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Urinary Tract Infection and Antibiotic Resistance in Pregnant Women: A Single-Center Cross-Sectional Study
Maria Tasneem,
Sadia Shoukat,
Tehreem Zahid,
Jahooran Mariyah Bibi Goolamnobee,
Nabila Salman
Issue:
Volume 10, Issue 6, November 2022
Pages:
236-242
Received:
27 June 2022
Accepted:
6 August 2022
Published:
10 November 2022
DOI:
10.11648/j.jgo.20221006.11
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Abstract: Urinary tract infections are one of the most prevalent infectious diseases which frequently reoccur and are difficult to eradicate. OBJECTIVE: To determine the frequency of the most common gram-positive and gram-negative organisms causing urinary tract infections, as well as their sensitivity/resistance to various antibiotics in pregnant women. Methods: A total of 160 cases were included in this cross-sectional study, which was conducted at the in-patient Department of Obstetrics and Gynecology at NESCOM hospital Islamabad. All patients fulfilling the inclusion criteria were enrolled in the study. After taking consent from the patient and explaining the purpose of the study, early morning mid-stream urine samples were collected in a sterile bottle to report pus cells, epithelial cells, and bacteria. If the patient had a urinary tract infection according to the urine report, then a culture and sensitivity test was performed. Results: A total of 160 patients presenting with urinary tract infections were included in the study. The mean age of the patients was 25.06 + 10.04 years. Out of 160 patients, 120 (75%) had asymptomatic UTIs, while 40 (25%) patients had symptomatic UTIs. The most common organisms were Escherichia coli (55.6%) followed by Staphylococcus aureus (18.2%), Klebsiella pneumoniae (11.9%), Pseudomonas aeruginosa (6.9%), Staphylococcus saprophyticus (4.3%) Streptococci (1.9%) and Proteus vulgaris (1.2%). Organisms causing symptomatic UTI were Pseudomonas aeruginosa, followed by Klebsiella pneumoniae, Escherichia coli, Staphylococcus saprophyticus and Staphylococcus aureus. E. coli showed the highest sensitivity to ceftriaxone (71%) but was resistant to cephalexin (89%) and co-amoxiclav (82%). Klebsiella pneumoniae was only 76% sensitive to cefixime and 93% resistant to Co-Amoxiclav. Ceftazidime was 81% effective against Pseudomonas aeruginosa, while cefixime was 69% effective. Pseudomonas aeruginosa was 95% resistant to Cephalexin and 86% resistant to Nitrofurantoin. Staphylococcus aureus was 81% susceptible to cephalexin and 93% resistant to cefixime. Staphylococcus saprophyticus was 97% sensitive to Co-Amoxiclav and 85% resistant to Ceftazidime and Nitrofurantoin. Streptococci sp. were 95% sensitive to Cephalexin and 95% resistant to Ceftazidime 88%. Conclusion: In conclusion, the empirical evidence reaffirms that the selection of medications for the treatment of UTIs is limited due to antibiotic resistance that the prevalent microorganisms display to medications utilised in the past. Drugs like co-trimoxazole and aminopenicillins, which were once thought to be useful against uropathogens, are now infrequently used as empirical therapy in regions with high rates of antibiotic resistance.
Abstract: Urinary tract infections are one of the most prevalent infectious diseases which frequently reoccur and are difficult to eradicate. OBJECTIVE: To determine the frequency of the most common gram-positive and gram-negative organisms causing urinary tract infections, as well as their sensitivity/resistance to various antibiotics in pregnant women. Met...
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Nonspecific Lesions in Patients with Chronic Vulvar Discomfort Revealed Vulvodynia as Chronic Reflex Pain Syndrome (CRPS) Type I
Vesna Harni,
Damir Babic,
Suzana Ljubojevic-Hadzavdic,
Dubravko Barisic
Issue:
Volume 10, Issue 6, November 2022
Pages:
243-252
Received:
16 October 2022
Accepted:
3 November 2022
Published:
10 November 2022
DOI:
10.11648/j.jgo.20221006.12
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Abstract: This study aimed to investigate the presence, type, and arrangement of nonspecific lesions considering the different histologies of the three vulvar rings in women with chronic vulvar discomfort to obtain reference data for the diagnostic procedure and a better understanding of women with chronic vulvar distress. The distribution of nonspecific lesions in the vulva based on vulvar rings was monitored as a secondary outcome measure within the framework of the prospective experimental study using diagnostic interventions called DATRIV, which included a total of 328 consecutive participants. Four patient groups were distinguished according to their medical history, structured International Society for the Study of Vulvovaginal Disease vulvodynia questionnaire results, and clinical examination, including inspection and cotton swab test. Asymptomatic participants were classified into normal vulva (N = 82) and impaired vulvar skin (N = 82) groups. Patients with chronic vulvar discomfort were categorized into groups of patients with primary, idiopathic vulvar distress/vulvodynia (N=82), and secondary complaints caused by vulvar dermatosis (N=82). Three rings vulvoscopy form data were used to collect clinical data, which were analyzed using StatSoft (Dell, Austin, TX, USA), Statistica 12 (TIBCO®, Palo Alto, CA, USA), and SPSS 20 (IBM, Armonk, NY, USA). This study was approved by the Institutional Review Board of Polyclinic Harni, and all patients provided written informed consent. Nonspecific changes in the outer vulvar ring were significantly more common in patients with vulvar dermatosis (70.7%). The opposite pattern of lesion incidence was observed, with a considerably higher frequency of nonspecific findings in the inner vulvar ring in patients with vulvodynia (98.8%) and impaired vulvar skin (96.3%). The inner vulvar ring in patients with vulvodynia demonstrated a peculiar and characteristic profile with significantly more frequent findings of erythema (92.7%), punctuations (54.9%), ischemia (48.8%), and papillae (25.6%). A high presence of nonspecific lesions in the middle vulvar ring was documented in all participants, with an evident distinction in the appearance and allocation of these findings between patients with vulvodynia and vulvar dermatosis. By establishing the characteristic pattern of the type and distribution of nonspecific lesions in patients with vulvodynia, the Budapest criteria for considering vulvodynia as chronic reflex pain syndrome (CRPS) type 1, formerly sympathetic dystrophy, are met. Due to the specific three rings anatomy of the vulva, revised Budapest criteria are proposed. This study creates a unique opportunity to introduce vulvoscopy in the differential diagnosis of chronic, primary, and secondary vulvar discomfort.
Abstract: This study aimed to investigate the presence, type, and arrangement of nonspecific lesions considering the different histologies of the three vulvar rings in women with chronic vulvar discomfort to obtain reference data for the diagnostic procedure and a better understanding of women with chronic vulvar distress. The distribution of nonspecific les...
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Giant Vulvar Lipoma: A Case Report and Literature Review
Mengru Zhao,
Ying Cao,
Yao Chen,
Yun Yang,
Mengyue Chen,
Huimin Tang,
Junling Liu,
Weiwei Wei,
Tingwei Xing,
Ruxia Shi,
Bairong Xia,
Jiming Chen
Issue:
Volume 10, Issue 6, November 2022
Pages:
253-256
Received:
31 October 2022
Accepted:
23 November 2022
Published:
8 December 2022
DOI:
10.11648/j.jgo.20221006.13
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Abstract: Lipoma is the common benign soft tissue tumors. However, to date, few reports of vulvar lipomas have been reported. This article reports a rarer and relatively large type of vulvar lipoma. Below is the case of a 32-year-old woman who has a huge right vulvar lump. She was admitted to the hospital because she touched a growing lump on the right side of her vulva. Self-reported no special discomfort, the mass is non-tender, no activity, slow-growing, and the size is about 11*6*5cm. She also reported discomfort when walking for nearly two months, accompanied by friction and a feeling of foreign bodies. In gynaecological clinics, ultrasonography suggests a possible diagnosis of lipoma, and further CT (computed tomography) and MRI (magnetic resonance imaging) studies show the diagnosis of lipoma. Combined with the patient's history and ancillary examination, surgery is currently indicated and the patient strongly requests surgery. Therefore, after improving the relevant blood and urine routine, coagulation function, liver and kidney function and other auxiliary examinations after admission, the patient had no obvious contraindications to surgery, and under general anesthesia, the author's team reconstructed the vulva, restored the beauty of the vulva, and completely removed the mass. Postoperative pathological findings suggest a diagnosis of lipoma. Since vulvar lipomas are uncommon, especially in young women. And there is a greater possibility of being misdiagnosed. Therefore, it is also important to identify this benign vulvar mass in daily management. Based on this, the author's team reported a relatively rare case of giant vulvar lipoma.
Abstract: Lipoma is the common benign soft tissue tumors. However, to date, few reports of vulvar lipomas have been reported. This article reports a rarer and relatively large type of vulvar lipoma. Below is the case of a 32-year-old woman who has a huge right vulvar lump. She was admitted to the hospital because she touched a growing lump on the right side ...
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The Correlation Between Gestational Diabetes Mellitus Patient’s Characteristics, Attitude and Knowledge to Antenatal Physical Exercise
Ogbutor Udoji Godsday,
Omorode V,
Ephraim Chukwuemeka,
Nkemakonam Ezeonu,
Ezunu Emmanuel,
Nwabueze Odegua Zuwaira
Issue:
Volume 10, Issue 6, November 2022
Pages:
257-263
Received:
31 October 2022
Accepted:
15 November 2022
Published:
8 December 2022
DOI:
10.11648/j.jgo.20221006.14
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Abstract: Background: Gestational diabetes mellitus (GDM) is currently emerging as a major global health concern for pregnant women. Considerably, knowledge has been gained regarding the diagnosis, implications, and management with improved outcomes for the mother and fetus. Scientific evidence support ante-natal regular participation in physical exercise as an essential part of management of GDM. However, despite the well-documented health benefits of physical exercise, 60 to 80% of pregnant women with GDM, do not engage in the recommended levels of physical exercise. This study was designed to examine the relationship between participant characteristics, knowledge and attitude to physical exercise. Materials and methods: A total of 76 subjects from the Ante-natal clinic of Federal Medical Center, Asaba, Delta State, Nigeria were engaged in this study. A modified and pre-tested self-administered questionnaire with a structured knowledge and attitude (KA) component was employed and data was collected for analysis. Results: The rate of response was 100%. The age range of the study group was 26-40 years. The majority (82.9%) of the study population were of the Ibo tribe of Nigeria while about 67.1% had a post primary education and 80.3% were self-employed. The total knowledge score was 67.1% while 65.8% were found to have a positive attitude toward physical exercise. The patients’ characteristics such as age, education, employment status, employment type, occupation, monthly income, duration of pregnancy, number of pregnancies, number of successful pregnancies and number of children were found to significantly correlate with knowledge of ante-natal physical exercise. Education, occupation, and gestational week of GDM were found to significantly correlate with attitudes toward physical exercise during pregnancy in women with GDM. Conclusion: The results of this study showed that, there is a high level of awareness of the need for physical exercise and positive attitude towards physical but the predominant circumstances around the women have a major influence on the exercise performance.
Abstract: Background: Gestational diabetes mellitus (GDM) is currently emerging as a major global health concern for pregnant women. Considerably, knowledge has been gained regarding the diagnosis, implications, and management with improved outcomes for the mother and fetus. Scientific evidence support ante-natal regular participation in physical exercise as...
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Experiences of Non-Medically Indicated Abortions Among Educated Nigerians
Sa’adatu Talatu Sule,
Boubacar Dieng,
Shedrack Anekwe
Issue:
Volume 10, Issue 6, November 2022
Pages:
264-269
Received:
16 November 2022
Accepted:
1 December 2022
Published:
15 December 2022
DOI:
10.11648/j.jgo.20221006.15
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Abstract: Termination of pregnancy for non-medical indications is one of outcomes of unwanted pregnancy. Majority of unwanted pregnancies can be prevented using effective modern contraceptives, however, the uptake of these contraceptives is low in Nigeria. This study was carried out to assess the prevalence of abortions among Nigerians with a view to planning effective services to prevent and manage such abortions within the limits of the law in Nigeria. The study was an anonymous online survey carried out using Google Forms. Statistical analyses including rates and comparative analyses were carried out using MINITAB statistical software version 19. Non-medically indicated abortions had been experienced by 21% of all respondents and 29% of female respondents. About half of these had experienced one abortion while the rest had two or three abortions, and a large proportion (>40%) had never been accompanied by their spouse/partner for the abortion service. Majority of the abortions occurred when the respondents were not married (>60%) and the woman was involved in the making the decision to terminate the pregnancy in up to 90% of cases (50% as the sole decision maker and 40% as a partner in joint decision making). Evacuation by a health worker was the method of abortion in 65% of cases while the medication abortion alone was used in 25% of cases and the rest were carried out using medication abortion followed by evacuation. Use of withdrawal method for contraception and sexual challenges were significantly associated with non-medically indicated abortions. Non-medically indicated abortions are common among educated Nigerians and are more common among those using less effective methods of contraception like the withdrawal method. There is a need for increased access to high quality contraceptive information and services to improve the reproductive health of Nigerians.
Abstract: Termination of pregnancy for non-medical indications is one of outcomes of unwanted pregnancy. Majority of unwanted pregnancies can be prevented using effective modern contraceptives, however, the uptake of these contraceptives is low in Nigeria. This study was carried out to assess the prevalence of abortions among Nigerians with a view to plannin...
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Pregnancy and Adolescence: Problem and Outcome at the University Hospital Center of Brazzaville (Republic of Congo)
Potokoue Mpia Nuelly Samantha Bialay,
Buambo Gauthier Regis Jostin,
Itoua Nadine,
Mokoko Jules Cesar,
Itoua Clautaire,
Iloki Léon Herve
Issue:
Volume 10, Issue 6, November 2022
Pages:
270-274
Received:
27 November 2022
Accepted:
14 December 2022
Published:
29 December 2022
DOI:
10.11648/j.jgo.20221006.16
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Abstract: Introduction: adolescence is a period of physical, psychological, and social maturation that extends between childhood and adulthood (10 to 19 years). The occurrence of teenage pregnancy is a high-risk situation about the complications associated with its outcome, the psychological and socioeconomic vulnerability of adolescents, and their anatomical and physiological immaturity. Objective: to analyze the problem and the outcome of adolescent pregnancy at the University Hospital Center of Brazzaville. Patients and Methods. Case-control study of women giving birth from January 1, 2018, to December 31, 2021, at CHU-B. Adolescents (< 20 years old) were compared to adults (≥ 20 years old). The variables studied were pre and per partum. Usual statistics and logistic regression were used to analyze the results. The probability p-value was deemed significant for a value less than 0.05. Results. The frequency of childbirth among adolescents was 14.28%. The teenagers were in secondary school (OR=5.44 [3.01-9.82]; p<0.05), with no remunerative activity (OR=78.0 [10.48580.3]; p<0.05), resident in the parents (OR=9.43 [4.69-18.95]; p<0.05), primigravida (OR=19.52 [9.69-39.34]; p<0, 05), unmonitored pregnancy (OR=3.97 [1.08-14.7]; p<0.05), caesarean section for mechanical dystocia (p>0.05). Conclusion. Teenage women in labor have unfavorable socio-demographic characteristics and are primigravidae. Antenatal care is of poor quality and starts late. Dystocia is the main indication for caesarean section.
Abstract: Introduction: adolescence is a period of physical, psychological, and social maturation that extends between childhood and adulthood (10 to 19 years). The occurrence of teenage pregnancy is a high-risk situation about the complications associated with its outcome, the psychological and socioeconomic vulnerability of adolescents, and their anatomica...
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A Diaphragmatic Rupture Due to Endometriosis and Iatrogenic Origin
Randrianambinina Fanomezantsoa,
Jonatana Arthur Daniel,
Le Pimpec Barthes Françoise,
Rakotovao Hanitrala Jean Louis
Issue:
Volume 10, Issue 6, November 2022
Pages:
275-278
Received:
21 November 2022
Accepted:
9 December 2022
Published:
29 December 2022
DOI:
10.11648/j.jgo.20221006.17
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Abstract: Introduction: A diaphragmatic rupture may have traumatic origin but may also have other causes such as endometriosis or iatrogenic origin. We report a rare case of right diaphragmatic rupture in a woman with thoracic and abdominal endometriosis that was treated surgically on the diaphragm. Observation: She was a 39-year-old woman diagnosed with thoracic and abdominal endometriosis in 2005 and had been performed with a talcage and stapling of an endometriosis nodule at the phrenic center by thoracoscopy and then operated twice with abdominal and gynecologic surgeries. She presented at the entrance of our service a bubble of emphysema, a chronic right pleural effusion and an image of a right diaphragmatic hernia with staples around the bank of the diaphragmatic perforation indicating a surgical re-intervention for diaphragmatic repair. She had, by a right lateral thoracotomy, a reparation of the diaphragmatic rupture with a non-resorbable prosthetic material. Conclusion: For diaphragmatic lesions or perforations, resection using the endoscopic stapler device is the most appropriate approach. Though, the diaphragm is weakened by endometriosis, and a small diathermic lesion or a small injury by the staples may enlarge. Even iatrogenic diaphragmatic hernias are rare, stapling should be avoided, and opt for resection or a manual diaphragmatic fold and suture by using of prosthetic materials.
Abstract: Introduction: A diaphragmatic rupture may have traumatic origin but may also have other causes such as endometriosis or iatrogenic origin. We report a rare case of right diaphragmatic rupture in a woman with thoracic and abdominal endometriosis that was treated surgically on the diaphragm. Observation: She was a 39-year-old woman diagnosed with tho...
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