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Welcome to Weakly seminar

Welcome to Weakly seminar. Dr. Shubha Prasad Das Intern Doctor Dept. of Gynaecology and Obstetrics. Particulars of the patient. Name: Marjina Registratio no: Age:45 years Bed No: Husband’s Name: Md. Akkas Address: Village: Makorpara, P.O:Sakrail,

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Welcome to Weakly seminar

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  1. Welcome to Weakly seminar Dr. Shubha Prasad Das Intern Doctor Dept. of Gynaecology and Obstetrics

  2. Particulars of the patient Name: Marjina Registratio no: Age:45 years Bed No: Husband’s Name: Md. Akkas Address: Village: Makorpara, P.O:Sakrail, Thana : Modhukhali, District: Faridpur Date of admission: 17th April,2011 Date of examination: 17th April,2011

  3. Chief complaints: - Irregular menstruation with excessive bleeding for 2 years. - Weakness

  4. History of present illness • According to the patient statement she was well 2 years back. Thereafter she developed irregular menstrual cycle which persist for 15-16 days. Menstrual period persist for 2-3 days. There is excessive bleeding during menstruation with passage of blood clots. She also complains generalized weakness with these symptoms. There is no associated dysmenorrhoea.

  5. History of past illness • She has no history of liver disease, thyroid disease, renal disease or bleeding disorders.

  6. Menstrual History Menarche: At the age of 13 years Menstrual period:3-4 days Menstural cycle: 28 days Since last 2 years : Menstrual period:2-2 days Menstural cycle: 15-20 days Menstrual flow: excessive LMP: 14/04/11 Dysmenorrhoea: Absent

  7. Obstetrics History Married for: 32 years Para: 5(NVD)+2( IUD) ALC: 13 years

  8. Family History: Nothing contributory Drug History:Nothing contributory Socio-economic History: Poor Contraceptive History: She don’t use any type of contraception.

  9. General Examination

  10. Abdominal Examination: • Inspection: No abnormality seen

  11. Palpation: • Non tender • No mass detected • Temperature – not raised

  12. Percussion: • No fluid thrill or shifting dulness

  13. Per- vaginal examination: • Inspection: vulva- healthy • Speculum examination: vagina and cervix looks normal • Bimanual examination: - Uterus bulky - Fornices free - Ovaries normal

  14. Investigations: • CBC • Blood grouping and Rh typing • RBS • Blood urea serum creatinine • Urine R/M/E • X-ray chest P/A view • T3, T4 and TSH • USG of Whole abdomen

  15. Salient feature : • My patient Mrs. Marjina wife of Mr. Akkas aged 45years Muslim lady from Sakrail Modhukhali admitted in FMCH with the complaints of irregular menstrual cycle with excessive bleeding. She also complains generalized weakness. She has no history of liver, thyroid diseases or bleeding disorder. She didn’t take any drug related to such type of symptoms. On general examination- she was found moderately anaemic and normotensive. Abdominal examination reveals no abnormality. On vaginal examination revealed bulky uterus, free Fornices. All the investigation normal except HB%.

  16. Diagnosis: • Clinically it appears to be a case of DUB

  17. Differential Diagnosis: • Adenomyosis • Fibroid Uterus

  18. Treatment : • Total Abdominal hysterectomy with conservation of both ovaries if they are look healthy.

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