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In your experience, what is the biggest barrier to effective diabetes management in India?

Fibroid uterus *Chief Complaints* Noticing mass per abdomen. Heavy menstrual bleeding *History* 45 year old para 2 previous 2 normal vaginal deliveries presented with history of heavy menstrual bleeding for 6 months with usage of 7-8 pads/ day and passage of clots . Also she had complaints of noticing mass in lower abdomen. Patient complaint of generalised weakness, lassitude, fatiguebility. *Vitals* Pulse 106/ min. BP 124/90 mmHg *Physical Examination* Per abdomen examination revealed uterus irregularly enlarged to 20 weeks size of Gravid uterus with multiple fibroids. Mobile from side to side. No tenderness Per vaginal examination cervix long os parous and uterus enlarged with multiple fibroids palpable *Investigations* Patient had severe anemia HB of 6 gm % she had received blood so now hb was 10 gm% Ultrasound revealed multiple fibroids indenting the endometrium *Diagnosis* Multiple fibroids in uterus *Management* Patient underwent hysterectomy. OT findings were uterus irregularly enlarged to 20 weeks size with fibroids. Bilateral fallopian tubes and ovaries normal Patient is fine post op

Osteoarthritis (OA) is one of the most common forms of arthritis and is a leading cause of disability, especially among older adults. 10-15% of people over 60 years old are affected by OA & it represents a significant public health concern due to the large aging population and increasing prevalence of risk factors like obesity, physical inactivity, and urbanization. Check few facts about OA and share your opinion.

A woman age 59 having complain of whitsince 4 month history of lower abdominal pain Having no history of hypertension, diabetes mellitus , asthma and TB *Chief Complaints* Lower abdominal pain with bleeding *History* History of lower abdominal pain since 1 year *Vitals* BP -130/80mm of Hg SpO2- 99% Pulse - 100 beat per min *Physical Examination* Pervaginal examination Uterus size 12 wt Bleeding Growth felt

OCST is a condition in which a fistulous tract forms between the skin and an infected tooth or its surrounding structures. The infection typically originates from a dental abscess or a chronic infection in the tooth or its supporting structures. Read more about it..