Dysmenorrhoes
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Dysmenorrhoea, or painful menstruation, is the most common problem affecting women of reproductive age. It can be primary, caused by increased prostaglandins during menstruation without underlying pelvic pathology, or secondary, caused by conditions like endometriosis, fibroids, or infection. Evaluation involves assessing pain severity and relationship to bleeding, as well as testing to rule out potential causes. Treatment of primary dysmenorrhoea focuses on NSAIDs, while secondary dysmenorrhoea requires treating the underlying condition.
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This document discusses various gynecological infections and abnormalities. It begins by defining and describing dysmenorrhea (painful periods) and its causes. It then discusses premenstrual syndrome (PMS), defining it as a cluster of physical and psychological symptoms before menstruation. Precipitating factors and common symptoms of PMS are provided. Treatment options for both dysmenorrhea and PMS focus on reducing pain and inflammation. These include NSAIDs, oral contraceptives, exercise, and tranquilizers or diuretics to help manage mood changes and bloating respectively.
Dysmenorrhea
Dysmenorrhea, or painful menstruation, is a common disorder affecting females of reproductive age. It can be primary or secondary. Primary dysmenorrhea is caused by increased prostaglandin production during menstruation leading to uterine cramps. Symptoms include nausea, back pain, and headaches. Treatment involves NSAIDs to reduce prostaglandins or hormonal methods like combined oral contraceptives. Secondary dysmenorrhea has an underlying cause like endometriosis or infections that must be investigated and treated. Managing stress and getting exercise can also help improve dysmenorrhea symptoms.
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This document discusses dysmenorrhea, or painful periods. It is divided into two sections: primary and secondary dysmenorrhea. Primary dysmenorrhea is caused by increased prostaglandin production during menstruation and affects 50-75% of women aged 17-22 with symptoms like lower abdominal cramping. Secondary dysmenorrhea has an identifiable cause like endometriosis and is treated by addressing the underlying condition. Diagnosis involves history, exam, and sometimes imaging or surgery to investigate causes of secondary dysmenorrhea. Treatment focuses on pain relief with NSAIDs or oral contraceptives.
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Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. There are two types - primary dysmenorrhea, which is caused by uterine contractions, and secondary dysmenorrhea, which is caused by underlying medical conditions. Symptoms include lower abdominal pain that may radiate to the thighs and back, along with nausea, vomiting, diarrhea, and headaches. Treatment involves NSAIDs to reduce prostaglandins and relieve pain, oral contraceptives, and lifestyle changes like exercise and hot baths.
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Dysmenorrhea
Dysmenorrhea, or painful menstruation, is a common disorder affecting females of reproductive age. It can be primary or secondary. Primary dysmenorrhea is caused by increased prostaglandin production during menstruation leading to uterine cramps. Symptoms include nausea, back pain, and headaches. Treatment involves NSAIDs to reduce prostaglandins or hormonal methods like combined oral contraceptives. Secondary dysmenorrhea has an underlying cause like endometriosis or infections that must be investigated and treated. Managing stress and getting exercise can also help improve dysmenorrhea symptoms.
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Long considered "Women's oldest hygenic problem".
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A rectal examination involves inserting a lubricated finger into the patient's rectum to examine the internal and external areas for any abnormalities. Key steps include obtaining consent from the patient, positioning them on their side, inspecting the external anal area, lubricating the finger, inserting the finger into the rectum while applying pressure, and sweeping the finger around the rectum clockwise and counter-clockwise. The prostate is assessed in males. The glove is then examined and any findings reported before concluding the examination.
Complication of breech delivery.
This document summarizes potential neonatal complications that can occur during breech delivery, including intrapartum death, asphyxia, hypoxic ischemic encephalopathy, intracranial hemorrhage, trauma to internal organs, fractures, brachial plexus injuries, and head entrapment. Specific risks include umbilical cord prolapse cutting off oxygen supply, rapid birth of the head causing brain damage, and traumatic injuries to the skull, spine, or long bones from obstetric maneuvers. Close monitoring during delivery and potentially expedited c-section are recommended to prevent complications from breech birth.
Upper GI endoscopy-GI surgery
Upper GI endoscopy is a procedure that uses a lighted, flexible endoscope to examine the esophagus, stomach, and duodenum. It can be used to detect various conditions like ulcers, abnormal growths, and inflammation. Upper GI endoscopy can determine the cause of symptoms like abdominal pain, bleeding, vomiting, and unexplained weight loss. During the procedure, the doctor may remove objects, stop bleeding, take biopsies, and perform other therapeutic interventions. Patients need to follow preparation instructions which involve fasting beforehand and having someone drive them home after the procedure.
Colonoscopy-GI surgery
Colonoscopy is a procedure where a gastroenterologist inserts a flexible tube with a camera into the rectum and entire colon to examine the intestinal lining. The colonoscope allows the doctor to detect polyps, ulcers, or other abnormalities. Common reasons for a colonoscopy include changes in bowel habits, abdominal pain, bleeding, or weight loss, as well as screening for colon cancer. Prior to the procedure, patients must follow a clear liquid diet and use laxatives or enemas to cleanse the bowels. During colonoscopy, the doctor may remove polyps, perform biopsies, and treat any bleeding. Possible complications include perforation of the colon, infection, or cardiovascular issues, though death is rare.
Cleft lip and palate
Cleft lip and palate is a birth defect that affects about 1 in 700 babies, occurring more commonly in males. It has both genetic and environmental causes such as certain drug exposures during pregnancy. Cleft lip involves a failure of the lip to fuse completely, resulting in an opening extending into the nose. Cleft palate occurs when the roof of the mouth does not join fully, leaving an opening into the nose. Surgical repair of the lip is often done in the first week of life for cosmetic reasons, while palate repair typically occurs several months after birth. Complications can include difficulties with feeding, ear infections, and speech problems. Management involves specialized feeding techniques and speech therapy.
Dengue Case scenario
- 8-year-old girl presented with 4 days of fever, abdominal pain, arthralgia and myalgia.
- Initial examination found fever, adequate hydration, tender abdomen, and tachycardia.
- Initial tests showed thrombocytopenia, raising suspicion for dengue fever.
- Over subsequent days, patient required careful fluid management and monitoring as clinical signs worsened, meeting criteria for dengue hemorrhagic fever.
- After several days in critical phase, patient's condition gradually improved with supportive care and returned to stable condition.
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Dysmenorrhoes
- 2. • Commonest problem affecting in most of the women in reproductive age group. “pain and discomfort during menses”
- 3. History • Assess the degree of pain by asking question ?Is pain disturb to your daily routine works ?Do you have to keep off work during menses ?Do you have to take analgesics during menses ?What analgesics do you take and how strong are they
- 4. • Find out the nature of the pain – gradually getting worse /remain same over the year • Relationship to bleeding ?Does the pain and bleeding come together ?Does the pain comes before the onset of bleeding ?Does the pain outlast the menses
- 5. Types • Primary or spasmodic –painful menstruation in absent of any pelvic pathology • Secondary dysmenorrhea –due to underling disease of pelvic organ
- 6. DD • Chronic or subcutaneous appendicitis • Irritable bowel syndrome
- 7. Primary dysmenorrhea • Management Medical management o Non hormonal –NSAID (prostaglandin synthetase inhibitors )-1st line of treatment Mefanamic acid 500mg 8 hly Naproxen sodium 275mg 6 hly Diclophenac sodium 75-100mg daily
- 8. o Hormonal-suitable for women who also trying to conceive Combined oral contraceptive pills Progesterone containing IUDs (mirena coil)
- 9. Secondary dysmenorrhea • Cause 1)Congenital abnormalities of the uterus o Redundant uterine horm o Imperforate hymen 2)Acquired condition of uterus o Submucus fibroid o Endometrial polyps o Adenomyosis 3)Infection-PID
- 11. Investigation 1)FBC ,CRP – to exclude PID 2)High vaginal swabs and endocervical swab to Infection of Chlamydia tracomatis and Neisseria gonorrhoea 3) CA-125 –increase in endomeriosis 4) Pelvic ultrasonography –exclude uterine abnormalities ,tubo- ovarian abscesses ,endometriosis
- 12. 5) Hysteroscopy to diagnosis endometrial polyps ,submucus fibroid 6)Laparoscopy –to diagnosis minimal endometriosis, pelvic adhesion, early PID Manage by treating underlying cause