RÉSUMÉ
Background: Hysterectomy is the most frequently performed major surgical procedure in gynaecology. It is an efficacious treatment option for numerous gynaecological conditions. This study aimed to investigate the different routes of hysterectomies, such as abdominal, vaginal, and laparoscopic, and their outcomes in benign gynaecological diseases in a tertiary care centre in Tamil Nadu.Methods: This retrospective observational study included 200 patients who were admitted to the department of obstetrics and gynaecology at Chettinad Hospital and Research Institute, Tamil Nadu, India underwent hysterectomy between January 2021 and January 2023, and were collected from the MRD. Patient history included age, parity, indication for surgery, duration of surgery, route of hysterectomy, intraoperative or postoperative complications, duration of hospital stay were collected.Results: This study analysed 200 patients who underwent hysterectomy, with the majority aged between 40-50 years (60%) and multiparous women (85%). The most common indications were abnormal uterine bleeding (80%), uterine prolapse (12%), benign ovarian cyst (5%) and post-menopausal bleeding (3%). Total abdominal hysterectomy (49%) was the most common approach, followed by vaginal/non-descent hysterectomy (19.5%), total laparoscopic hysterectomy (16.5%), and laparoscopic-assisted vaginal hysterectomy (15%). Complications included wound infections (3.5%), excessive bleeding (3%), bladder injuries (1%) and ureter injury (0.5%). The procedure duration and hospital stay were shorter for vaginal and laparoscopic approaches than for open abdominal hysterectomy. The laparoscopic approach had the lowest rates of complications such as bladder injuries and excessive bleeding.Conclusions: Vaginal hysterectomy is preferred for uterine prolapse, whereas laparoscopic techniques offer benefits such as reduced blood loss and lesser hospital stay and morbidities. Although rare, complications emphasize the need for careful postoperative monitoring to optimize patient care.
RÉSUMÉ
The implementation of enhanced recovery after surgery (ERAS) pathways represents a concerted effort to optimize patient outcomes in the perioperative period while minimizing postoperative complications and readmissions. ERAS achieves these objectives through the integration of various elements into a comprehensive perioperative management program, aimed at reducing surgical stress and its associated repercussions. Key principles of ERAS encompass preoperative counselling, nutritional strategies, emphasis on regional anaesthesia and nonopioid analgesics, meticulous fluid balance, maintenance of normothermia, and promotion of postoperative recovery strategies such as early mobilization and thromboprophylaxis. The benefits of ERAS are manifold, including shorter hospital stays, diminished postoperative pain and analgesic requirements, expedited return of bowel function, reduced complication and readmission rates, and heightened patient satisfaction, all achieved without elevating readmission, mortality, or reoperation rates. Effective adoption of ERAS necessitates institutions to evaluate their infrastructure and patient flow to support its implementation adequately. Furthermore, sustainable ERAS programs should be seamlessly integrated as a standard model of care within healthcare delivery systems. The success of ERAS hinges upon the simultaneous implementation of its multiple components, underscoring its holistic approach. Institutions are urged to endorse the adoption of ERAS pathways emphatically as a means to enhance patient care and improve perioperative outcomes.
RÉSUMÉ
Background: Gynaecological emergencies are common causes of emergency hospital presentation/admission. Majority of the emergencies are mostly pregnancy related and pose threat to two lives as well as the women’s future reproductive careers. There is therefore need to evaluate them to make better preparations in managing them.Methods: This was a 10 year (from 01 January 2012 to 31 December 2021) retrospective study of gynaecological emergencies managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), evaluating their management and outcomes.Results: The commonest cause of gynaecological emergency at AEFUTHA was miscarriage accounting for up to 69.1% out of which incomplete miscarriage contributed 70.8% and majority had manual vacuum aspiration with good outcome. Ruptured ectopic pregnancies were the commonest surgical emergencies with the incidence of 7.1% and all had laparotomy and partial salpingectomy. Gestational trophoblastic diseases accounted for 2.0% of gynaecological emergencies. The commonest non-pregnancy related gynaecological emergency was acute pelvic inflammatory diseases which accounted for 9.3% of cases. Other gynaecological emergencies reviewed were ovarian accidents (2.9%), abnormal uterine bleeding (3.9%), gynaecological malignancies (2.3%), coital laceration (1.5%), sexual assault (2.4%) and Bartholin’s abscess (0.2%). Factors that affected the outcome were the age of the patients, marital status and disease type and were statistically significant (p<0.05).Conclusions: Management outcomes of gynaecological emergencies were optimum. Mortality occurred in 1.3% of cases, with gynaecological malignancies accounting for 81.4%. There is usually a good prognosis when prompt, accurate diagnosis and treatment are administered.
RÉSUMÉ
The most common benign tumour in reproductive age group –uterine leiomyoma can rarely present with bleeding into the peritoneal cavity leading to hemodynamic instability. A 36-year parous woman presented with acute abdomen and hypovolemic shock. Pregnancy test reported to be negative. Emergency laparoscopy was done and detected to have a surface bleeder and emergency laparoscopic myomectomy done.
RÉSUMÉ
Backgrounds: Gynecological cancers are significant and probable life-threatening diseases that harm patients' physical and psychological health. The leading cause of death in female抯 psychological problems like depression endure and can cause an extra burden during their treatment. Therefore, this study helps evaluate depression and well-being among gynaecological malignancies. Methods: Women's depression was evaluated by a standardized CES-D Scale and QOL by WHOQOL Bref scale, a sample of 100 women with cancers admitted at HSK and Kerudi cancer hospital, Bagalkot was selected using a purposive sampling technique, descriptive survey design was adopted. Statistical data were tested and scrutinized using descriptive and inferential analysis. Results: 100% of women had moderate depression. The mean percentage of depression score was 61.45% with mean and SD (37�9). Of the women, 71 % had moderate, 21%had poor, and 8% had good QOL. The mean percentage of QOL of women was 48.1% with mean and SD (62.5�.1). A Strong relation was found between depression scores with your family members known to you (?=4.52, p<0.05), Area of residence (?=3.88, p<0.05), and whether you have undergone previously any surgery for the treatment of cancer (?=8.93, p<0.05). No association was found between QOL scores with study variables. A Negative correlation (r=-0.27, p<.05) was found between depression and Total QOL scores. Conclusion: Most patients have moderate depression and moderate QOL. This study is effective in identifying depression and QOL
RÉSUMÉ
Introduction: Lower limb lymphedema (LLL) is one of the most disabling side effects of surgical and radiotherapy treatment for gynecological cancers (carcinoma of the cervix, carcinoma of the ovary, carcinoma of the endometrium, and carcinoma of the vulva). The incidence of lymphedema varies in gynecological cancers and patients undergoing radiotherapy and surgery. This prospective study aims to determine the incidence of lower limb lymphedema after surgery and radiotherapy in gynecological malignancies.Methodology: A total of 512 subjects who undergo treatment for gynecological malignancies in the department of surgical oncology and / or radiotherapy were screened to find out the incidence of lymphedema by measuring limb circumference with inch tape and extracellular fluid (ECF) volume with bio-impedance analyzer at four intervals, before surgery/ radiotherapy, after surgery/radiotherapy, three months follow-up and six months follow-up. The limb circumference and ECF were used to find out the lymphedema.Results: Turkey's pairwise comparison test was carried out to determine the incidence of lymphedema in both subjects (radiotherapy & surgery). The percentage of incidence of lymphedema in subjects who have undergone radiotherapy and surgical treatment with gynecological malignancies is 18.94% overall.Conclusion: Many subjects developed lymphedema with post-treatment gynecological malignancies. It causes significant functional problems, emotional disturbances, adversely affecting the quality of life, and it also causes a financial burden to the family. Lymphedema can be diagnosed initially using a Bio-impedance analyzer and inch tape to minimize the complications and progression of the disease.
RÉSUMÉ
Background: In the fancy era of minimal invasive, day care and scarless surgery, abdominal operation through a laparotomy is but a last choice for the mediocre. Surgical site wound healing is a benchmark for patient as well as surgeon satisfaction following an abdominal operation. It is a determinant of preop preparation, intra and post op management by the healthcare system and the duration of hospital stay as well as burden of disease. Aim of the study was to study the spectrum wound healing, and post operative hospital stay in patients undergoing major gynaecological abdominal surgeries. To assess and correlate the underlying risk factors for wound healing.Methods: This was a hospital based prospective study carried out in a tertiary care centre in north A.P. on patients who underwent major abdominal gynaecological surgeries during one year from January 2022 to December 2022. Determinants like patient age, BMI, anaemia, HTN, Diabetes mellitus, hypothyroidism were studied & made observations on wound healing, SSIs and post operative hospital stay in all the cases. Statistical analysis was done using SPSS version 22, P value <0.05 taken as significant.Results: Among 100 major abdominal gynaecological surgeries studied, 20 cases developed delayed wound healing, one case developed complete dehiscence, thus, incidence of wound dehiscence was 1%, rate of SSI was 12%. Anaemia, DM, obesity and HTN were significantly associated with poor wound healing in that order.Conclusions: Optimisation of the patient抯 health condition before taking up for elective surgeries is important for better recovery of the patients.
RÉSUMÉ
Background: Gynaecological emergencies are a common cause of morbidity and mortality among women of reproductive age group worldwide and can be life threatening. They can be easily managed if diagnosed early. Ultrasonography (USS) is a readily available and excellent diagnostic tool in the prompt and accurate diagnosis of these conditions. This is a comparative study aimed at evaluating the ultrasonographic findings in gynaecological emergencies and comparing with the clinical diagnosis. Methods: 400 patients presenting with suspected gynaecological emergencies at the National Hospital, Abuja were evaluated. The USS findings of these patients were recorded and matched with their socio-demographic parameters and the radiological diagnosis was then compared with the clinical diagnosis at presentation. Results: The mean age of participants was 34.2±7.5 years. Pregnancy related emergencies were the most common, making up 65.8%. Abortion was the most common emergency seen. Pregnancy related cases were commoner in the younger age group 20-39 years. A higher proportion of USS diagnosis for pregnancy related cases (96.7%) corresponded with the clinical diagnosis when compared to a smaller proportion for non-pregnancy related cases (80.6%), and this had significant correlation (x2=256.12, df=1, p<0.0001) Conclusions: USS evaluation of gynaecological emergencies as seen in this study, allows for quick and accurate diagnosis so that appropriate emergent care can be instituted to improve the outcome in these cases.
RÉSUMÉ
Background: Women have unique health concerns and are affected by health issues that are either more prevalent in women than in men or a disease that is common in men too but require a different treatment approach in women and this is where women’s health comes into play. Women are afflicted by some or the other reproductive morbidity at least once in their lifetime. These reproductive morbidities are broadly categorised into obstetric, gynaecological or contraceptive morbidity. Among these three categories of reproductive morbidities, gynaecological morbidities are relatively more frequent and account for a major proportion (43%-92%) of the disease burden in women.Methods: This study was a prospective, single-centre, controlled, observational study conducted from January 2021 to December 2021 in the department of obstetrics and gynaecology of Bhaktivedanta hospital and research institute, Thane, India. The objective of this study was to study the magnitude and impact of a particular type of gynaecological problem in this region and to know the need of developing better preventive and therapeutic protocols including the start of specialised gynaecological clinics.Results: Among various reproductive health issues, there were three most frequently occurring issues reported which were menstrual disorder, abnormal vaginal discharge and lower abdominal pain with a frequency of 29%, 24% and 19% respectively. Among the menstrual disorders commonly observed in women, the most common disorders were irregularity of menstrual cycles (39%) and menorrhagia (31%). Out of all the characteristics of vaginal discharge, changes in its colour constituted the highest percentage (51%) with white and yellow colour discharge being the most common (23% and 24% respectively).Conclusions: Menstrual irregularities and reproductive tract infections were the major gynaecological morbidities observed. This study identifies major gynaecological problems and highlights the need for dovetailing health care resources towards it.
RÉSUMÉ
Las revistas piratas o depredadoras (predatory journals en inglés) son cada vez más frecuentes y sorprenden en su buena fe a investigadores/as que buscan publicar sus manuscritos. Este artículo presenta un caso de descubrimiento y demostración de publicación en una revista pirata y un conjunto de sugerencias para evitar este error, como un aporte a profesionales de ciencias de la salud que realizan actividades de investigación. El resultado de las investigaciones mostró que la revista European Journal of Gynaecological Oncology(EJGO) es una revista pirata: fundada en 1980, solo desde 2020 posee International Standard Serial Number (ISSN) digital: sus primeras editoras, hasta 2020, no trabajaban en el área disciplinar de la revista ni pudieron ser rastreadas en ORCID; su actual editor no responde correos; la dirección postal de la editorial es la misma de una empresa canadiense importadora de juguetes. Hasta 2021 no poseía una plataforma web para el envío del manuscrito sino se enviaba el trabajo a un correo electrónico genérico. A raíz de nuestras denuncias fue suspendida de Scopus (Scimago) y Clarivate (Web of Science). Cuando Clarivate forzó a EJGO a avisar a sus lectores que estaba suspendida, inmediatamente cambió su página web y la empresa editora. En síntesis, se muestra un caso real de publicación en una revista pirata, la detección y comprobación de que dicha revista efectivamente cae en esta categoría y el aporte de conceptos y definiciones para tener en cuenta a fin de evitar caer en este error. (AU)
Predatory journals are becoming more frequent every day and surprise researchers who seek to publish their manuscripts. This article presents a case of discovery and demonstration of publication in a predatory journal and a set of suggestions to avoid this error, in a contribution to the education of health science professionals. The result of the research showed that the European Journal of Gynaecological Oncology (EJGO) is a pirate journal: founded in 1980, it obtainthe digital International Standard Serial Number (ISSN) in 2020; its former editors, until 2020, do not work in the disciplinary area of the journal and could not be tracked in ORCID, the new editor did not respond any mail; the postal address of the publisher is the same as that of a Canadian toy import company. Until 2021, it did not have a web platform for sending the manuscript, but rather the work was sent to a generic email. As a result of our complaints, it was suspended from Scopus (Scimago) and Clarivate (Web of Science).When Clarivate forced EJGO to notify its readers that it was suspended, it immediately changed its website and publisher. In brief, a real case of publication in a predatory journal is shown, the detection and verification that this journal actually falls into this category and contribution of concepts and definitions to avoid falling into this error. (AU)
Sujet(s)
Éthique des Publications Scientifiques , Revues prédatrices comme sujet , Communication savante/éthiqueRÉSUMÉ
Breastcancerin females, which is consideredthe most dreadfuldisease in India andthe worldas compared toother gynaecological cancers,demands extensive care and proper medicationin order to control itsprogressive growth. In addition to the conventional care ofthe patients, Complementary andAlternative Medicine(CAM)is administeredin a controlled way through proper guidance and counselling in orderto attainimprovedphysical andmental health forthe patients.Objective: The aim of the study wasto assess the effectiveness of CAMcomprehensive nursing interventionsand their benefit forpatients who havebreast cancer and gynaecological tumours.Methods: Statistical data was used to map the adult womendiagnosed with breast and gynaecological cancer and who were set to start new chemotherapy treatments. A total of 450 patients from different states of East India were enrolled in the studyover a period of four years. The patients wereselectedbased on their preference for undergoing CAM.The research was conducted usingacross-sectionalanonymous self-administered questionnaireto examine women's perspectivestowards the use of CAM and itseffect on their mental andphysical health.Results:42%of the women preferred theuseofCAM astheir alternative treatment. Breast cancer patients disclosed that 48.1% of them had used CAM and 39% of women with gynaecological cancersstated that they had usedCAM. The results further indicated a less frequent deteriorationin the health of CAM users(38.4%) thantonon-users(55%). In terms of those who utilizedvitamins and nutritional diets,60% of the participants reported using a proper diet, including antioxidants, minerals, vitamins and herbs etc. 37% opted for spiritual healing through yoga, 26% utilized energy healing, 42.4% utilized acupuncture,72% preferred massagesand 23% of patients utilized chiropractic methods.The use of CAM was foundmainlyin the patients with proper education and awareness and those with a family history of cancer who were not receiving the necessary care from their previous primary physician.Conclusion:CAM still requiresextensive research in terms of its applications in dealing with patients and in orderto successfully launch programmes aimed at promoting its useworldwide andto eradicate all the other false notions about it.[Ethiop. J. Health Dev. 2022; 36(2):000-000]Keywords: Breast Cancerand gynaecological tumours,Complementary And Alternative Medicine (CAM), Complementary Oncology,Quality Of Life, Nutritional Diet and Spiritual Healing, HRQL (Health-Related Quality Of Life).IntroductionCancer has been the primaryconcern in Indiafrom the onset,resulting in thousands of deaths due to the lack of adequatemedication and therapy.Breast cancer is considered to bea common invasive form of cancer which is responsible for the second highest mortality rate among the primaryfatal conditions of cancer-causing deaths in women. Under the National Cancer Registry Program,the breast, cervix, uteri,and oral cavity(7)are the most common cancer sitesin women. According to statistics, 50-60% of all cancers amongIndian women are commonly found inthe cervix uteri, breast, corpus uteri and ovaries,which are the main organs forcancer invasion. The percentage of women who experience these types of cancer is increases, with more women becoming susceptible to breast cancer, in women up to 3-8% suffer fromovarian cancer,0.5-4.8%have cancer of the corpus uteri, 1-3% have vulva and/or gestational trophoblastic tumours and a staggering75,000 or more women have breast cancer. With the advancements of the disease through time,research programs were also improved in order to enable the improvement of existing measures and/or the development of new measures aimed at combating the diseas and decreasing mortality rates. Apart from the conventional chemotherapy technique,various other programs have been introduced andencorporated into treatment regimes in order to improve the lives of those who are affected by cancer.Complementary andAlternative Medicine (CAM) emphasizesthe methods and practices that are therapeutic and which help diagnose or curethe disease,these methods are intended tocomplement the conventional methods and can be used in place of mainstream medicine. Women with breast cancer and other gynaecological tumoursare increasingly inclined towards the use of CAM. With the increasing number of cancer reports in Indiaand the world,and with the principal amount leading to mortality, women with proper education and awareness are inclined to choosealternative methods rather than the old conventional ones. The side-effects resulting from the chemotherapy are immense and toxic,which is one of the reasons women are inclined to choose.Various research projects and cumulative studies have been conducted in order to review and discoverthe
Sujet(s)
Tumeurs du sein , Oncologie médicale , Médecine , Maladie résiduelle , Régime alimentaireRÉSUMÉ
@#Introduction: The aim of this study was to determine the spontaneous pregnancy rate and safety of our surgical technique of performing laparoscopy cystectomy for endometrioma
RÉSUMÉ
Factor V(FV) is a rare bleeding disorder that its incidence is one in a million. Patients with FV deficiency have typically mucosal bleeding and prolonged bleeding after an invasive procedure. There are no certain treatment modalities and there is no product of FV concentrates in the markets. The bleeding diathesis and protect the ovarian viability are a challenge as an opposite situation for treatment options and ovarian preservation after detorsion is controversial. We aimed to provide ovarian blood-stream,control bleeding and protect thromboembolism from the patient with all of our treatment in the light of literature and a few case reports.
RÉSUMÉ
Background: In many parts of the world, presentations for most gynecological cancers are late; this makes treatment difficult due to the cost of chemotherapy or radiotherapy which form the bedrock for cure or palliation. Objective of this study was to determine the types, stage at diagnosis, affordability of care and outcome of treatment of gynaecological cancers in Federal Medical Centre Azare, Bauchi State, Nigeria.Methods: All cases of gynaecological cancers seen over a ten-year period, from 1st January, 2003 to 31st December, 2012 were reviewed retrospectively. The number of all gynaecological cases seen during the period was also extracted.Results: Gynaecological cancer cases accounted for 11.84 % of 8,642 gynaecological cases seen during the period of study. The mean age and parity of the women were 42±5 SD years and 5±1 SD respectively. Cervical cancer accounted for 55 %, ovarian cancer 30%, endometrial cancer 6%, choriocarcinoma 5%, secondaries/ cancers of undetermined origin were 4%. Ninety-two percent presented with advanced stage of diseases. Only 25.3% could afford the cost of full treatment, and 8.4% attained cure of their disease. The modalities of treatment available were surgery and chemotherapy.Conclusions: Cervical and Ovarian Cancers remain the leading types of gynaecological cancers in our environment and late presentations are frequent occurrence. Late presentation and unaffordability of treatments are major challenges associated with the management of these patients. Early presentation and funding mechanisms for gynaecological cancers are keys to improved cure rate and reduced mortality.
RÉSUMÉ
Laparoscopic procedures have the advantages of minimal incision, early recovery, lesser post-operative pain and early ambulation. However, they are associated with an increased incidence of post-operative nausea and vomiting (PONV), which is all the more frequent in gynaecological laparoscopic surgeries. In our study, we have evaluated the effectiveness of intra-operative intravenous crystalloid infusion on post-operative nausea and vomiting after diagnostic gynaecological laparoscopy.METHODSInformed consent was obtained and patients were randomly divided into two groups. Group 1 received 30 mL/Kg intravenous crystalloid infusion intra operatively and group 2 received 15 mL/Kg intravenous crystalloid infusion. Incidence of nausea, incidence of emesis (retching or vomiting), the amount of rescue antiemetic used, and the haemodynamic parameters were noted in the postoperative period for 12 hours for both the groups.RESULTSIncidence of PONV was much more in group 2 in 0, 1, 2, 3, 4, 6 hours post operatively and rescue antiemetic use was much more in group 2 in total 12 hours post-operative period. There was no statistically significant difference in hemodynamic parameters between Group 1 and Group 2.CONCLUSIONSIntra-operative administration of 30 mL/Kg of crystalloid infusion significantly reduces the incidence of PONV and rescue antiemetic use compared to 15 mL/Kg crystalloid infusion in diagnostic gynaecological laparoscopy. So, it can be used as a non-pharmacological method for prophylaxis of PONV.
RÉSUMÉ
Background: Gynaecological disorders are a particularly common cause of morbidity and mortality among women of reproductive age and a common cause of hospital presentation/admission and surgery.Objective:This study sought to review gynaecological diagnoses and surgeries performed in a tertiary health facility from 2012 to 2017 and its implication for healthcare planning and budgeting.Methodology:This was a retrospective review of all gynaecological diagnoses and surgeries seen in the Rivers State University Teaching Hospital (RSUTH) from 2012 to 2017.Data were retrieved using a proforma comprising of year, gynaecological diagnosis and gynaecological surgeries. Data obtained was entered into Microsoft Excel for descriptive analysis.Results:The proportion of clinic attendees declined from an average of 23% in the first three years (2012-2014) to about 10% in the last three years (2015-2017). The most common gynaecological diagnosis were uterine fibroid (33.3%), infertility 28.1% (primary 5.7%, secondary 22.4%), PID (5.9%), ovarian tumour (4.2%), secondary amenorrhea (3.4%) and pelvic malignancies (3.4%). The commonest major surgeries were myomectomy 441(33.7%), salpingectomy 345(26.4%), hysterectomy 168(12.8%) and cervical cerclage 122(9.3%). The commonest minor surgeries were manual vacuum aspiration 314(41.0%), examination under anaesthesia and biopsy 110(14.3%) and adhesiolysis for synechiae 97(12.6%). The duo of uterine fibroid and infertility made up 50%-70% of all gynaecological diagnoses.Conclusion:This study showed that there has been a steady decline in gynaecological consultations over the years. However, the duo of uterine fibroid and infertility made up half to three-quarter of all gynaecological diagnoses over the 6 years. Infertility and uterine fibroids have a long cause and effect association. Healthcare policies and budgeting should be increased towards tackling these conditions, especially the setting up of a fertility center to provide assisted reproductive technologies and laparoscopy to improve practice and patient outcome
RÉSUMÉ
@#Introduction: Malnutrition is common among cancer patients and it is reported in a significant proportion of patients with gynaecological cancer (GC). The aim of this study was to determine the association between quality of life (QOL) and hand grip strength (HGS) among malnourished GC outpatients in the National Cancer Institute (NCI). Methods: This study was carried out in a Multidisciplinary Clinic of NCI. HGS was measured using Jamar Hand Dynamometer. Nutritional status was assessed using the scored Patient-Generated Subjective Global Assessment (PGSGA). QOL was measured using the validated European Organisation for Research and Treatment of Cancer Questionnaire (EORTC-QLQ C30). Results: A total of 69 patients were selected for the study. Fifty eight (84.1%) were classified as moderately malnourished or at risk of malnutrition (PG-SGA B) and 11 (15.9%) were classified as severely malnourished (PG-SGA C). There was a moderate, significant positive relationship between HGS and functional status (rs=0.275, p=0.022) observed in this study. Besides, in malnourished GC patients with low HGS, results indicated that they had problems with social functioning as well (r=0.255, p=0.035). Appetite was suggested as a predicting factor for low HGS among malnourished GC patients (F=12.253, p=0.001). Conclusion: HGS is a simple objective indicator of functionality and is, therefore, a valid item to be measured when assessing QOL of malnourished GC outpatients.
RÉSUMÉ
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.
RÉSUMÉ
Chronic inversion of uterus is a rare clinical entity which is usually associated with obstetrics complication and rarely with gynaecological disorder like fibroid present at fundus of uterus. We here present a case of 40-year-old female P3L3 with chronic inversion of uterus with fundal fibroid which present with 3year history of abnormal vaginal bleeding. Ultrasonography and MRI revealed cervical fibroid. Due to AUB secondary to cervical fibroid decision of hysterectomy was taken. On laparotomy chronic uterine inversion was present which was corrected by haultain’s procedure. Then hysterectomy was done. Histopathology report suggestive of uterine leiomyoma at fundus of uterus. Chronic uterine inversion associated most commonly with fundal submucous leiomyoma. Other causes are leiomyosarcoma, endometrial carcinoma, cervical carcinoma, rhabdomyosarcoma, mixed mullerian sarcoma. It is an extremely rare gynaecological condition and can be misdiagnosed as cervical fibroid, advanced cervical malignancy or other causes of AUB in females. It could be labelled as gynaecological near miss so a high index of suspicion is necessary for it’s diagnosis.
RÉSUMÉ
Background: This study is aimed to review indications, demographic data of patients, clinical outcomes and safety of total laparoscopic hysterectomy.Methods: This is a prospective observational study of total 150 patients who underwent total laparoscopic hysterectomy (TLH) from 1st June 2017 to 30th November 2018 in GMERS Civil Hospital Sola.Results: ~45% patients were between 40-50 years age group; 60% patients had 2 or more deliveries; commonest indication was symptomatic adenomyosis ; uterine size in ~57% of patients were up to 6 weeks; duration of surgery in ~91% of patients <120 minutes; intraoperative blood loss in all cases <200ml; no intra-operative and postoperative complications were encountered.Conclusions: TLH is safe procedure with minimal blood loss, minimal postoperative pain and discomfort and shorter duration of hospital stay when performed via expert hands.