scholarly journals Sonographic Signs of Adenomyosis Are Prevalent in Women Undergoing Surgery for Endometriosis and May Suggest a Higher Risk of Infertility

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Vered H. Eisenberg ◽  
Nissim Arbib ◽  
Eyal Schiff ◽  
Motti Goldenberg ◽  
Daniel S. Seidman ◽  
...  

Objectives. To determine the prevalence of ultrasound features suggestive of adenomyosis in women undergoing surgery for endometriosis compared with a control group of healthy women without endometriosis. Methods. Retrospective case-control study comparing women with intractable pain or infertility, who underwent transvaginal ultrasound and subsequent laparoscopic surgery, with a control group of healthy women without a previous history of endometriosis. A diagnosis of adenomyosis on TVUS was made based on asymmetrical myometrial thickening, linear striations, myometrial cysts, hyperechoic islands, irregular endometrial-myometrial junction, parallel shadowing, and localized adenomyomas and analyzed for one sign and for three or more signs. Results. The study and control groups included 94 and 60 women, respectively. In the study group, women were younger and had more dysmenorrhea and infertility symptoms. The presence of any sonographic feature of adenomyosis, as well as three or more signs, was found to be more prevalent in the study group, which persisted after controlling for age, for all features but linear striations. Women in the study group who had five or more sonographic features of adenomyosis had more than a threefold risk of suffering from infertility (OR = 3.19, p=0.015, 95% CI; 1.25–8.17). There was no association with disease severity at surgery. Conclusions. Sonographic features of adenomyosis are more prevalent in women undergoing surgery for endometriosis compared to healthy controls. Women with more than five features had an increased risk of infertility.

2021 ◽  
Vol 10 (11) ◽  
pp. 2355
Author(s):  
Dean Decter ◽  
Nissim Arbib ◽  
Hila Markovitz ◽  
Daniel S. Seidman ◽  
Vered H. Eisenberg

We compared the prevalence of ultrasound signs of adenomyosis in women with endometriosis who underwent surgery to those who were managed conservatively. This was a retrospective study of women evaluated at a tertiary endometriosis referral center who underwent 2D/3D transvaginal ultrasound. Adenomyosis diagnosis was based on the presence of at least three sonographic signs. The study group subsequently underwent laparoscopic surgery while the control group continued conservative management. Statistical analysis compared the two groups for demographics, symptoms, clinical data, and sonographic findings. The study and control groups included 244 and 158 women, respectively. The presence of any, 3+, or 5+ sonographic signs of adenomyosis was significantly more prevalent in the study group (OR = 1.93–2.7, p < 0.004, 95% CI; 1.24–4.09). After controlling for age, for all findings but linear striations, the OR for having a specific feature was higher in the study group. Women in the study group with ≥ 5 sonographic signs of adenomyosis had more than twice the risk of experiencing infertility (OR = 2.31, p = 0.012, 95% CI; 1.20–4.45). Sonographic signs of adenomyosis are more prevalent in women with symptomatic endometriosis who underwent surgery compared with those who continued conservative management. Women with 5+ findings have a significantly increased risk of infertility. Adenomyosis on ultrasound should be considered in the management decisions regarding these patients.


2021 ◽  
Vol 28 (2) ◽  
pp. 185-192
Author(s):  
Neha SAHAY ◽  
◽  
Felice FAIZAL ◽  

Background: Glucose tolerance testing in pregnancy identifies many women with glycaemic responses that exceed normal range but that do not meet the threshold required to diagnose Gestational Diabetes Mellitus. It is controversial whether maternal hyperglycemia less severe than in diabetes is associated with increased risk of adverse pregnancy outcome or not. Materials and methods: All women were subjected to Glucose Challenge Test(GCT) with 50 gram glucose either at first visit or between 24-28 weeks on the basis of risk profile. High risk cases were screened at first visit and the rest between 24-28 weeks. Patients with a GCT value ≥200mg/dl were not subjected for GTT and were diagnosed as GDM.Value of GCT <140 mg/dl was taken as normal. Irrespective of GCT result, women were subjected to Oral Glucose Tolerance Test (OGTT) as recommended by WHO with 75 gram glucose using WHO criteria. Study group was identified with 4 categories with abnormal glucose homoeostasis as defined by the following criteria: 1. Abnormal GCT (>140 mg/dl) with normal OGTT; 2. Normal GCT with only Impaired Fasting Glucose(IFG) in OGTT; 3. Normal GCT with Gestational Glucose Intolerance(GGI); 4. Patients diagnosed as GDM: a. If fasting is >126mg/dl; b. If 2hr OGTT ≥ 140mg/dl & ≤ 199 mg/dl; c. If value of either GCT or OGTT >200 mg/dl. The control group comprised of women with normal GCT and normal OGTT. In all the above groups, adverse prenatal outcome and maternal outcomes were evaluated by the primary and secondary outcome measures. Results: There were 10 cases (15.3%) of hypertensive disorder of pregnancy in the study group (3 cases of gestational hypertension in abnormal GCT, 3 cases of pre eclampsia in each GGI and GDM and 1 antepartum eclampsia in GGI category) and 2 cases in control group (3%) (p=0.03). There were 2 cases of Fetal Growth Reduction (FGR) and 5 cases of Premature Rupture Of Membranes(PROM) in both study and control group. There was 1 case of cholestasis of pregnancy in study group. Term inductions were 11 and 13 in the study and control group respectively.Within the study group number of cases induced were more in GGI(n=7) and GDM(n=4) category. There were 14 caesarean sections (21.5%) and 2 (3%) instrumental deliveries among the study group. However there were 6 caesarean sections (9.2%) and no instrumental deliveries among control groups. The rate of elective LSCS is more in GDM (n=5) vs other 3 categories and the difference is significant (p=0.04) The overall number of LSCS (14 cases) was significantly higher in GDM. Conclusion: Cases with abnormal glucose homeostasis of lesser degree than GDM, like only abnormal GCT, IFG and GGI also were observed to have adverse maternal outcomes than controls, in form of hypertensive disorders of pregnancy, significantly higher LSCS rates, and increased risk of macrosomia. Instead of 2 step procedure, single step screening cum diagnostic test with 75 gm OGTT for diagnosing GDM could be an option to be universally practiced.


2021 ◽  
Author(s):  
A T M Hasibul Hasan ◽  
Muhammad Sougatul Islam ◽  
Nushrat Khan ◽  
Nazmul Hoque Munna ◽  
Wahidur Rahman Choton ◽  
...  

AbstractBackgroundFatigue has been observed after a number of infectious disease outbreaks around the world. After the outbreak of SARS CoV-2 in Wuhan, China in 2019, the disease turned into a pandemic very rapidly. Mental health is a key issue associated with such outbreaks. To explore the fatigue level among physicians working in designated public and private hospitals in Bangladesh, we conducted a matched case-control study of post-SARS-CoV-2 fatigue.MethodIn this study 105 physicians who were diagnosed as COVID-19 infected, got treatment, and declared cured at least 6 weeks before the interview date, were recruited as cases and the same number of age and designation matched healthy physicians as control who are working in the same hospital. Case and control were selected in 1:1 ratio from each of the hospitals. The study population was selected by inclusion and exclusion criteria after taking informed written consent. Data collection was done by a semi-structured questionnaire. Diagnosis of COVID--19 infection was done by detection of SARS CoV-2 antigen by RT-PCR from reference laboratories in Bangladesh or by HRCT Chest.ResultAround two-thirds of the physicians were male (67.6% versus 32.4%). Most of them aged less than forty years (80.5%). The cases had a greater number of comorbid conditions than those who were negative. The FSS score (mean) was much higher for cases (36.7 ± 5.3 versus 19.3 ± 3.8) than the control group with a statistically significant difference with no significant gender differentiation. Similarly, around 67.7% of the previously COVID positive physicians represented in the highest FSS score tertile compared to the respondents in the control group had a mean score of less than 3. The difference was also highly significant.ConclusionPhysicians, who had a previous history of COVID-19 infection had a higher total and mean FSS score, signifying a more severe level of fatigue than the physicians who had never been COVID-19 positive while working in the same hospital irrespective of their age and sex.


2018 ◽  
Vol 5 (2) ◽  
pp. 414
Author(s):  
Butungeshwar Pradhan ◽  
Sagnika Tripathy ◽  
Chakradhar Majhi ◽  
Tushar K. Behera

Background: Sickle cell disease (HbSS) causes much of the morbidity and mortality due to its chronic anaemia and vaso-occlusive painful crisis. Hydroxyurea is now using to treat HbSS. Aspartame appears to have antisickling properties. The objective of this study was to asses the effects of prophylaxis oral Aspartame among HbSS patients on anaemia and vaso-occlusive painful crisis.Methods: 208 cases of HbSS patients with history of vaso-occlusive crisis (VOC) and/or anaemia were selected for the study and divided into study group (n = 104) and control group (n = 104). 31 and 38 patients were on Hydroxyurea in study group and control group respectively. Baseline hemoglobin was estimated in all cases and oral Aspartame was given in a dose of 4 mg/kg/day in three divided doses. Monthly hemoglobin levels were measured in all cases for six months. Data were collected and compared with control data by using SPSS software version 25.Results: Mean baseline hemoglobin was 6.99 gm% and increased to 8.43 gm% (P <0.05) after receiving Aspartame prophylaxis. Aspartame add on to Hydroxyurea also had increased in haemoglobin levels. Incidence of VOC was 7.26% in control group. In Hydroxyurea group 3.58% had VOC. In study group 1.2% and in add on to Hydroxyurea group had 1.125 of milder degree of VOC (P <0.05).Conclusions: Aspartame appears to have antisickling properties and improves anaemia and decreases frequency and severity of VOC among HbSS patients and is non-inferior to Hydroxyurea.


2022 ◽  
Vol 24 (1) ◽  
Author(s):  
Tal Gazitt ◽  
Jacob Pesachov ◽  
Idit Lavi ◽  
Muna Elias ◽  
Amir Haddad ◽  
...  

Abstract Background Although the risk of cardiovascular disease has been discussed extensively in both psoriasis (PsO) and psoriatic arthritis (PsA), very few studies have addressed the occurrence of venous thromboembolic (VTE) events among PsO patients, and even fewer in PsA. Thus, our goal was to assess the association between PsA and VTE events using a large population-based database. Methods This retrospective cohort study includes all 5,275 patients with newly diagnosed PsA from the largest health care provider in Israel between January 2003 and December 2018. Identified PsA patients were matched by age, sex, ethnicity, and index date with 21,011 controls without PsA from the same database. Both groups were followed through June 30, 2019 for the occurrence of VTE event. Cox proportional hazard regression models were used to assess the association between PsA and VTE. Results PsA cohort consisted of 53.2% females with mean age of 51.7±15.4 Sixty-two patients (1.2%) were diagnosed with VTE in the PsA group and 176 patients (0.8%) in the control group (p=0.023, HR=1.40, 95% CI 1.05-1.87). However, there was no increased risk of VTE among PsA patients on multivariable analysis (p=0.16, HR=1.27, 95% CI 0.91-1.80). Within the PsA group, patients with VTE were more often of older age and with history of VTE. Conclusions This study suggests that the increased risk of VTE in PsA patients appears to be related to the underlying comorbidities and not independently associated with PsA. Age and previous history of VTE were the only risk factors associated with increased risk of VTE in patients with PsA. Addressing VTE risk is recommended especially in the era of Janus kinase inhibitors.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Dimuthu Vinayagam ◽  
Edwin Chandraharan

Background. Confidential enquiries into maternal deaths in the UK have repeatedly highlighted increased maternal morbidity and mortality associated with maternal obesity. Objective. To determine the impact of increased body mass index (BMI) on intrapartum outcomes. Materials and Methods. A retrospective case-control analysis of intrapartum outcomes of the study group (100 women), with a BMI above 40 kg/m2 (class III Obesity) at booking and a control group (100 women) with a booking BMI between 20 and 25 kg/m2 was performed. Results. A statistically significant increase in delivery by caesarean section (OR 2.32, 95% CI 1.26–4.29), minor and major postpartum haemorrhage (OR 5.93, 95% CI 2.34–11.98, OR 16.11, 95% CI 2.08–125.09, resp.), perineal trauma (OR 2.59, 95% CI 1.44–4.69), and fetal macrosomia (OR 3.11, 95% CI 1.25–7.79) was noted in the study group. Babies also had an increased risk of having a lower APGAR scores in the study group as compared to the control group (OR 3.09, 95% CI 1.07–8.94). Conclusion. Women with a BMI > 40 kg/m2 experience increased incidence of intrapartum complications and hence, input of skilled birth attendants during labour is essential to improve intrapartum outcomes.


2006 ◽  
Vol 13 (03) ◽  
pp. 423-430
Author(s):  
WAJID ALI ◽  
WAJEH UR REHMAN ◽  
NIAZ MAQSOOD

Objectives: To determine the different levels of drug non-compliance inpatients with schizophrenia and to find out its relationship to relapses of the disorder and admission to the hospital.Design: A randomized, retrospective, case- controlled study. Place and Duration of Study: Conducted at GovernmentMental Hospital Peshawar, from April 2001 to December 2002. Patients and Method: 50-Cases were randomly (eachfifth patient) selected from all the admissions with the DSM-IV diagnosis of Schizophrenia, 50- matched controls wererandomly (each fifth patient) selected from the outdoor patients. Both sexes were included. The basicsociodemographic characteristics and the clinical profile of all the patients were collected. The level of drug noncompliancewith previous history of admissions to hospital and total number of relapses. SPSS version 10 was usedfor statistical analysis. The applied method for group comparison was the Chi-square test. Results: The mean age ofstudy group was 33.54 ± 8.15 years as compare to 32.56 ± 9.02 years of control group, most participants were men,and a predominant proportion of participants were married. Majority of the patients were from the lower socio-economicclass. Scores on the drug non- compliance were statistically significant with a p value of (0.027). The differencebetween the two groups, regarding the previous number of relapses was statistically significant with a p value (0.002).The number of previous admission was also statistically significant and the p value was (0.017). 74.1% of the patientswith poor drug compliance relapsed, while 71% of patients with poor compliance needed admission. Conclusion: Animportant measure of out come is compliance with treatment. A substantial proportion of patients with schizophreniacontinues to relapse and are readmitted to the hospital as a result of non-compliance to treatment.


Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.


2017 ◽  
pp. 53-58
Author(s):  
Lam Huong Le

Objectives: Molar pregnancy is the gestational trophoblastic disease and impact on the women’s health. It has several complications such as toxicity, infection, bleeding. Molar pregnancy also has high risk of choriocarcinoma which can be dead. Aim: To assess the risks of molar pregnancy. Materials and Methods: The case control study included 76 molar pregnancies and 228 pregnancies in control group at Hue Central Hospital. Results: The average age was 32.7 ± 6.7, the miximum age was 17 years old and the maximum was 46 years old. The history of abortion, miscarriage in molar group and control group acounted for 10.5% and 3.9% respectively, with the risk was higher 2.8 times; 95% CI = 1.1-7.7 (p<0.05). The history of molar pregnancy in molar pregnancy group was 9.2% and the molar pregnancy risk was 11.4 times higher than control group (95% CI = 2.3-56.4). The women having ≥ 4 times births accounted for 7.9% in molar group and 2.2% in control group, with the risk was higher 3.8 times, 95% CI= 1.1-12.9 (p<0.05). The molar risk of women < 20 and >40 years old in molar groups had 2.4 times higher than (95% CI = 1.1 to 5.2)h than control group. Low living standard was 7.9% in molar group and 1.3% in the control group with OR= 6.2; 95% CI= 1.5-25.6. Curettage twice accounted for 87.5%, there were 16 case need to curettage three times. There was no case of uterine perforation and infection after curettage. Conclusion: The high risk molar pregnancy women need a better management. Pregnant women should be antenatal cared regularly to dectect early molar pregnancy. It is nessecery to monitor and avoid the dangerous complications occuring during the pregnancy. Key words: Molar pregnancy, pregnancy women


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Katarzyna Sołkiewicz ◽  
Hubert Krotkiewski ◽  
Marcin Jędryka ◽  
Ewa M. Kratz

AbstractEndometriosis is an inflammatory disease which diagnostics is difficult and often invasive, therefore non-invasive diagnostics methods and parameters are needed for endometriosis detection. The aim of our study was to analyse the glycosylation of native serum IgG and IgG isolated from sera of women classified as: with endometriosis, without endometriosis but with some benign ginecological disease, and control group of healthy women, in context of its utility for differentiation of advanced endometriosis from the group of healthy women. IgG sialylation and galactosylation/agalactosylation degree was determined using specific lectins: MAA and SNA detecting sialic acid α2,3- and α2,6-linked, respectively, RCA-I and GSL-II specific to terminal Gal and terminal GlcNAc, respectively. The results of ROC and cluster analysis showed that the serum IgG MAA-reactivity, sialylation and agalactosylation factor may be used as supplementary parameters for endometriosis diagnostics and could be taken into account as a useful clinical tool to elucidate women with high risk of endometriosis development. Additionally, we have shown that the analysis of native serum IgG glycosylation, without the prior time-consuming and expensive isolation of the protein, is sufficient to differentiation endometriosis from a group of healthy women.


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