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 Otomycosis is a superficial fungal infection of the external auditory canal. Its main presenting symptoms are itching, aural fullness, earache and hearing loss. The aim of the study is to identify the most common fungal pathogen and predisposing factors for otomycosis and observe the response to treatment. MATERIALS AND METHODS We conducted an institution-based prospective study on 50 clinically-diagnosed cases of otomycosis attending the ENT Outpatient Department. According to a predesigned proforma, each patient was studied for gender, age, occupation, presenting symptoms, predisposing factors, co-existing systemic diseases, fungal species identified and response to treatment with conventional antifungals. RESULTS Out of 50 patients, 30 were females and 20 males. In this study, age group 11-20 years were more affected. Otomycosis was found to be predominantly unilateral with the left side of ear being more affected when compared to right. However, bilateral infection was also observed and few cases reported negative for growth of fungi after microbiological study. In this study, Aspergillus niger (52%) was the commonest isolate followed by Candida (16%). Most of the clinically-diagnosed cases responded to topical antifungal ear drops with only few cases requiring additional treatment at follow up. CONCLUSION In this study, we found that otomycosis is more common in adolescent age group and in females than males. Aspergillus niger is the major aetiological agent. The major predisposing factors for otomycosis are hot and humid climate repeated manipulation with unsterile sticks and swabs in the external auditory canal, use of unsterile coconut oil and swimming. Thorough cleaning of external auditory canal and instilling topical antifungal drops still remains the gold standard treatment option for otomycosis per se.
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