ABSTRACT
Background: Emergence of hypothyroidism as a public health issue apart from a common clinical entity, has gained much attention nowadays. The non-specific features of hypothyroidism lead to incorrect diagnoses, inadequate treatment and complications in the future. The present study was designed to unravel the effects of hypothyroidism on physiological parameters and to highlight the importance of early diagnosis and treatment. This study was done to assess the effects of hypothyroidism on pulse rate, blood pressure and respiratory rate.Methods: This descriptive cross-sectional study was done in 60 hypothyroid patients of 18-45 years age, both males and females, who were either newly detected or on treatment for less than 6 months. Patients with history of other systemic diseases, pregnancy and hyperthyroidism were excluded. After obtaining written consent from the patients, clinical examination was done.Results: Student t-test and ANOVA were used for analysis. Physiological parameters like pulse rate, blood pressure and respiratory rate had variations in the patients and there were changes with age, gender and BMI even though they were not significant. These changes were attributed to increased arterial wall thickness and endothelial dysfunction in blood vessels.Conclusions: The patients showed changes in cardiovascular and respiratory profiles. The variations in systolic and diastolic blood pressures were significant with increase in age. Physiological parameters had variations with gender and BMI also. This proves the cardiovascular and respiratory morbidity in newly detected hypothyroidism, which emphasizes the importance of early diagnosis and treatment in them.
ABSTRACT
Congenital anomalies that involve the distal segment of urogenital sinus [giving rise to female urethra and vagina] may lead to abnormal urethral development ranging from absent to markedly deficient urethra. The abnormal division may also cause a short and patulous urethra. Sphincteric defects are likely to be associated and when combined with the short urethral length is a cause for severe urinary incontinence. Urinary incontinence due to a congenital cause requiring repeated urethral reconstruction to relieve symptoms is presented. A 15 year old girl was referred for bothersome urinary incontinence due to a short, wide, patulous urethra with defective sphincteric mechanism as part of urogenital sinus developmental anomaly. She was initially managed by reconstruction of bladder neck and proximal urethra with sphincter augmentation using autologous pubovaginal sling. Persistent urinary incontinence demanded a second urethral reconstruction using tubularised anterior bladder flap [modified Tanagho]. Surgical reconstruction of the urethra achieved socially acceptable continence.
Subject(s)
Humans , Female , Adolescent , Urinary Incontinence, Stress/etiology , Urogenital Abnormalities , Urinary Bladder , Surgical FlapsABSTRACT
To determine the appropriateness of vaginal approach for gynecological supratrigonal vesicovaginal fistulae. Retrospective review of consecutive women with gynecological supratrigonal Vesico Vaginal Fistulae [VVF] repaired at the fistula unit of Urogynecology department between 1996 and 2011 was done.Out of 48 cases of supratrigonal VVF of gynecological origin identified; 34 [70.8%] cases were repaired vaginally and 14 [36.8%] abdominally with a mean follow-up period of 52.8 [2-132] months. Overall 95.8% were successfully cured at first attempt. The success rate of vaginal repair [94.8%] at first attempt was comparable to that of abdominal repair [100%] [P value = 0.8946]. Amongst two failed vaginal repairs, one was successfully cured by subsequent vaginal repair and other by abdominal repair. Three fourth gynecological supratrigonal VVF can be repaired vaginally in first attempt with success rate comparable to abdominal approach. On the basis of this study we postulate that vaginal approach should be preferred over abdominal approach for repair of all vaginally accessible supratrigonal VVF of gynecological origin