RESUMEN
The Van Wyk-Grumbach syndrome (VWGS) (hypothyroidism, ovarian mass, and precocious puberty) has been extensively documented in the literature as long-term hypothyroidism manifesting as an ovarian mass. The authors of this study describe this entity in a young girl, aged 10, who presented with abdominal pain with a multiloculated ovarian cyst. She was evaluated, and it was discovered that she had delayed bone age, precocious puberty, and a small height. Following her diagnosis of autoimmune thyroiditis and the initiation of thyroxine replacement therapy, the ovarian cysts spontaneously regressed. To avoid needless assessment and surgical mishaps, this entity should be considered in situations of ovarian mass, particularly those with precocious puberty and thyroid disorders.
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The journey of addressing fertility challenges, especially in the context of fallopian tubal issues, has witnessed remarkable advancements. This comprehensive review delves into microsurgery for fallopian tubal re-canalization within the era of in vitro fertilization (IVF). The review begins by providing the historical backdrop, tracing the evolution of this surgical technique, and highlighting the transformative impact of microsurgical methods and instrumentation on its precision and outcomes. Microsurgery for fallopian tubal re-canalization is characterized by a range of patient-specific considerations, diagnostic modalities, and factors influencing the choice between re-canalization and IVF. Microsurgical techniques are elaborated upon, showcasing the importance of laparoscopy and hysteroscopy, which not only diagnose but also treat tubal and uterine conditions. The review delves into the pivotal elements that steer the decision-making process, including patient preferences, medical necessity, ethical and religious considerations, financial constraints, and clinical evaluation. Furthermore, the intricate complications and risks associated with tubal re-canalization, both intraoperative and postoperative, are elucidated. Insights into recent advances in microsurgery, emerging research, and promising future directions set the stage for innovative and effective solutions. Recognizing the significance of patient counseling, shared decision-making, ethical considerations, and informed consent, the review underlines the critical role of healthcare providers in guiding individuals and couples through the complexities of fertility treatment choices. Finally, the conclusion synthesizes the key findings, implications for clinical practice, and future research directions, emphasizing the importance of tailored and patient-centered approaches to address fertility challenges in the modern era.
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The hydatidiform mole is a rare gynaecological condition originating from trophoblastic cells, with an incidence of 1-3 per 1000 pregnancies. Theca lutein cysts (TLCs) and an invasive mole are rarely observed in association with a partial mole. This case describes an unusual case involving a 17-year-old primigravida at 11 weeks of gestation. She presented with abdominal pain and was diagnosed with a molar pregnancy with post-evacuation rupture of TLC, presenting as an acute abdomen, subsequently undergoing laparoscopy. Post-molar pregnancies exhibit a highly variable course, ranging from recurrent pregnancy loss and stillbirths to preterm deliveries and recurrent molar pregnancies. Few studies are available on obstetric outcomes after a molar pregnancy; most available data originate from national databases and monocentric research.
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Preterm delivery remains a critical global health concern, with numerous adverse consequences for both neonate and healthcare systems. Understanding the relationship between maternal ferritin levels, as a marker of iron status, and the risk of preterm birth is the focal point of this comprehensive review. We provide insights into the multifaceted nature of this connection, highlighting factors that influence maternal ferritin levels, including dietary intake, genetic and physiological variations, comorbidities, and iron supplementation. While evidence suggests an association between low maternal ferritin levels and preterm birth, causality remains elusive, necessitating further research with robust study designs. The potential mechanisms linking maternal iron status to preterm birth, such as inflammation, infection, and oxidative stress, are explored, underscoring the need for in-depth investigations. This comprehensive review emphasizes the clinical importance of assessing and monitoring maternal ferritin levels in prenatal care and advocates for public health initiatives to raise awareness and provide targeted interventions, particularly in high-risk populations. As we strive to address these unanswered questions and embark on innovative research directions, the aim is to ultimately enhance our understanding of the complex relationship between maternal iron status and preterm birth, leading to improved maternal and child health outcomes.
RESUMEN
Gastrointestinal stromal tumors (GIST) are common mesenchymal tumors of the gastrointestinal tract. Some somatic factors have been linked to an increased incidence risk. The diagnostic process for GIST poses difficulties since it bears limited resemblance to ovarian masses, given its manifestation through symptoms like abdominal pain, abdominal mass, fever, weight loss, and loss of appetite. Patients with GIST usually exhibit clinical symptoms and signs of an abdominal mass and chronic pelvic pain might look like an ovarian mass, and diagnosed as GIST on histological examination. A 50-year-old woman presented to the gynecology outpatient department with complaints of an abdominal lump accompanied by pain and decreased appetite persisting for five months, leading to a preliminary diagnosis of an ovarian mass. Further evaluation by histopathological examination was confirmed to be GIST on the final diagnosis.
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This review article provides a comprehensive analysis of the role of human papillomavirus (HPV) vaccination in empowering women's health by preventing invasive cervical cancer. Cervical cancer remains a significant global health concern, with HPV infection identified as a primary causative factor. The review synthesizes current research findings, epidemiological data, and clinical outcomes to offer a nuanced understanding of the impact of HPV vaccination on cervical cancer prevention. The article explores the biology of HPV, emphasizing its association with cervical carcinogenesis and the development of precancerous lesions. It delves into the epidemiology of HPV infection, highlighting the global prevalence and the burden of cervical cancer, particularly in low-resource settings. The socio-economic factors influencing HPV transmission and cervical cancer incidence are also discussed. The focus of the review is on the efficacy and safety of HPV vaccines, including an examination of vaccine types, dosages, and long-term effectiveness. Insights into the immunological responses triggered by vaccination, as well as the duration of protection against HPV infection and associated cancers, are presented. Special attention is given to addressing myths and misconceptions surrounding HPV vaccination, aiming to enhance public awareness and acceptance. Additionally, the review discusses the impact of vaccination programs on population-wide HPV prevalence and the subsequent reduction in cervical cancer rates. It explores challenges related to vaccine accessibility, affordability, and coverage, especially in underserved populations. Strategies for improving vaccine uptake and ensuring equitable distribution are considered, with a focus on empowering women through education and healthcare access. Furthermore, the article touches upon emerging trends in HPV research, such as the development of next-generation vaccines, therapeutic interventions for existing infections, and the potential for global HPV elimination. The integration of HPV vaccination into comprehensive women's health programs is advocated, emphasizing the importance of a holistic approach to cervical cancer prevention. In conclusion, this review provides a multifaceted exploration of HPV vaccination as a pivotal tool in empowering women's health by preventing invasive cervical cancer. The synthesis of current knowledge underscores the need for continued research, education, and global collaboration to ensure the widespread success of HPV vaccination initiatives, ultimately contributing to the advancement of women's health worldwide.