ABSTRACT
Background: Infection of the endometrium, fallopian tubes, ovaries, pelvic peritoneam, and adjacent structures is known as Pelvic Inflammatory Disease (PID). Pelvic inflammatory disease and its consequences are still at epidemic levels, Despite the availability of effective broad-spectrum antibiotics. Tubo-ovarian abscess (TAO) may be difficult to identify since the clinical signs are comparable to those of other pelvic and abdominal illnesses. Case Description: Here we are reporting a case, 34 years nulligravida came to emergency department with acute abdomen, she was a known case of chronic PID, Emergency laparotomy was performed, per operatively ruptured tubo-ovarian abscess was present. Conclusion: The clinical diagnosis of PID and TAO is similar, imaging evidence from ultrasonography (US) or magnetic resonance (MR) should be used to supplement the clinical diagnosis. Clinical Significance: To avoid complications and resultant emergency surgeries and their consequences, a vigilant eye must be kept to promptly diagnose, and manage PID at the earliest.
ABSTRACT
Age at menopause influences the severity of post-menopausal symptoms to determine the symptoms and clinicodemographic links in post menopauseal women in a representative population from eastern Uttar Pradesh. All postmenopausal women presenting with symptoms in the Gynaecological Emergency Department for a period of one year were enrolled. Age and clinicodemographic details, symptoms severity, and reasons for delay in seeking treatment were noted. The data was analysed using Chi-square test. Overall 990/17,927 (5.52%) women visiting the gynaecological OPD presented with post-menopausal complaints. Among menopausal women, the mean age ranged from 40 to 60 years old with a mean age of 46.6012.48 years. Majority were para 3-4 (52.5%), age at menarche were >13 years (58.3%), uneducated (58.8 %) , lower/upper lower SES (57.5%), married (77.3%) and had BMI<18.5kg/m2 (62.1%). Tobacco/smoking addiction was reported in 55 (5.6%) women. A total of 145 (14.6%) were working women. Severity of symptoms was mild, moderate and severe in 57.2%, 28.3% and 14.5% cases. Majority had onset of symptoms for 4- 5 years (56.4%) after menopause. Joint pains and Backache/body ache were the most common presenting complaints (81.8%). A significant association of age at presentation was seen with parity, age at menarche, BMI category and occupational status. Severity of symptoms showed a significant association with age at presentation, parity, age at menarche, BMI category, occupational status and tobacco/smoking use. Most common reasons for delayed treatment were financial problems (22.2%), family problems (18.2%) and commonness of problem (12.6%). Only 2.1% women were aware about HRT. Among the relatively less informed members of our study population, low socioeconomic status, underweight, and menopause age were all influenced by clinicodemographic factors.
ABSTRACT
A 24 year old female P1L1 presented to our hospital on first post operative day of emergency caesarean delivery with complaint of fever with chills and rigors. The per-operative notes showed the presence of thick pinkish maternal blood when compared to cord blood, which turned opaque white while sampling. On examination she had pallor and raised blood pressure. Her lipid levels were very high and ultrasound showed bilateral mild pleural effusion with minimal ascites with increase echogenicity of peripancreatic fat. She was started on injectable antibiotics following which she improved in symptoms. She was also started on fenofibrate and orlistat following which her lipid profile improved and the blood stopped turning opaque white and she was then discharged against medical advice due to financial constraints
ABSTRACT
Background: CIN has gained increased attention in the clinical setting, particularly during cardiac intervention but also in many other radiological procedures in which iodinated contrast media are used. There is at present good clinical evidence from well-controlled randomized studies that CIN is a common cause of acute renal dysfunction. Methodology: This was a prospective study conducted among the patients who underwent coronary angiography and percutaneous coronary intervention in the Department of Cardiology, Dhaka Medical College Hospital during January 2010 to December 2010. A total of 111 patients age range from 25 to 75 years were included in the study. Serum creatinine level at baseline and at the end of 48 hours was done in all these patients. Study population was divided into two groups according to development of acute kidney injury (AKI). Group-I = AKI, Group II = Not developed AKI. Results: AKI developed 11.7% of the study patient. DM and Preexisting renal insufficiency were significantly higher in group I patients. HTN was (61.5% Vs 44.9%) higher in group I but not significantly. History of ACE inhibitor/ARB, NSAID intake and LVEF <40% were significantly higher in group I patients. The mean±SD volume of CM (Contrast Media) were 156.9±44.8 ml and 115.4±30.0 ml in group I and group II respectively, which was significant. The mean±SD of serum creatinine after 48-72 hours of CAG/PCI was 1.4±0.37 mg/dl and 1.1±0.2 mg/dl in group I and group II respectively. The serum creatinine level increased significantly (p<0.05) after 48-72 hours of CAG/PCI in group I. In group II, S. creatinine level increased but not significant (p>0.05). Impaired renal function was found 76.9% and 2.0% in group I and group II respectively. DM, HTN, preexisting renal insufficiency, ACE inhibitor/ARB, NSAIDs, contrast volume (>150 ml), eGFR (<60 ml/min/ 1.73m2) and LVEF (<40%) are significantly (p0.05) associated for CIN development, Conclusion: CIN is an iatrogenic but preventable disorder results from the administration of contract media. Although rare in the general population, CIN occurs frequently in patients with underlying renal dysfunction and diabetes. In patients with pre angiographic normal renal function, the prevalence is low but in pre-existing renal impairment it may pose a serious threat. Thus risk factors are synergistic in their ability to predispose to the development of CIN. A careful risk-benefit analysis must always be performed prior to the administration of contrast media to patients at risk for CIN.