Treatment Of Gynecological Patients Research Articles

Probiotic combinations for women. Effectiveness and safety from the points of evidence-based medicine

To date, probiotic medicinal products have a significant number of clinical studies, which is the basis for the formation of an evidence base and their inclusion in modern treatment standards. However, ideas about the optimal composition of a probiotic preparation and effective dosage remain problematic issues in modern medicine. Choosing an effective probiotic in gynecological practice is a particularly difficult and important issue.Objective of the review: to analyze the available clinical studies aimed at identifying strains of beneficial bacteria, their dosage, possible combinations in order to choose the optimal composition of a probiotic agent for the treatment of dysbiosis, including vaginal.Materials and methods. Modern methods recommended for theoretical analytical research were used: method of analysis, method of synthesis, method of induction. An electronic search was conducted in bibliographic databases, including PubMed, CENTRAL, MEDLINE, Embase, and CINAHL. 58 scientific publications were analyzed. Inclusion criteria were the following keywords: probiotics, optimal dosage, optimal composition, dysbiosis.Results. The most important probiotic microorganisms for restoring health in women are Lactobacillus acidophilus, L. crispatus, L. jensenii, L. gasseri, L. rhamnosus. Each of these lactobacilli maintains the normal vaginal pH, produces hydrogen peroxide, suppresses growth and prevents the reproduction of obligate anaerobes and opportunistic microorganisms when interacting with the peroxidase of cervical mucus.The mechanism of action of the above-mentioned probiotic microorganisms was analyzed. It was established that the effective dose of each of the components should not be less than 1-2 billion colony forming units.Conclusions. The analysis of scientific publications in the bibliographic databases was sufficient to establish that the oral use of probiotics in the treatment of gynecological patients is effective. The optimal components of the probiotic agent, which are effective for the therapy of vaginal dysbiosis, are L. crispatus, L. gasseri, L. jensenii, L. rhamnosus, L. acidophilus.

Bloodless surgery and gynecological patients among Jehovahs Witnesses.

The aim of this research is to present our experiences with the surgical treatment of gynecological patients among Jehovahs Witnesses. Moreover, the medical, moral, and ethical problems in this regard have been highlighted. 75Jehovahs Witnesses patients were operated on for various benign and malignant gynecological diseases between 2007and 2018. All of these patients were operated on according to the rules of blood-sparing surgery. The operations were assessed according to the dia-gnosis, mode of surgery, estimated blood loss, and disease outcome. Excessive blood loss did not occur during any of these operations, and the estimated blood loss for the same procedure was 10to 550 mL. Jehovahs Witnesses gynecological patients is agroup of high-risk patients because they refuse to undergo blood transfusion. Nevertheless, the principles of blood-sparing surgery should be applied to not only Jehovahs Witnesses patients but also to all patients in general. Even if ablood transfusion is the last resort to solve issues pertaining to excessive blood loss during complicated operations, the said procedure always carries certain risks. Therefore, blood transfusion should be performed only on rare occasions. Jehovahs Witnesses patients categorically refuse blood transfusion even if it is the only way to save ones life. Even though the legislation of the Czech Republic deals with this problem, there are other moral and ethical aspects that need to be addressed in this regard.

Досвід використання препаратів хлоргексидину в акушерстві та гінекології

The objective: generalization of the experience of using chlorhexidine drugs in obstetric and gynecological practice. Materials and methods. The efficacy of using Depantol and Hexicon for non-specific colpitis in patients of adolescent, reproductive age, pregnant women, women in perimenopause, as well as in patients after cervical, vaginal and perineal operations was evaluated and generalized. The surveyed groups contained 30 to 50 patients. The diagnosis of nonspecific vaginitis was verified by clinical and laboratory examination. Criteria for recovery were complete clinical and bacterial sanation. The effectiveness of therapy was evaluated immediately after treatment and after 1 and 3 months. The data were compared with the appropriate control groups or with the condition prior to treatment. Results. High efficiency of chlorhexidine preparations in the treatment of nonspecific colpitis in patients of different age categories and conditions was noted. The experience of using Depantol and Gecikon in obstetrics and gynecology is generalized, priorities are determined in the application of these drugs. Conclusion. Preparations of chlorhexidine Geksikon and Depantol are highly effective against the main pathogens of inflammatory nonspecific vulvovaginitis. They do not interfere with the functional activity of lactobacilli, which helps maintain a normal vaginal biocenosis. The drug Geksikon with success can be recommended both for the treatment of gynecological patients of reproductive age, and pregnant women. The use of Depantol, due to the regenerative activity of the dexpanthenol component, is a priority in the treatment of infectious processes in adolescence, perimenopausal age and in patients after operations on the cervix, vagina and perineum. Key words: chlorhexidine preparations, obstetrics and gynecology, Depantol, Geksikon.

Особливості перебігу післяопераційного періоду при хірургічному лікуванні лапаротомічним та лапароскопічним доступом гінекологічних захворювань у жінок з екстрагенітальною патологією

The objective: tactics definition postoperative period at surgical treatment of gynecologic patients with extragenital pathology. Patients and methods. Research included 240 patients who stayed on treatment in a hospital and were operative concerning diseases of internal genitals laparotomical and laparoscopic accesses. All patients had an extragenital pathology. Depending on operation access all patients were divided into two groups. The main group was made by 120 patients who were operated by laparoscopic access. The group of comparison was made by 120 patients whom was operative laparotomical access. Everything patients carried out a clinical-laboratory assessment of a current of the postoperative period. Results. Results of the conducted researches testify that at the compensated accompanying cardiovascular and pulmonary diseases, a diabetes mellitus and an obesity at gynecologic patients at identical gynecologic and extragenital pathology laparoscopic access is more preferable since takes less time, is less travmatical and morbid, is accompanied by a smaller hemorrhage in comparison with the laparotomical. Aftertreatment after laparoscopic operations takes less time that is bound to existence of less expressed pain syndrome, lack of disturbance of function of an intestine, faster restoration of a physical activity and thereof in the smaller postoperative afternoon. At the same time rising of intra abdominal pressure and the provision of Trendelenburg negatively affect hemodynamic indicators at patients with cardiovascular diseases though it doesn’t lead to a decompensation of activity of cardiovascular system. Conclusion. Tactics of maintaining the postoperative period at gynecologic patients with extragenital pathology depends on character of a somatic case rate, option quick to access, a hemorrhage and results of clinical-laboratory inspection. Key words: gynecologic operations, laparotomy, laparoscopy, postpoerative period.

Treatment of gynecological patients in the surgical department

In 1983-1987 in the surgical department of the 10th City Hospital 5352 patients were operated on, 99 (1.9%) of them were operated on because of the gynecological pathology. This group was represented by the following diseases: ectopic pregnancy (21 patients), ruptured ovarian cysts (37 patients); salpingitis of various severity accompanied by peritonitis was found in 41 patients. Among the patients of the latter group, pelvic peritonitis was detected in 21 women, and 12 of them had gonorrheal etiology. Disseminated peritonitis was detected in 20 women.

Experience in the treatment of gynecological patients at the mud resort "Slavyansk"

We have investigated and developed case histories of 701 gynecological patients who were treated in 1954 in Slavyansk. Of these, 540 (group I) had various chronic inflammatory processes of the female genital organs and 161 (group II) had primary infertility, mainly due to inflammatory processes. Among patients of group I with a disease duration of up to two years, it was 14.5%; up to three years - 12.2%; under 5 years - 19% and over 5 years - 54.3%.

Treatment of gynecological patients at the Bakirovo ATSSR resort

The importance of spa mud therapy for gynecological patients does not have to be proven - it has long been known to everyone. The need for this type of treatment on the part of a working woman is growing more and more every year. Allied resorts are not able to fully satisfy these needs. Due to this, it becomes necessary to widely use resorts of local importance, which are more accessible to the general population in terms of territorial proximity, which are often not inferior in terms of the results of their therapeutic effect to the more famous resorts.

The results of vaginal mud therapy with varziyatchi mud in a resort and out-of-resort environment

The method of vaginal mud therapy, first used in Russia (in Essentuki), was not only widespread in a resort setting, but acquired the rights of citizenship, along with other methods of conservative treatment of gynecological patients, and in outpatient practice in many large cities.