ABSTRACT
Background: Perimenopause is described as years prior to menopause that encompasses the change from normal ovulatory cycle to cessation of menses, ending 12 months after the last menses. International federation of gynaecology and obstetrics (FIGO) developed a new classification PALM-COEIN in order to standardize the factors associated with AUB. It classifies AUB as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia (PALM) - structural abnormalities Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified (COEIN) - unrelated to structural abnormalities. Objectives of this study were to categorise the causes of AUB in perimenopausal women in context to PALM COEIN classification system. Correlation of co-morbities (diabetes, hypertension and thyroid disorders) with AUB in perimenopausal age group.Methods: This is a retrospective study from the month of May 2019 to October 2019, considering 100 patients of perimenopausal age group (40 to 55 years of age group) in J. K. Hospital Bhopal, Madhya Pradesh with complaints of abnormal uterine bleeding, admitted in gynae ward.Results: Most of the patients in the current study were between 45-50 years of age i.e. 44%. Menorrhagia was the commonest menstrual disorder encountered in 52% of patients. As per FIGO; AUB-L constituted 42% AUB-O constituted 12%, AUB-P constituted 11%, AUB-A 10%, AUB-M constituted 8% AUB-E constituted 8%, not yet classified constituted 4% of total cases.Conclusions: AUB (PALM-COEIN) for causes of abnormal uterine bleeding classification was very useful in categorizing cases of AUB. It suggests that etiology of AUB and also gives place for presence of multiple factors as a cause of AUB in a particular case.
ABSTRACT
McCune Albright syndrome is characterized by the clinical triad of precocious puberty, polyostotic fibrous dysplasia, and café-au-lait pigmentation. Authors reported the case of a 6 years old girl presenting with vaginal bleeding. Investigations showed high serum oestrogen levels, with low FSH and LH levels. Ultrasonography revealed a multiloculated right ovarian cyst. Based on the history and investigations, the patient was diagnosed as a case of precocious puberty. In order to rule out the presence of any ovarian malignancy, tumour markers were sent and found to be within the normal range. A CT pelvis was done which revealed fibrous dysplasia of the pelvic bone. The coexistence of precocious puberty with fibrous dysplasia confirmed the diagnosis of McCune Albright syndrome.
ABSTRACT
Background: Diabetes is a chronic disease that has a prolonged prediabetic phase with specific microvasular complications like nephropathy ,retinopathy, neuropathy that can begin during prediabetic phase itself. objective: The study is intended to know the relative prevalence of retinopathy among prediabetes patients. Methodology: A total of 100 subjects with prediabetes ,visiting medicine OPD during the period of 6 months were included in the study. Qualifying patients underwent detailed history, clinical examination, direct and indirect ophthalmoscopy, Results: Among IFG and/or IGT (Prediabetes), 6% patients had very mild Non proliferative diabetic retinopathy. Conclusion: Microvascular complications such as retinopathy can be present in Prediabetes, though their prevalence is low.