Yeshey Dorjey*, Yezer Tshomo, Dorji Wangchuk, Purushottami Bhandari, Choki Dorji, Diptika Pradhan and Rinzin Pemo
Background: Primary abdominal ectopic pregnancy is extremely rare. Abdominal ectopic pregnancy is often overlooked. This case is to report an early primary abdominal ectopic pregnancy managed successfully.
Case report: A 32-year nulliparous woman presented with presented with sudden onset acute lower abdominal pain. Urine pregnancy test was positive. Ultrasonography of the pelvis showed a right adnexal mass with gestational sac. Emergency laparotomy was performed and noted an abdominal ectopic pregnancy on the right side of the adnexa adhered to large bowel. Adhesiolysis was done and the mass was removed. On postoperative day-4, inj methotrexate was administered and patient recovered.
Conclusion: Every gynaecologist needs to have a high index of suspicion and a better understanding and interpretation of clinical and image findings and deal promptly to obviate grievous consequences.
Teaching points: 1. Early primary abdominal ectopic pregnancy can be safely managed with surgical intervention without grievous consequences. 2. Inj. Methotrexate can be used in the management of abdominal ectopic pregnancy when there is doubt of residual trophoblastic tissues left behind.
Aeromonas hydrophila is a Disease-causing agent, which exists everywhere on, land and water-based environments, water-carried bacteria. They have been collected from marine waters, rivers, lakes, swamps, materials that sink in liquids, chlorine water, water distribution systems, drinking water, and extra waters; vital food, such as processed foods, meat, fish, seafood, vegetables, etc. The main disease-causing factors connected with Aeromonas are surface polysaccharides, S-layers, iron-binding systems, exotoxins and outside of a cell enzyme, release of fluid systems, fimbriae and other nonfilamentous adhesins, swimming strength, and flagella. They are becoming famous as enteric germs of a serious public health concern as they receive some disease that is linked with human sicknesses, such as gastroenteritis, soft-tissue, muscle infections, dangerous blood infection, and skin sicknesses. Proper sanitary procedures are extremely important in the prevention of the spread of Aeromonas infections. Oral fluid electrolyte substitution is employed in the prevention of not having enough water, and broad-spectrum germ-killing drugs are used in extreme Aeromonas sudden beginnings of bad things like disease.
The current experimental and medicine-based data available suggest that controlling of the intestinal microbiota could be an interesting target to reduce CKD development or increase over time of events or things and CV difficulties by decreasing URS production. Beside diet actions that help bad situations to reduce URS production by intestinal microbiota, other choices should be explored. Finally, it should be noted that most managed and done studies were early and subject to change and more medicine-based studies needs to be managed and did to further understand the effectiveness of these related to vitamins, protein, etc., in food ways of reaching goals. Especially, defining a more described the intestinal microbiota in CKD to target the disease-causing bacteria and figure out the effect of quality combination of different substances, objects, people, etc. in addition to the amount of protein on this symbiosis are desirable. Instead of a like nothing else in the world related to vitamins, protein, etc., in food option, a combined success plans of reaching goals which brings together vegetarian diet, LPD, ketoacid addition to something else, adjusting of quality of protein, and pro-prebiotics could be far more interesting for patients with CKD.
Vaccination is one of the most effective actions that help a bad situation measures known to medical science. Apart from the permanent removal of smallpox and the near permanent removal of poliomyelitis, the number of times something happens of major the time when a person is a child sicknesses has lowered in number very much in developed countries through the putting into use of related to the time when a person is a child procedure that protects people from disease programs. However, effective vaccination rules of conduct require a political will that is often not having enough many countries. Disease-preventing treatments against sicknesses such as liver disease B and certain harmless wart viruses will make progress into the number of human cancer caused by these viruses. The introduction of disease-preventing treatments against some viruses such as HIV, liver disease C virus, becoming popular covid-19 and others, has proved in a surprising and interesting way very hard, however, and lots of newer technologies have been examined something closely so the truth can be found.
Recently, chronic kidney disease (CKD) has been a global health concern. Some problems related to CKD include decreased renal function, increased uric acid (UA) levels, urate-lowering therapy (ULT), allopurinol administration, and decreased estimated glomerular filtration rate (eGFR). Preventing Early Renal Loss in Diabetes (PERL) is a meaningful study, showing no evidence of apparent benefits of UA reduction with allopurinol on renal outcomes. Another significant study is CKD-FIX, which stands for the Controlled trial of slowing of Kidney Disease progression From the Inhibition of Xanthine oxidase. The change in eGFR was -3.33 vs -3.23 mL/min/1.73 m2 for allopurinol vs placebo, respectively.
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