Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic a...Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic adhesiolysis is the primary treatment for IUA;however,studies specifically addressing its efficacy in tuberculosisinduced IUA remain scarce.This study aims to evaluate the therapeutic outcomes of hysteroscopic adhesiolysis for IUA caused by endometrial tuberculosis.Methods:This retrospective cohort study included patients diagnosed with tuberculosisinduced IUA who underwent hysteroscopic adhesiolysis at the Third Xiangya Hospital of Central South University between May 2014 and October 2022.Clinical data including age,medical history,adhesion severity,surgical treatment,and reproductive outcomes were analyzed.Results:Among 39 patients identified,2 were lost to follow-up.A total of 37 patients were included,with a follow-up duration ranging from 6 months to 9 years.Hypomenorrhea was reported in 24(64.9%)patients,secondary amenorrhea in 10(27.0%)patients,and normal menstruation in 3(8.1%)patients.Most patients presented with primary infertility(59.5%),and only 2(5.4%)had secondary infertility.The median American Fertility Society(AFS)score at initial assessment was 10(range,8−12);8(21.6%)patients had moderate IUA,and 29(78.4%)had severe IUA.A total of 86 surgical procedures were performed across 37 patients,with 27 patients undergoing 2 or more surgeries.Postoperatively,25(67.6%)patients achieved normalization of the uterine cavity,while 12(32.4%)still had a reduced cavity.Only 7(18.9%)patients had a grossly normal endometrium at the final surgery,all of whom had moderate adhesions at the initial procedure.Menstrual flow returned to normal in 12(32.4%)patients,while 25(67.6%)continued to experience hypomenorrhea.Of 29 patients who attempted in vitro fertilization and embryo transfer(IVF-ET),only 6(20.7%)conceived.Among these,4(13.8%)delivered at term via cesarean section;one case was complicated by postpartum hemorrhage due to uterine atony and another by placental adhesion.Conclusion:Endometrial tuberculosis can lead to severe IUA.Hysteroscopic adhesiolysis facilitates cavity restoration and improvement of menstrual conditions,but the overall reproductive outcomes remain suboptimal.展开更多
Objective To study the effect of changing heart rate on the ocular pulse and optic nerve head deformations with a viscoelastic lamina cribrosa.Methods An FE model of a healthy eye was reconstructed.The choroid was bip...Objective To study the effect of changing heart rate on the ocular pulse and optic nerve head deformations with a viscoelastic lamina cribrosa.Methods An FE model of a healthy eye was reconstructed.The choroid was biphasic and consisted of a solid phase(connective tissues)and a fluid phase(blood).The LC was viscoelastic as characterized by a stress-relaxation test.We applied arterial pressures at 18 entry sites(posterior ciliary arteries)and venous pressures at 4 exit sites(vortex veins).The heart rate was varied from 60 bpm to 120 bpm(increment:20 bpm).We reported the ocular pulse amplitude(OPA),pulse volume,optic nerve head(ONH)deformations and the dynamic modulus of the LC at different heart rates.Results With an increasing heart rate,the OPA decreased by 0.04 mmHg for every 10 bpm increase.The pulse volume also exhibited a linear relationship with heart rate,and decreased by 0.13 L.In addition,the storage modulus and the loss modulus of the LC center increased by 0.014 MPa and 0.04 MPa,respectively for every 10 pm increase in heart rate.Conclusions Our model predicted that the OPA,the pulse volume the ONH deformation decreased at a faster heartrate.We also found that the viscoelastic LC became stiffer with an increasing heart rate.Further studies are required to explore the potential links with the vascular dysregulation and axonal loss in glaucoma.展开更多
Objective:To identify the types and causes of eye injury in industrial workers. Methods: A cross sectional study of the pattern of ocular injuries in Delta state of Nigeria was carried out over 3 months. Five hundred ...Objective:To identify the types and causes of eye injury in industrial workers. Methods: A cross sectional study of the pattern of ocular injuries in Delta state of Nigeria was carried out over 3 months. Five hundred workers were interviewed and examined using the Snellen's chart, pen-torch, direct ophthalmoscope, magnifying loupe and the Perkin's hand-held applanation tonometer. Results: All the 500 workers were males. One hundred and twenty-three workers (24.6%) reported a history of ocular injury at work. The most common causative agents were sand dust, 53 workers (25.1%); cake dust, 27 workers (12.8%) and chemicals, 32 workers (15.1%). The main types of ocular injury were corneal/ conjunctival foreign bodies, 79 workers (64.2%); burns, 35 workers (28.5%) and blunt injury, 9 workers (7.3%). Only 36 (7.2%) workers used protective eye devices at work. Thirteen workers (2.6%) developed monocular blindness from ocular injury. Conclusion: Ocular injury at work is common and few workers wear protective devices at work in industries in Delta state, Nigeria. Industrial workers should have regular eye services and wear eye safety devices at work.展开更多
Tuberculosis involving the heart is rare,accounting for only 0.5% of cases of extrapulmonary tuberculosis.Here we are presenting a case of an immunocompetent host who took one-year empirical antitubercular treatment f...Tuberculosis involving the heart is rare,accounting for only 0.5% of cases of extrapulmonary tuberculosis.Here we are presenting a case of an immunocompetent host who took one-year empirical antitubercular treatment for probable loculated tubercular pericardial abscess.On investigations,loculated pericardial abscess due to Mycobacterium Tuberculosis was confirmed.As patient did not respond to one-year antitubercular treatment and abscess was enlarging on serial computed tomography thorax and could not be aspirated completely due to presence of loculations,pericardiectomy with drainage of pyopericardium was done.This case is an important reminder that TB can manifest as pericardial abscess without significant lung involvement and an early diagnosis and aspiration in above case could have prevented surgical intervention.展开更多
基金supported by the Wisdom Accumulation and Talent Cultivation Project of Third Xiangya Hosipital of Central South University,China(YX202112).
文摘Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic adhesiolysis is the primary treatment for IUA;however,studies specifically addressing its efficacy in tuberculosisinduced IUA remain scarce.This study aims to evaluate the therapeutic outcomes of hysteroscopic adhesiolysis for IUA caused by endometrial tuberculosis.Methods:This retrospective cohort study included patients diagnosed with tuberculosisinduced IUA who underwent hysteroscopic adhesiolysis at the Third Xiangya Hospital of Central South University between May 2014 and October 2022.Clinical data including age,medical history,adhesion severity,surgical treatment,and reproductive outcomes were analyzed.Results:Among 39 patients identified,2 were lost to follow-up.A total of 37 patients were included,with a follow-up duration ranging from 6 months to 9 years.Hypomenorrhea was reported in 24(64.9%)patients,secondary amenorrhea in 10(27.0%)patients,and normal menstruation in 3(8.1%)patients.Most patients presented with primary infertility(59.5%),and only 2(5.4%)had secondary infertility.The median American Fertility Society(AFS)score at initial assessment was 10(range,8−12);8(21.6%)patients had moderate IUA,and 29(78.4%)had severe IUA.A total of 86 surgical procedures were performed across 37 patients,with 27 patients undergoing 2 or more surgeries.Postoperatively,25(67.6%)patients achieved normalization of the uterine cavity,while 12(32.4%)still had a reduced cavity.Only 7(18.9%)patients had a grossly normal endometrium at the final surgery,all of whom had moderate adhesions at the initial procedure.Menstrual flow returned to normal in 12(32.4%)patients,while 25(67.6%)continued to experience hypomenorrhea.Of 29 patients who attempted in vitro fertilization and embryo transfer(IVF-ET),only 6(20.7%)conceived.Among these,4(13.8%)delivered at term via cesarean section;one case was complicated by postpartum hemorrhage due to uterine atony and another by placental adhesion.Conclusion:Endometrial tuberculosis can lead to severe IUA.Hysteroscopic adhesiolysis facilitates cavity restoration and improvement of menstrual conditions,but the overall reproductive outcomes remain suboptimal.
文摘Objective To study the effect of changing heart rate on the ocular pulse and optic nerve head deformations with a viscoelastic lamina cribrosa.Methods An FE model of a healthy eye was reconstructed.The choroid was biphasic and consisted of a solid phase(connective tissues)and a fluid phase(blood).The LC was viscoelastic as characterized by a stress-relaxation test.We applied arterial pressures at 18 entry sites(posterior ciliary arteries)and venous pressures at 4 exit sites(vortex veins).The heart rate was varied from 60 bpm to 120 bpm(increment:20 bpm).We reported the ocular pulse amplitude(OPA),pulse volume,optic nerve head(ONH)deformations and the dynamic modulus of the LC at different heart rates.Results With an increasing heart rate,the OPA decreased by 0.04 mmHg for every 10 bpm increase.The pulse volume also exhibited a linear relationship with heart rate,and decreased by 0.13 L.In addition,the storage modulus and the loss modulus of the LC center increased by 0.014 MPa and 0.04 MPa,respectively for every 10 pm increase in heart rate.Conclusions Our model predicted that the OPA,the pulse volume the ONH deformation decreased at a faster heartrate.We also found that the viscoelastic LC became stiffer with an increasing heart rate.Further studies are required to explore the potential links with the vascular dysregulation and axonal loss in glaucoma.
文摘Objective:To identify the types and causes of eye injury in industrial workers. Methods: A cross sectional study of the pattern of ocular injuries in Delta state of Nigeria was carried out over 3 months. Five hundred workers were interviewed and examined using the Snellen's chart, pen-torch, direct ophthalmoscope, magnifying loupe and the Perkin's hand-held applanation tonometer. Results: All the 500 workers were males. One hundred and twenty-three workers (24.6%) reported a history of ocular injury at work. The most common causative agents were sand dust, 53 workers (25.1%); cake dust, 27 workers (12.8%) and chemicals, 32 workers (15.1%). The main types of ocular injury were corneal/ conjunctival foreign bodies, 79 workers (64.2%); burns, 35 workers (28.5%) and blunt injury, 9 workers (7.3%). Only 36 (7.2%) workers used protective eye devices at work. Thirteen workers (2.6%) developed monocular blindness from ocular injury. Conclusion: Ocular injury at work is common and few workers wear protective devices at work in industries in Delta state, Nigeria. Industrial workers should have regular eye services and wear eye safety devices at work.
文摘Tuberculosis involving the heart is rare,accounting for only 0.5% of cases of extrapulmonary tuberculosis.Here we are presenting a case of an immunocompetent host who took one-year empirical antitubercular treatment for probable loculated tubercular pericardial abscess.On investigations,loculated pericardial abscess due to Mycobacterium Tuberculosis was confirmed.As patient did not respond to one-year antitubercular treatment and abscess was enlarging on serial computed tomography thorax and could not be aspirated completely due to presence of loculations,pericardiectomy with drainage of pyopericardium was done.This case is an important reminder that TB can manifest as pericardial abscess without significant lung involvement and an early diagnosis and aspiration in above case could have prevented surgical intervention.
