June 2019
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33 Reads
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1 Citation
Clinical Nuclear Medicine
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June 2019
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33 Reads
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1 Citation
Clinical Nuclear Medicine
December 2016
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58 Reads
Background: Surgical staging is the standard treatment of ovarian cancer. Pelvic and para-aortic lymphadenectomy is the important part of the surgery. The aim of this study was to evaluate the effect of para aortic lymph node dissection in early stage of patients with ovarian cancer. Methods: This descriptive cross-sectional cohort study was performed on all stage I of ovarian cancer patients admitted in department of gynecology oncology of Ghaem Hospital, Mashhad University of Medical Sciences in November 2012 to March 2014. Every patient with clinical early stage of ovarian cancer candidate to surgical treatment selected. All cases underwent surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy. In laparotomy after identification of left and right iliac artery, all lymph nodes have been properly exposed and dissected as a part of a staging laparotomy. The dissection was continued up to the nodal tissues surrounding the aorta, and inferior vena cava, until inferior mesenteric artery lymphadenectomy level. The procedure performed only by gynecologist oncologist. In addition, we assessed other parameters such as operation time, estimated blood loss, associated mortality and morbidity and vascular injuries. Finally, the effect of para aortic lymph node dissection in early stage of ovarian cancer evaluated. Results: Among a total of 57 ovarian cancer patients, 27 of them apparent stage I disease cases were selected. Surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy was carried for all of them. Positive para-aortic lymph node was found only in one case. The average number removed para-aortic lymph nodes in the pelvis was 9 and in para aortic was 7, respectively. In addition, 20 minutes increase in total length of operation time was observed duo to para-aortic lymphadenectomy. Also the rate increase in intra-abdominal hemorrhage rate was estimated 60 ml. Conclusion: Lymph node dissection will produce a significant benefit in accurate and complete surgical staging. Staging surgery in addition to systematic pelvic and para aortic lymph adenoctomy in early stage ovarian cancer is preferred in gynecologic oncology centers.
May 2016
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38 Reads
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2 Citations
Oman Medical Journal
Objectives: The frequency of adnexal masses in pregnant women ranges from 0.1% to 4%. Selecting the right approach to manage the subsequent intervention remains one of the most controversial challenges among gynecologists. Our aim in this cross-sectional study was to clarify the clinical-pathological differences among the adnexal masses that are excised during either the antepartum period or cesarean section (CS). Methods: In this study, we assessed 11,000 pregnancy cases referred to the Qaem Hospital in the Mashhad University of Medical Sciences, Iran, between 2010 and 2014. In total, 53 pregnant women with adnexal masses (other than non-gynecological mass and ectopic pregnancy) were selected for further investigation. We divided patients into two groups (group A and group B). Patients of group A had a diagnosed tumor that was excised antepartum while patients in group B had a mass taken out during CS. We then assembled data based on maternal age, parity, gestational age, surgery type, delivery mode, size and location of the tumor, complications, presentations, histopathological diagnosis, and ultrasonography findings for further analysis. Results: The major proportion of masses (62.3%) were excised during CS whereas the remainder (37.7%) were removed antepartum. The mean size of the detected tumor for benign and malignant cases was 10.0 cm and 13.8 cm in group A, and 8.0 cm and 9.3 cm in group B, respectively. There was a statistically significant difference observed between patients in the two groups regarding the benign/malignant status of the mass (p = 0.008), its size (p = 0.019) and simplicity/complexity (p = 0.004). Conclusions: The rate of malignant tumors was considerably higher in women who had antepartum mass excision compared to those with mass resection during CS. Also, tumors were larger (and more complex) in patients in group A compared to group B.
September 2015
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13 Reads
Iranian Journal of Obstetrics, Gynecology and Infertility
Introduction: The majority of adnexal tumors in pregnancy are benign. It is important to distinguish between benign and malignant ovarian tumors. Due to the sensitivity of pregnancy, especially malignant adnexal masses in pregnancy and the lack of accurate information from the prevalence of this malignancy, this study was performed with aim to evaluate the prevalence of adnexal masses in pregnancy. Method: This cohort study was performed on 53 pregnant women with adnexal mass who needed to surgery referred to gynecology oncology department of Mashhad Ghaem Hospital during 2010-2014. Evaluating variables included maternal age, gestational age, sonographic characteristics of tumor, clinical symptoms of patient, type of surgery, pathology status of tumor, performed chemotherapy and prognosis of mother and fetus. Data collection tool was a questionnaire. Data was analyzed by SPSS statistical software (version 16), and Mann-Whitney and Kruskal-Wallis tests. PResults: the prevalence of malignancy was 21% (11patients). The most frequent malignancy in adnexal masses and pregnancy was germ cell tumors. 55% of these tumors were in stage 3 and 4. Borderline tumors included 18% of malignant tumors. In this study, maternal mortality rate of 5.6% and maternal mortality rate of 3.8% was reported. Conclusion: Adnexal masses in pregnancy should be evaluated with more care and sensitivity and in cases of suspected or stable tumors, it is better to perform surgery in gynecologic oncology centers. © 2015, Mashhad University of Medical Sciences. All rights reserved.
July 2015
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12 Reads
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3 Citations
Iranian Journal of Obstetrics, Gynecology and Infertility
Introduction: Cesarean scar ectopic pregnancy (CSP) is a rare type of ectopic pregnancy, but is very important because of potentially dangerous complications. The patients complicated by this usually refer with abdominal pain or vaginal bleeding. The diagnosis is usually difficult and done by an experienced radiologist. This article presents a case of ectopic pregnancy in previous caesarean scar. Case report: in this study, the patient was a 36 years old woman with a diagnosis of ectopic pregnancy in previous cesarean scar who underwent laparotomy because of abdominal pain and bleeding, with regard to the patient's tendency for fertility preserving, the pregnancy sac was resected and the myometrium was sutured in multi-layers, and fortunately, the uterus was eserved. Conclusion: Because of the high prevalence of patients with previous cesarean section, it is very important to early diagnose the cesarean scar pregnancy, and the best diagnosis method is transvaginal sonography. According to the gestational age and the patient's condition, treatment can be medical or surgical. © 2015, Mashhad University of Medical Sciences. All rights reserved.
January 2015
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35 Reads
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4 Citations
Iranian Journal of Obstetrics, Gynecology and Infertility
January 2015
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29 Reads
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5 Citations
Iranian Journal of Obstetrics, Gynecology and Infertility
Introduction: Gynecologic cancers can have profound effects on function of women's life. In women with ovarian cancer, treatment leads to changes in the anatomy and function of the vagina. This study was performed with aim to evaluate sexual dysfunction in women with ovarian cancer. Methods:This cross-sectional study was performed on 210 women with ovarian cancer admitted to Mashhad Ghaem and Omid hospitals and 130 healthy women who were matched with our patients in terms of age from 2009 to 2013. The subjects completed the form of sexual function questionnaire (FSFI) through an independent inquiry. Data was analyzed by SPSS software (version 16.5). PResults: 31.9% of patients were within 5 decades of life and had mean age of 48.15 years. According to Pearson test, the prevalence of sexual dysfunction was 85.7% in patients with ovarian cancer and 52.9% in healthy women that the difference was significant (P< 0.001). Conclusion: Sexual dysfunction is more prevalent in patients with cancer compared to healthy subjects. Disorders were highly prevalent in the excitement and libido, vaginal moisture, orgasm and pain during intercourse. © 2015 Mashhad University of Medical Sciences. All rights Received.
September 2014
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7 Reads
Iranian Journal of Obstetrics, Gynecology and Infertility
Introduction Basic treatment of patients with cervical intraepithelial neoplasia is prevention of regress to invasive carcinoma. One of the treatment methods of these patients is conization. This study was performed with the aim to evaluate the related factors of remained dysplasia after treatment of cervical intraepithelial neoplasia (CIN) by cold knife conization.
January 2014
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22 Reads
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3 Citations
Iranian Journal of Obstetrics, Gynecology and Infertility
Introduction: Ovarian cancer is one of the most common gynecological malignancies with high mortality rate. This high mortality rate may be due to delay in diagnosis. Using tumor-specific markers that are sensitive in the early stages of cancer is very effective to improve results of therapy. The aim of this study was evaluation of the diagnostic value of serum levels of Heat-shock protein 70 and CA125 in patients with epithelial ovarian tumors. Methods: This analytical study was conducted on 37 patients with epithelial ovarian cancer and 35 patients with benign ovarian masses in 2011-2012. Blood samples were taken from all patients before the surgery. Patients with ovarian cancer underwent cytoreductive surgery and tumor staging. Also, patients with benign ovarian masses underwent cystectomy or oophorectomy. Serum levels of HSP70 and CA125 were measured by ELISA and RIA, respectively. Finally, HSP70 and CA125 levels were compared before surgery between two groups. Data were analyzed by SPSS software version 16 and Fisher, chi-square, t-student, Mann-Whitney, and ANOVA tests. P value less than 0.05 was considered significant. Results: Mean age of patients with malignant ovarian cancer was significantly higher than the benign ovarian masses group (p<0.001). Pain was the most prevalent symptom in 62.5% of cases in both groups. Mean levels of CA125 and HSP70 were respectively 672.95±470.55 and 0.859±0.461 in patients with ovarian cancer. The mean levels of CA125 and HSP70 in epithelial ovarian cancer was significantly higher than benign ovarian masses group (p=0.025 and p=0.001, respectively). Conclusion: HSP70 along with CA125 can be useful for early detection of malignant ovarian cancers.
January 2014
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22 Reads
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3 Citations
Iranian Journal of Obstetrics, Gynecology and Infertility
Introduction: Vaginal atrophy (VA) causes by estrogen deficiency and occurs in postmenopausal women. Today, clinical signs and symptoms are used for detection of vaginal atrophy. Laboratory techniques are other methods that can be used. The aim of this study was to compare the clinical and laboratory indexes for the diagnosis of vaginal atrophy in postmenopausal women. Methods: This correlational study was conducted in 2013 on 100 postmenopausal women who had attended tohealth centers number 1 and 3 and gynecology clinic of Ghaem hospital of Mashhad, Iran. Data were gathered by a demographic information form and observation and examination of vaginal atrophy form. Data were analyzed by SPSS software version 11.5, descriptive statistics and Spearman correlation coefficients. P value less than 0.05 was considered significant. Results: There was not significant correlation between vaginal dryness (p=0.08), elasticity of vagina (p=0.26), color of vagina (p=0.14), rugae (p=0.68) and vaginal petechiae (p=0.52) with vaginal maturation value but there was positive correlation between petechiae (p=0.00) and color of vagina (p=0.03) with vaginal PH. Conclusion: There are differences between the clinical and laboratory diagnosis of vaginal atrophy. Recognition of vaginal atrophy based on clinical signs and symptoms is not enough and according to the adverse effects of hormone therapy, it is recommended that definitive diagnosis of vaginal atrophy should be made based on laboratory evaluation.
... A 2016 study by Saghafi et al., carried out at the same center, showed that patients undergoing mass excision during pregnancy had a higher rate of malignant tumors compared to those who underwent mass excision during Caesarian section. Perhaps the type of tumors which was removed during the Cesarian section tends to be less malignant (16). The authors emphasized the accurate diagnosis and proper management of ovarian tumors alongside consultation by an oncologist gynecologist. ...
May 2016
Oman Medical Journal
... Additionally, compared to the above study, although the positive predictive value in our study was lower, the sensitivity and specificity values and the negative predictive value of the test were almost consistent with the results of this study. The results of Yousefi et al.'s study (2014) indicated that the mean age of patients with malignant mass was significantly higher than that of the patients with benign mass [12]. ...
January 2014
Iranian Journal of Obstetrics, Gynecology and Infertility
... 3 The validity of this tool has been confirmed in previous studies on menopause that have been conducted inside and outside of Iran. [18][19][20] The validity of the tool used in this study was confirmed using content validity and the opinion of 10 experts (reproductive health specialists, gynecologists and obstetricians). The reliability of the scale of subjective symptoms of vaginal atrophy was determined using the parallel reliability method. ...
January 2014
Iranian Journal of Obstetrics, Gynecology and Infertility
... Despite the fact that several treatments have been proposed for the condition, the literature has yet to reach a conclusion on definitive approach for CSP [15,16]. Based on the size of the gestational sac on imaging, gestational age, baseline β-hCG, patient's desire to maintain fertility, surgical expertise of the primary physician, CSP treatments encompass a variety of choices including expectant treatment, hysteroscopy, methotrexate or KCL administration, or EP removal and uterine wall repair via laparotomy [17][18][19][20]. Suction curettage may also be utilized as well; however, due to the limited exposure and low myometrial thickness, there is a risk of uterine perforation, injury to the surrounding organs, and air embolism formation [21]. ...
July 2015
Iranian Journal of Obstetrics, Gynecology and Infertility
... In spite of the side effects of mastectomy, sexual issues have been an important consideration for them. In fact, loss of a breast, as an important organ during sexual relationships, threatens women's sexual and marital life [16,17]. The quality of women's sexual life can be influenced by different factors that are related to sexual behaviors [18]. ...
January 2015
Iranian Journal of Obstetrics, Gynecology and Infertility