scholarly journals REPRODUCTIVE OUTCOMES AFTER ABDOMINAL MYOMECTOMY

2021 ◽  
Vol 71 (4) ◽  
pp. 1311-13
Author(s):  
Yasmin Fatima ◽  
Mumtaz Amir
Keyword(s):  
Uterine Fibroids ◽  
Case Series ◽  
Military Hospital ◽  
Reproductive Outcomes ◽  
Assisted Reproductive Technique ◽  
Infertile Women ◽  
Abdominal Myomectomy ◽  
Spontaneous Conception ◽  
Study Results ◽  
Reproductive Technique

Objective: To determine the frequency of reproductive outcomes after abdominal myomectomy in infertile women. Study Design: Case series. Place and Duration of Study: at Combined Military Hospital, Multan Pakistan, from Sep 2015 to Feb 2017. Methodology: This study included 60 women who underwent myomectomy to retain their capabilities of reproduction. Inclusion criteria were infertile women with uterine fibroids. Routine investigation was done to all patients like ultrasound and hysterosalpingogram before and after the procedure. The procedure of abdominal myomectomy was done under general anesthesia. All fibroids were enucleated and large blood vessels were tied. Vicryl no.1 was used to close the uterine defect. All patients were followed up for 3, 6 and 12 months interval and data was collected for conception, spontaneous conception, and conception with assisted reproductive technique, live birth and miscarriage. Results: In this study mean age was 27.33 ± 4.03 years, mean number of fibroid was 1.366 ± 0.48 and mean size of fibroid was 7.06 ± 1.64 cm. Twenty eight (46.7%) women had conceived after myomectomy, in which 92.9% had spontaneous conception and 7.1% by assisted reproductive technique. Conclusion: Abdominal myomectomy should be the standard treatment of infertile women with uterine fibroids if no other underline cause of infertility. Moreover, this study results also showed that younger patients might be benefited more in term of reproductive outcomes after abdominal myomectomy.

scholarly journals DISORDERS OF SEXUAL DEVELOPMENT

2015 ◽  
Vol 22 (04) ◽  
pp. 401-407
Author(s):  
Naima Rasool
Keyword(s):  
Surgical Management ◽  
Reconstructive Surgery ◽  
Sexual Development ◽  
Case Series ◽  
Military Hospital ◽  
Team Approach ◽  
Complex Spectrum ◽  
Disorders Of Sexual Development ◽  
Clinical Presentations ◽  
Study Results

Objectives: To evaluate the etiology, clinical presentations, investigationsand surgical management of patients presenting with atypical genitalia in Pediatric surgerydepartment. Disorders of Sexual development are one of the most complex congenitaldisorders encountered by the treating physicians. In recent years, the diagnostic ability andsurgical techniques of gender reconstructions have improved remarkably. The spectrumincludes chromosomal, genotype and phenotype abnormalities. The birth of a baby withatypical genitalia poses diagnostic and treatment challenges. This article focuses on etiology,clinical presentations, investigations and surgical management of patients presentingwith ambiguous genitalia. Study Design: A descriptive, prospective case series. Setting:Department of Pediatric Surgery, Military Hospital, Rawalpindi, Pakistan. Period: October 2010to June 2014. Methods: All patients with atypical genitalia, who underwent any kind of genitalreconstruction surgery were included in the study. Results: A total of 28 patients were operatedupon during the study period. Age ranged from 11months to 12 years. Patients were dividedinto two groups on the basis of their karyotyping. Seventeen patients had 46 XY and 11 had 46XX. No mosaic pattern was seen. Male genital reconstructive surgery was done in 16 patientswhile 12 underwent female genital reconstructive surgery. Conclusions: Disorders of sexualdevelopment present as a complex spectrum of psychosocial, sexual, endocrine and surgicalimplications, thus management demands a multidisciplinary team approach. Appropriatelytimed surgical intervention after thorough work up and detailed counseling, produce excellentcosmetic and functional results.

scholarly journals Dietary Fatty Acid Intakes and the Outcomes of Assisted Reproductive Technique in Infertile Women

2021 ◽  
Author(s):  
Maryam Jahangirifar ◽  
Mahboube Taebi ◽  
Mohammad Hossein Nasr-Esfahani ◽  
Motahar Heidari-Beni ◽  
Gholam Hossein Asgari
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Saturated Fatty Acids ◽  
Fertilization Rate ◽  
Dietary Intakes ◽  
Chi Square ◽  
Assisted Reproductive Technique ◽  
Infertile Women ◽  
Total Fatty Acids ◽  
Reproductive Technique

Background: The purpose of this study was evaluating the relationship between fatty acid (FA) intakes and the Assisted Reproductive Technique (ART) out-comes in infertile women. Methods: In this descriptive longitudinal study, a validated food frequency questionnaire (FFQ) was used to measure dietary intakes among 217 women with primary infertility seeking ART treatments at Isfahan Fertility and Infertili-ty Center, Isfahan, Iran. The average number of total and metaphase II (MII) oocytes, the fertilization rate, the ratio of good and bad quality embryo and bio-chemical and clinical pregnancy were assessed. Analyses were performed using mean, standard deviation, Chi-square test, ANOVA, ANCOVA, logistic regres-sion. Results: A total of 140 women were finally included in the study. There was a positive relationship between the average number of total and MII oocytes and the amount of total fatty acids (TFAs), saturated fatty acids (SFAs), monoun-saturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), linoleic ac-ids, linolenic acids, and oleic acids intakes, while eicosapentaenoic acids (EPAs) and docosahexaenoic acids (DHAs) intakes had an inverse relationship. Consuming more amounts of TFAs, SFAs, PUFAs, MUFAs, linoleic acids, and oleic acids was associated with the lower fertilization rate, whereas the con-sumption of linolenic acids and EPAs increased the fertilization rate. The ratio of good quality embryo was directly affected by the amount of PUFAs intakes. Additionally, there was a negative correlation between the amount of SFAs in-takes and the number of pregnant women. Conclusion: TFAs, SFA, PUFA, and MUFA intakes could have both beneficial and adverse impacts on ART outcomes.

Percutaneous Pulmonary Valve Implantation in a Bangladeshi Center: A Case Series

2020 ◽  
Vol 28 (1) ◽  
pp. 1-6
Author(s):  
Fatema Nurun Nahar ◽  
Jufan Mansur Al ◽  
Shubert Stephan ◽  
Hossain Mir Mahmud
Keyword(s):  
Heart Disease ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Valve ◽  
Case Series ◽  
Military Hospital ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Pulmonary Valve Implantation

INTRODUCTION Incidence of congenital heart disease is 25 per thousand live birth in Bangladesh which is much higher than other countries. Tetralogy of Fallot, the commonest cyanotic heart disease (5%) and some other complex diseases with right ventricular outflow tract abnormality demand surgical correction and revision in many occasions including percutaneous intervention. As a resource constraint country, it was a difficult task to introduce percutaneous pulmonary valve implantation (PPVI) with MelodyTM. However, it was started on 12th December 2012 in Combined Military Hospital Dhaka, Bangladesh and cases performed till October 2019 were included in this series. METHODS Retrospective analysis of six cases who had PPVI with MelodyTM in Combined Military Hospital, Bangladesh. Patient with dysfunctional conduit between right ventricle (RV) and pulmonary artery causing (a) Symptoms of exceptional dyspnoea of various grade (NYHA II,III, IV) (b) RVEVD >150 ml/m2 ±regurgitant fraction >40% (c) RVOT peak instantaneous gradient > 30 mm Hg. (d) RV dysfunction (RVEF<40%) were accepted for the procedure and outcome were analyzed. RESULTS Mean age was 9.56 ± 2.96 years, weight was 28.75 ± 8.61 kg, height was 137.5 ± 17.52 cm. Mean age at surgery was 4.25 ± 2.72 years. Female were 66.66%. Aortic homograft was used in 66.66% cases. Eighteen mm Ensemble was used in four (66.66%) cases and 20 mm and 22 mm in one each. Immediate result was excellent with no residual PS in two cases and negligible residual flow acceleration across pulmonary valve in four cases. No PR seen in all except one. One patient developed Bacterial endocarditis after 3 years and was treated. CONCLUSION Aim of PPVI is to prolong the life expectancy of conduits which were placed surgically from right ventricle to pulmonary artery. In our case series, we found that Melody valve is functioning well without any complications like infective endocarditis or stent fracture. KEYWORDS PPVI, MelodyTM, RVOT, Outcome

scholarly journals Symptom Cluster-Matching Antidepressant Treatment: A Case Series Pilot Study

2021 ◽  
Vol 14 (6) ◽  
pp. 526
Author(s):  
Sławomir Murawiec ◽  
Marek Krzystanek
Keyword(s):  
Depressive Symptoms ◽  
Pilot Study ◽  
Antidepressant Treatment ◽  
Case Series ◽  
Symptom Cluster ◽  
Study Results ◽  
Cluster Matching ◽  
The Individual ◽  
Meta Analyses ◽  
Effectiveness Studies

Despite treating depression with antidepressants, their effectiveness is often insufficient. Comparative effectiveness studies and meta-analyses show the effectiveness of antidepressants; however, they do not provide clear indications as to the choice of a specific antidepressant. The rational choice of antidepressants may be based on matching their mechanisms of action to the symptomatic profiles of depression, reflecting the heterogeneity of symptoms in different patients. The authors presented a series of cases of patients diagnosed with depression in whom at least one previous antidepressant treatment was shown to be ineffective before drug targeted symptom cluster-matching treatment (SCMT). The presented pilot study shows for the first time the effectiveness of SCMT in the different clusters of depressive symptoms. All the described patients obtained recovery from depressive symptoms after introducing drug-targeted SCMT. Once validated in clinical trials, SCMT might become an effective and rational method of selecting an antidepressant according to the individual profile of depressive symptoms, the mechanism of their formation, and the mechanism of drug action. Although the study results are preliminary, SCMT can be a way to personalize treatment, increasing the likelihood of improvement even in patients who meet criteria for treatment-resistant depression.

scholarly journals Reproductive Performance Following Hysteroscopic Surgery for Uterine Septum: Results from a Single Surgeon Data

2021 ◽  
Vol 10 (1) ◽  
pp. 130
Author(s):  
Ertan Saridogan ◽  
Mona Salman ◽  
Lerzan Sinem Direk ◽  
Ali Alchami
Keyword(s):  
Reproductive Performance ◽  
Observational Studies ◽  
Patient Characteristics ◽  
Reproductive Outcomes ◽  
Hysteroscopic Surgery ◽  
High Quality Evidence ◽  
Study Results ◽  
Significant Difference ◽  
Uterine Septum

Uterine septum can negatively affect reproductive outcomes in women. Based on evidence from retrospective observational studies, hysteroscopic incision has been considered a solution to improve reproductive performance, however there has been recent controversy on the need for surgery for uterine septum. High quality evidence from prospective studies is still lacking, and until it is available, experts are encouraged to publish their data. We are therefore presenting our data that involves analysis of the patient characteristics, surgical approach and long-term reproductive outcomes of women who received treatment for uterine septum under the care of a single surgeon. This includes all women (99) who underwent hysteroscopic surgery for uterine septum between January 2001 and December 2019. Of those 99 women treated for intrauterine septum who were trying to conceive, 91.4% (64/70) achieved pregnancy, 78.6% (55/70) had live births and 8.6% (6/70) had miscarriages. No statistically significant difference was found in the live birth rates when data was analyzed in subgroups based on age, reason for referral/aetiology and severity of pathology. Our study results support the view that surgical treatment of uterine septa is beneficial in improving reproductive outcomes.

scholarly journals An Endovascular Surgery Experience in Far-Forward Military Healthcare—A Case Series

2020 ◽  
Vol 185 (11-12) ◽  
pp. 2183-2188
Author(s):  
Daniel J Coughlin ◽  
Jason H Boulter ◽  
Charles A Miller ◽  
Brian P Curry ◽  
Jacob Glaser ◽  
...  
Keyword(s):  
Case Series ◽  
Interventional Neuroradiology ◽  
Military Hospital ◽  
Lingual Artery ◽  
Trauma Patients ◽  
Military Hospitals ◽  
Life Saving ◽  
Military Healthcare ◽  
Internal Iliac ◽  
First World

Abstract Summary   Introduction The advancement of interventional neuroradiology has drastically altered the treatment of stroke and trauma patients. These advancements in first-world hospitals, however, have rarely reached far forward military hospitals due to limitations in expertise and equipment. In an established role III military hospital though, these life-saving procedures can become an important tool in trauma care. Materials and Methods We report a retrospective series of far-forward endovascular cases performed by 2 deployed dual-trained neurosurgeons at the role III hospital in Kandahar, Afghanistan during 2013 and 2017 as part of Operations Resolute Support and Enduring Freedom. Results A total of 15 patients were identified with ages ranging from 5 to 42 years old. Cases included 13 diagnostic cerebral angiograms, 2 extremity angiograms and interventions, 1 aortogram and pelvic angiogram, 1 bilateral embolization of internal iliac arteries, 1 lingual artery embolization, 1 administration of intra-arterial thrombolytic, and 2 mechanical thrombectomies for acute ischemic stroke. There were no complications from the procedures. Both embolizations resulted in hemorrhage control, and 1 of 2 stroke interventions resulted in the improvement of the NIH stroke scale. Conclusions Interventional neuroradiology can fill an important role in military far forward care as these providers can treat both traumatic and atraumatic cerebral and extracranial vascular injuries. In addition, knowledge and skill with vascular access and general interventional radiology principles can be used to aid in other lifesaving interventions. As interventional equipment becomes more available and portable, this relatively young specialty can alter the treatment for servicemen and women who are injured downrange.

Medical abortion in women with large uterine fibroids: a case series

Contraception ◽  
2016 ◽  
Vol 94 (5) ◽  
pp. 572-574 ◽  
Author(s):  
Katrina Mark ◽  
Barbara Bragg ◽  
Kiranpreet Chawla ◽  
Katherine Hladky
Keyword(s):  
Uterine Fibroids ◽  
Case Series ◽  
Medical Abortion
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