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Objective Dysmenorrhea is the most important cause of chronic pelvic pain in women. Sometimes, dysmenorrhea can be severe enough, leading women to present to emergency departments. The aim of this study was to investigate factors affecting dysmenorrhea in female patients who presented to the emergency department of our hospital. Methods Female patients who presented to our emergency department with dysmenorrhea between January 2012 and January 2014 were included in the study. Patients' demographic and clinical data were filled in the Dysmenorrhea Data Form, which was designed by the researcher by screening the relevant literature. Patients' age, educational status, smoking status, age and regularity of menarche, sexual activity, and age of dysmenorrhea onset were recorded and analyzed. Results The mean age of the patients was 21.80 ± 3.75 years. There was a significant correlation between the type of dysmenorrhea and sexual activity (p=0.001). There was a statistically significant difference between age at menarche and age of dysmenorrhea onset (p less then 0.001). Absenteeism was less common in patients with an age of dysmenorrhea onset of less then 12 years compared with the other age groups (p less then 0.05). Conclusions There was a significant correlation between age at menarche and age of dysmenorrhea onset. Data obtained in this study could be used in developing educational programs on dysmenorrhea for adolescents at the age of menarche.Polycystic liver disease (PCLD) is a rare condition that most often occurs in patients with polycystic kidney disease and less commonly as an isolated liver disease. Complications include cyst rupture, infection, hemorrhage, and compression of surrounding organs by large cysts. We present the case of a patient with a history of PCLD who presented to our hospital with palpitations and was found to have atrial fibrillation. Imaging and echocardiograph revealed a dominant large cyst compressing the right atrium. Other etiologies including thyroid disease, ischemic heart disease, and electrolytes abnormalities were excluded. The patient refused surgical intervention and was conservatively treated with rate control and anticoagulation. To the best of our knowledge, this is the first case of new-onset atrial fibrillation secondary to right atrial compression by a liver cyst. Compression of cardiac chambers resulting in new-onset arrhythmia should be considered when evaluating patients with PCLD.The urachus is a remnant of the embryonic allantois that connects the urinary bladder to the umbilicus. In most cases, it commonly obliterates before birth. Here we present the case of a 60-year-old man with a past medical history of human immunodeficiency virus (HIV) and anal human papillomavirus (HPV). He was referred for an abdominal mass that had been found incidentally while being admitted for an acute kidney injury; it had been excised, and pathological examination showed urachal mucinous cystadenocarcinoma. Surgical excision is performed for the majority of cases with a higher survival rate when diagnosed early.A 93-year-old woman on Coumadin with history of atrial fibrillation and chronic obstructive pulmonary disease (COPD) presented with urinary retention for one day. Computed tomography (CT) of abdomen and pelvis demonstrated grade 3 rectus sheath hematoma (RSH), with the hematoma dissecting between the transversalis fascia and muscle into the prevesical space. The large-sized hematoma caused compression at the bladder outflow tract causing urinary retention. In view of age and the patient being a poor surgical candidate, the patient was managed by percutaneous drain of the hematoma to reduce size to relieve urinary symptoms. The hematoma shrunk in size over the period of next few weeks and thereby avoided surgical intervention.Unintentional ingestion of fish bones is a common but frequently unrecognized occurrence at the emergency room. Most ingested fish bones pass through the gastrointestinal tract without complications, but approximately 1% may perforate and cause acute abdomen, peritonitis and/or abscesses, requiring emergent surgery. Clinical presentation is non-specific and computed tomography is essential to confirm the diagnosis and guide the surgery. We present a case of gastric perforation by fish bone and discuss the clinical and radiological challenges in the diagnosis of this condition.Ganglion cysts are benign cystic lesions that are lined by a synovium and are filled with a gelatinous mucoid material. Ganglion cysts are most commonly located in the hand and the wrist. We present a rare case report of a 45-year-old male with a recurrent intramuscular ganglion cyst in the peroneus longus for two years. The patient underwent drainage one year back, but the swelling recurred one month after surgery. Magnetic resonance imaging showed a delineated, round, lobulated fluid collection consistent with the appearance of a ganglion cyst that was present within the proximal part of peroneus longus. MDMX inhibitor Surgical exploration revealed an encapsulated mass present within the peroneus longus muscle belly. The complete excision of the ganglion cyst was performed, and the diagnosis was confirmed by histology. Postoperatively, at a two-month and six-month follow-up, he was completely asymptomatic with no recurrence and a normal neurological function. Ganglion, which arises from the peroneus longus muscle or tendon, presents with swelling over the lateral aspect of leg due to compression of the common peroneal nerve. Careful preservation of the nerve with complete ganglion excision gives excellent results.Clozapine induced gastrointestinal hypomotility (CIGH) has been suggested as one of the most common causes of significant morbidity and mortality. It commonly presents as constipation, but the reports of other small or large intestinal complications with fatal outcomes are not uncommon. Hereby, we report the case of a 24-year-old male, suffering from schizophrenia and being managed with clozapine, who developed symptoms of acute intestinal obstruction due to ceco-colic volvulus. Subsequently, he was found to have intestinal malrotation at emergency laparotomy and underwent de-rotation of cecal volvulus and right hemicolectomy. He did well in the postoperative period and afterwards. Cecal volvulus which in itself is a rare cause of intestinal obstruction in adults has not been observed consequent to clozapine treatment and required surgical therapy.
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