Intramural pregnancy at 6 and 8 weeks gestation with no predisposing factors: As two uncommon case reports.

Ectopic pregnancies are extremely rare causing severe consequences such as uterine rupture and may lead to death. The clinical symptomatology is very atypical, essentially pelvic pain and metrorrhagia, for this reason, a misdiagnosis can be fatal. Here we report two cases of an intramural pregnancy in a 33-year-old primigravida at 6 weeks gestation after a medically assisted reproduction and a 26-year-old primigravida at 8 weeks gestation with no predisposing factors, making the diagnosis more challenging.

Beneficial effects of oral antioxidant supplementation on semen quality parameters, reproductive hormones, and sperm DNA integrity in men with idiopathic oligoasthenoteratozoospermia.

OBJECTIVE: Recently, oral antioxidants in combined forms have been used to treat men with idiopathic infertility. This study aimed to evaluate the effects of treatment with vitamin C, vitamin E, selenium, zinc, arginine, L-carnitine, and coenzyme Q10 on sperm quality parameters, DNA integrity, reproductive hormones, and pregnancy rates in men with infertility and idiopathic oligoasthenoteratozoospermia (OAT). METHODS: A prospective study was conducted on 420 men with infertility and idiopathic OAT who took an oral supplement of antioxidant SP-Power tablets twice daily for 6 months. Semen quality, reproductive hormones, and the DNA fragmentation index (DFI) were evaluated at baseline and at 3 and 6 months after supplementation, using the World Health Organization 2021 guidelines. RESULTS: No significant difference was observed in volume or the percentage of typical morphology during treatment. A significant improvement in sperm concentration was observed after supplementation (8.67±1.41, 12.17±1.91, and 19.01±0.86 at baseline, 3, and 6 months respectively, p<0.01). The total motility, progressive motility, and total motile sperm count also increased significantly (p<0.01), whereas the DFI decreased after 6 months. There was an increase in normal FSH levels and testosterone levels after 6 months of supplementation of antioxidant SP-Power but these differences were not statistically significant (p=not significant and p=0.06, respectively). CONCLUSION: Supplementation with SP-Power tablets improved sperm quality parameters, sperm DFI, some reproductive hormones, and pregnancy rates in men with infertility and idiopathic OAT, which could be attributed to the supplement's synergistic antioxidant action. Further studies are needed to determine the effects of supplementation on oxidative stress markers.

Deep endometriosis of ileocecum complicated by acute intestinal obstruction: a case report.

Endometriosis is a frequent gynecological pathology. Digestive localization complicated by acute intestinal obstruction is exceptionally rare. We herein report a case involving a 48-year-old woman who had a long-term history of endometriosis symptoms. She was diagnosed with endometriosis by ultrasound 1 month before her admission to the emergency room with acute intestinal obstruction. The diagnosis was confirmed by histopathological examination following surgical resection. Further medical management resulted in a satisfactory outcome.

Hormonal, clinical, and genetic profile of infertile patients with azoospermia in Morocco.

Introduction: azoospermia affects more than 10%-15% of infertile male subjects attending the infertility center. In Morocco, there have been no studies on male infertility with azoospermia. Thereby, our objective was to evaluate the clinical, hormonal, and genetic characteristics of infertile men with azoospermia in Morocco. Methods: we conducted a retrospective descriptive study performed with a convenience sample of 80 infertile men from 2021 to 2022, in the Assisted Reproductive Technology Unit of the Mohammed VI University Hospital Center in Oujda-Morocco. All patients with azoospermia were subjected to a quantitative hormone assay to evaluate the functionality of the sertolic and leydigial compartments. Human karyotyping and AZF microdeletion analysis are routinely performed in azoospermic patients. Results: the results show that the mean age of patients in the study was 45.7 ± 3.5 years. Primary infertility accounts for the majority, with a rate of 96% (n=77). There were 12 cases of azoospermia of secretory origin, 22 cases of excretory origin, and 3 of undetermined origin. Azoospermia was associated with hydrocele in 29% (n=27) of cases. The average levels of FSH, LH, testosterone, and inhibin B were 15.54 ± 5.5 mIU/mL, 7.71 ± 2.7 mIU/mL, 405.09 ± 6.13 ng/dl and 38.44 ± 5.13 pg/ml, respectively. The prevalence of chromosomal abnormalities was 30.7%. Of these, the sex chromosome aneuploidy with 47, XXY karyotype (Klinefelter syndrome) accounted for 11% (n=9). The incidence of microdeletions of azoospermia factors (AZF) was 9%, and AZFc deletion was the most common at the rate of 3%. Conclusion: our research shows that hydrocele, varicocele, and chromosomal abnormalities are the leading causes of azoospermia. In the Moroccan population, azoospermia is essentially of excretory origin.

Spontaneous twin pregnancy in uterus bicornis unicollis complicated with preeclampsia: A case report.

INTRODUCTION AND IMPORTANCE: Bicornuate uterus is a uterine malformation caused by abnormal Müllerian fusion, often leading to multiple obstetric complications. A twin pregnancy in this condition is extremely rare. CASE PRESENTATION: A 27-year-old patient (Gravida 3, Para 0) with a previous history of two spontaneous early miscarriages was diagnosed with uterus bicornis unicollis (unicervical bicornuate uterus). She presented with spontaneous twin pregnancy complicated with preeclampsia at 34 weeks + 6 days. Thus, she underwent cesarean section with two separate lower-segment incisions. Consequently, healthy twins were delivered successfully. CLINICAL DISCUSSION: Bicornuate uterus is a rare congenital uterine malformation, and only 16 cases of twin pregnancy associated with uterus bicornis unicollis have been reported worldwide. This uterine malformation can be discovered spontaneously in imaging or during obstetric complications such as spontaneous abortions, premature labor, premature rupture of membranes, malpresentations, and intrauterine growth restriction. In addition, the risk for preeclampsia in twin pregnancies is twice higher than singleton gestations. CONCLUSION: Twin pregnancy in a bicornuate uterus is extremely rare; this phenomenon is yet to have guidelines for monitoring pregnancy and the mode of delivery.

Successful maternal and fetal outcomes in a kidney transplant patient under everolimus throughout pregnancy complicated by pyelonephritis and preeclampsia.

Pregnancy in kidney transplant patients has many risks such as worsening renal function and/or proteinuria, allograft rejection, preeclampsia, spontaneous abortion, premature fetal delivery, and low fetal birthweight. We report a case of a 35-year-old patient with a history of kidney transplant, who received everolimus throughout pregnancy and experienced a successful cesarean delivery with positive maternal and fetal outcomes. Information regarding everolimus use in pregnancy is limited. However, data from animal studies suggest that everolimus may cause fetal harm when administered during pregnancy. In our case, everolimus did not affect the pregnancy of this patient; cesarean delivery was performed without complications. Owing to the increased risks and monitoring required during pregnancy in patients with a previous kidney transplant and limited information regarding the use of antirejection agents during pregnancy, care throughout pregnancy should involve a multidisciplinary team, including transplant, maternal fetal medicine, and nephrology.

[The role of transvaginal ultrasound in the evaluation of endometrial infertility]. / Place de l´échographie endovaginale dans l´exploration de l´infertilité d´origine endométriale.

The assessment of the uterine cavity in patients with infertility is essential as many intrauterine lesions can be detected. Transvaginal ultrasound (TVE) is a front-line testing for female infertility. It allows assessment of the uterine cavity for detection of abnormalities responsible for fertility disorder as well as of lesions that may lead to transfer or implantation failures. It is an easily perfomable and reproducible exam. The purpose of our study is to describe endometrial lesions detectable on TVE in order to highlight the role of TVE in the evaluation of infertility.

[Idiopathic granulomatous mastitis: 4 case-reports and literature review]. / La mastite granulomateuse idiopathique: à propos de 4 cas et revue de littérature.

Idiopathic granulomatous mastitis is a rare benign inflammatory mastopathy. Histological examination of the surgical biopsy can confirm the diagnosis and thus exclude carcinomatous mastitis. Although its etiologies are undeterminated and it occurs mainly in young women, its idiopathic nature is confirmed after exclusion of the other causes of granulomatous disease. Medical treatment is based on antibiotic therapy and anti-inflammatory drugs. Patients with complicated forms are treated with surgery. We here report four cases of idiopathic granulomatous mastitis whose data were collected in the Department of Gynecology and Obstetrics at the University Hospital MED VI of Oujda (Morocco).

[Homozygous familial hypercholesterolemia: development and a case illustration]. / Hypercholestérolémie familiale homozygote : mise au point et illustration par un cas.

Familial hypercholesterolemia (FH) is a genetic disease caused by a mutation of the gene encoding for the low density lipoproteins (LDL) membrane receptor. The mutation is transmitted in an autosomal dominant mode and is manifested by permanent elevation of the plasma LDL-cholesterol concentration; such elevation is responsible for the early onset of cardiovascular complications. The other clinical manifestation is the existence of extravascular cholesterol deposits: xanthomas and corneal arcus. There are two forms of familial hypercholesterolemia: homozygous FH and heterozygous FH which is generally less severe biologically and clinically. We report in this work, a case of FH diagnosed at the laboratory of clinical chemistry of Rabat children's hospital. The lipid profile revealed a dramatic LDL-cholesterol elevation (24 mmol/L) with normal triglycerides concentration (0.84 mmol/L). The physical examination revealed cutaneous xanthomas. The diagnosis of homozygous FH was strongly suggested by family study.

[Mantle cell lymphoma diagnosis]. / Diagnostic du lymphome du manteau.

Recent classifications of non-Hodgkin's lymphomas based on combination of morphologic, immunophenotypic, and cytogenetic criteria have individualized mantle cell lymphoma (MCL). This clinico-biological entity which accounts for 3 to 10% of all non-Hodgkin's lymphomas, now appears to be a biological and therapeutic model for the understanding and treatment of hematologic malignancies. The present study consisting of two cases of MCL collated at laboratory of hematology of Rabat Ibn Sina hospital. The morphological appearance of MCL is characterized by diffuse or nodular lymph infiltration in the mantle zone, the osteo-medullary biopsy shows an interstitial infringement characterized by the presence of lymphocytes resembling centrocytes with cleaved and angular nuclei, dispersed chromatin, inconspicuous nucleoli and scanty cytoplasm. The flow cytometry showed immunophenotype positive for surface Ig, CD19, CD20, CD22, CD79b, CD5 and cyclin D1, and negative for CD10, CD23 and CD25. In conclusion, the methods of diagnosis and prognosis evaluation of mantle cell lymphoma are based on the nodular, medullary and blood morphology, the immunophenotypic, cytogenetic and molecular study of neoplastic cells.