Clinicopathologic study of large abdominal masses in gynaecological practice and their outcome

Background: In female reproductive tract the differential diagnosis of pelvic mass is quite variable because abnormality may arise from gynaecological or non-gynaecological origin. The aim of the present study is to find out the causes why these patients come with large abdominal masses, to find out the risk factors and to do proper management.Methods: This study is a retrospective study of all cases of large abdominal mass All the patient coming with palpable abdominal and pelvic adnexal mass in the gynaecologic OPD were included in the study. Study population included women of all ages and the relevant population of women with treatment for fibroids and ovarian mass. The data was analysed retrospectively and the results were computed accordingly.Results: Incidence of large ovarian mass was found out to be 2.82% and of large fibroid was 2.31%. Our study showed the peak incidence of ovarian tumors in age group more than 40 years. 90.5% of patients were illiterate and only 10 patients were literate. In the study only 8.57% patients had addiction to some drug and all were tobacco chewer. The incidence of benign tumor was 83.33% (commonest being ovarian tumours) and that of malignant tumors is 16.66%.Conclusions: Ultrasound is effective in detecting the abdominal mass, size and type of abdominal mass, so that early diagnosis can be done and treatment can be given as soon as possible. Apart from already established risk factors, obesity and uterine fibroid have an important association

Correlation of waist circumference with metabolic syndrome in females attending gynaecology OPD at a tertiary care centre

Background: The metabolic syndrome is an aging-related cluster of metabolic disorders associated with excess adiposity, and plausibly mechanistically linked. The primary goal of recognizing an individual as having the metabolic syndrome was to identify persons at heightened risk for cardiovascular disease (CVD). Secondarily, by design, the diagnosis also helped identify individuals with high risk for other endocrinal imbalance if they did not already have it. So this study was carried out to identify the co-relation between waist circumference and other risk factors with metabolic syndrome and to ascertain their significance.Methods: This is a prospective observational study conducted in Out Patient Department (OPD) of a tertiary care centre with a study population of 50 patients attending OPD with any gynaecological problem having waist circumference > 85 cm.Results: Twenty eight patients (56%) had metabolic syndrome depicting a significant co-relation (p value < 0.05). Thus, increase in WC more than 85cm is directly proportional to the prevalence of metabolic syndrome.Conclusions: We conclude that Waist circumference is directly related to prevalence of metabolic syndrome which is on increase due to sedentary life style. Such patients are also prone to hormonal imbalance, specifically hypothyroidism

An observational study of effect on quality of life in perimenopausal females suffering from urinary incontinence

Background: Urinary incontinence (UI) affects many older adults. Some of its deleterious consequences include stress, major depression, diminished quality of life, sexual dysfunction, and familial discord. Despite a wealth of research contributions on this topic, the available literature is under representative of ethnic minority older women.Methods: A cross-sectional observational study was conducted by taking a group of 225 females of perimenopausal age group. Patients were assessed clinically for the diagnosis of urinary incontinence and effect on quality of life was assessed. Further testing was done depending on the storage symptoms & voiding symptoms and included residual volume assessment by ultrasound, cystometry, complex urodynamic test and cystoscopy. The data obtained and the socio-demographic data recorded in a structured proforma. The data obtained was assessed, analysed and results were drawn thereafter.Results: In our study the prevalence of UI was found to be 18%. Maximum prevalence was seen in the age group of 61-70 years. Highest numbers were found to have stress incontinence 60.44%, followed by 23.55% of urge, overflow 5.33% and 10.66% mixed symptoms. The impact was equitable over all dimensions measured for QOL, namely activity limitation (28.44%), social interaction limitation (35.11%), sexual activity limitation (16%), financial burden increased (3.55%), emotional upset and distress (16.88%).Conclusions: In the present study, we determined the prevalence of UI among 200 community-dwelling, ethnically diverse older women, discovered that our new UI screener is reliable, and did not find the UI-depression link to be significant

Trend of caesarean section at two Government Medical College in Madhya Pradesh, India over one year of time period: a retrospective comparative study

Background: There is a massive public interest and debate on both the cause and appropriateness of increasingly employing a surgical procedure to short circuit or entirely bypass labour and delivery. The indications of caesarean sections vary among institutions as there is no standard classification system exists for indications of C-Section. Present study analysed pattern of caesarean section at two tertiary centre in Madhya Pradesh, India.Methods: A structured proforma was filled up for every case and results were recorded on excel sheet. All the cases included in study were further divided in group 1 (deliveries conducted in year 2014-2015 at Govt. Medical College Indore, M.P.), group 2 (deliveries conducted at Govt. Medical College Rewa at same time. Comparative analysis between study group1 and group 2 was done using Pearson Chi square test.Results: In group 1 there were 10525 deliveries out of which 3705 were delivered by caesarean section (35.2%), in group 2 there were 8674 deliveries out of which 1182 were delivered by caesarean section (13.6%). This difference in caesarean section at both medical college may be due to the more no. of referrals from the periphery to the medical college Indore and having more no of private institutions and district hospital which cater the normal delivery.Conclusions: There is a reliable and reproducible framework is required for audit and analysis of Caesarean section trends in specific obstetric subgroups to permit comparisons of practice between different institutions and over time in the same institution

A prospective study to assess role of serum lactate dehydrogenase in prediction of adverse outcomes of pre-eclampsia and eclampsia

Background: Pregnancy induced hypertension is one of the most dreaded complication in developing countries. The purpose of this study is to evaluate incidence, risk factors and complications of pre-eclampsia and eclampsia and its relation to serum LDH levels. This was done with a view to making recommendations towards furtherance of objectives of this initiative.Methods: 380 patients with diagnosed eclampsia and preeclampsia were included based on a proforma.Results: Higher grades of proteinuria, higher BP and serum LDH levels >600 IU/L are significantly associated with adverse maternal and fetal outcome.Conclusions: LDH co-relates with adversity of maternal and fetal outcome in eclampsia and pre-eclampsia

Vaginal leiomyoma, post hysterectomy, mimicking vault prolapse: case report

Leiomyomas are common benign smooth muscle tumours of the uterus. Leiomyoma of the vagina are very rare with only about 300 reported cases. Correct diagnosis and differentiation from urethral lesions are important but is usually difficult on clinical examination alone. A 40-year P3L3, with a previous history of abdominal hysterectomy 5 years back, for multiple fibroids presented with complaints of a mass descending per-vagina since the last 2 years. Since the last 6 months she had dyspareunia, dysuria and perineal discomfort. On external appearance the mass looked like a vault prolapse. However, on vaginal examination, it appeared as a single well circumscribed mass arising from the anterior vaginal wall and the vault. Transvaginal sonography showed a hypoechoic mass arising from the anterior vaginal wall of dimension 50×54×63 mm pressing on the urethra. Contrast CT revealed a rounded homogeneous well-defined soft tissue density mass lesion measuring approximately 63×52 mm in the region of the vaginal vault interposed between the bladder base and the rectum. Bilateral ovaries and adnexa appeared normal. Surgical excision of the tumour through the vagina was done. Histopathology confirmed leiomyoma.  The diagnosis of vaginal leiomyoma is based on careful examination and preoperative imaging both by ultrasonography and a CT scan/MRI for ascertaining its location, extent, its relationship to adjacent structures and characterization before attempting surgical excision. The correct clinical diagnosis of a vaginal fibroid is frequently overlooked in favour of much more common urethral diverticulum

Giant Primary Retroperitoneal Teratoma in an Adult: A Case Report

Teratomas are bizarre neoplasms derived from embryonic tissues that are typically found only in the gonadal and sacrococcygeal regions of adults. Retroperitoneal teratomas are rare and present challenging management options. We report here the case of a histologically unusual retroperitoneal tumor detected on computed tomography during the workup of abdominal pain in a 32-year-old male. The evaluation and treatment of this condition and a review of the literature are included in this paper

The retina in hypertensive disorders of pregnancy: a study of the prevalence and association with severity of disease in a tertiary referral centre in India

Background: Hypertensive disorders of pregnancy remains to be a major cause of maternal and fetal morbidity and mortality. The retina offers the unique opportunity to directly observe changes in the vasculature due to preeclampsia. Fundoscopy can be used to prognosticate and assess the severity of disease and offer an optimum time of delivery to improve fetomaternal outcome. There are limited number of studies from northern India assessing the relationship between hypertensive disorders of pregnancy and retinopathy. This study was undertaken to bridge this gap.Methods: This was an observational cohort study undertaken in a tertiary hospital, 225 patients of preeclampsia coming to the department were identified and a structured proforma used to gather relevant information. All patients underwent fundoscopy and were classified into groups on the basis of fundal grade observed. The groups were compared in terms of clinicodemographic variables. Appropriate statistical tests were applied.Results: A total 68% patients had retinal changes of which the most common grade was grade 1 There was a significant rise in the mean systolic and diastolic blood pressure with increasing grade of fundal change. The (p-value 0.001). 65.5% of patients of preeclampsia without severe features (i.e. mild cases) had no retinopathy. None of these patients had grade 3 or 4 changes. In the patients of preeclampsia with severe features, 88.9% cases had varying degrees of retinopathy.Conclusions: As severity of preeclampsia increases, incidence of retinopathy also increases. Fundoscopy is a useful diagnostic aid and should be done to optimize fetomaternal outcome

Crafting Conscious Employee Engagement through Wellbeing: A Key Differentiator to Long-Term Organizational Success within the Hospitality Industry

Discussions on pandemics that hit the human race have dominated the scientific research world, on the contrary, due to the developments in technology and globalisation the work environment has evolved into a complex space and for this reason, there is a wide research gap on how the workforce can get back to normal or cope with an ever-changing pandemic phenomenon. The objectives of the current paper are aligned to identify the impact of Covid-19 on different levels of the employees’ life, to analyse the effect on mental health and wellbeing, and to formulate a relationship between mindful employee engagement and its impact on organisational success. The current scenario requires the employees to continue working from home for the businesses to sustain themselves in the future. By reviewing 20 research articles, an understanding is developed of the remote-work model and its positive and negative impacts on employees as well as organisations. Using a semi-structured questionnaire to interview service industry professionals, data has been gathered. Using a semi-structured analysis the authors aim to illustrate the pandemic’s effects from the employees’ perspective. The researchers found three significant findings: loyalty to self-preservation, mindfulness to address mental health and improve performance and success of organisations during the pandemic depends on a purpose-driven culture