Showing 6 results for Behtash N
Behnamfar F, Hamedi B, Ramezanzadeh F, Behtash N,
Volume 64, Issue 9 (1 2006)
Abstract
Background: Cerebral metastases from choriocarcinoma are poor prognostic indicator of outcome in both the World Health Organization and FIGO classification systems. Although gestational trophoblastic neoplasia has become the most curable gynecological malignancy, failure rate among “high-risk” patients is still high despite the use of aggressive multidrug regimens.
case: A 27 year old woman (G4P2Ab1) presented with hemiplegia due to brain metastases of choriocarcinoma one year after spontaneous abortion. She underwent craniotomy and was treated with nine courses of multiple agent etoposide, methotrexate, actinomycin-etoposide and cisplatinum (EMA-EP) regimen combined with whole brain irradiation. She delivered a term healthy child two years after termination of treatment.
Conclusion: Multiagent EMA-EP chemotherapy and whole brain irradiation with craniotomy in selected patients preserves fertility and may improve a patient overall prognosis.
Methods: In a descriptive study from February to April 2005, two hundred sixty six consecutive pregnant women referring to a university hospital were asked to answer a questionnaire containing questions their sexual status and some demographic data. In 122 cases the answers of the spouses was collected also. The answers were compared in divided groups according to age range, duration of marriage, parity and educational status.
Results: Fifty five percent of men and fifty eight percent of women had a negative attitude about sexual relations during pregnancy, and 60% of men and 75% of women presented incorrect knowledge about sexuality during pregnancy. Main reasons for decreased sexual relations in pregnancy were mentioned to be dysparaunia, and the fear of trauma to the baby, abortion, membrane rapture, preterm labor and infection.
Conclusion: As couples’ knowledge and attitudes about sexuality affect their general sexual behavior during pregnancy it is crucial to provide proper consultation regarding sexual relations in prenatal care services.
Modarres M, Mosavi A, Mohammadifar M, Behtash N, Ghaemmaghami F, Soltanpour F,
Volume 64, Issue 11 (7 2006)
Abstract
Background: Access to a safe and efficient chemotherapy regimen for improving the survival and live quality is a goal in ovarian carcinoma. Despite surgery is the base treatment of ovarian cancer, but in most patients chemotherapy is used due to progression of their disease. This study designed to compare two important chemotherapy regimens.
Methods: This historical cohort study compared two chemotherapy regimen cisplatin (75mg/m2)+ cyclophosphamide (750mg/m2), versus taxol (175mg/m2)+ carboplatinium (GFR+25)AUC between 1998-2005 in valiasr hospital. In this study toxicities of two regimes were compared. The survival function in these two groups were analysed with Kaplan-Meire curve.
Results: Gastrointestinal and mucosal toxicity were significantly higher in CP group compared TC group (p=0.02). Also there were no significant relation between decrease of serum CA125 and patient remission length in CP group but in other group with decrease of CA125 in lower than three cycle we had an increase in patient remission period. (P=0.02). Disease free interval in cisplatin group was longer versus taxol group (p<0.05), there was no significant difference in overall survival in two group.
Conclusion: This study revealed that cisplatin plus cyclophosphamide regimen can yet be used as a chemotherapy treatment in ovarian cancer. In this study there was no significant benefit in taxol regimen compared CP. In the adjuvant therapy of epithelial ovarian carcinoma.
Behtash N, Karimizarchi M,
Volume 64, Issue 12 (6 2006)
Abstract
Cervical cancer is the second most common gynecologic cancer. A steady 70% annual decline in mortality from cervical cancers has been observed since the mid 20th century after the introduction of widespread papanicolaou cytological screening. But also cervical cancer continues to be an important world health problem for women. Cervical cancer is one of the best- understood neoplasm given its well known viral cause of persistent infection with high risk human papillomavirus (HPV). To date, two manufacturers have developed HPV vaccines composed of noninfectious, recombinant HPV viral-like particles (VLPs). This article presents current advances and perspectives on HPV vaccines.The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13--26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.
Mous0avi A.s, Behtash N, Karimi Zarchi M, Modarres Gilani M, Ghaemmaghami F,
Volume 65, Issue 2 (8 2008)
Abstract
Background: Although endometrial cancer is primarily a disease of the postmenopausal female, 25% of patients are premenopausal, with 3-5% in women 40 years old or younger. The younger group of women with endometrial carcinoma are frequently nulligravid with a history of infertility, and a strong desire to preserve fertility. This may pose a therapeutic dilemma for both patients and treating physician.
Case report: We reported 3 young patients with atypical complex hyperplasia or early stage endometrial cancer that treated with conservative hormonal therapy.
Conclusion: Medical treatment of young patients with endometrial carcinoma and complex atypical hyperplasia who wish to preserve fertility is a reasonable and appealing option. A comprehensive evaluation prior to counseling the patient should include
A complete history and physical examination. A formal D&C with review of history with an experienced gyn-onc pathologist. Evaluation of the pelvic and abdomen preferably with contrast-enhanced MRI or transvaginal ultrasound. In patients found to have a clinical stage I grade I tumor and who want to preserve fertility , thorough counseling include risks and benefits, and explanation that the data is partial and incomplete due to the lack of appropriate controlled studies is mandatory. In patients considered for medical treatment, a high dose progestin regimen should be started with endometrial sampling every 3 months until complete regression of the tumor is documented. Although most responses are long standing, there is a small risk of progression during or after cessation of progestin therapy.
Behtash N, Fakhrejahani F, Khafaf A, Ghayouri Azar E,
Volume 65, Issue 3 (2 2007)
Abstract
Background: The aim of this study was to evaluate the association between atypical glandular cell (AGC) on Pap smear and significant pathologic finding to tailor management protocols.
Methods: Between 2002 and 2005, Among 26893 Pap smears 122 women with AGC Pap smears (prevalence=0.45%) were referred to our colposcopy clinic. Forty one women underwent colposcopy directed biopsy, endocervical curettage, endometrial sampling and cervical conization to determine the cytologic and histologic correlations of AGC on pap smears.
Results: A total of 122 women with AGC Pap smear were found. Only 41 women accepted to participate in the study and followed the workup procedures. The mean age of the patients was 46.92 ±11.48 years (range, 23-80 years). Of these patients 13 patients (31.7%) were post menopause and 28 patients (68.2%) were in reproductive age.
We found 13 (31.7%) significant pathologic findings including 4 (9.7%) high grade squamous intraepithelial lesion (HG-SIL), 3(7.3%) low grade squamous intraepithelial lesion (LG-SIL), 2(4.8%) Endometrial hyperplasia, 1(2.4%) Endometrial adenocarci-noma, 1(2.4%) adenocarcinoma of cervix, 1(2.4%) squamous cell carcinoma of cervix and 1(2.4%) papillary serous tumor of ovary. There was not any significant difference in the prevalence of significant pathologic findings and subtype of squamous or adenomatous lesions between pre and postmenopausal group.
Conclusion: AGC on Pap smear was associated with a clinically significant diagnosis in approximately one third of our cases. The women with a diagnosis of AGC on cervicovaginal smear are needed to be evaluated at least with colposcopy, endocervical and endometrial curettage. Clinicians should be careful about the significance of AGC in pap smears.
Ghaemmaghami F, Hasanzadeh M, Modarresgilanimadani M, Behtash N, Mousavi As, Ramezanzadeh F,
Volume 65, Issue 4 (3 2007)
Abstract
Background: The aim of this study was to compare the outcome of treatment for ovarian cancer patients who have been treated by gynecologist oncologists and patients who have been treated by general gynecologists or general surgeons.
Methods: We enrolled in this cohort retrospective study all patients diagnosed with primary ovarian cancer in Vali-e-Asr Hospital, Tehran, Iran, between April 1999 and January 2005. A total 157 consecutive patients with ovarian cancer were available for analysis. Of these, 60 patients were treated by gynecologist oncologists and 95 by general gynecologists, and two patients were treated by general surgeons.
Results: The number of patients who underwent optimal cytoreductive surgery (residual tumor <1 cm) was higher in the gynecologist oncologist group, than in the general gynecologist group (P<0.001). Repeated surgeries were required for a majority of patients in the general gynecologist group, while only a few patients in the gynecologist oncologist group needed a second operation (P<0.0001). The interval between the initial surgery and the beginning of chemotherapy was significantly longer in the gynecologist oncologist group compared to that of the general oncologist group (P=0.001). Overall survival and disease-free survival was considerably greater in the gynecologist oncologist group. Optimal cytoreductive surgery and stage of disease are prognostic factors in patients with ovarian cancer. We can therefore conclude that patients with ovarian cancer who are treated by gynecologist oncologists have a better outcome.
Conclusions: We suggest that patients requiring cytoreductive surgery for ovarian cancer be referred to a gynecologist oncologist rather than having a less specialized physician care for such cases.
