Carpal Tunnel Syndrome results in considerable discomfort and pain, limitation of activities of daily living, loss of sleep and work disability. Carpal tunnel Syndrome is more frequent in pregnancy because the systemic process increases the extra capsular fluid retention by the hormone Prolactin and produce soft tissue swelling in the later stages (third trimester) of their pregnancies. Many therapies have been advocated for treating the carpal tunnel syndrome including Mobilizations, nerve gliding, tendon gliding, Ultrasound, icing, Massaging, Elevating the arm or flicking, Neural mobilization, wrist splints and invasive treatments like injecting corticosteroids in the carpal tunnel and eventually releasing the median nerve by surgery.etc. Women experience pregnancy several times, and if they acquire CTS, invasive treatments cannot be used, and pregnancy increases the probability of reoccurrence of CTS in the next pregnancy with higher intensity. So it is necessary to use non-invasive treatment methods. The disease is becoming very common nowadays as most of the population is engaged in computer work by some means especially the IT ladies who always use the conventional mouse for their work with the PC. One of the non invasive method of using the wearable device (wearable glove mouse) along with the tendon and nerve gliding exercises prescribed by the physiotherapists improves the condition. The occurrence of CTS is diagnosed by positive Tinel’s sign and positive Phalens test. This work tries to give possible non invasive solution for the CTS during pregnancy for IT women professionals and the relief of symptoms is measured with the help of VAS Scale, Functional Status Scale.
An interesting case of uterine smooth muscle tumours of uncertain malignant potential is a rare tumour and is between classification of benign and malignant. It is diagnosed based on histomorphology with ill-defined criteria which as yet has no consensus and is technically challenging.
Ectopic pregnancy is a common cause of mortality and morbidity among the women of reproductive age group. Tubal pregnancy is the commonest. It can occur in cervix, ovaries, previous caesarean scar, interstitial portion of the tube and abdominal cavity. Here we report a case of caesarean scar ectopic pregnancy which was managed conservatively. 31 yrs old gravid 3 previous 1 LSCS and 1 tubal ectopic come for antenatal consultation at 35 days of gestation. UPT was Positive. USG showed no evidence of intra uterine sac. Repeat scan after 10 days showed a gestational sac at the lower uterine segment scar. Hence it was decided for conservative management, injection methotrexate 50 mgm X 2 doses given. This was followed by misoprost vaginal insertion. Since patient did not expel the sac, injection PG F2 alpha 125 mg x 2 doses were given. Patient expelled the products of conception partially. This was followed by hysteroscopic guided evacuation.Caesarean scar ectopic was reported in 1978. Early diagnosis is by TV USG / MRI. Early ectopic can be treated medically. In delayed diagnosis, laparoscopic excision of the scar has to be done. In rupture of the scar site ectopic pregnancy laparotomy is indicated. In the event of heavy bleeding, hysterectomy has to be done. After conservative management and excision of the scar, fertility is not altered. Caesarean section scar pregnancy is a rare form of ectopic pregnancy which can lead to life threatening complications leading to mortality and morbidity. Treatment has to be individualized according to the gestational age, haemodynamic stability and desire for future fertility.
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