scholarly journals Clinical study of ectopic pregnancy

Author(s):  
Meenakshi T. Chate ◽  
Bhagyashree Chate ◽  
Kranti Chate

Background: Ectopic pregnancy is pregnancy that develops following implantation anywhere other than the endometrial cavity of uterus. Objective of present study was to investigate the risk factors, clinical presentation and sites of ectopic pregnancy along with management and assessment of risk of maternal mortality and morbidity.Methods: The study was undertaken at Dr. Shankar Rao Chavhan Government Medical College and Guru Govind singhji hospital, Nanded between December 2012 and May 2014 after obtaining clearance from the Hospital Ethical Committee.Results: Maximum incidence of tubal gestation occurred between the age group of 21-25 years. Greater incidence was noted in multiparous woman. Tubectomy was the most common risk factor seen in 23.65% cases. The most common symptom observed is abdominal pain seen in 92.47% cases. The most common site of ectopic was ampulla seen in 51.61% cases. The most common mode of presentation was rupture seen in 71 cases about 76.35% cases. Unilateral salpingectomy was done in 70 cases about 75.26% cases.Conclusions: Since ectopic pregnancy remains a gynecological catastrophe in countries and a major challenge to the reproductive performance of women worldwide, it should be considered a relevant public health issue. With its rising incidence, which is likely to continue increasing because of the various factors discussed, it is necessary to devise means of early detection and treatment.

2021 ◽  
Vol 18 (4) ◽  
pp. 698-701
Author(s):  
Sita Pokhrel Ghimire

Background: Ectopic pregnancy can be managed expectantly, medically or surgically. Laparoscopic surgery is considered gold standard. The aim of this study was to find incidence, risk factors, clinical presentation and mode of management of ectopic pregnancy.Methods: Prospective descriptive study was conducted at Nobel Medical College and Teaching Hospital, Biratnagar. All the cases of diagnosed ectopic pregnancy were enrolled in the study. All the relevant data of the patients were recorded in pre-designed Performa. The collected data were entered in MS Excel and exported into SPSS 21 version for statistical analysis.Results: The incidence of ectopic pregnancy was 0.8%. Most of the patients (35 ;( 58.3%) belonged to 20-30 age group. The classic triad of pain abdomen, amenorrhea and per vaginal bleeding was present in 41 (68.3%) cases. The most common risk factor associated was PID (39 ;-( 65%) followed by abortion 98 ;-( 13.3%). USG findings were suggestive of ruptured ectopic pregnancy, which was seen in 52(86.7%) cases and. 93.3% of the cases were managed surgically. The most common site of ectopic pregnancy was found to be ampulla 35(58.3%) followed by isthmus 11(18.3%). There was no mortality.Conclusions: Pelvic inflammatory disease was the commonest risk factor, laparotomy was the commonest modality of surgical management and ampulla was the commonest site of ectopic pregnancy. Early diagnosis, referral and treatment in the tertiary care center prevents morbidity and mortality related to ectopic pregnancy.Keywords: Ectopic pregnancy; methotrexate; ultrasonography


2021 ◽  
Vol 14 (3) ◽  
pp. 85-88
Author(s):  
Jok Thikuiy Gang ◽  
Sisay Kirba Kea ◽  
Samson Gebremedhin

Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.


Author(s):  
Indu Verma ◽  
Punya Priya ◽  
Charvi Chugh ◽  
Harsharan Kaur ◽  
Dinesh Sood

Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres.


Author(s):  
Juhi Goel ◽  
Swapnila Prasad ◽  
Ashutosh Dokania

ABSTRACT Conjunctival cysts are of a common occurrence in clinical parlance. These tend to be mostly asymptomatic. However, the underlying cause may be vision threatening. Thus, we conducted a clinicohistopathological study of conjunctival cysts in pediatric age group who presented to our outpatient department in Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. The aim was to analyze the risk factors, clinical presentation, treatment modalities, and a certain type of cysts in order of their frequency. Significant history, detailed ocular examination, and relevant investigations that were carried out in 10 cases of conjunctival lesions were noted. The management was done and the histopathological examination (HPE) reports were charted. Despite a similar clinical presentation, HPE revealed varied diagnosis. These comprised choristomatous cysts (4), subconjunctival cysticercosis (2), inclusion cysts (2), inflammatory cyst (1), and capillary hemangioma (1). Conjunctival cysts are not just a cosmetic blemish. A detailed ocular examination, early diagnosis, and treatment can help prevent various vision-threatening complications. How to cite this article Goel J, Prasad S, Dokania A. A Clinicopathological Study of Various Conjunctival Lesions in Children. Int J Adv Integ Med Sci 2016;1(4):143-147.


2020 ◽  
Vol 3 (2) ◽  
pp. 28-33
Author(s):  
Shirish Ardhapuskar ◽  
Raghu Rammulu

Background: Anemia is one of the common Hematological disorders in India and worldwide. It affects all the age groups both in Males and Females. Moderate to Severe Anemia causes increased morbidity and mortality in elderly patients (AWHO expert group) - According to Worlds Health Organization, Anemia is a define when adults males are having Hemoglobin less than 13.5gr% when adults females non-pregnant less than 12 gr% and when pregnant females are having less than 11 ger%. The incidence of Anemia is very high in old age people who are more than 75 years of age. It ranges from 9% to 41%. In India Anemia is commonly due to nutrition, pregnancy, Hookworm infestation, DUB in the case of females, and Malignancy. The prevalence of anemia in the elderly has been found to range from 9% to 42% with the highest prevalence in 80 years and above. The common causes of anemia in India are Nutritional, Pregnancy, Hookworm infestation, and DUB in the case of Females and Malignancy. The common symptom is General weakness, Fatigue, Lack of concentration, Shortness of Breath, and Palpitations. A WHO expert group proposed that anemia should be considered when hemoglobin level below 13.5gr& in adult males; 12gr% in adults females non-pregnant; 11 gr% in adult female pregnant; 12gr% in children over 14yrs(1). The aim is to evaluate the etiology and clinical features of anemia in adults in rural medical colleges. Subjects & Methods: This study is conducted at GEMS Medical College, Srikakulam, A.P for the period of 1 year from April 2018 to March 2019. This study includes 120 patients with Anemia. The age group is between 20 years and 70 years. Males were 56 and females were 64. Results: We have conducted this study at GEMS Medical College, Srikakulam for 1 year, from April 2019 to March 2019 total no. of patients included in this study are 120 males 56 and females 64. The age group is between 20 years and 70 years. The maximum patients are in between 30 years and 70 years in both sexes. Conclusion: Anemia is a common medical problem in developing countries. In a rural part of India, the disorders will complicate the pregnancy also. So periodical examination and education of the people can decrease morbidity and mortality. In our area still, the common cause is nutritional.


Author(s):  
Bibhu P. Behera ◽  
D. N. Maharana ◽  
Partha S. Mohanty

Background: Stroke is one of the leading causes of morbidity and mortality in India. The objective was to study the clinical profile, risk factors, neurological characters, pattern of brain stroke, areas of brain affected as per CT scan findings in patients with stroke.Methods: This observational study was carried out from June 2018 to Jan 2019 of all new patients admitted with stroke in Pandit Raghunath Murmu Medical College and Hospital, Baripada, Mayurbhanj, Odisha, India.Results: The incidence of stroke is maximum in 46-60 years of age group. The average age+SD was 59.3+13.5 in our study. 274 (46.52%) patients had ischemic stroke and 315 (53.48%) patients had hemorrhagic stroke. The male to female ratio was 1.46:1. Anterior circulation (86.42%) was the most common territory involved in the brain. The most common risk factor was hypertension with 77.76% followed by dyslipidemia (53.99%). The most common clinical presentation was hemiplegia (85.23%).Conclusions: The incidence of stroke is maximum in 46-60 years of age group. The average age+SD was 59.3+13.5 in our study. 274 (46.52%) patients had ischemic stroke and 315 (53.48%) patients had hemorrhagic stroke. The male to female ratio was 1.46:1. Anterior circulation (86.42%) was the most common territory involved in the brain. The most common risk factor was hypertension with 77.76% followed by dyslipidemia (53.99%). The most common clinical presentation was hemiplegia (85.23%). 


2021 ◽  
Vol 53 (1-2) ◽  
pp. 23-26
Author(s):  
SK Moazzem Hossain ◽  
Farjana Kabir ◽  
SK Mamun Ar Rashid

Background: Snake bite is an important but under recognised public health issue in Bangladesh. It is one of the important cause of mortality in our country specially in this southern part of Bangladesh. Objective: This study was carried out to evaluate the common type of snake bite in local area with their clinical presentation and outcome of admitted patients in hospital. Methods: Patients of snake bite diagnosed by history and clinical examination were consecutively selected for the study after fulfillment of inclusion criteria in the inpatient department of medicine ward, Khulna Medical College Hospital from July 2017 to June 2018. Data were collected and analysed afterwards. Results: Among 54 snake bite patients 27 (50%) were female and 27 (50%) were male. Twenty nine (53.7%) were venomous snake bite and 25 (46.3%) were non venomous. The common victims were farmers 14 (25.9%) and housewife 19 (36.2%). The bites were commonly encountered during walking (30%) in rural area. Bite also occured during sleeping (20%). The majority of the snake bite was observed during the month of June & July. Total 95% patient applied multiple tight tourniquet in the affected limb. A common local practice was to receive prehospital treatment from 'Ohzas'. Among 29 poisonous cases, drooping of the upper eyelid was present in 29 (100%) patients, External Opthalmoplegia and broken neck sign were present in 19 (66.6%) patients. Among the venomous snake bite cases 25 (93%) patients recovered completely after getting antivenom. Conclusion: Neurological manifestation (Ptosis, Opthalmoplegia, Broken neck sign) are very common in venomous snake bite. Early detection and application of antivenom is needed for better outcome. Treatment of venomous snake bite with Polyvalent serum is successful and safe. Bang Med J Khulna 2020: 53 : 23-26


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.


2021 ◽  
pp. 38-40
Author(s):  
Manu Jethalya ◽  
Saurabh Totla

Background: Stomach is an important site for variety of lesions especially malignant tumours. Gastric biopsies along with clinical prole of cases play an important role in the diagnosis of gastric neoplasm and therefore aids in early management. Aim and Objectives: To study the histopathology of Gastric biopsies and correlate them with clinical presentation, age, sex and to differentiate them between neoplastic and non neoplastic lesions. Materials and Methods: The prospective study was done in the Department of Pathology Geetanjali Medical College and Hospital, Udaipur between 1stJanuary 2019 to 30thJune 2020. A total of 83 gastric biopsies were included in the study and were analyzed along with their clinical proles. Results: A total of 83 gastric biopsies were included in the study. Most commonly affected age group was 50-69 years with 41 patients (49.40%) followed by 40-49 years with 14(16.87%). Out of 83 cases, 58 (69.88%) were males & 25 (30.12%) were females, 26 (31.33%) cases were non neoplastic & 57 (68.67%) cases were neoplastic.Conclusion: The gastric biopsy not only permits exact diagnosis of specic entity but also helps to plan for early medical or surgical therapy. The histopathological study detects mucosal lesions at an early stage especially atrophy, metaplasia and dysplasia as to prevent progress of these lesions to invasive cancer.


Author(s):  
Ishrat Zuber ◽  
Vaishali Chaurasia

Background: Ectopic pregnancy is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergency in day-to-day practice. Objectives of present study were to know the incidence of Ectopic pregnancy at Tertiary care centre, the age group, parity and risk factor of ectopic pregnancy, the clinical presentation of ectopic pregnancy and the outcome and management of ectopic pregnancy.Methods: It was a retrospective study conducted at Chirayu Medical College and Hospital, Bhopal from 1st June 2009 to 31st May 2014. A total of 42 patients with ectopic pregnancy were analyzed on clinical presentation, clinical findings, investigations, operative findings and outcome.Results: A majority of women (64.29%) were in the age group of 21-30 years and 78.57% were multigravida. Commonest risk factors were previous history of abortion (23.80%) and pelvic inflammatory disease (14.28%) Amenorrhea (92.85%) and pain abdomen (89.22%) were the most common presenting symptoms. Ampulla of fallopian tube was the commonest site (45.23%). Unilateral salpingectomy was performed in 40.47% patients. There were no maternal deaths and majority (80.96%) were discharged within seven days.Conclusions: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. Early diagnosis and referral in hemodynamically stable state along with use of minimal access surgery or medical management can change the scenario of ectopic pregnancy in the developing world.


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