Introduction. The association of gonadal dysgenesis and Mayer-Rokitansky-Kuster-Hauser syndrome is very rare and appears to be coincidental, independent of chromosomal anomalies. Case Report. We report the case of a 19-year-old woman who presented primary amenorrhea and impuberism. The endocrine study revealed hypergonadotrophic hypogonadism. The karyotype was normal, 46XX. No chromosome Y was detected at the FISH analysis. Internal genitalia could not be identified on the pelvic ultrasound and pelvic MRI. Laparoscopy was undertaken and revealed concomitant ovarian dysgenesis and Mayer-Rokitansky-Kuster-Hauser syndrome. There were no other morphological malformations. Conclusion. The pathogenesis of the association of gonadal dysgenesis and Mayer Rokitansky kuster hauser syndrome is still mysterious. The treatment is based essentially on hormone substitution therapy. The fertility prognosis is unfortunately compromised.
Introduction: Epidemiological studies have shown the association between risk of developing cervical cancer and the persistence of high-risk papillomavirus types in addition to some co-factors. However, little is known about co-factors associated with human papillomavirus (HPV) infection, especially in developing countries. This study aims to determine HPV status and associated risk factors in women with normal cytology living in the north-central area of Morocco. Methodology: From February 2007 to December 2008, a total of 925 women consulting in the gynaecological department of Fez University Hospital were asked about sociodemographic characteristics and reproductive and sexual health. Cervical samples were collected for cytological examination and HPV DNA detection. Data collected from 751 women with normal cytology were used in this study to assess the correlation between HPV infection and potential risk factors. Results: High prevalence of HPV infection was detected (42.5%). The highest infection rate was observed in women aged >45 years and in those with history of abortion (OR:3.76; 95%CI[1.77-7.98]) fibroma, polyp or cysts (OR:1.68; 95%CI[1.07-2.65]). No significant association was detected with other reproductive health and risk factors including oral contraception. Conclusion: In spite of the insignificant association of HPV infection with age, health authorities should seriously consider and implement strategies to increase and maintain a cervical cancer screening programme in women aged 45 and above. More attention must be given to women with gynaecological history (abortion, fibroma, polyp or cysts) since these events may be predictors of HPV infection. Investigations on partner sexual behaviour and some specific hygienic habits, especially public Turkish bath use, are needed to clarify the HPV incidence in this region.
Objectives To identify the prevalence and the types of Neisseria gonorrhoeae (NG) resistance plasmids-mediated penicillin (PPNG) and tetracycline (TRNG), the ciprofloxacin resistance (CRNG), and related risk factors of each types of resistance. Methods The beta-lactamase-producing plasmid types (Africa, Asia, and Toronto), tetM tetracycline resistance plasmid types (America and Dutch), and the determination of the Ser-91 mutation of GyrA were detected by specifics PCRs on 149 diagnosed NG positives samples followed by Hinf1 digestion for tetM and gyrA mutation. Results 135 (90.1%) samples showed a profile of molecular resistance to at least one antibiotic with predominance of ciprofloxacin resistance. In fact, 36 (24.2%) and 69 (46.3%) cases harbored PPNG and TRNG, respectively, and 116 (77.9%) cases showed the mutation Ser-91 of GyrA (CRNG). From a total of 36 PPNG isolates, the Toronto, Asian, and Toronto/Asian types were detected in 13 (36.1%), 10 (27.8%), and 13 (36.1%) cases, respectively, whereas the African type was not detected. In addition, the American type of TRNG was detected in 92.8% (64/69) of cases, while the Dutch type was detected in 7.2% (5/69) of cases. The association of demographics and clinical variables with NG resistance to ciprofloxacin, penicillin, and tetracycline was studied and the risk factors have been determined. Conclusion Resistance to penicillin, tetracycline, and ciprofloxacin among NG samples positives remained at high levels in Morocco as determined by molecular profile. So, the use of molecular tools for NG antimicrobial resistance detection can help in the management and spread limitation of this infection.
The puerperal uterine inversion is a rare and severe complication occurring in the third stage of labour. The mechanisms are not completely known. However, extrinsic factors such as oxytocic arrests after a prolonged labour, umbilical cord traction or abdominal expression are pointed. Other intrinsic factors such as primiparity, uterine hypotonia, various placental localizations, fundic myoma or short umbilical cord were also reported. The diagnosis of the uterine inversion is mainly supported by clinical symptoms. It is based on three elements: haemorrhage, shock and a strong pelvic pain. The immediate treatment of the uterine inversion is required. It is based on a medical reanimation associated with firstly a manual reduction then surgical treatment using various techniques. We report an observation of a 25 years old grand multiparous patient with a subacute uterine inversion after delivery at home.
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