Conservative Management of a Case of Peripartum Cardiomyopathy in a Young Multigravida.

Peripartum cardiomyopathy (PPCM) is a rare disorder that generally affects the elderly multigravida females. It is a type of dilated cardiomyopathy that generally affects the last trimester of pregnancy or early postpartum period. Several risk factors are associated with the development of PPCM. Even though PPCM has greater morbidity, if managed promptly, it can be reverted with minimal morbidity or mortality. We present a case of a young woman, multigravida, with moderate anemia corrected, who was taken for emergency lower segment cesarean section, without previous cardiac evaluation, and ended up with pulmonary edema intraoperatively. Later on, her evaluation was done which came out to be PPCM. She was managed conservatively thereafter with no significant morbidity and a good maternal and perinatal outcome. We should be alert in diagnosing a case of PPCM with prompt treatment to reduce mortality. Cardiovascular conditions cause approximately 26 percent of pregnancy-related deaths which include valvular heart disease and congenital heart disease. Appropriate diagnosis and management are necessary for preventing mishaps.

Sensitivity and Specificity Analysis of Fine Needle Aspiration Cytology (FNAC) for Thyroid Swelling.

Introduction Thyroid gland disorders, such as goiters or tumor masses, are the result of localized or systemic aberrations of the thyroid gland. The purpose of this research was to see how effective fine needle aspiration cytology (FNAC) was in detecting thyroid swelling in patients with thyroid swelling. It is critical to be able to differentiate between benign and malignant thyroid nodules to reduce unnecessary thyroid surgeries. It is hypothesized that FNAC is not a reliable diagnostic tool to detect thyroid nodules in patients with thyroid swelling and that there is a significant variation between the number of thyroid nodules detected by FNAC and the number of thyroid nodules that were eventually diagnosed as malignant by surgery. The significance of this research shows the effectiveness of diagnostic tests for thyroid nodules in patients with thyroid swelling can help reduce unnecessary surgeries and improve patient care. Methods This cross-sectional study was carried out at the Department of Pathology at a tertiary care hospital in central India, from March 1, 2022 to June 31, 2022. Fifty patients with thyroid swelling were covered in the study. All patients were chosen after an ultrasound revealed goiter on clinical grounds. Results The majority of patients in the age group 31-40 years (33.33%) were female (74.67%). About 54.67% of the patients had a single thyroid nodule. FNAC had a sensitivity of 95.38%, a specificity of 53.33%, a positive predictive value of 86.67% and a negative predictive value of 88.57%. Conclusion FNAC is a simple, economical, and commonly used first-line diagnostic method for thyroid cancer. A false negative or false positive cytological diagnosis may be produced as a result of thyroid cytology. The study emphasizes the need to improve basic healthcare in rural India by treating FNAC as a first-line diagnostic test for thyroid swellings to guide management, although it does not replace histopathology.

Comparison of Colposcopy and Histopathology in Abnormal Cervix.

Cervicovaginal cancer (CVC) is the most common malignancy of the genital tract. Colposcopy is a diagnostic procedure that is used to examine the cervix and tissue samples of the urethra and vulva in a magnified view. The colposcopy and histological findings of unhealthy cervixes in a tertiary care hospital were compared. This comparative cross-sectional study was conducted from November 2022 to March 2023 among women with a variety of gynecological complaints who visited the Department of Obstetricians and Gynecologists in a tertiary care facility. One hundred participants were included in this study. The data collected were analyzed using Microsoft Excel 2016 (Microsoft Corporation, Redmond, Washington, United States). Participants had an average age of 35.22 ± 7.18 years, and white discharge was the most reported ailment (73%). Comparing the results of the colposcopy with the histological findings revealed a sensitivity of 91.5% and a specificity of 72.2%. The high sensitivity of colposcopy highlights the need to combine it with histological techniques to obtain better results.

Epilepsy and Issues Related to Reproductive Health.

Sexual disorders are prevalent and vary in men and women with epilepsy (WWE). Infertility and reproductive abnormalities are twice as common in females with epilepsy. Antiepileptic medications and seizures can both have an impact on sexual health in people with epilepsy. Seizures can alter the release of pituitary and hypothalamic hormones, and some antiepileptic drugs (AEDs) can alter sex steroid hormones (gonadal steroids and gonad corticoids). Females with epilepsy are more susceptible to menstrual cycle irregularity and polycystic ovary syndrome. Females and males had lower reproductive rates, and the causes are likely psychological and physiological, with epilepsy and AEDs again playing a role. Sexual disorders are common in WWE and men with epilepsy and can be caused by psychological, physical, or social factors. Specialists must address the gender-based biology of epilepsy and the impact of AEDs on sexual well-being to offer the best treatment possible for patients with epilepsy, particularly women of sexual maturity.

Challenging Diagnosis and Management of an Ovarian Cyst Torsion in a Postmenopausal Woman: A Case Report.

Ovarian masses are rare in the postmenopausal age group, and ovarian torsion is a gynecological emergency. We present a case report of a 63-year-old postmenopausal woman who presented a massive abdominal mass with pain that gradually increased during the previous 12 months. A contrast-enhanced computed tomography scan of the abdomen and pelvis suggested a 16.6 cm × 14 cm × 13 cm originating from the right ovary. Total abdominal hysterectomy, bilateral salphingo-oophorectomy, and partial omentectomy were performed in an emergency as the patient's symptoms worsened. A massive cyst was visualized from the right ovary, which had undergone a torsion of three turns. Histopathological analysis revealed a serous cystadenoma. The twisted ovarian cyst typically manifests as an acute abdomen, although there are cases where this presentation can cause a significant delay in diagnosis. Therefore, high clinical suspicion is often necessary to prevent morbidity and mortality.

A Study of Patients Undergoing Abdominal Hysterectomy in Tertiary Care Institute.

Background Hysterectomy is one of the most common surgical procedures performed.Patient education, compliance, and socioeconomic status are important determinants in choosing the mode of treatment; however, medical treatment is usually inadequate.Thus, in the present study, we tried to study the various profiles of patients undergoing abdominal hysterectomies reported in tertiary care centers. Materials and Methods  Brief clinical data were noted from the case records, which include age, parity, presenting symptoms, past surgical and medical history, hemoglobin status, preoperative dilatation and curettage, and indications of hysterectomy. Results Most hysterectomies were performed on women between the ages of 41 and 45, with the average parity being 3.2 and the majority of cases having three children. Abnormal vaginal bleeding associated with various forms of menstrual irregularities was the most common complaint for which patients sought advice, and the incidence of patients undergoing tubal ligation was the most common previous surgery procedure, with anemia being the most common preoperative-associated condition. The fibroid was the most common demonstration in the current study, which brought forth abdominal hysterectomy for the chosen participants. Conclusion Findings from the current study suggest abdominal hysterectomy to be the most preferred route of surgery commonly in the women of age group 40 to 45 years or higher, precisely due to the occurrence of a higher parity rate in this age category. Fibroid uterus, dysfunctional uterine bleeding, and the presence of other menstrual complaints were the most probable indications for abdominal hysterectomy demonstrated by the individuals in the present study. Moreover, anemia was the most predominant complication associated pre-operatively, followed by other clinical manifestations such as hypertension, diabetes mellitus, and urinary tract infection.

A Case of Twisted Ovarian Dermoid Cyst During Pregnancy.

Ovarian cysts are common during pregnancy as an outcome of routine prenatal ultrasounds. Although most cases are benign, complications, such as torsion, rupture, and malignant changes, can occur. Torsion risk increases fivefold during pregnancy. It is extremely hazardous to expectant mothers and unborn children. In a rural health tertiary center, we report the case of a 23-year-old primigravida with 14 weeks of pregnancy presented with acute abdomen and nausea, vomiting for four hours. On ultrasonography, she was diagnosed with a 14 cm × 11 cm left dermoid cyst. She underwent a laprotomy, and a twisted dermoid cyst was found; therefore, a left oophorectomy was performed with consent. Histopathological examination revealed the presence of a dermoid cyst. She is regularly followed up at our center with a healthy intrauterine fetus growing within. Although antepartum surgical intervention has been proven safe, there are some risks associated with abdominal surgery for both pregnant women and their unborn children. As a result, the management strategy must be chosen based on a risk-benefit analysis of adnexal mass characterization and gestational age.