Background Aggressive Angiomyxoma is a benign, slowly growing, locally aggressive and recurrent tumour that occurs in the pelvic-perineal region of females in their reproductive years. It presents as a painless, soft, gelatinous mass and metastasizes rarely. Suspicion can be made based on clinical examination and radiological imaging but final diagnosis is confirmed only after histopathology and immunohistochemistry. The choice of treatment is surgical wide local excision. Case presentation We hereby present a case of a 19-year, unmarried lady, with a body mass index of 21 kg/m2, who presented with a chief complaint of painless mass in left vulva which progressively increased in size in the past one year. Clinical examination revealed a large, cauliflower like, exophytic mass of 10 cm × 10 cm size. Radiological imaging confirmed involvement of lymph nodes. Wide local excision with adequate tumour free margin and depth was used as a treatment modality. The diagnosis was confirmed via histopathological examination of the excised specimen. There is no recurrence in the patient up to date. Conclusion Aggressive Angiomyxoma is a rare tumour and it is most often misdiagnosed. This report highlights the importance of considering Aggressive Angiomyxoma as a differential diagnosis of vulval masses and the two-step surgical approach for its treatment in low resource setting.

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Introduction: The development of pharmaceutical industry has been adding new knowledge about drugs continuously making it difficult to remember each piece of information. The physicians need to be supplemented with new information using various unbiased and reliable drug information (DI) sources which will promote rationale use of medicines. This study aims to understand the commonly used sources of DI by prescribers at our institute, their usefulness and the need for an independent drug information unit at the institute. Methods: A cross-sectional descriptive study that included all prescribers presently working at this institute and actively involved in patient care was conducted. Consenting participants were requested to fill in the self-administered questionnaire. Data thus collected were entered using EpiData version 3.1 and were analysed using SPSS version 18. Results: Filled-in questionnaires were obtained from 147 prescribers. Almost all of the participants (95.80%) used textbooks and Online Medical Sites (OMS) as sources of DI. Among participants using OMS for DI, 80 (58.39%) classified them as sometimes biased. Less than half (41.25%) agreed that they will absolutely be benefitted from having unbiased DI services at the hospital. The participants most commonly (136, 92.50%) had queries related to dosage / administration on a daily basis. Conclusions: Most prescribers relied on textbooks and OMS for DI which in their opinion had some level of biasness associated with them. They also agreed on the need of independent DI services in the institution to support prescription practices.

Background: Menstrual abnormalities are menstrual problems that women face during their reproductive years. Globally, they are the most prevalent disorders affecting quality of life in females. This study aimed to assess the prevalence of menstrual abnormalities, its effects and health seeking behaviour of the respondents. Methods: A cross-sectional study of 30 days was conducted among the undergraduate female students of BP Koirila Institute of Health Sceince who were more than 18 years and had attained their menarche. Total number of responses recorded were 137. Data was collected online via google forms and descriptive analysis was done using SPSS 23.Results: Out of 137 participants, 94.89% had menstrual abnormalities. Among which, 75.38% females sought treatment. Dysmenorrhea and Pre-menstrual syndrome were found to be the most prevalent abnormality. The quality of life was affected in most of the females in terms of lack of concentration in study (91.54%), missing the opportunity for socialization (95.39%), inability to perform physical exercises (82.31%), extra hours of confinement to bed (38.46%) and unable to attend lectures (30%).Conclusions: The prevalence of menstrual abnormalities were high. Quality of life was affected in all the subjects with menstrual abnormality but only few of them were seeking treatment with a professional doctor.Keywords: Menstrual abnormality effects; menstrual abnormality prevalence; menstrual abnormality medical students.

Introduction and Importance: Guillain–Barré syndrome (GBS) is an immune-mediated disorder of the central nervous system presenting as symmetrical, progressive weakness and areflexia. The incidence of GBS is very low during pregnancy, but the risk increases in the postpartum period. The management is done by intravenous immunoglobulin or conservatively. Case Presentation: Case of 27 years female with parity 1, living 1, on postpartum day 20 presented to the emergency department (ED) with weakness over legs and hands since 20 days following emergency lower segment cesarean section for her delivery. The weakness prevailed over the lower extremities and progressed to the upper extremities in 4–5 days, affecting her grip strength and ability to stand alone. No history of prior diarrheal or respiratory illness. Cerebrospinal fluid analysis revealed albuminocytologic dissociation. A nerve conduction study showed in-excitable bilateral radial, median, ulnar, and sural nerves. Intravenous immunoglobulin was administered at the rate of 0.4 g/kg once daily for 5 days. Patient was discharged after 2 weeks with regular physiotherapy follow-up. Conclusion: GBS in the postpartum period is very rare. There must be a high degree of suspicion among physicians for GBS if a pregnant female or a woman during her postpartum period presents with ascending muscle paralysis, even if there is no recent antecedent history of diarrheal episodes or respiratory illness. An early diagnosis with multidisciplinary supportive measures helps improve the prognosis for both the mother and the fetus.