Fertility preservation in young patients with cancer

AbstractInfertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the forefront the potential for fertility preservation in patients being treated for cancer. Many survivors will maintain their reproductive potential after the successful completion of treatment for cancer. However total body irradiation, radiation to the gonads, and certain high dose chemotherapy regimens can place women at risk for acute ovarian failure or premature menopause and men at risk for temporary or permanent azoospermia. Providing information about risk of infertility and possible interventions to maintain reproductive potential are critical for the adolescent and young adult population at the time of diagnosis. There are established means of preserving fertility before cancer treatment; specifically, sperm cryopreservation for men and in vitro fertilization and embryo cryopreservation for women. Several innovative techniques are being actively investigated, including oocyte and ovarian follicle cryopreservation, ovarian tissue transplantation, and in vitro follicle maturation, which may expand the number of fertility preservation choices for young cancer patients. Fertility preservation may also require some modification of cancer therapy; thus, patients’ wishes regarding future fertility and available fertility preservation alternatives should be discussed before initiation of therapy.</jats:p

Role of 256 slice CT scan in pre and postoperative evaluation of congenital cardio-vascular anomalies: our experience at a tertiary care teaching hospital

Background: Ultrafast CT (UCT) scan plays an important role in the evaluation of congenital cardiovascular anomalies (CCVA). A major advantage of higher slice multi-detector CT (MDCT), is improved temporal as well as spatial resolution, that helps accurately to delineate complex cardiac and extra-cardiac anomalies with relative ease. Hence this study was aimed to highlight the utility of UCT in the evaluation of congenital cardiovascular anomalies in a large series of patients.Methods: All consecutive patients with suspected CCVA were evaluated by cardiac CT angiography (CCTA) on 256 slice CT scan in a multispecialty tertiary care teaching institute from June 2013 to December2015.Results: A total of 160 cases of CCVA were evaluated by CCTA. 50 patients had multiple anomalies. A total of 216 anomalies were diagnosed. Tetralogy of fallot (TOF) dominated the list of CCVAs (60, 28%) than the other abnormalities. Of them, 25 patients underwent Blalock Taussig (BT) shunt surgeries, 20 patients underwent total repair operation like Rastelli’s operation or augmentation of pulmonary arteries (PAs) while 15 patients were lost to follow up. Most of the patients diagnosed with CCVAs were managed successfully based on the imaging diagnosis of the cardiovascular anomaly.Conclusions: Ultrafast CT scans have immense role in the evaluation of various types of congenital cardiovascular anomalies. It is particularly helpful in the evaluation of extra-cardiac systemic and pulmonary arterial and venous system, postoperative complications, to see the status of shunts, stents and conduits.</jats:p