Tubocutaneous Fistula

Introduction. Tubocutaneous fistula is a very rare condition; most cases described in the literature are secondary to endometriosis, tuberculosis, and complications of child birth and gynecological operations. Case Presentation. We report a case of 40-year-old woman who presented with tubocutaneous fistula secondary to pelvic inflammatory disease which was diagnosed in the setting of persistent discharging wound in the right groin. Conclusion. Tubocutaneous fistula is a rare condition. Salpingectomy and resection of fistulous tract is the treatment of choice as is treating the underlying cause. Early diagnosis and treatment of these patients are essential for avoiding long term complications

Circulating LH/hCG receptor (LHCGR) may identify pre-treatment IVF patients at risk of OHSS and poor implantation

<p>Abstract</p> <p>Background</p> <p>Successful pregnancy via <it>in vitro </it>fertilization (IVF) depends on the recovery of an adequate number of healthy oocytes and on blastocyst implantation following uterine transfer. Two hormones, LH and hCG, utilize a common LH/hCG receptor (LHCGR), variations in which have profound implications in human reproduction. Soluble LHCGR (sLHCGR) is released from experimental cell lines and placental explants and it can be detected in the follicular fluid and serum.</p> <p>Methods</p> <p>To evaluate the impact of circulating soluble LHCGR (sLHCGR) in fertility treatment, we measured sLHCGR and LH-sLHCGR complex in serum from women seeking IVF using specifically developed quantitative enzyme-linked immunosorbent assays (ELISA). Following an IVF cycle of treatment, patients were grouped according to oocyte yield into low (lower than or equal to 7 oocytes), intermediate (8-14 oocytes) and high (greater than or equal to 15 oocytes) responders and pregnancy outcome noted.</p> <p>Results</p> <p>Pre-treatment sLHCGR identified many women at risk of ovarian hyperstimulation. Low levels of sLHCGR were associated with pregnancy in both high and low responders but sLHCGR did not significantly affect the treatment outcome of intermediate responders. Low responders who failed to become pregnant had high levels of circulating sLHCGR bound to LH (LH-sLHCGR).</p> <p>Conclusions</p> <p>Pre-treatment measurement of sLHCGR could be used to tailor individual fertility treatment programs and improve outcomes by avoiding ovarian hyperstimulation and poor embryo implantation.</p

Emprical Validity of Asset pricing models in Iran's Stock Market: Application of Optimal Significance Level and Equal Probability Test

One of the most usage of evaluating Empirical Validity of Asset-pricing Models is GRS test. In this paper we implement the GRS test for CAPM and Fama-French 3-factor asset pricing models with explicit consideration of statistical power, by employing the optimal significance level and equal-probability test. In this regard we use the 25 size-B/M portfolios analysed by Fama and French to facilitate the empirical comparison among the alternative models. The result show GRS test rejects all two asset pricing models at the conventional significance level.. At the optimal significance, we find that the GRS test cannot reject the null hypothesis of portfolio efficiency most of the time for CAPM and Fama-French 3-factor models

To assess whether anti-mullerian hormone varies between women of different race/ethnic backgrounds

Author(s) Pre or Post Print Version Only. No PDFIntroduction: Anti-Mullerian hormone, secreted by the granulosa cells in the ovary, is used as an estimate of ovarian reserve and to predict the ovarian response to ovarian stimulation during assisted conception treatments. Differences in serum AMH levels amongst various ethnic groups have been reported in the literature. The results from literature have been conflicting and not uniform as regards the population and ethnic groups studied. Ovarian reserve remains an important predictor of the success of fertility treatments, ethnic differences in AMH may contribute to the differences in outcome of these treatments. Methods: Observational cross-sectional study of 1215 patients who had levels measured between April 2009 to September 2014 at Royal Derby Hospital over a period of 5 years. Serum Anti-Mullerian hormone levels were compared amongst women from three different ethnic groups. Results: A total of 1215 women studied, 874 were Caucasians, 178 were Asians, 23 were Afro Caribbean's, 4 from mixed back ground and 128 of them have not stated their ethnicity. The data shows that Caucasians had high levels of Anti-Mullerian hormone compared to Asian and African women at younger age (up to 30 yrs). Caucasian women showed highest decline in Anti-Mullerian hormone levels compared to Asian and African women between 30-44yrs. African women had lowest Anti-Mullerian hormone levels throughout their reproductive period compared to Caucasians and Asians. Discussion / Conclusion: As age advances AMH levels decrease, the degree of age related AMH decline vary depending on ethnicity, cause of subfertility and type of subfertility. Ethnicity should be considered while interpreting AMH results. Improving our understanding of racial differences in ovarian reserve and their underlying causes may be essential for reproductive planning, improved treatment outcomes