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Resumo: Introdução: A graduação no curso de Medicina se dá por meio de uma formação teórico-prática que tem nos hospitais universitários o seu principal cenário de práticas. Nas consultas que envolvem questões da intimidade do paciente, o constrangimento é uma possibilidade. Isso pode comprometer a qualidade da assistência e/ou da formação médica. Objetivo: Este estudo teve como objetivo investigar os aspectos psicoafetivos da consulta ginecológica, a partir da percepção das pacientes, de modo a encontrar elementos que possam favorecer a adequação da formação médica à humanização do atendimento. Método: Trata-se de um estudo observacional, transversal, de abordagem qualitativa, realizado no ambulatório de ginecologia de um hospital universitário. Foram incluídas as usuárias do ambulatório que estavam na sala de espera para atendimento ginecológico, configurando-se como uma amostra por acessibilidade. A coleta de dados se deu entre os meses de fevereiro e agosto de 2021, por meio de uma entrevista semiestruturada com perguntas norteadoras previamente elaboradas. Realizaram-se 50 entrevistas, cujos discursos foram posteriormente transcritos e analisados pelo software IRaMuTeQ. Resultado: Sob a perspectiva das pacientes, o momento da consulta ginecológica envolve duas esferas de interesse principais: a assistência médico-ginecológica dada a elas e o ensino-aprendizado destinado aos estudantes. A partir dessa divisão, emergem duas perspectivas: aquela que parte da demanda pessoal, e a que considera o interesse do outro (o estudante). Nos discursos sobre a assistência ginecológica, as falas concentram o olhar para si, para o constrangimento vivenciado durante a assistência. Já nos discursos sobre o ensino e a aprendizagem dos estudantes, as falas referem-se, em sua maioria, ao reconhecimento da importância da prática clínica na formação médica. Dessa forma, ocorre uma intersecção entre "a assistência fornecida a mim" e o "processo de ensino-aprendizagem do outro". O constrangimento das pacientes parece ser superado em favor de um objetivo maior: contribuir para a formação de futuros médicos. Conclusão: Apesar do constrangimento experimentado na consulta ginecológica em ambiente acadêmico, a compreensão das usuárias acerca da sua contribuição para a formação médica promove um posicionamento colaborativo, revelando-se como elemento facilitador da assistência nesse cenário. Foi revelada também uma atenuação do constrangimento proporcional à experiência da mulher nesse tipo de atendimento.
ABSTRACT Introduction: Undergraduate medical training involves both theoretical and practical learnings, with university hospitals being the main practice setting. In consultations involving issues of patient intimacy, embarrassment is a possibility. This may compromise the quality of care and/or medical training. Objective: The objective of this study was to investigate the psycho-affective aspects of gynecological consultation, based on the patients' perceptions, in order to find elements to help shape medical education toward humanized care. Method: This is an observational, cross-sectional, qualitative study, carried out in the gynecology outpatient clinic of a university hospital. Outpatient users who were in the waiting room for gynecological care were included, representing a sample for accessibility. Data collection took place between the months of February and August 2021 through a semi-structured interview with previously prepared guiding questions. A total of 50 interviews were conducted, which were later transcribed and analyzed by the IRaMuTeQ software. Result: From the perspective of the patients, the gynecological consultation involves two main spheres of interest: the medical-gynaecological assistance given to them and the teaching-learning aimed at students. Within this division, two perspectives emerge: firstly, that which draws on the personal demand and, secondly, that which considers the interest of the other (the student). In the discourses on medical- gynecological assistance, the speakers focus on themselves, on the embarrassment experienced during the assistance. In the discourses on the teaching and learning of the students, the speakers primarily focus on the importance of clinical practice in medical training. Thus, there is an intersection between "the care provided to me" and the "other's teaching-learning process". The patient's embarrassment seems to be overcome in favour of a greater goal: to contribute to the training of future doctors. Conclusion: Despite the embarrassment experienced in gynecological consultation in an academic environment, the users' understanding of their contribution to medical education promotes a collaborative attitude, which is found to facilitate care in this scenario. The attenuation of the embarrassment was also found to be proportional to the experience of the woman in this type of care.
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Resumen OBJETIVO: Determinar la sensación de maltrato o de acciones contra el natural modo de proceder durante la atención obstétrica e identificar los factores asociados con esa percepción por parte de las pacientes atendidas en un hospital público de Ciudad Juárez, Chihuahua. MATERIALES Y MÉTODOS: Estudio descriptivo, prospectivo, de serie de casos al que se incluyeron todas las pacientes internadas en el área de Ginecología del Hospital 66 del Instituto Mexicano del Seguro Social de Ciudad Juárez, Chihuahua, con diagnóstico de puerperio de parto, cesárea y aborto atendidas entre los meses de junio a diciembre de 2022. RESULTADOS: De 496 pacientes, 13.9% (n = 67) percibieron algún tipo de procederes incorrectos en las dimensiones de: mal trato y abuso 9.9% (n = 49), atención médica no autorizada 2.4% (n = 12). En percepción de acciones contra el natural modo de proceder: 22% (n = 109) de las mujeres entre 14 y 19 años percibieron que el trato recibido no fue el adecuado. De las pacientes atendidas en el turno nocturno 18% percibieron tratos inadecuados. El 17% de las mujeres atendidas por aborto percibieron que el trato recibido no fue adecuado. Riesgo de atención alejada del natural modo de proceder: grupo de edad de 14 a 19 años (RR 1.96; 1.30-3.72), las mujeres que han tenido 1 embarazo tuvieron un RR 1.92 (1.15-3.21) y con escolaridad secundaria RR 1.35 (0.81-2.24). CONCLUSIONES: Las pacientes en mayor riesgo de no recibir una atención obstétrica apegada a las normas de buen trato fueron las adolescentes de entre 14 a 19 años, las mujeres con escolaridad secundaria, las atendidas en el turno nocturno y las primíparas. Esto evidencia que la atención obstétrica no estrictamente apegada al natural modo de proceder sigue siendo una problemática importante en nuestra población de estudio.
Abstract OBJECTIVE: To determine the feeling of mistreatment or actions against the natural way of proceeding during obstetric care and to identify the factors associated with this perception on the part of patients attended in a public hospital in Ciudad Juárez, Chihuahua. MATERIALS AND METHODS: Descriptive, prospective, case series study including all patients admitted to the Gynaecology Department of Hospital 66 of the Instituto Mexicano del Seguro Social in Ciudad Juárez, Chihuahua, with a diagnosis of postpartum labour, caesarean section and abortion attended between June and December 2022. RESULTS: Of 496 patients, 13.9% (n = 67) perceived some type of incorrect procedures in the following dimensions: mistreatment and abuse 9.9% (n = 49), unauthorised medical care 2.4% (n = 12). In perception of actions against the natural way of proceeding: 22% (n = 109) of the women between 14 and 19 years of age perceived that the treatment received was not adequate. Of the patients seen during the night shift, 18% perceived obstetric violence. 17% of the women attended for abortion perceived that the treatment received was inadequate. Risk of care away from the natural way of proceeding: age group 14-19 years (RR 1.96; 1.30-3.72), women who have had 1 pregnancy had a RR 1.92 (1.15-3.21) and with secondary schooling RR 1.35 (0.81-2.24). CONCLUSIONS: Patients at highest risk of not receiving obstetric care adhering to standards of good treatment were adolescents aged 14-19 years, women with secondary schooling, those seen on the night shift and primiparas. This shows that obstetric care that is not strictly adherent to the natural way of proceeding continues to be a major problem in our study population.
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Background: Adolescents in India contribute to 22% of the country’s population and are susceptible to various preventable and treatable health issues. Objectives: To estimate the burden and to describe the pattern of gynaecological disorders among adolescent girls attending the outpatient and inpatient departments of a private medical college hospital in South India. Materials and methods: This was a hospital based cross sectional analytical study done among 500 adolescent girls of 10-19 years age group in a private medical college hospital in South India during December 2020 to December 2021 using a pretested questionnaire. Data was analysed using IBM SPSS version 23. Chisquare test or Fischer exact test was done to find the association between categorical variables. Mann Whitney U test was used to compare the difference between means. P value less than 0.05 was considered to be significant for all comparisons. Results: Mean age of study population was 15.94 ± 2.52 years. Menstrual abnormalities reported in 303 (60.6%) girls followed by 240 (48%) girls had leucorrhoea, 68 (13.6%) had urinary tract infection and 54(10.8%) had PCOS. Conclusion: There is a high burden of gynaecological disorders and lack of awareness on various components of adolescent reproductive and sexual health among adolescents.
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Objective:To explore the effect of teaching based on task-driven joint feedback mechanism on improving the quality and satisfaction of teaching practical nursing students in department of gynaecology and obstetrics.Methods:A total of 203 practical nursing students who had internship in the Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Hainan Medical University from June 2019 to June 2020 were selected as the research objects. They were divided into a control group ( n=96) and a study group ( n=107) according to the order of admission. The control group used traditional teaching, and the study group used task-driven joint feedback mechanism-based teaching. After the teaching, the teaching effect of the two groups of practical nursing students was evaluated through theoretical assessment, skill operation assessment and teaching satisfaction. SPSS 22.0 was used for t test and non-parametric rank sum test. Results:The theoretical assessment scores [(93.51±4.22) vs. (89.62±4.08)] and the total scores of the skill operation assessment [(93.20±4.14) vs. (82.06±3.82)] of the practical nursing students in the study group were better than those of the control group, and the difference was statistically significant ( P<0.05). The results of teaching satisfaction evaluation (teacher's ability and execution ability, teaching content and task design, teaching task completion, feedback mechanism execution and improvement after feedback) of the study group were better those of the control group, and the difference was statistically significant ( P<0.05). Conclusion:The teaching based on the task-driven joint feedback mechanism can effectively improve the teaching quality and teaching satisfaction of the practical nursing students in the department of obstetrics and gynecology.
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Background:Certain life-threatening complications and morbidities may occur following consensual sexual intercourse which may not be commonly experienced in clinical practice. One of such complications is hypovolaemic shock resulting from profuse bleeding.AbstractMethods:Two cases of vaginal laceration complicated by hypovolaemic shock following consensual sexual intercourse are presented.Results:Both patients had resuscitation with intravenous fluid, blood transfusion and subsequent examination under anaesthesia with repair of laceration in theater. Post-operative recovery period was uneventful and they were both discharged after proper counselling. Conclusion:Bleeding from coital laceration could be life threatening. Prompt treatment should be instituted in such cases
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Therapeutics , Coitus , Peritonitis , Shock , Inflammatory Bowel Diseases , Morbidity , LacerationsABSTRACT
A 50-year-old woman with a history of tubal ligation nine years earlier, presented with a complaint of discharge from the scar site. She was found to have an enterocutaneous fistula. The patient underwent an exploratory laparoscopy. The tract excised and primary repair of bowel done. A unique feature of the case is the formation of an enterocutaneous fistula after an extremely long latency due to gauze threads, which has not been previously reported in the literature.
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Objective: The purpose of the six months observational study is to evaluate the gynaecological problems of the adolescent girls, attending the gynaecological outpatient department of a secondary care referral healthcare facility in rural south India. Methods: After ethical clearance, adolescent girls in the age group of 10-19 y having gynaecological problems, who had experienced at least 3 consecutive menstrual cycles, and who showed willingness towards study were included; and adolescent girls in 10-19 y age group having a pregnancy and its complications were excluded. Results: Out of 161 adolescent girls, 46.01% belong to late adolescence with more distribution of gynaecological problems. The gynaecological problems majorly observed were menstrual disorder 59.63%, abdominal pain (11.18%), white discharge per vagina (9.94%), and 8.07% of heavy menstrual bleeding. The menstrual disorder complained with amenorrhea 40.63%, polymenorrhea 18.75%, and menorrhagia 16.67%. In our study, 26.09% and 32.3% of adolescent girls were anaemic and underweight, respectively. Conclusion: In conclusion, our study showcased evidently that young adolescent girls are at higher risk of both gynaecological problems and menses disorders in the rural setting; for whom more amount of awareness to be parented and education of menstrual hygiene and hemodynamic effects has to be culminated through health education, for a future healthier nation.
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Laparoscopy is traditionally done under General Anaesthesia (GA) with endotracheal intubation. As the number of cases of laparoscopy increased over the years, regional anaesthesia has been quite frequently used for laparoscopy.METHODSA total of 495 cases of laparoscopic surgeries done in the age group 12 to 47 years during the period August 2015 till September 2019 was considered. Spinal anaesthesia was administered with 25G spinal Needle at L4-L5 intervertebral space with 3-4 ml bupivacaine (0.5%, heavy) and the surgeries were completed. The segmental level achieved was T-6. Intra-abdominal pressure after CO2 insufflation for pneumoperitoneum was maintained at 10-12 mmHg. Post-operative monitoring was done.RESULTSOnly 15 cases (3%) required midazolam. 2 patients stayed for >48 hrs post-surgery (0.4%). 4 GA cases required immediate analgesic infusion. In SA cases, analgesic was required almost 2-3 hours after the surgery was over. Onset of bowel sounds was early with SA cases. In the 4 GA cases (0.8%) PONV was noted. Two patients (0.4%) had spinal headache. 6 patients experienced post laparoscopic shoulder pain (1.21%).CONCLUSIONSSpinal Anaesthesia provides a good field for gynaecologic laparoscopic surgery with excellent muscle relaxation, decreased surgical bed oozing, and a rapid return of gut function, good post-operative analgesia, and decreased incidence of PONV than GA.
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Background: The objective of the study was to study the prescribing pattern of the antibiotics in postoperative patients admitted in gynaecology and obstetrics.Methods: Current prospective observational study was conducted in the department of pharmacology, Government Medical College, Kathua in collaboration with department of gynaecology and obstetrics for a period of six months duration from 1st May 2019 to 31st October 2019. The case sheets of all post operated patients above eighteen years of age admitted were studied and analyzed.Results: Total of 1807 case sheets were analyzed and showed that 4245 antibiotics were prescribed with an average of 2.3 antibiotics prescribed. Oral cefuroxime (17.3%) was maximally prescribed in patients who delivered normal presentation with episiotomy and injection ceftriaxone along with tinidazole and gentamycin were prescribed (58.4%) where caesarean section was done. While injection ceftriaxone and sulbactum along with tinidazole and gentamycin (17.09%) was prescribed in patients who were operated for gynaecological diseases. Maximum (80%) of the antibiotics were prescribed under brand name.Conclusions: Cephalosporin’s are commonly prescribed antibiotic and in eighty percent brand names were prescribed. Results underscore that antibiotic in generic name should be encouraged.
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Background: Gynaecological diseases are common in India because of socioeconomic, hygienic and literacy problems. Gynaecological drugs are one of the strong selling drugs in pharmaceutical market. Drug utilization research facilitate appropriate use of drugs in patient, minimize the adverse event and lead to better patient outcome. So, the present study was carried out to examine the patterns of drug prescription.Methods: A retrospective, observational study was done by collecting the prescriptions of the patients who attended the Gynaecology out-patient department in our institute for the period of six months. Total 300 prescription were collected and analysed. Patient’s demographic data, total number and category of drugs prescribed, percentage of individual drug and their dosage forms, drugs prescribed by generic name, brand names and percentage of drugs prescribed from essential drug list were analysed.Results: The mean age of presentation was 36.6±10.98 years. Among infective group breast abscess were common and among non-infective cases dysmenorrhea was most common. Out of 754 drugs prescribed, minerals were most commonly prescribed (42.70%) followed by antimicrobials (24.53%). Tablet form were prescribed more commonly (96.02%) followed by capsules (2%) and injections (1.06%). The average no. of drugs per prescription was 2.51±1.26 SD. Percentage of drugs prescribed by generic name were 98.01% and drugs prescribed from essential drug list were 85.41%.Conclusions: The overall drug use pattern in our study correlates with various gynaecological diseases. Majority of the women from rural background depend on primary health services for gynaecological diseases in their areas so, strengthening of gynaecological health care services reduce the morbidity among the women from rural areas.
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Background: The study is done to understand the gynaecological problems in adolescent girls. Do counseling, imparting knowledge for the girl and her mother, hence creating a holistic approach towards the women health in the family by dual client approach.Methods: 400 adolescent girls attending the clinic were studied (prospective observational study). Hb%, S.TSH was done for all the girls. Ultrasonography abdomen and pelvis was done on patient basis. Treatment was given. Mothers were counseled regarding their gynecological issues and screening tests (pap smear, self breast examination) was done after taking consent.Results: 70% girls had menstrual disturbances, 20% had complains of vaginal discharge. 44% had anemia (4% had severe anemia). Subclinical hypothyroidism was detected in 8% of cases. Ultrasonography was done in 52% of cases in which 81 patients had features suggestive of polycystic ovaries. 85.5% of the adolescent girls were accompanied by their mothers. 12% girls took HPV vaccination and 52% mothers underwent pap smear.Conclusions: Teenage problems need to be dealt very sensitively. Counseling is an integral component of treatment strategies. At present, adolescent gynaecology remains an area to which increased awareness and greater attention should be given to promote the health of teenagers and incult healthy lifestyle practices. In the same set up even the mothers of girls can be given counseling and address their gynaecological issues as majority of times mothers are the accompanying person creating the dual client approach in one setting. Hence adolescent clinic should aim for holistic, dual client approach for improvement of overall women health in the family.
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@#Introduction Women as patients is a normal situation. However, women patients of the obstetric and gynaecology category are of a different category. This is because obstetric and gynaecology patients will be warded in the maternity ward and labour room according to the needs of their care and treatment. The care and treatments in the maternity ward and labour room involving the care and treatments by a special team of trained medical doctors, midwives and nurses in obstetrics and gynaecology areas of expertise. Hence, the importance of scutinising the relevant laws and legislations pertaining to the protection of female patients’ rights when they are utilising the maternity ward and labour room are fundamental in determining whether such rights existing in our healthcare services pertaining to pregnant women. Healthcare laws relating to women’s healthcare and government health policy on pregnant women are scrutinised to ascertained whether the laws and policy give impact or effect to the healthcare services rendered, including scrutinising the qualification, capability and the quantity of obstetric and gynaecology doctors on whether it fulfils the requirement of the government hospitals’ maternity ward and labour room. Methods Doctrinal research method is adopted with applying the empirical approach whereby interviews and a focus group discussion were held with the O&G specialist doctors and selected medical officer and staff nurses of Maternity Hospital Kuala Lumpur. Results The finding shows that there are already in placed a policy of the Ministry of Health Malaysia outlining the women patients’ rights in maternity ward and labour room. However, there are deficiencies from the aspect of law and government policy wherein there is no specific laws in relation to pregnant patient rights nor is there a clear policy on women health. Conclusions The writing concludes that there is a need for a new policy to re-establish governance in maternity ward and to further enhance health care quality for women patients hence, to appropriately define the position of women patients’ rights in the government hospital’s maternity ward.
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O aborto é um importante tema sob a perspectiva da saúde pública e permeia a prática de diversas especialidades. Enfocamos a assistência a processos de abortamento e sua relação com a formação recebida em Ginecologia e Obstetrícia (GO) e Medicina de Família e Comunidade (MFC) por residentes de duas faculdades públicas paulistas. A pesquisa seguiu a metodologia qualitativa, e a produção dos dados empíricos se norteou pela técnica de entrevista em profundidade (13 residentes). Os residentes em GO relatam pautar-se nas experiências práticas para condução dos casos de abortamento. Os residentes em MFC relatam discussões sobre o tema e suas conexões com questões de gênero. O conhecimento clínico, o desenvolvimento de habilidades e técnicas e a maior inserção da abordagem de gênero na formação se revelam fundamentais para o exercício do cuidado integral às mulheres em processo de abortamento.(AU)
Abortion is a major public health issue that cuts across various specialities. This study focused on abortion care and its relatioship with the training received in Gynecology and Obstetrics and Family and Community Medicine by residents of two public Colleges in Sao Paulo. A qualitative research design was adopted consisting of the administration of in-depth interviews with 13 residents. The obstetrics and gynaecology residents reported that they relied on practical experience to provide abortion care, while the family and community medicine residents recounted that they discussed the theme and its connection with gender isssues. Clinical knowledge, the devlopment of skills and techniques, and adopting a gender-sensitive approach in training were revealed to be vital components of comprehensive abortion care.(AU)
El aborto es un tema importante bajo la perspectiva de la salud pública y está presente en la práctica de diversas especialidades. Enfocamos la asistencia a procesos de aborto y su relación con la formación recibida en Ginecología y Obstetricia (GO) y Medicina de Familia y Comunidad (MFC), de residentes de dos facultades públicas de São Paulo. El estudio siguió la metodología cualitativa y la producción de los datos empíricos se rigió por la técnica de entrevista en profundidad (13 residentes). Los residentes de GO relatan que se rigen por las experiencias prácticas para la dirección de los casos de aborto. Los residentes de MFC relatan discusiones sobre el tema y sus vínculos con cuestiones de género. El conocimiento clínico, el desarrollo de habilidades y técnicas y la mayor inserción del abordaje de género en la formación se revelan como fundamentales para el ejercicio del cuidado integral a las mujeres en proceso de aborto.(AU)
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Background: The alarming increase in caesarean section rates worldwide has led to a shift of focus to caesarean section rates and indications for caesarean section. The main objective of the study was to analyse the indications for caesarean section with the aim of finding viable interventions which could help decrease the caesarean rates. Methods: A retrospective study from 1st January 2017 to 31st December 2017 was conducted in which we analysed patient records of those delivering in unit III of our institute. Analysis of patient records was done and indication for caesarean was analysed. Results: A total of 496 women delivered in our unit in 2017, of these, 303 (61.09%) had a vaginal delivery and 193 (38.91%) had caesarean section. 108 patients (21.77%) had a history of at least one previous caesarean section and of these 94 (87.03%) underwent a repeat caesarean section. The primary caesarean section rate was 25.51%. Section was done for breech presentation in eleven primigravidae (5.7% of sections) and in fifteen multigravidae (7.77% of sections) including those with a previous section. Four patients had multiple pregnancy (2.04% of all sections). Eleven patients had a preterm section (5.7% of sections). Conclusion: In order to decrease caesarean rates the group that requires most focus is those in whom a primary section is being done. Few patients who have undergone at least one prior surgery are willing to take the risk inherent to a trial of labour (TOLAC). Classification and reporting of caesarean section according to the Robson ten point criteria will help in a better understanding of the indication, comparison and auditing and help to establish guidelines that can help decrease the caesarean rates.
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Background and objectives Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a dangerous and life threatening complication in severe preeclampsia. It remains as an important cause of maternal and perinatal morbidity and mortality globally. The objective of this study was to find out the incidence of HELLP syndrome in pregnancies complicated by severe pre eclampsia and to assess the maternal and perinatal morbidity and mortality in women with HELLPsyndrome secondary to severe pre eclampsia. Methodology A one year Cross sectional study was conducted in the labour room of KLE Academy of Higher Education and Research (KAHER), Belagavi for the period of one year from January 2016 to December 2016. Ethical clearance was obtained from the JNMC Institutional Ethics committee. The primary objective was to determine the incidence of severe pre eclampsia and HELLPsyndrome in patients of severe pre eclampsia. The secondary objective was to study the associated maternal and perinatal morbidity and mortality. Results During the study period, a total of 6236 number of deliveries were conducted in the hospital. Among them, 312 (5%) pregnant women developed severe preeclampsia and 33 women developed HELLPsyndrome(10.57%). The mean age was 25.18±3.81 years. Labour was induced in 21.21% of the women. Majority (66.67%) of the women had vaginal delivery, while the rest had caesarean section (33%) . The most common indication for LSCS was HELLP 81.82%. Majority (84.85%) of the women had complications of HELLP alone while 9.09% of the women had HELLP syndrome associated with abruption. The mean birth weight was 2.27±0.69 Kgs. All cases had live births. The requirement of NICU admission was noted in 18.18% and the most common cause of NICU admission was Meconium aspiration syndrome with fetal distress (50%). The perinatal mortality rate was 16.67%. Conclusion and interpretation HELLPsyndrome is one of the rare complications of severe pre eclampsia. This study shows 5% incidence of severe preeclampsia and incidence of HELLP syndrome in pregnancy complicated by severe preeclampsia as 10.57%. The incidence in our study is high as our hospital is a tertiary care centre that receives referral cases (high risk with poor prognosis) from North Karnataka for further management.
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Background: Premenstrual syndrome is a multifactorial psychoneurendocrine disorder. Etiology of PMS is still not demarcated & research continues in this area. Role of corelates age, parity, marital, educational & occupational status of PMS is being explored in various regions. Objective: To study sociodemographic correlates of psychological symptoms of premenstrual syndrome in woman of reproductive age group. Material and Methods: Prospective observational study was carried on 247 females in the reproductive age group. The participants were given the list of 18 preliminary symptoms and asked to encircle the symptoms they suffer during later part of the menstrual cycle in any of the last 3 cycles. In participants reporting ≥3 symptoms, the psychological symptoms were analysed and their association was observed with various sociodemographic parameters (age, location- rural/urban, marital status, parity, education, occupation). Results: 155(62.57%) reported 3 or more symptoms during later part of the menstrual cycle in the last 3 cycles. 149(96.1%) females reported at least one psychological symptom. These women showed following demographic correlates. 74.5% of females belonged to 18-26 years age group. 75.8% were unmarried. 81% had no child. 87.2% were from urban area. 71.1% were senior secondary. 96% females had mental work occupation. Conclusion: On retrospective screening there was 62.57% prevalence but on prospective follow up with PMTS & daily diary prevalence was found to be only 4.05%. Most common psychological symptom reported was irritability & there was significant association of irritability with educational status, type of work & parity. Mood swings were significantly more in females doing mental work.
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Ovary is one of the common sites of neoplasm in females. They manifest in wide spectrum of clinical, morphological and histological features. Ovary is the second most common site of primary malignancy in female genital tract.
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A sebaceous cyst is a retention cyst. The classical management of scrotal sebaceous cysts is complete surgical excision and in the current era and as expected from the patient from the doctor and as the duty of the doctor, excellent outcome, minimal morbidity with good cosmetic results.
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Background: Bacterial vaginosis is a common cause of vaginal infection worldwide in women of child bearing age. It can be asymptomatic or mild infection but can lead to many complications especially during pregnancy. Recurrence is also frequently seen in women suffering from bacterial vaginosis. This infection usually occurs when normal lactobacillus flora in vagina is disrupted and replaced by pathogens. Administration of probiotics will restore normal vaginal flora and maintain normal pH and it could prove to be a reliable alternative to antibiotics in future. Objective: To assess the effect of supplementation of standard antibiotic therapy with oral probiotics (Lactobacillus) for treatment of bacterial vaginosis. Material Methods: It was an open labeled prospective study in which 100 women diagnosed with bacterial vaginosis were randomly divided into two groups. Diagnosis was made using Amsel’s criteria and Nugent scoring was done. Group A was given Oral Metronidazole, 400 mg BD for 7 days along with oral probiotic tablet containing Lactobacillus rhamnosus BD for 6 weeks whereas Group B was administered Oral Metronidazole, 400 mg BD for 7 days. Patients were assessed at 7 days for symptomatic improvement and again at the end of 6 weeks using Nugent scores. Results obtained were then compared. Results: Out of all patients 2 patients in Group A and 5 patients in Group B could not complete the study. At the end of 7 days, there was improvement in symptoms ie decrease in itching, odour and discharge. There was a significant difference in mean Nugent score before and after treatment between group A and group B at the end of 6 weeks. Conclusion: This study concluded that improvement in patients taking probiotics along with standard antibiotic therapy was significantly more as compared to antibiotics alone.
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Patient with compressive cervical myelopathy sometimes present with localized girdle sensation in the mid trunk (called false localizing sign). This symptom often confuses physicians, but the clinical features and mechanism are still unclear. We present a male patient presented with localized girdle sensation in the middle trunk following fall. Later on diagnosis of compressive cervical myelopathy was made after MRI cervical spine