RESUMEN
Introduction: Abnormal uterine bleeding should include all abnormalities of menstruation like hypermenorrhea as well as hypomenorrhea. Abnormal bleeding is synonymous only with excessive menstruation. Abnormal uterine bleeding (AUB) is one of the most common conditions for which women consult their gynaecologists. Material and methods: This was a retrospective study done in Dhiraj Hospital over a period of six month on patients presenting with AUB. Patients were selected based on clinical details. The study material included a total no. of 60 patients which were inclusive of endometrial samples. Patients with isolated endometrial causes of abnormal uterine bleeding were included for this study and those with pregnancy, profusely bleeding per vaginum, anemic patients were excluded. All specimens were transported in 10% formalin to the pathology laboratory. The gross morphology was recorded. Microscopic examination was done by two pathologist so as to reduce inter observer findings. The data collected for this study was statistically analyzed using chi-square test.
RESUMEN
Thrombotic thrombocytopenia purpura (TTP) is a rare hematological disease and only 20%–30% of patients present with classic pentad. About 20% of patients with TTP are resistant to plasma exchange. We have described a 28-year-old female patient with TTP who did not have classic pentad of TTP. We ruled out all other differential diagnosis. She was refractory to plasmapheresis and was treated successfully with rituximab. It was thus concluded that on the basis of the literature review, rituximab should be considered in TTP patients who fail to respond after 7–14 days of standard treatment with daily plasmapheresis and glucocorticoids.
RESUMEN
OBJECTIVES: This study discusses incidence and clinical profile of pulmonary involvement in leptospirosis in South Gujarat. It also tries to evaluate the effect of high dose glucocorticoid pulse therapy (GPT) on it. METHOD: A study was carried out on hundred and two patients of suspected leptospirosis, referred to Government Medical College, New Civil Hospital, Surat between June 99 to September 99. The incidence, clinical profile, and specific investigations were studied in patients having pulmonary involvement. Some of the patients were given high dose glucocorticoid pulse therapy. Their outcomes were compared with those who had not been given glucocorticoid pulse therapy. RESULTS: Out of seventy seven seropositive patients 13 (16.8%) developed pulmonary involvement. Mortality was two out of eight patients in the group that received GPT and four out of five patients in the group that did not receive GPT. Two patients who died in the steroid treated group received the drug after 12 hours of onset of dyspnea. CONCLUSIONS: High dose GPT should be given as early as possible after the onset of dyspnea to all the patients with pulmonary involvement in leptospirosis. Further studies are required to establish the GPT as a standard regimen in treatment of pulmonary involvement in leptospirosis.