Arteriovenous malformations (AVM) of the brain are uncommon congenital lesions with a complex array of arterial to venous shunts. The common clinical manifestations include haemorrhage, seizures, headache, progressive neurologic defi cits and congestive cardiac failure. We report a child who presented with bilateral acquired ptosis, a very rare presentation of AVM which has not been previously reported.

OBJECTIVES: This study was done to determine the effect of multiparity and prolonged lactation on bone mineral density (BMD). METHODS: This cross-sectional study included 196 perimenopausal and postmenopausal women aged 40 to 60 years old. Age, body mass index (BMI), menopausal status, duration of menopause, parity and total duration of lactation, nutritional history were recorded. Lumbar spine (LS; L2-L4) and femur neck (FN) BMD were measured using dual energy X-ray absorptiometry. Correlation of parity and lactation with BMD were investigated using multiple regression analysis. RESULTS: Parity was inversely correlated to BMD for LS (β = −0.266, P = 0.001) and FN (β = −0.380, P = 0.000). This relation remained significant even after adjusting for age, BMI and duration of menopause. Duration of lactation was inversely correlated with BMD for LS (β = −0.271, P = 0.001) but no for FN (β = −0.124, P = 0.130). CONCLUSIONS: Multiparity and prolonged lactation have negative impact on BMD especially with in a socioeconomic group whose nutritional intake is borderline. Our data support that parity and duration of lactation can be associated with future osteoporosis.
Absorptiometry, Photon ; Body Mass Index ; Bone Density* ; Cross-Sectional Studies ; Female ; Femur Neck ; Humans ; Lactation* ; Menopause ; Osteoporosis ; Parity* ; Spine

Pyometra is collection of purulent material which occurs when there is interference with its normal drainage. It is an uncommon condition with incidence of 0.1 to 0.5% of all gynecological patients. Spontaneous rupture of uterus is an extremely rare complication of pyometra. A 65-year-old lady presented with pain abdomen and purulent vaginal discharge. Preoperative diagnosis of pyometra was made by magnetic resonance imaging (MRI). Laparotomy followed by peritoneal lavage and repair of perforation was performed. Although spontaneously perforated pyometra is rare, the condition must be borne in mind with regard to elderly women with acute abdominal pain. Preoperative diagnosis of perforated pyometra is absolutely essential. Computed tomography (CT) and MRI are diagnostic tools. In selected cases conservative approach at surgery can be opted.
Abdomen ; Abdominal Pain ; Aged ; Diagnosis ; Drainage ; Female ; Humans ; Incidence ; Laparotomy ; Magnetic Resonance Imaging ; Peritoneal Lavage ; Peritonitis ; Postmenopause ; Pyometra* ; Rupture, Spontaneous ; Uterus ; Vaginal Discharge

The occurrence of a second primary cancer in a cancer survivor is well documented. It may be synchronous or metachronous. Incidence of metachronous cancer involving cervix is 0.82% to 1.33%. One such metachronous cancer is that of breast and cervix. We present a case of a woman who received tamoxifen for invasive ductal cancer of breast following a modified radical mastectomy and subsequently developed adenocarcinoma of cervix after six month of tamoxifen therapy. The role of tamoxifen in pathogenesis of cervical cancer and that of human papillomavirus infection in pathogenesis of both cancer of cervix and breast cancer has been well recognized. In our patient, the adenocarcinoma of cervix (rare occurrence) which is likely due to six month of tamoxifen therapy is a perplexing question. Women diagnosed and treated for breast cancer need to be followed up for development of other metachronous gynecological cancers.
Adenocarcinoma* ; Breast ; Breast Neoplasms* ; Cervix Uteri* ; Female ; Humans ; Incidence ; Mastectomy, Modified Radical ; Neoplasms, Second Primary ; Papillomavirus Infections ; Survivors ; Tamoxifen ; Uterine Cervical Neoplasms