Anesthesia
Shahram Sayadi; Shideh Ariana; Maral Hosseinzadeh; Arezou Ashari; Tannaz Yeganegi; Elham Memari; Ebtehaj Heshmatkhah; Dariush Abtahi
Volume 8, Issue 3 , May and June 2023, , Pages 194-203
Abstract
Background & Objective: Postpartum hemorrhage is the most common cause of maternal morbidity and mortality, which can occur unexpectedly without warning, and without any underlying causes. We hypothesized that administering fibrinogen concentrate to cesarean section patients before surgery would ...
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Background & Objective: Postpartum hemorrhage is the most common cause of maternal morbidity and mortality, which can occur unexpectedly without warning, and without any underlying causes. We hypothesized that administering fibrinogen concentrate to cesarean section patients before surgery would reduce perioperative blood loss.Materials & Methods: In this double-blind randomized controlled parallel group study, a single dosage of fibrinogen concentrate or a placebo was given to 260 cesarean section patients at random (by G*Power software, Heinrich-Heine-Universität Düsseldorf, Germany) in a university-affiliated general hospital between November 11, 2022, to January 8, 2023. Individuals in the fibrinogen group received a dose of one gram of fibrinogen concentrate and those in the placebo group received normal saline solution with the same volume in the placebo group. Total blood loss was the primary outcome of this study.Results: A total of 280 cases were screened and 260 were randomized. With a P-value of 0.001, the median (IQR) volume of bleeding in the fibrinogen group was 660 (341.25) mL, as opposed to 790 (475.00) mL in the placebo group. Comparatively, only 10 (7.7%) of the fibrinogen group and 26 (20%) of the placebo group required blood transfusions (P=0.006). No adverse event related to fibrinogen was reported.Conclusion: Empiric treatment with fibrinogen concentrate results in reduced blood loss.
Gynecology Oncology
Maryam Rahimi; Setareh Talebi Kakroodi; Mansoureh Tajvidi
Volume 7, Issue 4 , March and April 2022, , Pages 258-271
Abstract
Receptor tyrosine kinase (RTK) signaling is a crucial pathway in the development of many cancers. KIT, PI3K, and AKT are the major genes in this pathway. KIT RTK functions in cell signal transduction in various cell types, such as cancer cells. A central element of RTK signaling is phosphatidylinositol-4, ...
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Receptor tyrosine kinase (RTK) signaling is a crucial pathway in the development of many cancers. KIT, PI3K, and AKT are the major genes in this pathway. KIT RTK functions in cell signal transduction in various cell types, such as cancer cells. A central element of RTK signaling is phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit A (PIK3CA), involved in cell proliferation, survival, and growth. AKT is a serine/threonine-specific protein kinase that has an important role in several processes, such as apoptosis and cell proliferation. The importance of mutations and overexpression of KIT, PI3K, and AKT genes in breast cancer has been previously demonstrated. This review investigated the relationship between gene mutations and overexpression and clinicopathological variable of KIT, PI3K, and AKT in breast cancer. Finally, the role of inhibitor drugs of these genes in breast cancer treatment. These data were collected from PubMed and Google Scholar databases from 2000 to 2021. The expression of KIT, PI3K, and AKT genes in normal breast tissues has been observed. However, mutations and overexpression of these genes are associated with malignancies. The mutations in KIT, PI3K, and AKT genes are different from those found in other malignancies. Also, most of the drugs that inhibit the RTK signaling are being tested in clinical trials for the treatment of breast cancer. Monitoring and timely management of adverse effects are critical to minimize toxicities and optimize the efficacy of this targeted therapy. Therefore, further development of predictive biomarkers can better select patients who will benefit from RTK inhibitors.
Reproductive Medicine
Mahrokh Abouali Gale Dari; Mona Keivan; Farideh Moramezi; Najmieh Saadati; Roshan Nikbakht; Maryam Farzaneh
Volume 8, Issue 4 , July and August 2023, , Pages 308-314
Abstract
Polycystic ovary syndrome (PCOS) is a hormonal disorder and a common health problem that affects women at the early to late reproductive stage. Several genetic and environmental factors such as obesity, liver diseases, imbalance of androgens, and menstrual dysfunction have contributed to the progression ...
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Polycystic ovary syndrome (PCOS) is a hormonal disorder and a common health problem that affects women at the early to late reproductive stage. Several genetic and environmental factors such as obesity, liver diseases, imbalance of androgens, and menstrual dysfunction have contributed to the progression of PCOS. Research has shown a link between diabetes, hypertension, miscarriages, and cardiovascular disease with PCOS. Experimental discoveries have begun to evaluate the mechanisms involved in PCOS. Although various classical interventions are used in the treatment of PCOS, current medications are not able to control outcomes of PCOS and the management of this syndrome is still challenging. Accumulating evidence showed that dysregulation of long non-coding RNAs (lncRNAs) is essential to PCOS pathogenesis. LncRNAs are a class of transcripts that mediate the process of gene expressions at the level of transcription and post-transcription. It has been found that lncRNA metastasis‐associated lung adenocarcinoma transcript‐1 (MALAT1 or nuclear-enriched abundant transcript 2 (NEAT2)) presents a vital role in regulating PCOS. MALAT-1 as a competing endogenous RNA (ceRNA) can suppress microRNAs (miRNAs) and decrease granulosa cell proliferation, apoptosis, and pathogenesis. Abnormal expression of MALAT1 is one of the prognostic factors for cell autophagy, migration, and drug resistance. MALAT1 can be used as a potential biomarker for treatment of PCOS. However, the exact roles of MALAT1 in granulosa cells of women with PCOS remain largely unknown and further studies are required to confirm its action. In the present article, we summarize the functions of the lncRNA MALAT-1/miRNA axes in women with PCOS.
Gynecology Oncology
Soheila Aminimoghaddam; Nima Azh; Somayyeh Noei Teymoordash; Firouzeh Ghaffari
Volume 7, Issue 5 , July and August 2022, , Pages 362-373
Abstract
Uterine cancer affects more than 1.28 million people worldwide; considering current world trends in obesity and aging, a +52.7% growth by 2040 is foreseen. Around 5% of endometrial cancer patients are less than 40 years old, meaning that conventional oncologic approaches would result in fertility loss; ...
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Uterine cancer affects more than 1.28 million people worldwide; considering current world trends in obesity and aging, a +52.7% growth by 2040 is foreseen. Around 5% of endometrial cancer patients are less than 40 years old, meaning that conventional oncologic approaches would result in fertility loss; thus, it is essential to consult patients regarding their fertility and family planning.Owing to developments of oncofertility, patients are now able to preserve their fertility and complete their childbearing, drafting from the standard of care in endometrial cancer. Strict criteria should be applied to make sure of selecting patients who benefit most from the fertility preservation approach. Furthermore, careful selection of patients increases the possibility of successful treatment.Most candidates for fertility preservation have risk factors in common with infertility, including polycystic ovarian syndrome, obesity, increasing of age and irregular menses; therefore, Advanced Reproductive Technology (ART) can improve their chances for pregnancy.Current applied knowledge towards the fertility preservation approach in patients with endometrial cancer is reviewed in this article.
Gynecology Oncology
Roya Dolatkhah; Mehrnaz Hosseinalifam; Zohreh Sanaat; Neda Dolatkhah; Saeed Dastgiri
Volume 8, Issue 5 , September and October 2023, , Pages 422-430
Abstract
Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the ...
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Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the end of 2030. Incidence of breast cancer had a clustering pattern in Iran, while central provinces had the highest ASIR (72 per 100,000 population), and South East provinces had the lowest ASIR (5-11 per 100,000 population). Numerous studies have shown that the peak incidence of breast cancer was occurred in the age group of 40-49 years in Iran. There has also been reported a rapid increase in the incidence in young women from different regions of the country. Known molecular and cellular processes involved in the development of breast cancer in Iranian BCs have been reported from various studies in recent decades, and the most well-known and prominent genes susceptible to breast cancer were BRCA1 and BRCA2. They acted as tumor suppressor genes and inherited mutations leading to chromosomal instability. However, non-coding RNAs, epigenetic alterations, signaling pathways, immune responses, and antioxidant-related genes are the main molecular processes associated with the progression of breast cancer among Iranian patients. While we are facing a significant increase in the incidence of breast cancer, with a lower survival rate, breast cancer is currently considered as one of the major health problems in Iran, which emphasizes the importance of providing and designing prevention and early detection program of breast cancer.
Maternal Fetal Medicine
Sedigheh Hantoushzadeh; Taraneh Geran Orimi; Mohammad Reza Zarkesh; Tahmineh Geran Orimi
Volume 7, Issue 6 , September and October 2022, , Pages 471-478
Abstract
Several studies have described multisystem inflammatory syndrome (MIS) in children, but very few investigations presented this syndrome among neonates (MIS-N). The present study has reviewed the current knowledge about MIS-N, its etiology, symptoms, and outcomes to attract special attention with an eye ...
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Several studies have described multisystem inflammatory syndrome (MIS) in children, but very few investigations presented this syndrome among neonates (MIS-N). The present study has reviewed the current knowledge about MIS-N, its etiology, symptoms, and outcomes to attract special attention with an eye on earlier diagnosis and treatment of newborns affected by perinatal SARS-CoV-2-infection. A narrative review study was conducted (Tehran, Iran, 2021). All types of full English articles (up to October 1 2021) were included. Detailed research on academic search engines was performed. The implemented Mesh-based keywords were "SARS-COVID-2" OR "COVID-19" OR "coronavirus" AND "Neonate" OR "Neonatal" OR "Newborn" AND "Multisystem Inflammatory Syndrome" OR "MIS-N" OR "inflammatory response syndrome" AND "Pregnancy" OR "Perinatal" OR "prenatal". Finally, 15 Full-text articles were included that met the eligibility criteria. Available data related to the disease, its etiology, presentations, and its outcome were collected and discussed. The cause of MIS-N is the transmission or production of SARS-CoV2 antibodies in response to SARS-CoV2 infection. By involving different organs, the clinical manifestations of MIS-N may mimic sepsis, toxic shock syndrome, RDS, Kawasaki disease, necrotizing enterocolitis, myocarditis, meningitis/encephalitis, aortic thrombosis, ETC. Besides the clinical presentations, detecting reactive anti-SARS-CoV-2 IgG antibodies could be a notable clue in MIS-N diagnosis. Supportive therapy, suppressing the autoimmune and inflammatory responses, anti-platelet agents, and anticoagulants were reported as effective therapeutic agents to improve the outcome. The present study highlighted the possibility of MIS-N as an infrequent but severe syndrome consequent to perinatal COVID-19 infection. Although the diagnosis is still controversial, clinical suspicion, laboratory findings, and early treatment initiation could improve the outcome of this immunological disease.
Obstetrics and Gynecology
Mahdi Seyfi-Ghale-Jogh; Marjan Mehrali; Rezvaneh Rakhshanimehr; Fatemeh Mohammadyari; Elahe Safari; Mohammad Salehi-Shadkami; Sepehr Nanbakhsh; Katayoun Haryalchi
Volume 8, Issue 6 , November and December 2023, , Pages 542-548
Abstract
The COVID-19 pandemic has disrupted people’s lives all over the world, and vaccination is one of the best ways to eradicate this pandemic and save people’s lives. Despite this, vaccines have many known and unknown side effects like fever, fatigue, headache, etc. Fertility is an important ...
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The COVID-19 pandemic has disrupted people’s lives all over the world, and vaccination is one of the best ways to eradicate this pandemic and save people’s lives. Despite this, vaccines have many known and unknown side effects like fever, fatigue, headache, etc. Fertility is an important aspect of human life, but there are too many concerns about its relationship with COVID-19 and its vaccines. Women are complaining of menstrual irregularities like postmenopausal bleeding, heavy menstrual bleeding, polymenorrhea and fertility concerns after receiving the second dose of the COVID-19 vaccine. The immunologic reactions between vaccine ingredients and the immune system of the body seem to be responsible for this global issue. Angiotensin-converting enzyme 2 (ACE2) and Basigin (BSG) are the receptors for SARS-COV-2. ACE2 is expressed in the human respiratory system, kidney, vagina, uterus and particularly widely in the ovaries, and BSG is expressed in the uterus, ovary stroma and granulosa cells. Therefore, SARS-COV-2 can invade the target cells by attachment to ACE2 and BSG and modulate their expression, and through these probable mechanisms, it can disturb female reproduction and menstruation. According to this accumulated evidence, in this study we aimed at summarizing the recent studies with a focus on probable mechanisms by which SARS-COV-2 and COVID-19 vaccines affect menstruation irregularities and reproduction complications.
Soheila Aminimoghaddam; Sahereh Arabian; Shirin Haghighi; Ladan Haghighi
Volume 1, Issue 1 , May and June 2016
Abstract
Introduction: Sarcoma of the cervix is uncommon and its prevalence is about 1% of malignancies of the cervix. One type of sarcoma is leiomyosarcoma and the location of this tumor in cervix is very rare. Although uterine sarcoma can involve the cervix and lead to misdiagnosis of cervical leiomyosarcoma, ...
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Introduction: Sarcoma of the cervix is uncommon and its prevalence is about 1% of malignancies of the cervix. One type of sarcoma is leiomyosarcoma and the location of this tumor in cervix is very rare. Although uterine sarcoma can involve the cervix and lead to misdiagnosis of cervical leiomyosarcoma, the location of the bulk of the tumor in uterine cervix (not isthmus) for diagnosis of cervical leiomyosarcoma is mandatory. The origin of sarcoma is from mesodermal tissue. Due to the rarity of cervical leiomyosarcoma and response to debulking surgery after recurrence, report of this case is interesting.
Case Presentation: We hereby report on a 34-year-old unmarried patient, who was a known case of leiomyosarcoma of uterine cervix that was referred with recurrence of tumor in parietal peritoneum, retropobic retzius space and around the bladder and ureter and sigmoid colon. The patient was treated with debulking surgery of the tumor and chemotherapy.
Conclusions: Sarcoma as a genital tract malignancy is very rare and the location of sarcoma at pediatric age is in the vagina and at middle age is in the cervix and at postmenopausal women in the uterine corpus. Cervical sarcoma as a rare tumor of the cervix arises from stromal tissue. Due to hematogenous spread of sarcoma, metastasis in lungs is seen and recurrence of this tumor is not uncommon. In this article, recurrence of a known case with leiomyosarcoma of uterine cervix in previous hysterectomy that responded to debulking surgery with removal of metastatic lesions in peritoneal and retroperitoneal spaces and adjuvant therapy with standard chemotherapy drugs and monoclonal antibody therapy is reported. Due to non-hormonal dependence of sarcoma to hormonal secretion from the ovaries and benefit of the ovaries in young women for protection of bone health and cardiovascular system, oophorectomy is a challenging idea and an issue of debate, thus primary surgery, in this case oophorectomy, was not done.
Soheila Aminimoghaddam
Volume 1, Issue 2 , September and October 2016
Hamid Zahedi
Volume 1, Issue 3 , November and December 2016
Mehdi Yousefi; Malihe Hasanzadeh; Vesam Rostaminezhad; Maryam Gaffarean; Azam Sadat Mousavi
Volume 2, Issue 1 , March and April 2017
Malihe Hasanzadeh; Mina Baradaran Khalkhale; Akram Behroznia
Volume 2, Issue 2 , May and June 2017
Abstract
Introduction: The prevalence of ectopic pregnancy is 1 to 2% and a previous cesarean section scar ectopic pregnancy or hysterectomy occurs as rare as 1 per 2000 pregnancies. In the current case report, the authors introduced ectopic pregnancy in cesarean scar with unstable hemodynamic condition and surgical ...
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Introduction: The prevalence of ectopic pregnancy is 1 to 2% and a previous cesarean section scar ectopic pregnancy or hysterectomy occurs as rare as 1 per 2000 pregnancies. In the current case report, the authors introduced ectopic pregnancy in cesarean scar with unstable hemodynamic condition and surgical management to preserve uterus.
Case Presentation: A 31-year-old pregnant female in the 9th week of pregnancy was admitted with vaginal bleeding and slight pain in the hypogastrium. The cesarean scar pregnancy was confirmed by sonography. In the course of hospitalization, due to the patient’s hemodynamic instability, the emergency laparotomy was performed. In the previous cesarean section scar, a 3 × 4 cm mass with a massive hematoma was found. It was removed and placental bed was sutured. Since the vaginal bleeding continued, the uterine artery ligation was carried out and due to severe bleeding, Foley catheters were packed inside the uterus. Two days later, the patient was discharged from the hospital in good general condition.
Conclusions: Despite the rarity of ectopic pregnancies in the previous cesarean section scars, paying attention and having this kind of pregnancy in mind can aid its early diagnosis and reduce possible morbidity and mortality including uterine rupture and severe bleeding, which can be considered as its irreversible complications.
Setare Nasiri; Shahrzad Sheikh Hasani; Mohammad Rahim Vakili; Fateme Nilli
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: Synovial sarcoma of the ovary is a very rare tumor reported only once in the past. It is the second softest tissue mass after rhabdomyosarcoma in adults but its usual site is extremities not ovary.
Case Presentation: Here we describe a 53-year-old woman with primary synovial sarcoma of ...
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Introduction: Synovial sarcoma of the ovary is a very rare tumor reported only once in the past. It is the second softest tissue mass after rhabdomyosarcoma in adults but its usual site is extremities not ovary.
Case Presentation: Here we describe a 53-year-old woman with primary synovial sarcoma of the ovary with insufficient treatment and lung metastasis of the tumor.
Conclusions: Because of harmlessness symptoms, it is usually missed and correct treatment is delayed. When facing this type of tumor, referring to well-equipped centers with experienced surgeons in this field is recommended for sufficient treatment and best results.
Mojgan Karimi Zarchi; Soraya Teimoori
Volume 2, Issue 4 , November and December 2017, , Pages 1-2
Soheila Aminimoghaddam; Nastaran Abolghasem
Volume 4, Issue 1 , March and April 2019, , Pages 5-11
Abstract
Vasomotor symptoms, also known as hot flashes, can be defined as a sensation of heat, intense sweating, and flushing, which are experienced episodically by many perimenopausal women. This sensation usually affects the face, neck, and chest. It is estimated that about 75% to 80% of women would suffer ...
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Vasomotor symptoms, also known as hot flashes, can be defined as a sensation of heat, intense sweating, and flushing, which are experienced episodically by many perimenopausal women. This sensation usually affects the face, neck, and chest. It is estimated that about 75% to 80% of women would suffer from hot flashes at some point during their perimenopausal years. A decline in oestrogen levels during menopause seems to be responsible for the appearance of hot flashes. This decline increases norepinephrine levels, leading to an up-regulation of serotonin receptors in the hypothalamus, which are involved in temperature regulation. The outcome of the activation of this norepinephrine serotonin pathway is believed to be the narrower thermoregulation zone, which in turn results in a greater risk of crossing the upper and lower thresholds of the thermoregulatory zone. Thus, it causes sweats and chills in this group of women. The most known effective treatment of hot flashes is hormone replacement therapy (HRT); however, in recent years, other non-hormonal options have become available for those women who cannot or do not want to take HRT.
Maternal Fetal Medicine
Fahimeh Hassani; Farideh Movahed; Fatemeh Lalouha; Enayatollah Noori
Volume 5, Issue 1 , August 2020, , Pages 6-10
Abstract
Background & Objective: In this study, thyroid dysfunction in women with gestational diabetes mellitus was examined and compared to that in healthy pregnant women referred to Kowsar Hospital in Qazvin in 2017 and 2018.Methods: In this case-control study, 100 women with gestational diabetes mellitus ...
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Background & Objective: In this study, thyroid dysfunction in women with gestational diabetes mellitus was examined and compared to that in healthy pregnant women referred to Kowsar Hospital in Qazvin in 2017 and 2018.Methods: In this case-control study, 100 women with gestational diabetes mellitus and 100 non diabetic healthy pregnant women who referred to Kowsar Hospital in Qazvin from 2017 to 2018 were selected using the convenience sampling method, and their serum thyroxine, anti-TPO, and TSH levels were determined and compared. Moreover, Apgar scores and anthropometric variables were compared between the two groups.Results: In the present study, there were statistically significant differences between the groups in terms of the TSH level (P < /em>=0.012), assessed by the independent t-test, the thyroxine (P < /em>=0.0001) and anti-TPO (P < /em>=0.008) levels, both examined by the Mann-Whitney test, which associated with high levels of TSH and anti-TPO and low levels of thyroxine in the diabetic group. No differences were found regarding the Apgar scores and anthropometric variables between the groups (P < /em>>0.05).Conclusion: Overall, according to the obtained results, it can be inferred that thyroid dysfunction, realized as hypothyroid with high anti-TPO levels, was more prevalent in women with gestational diabetes mellitus compared to healthy pregnant women.
General Gynecology and Pelvic Floor
Zahra Rezaei; Negin Azimi
Volume 6, Issue 1 , January 2021, , Pages 6-9
Abstract
Background & Objective: Persistent ectopic pregnancy (PEP) occurs due to incomplete removal of trophoblastic tissue during tubal pregnancy surgery treatment. If PEP is not diagnosed and treated in time, it can have high mortality and morbidity. This study aimed to evaluate the efficacy ...
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Background & Objective: Persistent ectopic pregnancy (PEP) occurs due to incomplete removal of trophoblastic tissue during tubal pregnancy surgery treatment. If PEP is not diagnosed and treated in time, it can have high mortality and morbidity. This study aimed to evaluate the efficacy of methotrexate (MTX) administration in the prevention of PEP after linear laparoscopic salpingostomy in tubal pregnancy.Materials & Methods: This randomized clinical trial study was conducted on 140 subjects with a diagnosis of unruptured tubal pregnancy, who were randomly divided into intervention and control groups. While the intervention group underwent a prophylactic injection of 50 mg MTX, the control group did not receive any dose of MTX. PEP was considered if there was an increase in serum BHCG levels or a decrease of less than 20% in serum BHCG levels.Results: There was no significant difference between the intervention and control groups in terms of baseline variables such as age, severity, parity, and gestational age. While in the intervention group only one patient (1.4%) had PEP, in the control group 11 (15.7%) patients had PEP (P < /em>=0.003).Conclusion: MTX administration seems to be an effective method in preventing PEP after linear laparoscopic salpingostomy in tubular pregnancy.
Reproductive Medicine
Mohammad Nasir Hematian; Mahnaz Ghiasi; Somayeh Baharian; Sedighe Safaie; Mojgan Rahmanian; ُُShirin Torabi; Samaneh Vahdatnia
Volume 7, Issue 1 , September and October 2021, , Pages 7-14
Abstract
Background and Objective: Concerns about adaptation to a new situation can cause anxiousness in pregnant women, which could lead to dangerous consequences. The aim of this study was to evaluate the severity of pregnancy anxiety in mothers with fetuses having cardiac anomalies and their association with ...
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Background and Objective: Concerns about adaptation to a new situation can cause anxiousness in pregnant women, which could lead to dangerous consequences. The aim of this study was to evaluate the severity of pregnancy anxiety in mothers with fetuses having cardiac anomalies and their association with birth outcomes.Materials and Methods: A number of 50 pregnant women were enrolled as the accessible sampling. The diagnosis of congenital heart anomaly was considered in prenatal ultrasound screening (NT ultrasound and anomaly scan). The General Health Questionnaire (GHQ-28), Spielberger State-Trait Anxiety Inventory (STAI), Cambridge Worry Scale (CWS), and Pregnancy Concern Questionnaire (PCQ) were used to evaluate fear, concern and anxiety. Data were analyzed using Wilcoxon statistical test.Results: Six infants had fetal outcomes including low birth weight (IUGR). Fetal prematurity was observed in only one infant. The highest and the lowest levels of anxiety were reported before the echocardiography and within one week after the echocardiography. There was a significant difference between maternal general health score before and 5 days after echocardiography as well as 5 days after echo and 35th week of pregnancy (P < /em><0.05). A significant difference between maternal general health score was observed before fetal echocardiography and at 35th week of pregnancy (P < /em><0.05).Conclusion: The results showed that mothers' anxiety increased significantly after the diagnosis of fetal cardiac anomaly. However, after fetal echocardiography and in the late pregnancy period, the anxiety level reduced in both stages. It was clear that receiving information about unhealthy fetus can cause significant anxiety in mothers.
Pathology
Fereshteh Ameli; Maryam Entezarian; Noraidah Masir; Tan Geok Chin
Volume 9, Issue 1 , January and February 2024, , Pages 7-13
Abstract
Background & Objective: The highest mortality rate in gynecologic cancers is attributed to ovarian origin. Expression of the estrogen and progesterone receptors (ER and PR); and Human epidermal growth factor receptor 2 (Her2/neu) in endometrial cancer and breast cancer were found to be associated ...
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Background & Objective: The highest mortality rate in gynecologic cancers is attributed to ovarian origin. Expression of the estrogen and progesterone receptors (ER and PR); and Human epidermal growth factor receptor 2 (Her2/neu) in endometrial cancer and breast cancer were found to be associated with the response to treatment and prognosis. However, because of inconsistent results from previous studies, the data regarding ovarian cancer are still inconclusive.Materials & Methods: Current retrospective cross-sectional study was performed on 234 tissue samples of different types of ovarian tumors (benign, borderline and malignant) from the archive of the University Kebangsaan Malaysia Medical Center during 10 years. Tissue microarrays were constructed on representative areas from formalin fixed paraffin embedded tissue blocks using ER, PR and HER2 immunohistochemical staining.Results: Prevalence of ER and PR overexpression was 36% and 35% in benign, 8% and 24% in borderline tumors with 51% and 46% in malignant tumors, respectively. ERα overexpression was more common among serous malignant ovarian tumors (49%) (p<0.001). PR positivity was more prevalent in serous benign tumors (p=0.02).There was no significant relationship between stage and the status of ERα (p=0.12) and PR (p=0.19). Her2/neu overexpression was only seen in borderline neoplasms (8%) and malignant mucinous tumors (4%). No association was found between Her2/neu overexpression and the level of tumor differentiation, tumor stage, size, and patient’s age.Conclusion: The observed ERα positivity in serous carcinoma and Her2/neu overexpression in malignant mucinous tumor, could be considered as a clue for choosing therapeutic agents. The role of anti-HER2 therapy in clear cell carcinoma is still debated and needs more investigations.
Mohammadreza Effatparvar; Nima Jamshidi; Mahsa Hasani
Volume 3, Issue 1 , March and April 2018, , Pages 9-12
Abstract
Aims: The skin suture is one of the inseparable sections of all surgeries; therefore, using noninvasive methods could be very applicable. The skin stapler is one of the methods which is commonly used for skin and is fast. This is while it is risky and may lead to an infection and undesirable cosmetic ...
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Aims: The skin suture is one of the inseparable sections of all surgeries; therefore, using noninvasive methods could be very applicable. The skin stapler is one of the methods which is commonly used for skin and is fast. This is while it is risky and may lead to an infection and undesirable cosmetic results. The current study aimed to analyze the noninvasive Zipline™ suture and to compare it with the stapler.
Materials and Methods: This experimental study was conducted at the University of Isfahan and 15 operating room technicians who experienced all three methods of suturing were questioned. The noninvasive Zipline™ suture was structurally analyzed and tested for the power of skin protection and flexibility by tensioning. An artificial skin was tested and tensioned 1cm from each side and the space of the incision between the edges was measured.
Findings: The Zipline™ suture had a low incision edge space, a good cosmetic outcome, low pain, and low risks of developing an infection considering the viewpoints of those who voted. The structure of Zipline™ which was zigzag led to a high rate of flexibility from one side and created more strength from another side.
Conclusion: A high strength rate and installation speed of this noninvasive suture (Zipline™) which can be used in many operations and substitute for invasive sutures. It should be considered that the Zipline™ suture can only be used for the skin and the suture of dermal tissue should be tightly done before using in surgeries.
Gynecology Oncology
Fariba Behnamfar; Fatemeh Ahmadi Solush; Tajossadat Allameh
Volume 8, Issue 1 , January and February 2023, , Pages 11-16
Abstract
Background & Objective: Cervical Cancer (CC) is a common cancer which is associated with HPV-infection. The aim of this study is to investigate the risk factors which affects HPV-clearance.Materials & Methods: This study was carried out on women with high risk HPV infection. All the patients ...
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Background & Objective: Cervical Cancer (CC) is a common cancer which is associated with HPV-infection. The aim of this study is to investigate the risk factors which affects HPV-clearance.Materials & Methods: This study was carried out on women with high risk HPV infection. All the patients underwent pap smears and cervical biopsy. Demographic data, marital status, vaccination history and consumption of tobacco, alcohol, opium and oral contraceptive pills were asked through a questionnaire. Results: The results showed that in one year follow-up, 142 (67.1%) patients showed HPV clearance. The HPV clearance decreased by increasing age (P=0.028) or higher CIN grades (P=0.017). In case of parity, there was no significant difference in univariate analysis (P=0.147), but it was significant in multiple logistic regression analysis (95% CI: 0.413-0.941, OR=0624, P= 0.024).Conclusion: It seems that age and cervical histology at the start of HPV infection are the most important factors for HPV clearance.
Sara Masihi; Elahe Shirazi; Farideh Moramezi; Najmieh Saadati; Mojgan Barati
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
AbstractPurpose: This study aimed to compare CGH array and karyotype for prenatal diagnosis in high-risk individuals in the first trimester screening.Materials and Methods: The present cross-sectional descriptive prospective study was performed on high-risk mothers screened in the first trimester of ...
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AbstractPurpose: This study aimed to compare CGH array and karyotype for prenatal diagnosis in high-risk individuals in the first trimester screening.Materials and Methods: The present cross-sectional descriptive prospective study was performed on high-risk mothers screened in the first trimester of pregnancy. Individuals were allocated into two groups under karyotype and CGH array. Because this study is based on genetic testing data, it does not require a follow-up. Information on age, number of pregnancies, history of abortion, history of disease and screening results were collected and analyzed. Data analysis was done using SPSS Version 22 (IBM).Results: In total 247 cases were analyzed with 128 cases in the karyotype group and 119 cases in the CGH group. 116 samples (90.6%) in the karyotype group and 99 samples (83.2%) in the CGH group showed a normal karyotype. 4.2% (5 samples) and 7.9% (10 samples) of chromosomal abnormalities were trisomy in the CGH group and the karyotype group, respectively. CGH array analysis on chromosomal abnormalities identified copy number variation (CNV) in about 9.2% (11 samples) of cases. In terms of risk factors structural chromosomal, there was a statistically significant relationship in terms of history of disabled children in the family, maternal age, history of anomalies, screening of the first trimester of pregnancy, and increased NT (p<0.05).Conclusions: High-resolution arrays specifically prevented fetal malformations. Until now, normal prenatal chromosome analysis has been shown a relatively standard method but CGH may be helpful to specialists in diagnosing chromosomal abnormalities, especially in unknown chromosomal abnormalities.
Obstetrics and Gynecology
Zahra Rezaei; Khadijeh Adabi; Adele Sadjadi
Volume 5, Issue 2 , October 2020, , Pages 39-43
Abstract
Background & Objective: An endometrial thickness of less than 7 mm adversely affects pregnancy outcomes. There is also ample evidence of the impact of granulocyte colony-stimulating factor (G-CSF) on treatment-resistant thin endometrium. Therefore, this study compares the effects of intrauterine ...
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Background & Objective: An endometrial thickness of less than 7 mm adversely affects pregnancy outcomes. There is also ample evidence of the impact of granulocyte colony-stimulating factor (G-CSF) on treatment-resistant thin endometrium. Therefore, this study compares the effects of intrauterine and subcutaneous injections of G-CSF on increasing endometrial thickness (ET) and pregnancy outcomes in infertile women who were candidates for in vitro fertilization (IVF). Materials & Methods: In the current randomized, double-blind clinical trial, 34 patients with a history of failed IVF cycles and treatment-resistant thin endometrium were randomized into two routes of G-CSF injection, i.e., intrauterine and subcutaneous, by using a random number table method. Outcomes including ET and chemical and clinical pregnancy rates were compared in two groups.Results: ET increased significantly in both groups after G-CSF administration (intrauterine and subcutaneous); however, this increase in thickness was significantly greater in the intrauterine injection group than in the subcutaneous injection group. Pregnancy outcomes were similar in two groups. Drug side effects were significantly lower in the intrauterine injection group than in the subcutaneous injection group.Conclusion: G-CSF can significantly increase ET in cases of repeated IVF failure, and intrauterine injection of this drug was more effective than subcutaneous injection.
Fahimeh Ghotbizadeh Vahdani; Sedigheh Hantoushzadeh; Maryam Deldar Pasikhani; Azin Ghamari; Maryam Hajatpour; Zahra Panahi
Volume 4, Issue 2 , May and June 2019, , Pages 51-56
Abstract
Background & Objective: Due to increased rate of risk factors, the incidence of placenta accreta (PA) is increasing worldwide. This study aimed to investigate the important factors regarding the occurrence of PA, as well as outcomes and complications of Trans Abdominal Hysterectomy (TAH) in the patients ...
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Background & Objective: Due to increased rate of risk factors, the incidence of placenta accreta (PA) is increasing worldwide. This study aimed to investigate the important factors regarding the occurrence of PA, as well as outcomes and complications of Trans Abdominal Hysterectomy (TAH) in the patients with PA.
Materials & Methods: The study was performed as an observational cross-sectional study. Between March 2011 and March 2017, 177 patients, known cases of PA that undergone TAH, were enrolled in our study. Extracted data include demographic characteristics, patient’s medical history, surgical approach and complications, such as blood loss and urologic problems.
Results: The average of maternal age and gestational age were 33.6±4.70 (range= 22-43) years and 34.6±3.16 weeks, respectively. Neither maternal age (P < /em>=0.652) nor BMI (P < /em>=0.659) had significant association with abnormal placentation. Previous history of dilation & curettage (D&C) was found in 34 patients that was not related to the occurrence of the PA (P < /em>=0.508).Twenty-one (11.9%) of the patients needed urological intervention that did not associated with placental position, skin and uterine incision (P < /em>=0.258, 0.410 and 0.219). There is no relation between amount of blood loss with gestational age (P < /em>=0.7) and number of C/S (P < /em>=0.4), gestational age (P < /em>=0.7), anesthesia (P < /em>=0.2), and curettage history (P < /em>=0.3).
Conclusion: Our mortality and morbidity rate is much lower than reported ones, indicating the high-level ability, skill and knowledge of the surgeons.
Freshteh Osmani; Ebrahim Hajizadeh; Ali Akbar Rasekhi
Volume 3, Issue 2 , May and June 2018, , Pages 53-58
Abstract
Aims: Breast cancer is one of the most prevalent recurrent cancers among women. Several factors affecting multiple recurrences of this disease have been studied and recognized in various studies. One of the various types of models used to analyze recurrent events considering the lack of homogeneity among ...
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Aims: Breast cancer is one of the most prevalent recurrent cancers among women. Several factors affecting multiple recurrences of this disease have been studied and recognized in various studies. One of the various types of models used to analyze recurrent events considering the lack of homogeneity among patients is a frailty model. The aim of the present study was to investigate joint frailty modeling for multiple recurrent events and its application in patients with breast cancer.
Materials and Methods: In this survival and retrospective analysis, 342 patients with breast cancer whose records were registered for follow-up in a Cancer Research Center at Shohadaye Tajrish Hospital, Tehran, Iran, from 2006 to 2015, were selected. The sampling method was purposive. These patients were monitored for at least 6 months after diagnosis and their latest statuses. For data analysis, the joint frailty survival model was used. Running the model and conducting the data analysis were performed by codes in Frailtypack using R 3.4.1 statistical software.
Findings: Three-year and five-year survival rates for the patients were 0.79 and 0.68, respectively. The risk of multiple recurrences (Local and metastases) increased for the patients with tumor grades greater than I. It was found that when neglecting the relationship between multiple recurrences in the patients with breast cancer, a significant correlation was missed.
Conclusion: With regard to the significant variance of the frailty component of the metastases event, the patients with the same predictive variables are prone to different levels of metastases risk.
