IntroductionGestational trophoblastic neoplasms have highly been malignant potential, which usually occurred in child-bearing age women. Unusual feature of this malignancy would be rare, it was important to take in mind the possibility of GTN in different manifestation. Based on the above mentioned, the aim of this presentation would be the management and outcome of a case series of choriocarcinoma patients with abnormal manifestation.Case PresentationWe have presented four patients, first who initially manifestation with signs of septic shock, the second case with severe gastrointestinal hemorrhage, the third case with postpartum infection and the forth case was a postmenopausal bleeding patient.ConclusionsIn case of metastatic choriocarcinoma with precise history, accurate diagnosis and appropriate treatment have led us to curable results.
The incidence of smear-positive PTB among migratory nomads is approximately nine-fold higher than in the general population. Active screening of TB in migratory nomads should be integrated into Iran's national TB control programme. The issue of destigmatisation, particularly among female TB patients, should also be addressed.
Background: COVID-19 patients, especially the patients requiring hospitalisation, have a high risk of several complications such as opportunistic bacterial and fungal infections. Mucormycosis is a rare and opportunistic fungal infection that mainly affects diabetic and immunocompromised patients. An increase has been observed in the number of rhino-orbital mucormycosis in patients with COVID-19 admitted to Imam Khomeini Hospital, Kermanshah, Iran, since October 2020. This is a report of the frequency, risk factors, clinical manifestations, treatment and prognosis of COVID-19 associated with mucormycosis infection. Methods: The medical records of COVID-19 patients with rhino-orbital mucormycosis who were diagnosed in an educational therapeutic hospital in Kermanshah, west of Iran were surveyed. Several parameters were analysed including demographic, clinical, therapeutic and laboratory characteristics.Results: Twelve patients with COVID-19-associated rhino-orbital mucormycosis were identified from 12 October to 18 November 2020. All cases reported as proven mucormycosis had a history of hospitalisation due to COVID-19. Comorbidities mainly included diabetes mellitus (83.33%) and hypertension (58.33%). Seventy-five per cent of patients received corticosteroids for COVID-19 treatment. The sites of involvement were rhino-sino-orbital (83%) and rhino-sino (17%). Amphotericin B/ liposomal amphotericin B alone or in combination with surgical debridement or orbital exenteration was used as the first-line therapy. The overall mortality rate was 66.7% (8/12). Conclusions:We found a high incidence of mucormycosis among COVID-19 patients. Diabetes mellitus and corticosteroid use were the dominant predisposing factor of mucormycosis. Mucormycosis is a life-threatening and opportunistic infection;
Background and Aims Olfactory dysfunction is a recognized manifestation in patients infected with Coronavirus Disease 2019 (COVID‐19). This investigation aimed to assess the effect of mometasone furoate intranasal spray on the improvement of smell dysfunction in post‐COVID‐19 patients. Materials and Methods This randomized placebo‐controlled trial included 80 non‐hospitalized adult patients who had persistent anosmia or severe microsmia for more than 4 weeks due to COVID‐19 infection. The participants were randomly allocated to the intervention or placebo group to receive mometasone furoate nasal spray or sodium chloride intranasal spray during 4 weeks of follow‐up, respectively. The patients' olfactory dysfunction was assessed in terms of visual analog scale (VAS), and smell test score according to the modified version of the University of Pennsylvania smell identification test for the Iranian population. Results A total of 70 participants completed the follow‐up period and were analyzed in this study. By comparing the olfactory scores including smell test and VAS scores, no significant differences were found between case and control groups at baseline, 2, and 4 weeks intervals. However, the change of both olfactory scores at pre to post‐treatment intervals and 2–4 weeks was significantly higher in the mometasone group relative to the placebo group. At post‐treatment, the frequency of anosmia was 22.9% reduced in the case group compared to the control group. Conclusion Overall, there was no significant difference in olfactory dysfunction between the two groups during follow‐up. However, based on the significant between‐group difference in terms of olfactory scores changes, it seems that the nasal corticosteroids may be a positive effect on the recovery process of patients who received more than 2 weeks. Level of Evidence II Laryngoscope , 2022
Introduction: Choriocarcinoma is a gestational trophoblastic tumor that mainly affects women of childbearing age and rarely occurs in postmenopausal women especially following a long latent period from previous pregnancies. In this case report, we introduce three cases of postmenopausal choriocarcinoma with different clinical signs and symptoms. Case Report: The first patient was admitted with vaginal wall metastasis, and the second and third cases with postmenopausal vaginal bleeding. They were referred to the department of gynecology-oncology at Ghaem hospital in 2015. One case had stage I and two patients stage III of the disease. Treatment was initiated with EMA-CO regimen according to the histopathology of choriocarcinoma in these patients. Complete remission was achieved with chemotherapy for all three cases. Concusions: The possibility of choriocarcinoma should be considered as a differential diagnosis in postmenopausal vaginal bleeding and in postmenopausal women with metestatic lesions.
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