scholarly journals Reproductive outcomes in women with hypogonadotrophic hypogonadism, a case series study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ahmed Elsayed Abdelaal ◽  
Mohamed Atef Behery ◽  
Ahmed Farouk Abdelkawi
Keyword(s):  
Hypogonadotropic Hypogonadism ◽  
Case Series ◽  
Rare Condition ◽  
Live Birth Rate ◽  
Serum Levels ◽  
Reproductive Outcomes ◽  
Miscarriage Rate ◽  
Hypogonadotrophic Hypogonadism ◽  
Case Series Study

Abstract Background Hypogonadotropic hypogonadism (HH) is a rare condition in which there is gonadal hypofunction due to absence of gonadotropin drive. In this condition, there are very low serum levels of gonadotropins. Pituitary gland may itself have some disease or disorder, or there may be loss of gonadotropin-releasing hormone (GnRH) pulses from the hypothalamus. The pharmacological interventions in HH women formed the basis for superovulation strategies for assisted reproduction techniques (ART) with a special reference to the role of LH and its impact on oocyte and embryo quality. Results The medians ±inter quartile ranges for number of oocytes retrieved, number of MII oocytes, and number of embryos transferred were 5±7, 4±3, and 3±1 respectively. The pregnancy rate was 31.5% for this group of patients. The live birth rate and miscarriage rate were 21% and 11.5% respectively. Conclusion The reproductive outcomes of patients of hypogonadotrophic hypogonadism are reasonable after ICSI and clinical trials are recommended to corroborate this concern.

scholarly journals Management of Pseudotumor Cerebri Secondary to Dural Venous Sinus Thrombosis in Children

2021 ◽  
Vol 3 (3(September-December)) ◽  
pp. e892021
Author(s):  
Mohamed M Elsherbini ◽  
Hatem Badr ◽  
Mohamed Kassem ◽  
Amr Farid Khalil
Keyword(s):  
Sinus Thrombosis ◽  
Case Series ◽  
Rare Condition ◽  
Pseudotumor Cerebri ◽  
Dural Sinus ◽  
Time Interval ◽  
Pediatric Clinic ◽  
Case Series Study ◽  
History Of ◽  
Csf Diversion

Background: The purpose of this study is to follow the clinical course and required management of children suffering from Pseudotumor cerebri (PTC) secondary to Dural Sinus Thrombosis (DST) to understand the natural history of a rare condition and its need for surgery as well as outcome after Cerebro-Spinal Fluid (CSF) diversion surgeries. Methods: A retrospective consecutive case series study based on examining medical records of patients who were referred to neurosurgical pediatric clinic  suffering from PTC secondary to DTS. Data review included patients’ archives for clinical, radiological, surgical records and follow up visits. Only patients below 18 years old were included. Results: Fourteen patients met inclusion criteria, 7 of them required CSF diversion procedure, while the other 50% responded to medical conservative therapy. Headache improved immediately for most of the surgical group, while took 7 weeks to reach satisfactory results for medical group. Visual improvement took place for both groups approximately at the same time interval with average 5 weeks. Conclusion: Surgical intervention in the form of CSF diversion procedure was required for 50 % of the patients, which is safe and effective line of treatment to prevent further deterioration of vision for case who were not responsive to medical therapy.

scholarly journals Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

2014 ◽  
Vol 2 (1) ◽  
pp. 9-14
Author(s):  
Sheikh Shawkat Kamal
Keyword(s):  
Middle Ear ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Retrospective Case ◽  
Middle Ear Mucosa ◽  
Case Series Study ◽  
Temporal Bones ◽  
Mastoid Antrum

Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum.Materials & Methods: Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27  ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes- assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum.Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum.Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

scholarly journals Role of clobetasol propionate 0.025% topical therapy in various dermatoses

2021 ◽  
Author(s):  
Vishalakshi Vishwanath ◽  
Arvind Chaudhary ◽  
Ankit Agarwal ◽  
Bhukya Jyothi ◽  
C. Chitharanjan ◽  
...  
Keyword(s):  
Topical Therapy ◽  
Case Series ◽  
Serum Levels ◽  
Hand Eczema ◽  
Clobetasol Propionate ◽  
Cream Formulation ◽  
Chronic Hand Eczema ◽  
Therapeutic Benefits ◽  
Skin Conditions

The anti-inflammatory and vasoconstrictive properties of topical corticosteroids (TCs) contribute in providing therapeutic benefits in several skin conditions, including atopic eczema, localized vitiligo, psoriasis, and chronic hand eczema. Clobetasol propionate (CP) is the most common topical agent used for psoriasis management and demonstrates an efficacy superior to other TCs. A new CP 0.025% cream formulation has demonstrated hypoallergenic effects due to the absence of known contact allergens, such as propylene glycol, short-chain alcohols, and sorbitol-based emulsifiers. Lower CP serum levels and less hypothalamic–pituitary–adrenal axis suppression with CP 0.025% cream formulation than with CP 0.05% ensure better safety. The present case series discusses the clinical experience of using CP 0.025% cream in various dermatological conditions.

scholarly journals Optimizing Management of Otophyma: A Case Series Highlighting the Role of Surgical and Retinoid Therapy

2020 ◽  
pp. 014556132094761
Author(s):  
Michela M. Paradiso ◽  
Benjamin H. Kaffenberger ◽  
Alexander N. Rock ◽  
Edward E. Dodson
Keyword(s):  
Clinical Decision Making ◽  
Case Series ◽  
Chronic Otitis Media ◽  
Rare Condition ◽  
Clinical Decision ◽  
Substantial Improvement ◽  
Functional Improvement ◽  
Successful Approach ◽  
Conductive Hearing

Otophyma is a rare condition that can result in conductive hearing loss. Current otophyma literature does not examine validated treatment outcomes for patients. Utilizing a medical and surgical approach to maintain a patent canal can lead to significant objective improvements. The aim of this case series is to describe a combined successful approach in 3 cases from an academic, multidisciplinary center. The main outcomes analyzed were pre and post air-bone gap audiogram analysis and disimpaction frequency. The results showed that post-management, patient 1 had substantial improvement in hearing, recovering 49 dB in his right ear and 25 dB in his left ear, demonstrating near complete air-bone gap closure. Patient 2 showed a similar dermatologic and functional improvement, although objective audiometric assessment related to otophyma could not be performed due to coexisting chronic otitis media and cholesteatoma. Patient 3, in the 12 months prior to comanagement, had 8 bilateral disimpactions, and following comanagement had 2 disimpactions in 23 months. All 3 patients were pleased with the resultant functional and physical appearance following comanagement. By presenting this approach and objective measures of treatment, we hope to improve future clinical decision-making in a rare condition.

scholarly journals Thyroglossal Duct Carcinoma: A Case Series and Approach to Management

2011 ◽  
Vol 3 (2) ◽  
pp. 59-63 ◽  
Author(s):  
MJ Paul ◽  
Rajiv C Michael ◽  
John Mathew Manipadam ◽  
Marie Therese Manipadam ◽  
Elsa Mary Thomas ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Case Series ◽  
Rare Condition ◽  
Needle Aspiration ◽  
Duct Carcinoma ◽  
Thyroglossal Duct ◽  
Atypical Cells ◽  
Thyroglossal Duct Carcinoma ◽  
Clinical Records

ABSTRACT Thyroglossal duct carcinoma (TGDC) is a rare disease with few reported series. No clear consensus exists regarding further management after adequate excision of the cyst, especially the role of total thyroidectomy and postoperative radioiodine therapy. We review our experience of nine cases and the literature to clarify the management of this rare condition. A retrospective study over a period of 10 years was performed using the clinical records from Christian Medical College, Vellore to identify patients with TGDC and to assess the frequency of cases with concomitant papillary carcinoma of the thyroid. The clinical presentation, fine needle aspiration cytology (FNAC), imaging, treatment and follow-up were analyzed. There were a total of nine cases of TGDC with five males. Imaging available in six patients detected a suspicious lesion in four cysts and three thyroid glands. Preoperative FNAC detected atypical cells in two of five cases. Thyroid carcinoma was seen in four (44.4%) after histopathological evaluation. Ultrasound of the neck and image-guided FNAC of the cyst may be adequate initial investigation for thyroglossal cysts. FNAC by itself is not a good investigation to diagnose TGDC as rate of false-negatives and inadequate specimens were high. Solid components and calcification on imaging were predictive of carcinoma within a thyroglossal cyst in 100% cases. All patients with TGDC may be offered total thyroidectomy as a simultaneous or staged procedure to address the high incidence of concomitant thyroid foci of cancer. The role of adjuvant therapy is still debatable.

The Role Of Shunt In The Norwood Procedure

2021 ◽  
Author(s):  
Nihat Çine ◽  
Fatih Yiğit ◽  
Ergin Arslanoğlu ◽  
Hakan Ceyran
Keyword(s):  
Right Ventricle ◽  
Clinical Outcomes ◽  
Case Series ◽  
Early Mortality ◽  
Long Term Results ◽  
Single Center ◽  
Case Series Study ◽  
Series Study

Objectives: In this study we observed that the effect of post-Norwood 3.5 mm modified BTS(mBTS and 5 mm right ventricle to pulmonary (Sano modification) shunt models on clinical outcomes. Patients and Methods: 54 patients who were operated in our hospital between 2011and 2020 years, were included in our study and this is a retrospective, observational, single-center case series study. Results: The effect of shunt type on mortality was statistically significant, and the rate of death was lower in patients who used SANO type shunts. (p <0.05) The effect of VISC score on early mortality was significant, and VISC score was higher in the group with exitus. (p <0.05). Conclusion: Although Sano shunt seems more preferred in Norwood, the experience of the surgeon and the center's experience may have led to variation in results at HLHS. Nevertheless, it will be clinically important for studies to evaluate the long-term results between the two shunt types.

Low Expression of FOXP2 is Associated with Better Prognosis in Glioblastoma.

2020 ◽  
Author(s):  
Julio Plata-Bello ◽  
Helga Fariña-Jerónimo ◽  
Isabel Betancor ◽  
Eduardo Salido
Keyword(s):  
Protein Level ◽  
Cox Regression ◽  
Statistical Tests ◽  
Case Series ◽  
Rank Test ◽  
Special Focus ◽  
Case Series Study ◽  
Worse Prognosis ◽  
Low Expression

Abstract FOXP2 expression has been associated with the prognosis of some tumors, but the role of FOXP2 in glioblastoma has not been studied in-depth until now. The aim of the present work is to study the role of FOXP2 as a prognostic biomarker in glioblastoma.This is a retrospective observational case series study in which the expression of FOXP2 has been analyzed both at the protein level (immunohistochemistry) and at the mRNA level (RNAseq, in a cohort of glioblastoma patients from The Cancer Genome Atlas [TCGA] database). Other molecular and clinical data have also been included in the study, with special focus on miRNA expression data.Survival analysis using Log-Rank test and COX-regression have been used. Non-parametric statistical tests were also used to study differences between low and high FOXP2 expression groups.Patients with a high expression of FOXP2 protein showed a worse prognosis than those patients with low expression in both, progression free survival (PFS) (HR=1.711; p=0.034) and overall survival (OS) (HR=1.809;p=0.014). These associations were still statistically significant in multivariate analysis.No prognostic association was found with FOXP2 RNA expression. Interestingly, two miRNAs that target FOXP2 (hsa-miR-181a-2-3p and hsa-miR-20a-3p) showed an interaction effect on OS with FOXP2 expression. A low level of these miRNAs expression was associated with a significantly worse prognosis in patients with high FOXP2 RNA expression.Higher expression of FOXP2 at the protein level is associated with a worse prognosis. This protein expression may be regulated by the expression of specific miRNAs that target FOXP2 mRNA: hsa-miR-181a-2-3p and hsa-miR-20a-3p.

P–264 Clinical relevance of re-expansion after blastocyst thawing

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Aparici. González ◽  
L Herrer. Grassa ◽  
L Cascale. Romero ◽  
J Lláce. Aparicio ◽  
J Te. Morro ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Live Birth Rate ◽  
Clinical Results ◽  
Blastocyst Stage ◽  
Good Prognosis ◽  
Culture Conditions ◽  
Miscarriage Rate ◽  
Registration Number ◽  
The Subject

Abstract Study question Are there any differences in clinical outcomes after SET of re-expanded versus non-re-expanded blastocysts? Summary answer The transfer of re-expanded thawed blastocysts is associated with improved clinical outcomes. What is known already Improvements in embryo culture conditions, endometrial receptivity protocols and vitrification as a revolutionary cryopreservation technique have allowed the expansion of blastocyst stage transfers (Lieberman and Tucker, 2006; Stanger et al., 2012; Rienzi et al., 2017), increasing clinical pregnancy and implantation rates in IVF cycles. The re-expansion of thawed blastocyst at the time of transfer has been considered as a good prognosis factor, but not always thawed embryos re-expand. To evaluate the relevance of this event, we compared the clinical results of the re-expanded embryos versus the collapsed ones after their thawing and transfer. Study design, size, duration A total number of 1.125 frozen-thawed blastocyst transfers were included in this retrospective observational study between January 2018 and December 2020. Seven hundred and eighty-six thawed blastocyst were fully expanded at the time of the transfer and 339 thawed blastocysts were non-re-expanded when they were transferred. Participants/materials, setting, methods 1.125 single frozen-thawed blastocyst embryo transfer (SET) cycles (802 from donated and 319 from autologous oocytes) were divided in two groups (re-expanded vs non-re-expanded). Positive beta human chorionic gonadotrophin (bHCG), pregnancy rate (PR), early miscarriage rate (EMR) and live birth rate (LBR) were compared between the two groups. Blastocysts were thawed using an Irvine Scientific® Thaw kit, Irvine Scientific® and were transferring in culture medium (Global® Total® LP, CooperSurgical®). Main results and the role of chance During 2018, 190 re-expanded blastocyst and 94 non-re-expanded were transferred. Statistical significant differences were found in the percentage of positive bHCG (48.4% vs 30.9%, p &lt; 0,0048) and PR (39.5% vs 25.5%, p &lt; 0,0203), respectively. In 2019, statistical differences were found in the LBR between 307 re-expanded blastocyst and 124 non-re-expanded (30.6% vs 12.9%; p &lt; 0,00001). Differences were also found in positive bHCG (50.2% vs 21.8%, p &lt; 0,00001) and PR (40.7% vs 15.3%, p &lt; 0,00001), respectively. Finally, in 2020, 289 re-expanded blastocyst and 121 non-re-expanded were transferred, and significant differences were obtained in the percentage of positive bHCG (46.8% vs 22.3%, p &lt; 0,00001) and PR (32.9% vs 15.7%, p &lt; 0,00001), respectively. Globally, all the variables analysed were statistically significant in favour of the re-expanded embryo group: positive bHCG (48.7% vs 24.5%; p &lt; 0,00001), PR (37.5% vs 18.3%; p &lt; 0,00001) and LBR (20.1% vs 9.5%; p &lt; 0,00001), except for EMR. Limitations, reasons for caution The inherent limitations to a retrospective design. Larger studies are warranted in order to reach robust conclusions on the subject. Wider implications of the findings: Transfer of re-expand blastocyst could be a positive indicator of clinical outcomes. In case of non-re-expand embryos, transfer of two could be reasonable. Trial registration number NONE

scholarly journals High-Normal Preconception TSH Levels Have No Adverse Effects on Reproductive Outcomes in Infertile Women Undergoing the First Single Fresh D5 Blastocyst Transfer

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yuchao Zhang ◽  
Wenbin Wu ◽  
Yanli Liu ◽  
Yichun Guan ◽  
Xingling Wang ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Blastocyst Transfer ◽  
Reproductive Outcomes ◽  
Miscarriage Rate ◽  
Infertile Women ◽  
Live Birth Rates ◽  
Serum Tsh ◽  
Tsh Levels

Purpose. To investigate the association between high-normal preconception TSH levels and reproductive outcomes in infertile women undergoing the first single fresh D5 blastocyst transfer. Methods. This was a retrospective study. Euthyroid patients undergoing the first single fresh D5 blastocyst transfer from January 2018 to May 2019 were initially included. The patients were divided into a low TSH (0.27–2.5 mIU/L) group and a high-normal TSH (2.5–4.2 mIU/L) group. The reproductive outcomes were compared between the groups. Results. A total of 824 women were ultimately included, 460 of whom had serum TSH levels less than 2.5 mIU/L and 364 of whom had serum TSH levels between 2.5 and 4.2 mIU/L. The patients were highly homogeneous in terms of general characteristics. High-normal TSH levels had no adverse impact on the clinical pregnancy rate, miscarriage rate, or live birth rate (respectively, aOR = 0.84, 0.65, 0.61, and P=0.234, 0.145, 0.083). No significant differences were observed in terms of gestational age, single live birth rates, birth weight, or birth length. Conclusion. High-normal TSH levels did not significantly influence reproductive outcomes in infertile women undergoing the first single fresh D5 blastocyst transfer. Further studies are needed to test whether the results might be applicable to a wider population.

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