Adult granulosa cell tumor: a small mass producing troublesome morbidity to a woman

Granulosa cell tumors are sex-cord stromal tumor ofovary, a rare neoplasmaccounting for approximately 3-5% of all ovarian malignancies. Hormone producing tumor, a total of 95% of all GCTs are adult type and of large size. A majority of women present with abdominal mass and diagnosis made on histopathology. While small size symptoms producing Granulosa cell tumors are rare and it's a rare virilizing tumor of adolescents. Adult Granulosa cell tumor is a clinically and molecularly unique subtype of ovarian cancer. The present case study reports on a case of a small size Granulosa cell tumor producing postmenopausal bleeding in 56-year-old woman

Cornual ectopic pregnancy: a threat to the life of mother

Cornual [interstitial] ectopic pregnancy, an uncommon variant of ectopic pregnancy often poses a diagnostic and therapeutic challenge with a significant risk of rupturing and bleeding. Early diagnosis and treatment of interstitial ectopic pregnancy is very crucial, as they carry a very high risk of morbidity associated with the rupture. If they continue without diagnosis, a life-threatening situation may occur even when surgical intervention with laparotomy is performed. We present a case who reported with lower abdominal pain and 2 months amenorrhea. The patient was diagnosed with a cornual ectopic pregnancy and managed timely

Outcome of induction of labour with intracervical foley catheter in women with previous one caesarean section

Objective: To compare the rates of vaginal delivery after one caesarean section in mechanically induced and spontaneous labour

Study design: Cross Sectional Study

Place and Duration of study: Department of Obstetrics and Gynecology Unit-II, Jinnah Postgraduate Medical Centre Karachi, from January 2011 to July, 2011

Methodology: Pregnant women with one previous caesarian section were included in the study after informed consent. They were divided into two groups. Group I included women in whom labour occurred spontaneously. Those women who did not enter into labour up to 40 weeks of gestation were put into group II. They were induced with intracervical Foley catheter. Satisfactory outcome measure was the vaginal birth

Results: A total 112 patients were included. Significant difference was not observed between groups in relation to mode of delivery [Chi square = 1.09, p=0.57]. Out of 112 pregnant women, satisfactory outcome was observed in 74 [66.1%], which was not significant between the two groups [66.1% vs. 66.1% p=0.999]

Conclusion: Mechanical induction of labour in patients with previous one caesarean section is the reasonable option, when patients are carefully and properly selected, coupled with vigilant intrapartum monitoring

Mitigating effects of Jambul against lead induced toxicity in epididymis and vas deferens of mice

Background: Precious fruits like jambul are neglected and wasted while environmental pollutants like lead intake remain overlooked

Objective: The aim of this study was to investigate the effects of the Jambul pulp extract on lead detrimental effects in pseudostratified epithelium and the stereocilia of mice epididymis and vas deferens

Materials and Methods: Thirty young males mice [Mus musculus] were distributed randomly in 3 groups [n= 10] called control, Pb [Lead] and Pb-J [Lead-Jambul]. The Pb and Pb-J were provided 50ppm Pb in drinking water ad libitum for 15 days and Pb free water for the next 5 days. The Pb-J group received 0.2ml jambul pulp extract on 12 hourly bases. Control group was not given any treatment. Organs [epididymis and vas deference] were recovered on 21[st] days after euthanasia. The organs were finally processed for histological and micrometric studies

Results: Marked histologic and micrometric changes in both organs were noted in Pb group. These include significant [P

Conclusion: The results indicate that epididymis and vas deferens are highly sensitive to Pb exposure while Jambul pulp extract has shown rich mitigating potentials against such histopathologies

Abnormalities of semen in infertile couples

Objective: to determine the frequency of abnormality of semen in infertile couples presenting to a tertiary care hospital

Study design: cross sectional study

Place and Duration of Study: department of Obstetrics and Gynaecology, Unit II [ward-9] Jinnah Postgraduate Medical Centre Karachi, from January 2012 to June 2012

Methodology: sixty male members of infertile couples with ages between 18 - 50 year, who were referred to infertility clinic included in this study. After five days of sexual abstinence, patient's semen analysis was done according to the WHO protocol

Results: the mean age of the patients was 33.32 +/- 6.04 year. Abnormality of semen was found in 18[30%] cases. Out of this azoospermia was found in one [1.7%], oligozoospermia in three [5%] and asthenozoospermia in 14[23.3%] men

Conclusions: this study demonstrated that abnormal semen quality was a major factor of infertility in present cohort. The most common abnormality was poor motility of sperms

Remarkable reduction of exposure rate in patients with stress-only myocardial perfusion scan: let's safe mankind from unjustified radiation exposure

To measure radiation exposures rate in low-risk patients having stress-only and stress-rest myocardial perfusion imaging. This was a prospective study conducted from January 2012 till November 2012 upon patients with low pre-test probability for coronary artery disease [CAD]. A stress MPI [stress-only if MPI is normal and no resting study] followed by a resting MPI study [same day] if stress study was positive or equivocal. Exposure rates [in milli-Roentgen/hour, mR/hr] from injected patients at 1 meter distance were measured at 10 minutes, 1 hour and at time of releasing patients in both groups. Total 369 patients were included and 104 [28%] patients had stress-only and 265 [72%] had stress-resting studies. Mean administered [99m]Tc-MIBI dose in Stress-only and Stress-rest groups was 8 +/- 1 mCi and 24 +/- 03 mCi respectively [p<0.05]. Exposure rates[in mR/hr] within 10 min, 1 hour and at release time in Stress-only and stress-rest groups were 0.394, 0.294, 0.194and 1.540, 1.431, 1.207 respectively [p<0.05]. Mean stay of patients in laboratory was 90 +/- 39 minute in Stress-only and 156 +/- 53 minute in Stress-Rest group [p <0.0001]. There was a significantly widening gap between exposure rates from patients with Stress-only and stress-rest protocols as 26:74%, 21:79% and 16:84% at 10 min, 1 hour and at time of release respectively. We conclude that adopting a Stress-only MPI protocol in low risk patients ensures significantly lower radiation doses to patients and technologists. A worldwide paradigm shift in nuclear cardiology practice would safe mankind from unjustified radiation exposure

Alternative to surgical evacuation of uterus: misoprostol for post-abortion care

To compares the effectiveness of single 600 micrograms [micro g] dose of sublingual misoprostol with manual vacuum aspiration [MVA] for treatment of incomplete and missed abortions. Quasi- Experimental study. Post-abortion care room, Jinnah Postgraduate medical centre [JPMC] Karachi, from September 2008 to December 2008. Hundred consenting women with incomplete and missed abortions were randomized to either a single dose of 600 micrograms of sublingual misoprostol or MVA for treatment of their condition. Main outcome measure was complete abortion following initial treatment. Secondary outcome measures were satisfaction rate and acceptability of the method. Regardless of treatment assigned, nearly all participants had a complete uterine evacuation [Misoprostol =92% MVA= 100% p=0.12]. A slightly more satisfaction rate was observed in the misoprostol group [p=0.001] as 86% participants expressed desire to choose misoprostol again while the number was 76% in MVA group. Sublingual misoprostol is as safe and as effective as manual vacuum aspiration for post-abortion care