Introduction: Bilateral tubal ectopic pregnancy without prior fertility treatment is rare and, although true incidence is unknown, about 250 cases have been reported in medical literature so far. Its diagnosis is commonly made during surgery as pre-operative diagnosis is difficult. To the best of our knowledge, this is the first reported case of spontaneous bilateral tubal ectopic pregnancy in Ghana. Case Presentation: We report on a 25-year-old G2P1A who had an exploratory laparotomy done on account of a ruptured right ectopic pregnancy. Examination of the contralateral tube at surgery, however, revealed an unruptured ampullary ectopic pregnancy and diagnosis was thus revised to a bilateral tubal ectopic pregnancy. A right salpingectomy and left salpingostomy were carried out as she had future fertility wish. Conclusion: Bilateral tubal ectopic pregnancies present a number of diagnostic challenges pre-operatively and examination of the contralateral tube, especially for those cases requiring surgical intervention, cannot be over – emphasized in the management of tubal ectopic pregnancies in general.
{"title":"Bilateral tubal ectopic pregnancy: case report.","authors":"J. Ashong, Evans Kofi Agbeno, Betty Anane -Fenin, Kofi Ulzen-Appiah, Aaron Agyekum","doi":"10.60014/pmjg.v12i1.312","DOIUrl":"https://doi.org/10.60014/pmjg.v12i1.312","url":null,"abstract":"Introduction: Bilateral tubal ectopic pregnancy without prior fertility treatment is rare and, although true incidence is unknown, about 250 cases have been reported in medical literature so far. Its diagnosis is commonly made during surgery as pre-operative diagnosis is difficult. To the best of our knowledge, this is the first reported case of spontaneous bilateral tubal ectopic pregnancy in Ghana.\u0000Case Presentation: We report on a 25-year-old G2P1A who had an exploratory laparotomy done on account of a ruptured right ectopic pregnancy. Examination of the contralateral tube at surgery, however, revealed an unruptured ampullary ectopic pregnancy and diagnosis was thus revised to a bilateral tubal ectopic pregnancy. A right salpingectomy and left salpingostomy were carried out as she had future fertility wish.\u0000Conclusion: Bilateral tubal ectopic pregnancies present a number of diagnostic challenges pre-operatively and examination of the contralateral tube, especially for those cases requiring surgical intervention, cannot be over – emphasized in the management of tubal ectopic pregnancies in general.","PeriodicalId":39209,"journal":{"name":"Texas Medicine","volume":"71 7 1","pages":"62-4"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46284500","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 : 2022-12-05DOI: 10.33004/reumatizam-68-2-1
K. Borić, D. Perković
Sjögren’s syndrome (SS) is a heterogeneous disease which, in the majority of cases, includes a mild clinical course. However, in some patients it takes on a severe form with numerous systemic manifestations and results in an adverse outcome. Systemic manifestations occur in approximately 25% of patients with primary Sjögren’s syndrome (pSS). The clinical presentation of systemic manifestations of SS is very diverse and can involve any organ system. Systemic manifestations can occur due to lymphocytic infiltration of organs or proliferation of B lymphocytes and deposition of immune complexes. fatigue is the most common systemic manifestation. The most significant cutaneous manifestations of the disease are palpable purpura, ulcerations, urticarial vasculitis and leukocytoclastic vasculitis. musculoskeletal manifestations can range from arthralgias to erosive arthritis. Pulmonary involvement may include symptoms such as nonspecific interstitial pneumonia with fibrosis and tracheobronchial disease. renal changes are observed in 10% to 30% of patients with SS. tubulointerstitial nephritis, type 1 renal tubular acidosis and nephrogenic diabetes insipidus can develop as a consequence of lymphocytic infiltration. Less often, the inflammatory process affects the glomeruli which leads to glomerulonephritis. Liver diseases are found in approximately 20% of patients with SS and their symptoms usually include inflammation of intrahepatic bile ducts resembling primary biliary cirrhosis. The manifestations of peripheral nervous system involvement include sensorimotor axonal polyneuropathy, mononeuritis multiplex, neuropathies and radiculopathies. optic neuropathy, hemiparesis, movement disorders, cerebellar syndromes, transient ischemic attacks, transverse myelitis (less commonly), and progressive myelopathy have been described as central nervous system changes. Symptoms of vasculitis can range from mononeuritis multiplex to intestinal ischemia and dysfunction of the affected organs. The development of non-Hodgkin’s B-cell lymphoma is a major complication of the disease which occurs in 5%–7% of patients with SS.
{"title":"Systemic manifestations of Sjögren’s syndrome","authors":"K. Borić, D. Perković","doi":"10.33004/reumatizam-68-2-1","DOIUrl":"https://doi.org/10.33004/reumatizam-68-2-1","url":null,"abstract":"Sjögren’s syndrome (SS) is a heterogeneous disease which, in the majority of cases, includes a mild clinical course. However, in some patients it takes on a severe form with numerous systemic manifestations and results in an adverse outcome. Systemic manifestations occur in approximately 25% of patients with primary Sjögren’s syndrome (pSS). The clinical presentation of systemic manifestations of SS is very diverse and can involve any organ system. Systemic manifestations can occur due to lymphocytic infiltration of organs or proliferation of B lymphocytes and deposition of immune complexes. fatigue is the most common systemic manifestation. The most significant cutaneous manifestations of the disease are palpable purpura, ulcerations, urticarial vasculitis and leukocytoclastic vasculitis. musculoskeletal manifestations can range from arthralgias to erosive arthritis. Pulmonary involvement may include symptoms such as nonspecific interstitial pneumonia with fibrosis and tracheobronchial disease. renal changes are observed in 10% to 30% of patients with SS. tubulointerstitial nephritis, type 1 renal tubular acidosis and nephrogenic diabetes insipidus can develop as a consequence of lymphocytic infiltration. Less often, the inflammatory process affects the glomeruli which leads to glomerulonephritis. Liver diseases are found in approximately 20% of patients with SS and their symptoms usually include inflammation of intrahepatic bile ducts resembling primary biliary cirrhosis. The manifestations of peripheral nervous system involvement include sensorimotor axonal polyneuropathy, mononeuritis multiplex, neuropathies and radiculopathies. optic neuropathy, hemiparesis, movement disorders, cerebellar syndromes, transient ischemic attacks, transverse myelitis (less commonly), and progressive myelopathy have been described as central nervous system changes. Symptoms of vasculitis can range from mononeuritis multiplex to intestinal ischemia and dysfunction of the affected organs. The development of non-Hodgkin’s B-cell lymphoma is a major complication of the disease which occurs in 5%–7% of patients with SS.","PeriodicalId":39209,"journal":{"name":"Texas Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69479963","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}
A decade ago, the Texas Legislature made a funding decision that devasted low-income women's access to health care and the physicians and community clinics that care for them. After 10 years, with the help of TMA advocacy and the formation of the Texas Women's Healthcare Coalition, funding for family planning and overall women's health is in significantly better shape.
{"title":"Ten Years Later: TMA Advocacy Nets Investments in Women's Health.","authors":"Joey Berlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A decade ago, the Texas Legislature made a funding decision that devasted low-income women's access to health care and the physicians and community clinics that care for them. After 10 years, with the help of TMA advocacy and the formation of the Texas Women's Healthcare Coalition, funding for family planning and overall women's health is in significantly better shape.</p>","PeriodicalId":39209,"journal":{"name":"Texas Medicine","volume":"117 12","pages":"32-34"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685497","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}
On May 27, 1936, May Owen, MD, answered a scientific riddle in a speech before the Texas Medical Association, explaining research that would soon make her a statewide celebrity. Dr. Owen's pioneering work continued in the decades to come, making her the first female president of the Texas Society of Pathologists in 1946, the first female president of the Tarrant County Medical Society in 1947, and the first female president of TMA in 1960.
1936年5月27日，医学博士梅·欧文(May Owen)在德克萨斯州医学协会(Texas Medical Association)的一次演讲中回答了一个科学谜题，她解释的研究很快使她成为全州的名人。欧文博士的开创性工作在接下来的几十年里一直在继续，使她在1946年成为德克萨斯病理学家协会的第一位女主席，1947年成为塔兰特县医学协会的第一位女主席，1960年成为TMA的第一位女主席。
{"title":"A Texas Trailblazer: May Owen, MD, a Medical Pioneer and TMA's First Female President.","authors":"Sean Price","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>On May 27, 1936, May Owen, MD, answered a scientific riddle in a speech before the Texas Medical Association, explaining research that would soon make her a statewide celebrity. Dr. Owen's pioneering work continued in the decades to come, making her the first female president of the Texas Society of Pathologists in 1946, the first female president of the Tarrant County Medical Society in 1947, and the first female president of TMA in 1960.</p>","PeriodicalId":39209,"journal":{"name":"Texas Medicine","volume":"117 12","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685496","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}
After growing up on a South Alabama cattle farm in the 1940s and '50s, Martha Pugh, MD, went on to have a 51-year career in a different male-dominated field: medicine. Often one of few women in the building, whether at medical school or in hospitals, Dr. Pugh - now 82 and retired - found common ground with her male peers and went on to become one of the Texas Medical Association's longest-serving members for 42 years.
医学博士玛莎·皮尤(Martha Pugh)上世纪四五十年代在南阿拉巴马州的一个养牛场长大，之后在另一个男性主导的领域——医学——从事了51年的职业生涯。无论是在医学院还是在医院，皮尤医生都是这栋楼里为数不多的女性之一，现年82岁的她已经退休，她与男性同行找到了共同点，并成为德克萨斯医学会(Texas medical Association)服务时间最长的成员之一，任职时间长达42年。
{"title":"Martha Pugh, MD: One of TMA's longest-Serving Members Flourished in Male-Dominated Medicine.","authors":"Emma Freer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>After growing up on a South Alabama cattle farm in the 1940s and '50s, Martha Pugh, MD, went on to have a 51-year career in a different male-dominated field: medicine. Often one of few women in the building, whether at medical school or in hospitals, Dr. Pugh - now 82 and retired - found common ground with her male peers and went on to become one of the Texas Medical Association's longest-serving members for 42 years.</p>","PeriodicalId":39209,"journal":{"name":"Texas Medicine","volume":"117 12","pages":"48"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685494","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}
The rise of telemedicine during the COVID-19 pandemic has spurred a change in state law that will not only help make certain telemedicine services permanent but also give out-of-state physicians an easier pathway to join the Texas workforce.
{"title":"Compact for Care: Texas Joins Interstate Agreement for Out-of-State Licensure.","authors":"Sean Price","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The rise of telemedicine during the COVID-19 pandemic has spurred a change in state law that will not only help make certain telemedicine services permanent but also give out-of-state physicians an easier pathway to join the Texas workforce.</p>","PeriodicalId":39209,"journal":{"name":"Texas Medicine","volume":"117 12","pages":"38-42"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685495","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}
Texas has taken some big steps to combat maternal death and illness in recent years. That was highlighted by one of the Texas Medical Association's biggest wins in the 2021 regular session of the Texas Legislature, when medicine's longtime advocacy resulted in an extension of Medicaid coverage for postpartum maternal care from two to six months under House Bill 133. This partial victory is just one of many that shows promise in addressing a major public health priority for TMA and the state.
{"title":"Saving Mothers' Lives: Texas Physicians Prioritize Fighting Maternal Mortality and Morbidity.","authors":"Sean Price","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Texas has taken some big steps to combat maternal death and illness in recent years. That was highlighted by one of the Texas Medical Association's biggest wins in the 2021 regular session of the Texas Legislature, when medicine's longtime advocacy resulted in an extension of Medicaid coverage for postpartum maternal care from two to six months under House Bill 133. This partial victory is just one of many that shows promise in addressing a major public health priority for TMA and the state.</p>","PeriodicalId":39209,"journal":{"name":"Texas Medicine","volume":"117 12","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685498","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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