ABSTRACT
Purpose: This case report aims to present a rare instance of conjunctival melanoma in a 5-year-old patient and contribute to the limited body of knowledge on pediatric conjunctival melanoma. The purpose is to understand the characteristics, diagnosis, and management of this uncommon malignancy in young individuals. Observations: The case describes a 5-year-old female with a progressively growing pigmented conjunctival lesion. The lesion was observed to be located on the temporal conjunctiva of the right eye and displayed distinctive features, including feeder vessels. Imaging revealed specific dimensions of the lesion and ruled out deeper invasions. Histopathological examination revealed architectural and cytologic atypia, positive immunohistochemical staining for HMB-45, and a Ki67 proliferation index of 20 %, confirming the diagnosis of conjunctival melanoma. Conclusions: Conjunctival melanoma, an uncommon malignancy even more so in pediatric patients, typically presents with pigmented growths and feeder vessels. This case underscores the need for thorough diagnosis and early intervention, as conjunctival melanoma can lead to devastating outcomes. The rarity of such cases limits our understanding of their etiology and progression. This case contributes to the literature on pediatric conjunctival melanoma and reinforces the importance of vigilance in detecting and managing ocular pigmented lesions in children.
ABSTRACT
BACKGROUND: Convenience stores in Guatemala provide essential consumer goods in communities, but many dispense antibiotics illegally. Federal legislation, passed in August of 2019, requires prescriptions for antibiotic purchase at pharmacies but it is unclear if this legislation is enforced or if it has any impact on unlawful sales of antibiotics. METHODS: To determine if antibiotic availability changed in convenience stores, we carried out a repeated measures study collecting antibiotic availability data before and after implementation of the dispensing regulation. RESULTS: There was no statistical difference in the proportion of convenience stores that sold antibiotics before and after antibiotic regulations [66.6% (295/443) and 66.7% (323/484), respectively, P>0.96], nor in the number of stores selling amoxicillin [55.5% (246/443) and 52.3% (253/484), respectively, P>0.96], but fewer stores (20%) sold tetracycline capsules after regulation was passed (P<0.05). For stores visited both before and after passage of legislation (n=157), 15% stopped selling antibiotics while 25% started selling antibiotics. Antibiotics from convenience stores were reportedly sold for use in people and animals. CONCLUSIONS: Antibiotics remain widely available in convenience stores consistent with no significant change in the informal sector after implementation of prescription requirements for pharmacies. Importantly, effects from regulatory change could have been masked by potential changes in antibiotic use during the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic.
Subject(s)
Anti-Bacterial Agents , Pharmacies , Humans , Anti-Bacterial Agents/therapeutic use , Commerce , Drug Prescriptions , Amoxicillin , TetracyclineABSTRACT
PIP: 5 different types of IUDs were used in 1020 women after placental expulsion: T Cu220 in 101 cases; Lippes Loop in 407 cases; T Cu200 in 180; Progestasert in 196; and the Multiload 250 in 136. IUD insertion was accomplished by 3 different techniques: manual, with Forester's forceps, and with an experimental applicator. There were more expulsions and more pregnancies when the applicator was used. Expulsion and pregnancy rates were higher with the Progestasert. The T Cu220C showed the lowest number of expulsions and pregnancies and the highest continuation rate. Removals for medical reasons were similar among all IUD types. (author's modified)^ieng
Subject(s)
Intrauterine Devices , Postpartum Period , Adolescent , Adult , Evaluation Studies as Topic , Female , Humans , Intrauterine Devices, Copper , Intrauterine Devices, Medicated , Methods , Middle Aged , Pregnancy , Progesterone/administration & dosageABSTRACT
Se analizan los resultados obtenidos en 1020 casos de aplicacion, inmediatamente despues del nacimiento de la placenta, de cinco tipos diferentes de dispositivos intrauterinos. En 101 casos se utilizo T Cu 220 C, en 407 Asa de Lippes, en 180 T Cu 200, en 196 Progestasert y en 136 Multiload 250. La aplicacion se hizo mediante tres tecnicas: a) manual, b) con pinza de Forester y c) con un aplicador en experimentacion. Cuando se utilizo el aplicador se observo mayor tasa de expulsiones y por tanto de embarazos. Las tasas de expulsiones y embarazos fueron mayores con el Progestasert. Con la Teu 220 C se observo el menor numero de expulsiones y de embarazos, asi como la mayor continuidad de uso.Los retiros por causas medicas fueron semejantes para todos los dispositivos intrauterinos
Subject(s)
Humans , Female , Intrauterine Device Expulsion , Intrauterine Devices , ParturitionABSTRACT
PIP: A study was conducted into the efficacy of high fundal insertion of IUDs immediately postplacental delivery. 1008 women who were delivered at 5 large hospitals in Mexico during 1978 accepted this method of contraception. 5 different types of IUD were inserted by approximately 75 persons (ranging from medical students through interns and residents to certified gynecologists) by 3 different insertion techniques. Age and parity of the acceptors are tabulated. Life table follow-up analysis is used to cover cumulative pregnancy, expulsion, removal and continuation events at 3, 6, 9, and 12 months postinsertion. The continuation rate at the end of a year was 61.8 and this rate may rise as the study is completed. There were no differences as to any of these events or in the extent of postinsertion bleeding among the groups using the 5 different devices or with the 3 different techniques. High fundus placement seems to have improved the retention of IUDs inserted immediately after delivery. Rates for accidental pregnancy and medical removal were the same as those obtained with interval IUD insertion. Infection rates did not increase with this timing of insertion. Patient acceptance of this method was high.^ieng
Subject(s)
Contraception , Hemorrhage , Intrauterine Devices , Life Tables , Postpartum Period , Retention, Psychology , Age Factors , Americas , Contraception Behavior , Demography , Developing Countries , Diagnosis , Disease , Family Planning Services , Latin America , Mexico , North America , Parity , Reproduction , Research , Signs and SymptomsABSTRACT
A randomized, crossover study comparing the acceptability of two presentations of the same oral contraceptive, a paper formulation and the conventional tablet, was carried out among two-hundred-and-seventy women attending two urban family planning clinics in Mexico City. During the first three cycles of use, the percentage of women discontinuing the medication for side effects was almost identical in the two groups. Although the paper formulation failed to demonstrate any major advantage in terms of continuation or acceptability, it was preferred by a majority of the women who began oral contraception with its use.