BACKGROUND AND OBJECTIVE

Tuberculosis (TB) remains to be prevalent in the Philippines and globally. Female genital tuberculosis has devastating and permanent consequences, hence, timely and adequate treatment is needed. Since more data regarding optimal duration of treatment of genital tuberculosis are needed, this study compares the treatment response at six months and after at least nine months of treatment, with the intention of determining the most practical management for genital tuberculosis.

METHODS

A retrospective chart review was conducted for newly diagnosed cases of genital tuberculosis who met the inclusion criteria. Treatment response was categorized into clinical, microbiologic, histologic, radiologic, and sonographic responses. Responses to treatment were evaluated as either partial or complete at the 6th month and after at least 9 months of treatment, and the proportions were compared.

RESULTS

Out of 140 charts retrieved, only 43 were included. Statistically significant difference was found only in clinical response, primarily due to patients who did not achieve resumption of menstruation within the f irst six months of treatment. The rest of the treatment responses and adverse drug events are equally the same for both time periods.

CONCLUSION

Results of this study show that the proportion of patients with microbiologic, histologic, radiologic, and sonographic response to treatment at the 6th month did not significantly differ to the proportion of patients who responded at the 9th or 12th month of treatment. This leads to a conclusion that the 6-month treatment regimen will be more practical in treating genital tuberculosis, except in amenorrheic premenopausal women who may warrant extension of treatment. Further studies on post-treatment rates of relapse and sonographic resolution are needed.

Human ; Female ; Tuberculosis, Female Genital ; Philippines

BACKGROUND AND OBJECTIVE

Tuberculosis (TB) remains to be prevalent in the Philippines and globally. Female genital tuberculosis has devastating and permanent consequences, hence, timely and adequate treatment is needed. Since more data regarding optimal duration of treatment of genital tuberculosis are needed, this study compares the treatment response at six months and after at least nine months of treatment, with the intention of determining the most practical management for genital tuberculosis.

METHODS

A retrospective chart review was conducted for newly diagnosed cases of genital tuberculosis who met the inclusion criteria. Treatment response was categorized into clinical, microbiologic, histologic, radiologic, and sonographic responses. Responses to treatment were evaluated as either partial or complete at the 6th month and after at least 9 months of treatment, and the proportions were compared.

RESULTS

Out of 140 charts retrieved, only 43 were included. Statistically significant difference was found only in clinical response, primarily due to patients who did not achieve resumption of menstruation within the f irst six months of treatment. The rest of the treatment responses and adverse drug events are equally the same for both time periods.

CONCLUSION

Results of this study show that the proportion of patients with microbiologic, histologic, radiologic, and sonographic response to treatment at the 6th month did not significantly differ to the proportion of patients who responded at the 9th or 12th month of treatment. This leads to a conclusion that the 6-month treatment regimen will be more practical in treating genital tuberculosis, except in amenorrheic premenopausal women who may warrant extension of treatment. Further studies on post-treatment rates of relapse and sonographic resolution are needed.

Human ; Female ; Tuberculosis, Female Genital ; Philippines

BACKGROUND: Bacterial vaginosis is the most common vaginal infection among reproductive age women. It has been associated with preterm labor and emerged as a formidable disease entity associated with catastrophic sequelae especially in pregnant patients. Papanicolaou smear is the most successful screening test for cervical carcinoma in the history of medicine. Albeit being used by some clinicians as screening tool for bacterial vaginosis, it was not well established.

OBJECTIVE: To determine the diagnostic accuracy of papanicolaou smear in making the diagnosis of bacterial vaginosis in pregnant patients with the vaginal gram stain used as diagnostic standard.

METHODOLOGY: A total of 321 pregnant patients who consulted for prenatal care at the outpatient department of obstetrics and gynecology of the tertiary training hospital between November 2013 to-June 2014 were included in the study. Each patient had gram-stained vaginal smear and standard pap smear done consecutively. The sensitivity, specificity, positive predictive value, negative predictive value and the likelihood ratios of pap smear were determined.

RESULTS: The sensitivity of pap smear in determining the presence of bacterial vaginosis is 70.5%, its specificity of 93.6%, positive predictive value of 80.5%, negative predictive value of 89.3%. Likelihood ratio of a positive result is 10.9 and 0.3 for a negative result with diagnostic accuracy of 87.23%.

CONCLUSION: These results support the reliability of the pap smear in the diagnosis of bacterial vaginosis in asymptomatic pregnant patients. Since pap smear and gram stain have close diagnostic accuracy, duplication of the test could reasonably be avoided in most patients.

Human ; Female ; Adult ; Young Adult ; Adolescent ; Postmenopause ; Ovary ; Neoplasms ; ROC Curve ; Endometrial Neoplasms

OBJECTIVE: The general objective of this study was to compare the efficacy of chlorhexidine and povidone iodine for cleansing the operative field for abdominal deliveries and exploratory laparotomy for ectopic pregnancy. The specific objective was to compare the incidence of fever and surgical site infection (551) between the povidone iodine group and chlorhexidine group.

STUDY DESIGN: This is a randomized controlled trial comparing 0.2% chlorhexidine digluconate and povidone iodine 7.5% scrub followed by 10% povidone iodine paint as surgical site antiseptics. Primary outcome measured were postoperative fever and surgical site infection (551). The wounds were inspected 1, 2, 3, 7 and 14 days postoperatively. The agent used during the pre-operative antisepsis was continued during the postoperative wound dressing.

RESULTS: A total of 552 patients were enrolled between March and August 2008. There were no differences between the povidone iodine (n=277) and chlorhexidine (n=275) groups with respect to age, gravidity, distribution of cases, presence of previous cesarean section/s, past medical history, presence of co-morbid illness, smoking and alcohol use, 8MI, number of internal examinations, length of labor, length of rupture of bag of waters, type of surgery, amount of adhesions, length of operation, amount of intraoperative blood loss, use of prophylactic antibiotic, presence of break in asepsis, year level of surgeons, pre- and postoperative anemia and leukocytosis. The only variable observed to be significantly different was place of operation with 92.4% of operation being performed at the 08 Admitting Section among the chlorhexidine group (vs 84.5% in povidone iodine group). Results on the analysis of intent to treat data were comparable with that of complete data. There was no significant difference in the incidence of fever on 3, 7 and 14 days postoperatively between the povidone iodine group and chlorhexidine group. Likewise, there was no significant difference in the incidence of surgical site infection on 3 and 14 days postoperatively between the two study groups. However, there was a significant difference in the incidence of 5517 days postoperatively, occurring in 7.63% and 2.75% under the complete data (P=.0132), 6.9% and 2.6% under the positive outcome assumption (P=.0168), and in 16.6% and 7.6% under the negative outcome assumption (P=.0013) for povidone iodine and chlorhexidine group, respectively.

CONCLUSION: It appears that chlorhexidine is superior to povidone iodine in the control of surgical site infection 7 days after abdominal delivery and exploratory laparotomy for ectopic pregnancy.

Human ; Female ; Povidone-iodine ; Chlorhexidine Gluconate ; Chlorhexidine ; Anti-infective Agents, Local ; Surgical Wound Infection ; Asepsis ; Leukocytosis ; Laparotomy ; Antisepsis ; Cesarean Section ; Pregnancy, Ectopic

Objective: To determine whether giving of magnesium sulfate to patients with mild preeclampsia is beneficial. Design: Retrospective cohort study. Setting: Tertiary-care training hospital. Participants: Patients admitted from January 2001-June 2005 with BP > 140/90 and with a +1 albuminuria by dipstick method. Patients were grouped into three arms: those who received complete magnesium sulfate doses (14 grams loading dose + 20 grams succeeding doses), those who received loading dose of magnesium sulfate only (14 grams), and those without treatment. Interventions: Review of charts. Main outcome measure: The primary outcome was the occurrence of eclampsia and magnesium toxicity. Results: There were 123 patients fiagnosed with mild preeclampsia from January 2001 to June 2005. Ninety four charts (76.42 percent) were retrieved and reviewed. Of the 94 reviewed, 21 (22 percent) did not receive magnesium sulfate, 23 (24 percent) received the loading dose of magnesium sulfate only, and 50 (53 percent) received the complete doses of magnesium sulfate. There were no statistically significant differences in the occurrence of eclampsia among the three groups, as well as the occurrence of magnesium toxicity among the treated groups; however, the numbers were small. Conclusion: All patients included in the study did not develop eclampsia, and those patients who received magnesium sulfate, whether loading dose only or complete doses, did not develop magnesium toxicity. (Author)
Magnesium Sulfate ; Preeclampsia ; Eclampsia ; Malbuminuria