scholarly journals Uterine arteriovenous malformation-beyond surgery: a case series

2017 ◽  
Vol 6 (10) ◽  
pp. 4727
Author(s):  
Uma A. Pankar ◽  
Indusekhar S. ◽  
Pannag Desai ◽  
Vidya Bhargavi
Keyword(s):  
Case Series ◽  
Arterial Embolization ◽  
Reproductive Age ◽  
Selective Embolization ◽  
Technical Success Rate ◽  
Uterine Arteriovenous Malformation ◽  
Good Treatment Option ◽  
Pva Particles ◽  
Reproductive Age Group

Uterine arteriovenous malformations (AVM) are a rare entity, presenting in women of reproductive age. The presentation may vary with bleeding being the chief presenting symptom. Though traditionally hysterectomy has been a definitive form of treatment, trans-catheter embolization is being considered as a good treatment option.  We present three cases with uterine AVM who presented with heavy bleeding per vaginam. Three patients of reproductive age group (29-33 years) presented with heavy bleeding per vaginam from January 2017- May 2017. Two had previous miscarriages for which curettage was done and one had undergone a Caesarean section previously. Diagnosis of uterine AVM was made by ultrasound-grey scale, colour Doppler, followed by MRI. All patients underwent trans-catheter angiogram followed by selective embolization of the AVM with n-BCA (n- Butyl Cyanoacrylate) and polyvinyl alcohol (PVA) particles. Successful embolization was done in all of our patients with technical success rate of 100%. On follow-up, all patients are currently asymptomatic. Trans-catheter arterial embolization of uterine AVM is a simple and effective treatment alternative with less morbidity associated with anaesthesia and surgery in turn reducing hospital stay. It has to be considered in patients who need to preserve their fertility.

scholarly journals Umbilical endometriosis along with peritoneal endometriosis: a case report

2019 ◽  
Vol 8 (5) ◽  
pp. 2106
Author(s):  
T. Ramani Devi ◽  
C. Archana Devi ◽  
C. Aparna Devi
Keyword(s):  
Surgical Excision ◽  
Reproductive Age ◽  
Rare Entity ◽  
Pelvic Endometriosis ◽  
The Past ◽  
Peritoneal Endometriosis ◽  
Laparoscopic Sterilization ◽  
Reproductive Age Group ◽  
Umbilical Endometriosis

Incidence of endometriosis is around 10 to 15% in women of reproductive age group. Umbilical endometriosis is a very rare entity. Extra genital endometriosis accounts to 3% of endometriosis. Incidence of umbilical endometriosis is 0.5%-4% of extra genital endometriosis. 30 years old multi gravida was referred to our hospital with c/o periodic bleeding from the umbilicus for the past 3 months. She was also having dysmenorrhoea for about 3 months. On examination, patient had a small bluish nodule in the umbilicus around 1.5x1.2 cm in size. Clinically there was suspicion of pelvic endometriosis as the uterus was retroverted and fixed. CT abdomen showed a small hypo-echoeic area in the umbilicus and uterus was adenomyotic with normal ovaries. Patient was given the option of laparoscopy and excision of umbilicus, as there was suspicion of peritoneal endometriosis and the patient also insisted upon laparoscopic sterilization. Laparoscopy showed early peritoneal endometriosis with pelvic adhesions and the same adhesiolysis was done along with cauterization of endometriosis. Sterilization was also done as per the patient’s request. Umbilical excision and layer closure was done. Umbilical endometriosis is a rare entity. This patient had associated early pelvic endometriosis. Umbilical endometriosis could be secondary to the lympho vascular spread from the pelvic endometriosis or primary umbilical endometriosis. History, clinical and imaging were pointing towards umbilical endometriosis. Surgical excision of umbilical endometriosis and cauterisation of early pelvic endometriosis were done. Patient needs follow up. Umbilical endometriosis may be primary or secondary which needs total excision and follow up.

scholarly journals Assessment of Gonadal Function Following Single Dose of Radioiodine Therapy in Differentiated Thyroid Cancer Patients of Reproductive Age

2018 ◽  
Vol 19 (2) ◽  
pp. 92
Author(s):  
Md Sunny Anam Chowdhury ◽  
Sadia Sultana ◽  
Md Abdul Awal ◽  
Suraya Sarmin ◽  
Mohammad Simoon Salekin
Keyword(s):  
Thyroid Cancer ◽  
Single Dose ◽  
Differentiated Thyroid Cancer ◽  
Reproductive Age ◽  
Age Group ◽  
Gonadal Function ◽  
Male Patients ◽  
The Mean ◽  
Reproductive Age Group

<p><strong>Objective</strong>: This interventional study has undertaken to assess the gonadal function of differentiated thyroid cancer (DTC) patients within reproductive age group following single dose of radioactive iodine (131I) therapy/ablation.</p><p><strong>Patients and Methods:<em> </em></strong>A total of 69 patients (25 male and 44 female) of DTC were included in this study, those were referred for 131I ablation after total thyroidectomy. Following RAI, these patients were followed-up three times at three months interval.  The usual I-131 dose was 75 or 100 m Ci for ablation of thyroid residues and 150 mCi for treatment of nodal metastasis. All the patients were interviewed about menstrual (female only) and reproductive history and investigated of the level of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone of male patients and FSH, LH, estradiol (E<sub>2</sub>) of female patients before administration of  131I and three, six and nine months after therapy.</p><p><strong>Result</strong>: In this study all of the 25 (100.0%) male patients showed high FSH level after three months of therapy. The mean± SD FSH level of male patients was found significantly (p-0.001) higher (15.59±7.53 IU/L) after three months of therapy than the pretherapy (4.85±2.57 IU/L) level.  The mean± SD of FSH level was significantly declining in six months and nine months of follow up. The mean± SD of LH hormone level of these patients was found 6.1±3.67 IU/L in pretherapy which was significantly increased to 7.67±4.33 IU/L after three months. The mean LH level was 7.20±3.98 IU/L at six months follow up and 7.3±3.5IU/L after nine months. The differences of LH level between 3 months to 6 months and 6 months to 9 months are not statistically significant. No significant change was observed in testosterone level throughout the study period. In female, five patients developed irregular menstruation (changed duration of cycle or lighter amount), three patients developed amenorrhea associated with hot flashes within six months of 131I administration. Biochemical study of the patients with amenorrhoea showed markedly elevated serum FSH, LH level and declined E<sub>2 </sub>level. The FSH, LH levels of the two patients with amenorrhea became normal within study period and one patient had persistent amenorrhea at 9 months. E<sub>2</sub> level raised slowly.</p><p><strong>Conclusion</strong>: A single dose of radio-iodine (131I) therapy causes impairment of gonadal function of male patients within reproductive age group. In case of female patients the effect is insignificant. The effect is usually reversible and gonadal function of the patients restores within the study period.</p><p>Bangladesh J. Nuclear Med. 19(2): 92-97, July 2016  </p>

Outcomes of Catheter-Directed Thrombolysis in Patients with Acute Arterial Thrombotic Limb Ischemia: A Prospective Interventional Case Series

2021 ◽  
Author(s):  
Javad Salimi ◽  
Ehsan Rahimpour ◽  
Hossein Zabihi Mahmoudabadi ◽  
Pezhman Farshidmehr
Keyword(s):  
Success Rate ◽  
Treatment Success ◽  
Case Series ◽  
Pulmonary Hemorrhage ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Technical Success Rate ◽  
Catheter Directed Thrombolysis ◽  
One Year

Introduction: Acute limb ischemia is a critical medical condition that can quickly become a life threat. Therapeutic modalities such as catheter-directed thrombolysis (CDT) have demonstrated various levels of efficacy in previous studies. Objective: This study presents the descriptive findings of a series of cases who presented with acute arterial thrombotic limb ischemia and underwent CDT. Methods: This was a cross-sectional single-hospital-based case series, in which all patients who were diagnosed with acute arterial thrombotic limb ischemia, and consequently underwent CDT during the oneyear study period were included. Detailed baseline characteristics and clinical findings of the studied patients on presentation, after intervention and at one-year follow-up are presented. Results: A total of 21 patients with a mean age of 60.7±15.2 years, including 16 males (76.2%) were included. The initial technical and treatment success rates were 20 (95.2%) and 14 (66.7%), respectively. The amputation-free and the overall survival rates after the one-year follow-up were 15 (71.4%) and 17 (81%), respectively. Four patients (19%) developed complications, two (9.5%) of which were significant (pulmonary hemorrhage and intraventricular hemorrhage). Amputation was performed in 6 (28.6%) cases. Conclusion: In this study, the treatment success rate and the technical success rate were satisfactory.

Safety of Transcatheter Arterial Embolization for Visceral Artery Pseudoaneurysms: Incidence of Intraprocedural Rupture

2021 ◽  
Vol 55 (4) ◽  
pp. 361-366
Author(s):  
Masashi Shimohira ◽  
Keiichi Nagai ◽  
Kengo Ohta ◽  
Yusuke Sawada ◽  
Keita Nakayama ◽  
...  
Keyword(s):  
Success Rate ◽  
Transcatheter Arterial Embolization ◽  
Arterial Embolization ◽  
Major Complication ◽  
Visceral Artery ◽  
Technical Success ◽  
Advanced Level ◽  
Technical Success Rate ◽  
A Minor

Introduction: Transcatheter arterial embolization is the first-line treatment for visceral artery pseudoaneurysms (VAPAs); however, the intraprocedural rupture of pseudoaneurysms is an important complication. The present study was performed to evaluate the safety of embolization for VAPAs, including the incidence of intraprocedural rupture. Methods: Among 56 consecutive patients with 57 VAPAs who underwent treatment between April 2009 and October 2020, 46 patients with 47 VAPAs underwent embolization. Complications related to embolization including intraprocedural rupture, the technical success rate, and clinical outcomes were evaluated. Complications that required extended hospitalization, an advanced level of care, or resulted in permanent adverse sequelae or death were classified as major complications, while the remainder were considered to be minor. Technical success was defined as the completion of embolization. Results: The intraprocedural rupture of pseudoaneurysms occurred in 3 out of 47 VAPAs treated with embolization (6%) and resulted in minor complications. One liver abscess requiring drainage was regarded as a major complication (2%). Focal infarction after embolization was observed as a minor complication in 20 cases. Complications occurred in 24 out of 47 cases (51%), comprising one major complication (2%) and 23 minor complications (48%). The technical success rate was 100% (47/47). Fifty-three out of 56 patients (95%) were alive in a median follow-up period of 18 months (range: 2 days-137 months). Conclusions: Embolization is safe and useful for the treatment of VAPAs; however, the intraprocedural rupture of pseudoaneurysms may occur, and, thus, care is needed during this procedure.

scholarly journals A rare case report of gestational trophoblastic disease in peri menopausal women

2020 ◽  
Vol 9 (11) ◽  
pp. 4716
Author(s):  
Nagashree U. ◽  
Wahida Suresh
Keyword(s):  
Early Recognition ◽  
Gestational Trophoblastic Disease ◽  
Reproductive Age ◽  
Trophoblastic Disease ◽  
Menopausal Women ◽  
Rare Case Report ◽  
Abnormal Bleeding ◽  
Post Menopausal ◽  
Reproductive Age Group

Benign gestational trophoblastic disease (GTD) generally occurs in reproductive age group women; but is extremely rare in peri and post-menopausal women. We report a case of molar pregnancy in a 48-year-old lady with complaints of bleeding per vaginum with severe pain abdomen. The intention was to highlight the need to include GTD as a possible cause of abnormal bleeding per vaginum in peri and post-menopausal women. So early diagnosis and management with proper follow up is possible. It stresses the need for early recognition to avoid high malignant sequelae.

scholarly journals Endometrioma masquerading an ovarian carcinoma

2021 ◽  
Vol 10 (3) ◽  
pp. 1205
Author(s):  
Amanat Sidhu ◽  
Ripan Bala ◽  
Pooja Tandon ◽  
Rajdeep Chhina
Keyword(s):  
Ovarian Carcinoma ◽  
Malignant Tumor ◽  
Chronic Pelvic Pain ◽  
Young Female ◽  
Malignant Potential ◽  
Reproductive Age ◽  
Age Group ◽  
Increased Risk ◽  
Reproductive Age Group

Endometriosis is the presence of endometrial tissue outside the uterus. Endometriosis affects 10-15% of all women in reproductive age group and 70% of the women with chronic pelvic pain. The risk of malignant transformation in an endometrioma has been reported to be low, though there is an increased risk for certain gynecological as well as non-gynecological carcinomas with endometriosis. We present a case diagnosed as having endometrioma transforming into a malignant tumor in a young female. We intend to emphasize that all the clinicians should make their patients aware of the malignant potential of endometriosis and a strict follow up of all cases being treated conservatively should be a must.

A Case Series of a Hybrid Approach to Aortic Arch Disease

2013 ◽  
Vol 16 (4) ◽  
pp. 225 ◽  
Author(s):  
Robert E. Michler ◽  
Evan Lipsitz ◽  
Siyamek Neragi-Miandoab
Keyword(s):  
Aortic Arch ◽  
Aortic Surgery ◽  
Hybrid Approach ◽  
Case Series ◽  
Chronic Obstructive ◽  
Type I ◽  
Endovascular Stent ◽  
Technical Success Rate ◽  
The Mean

<p><b>Objective:</b> Debranching of the aortic arch and endovascular stent placement as a combination therapy for complex aortic arch pathology has emerged over the past few years as an alternative to traditional repair. This hybrid approach is a viable option for patients who would not tolerate conventional arch replacement, as well as for patients with a failed stent graft of the descending aorta and a subsequent type I endoleak.</p><p><b>Methods:</b> We retrospectively reviewed the preoperative characteristics and postoperative outcomes of 5 patients who underwent debranching of the aortic arch and implantation of an endovascular stent across the aortic arch between 2008 and 2011. Data were analyzed with the Student t test and the Kaplan-Meyer method.</p><p><b>Results:</b> The mean age was 70.6 � 18 years; 4 men and 1 woman were evaluated. One patient had previous aortic surgery for dissection. The preoperative morbidities included arrhythmia (1 patient), chronic obstructive pulmonary disease (2 patients), cerebrovascular accident (1 patient), diabetes mellitus (2 patients), coronary artery disease (2 patients), and active angina (1 patient). One patient had a myocardial infarction 3 weeks before surgery. The primary technical-success rate was 100%, and none of the patients died in the perioperative phase. The mean follow-up time was 22 � 18.4 months, and the median follow-up time was 13.8 months (range, 7.13-50.7 months). Two patients died during follow-up. The pathology of the aorta in the patients who died was arch aneurysm; the 3 remaining patients are alive and regularly followed at our institution.</p><p><b>Conclusion:</b> The combination of surgery and simultaneous endovascular stenting in the operating room is an alternative approach for patients who are poor candidates for traditional arch repair under circulatory arrest.</p>

FETO–MATERNAL OUTCOME IN CASES OF ACCIDENTAL HAEMORRHAGE

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Charmi Pawani ◽  
Pooja Ghori ◽  
Snehal Kukadiya
Keyword(s):  
Perinatal Mortality ◽  
Management Strategies ◽  
Adverse Outcomes ◽  
Reproductive Age ◽  
Gestation Age ◽  
Obstetric Emergencies ◽  
Abruptio Placenta ◽  
Obstetrical Emergency ◽  
Reproductive Age Group

Background: Accidental haemorrhage is a grave obstetrical emergency that refers to bleeding at the decidual-placental interface which causes placental detachment over 28 weeks of gestation age and prior to delivery of the fetus. WHO reported 2.1% maternal mortality rates due to Abruptio placenta, and the fetal perinatal mortality rate was 15% while its incidence was 0.65%. Abruption may be “revealed,” in which case blood tracks between the membranes and the decidua, and escapes through the cervix into the vagina. The less common “concealed” abruption occurs when blood accumulates behind the placenta, with no obvious external bleeding. Aim: The study aimed to understand the incidence and predictors of adverse outcomes of Accidental hemorrhage in our setting and Knowledge from this study will help in determining the outcomes and designing management strategies improving Fetal maternal outcomes. Methods: It was an observational prospective hospital-based study design with a follow-up component. All pregnant women diagnosed to have abruption placenta from 28 weeks of gestation and above; all babies delivered by mothers with abruptio placenta. Result: The majority of cases 86(86%) belonged to the reproductive age group of 21-30 years. 60(60%) cases were multipara within 2-4 range of parity and 5 (5%) patients were grand multiparous. Thus the present study would tend to support multiparity as a risk factor. In the present study, higher frequency of unbooked cases 62 (62%) was seen as they were referrals, most of them had no antenatal checkups and only presented in hospital as obstetric emergencies. Majority of the cases came with complaint of bleeding per vaginum, as blood escapes out the cervix after travelling between membranes. 78% of the neonates were born alive. 70% of the patients had an APGAR score ranging from 5-10. The neonatal weights ranged from 1.0 -4.0 kg, the distribution pattern shows 48 (48%) neonates in the range 1500-2499 gms, 14 (14%) neonates in the range 1000-1499 gms and 38 (38%) neonates in the range 2500-3999 gms. Conclusion: In light of the current study, it was found that the incidence of Accidental haemorrhage was 0.4%. The study also identified that 60% of the cases were multigravida having parity from 2-4. Furthermore, the study found that 22% of cases were stillbirth; there was 8 neonatal death contributing to increased perinatal mortality of 30%.

Solitaire stents for the treatment of complex symptomatic intracranial stenosis after antithrombotic failure: safety and efficacy evaluation

2015 ◽  
Vol 8 (7) ◽  
pp. 680-684 ◽  
Author(s):  
Guoli Duan ◽  
Zhengzhe Feng ◽  
Lei Zhang ◽  
Ping Zhang ◽  
Lei Chen ◽  
...  
Keyword(s):  
Success Rate ◽  
Balloon Angioplasty ◽  
Stent Placement ◽  
Case Series ◽  
Intracranial Stenosis ◽  
Technical Success ◽  
Safety And Efficacy ◽  
Technical Success Rate ◽  
Case Series Study

ObjectivesTo evaluate the feasibility, safety, and efficacy of Solitaire stent placement after balloon angioplasty for the treatment of complex symptomatic intracranial atherosclerotic stenosis (ICAS).MethodsWe retrospectively reviewed the clinical data from 44 patients who underwent Solitaire stent placement for complex symptomatic ICAS at our department between November 2010 and March 2014, with focus on the clinical factors, lesion characteristics, treatment results, and periprocedural complications. We also summarized the early outcomes and imaging findings during the follow-up period.ResultsOverall, the technical success rate was 100% (44/44). Post-stenting residual stenosis ranged from 0% to 40% (mean 15.00±12.94%). The overall 30-day rate of procedure-related complications was 9.09% (4/44). The incidence of recurrent ischemic events related to the territory artery was 4.55% during a mean clinical follow-up period of 25.5 months. Five patients (11.36%) developed in-stent restenosis during a mean angiographic follow-up period of 9.3 months.ConclusionsThis is the first case series study of ICAS treated by Solitaire stent placement. Deployment of a Solitaire stent with balloon angioplasty in the treatment of complex severe intracranial stenosis appears safe and effective, with a high technical success rate, relatively low periprocedural complication rate, and favorable outcome during follow-up.

scholarly journals Universal screening for hypothyroidism in pregnancy: is it necessary?

2019 ◽  
Vol 8 (7) ◽  
pp. 2683
Author(s):  
Meena Priyadharshini V. ◽  
Seetha Panicker
Keyword(s):  
Pregnant Women ◽  
Universal Screening ◽  
Reproductive Age ◽  
Antenatal Visit ◽  
Endocrine Disorders ◽  
Maternal Complications ◽  
Reproductive Age Group ◽  
Ethical Clearance ◽  
In Pregnancy

Background: Thyroid diseases are one of the commonest endocrine disorders affecting women of reproductive age group, and hence constitute one important disorders complicating pregnancy. The objective of this study was to determine the importance of universal screening for hypothyroidism in pregnancy at the first antenatal visit and to formulate whether this routine screening is mandatory in our country.Methods: This retrospective study was conducted in the year 2018 at PSG IMSR Hospital for all pregnant women who attended the first antenatal visit between Jan 2012 to Dec 2012 after obtaining ethical clearance. Pregnant women who were already taking treatment for hypothyroidism, diabetes mellitus, hypertension and those pregnant women who lost their follow up were excluded from the study.Results: The incidence of subclinical hypothyroidism among antenatal women were 7.06%. In our study the maternal complications like anemia 12 (8%), preeclampsia 26 (17.3%), gestational diabetes 25 (16.7%), fetal growth restriction 8 (5.3%), Oligohydramnios 13 (8.7%), pre mature rupture of membranes 25 (16.7%), placental abruption in 2 (1.33%), APLA syndrome 2 (1.33%), low birth weight 26 (17.3%) were observed.Conclusions: Universal screening for hypothyroidism is recommended for all antenatal women especially in iodine depleted country like India.

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