scholarly journals Parasitic twin with major cardiac defect: a case report

2020 ◽  
Vol 7 (6) ◽  
pp. 1448
Author(s):  
Arindam Ghosh ◽  
Akshay Prasad ◽  
Tanusree Kundu ◽  
Priya Shalini Lakra ◽  
Kaushik Saha
Keyword(s):  
Single Ventricle ◽  
Anterior Abdominal Wall ◽  
Abdominal Mass ◽  
External Genitalia ◽  
Postoperative Recovery ◽  
The Other ◽  
Cardiac Defect ◽  
Rare Form ◽  
Parasitic Twin ◽  
Single Ventricle Heart Defect

Parasitic twins are an extremely rare form of asymmetrical conjoined monochorial monoamniotic twins where one of them has a mostly intact body that is able to survive and which is referred to as ‘autosite’, while the counterpart, referred to as ‘parasite’, is only rudimentarily developed being physically attached to and nourished by the other twin. Our case is a baby boy with Single Ventricle Heart defect with a thoraco-abdominal mass (epigastric heteropagus twin) attached to the anterior abdominal wall near the umbilicus with minimal visceral sharing. The twins had two external genitalia both in host and parasite micturating separately. After high risk surgery the parasite could be separated completely from the host and postoperative recovery was uneventful.

Comparison of analgesic efficacy between rectus sheath blockade, intrathecal morphine with bupivacaine, and intravenous patient-controlled analgesia in patients undergoing robot-assisted laparoscopic prostatectomy: a prospective, observational clinical study

2020 ◽  
Author(s):  
Jung-Woo Shim ◽  
Yun Jeong Cho ◽  
Minhee Kim ◽  
Sang Hyun Hong ◽  
Hyong Woo Moon ◽  
...  
Keyword(s):  
Severe Pain ◽  
Intrathecal Morphine ◽  
Rectus Sheath ◽  
Postoperative Recovery ◽  
The Other ◽  
Patient Controlled Analgesia ◽  
Research Information ◽  
Robot Assisted ◽  
Laparoscopic Prostatectomy ◽  
Pain At Rest

Abstract Background: We explored the analgesic outcomes on postoperative day (POD) 1 in patients undergoing robot-assisted laparoscopic prostatectomy (RALP) who received intravenous patient-controlled analgesia (IV-PCA), rectus sheath bupivacaine block (RSB), or intrathecal morphine with bupivacaine block (ITMB). Methods: This was a prospective, observational clinical trial. Patients were divided into three groups: IV-PCA (n = 30), RSB (n = 30), and ITMB (n = 30). Peak pain scores at rest and with coughing, cumulative IV-PCA drug consumption, the need for IV rescue opioids, and Quality of Recovery-15 (QoR-15) questionnaire scores collected on POD 1 were compared among the groups.Results: The preoperative and intraoperative findings were comparable among the groups; the ITMB group required the least remifentanil of all groups. During POD 1, the ITMB group reported lower levels of pain at rest and with coughing, compared with the other two groups. During POD 1, incidences of severe pain at rest (10.0% vs. 23.3% vs. 40.0%) and with coughing (16.7% vs. 36.7% vs. 66.7%) were the lowest in the ITMB group compared with the RSB and IV-PCA groups, respectively. After adjustment for age, body mass index, diabetes mellitus, hypertension, and intraoperative remifentanil infusion, severe pain at rest was 0.167-fold less common in the ITMB group than in the IV-PCA group, while pain with coughing was 0.1-fold lower in the ITMB group and 0.306-fold lower in the RSB group, compared with the IV-PCA group. The ITMB group required lower cumulative IV-PCA drug infusions and less IV rescue opioids, while exhibiting a better QoR-15 global score, compared with the other two groups. Complications (nausea and pruritus) were significantly more common in the ITMB group than in the other two groups; however, we noted no ITMB- or RSB-related anesthetic complications (respiratory depression, post-dural headache, nerve injury, or puncture site hematoma or infection), and all patients were assessed as Clavien-Dindo grade I or II during the hospital stay.Conclusion: Although ITMB induced complications of nausea and pruritus, this analgesic technique provided appropriate pain relief that enhanced patient perception related to early postoperative recovery.Trial registration: Clinical Research Information Service, Republic of Korea, (approval number: KCT0005040) on May 20, 2020https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15943&sLeft=2&ltype=my&rtype=my

Transsexualism

2011 ◽  
pp. 1463-1468
Author(s):  
Louis J. G. Gooren
Keyword(s):  
Sexual Differentiation ◽  
External Genitalia ◽  
The Other ◽  
Stria Terminalis ◽  
Bed Nucleus ◽  
Psychological Phenomenon ◽  
Opposite Sex ◽  
Male To Female ◽  
The Brain

Transsexualism is the condition in which a person with apparently normal somatic sexual differentiation is convinced that he/she is actually a member of the opposite sex. It is associated with an irresistible urge to be hormonally and surgically adapted to that sex. Traditionally transsexualism has been conceptualized as a purely psychological phenomenon, but research on the brains of male-to-female transsexuals has found that the sexual differentiation of the brain—the bed nucleus of the stria terminalis (BSTC) and the hypothalamic uncinate nucleus—had followed a female pattern (1). This finding may lead to a concept of transsexualism as a form of intersex, where the sexual differentiation of the brain (which in mammals also undergoes sexual differentiation) is not consistent with the other variables of sex, such as chromosomal pattern, nature of the gonad and nature of internal/external genitalia. Thus it can be argued that transsexualism is a sexual differentiation disorder.

scholarly journals Operation procedure of sacrococcygeal fetus in fetu

2011 ◽  
Vol 51 (1) ◽  
pp. 58 ◽  
Author(s):  
Rochadi Rochadi
Keyword(s):  
Adrenal Gland ◽  
Abdominal Mass ◽  
Rare Condition ◽  
Mature Embryo ◽  
First Year ◽  
Fetus In Fetu ◽  
Sacrococcygeal Region ◽  
Parasitic Twin ◽  
Operation Procedure ◽  
First Year Of Life

Fetus in fetu is a condition in wich a fetiform calcified mass often presents in the abdomen of its host, a newborn. It is extremely rare condition, estimated once in 500,000 deliveries and has a 2: 1 male predominantly; with most patient presenting with an abdominal  mass in the first year of life. 5,13 The term fetus in fetu is used to point out an unequal division of totipotential cells of blastocyst where the result is the inclusion of a small cellular mass in the more mature embryo. It was encapsulated, pedunculated and represents a malformed monozygotic, monochorionic, diamniotic parasitic twin. In 80% cases, fetus in fetu is located  retroperitonealy but can be found in unusual location such as in oropharynx, neck, skull mediastinum, pelvis, iliac mesentery, adrenal gland, sacrococcygeal region and scrotal sac.

scholarly journals Limited Dorsal Myeloschisis with and without Type I Split Cord Malformation: Report of 3 Cases and Surgical Nuances

Medicina ◽  
2019 ◽  
Vol 55 (2) ◽  
pp. 28
Author(s):  
Yusuf Izci ◽  
Cahit Kural
Keyword(s):  
Spinal Cord ◽  
Tethered Cord ◽  
Intraoperative Neuromonitoring ◽  
The Other ◽  
Split Cord Malformation ◽  
Type I ◽  
Cystic Lesions ◽  
Rare Form ◽  
Urological Complications ◽  
Spinal Malformations

Limited dorsal myeloschisis (LDM) is a rare form of spina bifida which is characterized by a fibroneural stalk between the inner part of the skin and the spinal cord. It may be associated with split cord malformation (SCM). Diagnosis and management of this complex malformation is challenging. We presented 3 different cases of LDM. Two of them were associated with Type I SCM and the other had no associated malformation. All of them were evaluated radiologically just after the birth and underwent surgical treatment under intraoperative neuromonitoring. They discharged without any complication. Newborns with spinal cystic lesions should be carefully evaluated for spinal malformations after the birth and treated surgically as soon as possible in order to prevent neurological and urological complications secondary to tethered cord syndrome. Surgical technique in LDM-SCM patients is quite different than the patients with solitary LDM.

Structural constraints of secondary asymmetry in male external genitalia of Noctuidae

2013 ◽  
Vol 44 (3-4) ◽  
pp. 349-372 ◽  
Author(s):  
Zoltán Varga ◽  
László Ronkay
Keyword(s):  
Reproductive Success ◽  
Complex Structure ◽  
External Genitalia ◽  
The Other ◽  
Structural Constraints ◽  
Asymmetric Structures ◽  
Other Hand ◽  
Spatial Geometry ◽  
Male External Genitalia ◽  
Working Hypotheses

The basic architecture of the external genitalia of Noctuidae (“genital capsula”) is bilaterally symmetric. Secondary asymmetry is well-known in different subfamilies and tribes. We review and interpret the functions and processes which may be responsible for secondary asymmetry (i.e., dissymmetry) of these structures in terms of structural vs. behavioural working hypotheses. We consider the genital structures as correlated elements of a complex structure (“bauplan”) in which some changes in details can be explained by selection due to optimization of the reproductive success. Major pathways of changes are, however, delimited by some structural constraints which appear in parallel in different phyletic lines of trifine Noctuidae. One of these constraints is the subsistence of symmetry in structures with own musculature. On the other hand, some rigid parts without own musculature can evolve more rapidly and divergently in connection with the different allocation of functions. Such asymmetric structures may have some selective advantages due to the more effective stimulation, on one side, and fixation of genital parts during copulation, on the other. Asymmetric structures can effectively enhance the variations of the spatial geometry but without change of the “bauplan” which can be preserved in parallel in different taxonomical groups. It means that the originally symmetric “bauplan” with its homologies can be considered as a phyletic “heritage”, while the functional dissymmetrisation driven by selective optimization is the “habitus” in which numerous homoplasies can occur.

scholarly journals Rapunzel syndrome

2012 ◽  
Vol 69 (8) ◽  
pp. 717-720 ◽  
Author(s):  
Gordana Petrovic ◽  
Aleksandar Nagorni ◽  
Goran Bjelakovic ◽  
Daniela Benedeto-Stojanov ◽  
Biljana Radovanovic-Dinic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Foreign Bodies ◽  
Psychiatric Treatment ◽  
Abdominal Mass ◽  
Rare Form ◽  
Rapunzel Syndrome ◽  
Younger Women ◽  
Palpable Abdominal Mass ◽  
Over Time

Introduction. Trichobezoars are foreign bodies in gastrointestinal tract, composed of hair. They occur mainly in children and adolescents suffering from trichotillophagia. They commonly occur in the stomach, but as they enlarge over time, they can extend through the pylorus into distal parts of the small intestine resembling a tail. This rare form of trichobezoar is named Rapunzel syndrome. Case report. We presented a 19-year-old female patient, who suffered from trichotillomania and trichotillophagia, which led to trichobezoar formation. Intra-abdominal tumour was suspected after initial clinical examination. Abdominal echosonography, endoscopy and abdominal computed tomography (CT scan) in the pre-operational period revealed trichobezoar formation. The patient was operated on and subjected to further psychiatric treatment. Conclusion. Trichobezoar should be differentially diagnostically taken into consideration in younger women with abdominal pain, nausea, vomiting, palpable abdominal mass and psychiatric disorders. Most trichobezoar cases require surgical treatment, whereas the patients need long-term psychiatric treatment and monitoring.

Conjoined Epigastric Heteropagus Twins: Excision of a Parasitic Twin from the Anterior Abdominal Wall of Her Sibling

2007 ◽  
Vol 17 (1) ◽  
pp. 66-71 ◽  
Author(s):  
J. Hager ◽  
M. Sanal ◽  
R. Trawöger ◽  
I. Gassner ◽  
E. Oswald ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Parasitic Twin

scholarly journals Mixed Phenotype Acute Leukemia with 3 lineages differentiation & the challenge in the establishing of the diagnosis: a case report

2020 ◽  
Vol 8 (4) ◽  
pp. 71-73
Author(s):  
Mariam Al Ghazal ◽  
Rehab Bu Khamseen
Keyword(s):  
Acute Leukemia ◽  
Clinical Presentation ◽  
Flow Cytometric Analysis ◽  
The Other ◽  
Antigenic Determinants ◽  
Rare Form ◽  
Lineage Differentiation ◽  
Flow Cytometric ◽  
Mixed Phenotype Acute Leukemia ◽  
Mixed Phenotype

Mixed phenotype acute leukemia (MPAL) is a rare form of acute leukemia comprising 2% to 3% of all acute leukemia diagnoses. The diagnosis of MPAL is based on flow cytometric analysis of the immunophenotype, which demonstrates expression of differentiation-related antigens belonging to multiple lineages commonly, one lineage is myeloid and the other is B and/or T lymphoid. Whether lineage differentiation determines clinical presentation and outcomes is unclear. Here we report a case of 37 years old man who presented with leukocytosis & found to have MPAL (mixed phenotype acute leukemia) with possible differentiation to 3 lineages as evident by flowcytometry cases with trilineage antigenic determinants are very rare.

scholarly journals Spontaneous cholecystocutaneous fistula: empirically treated for a missed diagnosis, managed by laparoscopy

2019 ◽  
Vol 12 (2) ◽  
pp. e228138 ◽  
Author(s):  
Manjunath Maruti Pol ◽  
Surabhi Vyas ◽  
Priyanka Singh ◽  
Yashwant Singh Rathore
Keyword(s):  
Anterior Abdominal Wall ◽  
Health Centre ◽  
Sinus Tract ◽  
Postoperative Recovery ◽  
Primary Health Centre ◽  
Primary Health ◽  
Missed Diagnosis ◽  
Normal Ultrasound ◽  
The Right ◽  
Wedge Biopsy

A 70-year-old woman was referred to our hospital from primary health centre with complaints of pain in the abdomen, swelling and discharging sinus in the right hypochondrium since 2 years. She had received anti-tubercular treatment for 18 months as the wedge biopsy of the sinus tract suggested granulomatous lesion. As the symptoms did not subside she was referred to our hospital. Her blood investigation reports at our hospital were normal. Ultrasound of the abdomen suggested cholelithiasis with normal common bile duct. CT fistulogram findings were diagnostic of cholecystocutaneous fistula (CCCF). She underwent laparoscopic cholecystectomy and excision of the sinus tract. Postoperative recovery was uneventful. Indiscriminate usage of anti-tubercular drugs should be discouraged and possibility of CCCF should be considered in patients presenting with discharging sinus in the anterior abdominal wall. CT fistulogram is helpful in making diagnosis of CCCF. Cholecystectomy with excision of the sinus tract is the treatment of choice.

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