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Mansouri G, Allahqoli L, Salehiniya H, Alkatout I. External Genitalia Myiasis in a 40-Year-Old Woman. Case Rep Obstet Gynecol 2023; 2023:5579531. [PMID: 37593321 PMCID: PMC10432004 DOI: 10.1155/2023/5579531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/21/2023] [Accepted: 07/26/2023] [Indexed: 08/19/2023] Open
Abstract
Human myiasis is an infestation produced by fly larvae invading the tissues. We present a case of a 40-year-old virgin woman with vulvar myiasis. She reported at the gynecology clinic with a bloody discharge, severe pain, and swelling of the genital area for six days. Her menstrual history revealed the use of folded clothes. She had no specific gynecological disease. At the examination of the external genitalia, a tender mass measuring 6 cm × 4 cm and an ulcer measuring 1 cm × 1 cm on the surface of the labia majora were found. The patient was hospitalized. Serology, blood, and urine tests were requested; all laboratory tests were normal. The patient was transferred to the operating room (OR) with the diagnosis of necrotizing fasciitis. In the OR, we performed a longitudinal incision on the mass and removed nearly 30 visible maggots. After washing with normal saline, the patient was transferred to the ward without wound suturing. Debridement of the necrotic vulvar mass along with daily washing was performed for 7 days. The wound was sutured on the seventh day at the OR. Antibiotic therapy was continued for 4 days, and the patient was discharged with normal laboratory tests on the eleventh day after admission. We believe that poor sanitary hygiene was the cause of vulvar myiasis in our patient. We conclude that appropriate measures must be taken to reduce the risk of human myiasis, especially in tropical rural regions.
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Affiliation(s)
- Ghazal Mansouri
- Department of Obstetrics and Gynecology, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Mansouri G, Alkatout I, Iranpour M, Pourkhandani E, Allahqoli L. Unexpected presentation of accessory breast: vulvar accessory breast tissue: a case report. J Med Case Rep 2023; 17:189. [PMID: 37150807 PMCID: PMC10165762 DOI: 10.1186/s13256-023-03930-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/12/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND The accessory breast is composed of residual glandular mammary tissue that persists after normal embryonic development. The entity is so rare that it is easily neglected in the diagnosis of disease. CASE PRESENTATION We report a 24-year-old virgin Persian woman with a left-sided vulvar mass and no pain or discomfort until shortly before her presentation at our department. Ectopic breast tissue in the vulva was diagnosed. We performed wide local resection of the lesion. Pathological investigation of the lesion confirmed the presence of ectopic breast tissue with secretory changes. She had no specific developmental abnormalities and had no relevant family history. She was followed up for 10 months and had recovered fully by this time. CONCLUSION Accessory breast tissue should be considered as a diagnosis when a mass is seen along the embryonic milk line, especially if the clinical findings reveal changes in the mass accompanied by changes in sex hormones.
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Affiliation(s)
- Ghazal Mansouri
- Department of Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Iran
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Arnold-Heller-Str. 3, Haus 24, 24105, Kiel, Germany
| | - Maryam Iranpour
- Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Pourkhandani
- Department of Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Iran
- Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran, Iran.
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Mansouri G, Safinataj M, Shahesmaeili A, Allahqoli L, Salehiniya H, Alkatout I. Effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cyst. Front Endocrinol (Lausanne) 2022; 13:964229. [PMID: 36120464 PMCID: PMC9476315 DOI: 10.3389/fendo.2022.964229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cysts. MATERIAL AND METHODS This prospective study was performed on 113 women with ovarian cysts in a tertiary referral teaching hospital. All patients underwent laparoscopic cystectomy. Serum levels of antimüllerian hormone (AMH) were measured pre-and, 3 months postoperatively. The primary outcome of the study was to assess the effect of laparoscopic cystectomy on ovarian reserve based on alterations in serum AMH levels. The secondary outcome of the present study was to evaluate the impact of the number of cauterizations, size and type of cysts, bilaterality (bilateral or unilateral), age, and body mass index (BMI) on the ovarian reserve after laparoscopic excision. RESULTS Laparoscopic cystectomy reduced the serum AMH levels preoperatively (1.32 ± 4.48 ng/ml) to postoperatively (3.2 ± 1.93 ng/ml) and the difference (- 1.28 ng/ml) was statistically different (0.001 >P). There was a negative significant relationship between the number of cauterizations used and postoperative serum AMH levels (p ≤ 0.001). There was a significant relationship between the location (p ≤ 0.01), type of cyst (p ≤ 0.001) and the serum AMH levels reduction. CONCLUSION The number of cauterizations used during surgery, the type of cyst, and bilaterality can affect AMH levels that need to be addressed.
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Affiliation(s)
- Ghazal Mansouri
- Department of Obstetrics and Gynecology, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Safinataj
- Department of Obstetrics and Gynecology, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
- *Correspondence: Ibrahim Alkatout, ; Maryam Safinataj,
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and World Health Organization (WHO) Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany
- *Correspondence: Ibrahim Alkatout, ; Maryam Safinataj,
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Vahdat M, Mansouri G, Kashanian M, Mirzaei H, Mostafavi SRS, Shahesmaeili A. One-Step Resection via Hysteroscopic Myomectomy and Prostaglandin F2α for Large Submucosal Myoma. J Minim Invasive Gynecol 2020; 27:826-831. [PMID: 32105820 DOI: 10.1016/j.jmig.2019.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 11/28/2022]
Abstract
STUDY OBJECTIVE To assess the efficacy of prostaglandin F2α (PGF2α) in hysteroscopic myomectomy of submucous myomas. DESIGN Single-blind, randomized clinical trial study. SETTING Teaching hospital, affiliate of Iran University of Medical Sciences, Tehran, Iran. PATIENTS Forty-four patients with symptomatic submucous myomas were randomly assigned to the intervention group (n = 21; 1 excluded owing to myoma not identified on pathologic examination) and the control group (n = 22). INTERVENTIONS In the intervention group, PGF2α was injected into the cervix twice: before the beginning of the surgery and after the resection of the intrauterine portion of the submucous myoma. TIn the control group, the myomas were resected without the PGF2α injection. The same procedure was performed in the control group without the PGF2α injection. MEASUREMENTS AND MAIN RESULTS There were no differences in the demographics, size, or type of myomas among the groups at baseline. Although the proportion of complete removal of the submucous myomas in the intervention group (PGF2α) was higher (20/23 myomas or 87%) than that in the control group (15/23 myomas or 65.2%), the difference was not significant (p = .1). The number of 1-step complete removal of large submucous myomas (>5 cm) in the PGF2α group was significantly higher than that in the control group (8/10 myomas [80%] vs 2/8 myomas [25%], p = .03). The mean duration of operative time was significantly longer in the intervention group than in the control group (p = .01). The intervention group experienced more days of postoperative bleeding than the control group (p = .001). There were no differences regarding the length of stay at the hospital or hemoglobin levels between the groups (p = .07). CONCLUSION In the current study, injection of PGF2α was beneficial for 1-step complete resection of large (>5 cm) submucous myomas via hysteroscopic myomectomy.
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Affiliation(s)
- Mansoureh Vahdat
- Endometriosis Research Center (Drs. Vahdat and Mansouri); Iran University of Medical Sciences, Tehran, Iran , (Dr. Kashanian); Department of Radiology, School of Medicine (Dr. Mostafavi), Iran University of Medical Sciences, Tehran; Department of Gynecology (Dr. Mansouri); HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health (Mr. Mirzaei and Dr. Shahesmaeili), Kerman University of Medical Sciences, Kerman, Iran
| | - Ghazal Mansouri
- Endometriosis Research Center (Drs. Vahdat and Mansouri); Iran University of Medical Sciences, Tehran, Iran , (Dr. Kashanian); Department of Radiology, School of Medicine (Dr. Mostafavi), Iran University of Medical Sciences, Tehran; Department of Gynecology (Dr. Mansouri); HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health (Mr. Mirzaei and Dr. Shahesmaeili), Kerman University of Medical Sciences, Kerman, Iran.
| | - Maryam Kashanian
- Endometriosis Research Center (Drs. Vahdat and Mansouri); Iran University of Medical Sciences, Tehran, Iran , (Dr. Kashanian); Department of Radiology, School of Medicine (Dr. Mostafavi), Iran University of Medical Sciences, Tehran; Department of Gynecology (Dr. Mansouri); HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health (Mr. Mirzaei and Dr. Shahesmaeili), Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Mirzaei
- Endometriosis Research Center (Drs. Vahdat and Mansouri); Iran University of Medical Sciences, Tehran, Iran , (Dr. Kashanian); Department of Radiology, School of Medicine (Dr. Mostafavi), Iran University of Medical Sciences, Tehran; Department of Gynecology (Dr. Mansouri); HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health (Mr. Mirzaei and Dr. Shahesmaeili), Kerman University of Medical Sciences, Kerman, Iran
| | - Seyed Reza Saadat Mostafavi
- Endometriosis Research Center (Drs. Vahdat and Mansouri); Iran University of Medical Sciences, Tehran, Iran , (Dr. Kashanian); Department of Radiology, School of Medicine (Dr. Mostafavi), Iran University of Medical Sciences, Tehran; Department of Gynecology (Dr. Mansouri); HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health (Mr. Mirzaei and Dr. Shahesmaeili), Kerman University of Medical Sciences, Kerman, Iran
| | - Armita Shahesmaeili
- Endometriosis Research Center (Drs. Vahdat and Mansouri); Iran University of Medical Sciences, Tehran, Iran , (Dr. Kashanian); Department of Radiology, School of Medicine (Dr. Mostafavi), Iran University of Medical Sciences, Tehran; Department of Gynecology (Dr. Mansouri); HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health (Mr. Mirzaei and Dr. Shahesmaeili), Kerman University of Medical Sciences, Kerman, Iran
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