Swyer syndrome is a medical condition that begins with a mutation in the SRY gene that favors the development of female reproductive organs despite the presence of Y chromosome. The aberrancy in testicular differentiation will lead to abnormal testosterone production and impaired Mullerian Inhibiting Substance secretion resulting in the formation of Mullerian derived structures and regression of Wolffian ducts. Since an XY karyotype is incompatible with follicle formation, the gonads will degenerate and become streak fibrous tissue. Patients are phenotypically female at birth with a uterus, fallopian tubes and bilateral steak gonads. Management involves puberty induction and bone loss prevention through combined hormonal replacement therapy. Bilateral gonadectomy should be performed soon after the diagnosis because of the risk of malignancy. Infertile, childbearing is only through assisted reproductive technology and oocyte donation.
Human ; Adult ; GONADAL DYSGENESIS, 46,XY ; AMENORRHEA

Objective: To validate the Filipino Translation of the Fertility Problem Inventory as a measure of infertility-related stress among female infertile patients. Design: Cross-sectional study Setting: Tertiary referral center Study Population: Female infertility patients aged 21-40 years, with at least one year of attempting to achieve pregnancy. Outcome Measures: Patients' infertility-related stress was assessed by written questionnaire using the Filipino translation of the Fertility Problem Inventory. Results: Global stress scores were identical across all ages and educational level attained. increasing number of years trying to conceive has no impact on the global stress scores. Conclusion: The Filipino translation of the Fertility Problem Inventory provides a valid measure of infertility-related stress.
Human ; Female ; Adult ; INFERTILITY ; INFERTILITY, FEMALE

Septic pulmonary embolism is an uncommon disorder in which septic thrombi are mobilized from an infectious nidus and transported in the vascular system of the lungs. We report a case of a 52-year-old immunocompetent female who suffered from septic pulmonary embolism associated with polymyositis, deep venous thrombosis and pericardial effusion. Oxacillin-sensitive staphylococcus aureus (MSSA) was isolated from her sputum. Clinical presentation improved after incision of the muscle abscess and vancomycin treatment.

Human ; Female ; Middle Aged ; Abscess ; Communicable Diseases ; Oxacillin ; Pericardial Effusion ; Polymyositis ; Pulmonary Infarction ; Sputum ; Staphylococcal Infections ; Staphylococcus Aureus ; Vancomycin ; Venous Thrombosis ; Pyomyositis

Human ; Female ; Adult ; Prevalence ; Daucus Carota ; Tertiary Care Centers ; Streptococcal Infections ; Sensitivity And Specificity ; Streptococcus

BACKGROUND: Narrow-band UVB and topical corticosteroids are treatments for vitiligo. The possible synergistic effect of these modalities has not yet been investigated.
OBJECTIVE: This study aims to compare the efficacy of combining narrow-band UVB (NB-UVB) and 0.05% clobetasol propionate ointment (CP) with that of NB-UVB and placebo in inducing initial and overall repigmentation and control of disease activity after 6 months of therapy. Moreover, it aims to assess the safety and determine the permanence ofrepigmentation within I year post-treatment in both regimens.
METHODS: Randomized, placebo-controlled, double-blind, left-right comparison was conducted on generalized vitiligo patients with 5-50% body surface area involvement, having at least 2 bilateral, comparative lesions. CP or placebo was applied once daily on either side of the body, each combined with NB-UVB thrice weekly for 6 months.
OUTCOME MEASURES: (1) number of exposures and cumulative dose (CD) of NB-UVB that induced initial repigmentation; (2) quantity of repigmentation after 6 months estimated by comparing pre- and post-treatment photographs; (3) effect on disease activity by comparing pre- and post-treatment VIDA (vitiligo disease activity) scores; and (4) permanence of repigmentation and development of new lesions within 1 year post-treatment documented by photographs.
ANALYSIS: Sample size was calculated using formula for testing two proportions at 0.05 level of significance and a power of 0.80. Data was analyzed with Student t test (paired), Exact test for symmetry and Wilcoxon signed rank test, depending on the data set involved.
RESULTS: Twenty-five patients were recruited, but only 20 were evaluable at the end of the study. Initial repigmentation was noted after a mean of 9.30 +/- 3.54 exposures (mean CD 1,887.8 +/- 1195.81 mJ/cm2) of NB-UVB on the CP-treated side, and after a mean of 15.85 +/- 5.61 exposures (mean CD 4,152.2 +/- 2231.9 mJ/cm2) on the placebo side. After 6 months, 55% (11/20) and 40%(8/20) of patients exhibited marked (>75 %) repigmentation in the NB-UVB with CP side, and NB-UVB with placebo side, respectively. Adverse events were minimal and transient. VIDA scores improved and repigmentation induced by both treatment regimens remained stable in majority within one year post-treatment.
CONCLUSIONS: Combination NB-UVB and CP induced repigmentation earlier, requiring significantly lower cumulative dose of NB-UVB than NB-UVB plus placebo. Over all quantity and permanence of repigmentation, as well as control of disease activity and safety, were comparable in the two regimens.

 

 

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Adrenal Cortex Hormones ; Clinical Protocols ; Clobetasol ; Dermatologic Agents ; Outcome Assessment (health Care) ; Ultraviolet Therapy ; Vitiligo

No abstract available.

Whipple operation, or open pancreaticoduodenectomy, is perhaps one of the most technically challenging operations in the abdomen. The overall perioperative mortality rate is about 2% to 5% and with operative morbidity of about 25% to 45%. In the past, minimally invasive techniques were only used for laparoscopy, staging of pancreatic cancer, and palliative procedures for unresectable pancreatic cancer. Recent advances in operative techniques and instrumentation have empowered laparoscopic surgeons to perform virtually all procedures in the pancreas, including the Whipple procedure. Presented is the first case of laparoscopic pancreaticoduodenectomy. Key words: laparoscopy, laparoscopic pancreaticoduodenectomy
NOT IDENTIFIED

Dissociation, including multiple personality disorder, has long been a controversial topic. Patients with suggestive symptoms are often misdiagnosed as malingering or even having schizophrenia. The former as a result of the overlooking of a clinician on the fact that suggestibility itself plays a key role in the emergence and perpetuation of this illness and the latter due to the lack of knowledge of the whole dissociative disorder spectrum, often resembling that of a psychotic disorder. Another contributing factor to the small number of patients with this diagnosis is due to the reluctance of a psychiatrist to do so because of his/her lack of experience and also fear of humiliation of being accused of seeking fame from diagnosing this somewhat glamorous phenomenon. In Malaysia, various culture bound syndromes often present with similar symptoms too. This article will attempt to understand this dissociation on the local context using case studies as a reference point.

Dissociation, including multiple personality disorder, has long been a controversial topic. Patients with suggestive symptoms are often misdiagnosed as malingering or even having schizophrenia. The former as a result of the overlooking of a clinician on the fact that suggestibility itself plays a key role in the emergence and perpetuation of this illness and the latter due to the lack of knowledge of the whole dissociative disorder spectrum, often resembling that of a psychotic disorder. Another contributing factor to the small number of patients with this diagnosis is due to the reluctance of a psychiatrist to do so because of his/her lack of experience and also fear of humiliation of being accused of seeking fame from diagnosing this somewhat glamorous phenomenon. In Malaysia, various culture bound syndromes often present with similar symptoms too. This article will attempt to understand this dissociation on the local context using case studies as a reference point.