Trichomonas vaginitis.pptx

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Introduction Causative agent : Trichomonas vaginalis Transmission : Sexual contact Incubation period : 3 – 28 days. Clinical features Sudden profuse and offensive vaginal discharge. Severe irritation and itching around introitus. Dysuria and increased frequency of urine. Examination: Thin, greenish yellow frothy offensive vaginal discharge. Inflammed vulva Vaginal examination may be painful. Diagnosis: Culture of discharge : Diamonds TYM or Feinberg Whittington medium. Treatment: DOC : Metronidazole 200mg TDS x 1 week. Tinidazole

Gesundheit & Medizin

Trichomonas vaginitis
Dr. Yashika

Introduction
• Causative agent : Trichomonas vaginalis
• Transmission : Sexual contact
• Incubation period : 3 – 28 days.
Sharing of toilet articles
Examination through infected gloves.

Clinical features
• Sudden profuse and offensive vaginal discharge.
• Severe irritation and itching around introitus.
• Dysuria and increased frequency of urine.

Examination:
• Thin, greenish yellow frothy offensive vaginal
discharge.
• Inflammed vulva
• Vaginal examination may be painful.

Diagnosis:
Culture of discharge :
• Diamonds TYM or Feinberg
• Whittington medium.

Treatment:
• DOC : Metronidazole
200mg TDS x 1 week.
• Tinidazole

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Moniliasis(Candida vaginitis)

Moniliasis(Candida vaginitis)

Moniliasis(Candida vaginitis)

Lymphogranuloma Venereum Dr. Yashika Causative agent : Chlamydia trachomatis Incubation period: 3-30 days Clinical features : Initial phase: Painless papule, pustule or ulcer in vulva, urethra, rectum or cervix. Involved inguinal nodes feels rubbery. Acute lumphangitis and lymphadenitis. Necrosed glands and abscess formation. Rupture of abscess occurs within 7-15 days. Sinus and fistula formation. Intense fibrosis with lymphatic drainage. Secondary phase : Painful adenopathy. Classical clinical sign: Groove sign A depression between the groups of inflammed nodes. Complication: Vulval elephantiasis Perineal scarring Rectal stricture Sinus and fistula formation. Diagnosis Culture and isolation Detection of LGV Treatment: Doxycycline 100 mg BID x 21days. Azithromycin 1 gm PO weekly x 3 weeks Abscess aspiration

Lgv (Lymphogranuloma Venereum)

Lgv (Lymphogranuloma Venereum)

Lgv (Lymphogranuloma Venereum)

Leucorrhoea Dr. Yashika Abnormal Vaginal Discharge Frequent complaint. Discharge may vary from excess to normal. Discharge may be blood-stained / contaminated with urine or stool. Characteristics of normal vaginal fluid Nature - watery Colour - white Odour - Odourless pH - 4.0 Microscopically - Squamous epithelial cells, Leucorrhoea Leucorrhoea is defined as excessive normal vaginal discharge. Features of vaginal discharge in leucorrhoea : Excess secretion. Non purulent Non offensive Non irritant Never causes pruritis. Etiology : Physiological excess Cervical causes Vaginal causes Physiologic excess Puberty Menstrual Cycle Pregnancy Sexual excitement Cervical causes: Cervicitis Cervical ectopy Cervical polyp Treatment General health improvement Surgical treatment of cervical factors Pill users are asked to stop pill immediately Local hygiene

Leucorrhoea

HYSTERECTOMY Hysterectomy Hysterectomy Term origin: hyster + ectomy uterus surgical removal Definition: Hysterectomy is defined as the surgical removal of uterus. Routes for Hysterectomy Abdominal Hysterectomy Vaginal Hysterectomy Laparoscopic Hysterectomy Caesarean Hysterectomy Types of Hysterectomy Total Hysterectomy Removal of entire uterus. Subtotal Hysterectomy Removal of body or corpus leaves behind the cervix. Panhysterectomy / Hysterectomy with bilateral salpingo oophorectomy Removal of uterus along with tubes and ovaries of both sides. Indications

Hysterectomy

Herpes Genitalis Dr. Yashika Introduction Causative organism : Herpes Simplex virus type 1 and 2 Transmission : Orogenital contact Incubation period : 2 – 14 days. Clinical features: First attack with 7 days of sexual contact. Red painful inflammatory area around clitoris, labia, vestibule, vagina, cervix and perineum. Appearance of multiple vesicles which progress into ulcers then heals up by crusting Lymphadenopathy Fever, malaise and headache. Diagnosis: Virus tissue culture and isolation ELISA Fluorescent method PCR test Treatment Specific treatment is yet to b explored. Acyclovir 200 mg 5 times x 5days. Saline water bath.

Hsv Herpes Genitalis

Hsv Herpes Genitalis

Hsv Herpes Genitalis

Hysterosalpingography Dr. Yashika Hysterosalpingography(HSG) Hystero + Salpingo + Graphy HSG is a radiological procedure done to assess the interior anatomy of the uterine cavity and the shape and patency of the fallopian tubes. It is a radiographic study using fluorescent dye to visualise the anatomy of uterus and fallopian tubes. Indications: Assessment of tubal patency. Detection of uterine malformation. Diagnosis of cervical incompetence. Detection of translocated IUD. Diagnosis of uterine synechiae. Diagnosis of uterine fibroid , uterine polyp. Diagnosis of abdominal pregnancy. Uterine Malformation Steps of operation The patient is asked to remain empty bladder. Operation is done under general anaesthesia. The patient is placed in lithotomy position. Local antiseptic cleaning is done. Posterior vaginal speculum is introduced. Anterior lip of cervix is grasped with Allis tissue forcep. HSG cannula is fitted with a syringe containing radio opaque dye. About 5- 10 ml of dye is slowly introduced. The passage of the dye is observed by using X-ray intensifier and a video display unit. Two radiographic X-rays are taken. First one to show the filling of uterine cavity and other one 10-15 mins after the completion of procedure. Timing of procedure : HSG is done between D6 and D10 of cycle. Antibiotics are given one day prior the procedure up to 5 days. Contrast media Complications Peritoneal irritation. Pelvic pain. Vasovagal attack. Intravasation of dye into the venous or lymphatic channels. Flaring up of pelvic infections.

Hsg

AIDS Dr. Yashika Introduction Causative agent : Human Immunodeficiency Viruses (HIV) HIV belongs to retrovirus family (double stranded RNA). Mode of transmission Sexual intercourse IV drug abusers Blood transfusion Use of contaminated needles Breastfeeding Perinatal transmission Immunopathogenesis Immunological Markers CD4 T lymphocyte count RT-PCR Raised P-24 antigen titre Raised serum β2 microglobulin Clinical Presentation Development of Ab marks the stage of seroconversion aka flu-like syndrome. Acute infection syndrome characterized by fever, skin rash, arthralgia, lymphadenopathy and diarrhoea. This is called seroconversion illness lasts upto 2-3 weeks and gets resolved itself spontaneously. Gynaecological Symptoms Infections of genital tract. Neoplasm of genital tract. Menstrual abnormalities. Fertility and pregnancy are not affected. Diagnosis Detection of IgG antibody. ELISA Western blot PCR Treatment

Human Immunodeficiency Virus - Acquired Immuno Deficiency Disease

Human Immunodeficiency Virus - Acquired Immuno Deficiency Disease

Human Immunodeficiency Virus - Acquired Immuno Deficiency Disease

GONORRHOEA Dr. Yashika Introduction Causative agent : Neisseria gonorrhoea (gram negative diplococcus). Incubation period : 3-7 days. Site of invasion : columnar and transitional epithelium of the genitourinary tract. Primary sites of infection : endocervix, urethra and Bartholins gland. Other sites of infection : Oropharynx, anorectal and conjuctiva. Clinical features : Local: Excessive irritant vaginal discharge Dysuria Acute unilateral pain Swelling over labia. Pharyngeal infection Intermenstrual bleeding. Rectal discomfort. Signs : Swollen labia and inflammed. Mucopurulent vaginal discharge. Speculum examination reveals congested endocervix. Distant symptoms : Perihepatitis Septicaemia Complications: PID Infertility Ectopic pregnancy Chronic pelvic pain Tubo ovarian mass Bartholins gland abscess. Diagnosis Nucleic acid amplification test (NAAT) urine culture Drug sensitivity test. Treatment Adequate therapy for gonococcal infection. To treat both the partner simultaneously. To avoid multiple sex partner. To use condom till free from disease.

Gonorrhoea

Dilatation and Insufflation Dr. Yashika Dilatation and Insufflation(D&I) Also known as Rubin’s test. Operation for dilatation of cervix and insufflation of air (CO2) in to the uterine cavity to know the patency of fallopian tubes. Indications of D&I Investigation for fertility. Following tuboplasty. Contraindication : Pelvic infections. Steps of operation The patient is asked to remain empty bladder. Operation is done under general anaesthesia. The patient is placed in lithotomic position Local antiseptic cleaning is done. Posterior vaginal speculum is introduced. Anterior lip of cervix is grasped with Allis tissue forceps. 7. Uterine sound is introduced to confirm the position and to note the length of cervical canal. Cervical canal is dilated with graduated dilators. After the desired dilatation, the insufflation cannula is introduced into the cervical canal. 10. Air is introduced in the uterus and the hissing sound is auscultated over the flanks. Test Positive Test: An audible hissing sound on the flanks due to exit of air. Patient complains of shoulder painon sitting. Negative Test: No hissing sound over the flanks. Complications Complications

Dilatation and Insufflation

Dilatation and Insufflation

Dilatation and Insufflation

Cervix Anatomy Lowermost part of uterus Cylindrical shape Diameter and length are 2.5 cm. Parts Supravaginal Infravaginal Extends from histological internal os to anatomical external os. Nulliparous - Pin hole cervix Parous - Bilateral slit Cervical Biopsy Punch Biopsy Wedge Biopsy Ring Biopsy Whole of squamo-columnar junction area of the cervix is excised with a special knife. The tissue is subjected to serial section to detect cervical intraepithelial neoplasia (CIN) or early invasive carcinoma. Cone Biopsy - Conization Complications Thank you

Cervical biopsy

Cervical biopsy

Cervical biopsy

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Trichomonas vaginitis.pptx

1. Trichomonas vaginitis Dr. Yashika

2. Introduction • Causative agent : Trichomonas vaginalis • Transmission : Sexual contact • Incubation period : 3 – 28 days. Sharing of toilet articles Examination through infected gloves.

3. Clinical features • Sudden profuse and offensive vaginal discharge. • Severe irritation and itching around introitus. • Dysuria and increased frequency of urine.

4. Examination: • Thin, greenish yellow frothy offensive vaginal discharge. • Inflammed vulva • Vaginal examination may be painful.

5. Diagnosis: Culture of discharge : • Diamonds TYM or Feinberg • Whittington medium.

6. Treatment: • DOC : Metronidazole 200mg TDS x 1 week. • Tinidazole