30 yr f plz suggest urs valuable opinion nd management



30 yr/P3A3/BOH/CHRONIC CERVICITIS/PID. Examine her .do a speculam examination.find out the cause of discharge candidiasis /bacterial vaginosis /Chlamydia /gonorrhoea /trichomoniasis Cervicitis is due to IRRITATION,INFECTION INFLAMMATION OR INJURY OF CELLS THAT LINE THE CERVIX. Examine the discharge to find out the causative organism. If an infection is the cause of cervicitis,the main goal of treatment is to eliminate the infection and prevent it's spread to the uterus and tubes. Depending on the type of infection you have to give Antibiotics Anti fungal medications. Anti viral medications. Treat the partner also. After adequate antibiotic course examine her clinically and repeat a scan. Once the infection is cleared,investigate the couple for bad obstetric history.

This is a case of PID with cervicitis. Vag.swab for c/s.Give her antibiotics:Doxycyclin 100mg b.d and Tab. Metronidazole 400 mg b.d for two weeks or Oflaxacin and Ornidazole combinaton for two weeks. Candid CL vag tab. for six days. Tab. Fluconazole 150 mg weekly for 4 wks. Her partner should be treated. Do PAP smear after treating infection and scan after 1 month on day7/8 of her mens.cycle.lnvestigate to know d reason for her 3 abortions.

Agree with Dr.Mustafa Ameena Parveen Add Inj. Placentrax for 15 days inThe prescription.

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Dr Preeti , PID with cervicitis Pt needs further investigations like Pap smear Endocervical biopsy Mean while treat with vainal pessaries Vaginal wash with Intiwash Apply silver nitrate on CX Systemic ornidazole+ doxy com Or doxy + metronidazole Antioxidants Antiinflammatory if pain Ovarian cyst follow up after 1 mth If increasing excision . Inj placentrex im daily _15 days for PID

Treat her as a case of PID with vulvo vaginitis. Broad spectrum antibiotic and antifungal to be given orally. Candid cl vaginally for 6 days probitics for 15 days. Repeat usg and paps smear postmenstrually after infection is treated completely.

C.Minicycline 100 mg 1 BD for 20dayz Inj Placentrex 1 amp I.m. for 10 dose s and then alternate days for 5 doses T.Fluconazole 150mg 1 stat T.Ginlac - V or any mixed vaginal pesssry for 4 days On 6 th day call pt ..do a PS ..if cervix appears erodrd then plan post - menstrual cauterization once PID is cured Adter 20 days repeat USG

Good evening Dr for white discharge and itching Itacanazole 100mg bd for 7days when white discharge decreases back ache also comes down logi fine A or cypon syrup 2tblsps 2sdaily before food Dubix k bd for 3days plenty of fluids Neeri syrup 2tsp 2sdaily with a glass of water get her urine routine and harmonal test for her repeated abortions ANA IgG IgM LA aTh

As there is H/ o 3 consecutive pregnancy losses and Mantoux ?+ Ve , lymphocytes increased with chronic PID and cervicitis better to r/o pelvic Tuberculosis .APLA test may be done before embarking on next pregnancy

Any past history of Koch's?advice D&c biopsy,endometrial curetting for AFB smear and culture

Pap smear Vaginal pessary Doxy and metro for 7 days.. Usg scan follow up for cyst size monitoring

After counselling adv usg for site of m arena and other cause of heavy bleeding and then remove ouch and coil even some time polyp can cause bleeding

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