Evaluation of thyroid dysfunction in patients with menstrual disorders of reproductive age group: a prospective cross-sectional study

Background: Thyroid disorders specifically the hypothyroidism has been associated with menstrual disturbances in women of reproductive age group. The objective of this study was to estimate the prevalence of thyroid dysfunction and its correlation with menstrual disorders in women of reproductive age group.Methods: A hospital based prospective analytical study was carried out in the department of Obstetrics and Gynaecology of Nalanda Medical College and Hospital, Patna from March 2017 to March 2018. 56 women of reproductive age group between 18 to 45 years presenting with menstrual disorders (like menorrhagia, oligo/hypomenorrhea, polymenorrhea, metrorrhagia, and amenorrhea) were recruited in this study. Thyroid function test was done in all patients. Statistical analysis done.Results: Maximum number of patients were seen in the age group of 31-40 years. Most common menstrual complain was menorrhagia (46.42%) followed by hypo/oligomenorrhoea (17.86%). In patients with menstrual disorders, 41.07 % had thyroid disorders in which subclinical hypothyroidism was prevalent in 17.86%, overt hypothyroidism in 12.5%, and overt hyperthyroidism in 5.35% of the women. Menorrhagia was the commonest menstrual disorder (52.94%) seen in hypothyroid patients followed by polymenorrhoea. A high degree positive correlation was observed between thyroid dysfunction and menstrual disorder (Pearson correlation coefficient, r=0.93).Conclusions: Our study concluded that thyroid dysfunction should be considered as an important etiological factor for menstrual irregularity. Thus, thyroid function tests should be performed in all patients with menstrual irregularities to avoid unnecessary interventions like curettage and hysterectomy

Vulvar lichen sclerosus: recent advances in understanding and management

Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. It is one of the most common pathologies presenting to vulvar clinics. However, uncertainty continues to exist about its etiopathogenesis, diagnosis and treatment. Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal and local infectious background. There is often a delay in diagnosis of VLS due to its asymptomatic nature and lack of awareness in patients as well as physicians. Embarrassment of patients due to private nature of the disease and failure to examine the genital skin properly are the other reasons for delay in diagnosis. Conventionally, treatment includes topical corticosteroids as a first-line therapy with alternative options such as topical calcineurin inhibitors, topical and systemic retinoids, other steroid creams, various destructive techniques and surgical removal of affected tissues. New therapeutic approaches are coming into effect in gynecological practice due to potential risks of the above-mentioned methods. Stem cell and platelet-rich plasma therapy, energy-based modalities such as the fractional CO2 laser, photo dynamic therapy, and high intensity focused ultrasound, and new topical medicines, are some of the new options applied to improve the efficacy of treatment avoiding the side effects of conventional methods. Refinement of surgical techniques for restoring vulvar anatomy is leading to improved patient outcomes. This review summarizes current perspectives on the etiopathogenesis, diagnosis and treatment for vulvar lichen sclerosus.

Comparative study of intravenous hydralazine and labetalol in severe hypertensive disorders of pregnancy

Background: Hypertensive disorders of pregnancy are among the most common medical complications of pregnancy and major cause of maternal, fetal and neonatal morbidity and mortality. The purpose of this study was to compare the efficacy and safety of intravenous hydralazine and labetalol for management of severe hypertensive disorders of pregnancy.Methods: This prospective study was conducted among 100 women admitted with SBP ≥ 160 or DBP ≥ 110 mmHg or both. Patients were divided into 2 groups randomly: labetalol and hydralazine group.Results: Majority of patients (38%) were in the age group of 21-25 years and primigravida (52%). There was more significant decrease in the systolic, diastolic and mean arterial blood pressure at the end of 15 and 30 minutes in labetalol group. Labetalol required fewer doses as compared to hydralazine to achieve the target blood pressure (average 1.95 versus 3.1). Total numbers of term deliveries were 19 (38%) in hydralazine group and 16 (32%) in labetalol group. Pre-term deliveries in hydralazine and labetalol group were 14 (28%) and 15 (30%) respectively. Headache was significantly more common in hydralazine treated patients than labetalol group.Conclusions: Both hydralazine and labetalol were effective and well-tolerated in the treatment of severe hypertensive disorders of pregnancy. Labetalol may be preferred because it was more effective in lowering the systolic blood pressure, diastolic blood pressure and mean arterial pressure to achieve target levels with less number of doses

A Study of Socio-Demographic Characteristics and quality of life in post menopausal women- A questionnaire study

Background: With the increase in life expectancy of women all over the world, women are expected to spend almost 1/3rd of their life in menopause phase, usually starting in 4th to 5th decade of life.Aim: This study was planned to look for quality of life in post menopause.Material and methods: This cross-sectional study was conducted at Gynaecology and Obstetrics department. Menopause-Specific Quality of Life Questionnaire (MENQOL) was distributed among 115 patients presenting in Outdoor department of the institution. All the demographic details and MenQol results were analyzed. Also Odd’s ratio (OR) was calculated for these symptoms according to age groups of the patients.Results: The mean age of the patients was 60 ± 5.8 years. The mean age of patients at time of menarche was calculated as 13.4 ± 1.80 years and the mean age at menopause was 49.10 ± 3.98 years. We found that the most common symptom of the patients in our study was low backache and the least reported symptom was drying skin. The OR was also calculated for various symptoms according to age of the patients but it was found significant only (OR:10.9; (4.467 – 26.58) for vasomotor symptoms in our study.Conclusion: Menopausal symptoms may vary in different parts of the world. Therefore exact determination of these symptoms in our society is essential as it can help us to identify preventable factors and educate our women about their quality of life