scholarly journals Association between serum chlamydial antibody levels and tubal infertility in tertiary health facility in South-East Nigeria: a case-control study

2021 ◽  
Vol 55 (3) ◽  
pp. 183-189
Author(s):  
Augustine D. Onyeabochukwu ◽  
Emmanuel O. Izuka ◽  
Onyema A. Onyegbule ◽  
Chiemeka C. Onumajuru ◽  
Uchenna T. Ejelonu ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Health Facility ◽  
Lower Abdominal Pain ◽  
Case Control ◽  
Sexual History ◽  
P Value ◽  
Tubal Factor Infertility ◽  
History Of ◽  
Tubal Factor ◽  
Chlamydial Antibody

Objectives: This study evaluates the association between genital Chlamydial infection and tubal factor infertility in a tertiary health facility in South-East Nigeria.Design: This was a case-control analytical study.Setting: Gynaecology Clinic and Maternity Unit of the Department of Obstetrics and Gynaecology of the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria.Participants: Ninety-six (96) women with confirmed tubal factor infertility served as the cases, and 96 women with normal intra-uterine pregnancy matched in age served as the control.Data Collection/Intervention: A structured questionnaire was used to extract information on the sociodemographic data and the sexual history of the participants. About 2mls of blood was collected, the blood was allowed to clot, and the sera were used for the test.Statistical analysis/Main outcome measure: Pearson Chi-square, Fisher’s exact test, likelihood ratio and multivariate logistic regression were used to determine risk associations and identify factors independently related to tubal factor infertility. P-value < 0.05 was considered significant.Results: The sociodemographic characteristics of both cases and control did not differ (P = 0.975). The Chlamydial antibody seropositivity was significantly higher in the cases than the control 78(81.2%) versus 13(13.5%) respectively {(P < 0.001; OR (95% CI) = 27.7(12.7-60.2)}. Only lower abdominal pain {(P = 0.011); OR (95% CI) = 4.3(1.4-13.3)}; was independently associated with tubal factor infertility.Conclusion: Tubal factor infertility is strongly associated with chlamydial IgG antibodies, and a history of lower abdominal pain significantly predicted tubal factor infertility.

scholarly journals Appendicitis Mimicking Orchitis-A Case Report

2019 ◽  
pp. 1-2
Author(s):  
NG Bertrand RJ ◽  
Subramanian Pradeep
Keyword(s):  
Abdominal Pain ◽  
Past History ◽  
Inflammatory Marker ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Perforated Appendicitis ◽  
Sexual History ◽  
Atypical Presentation ◽  
Testicular Pain ◽  
History Of

Acute appendicitis is one of the most common emergency surgical procedure, yet atypical presentation sometimes can be challenging for clinician. I present a case of 19-year-old gentleman that initially presented with 1day history of bilateral testicular pain and lower abdominal pain. His past history includes a positive sexual history. Initial ultrasound of the testis showed bilateral orchitis and an equivocal appendix. With a significantly raised inflammatory marker and highly suspicious for appendicitis, a CT scan was obtained which showed perforated appendicitis and the patient underwent laparoscopic appendicectomy with resolution of symptoms after that. We encourage clinician to be aware of this clinical pitfall as patient can sometimes be managed in other department to minimise any delayed diagnosis or any unnecessary procedure.

scholarly journals Role of IgG Chlamydia antibody in tubal factor infertility

2017 ◽  
Vol 6 (3) ◽  
pp. 837
Author(s):  
Sheila Balakrishnan ◽  
Anitha Malathi ◽  
Geetha Raveendran ◽  
Dolly Johnrose ◽  
Sreekumari Radha
Keyword(s):  
Chlamydial Infection ◽  
Venous Blood ◽  
Igg Antibody ◽  
Infertile Women ◽  
Tubal Factor Infertility ◽  
Tubal Factor ◽  
Tubal Disease ◽  
The Difference ◽  
Chlamydial Antibody ◽  
The Relationship

Background: Chlamydial infection is considered to be one of the important causes of tubal factor infertility. This study will help to explore the relationship between positive Chlamydial infection and tubal damage in infertile women assessed by diagnostic laparoscopy. The results will help to determine whether a policy of routine screening for Chlamydia antibody is justifiable in infertile women to suspect tubal factor so that they can be taken up for laparoscopy earlier.Methods: A prospective study was performed on 158 consecutive patients who underwent laparoscopy as part of infertility evaluation. About 5 mL of venous blood was drawn preoperatively to detect Chlamydia IgG antibody in all the patients by ELISA. The laparoscopic findings were documented and the relationship to Chlamydial antibody evaluated.Results: Of the 158 patients who underwent laparoscopy, 95 patients had evidence of tubal disease as evidenced by unilateral or bilateral tubal block, peritubal adhesions, hydrosalpinx, beading of the tube and unhealthy shaggy appearance. Of the 95 patients with documented tubal disease at laparoscopy, 14 (14.7%) had antibodies to Chlamydia. Of the 63 patients with normal tubes, 12 (19%) had Chlamydial positivity. The difference is not statistically significant. However of the 26 patients who were positive for Chlamydia antibodies 14 patients (53.8%) had abnormal tubes. Out of the 158 patients who underwent laparoscopy 26 patients were positive for Chlamydia. Hence the prevalence in our study is 16.4% (26/158). The sensitivity is 14.7% and the specificity is 81%.Conclusions: This study showed no difference in Chlamydial positivity between infertile women with abnormal tubes and those with normal looking tubes in our population. The absence of Chlamydial antibodies cannot be taken as a marker for normal tubes. Hence screening for chlamydial antibody can neither be used as a screening test for tubal factor infertility nor to decide on the need for laparoscopy in the present population.

Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan
Keyword(s):  
Abdominal Pain ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Sudden Onset ◽  
Greater Omentum ◽  
Caribbean Woman ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right ◽  
Fat Stranding

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

SP3.2.1 Consultant-led Urgent Ambulatory Management of Righted-sided Lower Abdominal Pain: Prospective data collection

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Mubashar Hussain
Keyword(s):  
Abdominal Pain ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Clinical History ◽  
P Value ◽  
Prospective Data ◽  
Female Ratio ◽  
Blood Tests ◽  
Complications Rate ◽  
Male To Female

Abstract Aims To study if right lower abdominal pain could be managed safely on ambulatory basis when referred from emergency department or primary healthcare as suspected acute appendicitis to surgical ambulatory unit (SAU). Methods Data collated prospectively involving 586 patients, who presented with right iliac fossa/right-sided pelvic pain from january 2019 to January 2021. Results 0ut of 586 patients, 234 (40%) were admitted and 352 (60%) managed in ambulatory settings after being reviewed by Consulant-lead surgical oncall team. Age ranged from 3 to 92 years. Male to female ratio was 3:2. Their management included clinical history/and examination, urinalysis and blood tests. 157 (44%) patients had scans, 43 (12%) had CT scans and 114 (32%) had pelvic USS the same day or the following morning/day and were reviewed by oncall-surgeons and 107 (30%) patients had repeat blood tests. 39 (11%) out of 352 paitents were admitted the following day review, of which 18 (5%) patients underwent laproscopic appendicectomy (LA) and 8 (2.2%) patients treated conservatively. 9 (1.98%) patients represented with persistent/or worsening symptoms and 5 (1.4%) patients of these had LA and 2 (0.56%) patients had pelvic collection, drained radiologically and 2 (0.56%) had wound infections treated with antibiotics. Complications rate in ambulatory patients compared to in-patients was insignificant, P-value set at 0.05% using Mann-Whitney U test. Conclusions

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

scholarly journals Epiploic Appendagitis: An Often Misdiagnosed Cause of Acute Abdomen

2019 ◽  
Vol 13 (3) ◽  
pp. 364-368
Author(s):  
Vishnu Charan Suresh Kumar ◽  
Kishore Kumar Mani ◽  
Hisham Alwakkaa ◽  
James Shina
Keyword(s):  
Abdominal Pain ◽  
Bowel Wall ◽  
Acute Diverticulitis ◽  
Lower Abdominal Pain ◽  
Wall Thickening ◽  
Antibiotic Administration ◽  
Epiploic Appendagitis ◽  
High Attenuation ◽  
History Of ◽  
Bowel Wall Thickening

Epiploic appendages are peritoneal structures that arise from the outer serosal surface of the bowel wall towards the peritoneal pouch. They are filled with adipose tissue and contain a vascular stalk. Epiploic appendagitis is a rare cause of acute lower abdominal pain. It most commonly results from torsion and inflammation of the epiploic appendages, and its clinical features mimic acute diverticulitis or acute appendicitis resulting in being often misdiagnosed as diverticulitis or appendicitis. This frequently leads to unnecessary hospitalization, antibiotic administration, and unwarranted surgeries. Epiploic appendagitis is usually diagnosed with CT imaging, and the classic CT findings include: (i) fat-density ovoid lesion (hyperattenuating ring sign), (ii) mild bowel wall thickening, and (iii) a central high-attenuation focus within the fatty lesion (central dot sign). It is treated conservatively, and symptoms typically resolve in a few days. Therefore, epiploic appendagitis should be considered as one of the differential diagnosis for acute lower abdominal pain and prompt diagnosis of epiploic appendagitis can avoid unnecessary hospitalization and surgical intervention. In this case report, we discuss a 72-year-old woman who presented with a 2-day history of acute left lower abdominal pain.

scholarly journals Procidencia with rare complication -a case report

KYAMC Journal ◽  
2013 ◽  
Vol 3 (1) ◽  
pp. 262-264
Author(s):  
Mst Atia Sultana ◽  
Monira Akter ◽  
Shafiul Anam
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Rare Complication ◽  
Lower Abdominal Pain ◽  
Chemical Substances ◽  
Abdominal Tenderness ◽  
History Of

Mrs. Lalbanu 65 years old lady presented to us with the complaints of something coming down per vagina for 10 years, foul smelling discharge for 2 months, fever & maggot formation for 5 days, she  also gave history of applying some chemical substances on her prolapsed mass of genitalia, and she also complains of lower abdominal pain for last 5 days. On examination, prolapsed mass was distorted, edematous, infected, irreducible & there were maggots, her temperature was raised & having lower abdominal tenderness. She was treated at first conservatively & then surgically. Now  she is well & with our follow up.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13662 KYAMC Journal Vol. 3, No.-1, June 2012 pp.262-264

scholarly journals Underestimating the Burden of Disease in Sarcomatoid Carcinoma of The Lung: A Case Report and Literature Review

2019 ◽  
pp. 1-7
Author(s):  
Laleh Melstrom ◽  
Indra M. Newman ◽  
Jae Kim ◽  
Laleh Melstrom ◽  
Massimo D’Apuzzo ◽  
...  
Keyword(s):  
Past History ◽  
Inflammatory Marker ◽  
Delayed Diagnosis ◽  
Sarcomatoid Carcinoma ◽  
Lower Abdominal Pain ◽  
Perforated Appendicitis ◽  
Sexual History ◽  
Atypical Presentation ◽  
Testicular Pain ◽  
History Of

Acute appendicitis is one of the most common emergency surgical procedure, yet atypical presentation sometimes can be challenging for clinician. I present a case of 19-year-old gentleman that initially presented with 1day history of bilateral testicular pain and lower abdominal pain. His past history includes a positive sexual history. Initial ultrasound of the testis showed bilateral orchitis and an equivocal appendix. With a significantly raised inflammatory marker and highly suspicious for appendicitis, a CT scan was obtained which showed perforated appendicitis and the patient underwent laparoscopic appendicectomy with resolution of symptoms after that. We encourage clinician to be aware of this clinical pitfall as patient can sometimes be managed in other department to minimise any delayed diagnosis or any unnecessary procedure

scholarly journals A Case of Isolated Cecal Necrosis Preoperatively Diagnosed with Perforation of Cecum

Medicina ◽  
2019 ◽  
Vol 55 (1) ◽  
pp. 9 ◽  
Author(s):  
Atsushi Kohga ◽  
Kiyoshige Yajima ◽  
Takuya Okumura ◽  
Kimihiro Yamashita ◽  
Jun Isogaki ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Preoperative Diagnosis ◽  
Previous History ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Ileocecal Resection ◽  
Urgent Surgery ◽  
Ischemic Change ◽  
History Of ◽  
Laparoscopic Assisted

Isolated cecal necrosis (ICN) is a rare condition which is developed under decreased mesenteric perfusion. Only a few dozen cases of ICN have been reported previously. The patient was a 59-year-old male with a previous history of atrial fibrillation. He presented to our emergency room with the chief complaint of lower abdominal pain. Computed tomography imaging revealed a dilated cecum and presence of free air. With a preoperative diagnosis of perforation of the cecum; an urgent surgery was conducted. Intraoperative findings revealed an ischemic change of the cecum and a laparoscopic-assisted ileocecal resection was performed. The pathological findings showed transmural ischemic change on the anti-mesenteric side of the cecum, and the diagnosis of ICN was achieved. Preoperative diagnosis of ICN is difficult because of its non-specific radiological features. In patients with right lower abdominal pain, ICN should be considered as a differential diagnosis especially if the patient has a comorbidity causing hypotension attack.

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