Reported is a case of a 43 year-old Gravida 3 Para 3 (3003) admitted due to progressive abdominal enlargement, weight loss and dyspnea. Admitting Impression was Ovarian New Growth, bilateral, malignant, with secondary Pleural Effusion. She underwent Total Abdominal Hysterectomy, with Bilateral Salpingooophorectomy, bilateral lymph node dissection, peritoneal fluid cytology, and infracolic omentectomy. Histopathology report showed a Malignant Mixed Mullerian Tumor of both ovaries with metastasis to the colorectal serosa. It is noteworthy that the patient has two siblings who succumbed to advanced stage ovarian cancer. This case report will discuss the possible hereditary genetic mutations involved in the development of familialovarian carcinoma.

Human ; Female ; Adult ; Neoplasms ; Ovarian Neoplasms ; Mixed Tumor, Mullerian ; Hereditary Breast and Ovarian Cancer Syndrome

A case of a 17-year-old nulligravid with onset of seizure episodes since menarcheis reported. She was diagnosed with Seizure Disorder treated with Phenobarbital and was seizure free for 2 years. Two years prior to consult, seizure recurrences were noted to coincide with menstruation, hence, was diagnosed with Catamenial Epilepsy. Patient was shifted to Lamotrigine but seizure exacerbations were still observed, prompting referral to the Reproductive Medicine service for adjunctive hormonal therapy. Depot medroxyprogesterone acetate was added to the antiepileptic drug which provided seizure control. Adjunctive hormonal therapy proved to be helpful in the management of intractable seizures in this patient.

The report aims to give a better understanding of the neuroactive properties of estrogen and progesterone and its role in the development of Catamenial Epilepsy. Gender-related and psychosocial issues in the treatment of Epilepsy in the child-bearing years up to the menopause are also discussed.

Human ; Female ; Adolescent ; Anticonvulsants ; Seizures ; Progesterone ; Lamotrigine ; Medroxyprogesterone Acetate ; Menstruation ; Epilepsy ; Triazines ; Phenobarbital ; Menopause ; Estrogens ; Reproductive Medicine

A case of a 17-year-old nulligravid with onset of seizure episodes since menarcheis reported. She was diagnosed with Seizure Disorder treated with Phenobarbital and was seizure free for 2 years. Two years prior to consult, seizure recurrences were noted to coincide with menstruation, hence, was diagnosed with Catamenial Epilepsy. Patient was shifted to Lamotrigine but seizure exacerbations were still observed, prompting referral to the Reproductive Medicine service for adjunctive hormonal therapy. Depot medroxyprogesterone acetate was added to the antiepileptic drug which provided seizure control. Adjunctive hormonal therapy proved to be helpful in the management of intractable seizures in this patient.

The report aims to give a better understanding of the neuroactive properties of estrogen and progesterone and its role in the development of Catamenial Epilepsy. Gender-related and psychosocial issues in the treatment of Epilepsy in the child-bearing years up to the menopause are also discussed.

Human ; Female ; Adolescent ; Anticonvulsants ; Seizures ; Progesterone ; Lamotrigine ; Medroxyprogesterone Acetate ; Menstruation ; Epilepsy ; Triazines ; Phenobarbital ; Menopause ; Estrogens ; Reproductive Medicine

Reported is a case of a 29-year old Gravida 5 Para 4(4004), 23 6/7 weeks pregnant, known diabetic with hepatic hemangioma, who previously underwent ligation of ruptured esophageal varices, was admitted for the first time on February 21, 2015 due to left-sided hemiparesis. Identifying the cause of the pontine bleed and its possible association with coexisting medical problems was an arduous process since there are no existing management guidelines. Emergency Caesarean Section with bilateral tubal ligation under general anesthesia was done at 35 weeks AOG and a live baby girl was delivered with an Apgar score of 9,9. Magnetic Resonance Angiography (MRA) of intracranial vessels postpartum revealed a Cavernoma. This case is of particular importance due to the following reasons: 1.) Cerebral Cavernous Malformation (CCM) is a rare disease, 2.) There is scant data associating CCM with pregnancy, 3.) Current literature has not reported CCM with Hepatic Hemangioma in a single patient, 4.) No data has linked it with diabetes mellitus, 5.) There are still no management guidelines of CCM in pregnancy, 6.) A multidisciplinary approach is necessary for optimal maternal and fetal outcomes.

Human ; Female ; Adult ; Hemangioma, Cavernous

Background: Although decreased potassium levels may have a role in the etiopathogenesis of preeclampsia, small number of studies has been done to determine their relationship. Objectives: This study was done to know whether serum potassium is significantly decreased in hypertensive disorders of pregnancy, to determine if the level of potassium correlates with the severity of hypertension, to know whether we can recommend serum potassium as part of preeclamptic work up, and ultimately, to determine if potassium supplementation can be advised to preeclamptic women during prenatal check-up. In this prospective, cross sectional study, subjects were 338, 169 of whom had uncomplicated pregnancies, while 169 had preeclampsia (72 of whom had systolic BP(SBP) 140-150mmHg, while 97 had SBP ?160mmHg). Baseline serum potassium were taken upon admission. The mean serum potassium was significantly lower at 3.37±0.41mmol/L (p-value<0.0003) in hypertensive women (versus 3.62±0.31mmol/L in uncomplicated pregnancies). Furthermore, the serum potassium was significantly decreased in patients with SBP>160mmHg (3.31±0.46) when compared with those with SBP140-150mmHg (3.45±0.32), with p0.013. Wilcoxon Signed-Rank Test showed Z-value -5.68 (significant at p?0.05), showing a significant difference between the level of serum potassium in normotensive compared to hypertensive patients. Chi-Square test showed X2?45.46 (in the critical region 5.9), therefore the level of serum potassium is dependent on the level of BP. Pearson Correlation coefficient showed r -0.1135 stating a negative correlation, hence, as the BP increases, serum potassium decreases. Conclusion This study suggests that hypokalemia observed in preeclamptic patients may bring about altered homeostatis in serum and therefore may act as predisposing factors in pathogenesis of preeclampsia. The authors recommend the addition of serum potassium as part of the criteria of severity of preeclampsia. Hypertensive pregnant women are advised to consume diet containing adequate amount of potassium or have a potassium supplementation during prenatal check up.
Hypokalemia ; Pre-Eclampsia