Successful Outcome of a Rare Complication of Vaginal Birth: A Case Report

Uterine inversion is a condition in which the interior surface of the relaxed uterus protrudes through the vaginal entrance. Its causes are divided into two categories: puerperal and non-puerperal, with puerperal uterine inversion being more common than non-puerperal uterine inversion. The most common variety is acute inversion, which occurs immediately or within 24 hours after delivery. Chronic Uterine Inversions (CUI) that occur more than four weeks after delivery are uncommon. In this study we discuss a case of a 30-year-old woman who came with the complaints of feeling of a mass in the vagina after her last confinement which was gradually coming down through the vagina and remain outside the introitus for 5 years. Based on clinical and sonographic evaluation, she was diagnosed with CUI and developed post partum haemorrhage. We adopted Haultain’s method for correction of CUI. Since, CUI as a painless vaginal mass in the delayed post-partum period is uncommon and hence documented.

Isoniazid Preventive Chemotherapy in Children Contact with Adult Open Pulmonary Tuberculosis

Background: To investigate importance of INH preventivechemotherapy among the children age above 5 years whowere contacted with adults having open pulmonarytuberculosis, as well as the effectiveness of INH prophylaxisamong the children age under 5 years regarding Bangladeshicontext.Objectives: This prospective observational study was carriedout to detect the frequency of tuberculosis and also effect ofisoniazid preventive chemotherapy in children contact withadult open pulmonary tuberculosis.Methods: This study was conducted in the department ofPediatrics, Shaheed Suhrawardy Medical College andHospital, Dhaka for duration of three (3) years, from July 2015to July 2018. About 384 population under 12 years childrenwho were close contacted with adult open pulmonarytuberculosis patients, were taken as study sample. Thereprospectively document adherence to six months of INHchemoprophylaxis and outcome in children with householdexposure to an adult open pulmonary tuberculosis index caseon purposive sampling technique. All the children werefollowed up and evaluated after 6 and12 months with monthlymonitoring. Ethical issues were maintained accordingly.Results: In current study subjects, the mean age was6.27±3.08 years and gender distribution were near about equal(Male: 49.5% vs. Female: 50.5%).Among the ≤5 yearschildren, only 52.7% of them received INH prophylaxis andnobody developed TB. But TB was noticeably found in 21.3%of children aged ≤5 years those who didn’t take INHprophylaxis. The majority of tuberculosis patients was foundstayed in urban slum in comparison to LTBI and healthycontact (81.25% vs. 30.77% vs. 39.26%). More than 90% oftuberculosis patients were severe underweight in this study.Conclusion: INH preventive chemotherapy is an importantfactor in children contact of adult tuberculosis. It isrecommended to provide INH chemoprophylaxis in children upto 12 years age. So it should be consider in national policymaking of Bangladesh to reduce tubercular burden inchildhood age.