Results and experiences after 2000 performed hysteroscopies

Introduction. Hysteroscopy is one of the oldest endoscopic procedures which uses the cervix for introducing a telescope to place a camera into the uterine cavity. Objective The aim of the study was to present our experiences with this procedure during the long-term work starting from the time when hysteroscopic method of treatment was first introduced at this Clinic until today. Methods. This prospective study involved 2000 female patients referred to the Clinic for Gynecology and Obstetrics in Novi Sad from January 2005 till January 2011 for diagnostic and operative hysteroscopy. The following parameters were analyzed: the presence of minor and major pathology of the endometrium, type of anesthesia, technique of operative work, instruments and energy used during hysteroscopy and complications. Results. Seventy-eight percent of all procedures were done under intravenous anesthesia. The most common operative procedure was polypectomy and the most complicated one was myomectomy. By histopathological examination of hysteroscopic biopsy specimens four endometrial carcinomas were revealed. The combination of mechanical instrument and bipolar energy were used in most of the cases, while the percentage of complications was extremely low. Conclusion. Hysteroscopy is a safe, highly sensitive, precise diagnostic and operative endoscopic procedure. Our experiences and dilemmas open a field for discussion and offer salutations to everyday problems. The introduction of this procedure into out-patients conditions has contributed to the efficiency of the treatment of vaginal pathological processes, thus enabling that the method has become available to all gynecologists. This fact requires further study and new results.

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Morphology and immunohistochemical studies of ovarian strumal carcinoid

Medicinski pregled ◽

10.2298/mpns1204102m ◽

2012 ◽

Vol 65 (3-4) ◽

pp. 102-105

Author(s):

Mihaela Mocko-Kacanski ◽

Aleksandra Levakov ◽

Matilda Djolai ◽

Snezana Bozanic ◽

Jelena Amidzic

Keyword(s):

Histopathological Examination ◽

Thyroid Tissue ◽

Brown Tumor ◽

Thyroid Transcription Factor 1 ◽

Gynecology And Obstetrics ◽

Eosinophilic Cytoplasm ◽

The Right ◽

Immunohistochemical Studies ◽

Novi Sad ◽

Strumal Carcinoid

Introduction. Teratomas are tumors derived from pluripotent germ cells, and they appear most frequently in ovaries. Strumal carcinoid belongs to the group of monodermal teratomas. Strumal carcinoid is characterized by the presence of carcinoid tumor, intermingled with thyroid tissue. Case report. A 52-year-old postmenopausal woman was referred to the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi Sad with complex right adnexal mass for surgery. Laparotomy revealed tumor arising from the right ovary, of firm consistency and intact capsule. On gross examination, yellowish brown tumor was 26 x 17 x 10 cm, with vague nodularity. The cut sections revealed predominantly solid mass with two cystic areas, and one of the cysts showed a tuft of hair. On histopathological examination, the cystic spaces were lined with skin and mucinous epithelium. The solid areas showed a population of monomorphic cells with eosinophilic cytoplasm and nuclei with ?salt and pepper? chromatin, arranged in acinar and trabecular patterns, respectively. In addition, focally follicular structures with central eosinophilic colloid-like material were seen. Based on the presence of these two components, a diagnosis of Strumal Carcinoid was made and confirmed on immunohistochemistry. The tumor cells were diffusely immunopositive for synaptophysin, chromogranin, and the follicles including the central colloid were immunopositive for thyroglobulin and Thyroid transcription factor-1. Neither proliferative or mitotic activity nor capsular or angiolymphatic invasion were noticed. At 3 year follow up the patient was disease free. Conclusion. In order to diagnose this rare tumor a team, consisting of a pathologist, surgeon and radiologist, is needed. Diagnosis of strumal carcinoid has to be confirmed on immunohistochemistry.

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A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

Asian Journal of Medical Sciences ◽

10.3126/ajms.v11i5.29548 ◽

2020 ◽

Vol 11 (5) ◽

pp. 54-60

Author(s):

Apurba Mandal ◽

Shibram Chattopadhyay ◽

Sushanta Mondal ◽

Arunava Biswas

Keyword(s):

Ovarian Cancer ◽

Adnexal Mass ◽

Malignant Tumors ◽

Histopathological Examination ◽

Tertiary Care ◽

Ca 125 ◽

Tertiary Care Centre ◽

Gynecology And Obstetrics ◽

Risk Of Malignancy ◽

Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

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Abnormal Uterine Bleeding in Perimenopausal Age: Different causes and its relation with histopathology

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v13i2.18295 ◽

2014 ◽

Vol 13 (2) ◽

pp. 135-139 ◽

Cited By ~ 1

Author(s):

Nazlima Nargis ◽

Iqbal Karim ◽

Khondaker Bulbul Sarwar

Keyword(s):

Histopathological Examination ◽

Medical Science ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Sonography ◽

Age Group ◽

Histopathological Findings ◽

Medical College ◽

Gynecology And Obstetrics ◽

Study Results

Background: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. Objective: This study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with ultrasonographic and histopathological examinations. Study Method: This descriptive study was conducted in the department of gynecology and obstetrics, Ibn Sina Medical College, Dhaka during January to December 2012. Two hundred and eleven women were selected for this study, who admitted into the hospital with abnormal uterine bleeding in perimenopausal age. The clinical, ultrasonographic and histopathological findings of these women were evaluated in this study. Results: Menorrhagia was the major symptom (52.6%) irrespective of age and parity. All these women underwent D&C followed by either medical management or hysterectomy depending upon the diagnosis. The histopathological findings of endometrium were analyzed and confirmed as fibroid uterus (58.28%) and DUB (17.58%) correlated well with transvaginal sonography (TVS) and histopathological examination. Hysterectomy conferred other uterine lesions as adenomyosis (18.71%), endometrial polyp (4.81%) and malignancy (1.06%). Conclusion: Abnormal uterine bleeding in perimenopausal age group is a common but ill-defined entity which needs proper evaluation. Accurate diagnosis of the causative factors of AUB in this age group is of utmost importance so that appropriate management can be established early that leads the minimization of the patients sufferings. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18295 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.135-139

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Multiple endometrial polyps in patient undergoing long-term gestagen therapy

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0510438z ◽

2005 ◽

Vol 133 (9-10) ◽

pp. 438-440

Author(s):

Milena Zamurovic ◽

Pavle Srbinovic ◽

Jovana Petrovic

Keyword(s):

Progesterone Receptors ◽

Uterine Cavity ◽

Reproductive Period ◽

Histopathological Analysis ◽

Endometrial Polyps ◽

Endometrial Cells ◽

Gynecology And Obstetrics ◽

Irregular Bleeding ◽

Continuous Presence ◽

Cell Genome

Endometrial polyps represent a limited focal, circumscribed overgrowth of the endometrium. Their aetiopathogenesis has not been completely explained yet. They are often found in perimenopausal women; during the reproductive period they are less common. We present the case of a 32-year-old patient, who came for a check-up to the Gynecology and Obstetrics Clinic "Narodni Front" because of irregular bleeding. The patient was subjected to hormonal linestrenol therapy, which she had administered herself, without further consultations with her gynecologist, during the previous 10 years. Complete diagnostic examinations were performed. Contrast sonohysterography enabled the visualization of multiple polyps inside the uterine cavity, which were confirmed by histopathological analysis of material obtained via explorative curettage. Histopathological material contained over 30 endometrial polyps. A control check-up after one month, as well as subsequent quarterly check-ups, resulted in normal findings. Analysis of the described case has indicated that the loss of sensitivity of progesterone receptors in endometrial cells is possible if there is a continuous presence of progesterone agonists in circulation, as is true of linestrenol in this case. The loss of sensitivity of progesterone receptors upsets normal hormonal activity during the secretory phase of the menstrual cycle, leading to copious, irregular bleeding. These changes may, however, have even deeper effects. More recent research shows that, if the agent causing the loss of sensitivity of the receptors is present in circulation over a longer time period, changes may also appear at the DNA molecular level, i.e. in the cell genome itself. This, in turn, may lead to the beginning of the process of oncogenesis and the formation of timorous tissue.

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Development of the city hospital in Novi Sad - part II

Medicinski pregled ◽

10.2298/mpns1908251d ◽

2019 ◽

Vol 72 (7-8) ◽

pp. 251-256

Author(s):

Dusanka Dobanovacki ◽

Nada Vuckovic ◽

Radmila Gudovic ◽

Vladimir Sakac ◽

Milanka Tatic ◽

...

Keyword(s):

Medical Rehabilitation ◽

City Hospital ◽

Financial Difficulties ◽

Gynecology And Obstetrics ◽

Clinical Center ◽

Bed Capacity ◽

1960S And 1970S ◽

The 1960S ◽

Novi Sad ◽

Rehabilitation Clinic

At the end of the Second World War, the General State Hospital had seven departments, the same facilities, and the same bed capacity as in the pre-war period. In the newly formed state of Yugoslavia, intensive growth and modernization of the hospital began, despite the great financial difficulties. The hospital became the Main Provincial Hospital and new departments and services were established. Mainly during the 1960s and 1970s, ten new surgery departments were established, which later became independent clinics. The surgery departments occupied pavilions 1, 2, 3 and 4. Complex and contemporary abdominal and thoracic surgeries were performed. The Department of Internal Diseases became the Clinic of Internal Diseases and in 1964 it was moved to a newly equipped four-story building. The Clinic of Gynecology and Obstetrics was founded and it was moved into a modern, purpose-built facility with a 230 bed capacity for adult patients and 105 for newborns. Rapid progress has also been made in the development of the Clinic of Infectious Diseases, Clinic of Eye Diseases, Clinic of Ear, Nose and Throat Diseases, Neurology and Psychiatry Clinics, Clinic of Dermatovenereology Diseases, Medical Rehabilitation Clinic - as well as a modern laboratory, X-ray, blood transfusion, and polyclinic services. After the establishment of the Faculty of Medicine and the Clinical Center of Vojvodina, this large tertiary medical institution is the source of pride for Novi Sad. Founded 110 years ago, the hospital is still dedicated to providing better healthcare for patients.

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Uterine leiomyoma: modern aspects of clinic, diagnosis and treatment

Reproductive health of woman ◽

10.30841/2708-8731.5.2021.240017 ◽

2021 ◽

Vol 5 ◽

pp. 7-18

Author(s):

О.V. Golyanovskiy ◽

O.Yu. Kachur ◽

M.А. Budchenko ◽

K.V. Supruniuk ◽

S.V. Frolov

Keyword(s):

Magnetic Resonance ◽

Uterine Leiomyoma ◽

Clinical Manifestations ◽

Uterine Fibroids ◽

Uterine Cavity ◽

Diagnosis And Treatment ◽

Scientific Publications ◽

Genetic Components ◽

Gynecology And Obstetrics ◽

Gynecological Examination

According to the WHO, neoplastic processes of the uterus remain one of the important and relevant areas of modern gynecology. Uterine leiomyoma is one of the most common tumors of the female reproductive system. According to the latest data, every 4–5th woman in the world is diagnosed with leiomyoma, the incidence of which under the age of 35 reaches 50%, and according to autopsy data reaches 80%.The article provides a review of the scientific publications in recent years devoted to the study of the problem of uterine fibroids – relevance, causes and mechanisms of development, provides a classification, clinical manifestations, modern diagnostics and management tactics.The etiological factors of leiomyoma are numerous, there is no a single theory of the disease. Among the pathogenetic factors of leiomyoma are hormonal disorders, genetic components, infections, injuries. There are several classifications of leiomyoma, the most common classification was proposed by the International Federation of Gynecology and Obstetrics, which reflects the types of leiomatous nodes depending on their location and relationship to the uterine cavity and myometrium.Clinical manifestations of uterine fibroids range from asymptomatic to painful sighns and hemorrhagic syndromes, symptoms of compression of adjacent organs, the development of uterine bleeding, which lead to severe anemia. The nature of clinical features significantly depend on the localization of the leiomyoma nodes in the uterine body and their relationship to the uterine cavity (submucosal, intramural, subserous), as well as their number, size and blood supply.Modern diagnosis of leiomyoma is based on anamnesis, bimanual gynecological examination, ultrasound examination, and in some cases – magnetic resonance imaging and computed tomography examinations, hysteroscopy and laparoscopy. Today, the main methods of treatment of leiomyoma are conservative, surgical and radiological methods (uterine artery embolization, magnetic resonance-guided focused ultrasound).In addition to the listed modern aspects of the clinic, diagnosis and treatment of uterine leiomyoma, the article emphasizes the importance of preventive measures to reduce the incidence of this gynecological pathology.

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Comparative evaluation of KOH mount, fungal culture and PAS staining in onychomycosis

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20192107 ◽

2019 ◽

Vol 5 (3) ◽

pp. 554

Author(s):

Venkateswaramma Begari ◽

Prathyusha Pathakumari ◽

Anant A. Takalkar

Keyword(s):

Andhra Pradesh ◽

Histopathological Examination ◽

Nail Plate ◽

Fungal Culture ◽

Highly Sensitive ◽

Common Ailment ◽

Pas Staining ◽

Toe Nails ◽

Morbid Conditions ◽

Isolated Species

Background: Onychomycosis is a common ailment associated with significant physical and psychological morbidity. Increased prevalence in the recent years has attributed to enhanced longitivity, co morbid conditions like diabetes, avid spots participation and emergence of HIV. The objective of the study was to evaluate KOH mount, fungal culture and PAS staining of affected nail plate in diagnosis of onychomycosis.Methods: The present study was carried out in OPD of Dermatology, PESIMSR, Kuppam, Andhra Pradesh during the period of October 2010 to October 2012 including all patients showing classical clinical features of onychomycosis.Results: Majority of patients were from 21-40 years age group i.e. 46%. 56% of finger nails were commonly involved than 36% toe nails. DLSO is the most common clinical variant accounting for 80%. Most common isolated species as Trichophyton rubrum (31.6%) followed by T. mentagrophytes and Aspergillus niger 15.8% each. The sensitivity of KOH (81.82%), PAS (84.56%) and culture 57%. Both PAS and KOH were more sensitive than culture (p<0.001). PAS was also more sensitive than KOH. The specificity of KOH 92.86%, culture 92.86% and PAS 57.14%.Conclusions: Fungal culture though is the gold standard for the identification of pathogens but it takes minimum 2-3 weeks. Histopathological examination of nail clippings with PAS stain is simple, highly sensitive screening test.

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Results and experiences after 1000 IVF cycles at the Clinic for gynecology and obstetrics in Novi Sad

Medicinski pregled ◽

10.2298/mpns1112565k ◽

2011 ◽

Vol 64 (11-12) ◽

pp. 565-569

Author(s):

Vesna Kopitovic ◽

Stevan Milatovic ◽

Aleksandra Trninic-Pjevic ◽

Artur Bjelica ◽

Irena Bujas ◽

...

Keyword(s):

In Vitro Fertilization ◽

Intracytoplasmic Sperm Injection ◽

Clinical Pregnancy ◽

Reproductive Age ◽

Male Factor ◽

Fertilization Program ◽

Vitro Fertilization ◽

Gynecology And Obstetrics ◽

Novi Sad

Introduction. Infertility affects 15-17% of reproductive age couples in our country, and 10-15% of couples worldwide. The aim of this paper was to present results and experience gained after the first 1000 cycles of the national In Vitro Fertilization (IVF) program, to offer professional standard of work in our country and to compare it with results obtained in Europe and worldwide. Material and methods. The study prospectively included 1000 women who had undergone national In Vitro Fertilization program from October 2006 until November 2009 at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi Sad. Results. The analysis included 1000 in vitro fertilization cycles. Male factor infertility was the leading cause (56.9%) followed by tubal factor (45.9%). The classic method of in vitro fertilization constituted 72.3% of all cycles, while intracytoplasmic sperm injection (ICSI) method was used in 27.7% of all cycles. The average number of embryos transferred was 2.67. The cycle cancellation rate was 14.10% and the aspiration rate was 94.40%. The clinical pregnancy and live birth rate were 33.41% and 26.78% per embryo transfer, respectively. Discussion and conclusion. The results in our study showed that in our setting there are far less intracytoplasmic sperm injection cycles compared with the European average of 66.5% of all fresh cycles, and that we transferred more embryos on average. Our success rates are comparable with those in other European countries where the clinical pregnancy rates per aspiration and per transfer for in vitro fertilization were 29 and 32.4%, respectively in the period of observation. For intracytoplasmic sperm injection, the corresponding rates were 29.9 and 33%.

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Peripartum Predictors of the Risk of Postpartum Depressive Disorder: Results of a Case-Control Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238726 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8726 ◽

Cited By ~ 1

Author(s):

Kornelia Zaręba ◽

Jolanta Banasiewicz ◽

Hanna Rozenek ◽

Stanisław Wójtowicz ◽

Grzegorz Jakiel

Keyword(s):

Risk Factors ◽

Mood Disorders ◽

Medical Records ◽

Case Control Study ◽

Uterine Cavity ◽

Control Group ◽

Gynecology And Obstetrics ◽

Increased Risk ◽

Retrospective Comparative Study ◽

Control Study

Background: The study aimed at the identification of the risk factors present during delivery, which might be present in prophylactic programs concerning postpartum mood disorders. Material and Method: This was a retrospective comparative study. The study material included data retrieved from the medical records of patients hospitalized in the Teaching Department of Gynecology and Obstetrics of Professor Orłowski Hospital in Warsaw, in the years 2010–2017. The EPDS data of 604 patients were analyzed. The study group included 75 women who obtained at least 12 points in the EPDS and the control group was made up of 75 women who obtained no more than 5 points in the EPDS. Results: The women in whom we noted an increased risk of developing mood disorders had blood loss >1000 mL and had a significantly longer stage II and III of labor than the control group. Other risk factors were cesarean section, vaginal delivery with the curettage of the uterine cavity, slightly lower APGAR scores (0.4 pts), and lower birth weight (approximately 350 g) of the child. Women at a low risk of postpartum mood disorders more commonly underwent episiotomy during delivery (76%). Conclusions: Increased supervision and support should be offered to women who experienced the above-mentioned risk factors.

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A Comparison of Death Domain-Associated Protein 6 in Different Endometrial Carcinomas Histotypes

Biomarker Insights ◽

10.1177/1177271919864892 ◽

2019 ◽

Vol 14 ◽

pp. 117727191986489

Author(s):

Cao Jin ◽

Sean Hacking ◽

Miglena K Komforti ◽

Mansoor Nasim

Keyword(s):

Clear Cell ◽

Point Mutations ◽

Low Grade ◽

Nuclear Staining ◽

High Grade ◽

Death Domain ◽

Gynecology And Obstetrics ◽

Grade 3 ◽

Histologic Types ◽

Endometrial Carcinomas

Background: Death domain-associated protein 6 (DAXX) is involved in regulating apoptosis via subcellular localization. The presence of DAXX point mutations correlates well with loss of nuclear expression on immunohistochemistry (IHC). In this study, we sought to determine (1) whether DAXX expression pattern is the same across different uterine carcinoma subtypes, and (2) which uterine carcinomas show loss of nuclear DAXX IHC. Design: We studied 65 uterine carcinomas of the following histologic types: 30 endometrioid (12 FIGO [The International Federation of Gynecology and Obstetrics] grade 1, 12 FIGO grade 2, and 6 FIGO grade 3), 8 serous, 14 clear cell, and 13 undifferentiated/dedifferentiated type (UEC/DDEC). Nuclear DAXX IHC was assessed in each tumor and was graded semi-quantitatively as follows: 0% to 50%, 50% to 75%, and greater than 75% of lesional cells react. Results: A total of 61% (25/41) of high-grade carcinomas (FIGO grade 3, serous, clear cell, and UEC/DDEC]) showed retained DAXX nuclear staining in >75% of lesional cells, compared with only 4.2% (1/24) of the low-grade carcinomas (FIGO grades 1 and 2) ( P = .0001), where DAXX expression was cytoplasmic. In addition, in the 11 DDEC cases, all the differentiated components showed loss of nuclear DAXX compared with the undifferentiated components which retained nuclear DAXX expression. Conclusions: We demonstrate that loss of nuclear DAXX is present in low-grade endometrial carcinomas and the differentiated components in UEC/DDEC, but not in high-grade ones, suggesting DAXX’s role in tumor progression and its potential as a therapeutic target in high-grade endometrial carcinomas.

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