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Unusual Multiple Recurrence of Lipschütz Ulcer of the Vulva in a Young Woman: Case Report and Review of the Literature
Carriero Carmine,
Schonauer Luca Maria,
Loverro Giuseppe
Issue:
Volume 3, Issue 6, November 2015
Pages:
107-110
Received:
30 September 2015
Accepted:
16 October 2015
Published:
28 October 2015
Abstract: Case: A case of 23-year-old woman, virgin, presenting a painful ulcerated vulvar lesion of the vestibular mucosa, with characteristics of Lipschütz ulcer, is reported. Lab tests showed no significant abnormalities, positivity for IgG of HSV1, rubeola, and VZV (with very high title: 2700 mUI/ml), positivity for EBV IgG of VCA and EBNA components and IgM negative (indicating a past infection serologic profile). A moderate insufficiency of Vitamin D was found. A treatment with topical antibiotics and oral antinflammatory drugs was planned and healing was complete without scars in less than 2 weeks. During a period of 6 months the lesion relapsed twice, with the same benign course of the first episode. DISCUSSION: such homogeneous clinical pattern is related to a heterogeneous etiologic spectrum, in which Epstein-Barr virus appears somehow prevalent, but not exclusive, as demonstrated by review of the literature. It is important to have well in mind this differential diagnosis, as Lipschütz ulcer may be overestimated and treated as for other more alarming causes of genital ulceration, with more complicated and unnecessary diagnostic and therapeutic procedures. These four points must be stressed: (1) Acute mononucleosis should always be in a clinician's differential diagnosis of Acute Genital Ulcer (AGU); (2) Failure to consider causes other than genital aphthosis (Behçet) or herpes may expose patients and their family to unnecessary investigations, treatments, and stress; (3) The symptoms of AGU are essentially nonspecific; (4) The physiopathology and aetiology of nonherpetic AGU still constitute broadly unexplored research fields in which further prospective clinical and microbiological studies are needed. Moreover, according to the findings of the reported case, a recurrent Lipschutz ulcer of the vulva in a young women could be related to Herpes Simplex or Varicella Zoster virus.
Abstract: Case: A case of 23-year-old woman, virgin, presenting a painful ulcerated vulvar lesion of the vestibular mucosa, with characteristics of Lipschütz ulcer, is reported. Lab tests showed no significant abnormalities, positivity for IgG of HSV1, rubeola, and VZV (with very high title: 2700 mUI/ml), positivity for EBV IgG of VCA and EBNA components and...
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The Balance of Matrix Metalloproteinase-2 (Mmp-2) and Tissue Inhibitor of Matrix Metalloproteinase-2 (Timp-2) on Severe Endometriosis
Samrichard Rambulangi,
Nusratuddin Abdullah,
Irawan Yusuf,
Syahrul Rauf
Issue:
Volume 3, Issue 6, November 2015
Pages:
111-114
Received:
2 November 2015
Accepted:
17 November 2015
Published:
10 December 2015
Abstract: The objective of this study is to examine the level balance of serum and peritoneal fluid MMP-2 and TIMP-2 in patients with severe endometriosis. The method of this study was a cross sectional study with twenty patients were diagnosed as severe endometriosis based on laparoscopy and laparotomy with five controls. Serum samples were taken before surgery, peritoneal fluid samples were taken during surgery, and MMP-2 and TIMP-2 examination was conducted in the end of the study by using ELISA method. The mean level of serum, peritoneal fluid MMP-2 and TIMP-2 were compared by using unpaired t-test. Based on this study, we found that MMP-2 level of serum and peritoneal fluid was significantly different in the case compared to the control, 5.848±3.016 vs. 1.600±0.063 ng/mL and 1.977±1.883 vs. 0.573±0.084 ng/mL respectively. When TIMP-2 level of serum and peritoneal fluid compared to the control, the significant difference was only found in serum (p < 0.05), 0.853±0.343 vs. 0.637±0.116 ng/mL and 1.339±2.141 vs. 0.105±0.028 ng/mL respectively. This study showed that there was an increase of MMP-2 level of serum and peritoneal fluid and low level of serum and peritoneal TIMP-2 in severe endometriosis. Serum and peritoneal fluid MMP-2 as well as TIMP-2 in serum had a significant relationship with the incidence of severe endometriosis. Meanwhile, TIMP-2 in peritoneal fluid had no significant relationship with the incidence of severe endometriosis.
Abstract: The objective of this study is to examine the level balance of serum and peritoneal fluid MMP-2 and TIMP-2 in patients with severe endometriosis. The method of this study was a cross sectional study with twenty patients were diagnosed as severe endometriosis based on laparoscopy and laparotomy with five controls. Serum samples were taken before sur...
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Children Born After Intracytoplasmic Sperm Injection Compared with Spontaneously Conceived Children a Prospective Study
Moez Kdous,
Jad Diari,
Fethi Zhioua,
Amel Zhioua
Issue:
Volume 3, Issue 6, November 2015
Pages:
115-120
Received:
8 October 2015
Accepted:
19 October 2015
Published:
30 December 2015
Abstract: Objective: To study the outcome of ICSI conceived children in our IVF center; their growth, their psychomotor development and to find out possible birth defects and genetic anomalies. Material and Methods: This is a prospective survey about ICSI conceived children and naturally conceived children in our IVF center over the period between 2007 and 2012. One hundred ICSI children aged between 2 and 6 years were invited in order to get a thorough physical examination and to undergo ultrasound imaging and genetic explorations for birth defects. One hundred naturally conceived children paired by age and sexduring the same period were taken as a control population. Results: The comparison of both ICSI and natural conception groups showed that the rate of prematurity was higher in the ICSI group with 50% vs 6% in the natural conception group, p<0.05.The rate of low birth weight was also higher in the ICSI group 35% vs 4% in the natural conception group, p<0,05. In the ICSI group, no child had slow growth or slow psychomotor development. 4% of the major birth defects were found in the ICSI group and 2% in the control group, the difference was not significant (p=0.52). These defects were essentially urogenital, orthopedic and facial. In both groups, the affected children were boys. The rate of minor birth defects found in the ICSI children is significantly higher than that in control group (23% vs 4%; p<0.05). These malformations were mainly facial, cardiac, gastrointestinal, orthopedic, neurological, urogenital and inguinal hernia type. In the ICSI group, there was a male predominance (sex ratio=1.3) without any significant difference, while in the control group there was no sex predominance. As for genetic anomalies, 3% of balanced genetic defects were detected in the ICSI children, 1% of which were in the sexual chromosomes and 2% in the autosomes. These anomalies were found in 2 boys and one girl without any significant difference. Conclusion: This work is greatly reassuring about the future of ICSI children. Larger series with long term follow-up are needed as an only guarantee in assessing the safety of ICSI technique.
Abstract: Objective: To study the outcome of ICSI conceived children in our IVF center; their growth, their psychomotor development and to find out possible birth defects and genetic anomalies. Material and Methods: This is a prospective survey about ICSI conceived children and naturally conceived children in our IVF center over the period between 2007 and 2...
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Risk Factors Associated with Group B Streptococcus Colonization and Their Effect on Pregnancy Outcome
Lucia Matsiane Lekala,
Rooyen Tinago Mavenyengwa,
Sylvester Rogers Moyo,
Sogolo Lucky Lebelo,
John Yenga Bolukaoto,
Martina Onyedi Chukwu,
Charles Maropeng Monyama,
Maphoshane Nchabeleng,
Tshimane Charles Tshepuwane,
Sam Monokoane
Issue:
Volume 3, Issue 6, November 2015
Pages:
121-128
Received:
12 November 2015
Accepted:
24 November 2015
Published:
30 December 2015
Abstract: Background: Group B Streptococcus (GBS) is an important cause of maternal and neonatal morbidity and mortality in many parts of the world. It has been implicated in adverse pregnancy outcomes. Maternal colonization has been found to be a major risk factor for invasive neonatal GBS disease. The main objective of this study was to identify the risk factors of Group B streptococcus colonization and its effect on pregnancy outcome. Methods: This was a prospective study in which pregnant women attending antenatal clinic (ANC) at Dr George Mukhari Hospital (DGMH) were recruited. These were at least18 years old and were at 16 weeks gestation. Vaginal and rectal swabs were taken at recruitment. Follow up of mothers until six weeks post-delivery and babies until three months of age was done. Results: A total of 340 pregnant women were then investigated for GBS colonization. Out of this number, 164 (48.2%) were GBS positive. The majority of the women (62.1%) were parity 1 and 2. Group B Streptococcus colonization was significant in women who had no matric education and who were unemployed. There was a significantly higher GBS colonization in women with previous history of miscarriages and stillbirths. The proportion of HIV positive, GBS colonized women was significant at 41.5% as compared to HIV negative GBS colonized (34.7%). Eight women (4.9%) presented with premature rupture of membranes (PROM) and the duration ranged from 0.5 to 72 hours. Ten (6.1%) women had preterm deliveries. Three (1.8%) women had wound sepsis post caesarean section and one (0.6%) had endometritis post vaginal delivery. A total of 7 (24.1%) babies were GBS positive. The number of live babies delivered was 167, with 1 case of miscarriage due to severe preeclampsia. There were 2 cases of early neonatal deaths which included 1 case of sepsis whereas the other one had multiple congenital abnormalities. Conclusion: Colonization by GBS in pregnant women at DGMH was high. Maternal risk factors identified were previous history of stillbirths/miscarriages, lack of education and being HIV positive. Overall pregnancy outcome both maternal and foetal was good.
Abstract: Background: Group B Streptococcus (GBS) is an important cause of maternal and neonatal morbidity and mortality in many parts of the world. It has been implicated in adverse pregnancy outcomes. Maternal colonization has been found to be a major risk factor for invasive neonatal GBS disease. The main objective of this study was to identify the risk f...
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