bluuebunny/crossref_metadata_2025 huggingface dataset:
Normal neurophysiologic parameters of the median nerve among adult healthy Sudanese population
Authors: Elmagzoub Mohammed Salah , Ahmed Ahmed Hassan , M A Hameed Hussam
Published: May 2021

Background: Nerve conduction studies (NCSs) help in delineating the extent distribution of neural lesion, and the diagnosis of peripheral nerve disorders. Because normative nerve conduction parameters were not yet established in Sudan EMG laboratories, this study aims towards having our own reference values, as we are using the American and British parameters. This will allow avoiding the discrepancies that might be induced by many factors. Methods: NCSs were performed in 200 Median nerves of 100 adult healthy Sudanese subjects using standardized techniques. Results: The median SNAP (sensory nerve action potential) values were as follows: distal latency, 2.6±3 ms with a range of (2.3-2.9); peak latency, 3.5±0.5 ms (3.0-4.0); amplitude, 47.7±18.0μV (29.7-65.7); conduction velocity, 53.0±7.8 m/s (45.2-60.8). The following values were obtained for the Median nerve CMAP (compound muscle action potential) at wrist stimulation: distal latency, 3.5±0.5 ms with a range of (3.0-4.0); peak latency, 9.4± 1.0 ms (8.4-10.4); duration, 5.9±0.9 ms (5.0-6.8); amplitude, 12.3±2.5 mV (9.8-14.8); area, 43.0±10.4 mVms (32.6-53.4); conduction velocity, 63.6±6.2 m/s (57.4-69.8). The F wave was 28.4±1.8 ms (26.6-30.2). Conclusion: The overall mean sensory and motor nerve conduction parameters for the tested nerve compared favorably with the existing literature with some discrepancies that were justified.
Concerns of cerebrospinal fluid leak in aggressive expanded endonasal endoscopic approach for craniopharyngiomas
Authors: Machín Marlon Ortiz , Arbolay Omar López
Published: May 2021

Cerebrospinal fluid leak represents a frequent complication in Craniopharyngioma´s Endoscopic Endonasal Approach. A descriptive observational investigation was performed in 50 adult patients operated of Craniopharyngiomas by aggressive Expanded Endonasal Endoscopic Approach (EEEA) in “Hermanos Ameijeiras” Hospital since 2010 to 2019 using nasoseptal flap. The 14% of all patients develop CSF leak and 85,7 % of these cases had a great communication into third ventricle creating a cisternoventricular space. Was identified relation with tumor size, hypothalamic invasion and adhesion strength of tumour. Surgical cavity suffered hydrostatic and hydrodynamic pression than lead to CSF leak independent of multilayer reparation.
Isolated necrosis of central tegmental tracts due to neonatal hypoxic-ischemic encephalopathy: MRI findings
Authors: Lourenção Freddi,  Tomás de Andrade
Published: May 2021

Perinatal hypoxia is an old entity that still prevails today and may lead to neurological sequelae that can go unnoticed until a certain age, generating many costs for public health. In this case report, we demonstrate on magnetic resonance imaging an unusual pattern of perinatal hypoxia in a preterm 5-month-old infant, involving the central tegmental tracts and briefly discuss its possible pathophysiology.
Epidemiological and anatomopathological features of pediatric head and neck tumors in Benin
Authors: Raoul Hounkpatin Spéro H , Valere C Brun Luc , Claire Balle Marie , Abdias Bossou Tire , Alabi Bouraima Fatiou , Akpo MT Akélé
Published: May 2021

Objective: This research work aims to investigate the epidemiological and anatomopathological characteristics of ENT and head and neck tumors among children in Benin. Materials and methods: It was a cross-sectional and descriptive study carried out from January 1, 2009 to December 31, 2014. It was focused on all the reports of anatomopathological examinations of ENT, head and neck tissue mass among subjects aged no more than 15years identified in Benin and whose histological diagnosis was a tumor. Findings: Among a total of 611ear, nose-& throat (ENT), head and neck tumors colligated, 100 were about children (16.4%). These were 23 cases of malignant tumors and 77 cases of benign tumors. Sex ratio was 1.3 for all the tumors; it was 1.1 for benign tumors and 2.3 for malignant tumors. Cancers were primarily located in the pharynx with 9 cases out of 23, followed by 7 cases in nose and maxillary sinus. Benign tumors were mainly related to nose and maxillary sinus with 30 cases (39% of benign tumors) and larynx with 24cases (31.2%). Various histological types were investigated. As regards cancers, they were mainly squamous cell carcinoma cancers (8 cases out of 23 cancers); and benign tumors were mainly papilloma (46.8%) followed by fibroma (16.9%) and hemangioma (13%). Conclusion: The predominance of papillomas suggests the possibility of prevention due to the important role of human papillonavirus (HPV) in their genesis.
Laryngeal complaints and videolaryngoscopic laryngeal alterations in rheumatoid arthritis patients and its association with disease activity and duration
Authors: Baraka Mohamed , ElDessouky Hossam , Azeez Labeeb Alaa Abdel , Ezzat Eman , ElDessouky Asmaa
Published: May 2021

Background: Rheumatoid arthritis (RA) is an autoimmune systemic disease with a wide clinical presentation. The laryngeal manifestations are often masked by the articular disability often experienced in the early and late stages of the disease. Objective: Association between different laryngeal complaints and videolaryngoscopic laryngeal alterations in patients with RA, and disease activity and duration. Patients and methods: A retrospective study was conducted on 79 patients with RA. All subjects were recruited from the out-patient clinic of physical medicine, rehabilitation, and rheumatology in Al-Menoufia University Hospitals during the period from March 2015 to March 2017. All patients were subjected to both phoniatric and rheumatological assessment. Results: Patients with phonasthenic symptoms and globus pharynges had significantly (p=0.01, 0.008 respectively) higher disease duration than patients without. No significant association found between rheumatoid arthritis duration and different videolaryngoscopic laryngeal alterations, patient’s self-assessment of the impact of laryngeal complaints on their lives, and auditory perceptual assessment (APA) of patient’s voice characters. As regards rheumatoid disease's activity no significant correlation has been established (p>0.05) with different laryngeal complaints except for patients in remission who had higher prevalence of intermittent dysphonia than patients with low activities. Rheumatoid disease's activity had no significant association with different laryngeal findings except those with moderate activity; they had significantly higher prevalence of vocal folds nodules than patients with high activity and patients in remission. Conclusion: A significant association between the disease's duration and presence of laryngeal complaints, dysphonia, and its persistence has been established. Also, patients with phonasthenic symptoms and globus pharynges had significantly higher disease duration than patients without. Rheumatoid diseases activity had significant association with different laryngeal complaints in patients with remission that had higher prevalence of intermittent dysphonia than patients with low activities. No significant association between the disease activity and different laryngeal findings that has been found except for patients with DAS-28>3.2, they had significantly higher prevalence of rheumatoid nodules.
Nasal obstruction due to septochoanal polyp with bone metaplasia: Case report
Authors: S Ruggeri Carlos , Bedini Ivo , Acosta Lautaro , Lorea Agustina
Published: May 2021

In this study we describe the case of a patient with a choanal polyp that was implanted in the posterior sector of the nasal septum and spread and occupy the entire rhinopharynx. It was resected by an endonasal approach with endoscopes and extracted by mouth. In the computed tomography, areas of hyperdensity were identified, which in the histopathological study were diagnosed as mature bone trabeculae (bone metaplasia). Seven cases of septochoanal polyps were found in the literature review and only two with bone metaplasia.
The new in management of recurrent laryngeal granuloma: long term follow-up
Authors: Ezzat Eman
Published: May 2021

Background/Aim: Vocal fold granuloma (VFG) is a nonspecific inflammatory process with no well-defined pathogenesis so its clinical and surgical treatment is not standardized. The aim of the study is to determine accurately the longest permissible period of conservative treatment of recurrent VFG, after which the decision of surgery must be made through long-term follow-up of cases with large recurrent posterior VFG, in addition to assessing the results of anew regimen in management of VFG. Material and Methods: this study conducted on 42patients with large recurrent posterior VFG that were on conservative management as long as the granulomas regress in size with follow-up intervals of 3 months through videolaryngoscope (VLS). Those with resistance VFG were subjected to surgical excision with intra-lesional steroid injection in the pedicle. Results: The most frequent related etiopathogenic factor was gastroesophageal reflux, followed by laryngeal intubation and idiopathic. Clinical management with proton pump inhibitor, systemic or local steroids and voice therapy in addition to behavior modification techniques were enough for remission on 80.95% of the patients. Surgical excision for granulomas was effective in 87.5% of the patients. Early recurrences were noticed in only one patient that proved to have a major gastroesophageal problem. Conclusion: VFG well responds to conservative treatment with complete recovery of maximum period 24months even if it is large and recurrent. Managing recurrent or large posterior VFG needs interdisciplinary team that involves an otolaryngologist, phoniatrician, gastroenterologist, and gastrointestinal surgeon. Voice abuse alone couldn't evoke the condition. Steroids are as important as anti-reflux medication in treatment of VFG.
Performance of normal hearing school age children on Hindi minimal pair test
Authors: Sahoo Subhasmita , Nandurkar Aparna
Published: May 2021

Speech perception is the process of transforming a continuously changing acoustic signal into discrete linguistic units and is a developmental process having several aspects i.e. Pattern perception, Perception of phonemic contrasts, Vowel & Sentence perception. There is no standardized minimal pair test material available for testing Hindi school aged children and no normative data for this test is available in Indian scenario. Such normative data will act as a reference for using of Hindi Minimal Pair Test (HMPT) test with children with hearing impairment in clinical situation. Hence, this study is warranted. The aim of study is to obtain normative data for school aged children on HMPT of speech perception. A total of 200 participants were included in the study. Each subject underwent Otoscopic examination, Oto Acoustic Emission, Pure tone audiometry, Immittance audiometry and Screening for CAPD. This study indicates perception of minimal pair contrast significantly improves as the age increases. P value obtained for comparison between males and females is 0.62 which is greater than 0.05 suggesting no significant difference between mean scores of male and female participants. For age comparison obtained p value is 0.00, suggesting a significant difference between the two age groups. P value of 0.051 for interaction suggests no significant interaction between age and sex statistically.
Sensitivity and specificity of tympanometry in diagnosis of serous otisis media (SOM)
Authors: Darraj Eyad , Fakoury Mouhannad , Abdulghafoor Yusur
Published: May 2021

Background: Serous Otitis media (SOM) is one of the most commonly encountered pathologies in children population. Fluids collection often leads to hearing loss with subsequent speech and language delay. So early diagnosis and management are of paramount importance to prevent these sequela. Effective management is often surgical: myringotomy and fluid aspiration. Myringotomy is not only therapeutic procedure, it is also the gold standard diagnostic method. It has been noticed that many ENT Surgeons in Gulf region depend on Tympanometry only for SOM diagnosis and ignore a complete clinical approach (history, physical examination including pneumatic endoscopy), this has ended up to a considerable unnecessary surgeries with high false positive diagnosis. The aim of this study is to evaluate the sensitivity and specificity of Tympanometry in diagnosis of SOM in a local study, and to draw the attention of ENT Surgeons in this part of the world not to rush to book patients for myringotomy based on Tympanometry results only. Methods: This cross-sectional study involved patients aged ≤12 yo, whom underwent myringotomy for SOM management during the period: from June 2018 to March 2019 at the ENT - department Dubai Hospital. The evaluation included the presenting complaint, physical examination, preoperative tympanometry result and intraoperative findings. Typ B tympanometry was considered (positive) for the diagnosis of SOM, while other graph types were deemed (negative). Gold standard SOM diagnosis was the intraoperative existence of fluid (positive), and subsequently absence of fluids was (negative) Intraoperative findings were matched with the preoperative tympanometry results, proper statistical schedules were performed and tympanometry sensitivity and specificity were calculated. Results: The study included 139 patients: 90 patients are male (64.7%) and 49 are female (35.3%) with mean age of 5.2 year (SD=2.1). The most common complaint was hearing loss in 77 patient (55.4%). Type B tympanometry found in 113 patients (82.5%) and fluid was found in 111 patients (79.9%). The sensitivity and specificity of Type B tympanometry: 88.2% and 80.7% respectively. Statistical tests found significant findings with P value < 0.05. Conclusions: SOM is common in age group 3-7years. History of hearing loss along with dull tympanic membrane and type B tympanometry strongly suggest SOM. However, in our study we found out that Type B graph highly suggests SOM, while the absence of this graph not necessarily rule out fluid collections. So Physicians should be aware while interpreting tympanometry graphs and evaluate these results in the context of patients’ history and examination. In order to enhance SOM diagnosis, we suggest combining Pneumatic otoscopy findings with Tympanometry graphs. This could be a future research topic: the addition value of Pneumatic otoscopy to Tympanometry graphs in the diagnosis of SOM.
Vestibular assessment of a patient with myasthenia gravis: case report
Authors: Chua Kenneth , J Sakumura
Published: May 2021

Vestibular Assessment in patients with Myasthenia Gravis (MG) is challenging, as diagnostic evaluation requires good recording of eye movements. Reports on Vestibular Function Testing (VFT) in MG patients have been scant and it is arguable that VFT will have little clinical value in the MG population. A 75-year-old man, with late onset acquired autoimmune MG presented with dizziness for evaluation. He completed VFT with no significant abnormalities in all tests and was elated to have vestibular ruled out as a contributing factor to his dizziness and imbalance. However, his functional impairments were still addressed and managed regardless of the test results. MG is a heterogenous condition that may be well-controlled with treatment. Patients with dizziness can still be diagnostically evaluated to rule in or out a vestibular involvement and should not be precluded from VFT. Patients should also be assessed for their functional impairments and not based on symptom checklist and objective test results alone. Hence, patients with normal VFT results can still benefit from a hybrid of vestibular rehabilitation therapy (VRT) with focus on habituation.
Mechanical and sensorineural vestibular dysfunction: a case study of “mixed” vestibulopathy
Authors: T Sakumura Joseph , E Gans Richard
Published: May 2021

A diagnosis of hearing loss typically consists of categorizing the locus of involvement; conductive, sensorineural, retrocochlear, or mixed. It is this designation that provides guidance as to whether medical or a non-medical approach e.g. amplification is the preferred treatment. When a “mixed” loss occurs, a combination of medical and non-medical management strategies will be utilized. When vestibular dysfunction, is discussed, however, we rarely think about this combined causation. A unilateral vestibulopathy dysfunction (UVD) from a vestibular neuritis, may cause either hair cell damage and/or a neuropathy. This may be considered as a “sensorineural” dysfunction. The literature, and clinical experience, suggests, that an onset of Benign Paroxysmal Positional Vertigo (BPPV) often follows, within days or weeks. BPPV may be considered the “mechanical” component, requiring treatment with Canalith Repositioning. Such patients, therefore, may be considered to have a “mixed” dysfunction. This requires two different treatments in order to successfully extinguish or ameliorate two differing sets of functional impairments. We present a case report of a 52-year-old female patient with complaints of initial acute onset vertigo, positional dizziness, oscillopsia and visual provocation. Attending physician, suspected BPPV and referred her for testing. The evaluation confirmed a left ear BPPV-PC, in addition to a non-compensated left unilateral vestibular dysfunction (UVD). The BPPV was successfully cleared with Canalith Repositioning Maneuvers (CRM) at her first treatment visit. Based on her profile ensuring safety and no fall-risk, she was prescribed an individualized self-directed vestibular rehabilitation therapy home exercise program to address the non-BPPV related symptoms. She returned to The American Institute of Balance (AIB), at one-month, reporting complete amelioration of the movement and visually provoked symptoms. Post-therapy objective testing demonstrated compensation of the previously identified UVD. This case demonstrates, that for many patients presenting with BPPV symptoms, there may also be compounding underlying functional impairments. Without the benefit of a thorough evaluation, the “sensorineural” aspect of the “mixed” vestibular dysfunction, may go unresolved. This will further delay their recovery and return to a normal active lifestyle or employment.
New concept for uvula manipulation to treat puberphonia
Authors: Kumaresan M , Bharath Navin
Published: May 2021

Speech organs or articulators produce the sounds of language. The organs used for speech include the lips, teeth, alveolar bridge, hard palate, velum (soft palate), uvula, glottis, nasal cavity, pharynx and various parts of tongue. The vocal fold, in the larynx vibrates creating fluctuation in air pressure known as sound waves. The resonators of the mouth create formant regions and so different qualities sonorant (voiced) sound. We have a large series of vocal track vibrating endoscopic movie bank. We have created by treating 600 cases of puberphonia. We are able to record the change in the shape of the vocal tract and vibrating power of the airflow in the vocal tract. We are able to deduct and distinguish the different shape of the uvula and how airflow directed to the mouth by uvula. We are doing only uvula manipulation in treating puberphonia which gives immediate and persistent result. We are trying to bring out the importance of uvula in speech productions. The study concludes that the pharyngeal/uvula resonance manipulation therapy may be considered as an essential mode of treatment for puberphonia. Yet we like to inform that uvula is the structure in our body so little understood, so often abused and maligned.
Upper third auricular reconstruction surgery of cauliflower ear following auricular perichondritis: a case report
Authors: MH Reksodiputro , AS Sriyana , LA Reksodiputro , T Mufida
Published: May 2021

Cauliflower ear is the deformity result of necrosis of the cartilage and which is caused by several etiologies. One of the etiology was perichondritis and as the disease progress, abscess will developed and peel the perichondrial layer off the cartilage and resulting the necrosis and deformity of the auricle. This paper will discuss about male patient who developed cauliflower ear after had several episodes of perichondritis. This paper will further discuss about the reconstruction surgery for the deformity.
Wegener’s granulomatosis: surgical repair of severe subglottic stenosis
Authors: Costa Isabel , Lim António , Azevedo Cátia , Mar Fernando , Rodrigues Berta , Dias Luís
Published: May 2021

Laryngeal and subglottic stenosis are present in about 20% of patients with granulomatosis with polyangiitis. This atypical form of the disease can be severe and life-threatening. In what concerns to treatment, subglottic lesions are less responsive to conventional systemic therapy and interventional and surgical procedures should be considered. The authors present a case of a 30-year-old woman with diagnosis of Wegener’s granulomatosis who presented to our department with dyspnea and stridor due to a severe subglottic stenosis, requiring an emergent tracheostomy. The obstructive defect was electively and effectively repaired through a transoral laser microsurgery using local application prednisolone and mitomycin C followed by balloon dilation.
Training of students of physiotherapy, an antique look and postmodernist
Authors: Becerra Ostos Luisa Fernanda
Published: May 2021

With this article is to describe in general terms the areas least performed by physiotherapists and in the workplace; where a series of situations from developing their skills, either through ignorance and/or perform insecurity occur. In addition, it is important to raise awareness among universities, associations and bodies representing us at the government level, since their experiences contribute to unification of curricula, which are the backbone of every profession. Why different studies found that supports the curriculum of several universities pensums by major regions and departments could be observed in the same inequality and disadvantages that later are going to be facing the future graduates by the lack of skills in different areas of performance of the race. As consistent with the above, will result in an inequity in the competency framework, which in future will be an obstacle to compete scientifically with other races in the area of ​​health, such as medicine, therapy, dentistry and nursing. Finally, the process identity is emphasized at national and global level as described in our international representative World Confederation for Physical Therapy (WCPT) in terms of art, science and technique of physical therapy. And just to show that we are much more than a "massage" as we currently perceive and demonstrate the skills learned in the university cloister really promotion and prevention.
Effect of probiotics on total salivary antioxidant level and physical properties of saliva: An ex-vivo study
Authors: N Hegde Mithra , A Mrinalini
Published: May 2021

Background: Role of oxidative stress in pathophysiology of various diseases has already been established. Antioxidants act as free radical scavenger and prevent damage to cell, at the same time affects the metabolism of several pathogenic microbes. With increasing incidence of antibiotic resistance, alternative therapeutic treatment options are coming into picture. WHO claims probiotics to be the next most important immune defence system following antibiotic resistance. Even though there are several studies emphasising on the positive outcome of probiotics on diseases, their exact mechanism of action still remains debatable. The present study tried to unveil the antioxidant property of probiotics in saliva along with its effect on salivary pH and buffering capacity. Methods: Unstimulated saliva from 10 individuals were analysed for total antioxidant level, pH and buffering capacity using spectrophotometer, pH paper and buffering strips respectively, before and after probiotic intake for 2 weeks. Results: Probiotic intake led to increase in total salivary antioxidant level with no significant changes in pH and buffering capacity. Results obtained were statistically analysed using “paired t-test”. Conclusions: Probiotics are effective in increasing antioxidant level thereby minimizing cellular damage and hence can be used for prevention of several diseases. Also increase in antioxidant level can be easily assessed in saliva, thus, saliva can be used as a routine diagnostic tool.
Side effects of mirabegron studied on ants as models
Authors: Cammaerts Marie-Claire , Cammaerts Roger
Published: May 2021

The overactive bladder syndrome (OAB) affects the quality of life. It is most often treated with anticholinergic drugs, but at the cost of many unwanted effects. In the last decade to date, mirabegron, an adrenergic receptor agonist drug used to relieve OAB has appeared in the pharmacopoeia. It works through a different mechanism than antimuscarinic drugs, with apparently fewer side effects. In the same way that we have examined the adverse effects of the anticholinergic oxybutynin on the ant Myrmica sabuleti used as a biological model, here we examine the side effects of mirabegron. Unlike oxybutynin, mirabegron had no adverse effect on ants, except that it increased their meat consumption, reduced their sugar water intake and decreased their general activity. No adaptation was observed for this last- mentioned effect, which may correspond to the tiredness reported in humans. The ants did not become dependent on the consumption of mirabegron, whose effect on general activity decreased very slowly and disappeared about 52 hours after weaning. Patients are advised to take mirabegron daily though its elimination half-life is 50 hours, and fatigue is one of the side effects of the treatment. In the event that patients under mirabegron medication show a decrease in activity over their treatment, it would be careful to space out the medication or to add an appropriate stimulant or to alternate mirabegron with an anticholinergic drug that does not affect the patient’s level of activity. The kind of antimuscarinic drug that could be used together with mirabegron, the respective dosage and the timing of each drug should be defined depending on their combined efficacy and side effects, and taking into account their elimination time.
Side effects of the cough drug dextromethorphan, studied on ants as models
Authors: Claire Cammaerts Marie , Cammaerts Roger
Published: May 2021

Dextromethorphan, the currently preferred cough drug, tested on ants used as biological models, decreased the food consumption of these insects, increased their sinuosity of movement, reduced their tactile (pain) perception, and impacted their social relationships. It did not affect the ants’ orientation ability, audacity, cognition, conditioning acquisition and memory. The ants did not adapt themselves to the side effects of dextromethorphan and became dependent on its consumption. The effect of the drug quickly and linearly decreased after weaning, becoming very weak after 4 – 6 hours and null after 10 – 12 hours. Dextromethorphan led to dependence, what can also occur in humans. Being safer than previously used cough drugs, dextromethorphan can be consumed for treating dry cough, but in order to prevent dependence, should be used only at therapeutic doses and during a limited time.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Why is it so lethal?
Authors: Tursa Promi Anika , Islam Bristi Sanzida , Akhter Farhana , Noor Rashed
Published: May 2021

COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has been the most dreadful mass public health threat for more than a year. An array of clinical trials with repurposed and repositioned drugs as well as with the candidate vaccines are being conducted with the aim of mitigation of COVID-19. While a few antiviral drugs and several candidate vaccines showed satisfactory results in the clinical trials, the side effects after vaccination and the evolution of new SARS-CoV-2 variants appear as a major challenge for the scientists. Present review focused on the possible reasons behind the lethality of SARS-CoV-2.
A brief note on the scope of RNA interference(RNAi) therapy in mitigating COVID-19
Authors: Islam Bristi Sanzida
Published: May 2021

Together with the use of number of repurposed/ repositioned antiviral drugs and immunomodulatory agents against the severe acute respiratory coronavirus 2 (SARS-CoV-2) infection, currently several vaccines are under human trials to mitigate the COVID-19 worldwide. Although the drugs and vaccines appear to be effective in maximum cases or trials; however, the associated side effects, the required induction of the long-lasting immunity, and finally, the safety concerns are of significance in terms of their consistent application/ administration. A vast research on the SARS-CoV-2 genomics and on its similarities with SARS-CoV-1 and with the Middle East Respiratory Syndrome coronavirus (MERS-CoV) have unraveled the viral avoidance of the host immunity which creates a challenge in course of effective vaccine development although several COVID-19 vaccines are currently being used commercially worldwide. Such an unsteady circumstance led the scientists also to think on a new remedial approach i.e., the RNA interference (RNAi) therapy to inhibit the SARS-CoV-2 proliferation by degrading the viral RNAs. Present review discussed such strategy and its effectiveness during the ongoing COVID-19 pandemic.
Which is the best fertility-sparing treatment for uterine fibroids? Review of literature
Authors: Bardi Massimo , Pezzetti G , Chiesa A , Gangarossa G , Iliakis A , Cesare Cristina C Di , Rosaschino P
Published: May 2021

Uterine fibroids are benign tumors of the smooth muscle cells of the uterus that are the most common benign tumors in women during their reproductive years. The etiopathogenesis is multifactorial but we know that mainly estrogen and progesterone induce UF formation and growth. UF vary greatly in size, location, and symptoms: most tumors are largely asymptomatic, but they may also cause a wide range of severe and chronic symptoms that impact negatively with familiar and social relationships. UF might cause infertility. Their adverse effects on pregnancy because distort the endometrial cavity and thin the endometrium. In fact the negative action of fibroids on fertility is mainly due to produce numerous cytokines and growth factors that produce an endometrial inflammation that, with an altered local hormonal environment, may impede embryo-implantation. The type of treatment may depend on the location, size and number of UF and it should be related to understanding if the therapy improves the reproductive capacity of the woman. In this review of the literature we evaluate the various therapeutic possibilities that we have available if we decide to treat UF to improve the fertile capacity of the woman who wishes to have children. We will exclude medical therapy, which is predominantly birth control, although in recent years new substances are being studied, such as vitamin D and epigallocatechin gallate, which promise interesting therapeutic developments. A proper mention will be made of laparotomy, laparoscopic and hysteroscopic myomectomy, but particular importance will be given to the evaluation of new therapeutic trends such as high-intensity focused ultrasound, also guided by nuclear magnetic resonance, and thermal ablation with radio frequency and microwaves. The embolization of UF will also be addressed, but we know it is contraindicated for women who wish to become pregnant.
Bilateral uterine artery embolization for the management of bilateral uterine artery pseudoaneurysm during puerperium: A case report
Authors: Damra Elnour Mohammed Sally , Khidir Tayfor Mohammed , Mutasim Hamad Isra , Osama Mashaar
Published: May 2021

Background: Uterine artery Pseudoaneurysm is a rare cause of secondary postpartum hemorrhage (PPH) and can develop after various gynecological or obstetric procedures. The delayed diagnosis of such cases often results in life threatening situations. We report a rare case of bilateral uterine artery pseudoaneurysm that led to life threatening secondary PPH after Caesarean section in a patient who had several Caesarean sections before. Case description: A 35 years old multiparus women, who had all her four deliveries by Caesarean sections, presented with recurrent massive attacks of secondary PPH 35ays after her last delivery. Rupture of aneurysm of the uterine artery was suspected and CT angiography showed that the left uterine artery seemed more dilated and was probably the source of the PPH. The bleeding site was successfully tackled by selective arterial embolization. About three weeks later the patient presented again with severe recurrence of PPH. Repeat of CT angiography showed that the source was the right uterine artery this time, which was again selectively embolized. No further bleeding events occurred up to two years follow-up. Conclusion: Rupture of aneurysm of the uterine artery can be a life-threatening condition. Clinical suspicion is essential for a prompt diagnosis Definitive diagnosis can be achieved by CT-angiography. Treatment by selective embolization can effectively stop the bleeding.
Moving knowledge across distance to improve healthcare – How telemedicine was used to improve maternal healthcare in bonsaaso cluster of amansie south district of Ghana
Authors: Ebo Nsarko Nathaniel , Akosah Eric , Sakyi Baah Joseph , Eliasu Mahama John
Published: May 2021

Introduction: Unintended pregnancies and unplanned births can have serious health, economic, and social consequences for women and their families. The immediate outcome of some unintended pregnancies is induced abortion which is unsafe in many countries that have highly restrictive abortion laws. In these countries, abortion often damages women’s health and sometimes results in their death. Method: A community based cross-sectional study was conducted. A total of 420 study participants were recruited. Simple random sampling was used to draw participants; the collected data were entered into EPI- Data version (7.9.0.) and then exported to SPSS Version 20.0 for analysis. Descriptive statistics, binary and multiple logistic regression analysis were carried out, Odds ratio with 95% CI were calculated. Result: the prevalence of unintended pregnancy was found to be 30.2%. Multiple logistic regression results showed that the previous history of abortion (AOR=8.262; 95%CI=3.692, 18.489), not discussing the sexual reproductive health (SRH) issues with their husband (AOR=3.086; 95%CI=1.830, 5.205) age of the last child less than three years (AOR=1.870; 95%CI=1.100, 3.179) were significantly associated with unintended pregnancy. Conclusion: This study shown that the prevalence of unintended pregnancy is high in the study area, hence, strengthening the provision of post abortion services, counseling on long term family planning services and male involvement in all reproductive health services are highly recommended.
Prevalence and associated factors of unintended pregnancy among pregnant women of reproductive age group in chencha woreda, gammo gofa zone, Southern Ethiopia
Authors: Abebe Sintayehu , Tunja Abayneh , Gebretsadik Woiynshet
Published: May 2021

Introduction: Unintended pregnancies and unplanned births can have serious health, economic, and social consequences for women and their families. The immediate outcome of some unintended pregnancies is induced abortion which is unsafe in many countries that have highly restrictive abortion laws. In these countries, abortion often damages women’s health and sometimes results in their death. Method: A community based cross-sectional study was conducted. A total of 420 study participants were recruited. Simple random sampling was used to draw participants; the collected data were entered into EPI- Data version (7.9.0.) and then exported to SPSS Version 20.0 for analysis. Descriptive statistics, binary and multiple logistic regression analysis were carried out, Odds ratio with 95% CI were calculated. Result: the prevalence of unintended pregnancy was found to be 30.2%. Multiple logistic regression results showed that the previous history of abortion (AOR=8.262; 95%CI=3.692, 18.489), not discussing the sexual reproductive health (SRH) issues with their husband (AOR=3.086; 95%CI=1.830, 5.205) age of the last child less than three years (AOR=1.870; 95%CI=1.100, 3.179) were significantly associated with unintended pregnancy. Conclusion: This study shown that the prevalence of unintended pregnancy is high in the study area, hence, strengthening the provision of post abortion services, counseling on long term family planning services and male involvement in all reproductive health services are highly recommended.
Lymphangioms of the women's reproductive system
Authors: Victor Manuel Vargas-Hernandez
Published: May 2021

Lymphangiomas are congenital, hamartomatous and uncommon malformations of the lymphatic system that affect the skin and subcutaneous tissues. The most frequently used classification divides these lesions into 2 main groups according to the depth and size of these abnormal lymphatic vessels; arise from kidnappings of lymphatic tissue that should normally communicate with the lymphatic system. Most appear to be developmental lesions that occur relatively early in life, rarely occur in adulthood. The histological features that favor diagnosis are the presence of lymphoid aggregates in the stroma; They appear on any part of the skin and mucous membranes and surgical management with complete surgical excision.
Evaluation of transperineal ultrasound in diagnosis and grading of female genuine urinary stress incontinence
Authors: lithy Ahmed El
Published: May 2021

Stress urinary incontinence (SUI) has an observed prevalence of between 4%and 35%. Purpose: To determine the role of transperineal ultrasound in diagnosing stress incontinence, its degree and the possible cause by: Measuring the BN descent, urethral hypermobility, funneling of BN or proximal urethra, urethral diameter, posterior urethra vesical angle, associated cystocele Using color Doppler to detect escape of urine through the urethra. Methods: 52 female patients diagnosed to have genuine stress incontinence using 3 day voiding diary, simple questionnaire and confirmed by standard urodynamics. Classification of stress incontinence into mild, moderate and severe using Valsalva leak point pressure during urodynamic study. Transperineal ultrasound for evaluation of the anterior pelvic compartment regarding: bladder neck descent, urethralhy permobility, Funneling of the BN, posterior urethrovesical angle ,urethral diameter, associatedcystocele, and finally the Doppler detection of urinary escape both at rest and with Valsalva maneuvers. Results: 28/52 cases (53.8%) of SUI didn’t show clinical evidence of cystocele; 11 cases (21.2%) showed grade 1 cystocele and 13cases (25%) showed grade 2 cystocele. The presence or absence of cystocele and also the grade of cystocele did not show a statistically significant relation to the degree of SUI; p=0.089 and 0.086 respectively Conclusion: We came to conclusion that transperineal ultrasound can be used in accurate diagnosis and grading of female urinary stress incontinence with our given cutoff values for bladder displacement, α angle, β angle and urethral diameters and from this grading by transperineal ultrasound comes the novelity of our research.
HIV infection and Mycoplasma co-infection: case-control study in a female population of Douala (Cameroon)
Authors: Henri Essome , Colette Nida Martine , Valère Mve Koh , Roger Ekono Michel , Théophile Nana Njamen , Merlin Boten , Grâce Tocki Toutou , Gregory Halle Ekane , Dieudonné Adiogo
Published: May 2021

Objective: To determine the impact of Human Immuno-Deficiency Virus (HIV) on co-infection with Mycoplasma hominis and Ureaplasma urealyticum in HIV-infected women. Methodology: A case-control analytical study based on standardized questionnaire interview and cervical sample collection after informed consent obtained among HIV-positive and HIV-negative women from January 2nd, 2017 to June 30th, 2017 received at the laboratory of Laquintinie Hospital in Douala. Samples collected were used for mycoplasma research, quantification, and antibiogram using the mycoplasma IES kits. Socio-demographic, clinical and biological variables of interest were entered and analyzed on Microsoft Office Excel 2013 and Statistical Package for Social Sciences (SSPS) software version 20 and the chi-square correlation test was used with significance at the threshold of P <5%. Results: We analysed 136 samples of women aged 18-65years, among which 96 HIV+(cases) matched with 40 HIV-(controls). The mean age of the case group was 39.08±10.22 years and that of the control group was 33.28±8.68 years. Genital mycoplasmas were found in 58.3% of cases, with a high frequency for U. urealyticum (19.8%) against 2.1% for M. hominis and the two germs were associated in 32.3% of cases. In the control group, the carrier rate was 62.5%, with a frequency of 17.5% for Ureaplasma alone and no carrier for M. hominis alone. Co-infection with the two germs in this group was 40%. The majority of HIV+women had a CD4 count above 200, and no significant association was found between CD4 count and the presence of mycoplasma in these women (P=0.094). Conclusion: Mycoplasma infection is common in HIV+ women. However, there is no significant association between the CD4 count and the presence of these mycoplasmas.
A community based survey on home birth: mothers’ attitude, reasons and perceived consequences
Authors: Mbadugha Chisom Joy , Obiekwu Ada Lilian , Okafor Chiamaka Jennifer , Omotola Ngozi Joy , Chukwujama Nonye Ann
Published: May 2021

Home birth when unplanned and in the absence of a skilled attendant has been associated with adverse infant and maternal outcome. Sometimes, women give birth in a familiar place with family members or other trusted companions who may not have the necessary skill to conduct deliveries. In developing countries like Nigeria, conditions are not safe enough to encourage women especially those living in rural and remote areas to deliver at home. The purpose of the study was to assess mother’s attitude, perceived reasons and consequences of home births in Ugwuogo Nike, Enugu state. This community based study adopted a cross-sectional descriptive survey design. Purposive sampling technique was used to draw 208 respondents from a population of women of reproductive age (15 -49) in Ugwuogo Nike. Data were collected using a structured questionnaire developed by the researchers. Data generated were statistically analyzed using descriptive statistics. The study findings revealed home birth prevalence of 25.5% with one-third (73.5%) being unplanned. Majority of the mothers had negative attitude (2.42) towards home birth. The major reasons women deliver at home were precipitate labor (3.34), familiar environment (3.08) and previous successful home births (3.04). The most common consequences of home births reported by respondents were uncontrollable bleeding-85.2% (for the mother) and delayed response after birth–86.5% (for the baby). In conclusion, attitude towards home birth in the community was largely negative although the incidence was high. Precipitate labour, familiar environment and previous home births were the major identifiable reasons for home births. It is thus recommended that mothers be educated on early signs of labor; need to report immediately to the health facility, risks associated with home births and, importance of a skilled birth attendant. This will help reduce the incidence and fatalities associated with home births.
Our experience of sling operative correction of stress incontinent in women of Uzbekistan
Authors: Kasimovna Djabbarova Yulduz , JM Gafurov , NKh Ruzieva
Published: May 2021

Stress urinary incontinence (SUI) occurs in 38-45% of women and with increasing age reaches 60%. In recent years, synthetic materials have been used for surgical correction. Purpose: Is to conduct a comparative evaluation of the effectiveness of urethropexy with prolene tape with anterior and posterior colpoperineolevatoroplasty in the correction of stress urinary incontinence. Materials and methods: The results of plastic surgery with a free synthetic loop made of Prolene - TVT-O for stress urinary incontinence in 54 patients are presented. The comparison group consisted of 30 patients who underwent typical front and rear colpoperineorrhaphy. Results: Normal urination function was restored 1 day after surgery. Blood loss, the course of the postoperative period, and the length of hospital stay were almost identical in both groups. There were no complications for 5 years (100%) in the main group. Сonclusion: Sling surgical correction is an effective and reliable method of treating stress incontinence in women.
A new marker in preterm labor: RDW and MPV
Authors: Kurban Yüksel , Alan Yasemin , Alan Murat , Kurt Mustafa , Gurlek Beril , Cegilli Burak , Taner Cüneyt Eftal , Öktem Abdulmecit
Published: May 2021

Aim: To evaluate whether serum platelets Mean Platelet Volum (MPV), and Red Cell Distribution width (RDW) are useful as predictors of preterm labour (PL) in patients with preterm labour (PL), and to compare the clinical efficacy of various serum inflammatory markers to predict the risk of preterm delivery (PD). Materials, and methods: The main group consisted of pregnant women who were earlier than the 37th gestational week. The control group has consisted of pregnant bigger than 37th weeks of gestation. The patients with PL who participated in the study group were divided into early preterm labour (EPL), and late preterm labour (LPL) groups. The two groups were investigated in terms of clinical aspects of RDW, and MPV and serum markers studied at admission. ROC curve analysis was used to determine the optimal MPV, RDW cut-off levels predicting PL. Results: Neutrophil (NEU), MPW, RDW, and neutrophil to lymphocyte ratio (NLR) were significantly higher in LPL than in women who gave birth at term (p=0.006, OR=1.411; p<0.001, OR=1.410; 0.002, OR=1.612, p=0.035, OR=1.294). In multivariate regression analysis, MPV positive was the strongest predictor variable. Besides, there was a significant correlation between MPV and RDW elevation, and neonatal intensive care needs (NICU) in women who delivered between 34 weeks, and 37 weeks. Conclusion: High RDW and MPV are independent predictors of preterm delivery in patients with LPL. In our study, we found that the increase of RDW and MPV was higher in women with high PL risk more than in healthy individuals. MPV has the highest area for prediction of preterm birth, and RDW>14,5, and MPV>9,6 have the highest sensitivity and specificity. RDW may be more significant than measuring any of the individual markers in the simultaneous use of preterm delivery. The simultaneous use of RDW and MPV with existing markers to increase our identifying abilities of preterm labour may be stronger than that of any of the individual markers.