scholarly journals An analysis of endometrial bleeding patterns in perimenopausal women

2017 ◽  
Vol 6 (7) ◽  
pp. 2776
Author(s):  
Mukhopadhyay Indrani ◽  
Rao P. S. ◽  
Nataraj S. ◽  
Manash Biswas
Keyword(s):  
Clinical Diagnosis ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Armed Forces ◽  
Uterine Bleeding ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Menstrual Irregularities ◽  
Study Population

Background: Perimenopause is the period surrounding menopause characterized by ovulatory dysfunction and menstrual irregularities. Taking into consideration the importance of perimenopause and its consequences, we decided to study this topic in order to know the different menstrual irregularities in relation to age, the spectrum of endometrial histopathology, in relation to various gynaecological conditions as per the PALMCOEIN classification of AUB.Methods: The study population comprised of 100 women in the age group of 40- 59 years who reported to our tertiary care centre of Armed Forces for evaluation of abnormal uterine bleeding. The study was a community based cross - sectional descriptive study. Patients were examined, using one of the three techniques – Dilatation and curettage, suction aspiration and hysteroscopy and endometrial biopsy.Results: Out of the 100 women evaluated for perimenopausal bleeding, heavy menstrual bleeding was the commonest in 53% cases. The maximum no. of cases was in 40-44-year age group (57.44 %). The clinical diagnosis of fibroid uterus was found in 45% cases, AUB (O) in 36% cases, AUB (Polyp) in 8% cases, AUB (Adenomyosis) in 9% cases and AUB (Malignancy) in 2% cases. On endometrial curettage, proliferative type of endometrium was found in 43% cases, secretory type in 18% cases and hyperplasia was found in 37% cases. Out of 2 cases of atypical hyperplasia 1 case each (50%) was found in the age group of 50-54 years and 55-59 years, respectively.Conclusions: In the present study, there was good correlation between abnormal uterine bleeding, clinical diagnosis and histopathological findings.

scholarly journals Profile of animal bite cases at immune prophylaxis clinic, tertiary care centre

2017 ◽  
Vol 4 (7) ◽  
pp. 2587
Author(s):  
Jyoti Dattaramji Bhise ◽  
Swati Dattaramji Bhise
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Age Group ◽  
Care Centre ◽  
Class Iii ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
First Case ◽  
Rabies Control ◽  
Study Population

Background: Animal bite, one of the common causes of physical injuries in spite of a long standing nature of the dog bite problem and the presence of effective intervention strategies for rabies control, it continues to pose a major public health challenge to program planners. So the present study is conducted to study Profile of animal-bite cases at immuno-prophylaxis clinic, at tertiary care centre.Methods: The present study was an observational cross-sectional study carried out at immune prophylaxis clinic of tertiary care centre, from 1st January 2013 to 31st December, 2013. All the registered cases of animal bite attending immune-prophylaxis clinic, which are ready to participate in the study were included as study population. The method used was systematic random sampling. First case was selected randomly using lottery method and then every fifth case reporting to immune prophylaxis clinic was taken in the study group. Total 3504 cases of animal bite were reported during the study period. 20% of these i.e. 700 cases of animal bite were included in the study.Results: Out of 700 study subjects, highest number of bites occurred in the age group 21-30 years i.e. 155 (22.1%). Maximum study subjects 471 (67.3%) were from urban area and 53% of bites occurred during daytime. Maximum cases were the class-III bite i.e. 600 (85.7%).Conclusions: Maximum number of bites seen among 21-30 years of age group predominantly seen among male study subjects. 49.6% study subjects were bitten by pet animals and 47.6% were bitten by stray animals. Dog was the principle animal responsible for the bite of study subjects. 85.7% of study subjects were of class III bite among them 75% study subjects had reported to hospitals within 24 hours. Severe the degree of exposure, earlier was reporting to the hospital was statistically significant.

scholarly journals Prevalence of adenomyosis and associated gynaecological pathologies in hysterectomy samples: a retrospective study

2021 ◽  
Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya
Keyword(s):  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Serous Cystadenoma ◽  
Uterine Bleeding ◽  
Research Centre ◽  
Common Symptom ◽  
Age Group ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Case Record

Background: Adenomyosis is a prevalent gynaecological disorder among women and it is a major cause for AUB. Its diagnosis is confirmed by histological examination of hysterectomized samples. Moreover it is associated with other benign gynaecological pathologies. The aim of this study is to identify the prevalence of Adenomyosis and its association with other benign gynaec pathologies in hysterectomized samples.Methods: This retrospective of two year duration was conducted in obstetrics and Gynaecology department of Malabar Medical College Hospital and Research Centre, a tertiary care centre in Kozhikode, Kerala from 2019 June to 2021 June. 452 patients underwent hysterectomy for abnormal uterine bleeding during this period. Among this, 76 patients had histologically proven adenomyosis in hysterectomy specimen and their case record were reviewed and the data was analysed.Results: The prevalence of Adenomyosis in this study was 16.8%. Majority of women were in age group of 41 to 46 (36.8%), followed by 46 to 50 age group (26.3%). 94 % of women were multipara with majority in para2 and para3 group. Only 6 % of women were nulliparous. Most common symptom was abnormal uterine bleeding (92%), followed by dysmenorrhoea and chronic pelvic pain. Majority had overlap of symptoms. 7% of women were asymptomatic. In 60 % of women no other gynaec pathologies were identified. Most common associated pathology was leiomyoma (15.8%), closely followed by endometriosis (13.2%). Endometrial hyperplasia was associated with adenomyosis in 3.9%of women and endometrial polyp in 2.6%. Ovarian pathologies identified were simple ovarian cyst (2.6%) and serous cystadenoma (1.3%).Conclusions: In the present study, the prevalence of adenomyosis was high and abnormal uterine bleeding was the patients’ most prevalent complaint. Among the associated gynaec pathologies, leiomyoma had the highest correlation with adenomyosis.

scholarly journals CLINICO-PATHOLOGICAL EVALUATION OF PATIENTS WITH ABNORMAL UTERINE BLEEDING

2021 ◽  
Vol 71 (3) ◽  
pp. 870-74
Author(s):  
Rabiah Anwar ◽  
Nighat Jamal ◽  
Sobia Anwar
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Clinical Spectrum ◽  
Menstrual Bleeding ◽  
Age Group ◽  
Cross Sectional ◽  
Gynecology And Obstetrics ◽  
Menstrual Irregularities

Objective: To evaluate clinical spectrum in women of different age groups presenting with menstrual irregularities without any organic pelvic pathology and to correlate clinical and pathological aspects in these women. Study Design: Cross sectional analytical study. Place and Duration of Study: Department of Gynecology and Obstetrics, Pakistan Naval Ship (PNS) Shifa Hospital, Karachi from Feb 2018 to Jan 2019. Methodology: Complete history, clinical examination, laboratory investigations, pelvic scan and endometrial biopsy of patients were done to diagnose abnormal uterine bleeding without organic (structural) pathology. Evaluation of clinical spectrum of menstrual irregularities in different age groups and histopathology of their endometrial samples was done. Results: A total of 184 cases were included. Mean age of patients presented with abnormal uterine bleeding was 38.49 ± 9.158. It was most common in the age group 41-50 years (41.84%) followed by 31-40 years (29.34%). Majority of them were multipara 146 (79.34%). The most common presentation was heavy menstrual bleeding (50.54%) followed by irregular menstrual bleeding (17.93%). Histopathology of endometrium revealed proliferative (41.30%) followed by hyperplastic (27.71%) and secretory (21.19%) pattern. 3.26% had atrophic endometrium and 1.63% cases had endometrial carcinoma. Conclusion: In conclusion, 41-50 year age group was mostly affected by abnormal uterine bleeding. Their menstrual pattern was heavy, irregular, frequent and prolonged. Proliferative and hyperplastic pattern of endometrium was observed in these patients.

scholarly journals Etiological factors of abnormal uterine bleeding according to PALM- COEIN classification in perimenopausal women in a tertiary care centre

2020 ◽  
Vol 9 (2) ◽  
pp. 799
Author(s):  
Nishi Mitra ◽  
Pooja Patil ◽  
Ayushi Sethia
Keyword(s):  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
Ovulatory Cycle ◽  
New Classification ◽  
Tertiary Care Centre ◽  
Ovulatory Dysfunction ◽  
Perimenopausal Women ◽  
Structural Abnormalities

Background: Perimenopause is described as years prior to menopause that encompasses the change from normal ovulatory cycle to cessation of menses, ending 12 months after the last menses. International federation of gynaecology and obstetrics (FIGO) developed a new classification PALM-COEIN in order to standardize the factors associated with AUB. It classifies AUB as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia (PALM) - structural abnormalities Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified (COEIN) - unrelated to structural abnormalities. Objectives of this study were to categorise the causes of AUB in perimenopausal women in context to PALM COEIN classification system. Correlation of co-morbities (diabetes, hypertension and thyroid disorders) with AUB in perimenopausal age group.Methods: This is a retrospective study from the month of May 2019 to October 2019, considering 100 patients of perimenopausal age group (40 to 55 years of age group) in J. K. Hospital Bhopal, Madhya Pradesh with complaints of abnormal uterine bleeding, admitted in gynae ward.Results: Most of the patients in the current study were between 45-50 years of age i.e. 44%. Menorrhagia was the commonest menstrual disorder encountered in 52% of patients. As per FIGO; AUB-L constituted 42% AUB-O constituted 12%, AUB-P constituted 11%, AUB-A 10%, AUB-M constituted 8% AUB-E constituted 8%, not yet classified constituted 4% of total cases.Conclusions: AUB (PALM-COEIN) for causes of abnormal uterine bleeding classification was very useful in categorizing cases of AUB. It suggests that etiology of AUB and also gives place for presence of multiple factors as a cause of AUB in a particular case.

scholarly journals CLINICAL PROFILE OF INTUSSUSCEPTION IN CHILDREN ADMITTED TO A TERTIARY CARE CENTRE IN KERALA

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Neethu Jose ◽  
Aparna Namboodiripad ◽  
Regi George A N
Keyword(s):  
Tertiary Care ◽  
Spontaneous Resolution ◽  
Reduction Technique ◽  
Clinical Profile ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hydrostatic Reduction ◽  
Duration Of Hospital Stay ◽  
Study Population

Background and objectives: Intussusception is the commonest cause of bowel obstruction and is one of the common abdominal emergencies in children younger than 2 years of age.The objective of the study was to assess the clinical profile of intussusception in children and the management and the outcome  and  to assess whether the characteristics mentioned in clinical profile are predictive of subsequent management and outcome of the disease. Methods: A hospital based descriptive study conducted in a tertiary care centre in Kerala, using purposive sampling technique. 120 children admitted with diagnosis of intussusception   fulfilling inclusion criteria and whose parents consented for study were included in the study population, during the study period from November 2018 to June 2020. Detailed history, clinical examination including per rectal examination  and USG was done to make diagnosis of intussusception in suspected cases. Follow up is done at 72 hours,1 week after the admission and 1month later. To assess the clinical profile and outcome of patients, frequency and percentage is used. To obtain the association of clinical profile with outcome chi square test is applied. Results: Outcome of the problem was correlated with age, sex, symptoms, risk factors sonological findings treatment protocol and duration of hospital stay. Out of the 120 children in study population, majority were males(65.8%) with male to female ratio 1.9:1 and majority was in the age group 7- 12 months, which is similar to many other similar studies. Maximum number of cases were in the month of February(14.2%) and November(15%).  Majority of the patients(57.5%) presented to healthcare facility within 24 hours of onset of first symptom.Irritability was the most common clinical symptom(62.5%) followed by vomiting(58.3%) and abdominal pain(49.2%). Ileocolic intussusception (96.7%) was the commonest type. Majority of the cases could be managed with hydrostatic saline reduction(73.3%) and significantly lesser number of patient went for surgical intervention(7.5%) and spontaneous resolution(19.2%). Conclusions: Incidence of intussusception is more common among males and more in the 7-12 month age group.  Majority of the cases presented to health care facility within 24 hours of onset of symptom and could be managed with hydrostatic reduction technique and had a shorter duration of hospital stay compared to surgical reduction technique. Even recurrent cases could be managed with hydrostatic saline reduction. Keywords: Intussusception;  Intestinal obstruction;  Hydrostatic reduction; Spontaneous resolution

scholarly journals The study of thyroid profile in abnormal uterine bleeding at tertiary care center, Rajasthan, India

2019 ◽  
Vol 8 (6) ◽  
pp. 2429
Author(s):  
Dinesh Gurjar ◽  
Purnima Pachori ◽  
Sandhya Chaudhary ◽  
Dharmendra Singh
Keyword(s):  
Thyroid Dysfunction ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Selective Screening ◽  
Age Group ◽  
Subclinical Disease ◽  
Menstrual Irregularities ◽  
Thyroid Abnormalities ◽  
Reproductive Age Group

Background: Hypothyroidism and Hyperthyroidism leads to menstrual irregularities. Females with thyroid gland abnormality have chances of reproductive abnormalities ranging from abnormal sexual development, menstrual irregularities, infertility and premature menopause. The objectives were to study the association between thyroid dysfunction and AUB in the reproductive age group (18-45 years), To study the thyroid abnormalities in different types of AUB in the reproductive age group, to establish if screening for thyroid abnormalities is justified using T3, T4 and TSH.Methods: This cross-sectional study conducted among 250 women with ‘abnormal uterine bleeding’ (AUB). Inclusion criteria for participants were females in the age group of 18-45 years, females presenting with abnormal uterine bleeding, with thyroid dysfunction, females who do not have signs of demonstrable pelvic pathologyincluding PID.Results: Majority of the patients belonged to the age group of 24 - 32 years i.e.56.8%, 9.2% cases were nullipara, 44.0% cases have menorrhagia, 32.2% have oliogomennorrhea, 19.6% have amenorrhea. Around 3.6% had Thyromegaly, 12.4% have weight gain in hypothyroidism, 28.4% have fatigue in hyperthyroidism, 6.8% cases have higher T4 level, 18.0% cases have higher TSH level.Conclusions: The risk of progression to overt hypothyroidism (about 5% per year) in patients with subclinical disease and the cost-benefit ratio also emphasises the need for selective screening. Early detection of subclinical disease by selective screening facilitates appropriate therapy early in the course of the disease.

scholarly journals Assessment of thyroid and prolactin levels among the women with abnormal uterine bleeding

2017 ◽  
Vol 6 (6) ◽  
pp. 2547
Author(s):  
Jovita Deepthy John ◽  
Vimala Damodaran ◽  
Shankar Radhakrishnan
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
High Serum ◽  
Uterine Bleeding ◽  
Serum Prolactin ◽  
Age Group ◽  
Free T4 ◽  
Cross Sectional ◽  
The Mean ◽  
Tsh Levels

Background: Thyroid disorders are 10 times more common in women than men.1 Menstrual disturbances usually accompany clinical alterations in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from either hypo or hyper thyroidism. A high serum prolactin level can distrurb the follicular maturation and corpus luteum function, and leads to inhibition of normal pulsatile secretion of gonadotrophin-releasing hormone in hypothalamus resulting in anovulation. The aim of the study was to assess the thyroid and the prolactin levels among the women with abnormal uterine bleeding and to evaluate the association between them by comparing with normal females.Methods: A cross sectional study was conducted for a period of one year between Jan 2016 and December 2016 in our institution at the gynaecology OPD. Patients in the age group of 15 to 45 with the complaints of abnormal uterine bleeding and with the ultrasound findings showing normal uterus and ovary were included in the study. Hundred age and sex matched controls without any complaints of abnormal uterine bleeding in the age group of 15 – 45 years were also included in the study. Free T3, Free T4, TSH and prolactin estimation was done by chemiluminescent immunoassay for both the patients and the controls.Results: The mean TSH levels among the cases were much higher than that of the controls and the difference in the levels found to be statistically significant. Similarly, hyperprolactinemia was found in 18 cases when compared to 2 cases in controls and the mean prolactin levels were higher in cases. The serum prolactin levels and the serum TSH levels showed a perfect positive correlation which indicates that as the TSH level increases prolactin levels also increases with the R value >0.5.Conclusions: Early detection of hypothyroidism in such subjects saves the patient from recurrent curettage and at times hysterectomy. The financial implications of screening for prolactin/thyroid hormone abnormalities will have to be evaluated before a general recommendation can be made.

scholarly journals Role of diagnostic hysteroscopy in evaluating patients with abnormal uterine bleeding in a tertiary care centre

2021 ◽  
Vol 10 (12) ◽  
pp. 4464
Author(s):  
Apeksha M. Mohite ◽  
Deepali S. Kapote ◽  
Michelle Fonseca
Keyword(s):  
Tertiary Care ◽  
Screening Method ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Uterine Bleeding ◽  
Systematic Evaluation ◽  
Contraceptive Device ◽  
Tertiary Care Centre

Background: Abnormal uterine bleeding is one of the commonest conditions amongst patients attending gynaecology OPD which also leads to significant disruption in a normal lifestyle. The causes of abnormal uterine bleeding are heterogeneous and complex. A systematic evaluation with detailed history and physical examination is foremost important in reaching diagnosis. Hysteroscopy is not only safe, quick and observes entire uterine cavity but also helps in precision in sampling and increases accuracy of diagnosis. It is also curative in conditions such as polyps, fibroids, uterine synechiae, menorrhagia and lost intrauterine contraceptive device. The aim of the study is to evaluate the role of hysteroscopy as a screening method in patients with AUB & compare to their USG findings and to the histopathological reports of the endometrial biopsy.Methods: This is a prospective observational study conducted at a tertiary healthcare centre over a period of 18 months, in 50 females belonging to pre, peri and post-menopausal age group. Sampling was done based on selection criteria after obtaining valid consent from the study group.Results: Hysteroscopy has a definitive role in evaluation of patients presenting with abnormal uterine bleeding with high sensitivity, specificity, PPV and NPV with immediate results.Conclusions: The above study concludes that the accuracy of diagnosing the cause of abnormal uterine bleeding is more with hysteroscopy followed by D and C then USG combined with D and C.

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