Pub Date : 2019-01-01DOI: 10.4172/2161-0932.1000498
A. Re, A. Alitto, C. Mazzarella, F. Catucci, A. Martino, G. Mantini, G. Palazzoni
Background: Uterine leiomyosarcomas (uLMS), although rare (3%-7% of all uterine malignancies), represent an important share of mortality due to uterine pathology. Surgery is the cornerstone of treatment but the lack of data from randomized clinical trials makes the function of adjuvant therapy still nebulous. For these reasons, the treatment of the uLMS is still a challenge in progress.Case presentation: We report the case of 72-years old woman who underwent several lines of therapy. After systemic disease progression, was subjected to a genetic test that showed a mutation of CDKN2A. Basing on these results, the patient started Palbociclib, which is still ongoing.Conclusion: The choice of drug was based on the presence of the patient’s specific mutation and not on therapeutic options recommended by guidelines. In this woman, heavily pretreated, Palbociclib showed the stability of disease at the first re-evaluation with an acceptable safety profile and no signs of cumulative toxicity
{"title":"Gene Profiling and Therapy: What's the Future? A Case Report of Uterine Leiomyosarcoma","authors":"A. Re, A. Alitto, C. Mazzarella, F. Catucci, A. Martino, G. Mantini, G. Palazzoni","doi":"10.4172/2161-0932.1000498","DOIUrl":"https://doi.org/10.4172/2161-0932.1000498","url":null,"abstract":"Background: Uterine leiomyosarcomas (uLMS), although rare (3%-7% of all uterine malignancies), represent an important share of mortality due to uterine pathology. Surgery is the cornerstone of treatment but the lack of data from randomized clinical trials makes the function of adjuvant therapy still nebulous. For these reasons, the treatment of the uLMS is still a challenge in progress.Case presentation: We report the case of 72-years old woman who underwent several lines of therapy. After systemic disease progression, was subjected to a genetic test that showed a mutation of CDKN2A. Basing on these results, the patient started Palbociclib, which is still ongoing.Conclusion: The choice of drug was based on the presence of the patient’s specific mutation and not on therapeutic options recommended by guidelines. In this woman, heavily pretreated, Palbociclib showed the stability of disease at the first re-evaluation with an acceptable safety profile and no signs of cumulative toxicity","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84942202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2161-0932.1000495
Temesgen Tilahun Bekabil, Bedasa Elias Erena
Though rare in developed nations, uterine rupture from obstructed labor still remains as one of obstetrics dilemma in developing countries, particularly in a resource-limited setting, causing significant perinatal morbidities and mortalities. This is the case of a 35-year-old Gravida-V female patient, who claims to be amenorrheic for nine months, presented to the hospital after she sustained penetrating ox horn injury to her abdomen and uterus. She has managed with a cesarean section to a delivery alive neonate with a good health condition. In conclusion, penetrating trauma to the gravid uterus is a life-threatening condition for both the mother and developing fetus but early intervention can prevent complications.
{"title":"Delivering Alive Fetus After the Mother Sustained Penetrating Ox Horn Injury to the Gravid Uterus: Case Report and Literature Review","authors":"Temesgen Tilahun Bekabil, Bedasa Elias Erena","doi":"10.4172/2161-0932.1000495","DOIUrl":"https://doi.org/10.4172/2161-0932.1000495","url":null,"abstract":"Though rare in developed nations, uterine rupture from obstructed labor still remains as one of obstetrics dilemma in developing countries, particularly in a resource-limited setting, causing significant perinatal morbidities and mortalities. This is the case of a 35-year-old Gravida-V female patient, who claims to be amenorrheic for nine months, presented to the hospital after she sustained penetrating ox horn injury to her abdomen and uterus. She has managed with a cesarean section to a delivery alive neonate with a good health condition. In conclusion, penetrating trauma to the gravid uterus is a life-threatening condition for both the mother and developing fetus but early intervention can prevent complications.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"413 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76494951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2161-0932.19.9.504
L. Pillarisetty, M. Buschardt, M. Mannem
Background: Breast cancer diagnosis and treatment during pregnancy is relatively rare, and breast sarcomas constitute a small, aggressive subset of breast malignancies. This paper describes a novel case of metastatic breast sarcoma diagnosed and treated during pregnancy. Surgery, chemotherapy, and radiation given at the right time remain a cornerstone of breast cancer treatment during pregnancy. Current evidence suggests minimal treatment effects on immediate and longer-term fetal outcomes. Maternal outcomes are also significantly improved with prompt diagnosis and treatment. Case Report: This report describes the case of a 24-year-old female diagnosed with breast sarcoma metastasizing to the lungs, liver and the brain in pregnancy. She was 33 weeks of gestation at the time of diagnosis and had bilateral lung and liver metastasis at the time of presentation. Labor was induced at 34 weeks gestation. She had a spontaneous vaginal delivery without complications, and the infant weighed 5.07 pounds with an Apgar score of 8 and 9. Immediate treatment with Doxorubicin and Ifosfamide (Mesna was also given) was initiated after delivery. Her postpartum course was complicated by a collapsed lung, MRI did later reveal metastasis to the brain as well. Palliative chemotherapy was ultimately pursued. Conclusion: This paper describes a novel case of metastatic breast sarcoma diagnosed during pregnancy, and reviews the current literature regarding sarcomas and breast cancer treatment in pregnancy. Sarcoma is a rare type of breast cancer, and presentation in this age group is very unusual. To the best of our knowledge, this is the first case report on breast sarcoma in pregnancy.
{"title":"Metastatic Breast Sarcoma in a Young Pregnant Woman-A Case Report and Review","authors":"L. Pillarisetty, M. Buschardt, M. Mannem","doi":"10.35248/2161-0932.19.9.504","DOIUrl":"https://doi.org/10.35248/2161-0932.19.9.504","url":null,"abstract":"Background: Breast cancer diagnosis and treatment during pregnancy is relatively rare, and breast sarcomas constitute a small, aggressive subset of breast malignancies. This paper describes a novel case of metastatic breast sarcoma diagnosed and treated during pregnancy. Surgery, chemotherapy, and radiation given at the right time remain a cornerstone of breast cancer treatment during pregnancy. Current evidence suggests minimal treatment effects on immediate and longer-term fetal outcomes. Maternal outcomes are also significantly improved with prompt diagnosis and treatment. Case Report: This report describes the case of a 24-year-old female diagnosed with breast sarcoma metastasizing to the lungs, liver and the brain in pregnancy. She was 33 weeks of gestation at the time of diagnosis and had bilateral lung and liver metastasis at the time of presentation. Labor was induced at 34 weeks gestation. She had a spontaneous vaginal delivery without complications, and the infant weighed 5.07 pounds with an Apgar score of 8 and 9. Immediate treatment with Doxorubicin and Ifosfamide (Mesna was also given) was initiated after delivery. Her postpartum course was complicated by a collapsed lung, MRI did later reveal metastasis to the brain as well. Palliative chemotherapy was ultimately pursued. Conclusion: This paper describes a novel case of metastatic breast sarcoma diagnosed during pregnancy, and reviews the current literature regarding sarcomas and breast cancer treatment in pregnancy. Sarcoma is a rare type of breast cancer, and presentation in this age group is very unusual. To the best of our knowledge, this is the first case report on breast sarcoma in pregnancy.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"1 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88692688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2161-10932.19.9.510
Y. Baykuş, R. Deniz, Y. Adalı, F. Kara, Ömür Öztürk, S. Aydin, SuleymanAydin
Background: Ovarian torsion is a serious gynecological condition, encountered especially during reproductive age. Medical ozone has therapeutic effects with its antioxidant, apoptotic, and anti-inflammatory properties. Objective: This study aimed to determine the effects of medical ozone on the ovarian functions and ovarian morphology in an experimental rat ovarian torsion-detorsion model. Methods: Twenty female Wistar albino rats were used in this study. The rats were randomized into two groups: Group 1 (torsion/detorsion+ozone) (n=10) and Group 2 (only torsion/detorsion) (n=10). Histopathological evaluation of the ovarian tissue was performed. Additionally, Total Antioxidant Capacity (TAC), Follicle-Stimulating Hormone (FSH), Estradiol (E2), and Lactate Dehydrogenase (LDH) levels were measured in the serum. Results: Ozone application has to lead to a decrease in histopathological parameters such as hemorrhage, vascular congestion, cellular apoptosis, and necrosis while no histopathological changes were detected concerning edema and inflammatory cells. High TAC in Group 1 and high FSH in Group 2 were detected. A statistically significant difference between the two groups was detected in terms of TAC (p=0.001) and FSH (p=0.002). There were no significant differences between Group1 and Group2 regarding E2 (p=0.757), and LDH levels (p=0.453). Conclusion: edical ozone is shown to positively affect the histopathological markers of cellular damage and increase the antioxidant capacity in the torsion-detorsion model. We suggest that further animal model studies may be designed to reveal the factors behind the effect of medical ozone.
{"title":"Therapeutic Effects of Medical Ozone in the Functions and Histopathological Features of the Ovary in an Experimental Torsion-Detorsion Model","authors":"Y. Baykuş, R. Deniz, Y. Adalı, F. Kara, Ömür Öztürk, S. Aydin, SuleymanAydin","doi":"10.35248/2161-10932.19.9.510","DOIUrl":"https://doi.org/10.35248/2161-10932.19.9.510","url":null,"abstract":"Background: Ovarian torsion is a serious gynecological condition, encountered especially during reproductive age. Medical ozone has therapeutic effects with its antioxidant, apoptotic, and anti-inflammatory properties. Objective: This study aimed to determine the effects of medical ozone on the ovarian functions and ovarian morphology in an experimental rat ovarian torsion-detorsion model. Methods: Twenty female Wistar albino rats were used in this study. The rats were randomized into two groups: Group 1 (torsion/detorsion+ozone) (n=10) and Group 2 (only torsion/detorsion) (n=10). Histopathological evaluation of the ovarian tissue was performed. Additionally, Total Antioxidant Capacity (TAC), Follicle-Stimulating Hormone (FSH), Estradiol (E2), and Lactate Dehydrogenase (LDH) levels were measured in the serum. Results: Ozone application has to lead to a decrease in histopathological parameters such as hemorrhage, vascular congestion, cellular apoptosis, and necrosis while no histopathological changes were detected concerning edema and inflammatory cells. High TAC in Group 1 and high FSH in Group 2 were detected. A statistically significant difference between the two groups was detected in terms of TAC (p=0.001) and FSH (p=0.002). There were no significant differences between Group1 and Group2 regarding E2 (p=0.757), and LDH levels (p=0.453). Conclusion: edical ozone is shown to positively affect the histopathological markers of cellular damage and increase the antioxidant capacity in the torsion-detorsion model. We suggest that further animal model studies may be designed to reveal the factors behind the effect of medical ozone.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"21 19","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72388165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2161-0932.1000494
T. Piro
Aim: The researcher in the present study aimed to investigate the patients’ experiences who suffered from breast cancer. Since few studies have been conducted in Kurdistan in Iraq, and the experiences of patients have not been studied, by gaining insight into and awareness of these hurtful people, the world can be seen from their point of view. Material and Methods: This qualitative study was carried out using a phenomenological approach. In this regard, a purposive sampling method was used in to select 12 women who suffered from breast cancer, a semi-structured interview was used to data gathering. Results: The experiences of patients with breast cancer and understanding those involved in the disease are reflected in four main meanings or themes such as “looking for hope but promising”, “Grief over Inability”, “to do tasks”, “fear of rejection”, and “wounded but not scarred”. Conclusion: It can be said that breast cancer affects all aspects of the spiritual and social health of women and leads to a sense of frustration and disappointment. Therefore, they make an attempt to find hope which reduces the length of treatment. Therefore, this study can increase the caregivers’ knowledge about the impact of the disease on the lives of the patients and whoever involved with the treatment system.
{"title":"Post-Diagnosis Experience of Iraqi Women with Breast Cancer: A Phenomenological Study","authors":"T. Piro","doi":"10.4172/2161-0932.1000494","DOIUrl":"https://doi.org/10.4172/2161-0932.1000494","url":null,"abstract":"Aim: The researcher in the present study aimed to investigate the patients’ experiences who suffered from breast cancer. Since few studies have been conducted in Kurdistan in Iraq, and the experiences of patients have not been studied, by gaining insight into and awareness of these hurtful people, the world can be seen from their point of view. Material and Methods: This qualitative study was carried out using a phenomenological approach. In this regard, a purposive sampling method was used in to select 12 women who suffered from breast cancer, a semi-structured interview was used to data gathering. Results: The experiences of patients with breast cancer and understanding those involved in the disease are reflected in four main meanings or themes such as “looking for hope but promising”, “Grief over Inability”, “to do tasks”, “fear of rejection”, and “wounded but not scarred”. Conclusion: It can be said that breast cancer affects all aspects of the spiritual and social health of women and leads to a sense of frustration and disappointment. Therefore, they make an attempt to find hope which reduces the length of treatment. Therefore, this study can increase the caregivers’ knowledge about the impact of the disease on the lives of the patients and whoever involved with the treatment system.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81963421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2161-0932.1000499
N. R. Ngbale, Christelle Edith Gaunetfet, A. Koirokpi, Simeon Matoulou, Gertrude Kogboma-Gongo, K. Mbano-Dede, A. Sépou, Alex, re Manirakiza
Introduction: Severe preeclampsia is one of the most serious pathologies during pregnancy, with heavy morbidity and maternal-fetal mortality. The aim of our study was to help improve the management of severe preeclampsia. Methods: We conducted a cross-sectional analytical study from 1st September 2015 to 30th August 2016, at the Obstetrics and Gynecology Department of the Hopital communautaire of Bangui. The study population was pregnant and parturient patients with severe pre-eclampsia. Results: Out of 4021 registered cases, 41 met the inclusion criteria, with a prevalence of 1.0%. The primiparous were the most represented (48.8%). Magnesium sulfate was the most used as an anticonvulsant (70.7%) and dihydralazine was the most used for the High Blood Pressure (HBP). The main complications of pre-eclampsia were eclampsia (29.3%) and acute renal failure (19.5%). Overall, maternal mortality was 9.8% and perinatal mortality was 31.7%. Conclusion: The complications of severe preeclampsia are common in our study. The maternal and fetal prognosis remains a concern. Hence, we suggest early screening of pre-eclampsia symptoms during prenatal consultations to improve pregnancy outcome.
{"title":"Epidemiological Aspects and Prognosis of Severe Pre-eclampsia in Bangui, Central African Republic","authors":"N. R. Ngbale, Christelle Edith Gaunetfet, A. Koirokpi, Simeon Matoulou, Gertrude Kogboma-Gongo, K. Mbano-Dede, A. Sépou, Alex, re Manirakiza","doi":"10.4172/2161-0932.1000499","DOIUrl":"https://doi.org/10.4172/2161-0932.1000499","url":null,"abstract":"Introduction: Severe preeclampsia is one of the most serious pathologies during pregnancy, with heavy morbidity and maternal-fetal mortality. The aim of our study was to help improve the management of severe preeclampsia. Methods: We conducted a cross-sectional analytical study from 1st September 2015 to 30th August 2016, at the Obstetrics and Gynecology Department of the Hopital communautaire of Bangui. The study population was pregnant and parturient patients with severe pre-eclampsia. Results: Out of 4021 registered cases, 41 met the inclusion criteria, with a prevalence of 1.0%. The primiparous were the most represented (48.8%). Magnesium sulfate was the most used as an anticonvulsant (70.7%) and dihydralazine was the most used for the High Blood Pressure (HBP). The main complications of pre-eclampsia were eclampsia (29.3%) and acute renal failure (19.5%). Overall, maternal mortality was 9.8% and perinatal mortality was 31.7%. Conclusion: The complications of severe preeclampsia are common in our study. The maternal and fetal prognosis remains a concern. Hence, we suggest early screening of pre-eclampsia symptoms during prenatal consultations to improve pregnancy outcome.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84639789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2161-0932.19.9.507
Muntaha Virk, Aleena Tahir, H. Shahid, Ayesha Habib
Background: Premenstrual syndrome is the medical condition which is the combination of physical, psychological and behavioral changes in the late secretory phase of the regular menstrual cycle and interferes with relationships or activities of an individual which occurs just before the menses. Aim and Objectives: To determine the effectiveness of 8 weeks’ aerobic exercise non-athlete girls showing PMS symptoms. To investigate the coping strategies of PMS Procedure: Apparatus and techniques which we used for the detection and revelation of PMS symptoms were a premenstrual symptoms screening tool for adolescent PSST while the symptoms of pain were accessed and identified using a visual analog scale. Various females were considered and requested to practice aerobic exercises such as walking, jumping, jogging, hamstring quadriceps stretching for 8 weeks. Result: Outcome of the commencement of aerobic exercise was positive as it was clearly visualize-able and relatable that the discrimination in the symptoms of PMS in pre-exercise and post-exercise faces were significantly distinct. Aerobic exercise diminished the effect of psychological and physical symptoms, hence can be used as a treatment to cure and minimize PMS symptoms. Conclusion: The finalized verdict of overall research and practical implementation of tests and procedures lead us to conclude although PMS symptoms are frequently detected in the majority of the female, yet aerobic exercises such as walking, jogging, running, stretching of quadriceps and hamstrings proved as a fruitful.
{"title":"Effects of the 8 Weeks' Aerobics Exercises on Non-Athlete Girls Showing a Symptom of the Premenstrual Syndrome","authors":"Muntaha Virk, Aleena Tahir, H. Shahid, Ayesha Habib","doi":"10.35248/2161-0932.19.9.507","DOIUrl":"https://doi.org/10.35248/2161-0932.19.9.507","url":null,"abstract":"Background: Premenstrual syndrome is the medical condition which is the combination of physical, psychological and behavioral changes in the late secretory phase of the regular menstrual cycle and interferes with relationships or activities of an individual which occurs just before the menses. Aim and Objectives: To determine the effectiveness of 8 weeks’ aerobic exercise non-athlete girls showing PMS symptoms. To investigate the coping strategies of PMS Procedure: Apparatus and techniques which we used for the detection and revelation of PMS symptoms were a premenstrual symptoms screening tool for adolescent PSST while the symptoms of pain were accessed and identified using a visual analog scale. Various females were considered and requested to practice aerobic exercises such as walking, jumping, jogging, hamstring quadriceps stretching for 8 weeks. Result: Outcome of the commencement of aerobic exercise was positive as it was clearly visualize-able and relatable that the discrimination in the symptoms of PMS in pre-exercise and post-exercise faces were significantly distinct. Aerobic exercise diminished the effect of psychological and physical symptoms, hence can be used as a treatment to cure and minimize PMS symptoms. Conclusion: The finalized verdict of overall research and practical implementation of tests and procedures lead us to conclude although PMS symptoms are frequently detected in the majority of the female, yet aerobic exercises such as walking, jogging, running, stretching of quadriceps and hamstrings proved as a fruitful.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85073171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Badary, H. A. Taleb, Hossam Samir, Ahmed Abdel-Allah
Objective: AUB is one of the most serious problems that face females all over the world not only through their reproductive age but also after menopause. This study aims to determine the types and frequencies of pathological causes of AUB in Upper Egypt women aged in different age groups and to study the necessity and significance of endometrial curetting in abnormal uterine bleeding. Methods: A Retrospective study carried out on 676 specimens obtained by from patients with AUB. Data is being received from clinical and pathological records at Assuit University Hospital covering the period of 3 years from April 2015- April 2018. The total tissue submitted was processed and examined in details microscopically by the pathologist. Results: A total of 676 cases with AUB, Endometrial polyp seen in 37.9% (the most common). Leiomyoma was seen in 9.2%. Complication of pregnancy (8%), disordered proliferative endometrium (6.8%), adenomyosis (5.9%), proliferative endometrium (4.7%), endometritis (4.1%), Abnormal secretory phase pattern (2.1%), simple hyperplasia without atypia (3.6%) and complex hyperplasia with atypia (6.2%). Both secretory endometrium and endometrium with evidence of exogenous hormone therapy had the same percentage (2.4%). Finally, malignancy was seen in (5.3%) cases. Conclusion: We conclude that Endometrial polyp, endometrial hyperplasia, and Leiomyoma represent the most common causes of abnormal uterine bleeding in Egyptian women, so as organic causes of abnormal uterine bleeding represent a high percentage, we can say that endometrial curetting and biopsy as a diagnostic procedure has an important role in AUB patients. Histological diagnosis of different pathologies help in their treatment easily once diagnosed and also helps in prophylaxis against malignancy transformation and progression.
{"title":"Histopathological Spectrum of Abnormal Uterine Bleeding in Upper Egypt: A Study of 676 Cases","authors":"D. Badary, H. A. Taleb, Hossam Samir, Ahmed Abdel-Allah","doi":"10.24015/2161-0932/505","DOIUrl":"https://doi.org/10.24015/2161-0932/505","url":null,"abstract":"Objective: AUB is one of the most serious problems that face females all over the world not only through their reproductive age but also after menopause. This study aims to determine the types and frequencies of pathological causes of AUB in Upper Egypt women aged in different age groups and to study the necessity and significance of endometrial curetting in abnormal uterine bleeding. Methods: A Retrospective study carried out on 676 specimens obtained by from patients with AUB. Data is being received from clinical and pathological records at Assuit University Hospital covering the period of 3 years from April 2015- April 2018. The total tissue submitted was processed and examined in details microscopically by the pathologist. Results: A total of 676 cases with AUB, Endometrial polyp seen in 37.9% (the most common). Leiomyoma was seen in 9.2%. Complication of pregnancy (8%), disordered proliferative endometrium (6.8%), adenomyosis (5.9%), proliferative endometrium (4.7%), endometritis (4.1%), Abnormal secretory phase pattern (2.1%), simple hyperplasia without atypia (3.6%) and complex hyperplasia with atypia (6.2%). Both secretory endometrium and endometrium with evidence of exogenous hormone therapy had the same percentage (2.4%). Finally, malignancy was seen in (5.3%) cases. Conclusion: We conclude that Endometrial polyp, endometrial hyperplasia, and Leiomyoma represent the most common causes of abnormal uterine bleeding in Egyptian women, so as organic causes of abnormal uterine bleeding represent a high percentage, we can say that endometrial curetting and biopsy as a diagnostic procedure has an important role in AUB patients. Histological diagnosis of different pathologies help in their treatment easily once diagnosed and also helps in prophylaxis against malignancy transformation and progression.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"4 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75307152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2161-0932.1000497
R. John
Background: Clinical decision-making dilemmas are particularly notable in IVF practice, given that large datasets are often generated which enable clinicians to make predictions that inform treatment choices. This study applied machine learning by using IVF data to determine the risk of twins when two or more embryos are available for transfer. While most classifiers are able to provide estimates of accuracy, this study went further by comparing classifiers both by accuracy and Area Under the Curve (AUC).Methods: Study data were derived from a large electronic medical record system that is utilized by over 140 IVF clinics and contained 135,000 IVF cycles. The dataset was reduced from 88 variables to 40 and included only those cycles of IVF where two or more blastocyst embryos were created. The following classifiers were compared in terms of accuracy and AUC: a generalized linear model, linear discriminant analysis, quadratic discriminant analysis, K-nearest neighbors, support vector machine, random forests, and boosting. A stacking ensemble learning algorithm was also applied in order to use predictions from classifiers to create a new model.Results: While the ensemble classifier was the most accurate, none of the classifiers predominated as being significantly superior to other classifiers. Findings indicated that boosting methods for classifiers performed poorly; logistic and linear discriminant analysis classifiers performed better than the quadratic discriminant analysis classifier, and the support vector machine performed almost as well as the tree classifier. AUC results were consistent with the comparisons for accuracy. External validation was also performed using a different dataset containing 588 observations. All models performed better using the external validation dataset, with the random forest classifier performing markedly better than any other classifier.Conclusions: These results support the impression that big data can be of value in the clinical decision-making process; but that no single statistical algorithm provides maximum accuracy for all databases. Therefore, different datasets will require investigation in order to determine which algorithms are the most accurate for a particular set of data. These findings underscore the premise that clinicians with access to large amounts of data can use advanced predictive analytic models to create robust clinical information of vital importance for patient care.
{"title":"An Application of Machine Learning in IVF: Comparing the Accuracy of Classification Alogithims for the Prediction of Twins","authors":"R. John","doi":"10.4172/2161-0932.1000497","DOIUrl":"https://doi.org/10.4172/2161-0932.1000497","url":null,"abstract":"Background: Clinical decision-making dilemmas are particularly notable in IVF practice, given that large datasets are often generated which enable clinicians to make predictions that inform treatment choices. This study applied machine learning by using IVF data to determine the risk of twins when two or more embryos are available for transfer. While most classifiers are able to provide estimates of accuracy, this study went further by comparing classifiers both by accuracy and Area Under the Curve (AUC).Methods: Study data were derived from a large electronic medical record system that is utilized by over 140 IVF clinics and contained 135,000 IVF cycles. The dataset was reduced from 88 variables to 40 and included only those cycles of IVF where two or more blastocyst embryos were created. The following classifiers were compared in terms of accuracy and AUC: a generalized linear model, linear discriminant analysis, quadratic discriminant analysis, K-nearest neighbors, support vector machine, random forests, and boosting. A stacking ensemble learning algorithm was also applied in order to use predictions from classifiers to create a new model.Results: While the ensemble classifier was the most accurate, none of the classifiers predominated as being significantly superior to other classifiers. Findings indicated that boosting methods for classifiers performed poorly; logistic and linear discriminant analysis classifiers performed better than the quadratic discriminant analysis classifier, and the support vector machine performed almost as well as the tree classifier. AUC results were consistent with the comparisons for accuracy. External validation was also performed using a different dataset containing 588 observations. All models performed better using the external validation dataset, with the random forest classifier performing markedly better than any other classifier.Conclusions: These results support the impression that big data can be of value in the clinical decision-making process; but that no single statistical algorithm provides maximum accuracy for all databases. Therefore, different datasets will require investigation in order to determine which algorithms are the most accurate for a particular set of data. These findings underscore the premise that clinicians with access to large amounts of data can use advanced predictive analytic models to create robust clinical information of vital importance for patient care.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81627111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2161-10932.19.9.512
E. Belinga, C. C. N. Ndoua, E. Um, G. Ayissi, JunieMetogo Ntsama, Hanen Chatour, G. Dauptain, Alain Cordesse, P. Foumane
Background: Laparoscopic surgery in gynecology is a minimally invasive technique, which is not void of complications. Our objective was to assess the various complications which occur during gynecological laparoscopy and their associated risk factors at the Gonesse General Hospital (GGH). Method: We carried out a cross-sectional study with retrospective data collection over a two year period from August 1, 2009 to July 31, 2011, at the maternity ward of the GGH. We included all the patients operated by laparoscopy during the study period. A complication was defined as any event that affected the normal course of the procedure and resulted in a rescue action like laparotomy or close surveillance. The proportions were calculated and compared using the Chi-square test. The statistically significant threshold was set at 0.05. Results: A total of 266 women underwent gynecological laparoscopy during the study period. The mean age was 35.78 ± 12.34 years; up to 12.4% of the patients had a past history of laparotomy, while 17.3% had history of laparoscopy. Nearly half of the number of laparoscopic procedures was carried out in the context of an emergency (54.5%) and the major indications were ovarian cysts (25.2%) and ectopic pregnancies (20.3%). A total of 18 surgical complications were identified, representing 6.77% of the sample size. The complications were mostly hemorrhagic in up to 50% of the cases and laparotomy was the main recourse when the complications occurred in 66.7% of the cases. The occurrence of complications was significantly associated with major procedures, p=0.000. Conclusion: There was a high rate of complications in our study and these complications were mostly haemorrhagic in nature and associated with major procedures. The most frequent method of management of these complications was by laparotomy.
{"title":"Complications of Gynaecological Laparoscopy and Associated Factors at theMaternity Ward of the Gonesse General Hospital","authors":"E. Belinga, C. C. N. Ndoua, E. Um, G. Ayissi, JunieMetogo Ntsama, Hanen Chatour, G. Dauptain, Alain Cordesse, P. Foumane","doi":"10.35248/2161-10932.19.9.512","DOIUrl":"https://doi.org/10.35248/2161-10932.19.9.512","url":null,"abstract":"Background: Laparoscopic surgery in gynecology is a minimally invasive technique, which is not void of complications. Our objective was to assess the various complications which occur during gynecological laparoscopy and their associated risk factors at the Gonesse General Hospital (GGH). Method: We carried out a cross-sectional study with retrospective data collection over a two year period from August 1, 2009 to July 31, 2011, at the maternity ward of the GGH. We included all the patients operated by laparoscopy during the study period. A complication was defined as any event that affected the normal course of the procedure and resulted in a rescue action like laparotomy or close surveillance. The proportions were calculated and compared using the Chi-square test. The statistically significant threshold was set at 0.05. Results: A total of 266 women underwent gynecological laparoscopy during the study period. The mean age was 35.78 ± 12.34 years; up to 12.4% of the patients had a past history of laparotomy, while 17.3% had history of laparoscopy. Nearly half of the number of laparoscopic procedures was carried out in the context of an emergency (54.5%) and the major indications were ovarian cysts (25.2%) and ectopic pregnancies (20.3%). A total of 18 surgical complications were identified, representing 6.77% of the sample size. The complications were mostly hemorrhagic in up to 50% of the cases and laparotomy was the main recourse when the complications occurred in 66.7% of the cases. The occurrence of complications was significantly associated with major procedures, p=0.000. Conclusion: There was a high rate of complications in our study and these complications were mostly haemorrhagic in nature and associated with major procedures. The most frequent method of management of these complications was by laparotomy.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"16 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90482961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：