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Analysis of the Diagnosis and Treatment of Recurrent Rupture and Hemorrhage of Ovarian Corpus Luteum Cyst Induced by Imatinib
Huan Xia,
Weiwei Huang,
Yang Song,
Wenying Liu,
Huajuan Dong,
Li Qiu,
Jiming Chen
Issue:
Volume 9, Issue 4, July 2021
Pages:
100-103
Received:
11 June 2021
Accepted:
5 July 2021
Published:
10 July 2021
Abstract: Objective: Rupture and hemorrhage of corpus luteum cyst is one of the common acute abdominal diseases in gynecology, which occurs in the middle and late menstrual cycle, and is often seen in women of childbearing age, often under the inducement of exercise and sexual life. There are few reports about drug-induced rupture and hemorrhage of corpus luteum cyst. Chronic myeloid leukemia (CML) is a common hematological disease and a chronic clonal myeloproliferative disease. Imatinib is a first-line drug for the treatment of chronic myeloid leukemia, and its efficacy and safety have been widely recognized, but there are still some adverse reactions. Among them, it is rare that the drug causes ovarian corpus luteum rupture and bleeding. In our clinical work, we just treated a patient with recurrent ovarian luteal cyst rupture and bleeding from imatinib, and followed up the whole course of the patient's pathogenesis, diagnosis and treatment effect. Therefore, this paper analyzes the clinical data and treatment of the case, in order to improve the clinical understanding and treatment of recurrent ovarian luteal cyst rupture and hemorrhage induced by imatinib. Methods: The clinical data and treatment of 1 case of recurrent ovarian corpus luteum cyst rupture bleeding from imatinib were analyzed, and the therapeutic effect was followed up. Results: Imatinib led to 6 times of corpus luteum rupture bleeding, which were successfully treated with conservative treatment. After taking Diane-35, the patient did not have corpus luteum rupture bleeding once again. And no adverse drug reactions. Conclusion: Imatinib can cause recurrent ovarian luteal cyst rupture and bleeding, conservative treatment is often effective. Diane-35 can effectively prevent and treat recurrent ovarian luteal cyst rupture and bleeding induced by imatinib. And the incidence of adverse drug reactions was low. But the specific mechanism that imatinib causes rupture of recurrent ovarian luteal cyst is unclear.
Abstract: Objective: Rupture and hemorrhage of corpus luteum cyst is one of the common acute abdominal diseases in gynecology, which occurs in the middle and late menstrual cycle, and is often seen in women of childbearing age, often under the inducement of exercise and sexual life. There are few reports about drug-induced rupture and hemorrhage of corpus lu...
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Epidemiological and Anatomopathological Characteristics of Breast Tumors in Young Women in Cotonou in the Republic of Benin from 2015 to 2019
Dangbemey Djima Patrice,
Ogoudjobi Mathieu,
Aboubakar Moufalilou,
Gnangnon Freddy,
Azonbakin Simon,
Tognifode Veronique,
Lokossou Symphorose,
Hounmenou Ulysse,
Tshabu-Aguemon Christiane,
Hounkpatin Benjamin,
Tonato-Bagnan Josiane,
Denakpo Justin Lewis
Issue:
Volume 9, Issue 4, July 2021
Pages:
104-111
Received:
26 June 2021
Accepted:
12 July 2021
Published:
23 July 2021
Abstract: Objective: Study the epidemiological and anatomopathological characteristics of breast tumors of young woman. Patients and Methods: This was a retrospective and evaluative cross-sectional study of patients treated for a breast tumor between January 1, 2015 and December 31, 2019 in two hospitals in Cotonou. All the complete files of patients under the age of 40 treated for breast tumors of whatever nature were listed. The patients were recalled for clinical and / or radiological evaluation. The epidemiological and histological characteristics of breast tumors were analyzed. Results: The study involved 231 breast tumors including 12 cancers (5.2%) and 219 benign tumors (94.8%). The mean age of the patients was 25.7 years±7.2. Self-examination was the most common discovery (81%). The average consultation time was 6.4 months. The right breast and the upper-external quadrant were the most affected in 53% and 31.1%, respectively. Fibroadenomas (70.7%) and invasive ductal carcinomas (9/12) were the most frequent. Obesity and a family history of breast cancer were associated with the occurrence of breast cancer in young women (p ≤ 5%). The relative risk of developing breast cancer was practically zero before the age of 30. Benign breast tumors spontaneously regressed in part or in whole in 35.3% of cases (n=55), they were stable in 44.8% of cases (n=70) and increased in volume in 19.8% of cases (n=31). The age of diagnosis strongly influenced the evolution of tumors in the young woman in Cotonou (p=0.02). In 56% of cases, breast tumors diagnosed before the age of 20 spontaneously resolved in part and in whole. The breast cancer case fatality in women under 40 was 11.1%. Conclusion: Breast tumors in young women are mostly benign. More than half of these tumors diagnosed before the age of 20 resolve spontaneously. The risk of breast cancer is virtually zero before the age of 30 in our series.
Abstract: Objective: Study the epidemiological and anatomopathological characteristics of breast tumors of young woman. Patients and Methods: This was a retrospective and evaluative cross-sectional study of patients treated for a breast tumor between January 1, 2015 and December 31, 2019 in two hospitals in Cotonou. All the complete files of patients under t...
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Outcome of Myomectomy for Urinary Complications During the Second Trimenon of Pregnancy: 2 Cases Reports at the University Teaching Hospital of Angre / Abidjan
Koffi Soh Victor,
Adjoby Roland,
Effoh Ndrin Denis,
Kouakou-Kouraogo Ramata,
Akobé Privat,
Soumahoro Zingbe Gondo,
Loba Okoin Paul José,
Gbary-Lagaud Eléonore
Issue:
Volume 9, Issue 4, July 2021
Pages:
112-115
Received:
14 July 2021
Accepted:
24 July 2021
Published:
2 August 2021
Abstract: Uterine myomas are observed in about 3-12% of pregnant women. These uterine fibroids can affect the outcome of pregnancy. There is an increased risk of spontaneous abortion, irregular fetal presentation, aseptic necrosis, placenta previa, premature birth, caesarean section, peripartum hemorrhage and also compression of nearby organs. Although myomectomy during pregnancy is not recommended, some emergency situations lead to retain this surgical indication. The authors report 2 cases of voluminous uterine myomas (FIGO type VI) that caused mechanical compression of the urinary tract with ureterohydronephrosis during the second trimenon of pregnancy. In our first clinical observation, the presence of fibroid was associated with severe bilateral ureterohydronephrosis, myomectomy was essential before the evolutionary risk towards renal failure. In our reported second case, there was no pain but acute retention of urine that required bladder catheterization. This retention was associated with sub-occlusive symptoms with stopping the materials for two weeks without gas. They benefited from a laparotomic myomectomy before term, with a favourable outcome for the mother and the child. The myomectomy during pregnancy remains exceptional and the evolutionary modalities are unpredictable with an increased risk of haemorrhage which can darken the obstetric prognosis, or even the vital one of the mother-child couple. Close prenatal monitoring is still necessary after the myomectomy.
Abstract: Uterine myomas are observed in about 3-12% of pregnant women. These uterine fibroids can affect the outcome of pregnancy. There is an increased risk of spontaneous abortion, irregular fetal presentation, aseptic necrosis, placenta previa, premature birth, caesarean section, peripartum hemorrhage and also compression of nearby organs. Although myome...
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Colposcopic Evaluation of Clinically Unhealthy Cervix
Khaleda Akter,
Shaikh Zinnat Ara Nasreen,
Daharul Islam,
Sakhawat Hossain
Issue:
Volume 9, Issue 4, July 2021
Pages:
116-119
Received:
22 March 2021
Accepted:
12 April 2021
Published:
18 August 2021
Abstract: Cervical cancer is the commonest malignancy found amongst Bangladeshi women and the third most common cancer in the world. New cases of invasive cervical cancer are diagnosed over 5,00,000 annually worldwide. For Cervical Intra-Epithelial Neoplasia (CIN) and for invasive cancer of the uterine cervix, Papanicolaou’s (Pap) smear is the primary screening tool. The Pap smear accuracy, which was recently assumed found to be 80% to 95% for detecting CIN and early invasive cancer, was questioned. Colposcopy and directed biopsy are needed to clarify the clinically unhealthy cervix in women. This study was conducted to evaluate the role of colposcopy in identifying. The aim of the study was to assess the role of colposcopy of the unhealthy cervix to localize the lesions and to obtain biopsies from the selected areas. This prospective observational study conducted from January 2016 to December 2016 in the Department of Obstetrics and Gynaecology, Sikder Medical College, Dhaka including 104 patients who were aged between 25-65 years with clinically unhealthy cervix, were exposed to a colposcopic evaluation. All the patients underwent colposcopic-directed biopsies. The biopsies were taken from the act white areas and the iodine negative areas. Among 104 patients, 49 (47.1%) were in the age group of 25-34 years. In the parity, 97 (93.3%) 0-4 child, 61 (58.7%) were married before 18 years of age. 17 (16.35%) had normal colposcopic findings. The colposcopic evaluation and the guided biopsy were successful in detecting abnormalities in 26 out of 31 cases. The incidence of CIN 1 and CIN2, 3 were found colposcopically and histologically 33.65%, 24.04%, and 11.54%, respectively. In the present study, the sensitivity of colposcopy was 83.33%. Both the neoplastic and the non-neo-plastic ones, colposcopy was found to be useful in understanding the morphology of the cervical lesions and this would very helpful in planning their management in the future.
Abstract: Cervical cancer is the commonest malignancy found amongst Bangladeshi women and the third most common cancer in the world. New cases of invasive cervical cancer are diagnosed over 5,00,000 annually worldwide. For Cervical Intra-Epithelial Neoplasia (CIN) and for invasive cancer of the uterine cervix, Papanicolaou’s (Pap) smear is the primary screen...
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Ethical Dilemmas Related to Foetal Diagnosis and Foetocide
Issue:
Volume 9, Issue 4, July 2021
Pages:
120-124
Received:
20 July 2021
Accepted:
5 August 2021
Published:
18 August 2021
Abstract: Ethics is an essential dimension of obstetrics and gynaecology and helps balance beneficence and autonomy-based obligations with professional conscience ensuring respect for the pregnant woman’s autonomy. The Law defines what can be offered in our country and guides the obstetrician as well as the parents. In South Africa termination of pregnancy is legal. A woman can request termination of her pregnancy up until 12weeks if she chooses so. The South African law allows termination of a pregnancy up to 20weeks and beyond 20weeks if there are significant reasons for this to be requested or offered. The question of what foetal abnormalities are considered significant and therefore should be considered for termination has led to ongoing discussions and debates in various levels of medical and legal societies. The obstetrician has the right to exercise his or her own autonomy in dealing with these situations. Exercise of autonomy by a patient cannot justifiably oblige a physician to act in a way that is unacceptable as a matter of his/her individual conscience. Citing case laws, the Courts in the country are asked to decide on “wrongful birth”- which would require a Court to determine whether a child should have been born. The South African Constitutional Court in a recent ruling determined that "this goes to the heart of what it is to be human, something that should not be asked of the law". Medical and legal societies need to work together and help guide our doctors, our patients and society as to what is ethical and acceptable practice in complex situations where children’s genetic and structural abnormalities alone perhaps should not decide their entire destiny.
Abstract: Ethics is an essential dimension of obstetrics and gynaecology and helps balance beneficence and autonomy-based obligations with professional conscience ensuring respect for the pregnant woman’s autonomy. The Law defines what can be offered in our country and guides the obstetrician as well as the parents. In South Africa termination of pregnancy i...
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Ruptured Interstitial Ectopic Pregnancy at 18 Weeks: How Failure of Early Detection Resulted in a Maternal Near-miss
David Putiero Suoseg,
Anwar Sadat Seidu,
Ubeida Koray,
Safia Iddrisu,
Munkaila Mohammed,
Shafawu Mustapha Baba,
Abraham Babatuiamu Titigah,
Ana Maria Simono Charadan
Issue:
Volume 9, Issue 4, July 2021
Pages:
125-127
Received:
6 August 2021
Accepted:
19 August 2021
Published:
27 August 2021
Abstract: Interstitial ectopic pregnancy occurs when a gestational sac implants within the interstitial portion of the Fallopian tube. It is an uncommon and dangerous type of ectopic pregnancy with high morbidity and mortality. Rupture of interstitial ectopic pregnancy usually leads to life-threatening hemorrhage. This case report illustrates how failure of early detection of interstitial ectopic pregnancy resulted in a maternal near-miss and calls for the need for increased awareness and high index of suspicion among sonographers and clinicians. A case of a 24-year-old gravida two para zero, one previous ectopic pregnancy (G2P01EP) was brought into our facility with generalized abdominal pain and hemorrhagic shock. She had a previous history of left salpingectomy for a ruptured tubal ectopic pregnancy four years earlier at a secondary health care facility. Emergency laparotomy after aggressive resuscitation revealed ruptured interstitial ectopic pregnancy with massive hemoperitoneum and a dead fetus. Wedge resection of the right cornua along with the Fallopian tube was done. Diagnosis of interstitial ectopic pregnancy is challenging due to its rarity and location in the intrauterine portion of the Fallopian tube. Ultrasonographic diagnosis in early pregnancy is key. Awareness creation and a high index of suspicion is required among sonographers and clinicians to prevent needless morbidity and mortality.
Abstract: Interstitial ectopic pregnancy occurs when a gestational sac implants within the interstitial portion of the Fallopian tube. It is an uncommon and dangerous type of ectopic pregnancy with high morbidity and mortality. Rupture of interstitial ectopic pregnancy usually leads to life-threatening hemorrhage. This case report illustrates how failure of ...
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A Rare Arthrogryposis Syndrome with Multiple Anomalies Diagnosed by Whole Exome Sequencing
Audrey Rae Norby,
Caitlin Madden Clifford,
Deborah Rose Berman
Issue:
Volume 9, Issue 4, July 2021
Pages:
128-131
Received:
24 May 2021
Accepted:
29 June 2021
Published:
31 August 2021
Abstract: A 31-year-old gravida 1 para 0 was referred to our institution following a fetal anatomic survey demonstrating clubbed feet, flexed wrists, and skin edema. Ultrasound evaluation demonstrated these findings in addition to hemivertebrae, short long bones, contractures of the elbows, wrists, knees, and ankles with limited movement at the shoulders and hips. Further, macrocephaly, microphthalmia, low set ears, micrognathia, hepatomegaly, and an omphalocele were noted. Following termination of the pregnancy, whole exome sequencing ultimately identified compound heterozygous mutations in the NEK9 gene. One mutation in our case, c.136G>T, has never been reported; the other, c.1432del, has been reported once. To date, NEK9 mutations have been documented in three families with all affected individuals diagnosed with arthrogryposis. Our patient underwent targeted gene variant testing in two subsequent pregnancies, confirming identification of one of the two familial NEK9 gene mutations each time. Both pregnancies culminated in term deliveries of healthy neonates. This case illustrates a diagnosis of an extremely rare single gene disorder in the pregnancy of a non-consanguineous German couple, providing further evidence toward arthrogryposis with other anomalies as a recessive disease associated with NEK9 gene mutations. Finally, this case demonstrates whole exome sequencing as a valuable adjunct tool for investigating etiology when multiple fetal anomalies are identified without diagnosis on more standard tests.
Abstract: A 31-year-old gravida 1 para 0 was referred to our institution following a fetal anatomic survey demonstrating clubbed feet, flexed wrists, and skin edema. Ultrasound evaluation demonstrated these findings in addition to hemivertebrae, short long bones, contractures of the elbows, wrists, knees, and ankles with limited movement at the shoulders and...
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SYCFIM, Clinical Study in Patients with Stress Urinary Incontinence, Urgency and Mixed
Oscar Raúl Muñoz Ángel,
Miguel Ángel Gómez,
Cristian Mauricio Bedoya
Issue:
Volume 9, Issue 4, July 2021
Pages:
132-135
Received:
22 July 2021
Accepted:
16 August 2021
Published:
31 August 2021
Abstract: The history, evolution and treatment of urinary incontinence have relevant nuances, such as the establishment of world urinary incontinence day, among others. Large studies show the psychological condition of the women who suffer from it, the high state and personal economic expenses, the medical ignorance of the importance of this pathology, even reaching the environmental topic of contamination due to the exponential increase in the consumption of diapers. This article shows that the SYCFIM hysterectomy surgical technique achieves the curative treatment of patients with stress, urgency, and mixed urinary incontinence, on the basis that the surgical technique achieves the anatomical restoration of the urethral vesicle in its original position, achieving with this, the most important causes of these incontinences disappear. It was evidenced in this study that in the early postoperative control of the SYCFIM technique it achieved the disappearance of urinary incontinence in all patients, it was also observed that after a few years some patients reported the reappearance of incontinence in patients who stopped exercising Kegel, and in the patients who resumed Kegel exercise, incontinence disappeared again, establishing that this exercise is relevant in the treatment of urinary incontinence. A small group of patients who could not or did not want to do the Kegel exercise were provided with electrostimulation equipment that is used in physiatry, achieving a positive response to the disappearance of incontinence in all these patients. And an even smaller group of patients who presented stress incontinence and if they did the Kegel exercise (confirming their tonicity by vaginal touch), the SYCFIM exercise was established (which is Kegel, only that it is performed prior to events that generate increased abdominal pressure, that is, before sneezing or before coughing, sustained Kegel must be performed, thus avoiding urine leakage), also achieved the disappearance of incontinence with this management. The evaluations of the type of incontinence that the patient presents, the postoperative evolution of the presence or absence of incontinence, and its management with the Kegel exercise were carried out by a professional psychologist. The excellent results obtained with the SYCFIM technique for stress, urge and mixed incontinence, force the urology and gynecology guild to review the traditional technique, which could even be classified as iatrogenic, since it increases two and a half times the incidence of urinary incontinence.
Abstract: The history, evolution and treatment of urinary incontinence have relevant nuances, such as the establishment of world urinary incontinence day, among others. Large studies show the psychological condition of the women who suffer from it, the high state and personal economic expenses, the medical ignorance of the importance of this pathology, even ...
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An Unusual Case of Spontaneous Uterine Rupture After a Salpingectomy Following an Interstitial Ectopic Pregnancy
Koffi Soh Victor,
Kouakou-Kouraogo Ramata,
Loba Okoin Paul Jose,
Akobe Privat,
Konan Koffi Joachim,
Soro Ngolo Alassane,
Gbary-Lagaud Eleonore,
Adjoby Cassou Roland
Issue:
Volume 9, Issue 4, July 2021
Pages:
136-138
Received:
11 August 2021
Accepted:
26 August 2021
Published:
31 August 2021
Abstract: Spontaneous uterine rupture following a history of surgical treatment of an interstitial tubal ectopic pregnancy (EP) is a rare clinical form. This uterine rupture occurring after a wedge resection of the uterine horn, is a serious obstetric complication involving maternal and fetal vital prognosis and obstetric fate of patients in the absence of immediate management. Our observation concerned a 32-year-old gestant, G3P1 (without living children), with a history of interstitial EP dating back to 3 years during which a uterine wedge resection was performed. For this patient, a prophylactic caesarean was recommended between 36 and 37 weeks of amenorrhea. The patient presented during her prenatal follow-up at 37 weeks and 6 days, a complete uterine rupture involving the right uterine horn with the death of a fetus weighing 2900g. The rupture extended throughout the uterine horn, with the right uterine pedicle intact and the right fallopian tube absent. A conservative treatment of the uterus was decided since the patient had no living children. The purpose of our observation is to recall the risk of uterine rupture after cornual uterine excision hence the importance of performing during a EP if possible, a salpingectomy at the level of the uterine horn and if necessary coagulate the intramural portion of the tube. And also in case of uterine wedge resection, to hasten the prophylactic caesarean section as soon as sufficient maturity of the fetus to reduce the incidence of this pregnancy complication.
Abstract: Spontaneous uterine rupture following a history of surgical treatment of an interstitial tubal ectopic pregnancy (EP) is a rare clinical form. This uterine rupture occurring after a wedge resection of the uterine horn, is a serious obstetric complication involving maternal and fetal vital prognosis and obstetric fate of patients in the absence of i...
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