Sharda B Ahmed

Sharda B Ahmed

Profile ID RP-000-6137 Joined 2023-01-22 2 articles
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Articles(2)

Authors: Sharda B Ahmed

DOI: 10.18231/j.ijogr.2019.048  

Volume6

Issue2

Pages211-215

Abstract

Introduction: The complaint of excessive vaginal discharge is very common in women attending the gynecology out-patient department. It is associated with considerable emotional stress, health seeking associated cost and has a substantial impact on female health and behavior. Objective: To find out socio-demographic variables associated with the complaint of vaginal discharge wherein no biomedical cause of leucorrhoea can be detected. Socio-cultural perspectives have an exaggerative effect on the normal vaginal discharge and in absence of pathological diagnosis, they create fear and anxiety in couples. The problem of vaginal discharge can be best understood not only in the biomedical perspective but also in the socio cultural perspective. Materials and Methods: This is a hospital based study, conducted in out-patient department of obstetrics and gynecology department, AIIMS, Udaipur (Raj). Women with complaint of vaginal discharge without any evident pathological or infectious causes were counted in the study. The women with vaginal discharge which is non-infected, non-blood stained, non-purulent, without pruritus vulvae were interviewed with a pretested questionnaire. Socio-demographic details, personal and menstrual hygiene, obstetric history and contraceptive practices were noted and tabulated. Conclusion: To mitigate the problem of vaginal discharge, socio-demographic status of women should be taken in consideration. Improvement of literacy rate, economic status and women’s empowerment are the key areas of interventions. Proper understanding of this problem helps in initiating appropriate medical education programs and framing health policies. Keywords: Excessive vaginal discharge, Socio-demographics, Somatic symptoms, Leucorrhoea, Pruritus tubectomy.

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Authors: Sharda B Ahmed, Sushma Mogri

DOI: 10.18231/2394-2754.2018.0061  

Volume5

Issue2

Pages278-281

Abstract

Objective: The aim is to categorize women with AUB as per the PALM-COEIN classification system as this is a step towards cause based diagnosis and focused management of patients. The acronym PALM-COEIN comes from arranging 9 basic categories of the classification system. The PALM group comprises the structural entities, which can be measured visually or by using imaging techniques and histopathology. The COEIN group comprises the non-organic types which cannot be defined by imaging or histopathology. Materials and Methods: The study comprises 350 women of reproductive age with AUB for minimum 3 months time span. It describes and observes AUB in amount, interval and frequency for women attending outpatient Gynae department of AIIMS, Udaipur (Raj) from Nov 16 to Oct 17. They were assessed on the basis of structured history, physical examination, local pelvis examination, investigations, USG findings and endometrial histopathological report. Cause of AUB was determined and treatment was given to the patient as appropriated by categorization done in agreement with the PALM-COEIN classification. Results: The most prevalent cause of AUB was ovulatory dysfunction (n=99, 28.2%). Next common cause was leiomyoma (n=90, 25.7%), followed by endometrial causes (n=52, 14.5%), adenomyosis (n=30, 8.5%), not yet classified (n=32, 9.7%), Malignancy & Hyperplasia (n=28, 8.1%), Polyp (n=9, 2.5%), Iatrogenic (n=7, 2.2%) and Coagulopathy (n=1, 0.3%). Conclusion: The PALM-COEIN classification helps to practically ascertain the cause of AUB, and thereby effectively adopt the correct treatment for AUB patients. Keywords: Abnormal uterine bleeding, AUB, Classification system, Polyp leiomyoma, Adenomyosis, Ovulation, Malignancy

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