Uterus bicornis unicollis with multiple lieomyomas

Uterine anomalies are congenital malformations caused by fusion or resorption defects during embryogenesis. Uterus bicornis unicollis (bicornuate uterus) is a rare condition which results from incomplete fusion of uterovaginal horns at the level of the fundus. Here we report a case of a 30 year old (P2L0) female, with uterus bicornis unicollis with multiple lieomyomas (fibroids). The patient underwent hysterectomy with adnexa removal. The specimen showed multiple lieomyomas with hyaline degeneration.

Vulvar schwannoma: a case report

Schwannoma is a benign, slow growing nerve sheath neoplasm that is rarely found in female genital system. Only a few cases of vulvar schwannomas have been reported. We report a case of vulvar Schwannoma arising in labium minus in a patient without neurofibromatosis. A 26 year old woman had two 1cm x 1cm and 1.5cm x 2cm sized oval nodules at the right labium minus. Complete excision was done and the histological report confirmed to be vulvar Schwannoma. Although it has a very low incidence, Schwannoma should be considered as a differential diagnosis of a vulvar mass

Detecting Breakage Fusion Bridge cycles in tumor genomes -- an algorithmic approach

Breakage-Fusion-Bridge (BFB) is a mechanism of genomic instability characterized by the joining and subsequent tearing apart of sister chromatids. When this process is repeated during multiple rounds of cell division, it leads to patterns of copy number increases of chromosomal segments as well as fold-back inversions where duplicated segments are arranged head-to-head. These structural variations can then drive tumorigenesis. BFB can be observed in progress using cytogenetic techniques, but generally BFB must be inferred from data like microarrays or sequencing collected after BFB has ceased. Making correct inferences from this data is not straightforward, particularly given the complexity of some cancer genomes and BFB's ability to generate a wide range of rearrangement patterns. Here we present algorithms to aid the interpretation of evidence for BFB. We first pose the BFB count vector problem: given a chromosome segmentation and segment copy numbers, decide whether BFB can yield a chromosome with the given segment counts. We present the first linear-time algorithm for the problem, improving a previous exponential-time algorithm. We then combine this algorithm with fold-back inversions to develop tests for BFB. We show that, contingent on assumptions about cancer genome evolution, count vectors and fold-back inversions are sufficient evidence for detecting BFB. We apply the presented techniques to paired-end sequencing data from pancreatic tumors and confirm a previous finding of BFB as well as identify a new chromosomal region likely rearranged by BFB cycles, demonstrating the practicality of our approach

The elusive evidence for chromothripsis.

The chromothripsis hypothesis suggests an extraordinary one-step catastrophic genomic event allowing a chromosome to 'shatter into many pieces' and reassemble into a functioning chromosome. Recent efforts have aimed to detect chromothripsis by looking for a genomic signature, characterized by a large number of breakpoints (50-250), but a limited number of oscillating copy number states (2-3) confined to a few chromosomes. The chromothripsis phenomenon has become widely reported in different cancers, but using inconsistent and sometimes relaxed criteria for determining rearrangements occur simultaneously rather than progressively. We revisit the original simulation approach and show that the signature is not clearly exceptional, and can be explained using only progressive rearrangements. For example, 3.9% of progressively simulated chromosomes with 50-55 breakpoints were dominated by two or three copy number states. In addition, by adjusting the parameters of the simulation, the proposed footprint appears more frequently. Lastly, we provide an algorithm to find a sequence of progressive rearrangements that explains all observed breakpoints from a proposed chromothripsis chromosome. Thus, the proposed signature cannot be considered a sufficient proof for this extraordinary hypothesis. Great caution should be exercised when labeling complex rearrangements as chromothripsis from genome hybridization and sequencing experiments

Levonorgestrel intrauterine system in menorrhagia-an effective and acceptable alternative

Background: To study the efficacy, performance and acceptability of levonorgestrel intrauterine device (LNG-IUS) in treatment of women with menorrhagia.Methods: This was a descriptive, prospective and observational study conducted over a period of January 2015 to September 2020. Seventy-five (75) women presented with heavy menstrual bleeding having no contraindication for device underwent LNG-IUS insertion after consent. Menstrual pattern, pictorial blood loss assessment chart score (PBAC), rate of acceptability and satisfaction were recorded at 3 months, 6 months, 1, 2 and 3 years after insertion of LNG-IUS.Results: The most common bleeding pattern at 3 month post-insertion was inter-menstrual spotting followed by infrequent menses, oligomenorrhea and amenorrhea. LNG-IUS caused 45.19% reduction in menstrual blood loss (MBL) at 3 months, 81.48% at 1 year, 91.85% at 2 years and 97% at 3 years. Hemoglobin levels improved from mean baseline 8.9 mg/l to 12.8 mg/l at 3 years. Majority of women were satisfied with this minimally-invasive treatment with continuation rate of 94.66%. No major side-effects were noted.Conclusions: LNG-IUS is an excellent minimal invasive, highly effective in controlling blood loss and well-tolerated alternative for women with menorrhagia. Its fertility-sparing property makes it an emerging option for young women.

Tackling gynecological health problems in adolescent girls of rural India: need of the hour

Background: Adolescence is a transient and dynamic period characterised by several changes in the child’s body and mind. Onset of menarche is major physiological milestone in adolescent girls which is often associated with menstrual irregularities and other hormonal events. Aim of the present study was to evaluate the profile of adolescent girls attending the outpatient clinic.Methods: This hospital based cross-sectional, prospective, observational study was conducted at Bafna hospital from January 2019 to December 2020. We analysed 220 consecutive adolescent girls with gynaecological health issues. The data was collected and analysed using pre-designed questionnaire.Results: Menstrual disorders (64.5%) were most common followed by teenage pregnancies (20.9%). Other complaints included vulvar disorders, breast diseases, genital trauma, hirsuitism, UTI and psychological problems. Anemia (28.1%) and PCOS (30.9%) were also diagnosed. Hormonal treatment was offered to 59.5% girls whereas surgical intervention done in 4% for various indications.Conclusions: Menstrual disorders, teenage pregnancies, PCOS and anemia were the most common issues seen. Adolescent gynaecological problems are unique and specific regarding presentation, diagnosis and treatment options. It is important to tackle them on top priority due to its impact on future reproductive health

Successful Intra-peritoneal Antibiotic Therapy for Primary Abdominal Nocardiosis in an Immunocompetent Young Female Masquerading as Carcinoma Ovary

Nocardiosis is a common opportunistic infection in the immunocompromised and in patients with chronic debilitating diseases,e.g continuous ambulatory peritoneal dialysis (CAPD) patients. Primary abdominal nocardiosis is rare and is indeed a very rare infection in immunocompetent persons. Only two cases have been reported in immunocompetent patients so far and this may be third case to the best of our knowledge and first in India. About 11 cases have been reported in CAPD patients and AIDS patients.We report a case of Nocardiosis in an immunocompetent young female who presented with an abdomino-pelvic mass masquerading as carcinoma ovary.After initial resistance to various antibiotics, she responded to intraperitoneal and oral linezolid and oral ciprofloxacin