Heavy Menstrual Bleeding is one of the common Gynaecological issues. There are several causes. Some of the women presented with these issues found to have underling thyroid abnormality which was not discovered earlier. This research tries to find the prevalence of the Thyroid Disorder among the women present with Heavy menstrual bleeding in Sri Lankan women.
BACKGROUND Acute lower gastrointestinal bleeding(LGIB)is a common occurrence in clinical practice.However,appendiceal bleeding is an extremely rare condition that can easily be overlooked and misdiagnosed.The preoperative detection of appen-diceal bleeding often poses challenges due to the lack of related guidelines and consensus,resulting in controversial treatment approaches.CASE SUMMARY We presented a case of a 33-year-old female who complained of hematochezia that had lasted for 1 d.Colonoscopy revealed continuous bleeding in the appen-diceal orifice.A laparoscopic appendectomy was performed immediately,and a pulsating blood vessel was observed in the mesangium of the appendix,accor-dingly,active bleeding into the appendicular lumen was considered.Pathological examination revealed numerous hyperplastic vessels in the appendiceal mucosa and dilated capillary vessels.CONCLUSION The preoperative detection of appendiceal bleeding is often challenging,colo-noscopy is extremely important,bowel preparation is not routinely recommend-ed for patients with acute LGIB or only low-dose bowel preparation is recom-mended.Laparoscopic appendectomy is the most appropriate treatment for appendiceal bleeding.
Mid-gastrointestinal bleeding accounts for approximately 5%-10%of all gastrointestinal bleeding cases,and vascular lesions represent the most frequent cause.The rebleeding rate for these lesions is quite high(about 42%).We hereby recommend that scheduled outpatient management of these patients could reduce the risk of rebleeding episodes.
Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.
Gustavo Adolfo Hernández ValdezDiana Estefanía Ibarra GarcíaJuan Antonio Contreras EscamillaJanette Alejandra Gamiño GutierrezFrancisco Manuel Tonatiuh Carrillo BeltranUlises Solis GomezJocelyn Nataly Quintero MeléndezIvan Alejandro Medina JimenezMarco Antonio González VillarJorge Rojas Morales
Glanzmann thrombasthenia (GT) is a rare and often underdiagnosed congenital bleeding disorder caused by mutations in the genes encoding glycoproteins GPIIb or GPIIIa, resulting in platelet dysfunction. Inherited in an autosomal recessive manner, GT is characterized by the inability of platelets to aggregate. Clinically, it presents with mucocutaneous bleeding, such as easy and extensive bruising, severe epistaxis, menorrhagia, gingival bleeding, postpartum hemorrhage, and unexpected bleeding following procedures, despite a normal platelet count. We present a case involving a 6-year-old male patient who experienced spontaneous gingival bleeding for the past 4 weeks due to the eruption of his first permanent molars. The bleeding was particularly severe at night, disrupting the child’s sleep. The patient had been diagnosed with GT at the age of 16 months. Dental management was pursued, and the use of tranexamic acid mouthwash, combined with meticulous oral hygiene, resulted in an excellent response.
Nahla A. AbdulrahmanMotaz A. AtiaNada A. AbdelwahabMalaz M. Mustafa
BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(ANVUGIB)is a frequent lifethreatening acute condition in gastroenterology associated with high morbidity and mortality.Over-the-scope-clip(OTSC)is a new endoscopic hemostasis technique,which is being used in ANVUGIB and is more effective.AIM To summarize and analyze the effects of the OTSC in prevention of recurrent bleeding,clinical success rate,procedure time,hospital stay,and adverse events in the treatment of ANVUGIB,to evaluate whether OTSC can replace standard endoscopic therapy as a new generation of treatment for ANVUGIB.METHODS The literature related to OTSC and standard therapy for ANVUGIB published before January 2023 was searched in PubMed,Web of Science,EMBASE,Cochrane,Google,and CNKI databases.Changes in recurrent bleeding(7 or 30 days),clinical results(clinical success rate,conversion rate to surgery,mortality),therapy time(procedure time,hospital stay),and adverse events in the OTSC intervention group were summarized and analyzed,and the MD or OR of 95%CI is calculated by Review Manager 5.3.RESULTS This meta-analysis involved 11 studies with 1266 patients.Total risk of bias was moderate-to-high.For patients in the OTSC group,7-and 30-days recurrent bleeding rates,as well as procedure time,hospital stay,and intensive care unit stay,were greatly inhibited.OTSC could significantly improve the clinical success rate of ANVUGIB.OTSC therapy did not cause serious adverse and was effective in reducing patient mortality.CONCLUSION OTSC may provide more rapid and sustained hemostasis,and thus,promote recovery and reduce mortality in patients with ANVUGIB.In addition,the safety of OTSC is assured.
The current study aimed to evaluate the first aid knowledge and general awareness of bleeding control, and their relations with different variables among the population of Jazan City, Saudi Arabia, in 2023. A cross-sectional study was conducted in Jazan City, Saudi Arabia between April 2023 and May 2023. Participants, >13 years old, living in Jazan City, were self-enrolled. Data collection was carried out by distributing a self-reported online survey questionnaire via email and social media apps. A validated, pretested online self-report questionnaire was used for data collection, with data analysis performed using (MS) Excel 2022 and SPSS version 26. A Chi-square test was used to determine the association of sociodemographic variables and Bleeding Control (BC) knowledge with, significance set at p < 0.05. A total of 250 participants completed the questionnaire, predominantly aged between 16 - 25 years, with 152 (60.8%) being male, and about 90% being Saudi citizens. Only 53 (21.2%) participated in previous first aid training concentrating on bleeding control. Only 76 (30.4%) of participants had good knowledge, while 131 (52.4%) exhibited positive attitude towards BC first aid. There were no statistically significant associations between BC knowledge and age, gender, occupation, nationality, and education. However, a significant association was observed between previous BC training and knowledge (Chi-test = 40.373, d.f = 1, p = 0.000) at p < 0.05. Conclusion: The prevalence of poor knowledge of bleeding control among community members in Jazan City was high. The findings of this study should be carefully considered by various healthcare organizations to implement educational first-aid programs and activities aimed at enhancing community awareness and knowledge of bleeding control.
Md Mazharul HoqueHamoud Yahya AlsurihaMohamed E. MoukhyerBahja SiddigMohamed Mubarak AlmakiAmna MoukhyerFawaz Yahya MasswadiMofareh Salman HarubiElias Yosef ModabishTalal Omar KhasawiYaser Mohammed HantoolMohammed Awaji Mohammed MadkhaliAziza Mukhayer
Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in the last few decades,thus presenting a significant challenge.This editorial outlines the key causes and risk factors of ANVUGIB and explores the current standards and recent updates in risk assessment scoring systems for predicting mortality and endoscopic treatments for achieving hemostasis.Since ANUVGIB predominantly affects the elderly population,the impact of comorbidities may be responsible for the poor outcomes.A thorough drug history is important due to the increasing use of antiplatelet agents and anticoagulants in the elderly.Early risk stratification plays a crucial role in deciding the line of management and predicting mortality.Emerging scoring systems such as the ABC(age,blood tests,co-morbidities)score show promise in predicting mortality and guiding clinical decisions.While conventional endoscopic therapies remain cornerstone approaches,novel techniques like hemostatic powders and over-the-scope clips offer promising alternatives,particularly in cases refractory to traditional modalities.By integrating validated scoring systems and leveraging novel therapeutic modalities,clinicians can enhance patient care and mitigate the substantial morbidity and mortality associated with ANVUGIB.
