No abstract

Leiomyomas are the commonest of all pelvic tumors. One-fifth women of reproductive age group suffer from this condition. Tumors of broad ligament are rare. Most common solid tumor of the broad ligament is a leiomyoma. It can originate from the uterus or broad ligament itself. Here, we report a case of broad ligament leiomyoma in a woman having secondary infertility and it posed a diagnostic dilemma.Birdem Med J 2015; 5(2): 116-118

Objective: To compare the effects of the natural and the surgical menopause (SM) on climacteric condition. Materials and methods: This prospective study was conducted from Jan 2008 to Jan 2013 in ZHSWMCH. Initially, 4,000 women were enrolled but finally 1,743 of natural menopause (NM) and 554 of SM were analyzed. All women were aged between 45 and 50 years, and they were of menopause for 1 to 5 years. Ethical and patient's permission was taken. Once enrolled, they were asked questions. The questions were related to menopausal symptoms (MS). Data was collected and analyzed by SPSS software. Results: Hot flushes, (535 vs 290, p < 0.001), sweating (344 vs 122, p < 0.001), poor memory (99 vs 65 p < 0.001), feeling depressed (335 vs 126, p < 0.001), dry skin/mucosa (229 vs 91, p < 0.001), decreased libido (289 vs 117, p < 0.001), dry vagina (99 vs 65, p < 0.001) and urinary complains (59 vs 42, p < 0.001) were found in SM vs NM. Hypertension or cardiovascular disease was more (191 vs 92, p < 0.01), blood sugar were more (90 vs 32, p < 0.001) and metabolic syndrome are also more (48 vs 26, p < 0.07) in SM than NM but this did not reach the significance. Conclusion: Menopausal symptoms are common in both NM and SM. These MS were significantly higher in surgically menopause women and they were troubled more, so we need to be cautious about oophorectomy, and ovarian preservation should be the aim in all benign cases. Of course, we need to assess the risks and benefit where there is risk of ovarian cancer during the time of total abdominal hysterectomy. Both hormone replacement therapy (HRT) (following a risk/benefit analysis) and treatment of osteoporosis may be recommended after surgery to decrease the climacteric symptoms and osteoporosis in women with menopausal symptoms.

Tocolysis is the relaxation of the pregnant uterus to postpone delivery. Tocolytics are a wide variety of agents used to suppress uterine contraction given when delivery would result in preterm birth. Preterm birth the most important single determinant of adverse outcome in terms of both survival and quality of life of baby. Although preterm birth is defined as being before 37 completed weeks most mortality and morbidity is experienced by babies born before 34 weeks. Prevention and treatment of preterm birth is important though it is not possible when labour is too advanced, cervix is dilated for more than 4 cm and prolongation of pregnancy is hazardous because of intrauterine infection, placental abruption, IUGR, lethal congenital anomaly, severe PIH, eclampsia, active vaginal bleeding or cardiac disease 1,2. The aim of this paper is to review available data about the tocolytics. The tocolytic therapy also helpful for getting time for the administration of dexamethasone/betamethasone, a glucocorticoid drug which greatly accelerates fetal lung maturity. There is no clear first line tocolytic agent 3,4. Various types of drugs are used, with varying success rates and side effects that includes calcium-channel blockers, ? adrenergic receptor agonists, magnesium sulphate, prostaglandin-synthetase inhibitors, oxytocin receptor antagonists. Their specific effects on myometrial contractility, their safety, their efficiency, doses, route of entry, and side effects profile for the mother and the fetus are presented. The main question which tocolytic should be administrated is discussed.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 21-26