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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

Welcome to Weakly seminar

Dr. Shubha Prasad Das

Intern Doctor

Dept. of Gynaecology and Obstetrics


Particulars of the patient
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


Chief complaints
Chief complaints:

- Irregular menstruation with excessive bleeding for 2 years.

- Weakness


History of present illness
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.


History of past illness
History of past illness

  • She has no history of liver disease, thyroid disease, renal disease or bleeding disorders.


Menstrual history
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


Obstetrics history
Obstetrics History

Married for: 32 years

Para: 5(NVD)+2( IUD)

ALC: 13 years


Family history nothing contributory
Family History: Nothing contributory

Drug History:Nothing contributory

Socio-economic History: Poor

Contraceptive History: She don’t use any type of contraception.



Abdominal examination
Abdominal Examination:

  • Inspection: No abnormality seen


Palpation
Palpation:

  • Non tender

  • No mass detected

  • Temperature – not raised


Percussion
Percussion:

  • No fluid thrill or shifting dulness


Per vaginal examination
Per- vaginal examination:

  • Inspection: vulva- healthy

  • Speculum examination: vagina and cervix looks normal

  • Bimanual examination:

    - Uterus bulky

    - Fornices free

    - Ovaries normal


Investigations
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


Salient feature
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%.


Diagnosis
Diagnosis:

  • Clinically it appears to be a case of DUB


Differential diagnosis
Differential Diagnosis:

  • Adenomyosis

  • Fibroid Uterus


Treatment
Treatment :

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


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