1.
Successful Application of Combined Autologous Bone Marrow-Derived Stem Cells and Platelet-Rich Plasma in a Case of Severe Asherman Syndrome and Subsequent in vitro Fertilization Conception.
Tandulwadkar, S, Mishra, S, Gupta, S
Journal of human reproductive sciences. 2021;(4):446-449
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Abstract
The application of stem cells in infertility is still experimental. Thin endometrium is an important cause of cancelled or less successful frozen embryo transfer cycles. Clinically, numerous strategies have been adopted to promote endometrial regeneration including extended oestrogen administration, low-dose aspirin, pentoxifylline, tocopherol, vaginal sildenafil citrate and intrauterine perfusion with granulocyte colony-stimulating factor. However, even with the use of these therapies, the endometrium in some patients still remains unresponsive. Latest research shows that autologous bone marrow-derived stem cells (ABMDSCs) can be used for regeneration of damaged endometrium. We present a case report of patient with thin endometrium who was successfully treated with the combined use of ABMDSCs mixed with platelet-rich plasma, leading to successful in vitro fertilization conceived pregnancy. Patient consent and due ethical clearance were taken before starting the procedure.
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Malignant perivascular epithelioid tumor of the vagina: Report of a rare case with brief review of literature.
Gupta, R, Hariprasad, R, Dhanasekaran, K, Gupta, S
Diagnostic cytopathology. 2020;(5):483-488
Abstract
Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors with immunohistochemical co-expression of melanocytic and myoid markers. Vaginal PEComas have been described in only nine cases so far. We describe the case of a 65-year-old female with a large growth in the left lateral vaginal wall. Biopsy imprint smears showed dispersed tumor cells with anisonucleosis, multinucleation, and bizarre forms, suggestive of a malignant tumor. Histopathology, however, showed perivascular arrangement of clear epithelioid cells, focal necrosis, intracellular brown pigment in few cells, and mitotic activity at 2 to 3 per 50 high power fields. Immunohistochemical positivity for vimentin, HMB-45, S-100 protein, desmin, and MyoD1 assisted in rendering a final pathological diagnosis of malignant PEComa of the vagina. Further work-up revealed metastatic deposits in liver and retroperitoneal lymph nodes. PEComa arising in vagina is an unusual phenomenon with the malignant variant being an extremely rare tumor. Awareness of the characteristic morphology and utilization of a panel of immunohistochemical stains are mandatory to be able to make a precise diagnosis and appropriate prognostication.
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Personalized treatment approach to gastroenteropancreatic neuroendocrine tumors: a medical oncologist's perspective.
Paul, D, Ostwal, V, Bose, S, Basu, S, Gupta, S
European journal of gastroenterology & hepatology. 2016;(9):985-90
Abstract
The medical management of gastroenteropancreatic neuroendocrine tumors involves treatment of symptomatic disease related to hormone secretions or bulky unresectable metastatic disease. Combining gallium DOTA with fluorine-18 fluorodeoxyglucose-PET along with histopathological grading helps to determine tumor heterogeneity and seek reasons for poor response to therapy. In the light of adding chemotherapy in selected patients with intermediate-grade tumors, the newer scan helps in personalization of the therapy along with the biopsy. The tumor dedifferentiation over the particular time period leading to aggressive behavior, a well-known entity, is contrasted with the redifferentiation phenomenon in some patients as a result of chemotherapy or targeted drug therapy. This may support the basis for combining peptide receptor-targeted radiotherapy/octreotide therapy with chemotherapy or mTOR inhibitors such as everolimus.
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Acute non-ST elevation myocardial infarction following paclitaxel administration for ovarian carcinoma: a case report and review of literature.
Shah, K, Gupta, S, Ghosh, J, Bajpai, J, Maheshwari, A
Journal of cancer research and therapeutics. 2012;(3):442-4
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Abstract
We report a case of an acute non-ST elevation myocardial infarction (AMI) induced by paclitaxel in a patient with ovarian cancer. A 45-year-old premenopausal lady without any co-morbidity was started on the first cycle of neoadjuvant chemotherapy with paclitaxel-based regimen for advanced stage ovarian cancer. The patient developed chest pain 3 h after paclitaxel infusion with characteristic electrocardiographic changes of antero-apical myocardial infarction. The patient recovered on conservative medical management with reversion of electrocardiogram (ECG) changes. Cardiac ischemia and myocardial infarction, possibly due to coronary vasospasm, are rare adverse effects of paclitaxel with reported incidence of 0.26%. We have reported a case of paclitaxel-induced myocardial infarction with reversible cardiac dysfunction. The possibility of myocardial infarction should be considered in patients who develop chest pain or other symptoms after paclitaxel infusion.