Ileo-uterine fistula in a degenerated posterior wall fibroid after Caesarean section / 대한생식의학회지

Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.

Effect of adding garlic therapy to a comprehensive rehabilitation program on control of clinical manifestations and quality of life of knee osteoarthritis

To compare the effect of comprehensive rehabilitation program versus combined garlic therapy and comprehensive rehabilitation program in controlling the clinical manifestations and quality of life in patients with knee osteoarthritis. This was a randomized clinical trial in an outpatient setting. Participants were 43 patients with knee osteoarthritis randomized to group I [comprehensive rehabilitation] [n = I5] and group II [combined garlic therapy and comprehensive rehabilitation] [n-28]. All patients had diet modification, electrotherapy, resistive and flexibility exercises for legs 3 times weekly for 8 weeks. Group II received garlic capsules 900 mg daily with breakfast for 8 weeks. Evaluation was performed using knee pain with visual analogue scale [VAS], Stanford health assessment questionnaire [HAQ], one repetition maximum [1RM] for quadriceps, body mass index [BMI], synovial fluid level of interleukinl-beta, inrerleukin-6, tumor necrosis factor- alpha and selenium level. BMI significantly decreased in both groups [P<.05] without significant difference between groups. Knee pain significantly decreased in group II mean_ standard deviation [-51.77 +/- 11.17%] more than in group I [-22.92 +/- 5.31%] [p-.00001]. 1 RM significantly increased in group II [105.10_ 65.90%] more than in group I [64.78 +/- 54.77%] [p=.01986]. Percent change of HAQ was more in group II [-36.56 +/- 12.2] than in group I [-16.42 +/- 14.10] [p=.00004]. Synovial selenium significantly increased only in group II [213.19 +/- 28.26%] [p=.00001]. Synovial inflammatory mediators significantly reduced only in group II [interleukin 1 beta [-89.67% +/- 3.73] [p=.00001], interleukin 6 [-92.98% +/- 5.02] [p=.00001], tumor necrosis factor alpha [-83.20% +/- 8.52] [p=.00001]. Garlic improves rehabilitation outcome of knee osteoarthritis