The ways to ameliorate the efficiency of treatment for women with pelvic inflammatory disease

2020 ◽  
pp. 54-58
Author(s):  
I.V. Lakhno ◽  
◽  
A.E. Tkachov ◽  
O.V. Grischenko ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Vaginal Discharge ◽  
Inflammatory Diseases ◽  
Lower Abdominal Pain ◽  
Resistance Index ◽  
Reproductive Age ◽  
Infusion Therapy ◽  
Control Group ◽  
Pelvic Organs ◽  
Abnormal Vaginal Discharge

The inflammatory diseases of the pelvic organs are known to be one of the important problems of modern gynecology, which is due to the high frequency of chronicity of the process and a large number of complications. The article provides a theoretical and practical substantiation of the use of the drugs Rheosorbilact and Grandazol to increase the efficacy of empirical therapy in patients with acute salpingo-oophoritis. The objective: study of the effectiveness of the use of hyperosmolar combined solution of sorbitol with a balanced content of electrolytes for low-volume infusion therapy (Rheosorbilact) and a solution of levofloxacin 2.5 mg and ornidazole 5 mg (Grandazole) in the treatment of women with acute PID. Materials and methods. Totally 98 women of reproductive age were examined and divided into three clinical groups. The I (control) group included 30 healthy women. In group II (comparison), 33 patients with acute bilateral adnexitis were included, who were prescribed traditional treatment. In group III (main) group, there were 35 women who were additionally prescribed Rheosorbilact and Grandazole was used as an antibacterial agent. Results. A survey of women with acute bilateral adnexitis found that among all clinical characteristics the most common were: lower abdominal pain (89.7%), abnormal vaginal discharge (88.2%), and fever (83.8%). The variables of the level of C-reactive protein, the number of leukocytes, and the value of the resistance index in the ovarian arteries were elevated in the study population before treatment, respectively: 52.4±8.3 mg/l, 11.8±2.2×109/l, 1.4±0.2, which differed from the control values (p<0.05). The study of the pseudo-R2 Nagelkerke confirmed the relationship between increased resistance index and lower abdominal pain, abnormal vaginal discharge and fever with high sensitivity (88,2%) and insufficient specificity (60.4%). Thus, in women with acute salpingo-oophoritis, the presence of inflammatory symptoms (even in the absence of Doppler data) is an indication for the use of infusions of vasotrophic drugs with the hemorheological action.The priority effect of this method of treatment was the optimization of hemodynamics in the large vessels of the small pelvis, which provided the effective delivery and accumulation of antibacterial drugs in the inflammation focus. Conclusion. The specified combination of drugs Rheosorbilact and Grandazole has demonstrated the maximum clinical effect, which justifies the possibility of widespread use of this method of therapy. Keywords: inflammatory diseases of the pelvic organs, Doppler ultrasound, treatment, Rheosorbilact, Grandazole.

scholarly journals Clinicomicrobiological spectrum of abnormal discharge from vagina in women in costal Andhra Pradesh

2020 ◽  
Vol 10 (1) ◽  
pp. 150
Author(s):  
Jyothi Singamsetty ◽  
G. Sravani
Keyword(s):  
Abdominal Pain ◽  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Exclusion Criteria ◽  
History Of ◽  
Abnormal Vaginal Discharge ◽  
Trichomonas Vaginitis ◽  
Reproductive Age Group

Background: When there is change in colour, consistency, order and volume of discharge then it is called abnormal vaginal discharge and associated with vulvar pruritus, dyspareunia, dysuria and lower abdominal pain. There is variability in organism isolated and treatment used.Methods: Sexually active women in reproductive age group with complain of abnormal vaginal discharge were included in this study based in following inclusion and exclusion criteria. . A detailed history of patient was taken regarding nature of discharge, colour, smell along with dysuria, dyspareunia, itching of vulva and lower abdominal pain.Results: Out of 160 patients 88 patients have bacterial vaginosis. Trichomonas vaginitis was present in 7.5% patients. Candidiasis was present in 6.25% patients. Some patients were having more than one infection like Bacterial vaginosis and Trichomonas vaginitis was coexisting in 13.75%, Bacterial vaginosis + Candidiasis were present in 8.75% patients. Mixed infection was present in 8.75%.Conclusions: From present study we can conclude that vaginal discharge is more common in married women in young age. Patients commonly presented with curdy white discharge, pruritus vulva and lower abdominal pain. Erythema and excoriation in vulva were common presentation, followed by erythema of vagina. Nature of discharge was mucopurulent in most patients. Bacterial vaginosis was most common followed by Trichomonas vaginitis.

Efficacy of Tamarindus indicus, Melia azadirach and Santalum album in syndromic management of abnormal vaginal discharge: A single-blind randomised controlled trial

2017 ◽  
Vol 15 (2) ◽  
Author(s):  
Tabasum Ali Bhat ◽  
Wajeeha Begum
Keyword(s):  
Abdominal Pain ◽  
Vaginal Discharge ◽  
Controlled Trial ◽  
Lower Abdominal Pain ◽  
Test Group ◽  
Control Group ◽  
Santalum Album ◽  
Syndromic Management ◽  
Abnormal Vaginal Discharge ◽  
Single Blind

Abstract Background At least 25 % of women attending genitourinary medicine (GUM) clinics receive treatment for one of the three common causes of abnormal vaginal discharge: bacterial vaginosis, candidiasis and trichomoniasis. Syndromic diagnostic approach was adopted by National AIDS Control Organisation (NACO) India, at the primary health centre level. Syndromic management implies the simultaneous treatment of two or more infections. The aim of this study was to assess efficacy of sandal sufaid, maghze tukhme bakayin and khaste tamar hindi in syndromic management of Sailanur rehm. Methods This study was a randomized, single blind, standard controlled trial. It was conducted to compare efficacy of formulation which contains buradae sandal safaid, safoofe maghze tukhme bakayin, safoofe khaste tamar hindi and safoofe shakkar safaid against combination of azithromycin, fluconazole and secnidazole on diagnosed subjects of Sailanur rehm. Test group received 10 g of test drug B.D for 21 days while control group received single dose of standard drug to both the partners. Vaginal symptom score (VSS) was used for assessing discharge and associated complaints. Visual analogous scale (VAS) was used for assessing low backache and lower abdominal pain. Results There were no significant differences between the two groups concerning baseline characteristics (p>0.05). VSS was significantly decreased with p<0.001 for both control and test group. VAS was significantly decreased with p<0.001 and p=0.07 in test and control group respectively for low backache. For lower abdominal pain p=0.006 for both groups after the completion of treatment. Conclusions The formulation can effectively alleviate the disease with associated symptoms without any side effects. It can be used in syndromic management of vaginal discharge. Future research is on large sample size.

scholarly journals Dynamics of proinflammatory cytokine serum levels in patients with acute inflammatory diseases of pelvic organs in the early stages of conservative treatment

2019 ◽  
Vol 9 (3-4) ◽  
pp. 612-616
Author(s):  
N. A. Burova ◽  
P. A. Soltys ◽  
N. A. Zharkin ◽  
M. S. Selikhova ◽  
N. I. Sviridova ◽  
...  
Keyword(s):  
Magnetic Field ◽  
Proinflammatory Cytokines ◽  
Inflammatory Diseases ◽  
Low Frequency ◽  
Serum Levels ◽  
Reproductive Age ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
Pelvic Organs ◽  
Frequency Laser

Dynamics of serum proinflammatory cytokines such as interleukins (IL)-1, -2 and -6, tumor necrosis factor alpha (TNFα) was examined in patients of reproductive age suffering from acute inflammatory diseases of the pelvic organs. Our study was carried out with female patients at hospital admission prior to therapy applied with conventional methods of treatment and improved treatment by using vaginal low-frequency laser in a constant continuous magnetic field. The data obtained were compared with serum cytokine level from 20 healthy female volunteers of reproductive age consulted on better contraception methods. It was found that cytokine profile of in patients with acute inflammatory processes in pelvic organs was characterized by a high level of proinflammatory cytokines. It was shown that patients receiving conventional treatment contained decreased level of serum IL-1, IL-2, IL-6 and TNFα displaying slight dynamics, which did not reach it in control group. This may contribute to ongoing inflammatory process, despite the positive clinical dynamics. In turn, imbalance of immune responses leads to a persistently impaired fertility in women and need to perform subsequent comprehensive rehabilitation measures. Moreover, patients applied with intravaginal low-frequency laser radiation in a constant magnetic field were found to contain serum TNFα < 100 pg/ml observed in 59.7% of cases, IL-6 level was lower than 20 pg/ml (prevalent in control group) found in 54.2% of cases. Serum IL-2 level was decreased by 3.5-fold compared to baseline, whereas for IL-1β it was higher than 100 pg/ml in as few as 23.6% patients. Such temporal pattern of inflammatory markers with rapid significant decrease of serum proinflammatory cytokines in patients with preformed pathogenic factors can reduce probability of connective tissue formation and activate their own repair as well as regenerative events. The results obtained allow to wider use combined physical interventional factors for therapy of patients with acute inflammatory diseases of the pelvic organs.

New approaches in complex therapy of inflammatory diseases of the pelvic organs in women of reproductive age

2017 ◽  
pp. 41-44
Author(s):  
O.V. Grischenko ◽  
◽  
T.A. Kozub ◽  
Keyword(s):  
Inflammatory Diseases ◽  
Reproductive Age ◽  
Control Group ◽  
Study Group ◽  
Complex Treatment ◽  
Women Of Reproductive Age ◽  
Urine Ph ◽  
Pelvic Organs ◽  
Standard Scheme ◽  
Group I

The objective: to study the efficacy of complex treatment of inflammatory diseases of the pelvic organs (vaginitis), occurring in conjunction with urinary tract infection (cystitis), with a combined medication of plant origin Tutukon produced by Miguel and Garriga, S. A. ("Grand medical Group AG", Spain/Switzerland) in women of reproductive age. Patients and methods. Were examined 60 women of reproductive age with the presence of vaginitis and associated cystitis. All the patients were divided into two clinical groups. In group I (control; n=30) treatment was carried out according to the standard scheme with the use of antimicrobial drugs, antispasmodics, local antiseptics for the sanitation of the vagina. In group II (study group; n=30) treatment was carried out according to the standard scheme with the inclusion of the drug Tutukon. All the patients were examined at 3-rd, 7-th, 10-th day of treatment and 30 days after discontinuation of therapy. Results. During the research was given the analysis of the dynamics of clinical and laboratory parameters in women of both groups before and after treatment. In patients of study group, the standard therapy which included Tutukon, the treatment was more effective than in patients of control group: a rapid onset of clinical effect, reducing the duration of the disease, a complete clinical response in 90% of cases versus 63%, alkalization of urine - pH 6.5±0.10, the absence of recurrence within 30 days after the end of therapy. Conclusion. Tutukon medicine is recommended for complex treatment of vaginitis, occurring in combination with cystitis in women of reproductive age. Key words: vaginitis, cystitis, dysuria, urine pH, Tutukon.

Reasoning of medical tactics at the preconception in patients with a history of miscarriage and abnormal vaginal discharge

2016 ◽  
pp. 52-56
Author(s):  
N.V. Schuruk ◽  
◽  
V.I. Pyrohova ◽  
Keyword(s):  
Vaginal Discharge ◽  
Patient Survey ◽  
Economic Benefits ◽  
Control Group ◽  
Positive Trend ◽  
Duration Of Treatment ◽  
Genital Infections ◽  
Reproductive Losses ◽  
Abnormal Vaginal Discharge ◽  
Complicated Pregnancy

The objective: evaluating the effectiveness and safety of the drug complex hinekit during preconception preparation for women with complicated pregnancy loss history and uncomplicated mixed genital infections. Patients and methods. The study involved 65 women with reproductive losses in history, who turned over the abnormal vaginal discharge. Diagnosis of sexual transmitted infections (C. trachomatis, T. vaginalis, HSV-II, HPV), assessment of vaginal microbiota was performed by PCR with detection results in real time. Bacterial Vaginosis verified by the Amsel system. Results. All the examinees in the history have miscarriage in the first (56.9%) or the second (43.1%) trimester of pregnancy. According to the results of the patient survey were divided into clinical groups. In 26.2% of women infectious pathology of the lower genital tract has not been confirmed, 26.2% of patients did not give consent to participate in the study and were formed in the control group that received therapy according to existing clinical settings. 31 patients with mixed genital infection (study group) received complex preparation gіnekit. This positive trend was observed in all the patients of the main group (the disappearance of subjective sensations on average 2.2±0.3 hours). After treatment T. vaginalis, BV were not detected in one patient, active mycotic process in the absence of complaints remained at 4.8% of women, complete eradication of C. trachomatis was achieved in 92.3% of patients. Conclusions. Reducing the duration of treatment of mixed genital infections at the preconception in women with reproductive losses in the history is achieved in terms of clinical, microbiological and pharmaco-economic benefits by prescribtion an gіnekit preparation. Summary of clinical and microbiological effects of the proposed approach is 96.0 ± 0.9%, which corresponds to all requirements for multimodal therapy of genital infections, and no side effects, short course of treatment provides a high compliance of patients (9.2±0.7 points). Key words: mixed genital infections, miscarriages, gіnekit, azithromycin, fluconazole, seknidazol.

scholarly journals Pyometra: An Atypical Cause of Abdominal Pain

2021 ◽  
Vol 9 ◽  
pp. 232470962110224
Author(s):  
Leonidas Walthall ◽  
Marc Heincelman
Keyword(s):  
Abdominal Pain ◽  
Vaginal Discharge ◽  
Elderly Women ◽  
Lower Abdominal Pain ◽  
Endometrial Biopsy ◽  
Laboratory Evaluation ◽  
Inpatient Service ◽  
Gynecologic Malignancy ◽  
Intravenous Contrast ◽  
Lower Quadrant

Pyometra, a purulent infection of the uterus, is a rare cause of a very common complaint—abdominal pain. Risk factors include gynecologic malignancy and postmenopausal status. The classically described presentation includes abdominal pain, fever, and vaginal discharge. In this article, we present an atypical presentation of nonperforated pyometra in an 80-year-old female who was admitted to the internal medicine inpatient service. She initially presented with nonspecific subacute right lower quadrant abdominal pain. Physical examination did not demonstrate vaginal discharge. Laboratory evaluation failed to identify an underlying etiology. Computed tomography scan of the abdomen and pelvis with oral and intravenous contrast demonstrated a 6.5 × 6.1 cm cystic containing structure within the uterine fundus, concerning for a gynecologic malignancy. Pelvis ultrasound confirmed the mass. Endometrial biopsy did not reveal underlying malignancy, but instead showed frank pus, leading to the diagnosis of pyometra. This report illustrates that pyometra should be considered in the differential diagnosis of lower abdominal pain in elderly women.

scholarly journals Per-vaginal Findings among the Women with Pelvic Inflammatory Diseases at a Tertiary Care Hospital in Dhaka City

2018 ◽  
Vol 8 (2) ◽  
pp. 90-93
Author(s):  
Tahamina Khanum ◽  
Nasima Begum ◽  
Kazi Mobina Akhter
Keyword(s):  
Vaginal Discharge ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Lower Abdominal Pain ◽  
Care Hospital ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Cervical Motion ◽  
Cervical Motion Tenderness

Background: Pelvic inflammatory disease (PID) is a major health problem for adult female. Women presented with pelvic inflammatory diseases give different per-vaginal findings. So we designed this study to assess the per-vaginal findings among the women presented with pelvic inflammatory diseases.Objective: The purpose of the present study was to measure the pervaginal findings among the women with PID.Materials and Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Dhaka Medical College & Hospital, Dhaka during January to June 2007. Women in the age group of 15−45 years presented with lower abdominal pain, tenderness, per-vaginal discharge and cervical motion tenderness were included in this study. After taking verbal consent from the patients, a pre-designed data collection sheet was filled in after per-vaginal examination.Results: The study was done on 50 cases, of which 20% patients had 1st degree perineal tear, 6% had utero-vaginal prolapse and 24% had foul-smelling vaginal discharge. Majority (90%) patients had healthy vagina. Ninety percent patients had anteverted uterus; and uterus was mobile in 60% cases. Cervical motion tenderness was present in 44% cases, tenderness of fornix was found in 34% cases and thickening of fornix was found in 22%.Conclusion: In this study first degree perineal tear, foul smelling vaginal discharge and cervical motion tenderness are the commonest findings among the women presented with pelvic inflammatory diseases.J Enam Med Col 2018; 8(2): 90-93

scholarly journals APC-resistance as a possible predictor of recurrent thrombosis in women with Factor V Leiden

2018 ◽  
Vol 67 (6) ◽  
pp. 50-59 ◽  
Author(s):  
Maria G. Nikolayeva ◽  
Andrey P. Momot ◽  
Marina S. Zaynulina ◽  
Ksenia A. Momot ◽  
Natalia N. Yasafova
Keyword(s):  
Thrombotic Event ◽  
Activated Protein C ◽  
Factor V Leiden ◽  
Resistance Index ◽  
Reproductive Age ◽  
Control Group ◽  
Factor V ◽  
Recurrent Thrombosis ◽  
Apc Resistance ◽  
Venous Thromboembolic

Hypothesis/aims of study. The current analysis was undertaken to elucidate the role of Factor Va resistance to proteolytic cleavage by activated protein C in FVL(1691)GA female carriers in the development of acute and recurrent thromboses. Study design, materials and methods. A prospective clinical cohort study of 1100 women of reproductive age was conducted, with the course and outcomes of 2,707 pregnancies analyzed. Two cohorts were specified: the main group consisted of 500 patients with FV(1691)GA genotype, and the control group consisted of 600 patients with FVL(1691)GG genotype. Results. FVL(1691)GA genotype was significantly associated with the development of venous thromboembolic complications (VTEC) compared to FVL(1691)GG genotype (OR 9.3; p < 0.0001). Episodes of recurrent thrombosis during and outside of pregnancy were registered only in FVL(1691)GA patients (OR 5.7, p = 0.2). In all cases, at the time of the thrombotic event and during the period before the episode of acute or recurrent thrombosis, an APC resistance normalized ratio (NR) value was ≤ 0.49, with no episodes of VTEC registered with an APC resistance NR value ≥ 0.5. Conclusion. Venous thromboses occur under the condition of expressed APC resistance with underlying FVL(1691)GA carriage. The APC resistance index can serve as an objective biochemical marker to determine the feasibility of thromboprophylaxis within the framework of personalized medicine.

A Phase II Randomized Controlled Trial to Evaluate the Safety and Efficacy of Praneem Polyherbal Vaginal Tablets Compared With Betadine Vaginal Pessary in Women With Symptoms of Abnormal Vaginal Discharge

2009 ◽  
Vol 21 (4) ◽  
pp. 461-468
Author(s):  
Sudha Salhan ◽  
Vrijesh Tripathi ◽  
Raman Sehgal ◽  
Gaurav Kumar ◽  
Gursaran P. Talwar ◽  
...  
Keyword(s):  
Vaginal Discharge ◽  
Reproductive Tract ◽  
Controlled Trial ◽  
Lower Abdominal Pain ◽  
Phase Iii ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Vaginal Pessary ◽  
Abnormal Vaginal Discharge ◽  
Tract Infections

Abnormal vaginal discharge (AVD) caused by a variety of reproductive tract infections is a widespread syndrome among women in India and in other developing countries. The purpose of this study was to determine whether a polyherbal formulation, Praneem, can be used for the regression of the syndrome. A phase ΙΙ randomized controlled study was carried out with Praneem polyherbal tablets and Betadine vaginal pessary in 99 women with AVD. The authors found that 92% of women using Praneem were relieved of their symptoms of AVD as against 81.6% women using Betadine. Significant reduction was also seen with both treatments in lower abdominal pain, vaginal itching, and dysuria. Thus, the study indicates the efficacy of Praneem for the treatment of AVD and provides a rationale for planning a further Phase III study on a larger sample size for definitive conclusions.

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