Primary omental leiomyosarcoma is a rare omental malignancy. Its usual manifestations are abdominal pain, abdominal mass and abdominal distension with or without constitutional symptoms. Primary omental leiomyosarcoma varies in its dimensions from being a small-sized leiomyosarcoma to a giant one and can mimic any huge intra-abdominal and pelvic malignancy. We are reporting a case of a 20-year old unmarried female who presented with a giant intra-abdominal mass occupying nearly entire abdomen. Clinically, it was difficult to comment on its site of origination. Abdominal ultrasonography and CT scan suggested that this heterogeneous tumor was arising from the left ovary. On exploratory laparotomy, the mass was found to be a giant primary omental tumor with no synchronous lesion. The tumor was successfully excised with total omentectomy. Histopathology and immunohistochemistry of the specimen was consistent with omental leiomyosarcoma. Owing to the absence of any synchronous intra-abdominal lesion, the tumor was labeled as primary omental leiomyosarcoma.

Gallbladder polyps are being increasingly detected due to availability and widespread use of advanced imaging modalities for evaluation of abdominal lesions. Hence, physicians should know about the course of these polyps so that the patients are treated in light of the best clinical evidence. This article reviews various aspects of gallbladder polyp development and management in the light of recent literature.

We report a 32-year-old female patient who presented with complaints of cough, chest pain and dyspnea for the past one and a half month and hemoptysis for one week. Work up for tuberculosis was negative. Chest X-ray demonstrated a  homogenous opacity in the left middle and lower zones. CT scan chest described a heterogeneously enhancing mass in the left hemithorax with well-circumscribed smooth margins. Patient was transferred to the surgical ward where a left-sided thoracotomy and left lower lobectomy was performed. Histopathology confirmed the diagnosis of  pulmonary synovial sarcoma. Post-operatively, she received adjuvant external beam radiotherapy and remains well at 6 months follow-up.

 Interferon based antiviral therapy is known to have many side effects, the commonest being myalgia, fever and psychiatric problems, while the rare ones include myositis and visual changes. We report a case of a patient with chronic hepatitis C who was started on pegylated interferon and ribavirin. After four months of antiviral therapy, treatment was stopped because the patient developed proximal myopathy that lead to severe functional disability. All possible causes of proximal myopathy were excluded. After three months of stopping the treatment, a gradual improvement was noted.

The described case deals with a relatively large dentigerous cyst in the area of left canine teeth of the mandible in a fourteen-year-old boy. Dentigerous cysts usually arise from the epithelial sac that surrounds the crown of the unerrupted third molar tooth, but very rarely involve the crown of other teeth like the mandibular canine in this case. Total enucleation of dentigerous cyst involving the tooth germ was performed after creating a window in the bone overlying the cyst, thus preventing defect in the mandible.

Antithyroid drug therapy with propylthiouracil (PTU) is commonly used in patients with Grave’s disease. Common side effects of PTU include leukopenia, agranulocytosis, skin rash and abnormal liver function tests. Rarely, it can induce anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis which is a serious adverse effect during PTU therapy for Grave’s disease. Withdrawal of PTU and the administration of corticosteroids ameliorates these manifestations. A case of propylthiouracil induced vasculitis is being reported here.

Pleomorphic liposarcoma of the scapula is one of the rarest entities occurring in a young adult female. We present a case of a 28-year-old female who presented with a large growing mass on the right scapula. Computed tomography and magnetic resonance imaging showed local invasion by the mass. Wide excision followed by adjuvant radiotherapy was done to treat the tumor successfully. A thorough histological analysis of all soft tissue masses should be done along with prompt diagnosis and intervention which can change the prognosis of this rare disease.

Mesonephric cysts are vestigial remnants of the Wolffian duct in female patients. While most of the mesonephric ducts degenerate, some remnants may persist in the mesovarium where they form the epophoron and paroophoron. The mesonephric cysts (Gartner duct cysts) are seen in 1-2% of the women. Diagnosis is usually made with pelvic examination. Treatment is with surgical excision.

BACKGROUND: Gender differences in mental health are not well-researched in Gilgit-Baltistan (GB), Pakistan. The present study was conducted to compare the gender differences in mental health in GB, high summit region of the three highest mountain ranges in Pakistan.

 METHODS: In this study, 408 participants (194 males) were recruited from the outpatient departments of the district headquarter hospitals who presented with various physical complaints. Structured interviews were conducted individually using a translated version of the Mental Health Inventory.

 RESULTS: Statistically significant gender differences were found in mental health and psychological distress. Female participants reported higher level of anxiety, depression, and loss of behavioral and emotional control as compared to male participants. However, there were no gender differences in general positive affect, emotional ties, and life satisfaction.

CONCLUSION: We found that women in GB, Pakistan have lower mental health with higher psychological distress as compared to men but have equal psychological well-being.

BACKGROUND: The aim of this study was to examine the influence of pre-examination intimation and counseling of women with urinary incontinence on physical and psychological discomforts during urodynamic assessment.

 METHODS: One hundred fifty-two women with urinary incontinence, who underwent urodynamic assessment, were studied prospectively. A questionnaire survey was used to study their awareness about the nature of the assessment, extent of physical discomfort, mental stress, and the pain level during the assessments and to determine if pre-examination counseling had any effect on the level of pain or distress.

RESULTS: Most patients felt that the urodynamic examination was important, but noted lack of detailed information. Although the patients were anxious, most were not in distress. There was no correlation between prior information and the extent of pain or distress. However, older women reported less pain during the procedure compared to the younger women. The results also indicated that the patients were comfortable with familiar doctors, and that most preferred a female doctor.

CONCLUSION: Our findings confirm the importance of pre-examination counseling in women before undergoing urodynamic examination to minimize the symptoms of anxiety and shame, which may indirectly result in fewer artefacts and better interpretation of the results.