Objective: To determine whether addition of letrozole to a misoprostol-based abortion regimen can increase the rate of complete abortion. Methods: The randomized, placebo-controlled, double-blind trial enrolled women with missed abortion in the first trimester of pregnancy attending Sadooghi Hospital, Isfahan, Iran, from 2016 to 2018. The women were randomly assigned to the study group, which received 10 mg of letrozole daily for 3 days, followed by two doses of 800 μg of vaginal misoprostol at a 4-hour interval, or the control group, which received a placebo, followed by the same dose of misoprostol. Sonography was performed to check the abortion status. Results: In total, 120 women completed the study: 60 in the misoprostol plus letrozole group, and 60 in the misoprostol only group. Complete abortion was documented for 93 (77.5%) women: 48 (80.0%) in the misoprostol plus letrozole group and 45 (75.0%) in the misoprostol only group (P=0.80). The mean duration of induction in the misoprostol plus letrozole and misoprostol only groups was 7.35 ± 3.54 hours and 8.2 ± 3.84 hours, respectively (P=0.21). Conclusion: Administration of misoprostol alone was found to be as effective as the administration of misoprostol plus letrozole for first-trimester missed abortion.
Introduction Cartilage is a specialized connective tissue containing extracellular matrix (ECM) rich in GAG and proteoglycans. This matrix can cause the cartilage to withstand mechanical pressure without permanent deformation. Also, these compounds create an appropriate smoothness and sliding in joints. 1 Cartilage tissue does not have a high regenerative power due to its lack of blood flow unlike the bone, which has a more efficient mechanism for repairing itself. 1 The damaged or eroded cartilage has limited ability to repair itself. It has also less power in malicious and wider damage. 2-6 Nowadays, cartilage diseases such as osteoarthritis are the most common skeletal diseases. These diseases are especially common in older people or athletes. According to a report, over 39 million people over 25 years in Europe and 26 million people in America experience osteoarthritis and have estimated this number to be doubled by 2020. 7,8 Today, the treatment of cartilage diseases is one of the biggest problems in the medical society. A series of new therapies has been taken into consideration based on tissue engineering in recent years for the treatment of cartilage diseases. The procedure requires proper scaffold, repairing cells, and growth factors. Tissue engineering of cartilage using stem cells is to either produce cartilage in the laboratory or to produce cartilage producing cells in the body. In the occasion that the cartilage is synthesized in the laboratory, it must be transplanted into the body and in the joints. In this type of treatment, the patient will not need artificial joints anymore. Among the appropriate treatment
Introduction: Immunosuppression conditions are the leading risk factors for opportunistic fungal infections. The clinical manifestation is related to the site of infection. Gastrointestinal (GI) mucormycosis is a rare form of this disease, even in immunosuppressed patients. Case Presentation: We report rare cecum necrosis with terminal ileum perforation resulting from infiltration of mucormycosis in the cecum wall and terminal ileum mesentery in a patient with diabetes mellitus and acute myeloid leukemia (AML). During chemotherapy for AML, the patient presented diarrhea followed by constipation, severe progressive abdominal pain, and fecaloid peritonitis. Perforation of the terminal ileum was observed during the surgery. Ileostomy, right hemicolectomy, and resection of necrotic tissue were performed, and bowel mucormycosis was confirmed on histologic examination. Unfortunately, the patient expired five days after surgery. Conclusions: Gastrointestinal mucormycosis is an uncommon infection with symptoms like abdominal pain, nausea, vomiting, and melena. The mortality of GI involvement is due to perforation, peritonitis, and GI bleeding.
The adult Bochdalek hernia is one of the right-sided diaphragmatic hernias that less than 30 cases reported until now. Here, we report a 64-year-old female patient who presented with dyspnea, abdominal pain, and nausea. Primary imaging showed a right-sided diaphragmatic hernia that contained the liver and right colon. At first, the patient underwent a right posterior thoracotomy, and the diaphragmatic defect was repaired. After 2 days, abdominal peritonitis happened then a midline laparotomy was performed. Finally, it was clear that the main problem was the obstructed and perforated descending colon mass that was presented with Bockdalek hernia. Unfortunately, the patient passed away 2 days after the operation. It should be considered that an increase in intra-abdominal pressure like the presence of obstructed colon mass can cause this rare hernia and It is important to determine the reason for the presentation of the symptomatic Bochdalek hernia in adult patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.