scholarly journals Calcitonin Changed During Pregnancy in MEN2A With MTC Patient: A Case Report

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A992-A992
Author(s):  
Thachanun Porntharukchareon ◽  
Phronpan Chutpiboonwat ◽  
Sirinrat Tangjittrong ◽  
Natnicha Houngngam ◽  
Thiti Snabboon
Keyword(s):  
Pregnant Women ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Exploratory Laparotomy ◽  
Atypical Cells ◽  
Normal Women ◽  
Normal Urine ◽  
The Right ◽  
Cytology Study ◽  
Men 2A

Abstract Background: The diagnosis of MTC during pregnancy was challenging. No definite calcitonin (Ct) cut-off level during pregnancy was defined. Moreover, cytology analysis accuracy in MTC was lower than other thyroid cancers. Stevenson et al. reported that the plasma Ct levels in pregnant women were much higher than normal women. The change in Ct levels during pregnancy was not well described. In this report, we present a case of a pregnant woman with recurrent MTC. The change in Ct levels during pregnancy, diagnosis methods, and proper management were presented here. Clinical Case: A 31-year Thai woman, gravida 2, para 0 at 17 weeks of pregnancy, previously diagnosed with MTC and treated with total thyroidectomy and neck dissection seven years ago. During antenatal care at 14 weeks of pregnancy, the Ct level was 126 pg/ml (raised from 34 pg/ml seven years ago). The neck’s USG demonstrates vascularized hypoechoic lesion at the right thyroid bed with multiple nodules. The Ct wash-out test from this lesion was 200,000 pg/ml. The cytology study showed several clusters of atypical cells possessing monotonous round eccentric nuclei, and the IHC for Ct was positive. Genetic analysis revealed germline mutation in exon 10 of the RET proto-oncogene (NM_020975.4: c.1858T>G, p.C620G). Finally, MEN 2A with recurrent MTC was diagnoses during pregnancy. The other associate diseases were not found (normal urine metanephrines and plasma calcium levels). The Ct level raised highest to 324 pg/ml at 28 weeks of pregnancy and declined to 236 pg/mL a few days after delivery. Within six weeks, the Ct levels raised again (335 and 362 pg/ml at six weeks and three months after delivery). After giving birth, she underwent neck dissection; The Ct level at one month after surgery was still elevated (85 pg/ml). The CT of the chest, abdomen, and bone scan revealed multiple LN and bone metastasis. She regularly followed up in the oncology clinic and did well until nowadays (two years after delivery). After birth, her son could not pass meconium. Causing underwent exploratory laparotomy with double end ileostomy at day nine of life. The histopathology study from serial bowel biopsy demonstrated aganglionosis of the entire colon, which compatible with Hirschsprung’s disease. Genetic study from colonic tissue and blood confirmed the diagnoses of MEN 2A like his mother. Total thyroidectomy before five years of age and investigate for other associated diseases were planned. Conclusion: The Ct levels were elevated throughout the pregnancy. Transient declined of Ct levels during delivery and raised within six weeks suggest that pregnancy did not affect the Ct levels. In this report, we want to present the change of Ct levels during pregnancy, emphasize the diagnosis of MTC and MEN2A in pregnant women, which may change the patient’s prognosis. Not only in the patients but also in their families. Clinicians should be aware of the management of these patients.

Outcome of Thyroid Surgeries at Patan Hospital

2018 ◽  
Vol 6 (1) ◽  
pp. 11-14
Author(s):  
Deepak Yadav ◽  
Bhawana Dangol ◽  
Anita GC ◽  
Namita Shrestha ◽  
Ishwor Raj Devkota ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Central Compartment ◽  
Neck Surgery ◽  
Laryngeal Nerve ◽  
Completion Thyroidectomy ◽  
Lateral Neck ◽  
Lateral Neck Dissection

Objective: To assess the outcome of thyroid surgeries at Patan HospitalMaterials and Methods: It is a retrospective study of in-patient records of patients undergoing thyroid surgeries for various indications from April 2013 to January 2015 at Patan Hospital, Lalitpur.Results: During the period of 21 months, 75 patients underwent thyroid surgeries. Majority of patients underwent hemithyroidectomy (35) followed by total thyroidectomy (28), subtotal thyroidectomy (7) and completion thyroidectomy (5). Out of 28 patients undergoing total thyroidectomy (TT), 11 underwent central compartment clearance (CCC), 5 underwent CCC and lateral neck dissection. Among 5 patients undergoing completion thyroidectomy, CCC was performed in all cases and in one patient lateral neck dissection was also performed.  A total of 13 patients developed unilateral recurrent laryngeal nerve palsy (RLN), among them 5 had permanent palsy. Tracheostomy had to be done in immediate postoperative period for stridor following total thyroidectomy (TT) in one case. Temporary hypocalcaemia was observed in 10 (10/28) cases following TT, out of which 8 had undergone CCC. Permanent hypocalcaemia was observed in 7 (7/28) cases following TT out of which 3 had undergone CCC. Chylous leak occurred in one of the patient undergoing left level II-IV neck dissection which was managed conservatively. None of the patient had to be transfused postoperatively.Conclusion: Complications to thyroid surgery are not uncommon. Visualization of recurrent laryngeal nerve alone in our context is adequate in experienced hands. Identification of parathyroid during thyroidectomy is recommended to avoid hypocalcaemia. Meticulous dissection can reduce the complications.Nepalese Journal of ENT Head and Neck Surgery, Vol. 6, No. 1, 2015

Jurisprudence Study of the Importance of the Role of a Woman’s Right to Have a Child: A Review

2020 ◽  
Vol 16 (3) ◽  
pp. 188-193
Author(s):  
Fatemeh Ghodrati
Keyword(s):  
Pregnant Women ◽  
Civil Law ◽  
Google Scholar ◽  
Review Of The Literature ◽  
Maternal Role ◽  
The Right ◽  
Time Limitations ◽  
Natural Barrier ◽  
Taking Care

Background: Every woman has the right to have children. Objective: This study aimed to investigate the Jurisprudence study of the importance of the role of a woman right to have a child. Methods: A review of the literature with keywords of motherhood. The viewpoints of the jurists, jurisprudent law, right contraception and breastfeeding, spiritual rewards, pregnant women, instinct of having a child and the Quran. The Information Centers such as Scopus and Iranmedex, Magi ran SID, Google Scholar, Science Direct, Pub med, and in the returns without any time limitations up to 2018. Therefore, Qur'anic verses based on the topic and authentic Hadith texts as well as authoritative, authentic scientific articles. Results: Narrations and Quran verses on greatness and respect of a mother show the importance of the maternal role. The maternal role is a fabulous facet of perfection of a woman and Islam has considered spiritual rewards for it. In the Quran, many biological changes such as pregnancy, childbirth, breastfeeding and taking care of a child and spiritual characteristics of mothers as the instinct seeking a child or generosity towards child have been mentioned. Islamic rules have a duty to extend this culture and aid mothers to achieve this right. Nobody can deprive a woman of it. Conclusion: In view of jurisprudent rules in Islam, if there is no limitation or natural barrier for a woman to have a child but her husband’s illogical unwillingness for having a child; this is, according to article 1130 of civil law, a kind of distress and embarrassment and the woman has the right to divorce.

SERIAL ESTIMATION OF PLASMA RENIN CONCENTRATION DURING PREGNANCY AND AFTER PARTURITION

1966 ◽  
Vol 35 (4) ◽  
pp. 373-378 ◽  
Author(s):  
J. J. BROWN ◽  
D. L. DAVIES ◽  
P. B. DOAK ◽  
A. F. LEVER ◽  
J. I. S. ROBERTSON
Keyword(s):  
Pregnant Women ◽  
Plasma Renin ◽  
Plasma Renin Concentration ◽  
Before And After ◽  
Normal Women ◽  
Made In

SUMMARY Plasma renin concentration has been measured in normal women at intervals throughout pregnancy. Further measurements have been made in the days and hours before and after delivery of the foetus and placenta. Plasma renin was consistently raised in the majority of pregnant women and did not change markedly until 24 hr. or more after delivery. The significance of these findings is discussed.

HETEROTOPIC PREGNANCY WITH INEVITABLE ABORTION (RIGHT ADNEXAL LIVE ECTOPIC AND COEXISTING INTRAUTERINE TRIPLETS WITH ABSENT FETAL CARDIAC ACTIVITY)

2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Short Period ◽  
The Right

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.

Prophylaxis of obstetric and perinatal pathology at women with pathological increase of body weight during pregnancy

2018 ◽  
pp. 7-79
Author(s):  
S.Yu. Vdovichenko ◽  
◽  
T.D. Fakhrutdinova ◽  
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Pregnant Women ◽  
Key Words ◽  
Perinatal Outcomes ◽  
Perinatal Complications ◽  
Perinatal Pathology ◽  
Fetoplacental Complex ◽  
The Right ◽  
Selection Of

The objective: depression of obstetric and perinatal complications at pregnant women with pathological increase of body weight during pregnancy on the basis of studying of clinical-functional, endocrinologic, metabolic, morphological features of condition of fetoplacental complex and development of advanced algorithm of treatment-and-prophylactic actions. Materials and methods. We conducted examination of 264 patients who consisted on the account concerning pregnancy in female consultations of Kiev. By a method of selection of 178 women were included in retrospective research and 86 – in prospective. The main group was made by 39 pregnant women with whom led individual discussions, control – 142 women, that received traditional references in female consultation. Results. Use of the algorithm improved by us allows to improve obstetric (decrease of frequency of a preeclampsia by 12.3%; anomalies of a patrimonial deyalnost for 8.4%) and perinatal outcomes (depression of level of an asphyxia at a delivery for 9.4% and post-natal adaptation for 7.8%) deliveries of women with an excessive increase of body weight during pregnancy. Conclusion. The received results grant the right to recommend the algorithm improved by us for wide use in practical health care. Key words: obstetric and perinatal pathology, pathological increase of body weight, prophylaxis.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Occurrence of parasitism by Dioctophyma renale in ring-tailed coatis (Nasua nasua) of the Tiete Ecological Park, São Paulo, Brazil

2009 ◽  
Vol 29 (12) ◽  
pp. 959-962 ◽  
Author(s):  
Liliane Milanelo ◽  
Márcia Bento Moreira ◽  
Lílian S. Fitorra ◽  
Bruno S.S. Petri ◽  
Melissa Alves ◽  
...  
Keyword(s):  
Population Control ◽  
Abdominal Cavity ◽  
Exploratory Laparotomy ◽  
Renal Tissue ◽  
Intermediate Hosts ◽  
Wild Mammals ◽  
Rigid Structure ◽  
Nasua Nasua ◽  
Males And Females ◽  
The Right

Dioctophymosis is a worldwide renal parasitosis caused by the Dioctophyma renale nematode, which results in progressive destruction of renal tissue. Aquatics annelids are considered the main intermediate hosts and the literature refers as permanent hosts of dogs, wild mammals and even humans. During procedures for population control of coatis (Nasua nasua) in the Ecological Park of Tietê (PET), was noticed the presence of parasitosis by D. renale. From 68 animals, males and females, young and adults, submitted to exploratory laparotomy, 51 were positive for the presence of worms, 9 were found only in the right kidney. In 10 cases, in addition to right kidney parasitism, worms were also observed in the abdominal cavity. In 24 cases D. renale was found only in the abdominal cavity and in 8 animals the right kidney was reduced to a small rigid structure. The study showed that the preferred site for parasitism of the worm, considered erratic, was the abdominal cavity in 66.66% of the cases.

scholarly journals Enterocutaneous fistulas due to stent migration. How reliable is its use on duodenal benign pathology? a case report

2020 ◽  
Vol 8 (6) ◽  
pp. 2316
Author(s):  
Aldo Edyair Jimenez Herevia ◽  
Luis Montiel Hinojosa ◽  
Diego Hinojosa Ugarte ◽  
Erick Martin Paez Hernandez ◽  
Enrique Obregon Moreno
Keyword(s):  
Enterocutaneous Fistula ◽  
Duodenal Bulb ◽  
Exploratory Laparotomy ◽  
Stent Migration ◽  
Metal Stents ◽  
Benign Pathology ◽  
Extraction Site ◽  
Self Expanding Metal Stents ◽  
Hepatopancreatobiliary Surgery ◽  
The Right

Duodenal stenting has been widely used on malignant pathology on selected patients with poor prognosis and advanced disease. In these last years, there has been a clear ampliation of the clinical applications of endoscopy procedures and stents. Its use on benign pathology is spreading but there is a lack of literature about the complications in this context. The incidence of stent migration is about 10-25% in self-expandable metal stent (SEMS), and 2-5% on covered self-expanding metal stents (CSEMS). We reported a clinical case of a 48 years old patient who developed a duodenal ulcer. The patient was submitted to exploratory laparotomy, with duodenal primary closure of the ulcer. Later, the patient developed a enterocutaneous fistula because of the duodenal leak. It was referred to our third level hospital to the hepatopancreatobiliary surgery service. A new exploratory laparotomy with duodenal exclusion was planned, but it was impossible to access due to frozen abdomen. CSEMS was placed in the duodenal bulb resulting in the resolution of leaking, but the stent could not be removed because of migration. The stent trajectory was followed by abdominal x ray and tomography. The patient developed multiple intestinal an fecal enterocutaneous fistulas. It was submitted to multiples endoscopies, colonoscopies and enteroscopy without any success to reaching it. It was decided to perform a right lumbotomy to extract the prothesis. The stent was surgically removed, a planned stoma was left on the right flank on the extraction site.

Sign in / Sign up

Export Citation Format

Share Document