scholarly journals Etiologic characterization of vulvovaginitis among females attending a tertiary care hospital: a one year study

Author(s):  
Chembetei Kavitha Kiran ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti

Background: Vulvovaginitis is one among the major pathologies encountered in reproductive age group. Etiologies are always multiple and candidiasis, bacterial vaginitis and trichomoniasis account for 90% of etiology. The incidence is dependable upon multiple factors like age group, ethnicity, socioeconomic status, geographical locale. Improperly treated and untreated vulvovaginitis is associated with long term complications like infertility, pelvic inflammatory disease in nulliparous females and preterm labour, miscarriage, ectopic pregnancy, chorioamnionitis among pregnant females and recurrent UTIs, cervicitis, endometritis, increased risk of acquiring STIs among normal females. The present study was undertaken with the objective of understanding the etiologies associated with vulvovaginitis among women attending Obstetrics clinic of a tertiary care hospital. The risk factors associated with the conditions, the features of the vaginal discharge and symptoms associated with each etiology were studied.Methods: A cross sectional study for a period of one year was conducted among 200 female patients attending the Department of gynecology for vaginitis and evaluated for etiology. Patient’s risk factors, clinical history, symptoms were collected by questionnaire and specimens were collected from all the cases and processed as per standard guidelines. Bacterial vaginosis was confirmed based on Neugent’s criteria, Trichomoniasis by wet mount examination and candidiasis by culture. The study was approved by the institutional ethical committee.Results: 137 cases of vulvovaginitis were diagnosed based on etiology. Vulvovaginitis was most common among 27-36 years and in multiparous women. Most common causative agent was Candida (59.12%) followed by bacterial vaginosis (22.63%) and Trichomoniasis (18.25%). Vaginal discharge was the commonest symptom (100%) followed by malodor and vulval irritation. Following unhygienic practices was the commonest risk factor associated with Vulvovaginitis.Conclusions: A regular evaluation is mandatory for all the females attending hospital for vaginitis. Successful management reduces the morbid conditions and it’s essential to treat the conditions during the pregnancy which prevents the complications associated like preterm birth, miscarriage etc. and adverse outcomes.

Author(s):  
Ved Prakash ◽  
Prem P Mishra ◽  
Lata Agrawal ◽  
HK Premi

ABSTRACT Background Bacterial vaginosis (BV) is highly prevalent among women especially in reproductive age group but it is found also in other age groups. Bacterial vaginosis is a great health concern in India because of its complications. Most of the healthcare centers in India are not well-versed in advance diagnostics for BV. Aim To assess the utility of conventional methods for diagnostic evaluation of BV in the patients of different age groups. Materials and methods In this 1 year cross-sectional study, the vaginal swabs were collected from women with signs and symptoms of BV like complaints of vaginal discharge, odor, itching, back ache, etc. attending the department of obstetrics and gynecology of a tertiary care hospital in Western UP. These specimens are subjected to vaginal pH determination and are sent to department of microbiology for Gram stain, wet-mount and whiff test. Amsel's criteria were used for confirming BV. Results A total of 206 women included in the study, n = 63 (29.61%) were found to be having BV based on Amsel's criteria. The mean age of the females were found to be 30.77 years. The most affected age group was found to be 26 to 35 years, n = 33 (54%). The vaginal pH was significantly higher in n = 61 (29.61%) women with BV. Vaginal discharge was prevalent in n = 108 (52.43%) women. Presence of clue cells and positive whiff test were found to be in n = 63 (30.58%) and n = 61(29.61%). Conclusion The characteristics of vaginal discharge, vaginal pH determination, clue cells and whiff test is relatively easier conventional methods for diagnosis of women with BV where better facilities are lacking. These tests are suitable for screening women with BV and in formulating the treatment to check the complications. How to cite this article Mishra PP, Prakash V, Agrawal L, Premi HK. Diagnosis of Bacterial Vaginosis by Conventional Methods in the Patients at a Tertiary Care Hospital. Int J Adv Integ Med Sci 2016;1(1):1-3.


Author(s):  
Basant Kumar Pati

Background: Ectopic pregnancy is a life-threatening emergency which is one of the important cause of maternal mortality. Ectopic pregnancy must be suspected in any woman in the reproductive age group, presenting with lower abdominal pain or vaginal bleeding. Our aim was to review all cases of ectopic pregnancy and determine the incidence, high risk factors, types of clinical presentation and mode of management.Methods: This was a retrospective cohort study, conducted at a tertiary care hospital. Medical records of all women with an ectopic pregnancy between 2016 and 2017 were seen. Demographic data, risk factors, clinical features, and mode of management were noted.Results: 90 patients, diagnosed with ectopic pregnancy during last one year was included in the present study, with an incidence of 1.2%. Majority of women were aged 20-30 years (50%). 74.4% cases were ruptured ectopic. The most common risk factors were previous ectopic (50%) and pelvic inflammatory disease (17.7%). Lower abdominal pain was seen in 80 (40.3%) patients. Majority of patients (91.1%) had tubal ectopic pregnancies. Most common mode of treatment was salpingectomy.Conclusions: Risk factors for ectopic pregnancy must be enquired and early diagnosis and management to be done to avoid maternal morbidity and mortality.


2013 ◽  
Vol 2 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Ajay Risal ◽  
Pushpa Prasad Sharma ◽  
Rajkumar Karki

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630


Author(s):  
Ushadevi Gopalan ◽  
Sathiyakala Rajendiran ◽  
Karthika Jayakumar ◽  
Ranganathan Karnaboopathy

Background: Bacterial vaginosis is the most prevalent lower genital tract infection in women of reproductive age. The aim of this study was to identify the causative organism in patients with vaginal discharge and to study the sensitivity of the organism to antibiotics.Methods: This was a hospital based prospective study in Department of Obstetrics and Gynecology in a tertiary care hospital over a period of two years. 2062 women with complaints of vaginal discharge were subjected to a high vaginal swab and the sample was cultured, the organisms were identified and antibiotic susceptibility was tested.Results: There was no growth found in 40.7% of patients. E. coli was found to be the most common organism isolated followed by Klebsiella pneumonia and Klebsiella oxytoca. Candida species was isolated in 1.4 % of women. An increased frequency of vaginal infection was found in the age group 26-35 years, followed by age group 36-45 years. 73.2% of the organisms were sensitive to Imipenam, 70.4 % to Amikacin and 65.7% to Gentamycin. There were 10 MRSA strains isolated all of which were sensitive to Vancomycin, Amikacin and Gentamycin.Conclusions: Our study provides information about the different microorganisms present in women with vaginal discharge. Since pathogenic bacteria were more common than Candida species it is recommended to offer treatment to patients after taking a high vaginal swab. Appropriate antibiotics based on culture and sensitivity has to be given along with antifungal agents.


2019 ◽  
Vol 6 (3) ◽  
pp. 916
Author(s):  
Prashant R. Shinde ◽  
Meghraj J. Chawada ◽  
Sudhir B. Deshmukh

Background: In hemorrhoids, the anal canal venous plexuses become engorged. It can lead to bleeding, thrombosis, prolapse, pain. Study of surgical profile helps to educate the patients to take proper precautions to avoid the severe forms of it. The objective of the study was to study the surgical profile of patients with hemorrhoids at a tertiary care hospital.Methods: Present study was hospital based cross sectional study. It was carried out at a tertiary care hospital in the department of general surgery among 100 patients who presented with symptoms suggestive of hemorrhoids during the study period from 1st January 2017 to 31st October 2018.Results: Majority of the patients 41% were in the age group of 35-45 years. The number affected by hemorrhoids was more in males i.e. 56%. Incidence of hemorrhoids was more in upper class. Incidence of hemorrhoids was less i.e. 21% among those who took only vegetarian diet. Majority of the patients (78%) presented after one year of occurrence of treatment. 54% of the patients had third grade of hemorrhoids. Bleeding was present in the majority i.e. 98% of the patients. On anorectal examination, it was found that 44% of the patients had fissure and 23% of the patients had peri anal skin tag. Anorectal examination was within normal limits in 33% of the cases.Conclusions: Vegetarian diet may be protective against hemorrhoids. Bleeding was the most common presenting symptom. Thus, study helped to identify that being male, younger age group, non-veg diet may be the risk factors for hemorrhoids.


Author(s):  
Rema V. Nair ◽  
Raja Preethi ◽  
M. Vijayalekshmi

Background: Vaginal discharge in reproductive age poses a serious problem in the developing countries. Bacterial vaginosis also known as non-specific vaginitis is the most common cause of vaginal infections, detecting the organism at an early stage and initiating a proper treatment is very difficult in our country due to lack of awareness and proper follow-up. The disease manifests in the form of vaginal discharge with or without itching. It has a strong association with preterm labor, preterm premature rupture of membranes and low birth weight in pregnancy. The objective of this study was to find out the prevalence of bacterial vaginosis among the reproductive age group women, in a tertiary care centre.Methods: A cross sectional study was conducted among 150 women of the reproductive age group in the department of obstetrics and gynaecology Sree Mookambika Institute of Medical Sciences over a period of one month October 2018 the diagnosis was made with history and nugents scoring system.Results: Out of the total 150 women enrolled in the study 74 had positive results, 50% of them were of the age group 26-30.Conclusions: The study shows us the high prevalence of bacterial vaginosis.


Author(s):  
Arati Behera ◽  
Ranjita Ghadei ◽  
Rudra Narayan Bal

Background: Ectopic pregnancy is a life-threatening emergency commonly encountered by medical practitioner. Diagnosis is frequently missed and should be considered in any women in the reproductive age group with abdominal pain or vaginal bleeding. The aim of the study is to assess the incidence, clinical presentation, risk factors, methods of diagnosis, treatment, outcome and complications.Methods: This was a prospective study at S.C.B. Medical college from January to December 2017. Parameters like age, parity, gestational period, risk factors, clinical presentations, findings on ultrasonogram and at surgery with morbidities associated with diagnosed cases of ectopic pregnancy (n=93) were noted and analysed with SPSS-19 software.Results: Incidence of ectopic pregnancy was 18/1000 deliveries. Maximum cases were in age group of 21 to 30 years (54.8 %) and parous (76.3%). Common risk factors were having history of abortions (46.2%), previous tubal sterilization (24.7%), having one or more caesarean section (17.2%) and h/o infertility (16.1%). Most common symptom was pain abdomen (96.8%). Commonest site was ampullo-isthmic region of tube and rupture was the commonest mode of presentation. All underwent laparotomy and unilateral salpingectomy was done in 86 % of cases. It contributed to 3.27 % of total maternal deaths.Conclusions: Suspicion in high risk group can direct one to investigate and diagnose early, thereby reducing morbidity, mortality and improving the prospect of future fertility.


2012 ◽  
Vol 34 (2) ◽  
pp. 44-50 ◽  
Author(s):  
AKM Moinuddin ◽  
Md Mizanur Rahman ◽  
Shaheen Akhter ◽  
Syeda Tabassum Alam ◽  
CA Kawser

Objective: Identifying the risk factors of poor seizure control in children in a setting of tertiary care hospital. Design: Retrospective study. Setting: Child Development and Neurology Unit in the department of Paediatrics of Bangabandhu Sheikh Mujib Medical University (BSMMU). Study period: January 2004 through December 2005. Subjects: One hundred and twenty epileptic children were studied. They were grouped into controlled group (seizure free for more than six months) and poorly controlled group (having one or more seizure per month over a period of six months or more and who had experienced trials of at least two different antiepileptic drugs at optimum doses alone or in combination with adequate compliance) at the end of intervention and compared. Results: In this study 76 (63.3%) children were male and 44 (36.7%) children were female. Out of 120 cases 79 (65.8%) were in controlled group and 41 (34.2%) cases had poorly controlled epilepsy. Mean age of the controlled group and poorly controlled group of children were 79 months and 40.3 months respectively. Focal epilepsy was found in 30 (68%) cases in controlled and in 14 (31.8%) cases of poorly controlled group and generalized epilepsy was found in 42 (72%) cases in controlled and in 19 (28.8%) cases in poorly controlled group. Idiopathic epilepsy was more common which was 37 (46%) in controlled group against 14 (34%) in poorly controlled group. But symptomatic and cryptogenic cases were more prevalent with poorly controlled group 57.5% than controlled group 53%. In poorly controlled group 48.8% had cerebral palsy in comparison to 22.8% of controlled group. Early onset of seizure before one year was 25.3% in controlled and 78% in poorly controlled group (odds ratio=.2322, p =.0082) and one or more seizure per week 43% in controlled and 92.7% in poorly controlled group (odds ratio=.1218, p=.0032) were found as risk factors of poorly controlled epilepsy. Conclusion: Early onset of seizure before one year, symptomatic epilepsy and one or more seizure per week at diagnosis were found as risk factors of poorly controlled epilepsy in children attending a tertiary care hospital. DOI: http://dx.doi.org/10.3329/bjch.v34i2.10216 BJCH2010; 34(2): 44-50


2021 ◽  
pp. 49-50
Author(s):  
Neha Yadav ◽  
Sonu Panwar

In women of reproductive age, vaginal discharge is one of the most frequent signs. Vaginal discharge may be physiological or pathological; thus, this study was conducted to ascertain the microbial diversity of vaginal discharge cases in relation to socioeconomic status and demographic history among women of reproductive age attending a tertiary care hospital. To diagnose the organism, simple wet laboratory preparation, 10% KOH, Gram staining, and pH paper were used, while to classify and categorise the pathogens, various differential agar media such as CHROM agar, Blood agar, and Sabouraud Dextrose agar were used, followed by some biochemical tests and the use of the Nugent Score. The majority of the patients were between the ages of 22 and 28. The patients were all from the lower middle class 41. (37.61 percent ). Microbial diagnosis revealed that 45 percent of patients had Bacterial Vaginosis, 41 percent had Candidiasis, 5% had Trichomoniasis, and 9% had both Bacterial Vaginosis and Candidiasis..


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