RESUMO
Dysfunctional uterine bleeding [DUB] is a common problem with complex management. It can be quite harrowing for the physicians as in most instances they are unable to pinpoint the cause of abnormal bleeding even after a thorough history and physical examination. Aim was to compare patient satisfaction for Levonorgestrel intra uterine system [LNG-IUS] and Norethisterone for the treatment of Dysfunctional Uterine Bleeding [DUB]. It is Descriptive case series conducted in Department Obstetrics and Gynaecology, Shifa International Hospital, Islamabad from September, 2011 to September, 2012. One hundred and nineteen [119] female patients of reproductive age Group with DUB were selected by consecutive sampling. Informed written consent was obtained. A structural patient satisfaction questionnaire [PSQ] was used to collect information regarding age of patients, type of method used for treatment of DUB [Levonorgestrel or Norethisterone], treatment outcome in terms of patient satisfaction scale, and decrease in bleeding after 6 months. The mean age of the patients was 41.03 +/- 4.415 year ranging from 28-60 years. The mean parity of women in the study was 3.22 +/- 1.188 with a range of 1-7. The satisfaction level was significantly [p<0.05] greater [90% versus 20%] in Group A [levonorgesterol-releasing intrauterine system] as compared with Group B [Norethisterone]. The blood loss was significantly [p<0.05] decreased in Group A [98%] as compared with Group B [80%]. The preference of continuing the method as well as recommendation to a friend was significantly greater in Group A as compared to Group B. The levonorgesterol-releasing intrauterine system [LNG-IUS] is a better choice as compared to Norethisterone, for treatment of DUB with 90% patients highly satisfied.
RESUMO
To determine Impact of Kegel exercises on control of urinary incontinence in patients of Cystocoele. A Randomized control trail [RCT]. It was conducted in the Department of Rehabilitation, Shifa International Hospital, Islamabad from May, 2012 to November, 2012. Fifty Patients of cystocoele [25 each] selected by consecutive sampling were included in two groups by randomization. Kegel's and postural correction exercises were introduced to the experimental group and back strengthening and postural correction exercises to the control group. Data analysis was carried out by using SPSS 17 software. 't' test was used to determine the effectiveness of Kegel's exercises on urinary incontinence in patients of Cystocoele. p-value [0.001] was significant. It was observed that 60% of the subjects responded well to Kegel's and postural correction exercises. On the other hand 40% subjects responded to the back strengthening and postural exercises. Eighteen subjects [36%] were included in post menopausal age and 11[22%] in pre menopausal status. Where as 21 subjects [42%] were in reproductive age group [20-40 years]. Thirty two subjects [64%] had Grade I, and 18 subjects [36%] had Grade II cystocoele. Moderate urinary incontinence persisted in 5 subjects [10%,] only, while maximum subjects 23 [46%] had no urinary incontinence, and 22 subjects [44%] had slight urinary incontinence. Kegel exercises were proved to be significantly effective [p= 0.03] in improving the urinary incontinence in the experimental group as compared to control group [back strengthening exercise].