Rheumatism

Banning cigarette smoking in public places in India has had some positive effects, but it has not been as effective as expected in reducing smoking rates. What do you believe is the main reason the ban has not achieved its full potential?

F.13 yrs. Findings & Diagnosis Please. MCU.

Cervical Fibroid Polyp with Cystic Degeneration *Chief Complaints* Infertility *History* 28 year old patient...married for 2 years presented to Our OPD with history of inability to conceive. Patient gave history of mass coming out per vaginum since 6 months. The mass used to reposit on itself on lying down. No history of intermenstrual bleeding. No history any menstrual irregularities. *Vitals* Vitals were stable. Pulse 80/ min. BP 116/ 80 mmHg. *Physical Examination* Per abdomen- soft non tender. No mass palpable. Per speculum examination revealed 9*9 cm polyp occupying full of vagina. It was difficult to make out whether it was fibroid polyp or uterine inversion. Probe test was not possible. On per vaginal examination polyp was 9*9 cm and uterus was felt separately and was normal size. Origin of the polyp was difficult to make out. *Investigations* Ultrasound done revealed uterus normal size with 8 mm endometrial thickness and mass in vagina with cystic areas within with a stalk on anterior lip of cervix. *Diagnosis* Cervical Fobroid Polyp With Cystic Degeneration. *Management* Patient was taken for examination under anaesthesia followed by cervical Fibroid polypectomy. Cervical fibroid polyp had undergone cystic degeneration with locules filled with whitish colored fluid.

F.47yrs. Slowly growing soft tissue swelling at posterior part of left ankle. Pain at moving joint. 3 months

M.ch.11yrs Limping right.