PURPOSE- Cervical cancer is a leading cause of cancer death in low and middle-income countries (LMICs). Loop Electrosurgical Excision Procedure (LEEP) is a valuable diagnostic and therapeutic tool for Cervical Intraepithelial Neoplasia Grade 2 or 3 (collectively referred to as CIN2+) lesions on outpatient visits. However, removing a part of the cervix during the procedure might affect a woman’s perception of sexual function This study was planned to assess the effect of LEEP on overall sexual satisfaction and other specific aspects of sexual function in women who are subjected to LEEP as a part of cervical dysplasia management. METHODS- All patients attending OPD at the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, India, between October 2020 to March 2021, diagnosed with CIN 2 and CIN 3 lesions and planned for LEEP; were enrolled in our study after taking consent. Women were interviewed regarding their sexual function before the LEEP procedure and after six months while on follow-up with self- structured pre- and post-procedural sexual function questionnaire. RESULTS- 61 sexually active women who underwent LEEP for high-grade CIN2+ lesions were enrolled in the present study. There was significant improvement in pain during vaginal penetration, post coital bleeding, level of anxiety related to sexual life, and overall sexual satisfaction post LEEP procedure. CONCLUSION- The present study concluded that LEEP poses no long-term effect on women's sexuality, with a reduction in dyspareunia and postcoital bleeding, along with improvement in overall sexual function, although small but statistically significant.
Bahadur et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Pregnancy is a transient state of immunosuppression. The objective of this study was to ascertain whether pregnant women are more susceptible to coronavirus disease 2019 (COVID-19) than non-pregnant women and the impact of pregnancy on the severity of COVID-19 and associated morbidity and mortality.Methods: A prospective observational study was performed at All India Institute of Medical Sciences (AIIMS) Rishikesh for a period of two months. A total of 42 and 33 COVID-19 positive women were included in the obstetric and non-obstetric cohorts respectively.Results: Baseline characteristics were similar in both groups. Approximately 48% of the obstetric cohort had no COVID-19-related symptoms. Whereas, 100% of the non-obstetric cohort was symptomatic and had a significantly higher number of patients presenting with fever, cough, and breathlessness. The obstetric cohort had a significantly higher incidence of mild disease (p=0.009). In the obstetric cohort, the mean gestational age was 32.59 ± 2.57 weeks, with patients spread across all trimesters. Most of the patients with severe disease were in their second trimester. There was no difference in intensive care unit (ICU) admission, duration of ICU stay, duration of hospital stay, and mortality among both groups. A significantly smaller number of patients in the obstetric cohort required ventilatory support (p=0.0002). The maternal mortality rate was 16.67%. All of them had severe diseases requiring ICU admission. The cause of death was attributed to severe COVID pneumonia with septic shock in all cases. The mortality rate was comparatively higher (27.27%) in the non-obstetric group.Conclusion: Pregnancy, unlike other immunocompromised conditions, does not seem to affect the prognosis of COVID-19 in terms of disease severity or mortality.
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