Fibromyoma of the uterus and its surgical management

Background: Uterine fibroids are the commonest tumor affecting the female reproductive tract. In many instances they are asymptomatic, but in some women there does appear to be an association with heavy menstrual blood loss and subfertility. Classically treatment has been surgical with hysterectomy the most common approach for women who have completed their fertility and myomectomy for those who wish to conceive. The surgery can be carried out laparoscopically, vaginally and abdominally, although all routes are associated with an appreciable rate of morbidity. The aims of this study are (i) to formulate the line of surgical treatment of fibromyomas according to age and parity of the patient, (ii) to assess their efficacy, safety and long-term outcome.Methods: A study of 50 patients attending the Obstetrics and Gynecology OPD of a tertiary care institute was conducted over a period of one year. Detailed history and examination of the patients were done.Results: The best surgical options for individual patients were evaluated according to age and parity of the patient. Various surgical options were Hysterectomy and Myomectomy.Conclusions: Uterine fibroids can cause multiple bleeding and pain symptoms, which might have a negative impact on women's life, influencing their sexual, social and work life. Despite these consequences uterine fibroid data, especially on epidemiology, symptomatology and their impact on women's health are still limited and further research is required

INTERNATIONAL JOURNAL OF ADVANCES IN CASE REPORTS VARIANT ULNAR HEAD OF FLEXOR CARPI ULNARIS MUSCLE

ABSTRACT During routine dissection, of the right upper limb of 70 years old donated embalmed male cadaver in the Department of Anatomy, K.J. Somaiya Medical College, Sion, Mumbai, India, we observed a separate humeral and ulnar heads of flexor carpi ulnaris muscle. To recognise Anatomical variations it is necessary to know the normal Anatomy. Normally the flexor carpi ulnaris muscle arises by two heads, humeral and ulnar, connected by a tendinous arch. The humeral head arises from the medial epicondyle via the common flexor tendon. The ulnar head arises from the medial margin of the olecranon process and an aponeurosis attached to the posterior sub cutaneous border of the ulna. The tendon of flexor carpi ulnaris inserted into the hamate and the fifth metacarpal bone through pisohamate and pisometacarpal ligaments. In the present case the ulnar head of flexor carpi ulnaris muscle was more bulky. It separated ulnar nerve and artery. The humeral and ulnar heads were separated from each other by ulnar nerve. These two heads fused with each other just before their insertion, where the ulnar artery came in contact with ulnar nerve. The further course and distribution of ulnar artery and ulnar nerve were normal. The knowledge of such unusual ulnar head separating ulnar artery and ulnar nerve may be clinically important for plastic surgeons doing flap surgeries and for the surgeon dealing with cubital tunnel syndrome. INTRODUCTION Flexor carpi ulnaris muscle is the medial most muscle of the superficial flexor group. It arises by two heads, humeral and ulnar, connected by a tendinous arch. The small humeral head arises from the medial epicondyle via the common flexor tendon. The ulnar head has an extensive origin from the medial margin of the olecranon process and proximal two-thirds of the posterior border of the ulna, an aponeurosis (along with flexor digitorum profundus and extensor carpi ulnaris) and from the intermuscular septum between it and flexor digitorum superficialis. A thick tendon forms along its anterolateral border in its distal half. The tendon is attached to the pisiform, and thence prolonged to the hamate and the fifth metacarpal bone by pisohamate and pisometacarpal ligaments (pisiform is the sesamoid bone developing in the tendon of flexor carpi ulnaris). Acting with the flexor carp