Résumé
Background: Medical method of termination of pregnancy is a very effective method when used as per recommended regimen and under proper supervision. Self-administration of these drugs has become a very common practice these days, resulting in incomplete abortion because of improper use. Traditionally surgical curettage has been the preferred mode of treatment for these cases but is associated with very high complication rates. Expectant management of incomplete abortion has been recently adopted as a better method of management of incomplete abortions worldwide. Present study compares expectant management with surgical curettage in cases of incomplete abortions caused by self medication.Methods: It was one-year prospective randomized controlled study. Total of 220 patients were recruited for the study out of which 103 were randomized to undergo expectant management while 117 to undergo surgical curettage. Results were compared using chi square test..Results: Success rate of expectant and surgical management was found to be 82% and 95% respectively. Complication rate was found to be comparable in both the group while acceptability of expectant management was found to be much higher in expectant group. However, significantly more unplanned admissions and unplanned surgical curettage occurred after expectant management than surgical management.Conclusions: Expectant management is a safe and efficacious option in carefully selected cases. If used properly it can avoid complications associated with surgical management and therefore should be utilized whenever suitable.
Résumé
Background: Syndromic management has been the centre for treating STIs in a resource constraint facility since its introduction by WHO and CDC more than a decade back. Recently there has been lots of debate on its empirical use in an era of antibiotics resistance and ever-changing varieties of microorganisms causing these infections. Present study evaluated the efficacy of pharmacotherapy of syndromic management measured by symptomatic improvement in females presenting with STIs.Methods: It was a two year cross-sectional prospective study including all the females of STI syndromes, attending Gynecology OPD of Sanjay Gandhi Memorial Hospital and results were assessed in pharmacology department, Gajra Raja medical college Gwalior from Jan 2015 to December 2016.Results: During the study period total of 24,556 patients attended the Gynecology OPD out of which 8562 patients presented with different STI syndromes. Lower abdomen pain with vaginal discharge was the most common symptom while Ulcerative lesions were the least common complaint. Maximum recurrence was seen in patients of vaginal discharge and itching followed by PID syndrome which responded to second line of drugs.Conclusions: Syndromic Management of STIs is an old approach to deal with a very common gynecological problem and needs to be reviewed in an era of wide spread antibiotics resistance.
Résumé
Background: Oxytocin is a drug commonly administered drug to a pregnant lady during labor, nowadays even without an indication, in the hope that the progress of labor can be improved and the need for cesarean delivery may be reduced. This study emphasizes the need for using safeguards like use of checklists before starting oxytocin augmentation, therefore ensuring its rational use to minimize maternal and neonatal complications when augmenting labor with oxytocin, including rigorous indications, use of minimal useful dose and careful efficacy evaluation.Methods: This is a retrospective, Case-Control, descriptive and analytical study. Study population included women delivering in labor room of Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa, from July 2015 to June 2016, then after data were compiled and assessed in department of pharmacology G.R. Medical College, Gwalior.Results: Results show that the use of oxytocin in labor stimulation can be detrimental to both the mother and the newborn, since they indicate that the use of oxytocin is associated with increased cesarean section rates both in primiparous and multiparous. Furthermore, it was also observed, a significant association between stimulation with oxytocin and low Apgar scores at 1 and 5 minutes both, of the newborns.Conclusions: Therefore, it may conclude that stimulation with oxytocin should not be used without any indication, but only in very specific cases, in which its use is particularly necessary. These results provide to health professionals a better understanding of the effects of the use of oxytocin during labor, which can be useful for decision-making in clinical practice.
Résumé
Background: Chronic Pelvic Pain (CPP) is one of the commonest symptomatology in gynaecologist’s outpatient clinics. CPP has a profound impact on a woman's health and quality of life, including an economic impact through loss of working hours. Treatment for chronic pelvic pain is often unsatisfactory. Present study compares Laparoscopic Uterosacral Nerve Ablation (LUNA) with laparoscopy without pelvic denervation in patients presenting with chronic pelvic pain to our outpatient clinic.Methods: It was a Randomised Controlled Trial Study. After considering inclusion and exclusion criteria, 120 patients were selected, out of which 60 (Group I) had undergone diagnostic laparoscopy and 60 (Group II) had undergone diagnostic laparoscopy with LUNA.Results: The overall success rate for group I and group II were 80%, 78.3% and 66.6% versus 85%, 81.6%, and 83.3% at 3, 6, and 12 months, respectively. However, on subgroup analysis it was found that in patients suffering from Congestive Dysmenorrhoea, there was a significant difference in success rate of both the groups.Conclusions: It was found in present study that there was a benefit for patients with dysmenorrheal, further research in this area is desirable to reach towards a discrete conclusion regarding the benefits of LUNA in patients of CPP.