ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents an ongoing global threat. Common clinical features reported in early confirmed infections included fever, cough, and myalgias or fatigue. But as testing capacity and case numbers have increased worldwide, gastrointestinal (GI) symptoms such as diarrhoea, nausea/vomiting, abdominal pain, and loss of appetite have been increasingly recognized. Authors present a case series of gastrointestinal symptoms in COVID-19 patients and how they were managed at the hospital. However, correlations between the presence of fecal virus RNA and severity of digestive symptoms, namely, diarrhoea severity could not be established due to unavailability of the test in the hospital setting. Although knowledge about the viability of SARS-CoV-2 is limited, the virus could remain viable in the environment for days, which could lead to faeco-oral transmission. Various studies conducted on COVID-19 patients recommended routine stool sample testing with real-time RT-PCR after the clearance of viral RNA in a patient’s respiratory samples. Strict precautions to prevent transmission should be taken for patients who are in hospital or self-quarantined if their faecal samples test positive. Optimally, testing for COVID-19 should be performed using both respiratory and stool samples, if available.
ABSTRACT
Background: The pelvic floor muscles (PFM) play an important role in supporting the pelvic and abdominal organs and controlling urinary and fecal continence, in addition to their role in the sexual function. The objective of this study was to compare pelvic floor muscle strength in primiparous 6 months after delivery and nulliparous women, to evaluate pelvic floor dysfunction (PFD) in these women and to find the association of PFD with pelvic floor muscle strength (PFMS).Methods: A total of 100 women were recruited in the cross-sectional study which included 28 nulliparous and 72 primiparous women 6 months after delivery. The assessment included general physical examination (GPE), POP-Q and assessment of pelvic floor muscle strength by modified oxford score and perineometer.Results: Endurance of PFMS measured by duration of contraction and number of contractions/min was higher in nulliparous. Mean of the duration of contraction was significantly higher in nulliparous group as compared to primipara i.e., 28.61 seconds and 23.9 seconds in nulliparous and primiparous group respectively (p=0.005). Mean of the number of contractions performed in one minute was significantly higher in nulliparous group as compared to primipara i.e., 31.04 and 19.97 in nulliparous and primiparous group respectively (p<0.0001). None of the nulliparous women had any PFD symptoms, while 4.17% of the primiparous patients had PFD in the form of bladder symptoms and 1.39% of them had PFD in the form bowel symptoms. Vaginal squeeze pressure was found to be affected by mode of delivery. It was lowest in instrumental delivery. It was 39.78±13.33 cmH20 in vaginal delivery, 51.42±12.88 cmH2O in Caesarean section and 31.67±14.36 cmH2O in instrumental delivery (p-0.039).Conclusions: Endurance of PFMS measured by duration of contraction and number of contractions/min was higher in nulliparous. Vaginal squeeze pressure was found to be affected by mode of delivery. It was lowest in instrumental delivery.