scholarly journals Uterine Myoma: A Profile of Nepalese women

1970 ◽  
Vol 1 (2) ◽  
pp. 47-50
Author(s):  
Pramila Pradhan ◽  
Nitish Acharya ◽  
Binit Kharel ◽  
Manoj Manjin
Keyword(s):  
Abdominal Mass ◽  
College Teaching ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Early Marriage ◽  
Early Completion ◽  
Medical College ◽  
Underlying Risk Factor ◽  
The Mean ◽  
Myoma Uteri

Objectives: To determine the most common age and parity for the development of myoma uteri. To find out any relation between age of the last child and the development of myoma uteri. To determine the treatment protocal and outcome of treatment. Materials/methods: This study was carried out at Nepal Medical College Teaching Hospital from Jan 2001 to 31st June 2006. All cases of myoma uteri admitted in Gynaecological ward was included.. Histological evidence of myoma confirmed the diagnosis. Age, parity and age of the last child, clinical features, surgical procedures and outcome of surgery were considered. Results: A total of 137 cases of myoma uteri was operated during five and half years period. This represented 38.5 %of all abdominal hysterectomy performed during the same period. The mean age was 43.3 years with median parity at 1-3 and the mean age of last child at 12years. Excessive menstrual bleeding 73.0%, abdominal mass and pain 58.4%, dysmenorrhea 18.2% and infertility 7.3% were the common symptoms. Total abdominal hysterectomy was the mainstay of treatment. Patients were happy with the treatment specially those with severe and multiple symptoms Postoperative complications were not significant. There was one death due to pulmonary embolism who had mesothelioma of pleura diagnosed by pleural biopsy before operation. Conclusion: Early marriage and early completion of the family is the social trend in Nepalese society. Myoma is common in 4th-5th decade of life in multi parity with the age of last child around 12years. This long standing secondary infertility may be an underlying risk factor in the development of myoma uteri.   doi:10.3126/njog.v1i2.2397 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 47-50 Nov-Dec 2006   

scholarly journals Clinico-Pathological Study of Hysterectomy Specimens in Kathmandu Medical College Teaching Hospital

2018 ◽  
Vol 3 (2) ◽  
pp. 423-426
Author(s):  
Sailesh Bahadur Pradhan ◽  
Mamata Sedhain ◽  
Sneh Acharya ◽  
Sailuja Maharjan ◽  
Samikchhya Regmi
Keyword(s):  
Teaching Hospital ◽  
Histopathological Examination ◽  
College Teaching ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Medical College ◽  
Chronic Cervicitis

Introduction: Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.Objective: To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings.Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.Results: A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.Conclusion: Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426.

scholarly journals CLINICAL PROFILE AND MANAGEMENT OPTION OF FIBROID UTERUS PATIENTS OF OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-2
Author(s):  
Sangeeta Singh ◽  
Renu Jha ◽  
Seema Seema ◽  
Debarshi Jana
Keyword(s):  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Management Options ◽  
Fibroid Uterus ◽  
Number Of Patients ◽  
Study Results ◽  
The Mean ◽  
Benign Tumours ◽  
Symptomatic Uterine Fibroid

Background: Fibroids are the most common benign tumours of smooth muscle cells of uterus in females and typically found during the middle and later reproductive years. As fibroid is an estrogen and progesterone dependent tumour, it gradually decreases in size during starting of menopause. The objective of this presented study was to determine management options among fibroid uterus patients. Methods: 50 number of patients were included in this study those who’s age of 20-55, with symptomatic uterine fibroid and undergone hysterectomy or myomectomy. Postmenopausal, Pregnancy and Asymptomatic fibroid were excluded from this study. Results: The study showed that 52 percent of patient having fibroid uterus were belonged to 31-40 years of age. The mean age was 41.2±6.07. The majority 74% of patients in this study presented with menstrual abnormalities, 40% presented with abdominal lump. Dysmenorrhoea was 26%, 6% patient had primary subfertility and 14% secondary subfertility. Total Abdominal Hysterectomy (TAH) with unilateral salpingo- oophorectomy done in 10% cases, TAH with bilateral salpino-oophorectomy in 22% cases, non descent vaginal hysterectomy in 6% cases, myomectomy done in 20% cases and polypectomy was done in 2% cases. Conclusion: Uterine fibroids are very common in women and frequently in late reproductive and perimenopausal years. It is also a common gynecological problem in our country, which frequently disturbs the lives of woman. Women now have choice of therapies for the treatment of fibroids.

scholarly journals HISTOMORPHOLOGICAL SPECTRUM OF LESIONS OF HYSTERECTOMY SPECIMENS IN GCS MEDICAL COLLEGE, HOSPITALAND RESEARCH CENTER, AHMEDABAD : A STUDY OF 100 CASES

2020 ◽  
pp. 80-82
Author(s):  
Shweta Shah ◽  
S.K. Suri ◽  
Ami Shah
Keyword(s):  
Retrospective Study ◽  
Age Groups ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Medical College Hospital ◽  
Research Centre ◽  
Age Group ◽  
Gynaecological Surgery ◽  
College Hospital ◽  
Medical College

Background: Most frequently performed gynaecological surgery is hysterectomy. The prevalence of hysterectomy varies within different regions. There are mainly two types of hysterectomies according to which part of uterus is removed. The main types of hysterectomy are total and subtotal or partial hysterectomy. The hysterectomy can be performed by three routes abdominal, laproscopic and vaginal hysterectomy. The main objective of our study is to know most common pathology and different age groups of the patients underwent hysterectomy. Materials and Methods: In this retrospective study was carried during period 6 months, at GCS medical college, hospital and research centre, Ahmedabad. Total 100 hysterectomy specimens were analyzed for histopathological lesions. We had taken the clinical and histopathological findings of these cases from the records of department of pathology, GCS medical college , hospital and research centre. Results: In our study of 100 cases, most common age group underwent hysterectomy was 40-49 years and least common age group was 20-29 years. Type of hysterectomy performed most commonly in this study was total abdominal hysterectomy with bilateral salpingoophorectomy. Most of lesions were seen in the myometrium 42 cases (42%), Endometrium 32 cases (32%), Cervix 16 cases (16%) and Ovary 10 cases (10%). Hysterectomy remains the widely used treatment modality.

scholarly journals Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Before And After ◽  
A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

Knowledge and Attitude Regarding Cervical Cancer Screening in Women attending Obstetrics and Gynaecological Opd at Birat Medical College Teaching Hospital

2020 ◽  
Vol 5 (2) ◽  
pp. 1055-1059
Author(s):  
Raj Deb Mahato ◽  
Amit Deo ◽  
Hanoon Pokharel
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Tertiary Care ◽  
Negative Attitude ◽  
College Teaching ◽  
Care Hospital ◽  
Medical College ◽  
The Mean ◽  
Knowledge And Attitude

Introduction: Cervical cancer is the most common Gynaecological cancer in Nepal which is preventable if appropriate screening and prevention measures are employed. Considerable reduction in cervical cancer incidence and cervical cancer related deaths can be achieved by effective screening. However, lack of knowledge and awareness can result in underutilization of the preventive measures.  Objectives: The objective of this study was to assess the knowledge and attitude regarding cervical cancer screening in women visiting Obstetrics and Gynaecology OPD at tertiary care Hospital in Eastern Nepal.  Methodology: A cross-sectional questionnaire-based study was conducted in Obstetrics and Gynaecology outpatient department of Birat Medical College Teaching Hospital from 1 January 2019 to 31 December 2019. Women were enrolled in the study by convenient sampling methods. Structured questionnaire was used to collect the data. The collected data was entered in Microsoft excel and analyzed by using SPSS version 22.  Results: Among 374 participants, the mean age was 31.13 years. More than three fourth (89.6%) of participants were literate. Regarding occupation, 89.8% of participants were housewives, and 82.9 % of participants were married. As per the findings, only 43.27 % of participants i.e. less than the mean, had adequate knowledge of cervical cancer and its screening. 65.50 % of participants had a negative attitude towards cervical cancer screening. Literate participants had good knowledge and positive attitude regarding cervical cancer screening than illiterate participants (P value less than 0.05).  Conclusion Considerable proportions of participants had inadequate knowledge and negative attitude regarding cervical cancer screening in Gynaecological patients visiting tertiary care Hospital in Eastern Nepal.

scholarly journals Association between Psoriasis and Obesity

2018 ◽  
Vol 16 (2) ◽  
pp. 58-61
Author(s):  
Sumit Pandey ◽  
Smita Jha ◽  
Shyam Kumar B.K ◽  
Shyam Kumar B.K. ◽  
Kumar Pokharel
Keyword(s):  
College Teaching ◽  
Control Group ◽  
Medical College ◽  
Pasi Score ◽  
Prevalence Of Obesity ◽  
Study Population ◽  
Duration Of Disease ◽  
The Mean ◽  
Chronic Skin ◽  
Chronic Skin Disease

Background: Psoriasis is primarily a chronic skin disease, the course being punctuated by remissions and relapses. Research has shown that hypertension, obesity, heart failure and diabetes are significantly more common in patients with psoriasis. Obesity is associated with severe psoriasis and is reported about twice as frequently among psoriasis patients as in the general population. In recent years many reports have demonstrated an association between psoriasis and metabolic syndrome. Objectives: The aim of this study was to identify the prevalence of obesity in patients with psoriasis and compare it with that of non-psoriatic population. Material and Method: This study is a case control hospital based study conducted in the Department of Dermatology, Venereologyand Leprology of Nepalgunj Medical College Teaching Hospital, Kohalpur between May 2017 to October 2018.Total 56 cases of psoriasis and similar number of healthy age and sex matched controls were enrolled in the study after taking written consent. Detailed history and physical examination was performed with measurement of body mass index which was recorded. Statistical analysis was done using SPSS 20. Result: The results of the study which included 56 patients with psoriasis and 56 subjects without psoriasis. Among them 26 male and 30 female in study population and 25 male and 31 female in control group. The mean age was41.68±19.04 years in study population and 39.46 ±16.27 years in control group. Duration of disease ranged from 2 months to 360months and PASI score ranged from 4.4 to 28.2 with mean PASI score 11.02±5.4. BMI in cases ranged from 16.7 to 34.2 with mean24.3±4.3 and in controls it ranged from 15.5 to 29.1 with mean 21.9±3. Mean BMI was significantly higher in cases than controls. Conclusion: The result of this study supports the significantly higher prevalence of obesity in study population than control group.

Recurrence patterns in patients with stage IIIC1 versus IIIC2 endometrial adenocarcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15501-e15501
Author(s):  
Catherine Bevan ◽  
Christa Irene Nagel ◽  
Todd Patrtick Boren ◽  
David Scott Miller ◽  
Siobhan Marie Kehoe ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Adenocarcinoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Distant Recurrence ◽  
Exact Test ◽  
Frontline Treatment ◽  
Recurrence Patterns ◽  
The Mean ◽  
To Receive

e15501 Background: To identify differences in recurrence patterns between stage IIIC1 and IIIC2 endometrial adenocarcinomas. Methods: A retrospective review was performed with IRB approval of all patients treated for stage IIIC1 and IIIC2 endometrial adenocarcinoma at our institution from 1989-2011. Patients were required to have comprehensive surgical staging including total abdominal hysterectomy, bilateral salpingo-ophorectomy, pelvic and paraaortic lymph node dissection. Descriptive statistics were performed using Microsoft Excel 2011 and Fischer’s exact test, Kaplan-Meier analyses were used to compare disease free (DFS) and overall survival (OS). Results: Eighty-seven patients with stage IIIC endometrial adenocarcinoma were identified, of which 69 were evaluable. The mean age was 59 years and the mean follow up was 32 months. There were 31 patients with stage IIIC1 and 38 patients with stage IIIC2 disease. There was no statistical difference in histology between the two groups: 47 endometrioid, 11 papillary serous, and 11 with other types of adenocarcinoma. Patients with stage IIIC1 disease were more likely to receive pelvic radiation (p=0.0004) and patients with IIIC2 disease were more likely to receive chemotherapy (p=0.014). Median DFS was 28.9 months (range 0-112) and 15.0 months (range 0-166) (p=0.017) and median OS was 31.9 months (range 0-134) and 18.0 months (range 0-166) (p=0.061) for the IIIC1 and IIIC2 groups respectively. Seven of 31 (23%) patients with stage IIIC1 disease recurred: 1 (14%) at the vaginal cuff and 6 (86%) distant. The patient who recurred locally was initially treated with chemotherapy alone. Of the 6 patients with distant recurrences only 1 received chemotherapy. Twelve of the 38 (32%) patients with stage IIIC2 experienced a recurrence: 6 (50%) vaginal/pelvic and 6 (50%) distant. There was a difference between the rates of local versus distant recurrence in patients with IIIC1 and IIIC2 endometrial cancer. Conclusions: IIIC1 patients were less likely to receive systemic chemotherapy and more likely to recur distantly. Our findings suggest a role for adjuvant chemotherapy and radiation in the frontline treatment of both IIIC1 and IIIC2 endometrial cancer.

Xenon Provides Faster Emergence from Anesthesia than Does Nitrous Oxide-sevoflurane or Nitrous Oxide-isoflurane 

1997 ◽  
Vol 86 (6) ◽  
pp. 1273-1278 ◽  
Author(s):  
Takahisa Goto ◽  
Hayato Saito ◽  
Masahiro Shinkai ◽  
Yoshinori Nakata ◽  
Fumito Ichinose ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Minimum Alveolar Concentration ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Patient Demographics ◽  
The Mean ◽  
American Society ◽  
End Tidal ◽  
To Receive ◽  
Rapid Emergence

Background Xenon, an inert gas with anesthetic properties (minimum alveolar concentration [MAC] = 71%), has an extremely low blood:gas partition coefficient (0.14). Therefore, we predicted that xenon would provide more rapid emergence from anesthesia than does N2O+isoflurane or N2O+sevoflurane of equivalent MAC. Methods Thirty American Society of Anesthsiologists class I or II patients undergoing total abdominal hysterectomy were randomly assigned to receive 60% xenon, 60% N2O + 0.5% isoflurane, or 60% N2O + 0.70% sevoflurane (all concentrations are end-tidal: n = 10 per group). After placement of an epidural catheter, anesthesia was induced with standardized doses of midazolam, thiopental, and fentanyl. Thirty minutes later, xenon, N2O+isoflurane, or N2O+sevoflurane was started as previously assigned. These regimens were supplemented with epidural anesthesia with mepivacaine so that the mean arterial pressure and heart rate were controlled within 20% of the preoperative values. At the end of operation lasting approximately 2 h, all inhalational anesthetics were discontinued, and the patients were allowed to awaken while breathing spontaneously on an 8 l/min inflow of oxygen. A blinded investigator recorded the time until the patient opened her eyes on command (T1), was judged ready for extubation (T2), could correctly state her name, her date of birth, and the name of the hospital (T3), and could count backward from 10 to 1 in less than 15 s (T4). Results Emergence times from xenon anesthesia were: T1, 3.4 +/- 0.9 min; T2, 3.6 +/- 1 min; T3, 5.2 +/- 1.4 min; and T4, 6.0 +/- 1.6 min (mean +/- SD). These were one half to one third of those from N2O+sevoflurane (T1, 6.0 +/- 1.7 min; T4, 10.5 +/- 2.5 min) or N2O+isoflurane (T1, 7.0 +/- 1.9 min; T4, 14.3 +/- 2.8 min) anesthesia. The three groups did not differ in terms of patient demographics, the duration of anesthesia, the amount of epidural mepivacaine administered, or the postoperative pain rating. No patient could recalls intraoperative events. Conclusions Emergence from xenon anesthesia is two or three times faster than that from equal-MAC N2O+isoflurane or N2O+sevoflurane anesthesia.

scholarly journals Ovarian dysgerminoma: a case report

2021 ◽  
Vol 10 (4) ◽  
pp. 1704
Author(s):  
Shamrao Ramji Wakode ◽  
Varsha Narayana Bhat
Keyword(s):  
Young Women ◽  
Ovarian Neoplasms ◽  
Abdominal Mass ◽  
Total Abdominal Hysterectomy ◽  
Malignant Tumour ◽  
Abdominal Hysterectomy ◽  
Tumour Mass ◽  
Mesenteric Lymph ◽  
Beta Hcg ◽  
Ovarian Dysgerminoma

An ovarian dysgerminoma is a rare, malignant tumour occurring in young women, accounting for 1% to 2% of all primary ovarian neoplasms. A 22 years old female presented with 6 months of amenorrhea and lump in the abdomen. Her physical examination was remarkable with 36 weeks sized huge abdominal mass. Subsequent computed tomography revealed 22×23×32.4 cm mixed density lesion in pelvi-abdominal region and multiple paraaortic and mesenteric lymph node with gross pleural effusion. On further evaluation raised beta-hcG and LDH were noted and hence dysgerminoma was suspected. Total abdominal hysterectomy with right salpingo-ophorectomy with resection of tumour mass with partial omentectomy and lymphadenectomy was performed. Histopathology reports were suggestive of dysgerminoma. 

scholarly journals A clinical study of elective hysterectomies for benign lesions

2021 ◽  
Vol 10 (6) ◽  
pp. 2414
Author(s):  
Mamta Meena ◽  
Urvashi . ◽  
C. P. Kachawaha ◽  
Dharmendra Singh Fatehpuriya
Keyword(s):  
Clinical Study ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Safe Procedure ◽  
Benign Lesions ◽  
Duration Of Surgery ◽  
The Mean ◽  
Adnexal Pathology ◽  
Histopathological Report

Background: Hysterectomy is widely used for treating a variety of gynecologic conditions. Most hysterectomies are elective and are performed to treat benign indications. Hence the present study was undertaken to determine the benign indication of hysterectomy, choice of surgical approach, safety and clinical aspect of hysterectomy as a surgical procedure and to correlate the findings with histopathological reports of the specimen.Methods: The present series represents a clinical study of 120 cases of elective hysterectomies for benign lesions. Out of which 73 were done by abdominal and 47 by vaginal route. Finally, all operated specimen were subjected to histological examination.Results: The main indications for elective hysterectomy were leiomyoma 53 (44.2%), prolapse 47 (39.2%) and dysfunctional uterine bleeding 11 (9.2%). Type of operation performed were mainly total abdominal hysterectomy with bilateral salphingo-oophorectomy in 60% cases and vaginal hysterectomy with anterior and posterior repair in 38.3% cases. The mean duration of surgery and average blood loss was more in vaginal procedure (90 min and 100ml) compared to abdominal (70 min and 80ml) respectively. Vaginal hysterectomy was associated with less morbidity and a smoother convalescence than abdominal hysterectomy. In 81.2% cases of abdominal hysterectomies correspondence of indication with histopathological report (HPR) were found, in vaginal 74.5% cases corresponded their histopathological report with their symptoms and investigations. Associated adnexal pathology was found in 8.3% cases. There was no mortality during the whole study period.Conclusions: Hysterectomy for benign pelvic lesions is a safe procedure and an important component of health care for women.

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