0 } style="page-break-after: always;" {/if}>
Royal Fertility center
Case Summary
|
Personal History
|
Date of current marriage :
{$patient->mirragefromdate}
|
| Wife |
Name :
{$patient->wifename}
|
Occupation :
{$patient->wifejob}
|
|
Age :
{$wAge}
|
Special Habits :
{$phpersonal->personal_habits}
|
|
Pr . Marriage :
{$phpersonal->present_marriage}
|
Offspring's :
{$phpersonal->offsprings}
|
| Husband |
Name :
{$patient->husdandname}
|
Occupation :
{$patient->husbandjob}
|
|
Age :
{$hAge}
|
Special Habits :
{$phpersonal->hus_personal_habits}
|
|
Pr . Marriage :
{$phpersonal->hus_present_marriage}
|
Offspring's :
{$phpersonal->hus_offsprings}
|
| Menstrual History |
Rhythm , Frequency :
{$phmenstrual->duration} - {$phmenstrual->length} - {$phmenstrual->phregularity} -
{$phmenstrual->phamount} - {$phmenstrual->phdysmenorrhoea}
|
L.M.P :
{$phmenstrual->phlMP}
|
| 0 }rowspan="4" {else} rowspan="3"rowspan="3" {/if} style="width: 11%;"> Obstetric History |
G :
{$myallobsteric}
|
P :
{$pcounter}
|
C.S :
{$cscounter}
|
AB :
{$abcounter}
|
Ectopic :
{$Ectopiccounter}
|
V.mole :
{$vmodelcounter}
|
|
Abnormal Deliveries :
{$cscounter}
|
Date Of Last Delivery :
{$lastCsDelivery}
|
|
Abortions:
{$abcounter}
|
{if $AbortiondataCount > 0 }
| |
{foreach $Abortiondata as $abortion }
|
Gestational age :
{$abortion.obstrduration}
|
Date Of Abortion :
{$abortion.obsdate}
|
{/foreach}
|
{/if}
| Past History |
Wife : |
|
Medical :
{$medical}
|
|
General Surgery :
{$surgical}
|
|
Gynecological Surgery :
{$gynecological}
|
|
Husband :
|
|
Medical :
{$hus_medical}
|
|
General Surgery :
{$hus_surgical}
|
| Family History |
Wife : |
|
{$family}
|
|
Husband :
|
|
{$hus_family}
|
|
Sexual History
|
Continuous / Interrupted :
{$phsexual->sexual_type}
|
|
Investigation
|
Semen analysis :
|
Date :
{$semen->sdate}
|
|
Total count :
|
{$semen->count}
|
|
Concentration :
|
{$semen->concentration}
|
|
Mobility :
|
Total :
|
{$semen->motilityab}
|
Progressive :
|
{$semen->motilitya}
|
|
Normal Forms :
|
{$semen->normal}
|
|
Abnormal Forms :
|
{$semen->abnormal}
|
|
Past hx. Of testicular biobsy :
|
{$phpasthx}
|
|
Hormones :
|
|
|
Serum TSH :
{$hormon->tsh}
|
Day 3 serum E2 :
{$hormon->etwo}
|
|
Serum Prolactin :
{$hormon->prl}
|
Day 3 serum FSH :
{$hormon->fsh}
|
|
Serum LH :
{$hormon->lh}
|
Serum AMH :
{$hormon->amh}
|
|
TVS :
|
{if $ustv->sdate } Date : {$ustv->sdate} , {/if}
{if $ustv->uterus } Uterus : {$ustv->uterus} , {/if}
{if $ustv->radnexa } R.adnexa : {$ustv->radnexa} , {/if}
{if $ustv->ladnexa } L.adnexa : {$ustv->ladnexa} , {/if}
{if $ustv->pelvis } Pelvis : {$ustv->pelvis} , {/if}
{if $ustv->notes } Notes : {$ustv->notes} {/if}
|
|
HSG :
|
{if $hsg->sdate } Date : {$hsg->sdate} , {/if}
{if $hsg->uterus } Uterus : {$hsg->uterus} , {/if}
{if $hsg->rtube } R.tube : {$hsg->rtube} , {/if}
{if $hsg->ltube } L.tube : {$hsg->ltube} , {/if}
{if $hsg->smear } Smear : {$hsg->smear} , {/if}
{if $hsg->notes } Notes : {$hsg->notes} {/if}
|
|
Laparoscopy :
|
{if $laparoscopy->sdate } Date : {$laparoscopy->sdate} , {/if}
{if $laparoscopy->uterus } Uterus : {$laparoscopy->uterus} , {/if}
{if $laparoscopy->radnexa } R.adnexa : {$laparoscopy->radnexa} , {/if}
{if $laparoscopy->ladnexa } L.adnexa : {$laparoscopy->ladnexa} , {/if}
{if $laparoscopy->pelvis } Pelvis : {$laparoscopy->pelvis} , {/if}
{if $laparoscopy->notes } Notes : {$laparoscopy->notes} {/if}
|
|
Hysteroscopy :
|
{if $hysteroscopy->sdate } Date : {$hysteroscopy->sdate} , {/if}
{if $hysteroscopy->cervix } Cervix : {$hysteroscopy->cervix} , {/if}
{if $hysteroscopy->uterine } Ut Cavity : {$hysteroscopy->uterine} , {/if}
{if $hysteroscopy->rostium } R.Ostium : {$hysteroscopy->rostium} , {/if}
{if $hysteroscopy->lostium } L.Ostium : {$hysteroscopy->lostium} , {/if}
{if $hysteroscopy->notes } Notes : {$hysteroscopy->notes} {/if}
|
|
Other Investigations :
|
{if $case_summary == 1 }
{$otherInvs}
{else}
{if $otherinvestDate} Date : {$otherinvestDate} , {/if}
{foreach $otherinvest as $data }
{if $data->value } {$data->investName} : {$data->value} , {/if}
{/foreach}
{/if}
|
|
Previous Art Cycles :
|
| Types |
No of cycles |
Center |
Date |
Result |
| IUI |
{foreach $iui as $data }
|
{$data->artcenter} |
{$data->artyear} |
{$data->result} |
{/foreach}
|
| ICSI |
{foreach $icsi as $data }
|
{$data->artcenter} |
{$data->artyear} |
{$data->result} |
{/foreach}
|
|
Final Diagnosis :
{if $newPage > 0 } {$patient.diagnosis } {elseif $case_summary == 1 }{$diagnosis}{/if}
|
|
Recommended Plan of treatment :
{if $case_summary == 1 }{$recommend}{/if}
|