Genital Tuberculosis

Causative organisms-. Mycobacterium tuberculosis or  Mycobacterium bovis.
Gentile tuberculosis is almost always a secondary infection, spread hemaatogenously,and the infection become located in the ovarduct.subsequentaly the bacilli usually spread to the endometriom and less commonly to the ovaries.However, the oviduct are the primary and predominant site of pelvic tuberculosis.In fallopian tube most common affected part is ampulla and encountered pathology is endosalpingitis.
Incidence- 
Most common age groups is 20 to 30 years
Most common symptoms is infertility.
If patients conceive spontaneously, Ectopic pregnancy is the most likely outcome.
Second most common site of involvement; uterus
Tube -90-100%
Uterus-50-60%
Ovaries -20-30%
Vagina and Vulva-1-2%
Symptoms-
Pyometra-pus-filled Uterine cavity.
Menstrual irregularities
   Oligomeorrhea,Amerorrhea
   Menorrhagia
Infertility
Constitution symptoms
Pelvic examination
Normal pelvic examination
Tenderness
Bilateral adnexal mass in adolescents girls.
Diagnosis-
PCR
Culture
Blood test
Chest x-ray
Hysterosalpingography in TB
......etc
Treatment-

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Third Complications of labor

चित्र
All women who deliver are at risk of complications in third stage of labor.These complications include Post partum Hemorrahege Retention of placenta (Retained placenta) Inversion of uterus Plumonary embolism Obsteric shock Injurier of birth canal     Retained placenta Management 1) Fundal pressure 2) Controll word traction 3) Manual remove of placenta under Genearl Anesthesia 1) Fundal pressure After seperation of placenta Pressure=Dounword and backward pressure on funda part and pull out the umblical word 2) Controll card traction  placenta separate Pressure on symphysis punia upword and backward Pull out with umblical word 3) Manual remove of placenta under general anesthesia Placent not seperat Female=General Anesthesia (Thiopentel sodiyam 4 to 5 mg/kg) Wear the gloves and insert hand in cone shape manner And reach hoti placenta margin Slicing movemen
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Anatomy and physiology of Vagina to prevent infection

चित्र
In adult female ,vagina is lined by stratified squamous epithelium.In newborn female,it is lined by transitional epithelium.squamous epithelium is resistant to gonococcal infection.Thus , gonococal vaginitis cannot occur in adult female. Vagina has local inhabitant bacteria called Doderlein's bacillus Which breaks down the glycogen present in vaginal epithelium into lactic acid resulting in acidic pH(4-5.5, average 4.5) of vagina.The acidic pH of vagina acts as a barrier for external organism and protect from infection. Physiological vaginal discharge..... Clear, white and flocculent odourless discharge. Smear contains epithelial cells, lactobacillus pH ranges from 3.8 to 4.2 pH increase with increased oestrogen States:in pregnancy,OCP,mid-cycle,PCOS or premenarchal If pH increase in primenopausal woman, investigation for other effects of excess oestrogen. This area is subject to both primary and secondary infection.Ascending infection can occur from the vagina and c
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Antepartum Heamorrhage APH

चित्र
Antepartum haemorrhage APH APH is usually define as bleeding form the birth canal after the 24 to 28 weeks of  pregnancy.It can occur at any time until the second stage of lobour is complete; bleeding following the birth of the baby is postpartum haemorrhage=Miscarriage Or  Any ammount of bleeding from genital tract after 28 weeks to before of bleeding 28wk ..... Delivery time....6wk APH_________IPH_________PPH ETIOLOGY  --- Idiopathic/unknown 2types    1) Placenta previa (pp) 2) Abrupto previa (AP) Placenta previa=in lower uterin segement Implantation posterior wall of bady of uterus near the fundus Abrupto precisa=premature separation of placenta Most common risk of APH Dropping down theory= Drop down in lower uterine segments Implantation Due to less endometrial reactions Increase that cilliary active of fallopian tube A)Types of placenta previa 1)Types 1 (PP)  low lying place
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