Hallazgos genitourinarios en mujeres con tumores ováricos / Genito-urinary findings in women with ovarian tumors

Los tumores de ovario son los trastornos ginecológicos más comunes. Los tumores de ovario son el tercer tumor más común en las mujeres. Los tumores de ovario a veces son asintomáticos y tienen síntomas no específicos, lo que hace que la mayoría de los casos sean difíciles de detectar temprano. El objetivo de este estudio fue investigar las características genitourinarias del tumor ovárico en un estudio hospitalario. Se realizó un estudio observacional en Bagdad, Iraq, entre septiembre de 2018 y febrero de 2021. Las mujeres diagnosticadas con tumores ovarios a los 18 años de edad o más. Un total de cincuenta mujeres que se inscribieron en nuestro hospital. Datos clínicos y patológicos recopilados y analizados. Los datos sobre comorbilidades y resultados fueron aprobados y diagnosticados por un equipo completo de médicos ginecológicos y urológicos multidisciplinarios. La incidencia general de tumores ováricos fue 70% maligna y 30% benigna. El estudio mostró que la mayor parte del grupo de edad de tumores ováricos era superior a 55 años (62%). La mitad de los pacientes eran nuliparidades. El nivel educativo era principalmente de bajo nivel en analfabeto (20%), primario (24%), secundario (36%) en comparación con el alto nivel. Las mujeres usaron anticoncepción en 52%. La historia familiar informó en el 18% de las mujeres. El tipo histopatológico más común era el carcinoma seroso ovárico 15 (30%). Las etapas regionales eran comunes en el 50% de los pacientes. Tumores de bajo grado en 32%, intermedio en 36%y alto en 32%. Casi, el 80% de las mujeres se sometieron a TAH. Alrededor del 60% de los pacientes recibieron quimioterapia. Los resultados de salud genitourinaria adversos a largo plazo incluyeron nefritis (6%), insuficiencia renal aguda (16%), enfermedad renal crónica (18%), infección urinaria (38%), cálculo (16%), hidronefrosis (20%), Obstrucción de la vejiga (2%), estenosis ureteral (12%), retención de orina (8%), incontinencia de orina (12%), hematuria (22%), PID (14%), adhesión de órganos (8%), cervicitis (2 %), Endometriosis (2%), quiste (6%), trastornos menstruales (24%), infertilidad (2%) y dolor menopáusica (32%). En conclusión, el cáncer de ovario representa el tercer tipo de cáncer ginecológico más común. Era más común en mujeres mayores de cinco décadas. El tipo histopatológico más común es el carcinoma seroso ovárico. Observamos que los sobrevivientes de cáncer de ovario experimentaron mayores riesgos de varias enfermedades genitourinarias. Comprender los escenarios de la morbilidad múltiple para los tumores ováricos es de vital importancia para mejorar la atención clínica después del diagnóstico.

Ovarian tumors are the most common gynecological disorders. Ovarian tumors are the third most common tumor in women. Ovarian tumors are sometimes asymptomatic and have non-specific symptoms, making most cases difficult to detect early. The aim of this study was to investigate genitourinary features of ovarian tumor in a hospital-based study. An observational study was conducted in Baghdad, Iraq, between September 2018 and February 2021. Women diagnosed with ovarian tumors at 18 years of age or older. A total of Fifty women who enrolled in our hospital. Clinical and pathological data collected and analyzed. Data about comorbidities and outcomes were approved and diagnosed by full team of multidisciplinary gynecological and urological doctors were recorded. Overall incidence of ovarian tumors was 70% malignant and 30% benign. The study showed that the most age group of ovarian tumors was above 55 years (62%). Half of patients were nulliparities. Educational level was mostly of low level in illiterate (20%), primary (24%), secondary (36%) compared to high level. Women used contraception in 52%. The family history reported in 18% of women. The most common histopathological type was ovarian serous carcinoma 15(30%). Regional stages were common in 50% of patients. Low grade tumors in 32%, intermediate in 36% and high in 32%. Almost, 80% of women underwent TAH. About 60% of patients received chemotherapy. The long-term adverse genitourinary health outcomes correlated included Nephritis (6%), Acute renal failure (16%), Chronic kidney disease (18%), UTI (38%), Calculus (16%), Hydronephrosis (20%), Bladder obstruction (2%), Ureteric stenosis (12%), Urine retention (8%), Urine incontinence (12%), Hematuria (22%), PID (14%), Organ adhesion (8%), Cervicitis (2%), Endometriosis (2%), Cyst (6%), Menstrual disorders (24%), Infertility (2%), and Menopausal pain (32%). In conclusion, ovarian cancer represents the third most common gynecologic cancer type. It was more common in women aged above five decades. The most common histopathological type is ovarian serous carcinoma. We observed that ovarian cancer survivors experienced increased risks of various genitourinary diseases. Understanding the multi-morbidity scenarios for ovarian tumors is of vital importance to improve clinical care after diagnosis.

Assessment of oral metronidazole in pain management post haemorrhoidectomy

Background: Haemorrhoids are a very popular disease. Approximately 50% to 66% of people have problems with haemorrhoids at some point in their lives. The pathophysiology of haemorrhoids is not exactly well known. Theories were developed trying to understand the pathophysiology of haemorrhoids e.g., varicose vein theory, anal lining sliding theory, hyperactivity of internal sphincter theory and vascular hyperplasia theory. Diagnosis is made by integration of available clinical data [symptoms], clinical examination and investigations. Although, we are using the term to refer to the disease resulting from their congestion and swelling, it is hard to evaluate the exact prevalence of haemorrhoids in a certain community as a lot of people suffering from the condition don't seek for medical advice

Objectives: This thesis study was done to assess the efficacy of oral metronidazole administration in management of post haemorrhoidectomy pain

Patients and Method: This study was conducted at El Demerdash Hospital and Damanhour National Institute in 1/1/2018 to 30/6/2018. 80 patients presented to the General Surgery Clinic and met the inclusion criteria in six month duration. The participants were divided into two groups 40 in each group

Results: When the results of both groups were put in a comparison, it showed that group A had a significant lower pain values in day 1 and 3 than group B but both groups[p=0.043*,p= 0.004]results were equivocal in day seven with no significant difference[p=0.268]. Also results showed that group B needed more analgesics than group A and that confirms that metronidazole do decrease pain experienced by the patients after the operation and decreased their need for analgesics[p=0.043]. Otherwise, both groups show no significant differences according to the time of first bowel movement[p=0.967]

Conclusion: Oral Metronidazole administration post haemorrhoidectomy significantly decrease the post-operative pain and decrease the need for more analgesics with no significant effect on the time of the first bowel movement

Study of the effect of repetitive transcranial magnetic stimulation on a sample of children with attention-deficit/hyperactivity disorder

Background: attention Deficit Hyperactivity Disorder [ADHD] is one of the most common neuropsychiatric disorder that affects children and young adults and cause significant functional impairment. Although there are effective medications and psychobehavioural therapies that help with management of ADHD, the medications can have significant side effects, which limit their use. There is need to explore other treatment options. transcranial magnetic stimulation [TMS] and repetitive transcranial magnetic stimulation [rTMS] are recent safe and non-invasive investigative and therapeutic tools

Aim of the work: to study the effect of repetitive transcranial magnetic stimulation on a sample of children with Attention-Deficit/Hyperactivity Disorder

Methods: the sample was consisted of [35] child; their ages were ranged from 6 to 12 years old after diagnosed clinically according to DSM-5 through a designed semi structured interview and through application of Conner's teacher-28 and parent-48 rating scales as ADHD combined type. Females were [11] children with percentage 31.4%, while males were [24] children with percentage 68.6%. All patients on the sample were not receiving any medical or behavioral therapy for ADHD

Results: means scores of inattention, hyperactivity and impulsivity were reduced significantly in the post 5 days and 2 weeks follow up [P-values > 0.001[, started to rise again in its evaluation after 4 weeks but not reaching its values before rTMS sessions. the percentage of severe cases in each scale category was dramatically decreased immediately and 2 weeks after rTMS sessions and started to rise again in its evaluation after 4 weeks but to lower percent than before rTMS sessions [70%, 100% and 60% had severe inattention, hyperactivity and impulsivity respectively before rTMS, reduced to 0%, 0%, 10% immediately and 2 weeks after rTMS but increased to [20%, 40% and 40%] after 4 weeks. no patient experienced any significant adverse effects during the study, except 3 children reported mild headache that resolved spontaneously within an hour without medication

Conclusion: this study concluded that r TMS over left dorso-lateral prefrontal cortex may be safe and effective way of providing relatively lasting relief of ADHD symptoms especially in children with severe symptoms

Reporting ureteroscopy complications using the modified Clavien classification system

Perioperative complications are one of the surrogate indicators of surgical outcomes. However, reporting these complications need a precise grading system. Our aim is to report and grade the complications of semirigid ureteroscopy in ureteral stone management according to the modified Clavien classification system. This is a prospective study conducted From January 2012 to June 2013. All patients with ureteral stones who were indicated for semirigid URS were evaluated. All procedures were performed by the same surgeon. The data recorded including patient demographics, clinical indication, stone size and location, operative time and complications were classified according to the modified Clavien classification system. The patients were followed for 8 weeks postoperatively.148 patients included, Stone distribution was: 89 [60.1%] lower ureteral, 26 [17.6%] mid ureteral, and 33 [22.3%] upper ureteral. the mean stone size was 8.6 mm. Urgent URS done in 23% of patient. The overall stone free rate was 88.5%, the individual stone free rate for the upper, middle and lower ureter were 87.9%, 84.6%, and 89.9%, respectively. The mean operative time was 31.9 min [20-50 min.]. Complications occurred in 26.35% of patients. Grade I complications occurred in 32 patients [26.1%], grade II in 9 [6.1%], grade IIIa in 7 [4.7%], grade IIIb in 8 [5.4%], grade IVa in two patient [1.35%], and grade IVb in one patient [0.7%]. No grade V complication was encountered. Ureteroscopy becomes the vanguard interventional therapy for ureteral stones with well-established efficacy and safety. It is of paramount importance to adopt a precise structured classification system for reporting surgical complications, that should be flexible and comprehensive in order to accommodate the various and rapidly expanding surgical fields

Trends of adult primary malignant renal tumors over six years

To assess the demographic and clinico-pathological trends, as well as the management options of adult patients with primary malignant renal tumors over 6 years. From July 2003 - July 2009, 55 adult patients with primary malignant renal tumors were treated in two teaching hospitals [Jordan University Hospital in Amman - Jordan and Al-Jumhory Teaching Hospital in Mosul - Iraq]. Their data were reviewed retrospectively. Of the 55 patients, 44 had renal cell carcinoma [RCC], eight patients had Transitional cell carcinoma [TCC] of the renal pelvis, two had Sarcoma and one Patient had primary renal lymphoma. Among patients with RCC: the mean age was 56 years, male to female ratio was 3:1. The most common presenting symptom was hematuria. Most of the patients were treated with radical nephrectomy, the clear cell subtype was predominant and most of the patients were diagnosed at stage T2. Regarding patients with TCC: mean age was 57 years, all were treated with radical nephro-ureterectomy and removal of bladder cuff, however [50%] of them developed TCC of urinary bladder within 12 months of radical nephro-ureterectomy. In our series of patients with RCC: there is a trend toward younger age at Diagnosis. We still encountered locally advanced and metastatic disease with a lower rate of incidentally Diagnosed tumors. With regard to patients with renal pelvis TCC: there are trends toward younger age affection, localized disease and early development of bladder TCC which indicate the importance of strict surveillance protocol

Aetiology of shigellosis in northern Pakistan.

People of northern Pakistan face health hazards because of poor sanitation practices. Bacterial gastrointestinal infections are very common, and sometimes outbreaks occur. The present study was aimed at evaluating and analyzing infestation of Shigella spp. in patients with suspected gastroenteritis and ascertaining the status of antibiotic therapy. Five hundred and eighty-five faecal samples of patients with suspected gastroenteritis, referred to the District Headquarter Hospital Gilgit, were investigated for common enteropathogenic bacteria from July 1997 to September 1999. Seventy-seven (13.2%) of the faecal specimens were infected with different strains of Shigella spp., 61% of which were Shigella dysenteriae, 15.6% were S. flexneri, and 23.4% were Shigella sp. All Shigella strains were sensitive to ceftriaxone, cefotaxime, ciprofloxacin, and enoxacin. Sixty-one percent of the strains were resistant to both ampicillin and chloramphenicol, and 3.9% to ampicillin and nalidixic acid, while 10.4% were resistant to ampicillin alone and 14.3% to chloramphenicol only. Only 10.4% of the strains were sensitive to all the antibiotics tested. Sixty strains of Shigella spp. were processed for isolation of plasmids, and 58 (97%) of these antibiotic-resistant bacteria harboured at least one plasmid. The number of plasmids varied from 1 to 9. Escherichia coli C600 were transformed with the isolated plasmids. Transformants, containing 23-kb plasmid, resisted growth in media containing antibiotics, thereby indicating that antibiotic resistance is plasmid-borne. Based on the findings of the study, it is concluded that the infestation of Shigella spp. is high in northern Pakistan, the aetiological agents are highly resistant to chloramphenicol and ampicillin, and the antibiotic resistance is mediated by the 23-kb plasmid.

Hoffmann external fixator management of intra articular, unstable Colle's fractures

Sixteen adults who had severely comminuted intra-articular fracture of the distal part of the radius were treated by closed reduction and Medium-C-Hoffmann external fixation. The patients were followed for an average of 2.4 years [range, two to four years]. Fourteen patients had excellent results, one, a good result; and one, a poor result, judging on the basis of pain, motion, strength, and radiographic appearance. There was no loss of fixation of the pins. The average grip strength was 92% of normal. Of the wrist and rotation of the forearm averaged 90% of that of the normal side