Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.22
V. Dogra, Manu Bhardwaj, Lakshay Beriwal
Introduction: For MTHFR as with homocysteine testing, no official guidelines exist as to who should be tested. Homozygosity for the MTHFR C677T mutation has been associated with an increase in blood clotting together with plasma homocysteine increase and DVT occurrence risk. Case report: A 28 year young male patient presented with complaints of sudden onset breathlessness for 5 days. The episodes of breathlessness were associated with diffuse anterior chest pain. There was no history of leg pain, cough, sputum, hemoptysis, fever. No history of prior hospitalization, trauma, surgery and immobilization could be elicited from the patient. He was a non smoker with no other comorbidities. On presentation his pulse rate was 120 per minute, respiratory rate was 22 per minute, blood pressure 146/92 mm Hg, temperature 98.8 ° F, SpO2 of 94% at room air. His general physical examination was unremarkable. Conclusion: Although it has been observed that elevated homocysteine levels are a common finding in patients with cardiovascular disease and thrombosis, its role in its pathogenesis is still under evaluation. Homozygosity for the MTHFR C677T mutation has been associated with increased homocysteine levels. Testing for this mutation is an important parameter in thrombophilia workup of patients with
{"title":"Hyperhomocystetenemia, MTHFR Mutation Presenting as Unprovoked Pulmonary Embolism.","authors":"V. Dogra, Manu Bhardwaj, Lakshay Beriwal","doi":"10.21276/ijcmr.2019.6.10.22","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.22","url":null,"abstract":"Introduction: For MTHFR as with homocysteine testing, no official guidelines exist as to who should be tested. Homozygosity for the MTHFR C677T mutation has been associated with an increase in blood clotting together with plasma homocysteine increase and DVT occurrence risk. Case report: A 28 year young male patient presented with complaints of sudden onset breathlessness for 5 days. The episodes of breathlessness were associated with diffuse anterior chest pain. There was no history of leg pain, cough, sputum, hemoptysis, fever. No history of prior hospitalization, trauma, surgery and immobilization could be elicited from the patient. He was a non smoker with no other comorbidities. On presentation his pulse rate was 120 per minute, respiratory rate was 22 per minute, blood pressure 146/92 mm Hg, temperature 98.8 ° F, SpO2 of 94% at room air. His general physical examination was unremarkable. Conclusion: Although it has been observed that elevated homocysteine levels are a common finding in patients with cardiovascular disease and thrombosis, its role in its pathogenesis is still under evaluation. Homozygosity for the MTHFR C677T mutation has been associated with increased homocysteine levels. Testing for this mutation is an important parameter in thrombophilia workup of patients with","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"358 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76513265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.42
C. Gupta, S. Akul, S. Mahapatra, Apala Lahiri, K. Maji, S. Sen
Introduction: The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. The present study was conducted to study on various facets of antihypertensive drugs prescribing at present scenario at Dr B.C. Roy Hospital, Haldia, and with objectives of studying prescribing patterns and rationality of antihypertensive drugs in essential hypertension with or without specific co-morbid conditions and to check compliance of treatment as per JNC-8 hypertension treatment guidelines in the outpatients attending the Department of Medicine. Material and Methods: Data regarding anti-HTN monotherapy and combination therapy was recorded. Evaluation for rational drug therapy by evaluating average number of drugs per prescription, fixed dose combination (FDC) prescription rate, prescription laying down importance of lifestyle management, prescription with defined anti-HTN goals, prescriptions with correct dose strength and dosage schedule was evaluated. Results: Out of 100 hypertensive patients under evaluation 67 was males (67%) with a M:F ratio of 2.03:1. Mean SBP was slightly higher in male patients. Hypertension was classified according to JNC-8 guidelines and found 22 (22%) (Prehypertension/pre-HTN), 57 (57%) (Stage 1 hypertension), and 13% (stage 2 hypertension) cases. Dyslipidemia was noted much more common associated disorders among newly diagnosed hypertensive of either sex. Conclusion: Diuretics (8%) were most widely prescribed drugs followed by ARBs (6%), ACE Inhibitors (5%) and calcium channel blockers (4%) as monotherapy. Adherence of JNC 8 guidelines among all study hypertensive participants while prescribing medications varied between 62% to 92%, with an average of 75%. None of the prescriptions mentioned ban drug formulation(s). Still 15% of the prescriptions had suggested combined drugs with debated rationality formulations.
{"title":"Evaluation of Antihypertensive Drug Prescription Patterns, Rationality, and Adherence to Joint National Committee-8 Hypertension Treatment Guidelines among Patients Attending Medicine OPD in a Tertiary Care Hospital.","authors":"C. Gupta, S. Akul, S. Mahapatra, Apala Lahiri, K. Maji, S. Sen","doi":"10.21276/ijcmr.2019.6.10.42","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.42","url":null,"abstract":"Introduction: The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. The present study was conducted to study on various facets of antihypertensive drugs prescribing at present scenario at Dr B.C. Roy Hospital, Haldia, and with objectives of studying prescribing patterns and rationality of antihypertensive drugs in essential hypertension with or without specific co-morbid conditions and to check compliance of treatment as per JNC-8 hypertension treatment guidelines in the outpatients attending the Department of Medicine. Material and Methods: Data regarding anti-HTN monotherapy and combination therapy was recorded. Evaluation for rational drug therapy by evaluating average number of drugs per prescription, fixed dose combination (FDC) prescription rate, prescription laying down importance of lifestyle management, prescription with defined anti-HTN goals, prescriptions with correct dose strength and dosage schedule was evaluated. Results: Out of 100 hypertensive patients under evaluation 67 was males (67%) with a M:F ratio of 2.03:1. Mean SBP was slightly higher in male patients. Hypertension was classified according to JNC-8 guidelines and found 22 (22%) (Prehypertension/pre-HTN), 57 (57%) (Stage 1 hypertension), and 13% (stage 2 hypertension) cases. Dyslipidemia was noted much more common associated disorders among newly diagnosed hypertensive of either sex. Conclusion: Diuretics (8%) were most widely prescribed drugs followed by ARBs (6%), ACE Inhibitors (5%) and calcium channel blockers (4%) as monotherapy. Adherence of JNC 8 guidelines among all study hypertensive participants while prescribing medications varied between 62% to 92%, with an average of 75%. None of the prescriptions mentioned ban drug formulation(s). Still 15% of the prescriptions had suggested combined drugs with debated rationality formulations.","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"117 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79763192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.43
Susanta Gorai, Writtika Chattaraj, D. Pramanik
{"title":"Association of Body Mass Index with Pulmonary Function Parameters in Males with Non-obstructive Airway Disease Identified by Spirometric Protocols Attending Bankura Sammilani Medical College.","authors":"Susanta Gorai, Writtika Chattaraj, D. Pramanik","doi":"10.21276/ijcmr.2019.6.10.43","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.43","url":null,"abstract":"","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"1998 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86227309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.13
Amit Peswani, Vernon J. Sequeira, M. D’Silva, S. Ghanwat, P. P. Shah, A. C. Pinto
introduction: Gallbladder stone disease is common and a leading cause of inpatient admissions for gastro-intestinal problem in modern world. Metabolic syndrome is slowly assuming shape of a global epidemic. There is currently only minimal data regarding the relationship between cholelithiasis and Metabolic syndrome in Indians. This study aims to assess if there is an association between the presence of gallstones and Metabolic Syndrome. Material and methods: At a tertiary care centre in Mumbai, 100 patients with cholelithiasis were compared with 100 controls to assess the profile with respect to Metabolic Syndrome. Result: 36% cases had Metabolic syndrome as against 16% controls. Of the components of Metabolic syndrome, obesity was the only one found to have a positive association. Conclusion: In our study, gallstone disease showed a statistically significant association with metabolic syndrome, however this association was positive only in female patients.
{"title":"Association between Gallstone Disease and Metabolic Syndrome.","authors":"Amit Peswani, Vernon J. Sequeira, M. D’Silva, S. Ghanwat, P. P. Shah, A. C. Pinto","doi":"10.21276/ijcmr.2019.6.10.13","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.13","url":null,"abstract":"introduction: Gallbladder stone disease is common and a leading cause of inpatient admissions for gastro-intestinal problem in modern world. Metabolic syndrome is slowly assuming shape of a global epidemic. There is currently only minimal data regarding the relationship between cholelithiasis and Metabolic syndrome in Indians. This study aims to assess if there is an association between the presence of gallstones and Metabolic Syndrome. Material and methods: At a tertiary care centre in Mumbai, 100 patients with cholelithiasis were compared with 100 controls to assess the profile with respect to Metabolic Syndrome. Result: 36% cases had Metabolic syndrome as against 16% controls. Of the components of Metabolic syndrome, obesity was the only one found to have a positive association. Conclusion: In our study, gallstone disease showed a statistically significant association with metabolic syndrome, however this association was positive only in female patients.","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"75 24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86390391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.2
A. Sahu, Pradnya B. Khadse, Abhilash Sadhankar
{"title":"Lateral Vs Classical Approach of Supraclavicular Brachial Plexus Block for Orthopedic Surgeries below Mid-Humerus: A Comparative Study.","authors":"A. Sahu, Pradnya B. Khadse, Abhilash Sadhankar","doi":"10.21276/ijcmr.2019.6.10.2","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.2","url":null,"abstract":"","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80885580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.3
S. Arulprakash, D. Dsouza
{"title":"Assessment of Quality of Life in Patients Reporting with Dermatological Conditions to a Primary Healthcare Setting in Goa, India.","authors":"S. Arulprakash, D. Dsouza","doi":"10.21276/ijcmr.2019.6.10.3","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.3","url":null,"abstract":"","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79310173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.37
Neeti Verma, R. Azad, N. Verma
Introduction: Lipomas are amongst the commonest tumors of human body. Approximately 15 to 20% occur in head and neck but oral cavity is an unusual site. They represent 0.15% of all benign intraoral tumors, with most lesions occurring in the buccal mucosa. We report a rare case of intramuscular lipoma of lateral border of tongue. Case report: A 55-year-old female presented with progressive swelling on lateral border of tongue. Complete excision along with healthy margins was done, and histopathology suggested it to be an infiltrating lipoma. Patient had no recurrence in 2 year follow up. Discussion and conclusion: This type of lipoma is rare (<25cases have been reported so far) and only two cases with histopathological documentation could be traced in literature. It has close resemblance to liposarcoma, a malignant tumor with high propensity to recur. Therefore, complete excision with healthy margin is mandatory for this rare clinical entity.
{"title":"How Important is Histopathology in Management of Benign Lesions of Tongue.","authors":"Neeti Verma, R. Azad, N. Verma","doi":"10.21276/ijcmr.2019.6.10.37","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.37","url":null,"abstract":"Introduction: Lipomas are amongst the commonest tumors of human body. Approximately 15 to 20% occur in head and neck but oral cavity is an unusual site. They represent 0.15% of all benign intraoral tumors, with most lesions occurring in the buccal mucosa. We report a rare case of intramuscular lipoma of lateral border of tongue. Case report: A 55-year-old female presented with progressive swelling on lateral border of tongue. Complete excision along with healthy margins was done, and histopathology suggested it to be an infiltrating lipoma. Patient had no recurrence in 2 year follow up. Discussion and conclusion: This type of lipoma is rare (<25cases have been reported so far) and only two cases with histopathological documentation could be traced in literature. It has close resemblance to liposarcoma, a malignant tumor with high propensity to recur. Therefore, complete excision with healthy margin is mandatory for this rare clinical entity.","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79126080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.5
Tolstoy Rajangam, Jagadeeswaran Govindarajan, Mohammad Zeya Ansari Ansari Vignesh
{"title":"A Tertiary Care Hospital based Study on the Prevalence of Pulmonary Hypertention in Patients with Glomerular Filtration Rate less than 30 Ml /Min Per 1.73 Meter Square on Dialysis.","authors":"Tolstoy Rajangam, Jagadeeswaran Govindarajan, Mohammad Zeya Ansari Ansari Vignesh","doi":"10.21276/ijcmr.2019.6.10.5","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.5","url":null,"abstract":"","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73909984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.45
Nitin N Jadhav, Anand Bang
Introduction: The introduction of combination anti-retroviral therapy (c-ART) have declined the mortality and morbidity from HIV. However use of anti retroviral therapy have lead to metabolic disorders like impaired glucose tolerance and diabetes, as well as lipid disorders leading to an increase of cardiovascular disease. This study was aimed at to find out the prevalence of the insulin resistance and association of the insulin resistance with clinical and biological variables, including serum adipokines in HIV infected non-diabetic population undergoing combination ART therapy. Material and Methods: A cross-sectional research was done in a cohort of HIV-1-positive patients attending Anti Retroviral Treatment Center (ART) of a tertiary care Hospital from December 2017 to December 2018. HIV-infected cases above 18 years, undergoing stable cART for at least 6 months were included in this study. The patients were asked to complete a questionnaire during the medical visit for demographic parameters and for personal and family medical histories. Investigations such as fasting plasma insulin, and circulating adiponectin, leptin, resistin, tumor necrosis factor alpha (TNFalpha) and interleukin-6. (IL-6) levels were carried out. Results: A total of 64 patients (aged 16–68 year, median: 31 years) including 40 men (62.5%) and 12 women (37.5%) were included in the study. Forty four patients (68.75%) were diagnosed with IR based on QUICKI values lower than the cut-off point. The presence of the IR was not influenced by either the time of the HIV diagnosis or by the duration of cART. Treatment with protease inhibitor therapy, decreased adiponectin and increased serum triglycerides were associated with increased IR. Conclusion: We observed that the prevalence of the insulin resistance more in non-diabetic cases with HIV infection undergoing antiretroviral therapy and also there is an increased risk of developing diabetes mellitus and other cardiovascular diseases. Hence this study recommends that the management insulin resistance should be a integral component of HIVinfection therapeutic strategy.
{"title":"A Cross Sectional Study to Determine Prevalence of Insulin Resistance among HIV Positive Subjects on Anti Retroviral Therapy.","authors":"Nitin N Jadhav, Anand Bang","doi":"10.21276/ijcmr.2019.6.10.45","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.45","url":null,"abstract":"Introduction: The introduction of combination anti-retroviral therapy (c-ART) have declined the mortality and morbidity from HIV. However use of anti retroviral therapy have lead to metabolic disorders like impaired glucose tolerance and diabetes, as well as lipid disorders leading to an increase of cardiovascular disease. This study was aimed at to find out the prevalence of the insulin resistance and association of the insulin resistance with clinical and biological variables, including serum adipokines in HIV infected non-diabetic population undergoing combination ART therapy. Material and Methods: A cross-sectional research was done in a cohort of HIV-1-positive patients attending Anti Retroviral Treatment Center (ART) of a tertiary care Hospital from December 2017 to December 2018. HIV-infected cases above 18 years, undergoing stable cART for at least 6 months were included in this study. The patients were asked to complete a questionnaire during the medical visit for demographic parameters and for personal and family medical histories. Investigations such as fasting plasma insulin, and circulating adiponectin, leptin, resistin, tumor necrosis factor alpha (TNFalpha) and interleukin-6. (IL-6) levels were carried out. Results: A total of 64 patients (aged 16–68 year, median: 31 years) including 40 men (62.5%) and 12 women (37.5%) were included in the study. Forty four patients (68.75%) were diagnosed with IR based on QUICKI values lower than the cut-off point. The presence of the IR was not influenced by either the time of the HIV diagnosis or by the duration of cART. Treatment with protease inhibitor therapy, decreased adiponectin and increased serum triglycerides were associated with increased IR. Conclusion: We observed that the prevalence of the insulin resistance more in non-diabetic cases with HIV infection undergoing antiretroviral therapy and also there is an increased risk of developing diabetes mellitus and other cardiovascular diseases. Hence this study recommends that the management insulin resistance should be a integral component of HIVinfection therapeutic strategy.","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86866565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.21276/ijcmr.2019.6.10.25
A. Soman, R. Rajendran
Introduction: Interstitial (cornual) gestation is the most hazardous type of ectopic, where pregnancy gets implanted in the proximal portion of tube that traverses myometrium . It constitutes 2-4% of all ectopic pregnancies.It poses a significant diagnostic and therapeutic challenge and carries a greater maternal mortality. It usually presents at a later gestation more than 7-12 weeks .The usual clinical presentation is profuse intraabdominal bleeding and shock. Transvaginal sonography can be helpful, but often is not conclusive. Case report: 21 year old nulliparous lady post laparascopic left salpingo-oopherectomy, diagnosed to have a live interstitial ectopic pregnancy in left lateral wall of uterus with very high levels of βhCG . She was treated with 2 cycles of folinic acid rescue regime and βhCG monitored accordingly. βhCG showed a decline of 15% initially (2365.9mIU/ml) and weekly βhCG monitored thereafter and reduced to 3.39mIU/ ml within 4 months. Conclusion: Cornual resection/hysterectomy used to be the traditional treatment for these cases. However conservative management has been increasingly practiced successfully including medical treatment with systemic methotrexate and laparoscopic conservative surgery.
{"title":"Methotrexate in Interstitial Pregnancy: A Miraculous Fertility Rescuer.","authors":"A. Soman, R. Rajendran","doi":"10.21276/ijcmr.2019.6.10.25","DOIUrl":"https://doi.org/10.21276/ijcmr.2019.6.10.25","url":null,"abstract":"Introduction: Interstitial (cornual) gestation is the most hazardous type of ectopic, where pregnancy gets implanted in the proximal portion of tube that traverses myometrium . It constitutes 2-4% of all ectopic pregnancies.It poses a significant diagnostic and therapeutic challenge and carries a greater maternal mortality. It usually presents at a later gestation more than 7-12 weeks .The usual clinical presentation is profuse intraabdominal bleeding and shock. Transvaginal sonography can be helpful, but often is not conclusive. Case report: 21 year old nulliparous lady post laparascopic left salpingo-oopherectomy, diagnosed to have a live interstitial ectopic pregnancy in left lateral wall of uterus with very high levels of βhCG . She was treated with 2 cycles of folinic acid rescue regime and βhCG monitored accordingly. βhCG showed a decline of 15% initially (2365.9mIU/ml) and weekly βhCG monitored thereafter and reduced to 3.39mIU/ ml within 4 months. Conclusion: Cornual resection/hysterectomy used to be the traditional treatment for these cases. However conservative management has been increasingly practiced successfully including medical treatment with systemic methotrexate and laparoscopic conservative surgery.","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82698532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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