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Article
Pyometra Presented With Rectal Pain, a Case Report and Review of Literature
مقدم تقيح الرحم مع الألم المستقيم، وتقرير حالة ومراجعة الأدب

Author: Yosra T. Jarjees يسرى طاهر جرجيس
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2011 Volume: 53 Issue: 3 Pages: 348-349
Publisher: Baghdad University جامعة بغداد

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Abstract

Pyometra is an uncommon gynecological condition resulted from occlusion of the cervix usually by a malignant condition. It has an incidence of 0.1%-0.5%. Untreated pyometra leads to rupture uterus and acute infective peritonitis presented as acute abdomen and needs urgent surgical intervention. Pyometra resulted from occlusion of the vagina is very rare. No cases have been described in the English literature to the best of our knowledge and in the PubMed. The purpose of reporting this case is to show that occlusion of the vagina could occur in postmenopausal women as a consequence of local infection and results in pyometra and also to show that pyometra can be presented in a different way apart from the classical presentation. The way to reach the diagnosis and how to manage the case has been also discussed thoroughly.

ان تقيح الرحم هي حالة نسائية نادرة تنتج من انسداد عنق الرحم عادة ما تكون بسبب ورم سرطاني ويحدث بنسبة 0,1%-0,5%. عدم معالجة الحالة يؤدي الى انفجار الرحم والتهاب غشاء المساريق الحاد وحدوث حالة البطن الحاد مما يلزم تداخل جراحي طارئ. تقيح الرحم الناتج من اسداد المهبل حالة نادرة ولم تسجل اي حالة على حد علمنا. ان الهدف من تسجيل هذه الحالة هو تبيان ان الاتسداد قد يحدث في المهبل في سن الامل نتيجة التهاب سابق ادى الى التصاق الجدار الامامي والخلفي للمهبل, كما تبين الحالة ان طريقة ظهور الاعراض تختلف عن الطريقة النمطية. تمت مناقشة طريقة التوصل الى التشخيص و كيفية معالجة المريضة بصورة مفصلة.


Article
SUCCESSFUL TRIAL OF LABOR AFTER PRIMARY AND REPEATED CESAREAN SECTIONS: A CASE REPORT

Author: Yosra T. Jarjees يسرى طاهر جرجيس
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 1 Pages: 103 -105
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

This is a case report of a patient who achieved a successful vaginal birth for five times attended by a traditional birth attendant twice after two cesarean sections and thrice after three cesarean sections.Keywords:Vaginal birth after cesarean delivery, VBAC, VBAC delivery, trial of labor after cesarean delivery, prior cesarean delivery, risks for uterine rupture, vaginal delivery


Article
Malignant gestational trophoblastic disease: a review of seventeen cases

Authors: Haifa Z. Beker هيفاء --- Aasem M. AL-Chalabi عاصم الجلبي --- Yosra T. Jarjees يسرى طاهر جرجيس
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2006 Volume: 32 Issue: 1&2 Pages: 23-28
Publisher: Mosul University جامعة الموصل

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Abstract

Objective: (a) To describe the demographic characteristics of malignant gestational trophoblasic disease (GTD) in Mosul. (b) To evaluate the classification system that stratifies the treatment of the malignant GTD. (c) To know the incidence of malignant changes of mole to malignant GTD.
Design: retrospective clinical case series study done over a period of 5 years.
Setting: Al-Batool Maternity Teaching Hospital and Ibn Seena Teaching Hospital.
Participants: The records of a series of 17 consecutively treated patients who had been diagnosed to have malignant GTD were reviewed. The records of these 17 patients were studied for their age, parity, and mode of presentation. All patients underwent staging studies which included chest x-ray and abdominal ultrasound and were classified as good prognosis group 8 patients (47%) and poor prognosis group 9 patients (53%).
Intervention(s): The good prognosis group was treated with courses of intramuscular methotrexate (50 mg on alternative days 1,3,5,7) with folinic acid rescue (7.5 mg orally on alternative days 2,4,6,8) .The poor prognosis group was treated with methotrexate (10 mg/m2 /day) intravenously (iv), dactinomycin (0.3 mg/m2 /day) iv, and cyclophosphamide (110 mg/m2 /day) iv, for three-day course. Both courses were repeated according to patients’ response.
Results: The mean age incidence of malignant GTD was 37.2 years; the mean parity was 4.6, equally presented from rural and urban areas. The presenting symptom of malignant GTD was vaginal bleeding in 47%, cough and shortness of breath in 41.1%, cough and hemoptysis in11.7%. The blood group was O+ve in 64.7%, A+ve in 17.5%, B+ve in 11.7% and AB+ve in 5.9%. The antecedent pregnancy for malignant GTD was complete mole in 88.2 % (the entire good prognosis group), term pregnancy in 5.9% and abortion in 5.9% (both of them in the poor prognosis group). The mean duration between the antecedent pregnancy and treatment of malignant GTD was 5.7 months. Complete response rate without recurrence was 75% for the good prognosis group and 44.4% for the poor prognosis group. The mortality rate was 0% for the good prognosis group and 33.3% for the poor prognosis group giving an overall cure rate of 58.8%. Hysterectomy was needed in 2 patients (22.2%) of the poor prognosis group. The ratio of changes from complete mole to malignant GTD was about one to nine.
Conclusion: Malignant GTD usually complicated complete mole and presented as poor prognosis type in nearly half of the patients. Classification into good and poor prognosis groups is a successful way for treatment selection.

Key words: Gestational trophoblastic disease, hydatidiform mole, neoplasm staging.

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