretation of physical signs and ultrasound findings together with early resort to laparoscopy resulted in a favourable outcome.

Adult↗
PubMed1991

Causes for infertility: a comparative study.

A representative group of 204 infertile couples from Kuala Lumpur, Malaysia were compared to a similar group of 633 couples from Aberdeen, UK in an attempt to study if there was any regional difference in the pattern of infertility seen. The protocol for investigation and diagnostic criteria for both centres were standardised. A significant difference (X2 = 63.43; p less than 0.001) was seen. The reasons for these differences are discussed.

Adolescent↗
PubMed1989

The association of anovulation and endometriosis in the infertile female.

Ninety-six infertile patients with endometriosis were studied and their endometriosis staged according to the Revised American Fertility Society Classification. Anovulation was detected in 19% of the 32 patients with Stage 1 disease but in only 3% in the remaining 64 patients with Stage II, III and IV disease. These results show that contrary to traditional belief, anovulation does occur in a significant number of patients with endometriosis, especially in minimal or mild disease.

Adult↗