Laparoscopic management of large benign ovarian cysts

Background: Laparoscopy has become an accepted method of management of ovarian cysts. Objective of present study was to assess the feasibility and outcome of laparoscopic surgery for the management of large ovarian cysts.Methods: Ten patients from May 2014 to April 2015, with large ovarian cysts, with diameter >10 cm, were managed laparoscopically. All the masses were cystic and were not associated with ascites or enlarged lymph nodes on ultrasound. Serum CA 125 levels were within the normal range (0-35 U/mL). Preoperative evaluation included history, clinical examination, sonographic images and serum markers. The management of these ovarian cysts included aspiration, cystectomy or salphingo-oophorectomy, depending on the patient's age, obstetric history and desire of future fertility.Results: Seven patients presented with pain abdomen, 3 patients with abdominal distension and discomfort. The average maximum diameter of the ovarian cysts was 14.75 cm (range, 10-22 cm). The mean duration of the operation was 80 minutes (60 -120 min). The postoperative hospital stay was 2 days. No intraoperative complications occurred, and the hospital course of all patients was uncomplicated. The patients did not report any complaints during follow-up and the clinical examination findings were normal in all, up to 9 months after discharge.Conclusions: With proper patient selection, the size of an ovarian cyst is not necessarily a contraindication for laparoscopic surgery

Clinical, ultrasonographical and hormonal correlation in women with polycystic ovarian syndrome

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of fertile age. The prevalence, time of onset and severity of clinical presentation vary among different ethnic and racial groups. Though there is significant reproductive, endocrine and metabolic morbidity of PCOS, very little is known about its different modes of presentation in Indian population. It is a cross sectional observational study. The objective To study the correlation between the clinical, ultrasonographical and hormonal features in women diagnosed as PCOS based on the revised diagnostic criteria, 2003.Methods: A cross-sectional study of 74 PCOS women who had oligo ovulatory cycles and polycystic ovarian morphology on ultrasound was done. Data about menstrual history and anthropometric measurements were collected. Clinical observations of acne and hirsutism were made.  Transvaginal ultrasonography and biochemical analysis for free testosterone was done.Results: In all, 74 PCOS women were studied and analyzed. The mean age was 24.88±4.03, mean BMI was 25.48 ±3.75 and mean free testosterone was 3.81±4.05. Among the PCOS women 39.8% were hirsute, 10.1% were obese, 2.3% had acne and 38% were hyperandrogenemic. Of the hyperandrogenemic women 61.2% were hirsute, 53.22% were obese and 36.54% had acne.  The association between BMI and free testosterone level was statistically significant (p=0.0023). BMI was moderately correlated with hyperandrogenemia (r=0.446). The mean left ovarian volume was higher in obese than in non-obese women, which was statistically significant (p=0.003). The mean left ovarian volume was high in hyperandrogenemic women which was statistically significant (p=0.00034).Conclusions: In the present study it was found that there is association between obesity and free testosterone level which was significant. There was statistically significant association between ovarian volume and obesity. Similarly, there was association between ovarian volume and hyperandrogenemia which was significant. Hirsutism and acne had no association with hyperandrogenemia

Impact of adolescent health education on adolescent girls in rural schools and colleges

Background: Adolescence is a transitional phase linking childhood to adulthood. Among adolescents, girls are especially vulnerable and more susceptible biologically to reproductive tract infections. In rural India, health education given to these girls, builds knowledge, motivates them to improve and maintain their health, prevent disease and reduce risky behaviors.  This study aims to evaluate the impact of adolescent health education on these rural teenage girls.Methods: This is a school-based educational interventional study on adolescent health education, on the girls 11 to 19 years old, in our area, during the period from January 2012 to February 2014. A pretest and post-test were done along with the health education, which covered various topics concerning adolescent health.Results: There were 1249 girl students enrolled into the study. The knowledge on menstruation and menstrual hygiene improved significantly after health education. The awareness of ill effects of child marriage, consanguineous marriage and teenage pregnancy was known by only 82.9%, 29.5% and 5.8% respectively. The knowledge about self-breast examination, Pap smears and awareness that chronic white discharge after marriage, leads to cancer of cervix in the long run, were known by none. By this study, it is seen that their knowledge was poor during pretest and remarkable improvement took place after the educational intervention.Conclusions: This study shows the feasibility of adolescent health education program implementation on girls in the rural schools

Laparoscopic management of large benign ovarian cysts

Background: Laparoscopy has become an accepted method of management of ovarian cysts. Objective of present study was to assess the feasibility and outcome of laparoscopic surgery for the management of large ovarian cysts.Methods: Ten patients from May 2014 to April 2015, with large ovarian cysts, with diameter >10 cm, were managed laparoscopically. All the masses were cystic and were not associated with ascites or enlarged lymph nodes on ultrasound. Serum CA 125 levels were within the normal range (0-35 U/mL). Preoperative evaluation included history, clinical examination, sonographic images and serum markers. The management of these ovarian cysts included aspiration, cystectomy or salphingo-oophorectomy, depending on the patient's age, obstetric history and desire of future fertility.Results: Seven patients presented with pain abdomen, 3 patients with abdominal distension and discomfort. The average maximum diameter of the ovarian cysts was 14.75 cm (range, 10-22 cm). The mean duration of the operation was 80 minutes (60 -120 min). The postoperative hospital stay was 2 days. No intraoperative complications occurred, and the hospital course of all patients was uncomplicated. The patients did not report any complaints during follow-up and the clinical examination findings were normal in all, up to 9 months after discharge.Conclusions: With proper patient selection, the size of an ovarian cyst is not necessarily a contraindication for laparoscopic surgery