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Background: Menopause is a biological event characterized by the complexity of factors. On an average one-third of the women’s life consists of the post-menopause years, and health care programs for women do not address concerns beyond reproductive ages. The aim of this study was to describe the magnitude of menopause-related symptoms, the pattern of health care seeking, and associated factors. To assess the prevalence of gynecological disease in post-menopausal women.Methods: This cross-sectional study was done in Karpaga Vinayaga Institute of Medical Sciences and Research Center - obstetrics and gynecology OPD. Over a period, months in the year 2019. Stages of reproductive aging workshop (STRAW) revised criteria and nomenclature are used for the ascertainment of menopause and inclusion of the women in the study. It provided a comprehensive basis for staging since there were more complexities on ascertainment of menopause explained. The STRAW criteria are considered as the gold standard for assessing menopausal stages.Results: A total of 600 participants were included in the study. The proportion of women who had at least one menopause-related symptom was 95.95 (95% CI 93.73-97.54) and 58.3% of women had severe symptoms. Severities of symptoms in psychological, physical, vasomotor, and sexual domains were 56.7%, 70.5%, 49.3%, and 10.2% respectively. Premature menopause (p<0.016), induced nature of menopause (p<0.031), dyslipidemia (p<0.006) and other medical condition (p<0.003) were associated with severity of menopausal related symptoms.Conclusions: A high proportion of women are affected by menopause-related symptoms. Care seeking for all symptoms is not uniform, indicative of a lack of knowledge about the treatable nature of many of these symptoms. Sensitization of both women and the health care system may serve to address this issue of menopause-related symptoms and the possibility of treatment for these.
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Background: Postdated pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks from the last menstrual period. If the pregnancy exceeds 40 weeks it is called as postdated pregnancy. The overall incidence of post term pregnancy is 7% of all pregnancies.Methods: This observational study was carried out in the department of obstetrics and gynecology in Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from September 2019 to February 2020. Total 100 postdated pregnancy enrolled in the study those willing to participate and fulfilling the inclusion and exclusion criteria. Aim is to assess maternal and fetal outcome in postdated pregnancy.Results: In present study, incidence of postdated pregnancy was found to be 5% and number of normal deliveries was 66 (66%), LSCS were 32 (32%) and 2 (2%) were instrumental delivery. Maternal complications were seen in 14 (14%) cases and fetal complications were found in 23 (23%) cases.Conclusions: Postdated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetrics complications like postpartum haemorrhage (PPH), perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and a careful advice and monitoring can alleviate maternal anxiety and untoward complications.
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Background: Gestational age is a critical factor in the management, decision making and follow up of new born infants. Identification of gestational age especially within 48 hours of life is crucial for new born. Since decades attempts have been made to find an alternative measurement for gestational age and birth weight estimation of the newborns. Last menstrual period is an inexpensive method and potentially efficient for calculating gestational age. Objective of this study was to the present study aims to compare the gestational age by New Ballards score with LMP, in pre term babies.Methods: A total 150 pre term babies who are born to mothers remembering LMP were enrolled for the study group. During the study period new Ballard scoring was done for babies within 48hrs and Gestational age was compared with LMP. The collected data was analyzed by using SAS-6.50 version. Study design a prospective observational study was conducted over a period of one year from January 2018 till December 2018 at Rajarajeswari Medical College and Hospital, Bengaluru, IndiaResults: The New Ballard score is found to be significantly correlated with GA above 29 weeks (p<0.01). The LMP mean was 35±2.0 weeks. Total 60.6 % of the childbirth is lead to normal vaginal delivery. The analysis shows LMP were found to be strongly correlated with GA (p<0.01).Conclusions: LMP alone can be reliably used in assessing the gestational age and can be assessed more accurately and be confirmed with new Ballard’s scoring for preterm babies of >29 weeks.
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OBJECTIVE@#To compare the clinical effect between wheat-grain moxibustion at Yinbai (SP 1) and oral administration of dydrogesterone tablet for menstrual period prolongation after down-regulation treatment of in vitro fertilization embryo transfer (IVF-ET).@*METHODS@#A total of 54 patients with prolonged menstrual period after down-regulation treatment of IVF-ET were randomly divided into an observation group and a control group, 27 cases in each one. In the observation group, when the menstrual period delayed more than 7 days, the wheat-grain moxibustion at Yinbai (SP 1) was performed, once a day, with an interval of 1 day between two 3-day treatments; when the menstrual blood was cleaned, the ovulation was continued and the eggs were taken. In the control group, when the menstrual period delayed more than 7 days, the oral administration of dydrogesterone tablet was provided, 10 mg each time, twice a day; when the menstrual blood was cleaned, the ovulation was continued and the eggs were taken. The number of days for menstrual blood to be cleaned, the area change of uterine cavity hemorrhage, the morphology of endometrium, the blood supply of endometrium, the number of oocytes obtained, the grade of frozen embryo and the clinical effect were observed between the two groups after treatment.@*RESULTS@#Compared with the control group, the number of days for menstrual blood to be cleaned was shorter in the observation group after treatment (0.05). The cured rate in the observation group was 100.0% (27/27), higher than 33.3% (9/27) in the control group (<0.05).@*CONCLUSION@#The wheat-grain moxibustion at Yinbai (SP 1) could more effectively treat prolonged menstrual period after IVF-ET down-regulation treatment, which is beneficial to the preparation of the endometrium, and has no effect on the oocyte collection and embryo culture.
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Introduction: Any pregnancy which has passed beyondexpected date of delivery (EDD) is called postdated pregnancyor prolonged pregnancy.Objective: Main goal of this study is to evaluate obstetricoutcome in postdated pregnancy.Method: This was a prospective observational type study.Patients whose pregnancy extended beyond 40 weeks ofgestational age, patients who were sure of the date of lastmenstrual period (LMP) along with 1st trimester obstetrics scanwere included for this study. Patients not sure of LMP wereexcluded in this study. The study was conducted in theDepartment of Obstetrics and Gynecology, of different privatehospital Sylhet for study duration of 3 years. Total 223 caseswere selected purposively for this study.Results: The study result shows fetus condition among the223 pregnant women highest 96.41% were alive and only3.59% were dead. Male baby and female baby was almostsame male 49.33% and female baby 50.67%. After deliverybaby admitted in hospital 76.23%, NICU 6.28% not admitted17.49%. Most of the pregnant women’s (88.34%) managementwas oligo induction failure and rest was laparoscopy. Peroperative finding of the patients shows highest 74.89% pretermpre-mature rapture of membrane, 18.83% Ectopic pregnancyand 6.28% rapture uterus.Conclusion: Postdated pregnancy having 50% risk ofrecurrence in next pregnancy. It is a high risk pregnancy thefoetal complication in the form of foetal distress, meconiumaspiration syndrome, birth trauma etc. It also increases rate ofinstrumental delivery and operative delivery.
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Introduction: Any pregnancy that has passed past expecteddate of delivery (EDD) is called post-dated pregnancy orprolonged pregnancy.Objective: The main objective of this study is to appraiseobstetric outcome for post-dated pregnancy in Patuakhali.Method: This was a potential observational type study.Patients whose pregnancy protracted beyond 40 weeks ofgestational age, patients who were certain of the date of lastmenstrual period (LMP) along with 1st trimester obstetrics scanwere included for this study. Patients not sure of LMP wereexcluded in this study. The study was conducted in thedepartment of obstetrics and gynaecology, of different privatehospital Patuakhali for study duration of 2 years. Total 150cases were selected purposively for this study.Results: Age segmentation of patients where the age ofpregnant women ranged from 16 to 30 years. Among the 150pregnant women highest 64% were in the age of 26-30 years.Delivery method amongst the 150 pregnant women are highestat 86% were caesarean delivery followed by normal deliveryonly 14%. Parity distribution among the 150 pregnant womenhighest 57.33% were Primigravida followed by Multigravida41.34% and 2nd pregnant were only 1.33%. Babies’ conditionamongst the 150 pregnant women, highest 96.30% foetuswere alive upon delivery and only 3.70% of the foetus weredead. In the gender distribution of the foetus, 49.33% wereborn as male and 50.67% were female. After delivery, thebabies that were admitted in hospital were 76.40%, in NICU6.40%, and not admitted in the hospital after delivery were at17.20% and 88.40% of the pregnant women’s managementresulted in oligo induction failure and the rest 11.60% wereconducted upon laparoscopy. Per operative findings of theselected patients show that the highest 74.40% were pretermpre-mature rupture of membrane, 18.80% were ectopicpregnancy and 6.80% had ruptured uterus.Conclusion: Post-dated pregnancy having almost 50% risk ofrecurrence in next pregnancy. It is a high-risk pregnancy thefoetal complication in the form of foetal distress, meconiumaspiration syndrome, birth trauma etc. It also raises rate ofinstrumental delivery and operative delivery.
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Background: Diabetes Mellitus is a complex disease with varying degree of systemic and oral complications. The prognosis is quite favorable if a disease is diagnosed in early stages. Since a large number of patients seek dental treatment routinely, screening procedures for early detection of subclinical cases can help in diagnosis of asymptomatic diabetes. Aim: The present study was undertaken to evaluate if gingival crevicular blood can be used for the estimation of blood glucose levels in periodontitis patients. Material and Methods: A prospective study was carried out comprising 150 patients Group A comprised of 75 subjects with gingivitis and group B comprised of 75 subjects with periodontitis. For gingival crevicular blood glucose (GCBG) level estimation, the blood was drawn onto the glucometer strip after gently probing the gingival sulcus and the readings were recorded. At the same time, blood Vijayendra Pandey, Akhilesh Chandra, Deepak Kumar, Anup Kumar Singh, Priyankesh, Alok Kumar Gupta. Estimation of gingival blood glucose using a sensitive self-monitoring device in periodontitis patients. IAIM, 2019; 6(6): 51-56. Page 52 was also collected from the index finger onto the glucometer strip for the capillary finger-prick blood glucose (CFBG) sample. Both the values were compared and statistical analysis of data was performed. Results: The mean GCBGL and CFBGL in group A was 98.43 mg/dl ± 18.62 and 103.48 mg/dl ± 13.90 respectively, while in group B it was 136.37 mg/dl ± 36.95 and 141.62 mg/dl ± 51.84, respectively. There was no statistically significant difference (p> 0.05) between the two values in both the groups. Conclusion: It can be concluded that GCBG levels are positively correlated with CFBG levels. Therefore, clearly indicating that gingival crevicular blood collected during diagnostic periodontal examination may be an excellent source of blood sample for glucometric analysis.
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In female patients with migraine, the triggering or exacerbating factors for migraine including stress, menstruation and fatigue, should be treated intensively in addition to treatment for headache. Patients with coldness and weak constitution become a state of qi and blood deficiency in terms of Kampo medicine under the circumstances of severe fatigue, lack of sleep and menopausal symptoms. They tend to suffer from migraine at around the 4th or 5th day of menstrual period after rather heavy menstrual bleeding on the 2nd or 3rd day. We experienced 4 patients with headache during the late period of menstruation whose symptoms were successfully treated by juzentaihoto known to improve qi and blood. In Case 1, daily prescription was changed from unkeito to juzentaihoto. In Case 2, during the 7 days of menstrual period, juzentaihoto was added to tokishigyakukagoshuyushokyoto, while juzentaihoto was substituted for tokishakuyakusan in Case 3 and Case 4. In 9 cases of headache, including these 4 cases, juzentaihoto was efficacious against migraine headache during the late period of menstruation with coldness (9/9 cases), fatigability (9/9 cases) and dryness symptoms (7/ 9 cases). These results indicate that juzentaihoto is effective for migraine during the late period of menstruation, especially in patients with fatigue after menstrual bleeding. The administration period of juzentaihoto should be individualized for each patient depending on the severity of qi and blood deficiency.
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Headache is one of patients' major complaints at medical examination. And in Kampo medicine, we select prescriptions for them by taking not only headache, but also other symptoms into consideration.We present five patients with headache, whose symptoms were improved with tokishakuyakusan. Four patients (cases 1 to 4) had a background of menopausal symptoms and one (case 5), menstrual pain. Besides headache, other symptoms, such as vertigo, edema, and numbness of the fingers, were improved with tokishakuyakusan. Goshuyuto was not effective for headache in case 4, though it was effective to some extent in case 5, except for headache during her menstrual period. Headache during the ovulatory phase and/or pre- and early menstrual period disappeared when tokishakuyakusan was added to goshuyuto.Eleven cases of headache treated with toshakuyakusan, including these five cases, revealed that tokishakuyakusan was efficacious against migraine-type headache, which becomes worse during the menstrual period, and coldness. Although tokishakuyakusan should sometimes be distinguished from goreisan or hangebyakujyutsutenmato, it may be effective in patients with so-called “blood pattern” headache, associated with menstrual period and menopausal symptoms, and in patients with a heavy feeling of the head and vertigo.
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Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent episodes of incapacitating nausea and vomiting interspersed with symptom free periods. Common triggers of cyclic vomiting include noxious stress, excitement, fatigue and menstrual period. Here, we report a case of cyclic vomiting syndrome in adult patient characterized by stereotypical vomiting attack, occurring in every menstruation period. Recurrent vomiting episodes began 6 years ago and we treated this patient with subcutaneous injection of goserelin, a gonadotropin-releasing hormone analogue (GnRHa) and oral estrogen. After 4 months of therapy, she was symptom free for the following 5 years, even with the resumed normal menstruation. Recurrence of vom - iting attack with same pattern occurred 1 month before readmission. Treatment with intravenous lorazepam aborted vomiting, but could not prevent recurrences of vomiting and epigastric pain. We treated the patient with GnRHa and oral estradiol again which effectively prevented recurrence of the symptoms.
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Adult , Female , Humans , Estradiol , Estrogens , Fatigue , Gonadotropin-Releasing Hormone , Goserelin , Injections, Subcutaneous , Lorazepam , Menstruation , Nausea , Recurrence , VomitingABSTRACT
The validity of three methods (last menstrual period [LPM], Ballard and Dubowitz scores) for assessment of gestational age for premature infants in a low-resource setting was assessed, using antenatal ultrasound as the gold standard. It was hypothesized that LMP and other methods would perform similarly in determining postnatal gestational age. Concordance analysis was applied to data on 355 neonates of <33 weeks gestational age enrolled in a topical skin-therapy trial in a tertiary-care children’s hospital in Bangladesh. The concordance coefficient for LMP, Ballard, and Dubowitz was 0.878, 0.914, and 0.886 respectively. LMP and Ballard underestimated gestational age by one day (±11) and 2.9 days (±7.8) respectively while Dubowitz overestimated gestational age by 3.9 days (±7.1) compared to ultrasound finding. LMP in a low-resource setting was a more reliable measure of gestational age than previously thought for estimation of postnatal gestational age of preterm infants. Ballard and Dubowitz scores are slightly more reliable but require more technical skills to perform. Additional prospective trials are warranted to examine LMP against antenatal ultrasound for primary assessment of neonatal gestational age in other low-resource settings.
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OBJECTIVE:To explore the changes of serum phenytoin levels and its pharmacokinetics in menstrual epilepsy.METHODS:9cases of menstrual epilepsy patients who were treated with phenytoin were collected,whose blood concentra?tions of phenytoin in menstrual period and ovulation period were respectively determined by HPLC,pharmacokinetics study was performed in three of them.RESULTS:The mean serum phenytoin levels in menstrual period and ovulation period were(9.25?2.71)?g/ml and(13.33?3.22)?g/ml,respectively(P
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OBJECTIVES: To evaluate whether the day of delivery for women with regular menstrual history was predicted best from the last menstrual period (LMP), crown rump length (CRL) and or biparietal diameter (BPD). METHODS: All of 561 women had estimated the day of delivery by LMP, CRL in the first trimester (In case of 217 women, it was available) and BPD in the second trimester. The accuracy of each method in predicting the day of delivery was determined. Those who were delivered after the spontaneous onset of labor were included. Differences among these methods were evaluated with nonparametric tests. RESULTS: The percentage of women who delivered within 3 days of the estimated day of delivery was 254(45.3%) and 216(38.5%) of the women with pregnancies by BPD and LMP, respectively. And within 7days of the estimated day were 408(72.7%), 390(69.5%) of the women from BPD and the LMP. In the women, the BPD estimate was significantly better predictor within the 7days of the day of delivery than LMP estimate (p=0.027). Compared to LMP estimate, CRL and BPD estimates seemed to be advanced the day of delivery about 2.6 days in CRL, and 0.9 days in BPD (p=0.004, p=0.034). But we could not find any advantage of the CRL measurement in first trimester than single BPD measurement in the second trimester for the predictor of the day of delivery. CONCLUSIONS: When the difference between the methods in predicting the day of delivery was less than 7 days, the BPD measurement was better than the last menstrual period.