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21 yr old unmarried girl c/o white discharge p/v and irregular cycles since last 18 months. she is taking treatment on and off from gynecologist and GP but her symptoms is not going away. usg report is attached. what should be the management of the case ?

A 50 year old female presented with acute urinary retention. The patient said that she experienced an episode of urinary retention for the first time 2 days before. She noticed voiding dysfunction with frequency and urging for urination even by small amount of urine. She reported no problem with defecation. The cystoscopic evaluations showed no pathologic changes. In urinary bladder there was about 1000 ml rest urine.

23 Yrs Female Pain in perineum off n on - 3Yrs (H/o-LSCS 3Yrs back) Cervical Pap Smear Study

TRICHOMONIASIS. Trichomoniasis is a sexually transmitted infection caused by the motile parasitic protozoan "TRICHOMONAS VAGINALIS". Humans are the only known host of T.vaginalis. Transmission occurs predominantly via sexual intercourse.The organism is most commonly isolated from vaginal secretions in women and urethral secretions in men. ETIOLOGY. Women who engage in higher-risk sexual activity are at a greater risk of infection. Risk factors are: 1.Multiple partners and new partners. 2.History of STD. 3.Current STD. 4.Sexual contact with an infected partner. 5.Using injection drugs. 6.Not using barrier contraception. CLINICAL PRESENTATION: WOMEN Frothy /bloody / purulent vaginal discharge. Abnormal vaginal odour (musty ) Vulvovaginal pruritis. Burning and soreness of the vulva and vagina. Dyspareunia and dysuria. TV cervicitis is characterised by purulent discharge in the endocervical canal and easily induced endocervical bleeding. MEN: Can be asymptomatic. Symptoms include purulent urethral discharge, dysuria and pruritis. PHYSICAL EXAMINATION: COLPITIS MACULARIS OR STRAWBERRY CERVIX is diffuse ,macular,erythematous lesion of the cervix.THIS IS A SPECIFIC SIGN FOR TRICHOMONIASIS. COMPLICATIONS Trichomoniasis can lead to Pelvic inflammatory disease and tubo-ovarian abscess. Increases the risk of HIV transmission. Increases the susceptibility to other infections like herpes and human papilloma virus. Increased risk of post hysterectomy vaginal cuff cellulitis and abscess. In pregnant women,there is increased risk of preterm labour,LBW and intrauterine infection. DIAGNOSIS: 1.Saline wet mount evaluation of vaginal discharge shows flagellated pyriform protozoan TRICHOMONAS. 2.CULTURE IS THE CURRENT CRITERION STANDARD FOR TRICHOMONAS DIAGNOSIS. 3.Pap smear in trichomoniasis shows coating of intermediate squamous cells with neutrophils often referred to as "CANNONBALL or POPCORN BALL "cells. TREATMENT AND MANAGEMENT. Treatment should be instituted immediately of the patient and the sexual partners. Metronidazole is the treatment of choice. 500 mg/bd/1 week. Tinidazole is also used. Partners should abstain from sexual intercourse until both have completed therapy and are asymptomatic.

A 28 year old unmarried female complaints of irregular menstruation since 6-7 months. She is skipping one month for menstruation. This time shez not having menstruation since 2 months. LMP 24th nov 2018. No pregnancy. Not on oral contraceptives. TVS report posted. Give your opinion.