Solving the Dilemma: Van Wyk-Grumbach Syndrome.

The Van Wyk-Grumbach syndrome (VWGS) (hypothyroidism, ovarian mass, and precocious puberty) has been extensively documented in the literature as long-term hypothyroidism manifesting as an ovarian mass. The authors of this study describe this entity in a young girl, aged 10, who presented with abdominal pain with a multiloculated ovarian cyst. She was evaluated, and it was discovered that she had delayed bone age, precocious puberty, and a small height. Following her diagnosis of autoimmune thyroiditis and the initiation of thyroxine replacement therapy, the ovarian cysts spontaneously regressed. To avoid needless assessment and surgical mishaps, this entity should be considered in situations of ovarian mass, particularly those with precocious puberty and thyroid disorders.

Hemolysis, Elevated Liver Enzymes and Low Platelet Count Syndrome Complicated by Disseminated Intravascular Coagulation and Posterior Reversible Encephalopathy Syndrome: A Case Report.

A 22-year-old pregnant woman was transferred from an external medical facility after experiencing an eclamptic seizure linked to hemolysis, elevated liver enzymes and low platelet count syndrome (HELLP) syndrome, and posterior reversible encephalopathy syndrome (PRES). Her situation was further complicated by intrauterine fetal demise and disseminated intravascular coagulation, necessitating a comprehensive multidisciplinary approach. This report details the diagnostic process and challenges in managing this complex patient with diverse medical requirements. Emphasis is placed on the observed hemostatic abnormalities, and we delineate the nuances in our approach compared to managing a similar condition in a nonpregnant patient. Heightened awareness among healthcare professionals is imperative for prompt diagnosis and effective intervention in such uncommon neurological complications during pregnancy.

Isolated Unilateral Hydrosalpinx Torsion in a Post-Tubal Ligation Patient: A Case Report and Review of Literature.

Isolated tubal torsion of the hydrosalpinx is a rare occurrence with a varied clinical presentation, presenting a diagnostic challenge. We present a case involving the isolated torsion of the right hydrosalpinx in a 33-year patient with a history of bilateral tubal ligation who presented with an acute abdomen. Based on ultrasound and clinical findings, an initial diagnosis of ovarian torsion was considered. However, escalating pain severity led to diagnostic laparotomy, revealing torsion in the right hydrosalpinx. Subsequent right salpingectomy was done, and as the patient had undergone tubal ligation, preventive left salpingectomy was also performed. Both ovaries were preserved. The patient experienced an uneventful recovery. A literature review uncovered fewer than 50 reported cases of unilateral or bilateral isolated fallopian tube torsion post-tubal ligation. This case underscores the diagnostic challenges associated with isolated tubal torsion and emphasizes the crucial role of early surgical intervention in preventing morbidity and preserving ovaries.

Navigating the Challenges: A Comprehensive Review of Adolescent Gynecological Problems.

This comprehensive review delves into the spectrum of adolescent gynecological problems, shedding light on the multifaceted challenges faced by individuals between the ages of 10 and 19. Covering normal developmental changes, common issues such as menstrual disorders, and the intricate interplay of psychosocial and cultural factors, the review provides a holistic understanding of adolescent gynecological health. Key findings underscore the importance of tailored education, destigmatizing reproductive health discussions, and recognizing the critical role of mental health in overall well-being. The conclusion issues a compelling call to action, urging healthcare providers to adopt patient-centered practices, educators to integrate comprehensive sexual education, and policymakers to advocate for inclusive policies. This review serves as a valuable resource, guiding collective efforts to enhance the well-being of adolescents as they navigate the challenges of gynecological health on their journey to adulthood.

Transvaginal Isthmocele Repair With Temporary Occlusion of Uterine Vessels in Caesarean Scar Pregnancy.

A uterine scar defect, or isthmocele, is one of the known complications of cesarean delivery. It can cause obstetric as well as gynecological problems. Diagnosis can be suspected based on complaints such as abnormal uterine bleeding, pelvic pain, dysmenorrhea, and subfertility. It can be investigated by transvaginal ultrasound and MRI hysteroscopy. A hysteroscopy gives a confirmatory diagnosis. Isthmoplasty may be offered to avoid future obstetric complications and treat symptoms. In the present case report, a patient with prolonged postmenstrual dark-colored spotting underwent isthmocele repair by a procedure that could be unique, which is transvaginal isthmocele repair with temporary occlusion of uterine vessels. This procedure offers efficacy, safety, good outcomes, and prospects. Cesarean scar pregnancy (CSP) is a rare but potentially serious complication of cesarean section deliveries. We describe the efficacy, safety, outcomes, and prospects of transvaginal Isthamocele repair with temporary occlusion of uterine vessels to manage CSP.

Echinococcal Disease of the Fallopian Tube as a Rare Cause of Primary Subfertility.

Echinococcosis is a significant zoonotic infection caused by Echinococcus granulosus, which has a worldwide distribution. In India, the annual incidence varies from one to 200 in 100,000 people. The liver and lungs are often affected, making diagnosis difficult when infections occur in uncommon areas. We report a case of a hydatid cyst in the fallopian tube, which presented as subfertility and was confirmed by radiological imaging.

Postpartum Mood Disorders: Insights into Diagnosis, Prevention, and Treatment.

Postpartum mood disorders pose significant challenges to women's mental health and well-being during the postpartum period. This review article provides insights into these disorders' diagnosis, prevention, and treatment. The article begins by discussing the background information on postpartum mood disorders, their significance, and the purpose of understanding them. It then delves into the classification and types of postpartum mood disorders, emphasizing the need for accurate diagnosis and differentiation. Prevalence and incidence rates are explored to highlight the scope and impact of these disorders. The review examines various risk factors associated with postpartum mood disorders, including biological, psychological, and socioeconomic factors. Understanding these risk factors helps identify high-risk populations and guide targeted interventions. Screening and diagnosis of postpartum mood disorders are crucial for early detection and intervention. The article provides an overview of screening tools, highlights the challenges in diagnosis, and emphasizes the importance of early identification for better outcomes. Prevention strategies are explored, including antenatal education, psychosocial support programs, and the role of healthcare professionals in promoting preventive measures. Effective prevention interventions and their outcomes are discussed to guide healthcare providers and policymakers in implementing evidence-based strategies. Treatment approaches for postpartum mood disorders include pharmacological interventions, psychotherapy options, alternative and complementary therapies, and multidisciplinary approaches. The article discusses the effectiveness and considerations of each approach, highlighting the importance of individualized care. Challenges and barriers in diagnosing, preventing, and treating postpartum mood disorders are addressed, including stigma, limited access to healthcare services, and gaps in healthcare provider knowledge and training. Recommendations are provided for healthcare professionals and policymakers to overcome these challenges and improve outcomes. The review concludes by highlighting the need for future research, innovations in prevention and treatment approaches, and collaborative efforts in the field of postpartum mood disorders. Promising areas for research are identified, including long-term outcomes, understanding risk factors, and cultural considerations. The article emphasizes the importance of interdisciplinary collaboration and stakeholder engagement in advancing the field.

Unicornuate Uterus with a Non-Communicating Rudimentary Horn: Challenges and Management of a Rare Pregnancy.

We present a unique case of pregnancy developed in a unicornuate uterus with a non-communicating rudimentary horn, emphasizing the importance of early identification, careful management, and counseling. Our patient, a 28-year-old woman, presented with abdominal pain and premature rupture of membranes at 37 weeks of gestation. She had a history of one previous normal vaginal delivery and no significant medical or genetic factors. An emergency cesarean section was performed, and a baby boy weighing 2900 grams was delivered without complications. The uterine anomaly was identified as a unicornuate uterus with a non-communicating rudimentary horn. This case report highlights the challenges and risks associated with unicornuate pregnancies, such as fetal growth restriction and preterm labor. Timely identification, meticulous monitoring, and comprehensive counseling are crucial for optimal outcomes in such cases. Further research and larger-scale studies are needed to enhance our understanding of these rare and complex pregnancies.

The International Ovarian Tumor Analysis-Assessment of Different Neoplasias in the Adnexa (IOTA-ADNEX) Model Assessment for Risk of Ovarian Malignancy in Adnexal Masses.

Ovarian cancers are one of the major leading causes of death across the world. In addition to many challenges to diagnose the disease, it is also hard to predict the type of cancer with effective tools and technology. Many attempts have been made to diagnose ovarian malignancies using ultrasonography, MRI, and CT scans, but seldom will they give the clinician a clear understanding of cancer's type and stage. It is of utmost importance to understand the mass peri-operatively, which will help the clinicians to decide on the course of management mortality. With technological advancements, many predictive models have come into the picture. Many of those were dependent on the Serum CA-125 markers. With ultrasonography machine usage, the International Ovarian Tumor Analysis (IOTA) group has developed a Simple Rules model, Logistic Regression (LR) models, and, most recently, the IOTA-assessment of different neoplasias in the adnexa (IOTA-ADNEX) model. It has been found to be effective and reliable among all the tools developed in the past. The ADNEX predicts the type of cancer (benign or malignant) and stages of cancer (borderline, Stage I, Stages II-IV, and secondary metastatic). These models can be used for people who are coming with persistent adnexal masses in the ovarian region, para ovarian region, or in the tubes and are recommended for the surgeries. The model is developed by a team of clinicians and statisticians, based on ultrasound and clinical data. This article reviews the IOTA-ADNEX model as a tool for predicting ovarian malignancies in people coming with adnexal masses, especially in comparison with other methods and models. It also tests its effectiveness in the hands of experienced technicians and non-expert technicians.

Peripartum dilated cardiomyopathy complicated by miliary tuberculosis-a maternal near miss (MNM): Case report.

The term 'Maternal Near Miss' (MNM) refers to women who have survived serious life-threatening complications during pregnancy, labour or within 6 weeks after termination of pregnancy, either by chance or due to good health care. The goal of this report is to emphasise the need for patients' education, emergency transportation and availability of multidisciplinary tools at all levels of the health care system. Severe acute maternal morbidity (SAMM) is a measure of maternal mortality that may also be used to assess the quality of obstetric treatment in a certain facility. Also, the motive of this report is to give an idea to primary care physicians of all the preliminary risk factors to be taken into consideration while treating the patient on arrival.

The Mysteries of Primary Amenorrhea: Swyer Syndrome.

Swyer syndrome is a hereditary condition seen in a few patients who present with primary amenorrhea, characterized by 46 XY and the presence of female internal genital tract and bilateral streak gonads in a female phenotype. A 25-year-old lady presented with primary amenorrhea. After the evaluation, she was diagnosed with Swyer syndrome due to a mutation in the SRY gene, leading to failure of testicular development. The clinical presentation was that of a female phenotype with no secondary sexual characteristics. On physical examination, she had a female phenotype with a short vagina and no secondary sexual characteristics. The MRI revealed a hypoplastic uterus with both fallopian tubes but with streak gonads. The patient's genotype was found to be 46 XY after genetic testing. The streak gonads were removed laparoscopically due to the future risk of gonadoblastoma, and the patient was given hormone replacement therapy (HRT). The patient started menstruating after six months of HRT and has been developing secondary sexual characteristics (Tanner stage II) till now.