Endometriosis affects approximately 10% of women of reproductive age. Characteristics robustly associated with a greater risk for endometriosis include early age at menarche, short menstrual cycle length, and lean body size, whereas greater parity has been associated with a lower risk. Relationships with other potential characteristics including physical activity, dietary factors, and lactation have been less consistent, partially because of the need for rigorous data collection and a longitudinal study design. Critical methodologic complexities include the need for a clear case definition; valid selection of comparison/control groups; and consideration of diagnostic bias and reverse causation when exploring demographic characteristics, medical history, and lifestyle factors. Reviewers and editors must demand a detailed description of rigorous methods to facilitate comparison and replication to advance our understanding of endometriosis.

The foreign bodies in respiratory tract have been major cause of morbidity and present as challenge to otolaryngologist. The spectrum of presentation varies widely from sudden death due to respiratory obstruction to accidental finding during routine investigation. One case of unusual presentation of laryngeal foreign body with loss of voice is described here. Key words: Respiratory obstruction laryngeal; foreign body DOI: 10.3126/jcmsn.v6i1.3601 Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 1, 44-46

The study of 155 patients with extra testicular scrotal lesions presented to SSG Hospital Baroda from December 2015 to November 2016 the following points can be emphasized. The commonest age group presenting with scrotal lesions was in the range of 31-40 years. Unilateral presentation was more common than bilateral presentation. The commonest presentation was scrotal swelling followed by pain and other associated complains of fever and urinary complaints. The commonest finding was cystic followed by inflammatory, and neoplasm being rare. Among cystic hydrocele was the main pathology followed by epididymal cystic lesions. Epididymitis was more common than epididymorchitis followed by Fournier's gangrene in inflammatory lesions. The commonest site of involvement was tunica vaginalis followed by epididymis and scrotal wall lesions. Ultrasonography helped to differentiate extra testicular lesions from intratesticular lesions in nearly all the cases, as well as the site of involvement but was not useful in confirming the etiology. FNAC was found useful in not only coming onto a final diagnosis but also had role in finding the etiology.

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Blunt trauma to the upper extremity may cause extensive vascular damage in addition to severe musculoskeletal injury. Over a 5.5-year period. 17 patients with a total of 23 arterial injuries were treated. Diagnosis was made in 16 patients before surgery by physical and Doppler ultrasonographic examination. Angiography performed in ten patients assessed the extent of injury. Associated orthopedic injuries were present in 11 patients and neurologic injury in 16. At surgery, 21 of 23 arterial repairs required autologous vein. The initial limb salvage rate was 76%. Pour patients underwent above-elbow amputation because of progressive sepsis and myonecrosis. A fifth underwent delayed amputation at 7 months due to loss of limb function. Neurologic impairment was the major long-term morbidity. The data show that outcome following blunt vascular trauma of the upper extremity is governed by the associated injuries.