Steroids are used in management of coronavirus disease 2019 (COVID-19) patients with severe illness and their use has been demonstrated to decrease mortality. Although life-saving, steroids are well documented as risk factors for osteonecrosis.Osteonecrosis of the hip can be debilitating and surgery may be required to improve the quality of life. With the increasing number of COVID-19 cases, osteonecrosis of the hip and other joints resulting from steroid use is expected to show a sharp rise in the coming years. In this review we discuss the association between steroids and osteonecrosis, indications for steroid therapy in COVID-19 patients, and incidence, diagnosis, and treatment of osteonecrosis secondary to steroids in COVID-19.

One major challenge in male factor infertility is nonobstructive azoospermia (NOA), which is characterized by spermatozoa-deficient semen without physical duct blockage. This review offers a thorough overview of the histopathology of the testes in NOA cases, clarifying its complex etiology and emphasizing the possible value of histopathology inspection for both diagnosis and treatment. Variable histopathological findings have been linked to NOA, such as tubular hyalinization, Sertoli cell-only syndrome, hypospermatogenesis, and germ cell arrest. Understanding the pathophysiology and forecasting the effectiveness of treatment are further enhanced by both morphometric and ultrastructural analyses. The potential significance of testicular biopsy in forecasting reproductive outcomes is assessed, especially concerning assisted reproductive technologies like intracytoplasmic sperm injection (ICSI). Besides, testicular microlithiasis, serum hormone profiles, and testicular size are investigated concerning NOA histopathology. It is concluded that understanding the histopathological patterns in NOA is crucial for its accurate diagnosis and appropriate management. Further research is still warranted to improve understanding of the complex pathophysiology underlying NOA.
Humans ; Azoospermia/etiology* ; Male ; Testis/pathology* ; Sertoli Cell-Only Syndrome/pathology* ; Sperm Injections, Intracytoplasmic

Steroids are used in management of coronavirus disease 2019 (COVID-19) patients with severe illness and their use has been demonstrated to decrease mortality. Although life-saving, steroids are well documented as risk factors for osteonecrosis.Osteonecrosis of the hip can be debilitating and surgery may be required to improve the quality of life. With the increasing number of COVID-19 cases, osteonecrosis of the hip and other joints resulting from steroid use is expected to show a sharp rise in the coming years. In this review we discuss the association between steroids and osteonecrosis, indications for steroid therapy in COVID-19 patients, and incidence, diagnosis, and treatment of osteonecrosis secondary to steroids in COVID-19.

Steroids are used in management of coronavirus disease 2019 (COVID-19) patients with severe illness and their use has been demonstrated to decrease mortality. Although life-saving, steroids are well documented as risk factors for osteonecrosis.Osteonecrosis of the hip can be debilitating and surgery may be required to improve the quality of life. With the increasing number of COVID-19 cases, osteonecrosis of the hip and other joints resulting from steroid use is expected to show a sharp rise in the coming years. In this review we discuss the association between steroids and osteonecrosis, indications for steroid therapy in COVID-19 patients, and incidence, diagnosis, and treatment of osteonecrosis secondary to steroids in COVID-19.

Background: Fatigue significantly affects health-related quality of life (HRQoL) in patients with immune thrombocytopenia (ITP). However, the interplay between fatigue and cytokines in ITP remains poorly understood. Methods: This study included 100 patients with persistent or chronic ITP who had not received ITP-directed therapy in the previous 8 weeks and 50 age-matched healthy controls. Fatigue and HRQoL were assessed using the Functional Assessment of the Chronic Illness Therapy (FACIT) scale. Concurrently, plasma levels of interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12, IL-17, and interferon-gamma (IFN-γ) were measured via enzyme-linked immunosorbent assay (ELISA). Results: ITP patients had significantly lower total FACIT scores [median 146 (range 59–160]) and fatigue subscale scores [median 45 (range 9–52]) than controls [155 (149–159) and 49 (44–52), respectively; both p < 0.001]. IL-12 levels were significantly elevated in patients (313.2 vs. 95.5 pg/mL; p < 0.001) and showed a significant negative correlation with FACIT scores (Spearman’s ρ = –0.272, p = 0.007). Multivariate analysis revealed that female sex, longer disease duration among patients with chronic ITP (> 24 months), and elevated IL-12 levels were independently associated with greater fatigue and poorer HRQoL. Conclusions ITP is associated with significant fatigue and HRQoL impairment, with IL-12 emerging as a potential immunological marker linked to this symptom burden.

Primary Ewing sarcoma of the uterine cervix is an exceptionally rare and aggressive malignancy, with only 34 cases reported in the literature. Early recognition and prompt multimodal treatment are essential due to its poor prognosis. We report a case involving a 32-year-old multiparous woman who presented with foul-smelling vaginal discharge and irregular bleeding. Clinical examination revealed a 6×6 cm friable cervical mass extending into the upper vagina. Imaging demonstrated an FDG-avid cervical mass with regional lymphadenopathy. Histopathological analysis, supported by immunohistochemistry and fluorescence in situ hybridization, confirmed Ewing sarcoma with EWSR1 gene rearrangement. The patient received neoadjuvant chemotherapy with VDC (vincristine, doxorubicin, cyclophosphamide) and PIE (cisplatin, ifosfamide, etoposide) regimens, followed by surgical resection, adjuvant chemotherapy, and pelvic radiotherapy. Although initial disease control was achieved, the patient experienced disease recurrence with distant metastases after a 7-month disease-free interval and succumbed to the illness 9 months after diagnosis. This case underscores the importance of including Ewing sarcoma in the differential diagnosis of rapidly growing cervical tumors, particularly in young women. A multidisciplinary approach involving early molecular diagnostics and aggressive combined therapy is critical to improving clinical outcomes in such rare and aggressive cases.