An accessory cavitated uterine mass (or malformation) (ACUM) is an isolated cystic uterine lesion located at the lateral aspect of the myometrium just below the insertion of the round ligament. Often the source of severe dysmenorrhea and pelvic pain, this condition is classified as a Müllerian abnormality. Understanding ACUMs, recognizing their clinical appearance, diagnosing an ACUM with ultrasound or magnetic resonance imaging, and advising patients about conservative, medicinal, and surgical treatment options is important to all clinicians. Although ACUM primarily presents with severe dysmenorrhea but can have other clinical symptoms, we have provided a few sample cases to help clinicians prepare for ACUM encounters. We also reviewed the other published literature available on ACUM regarding clinical presentation, etiology, and management. Last but not least, based on our research and the work of others, we offer a set of characteristics that will be useful in diagnosing and treating ACUM. ACUM diagnosis is crucial in clinically suspicious circumstances, and early treatment significantly enhances patients' quality of life.
: Accessory cavitated uterine malformations, or mass (ACUM) is a Mullerian anomaly which increasingly recognized as a cause of severe dysmenorrhoea and pelvic pain.: To know what ACUMs are and recognize their clinical presentation, able to diagnose an ACUM using ultrasound or MRI; and counsel patients with ACUMs on the different management options, including conservative, medical, and surgery.: ACUMs are less rare than previously believed; hence ACUM diagnosis is essential in clinically suspicious cases via ultrasound and MRI, and intra-operative assessment of uterine morphology and laparoscopic surgical excision is the definitive treatment for ACUM.
Objectives To determine fertility outcomes after diagnosing genital tuberculosis followed by anti-tubercular therapy (ATT) and response to different subfertility treatment modalities. Hysteroscopy and laparoscopy data were also analysed to determine whether or not starting ATT early on in the course of tuberculosis treatment was more effective. Study design Among the infertile women, presented in department Reproductive Medicine in Bansal Hospital, Bhopal from Feb 2014 to June 2022, who underwent diagnostic hysteroscopy and laparoscopy, 1083 women having positive finding(s) suggestive of tuberculosis were received anti-tubercular therapy for at least six months. Retrospectively, we analysed the pregnancy outcome of these women after receiving anti-tubercular therapy followed by different subfertility treatments. Results In vitro fertilization (IVF) was a primary modality of treatment. 551(55.88%) women undergoing IVF with their oocytes resulted in 348(63.15%) clinical pregnancies, 264(47.91%) ongoing pregnancies, 84(15.24%) first-trimester miscarriages, and live birth in 246(44.64%) women. Clinical pregnancy rate, ongoing pregnancy rate, and live birth rate all show a statistically significant (P = 0.039) improvement when illness is diagnosed early through hystero-laparoscopy and treated with ATT, followed by fertility therapy. Conclusions Diagnostic hysteroscopy and laparoscopy may be performed to examine high-risk infertile individuals by analysing the reproductive system, including tubal factor. This helps choose a treatment strategy and forecast its success. This study shows that if ATT initiated at early stage as suggested by endoscopy findings IVF reproductive outcomes equivalent to the background population. Late-stage ATT results are often quite dismal, despite the fact that IVF and other adjuvant therapy may improve fertility.
BACKGROUND Accessory cavitated uterine malformations, or mass (ACUM) is a Mullerian anomaly which increasingly recognized as a cause of severe dysmenorrhoea and pelvic pain. OBJECTIVE To know what ACUMs are and recognize their clinical presentation, able to diagnose an ACUM using ultrasound or MRI; and counsel patients with ACUMs on the different management options, including conservative, medical, and surgery. CONCLUSION AND WIDER IMPLICATION ACUMs are less rare than previously believed; hence ACUM diagnosis is essential in clinically suspicious cases via ultrasound and MRI, and intra-operative assessment of uterine morphology and laparoscopic surgical excision is the definitive treatment for ACUM.
Our study looks into the non-existence of transcendental entire solutions for partial differential-difference equation of Fermat typef(z)∂f(z)∂z1+∂f(z)∂z2+ .... +∂f(z)∂znm+ f(z + c)l = 1,where l, m are positive integers and c = (c1, c2, ...., cn) ∈ Cn\{0} with finite order constraintin Cn. Additionally, using the Nevanlinna theory of meromorphic functions in various complex variables, this article examines the existence and an explicit form of solutions to several Fermat-type partial differential-difference equations in Cn. We obtain conclusions about the existence and form of transcendental entire solutions for specific class of functional equation of the type of Fermat with more general form ofαf(z) + β1∂f(z)∂z1+ β2∂f(z)∂z2+ .... + βn∂f(z)∂zn2+ f(z + c)2 = eg(z),where α, βj (j = 1, 2, ..., n) are constants in C and g(z) form a polynomial in Cn with a finite order constraint. The conclusions offered as solutions to these equations have significantly improved the theorems previously proposed by Xu, Cao, Liu, Wang, Zhang, and Zheng [17, 32, 33, 34, 35]. The method used in this article is different from the one used in previous ones. The existence conditions and forms of transcendental entire solutions with a finite order of such equations are demonstrated by providing several examples. 2010 Mathematics Subject Classification. 30D35.
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