ABSTRACT
Fibroid is the most common benign tumour occurring in the reproductive age groups, the incidence is around 70%, mainly due to oestrogen. Other risk factors are nulliparity, obesity, early menarche, delayed menopause, family history, and ethnicity. Surprisingly smoking seems to reduce the risk. Other factors reducing the risk are OCP, pregnancy and lactation.Trans-vaginal ultrasound is the gold standard investigation. But MRI is helpful in mapping the site, number, size, depth, nature of lesion and associated pelvic pathology. It also helps in differential diagnosis of fibroid mainly adenomyosis and sometimes both conditions exist together. The most common complaint in fibroids are menstrual problems like menorrhagia, metrorrhagia, dysmenorrhea, infertility, pressure symptoms on bladder and rectum. The patient may become anaemic due to blood loss, our patient in spite of her menorrhagia, her Haemoglobin was nearly normal. Our patient with such a huge fibroid of size of 28 weeks, has no history of pain and the mass found to be non-tender, in spite of extensive cystic degeneration.
ABSTRACT
A study of 200 women with fibroids was conducted in southern most part of India, Kerala, in order to analyse the prevalence, clinical features and impact on life style.METHODSA group of 200 women in Karuna Medical College and Hospital, Kerala, were studied from the case sheet records during the period April 2019 - Feb 2020. Women included in the study were in the age group of 20 - 60 yrs. Different aspects like age, diet, BMI, family history, socio economic status, comorbidities, lifestyle, smoking history, surgical history, obstetric and menstrual history, pain and intra operative and post-operative findings were analysed.RESULTSPrevalence of uterine fibroids in the age group of 41-50 yrs. is 52.5%. Women with fibroids reported mostly with profuse menstrual bleeding like menorrhagia (44.5%) and metrorrhagia (9%). Pain was noted in 12.5% of women. Dysmenorrhoea was noted in 9% of women. Some women (10%) had no impact on the lifestyle; they were not aware of the presence fibroids. Some 9 % of women had dyspareunia, and infertility was noted in 15 % of women. In some patients, even large fibroids (as big as 24 weeks size) produced no complaints.CONCLUSIONSUterine fibroids sometimes even if they are humongous caused no pressure symptoms and pain. site of the fibroid causes problems and it is not the size of fibroid. Sometimes even huge fibroids can be asymptomatic as seen in few cases.
ABSTRACT
The incidence of polycystic ovary syndrome is found to be very common in patients attending gynaecology department. The incidence is growing rapidly among young adults. PCOS leads to multiple complications. A study of 120 women with PCOS was done in Kerala in India in order to analyse the prevalence, clinical features and impact on life.METHODSCase records of women who were diagnosed as Polycystic Ovarian Disease who attended the gynaecology OPD in Karuna Medical College Hospital in Kerala were randomly selected. Women included in the study were in the age group of 14 – 30 years. The sample size selected was 120. The study was carried out for a period of 12 months in our hospital with the help of the records available. The diagnosis was made as per Rotterdam’s criteria.RESULTS75 women were unmarried and 45 married. 2 of the women had subclinical hyperandrogenism. 70 women have DHEA increased. FSH: LH ratio > 2:1 seen in 84 women. Testosterone was normal. Anti-Mullerian Hormone was raised in 84 women, indicating hyperandrogenism. Serum Prolactin was normal in most women except in 2 women.CONCLUSIONSPCOD leads to many complications like diabetes, Metabolic X syndrome, cardiovascular complications, breast cancer, endometrial cancer and depression. Kerala is considered as the diabetic capital in India. There are several risk factors like, family history, lack of exercise, stress, and high carbohydrate diet. A screening programme for PCOD is essential to prevent the sequelae.