RESUMO
Background: The coexistence of a granulosa cell tumor with a teratoma is extremely rare and impossible to diagnose preoperatively. For most patients with advanced age and stage, the standard treatment is hysterectomy and bilateral salpingo-oophorectomy; however, fertility-preserving surgery should be considered for young nulligravid women. Case: We present a case of a 24-year-old nulligravid female with bilateral adnexal masses, imaging findings of ovarian teratomas, and normal levels of tumor markers. A laparotomy revealed bilateral dermoid cysts, and solid tissue invaded most of the remaining ovarian parenchyma with no signs of malignancy in the uterus and peritoneum space. Consequently, a bilateral oophorectomy was performed to preserve her fertility. Histopathology examination showed mature cystic teratomas coexisting with granulosa cell tumors on both ovaries. Within six months, there were no signs of recurrence on ultrasonography and tumor makers. Combined oral contraceptive pills were prescribed as hormone replacement therapy. Conclusion: Fertility-preserving surgery can be performed in young women with an ovarian granulosa cell tumor coexisting with a teratoma. Long-term examination, hormone replacement therapy, and in vitro fertilization are required.
RESUMO
This study aims to examine the impact of undergoing a central quarantine due to the lockdown of Bach Mai hospital on the psychological disorders and identify associated factors with depression among hospital employees in central hospitals of Hanoi, Vietnam. Employing a cross-sectional design, the study collected data from staff working in the lockdown hospital and other central hospitals during 1 week after the lockdown happened. The sample size included 373 staff from 3 hospitals, the study time was. Depression was tested using PH-Q9 scale. Multivariate logistics regression was employed to test for the impact of central quarantine on depression and identify other significant related factors. The study confirmed a high burden of psychological issues that hospital employees were facing. Staff working in the lockdown hospital had 2.3 times higher odds of being perceived depression than others. Those who contact directly about 21 to 20 patients/day had 3.19-times higher odds of being perceived depression than others. Staff who being stigmatization associated with COVID-19 had 2.63 times higher odds of perceived depression than others. Reducing these associated factors to depression may help to reduce the psychological burden HEs have to cope with during the pandemic.
RESUMO
BACKGROUND: N-methyl-d-aspartate receptor (NMDAR) antibody encephalitis appears common in the world, but the number of clinical cases in Vietnam which were recorded is rare. CASE REPORT: We describe two new cases of disease in recent years with the aim of contributing to diagnosis and treatment experiences. These cases were noted over the past 3 years with the patients who have been treated at lower levels but have no results. They came to us when symptoms became worse and therefore required prolonged treatment with special intensive care facilities. The atypical and easily confused symptoms are the reasons that make the disease be detected late; leading to a much higher cost of treatment and the complication may appear in the patient. In the past, patients with these manifestations were diagnosed with unexplained encephalitis and severe sequelae or death. Autoimmune encephalitis has many types; NMDA encephalitis associated with ovarian teratoma is the most common autoimmune encephalitis in young women. CONCLUSION: In conclusion, based on the case report, we hope to contribute some experiences on the diagnosis and the strategy in early treatment. With most female patients at very young age, early treatment to avoid complications will help patients have a quality life and maintain reproductive function.
