Pelvic Inflammatory Diseases (PID)
Definition:-
PID means Pelvic Inflammatory Diseases
Disease of upper genital tract organs involving fallopian tubes, ovaries and surrounding structures.
Endometritis, Salpingitis, pelvic peritonitis, tubo-ovarian abscess are included in PID
Causes/ Risk factors:-
1… Pyogenic= Aerobic and Anaerobic bacteria
2… STD= N.gonorrhoeae, T. Pallidum, Chlamydia etc
3… Iatrogenic= Dand C, MR, IUCD,
4… Multiple Sexual partners
5… Previous History of PID
Symptoms:-
1 LAP/ Pelvic pain
2 Irregular and excessive P/V/B
3 Vaginal Discharge
4 H/O Abortion/MR/ Exposure
5Fever, nausea
6 Dyspareunia
On examination:-
Rise of temp, ill-looking
P/A= Tender Lower abdomen
P/V= -Painful examination
-Abnormal vaginal discharge
– Congested cervix with purulent discharge
– Tenderness on fornix and movement of cervix
– Cervical Excitation test positive
Investigation :-
★ Vaginal swab C/S
★ CBC, RBS
★ Urine RME
★ VDRL, TPHA (Both partner)
★ USG of Pelvic Organs/TVS
★ Laparoscopy
★ Culdocentesis for pelvic absecss
Differential Dx:-
1. Appendicitis
2. Ectopic pregnancy
3. Torsion of ovarian pedicle
4. Ruptured ovarian cyst
5. UTI
Complication:-
1. Pelvic peritonitis
2. Septicaemia
3. Infertility
4. Chronic Dyspareunia
Treatment:-
1. Adequate rest
2. Analgesics
3. Antibiotics
4. Antimicrobial
5. Antifungal
6. If itching then Antihistamin or vaginal cream
7. In severe case like Pelvic abcess, tubo-ovarian mass need sugery so advice: reffered to hospital
Prevention:-
1. To increase public health awareness
2. Prevention of STD with knowledge of healthy and safer sex
3. Routine screening of high risk population
4. To control infection
5. Educating the patient to avoid reinfection and its hazards
6. Should warned against Multiple sexual partners
Advice:-
1Personal hygiene maintain
2 Take plenty of water
3 Evacuate bladder properly
4 Urinate when the need arises
5 Don’t use irritating feminine products like deodorant, powder etc
6 Wipe from front to back
7 Should be investigate the husband & treat
8 If find out any STI then take barrier method
9 Evacuate bladder before and after intercourse properly
10 Use Sanitary pad during menstruation
11 Should avoid frequently induced abortion or MR
12 Do investigations and complete treatment course properly
Note:-
অনেক সময় PID তে Vaginal Candidiasis থাকে তাই সাথে Antifungal oral/Cream/ Mixed VT দিলে ভালো রেসপন্স করে।
Note:-
PID মনে হলে অবশ্যই Per vaginal examination করতে হবে।
Note:-
History taking and investigations properly for Differential diagnosis
Note:-
Please Advice গুলি ভালো করে বুঝিয়ে দিবেন
Note:-
যদি মনে হয় চিকিৎসা দেয়া বা ডায়াগনোসিস করা আমার কাছে সম্ভব হচ্ছে না অবশ্যই রোগীকে প্রপারলি কাউন্সিলিং করে গাইনী কনসালটেন্ট এর কাছে রেফার করবেন নয়তো রোগী ঘুরেফিরে আবার কোয়াকের কাছে যাবেন
Raiyyan Tahsan Date:-20-12-2024 Friday Time:-11.09.30pm
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