Background: Vaginal discharge is the commonest reproductive tract infection among rural women in many community based studies in India. Recent evidence shows that the association between vaginal discharge and reproductive tract infection is weak. Psychosocial factors also contribute to vaginal discharge. So, the problem of vaginal discharge can be best understood not only in the biomedical perspective but also in the socio-cultural perspective. Proper understanding of this problem helps in initiating appropriate medical education programmes and framing health policies. This study is aimed to determine the prevalence of vaginal discharge, the socio demographic factors associated with it, women’s perceptions of vaginal discharge and their treatment seeking behaviour.Methods: This is a hospital based cross sectional study conducted in the outpatient department of Obstetrics and Gynaecology, MIMS, Nellimarla, Vizianagaram district of Andhra Pradesh. Women with the complaint of vaginal discharge were interviewed with a pretested questionnaire and sociodemographic details, details of obstetric history and contraceptive practices, personal and menstrual hygiene were noted. Statistical analysis of the significance of association of different variables was done.Results: The prevalence of vaginal discharge was found to be 28.99%. Its prevalence was found to be more in the younger age group, illiterate, women belonging to lower socioeconomic status and those who were married at less than 18 years of age. History of induced abortion, home deliveries, permanent method of sterilization, availability of toilet facility at home were significantly associated with vaginal discharge. Lower abdominal pain, dysuria and backache were the most prevalent co-morbidities with vaginal discharge.Conclusions: Improvement of the literacy rate, economic status and women’s empowerment will help to mitigate the problem of vaginal discharge.
BACKGROUND Thyroid disorders are the second most common endocrinological disorders seen in pregnant women. Thyroid hormone plays a crucial role in pregnancy both in the development of a healthy baby and in maintaining the health of the mother. Several studies have shown a rising prevalence of thyroid disease in India and in South Asian countries. The diagnosis of thyroid disease in pregnancy is difficult as many of the signs and symptoms of thyroid disease are also common to pregnancy. The aim of the study is to determine the prevalence of thyroid disease in pregnant women. MATERIALS AND METHODS This is a hospital-based cross-sectional study. 333 antenatal women were screened in their first visit to the antenatal clinic by serum TSH, fT3, fT4. Statistical analysis of the results was done. RESULTS 283 women out of 333 antenatal women screened were found to be euthyroid. 50 women were detected to be having thyroid disorder. 45 women had subclinical hypothyroidism, one woman had overt hypothyroidism and four women had subclinical hyperthyroidism. 4 women had hypothyroidism prior to pregnancy. The overall prevalence of thyroid disorders in pregnancy in our study was found to be 16.21%. CONCLUSION The prevalence was found to be high in our study and in several studies from India and in its neighbouring countries. This is probably due to iodine deficiency being prevalent in several areas in our country. The prevalence of subclinical hypothyroidism is high. This all the more stresses the need for universal screening of pregnant women for thyroid disease in our country.
BACKGROUNDUTI is the most frequent medical complication. It may be asymptomatic or symptomatic. Asymptomatic bacteriuria if left untreated might result in symptomatic UTI and adverse pregnancy outcomes.
INTRODUCTIONUrinary tract infection is a common medical complication of pregnancy. Women are more susceptible than men due to short urethra and contamination of the urogenital tract with faecal flora due to the proximity of the urogenital tract to the anal canal. Bacteriuria during pregnancy may be classified as Asymptomatic bacteriuria (ASB), infection of the lower urinary tract (cystitis) and infection of the upper urinary tract (pyelonephritis). Pregnancy in itself is a risk factor for the development of urinary tract infection due to the anatomical, physiological and immunological changes that occur in pregnancy. 90% of pregnant women develop urethral dilatation starting by about 6 th week of pregnancy, increase in bladder volume, ABSTRACTBackground: Urinary tract infection in pregnancy is a problem of global significance. Untreated asymptomatic bacteriuria in pregnancy is known to be associated with maternal and foetal outcome in the form of symptomatic urinary tract infection (UTI), acute pyelonephritis, anaemia, pregnancy induced hypertension (PIH), preterm labour (PTL), low birth weight (LBW), intrauterine growth restriction (IUGR) and prematurity. This study is aimed to compare the maternal and foetal outcome of pregnant women with bacteriuria with that of women without bacteriuria and also to see if screening later in pregnancy at 28-37 weeks of gestation is as effective as screening at less than 20 weeks of pregnancy in terms of maternofoetal outcome. Methods: 165 pregnant women attending the antenatal clinic at MIMS, Nellimerla, Vizianagaram district, Andhra Pradesh, India were screened for asymptomatic bacteriuria by urine culture and sensitivity. They were grouped into asymptomatic bacteriuria negative and culture positive groups. Culture positives were further grouped as early detected and late detected group based on the gestational age at sampling. They were followed up till delivery. The maternofoetal outcome was compared between different groups by computing Odd's ratio and P value of less than 0.05 was taken as significant. Results: There was no statistically significant increase in adverse maternofoetal outcome between early detected and bacteriuria negative group. The women of late detected group had greater odds of developing symptomatic UTI, PIH, PTL, LBW, IUGR and neonatal intensive care unit admissions when compared to early detected and bacteriuria negative group which was statistically significant. Conclusions: Screening for asymptomatic bacteriuria early in pregnancy at less than 20 weeks is more effective in reducing the adverse maternofoetal outcome.
Background: Stress urinary incontinence (SUI) is commonly encountered in Gynaecological practice. The management of stress urinary incontinence underwent a paradigm shift with focus changing from bladder neck suspension to support of mid urethra in the last two decades. The aim of our study is to know the safety, efficacy, subjective and objective outcomes of Transobturator Tension Free Tape (TOT) (in-out technique) in women with Stress urinary incontinence.Methods: This is a prospective study conducted in the departments of Gynaecology and Urology at Maharajah’s Institute of Medical Sciences, Nellimerla, Vizianagaram district, Andhra Pradesh, India. 62 patients were treated with Tension Free Trans-obturator tape with inside-out technique using polypropylene mesh. This study was conducted from June 2012 to May 2014. These women were followed up annually for a period of 3 years af-ter surgery. 3 year subjective and objective outcomes were assessed. Subjective outcome is defined as no loss or leak of urine on physical activity and objective outcome is defined as negative Pad test.Results: The subjective and objective cure rates were 91.93% and 95.16% respectively.Conclusions: Transobturator Tension free Tape is an effective treatment for Stress urinary in-continence in women providing high subjective and objective efficacy upto 3 years after surgery.
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