Gynecology Oncology
Zahraa Al-Tamimi; Mahmood A. Al Ani
Articles in Press, Accepted Manuscript, Available Online from 11 January 2024
Abstract
Background: Asymptomatic bacteruria is a form of lower urinary tract infections (UTIs) that is significant during pregnancy for its high prevalence, high tendendency for persistence and progression to the other symptomatic forms, besides posing adverse effects on pregnancy through effects on both maternal ...
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Background: Asymptomatic bacteruria is a form of lower urinary tract infections (UTIs) that is significant during pregnancy for its high prevalence, high tendendency for persistence and progression to the other symptomatic forms, besides posing adverse effects on pregnancy through effects on both maternal and fetal morbidity. In this respect, Cranberry has been suggested in the prevention and sometimes treatment with a big conflict in results and recommendations.
Materials & Methods: In our study we tried to search its role in treatment and prevention using capsules rather than juices (the most common form in previous studies) and comparing results of its use alone versus combined with antibiotics on the outcome.
Results: Results showed that it is less effective than antibiotics in the treatment ( 56% versus 88% cure rate) (X2: 6.3492; df=l; P value =0.01174), closely effective to them in prevention (26.7% recurrence on cranberry versus 12.5% on antibiotic) (X2:0.9954;P value=0.3184), but reducing the cure rate when used in combination with antibiotics in treatment versus antibiotics alone ( 28.6% versus 57.1% response) (X2=1.1667; P value = 0.2801). Regarding the most commonly reported side effects: headache was supervening consistent with reports in previous studies, whereas gastrointestinal upset commonly experienced in cranberry juice was reported in only (8%) of study cases.
Conclusion: In view of results we recommend using cranberry especially in what seems to be less harmful formulation (capsules) in the prevention of asymptomatic bacteruria in pregnant population and discourage using it in the treatment whether alone or in combination with antibiotics.
Radiology
Mohammad Babaei; Peiman Haddad; Behnood Farazmand; Mehdi Aghili; Ramin Jaberi; Farnaz Amoozgar Hashemi; Bita Kalaghchi; Hassan Ali Nedayi; Morteza Tabatabaeifar; Seyed Rabi Mahdavi; Reza Khodabakhshi; Alireza Naseri; Fatemeh Homayi; Mojtaba Vand Rajabpour
Articles in Press, Accepted Manuscript, Available Online from 11 January 2024
Abstract
Background & Objective: Considering the heterogeneity in the brachytherapy treatment process for cervical cancer in Iran, the Radiation Oncology Research Center of Tehran University of Medical Sciences) developed a guideline on brachytherapy for the treatment of patients with cervical cancer in cooperation ...
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Background & Objective: Considering the heterogeneity in the brachytherapy treatment process for cervical cancer in Iran, the Radiation Oncology Research Center of Tehran University of Medical Sciences) developed a guideline on brachytherapy for the treatment of patients with cervical cancer in cooperation with the Atomic Energy Organization of Iran, Cancer Research Institute, Iranian Society of Radiation Oncology, Iranian Association of Medical Physics, and Cancer Administration of the Ministry of Health and Medical Education.
Methods and Materials: This study was designed with the aim to provide a standard protocol of brachytherapy for the treatment of cervical cancer by the Iranian Brachytherapy Society at Radiation Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran in 2020.
Results: These guidelines, which address the principles and details of brachytherapy for cervical cancer, were localized and developed based on the references listed in the supporting document. This document was mainly developed based on a localized version of the American Brachytherapy Society (ABS) guidelines.
Conclusion: Brachytherapy should be introduced as a necessary part of the treatment plan in patients with cervical cancers. Here, we provided a comprehensive guideline for the treatment of cervical cancer radiotherapy using high-dose-rate brachytherapy which can help medical service providers involved in the treatment of cervical cancer to provide better services to cervical cancer patients and decrease the existing heterogeneity in radiotherapy approaches in Iran.
Obstetrics and Gynecology
Dina Hyari; Duha Arabiat; Ayman A. Qatawneh; Murad Rabadi; Katea Albawalsah; Rula Barham; Layan Budair; Omar Ahmed Abdelwahab
Articles in Press, Accepted Manuscript, Available Online from 17 January 2024
Abstract
Background: Menstrual irregularities after COVID-19 vaccines have been widely reported. This study aims to evaluate Jordanian women's menstrual changes after receiving the COVID-19 vaccine.
Methods: This study is an analytical cross-sectional study conducted through an online self-administered questionnaire ...
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Background: Menstrual irregularities after COVID-19 vaccines have been widely reported. This study aims to evaluate Jordanian women's menstrual changes after receiving the COVID-19 vaccine.
Methods: This study is an analytical cross-sectional study conducted through an online self-administered questionnaire distributed through social media during June and July 2022. It involved 384 women between the ages of 20 and 35 who took the vaccine and did not suffer from gynaecological or medical conditions that affect menstruation, were not pregnant or lactating, were not utilising hormonal or intrauterine contraceptives, and had normal menstrual cycle length and regularity prior to vaccination.
Results: The results of this study showed a statistically significant increase in menstrual cycle length with a mean difference of 2 days (p=<0.001), but not in menstrual duration (p=0.824). 55.4% had their first period after vaccination on time. Eight participants reported new-onset intermenstrual bleeding. Additionally, 41.3% experienced changes in menstrual volume, and their first period came on time. Around one-third of women reported increased or new-onset dysmenorrhea. As for premenstrual symptoms, 30% reported increased or new-onset mood disturbances, 20.6% had changes in their sleeping patterns, 17% had increased headaches.
Conclusion: The study revealed that COVID-19 vaccination might cause changes in menstrual cycle length and new or increased menstruation problems in some women, including dysmenorrhea, premenstrual symptoms, and intermenstrual bleeding. These results emphasize the need for additional longitudinal research to understand the effect of COVID-19 vaccination on menstrual health and to provide support and education to women who experience menstrual abnormalities after vaccination.
General Gynecology and Pelvic Floor
Hadeer Mahmoud Hazem; Baydaa Hussein abed awn
Articles in Press, Accepted Manuscript, Available Online from 22 January 2024
Abstract
Background & Objective: This study's main objective was to establish physical characteristics (pH and flow rate) and dental caries experience among women with PCOS and to perform an assessment of dental caries relationship to salivary antioxidant biomarker (total antioxidant capacity and uric acid).Materials ...
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Background & Objective: This study's main objective was to establish physical characteristics (pH and flow rate) and dental caries experience among women with PCOS and to perform an assessment of dental caries relationship to salivary antioxidant biomarker (total antioxidant capacity and uric acid).Materials and Methods: There was 80 women in the study (40 female with PCOS and 40 healthy female served as controls) with ages ranging from 25 to 30 years and with a range of body mass indices 18.5-24.9 (normal weight). Unstimulated saliva was obtained. Both salivary pH and flow rate were discovered immediately. After that, saliva was subjected to biochemical analysis to determine salivary TAC and UA levels using ELISA method. Dental caries diagnosis and registration were assessed using WHO in 2013.Results: In the PCOS group, the mean salivary flow rate and pH were lower than in the control group, with a statistically significant difference (P<0.05). The salivary (TAC) and (UA) mean values were higher in the PCOS group than in the healthy females, with a statistically significant difference (P<0.05). while dental caries fractions was positively not significant correlated with total antioxidant capacity and uric acid in the study group except (DMFT) was positively significant correlated with antioxidant Parameter (TAC) (P< 0.05 ) and (DS and DMFT) were positively significant with uric acid among women with PCOS (P< 0.05).Conclusions: Furthermore, Salivary TAC and UA were elevated in PCOS which can be used in the future as indicators for the PCOS diagnosis.
Obstetrics and Gynecology
KAVITHA NAGANDLA; Keeran Rajandram; Khaisro Ali Shah; Kathy Anne Rani A/P Arulraj; Lee Huang Ming; Joanne Wong Mei Jye
Articles in Press, Accepted Manuscript, Available Online from 23 January 2024
Abstract
Background & Objective: The COVID-19 pandemic has caused significant disruptions to healthcare systems worldwide, leading to changes in healthcare practices, including perinatal care delivery. As pregnant women are considered a vulnerable population, perinatal mental health has become a significant ...
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Background & Objective: The COVID-19 pandemic has caused significant disruptions to healthcare systems worldwide, leading to changes in healthcare practices, including perinatal care delivery. As pregnant women are considered a vulnerable population, perinatal mental health has become a significant concern during the pandemic. This systematic review aims to synthesise the current scientific evidence on the impact of the COVID-19 pandemic on perinatal mental health and its associated risk factors.
Materials & Methods: The review used a structured process based on JBI and PICOS strategy and searched three databases for studies published between July 2020 to December 2022 that measured specific mental health outcomes using validated measures. The PRISMA guideline was followed for the study selection process.
Results: Among the total 45 articles that have been included, the prevalence of depression and anxiety was found to be moderate to severe in pregnant and/or postpartum women during the pandemic, with a significantly higher level compared to prior to the pandemic. Additionally, pregnant and/or postpartum who tested positive for COVID-19 were more vulnerable to anxiety and depression. Furthermore, perinatal women with pre-existing mental illness showed further deterioration during the pandemic, and lastly, pregnant and/or postpartum women had higher levels of anxiety and depression compared to non-pregnant women.
Conclusions: This systematic review finds a significant increase in depression and anxiety among pregnant women during the COVID-19 pandemic, with risk factors such as unemployment and poor social support. Healthcare professionals should establish treatment plans to prevent adverse mental outcomes for this vulnerable population.
General Gynecology and Pelvic Floor
Zainab Abdulrazzaq Hameed; Abdul Karim salem Mahood; Zainab Abbas Hassooni
Articles in Press, Accepted Manuscript, Available Online from 30 January 2024
Abstract
Endometrial carcinoma (EC) is one of commonest ten cancers, and represents fourth most widespread malignancy in females, it mainly happen in postmenopausal women. Endometrial cancer creates from the endometrium and is classified, depend on the development mechanism, into kinds 1 and 2, which are responsive ...
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Endometrial carcinoma (EC) is one of commonest ten cancers, and represents fourth most widespread malignancy in females, it mainly happen in postmenopausal women. Endometrial cancer creates from the endometrium and is classified, depend on the development mechanism, into kinds 1 and 2, which are responsive and non-responsive to estrogen, respectively and have significantly diverse gene expression profiles. This study was carried out in Laboratories of the College of Science/ Department of Biology and in a local lab during the period between December 2021 to August 2022. The study of PCR was used to detection HOXA11 expression .We aimed to describe the histological changes of tumors malignant and benign and normal tissues of the endometrial and determine the relationships between HOXA11 expression with the histopathological variables involving, stage, grade, muscle and lymph nodes invasiveness and histological types. results shows the values of HOXA11 expression and a significant difference (P-value>0.001) between patients with endometrial cancer and control group, these results regarding the values means of HOXA11 expression a significant difference (P-value=0.021) between patients with benign tumor and the control and the values means of HOXA11 expression a significantly difference (P-value >0.001) between patients with endometrial cancer and benign tumor.
Obstetrics and Gynecology
Arti Sharma; Yashika Pehal; Namrata Saxena; Swati Agrawal
Articles in Press, Accepted Manuscript, Available Online from 31 January 2024
Abstract
Background and Objective: Iron deficiency anemia is a major public health problem worldwide. Oral iron intake is preferred, but parenteral administration of iron is necessary under certain circumstances. The objective of the present study is to compare the efficacy and safety of parenteral Iron Sucrose ...
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Background and Objective: Iron deficiency anemia is a major public health problem worldwide. Oral iron intake is preferred, but parenteral administration of iron is necessary under certain circumstances. The objective of the present study is to compare the efficacy and safety of parenteral Iron Sucrose to Ferric Carboxymaltose (FCM) in improving the hematological indices in anemic pregnant women.
Methods: The study was a comparative, observational study conducted at the Department of Obstetrics and Gynecology, SGRR Institute of Health and Medical Sciences, Dehradun from September 2018 to May 2020. The sample size was 120 pregnant women with iron deficiency anemia in each group. One group was treated with intravenous Iron Sucrose and the other group was treated with intravenous FCM. The outcome measures were improvement in hematological parameters and experienced side effects. Data was analyzed by using appropriate statistical tests.
Results: Both groups were comparable in terms of baseline parameters. Hemoglobin rise was rapid in the group treated with FCM (8.7 ± 0.47 g/dl to 11.6 ± 0.77 g/dl) than the iron sucrose (8.24 ± 0.57 g/dl to 10.60 ± 0.87g/dl) group. Rise in serum ferritin and MCV of RBC were also higher in FCM group than the iron sucrose group. Both groups have only mild side effects.
Conclusion: Hence we can conclude from our study that parenteral therapy with iron sucrose and FCM, both can successfully treat iron deficiency anemia in pregnancy but the improvement is faster, safer, and more convenient with the use of FCM than iron sucrose.
Obstetrics and Gynecology
Malihe Afiat; Nayere Khadem; Behnaz Ansari; Fedyeh Haghollahi; Mohadese Dashtkoohi; Mohammad Sadeq Najafi; Mohammad Dashtkoohi; MirFarbod Hojati Bagheri; Seyede Houra Mousavi Vahed
Articles in Press, Accepted Manuscript, Available Online from 05 February 2024
Abstract
Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact ...
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Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact of enoxaparin, an LMWH, and its outcomes in women with URPL.
Methods: This study presents a single-blinded randomized clinical trial involving 80 women with URPL and no history of thrombophilia. The participants were referred to the Infertility Clinic at Imam Reza Hospital (Milad Center) between March 2018 and February 2019. During the sixth week of gestation, the participants were assigned randomly to two groups. The treatment group (n = 40) received a daily subcutaneous injection of 40 mg of enoxaparin, while the control group (n = 40) received routine pregnancy care. Maternal and neonatal demographic data, pregnancy outcomes, complications, and live birth rates were recorded and subsequently compared between the two groups.
Results: A total of 80 eligible women were enrolled in the study, with equal distribution between the treatment and control groups. There were no significant differences in previous pregnancies or miscarriages between the groups, and the live birth rate was about 85% in both groups. The occurrence of pregnancy complications was significantly higher in the treatment group compared to the control group (38.2% VS. 5.7%; p = 0.021).
Conclusion: Treatment with enoxaparin in women with unexplained recurrent pregnancy loss and no history of thrombophilia did not improve the pregnancy outcome nor decrease pregnancy complications.
General surgery
Maryam Yousefi; Fariba Yarandi; Elham Shirali; Shahab Rajabzadeh; Pershang Nazemi
Articles in Press, Accepted Manuscript, Available Online from 07 February 2024
Abstract
We reported a 55-year-old woman with a history of recent surgery presented to the emergency room with complaints of erythema and foul-smelling discharge from her surgical incision site. Upon examination in the emergency room, the surgical incision site was promptly opened, thoroughly cleaned with a sizable ...
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We reported a 55-year-old woman with a history of recent surgery presented to the emergency room with complaints of erythema and foul-smelling discharge from her surgical incision site. Upon examination in the emergency room, the surgical incision site was promptly opened, thoroughly cleaned with a sizable amount of sterile normal saline, and evaluated and cultures were sent for microbiological and histological evaluation. The patient was promptly initiated on a combination antibiotic regimen, including ceftazidime, levofloxacin, metronidazole, and vancomycin, under the guidance of the infectious disease team. Fungal mycelium was found in the smear of wound discharge in recent microbiological exam. In response to the suspected fungal infection, fluconasol was promptly added to the treatment regimen to combat the fungal pathogen. According to result of microbiological cultures, non-albicans candida and its resistance to fluconasol, caspofungin was substituted. Patient's condition dramatically improved with the combined treatment of meropenem and caspofungin. The development of necrotizing fasciitis in this patient's case added a critical layer of complexity to an already challenging clinical scenario. The rapid recognition, aggressive surgical intervention, and targeted antimicrobial therapy collectively played a pivotal role in her successful recovery. This case underscores the importance of vigilance in monitoring postoperative patients, particularly those with risk factors, and highlights the need for a multidisciplinary approach in managing this severe soft tissue infection.
Gynecology Oncology
Aida Uzaya; Syahrul Rauf; Trika Irianta; Firdaus Hamid; John Rambulangi; Abdul Rahman
Articles in Press, Accepted Manuscript, Available Online from 12 February 2024
Abstract
Background and Aim: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.
Methods: ...
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Background and Aim: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.
Methods: This study used a cross-sectional design on 81 eligible patients with ovarian neoplasms who were undergoing surgery at the Dr. Wahidin Sudirohusodo Hospital and its networking hospital from October 2021 to June 2022. The ELISA technique was used to measure serum IL-6 from the peripheral vein. In addition, the CA-125 levels, risk of malignancy (RMI) index, and proportion of blood cells were analyzed. Chi-square analysis of the data had been used.
Results: Most of the subjects were presented as malignant ovarian neoplasms (66.7%), followed by benign ovarian neoplasms (33.3%). IL-6 level ≥ 3.75 pg/mL was found in 72.8% of patients. In individuals with epithelial ovarian neoplasms, IL-6 levels did not significantly differ between malignant and benign types (p > 0.05). CA-125 levels, RMI, ascites, and tumor size differed significantly in patients with ovarian epithelial neoplasms between malignant and benign types (p <0.05). Leukocyte levels, hemoglobin levels, platelet levels, age, parity, and age of menarche were not significantly different in epithelial ovarian neoplasm patients between malignant and benign types (p > 0.05).
Conclusion: The preoperative serum IL-6 level cannot be used as a marker of ovarian malignancy. However, this study confirms the relationship between the CA-125 level, RMI, ascites, and tumor size with the malignancy of ovarian tumors.
Obstetrics and Gynecology
Salma Samy Abdellateef; Safaa Kamal Marei; Nagwa Mahmoud Elghorab; Hesham Gaber Al-Anany
Articles in Press, Accepted Manuscript, Available Online from 21 February 2024
Abstract
Background and Objective: Intrauterine infusion of autologous platelet-rich plasma (PRP) is a novel modality that has a role in the treatment of thin endometrial layer. This study aimed to assess the efficacy of intrauterine infusion of autologous PRP on success rate of intracytoplasmic sperm injection ...
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Background and Objective: Intrauterine infusion of autologous platelet-rich plasma (PRP) is a novel modality that has a role in the treatment of thin endometrial layer. This study aimed to assess the efficacy of intrauterine infusion of autologous PRP on success rate of intracytoplasmic sperm injection (ICSI) and clinical pregnancy rates in females with history of implantation failure.
Methods: This prospective study was carried out on 109 females aged ˂ 40 y, with FSH level < 10mIU /ML, AMH > 1ng/mL, presented with either primary or secondary infertility and advised for IVF or ICSI after IVF/ICSI failure. Cases was divided in to two groups with history of implantation or previously unsuccessful IVF cycles: 1st group (n=50) did ICSI without PRP injection and 2nd group (n=50) did ICSI with PRP injection.
Results: Endometrial thickness at OR day was insignificantly different between both groups, but at ET day it was significantly elevated in PRP group in comparison with non-PRP group (P<0.001). The two groups were comparable regarding numbers of retrieved oocytes, mature oocytes, and numbers of fertilized ova but without significant differences. The numbers of good quality embryos showed no significant differences in PRP group in comparison with non-PRP group. There was no significant difference regarding numbers of embryos transferred at day of ET in both groups.
Conclusions: PRP is a new procedure of treatment in the field of reproductive medicine with high safety. Although it significantly increased endometrial thickness at day of ET day and consequently it increased the chemical pregnancy rate
Pathology
maryam deldar; Robab Anbiaee; Masoumeh Keshvari
Articles in Press, Accepted Manuscript, Available Online from 28 February 2024
Abstract
Background: Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival.
Objectives: ...
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Background: Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival.
Objectives: This study aimed to investigate the factors affecting the pathological complete response in breast cancer patients treated with NACT.
Methods: We identified non-metastatic breast cancer patients receiving NACT during 2010–2020. Patients’ and disease characteristics, rates of pCR based on these characteristics were recorded in different subgroups. Analyzes were performed by descriptive and analytical statistics using SPSS.ver26.
Results: 204 patients had mean age of 45.3 years, 32.4% had grade 3, and 89.7% had ductal histology. Overall pCR rate was 33.3% and differed according to disease subtype (p<0.001), receptor status (p<0.001), grade (p=0.015), ki-67 (p=0.004), but not according to age, BMI, menopausal status, tumor size, surgery type after NACT.
Conclusion: In our study, pCR rates are conformed with other studies. Many patients have residual disease following NACT that suggests lower survival or higher risk of recurrence, therefore determining the factors affecting the pathological complete response can help physicians in treatment decisions.
Gynecology Oncology
Fatemeh Sedaghat; zahra Shiravani; Ali Mohammad Karimi; Mohammad Reza Haghshenas; Abbas Ghaderi; Mohammad Javad Fattahi
Articles in Press, Accepted Manuscript, Available Online from 02 March 2024
Abstract
Objective: Endometrial cancer (EC) is the most prevalent gynecological malignancy in more developed countries. Multiple researches have been done about the role of IL-27 in different cancers that suggest a dual role for this cytokine. In the present study, we evaluated the serum level of IL-27 in endometrial ...
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Objective: Endometrial cancer (EC) is the most prevalent gynecological malignancy in more developed countries. Multiple researches have been done about the role of IL-27 in different cancers that suggest a dual role for this cytokine. In the present study, we evaluated the serum level of IL-27 in endometrial cancer patients. We also investigated the correlations between serum levels of IL-27 and the demographic and clinicopathologic features of the patients.
Material and Method: In this case-control study 65 endometrial cancer patients and 58 sex-age-match healthy controls were investigated. Serum levels of IL-27 in both cases and the control group were assessed by a reliable and specific sandwich enzyme-linked immunosorbent assay (ELISA) kit and results were analyzed with SPSS.
Results: We observed that the serum level of IL-27 in EC patients was dramatically higher than in the control group (P=0.003). Additionally, Higher grades of EC (grade II and III) showed higher IL-27 serum levels compared to the control (P=0.006 and P=0.01 respectively). No significant correlations between serum levels of IL-27 and lymph node involvement, tumor stage, tumor size, and demographic features of the patients were detected.
Conclusion: Our results showed that there is a statistically significant difference between serum levels of IL-27 in EC patients and controls. Therefore, the serum level of IL-27 may exert a role in the pathogenesis of endometrial carcinoma although further studies are needed.
Gynecology Oncology
Maha Saad Maki; Mohammed S. Ali; Hala Rawi
Articles in Press, Accepted Manuscript, Available Online from 03 March 2024
Abstract
Background: assess the level of serum Macrophage inhibitory cytokine-1 and high sensitive C - reactive protein level in the first trimester threatened miscarriage.Method: We conducted a case-control study on 91 pregnant women who were in their first trimester and had a positive fetal heart confirmed ...
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Background: assess the level of serum Macrophage inhibitory cytokine-1 and high sensitive C - reactive protein level in the first trimester threatened miscarriage.Method: We conducted a case-control study on 91 pregnant women who were in their first trimester and had a positive fetal heart confirmed by ultrasound. On the same day, a serum sample was taken to measure the levels of macrophage inhibitory cytokine-1 and high-sensitivity C-reactive protein using an enzyme-linked immunosorbent assay and particle-enhanced immunoturbidimetric assay, respectively. The study grouped the participants into two categories: control and patient.Result: We conducted a study with 91 pregnant women, out of which 30 had symptoms of threatened miscarriage such as vaginal spotting or bleeding, while the remaining 61 were healthy. In our study, we found that the concentration levels of serum Macrophage inhibitory cytokine-1 varied significantly between the two groups (control and patient groups) with a P-value of 0.005. The mean concentration for the control group was 622.77 ± 15.10, while for the patient group, it was 1860.13 ± 33.60. Additionally, we observed that high-sensitivity c-reactive protein (HS CRP) had a significant correlation with threatened miscarriage, with a P-value of 0.001. The mean concentration for the control group was 7.49 ± 0.89, while for the patient group, it was 16.02 ± 2.11.Conclusion: The results of this study provide valuable insights into the pathophysiology of miscarriage and may pave the way for the development of novel therapeutic interventions to prevent this adverse pregnancy outcome.
Obstetrics and Gynecology
Yuni Nurwati; Hardinsyah Hardinsyah; Sri Anna Marliyati; Budi Iman Santoso; Dewi Anggraini
Articles in Press, Accepted Manuscript, Available Online from 04 March 2024
Abstract
Abstract Background and Objective: Nowadays, a simple and reliable screening tool to identify the risk of low birth weight (LBW) infant remains limited, particularly in rural areas where advanced technology is not available. Hence, this study has developed a reliable tool to be simply used by midwives ...
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Abstract Background and Objective: Nowadays, a simple and reliable screening tool to identify the risk of low birth weight (LBW) infant remains limited, particularly in rural areas where advanced technology is not available. Hence, this study has developed a reliable tool to be simply used by midwives and cadres in detecting risk of LBW. Methods: This study used an analytic quantitative study based on retrospective data of 165 eligible pregnant women collected from a public hospital in Ternate City (2018-2023). Body height, body weight, body mass index (BMI), mid-upper arm circumference (MUAC), nausea and vomiting, gestational age of ANC visit (AV) of the first trimester of pregnancy, as well as marital age, age, occupation, education, parity, and abortion history of pregnant women were used as research variables. Binary logistic regression was applied to develop the model. Results: Body weight, marital age, education, and AV are statistically significant as screening indicators for detecting the risk of LBW infant with Area Under Curve (AUC) is 79.6%.Conclusion: Therefore, the model can be developed as a basis for developing a simple and reliable screening tool in the first trimester to detect the risk of LBW infant that can be implemented by midwives and cadres in rural area
Gynecology Oncology
elham sharafkhani
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Ovarian Low-grade serous carcinoma (LGSC), a type of epithelial ovarian tumor, is often diagnosed in the advanced stage, arising from fallopian tube cells or borderline tumors that cause symptoms like abdominal or pelvic pain, bloating, and unexplained weight loss. Treatment involves surgery and chemotherapy. ...
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Ovarian Low-grade serous carcinoma (LGSC), a type of epithelial ovarian tumor, is often diagnosed in the advanced stage, arising from fallopian tube cells or borderline tumors that cause symptoms like abdominal or pelvic pain, bloating, and unexplained weight loss. Treatment involves surgery and chemotherapy. Fertility may be affected depending on the cancer stage. In advanced stages (3 and 4), removing all tumoral implants with both the uterus and ovaries (debulking surgery) may be the first surgical goal, and it can be anticipated that the possibility of pregnancy will be diminished. We presented a case of a 38-year-old woman who became pregnant three years after being diagnosed with LGSOC at stage 3c. Although the standard surgery at a higher stage is debulking surgery and we resected all tumoral implants, the decision was made to preserve the uterus for her since there were no signs of tumor metastasis to the uterus, and the patient wanted to be pregnant. The patient underwent surgery then followed by a standard chemotherapy regimen with carboplatin (AUC 6) and paclitaxel (175 mg/m2) every three weeks for four cycles. During the three years of follow-up, there were no signs of tumor return; she decided to get pregnant by egg donation through an in vitro fertilization (IVF) procedure. She received routine supplements during her pregnancy with the incidence of gestational diabetes and HTN. A cesarean section was done in the week 35th, and the twin infants were born in good condition and with good APGAR scores.
Gynecology Oncology
Kavitha Nagandla; Khine Khine Lwin; Phyu Synn Oo; Thin Thin Win; Afshan Sumera
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched ...
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Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched the literature and extracted data from all studies that examined the efficacy and safety of platinum and taxanes in managing cervical cancer during pregnancy. A quantitative synthesis of the published articles was performed and Kaplan–Meier survival curves were estimated to determine the overall and progression-free survival.
Results: Overall, 43 studies with 114 patients were included in this systematic review. All patients received neoadjuvant chemotherapy during pregnancy; the majority received platinum-based chemotherapy. Cisplatin was the main platinum-based chemotherapy agent in 49% (n = 56) of patients, followed by combined platinum and paclitaxel therapy in 36% (n = 41) of patients. A few and two patients were treated with single-agent vincristine and platinum with external beam radiation therapy, respectively. Bleomycin and 5-fluorouracil were administered to two patients. The most frequent complications were grade 2 thrombocytopenia and grade 3 hepatotoxicity in 32 (28%) and 18(20.5%) cases, respectively. The common fetal complications were low birth weight and growth restriction. Chemotherapy was well tolerated by most women in the case group. The progression-free survival was 35% (n = 22).
Conclusion: Platinum and taxane neoadjuvant chemotherapy has proven to be safe and effective in preventing cervical cancer disease progression until definitive surgical treatment.
Obstetrics and Gynecology
Francesco Fedele; Giovanna Esposito; Fabio Parazzini
Articles in Press, Accepted Manuscript, Available Online from 24 March 2024
Abstract
We report the association between situs viscerum inversus and complete cervicovaginal agenesis. Situs viscerum inversus, a rare anomaly, is characterized by a mirror-image of the visceral organs. Cervicovaginal atresia is a rare variety of Müllerian duct aplasia, characterized by a functioning uterine ...
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We report the association between situs viscerum inversus and complete cervicovaginal agenesis. Situs viscerum inversus, a rare anomaly, is characterized by a mirror-image of the visceral organs. Cervicovaginal atresia is a rare variety of Müllerian duct aplasia, characterized by a functioning uterine body (normal or malformed) with the constant absence of the cervix and the total or partial absence of the vagina.
We describe a case of a 17-year-old female patient. During hospitalization at out gynecologycal department, a complete digestive tract x-ray resulted in a depiction of severe congenital intestinal malrotation. An initial gynecological misdiagnosis led to two an inadequate and unsuccessful attempts of conservative surgery before reaching our academic center. Despite a finally complete diagnosis and adequate conservative surgery, the results of previous surgeries have resulted in a failure of conservative therapy and the need for demolitive surgery. Knowledge of this malformative association is crucial for planning interventional procedures.
Obstetrics and Gynecology
Anak Agung Ngurah Jaya Kusuma; Endang Sri Widiyanti; I Gede Mega Putra; Kadek Ary Widayana; William Alexander Setiawan
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia. This study aimed to investigate the characteristics ...
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Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia. This study aimed to investigate the characteristics of patients with pre-eclampsia and eclampsia and serum magnesium levels during MgSO4 therapy.
Methods: A cross-sectional study design used secondary data from the Emergency Maternity Room of Prof. Dr. I.G.N.G. Ngoerah Hospital. The samples were all superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia cases in 2019. We collected and analyzed characteristic and laboratory data, including the MgSO4 serum levels of the patients. Participants' baseline characteristics (CBC, blood chemistry, and MgSO4) and their diagnosis were compared using the chi-square test for categorical data and the independent t-test for numerical data.
Results: The patients with severe pre-eclampsia were 183 patients, superimposed pre-eclampsia were 41 patients, and eclampsia 15 patients. Age <35 years old was the most influential characteristic variable in superimposed pre-eclampsia (adjusted odds ratio (aOR)=0.166, p<0,001, 95%CI=0.082-0.336) and severe pre-eclampsia (aOR=3.011, p<0,001, 95%CI=1.662-5.455). Hospital referrals were the most influential characteristic variable in eclampsia (aOR=3.653, p=0.016, 95%CI=1.273-10.486). The administration of MgSO4 was significant with severe pre-eclampsia (p<0.001). The highest serum magnesium occurred 6 hours before MgSO4 administration (3.97 ± 1.28 mg/dL).
Conclusion: Patients with superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia conditions have various characteristics associated with each state. During the use of MgSO4, there was a significant association between serum magnesium levels and the therapeutic target levels.
Gynecology Oncology
Ganesalingam Murali; CheeMeng Yong; Nagandla Kavitha; Chew Hua Yeoh
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological ...
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Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological cancers over 8 years from January 2011 to 31 December 2019 that were identified through hospital databases. Patient demographic characteristics, indications, surgical characteristics and outcomes were retrospectively assessed. Overall survival (OS) was analysed with Kaplan-Meier method and log rank test. Cox proportional hazards regression was used to model survival outcomes. Twenty- one patients were identified with recurrent cervical, endometrial, ovarian and, or vaginal cancer underwent PE. Local disease recurrence was the most common indication in 80.9%. The primary tumor origin was the cervix in 80.9%, followed by endometrial origin 9.5%. PE was performed as curative intent in 62% and in 38% as palliative intent. The most common early complication was wound infections and late complications included deep vein thrombosis, lymphocyst and recurrent urinary tract infections. The median survival at 6 months is 85.7% and 12 months is 57.1 %. Our five-year OS was 54.3 % (95% CI 34.2, 74.6). Our case series illustrates pelvic exenteration provides about 54.3% of 5-year survival chance in a selected group of patients. The early-and late complications rate are similar to those described historically. Pelvic exenteration results in sustained survival in selected patients and continued efforts must focus on identifying those patients who could potentially benefit most from PE.
Reproductive Medicine
Achmad Kemal Harzif; Mila Maidarti; Costan Tryono Parulian Rumapea; Sarah Miriam Ratna Pratamasari; Heidi Dewi Mutia; Nafi’atul Ummah; Aisyah Retno Puspawardani; Putri Nurbaeti; Budi Wiweko
Articles in Press, Accepted Manuscript, Available Online from 06 April 2024
Abstract
Abstract:
Background and Objective: Endometriosis is one of the primary etiology of subfertility in women; in severe cases, endometriosis surgery could result in infertility due to oophorectomy. Ovarian tissue cryopreservation is a method by which the ovarian cortex is frozen and retransplanted in patients. ...
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Abstract:
Background and Objective: Endometriosis is one of the primary etiology of subfertility in women; in severe cases, endometriosis surgery could result in infertility due to oophorectomy. Ovarian tissue cryopreservation is a method by which the ovarian cortex is frozen and retransplanted in patients. This method is unaffected by the menstrual cycle, can restore ovarian hormonal function, and does not require sperm donor or ovulation induction. This systematic review aims to review the utility of ovarian tissue cryopreservation in endometriosis patients.
Methods: We searched the literature using keywords such as “fertility preservation,” “cryopreservation,” “endometriosis,” and “ovarian tissue cryopreservation” for relevant articles in Pubmed and Embase. We included all relevant articles, including case reports, cohort studies, and clinical trials.
Results: A total of 6 articles were included in this systematic review, including three retrospective studies and three case reports. In screening for candidates of ovarian tissue cryopreservation, serum antimullerian hormone (AMH) is a good marker for primordial follicle count. Patients undergoing ovarian tissue implantation after cryopreservation demonstrated an excellent pregnancy rate (41.2%) in one study. Follicle viability and hormonal function were preserved post-transplantation.
Conclusion: The current evidence shows that endocrine function and fertility in patients grafted with cryopreserved ovarian tissue are good. However, the evidence on the long-term outcome of ovarian tissue cryopreservation in endometriosis patients is lacking.
General surgery
Ruqayah Ali Salman; Aiyat Alshugary
Articles in Press, Accepted Manuscript, Available Online from 12 April 2024
Abstract
Background & Objective: In 2020, breast cancer claimed the lives of approximately 684,996 women worldwide. The use of cancer biomarkers has greatly improved the effectiveness of treatment and early detection. The objective of this study was to identify testin as a potential biomarker.Materials & ...
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Background & Objective: In 2020, breast cancer claimed the lives of approximately 684,996 women worldwide. The use of cancer biomarkers has greatly improved the effectiveness of treatment and early detection. The objective of this study was to identify testin as a potential biomarker.Materials & Methods: Sixteen women participated by providing serum samples for measuring testin concentrations in Iraqi breast cancer patients. Additionally, a control group of 20 healthy individuals was selected. The testin protein concentration was detected using the serum ELISA method.Results: A significant difference was observed between the age groups of patients and healthy women. The majority of women with breast cancer were recorded to be in their thirties to sixties, with 16 (26.7%), 21 (35%), and 19 (31.7%) cases respectively. On the other hand, there were fewer breast cancer cases recorded in the twenties, with only 1 (1.7%) case out of the total study population of 60 (100%). This difference was found to be statistically significant, with a P-value of 0.01.Conclusion: The present study discovered that breast cancer patients have higher levels of testin compared to healthy women. There is a growing body of evidence suggesting that testin contributes to the development of breast cancer, making it an appealing protein to focus on for cancer treatment.
Gynecology Oncology
Mervet B. Jasim; Asmaa B. Al-Obaidi; Enas Adnan Abdulrasul
Articles in Press, Accepted Manuscript, Available Online from 12 April 2024
Abstract
Background: The infection can present in newborns in different ways, ranging from no noticeable symptoms to more serious conditions like meningoencephalitis, myocarditis, and disseminated sepsis.Methods: A cross-sectional study was conducted from November 2022 to June 2023. The study included 100 pregnant ...
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Background: The infection can present in newborns in different ways, ranging from no noticeable symptoms to more serious conditions like meningoencephalitis, myocarditis, and disseminated sepsis.Methods: A cross-sectional study was conducted from November 2022 to June 2023. The study included 100 pregnant women with gestational ages ranging from 0 to 16 weeks, aged between 15 and 40 years. Each participant completed a standardized questionnaire. Afterward, placental tissue samples were collected from women who underwent elective termination of pregnancy. These samples were then analyzed for the presence of Coxsackievirus B (CVB) genome using a molecular biology approach. The detection process involved RNA extraction, cDNA, and qRT-PCR.Results: A total of 100 women who had abortions were included in this study. Out of these, 88 had missed abortions, 10 had incomplete abortions, and 2 had spontaneous abortions. The mean ages of the women were as follows: 28±2.8 years for missed abortions, 29±1.5 years for incomplete abortions, and 32±0.5 years for spontaneous abortions. The mean gestational ages were 10±1.1 weeks for missed abortions, 10±1.5 weeks for incomplete abortions, and 14 weeks for spontaneous abortions. Our investigation found no presence of Coxsackie B virus nucleic acid in the placental tissues obtained from the women who had abortions. The internal control (quality control) and positive control both yielded positive results.Conclusion: Despite the assay's high sensitivity for accurate detection, the study produced only null findings. These negative results are likely to be true negatives, indicating the absence of the target analyte.
Gynecology Oncology
Ali D. Marhash; Mohammed S. Abdul-Razaq; Milal Muhammad AL-Jeborry; Wisam Jasim; Safa Khaleel khalaf
Articles in Press, Accepted Manuscript, Available Online from 13 April 2024
Abstract
Background and objective: Worldwide, cervical cancer stands as the leading cause of cancer-related fatalities. Cervical cancer is unequivocally attributed to the human papillomavirus (HPV) infection, which is both essential and adequate for its development. The particular prevalence of HPV in the population ...
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Background and objective: Worldwide, cervical cancer stands as the leading cause of cancer-related fatalities. Cervical cancer is unequivocally attributed to the human papillomavirus (HPV) infection, which is both essential and adequate for its development. The particular prevalence of HPV in the population of Iraq is currently unclear. The objective of this study is to determine the frequency of HPV and identify the most common genotypes present in a sample of the Iraqi population. Materials and Methods: From November 2022 to December 2023, a total of 300 women with cervical anomalies, who were referred to the Gynecological Oncology Departments in multiple hospitals in Babylon and Baghdad, had cervical swabs collected. Real-time polymerase chain reaction was utilized to conduct HPV DNA testing on all specimens.Result: A total of 300 women between the ages of 20 and 60 were screened during the collecting period. The average age was 30 years. The prevalence of High-risk HPV was 16.7% overall. The age group of women between 30 and 40 years exhibited the highest overall prevalence of HPV. Our population survey indicates a higher prevalence of genotyping for HPV 16, 18, and 31.Conclusion: In this work, we used multiplex real-time pcr. This approach has numerous advantages, including HPV detection and genotyping to known prevalent genotypes as well as cost effective and no time consuming.
Maternal Fetal Medicine
Nematullah Shomoossi; Mostafa Rad
Volume 8, Issue 3 , May and June 2023, , Pages 306-307
Abstract
This letter comes to you in the hope of stressing the need to understand age differences and relevant requirements in delivering bad news to end-stage children. Among variables affecting the way healthcare providers communicate bad news, the age of the recipient is a critical factor requiring caregivers’ ...
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This letter comes to you in the hope of stressing the need to understand age differences and relevant requirements in delivering bad news to end-stage children. Among variables affecting the way healthcare providers communicate bad news, the age of the recipient is a critical factor requiring caregivers’ meticulous tactfulness. For practical purposes, various strategies are already suggested in communicating unexpectedly bad news to patients abruptly taken to face their end of life (1). However, patients of different ages may require different strategies. For some healthcare providers and physicians, breaking bad news to an elderly end-stage client may be taken for granted because public mindset is wired to assent to end-of-life deaths. While this tendency appears controversial by itself, communicating bad news to younger patients with life-threatening irremediable diseases appears more perplexing which should be given due attention in practice and special priority in training.Young frivolous patients hope for life rather than death because children conceive of disease as a temporary stage of abnormal functioning of body systems; never do they expect dying if they become ill. The concept gradually transforms; for instance, school-age children may tend to blame themselves by attributing illness to their own actions but as they grow up, illness becomes increasingly attributed to external causes. Therefore, such conceptualizations should guide healthcare providers’ behavior toward their patients.
