Le léiomyome de la vessie est une tumeur bénigne rare réputée avoir un bon pronostic après traitement chirurgical. Ceci n'est malheureusement pas toujours vrai. Nous rapportons le cas d'une patiente âgée de 33 ans qui a consulté pour des douleurs lombaires droites. Les explorations réalisées ont conclu à une tumeur solide du plancher vésical avec, en amont, un rein droit non fonctionnel et des voies urinaires gauches dilatées. La cystoscopie a objectivé une tumeur solide de la vessie périméatique droite. Des biopsies tumorales ont été faites en même temps qu'une montée de sonde double J gauche. L’étude anatomopathologique a conclu à un léiomyome vésical. Elle a eu une myomectomie par voie transvésicale. Les suites opératoires étaient simples. La patiente a toutefois gardé comme séquelle un rein totalement détruit.
The study involved a 28-year-old female patient with no particular past medical history. At 7 weeks of amenorrhea, she presented at the Gynecological Emergency Department with pelvic pain. Clinical examination showed good general condition; vaginal examination objectified that the cervix was very far back (posterior), closed, without metrorrhagias or latero-uterine mass. Ultrasound showed fetal cardiac activity and all around the sac several “lacunae” (empty spaces) without leakage of fluid. Molar pregnancy was suspected based on image examination; hCG level was 37920 UI. The diagnosis of embryonated mole was evoked and complementary thoraco-abdominopelvic CT scan was performed to support the diagnosis and as staging evaluation. This showed partial hydatiform mole without signs of loco-regional or remote extension, with anterior intrauterine myoma. Ultrasound-guided aspiration was performed after availability of blood supply. During aspiration, vescicles were observed. Anatomo-pathological examination initially showed interrupted pregnancy with no chorionic villi. Given the strong suspicion of molar pregnancy, multiple sections were performed which showed rare large chorionic villi with edematous axis. These rare villi were lined with trophoblastic coverage of usual abundance and morphology, suggesting partial mole. The woman received effective contraception with weekly monitoring of BHCG levels. She was monitored until she experienced negative results from three consecutive tests (A, B, C, D).
A 49-year-old woman presented to the emergency room with very intense abdominal pain, fast heartbeat and a swollen, tender abdomen, with a mass arriving to the umbilicus. Blood test showed leukocytosis. US examination showed a solid centropelvic, polilobulated, heterogenous mass of 13cm, surrounded by free fluid,
The purpose of this study is to analyze and to predict the individuals’ income loss associated with education, job sector, income brackets during the COVID-19 pandemic in the Tunisian context. A direct survey was conducted in 1842 Tunisian active worker and self-employment aged over 20 years (mean=35.61% female) between December 20, 2020, and February 8, 2021 in Grand Tunis region. Multinomial logistic regression had been used to assess the COVID-19 impact on an individual’s income change in the Tunisian context. The education attainment, job sector and income level had been mobilized to explain the income loss. We find that the education attainment, job sector and income predictor variables are statistically significant. In particular (1) the log-odds will decrease of being in ‘Partial Income Loss’ versus ‘No Income Loss’ class if the responder has a university degree. (2) The log-odds of being in ‘Partial Income Loss’ class relative to ‘No Income Loss’ class will increase if the individual is not in the Job state sector (3) The log-odds will decrease of being in ‘No Income’ versus ‘No Income Loss’ class if the responder has a secondary, or a university degree. Our predictions point out that four fifth of the responders losing their income temporarily or permanently during the year 2020. Tunisian government has to assist the vulnerable social classes and reduce the inequality between social classes.
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