An unusual case of lateral vaginal wall leiomyoma: case report

Twenty to thirty percent of women in the reproductive age group are affected with leiomyomas, the most frequent benign tumor of the uterus. Only 300 occurrences of vaginal leiomyomas have been documented, hence they are still a rare condition. Because of their low incidence and wide range of nonspecific clinical symptoms, tumors are assumed to originate from Mullerian smooth muscle cells in the sub-epithelium of the vagina. However, these cells can easily be misdiagnosed. Usually located in the anterior vaginal wall are vaginal leiomyomas. Here, we describe a case of left upper lateral vaginal wall leiomyoma in a 40-year-old multigravida. She presented with pelvic fullness. Cervical fibroid was diagnosed based on physical examination and MRI. Under anesthesia, the tumor was removed vaginally, and histology revealed a vaginal leiomyoma. Vaginal leiomyomas are uncommon tumors; however, they can present with a range of clinical symptoms and be mistakenly classified as cervical fibroid before surgery. The most effective therapy approach seems to be vaginal tumor excision followed by a histological investigation. To raise awareness of the disease and lower the possibility of a misdiagnosis and improper treatment, the current instance was disclosed.

Comparison study of metformin versus insulin in the treatment of gestational diabetes during pregnancy

Background: Gestational diabetes was traditionally treated with insulin. Metformin is a peroral drug used worldwide in the treatment of type 2 diabetes and also in a few studies on patients with gestational diabetes. This study aimed to analyze and compare insulin and metformin in the treatment of gestational diabetes and to compare their effects on the pregnancy outcomes.Method: This comparative prospective observational study was conducted at Deen Dayal Upadhyay Hospital, New Delhi, a tertiary care teaching hospital. The data was collected over a period of 15 months (April 2021 till June 2022). So pregnant females in the age group 18-45 years with 20-30 weeks period of gestation, are diagnosed with gestational diabetes as per the diabetes in pregnancy India (DIPSI). The study group was divided into 2 groups of 40 each, one receiving oral metformin and the other group receiving insulin for treatment.Results: Metformin was found to be a better drug in controlling blood sugars vis a vis insulin in our study. GDM patients controlled on insulin were found to be associated with; higher weight gain, higher incidence of neonatal hypoglycemia, hyperinsulinemia and higher and longer ICU admissionConclusions: Metformin was better in controlling blood sugar in GDM than insulin, with better neonatal outcome.