5 research outputs found
Rare case of huge rectal and uterovaginal prol
A case of combined genital prolapse and rectal prolapse in a 60-year-old multipara is reported. The treatment of mixed prolapse remains surgical and should be treated the genital prolapse by vaginal hysterectomy with pelvic floor repair and the rectal prolapse by means of the Delorme operation. The mortality and morbidity rates are zero if this operation is used and the relapse rate is only 8 to 11% for the rectal prolapse. It would appear that the two approaches are rarely associated by the authors and would seem to be interesting to reconsider this question by indicating mixed treatment of the two prolapses whenever possible
Emergency obstretic hysterectomy: a retrospective study in a tertiary care center
Background: Obstetric hysterectomy remains a necessity in preventing maternal mortality in catastrophic rupture of the uterus or intractable postpartum hemorrhage when all the conservative management options fail. Uterine atony followed by abnormal placentation remains the primary indication of emergency obstratic hysterectomy worldwide. In majority of cases, anticipation, prompt resuscitation and earlier surgical intervention by skilled operator will reduce patient’s morbidity and mortality. The first successful operation was performed in 1876. The main objective of the study was to study frequency, indications and fetomaternal outcome of emergency obstetric hysterectomy in tertiary care center.Methods: Observational, retrospective and analytical study was done over 2 years from January 2017 to January 2019. A total of 11 cases of emergency obstretic hysterectomy (EOH) were recorded.Results: The overall incidence was 1.47 per 1000 deliveries. Atonic postpartum hemorrhage (54%) was the most common indication followed by placenta previa (18%) and placenta accreta (9%). Second gravida were mostly involved (45%) with previous LSCS (45%) as a common risk factor in commonest age group of 20-25 years (46%) amongst them. The most frequent squeal was disseminated intravascular coagulation (45%). Maternal mortality was nil while neonatal mortality being 9%. The decision of performing total or subtotal hysterectomy along with bilateral internal iliac ligation was influenced by patient’s condition.Conclusions: Emergency obstretic hysterectomy is the most demanding obstretic surgery performed in circumstances of life threatening hemorrhages where conservative surgical modalities fail and interventional radiology is not immediately available. Antenatal anticipation of the risk factors, involvement of experienced obstetrician at the early stage of management and prompt hystrectomy after adequate rescuitation will reduce fetomaternal mortality and morbidity
Visualization of the Cervix with Acetic Acid is an Alternative to Colposcopy in Evaluation of Cervical Cancer and Its Precursors
Abstract: Background: Cervical Cancer is the leading cause of morbidity and mortality among women worldwide. There are over 500,000 cases of Cervical Cancer found worldwide, and more than 280,000 women die of it every year. 85% live in developing countries. Cervical Cancer is the leading cause of years-of-life lost in women in South Central Asia, Latin America and Sub-Saharan Africa, resulting in a greater reduction in a women's life expectancy even when compared with AID's, TB, or maternal conditions in Latin America and Europe. (Yang, International Journal of Cancer 2004.) Objective(s): To evaluate visual inspection of cervix with acetic acid (VIA) in picking up preinvasive and invasive Cancers in abnormal cervix. Method(s): VIA was carried out in 380 symptomatic women as a pre-colposcopy procedure. Hundred patients with positive findings were then subjected to colposcopy. Directed biopsy was taken from those with abnormal appearances on colposcopy. Results: Out of 100 patients with positive findings on VIA, 70 were found to have abnormal findings on colposcopy. Cervical biopsy of these 70 patients revealed 20 cases as having low grade squamous intraepithelial lesions, nine as high grade squamous intra epithelial lesions, and six as pre-clinical invasive Cancers. Thirty five showed no abnormality in their Cervical biopsy. Conclusion(s): VIA is a simple method to pick up high grade squamous intra-epithelial lesions or early invasive Cancer of the cervix. Colposcopy is complimentary and not essential in identifying the true Cancer precursors. Hence VIA can be practiced by clinicians on wider scale to evaluate the cervix at risk
Study of prevalence and determinants of polycystic ovarian syndrome among adolescent girls in rural area: a prospective study
Background: Polycystic ovarian syndrome (PCOS) is the most frequent endocrinological disorder affecting 5-10% of women in the reproductive age. This prevalence ranging from 2.2% to 26% in adult women from 18-45 year. In a recent study the prevalence of a confirmed diagnosis of PCOS in adolescents aged 10 to 19 years was 5-15%, which increased to 10-22%. When undiagnosed cases with documented symptoms qualifying for PCOS according to NIH (National institute of Health) criteria were included. PCOS is a complex endocrine disorder which is most common in women of reproductive age. PCOS may first present in adolescence, but the incidence of PCOS in adolescence is not known, as diagnostic criteria for PCOS in the adolescent age-group is still not defined, PCOS symptoms tend to overlap with normal pubertal changes making the diagnosis even more challenging. The objective is to study prevalence and symptomatology of polycystic ovary syndrome (PCOS) in adolescent girls.Methods: Prospective Cross sectional study between April 2018 and March 2019. 150 adolescent girls aged 10 to 19 years attending OPD with oligomenorrhea, irregular menstrual cycle, obesity and/or hirsutism were advised for biochemical, hormonal, and ultrasonographic evaluation for diagnosis of PCOS on the basis of Rotterdam's criteria at the Department of Obstetrics and Gynaecology, Krishna Institute of Medical Sciences, Deemed University, Karad, Maharashtra, India.Results: Prevalence of PCOS in the study was 17.33% in the study group.Conclusions: PCOS is increasingly encountered during adolescence, although the overall prevalence is low and evaluation of PCOS in adolescents is challenging. At this age, lifestyle modification is imperative to prevent long-term metabolic and reproductive complications