mehri jafari

Ovarian granulosa cell tumors (GCT) are rare tumors with a late recurrence and a good prognosis. The current study investigated the fertility and obstetrics situation, survival, and the factors influencing the mortality of patients with these uncommon ovarian neoplasms.

This is a retrospective study on ovarian GCT patients admitted to the Al-Zahra hospital oncology department, the tertiary referral hospital in Tabriz, between 2009 and 2022. Data were collected from medical records. Chi-square/Fisher exact tests and t tests were used to compare categorical and quantitative variables between the alive and dead patients, respectively. The Kaplan-Meier curve was used to present patients’ survival.

The study involved 65 patients with ovarian GCT. The presence of ovarian cysts statistically increased the survival of GCT patients (P=0.028). The advanced tumor stage (P=0.023), fast tumor growth (P=0.001), and tumor relapse (P=0.001) are significantly correlated with mortality in the affected patients. However, age and adjuvant chemotherapy were not associated with survival.

There was no evidence of increased survival with the use of adjuvant chemotherapy. Tumor staging is an important prognostic factor. Advanced stages were associated with inferior survival, and only prospective studies can ascertain their definite role.

In this study, radical hysterectomy, followed by neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer (LACC) was compared with radical hysterectomy in patients with early-stage cervical cancer.

This retrospective comparative observational study was performed on 13 patients with LACC International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent a radical hysterectomy after NACT between March 2014 and November 2018. This group was compared with 18 patients undergoing radical hysterectomy with cervical cancer FIGO stage IIA-IB1 in the same period of time.

In the NACT group, 8 (61.5%) and 5 (38.4%) patients were in stages IIB and IB2, respectively, and 13 (72.2%) cases were in the IB1 stage in the non-NACT group. Post-operative blood transfusion in the NACT group was significantly higher compared to the non-NACT group [5 (38.4%) patients versus 0, P = 0.008]. The estimated blood loss (EBL) and operative time were similar between the groups. Finally, there were no significant differences in terms of intra-operative and other post-operative complications.

Radical hysterectomy after NACT in women with LACC seems to be safe and reduces the need for radiation in patients with NACT who are at stage IIB. These results need to be confirmed in studies with a larger patient sample.

Cervical cancer is a very common and lethal condition; however, owing to longstanding premalignant lesions, it is possible to prevent morbidity and mortality by screening tests. Pap smear, colposcopy, and biopsy are among the main modalities in this regard, however there is no consensus on the diagnostic utility of the first 2 methods. This study sought to examine the diagnostic utility of Pap smear, colposcopy, and cytology in evaluating the non-benign cervical lesions. A cross-sectional study was carried out between 2014 and 2016 in an out-patient setting at Alzahra teaching hospital of Tabriz University of Medical Sciences. After obtaining informed consent, all 315 participants with abnormal Pap test underwent colposcopy and biopsy from the abnormal areas. Cervical biopsy was considered as a gold standard and the diagnostic values of Pap smear and colposcopy were individually compared by calculating sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio. The mean age of patients was 38.49±10.31 years (17-68 years). On the basis of biopsy findings, non-benign cervical lesions were present in 31 cases (9.8%). Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio of Pap smear in revealing non-benign cervical lesions were 77.4%, 69.7%, 21.8%, 95.6%, 70.7%, and 2.55%, and for colposcopy, were 90.3%, 90.9%, 51.9%, 98.9%, 90.8%, and 99.2%, respectively. Based on our results, the colposcopy is a sensitive and specific method in differentiating benign cervical lesions from non-benign cervical lesions. The accuracy of Pap smear is intermediate in this regard, and the utility is limited. Therefore, this method should not be considered as the main criterion for decision making.

Apelin is secreted from visceral adipose tissue. However, the effect of resistance training and consequent detraining on the apelin level in obesity, has not yet been clearly determined. In the current research, the effect of 4 weeks of detraining after a period of resistance training, was investigated on the plasma apelin levels in overweight and obese girls.
In this quasi-experimental study, 22 overweight and obese girls were purposefully selected and randomly divided into two groups of experimental (n=12) and control (n=10). The experimental group exercised in an 8-week training program (4 sessions per week) according to a training program with an intensity of 65-80% of one maximum repetition, and then experienced 4 weeks of detraining. Blood sampling was performed after a 12-h fasting in various phases and the level of apelin was measured. Data were analyzed by Kolmogorov-Smirnov, repeated measure ANOVA, post-hoc LSD, and independent t-tests at a significance level of α Resistance training caused a significant decrease in weight, BMI, and body fat mass in the experimental group compared to the control group (p0.05). Also, after 4 weeks of detraining a slight increase was seen in the levels of apelin, but was not significant (p>0.05).
According to the results of this study, resistance training as a new non-drug therapy can be effective in reducing the levels of apelin. Also, apelin levels increases with discontinuation of exercise, which may lead to the emergence of inflammatory features in the cardiovascular system.

Ovarian cancer is the most lethal gynecologic cancer. Understanding the origin and pathogenesis of epithelial ovarian cancers is one of the most challenging issues of gynecology. According to one of the theories, ovarian cortical inclusion cysts can cause epithelial ovarian cancer, but there are a lot of criticisms against the theory. In this study, the effect of oral contraceptive pills (OCP) on the number and type of inclusion cysts were investigated. Parity is a strong factor in the prevention of ovarian epithelial cancer. The base of this study is that if parity reduced the total number of cortical inclusion cysts (CIC) and tubal metaplasia, the theory would be strengthened.
One hundred twenty-five patients under the total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH & BSO) due to causes other than conflict ovaries were considered for study. The patients were categorized in three groups based on their parity. Slides related to normal ovaries were considered for study by pathologist and the results analyzed.
The one-way analysis of variance (ANOVA) of total number of cysts revealed a statistically significant main effect, Welch’s F (2, 55.09) = 3.51, P Based on the results of this study, parity has significant effect on reducing total number of inclusions cysts, but number of tubal type inclusion cyst was not different.

Endometrial cancer (EC) is the most common malignancy of the female reproductive system. To date, no good marker for screening or disease monitoring of EC is available. The objective of this study was to investigate the sensitivity and specificity of CA125 and human epididymis protein 4 (HE4) in detection of EC. This case-control study was carried out on 40 women with EC and 60 women without cancer. Serum samples were prospectively obtained from all patients. Cut-off points for HE4 and CA125 were considered 70 pmol/L and 35 U/mL, respectively. The level of statistical significance is set at P < 0.05. The ROC-AUC, for HE4 was 0.82 and CA125 was 0.73 and for combination of HE4 and CA125 was 0.89. Compared to CA125, HE4 had higher sensitivity (57.7% vs. 40%), equal specificity (93.3% vs. 95%), equal positive predictive value (PPV) (85% vs. 84.2%) and higher negative predictive value (NPV) (76.71% vs. 70.37%) and in combination of two tumor markers sensitivity, specificity, PPV and NPV were 62.5%, 93.3%, 86.2% and 78.9%, respectively. It was clear that combination of two markers had higher sensitivity and higher NPV to detect EC, than each marker alone. HE4 and CA125 were significantly elevated in EC compared to controls (P < 0.001). There was significant correlation between median HE4 and age of the patients (r = 0.48, P = 0.002) and stage of the disease (r =0.50, P = 0.001). There was no significant correlation between CA125 and age, stage or grade of the disease (P = 0.39, P = 0.08 and P = 0.9, respectively). Our study showed that serum HE4 levels alone and in combination with CA125 are sensitive markers in diagnosing EC.

Nesfatin-1 is a newly discovered anti-appetite protein which is expressed in adipose tissue and appears in plasma. It has a significant role in energy homeostasis and metabolism. The aim of this study was to assess the effects of an 8-week endurance and resistance training on the plasma level of nesfatin-1, cardiorespiratory endurance, and body composition of overweight and obese females. A sample of 34 overweight and obese females were recruited and randomly allocated to the control (10 students), endurance training (12 students), and resistance training (12 students) groups. Females in the experimental groups did either endurance or resistance training for 8 weeks—four sessions per week and 32 sessions in total—with a severity of 65%–80% of maximum heart rate (HRmax) and 65%–80% of one repetition maximum (1RM). A blood sample was obtained from each participant before and after the study intervention and after twelve hours of fasting. The enzyme-linked immunosorbent assay (ELISA) method was employed for measuring the plasma level of nesfatin-1. The normality of the study variables was assessed by conducting the Kolmogorov-Smirnov test. Moreover, within-group comparisons were performed via the paired-samples t test while between-group comparisons were made by conducting the one-way analysis of variance (ANOVA) and the least significant difference (LSD) post hoc test at a significance level of less than 0.05. The means of participants’ age, weight, and body mass index (BMI) were respectively 22.29 ± 2.49 years, 77.23 ± 10.00 kg, and 30.19 ± 2.79 kg/m2. Compared with the control group, the plasma level of nesfatin-1 as well as cardiorespiratory endurance increased after the study intervention in both of the experimental groups. Besides, weight, body fat mass, BMI, and waist-to-hip ratio decreased significantly in the experimental groups (P < 0.05). As non-invasive non-pharmacological procedures, both endurance and resistance training can exert protective effects on overweight and obese females’ health through increasing the level of nesfatin-1 anti-inflammatory agent and improving obesity-related indices.

Gestational Diabetes (GD) is one of the major public health issues. The purpose of the present study was to perform a systematic review and meta-analysis to assess the risk factors and prevalence rate of this disorder in Iran. This systematic review and meta- analysis article was prepared using the databases of Science Direct, Pub-Med, Scopus, Magiran, Iranmedex and SID, Google search engine, Gray Literature, reference lists check and hand searching using keywords such as «prevalence», «gestational diabetes mellitus», «GDM», «risk factor*», «Iran» and «Postpartum Diabetes». The selected papers were fully reviewed and the required information for the systematic re-view was extracted and summarized using extraction table in Microsoft Office Excel software. Twenty-four of 1011 papers were quite relevant to the objectives of the review so they were included. The mean age of the participants was 29. 43±4. 97 yr and the prevalence of GDMwas 3. 41% (the highest and the lowest prevalence rates were 18. 6% and 1. 3% respectively). Among the influential factors mentioned in the literature, poten-tial causes of GDM are gestational age, history of gestational diabetes, family history of diabetes, body mass index, abortions and parity, and history of macrosomia. Considering the high prevalence of postpartum diabetes and its related factors in Iran, strategic planning for disease prevention and reduction is inevitable.

Obesity is accompanied with a lot of metabolic disorders such as changing Adipokines like Chemerin. The present study evaluated the effects of endurance and resistance training on Plasma levels of chemerin and Factors related to obesity in overweight and obese females. In this study 34 overweight and obese females with an average of age (22.29±2.49 years), body mass index (BMI) (30.19±2.79 kg/m2), weight (77.23±10 kg) participated voluntarily and were randomly assigned into two experimental groups (n=12) and one control group (n=10). Endurance and resistance training groups trained for 8 weeks (4 days a week), respectively with intensity of 65 to 80% maximum heart rate (HRmax) and 65 to 80% one repetition maximum (1RM). In two steps of pre-test and post-test, after 12 hours of fasting, the blood samples were collected in the same conditions and ELIZA method was used to assess Plasma levels of Chemerin. Kolmogorov-Smirnove test was used to evaluate the normal distribution of data, the variation within groups using paired t-test and variation between groups analysis of variance (ANOVA) and LSD were used in significant level (P<0.05). Plasma Chemerin decreased significantly after 8 weeks of training in endurance group (P<0.05), but there was no significant change in resistance group (P>0.05). Also In the experimental groups, factors related to obesity (weight, fat mass, WHR and BMI) were significantly decreased while the maximum oxygen consumption were significantly increased (P<0.05). Both endurance and resistance training, improved Factors related to Obesity and maximum oxygen consumption, but endurance training with a significant reduction in plasma chemerin, has a more effective role in health and reducing inflammation in overweight and obese females.

Making a decision on the extent of surgery for ovarian tumors depends on the intraoperative diagnosis. The aim of this study was to compare the intraoperative cytology and frozen section (FS) for diagnosis of ovarian masses. One hundred and thirty-one patients with ovarian masses who underwent surgery for ovarian neoplasms were evaluated by intraoperative scrape and FS techniques and compared to final pathologic diagnoses. Scrape cytology for intraoperative diagnosis of benign ovarian tumors had sensitivity of 89.06% compared to 90.62% for FS. Specificity of both scrape and FS techniques for benign tumors was 94.91%. Sensitivity and specificity of scrape for malignant ovarian tumors were 94.91% and 89.06%, respectively. The related values for FS were 94.91% and 90.62%. The overall accuracy percentage of scrape and FS for diagnosis of ovarian neoplasms was 91.86% and 92.68%, respectively. Intraoperative scrape cytology has high accuracy in diagnosis of ovarian tumors and is comparable with FS.

Making a decision on the extent of surgery for ovarian tumors depends on the intraoperative diagnosis. The aim of this study was to compare the intraoperative cytology and frozen section (FS) for diagnosis of ovarian masses. One hundred and thirty-one patients with ovarian masses who underwent surgery for ovarian neoplasms were evaluated by intraoperative scrape and FS techniques and compared to final pathologic diagnoses. Scrape cytology for intraoperative diagnosis of benign ovarian tumors had sensitivity of 89.06% compared to 90.62% for FS. Specificity of both scrape and FS techniques for benign tumors was 94.91%. Sensitivity and specificity of scrape for malignant ovarian tumors were 94.91% and 89.06%, respectively. The related values for FS were 94.91% and 90.62%. The overall accuracy percentage of scrape and FS for diagnosis of ovarian neoplasms was 91.86% and 92.68%, respectively. Intraoperative scrape cytology has high accuracy in diagnosis of ovarian tumors and is comparable with FS.

Cervical cancer is one of the most common female genital tract malignancies and one of the most common causes of female death. The majority of cervical cancers develop through a series of gradual, precancerous lesions. Screening asymptomatic women with regular Pap smear allows diagnosis of the readily treatable preinvasive phase. In regard of stopping the cervical cancer screening programs in health care centers of Iran cities, this study was undertaken to determine the precancerous lesions incidence and assess the effect of demographic, pathologic, and family economic factors on developing lesions. This cross sectional, descriptive study was carried out in 2003- 2005 on 6024 women under coverage of Tabriz health care centers. Pap smear was done in all subjects and questionnaires were filled by health providers. The data were analyzed with SPSS statistical software. Of 6024 Pap smears 62 (1.02%) demonstrated precancerous lesions of which 41(0.68%) were ASCUS (Atypical Squamous Cells of Undetermined Significance), 11 (0.18%) were LSIL (Low Grade Squamous Intraepithelial Lesion) and 10(0.16%) were HSIL (High Grade Squamous Intraepithelial Lesion). No invasive cancer case was observed in this study. According to the present study, the following factors increased the risk of precancerous lesions: multiparity≥3, abortion≥1, gravida≥3, and multi partnership. The protective effect of condom as a barrier contraceptive was observed. These results indicated that screening of asymptomatic women could be of great importance.