Showing 24 results for Cervical
Moghaddam M, Sazgar Aa,
Volume 58, Issue 4 (7-2000)
Abstract
Sarcoidosis is a chronic multisystem disorder of unknown etiology. All parts of the body can be affected but the organ most frequently affected is the lung. Otolaryngologic manifestations occur in 20% to 40% of cases of Sarcoidosis and the spectrum of lesions that may come under the purview of Otolaryngologist is broad. In this case report a patient is presented with large cervical lymphadenopathy and without other manifestation of disorder.
Mostaan M, Saberi H, Sharyarian Sh, Bahar Joo Hr, Mahdi Zadeh F,
Volume 58, Issue 4 (7-2000)
Abstract
This is retrospective double-blind research, which was carried out in Imam Khomeini hospital in order to study the accuracy of color Doppler ultrasonography for detecting the site and grade of stenosis in cervical carotid artery. 40 patients with mean age of 62 years studied with color Doppler before DSA angiography. The most common sites of stenosis were left internal carotid (39.5%) and right internal carotid arteries (38.4%). We measured peak systolic and end-diastolic velocities (PSA and EDV) and ratios of PSA and EDV at stenosis sites to CCA (PSV ratio and EDV ratio). Results showed that PSA has the highest sensitivity and accuracy in all grades of stenosis: Mild to moderate stenosis: Sensitivity (90.5%), accuracy (89.5%) Severe stenosis: Sensitivity (82.1%), accuracy (92.8%) Total occlusion: Sensitivity (93.8%), accuracy (96.5%). There is no difference between accuracy of Doppler parameters for detection of total occlusion (96.5%) but in other grades after PSV, EDV (Mild-moderate 86%, severe 87.2%). EDV ratio and PSV ratio (Mild-moderate both 84.8%, severe both 86%) have the highest accuracies. We concluded that color Doppler sonography can reliability detect stenosis in carotid arteries & PSV has the highest accuracy.
Behdani R, Moghimi R, Khavari Sh,
Volume 59, Issue 1 (4-2001)
Abstract
A randomized clinical trial study was undertaken to evaluate the effect of intravenous oxytoxin (50 cases) and intracervical prostaglandin E2 (0.5 mg Tab, 50 cases) on the ripening of the cervix and frequency of successful inductions in patients with low Bishop score (<5). Means of maternal age, gestational age, parity, BS at admission did not show any significant differences between the two groups. Until 6 hrs after beginning treatment, 72% of oxytoxin group and 74% of PGE2 group were achieved active labor and until 12 hrs, 70% and 76% delivered respectively. It was no statistically significant difference. The mean drug administration to delivery time was 7.3±3.1 hrs in oxytoxin group and 7.6±3.1 hrs in PGE2 group (without significant difference). No difference in route of delivery was found between the two groups. Maternal complications were seen in 60% of oxytocin group and 46% of PGE2 group, without significant difference. Between maternal complications, frequency of diarrhea was higher at PGE2 group (P=0.02). Fetal complications were seen 4% in the PGE2 group and 16% in oxytocin group, that was less in the first (RR=0.25 CI 95%: 0.06-0.97).
F Ghaem Maghami , F Ensani , N Behtash , S E Hosseini Nejad ,
Volume 62, Issue 4 (7-2004)
Abstract
Background: The aim of this investigation is to evaluate the histologic results of biopsy in women with atypical squamous cells of undetermined significance (ASCUS) cytologic diagnosis.
Materials and Methods: We reviewed a series of cases with ASCUS pap smears from March 1999 to Feb 2002 in Imam Khomeini Hospital (n= 104), Who had cervical biopsy indirected colposcopy (103) and in Onec endocervical biopsy obtained without colposcopy. In 60 patients before colposcopy and biopsy repeat pap smear was tabled.
Results: Biopsy revealed 28.8% SIL (14 LSIL and 16 HSIL), 1 invasive carcinoma and 1 endometrial carcinoma. Pap smear repeated for 60 women before colposcopy examination, which 7 (11.7%) of them were normal. ASCUS persisted in 45 cases (75%) and 8 cases (13.3%) turned out to be SIL (6 LSIL, 2 HSIL) of 7 normal repeat smear, 2 marked as LSIL by biopsy. In colposcopic examination 22 of 103 (21.4%) had normal view which one of them was LSIL histologically.
Conclusion: Based on these findings, it seems immediate colposcopy and directed biopsy are appropriate procedures for management of ASCUS and to detect underlying SIL.
Behtash N, Karimizarchi M,
Volume 64, Issue 12 (11-2006)
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.
Izadi Mood N, Hakimi J,
Volume 65, Issue 10 (1-2008)
Abstract
Background: Tumor diathesis (TD) refers to the granular proteinaceous precipitates on the slide surface of cytologic (Pap) smears. Found in the background of smears from some, but not all, invasive carcinoma cases, TD is present in the majority of smears from large cell nonkeratinizing carcinoma. It is more pronounced than keratinizing SCC also is almost always present in small cell carcinoma. Smears from patients with adenocarcinoma are frequently associated with dense inflammatory and fresh blood exudates and less often there is a recognizable tumor diathesis.
Methods: To determine the prevalence of TD in cervicovaginal smears from patients with uterine cervix carcinoma, cytologic smears and histologic slides of 46 patients with histologically-confirmed uterine cervix carcinoma were reviewed for the presence or absence of TD, red blood cells and neutrophils on cytologic smears, as well as depth of invasion, histologic types and grade of differentiation of tumor on histologic slides.
Results: TD was identified in 28 smears (60.9%), 18 patients with squamous cell carcinoma (62.1%), seven patients with adenocarcinoma (58.3%), two patients with adenosquamous carcinoma (66.7%) and one patient with endometrial carcinoma that involved the uterine cervix. TD was seen in smears from four (33.3%) patients with uterine cervix carcinoma with invasion <5 mm and 17 (65.4%) carcinomas with invasion >5mm. However, some of the patients with invasive carcinoma lacked TD on the cytologic smears. Red blood cells were identified on 16 (34.8%) smears.
Conclusions: Although TD is the hallmark of invasive carcinoma of the cervix on cytological smears, there have been few studies performed on it. We found that tumors with greater depth of invasion and reduced differentiation are associated with TD cytologic smears. TD was absent in some cases, particularly in micro-invasive carcinoma. This study reinforced what has been recognized from other studies.
Amouzegar Hashemi F, Esmati E, Kalaghchi B,
Volume 65, Issue 11 (2-2008)
Abstract
Background: Carcinoma of the uterine cervix is the sixth most common malignant neoplasm in women. Early stage diagnosis of uterine cervix carcinoma increases the cure rate of disease. Radiotherapy, with or without concurrent chemotherapy, is one of the most effective treatment modality in cervical carcinoma. After radiotherapy, accurate and regular follow-up results in early diagnosis and effective treatment of recurrence. The aim of this study is the assessment of the pathologic characteristics, setting and indications for postoperative radiotherapy and outcome of patients at the last follow-up.
Methods: In this retrospective study, we evaluated 346 cases of cervical carcinoma had received radiotherapy in radiation oncology department of the Cancer Institute of Imam Khomeini Hospital, Tehran, Iran, from 1995 to 2001.
Results: The age of the study group ranged from 26 to 78 years (mean=50.5, SD=11). Of these patients, 30.4% were in the early stage and 69.6% had advanced stage disease. Squamous cell carcinoma comprised 92.2% of the cases and 6.4% adenocarcinoma. Radical radiotherapy was the most frequent radiotherapy setting and adjuvant radiotherapy (post-op) was the second. A considerable number of patients did not come back for follow-up, and 43.7% were followed for a short time.
Conclusion: Accurate presurgical clinical staging and surgical treatment by an expert gynecologic oncologist can reduce expose the patients to risks of two modality treatments (surgery and radiotherapy). According to our results, patients do not pay enough attention to disease follow-up. An acceptable training plan with emphasis on regular follow-up, is recommended.
Yarandi F, Izadi Mood N, Eftekhar Z, Niakan R, Tajziachi S,
Volume 65, Issue 14 (3-2008)
Abstract
Background: Cervical cancer is the second most common cancer of the women
worldwide. It is also an important cause of cancer-related mortality in women, after breast
cancer. Nearly half million of new cases are identified yearly. The incidence rate in
developing countries is greater than the developed countries. Epidemiologic studies have
shown that the association of genital human papilloma virus (HPV) with cervical cancer is
strong, independent of other risk factors, and consistent in several countries. The aim of
this study was to determine the frequency of HPV in patients with high grade cervical
intraepithelial neoplasia (CINIII, CIN II) and squamous cell carcinoma (SCC) of cervix.
Methods: Hundred specimens from patients with SCC and CINIII, CIN II, confirmed by
histological review, referring to Mirza Koochak Khan Hospital from 1999-2004 were
enrolled in a cross sectional study. Polymerase chain reaction was utilized for identification
and typing of HPV DNA. To increase the sensitivity of HPV detection, nested PCRs were
performed using MY09/MY11 as outer and GP5/GP6 as inner primers.
Results: It was possible to extract 77 of 100 specimens that HPV DNA was detected in 47 of
77 specimens. Infection with HPV was present in 32 specimens (86.5%) among SCC patients
and in 15 specimens (37.5%) among CINIII, CIN II patients. The most frequent HPV types in
SCC patients were HPV 16 and 18 (59.38%) and then 33 (34.38%) and in CINIII, CIN II
patients was 16 (53.33%) and 18 (40%). the most frequent co-infection in both groups was
HPV 16 and 18 which was present in 40.62% and 26.7% of cases respectively.
Conclusions: The most frequent HPV types in patients with SCC and CINIII, CIN II
was 16 and 18 that is identical to many other countries infection pattern.
Valadan M, Rezaee Z, Mohammadpour J, Moghadami Tabrizi N,
Volume 66, Issue 8 (11-2008)
Abstract
Background: As an important diagnostic and therapeutic procedure for patients with intrauterine diseases, hysteroscopy permits a good view of the uterine cavity, thereby increasing diagnostic accuracy. Complications often encountered during hysteroscopy primarily concern problems with cervical dilatation and include uterine perforation, cervical tears, and the creation of false tracts. In this study, we investigate the utility of vaginal misoprostol for cervical dilatation in women undergoing hysteroscopy.
Methods: This triple-blind, randomized, placebo-controlled study was carried out at Mirza Khoochak Khan Hospital, Tehran, Iran. We excluded women who were pregnant, had genital tract infection, or history of cervical trauma. We randomly assigned 80 women with abnormal uterine bleeding or intrauterine lesions to receive either 200 μg vaginal misoprostol or placebo. Ten to twelve hours prior to hysteroscopy, the placebo or misoprostol was administered to the posterior vaginal fornix. Data regarding cervical response and outcome of operative hysteroscopy, as well as complications, were analyzed.
Results: The mean cervical width, as estimated by Hegar dilator, was significantly greater in the treated group (7.8±1.6mm) than that in the control group (5.6±2.2mm, p<0.001). In the misoprostol group, 28 (70%) patients required cervical dilatation, compared with 38(95%) in the placebo group (p=0.001). A significantly shorter median time of cervical dilatation to Hegar number 9 was found in the treated subjects than in the controls (60 vs. 180 seconds, p<0.001). The mean operative time was significantly shorter in the treated group (8.8±8.7 minutes) compared with that of the control group (13.1±10.1 minutes, p=0.043).
Conclusions: Vaginal misoprostol before operative hysteroscopy lessens the need for cervical dilatation, facilitating hysteroscopic surgery.
Amouzegar Hashemi F, Zahedi F, Farhan F, Kalaghchi B, Mehrdad N, Haddad P,
Volume 66, Issue 12 (3-2009)
Abstract
Background: Treatment of cervical carcinoma is routinely performed with Low Dose Rate (LDR) brachytherapy, but Brachytherapy in our department is done with Medium Dose Rate (MDR) due to the technical characteristics of the machine available here. Thus we decided to evaluate the results of this treatment in our department in a prospective study.
Methods: Between March 2006 and July 2008, 140 patients with histologic diagnosis of cervical carcinoma referred to Tehran Cancer Institute were treated with external beam radiotherapy (44-64 Gy to whole pelvis) and MDR brachytherapy (8-30 Gy to Point A) with a dose rate of 2.2±0.3 Gy/h.
Results: 121 patients were followed up for a median time of 18 months (range: 9-39 m). There were 11%(6/54) local recurrence for surgery and adjuvant radiotherapy group 25%(16/65) for radical radiotherapy group, and 19%(23/121) for all patients. Rectal and bladder complications incidence for all patients were 10%(12/121) and 13%(16/121) respectively. High grade complication was shown only in one patient in radical radiotherapy group. In this study 3-years disease free survival and overall survival were 73% and 92% respectively, and disease stage (p=0.007) and overall treatment time (p=0.05) were the significant factors affecting disease free survival.
Conclusions: Results of this series suggest that the use of external beam radiotherapy and MDR brachytherapy with about 20% dose reduction in comparison with LDR can be an acceptable technique with regard to local control and complications.
Mohammad Banazadeh , Mohsen Eshraghi , Mohammad Ali Noyan Ashraf,
Volume 68, Issue 8 (11-2010)
Abstract
Background: Acute Necrotizing Mediastinitis (ANM) is a lethal disease that without antibiotic therapy and surgical Intervention has a mortality rate about 40% in best medical centers. With development of imaging technology (spiral CT- Scan) and shortening in time of diagnosis and surgery, the outcome and prognosis of the patients are improved. The surgical modalities are trans- cervical and trans- thoracic approaches.
Case series: We present a series of four patients with acute necrotizing mediastinitis that admitted to thoracic surgery ward in vali-e-asr Hospital in Tehran, Iran, during years 2009 and 2010. A 31years old woman and three male patients with ages 21, 25 and 63 years. Odontogenic infection was the cause in two cases while pharyngeal perforation and cervical esophageal perforation were the causes of acute necrotizing mediastinitis the others.
Results: Mean±SD of hospitalization time was 24±6 days. Infection of cervical space (periviceral spaces) and the superior mediastinum were found in all patients while extension of infection below the carina was found in two of them. All patients were operated by trans- cervical approach. One patient was operated by trans- thoracic approach. All patients were discharged with good general condition.
Conclusion: Early usage of spiral CT- scan for diagnosis of acute necrotizing mediastinitis and early drainage with trans- cervical approach could be life saving in acute necrotizing mediastinitis patients with good results.
Mashhadian M, Marsosi V, Ziaei S, Asghari Jafar Abadi M,
Volume 68, Issue 10 (1-2011)
Abstract
Background: Preterm delivery is a relevant public health problem. The aim of this study was
to evaluate the association between spontaneous preterm delivery (SPTD)
before 35 and 37
weeks of gestational age and the measurement of the cervix length, cervical
funneling and Cervical Gland Area (CGA),
in high risk pregnant population.
Methods: A prospective cohort of 200
women carrying high risk pregnancies was evaluated by transvaginal
sonography between 14th and 28th gestational weeks. The data were analyzed using statistical methods.
A multiple linear regression model was estimated
in order to examine the relationship between the gestational age at delivery
and the cervical markers. A multiple logistic
regression was estimated in order to analyze the factors associated to
spontaneous preterm delivery and the transvaginal sonographic markers.
Results: Cervical length less than 18 mm and the presence
of cervical funneling presented a statistically significant association with
spontaneous preterm delivery before 35 weeks.
The nondetection of Cervical Gland Area demonstrated a strong association with
spontaneous preterm delivery before (p=0.0001,
OR=169.1, CI=2.6-3.1) and 35th and 37th gestational week (p=0.001, OR=115,
CI=2.12-3.5). The multiple logistic regression
analysis suggested the non-detection of CGA as
the only variable to reveal statistically significance association with
spontaneous preterm delivery.
Conclusion: Based on results of present study the absence of
cervical gland area (CGA) can be a new and important ultrasound marker for predicting spontaneous
preterm delivery and needs to confirm with future multicenter investigations.
Janbazvatan A, Foruhesh Tehrani Z, Izadi Mood N, Malayeri A,
Volume 68, Issue 11 (2-2011)
Abstract
Background: Thyroid transcription factor-1 (TTF-1) is widely used in the diagnosis of lung and thyroid carcinomas. Although there have been reports of TTF-1 immunoreactivity in tumors other than those originating from the lung or thyroid, endocervical and endometrial adenocarcinomas have not been studied in large numbers in this regard.
Methods: Thirteen endocervical adenocarcinomas, 39 endometrioid endometrial adenocarcinomas and four uterine serous carcinomas which had no neuroendocrine component were retrieved, stained by TTF-1 and examined. A semiquantitative grading system was used to evaluate the distribution of TTF-1 staining (0= negative, 1+ 5%, 2+= 5% to 25%, 3+= 26% to 50%, 4+= 51% to 75% and 5+ 75%). A qualitative system was also used to evaluate the intensity of TTF-1 staining (weak, moderate and strong).
Results: TTF-1 expression was seen in 1 out of 13 (7.7%) endocervical adenocarcinoma samples, showing 1+ distribution rate and weak intensity. The positive sample was moderately differentiated. TTF-1 expression was present in 2 out of 39 (5.1%) endometrioid adenocarcinoma samples (one grade I and the other grade II) with 1+ distribution rate and weak intensity. There was no apparent correlation between the degree of differentiation and TTF-1 positivity in the studied adenocarcinomas. None of the four endometrial serous carcinomas were positive for TTF-1.
Conclusion: Although some recent studies cast doubt about the specificity of TTF-1 for lung and thyroid carcinoma, our study showed that TTF-1 was negative in endocervical and endometrial adenocarcinomas and established the specificity of TTF-1 for lung and thyroid carcinomas.
Ghasemi A, Jahanlou A, Hamdi K, Rezaei A,
Volume 69, Issue 4 (7-2011)
Abstract
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Background: Intrauterine insemination (IUI) is a less expensive
and less invasive treatment in comparison with other assisted reproductive
techniques, and it has been widely used for a variety of indications as well as
in the treatment of couples with infertility. The outcome of IUI
may be affected by numerous factors but in this study, we evaluated the effects
of cervical mucus removal undertaken before IUI
on clinical pregnancy rates.
Methods : In this randomized clinical trial study, all infertile women who were
candidates for IUI and attended Shahid
Akbar Abadi Hospital during 2009 and 2010
were recruited. The participants were randomly assigned into two groups. Cervical
mucus was removed prior to IUI in patients in group
A but in group B,
a classic IUI was done without removing
the cervical mucus. Pregnancy rates were assessed in the two groups by serum
levels of β-HCG
and detection of fetus in the uterus.
Results : 291 women including 143
in the classic IUI group and 148
in cervical mucus removal group completed the study. The pregnancy rates were 14.2%
(21 pregnancies upon 148
cycles) in the cervical mucus removal group and 7% (10
pregnancies upon 143 cycles) in the
control group (P=0.04, OR: 2.199 CI 95%: 0.997-4.85).
Conclusion: The
findings showed that cervical mucus removal could result in a two-fold increase
in pregnancy rate in comparison with classic IUI.
Thus, we suggest this practical and noninvasive method to improve pregnancy
rate in these patients.
Amouzegar Hashemi F, Hamed Akbari E, Kalaghchi B, Esmati E,
Volume 69, Issue 9 (12-2011)
Abstract
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Background: More than 80 years, the standard treatment of locally advanced cervical
cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent
cisplatin-based chemoradiotherapy is the current standard of treatment for this
disease. Gemcitabine has potent radiosensitizing properties in preclinical and
clinical trials, so it can be utilized simultaneously with radiation.
Methods: Thirty Women with untreated invasive
squamous-cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in
Radiation Oncology department of Imam Khomeini Hospital in Tehran from
September 2009 to September 2010. Sixty mg/m2 gemcitabine followed by 35 mg/m2 cisplatin were
concurrently administered with radiotherapy to the whole pelvic region on day
one of each treatment week for five weeks One and three months after treatment,
patients underwent a complete physical examination and MRI to determine the response to treatment.
Results: The mean age of the participants was 58.13±11.83 (29-78) years. After 3 months of treatment, 73.3%
had complete and 26.7% had partial response to treatment.
Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3
leukopenia in 10% of the patients.
Conclusion: According to the positive results of this study in
stage IIB,
further phase II
and III
clinical trials are suggested to evaluate the role of chemoradiation by
gemcitabine in advanced cervical cancers.
A Mousavi, S Akhavan,
Volume 71, Issue 2 (5-2013)
Abstract
Background: Ovarian mucinous borderline tumors are divided into two morphologic groups: endocervical-like and intestinal type. Most endocervical adenocarcinomas exhibit mucinous and/or endometrioid differentiation, they infrequently metastasize to the ovaries but may simulate primary ovarian tumors (both atypical proliferative or borderline and carcinoma). In patients with mucinous adenocarcinoma in the abdominal cavity, caution should be exercised in interpreting the possible primary site of the tumor on the basis of the immunohistochemical profiles. The presence of human papillomavirus (HPV) DNA is assessed to determine whether the ovarian neoplasms were metastases or primary independent neoplasm. Approximately 90% of endocervical adenocarcinomas are related to high-risk human papillomavirus (hr-HPV) with the remainder being unrelated to HPV. Both types metastasize to the ovaries very infrequently. Ovarian endocervical-type (mullerian) mucinous tumors and tumors composed of a mixture of endocervical-type mucinous, serous endometrioid, squamous, and indifferent cells with abundant eosinophilic cytoplasm reported to date have been primarily limited to borderline and micro invasive types. We report a-36-yr old woman with adenocarcinomas of uterine cervix who also had ovarian mucinous borderline tumor.
Case presentation: The patient presented with abnormal uterine bleeding and lower abdominal pain. She had a history of uterine cervix polyps. Pelvic ultrasound showed a right adnexal mass and a large cervical size. Histological diagnosis in uterine cervix biopsy revealed adenocarcinoma of cervix. Radical hysterectomy type III with bilateral salpingo-oophorectomy was performed. Histological finding in adnexal mass revealed borderline mucinous tissue of ovarian tumor. Testing for HPV DNA in the tumoral tissue was negative. This confirms that the ovarian tumor is not metastatic from endocervical adenocarcinoma.
Conclusion: We conclude that in a patient with tumors that involve two organs, complete diagnostic investigation should be done to distinguish the primary origin. The factors that affect cell proliferation, can probably have synchronous effects on the two similar cells.
Mahvash Zargar , Mohammad Ali Nazari , Leila Hormozy , Hasti Madovi Mohammadi,
Volume 72, Issue 3 (6-2014)
Abstract
Background: Any time before labor that termination of pregnancy for mother and fe-tus is better than keeping pregnancy, this is indication of induction for labor. The condi-tion of cervix is the most important factor for labor induction. Cervical condition, In many cases that candidate for induction of labor before labor pain, is poor. As the cervical ripening is quite important for success of labor induction. This study is attempting to compare two methods of cervical ripening.
Methods: During this clinical study, 100 patients admitted in Ahwaz Imam Khomeini Hospital from 2010 to 2011. All of these patients had BISHOP score bellow 5, were di-vided to two groups for cervical ripening. Group one: trans cervical catheter and group two: laminaria. After placing transcervical foley catheter and laminaria for patient in-duction with oxytocin was started according to classic protocol. Then the time lapse from the beginning of induction to enter the active phase of labor and also from start of induction till delivery and appearing the side effect in both group was assessed. The result was analysed by SPSS 16 program.
Results: Fifty three of patient (53%) were primiparous and the rest 47 (47%) were mul-tiparous. All of them had bishop score bellow 5. The average age for the patient group 1 was 27.1 and the average age for other group was 27.18. The time lapse from start of induction to enter active phase of labor in first group was 5.7±2.67 hours and this time for 2nd group was 7.51±2.33 hours. Also the time interval between the start of induction and delivery in group 1 was 10.3±4.35 hours and this time for group 2 was 12.5±4.9 hours. In both cases there was meaningful difference between two groups. There was no difference between both group for appearing the side effects.
Conclusion: Based on this study, it seems using trans- cervical catheter for cervical rip-ening and aid to successful induction of labor is beneficial.
Sima Kadkhodayan , Golrokh Sherafati ,
Volume 72, Issue 10 (1-2015)
Abstract
Background: Cervix is a rare and dangerous site for ectopic pregnancy. When the placenta is implanted lower than internal cervical os, it is called “cervical pregnancy”. Known risk factors for cervical pregnancy are previous cesarean section, cigarette smoking, premature transfer of fertilized ovum before having suitable endometrium and pelvic inflammatory disease. In the past, hysterectomy was the usual treatment. Nowadays, with the newer diagnostic and therapeutic managements, cases of cervical pregnancy treated by fertility sparing methods have been reported. Conservative treatments include using methotrexate and KCl, hyperosmolar glucose, and prostaglandins. Also, surgical methods with fertility sparing have been reported. The purpose of this study is introducing two cases of cervical pregnancies treated by fertility sparing.
Case presentation: The first patient had six weeks pregnancy with live fetus and detectable fetal heart beat. There was six weeks menstrual retard and βhCG titer was 10.000 UI/ml. Two doses of methotrexate were prescribed and pregnancy terminated successfully. The other patient had eight weeks pregnancy with fetal heart beat. There was eight weeks retardation and βhCG titer was 70379 UI/ml with no gestational sac in sonography in both patients. After prescribing two doses of methotrexate and doing curettage three days after the last dose of methotrexate, pregnancy terminated. The known risk factors for our patients were history of endometrial curettage in one and history of cesarean section in both of them.
Conclusion: Conservative method may be considered for the treatment of cervical pregnancy in patients who desire to preserve their fertility. The treatment is associated with high success rates. Methotrexate (MTX) is the most common medicine for resolving ectopic cervical pregnancy, other medications such as KCl, hyperosmolar glucose, RU486 and prostaglandins have also been used with different success rate. Methotrexate may be administered systemic (intramuscular or intravenous) or local (intra-amniotic transfusion or intrauterine).
Mansoureh Ghaoomi , Soheila Aminimoghaddam , Hasan Safari , Ahmadreza Mahmoudzadeh ,
Volume 74, Issue 3 (6-2016)
Abstract
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Background: Cervical cancer is known to be preventable because of long period of pre-invasive stage, availability of screening tools, and effective treatments for early invasive cervical lesions. Screening is main measures to prevent the disease and Pap smear is a screening strategy for cervical cancer. Current paper aimed to evaluate levels of awareness and practice regarding Pap smear screening among women aged between 20 to 65 years in Tehran (Iran).
Methods: This was a descriptive-analytical study conducted in Tehran City of Iran in 2015 at Firoozgar Hospital. The research population included all married, widowed and divorced women aged 20-65 years. Data analysis was performed using the Pearson correlation and Student’s t-tests in SPSS, ver. 23 (Chicago, IL, USA).
Results: Among 90 individuals who have fill questionnaire completely, 66.6% subjects had Pap smear tests. 40% of the individuals aged between 30 to 39 and the education level is distributed equally between Intermediate, Diploma and graduate and only 3 percent of them, continue their education to higher level. There was a significant relationship between the awareness of Pap smear and educational level (of both wives and husbands). The people who have graduate degree, have the best awareness. Working women revealed higher level of awareness about Pap smear. Shame and fear of taking the cancer were the most common reasons which lead to avoidance in doing the test by the women, while the most encouraging factors for performing the test were the information mostly provided by physicians and after that, the information provided by friends.
Conclusion: The awareness of Pap smear test which was measured by weighting different questions in the questionnaire by experts, prove that the women aged above 39, have an average level of awareness of Pap smear test. Due to high prevalence of cervical cancer and prolonged pre invasive course, role of Pap smear for early diagnosis necessitate the use of proper and inexpensive instructional methods to increase awareness in women about cervical cancer and preventive strategies.
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Maryam Akhtari, Mahdi Kamali , Gholam Reza Javadi , Seyedeh Razieh Hashemi ,
Volume 74, Issue 4 (7-2016)
Abstract
Background: Human papilloma virus (HPV) is one of the most important factors in cervical cancer. Viral sequences are integrated into the host cell genome. In mild cases the virus causes skin damages, in severe cases it leads to cancer. Like many other cancers, telomerase gene expression was increased in cervical cancer. This enzyme is a reverse transcriptase that contains two common subunits: i) catalytic protein called human telomerase reverse transcriptase (hTERT) and, ii) RNA sequence called hTR. hTERT expression is hardly found in any somatic tissues. Detection of high telomerase activity in human cells, lead to tumor genesis. So hTERT can be used as a diagnostic tool in cancer detection.
Methods: This experimental study was carried out from May 2013 to April 2014 in Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences in Tehran, Iran. Caski and Hela cancer cell lines were used which contain HPV16 and HPV18 respectively. Cell lines were cultured and total RNA was extracted. Following normalization agent glyceraldehyde-3-phosphate dehydrogenase (GADPH), hTERT expression level was determining by real-time PCR method. For each sample, the expression level of hTERT and GAPDH were quantified as copy numbers (per reaction) using the standard curve. Finally, hTERT levels in Hela and Caski cell lines were compared quantitatively by t-test using GraphPad statistic software version 5 (San Diego, CA, USA).
Results: According to the charts real-time PCR, hTERT gene expression in Hela and Caski cancer cell lines is significantly different (t=0.0319).
Conclusion: All results confirm that hTERT expression levels in Hela and Caski cell lines are significantly different and the level of hTERT expression in the Caski cell line was slightly higher than that of Hela cell line. The significant difference between hTERT mRNA expression levels reported here could be used as a tumor marker for HPV16 and HPV18 in cervical cancer.
