Rapid recovery of a rectovaginal fistula with infliximab in a patient with Crohn's disease.
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We present the case of a female patient diagnosed with colonic Crohn's disease, having a clinical evolution with many recurrences and in whom conventional therapy had failed. The patient was admitted in our department 4 years after the onset of the disease, with an altered general state, diarrhea, malnutrition, fever and fecaloid vaginal discharge. Investigations classified the patient in a severe activity flare of Crohn's disease (CDAI 329), complicated with a rectovaginal fistula. Infliximab therapy was initiated. The evolution was rapidly favorable and the fistula closed after 4 weeks of therapy. (+info)
Current practices in treatment of female genital fistula: a cross sectional study.
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Perceived causes of obstetric fistulae from rural southern Tanzania.
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BACKGROUND: Although the magnitude of obstetric fistulae (OF) is reported to have decreased in industrialized countries, it is still a major problem in developing countries. While the main cause of OF is prolonged obstructed labour without prompt medical attention, misconceptions about OF exist. OBJECTIVE: To determine awareness and perceived causes of OF in rural areas of southern Tanzania. METHODS: A cross-sectional survey was conducted among women of reproductive age, men, health personnel, birth attendants, community leaders and OF cases using qualitative and quantitative approaches. RESULTS: More than 60% of interviewees reported to be aware of OF with a connotation of urine in the names. Perceived causes of OF include sorcery, prolonged labour, delivering by operation where doctors/nurses make mistakes perforate the urinary bladder, physique of the expecting mother, poor skills of doctors/nurses to conduct caesarean section, young or old age of an expecting mother and having sex before recovering from the operation. CONCLUSION: Although OF is not reported to exist, most of the interviewees were aware of them. However, were few respondents are able to mention the main cause of OF. Maternal health education is important as a strategy to minimize the spread of misconceptions about causes of OF. (+info)