Diagnostic dilemma of an unusual pelvic mass in a young girl.

Dysgerminoma of ovary is the most common germ cell tumor, accounting for 50% of all germ cell tumor cases. About 20% of cases are diagnosed during pregnancy, and 80% occur in women under 30. It is rare to find both ovaries to be involved in germ cell tumors. The prognosis of patients with malignant germ cell has improved significantly over the last two decades after the introduction of chemotherapy specially cisplatin. The only exceptions are stage 1, grade 1, immature teratoma and stage 1A dysgerminoima who are followed up after surgery without adjuvant chemotherapy. Normal ovarian functions and fertility can be retained in most patients by following the conservative surgery.

Prevalence of rheumatic and congenital heart disease in schoolchildren of Kathmandu valley in Nepal.

BACKGROUND: Rheumatic heart disease remains a major public health problem in developing countries with its very high prevalence. Rheumatic and congenital heart disease are significant causes of morbidity and mortality among Nepalese schoolchildren. The aim of our study was to determine the prevalence of rheumatic and congenital heart disease among schoolchildren of the Kathmandu valley in Nepal. METHODS AND RESULTS: The study included 9420 students, of whom 4466 were male and 4954 were female, with ages ranging from 5 to 18 years. A clinical survey was conducted by the examining team in selected schools, and involved answering standard questionnaires. A total of 83 children were suspected of having heart disease. Out of these 83 children, 23 were confirmed to have heart disease; 11 had rheumatic heart disease, and 12 congenital heart disease, giving a prevalence of 1.2/1000 and 1.3/1000, respectively. The commonest cardiac lesions were mitral regurgitation in the rheumatic heart disease group, and atrial septal defect in the congenital heart disease group. A higher prevalence of congenital heart disease was detected in females. CONCLUSIONS: The prevalence of rheumatic heart disease and congenital heart disease among schoolchildren of Kathmandu is 1.2/1000 and 1.3/1000, respectively, with mitral regurgitation and atrial septal defect being the commonest lesions.