Partial hydatidiform mole evolving into metastatic trophoblastic tumor: case report

Partial hydatidiform mole can evolve into a metastatic trophoblastic tumor. A 36-year-old, multiparous woman, pregnant with a 22-week embryonic hydatidiform mole, having spontaneously expelled. Histopathological examination showed a non-invasive partial mole. During biological monitoring, a trophoblastic tumor was diagnosed with pulmonary metastasis on CT-scan and myometrial invasion by MRI. Authors opted for a monochemotherapy with a good evolution. The potential risk of malignant transformation of the partial hydatidiform mole requires an adequate therapeutic strategy with strict monitoring

Uterine torsion of 90 degrees: case report

Uterine torsion is defined as a rotation of uterus more than 45 degrees along its long axis. However, a pathologic rotation of the uterus beyond 45 degrees-torsion of the entire uterus-is rarely seen in obstetrical practice, authors report a case of torsion of the uterus by 90 degrees. The patient, a 30-year-old gravida 3 para 2 at 37 weeks’ gestation with a singleton pregnancy, her prior obstetrical history included two uncomplicated term vaginal deliveries, and the current pregnancy had been uncomplicated until the date of presentation was admitted to the obstetrical unit  with  labour at 37 weeks 5 days ,on obstetric examination the patient was in labour with transversal presentation of the fetus so an emergency caesarean section (CS) was carried out for. At the time of CS, the diagnosis of uterine torsion of 90 degrees was made. After the delivery of the baby, uterus returned to anatomical position and the torsion corrected spontaneously. The patient recovered and was discharged home with her baby on the third postoperative day. Uterine torsion is an infrequently reported and potentially dangerous complication of pregnancy that occurs mainly in the third trimester

Idiopathic intracranial hypertension in pregnancy: about a rare case

In this work, study report the case of a 23-year-old primigravidae, in whom an idiopathic intracranial hypertension (IIH), formerly called pseudotumor cerebri, was diagnosed in the first trimester with visual field impairment, the management of which was similar to cases of benign intracranial hypertension in the general population. The parturient put under medical treatment with ophthalmological and obstetrical follow-up until 39 weeks of amenorrhea where she was cesarized for rescue of the visual prognosis. The objective of this work is to elucidate this pathology, caused by a defect of reabsorption of the CSF by the arachnoid plexus. The diagnosis is retained after elimination by radio-biological exploration of an infectious, tumor or traumatic etiology. Idiopathic intracranial hypertension has no impact on the evolution of pregnancy. In addition, the choice of delivery route is dependent on the patient's visual prognosis being brought into play

Gynandroblastoma: a rare case report of ovarian sex cord tumour

Gynandroblastoma is an extremely rare ovarian sex cord tumor with malignant potential. An 61-year-old woman, menopausic, consulted for an abdominal pelvic mass. a latero-uterine mass measuring 27.8 cm in diameter showed a predominantly cystic pattern with a partial solid component. A unilateral adnexectomy was performed. A histopathological examination showed gynandroblastoma composed of juvenile granulosa and Sertoli-Leydig cells, chirurgical treatment was completed by total hysterectomy with right adnexectomy, omentectomy with no proof of malignant cells. We opted for a close observation without adjuvanted chemotherapy. two years after surgery, no signs of recurrence have been noted. The present findings can help clinicians make an accurate preoperative imaging diagnosis of gynandroblastoma with a juvenile granulosa cell component and plan an adequate treatment strategy for this rare, potentially malignant neoplasm

Le kyste hydatique facial isole

Le kyste hydatique se présente exceptionnellement comme une masse faciale. Nous rapportons le cas d’un kyste hydatique de la région temporo-jugale chez un patient de 20 ans révélé par une tuméfaction faciale isolée. Le bilan radiologique a montré une formation liquidienne avec pseudo cloisons siégeant au niveau des parties molles temporales gauche. C’est l’exploration chirurgicale qui a posé le diagnostic de kyste hydatique, confirmé par l’étude anatomopathologique. Elle a permis une kystectomie totale. L’évolution a été marquée par l’absence de récidive à 3 ans.Mots clès : Kyste hydatique, face, kystectomie

Near death 18 weeks preeclampsia in molar pregnancy

Authors present a case of a molar pregnancy of 18 weeks with preeclampsia complicated with acute pulmonary oedema. A condition carrying a significant risk to mother, therefore, raising an important issue on preeclampsia symptoms on pregnancies before 20 weeks. A 31-year-old woman gravida 2, parity 1 presented with dyspnea at 18 weeks' gestation. Blood pressure was very high (180/110 mmHg) and there was markedly proteinuria (+4). She had severe dyspnea and her oxygen saturation level was 75%. Her chest X-ray graph showed massive acute pulmonary oedema. Ultrasonography shows endometrial cavity containing multiple small cystic spaces, creating a characteristic “snowstorm” and “cluster of grapes” appearance. Markedly elevated quantitative human chorionic gonadotropin (250.000 mIU/mL). The acute pulmonary oedema has been managed by diuretics (Furosemide) and oxygen. There was no cardiac abnormalities in the tranthoracic echocardiogram. Authors administered antihypertensive therapy (intravenous nicardipine and lmethyldopa in per os), and magnesium sulfate in prevention of eclamptic seizures. The pregnancy was terminated by uterine evacuation under oxytocin infusion by manual ultrasound aspiration. She was followed up intensive care unit for two days. Causes of secondary high blood pressure had been eliminated. The patient's blood pressure rapidly normalized two days after delivery. Dyspnea disappeared one day later. Pathologic and cytogenetic analyses revealed a complete hydatiform mole. Two days after delivery; the serum β-hCG level was 99000 mlU/ml. A control ultrasonography shows an empty uterus. Hydatidiform mole is classified into 2 different subtypes, complete hydatidiform mole and partial or incomplete hydatidiform mole development of preeclampsia prior to 20 weeks of gestation should prompt a clinical evaluation to exclude the possibility of an underlying hydatidiform molar pregnancy. Ultrasonography and level of serum BHCG are the initial investigation of choice for the detection of hydatidiform mole. Aspiration is the treatment of reference

THE SYNDROME OF OVERTRAINING AMONG THE ALGERIAN ELITE JUDOKAS (YOUNGER MEMBERS OF THE ALGERIAN NATIONAL TEAM) DURING A COMPETITION FOLLOW-UP

Introduction:  The main objective of this study is to detect the existence of a state of fatigue and a syndrome of overtraining among Algerians judokas of the youngest category (girls and boys) by the use of the questionnaire of fatigue among the child athlete (QFES) and to evaluate the variations of the score by report has its 07 dimensions. Method: 24 judokas cadets of the national team, 14 boys 58.3% and 10 girls 41,7%. The boys are an average age of 16.21±0.21 years, an average weight of 67±16,40kg and a stature of 171,64±9,49cm. They have a body mass index(BMI) of 22.69±4.94 kg/m².girls have an average age of 16.20±0.78 years, a weight of 59.1±7.89 kg and a stature of 163.9±3,14cm.The BMI is equal to 21,95±2.50 kg/sq. m. The athletes are attending school between the fourth average year at the College and the second year of secondary school. During the period of the microcycle stage of competition which is taking place between 01 March 2017 and 31 May 2017, we distributed the questionnaire at the end of the competition at the Championship in Algeria (Algiers, 27/05/2017). Results: The score of the questionnaire was to 40.01±8.58 (minimum=27, 00, maximum=54), 33.33% of athletes their scores to the QFES≥45. The average score for an item is 1.1±0.11. The ranking of items of the QFES by average quotation with significant threshold retained of p<0.05. The results are expressed in average ± standard deviation. Conclusion: The main results show that in the questionnaire QFES fatigue is a sensitive tool to detect a state of fatigue. However, a biological study is imperative in order to establish the correlation between syndrome of the overtraining and oxidative stress among young judokas  Article visualizations

Does time equal vision in the acute treatment of a cohort of AQP4 and MOG optic neuritis?

Objective To investigate whether visual disability which is known to accumulate by poor recovery from optic neuritis (ON) attacks can be lessened by early treatment, we investigated whether the time from symptom onset to high-dose IV methylprednisolone (IVMP) affected visual recovery. Methods: A retrospective study was performed in a consecutive cohort of patients following their first aquaporin-4 (AQP4)-IgG or myelin oligodendrocyte glycoprotein (MOG)-IgG-ON. Best-corrected visual acuity (BCVA) in ON eyes at 3 months (BCVA3mo) was correlated with time to IVMP (days). In cases of bilateral ON, 1 eye was randomly selected. Results: A total of 29 of 37 patients had ON (27 AQP4-seropositive neuromyelitis optica spectrum disorder [NMOSD] and 9 MOG-IgG-ON), 2 of whom refused treatment. Of the 27 patients included, 10 presented later than 7 days from onset. The median BCVA3mo of patients treated >7 days was 20/100 (interquartile range 20/100–20/200). Patients treated >7 days had an OR of 5.50 (95% CI 0.88–34.46, p = 0.051) of failure to regain 0.0 logMAR vision (20/20) and an OR of 10.0 (95% CI 1.39–71.9) of failure to regain 0.2 logMAR vision (20/30) (p = 0.01) compared with patients treated within 7 days. ROC analysis revealed that the optimal criterion of delay in IVMP initiation was ≤4 days, with a sensitivity and specificity of 71.4% and 76.9%, respectively. Conclusions: In this retrospective study of ON with AQP4 and MOG-IgG, even a 7-day delay in IVMP initiation was detrimental to vision. These results highlight the importance of early treatment for the long-term visual recovery in this group of patients. A prospective, multicenter study of the effects of timing of IVMP is currently underway. Classification of evidence: This study provides Class IV evidence that hyperacute treatment of AQP4 and MOG-ON with IVMP increases the chance for good visual recovery (20/20 vision) and that even a greater than 7-day delay in treatment is associated with a higher risk for poor visual recovery

Analyse économique de la compétitivité de la filière tomate dans la région du Souss-Massa (Maroc)

The aim of this study is to evaluate the government’s intervention policies for greenhouse tomato production. The study is based on data collected from a sample of farmers in the Souss-Massa. The choice of the Souss-Massa region was made for several reasons, including the potential of tomato crop production, the share of the greenhouse tomato production in relation to domestic production and the existence of different segments and operators involved in the fresh tomato industry. For this study, we used the Policy Analysis Matrix (PAM) method. Analysis of data showed that tomato production in farms of Souss-Massa region is profitable. It has a comparative advantage and can generate foreign currency. This is due to the lower social costs of tradable inputs and to the fact that actors use many domestic resources in their production systems. Thus, with a Domestic Cost Resources ratio (DRC) below one, the activity is competitive and will be more competitive in case of a decline in social costs of domestic resources. Key words: Tomato, Souss-Massa, policy analysis matrix, reference price, comparative advantageL’objectif de cette étude est l’évaluation des politiques d’intervention de l’État pour la production de la tomate sous serre. L’étude a été basée sur les données collectées auprès d’un échantillon d’agriculteurs de la zone de Souss-Massa. Le choix de la région de Souss-Massa a été fait pour plusieurs raisons, notamment, le potentiel de production des cultures sous serre, l’importance de la part de la production de la tomate sous serre par rapport à la production nationale et l’existence des différents segments et opérateurs qui interviennent dans la filière tomate. Pour cette étude, nous avons utilisé la méthode de la matrice d’analyse des politiques (MAP). L’analyse des données a montré que la production de la filière tomate dans les exploitations de la région de Souss-Massa est rentable. Elle a un avantage comparatif aux prix de référence et peut générer de la devise étrangère. Ceci s’explique par la diminution des coûts sociaux des intrants échangeables et par le fait que les acteurs utilisent beaucoup de ressources domestiques dans leurs systèmes de production. Par conséquent, avec un CRD (Coefficient de coût en Ressources Domestiques) inférieur à l’unité, l’activité est compétitive et elle sera plus compétitive en cas de régression des coûts sociaux (économiques) des ressources domestiques. Mots clés: Tomate, Souss-Massa, matrice d’analyse des politiques, prix de référence, avantage comparati

Supernova Neutrino Spectrum with Matter and Spin Flavor Precession Effects

We consider Majorana neutrino conversions inside supernovae by taking into account both flavor mixing and the neutrino magnetic moment. We study the adiabaticity of various possible transitions between the neutrino states for both normal and inverted hierarchy within the various solar neutrino problem solutions. From the final mass spectrum within diffrent scenarios, we infer the consequences of the various conversion effects on the neutronization peak, the nature of final spectra, and the possible Earth matter effect on the final fluxes. This enable us to check the sensibility of the SN neutrino flux on magnetic moment interaction, and narrow down possible scenarios which depend on: the mass spectrum normal or inverted, the solution of the solar neutrino problem; and the value of MuxB.Comment: 24pages, 7 figure