Steroid cell tumors (SCTs) of the ovary are a rare subgroup of sex cord tumors that account for less than 0.1% of all ovarian tumors. These tumors can produce steroids, especially testosterone, which produces symptoms such as hirsutism, amenorrhea/oligomenorrhea, and male patterned voice. For evaluation of the androgen excess, testosterone and dehydroepiandrosterone sulfate (DHEA-S) are the first laboratory tests to be measured. Abdominal ultrasound and magnetic resonance imaging (MRI) are useful radiologic imaging techniques. Although SCTs are generally benign, the risk of malignant transformation is always present. Surgical excision of tumor is the most important and hallmark treatment. The present case signifies the early preoperative diagnosis of a virilizing SCT, based on cytological features and its careful correlation with clinicopathological and radiological findings.
Background: Anaemia is the most common problems encountered by clinicians in Hadoti Region. The affected population includes male, female as well as children. Over the last two decades, it has been found that incidence of megaloblastic anaemia is increasing. Folic Acid and Vitamin B12 deficiency are the most common cause of megaloblastic anemia. Of these two micronutrients, Vitamin B12 deficiency is more common now, due to vegetarian life style of people. At present, Anemia control or prophylaxis program give only Iron and Folic acid. This study has been chosen to focus on this issue. The cases for increasing incidences of Folate / Vit. B12 deficiency needs to be elucidated.Objectives: To focus on the incidence of megaloblastic anaemia in Hadoti Region. & Probable Causative factors will be analysed Methods: All patients presenting to our hospital over a period of 2 months with a haemoglobin <10 g/dl and peripheral smear findings consistent with megaloblastic anaemia will be included in the study. Diet, drug intake, previous blood transfusion, presenting symptoms and other relevant history will be taken into consideration. Complete blood counts, peripheral film examination, reticulocyte count and cobalamin and folate assays will be recorded. Patients with chronic disease like renal disease, cancer, tuberculosis, liver disease etc will be excluded from the study. All data will be collected and evaluated statistically.
Result:In the present study, total 500 patients who were admitted in medicine, paediatric and gynaecology ward were evaluated. All these patients met the inclusion criteria. Depending on the MCV value, serum assay and peripheral smear finding, they were categorised into 3 groups-Macrocytic, normocytic and microcytic anaemia. The normal MCV value but with megaloblastic blood film or low serum markers were considered into macrocytic anaemia. Total 100 patients were diagnosed as macrocytic anaemia. The sex distribution were-70(male), 30(female). Fifty five per cent of patients with cobalamin deficiency and 08% of patients with folate deficiency were found. All the patients were vegetarian and from middle class and low socio economic group.
Conclusion:Cobalamin deficiency was responsible for megaloblastic anaemia in the majority of our patients. The supplementation program for Anemia control and prophylaxis should vary according to the regional requirements. Vitamin B12 should be included in the nutritional programme along with iron and folic acid. Awareness camp and Education program about megaloblastic anemia can be implemented for the prevention.
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