A 24-year-old unmarried woman had undergone laparoscopic myomectomy for single degenerated myoma of size 15 cm. Uncontained morcellation of the myoma was done with an electromechanical morcellator. Two years later, she presented with abdominal pain, and laparoscopy revealed enlarged uterus (20 weeks) with multiple degenerated myomas. There were multiple parasitic myomas measuring 1–3 cm in the pelvis and anterior abdominal wall which were removed laparoscopically. Histopathology of all the myomas including parasitic myomas confirmed the diagnosis of leiomyoma. The formation of parasitic myomas was assumed to be due to the myomatous fragments which were left behind during morcellation at the time of initial myomectomy. Methods to prevent this complication are colpotomy, mini-laparotomy, or in-bag morcellation.
Two hundred and fifty-four patients with post-operative pain following closed reduction of fractured long bones completed a double-blind study of dipyrone and aspirin. Compared with placebo both active treatments produced significant relief of pain, which was apparent 30 minutes after ingestion and was maintained for the 6-hour duration of the study. Dipyrone 500 mg produced significantly greater pain relief than aspirin 500 mg. Both drugs were generally well tolerated.
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