Malignant Struma ovarii: a case report

Objective: to report a rare case of papillary thyroid carcinoma arising in Struma ovarii

Management of meig's syndrome: experience at the Jordanian Royal Medical Services

Objectives: To describe our experience regarding the management of five different cases with histopathologicaly confirmed diagnosis of Meig's syndrome besides differentiation this benign disease from malignant ovarian disease with similar presentation

Methods: This study was performed at three different hospitals of the Jordanian Royal Medical Services. The study was conducted out in the period between June 2011 and June 2015. The files of five cases were reviewed and data were collected, arranged in tables and statistically analyzed. The results were extracted and conclusion made

Results: Five cases, which fitted the criteria for Meig's syndrome, were included in the study. The age of patients ranged from 31 to 67 years with a median age of 46 years. The most common presentation was abdominal pain. All cases had a solid component in pelvic mass with size more than 10 cm. All cases had an elevated level of tumor marker CA125. Management options included true cut biopsy, frozen section and performing laparotomy for excision of the mass that ranged from removal of the involved ovary to removal of both ovaries with uterus and omentum. All patients had an excellent recovery after surgery

Conclusion: Meig's syndrome presented with benign ovarian tumor [fibroma or thecoma] usually more than 10 cm in diameter, ascites, pleural effusion mainly right sided with their associated symptoms, and mild elevation of CA 125 tumor marker. It was differentiated from ovarian malignancy by absence of malignant cells in ascitic and pleural fluid cytology and certainly by benign ovarian histopathology

Frequency of gingivitis in pregnancy: a comparative study between first and third trimesters of pregnancy

The aims of this study were to determine the incidence of gestational gingivitis and assess oral health status in two groups of women at different stages of pregnancy. A comparative descriptive study was conducted on pregnant women attending the outpatient antenatal care clinic at Princess Haya Hospital in Aqaba from January 2010 to August 2010. Data were collected from 580 women. Two groups were created. The first group [n=260] included women at their first trimester and the second group [n=320] included women in their third trimester of pregnancy at the time of their dental examination. Data were collected from the women by face-to-face interview and intra-oral examination. The two groups were compared. Gingivitis was detected in 26.8% in women examined during their first trimester of pregnancy as compared to 32.1% in women examined during their third trimester. There was no statistical significant difference in the incidence of gingivitis between trimesters. However, there was significant difference between the first and third trimester of pregnancy regarding associated calculus [p<0.0001] and the presence of malodor [p=0.006] with both being more common in later pregnancy. Oral hygiene habits and regular dental care were much better during first months of pregnancy compared to the last three months [p<0.0001]. Our study confirms that the frequency of gingivitis during the third trimester of pregnancy is higher than during the first trimester. Further studies are needed to determine the relation of gingivitis to oral hygiene and dental care habits

Discontinuation rates among women using either the combined oral contraceptive pills or an intrauterine contraceptive device for contraception: a comparative study

To study the contraceptive practice of women using combined oral contraceptive pills and intrauterine contraceptive devices in 4 Jordanian military hospitals; [Prince Hashem Bin Al Hussein, Prince Ali Bin Al Hussein, Princess Haya Bent Al Hussein, and Queen Alia Hospitals] and to study the reasons for discontinuation of these methods among women less than 44 years of age. A retrospective analysis of the family planning medical files of 5800 clients who were current or past user of the contraceptive pills or intrauterine devices for contraception during the period between January 2007 and December 2009 was done. Fifty-eight percent [33671 5800] were current or past contraceptive pills users and 41% [2433/5800] were current or past intrauterine device users. Women included in the study were those who had discontinued using the pills or the devices for more than 6 months [n = 3200], which in turn were divided into two groups: Group A, oral contraceptive pills users [n=2050] and Group B, intrauterine devices users [n = 1.150]. We then analyzed according to age, parity, obstetric history, medical history, duration of contraception and reasons for discontinuation of these methods; the data were compared between the two groups.The use of contraceptive methods varies across age, but combined oral contraceptive pills was found to be the most commonly used method among the study population. Only 29% of group A discontinued the pills because of their desire to conceive compared to 23.6% of group B. Fifty-two percent of group A stopped the pills because of undesired side effects, compared to 65% among group B. Four-point-four percent of group A stopped the method due to medical indication compared to 3.2% in group B. Fourteen-point-six percent of group A stopped the pills for personal reasons or lack of availability of the drugs and 8.2% of group B had the device removed because it reached the expired date [being in uterus for 10 years]. However, this is not considered a reason for discontinuation. The main side effects of combined oral contraceptives were breast discomfort, mood changes, weight gain, headache, nausea and vomiting, whereas the commonest side effects related to intrauterine contraceptive device were menstrual bleeding disorders, recurrent vaginal infection, and pelvic pain. In spite of the safety and high efficacy of combined oral contraceptive pills and intrauterine devices as contraceptive methods more than half discontinued their use because of undesired side effects. This may be improved by careful patient selection and appropriate counseling