Plexiform neurofibromatosis of vulva

Plexiform Neurofibromatosis of vulva is a rare, benign tumor of genital tract arising from nerve sheath of peripheral nerve. It may present as solitary lesion or as part of Von Recklinghausen's disease. Genitourinary neurofibroma is rare, however clitoris and labia majus happen to be the most frequent location of neurofibromatosis involving female genital tract. We present a case of plexiform neurofibroma arising from left labia majora in a young patient having features of Von Recklinghausen's disease. She complained of discomfort while walking due to rubbing of pedunculated mass arising from her labia majora. We carried out the surgical excision of the mass followed by primary repair of labia majora. She has been followed up on out-patient basis for about three months without any recurrence so far. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down

A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone

Post TURP obliterative urethral stricture: Unusual presentation and favourable result

AbstractIntroductionUrethral stricture is a well known complication after TURP. Most of the cases present with recurrence of lower urinary tract symptoms. Infrequently, cases of complete obliteration of urethra is diagnosed. Management of these rare cases is always challenging and associated with poor outcome.We report a case of post TURP obliterative urethral stricture that was managed successfully by holmium laser core through urethroplasty. On discharge patient was continent and voided well.ConclusionHolmium laser core through is a useful technique for management of these complicated cases with satisfying result. It should be done by experienced endourologist

Assessment of depression and diabetes distress in type 2 diabetes mellitus patients in a tertiary care hospital of South India

Background: Depression is one of the many complications seen among diabetics. Depression leads to lack of self-care by the diabetic and endangers the therapeutic compliance, accounting for a derangement in metabolic control which in turn causes further diabetic complications and may even result in hospitalization. This leads to an increase in depressive symptoms and thus the vicious cycle continues.Methods: It is a Descriptive, cross sectional study conducted in the Medicine outpatient department. Depression was assessed by Hamilton depression rating scale. Diabetic distress was assessed by diabetic distress scale.Results: Out of the 250 study participants, 142 (56.8%) were found to be suffering from depression and 6 (2.4%) were found to have diabetes distress. The magnitude of depression was similar in both male and female. Depression was high among illiterates, unemployed (70%), single, separated individuals and patients with complications of diabetes. There was no significant association between religion and low economic status with depression. Treatment modalities, complications of diabetes, sociodemographic factors like age, sex, occupation, education, marital status, religion and socio-economic status had no significant correlation with diabetic distress. But there was a statistically significant association between diabetic distress and co-morbid conditions. 95.8% with depression had no distress and this association was found to be statistically significant (0.038).Conclusions: The magnitude of depression and distress is much high among diabetics. Early detection, counselling and treatment are required for all diabetics, especially those who have additional risk factors for the development of depression

Short communicationPost-TURP obliterative urethral stricture: Unusual treatment and favourable result

Urethral stricture is a well-known complication after TURP. Most cases present with recurrence of lower urinary tract symptoms. In rare incidences, complete obliteration of the urethra is diagnosed. Management of such cases is challenging and usually associated with a poor outcome. We report a case of post-TURP obliterative urethral stricture that was managed successfully by Holmium laser core-through urethrotomy. On discharge, the patient was continent and voided well.Keywords: Urethral stricture; TURP; Holmium laserAfrican Journal of Urology (2013) 19, 18–2

Clinical profile, maternal and fetal outcome in pregnant women with COVID-19 infection: a retrospective observational study in a tertiary care hospital of Himachal Pradesh

Background: The aim of this study was to evaluate the clinical characteristics and outcomes of pregnant women confirmed with COVID-19 infections and their neonates to provide more reference to contribute in managing this noval viral disease.Methods: We conducted a retrospective study over a period of six months; 20 March, 2020 to 8 October, 2020 at SLBSGMC Nerchowk (Himachal Pradesh). Total number of pregnant women who delivered in our hospital during the defined study period was recorded and analysed.Results: The total number of women were delivered over the study period was 13, out of which caesarean sections (CS) were 7 and NVDs were 6 in number. All of them were diagnosed mild COVID-19, and none one of the patients developed severe COVID-19 or died. Their all newborns were recorded healthy except one was COVID positive and one neonate had birth asphyxia.Conclusions: Apparently no difference was observed in relation to onset of disease, symptoms, cure rates or severity in pregnant women when compared to non-pregnant women and healthy men of similar age groups. Pregnancy does not seem to deteriorate the course and prognosis of the disease. Maternal and fetal outcomes are apparently favourable in these patients. Lastly COVID-19 is not an indication of cesarean section. More multicentre studies are the need of the hour to formulate the authentic management guidelines for this novel disease

Plexiform neurofibromatosis of vulva

Plexiform Neurofibromatosis of vulva is a rare, benign tumor of genital tract arising from nerve sheath of peripheral nerve. It may present as solitary lesion or as part of Von Recklinghausen’s disease. Genitourinary neurofibroma is rare, however clitoris and labia majus happen to be the most frequent location of neurofibromatosis involving female genital tract. We present a case of plexiform neurofibroma arising from left labia majora in a young patient having features of Von Recklinghausen's disease. She complained of discomfort while walking due to rubbing of pedunculated mass arising from her labia majora. We carried out the surgical excision of the mass followed by primary repair of labia majora. She has been followed up on out-patient basis for about three months without any recurrence so far

Paisatges funeraris i diversitat a Anglaterra i a Gal·les: l'establiment d'una agenda = Deathscapes and diversity in England and Wales: setting an agenda

Aquest article se centra en una dimensió poc discutida, però important, de les experiències dels migrants i les minories a Anglaterra i Gal·les: els cementiris i crematoris de què disposen. Basat en una àmplia investigació amb comunitats locals i proveïdors de serveis en quatre ciutats casos d’estudi, aquest article ex-plora les diverses necessitats funeràries culturals i religioses a Anglaterra i Gal·les, els reptes que hi estan associats i les formes en què tant les comunitats com els proveïdors de serveis (p. ex.: planifica-dors i directors funeraris) hi responen. Destaquen vuit temes clau: i)l’oferta de cementiris; ii)l’oferta de crematoris; iii)l’oferta desigual per diferents grups migrants i minoritaris; iv)la diversitat en la diversitat; v)els canvis de patrons de repatriació;vi)el foment del diàleg;vii)la comprensió entre professionals icomunitats, i viii)la planificació dels cementiris com aespais de trobada.Este artículo se centra en una dimensión poco discutida pero importante de las experiencias de los migrantes y las mi-norías en Inglaterra y Gales: los cemen-terios y crematorios de que disponen. Basándose en una amplia investigación con comunidades locales y proveedores de servicios en cuatro ciudades casos de estudio, este artículo explora las diver-sas necesidades funerarias culturales y religiosas en Inglaterra y Gales, los retos asociados a estas y las formas en que tanto las comunidades como los provee-dores de servicios (p. ej.: planificadores y directores funerarios) responden a ellos. Destacan ocho temas clave: i)la oferta de cementerios; ii)la oferta de crematorios; iii)la oferta desigual por diferentes grupos migrantes y minoritarios; iv)la diversidad en la diversidad;v)los cambios de patrones de repatri-ación; vi)el fomento del diálogo;vii)la comprensión entre profesionalesy comunidades, y viii)la planificación de los cementerios como espacios de encuentro.This paper focuses on a little discussed but important dimension of migrant and minority experiences in England and Wales: cemetery and crematoria provi-sion. Based on extensive research with local communities and service providers in four case study towns, this paper explores the varied cultural and religious funerary needs in England and Wales, the associated challenges and the ways in which both communities and service providers (e.g. cemetery managers, town planners and funeral directors) respond to them. It highlights seven key themes, namely:i)cemetery provision;ii)crematorium provision;iii)unequal provision across migrantand minority groups;iv)diversity within diversity;v)changing patterns of repatriation; vi)fostering dialogue;vii)understanding between profession-als and communities; and viii)planning for cemeteries as spacesof encounter. / Este artículo se centra en una dimensión poco discutida pero importante de las experiencias de los migrantes y las mi-norías en Inglaterra y Gales: los cemen-terios y crematorios de que disponen. Basándose en una amplia investigación con comunidades locales y proveedores de servicios en cuatro ciudades casos de estudio, este artículo explora las diver-sas necesidades funerarias culturales y religiosas en Inglaterra y Gales, los retos asociados a estas y las formas en que tanto las comunidades como los provee-dores de servicios (p. ej.: planificadores y directores funerarios) responden a ellos. Destacan ocho temas clave: i)la oferta de cementerios; ii)la oferta de crematorios; iii)la oferta desigual por diferentes grupos migrantes y minoritarios; iv)la diversidad en la diversidad;v)los cambios de patrones de repatri-ación; vi)el fomento del diálogo;vii)la comprensión entre profesionalesy comunidades, y viii)la planificación de los cementerios como espacios de encuentro. / This paper focuses on a little discussed but important dimension of migrant and minority experiences in England and Wales: cemetery and crematoria provi-sion. Based on extensive research with local communities and service providers in four case study towns, this paper explores the varied cultural and religious funerary needs in England and Wales, the associated challenges and the ways in which both communities and service providers (e.g. cemetery managers, town planners and funeral directors) respond to them. It highlights seven key themes, namely:i)cemetery provision;ii)crematorium provision;iii)unequal provision across migrantand minority groups;iv)diversity within diversity;v)changing patterns of repatriation; vi)fostering dialogue;vii)understanding between profession-als and communities; and viii)planning for cemeteries as spacesof encounter

Effects of a refugee elective on medical student perceptions

<p>Abstract</p> <p>Background</p> <p>There are growing numbers of refugees throughout the world. Refugee health is a relatively unstudied and rarely taught component of medical education. In response to this need, a Refugee Health Elective was begun. Medical student perceptions toward cultural aspects of medicine and refugee health before and after participation in the elective were measured.</p> <p>Methods</p> <p>Preliminary questionnaires were given to all preclinical students at the academic year commencement with follow-up questionnaires at the refugee elective's conclusion. Both questionnaires examined students' comfort in interacting with patients and familiarity with refugee medical issues, alternative medical practices, and social hindrances to medical care. The preliminary answers served as a control and follow-up questionnaire data were separated into participant/non-participant categories. All preclinical medical students at two Midwestern medical schools were provided the opportunity to participate in the Refugee Health Elective and surveys. The 3 data groups were compared using unadjusted and adjusted analysis techniques with the Kruskall-Wallis, Bonferroni and ANCOVA adjustment. P-values < 0.05 were considered significant.</p> <p>Results</p> <p>408 and 403 students filled out the preliminary and follow-up questionnaires, respectfully, 42 of whom participated in the elective. Students considering themselves minorities or multilingual were more likely to participate. Elective participants were more likely to be able to recognize the medical/mental health issues common to refugees, to feel comfortable interacting with foreign-born patients, and to identify cultural differences in understanding medical/mental health conditions, after adjusting for minority or multilingual status.</p> <p>Conclusion</p> <p>As medical schools integrate a more multicultural curriculum, a Refugee Health Elective for preclinical students can enhance awareness and promote change in attitude toward medical/mental health issues common to refugees. This elective format offers tangible and effective avenues for these topics to be addressed.</p