scholarly journals Experience of Persistent Gestation Trophoblastic Disease in a Tertiary Medical College Hospital, Bangladesh

2016 ◽  
Vol 27 (2) ◽  
pp. 50-56
Author(s):  
Kamrun Nahar ◽  
Halima Yesmin ◽  
Kanika Roy ◽  
Safiul Alam ◽  
Kashefa Khatun
Keyword(s):  
Clinical Presentation ◽  
Single Agent ◽  
Low Risk ◽  
Molar Pregnancy ◽  
College Hospital ◽  
Medical College ◽  
Trophoblastic Disease ◽  
Multi Agent ◽  
One Year ◽  
Methotrexate Chemotherapy

Objectives: To study the clinical presentation and risk factors of persistent trophoblastic disease and its outcome of treatment with chemotherapy.Materials and methods: This observational study was carried out on fifty patients of persistent trophoblastic disease who were admitted in the Department of Obstetrics & Gynaecology, Mymensingh Medical Hospital (MMCH) during one year period. Evaluation of disease was done by thorough clinical examination and a set of investigations including chest radiography, ultrasound scan of abdomen and pelvis and estimation of serum â hCG. The four factors under analysis of PTD were age of the patient, clinical presentation, gestational age at diagnosis of molar pregnancy and nature of antecedent pregnancy. Patients with non-metastatic trophoblastic disease and low risk metastatic trophoblastic disease were offered single agent chemotherapy with methotrexate and folinic acid rescue in consultation with the oncologist. When â hCG response was inadequate, multi-agent chemotherapy was given. Complications of chemotherapy were also observed and supportive treatment was given.Results: Out of 50 patients, 49 (98%) patients had antecedent molar pregnancy and 1(2%) had missed abortion. In cases of post molar trophoblastic disease, 28 (57.58%) were in 20-30 yrs. Mean ± SD was 31.35 ± 7.25. In these cases gestational size of molar pregnancy was between 16-20 weeks in 24 (48.98%), <16 wks in 19 (38.78%) and >20 wks in 6 (12.24%) cases. Mean ± SD was 16.78 ± 4.45 wks (p<0.001). Associated theca lutein cysts were present among higher number of cases (57.14%) but not statistically significant. Regarding clinical presentation, 40 (80%) patients presented with irregular pervaginal bleeding, 3(6%) patients with features of metastasis. Most of the of the study subjects 43 (86%) were treated with chemotherapy and 7 (14%) had undergone both hysterectomy and chemotherapy. Single agent methotrexate was given in 47 (94%) cases and multiple agent (EMA-CO) in 3 (6%). After giving 4 cycles of chemotherapy 11 (22%) patients were cured, 38 (76%) had declining â hCG level and one had static â hCG level. Overall remission was 98 %. Complication of chemotherapy was observed in 5 (10%) patients.Conclusion: Theca lutein cyst are important in the prediction of persistent disease after molar pregnancy. Methotrexate chemotherapy is effective and well tolerated in treating patients with nonmetastatic and low risk metastatic gestational trophoblastic neoplasia.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 50-56

scholarly journals Evaluation of molar pregnancy in Rajshahi Medical College Hospital

KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 24-27
Author(s):  
Mosammat Nargis Shamima ◽  
Rubayet Zereen ◽  
Mohd Alamgir Hossain ◽  
Nargis Zahan ◽  
Nurjahan Akter ◽  
...  
Keyword(s):  
Low Socioeconomic Status ◽  
Hydatidiform Mole ◽  
Treatment Protocol ◽  
Medical College Hospital ◽  
Molar Pregnancy ◽  
College Hospital ◽  
Low Socioeconomic ◽  
Medical College ◽  
One Year ◽  
Abnormal Vaginal Bleeding

Background: A molar pregnancy is also known as hydatidiform mole which is a benign tumour that develops in the uterus. It begins when an egg is fertilized but normal viable pregnancy not occurs, rather than the placenta develops into an abnormal mass of cyst. In all cases of molar pregnancy observation is essential to detect the reawakening of chorionic activity.Objectives: The aim of the study was to explore the incidence, clinical presentation, management and outcome of the molar pregnancy in our hospital.Materials & Methods: This prospective study was conducted in Rajshahi Medical College Hospital, Rajshahi, Bangladesh over a period of one year from July 2016 to June 2017. All pregnant women who were diagnosed as molar pregnancy were included in the study.Results: In this study the incidence of molar pregnancy was 5.3 per 1,000 deliveries that was 1 in 188 deliveries. Among the patients 54.7% were between (23 - 27 years) age group, 81.2% cases were multiparous and 58.4% patients belonged to low socioeconomic status. The prevalent blood group was A and constitute 56.6%. About 62.2% patient presented with amenorrhoea and abnormal vaginal bleeding. 45.3% admitted between (12-16) weeks of gestation. Most of the patients 58.4% were managed by suction and evacuation. Among all the cases 92.4% were complete mole and only 16.9% came for follow up.Conclusion: Results from this study showed that a small portion of patient of molar pregnancy came for routine follow up. To achieve high cure rate and low chemotherapy rate an effective registration programme and treatment protocol should be established.KYAMC Journal Vol. 9, No.-1, April 2018, Page 24-27

scholarly journals A PROSPECTIVE STUDY ON CLINICOEPIDEMIOLOGICAL PROFILE OF MOLAR PREGNANCY IN A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Ajit Kumar Nayak ◽  
Dr. Sumitra Hota ◽  
Dr. Maya Padhi ◽  
, Dr. Manju Kumari Jain
Keyword(s):  
Low Socioeconomic Status ◽  
Hydatidiform Mole ◽  
Tertiary Care ◽  
Single Agent ◽  
Gestational Trophoblastic Disease ◽  
Care Hospital ◽  
Molar Pregnancy ◽  
Medical College ◽  
Trophoblastic Disease ◽  
Common Time

Introduction: Gestational trophoblastic diseases (GTD) refers to a spectrum of pregnancy related trophoblastic abnormalities. The objective of this study was to determine the incidence of molar pregnancies in SCB Medical College & Hospital along with the demographics and risk factors associated and to evaluate its management and outcome.  Methods: The study was a prospective epidemiological study which includes fifty eight patients with gestational trophobastic diseases treated at the gynecological ward, S.C.B. Medical College & Hospital, Cuttack, Odisha during July 2015 to July 2017. Results: The incidence was 2.85 in 1000 deliveries in the institution. Most of the patients belonged to low socioeconomic status and in the age group of 21 to 30 years. Primigravida were more prone to the disease and no patients had history of molar in prior pregnancies. Most commonly encountered symptom was vaginal bleeding following a period of amenorrhea. Second trimester was the most common time of presentation with mean gestational age around 12 weeks. Out of 57 patients treated with suction and evacuation, 23 patients developed persistent trophoblastic disease who were further managed by methotrexate and folinic acid. Failure rate of single agent chemotherapy was 21.7% which were successfully managed by triple agent chemotherapy [EMA-CO regimen]. Conclusion: Incidence of molar pregnancies in this study was much higher as this hospital is the referral centre for South Eastern Odisha. However, proper reporting and follow up can prevent mortality associated with malignant transformation. Keywords: Beta hCG, Chemotherapy, Gestational trophoblastic disease, Hydatidiform mole, molar pregnancy

scholarly journals Clinical Presentation and Management of Hydatidiform Mole in a Peripheral Tertiary Hospital

2013 ◽  
Vol 25 (2) ◽  
pp. 59-64
Author(s):  
Jaglul Haider Khan ◽  
Jannatul Ferdous ◽  
Samiya Alam
Keyword(s):  
Clinical Presentation ◽  
Economic Status ◽  
Hydatidiform Mole ◽  
Tertiary Hospital ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
College Hospital ◽  
Medical College ◽  
Abnormal Vaginal Bleeding

This study was conducted in Faridpur Medical College Hospital, Faridpur, from January 2008  to December 2008 among fifty patients, diagnosed as a case of molar pregnancy. Incidenc of  molar pregnancy was 8.27 per thousand pregnancy. Sixty percent of the patients were multiparous  and eighty percent of low socio economic status . B positive blood group was prevalent (36%)  in this study.Sixty percent( 60%) of the patients presented with amenorrhoea and abnormal  vaginal bleeding.. Most of the patients (72%) were treated with suction evacuation and curettage.  Of them hemorrhage was the most common immediate complication (80%). Complication  like shock and perforation during evacuation was 14% and 4% respectively. Three patient  (6%) developed Persistent Gestational Trophoblastic Disease(GTD) and one (2%) patient  developed choriocarcinoma with lung metastasis and died. Thirty two (64%) patients attended  for regular follow up but ten patients (20%) had attended irregularly and eight patients (16%)  had dropped out .This study shows that follow up for molar pregnancy cases is not satisfactory  in a district medical college hospital.Further improvement can be done by increasing awareness  of the patients. DOI: http://dx.doi.org/10.3329/bjog.v25i2.13741 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 59-64  

scholarly journals Management of congential muscular toticollis under one year of age

2012 ◽  
Vol 1 (2) ◽  
pp. 2-5
Author(s):  
Abdul Matin ◽  
Md Rafiqul Islam ◽  
Ranjit Ranjan Roy ◽  
Bijoy Krishna Das ◽  
Sudesh Chandra Rakshit ◽  
...  
Keyword(s):  
Head And Neck ◽  
Sternocleidomastoid Muscle ◽  
Medical College Hospital ◽  
College Hospital ◽  
Congenital Muscular Torticollis ◽  
Medical College ◽  
One Year ◽  
Neonates And Infants ◽  
Muscular Torticollis ◽  
Postural Deformity

Background and study aim: Torticollis is the postural deformity of head and neck. Congenital Muscular Torticollis (CMT) is a postural deformity of head and neck detected at birth or shortly after birth, primarily resulting from unilateral shortening of Sternocleidomastoid muscle (SCM), In neonates and infants, patient may cure conservatively by physiotherapy but surgery is the treatment of choice for children and adolescents. Here we show our experience regarding management of congenital muscular torticollis with physiotherapy. Patients and Methods: This is an observational descriptive study. Verbal consent from parents was taken. Patients of congenital muscular torticollis with other disease or other congenital anomaly were excluded from study. Twenty patients of congenital muscular torticollis were treated. The cases were enrolled between Nov' 2005 to Oct' 2008 in Bangabandhu Sheikh Mujib Medical University, Gonosasthaya Somaj Vittik Medical College Hospital, ZH Sikder Women's Medical College Hospital, Shaheed Shurawardy Medical College Hospital. Neonates and infants were treated conservatively with physiotherapy and non responsive cases were referred for surgery. Results: Patients age range from 5 days to 1 year of which eleven were females and nine were males. Sternocleidomastoid muscle (SCM) was shortened in all cases (12 on right side and 8 on left side). Of 20 patients 6 neonates, rest 14 infants within 1 year age. Out of 20 neonates and infants 17 were cured conservatively with physiotherapy and rest 3 were referred for surgery. Conclusion: Most of the patient of congenital muscular torticollis can be treated conservatively during infancy. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12157 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.2-5

The clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation

2004 ◽  
Vol 14 (2) ◽  
pp. 366-369 ◽  
Author(s):  
A. M. Gillespie ◽  
E. A. Lidbury ◽  
J. A. Tidy ◽  
B. W. Hancock
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Gestational Trophoblastic Disease ◽  
Surgical Removal ◽  
Molar Pregnancy ◽  
Initial Management ◽  
Trophoblastic Disease ◽  
Treatment Centre ◽  
History Of ◽  
Park Hospital

The objective of this study was to determine the clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation registered with the Trophoblastic Disease Screening and Treatment Centre, Weston Park Hospital, Sheffield between 1986 and 2000. From the 5581 women registered, those with a diagnosis of ectopic molar pregnancy were identified from a computer database. Information regarding the relevant history of each patient and the clinical presentation, treatment, and outcomes of gestational trophoblastic disease (GTD) was determined by reviewing referral forms, case notes, and pro formas completed by the referring gynecologist. Histological review of the cases was undertaken where possible. Suspected ectopic molar gestations comprised 31/5581 (0.55%) of registrations. Known risk factors for ectopic pregnancy were identified in 79% of cases. Central histological review confirmed only six cases of GTD: three choriocarcinoma and three early complete moles. Four patients subsequently required chemotherapy. All patients are now in complete remission. We conclude that ectopic GTD is uncommon, with a UK incidence of approximately 1.5 per 1,000,000 births. Initial management is usually surgical removal of the conceptus, pathological suspicion of the diagnosis and registration with a screening center. Chemotherapy may be required and the prognosis is excellent.

scholarly journals A Study of Drugs Causing Fixed Drug Eruptions

2018 ◽  
Vol 27 (1) ◽  
pp. 29-33
Author(s):  
Md Moksedur Rahman ◽  
Md Abdullah ◽  
Moriom Nessa ◽  
Muhammad Afsar Siddique ◽  
Md Moazzem Hossain ◽  
...  
Keyword(s):  
Self Administration ◽  
Fixed Drug Eruption ◽  
College Hospital ◽  
Medical College ◽  
Provocation Tests ◽  
Drug Eruptions ◽  
Fixed Drug ◽  
Distinctive Type ◽  
One Year ◽  
Cutaneous Drug Reaction

Fixed drug eruption (FDE) is a distinctive type of cutaneous drug reaction that characteristically recurs in the same site or sites each time a particular drug is taken. FDEs are among the most frequent problems encountered by the dermatologists. The present study was carried out to recognize offending drugs, to educate the patients and to avoid self-administration of drugs and re-administration of the offending drugs. The study was conducted in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi over a period of one year. One hundred ten cases with established FDE were evaluated clinically. The causative drugs were identified and confirmed by provocation tests. Cotrimoxazole (25%) was the most common cause of FDE. Other drugs incriminated were NSAID (21.8%), Tetracycline (15.4%), Ciprofloxacin (10%), Amoxicillin (7.2%), Metronidazole (5.4%), Griseofulvin (2.7%) and Fluconazole (1.8%). The lesions were found to be distributed on the oro-genital mucosa, trunk and the acral regions.The main presentation of FDE was circularhyperpigmented lesion.TAJ 2014; 27(1): 29-33

scholarly journals Effectiveness and toxicity of first-line methotrexate chemotherapy in low-risk postmolar gestational trophoblastic neoplasia: The New England Trophoblastic Disease Center experience

2018 ◽  
Vol 148 (1) ◽  
pp. 161-167 ◽  
Author(s):  
Izildinha Maestá ◽  
Roni Nitecki ◽  
Neil S. Horowitz ◽  
Donald P. Goldstein ◽  
Marjory de Freitas Segalla Moreira ◽  
...  
Keyword(s):  
New England ◽  
Low Risk ◽  
Gestational Trophoblastic Neoplasia ◽  
First Line ◽  
Trophoblastic Disease ◽  
Methotrexate Chemotherapy

Treatment for Low-Risk Gestational Trophoblastic Disease: Comparison of Single-Agent Methotrexate, Dactinomycin and Combination Regimens

2008 ◽  
Vol 63 (5) ◽  
pp. 306-307
Author(s):  
Renato Antonio Abrão ◽  
Jurandyr Moreira de Andrade ◽  
Daniel Guimarães Tiezzi ◽  
Heitor RicardoCosiski Marana ◽  
Francisco José Candido dos Reis ◽  
...  
Keyword(s):  
Single Agent ◽  
Gestational Trophoblastic Disease ◽  
Low Risk ◽  
Trophoblastic Disease ◽  
Combination Regimens

scholarly journals Loop Electrosurgical Excision Procedure of the Transformation Zone: an out patient procedure

2016 ◽  
Vol 27 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Mukti Rani Saha ◽  
Iffat Ara ◽  
Sabera Khatun ◽  
Suvash Chandra Roy ◽  
Tapan Kumer Saha
Keyword(s):  
Local Anaesthesia ◽  
College Hospital ◽  
Transformation Zone ◽  
Outpatient Procedure ◽  
Medical College ◽  
Cin Iii ◽  
One Year ◽  
Adequate Tissue ◽  
Loop Electrosurgical Excision ◽  
Loop Electrosurgical Excision Procedure

Objective: A prospective, observational study in Dhaka Medical College Hospital was carried out to assess the efficacy of loop electrosurgical excision procedure (LEEP) of the transformation zone of cervix as an outpatient procedure as diagnostic and therapeutic purpose during visit of patients with the report of CIN II or CIN III on histopathology.Method: One hundred women over a period of one year from 1st January to 31st December 2011 were treated with LEEP as an outpatient procedure. Among these women 63 patients were CIN II and 37 patients were CIN III on histopathology report. LEEP were done under local anaesthesia. All patients were followed up for one year with colposcopy and also histology where appropriate.Results: In all cases, the specimens obtained were adequate for histopathological assessment and in 98 (98%) cases the lesion had been completely excised. Two cases of CIN III required a second excision. One patient needed cervical sutures to achieve haemostasis following the excision. One patient was admitted in the hospital with primary haemorrhage. Two patients were admitted with secondary haemorrhage.Conclusion: LEEP under local anaesthesia is an effective technique. It enables the treatment of patients with cervical intraepithelial neaplasia and exclusion of invasive cancer in a subsequent visit. Thus adequate tissue is made available for accurate diagnosis, thereby improving the accuracy of treatment.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 5-8

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