Obstetrics and Gynecology
Shahrzad Agha Amu; Fateme Silakhory; Setare Nassiri; Elham Saffarieh
Volume 5, Issue 1 , August 2020, , Pages 24-26
Abstract
Background & Objective: Spontaneous vulvar edema is not usual during pregnancy and can cause discomfort and anxiety for the patient. This is a serious situation that might be caused by some dangerous condition such as preeclampsia, diabetes vulvovaginitis, severe anemia, and neoplasms. The aim of ...
Read More
Background & Objective: Spontaneous vulvar edema is not usual during pregnancy and can cause discomfort and anxiety for the patient. This is a serious situation that might be caused by some dangerous condition such as preeclampsia, diabetes vulvovaginitis, severe anemia, and neoplasms. The aim of this study was to evaluate and manage the vulvar edema.Case Report: In this case report we introduce a 22-year-old woman which is primigravia and have massive vulvar edema after Bronchitis and influenza at 17 weeks’ gestation. After using oseltamivir, the patient showed progressive edema during 4 hours. Her symptoms were including edema and pain in labia, then she was treated with Dexamethazone and the edema disappeared after 5 days. Conclusion: Vulvar edema is a critical situation during pregnancy that needs attention and should be treated carefully since it can cause pain and discomfort for the pregnant woman. Our experience in this case was treatment by corticosteroid that had good response.
Soheila Aminimoghaddam; Afsar Ahmad; Setare Nassiri
Volume 4, Issue 3 , September and October 2019, , Pages 111-116
Abstract
Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 ...
Read More
Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 deliveries both in the United States and Europe. The aim of this study was to prove the noninferiuority and safety of misoprostol use in cervical ripening in patient with molar pregnancy.
Materials & Methods: This retrospective cohort study was performed on 150 women with molar pregnancy referred to Firuzgar and Mirza-koochack-khan hospitals in Tehran, between 2006 and 2013. We defined group 1 as 100 patients without Misoprostol pretreatment and group 2 as 50 patients with Misoprostol pretreatment. There was no significant difference in the number of complete or partial mole between the two groups. They were followed by serum ß-hCG level and if it became plateaued in 4 measurements or rose more than 10% in 3 measurements in a period of three weeks, would be defined as persistent.
Results: We found no significant difference of maternal age, fundal height, gestational age, gravity, parity, number of previous abortions and prevalence of complete and partial moles between the two groups. A total of 27 (27%) patients in non-Misoprostol group and 5 (10%) patients in Misoprostol group developed Persistent GTN (P < /em><0.05). We observed no case of trophoblastic embolism in the misoprostol group.
Conclusion: Misoprostol cervical ripening resulted in lower Persistent GTN incidence. Also, trophoblastic embolism following misoprostol administration is so rare that we observed no case.
Masoumeh Rahimian; Setare Nassiri; Elham Saffarieh
Volume 4, Issue 1 , March and April 2019, , Pages 16-23
Abstract
Background & Objective: Pregnancy is one of the most important stages of a woman’s life. Although this is a pleasant period for most women, it is often considered as a stressful period accompanied by physiological and psychological changes. This study aimed to examine pregnant women’s ...
Read More
Background & Objective: Pregnancy is one of the most important stages of a woman’s life. Although this is a pleasant period for most women, it is often considered as a stressful period accompanied by physiological and psychological changes. This study aimed to examine pregnant women’s attitude towards sexual desire and its relationship with quality of life and rumination in the last trimester of pregnancy.
Materials & Methods: The statistical population of this descriptive correlational study included all pregnant women in the last trimester of pregnancy. A total of 280 women were selected using a random sampling method. Data were collected using the Index of Sexual Desire, Rumination Scale, and Quality of Life Questionnaire. The data were analyzed by SPSS 11.5 using simultaneous regression analysis.
Results: The results showed that rumination was significantly and negatively predicted by sexual desire. Moreover, the subscales of physical functioning, emotional problems, and general health were positively and significantly predicted by sexual desire. However, sexual desire could not significantly predict other subscales of quality of life, namely fatigue or vitality, emotional health, social functioning, pain, and physical health status.
Conclusion: Our finding revealed that, if guided and employed properly, sexual desire during pregnancy can moderate stress.
Elham Saffarieh; Setare Nassiri; Ramin Pazoki
Volume 3, Issue 4 , November and December 2018, , Pages 157-163
Abstract
Background & Objective: This study aimed to evaluate the Obstetrics and Gynecology Department of Semnan University of Medical Sciences in 2015 and compare it with the existing evaluation conducted in 2002 to promote the quality of education in this department.
Materials & Methods: An accreditation ...
Read More
Background & Objective: This study aimed to evaluate the Obstetrics and Gynecology Department of Semnan University of Medical Sciences in 2015 and compare it with the existing evaluation conducted in 2002 to promote the quality of education in this department.
Materials & Methods: An accreditation pattern was used in the current study. In 2000, the Obstetrics and Gynecology Department of Amir-al-Momenin Teaching Hospital in Semnan designed its internal evaluation pattern, in which all educational, research, and therapeutic goals, institutional and organizational status, educational process, and equipment availability status were examined. A total of 40 questionnaires were applied. In each questionnaire, the criteria were scored from 1 to 5 (very poor to excellent). Gorman’s classification was employed for final analysis and a score lower than 2.51 was considered as unsatisfactory.
Results: In this evaluation, the educational goals achieved a score of 4.3 and were in the strong range of Gorman’s classification. The educational programs obtained a score of 5 and were in the range of very strong. Both educational goals and educational programs showed a significant progress compared to 2002. The educational process with a score of 3.11 was more than satisfactory; the therapeutic goals with a score of 4.3 were in the strong range; the institutional and organizational status of the department with a score of 4.43 was in the strong range; and the research goals with a score of 5 were in the strong range. Additionally, space, human resources, and equipment scored 4.4 based on Gorman’s classification and were in the strong range.
Conclusion: Overall, based on the obtained results, the Obstetrics and Gynecology Department with a score of 4.23 was in the strong range of Gorman’s classification, indicating its desirable status. Moreover, the therapeutic-research and educational goals showed a significant progress compared to 2002.
Babak Hosseinzadeh Zorofchi; Elahe Jahan; Setare Nassiri; Atosa Najmodin; Elham Saffarieh
Volume 3, Issue 2 , May and June 2018, , Pages 73-77
Abstract
Aims: Owing to the effects of anesthesia on pain after hysterectomy as well as different advantages and disadvantages of spinal anesthesia (SA) and general anesthesia (GA), giving priority to one of these techniques over the other still seems controversial. The aim of the present study was to compare ...
Read More
Aims: Owing to the effects of anesthesia on pain after hysterectomy as well as different advantages and disadvantages of spinal anesthesia (SA) and general anesthesia (GA), giving priority to one of these techniques over the other still seems controversial. The aim of the present study was to compare SA with GA in terms of pain intensity, the frequency of nausea and vomiting and morphine requirements after abdominal hysterectomy.
Instruments and Methods: This double-blind clinical trial was conducted on 40 abdominal hysterectomy candidates with American Society of Anesthesiologists I and II presenting to Kowsar Hospital, Semnan, Iran, in 2015. All the patients were briefed on the pain assessment scale the day before the surgery, randomly divided into two groups of GA and SA and underwent abdominal hysterectomy using the same technique. Postoperative pain was then recorded upon admission to post-anesthesia care unit and 6 and 12h later. Furthermore, frequency of nausea and vomiting as well as intravenous morphine requirements was recorded within the first 12h after the surgery. Data were analyzed using independent t-test and Chi-square by SPSS 16 software.
Findings: Postoperative pain was found to be significantly lower upon entering PACU and 6 and 12h later in the SA group compared to that in the GA group, as was the case for the frequency of nausea and vomiting as well as the dose of intramuscular morphine (p<0.05).
Conclusion: Generally, postoperative pain in SA is lower than in GA, although different postoperative complications such as nausea and vomiting are observed.
Leila Pirzade; Setare Nassiri; Mohammad Reza Vakili; Maryam Ameri
Volume 3, Issue 1 , March and April 2018, , Pages 45-48
Abstract
Introduction: Bartholin gland primary cancer occurs scarcely. Adenoid cystic carcinoma of the Bartholin gland is one of the rarest types of primary adenocarcinoma. Treatment delayed can lead to high rate of local recurrence and distant metastasis. The aim of this experimental case study was to discuss ...
Read More
Introduction: Bartholin gland primary cancer occurs scarcely. Adenoid cystic carcinoma of the Bartholin gland is one of the rarest types of primary adenocarcinoma. Treatment delayed can lead to high rate of local recurrence and distant metastasis. The aim of this experimental case study was to discuss a woman with misdiagnosed and mistreated ACC-BG, as a benign situation.
Patient Information: In this experimental case study, a 54-year-old woman referred to Joint Committee in Gynecology Oncology Department of Imam Khomeini Hospital of Tehran University of Medical Sciences, Tehran, Iran on Aug 2016 with a large mass within her vaginal distal wall. This woman was undertaken marsupialization for Bartholin cyst. Because of the bizarre manifestation of intervention, the biopsy was performed and revealed as adenoid cystic carcinoma of the Bartholin gland. Therefore, wide local excision and ipsilateral inguinal lymphadenectomy were considered. Adjuvant irradiation was planned. nificant difference in glucose levels in the first and second fingertip blood drops (p=0.257), while there was a significant difference between glucose levels in the first and second fingertip blood drops with standard venous sample (p<0.05). There was also a significant correlation between 2 drops in expression of glucometry results.
Conclusion: Adenoid cystic carcinoma of the Bartholin gland is very rare, but despite its low prevalence, it should be considered especially in the older patient or when the Bartholin cyst is unusually large and sticking to the surrounding tissue to prevent delays in diagnosis and treatment
Azamsadat Mousavi; Mahshid Shooshtari; Setare Nassiri; Abas Ali Aipour; Setare Akhavan; Narges Zamani
Volume 2, Issue 4 , November and December 2017, , Pages 1-5
Abstract
Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective ...
Read More
Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective factors on recurrence and fertility rate.
Methods: In this cohort study, the required information was collected from a file of 43 patients with final pathologic diagnosis of borderline ovarian tumor, who had undertaken fertility sparing surgery at Imam Khomeini Hospital, Tehran University of Medical Sciences, and recurrence rate, fertility rate, and the effect of different variables were studied.
Results: There were significant correlations between oral contraceptive pill (OCP) consumption, serous pathology, micro invasion in pathology, advanced stages, and recurrence rate of BOT, while this relationship was not found between parity, surgical methods (laparotomy and laparoscopy), surgical techniques (cystectomy and USO), papillary projection, and recurrence rate.
Conclusions: Although the recurrence rate was higher in the current research when compared to other previous studies, yet only in one patient, the pattern of recurrence was invasive epithelial carcinoma, thus in the current study the overall survival did not seem to change. The results of this study on fertility rate are comparable to other studies on this issue. Therefore, these methods are recommended for young patients and emphasis should be place on follow-up.
Setare Nasiri; Shahrzad Sheikh Hasani; Mohammad Rahim Vakili; Fateme Nilli
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: Synovial sarcoma of the ovary is a very rare tumor reported only once in the past. It is the second softest tissue mass after rhabdomyosarcoma in adults but its usual site is extremities not ovary.
Case Presentation: Here we describe a 53-year-old woman with primary synovial sarcoma of ...
Read More
Introduction: Synovial sarcoma of the ovary is a very rare tumor reported only once in the past. It is the second softest tissue mass after rhabdomyosarcoma in adults but its usual site is extremities not ovary.
Case Presentation: Here we describe a 53-year-old woman with primary synovial sarcoma of the ovary with insufficient treatment and lung metastasis of the tumor.
Conclusions: Because of harmlessness symptoms, it is usually missed and correct treatment is delayed. When facing this type of tumor, referring to well-equipped centers with experienced surgeons in this field is recommended for sufficient treatment and best results.
Setare Nasiri; Azamosadat Mousavi; Shahrzad Sheikh Hasani; Mohammad Rahim Rahim Vakili; Mitra Modarres Gilani; Setare Akhavan; Monire Mirzaei
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: The incidence of vulvar cancer is nearly 5% of all gynecologic malignancies and almost 95% of vulvar cancers are squamous cell carcinoma (SCC). Recurrence is possible in 4 ways: local, regional, pelvic, and distant. In a cohort of 391 patients with vulvar SCC, distant metastasis was reported ...
Read More
Introduction: The incidence of vulvar cancer is nearly 5% of all gynecologic malignancies and almost 95% of vulvar cancers are squamous cell carcinoma (SCC). Recurrence is possible in 4 ways: local, regional, pelvic, and distant. In a cohort of 391 patients with vulvar SCC, distant metastasis was reported 5% .The common sites of distant metastasis are pelvic nodes, lung, and liver. Both skin and bone metastasis are rare in vulvar SCC.
Case Presentation: The current report presented a 58-year-old female with the diagnosis of vulvar SCC. She was the 11th cutaneous metastasis, 13th bone metastasis, and the 1st case with simultaneous bone and skin metastasis reported in the last 60 years.
Conclusions: It is necessary to consider any lesion on the vulve, especially in menopause females, and it should be the low threshold for biopsy to avoid delay in detection. After completion of selective treatment, the exact follow-up should be considered to discover metastases.
Setare Nasiri; Shahrzad Sheikh Hasani; Azamosadat Mousavi; Mitra Modarres Gilani; Setare Akhavan; Mohammad Rahim Vakili
Volume 1, Issue 3 , November and December 2016
Abstract
Introduction: One of the rare ovarian neoplasms is sclerosing stromal tumor (SST). The most common age at presentation of sclerosing stromal tumor is the second and third decades of life. Usually this tumor presents with menstrual irregularity and pelvic pain as reported previously. Surgery is mandatory ...
Read More
Introduction: One of the rare ovarian neoplasms is sclerosing stromal tumor (SST). The most common age at presentation of sclerosing stromal tumor is the second and third decades of life. Usually this tumor presents with menstrual irregularity and pelvic pain as reported previously. Surgery is mandatory for diagnosis because there is not any distinctive feature to diagnose by imaging techniques.
Case Presentation: Our case in this report is a 26-year-old woman presented with pelvic pain. We conducted routine laboratory tests and checked ovarian mass tumor markers preoperatively. Due to her normal hormonal status in physical examination, we did not request more hormonal laboratory tests. However on imaging, we did not suspect benign tumor. Doppler sonography showed low resistance flow in peripheral and center of the mass. Right ovarian mass was resected and diagnosed as ovarian stromal tumor compatible with sclerosing stromal tumor. Unexpectedly at operation, we encountered severe hemorrhage from peritoneal surface so that conservative management such as packing and suturing or cauterization was not helpful. Finally, argon coagulation stopped bleeding. All coagulation laboratory tests requested by a hematologist were normal.
Conclusions: In conclusion, we believe that vascular endothelial growth factor (VEGF) production of tumor is responsible for massive bleeding.
Setare Nasiri; Shahrzad Sheikh Hasani; Azamosadat Mousavi; Mitra Modarres Gilani; Setare Akhavan; Mohammad Rahim Rahim Vakili
Volume 1, Issue 3 , November and December 2016
Abstract
Introduction: Mesonephric adenocarcinoma of uterine cervix is a rare variant of primary endocervical adenocarcinoma and a few cases have been reported previously. In fact in non-metastatic adenocarcinoma of the cervix, less than 5% possess mesonephric type. Because of the low incidence of mesonephric ...
Read More
Introduction: Mesonephric adenocarcinoma of uterine cervix is a rare variant of primary endocervical adenocarcinoma and a few cases have been reported previously. In fact in non-metastatic adenocarcinoma of the cervix, less than 5% possess mesonephric type. Because of the low incidence of mesonephric adenocarcinoma, various methods have been proposed for treatment of mesonephric adenocarcinoma. Nevertheless, there is no unity in treatment approaches.
Case Presentation: Here, we present a 45-year woman who had bloody discharge for 6 months period. Hormonal profile such as thyroid stimulating hormon (TSH) and prolactin was normal and all imaging studies showed a cervical fibroma as a mass. Abdominal hysterectomy -bilateral salpingectomy was performed. After pathologic report as a mesonephric adenocarcinoma, she received radiation and then she was candidate for bilateral oophorectomy.
Conclusions: Because of the diversity and an unusual appearance of mesonephric adenocarcinoma with aproblematic case of cervical mass, it is very important to consider mesonephric adenocarcinoma as a type of diagnosis. Numerous differential diagnoses should be considered for management of this type of carcinoma. In order to make a diagnosis, deep biopsy of infiltrative mass of uterine cervix, is mandatory.