Background: Bacterial Vaginosis is one of the most common causes of abnormal vaginal discharge in women of reproductive age, which can have a major impact on quality of life. Although the treatment course of oral metronidazole for 7 days results in curative rate of 70%–80% at four weeks of treatment, but is associated with high rates of recurrence occurred within twelve months, reaching up to 40%–50%. Methods: A Randomized Prospective Interventional Study was done on 1000 reproductive age group females (pregnant or non-pregnant) diagnosed with bacterial vaginosis from November 2020 to October 2022 at department of Obstetrics & Gynaecology, Kanpur. The study group were divided into two subgroups - Group 1 were given metronidazole 500 mg for 7 days and probiotics for 14 days and group 2 were given metronidazole 500 mg for 7 days and placebo for 14 days. The patients were followed after 3 months to know the recurrence. Results: Majority of patients belonged to rural background (63.1%) with lower socioeconomic (46.6%) and belong to age group 20-35 years. It was observed that there was significant change in Amsel’s criteria and Nugent’s scoring in Group 1 as compared to Group 2. The rate of recurrence at the end of the treatment for Amsel’s criteria in group 1 were 1.03 as compared to group 2 was 1.68 and for Nugent’s scoring, the rate of recurrence at the end of treatment in group 1 was 3.17 as compared to group 2 was 4.78. Conclusion: Probiotics can be considered as one the adjuvant therapy for treating bacterial vaginosis and re-establishing equilibrium in the vaginal microflora thus, preventing the recurrences.
Introduction: Severe Acute Maternal Morbidity (SAMM) is a tool which is more advantageous compared to maternal mortality as an indicator of obstetric care. The global MMR shows a reduction from 342 to 211 death per 1 lakh live birth from 2007 to 2017 with a 38% over 10 years. Under Millennium development goals (MDG)-5, goal was to reduce maternal mortality by 75% between 1990-2015. By the end of year 2020 MMR in India was 97 per lakh. Now the Sustainable development goal (SDG) is to reach MMR below 70 by 2030. Aims and Objectives: * To as certain the incidence of maternal near-miss indices * To as certain the reasons behind maternal mortality * To as certain the occurrences of near-miss instance Materials and Methods: A retrospective study was conducted at Cheluvamba hospital, Mysore, Karnataka, India during January 2022 to December 2022. Maternal fatalities and near miss incidents are included in the study population. Case definitions were made using the 2009 WHO criteria. Diagnoses of life-threatening illnesses were made, and cases that satisfied WHO 2009 criteria were chosen. Analyses of maternal mortality from the same time frame were also conducted. Anemia and other medical conditions were viewed as secondary causes leading to the mother's near-miss and death, while hemorrhage, hypertension, sepsis, and other conditions were classified as primary causes for patients based on their final diagnosis. Results: In our Institute, 8632 deliveries took place. In this study, the MMR was 251/100,000 live births, while the MNMIR (Maternal Near Miss Incidence Ratio) was 14/1000 live births. The ratio of MNM to MM was 5.7:1. The MI (total mortality) was 14.8%. The ratio of severe maternal outcomes to live births, or SMOR, was 16.8/1000. Hypertensive disorder (42.85%) was the leading cause of maternal mortality, with antepartum eclampsia being the main leading cause in our setup, followed by hemorrhage (19.04%). Among the near miss events, hypertensive disorder was the leading cause with 49.16%, followed by hemorrhage (31.66%), severe anemia, and abortion, which account for approximately 7.5%. Conclusion: Maternal morbidity and mortality can be decreased by recognizing the risk factors, identifying high-risk cases, promptly referring them, and stabilizing the referral system.
Background: Hypertension in pregnancy, called a disease of degree is more of a sign than a disease by itself. Hypertensive disorders of pregnancy, including chronic hypertension, with or without superimposed pre-eclampsia/eclampsia, gestational hypertension, HELLP syndrome, pre-eclampsia with or without severe features or eclampsia present a significant risk of morbidity to both mother and fetus. Effective pharmacologic therapy modifies the course of the disease. The effective use of anti-hypertensive therapy should be based on well designed controlled clinical trials and the experience of the clinician with the drugs. Hypertensive disorders complicate 5-10% of all pregnancies worldwide. 1 Dangerous hypertension is a harbinger of cerebrovascular accidents, eclampsia, hypertensive encephalopathy and other end organ damage with a poor perinatal outcome. 2 Methods: This prospective randomized double blind comparative clinical trial with randomization done using computer generated numbers study was carried out in 100 cases being brought in OBG department of AL Ameen Medical College, Bijapur, from July 2023 to December 2023. A detailed data of sociodemographic profile, general examination and obstetric examination were carried out. The pregnant women were randomized with computer generated numbers into two groups to receive either oral nifedipine or intermittent intravenous labetalol injections. Results: There is no significant difference in the parity of both the groups. Majority of the patients constituting 80% of group A and 58% of group B were primigravida. 69% enrolled in the study were primigravida. There is a higher incidence of pre-eclampsia in the first pregnancy. The majority of the patients had gestational age of 34 to 36 weeks constituting 48% on the whole with 50% and 46% respectively in group A and B. The recruited patients did not significantly differ in gestational age
Ovarian ectopic pregnancy is rare and constitutes around 3% of all ectopic pregnancies. Its presentation is similar to tubal ectopic pregnancy and is difficult to diagnose based on the presentation and ultrasound findings. Here, we describe one such case which we encountered in our practice. Primigravida patient at early gestation presented with vaginal spotting and pain in lower abdomen. She was suspected as ruptured ectopic pregnancy based on examination and ultrasound findings. Immediate laparotomy was performed and patient was diagnosed to have ruptured ovarian pregnancy intraoperatively. Partial ovariotomy was performed and the case was successfully managed. Histopathology confirmed the diagnosis. Surgery is the mainstay of definitive diagnosis and treatment. Identifying these cases early is imperative as such patients can collapse suddenly and there are high chances of maternal morbidity and mortality.
Background: Women who had undergone hysterectomy have to overcome problems related to physical, social and emotional well being. As the hysterectomy is one of the most common surgeries, a study was conducted to answer the question for the optimal surgical recovery. This study aims to describe the relationships between recovery time and the components of quality of life after hysterectomy. Aims and Objectives: To study the physical, social, and emotional well being of post hysterectomised patient. Methodology: Study was conducted in Department of Obstetrics and Gynaecology at Bharati hospital, Pune. It was a prospective observational study of patient related outcomes to study the physical, social, and emotional well being of post hysterectomised patient. Post hysterectomized women above 40 years were included in this study. 196 post hysterectomised women were included. Study was conducted from October 2021 to January 2024. Results: From third month onwards, degree of difficulty of majority of patients was reduced in all mentioned activities. Majority of cases there was gradual health improvement noted. The pain score was reduced over 3 months in 92% cases and in almost all patients over 6 months. Conclusion: It is important to assess quality of life after any surgery, so timely intervention suchasphysiotherapy, counselling,psychotherapy and medical therapy canaidin improvement of both physical and emotional health for betterment of patient care.
