Setare Akhavan; Azamsat Mousavi; Mitra Modaresgilani; Abbas Alibakhshi
Volume 2, Issue 1 , March and April 2017
Abstract
Anogenital warts (AGWs) are the most prevalent sexually transmitted viral infections in the United States of America. Symptomatic warts can be seen in nearly 1% of the population aged 15 to 49 years. Genital warts are highly contagious through sexual contact. AGWs can be diagnosed by careful visual inspection. ...
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Anogenital warts (AGWs) are the most prevalent sexually transmitted viral infections in the United States of America. Symptomatic warts can be seen in nearly 1% of the population aged 15 to 49 years. Genital warts are highly contagious through sexual contact. AGWs can be diagnosed by careful visual inspection. Several methods have been described for the treatment of warts; however, all have their own limitations and are not always successful. Warts often recur even after being completely removed. The treatments of warts can be divided into two broad categories, ie, surgical and nonsurgical methods. The patient himself/herself can apply the nonsurgical methods, or a physician can perform it. Podophyllotoxin is a good medical substance. Imiquimod can act as an immune response modifier and stimulate locally produced cytokine. Topical treatments of warts increase local production of interferon and decrease viral load of human papiloma virus (HPV). The surgical methods for genital warts include curettage, electrosurgery, and application of a scalpel under general or local anesthesia. Scattered keratinized lesions can be removed by electrosurgery. Patients with multiple or large warts of any location should be referred for surgical treatment under general anesthesia.
Setareh Akhavan; Azamsadat Mousavi; Mitra Modaresgilani; Abbas Alibakhshi; Maryam Rahmani; Nasrin Karimi
Volume 1, Issue 2 , September and October 2016
Abstract
Background: Gestational trophoblastic neoplasm (GTN) during pregnancy includes an associated heterogeneous group of lesions that originates from abnormal proliferation of placenta. It includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor.
Objectives: ...
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Background: Gestational trophoblastic neoplasm (GTN) during pregnancy includes an associated heterogeneous group of lesions that originates from abnormal proliferation of placenta. It includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor.
Objectives: The aim of this study was to predict the risk of invasive mole in patients with a molar pregnancy in association with β-hCG level after the evacuation of molar pregnancy.
Methods: The current study was a prospective cross-sectional cohort research conducted as a diagnostic study on 110 patients with molar pregnancy referring to Department of Gynecology and Oncology of Vali-Asr, Imam Khomeini Hospital of Tehran between the years of 2015 and 2016. Patients with molar pregnancy, who were hospitalized with a diagnosis of hydatidiform mole by transvaginal ultrasonography, were examined in the study. The ability to perform ultrasonography before and after evacuation as well as the consent to participate in the study was among the inclusion criteria for patients. The patients were studied for invasive mole followed by two ultrasonography examinations, one 48 hours and the other 21 days after evacuation. β-hCG levels were also measured in successive periods of one week to six months. The association of sonography findings 48 hours and 21 days after evacuation with post-evacuation β-hCG levels was investigated using Chi-square test and multinomial regression.
Results: In the current study conducted on 110 patients with hydatidiform mole, the results showed that 46 patients (41.8%) suffered from invasive mole. In 23 patients (50%) with invasive mole, the results of both ultrasonography 48 hours and 21 days after evacuation were positive. There was a significant correlation between ultrasonography after evacuation (positive and negative results) and the progress of β-hCG after evacuation in women with invasive mole (P = 0.001); this means that in 73% of women with invasive mole, the positive β-hCG results corresponded with positive 21-day sonography after evacuation, and in 41% cases, ultrasound results on day 21 were reported positive before the results of β-hCG.
Conclusions: Positive results of sonography accompanied with positive results of β-hCG have a high efficiency in the diagnosis of invasive mole; therefore, more definitive studies with a larger sample size are suggested to confirm this hypothesis.
Setareh Akhavan; Azamsadat Mousavi; Abbas Alibakhshi
Volume 1, Issue 1 , May and June 2016
Abstract
Borderline ovarian tumors (BOT) consist of epithelial ovarian lesions that express cytological features of malignancy, but unlike malignant ovarian tumors, do not show obvious stromal invasion. The tumor incidence is between 1.8 and 4.8 per 100,000 females per year. The two major groups of BOT include ...
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Borderline ovarian tumors (BOT) consist of epithelial ovarian lesions that express cytological features of malignancy, but unlike malignant ovarian tumors, do not show obvious stromal invasion. The tumor incidence is between 1.8 and 4.8 per 100,000 females per year. The two major groups of BOT include serous BOT (S-BOT) and mucinous BOT (M-BOT). S-BOTs are divided into two categories: tumors limited to ovary and tumors spreading outside the ovary. M-BOTs are divided into two categories. The more common type is intestinal that constitutes 85% of cases and the second type is endocervical or Mullerian. Mullerian M-BOTs is bilateral in 40% of cases, while it is accompanied by pelvic endometriosis in 20-30% of patients. Microscopic examination by intraoperative frozen section is necessary because macroscopic view of ovarian tumors alone is not reliable. It is better to perform conservative surgery until the final report is ready in patients who wish to preserve their fertility. It is hard to differentiate them based on clinical characteristics. Values of tumor markers including CA125, CA19-9 and CEA in diagnosis of BOT are confirmed. Standard treatment of BOT is surgery as is the case with invasive epithelial ovarian cancer. In the majority of patients referred for BOT, since there is no suspicion of malignancy, staging is not performed. In these cases, making decision to repeat surgery and staging depend on factors such as the type of histology, abdominal exploration results in the previous surgery and probability of the presence of residual tumor.
