Безопасностьометрия при непрерывной заместительной гормональной терапии 17b-эстрадиоло-эндопротезной заместительной гормональной терапии 17b-эстрадиолиин иниситисинисисиной

The aim of the study was to determine the endometrial safety of oral 17/3- oestradiol combined continuously with dydrogesterone in preventing endometrial proliferation. The low dose group comprised three 52-week (13 cycles of 28 days) studies (two of which were double blind) using a 17ft- о estradiol dose of 1 mg daily combined with dydrogesterone 2,5; 5; 10 or 20 mg daily. The high dose group comprised two 24-week double-blind studies using a 17ft-oestradiol dose of 2 mg daily combined with dydrogesterone 2,5; 5; 10 or 15 mg daily. Endometrial safety was verified by aspiration endometrial biopsies. Inadequate progestational response was defined as proliferative endometrium, endometrial polyp, hyperplasia and carcinoma. Endometrial protection was achieved with dydrogesterone at doses of 5 mg or higher combined with 1 or 2 mg 17^-oestradiol. So, 5 mg daily dydrogesterone appears to be the lowest effective dose to ensure endometrial safety in a continuous combined regimen with 1 or 2 mg 17p-oestradiol.

How Can We Treat Endometrial Polyp Without Using Curettage?

Introduction: Endometrial polyps are considered begin tumours that protrude inside the uterine cavity. It affects women in reproductive or in menopausal age. It can regress spontaneously or if symptomatic, it can be treated efficiently by hysteroscopy excision. Purpose: to demonstrate that endometrium polyps can be treated without using curettage but only using homeopathic medication without needing to do any invasive procedure. Methods: through two case report (47 and 57 years-old women respectively, with endometrium polyps diagnosed by routine ultrasound). Both patients were programed to do hysteroscopy. They were doing acupuncture (for treatment of low back pain and pain in the shoulder respectively) using needles and mustard seeds. I decided to prescribe for both patients a homeopathy medication called Medorrhinum to treat their miasma. In both cases, they intake the medication first with 30CHXX-20 ml. After one month, the patients need to have the second round of this medication, now with 200CHXX-20 ml. After one month from the first medication, it was possible to intake the third medication, now in 1000CHXX-20 ml. Results: the endometrial polyps disappeared completely after the intake of these medications in both patients without needing to use hysteroscopy exam. Conclusion: the use of homeopathy medication called Medorrinun was very important to recover from the endometrium polyp without the necessity in using hysteroscopy exam and do the curettage.

Immunohistochemical Analysis of the Expression of the Glycodelin Cytokine in Endometrial Tissue and the Endometrial Polyp, Before and After Hysteroscopy, in Infertile Female Patients

An endometrial polyp is most commonly a benign, localized proliferation of the glands and the endometrial stroma, covered with epithelium and protruding above the level of the mucosa. These polyps are most often diagnosed during investigation into the causes of irregular menstrual bleeding or infertility. It is produced in the highest concentration during the secretory phase of the endometrial cycle. The level of glycodelin reaches its peak 12 days after ovulation. The aim of this paper was to determine the changes in the immunohistochemical expression of glycodelin at the level of the endometrium and in the tissue of the polyp, before and after hysteroscopic polypectomy, in infertile female patients with an endometrial polyp, and in the endometrial tissue of female patients without an endometrial polyp. The study included 82 infertile female patients. The infertile patients were divided into two groups. The first was the experimental group which included 56 infertile female patients who had an endometrial polyp. The second group was the control group, composed of 26 infertile female patients who did not have an endometrial polyp. The results obtained primarily indicate the existence of changes in the immunohistochemical expression of the cytokine glycodelin in the female patients from both the experimental and the control group, not only prior to but also after hysteroscopy. A larger number of patients who have an endometrial polyp show a lack of glycodelin expression, more pronouncedly so in the bioptate of the endometrium than in the endometrial polyp.

Role of hysterolaparoscopy in evaluation and management of infertility

Background: This study was conducted to evaluate the role of hysteron-laparoscopy in evaluation and management of infertility.Methods: Prospective observational study was conducted in department of obstetrics and gynaecology, LLRM medical college, SVBP hospital Meerut from May 2019 to June 2020. It included 58 women aged 22-40 years with primary and secondary infertility with normal hormone profile without male factor infertility.Results: Out of total 58 cases for infertility evaluated, primary infertility were 42 (72.41%) and secondary infertility were 67 (27.59%). In hysteroscopy deep seated ostium (12.06%), followed by endometrial polyp (6.89%) ,intrauterine synechiae (6.89%) were the most common pathologies while common abnormalities in laparoscopy were tubal pathology (20.68%), endometriosis (15.51%), and PCOD (12.06%) .Some of the diagnosed pathologies were dealt surgically in same sitting.Conclusions: Hystero-laparoscopy is a feasible and acceptable procedure and it can be used as “one time approach” in the assessment of female infertility caused due to pelvic and uterine pathology. It helps in diagnosis of certain factors causing infertility, which cannot be diagnosed by any other method such as by USG, HSG and reveals whether surgery is possible and if so the nature of surgery most suited for patient which can be performed in the same sitting.

A Case Of Giant Cervical Polyp

Introduction: Cervical polyps are small pedunculate, often sessile neoplasm of the cervix. It is not known whether this is due to chronic inflammation, or abnormal local responsiveness to hormonal stimulation, or localized vascular congestion of cervical blood vessels. They occur most frequently in multiparous women in the fifth decade of life. Case Description: Here, we are reporting a case of a giant cervical polyp in a 38-year-old nulliparous lady who reported heavy menstrual bleeding and mass per vagina. Conclusion: Giant cervical polyp can mimic chronic inversion of the uterus, cervical fibroid, endometrial polyp, and cervical malignancy.