B/L PCOD

20 year old pt chief complain lower abdomen pain and gastritis. 6 day before pt feel severe pain in chest and take medicine from medical shop not a doctor advise. pt feel pyrexia,breathless during walking , laziness. past history-6 month before pt having cough and mild chest pain and feel pyrexia and take Rx many unregistered doctor. pt are not economical sound. sir/mam suggest dx and Rx.

60 year old woman with lower abdominal pain since 3 months and thickened endometrium

CRITERIA FOR DIAGNOSIS OF PI The clinical criteria for diagnosing pelvic inflammatory disease are as follows. MINIMUM CRITERIA : Any of these three criteria diagnose PID if no other cause can be found. 1.Uterine tenderness :Lower abdominal pain. 2.Adnexal tenderness:pain /tenderness when ovaries or fallopian tubes are touched or moved during examination. 3.Cervical movement tenderness:pain or tenderness when cervix is moved or touched during examination. ADDITIONAL CRITERIA THAT INCREASE THE LIKELIHOOD OF PID: 1.Abnormal green /yellow colored vaginal or cervical secretions. 2.Laboratory documentation of Neisseria gonorrhea or chlamydia . 3.Oral temperature of >>38°cor higher. 4.Presence of WBCs on saline microscopy of vaginal secretions. 5.Raised ESR. 6.Raised CRP. DEFINITIVE CRITERIA: 1.Endometrial biopsy with histopathological evidence of endometritis. 2.Transvaginal sonography / MRI showing thickened,fluid filled tubes-hydrosalpinx. free fluid in pelvis. Tubo-ovarian complex. 3.Doppler studies suggesting pelvic infection (tubal hyperaemia). 4.Laparoscopic abnormalities consistent with PID. Dont jump into conclusions of PID by just seeing free fluid in pelvis.Becoz it is a nonspecific finding. Take detailed history especially of sexual promiscuity and look for the above criteria.

A 36 yr unmarried female having lower abdominal pain with menstrual irregularities. USG report attached.. What will be management of this case. surgical or medical..??

A 52 y/o postmenopausal gravida 8, para 5, aborta 3 presented with a history of lower abdominal pain and distension for about 10 months. The patient's personal history revealed fatigue, loss of appetite, dyspnea and chronic constipation. LMP 1 year back and she had no post-menopausal bleeding. But her menstruation was 7-8 days of the 21-day menstrual cycle. On physical examination, an abdominopelvic mass with dullness on percussion - a solid mass was palpated. Abdominal tenderness was not present. Gynecologic examination revealed a large, mobile abdominopelvic mass with a normal external genitalia and uterine cervix. Lab tests normal except the Hb level, which was 8 g/dl.