A rare case of aggressive angiomyxoma of vulva since childhood

Aggressive angiomyxoma is a locally invasive benign mesenchymal tumour usually occurring in women of reproductive age and is rare in children. It carries a high risk of recurrence and hence needs to be differentiated from other masses. The diagnosis is difficult clinically and is almost always histological. Here is a rare case of aggressive angiomyxoma of vulva in a 15 year old female presented with presented with mass in vulva on left side since birth and increased to the present size since 3 years. The swelling was painless, no local rise of temperature, no visible veins. Attained menarche 2 years ago and cycles are regular with normal flow

AWARENESS ABOUT DOG BITE MANAGEMENT IN RURAL POPULATION

Background-Rabies is a major zoonotic disease that is always fatal common in children less than 15 years of age .Most of the deaths occur due to ignorance about urgency of wound management and vaccine administration   after dog bite.Methods-.A cross sectional study was carried out at Rural Health Training Center attached to Dr DY Patil Medical  College, Alandi by interviewing the persons accompanying the patients attending the daily outpatient  department and those accompanied by no one or children were excluded, similarly in case of more than one person accompanying the patient, only one adult willing to participate was included in the study . Consecutive patients (persons accompanying) attending RHTC OPD were included for the period of one month i.e. May 1st to 31st May 2013. The subjects were asked about whether  they had a menace of the stray dogs in their area and questions included  were to assess various parameters regarding their awareness about dogbite wound management ,  vaccine administration and misconceptions associated  with it .Results –Out of the 300 respondents majority  were in the age group of 26-35 years(39.70% males and 45.10% females). Only 112(37.30%) were aware that the dog should be watched for 10 days after dogbite, even in the areas where stray dog menace was present. A crucial knowledge about severity of bite revealed that 238(79.30%) knew that deep wound at any site is considered as severe bite .Less than 10% knew  that bites on head ,face or fingers was also a severe bite. It was encouraging to know that more than 85% i.e. 34(87.2%) out of 39(100%) had of had knowledge that wound should be cleaned with soap and water in areas where stray dog menace was present.Conclusions- The large knowledge gap about various parameters of dog bite management in rural population need to be addressed by well planned extensive health education programme (information about need for urgency of wound treatment, type of first aid, severity of bite, different misconceptions, vaccine awareness etc) with the help of volunteers at local level and Rabies control programme at the national level

Encephalocele presented in late third trimester: a case report

In present era, most of the NTDs are diagnosed at quite early gestation, thanks to advancement in imaging technology. So it is rare to see a case of NTD in late gestational age. Encephalocele is still rare type of NTD, when we come across such a case in late gestational period associated with another risk factor (Previous LSCS), it can really present a challenge for management. We had to face such a case requiring skillful management. A 23 year, G2 P1 L1 with previous LSCS was referred to our institution for severe anemia. USG showed 37 weeks single, live fetus with absence of cranial vault& irregular compressed cystic structure attached to vault attached in occipital region. Previous USG done at 12 weeks showed no abnormality, while USG at 27 weeks showed Acrania. Ideal management of this patient could have been done if this anomaly was diagnosed before 20 weeks where option of MTP was clearly available. Though with high resolution technical and instrument and with expert sonologist encephalocele can be diagnosed by 14 weeks