Local inj hydrocortisol at the site will be helpful alongwith nsad.
Dr assessment of improper stitches whether enmass stitching then restitch /if band is there it can be cut under la just tie only bleeders & let it to heal itself/ if there is shortening of any diameter then lubricants &exercises may help / please exclude pid if dyspareunia
a course of antibiotics along with anti-inflamatory
when episiotomy is improperly stitched. healing can reduce the introitus and dyparunia can occur. initially can give some lubricants and c. many times it works
Hot fermentation , tab trypsin chymotrypsin twice daily for at least 20 days , vtwo or goemate gel before intercourse. tell her next delivery in a reputed hospital.(in yr. nursing home)
Lubricants like K Y jelly would be useful along with analgesics and Sitz bath.
better give her sitz bath,antiinflamatory ,local application of metrogyl p ...
delivery 6mths bk so only lubrication will help .in due course it will become normal.
dysparunia due to lmproper healing of episiotomy can be treated with unani system of medicine by regimental therapy.
if there is no pain at episiotomy site at present, then only lubrication n revised sex position..
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PELVIC INFLAMMATORY DISEASE : DEFINITION : PID is defined as a spectrum of inflammatory disorders of the upper female genital tract , including any combination of endometritis, salpingitis,tubo-ovarian abscess and pelvic peritonitis. It is a serious complication of some STD's , especially chlamydia and gonorrhea. PID can damage the fallopian tubes and tissues in and near the uterus and ovaries. PID leads to serious consequences including infertility ,ectopic pregnancy,abscess formation and chronic pelvic pain. CAUSATIVE ORGANISMS : Causative organisms are bacteria ,fungi,virus and parasites Sexually transmitted organisms are implicated in most cases.especially N.GONORRHEA & C.TRACHOMATIS. Microorganisms that comprise the vaginal flora also have been associated with PID. Gardnerella vaginalis. Haemophilus influenza. Enteric gram negative rods. Streptococcus agalactiae. Other organisms involved are Cytomegalovirus. M.hominis. U.urealyticum. M.genitilium. RISK FACTORS : *H/O STDs,especially gonorrhea &chlamydia. *Teenage sex. *Multiple sexual partners. *Intra uterine device. *Prior episodes of PID. *HIV. TYPES: ACUTE PID : Patient has generalized symptoms. Lasts few days. May recur in episodes. Very infectious. CHRONIC PID : Patient may be asymptomatic. Occurs over months and years. Progressive organ damage. SYMPTOMS : 1.Lower abdominal pain,may worse when move 2.Dyspareunia 3.Dysuria. 4.Dysmenorrhoea. 5.Post coital bleeding /metrorrhagia. 6.Low back ache. 7.Fever . 8.Feeling of tiredness. 9.Abnormal vaginal discharge. 10.Nausea ,vomiting . SIGNS : 1.Lower abdominal tenderness. 2.Adnexal and cervical tenderness on bimanual palpation. 3.Muco purulent vaginal discharge. 4.Cervicitis seen on speculum examination. 5.May find palpable adnexal mass. 6.Pyrexia.Dr. Suvarchala Pratap15 Likes23 Answers
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A 26 yrs married female c/o 3mts ammenorhea with severe pelvic pain and right illiac region lower abdominal pain .her pregcolour test is negative, USG suggest mild fatty change liver rest all WNL. but TLC COUNT 11.3thousand/mm3 suggestive of inflammation. reports r attached. pls suggest diagnosis and further followup.Dr. Supriyo Banerjee1 Like18 Answers
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ABC OF : ENDOMETRIOSIS. MAY BE USEFUL. ***** ENDOMETRIOSIS :- MORE THAN 1 MILLION CASES PER YEAR (INDIA)....... TREATABLE BY A MEDICAL PROFESSIONALS....... REQUIRES A MEDICAL DIAGNOSIS....... LAB TESTS OR IMAGING OFTEN REQUIRED....... CHRONIC: CAN LAST FOR YEARS OR BE LIFELONG....... ** CONSULT A DOCTOR FOR MEDICAL ADVICE....... *** ENDOMETRIOSIS is an estrogen-dependent disease wherein endometrial-like tissue is found outside the uterus inducing a chronic inflammatory response....... Pelvic organs (esp ovaries) & peritoneum are frequently affected....... *** SYMPTOMS :- MAIN CLINICAL FEATURES INCLUDE: CHRONIC PELVIC PAIN (found in 70-80% of patients) DYSPAREUNIA (suggests deep posterior infiltration) INFERTILITY (21% prevalence rate) OTHER SYMPTOMS may include severe dysmenorrhea, pain on ovulation, noncyclical pelvic pain, cyclical bowel or bladder symptoms w/ or w/o abnormal bleeding or pain, chronic fatigue, or dyschezia....... 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A 35 years old female P3L3 presented with lower abdominal pain, dyspareunia and infertility. P/A Normal P/S Vagina healthy P/V Uterus normal but deviated towards left. Right adnexal mass felt. Tenderness and nodularity in posterior fornix. USG- Clear ovarian cyst Laparoscopy- Endometrioma present Treatment and advice to the patient?Megha Bhargava0 Like13 Answers
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