Reasoning of medical tactics at the preconception in patients with a history of miscarriage and abnormal vaginal discharge

2016 ◽  
pp. 52-56
Author(s):  
N.V. Schuruk ◽  
◽  
V.I. Pyrohova ◽  

The objective: evaluating the effectiveness and safety of the drug complex hinekit during preconception preparation for women with complicated pregnancy loss history and uncomplicated mixed genital infections. Patients and methods. The study involved 65 women with reproductive losses in history, who turned over the abnormal vaginal discharge. Diagnosis of sexual transmitted infections (C. trachomatis, T. vaginalis, HSV-II, HPV), assessment of vaginal microbiota was performed by PCR with detection results in real time. Bacterial Vaginosis verified by the Amsel system. Results. All the examinees in the history have miscarriage in the first (56.9%) or the second (43.1%) trimester of pregnancy. According to the results of the patient survey were divided into clinical groups. In 26.2% of women infectious pathology of the lower genital tract has not been confirmed, 26.2% of patients did not give consent to participate in the study and were formed in the control group that received therapy according to existing clinical settings. 31 patients with mixed genital infection (study group) received complex preparation gіnekit. This positive trend was observed in all the patients of the main group (the disappearance of subjective sensations on average 2.2±0.3 hours). After treatment T. vaginalis, BV were not detected in one patient, active mycotic process in the absence of complaints remained at 4.8% of women, complete eradication of C. trachomatis was achieved in 92.3% of patients. Conclusions. Reducing the duration of treatment of mixed genital infections at the preconception in women with reproductive losses in the history is achieved in terms of clinical, microbiological and pharmaco-economic benefits by prescribtion an gіnekit preparation. Summary of clinical and microbiological effects of the proposed approach is 96.0 ± 0.9%, which corresponds to all requirements for multimodal therapy of genital infections, and no side effects, short course of treatment provides a high compliance of patients (9.2±0.7 points). Key words: mixed genital infections, miscarriages, gіnekit, azithromycin, fluconazole, seknidazol.

Doctor Ru ◽  
2020 ◽  
Vol 19 (8) ◽  
pp. 86-90
Author(s):  
A.L. Tikhomirov ◽  
◽  
S.I. Sarsaniya ◽  
V.V. Kazenashev ◽  
◽  
...  

Objective of the Paper: To describe options for effective treatment, with high compliance rates, of bacterial vaginosis (BV). Key Points: Bacterial vaginosis is the most common cause of abnormal vaginal discharge in women of reproductive age. The paper describes some options for effective treatment, with high compliance rates, of BV and includes clinical cases of the use of clindamycin in obstetric/gynecological practice. Conclusion: High rates of compliance with the treatment, low rates of recurrence, a short duration of treatment, and a low incidence of side effects support the use of clindamycin in the treatment of BV. Keywords: bacterial vaginosis, abnormal vaginal discharge, biofilms, clindamycin, Dalacin.


2020 ◽  
pp. 54-58
Author(s):  
I.V. Lakhno ◽  
◽  
A.E. Tkachov ◽  
O.V. Grischenko ◽  
◽  
...  

The inflammatory diseases of the pelvic organs are known to be one of the important problems of modern gynecology, which is due to the high frequency of chronicity of the process and a large number of complications. The article provides a theoretical and practical substantiation of the use of the drugs Rheosorbilact and Grandazol to increase the efficacy of empirical therapy in patients with acute salpingo-oophoritis. The objective: study of the effectiveness of the use of hyperosmolar combined solution of sorbitol with a balanced content of electrolytes for low-volume infusion therapy (Rheosorbilact) and a solution of levofloxacin 2.5 mg and ornidazole 5 mg (Grandazole) in the treatment of women with acute PID. Materials and methods. Totally 98 women of reproductive age were examined and divided into three clinical groups. The I (control) group included 30 healthy women. In group II (comparison), 33 patients with acute bilateral adnexitis were included, who were prescribed traditional treatment. In group III (main) group, there were 35 women who were additionally prescribed Rheosorbilact and Grandazole was used as an antibacterial agent. Results. A survey of women with acute bilateral adnexitis found that among all clinical characteristics the most common were: lower abdominal pain (89.7%), abnormal vaginal discharge (88.2%), and fever (83.8%). The variables of the level of C-reactive protein, the number of leukocytes, and the value of the resistance index in the ovarian arteries were elevated in the study population before treatment, respectively: 52.4±8.3 mg/l, 11.8±2.2×109/l, 1.4±0.2, which differed from the control values (p<0.05). The study of the pseudo-R2 Nagelkerke confirmed the relationship between increased resistance index and lower abdominal pain, abnormal vaginal discharge and fever with high sensitivity (88,2%) and insufficient specificity (60.4%). Thus, in women with acute salpingo-oophoritis, the presence of inflammatory symptoms (even in the absence of Doppler data) is an indication for the use of infusions of vasotrophic drugs with the hemorheological action.The priority effect of this method of treatment was the optimization of hemodynamics in the large vessels of the small pelvis, which provided the effective delivery and accumulation of antibacterial drugs in the inflammation focus. Conclusion. The specified combination of drugs Rheosorbilact and Grandazole has demonstrated the maximum clinical effect, which justifies the possibility of widespread use of this method of therapy. Keywords: inflammatory diseases of the pelvic organs, Doppler ultrasound, treatment, Rheosorbilact, Grandazole.


Author(s):  
Tabasum Ali Bhat ◽  
Wajeeha Begum

Abstract Background At least 25 % of women attending genitourinary medicine (GUM) clinics receive treatment for one of the three common causes of abnormal vaginal discharge: bacterial vaginosis, candidiasis and trichomoniasis. Syndromic diagnostic approach was adopted by National AIDS Control Organisation (NACO) India, at the primary health centre level. Syndromic management implies the simultaneous treatment of two or more infections. The aim of this study was to assess efficacy of sandal sufaid, maghze tukhme bakayin and khaste tamar hindi in syndromic management of Sailanur rehm. Methods This study was a randomized, single blind, standard controlled trial. It was conducted to compare efficacy of formulation which contains buradae sandal safaid, safoofe maghze tukhme bakayin, safoofe khaste tamar hindi and safoofe shakkar safaid against combination of azithromycin, fluconazole and secnidazole on diagnosed subjects of Sailanur rehm. Test group received 10 g of test drug B.D for 21 days while control group received single dose of standard drug to both the partners. Vaginal symptom score (VSS) was used for assessing discharge and associated complaints. Visual analogous scale (VAS) was used for assessing low backache and lower abdominal pain. Results There were no significant differences between the two groups concerning baseline characteristics (p>0.05). VSS was significantly decreased with p<0.001 for both control and test group. VAS was significantly decreased with p<0.001 and p=0.07 in test and control group respectively for low backache. For lower abdominal pain p=0.006 for both groups after the completion of treatment. Conclusions The formulation can effectively alleviate the disease with associated symptoms without any side effects. It can be used in syndromic management of vaginal discharge. Future research is on large sample size.


Author(s):  
Ella Nissan ◽  
Abdulla Watad ◽  
Arnon D. Cohen ◽  
Kassem Sharif ◽  
Johnatan Nissan ◽  
...  

Polymyositis (PM) and dermatomyositis (DM) are autoimmune-mediated multisystemic myopathies, characterized mainly by proximal muscle weakness. A connection between epilepsy and PM/DM has not been reported previously. Our study aim is to evaluate this association. A case–control study was conducted, enrolling a total of 12,278 patients with 2085 cases (17.0%) and 10,193 subjects in the control group (83.0%). Student’s t-test was used to evaluate continuous variables, while the chi-square test was applied for the distribution of categorical variables. Log-rank test, Kaplan–Meier curves and multivariate Cox proportional hazards method were performed for the analysis regarding survival. Of the studied 2085 cases, 1475 subjects (70.7%) were diagnosed with DM, and 610 patients (29.3%) with PM. Participants enrolled as cases had a significantly higher rate of epilepsy (n = 48 [2.3%]) as compared to controls (n = 141 [1.4%], p < 0.0005). Using multivariable logistic regression analysis, PM was found only to be significantly associated with epilepsy (OR 2.2 [95%CI 1.36 to 3.55], p = 0.0014), whereas a non-significant positive trend was noted in DM (OR 1.51 [95%CI 0.99 to 2.30], p = 0.0547). Our data suggest that PM is associated with a higher rate of epilepsy compared to controls. Physicians should be aware of this comorbidity in patients with immune-mediated myopathies.


Author(s):  
Fatin Shallal Farhan ◽  
Ban Hadi Hameed ◽  
Muna Abdulghani Zghair

Objective: The effectiveness of progesterone in the prevention of threatened preterm labor has been established for many years, but the preferable route, dose, and duration of treatment are until now under the evaluation of researches. The aim of this study was to determine the effect of rectal progesterone on Doppler indices of the uterine arteries in pregnant women with threatened preterm delivery.Methods: A prospective case–control study was conducted at the obstetric ward and the Outpatients Department of Al-Yarmouk Teaching Hospital in Baghdad for the period of 1 year from April 1, 2017, to April 1, 2018. 100 women were enrolled in the study, 50 of them were pregnant women with a diagnosis of preterm labor assigned as a study group and the other 50 were apparently healthy pregnant women of the same gestational age assigned as a control group. Doppler study of uterine arteries was done to all participants, and the results were compared for both groups. The patients with preterm labor received nifedipine tocolysis initially until contractions subsided and Doppler study had been repeated for those women after 1 week of rectal progesterone therapy.Results: The study group had a significantly higher resistance index (RI) than the control group (0.58 vs. 0.52) as p<0.05, in spite of the pulsatility index (PI) being higher for the study group compared to the control group (0.78 vs. 0.77) but this difference was not statistically significant. The RI before the therapy (0.58) was significantly higher than the index after therapy (0.52), and the PI was again significantly higher before therapy (0.78) than after therapy (0.71) as p<0.05. During the follow-up period, 3 (6.5%), 4 (8.7), and 39 (84.8%) patients delivered within 1 week, after 1 week, and at term, respectively.Conclusion: Rectal progesterone can arrest threatened preterm labor, and this effect is possible in part explained by its action on uterine arteries.


2015 ◽  
Vol 96 (1) ◽  
pp. 5-9 ◽  
Author(s):  
K V Voronin ◽  
A M Alale ◽  
I I Alale ◽  
R M Banakhevich

Aim. Prevention of purulent and septic complications in females after planned caesarean section.Methods. Out of 60 pregnant women, who underwent comprehensive examination during the trial, 35 (58.3%) were included in the study group and were delivered off by planned cesarean section; 25 (41.7%) pregnant women, included in the control group, were delivered off by urgent cesarean section. Considering the goal of the study, bacteriology of vaginal discharge, amniotic fluid and placental tissues, DNA detection of vaginal discharge bacterial flora before and after treatment (using «Femoflor-16» test system) according to classification by M.N. Boldyreva (2010), uterine cavity aspirate cytology according to classification by M.A. Kupert (2003), sonography of the uterus and uterine adnexa on the 4-5 day after the surgery according to classification of A.P. Milovanov were added to the training program for pregnant women. In the study group, pregnant patients with severe anaerobic vaginal dysbiosis at the 36-38 weeks of gestation were administered causal treatment of severe anaerobic vaginal dysbiosis, pregnant patients of the control group were not treated if severe anaerobic vaginal dysbiosis was diagnosed.Results. Performed correction of vaginal microbiota in the study group has significantly improved the course of postoperative period, reduced the incidence of uterine subinvolution, signs of chorioamnionitis as a manifestation of ascending infection compared to the control group. Postpartum endometritis has developed in 1 (2.8%) patient of the study group and in 5 (20.0%) cases in the control group. Offered method for preparing the patients with vaginal dysbiosis to cesarean section reduced the risk for postpartum endometritis by 6.8 times.Conclusion. Strategy of preparation for planned Caesarean section should include vaginal discharge bacteriology and treatment of severe anaerobic vaginal dysbiosis, which reduces the risk for postpartum endometritis by 6.8 times.


Author(s):  
Vitaliy Demchenko ◽  

The article examines the effectiveness of interdisciplinary integration in the training of future physical education teachers. The purpose of the article is to test the effectiveness of interdisciplinary integration in the training of future teachers of physical education. Research methodology includes: empirical methods: observations, questionnaires, pedagogical experiment is for checking the effectiveness of interdisciplinary integration in the training of future teachers of physical education; methods of mathematical statistics are for processing the results of experimental work. Analysis of the effectiveness of the implementation of interdisciplinary integration in the training of future teachers of physical education is based on a certain system of standards: pedagogical orientation, independence and professional maturity, which we used to diagnose their development by those activities that included students of the experimental group. After analyzing the data, it was found that students of the control and experimental groups have significant differences on such scales as: awareness, decision-making, planning and communication; as well as a positive trend on the scales: mnemonic, volitional and mental. According to the study, it can be said that future physical education teachers of the experimental group are more knowledgeable and confident in choosing their profession, they more rationally and adequately assess the situation and plan their future more thoughtfully than students in the control group.


PEDIATRICS ◽  
1982 ◽  
Vol 70 (2) ◽  
pp. 193-198 ◽  
Author(s):  
Jan E. Paradise ◽  
Joseph M. Campos ◽  
Harvey M. Friedman ◽  
Gertrude Frishmuth

Fifty-four premenarcheal patients (median age 5.8 years) with symptoms or signs of vulvovaginitis were studied, and the results of cultures of vaginal secretions were compared with those from an age-matched control group. Vaginal discharge was found on examination in 24 of 42 patients with a complaint of discharge, and in two of 12 patients without a complaint of discharge. Convincing evidence of bacterial or monilial infection was found in 14 of the 26 patients with discharge on examination, but in none of the 28 patients without discharge (P &lt; .001). In the latter group pinworm infestation was present in one patient. Moniliasis occurred exclusively in girls who were pubertal (P &lt; .001). Four patients were found to have gonorrhea. No patient appeared to have symptoms or signs caused by Bacteroides sp, Chlamydia trachomatis, viruses, or Trichomonas vaginalis. Noninfectious causes were identified in four patients with and 13 without discharge (P &lt; .025); the most common cause was poor hygiene, implicated in six patients. Bubble bath use was implicated in only one patient. In 22 patients, no specific cause could be identified. All patients with poor hygiene as the only cause, and most with no demonstrable etiology, recovered after being advised to institute improved perineal hygiene. Patients with vaginal discharge are likely to have specific infections, and therefore cultures should be taken, in particular for Neisseria gonorrhoeae. Genital pruritus in prepubertal girls has little or no etiologic specificity, but in pubertal girls with vaginal discharge it suggests the presence of monilial vaginitis.


BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu-Hsia Lee ◽  
Shu-Chuan Lin ◽  
Pao-Yu Wang ◽  
Mei-Hsiang Lin

Abstract Background Culture serves as an adhesive to bind the lives of people. There are no objective, useful tools to assess cultural competence and practice. In this study, we evaluated whether the cultural competence of nurses was strengthened through the Cultural Competence Cultivation Programme. Methods A quasi-experimental research design was used to evaluate nurses working at a medical centre in Taiwan. They were randomly allocated into an experimental group (n = 47), which received the Cultural Competence Cultivation Programme, or a control group (n = 50), which did not receive the educational programme. After the intervention, learning efficacy of the participants was assessed using an Objective Structured Clinical Examination (OSCE). The research data were statistically analysed on SPSS. Results The average score of the experimental group was significantly higher in the ‘communication ability and skill’ category. Furthermore, OSCE scores and Standardised Patient Survey assessment and total scores were significantly and positively correlated. Conclusion The findings of this study can serve as a reference for designing future clinical education programmes.


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