Research Article
Comorbidity Pattern and Autonomic Nervous System Dysfunction in Patients with Chronic Vulvar Discomfort
Vesna Harni*
,
Damir Babic,
Suzana Ljubojevic Hadzavdic,
Dubravko Barisic,
Magdalena Karadza
Issue:
Volume 12, Issue 6, December 2024
Pages:
118-131
Received:
20 September 2024
Accepted:
10 October 2024
Published:
12 November 2024
DOI:
10.11648/j.jgo.20241206.11
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Abstract: This study examines novel concepts of comorbidity in patients with chronic vulvar discomfort using data from the DATRIV (Diagnostic Accuracy of Three Rings Vulvoscopy) study, which involved 328 participants categorized into four groups: asymptomatic individuals with normal or impaired vulvar skin and patients with chronic vulvar discomfort, classified as either vulvodynia or vulvar dermatosis. Clinical data were collected through a structured questionnaire and analyzed using statistical software, including StatSoft (Dell, Austin, TX, USA), Statistica 12 (TIBCO®, Palo Alto, CA, USA), and SPSS 20 (IBM, Armonk, NY, USA). The study received approval from the Institutional Review Board of Polyclinic Harni, and all participants provided written informed consent. The findings reveal significantly higher comorbidity rates in patients with chronic vulvar discomfort compared to other groups (p = 0.0000). A substantial percentage of asymptomatic participants with both normal (63.4%) and impaired (70.7%) vulvar skin also reported comorbid conditions. Analysis of comorbidity curves revealed distinct patterns of symptom progression, with a gradual increase in frequency from asymptomatic individuals to patients with vulvodynia, followed by a decline in vulvar dermatosis cases. These patterns highlight the central role of autonomic nervous system (ANS) dysfunction, where sympathetic hyperactivity and parasympathetic depression contribute to separate comorbidity chains. These dysfunctions may act independently or concurrently, leading to various health issues. The elevated comorbidity rates and overlapping symptomatology suggest complex pathophysiology driven by ANS dysregulation. Further research on comorbidity clusters may unveil new therapeutic targets and guide the development of multifaceted treatment strategies.
Abstract: This study examines novel concepts of comorbidity in patients with chronic vulvar discomfort using data from the DATRIV (Diagnostic Accuracy of Three Rings Vulvoscopy) study, which involved 328 participants categorized into four groups: asymptomatic individuals with normal or impaired vulvar skin and patients with chronic vulvar discomfort, classif...
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Research Article
Study of Knowledge, Attitudes and Practices of Family Planning: Case of Female Staff of the Communal Medical Center (CMC) of Flamboyants, Conakry, Guinea
Sow Alhassane II*,
Diallo Ibrahima Tangaly,
Bah Ibrahima Koussy,
Keita Massa,
Balde Abdoul Aziz,
Diallo Boubacar Sidy,
Balde Abdoulaye Djibril,
Sylla Aboubacar M’mah,
Balde Boubacar Talibe,
Diallo Abdourahamane,
Balde Ibrahima Sory,
Sy Telly
Issue:
Volume 12, Issue 6, December 2024
Pages:
132-139
Received:
29 September 2024
Accepted:
18 October 2024
Published:
12 November 2024
DOI:
10.11648/j.jgo.20241206.12
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Abstract: Introduction: The aim was to assess the knowledge, attitudes and practices of female staff on family planning at the Flamboyants Communal Medical Center. Methods: This was a 3-month cross-sectional, prospective, descriptive and analytical study involving women (doctors, midwives, laboratory technicians and nurses) working at the Flamboyants CMC and agreeing to participate in the study. Results: The contraceptive prevalence was 61.9%. All respondents were aware of FP (100%). The most commonly cited contraceptive methods were: the intrauterine device (IUD) at 85.7%, the Jadelle implant (79.4%) and the contraceptive pill (68.3%). More than 8 out of 10 respondents (81.0%) were in favor of using family planning. Most of the respondents, 74.5%, discussed family planning with their spouses and 70.2% of the spouses were in favor of FP. The most frequently used method was the pill (59.0%). The factors associated with the use of FP were: dialogue with the spouse on contraception (p = 0.018), marriage (p = 0.012) and good attitude of the spouse towards FP (p = 0.000). Conclusion: Improving this prevalence would require the involvement of spouses and midwives during counseling during antenatal and postpartum follow-up.
Abstract: Introduction: The aim was to assess the knowledge, attitudes and practices of female staff on family planning at the Flamboyants Communal Medical Center. Methods: This was a 3-month cross-sectional, prospective, descriptive and analytical study involving women (doctors, midwives, laboratory technicians and nurses) working at the Flamboyants CMC and...
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Research Article
The Effects of Intra-Operative Lidocaine Infusion on Post Operative Pain and Morphine Consumption Following Major Gynaecological Surgeries Under General Anaesthesia
Issue:
Volume 12, Issue 6, December 2024
Pages:
140-149
Received:
1 October 2024
Accepted:
22 October 2024
Published:
12 November 2024
DOI:
10.11648/j.jgo.20241206.13
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Abstract: Introduction: Major gynaecological surgeries are associated with considerable postoperative pain, which remains a challenge for many practitioners. Multimodal forms of analgesia significantly reduce the requirement of opioids for pain management. Despite its local anaesthetic effects, lidocaine infusion improves postoperative pain and morphine consumption following gynaecological surgeries. Materials and methods: Sixty patients were assigned randomly into 2 groups (A and B) with 30 patients per group. Group A received intravenous lidocaine 1.5 mg/kg at induction via a bolus injection and 1.5 mg/kg/hr in normal saline infusion from onset of surgery to the end of surgery, while the control group (Group B) received equal volume of normal saline at the same timelines. Pain scores were assessed postoperatively using the numerical rating scale and the cumulative morphine consumed postoperatively were also measured. Results: The mean pain scores were significantly higher in the Saline Group than in the Lidocaine group. The cumulative morphine consumption after 48 hours was significantly reduced in the study group 4.87 ± 1.80 mg vs 14.13 ± 4.10 mg (P<0.0001). Conclusion: The administration of a bolus dose (1.5 mg/kg) of intravenous lidocaine at induction and a continuous intravenous infusion of 1.5 mg/kg/hr from onset of surgery till skin closure reduced the postoperative pain intensity and morphine consumption in patients undergoing major gynaecological surgeries under general anaesthesia.
Abstract: Introduction: Major gynaecological surgeries are associated with considerable postoperative pain, which remains a challenge for many practitioners. Multimodal forms of analgesia significantly reduce the requirement of opioids for pain management. Despite its local anaesthetic effects, lidocaine infusion improves postoperative pain and morphine cons...
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