scholarly journals GYNAECOLOGICAL EMERGENCIES

2007 ◽  
Vol 14 (01) ◽  
pp. 43-49
Author(s):  
SARDAR Ali ◽  
SYED TAHIR AHMAD SHAH
Keyword(s):  
Ectopic Pregnancy ◽  
Genital Tract ◽  
Diagnostic Tools ◽  
Age Group ◽  
Delayed Wound Healing ◽  
Surgical Practice ◽  
Operative Care ◽  
Surgical Ward ◽  
Erroneous Diagnosis ◽  
Almost All

in all the patients. More specific investigations were performed where required. All the patients were resusscitated and operative treatment; where required; was performed under general anesthesia at the earliest possible time. The surgical procedure was tailored according to the circumstances. Further management, conservative or post operative care was done in surgical ward. Results: Pelvic Inflammatory Disease (PID) which is the inflamation of upper genital tract with its complications like pelvic cellulitis and pelvic peritonitis was the most common (40.9%) emergency. The age group between 16 to 30 years was the commonest having gynaecological problems. There was a clear predilection of married than unmarried females facing these problems. Because of lack of experience and limited diagnotistic facilities erroneous diagnosis was made to some extent in almost all the cases. 55.55% of patients suffering from PID were treated successfully by conservative means. Surgical procedurewas performed in all the patients (100%) suffering from ruptured ectopic pregnancy, perforated uterus and torsion of ovarian cyst and pedunculated subserosal fibroid. Wound infection and delayed wound healing were among the most common postoperative complications. Mortality occurred in ectopic pregnancy (16.66%) and PID (5.55%). Conclusion: The different gynaecological problems are commonly encounteredin general surgical practice. The surgeons often fall in this un-wary trap because of (1) close resemblance of clinical features (2) less exposure to gynaecological problems (3) non availability of more sophisticated diagnostic tools in emergency. The overall sufferings of patients can be reduced to some extent by overcoming these shortcomings.

scholarly journals A clinical study on ectopic pregnancy

2017 ◽  
Vol 5 (11) ◽  
pp. 4776
Author(s):  
Mamata Soren ◽  
Ranjita Patnaik ◽  
Bismoy Kumar Sarangi
Keyword(s):  
Ectopic Pregnancy ◽  
Reproductive Age ◽  
Medical Emergency ◽  
Diagnostic Tools ◽  
Age Group ◽  
Lower Abdomen ◽  
The Past ◽  
Surgical Emergencies ◽  
Β Hcg ◽  
Reproductive Age Group

Background: Ruptured ectopic pregnancy is a medical emergency; therefore, it is imperative to diagnose the unruptured ectopic pregnancy such that timely intervention will prevent morbidity and mortality Today with availability of monoclonal β-HCG, high resolution transvaginal scan and laparoscopy it is possible to make early diagnosis even before rupture.Methods: Prospective study of two years duration with sample of 72 cases of suspected ectopic pregnancy observed and treated out of total 20193 pregnant women admitted were included in this study.Results: The incidence was 0.36%, maximum between the age group of 26-30 years (33.3%). Risk factors were tubectomy (30.56%), D and C (6.94%), PID (5.6%), previous ectopic (1.39%), IUCD (2.78%). The typical triad of amenorrhoea, pain abdomen and bleeding was observed in 54.2% of cases. 19 patients were brought in shock (26.4%). Ultrasonography done in 56 cases.Conclusions: There is an increase in the incidence of ectopic pregnancy but a decrease in maternal mortality during the past two decades. Although the early diagnostic tools were available, we had to manage most of our patients as surgical emergencies, as they were brought late in the trial, with established diagnosis of ruptured ectopic pregnancy. Physicians should be sensitive to the fact that in the reproductive age group any women presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be entertained irrespective of the presence or absence of amenorrhoea, whether or not she has undergone sterilization. 

scholarly journals A Study of Varicella Seroprevalence in a Pediatric and Adolescent Population in Florence (Italy). Natural Infection and Vaccination-Acquired Immunization

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 152
Author(s):  
Beatrice Zanella ◽  
Angela Bechini ◽  
Benedetta Bonito ◽  
Marco Del Riccio ◽  
Alessandra Ninci ◽  
...  
Keyword(s):  
Natural Infection ◽  
Age Groups ◽  
Varicella Vaccination ◽  
Age Group ◽  
Disease Notification ◽  
Test Elisa ◽  
Vaccine Schedule ◽  
Almost All ◽  
Vaccination Campaigns ◽  
Dose Vaccine

Background: Varicella is a well-known infectious disease that can have severe complications, also in young children. The Universal Varicella Vaccination (UVV) program was introduced in Tuscany (Italy) in 2003, with a two-dose vaccine schedule given to children between their 13th and 15th month, and at 5–6 years old, as a monovalent for varicella (V) or tetravalent (measles, mumps, rubella and varicella (MMRV)) formulation. Although varicella notifications have dramatically fallen in the last two decades, varicella disease underreporting remains a challenge. Methods: A qualitative immunoenzymatic test (ELISA) was used to measure the presence of anti-varicella antibodies in 165 sera of subjects aged 1–18 years residing in the province of Florence (Italy). Information regarding the anamnestic and vaccination status (including disease notification) was also collected. Results: Our study showed an overall varicella seropositivity of 75.8% (reaching the maximum at 96.3% in the 15–18 years age group). We found that varicella disease notification had been recorded for only 7/165 subjects; however, since 42/165 recalled having had the disease, we can hypothesize that some of them must have been underreported. Furthermore, our study showed that the presence of antibodies after the varicella vaccination remained over time, lasting up to 12 years. Conclusions: Although varicella seroprevalence is <95% in almost all our age groups (except for the 15–18 years age group), our data are encouraging and reflect the success of the introduction of the UVV program and the vaccination campaigns promoted in the Tuscany region.

Characteristics and attitudes of family planners in Khartoum, Sudan

1982 ◽  
Vol 14 (1) ◽  
pp. 7-16 ◽  
Author(s):  
M. A. Khalifa
Keyword(s):  
Family Planning ◽  
Birth Control ◽  
Early Stage ◽  
Significant Proportion ◽  
Large Family ◽  
Capital City ◽  
Age Group ◽  
African Countries ◽  
The Mean ◽  
Almost All

SummaryIn a survey of 1475 urban Moslem wives in the age group 15–49 living in the capital city of the Sudan, knowledge of birth control was reported by almost all respondents while a significant proportion had used contraception at least once. The mean age of the users was 32·8 years, their duration of marriage was 15·1 years and their mean number of surviving children was 4·6. Those who had never used contraception had a higher mean age, a longer duration of marriage and more surviving children. Most of the users had an urban residential background and belonged to the high socioeconomic class. They held favourable attitudes to family planning. Although they thought that having a large family (more than five children) was not desirable, their mean preferred family size was no different from that of the never users.The results indicate that contraception is used for the purpose of spacing births rather than limiting their ultimate number. At this early stage of contraceptive adoption in Sudan, the characteristics of the pioneer acceptors are similar to those observed in other African countries.

scholarly journals Clinical study of ectopic pregnancy

2017 ◽  
Vol 6 (8) ◽  
pp. 3498
Author(s):  
Meenakshi T. Chate ◽  
Bhagyashree Chate ◽  
Kranti Chate
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Public Health Issue ◽  
Common Symptom ◽  
Age Group ◽  
Common Site ◽  
Common Risk Factor ◽  
Medical College ◽  
Endometrial Cavity ◽  
Rising Incidence

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.

scholarly journals Management of Ectopic Pregnancy in a Tertiary Care Hospital by Surgery

2016 ◽  
Vol 28 (1) ◽  
pp. 21-25
Author(s):  
Saida Akter ◽  
Sharmin Sultana
Keyword(s):  
Physical Examination ◽  
Ectopic Pregnancy ◽  
Radical Surgery ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Conservative Surgery ◽  
Diagnostic Tools ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional

Introduction: Tubal ectopics if large, uncontrollably bleeding or severely damaged need radical surgery (salpingectomy), otherwise conservative surgery (salpingotomy, salpingostomy) is the way of operative management. Laparoscopic surgery usually done in case of haemodynamically stable condition.Objective: To explore the different ways of surgical management of ectopic pregnancy in a tertiary care hospital.Materials and methods: This cross sectional study was carried out in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Hospital and Dhaka Medical College Hospital during August 2005 and June 2006. The study population consisted of 50 women with ectopic pregnancy. Selected women underwent meticulous history taking and physical examinations. Some investigations like ultrasonography, culdocentesis, urine for pregnancy tests were done. Patients were treated by either radical or conservative surgery.Results: All (100%) women had abdominal tenderness. Ectopic pregnancy was diagnosed by history, physical examination and culdocentesis (84%), ultrasonography (12%) and laparotomy (4%). Two (4%) women were treated by conservative surgery, while the rest by radical surgery; 40 (80%) underwent unilateral salpingectomy, 3 (6%) unilateral salpingectomy with contralateral tubectomy, 2 (4%) unilateral salpingo oophorectomy, 1 (2%) total abdominal hysterectomy and 2 (4%) resection of rudimentary horn.Conclusion: Most common diagnostic tools were by history, physical examination and culdocentesis and common management was unilateral salpingectomy.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 21-25

scholarly journals Antepartum hemorrhage and its fetomaternal outcome: a retrospective study

2020 ◽  
Vol 9 (11) ◽  
pp. 4562
Author(s):  
Saloni K. Gandhi ◽  
Ayushi P. Vamja ◽  
Kishor P. Chauhan
Keyword(s):  
Genital Tract ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Placenta Previa ◽  
Age Group ◽  
Cesarean Sections ◽  
Obstetrics And Gynaecology ◽  
Still Births ◽  
Abruptio Placenta ◽  
Nicu Admission

Background: Antepartum hemorrhage (APH) is defined as any bleeding from or into the genital tract after the period of viability and before the delivery of the baby. Aim of the research was to study the fetomaternal outcome in patients with APH.Methods: The present study was a retrospective observational study undertaken in Obstetrics and Gynaecology department of Dhiraj General Hospital, during a period of 1.5 years from November 2018 to May 2020 in 84 cases of antepartum hemorrhage. Only patients with APH >28 weeks gestational age and willing to participate in study were included. Open STAT statistical software has been used to analyse the data in this study.Results: The incidence of antepartum hemorrhage was 2.86%. Maximum patients of APH lie between the age group of 26-34 years. In abruptio placenta (AP) 65% and in placenta previa (PP) 77.2% of the patients were multiparous. APH presents mostly between 34-36 weeks. Around 90% patients of APH required blood transfusion. APH overall shows increased rate of cesarean sections upto 62%. Around 9.5% patients went into shock, 4.7% had disseminated intravascular coagulation (DIC), 3.5% postpartum hemorrhage (PPH) and 8.3% had wound gap and peurperial pyrexia. 23.8% babies had asphyxia of which 60% were contributed to PP and 40% were in AP group. Respiratory distress syndrome was in 7.1% babies of which both groups equally contributed. Septicemia was seen in 13% and jaundice in 29.8%.Conclusions: Higher rates of neonatal intensive care unit (NICU) admission and stay were seen with these complications. This study showed 20.2% perinatal deaths as outcome of APH and 14.2% still births. 

scholarly journals EPIDEMIOLOGICAL STUDY OF PERIORBITAL HYPERMELANOSIS

2020 ◽  
pp. 1-4
Author(s):  
Sonal Khade Ahuja ◽  
Ashish Deshmukh ◽  
Sanmitra Aiholli ◽  
Omkar Kulkarni
Keyword(s):  
Quantitative Assessment ◽  
Medical Center ◽  
Sun Exposure ◽  
Age Group ◽  
Single Patient ◽  
Psychosocial Consequences ◽  
History Of ◽  
Grade 3 ◽  
Almost All ◽  
Sleeping Habits

Background: Periorbital hypermelanosis also called dark circles form the major percentage of dermatology consultations. Importance of these disorders is growing as they cause easy visible cosmetic disfigurement and significant psychosocial consequences. Aims: To assess the patients of POH disorders for demographic, etiological and clinical profile. Methods: This prospective hospital-based clinical study, conducted in a tertiary medical center over a period of two years, involved 200 patients with POH disorders, assessed using detailed history taking and clinical examination for demographic, etiological and clinical data. Data is statistically described in frequencies (number of cases) and percentages(%) . Results: Majority of patients were in age group 18-40 years. Females dominated the study with a number of 169 (84.5%) , only 31 (15.5%) were males. Most of the patients belonged to Grade 2 (53%), grade 3 was seen in 27% patients followed by grade 1 (16.5% ) and grade 4 (3.5% ) POH. Family history was positive in 81.5% patients. POH was observed mostly in housewives 93 (46.5%) and patients with indoor occupation 69 (34.5%) and less commonly in patients with outdoor occupation 29 (14.5%). Almost all cases of POH gave history of exacerbation following sun exposure. Not a single patient showed hepatic, renal complaints, hypothyroidism or ecchymosis. Majority of patients (86.5%) had altered Sleeping habits. Alcohol and smoking did not have a significant co-relation with POH. It was found that only five percent females on oral contraceptives developed POH and there was no change in Pigmentation of POH in relation to menstrual cycle in any of the females. Limitations: The quantitative assessment of melanin by specialized instrument ( mexameter) could not be done because of lack of resources.

scholarly journals Study on Risk Factors, Clinical Presentation & Operative Management of Ectopic Pregnancy

2016 ◽  
Vol 28 (1) ◽  
pp. 9-14
Author(s):  
Kamrun Nahar ◽  
Turani Talukder ◽  
Sabiha Sultana ◽  
Md Anwar Hossain
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Operative Management ◽  
Age Group ◽  
Presenting Symptoms ◽  
Patient Profile ◽  
Short Period ◽  
History Of ◽  
Acute Condition

Introduction: Ectopic pregnancy is a major clinical problem in gynaecology because it is often difficult to diagnose as the patient present in different ways. An accurate history taking and physical examination is considered to be most important in the diagnosis of ectopic pregnancy. There are two treatment options, medical or surgical. Surgical treatment is the fastest treatment for ectopic pregnancy though surgical management decreased from approximately 90% to 65%1. Surgery may be the only treatment option if there is internal bleeding. In the medical treatment group, 15% of cases were categorized as failures and required surgery1.Objectives: This study was conducted in the department of obst and Gynae of Dhaka Medical College Hospital from January 2005 to June 2005 in an attempt to find out the risk factors of ectopic pregnancy, the way of presentation and to analyze the operative treatment of ectopic pregnancy.Materials and Methods: A total 50 consecutive patients who were clinically suspicious of ectopic pregnancy were included in this study between January 2005 to June 2005. Patients who were clinically suspicious of EP and also supported by positive urinary pregnancy tests, beta hCG and no intrauterine gestational sac in ultrasonography were included in this study. Detailed discussion about the study was done with the patient and then informed verbal consent was taken from them. Detailed history about patient profile, presenting symptoms, any risk factors and clinical examination done and the findings were recorded in the predesigned data collection sheet. Data was expressed in terms of frequencies and percentagesResults: Most of the patients were in the age group of 20-30 years and 38% of low parity (para- 1).Previous miscarriage, infertility,IUCD users and PID identified as the risk factors of ectopic pregnancy— 42% patients had history of previous abortion or MR, period of infertility 22%, pelvic infection 12%, IUCD users 16%. In this study acute abdominal pain after a short period of amenorrhoea was found to be the main symptoms in ectopic pregnancy—100% patients were presented with lower abdominal pain, 70% with period of amenorrhea and 50% patients with per vaginal bleeding. All the patients were presented with acute condition and were surgically managed fastest treatment. At the time of operation 84% of ectopic tubal pregnancy were found ruptured, 10% were tubal abortion and 4% unruptured. Sites of ectopic pregnancy were ampullary 50%, isthmic 20%, fimbrial 10%.Conclusion: Most of the patient presented in acute condition with the classical features of ruptured ectopic pregnancy. Near half of the patient were in younger age group (26 – 30 years) having risk factors like history of previous abortion/MR 42%, infertility 22% use of IUCD 16%, PID 12%. More then three forth( 84%) of cases were diagnosed as ruptured ectopic during operation. Operative management was done on the basis of site of ectopic and parity of the womanBangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 9-14

scholarly journals Lower Genital Tract Trauma in a Tertiary Care Centre in Mid-Western Nepal

2017 ◽  
Vol 56 (205) ◽  
pp. 137-140
Author(s):  
Anil Kumar Adhikari ◽  
Mahuya Dutta ◽  
Chittra Ranjan Das
Keyword(s):  
Genital Tract ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Genital Tract ◽  
Clinical Presentations ◽  
Fall From Height

Introduction: The study of lower genital tract trauma has become important in gynaecological practice. There is paucity of reports on this clinical entity from our settings. The main aim of this study is to document injuries in female lower genital tract in Mid-Western Nepal. Methods: Sixty female patients admitted to the hospital with genital tract injuries caused by coitus or accidents were included in the study. Details of the causes of trauma clinical presentations and management were recorded. Results: These injuries were grouped according to etiological factors. This study included 33 (55%) coital injuries and 27 (45%) non- coital injuries. Out of coital injury, 12 cases were criminal assault (rape) in age group of 4 to 18 years. Four unmarried girls had consensual sex. Non-coital injuries were due to fall from height, cattle horn injuries, straddle type of trauma, vulvar haematoma and anorectal injuries. Conclusions: Appropriate surgical intervention can avert morbidity and mortality. Keywords: accident; lower genital tract; Nepal; trauma.

scholarly journals Two cases of ectopic pregnancy

2020 ◽  
Vol 6 (1) ◽  
pp. 52-53
Author(s):  
F. Kuhn
Keyword(s):  
Ectopic Pregnancy ◽  
Genital Tract ◽  
The Past ◽  
Fetal Movements ◽  
Mild Fever

Mrs. F. 44 years old, 25 years old married; two miscarriages and 6 normal births, the last birth in August 1884. Amenorreya from January 1890 to August inclusive. In July, within two weeks, watery discharge from the genital tract. Over the past months, the breasts have swollen, but in August they fell off again. Severe at times abdominal pains stopped along with the cessation of fetal movements. In September, mild fever. When investigated, an asymmetric semi-dense tumor is found in the abdomen.

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