Journal of Obstetrics, Gynecology and Cancer Research
Volume:1 Issue: 2, Summer 2016

Different studies found that zinc is necessary for sexual maturity, growth and fertility. But there are no distinct studies that clarify the role of zinc supplements on semen parameters.

The current study aimed to evaluate the zinc supplement therapeutic effects on semen samples of infertile males.

The study comprised one-hundred-twenty sub fertile males. The study was a double-blinded placebocontrolled clinical trial. The subjects were randomly allocated to treatment with zinc supplement (n = 60) or placebo (n = 60) groups. Subjects in both groups were given 10 mL, three times daily. In order to determine the sperm concentration, Motility and morphology, standardized semen and blood samples were obtained before and after treatment, according to the World Health Organization (WHO) guidelines; semen morphology according to strict criteria, and blood and semen zinc concentration also were measured. Effects of the two interventions were evaluated in sub fertile males.

Sub fertile males demonstrated a significant increase (8.8±7.4×106 cells/mL to 17.2±13.5×106 cells/mL) in concentration and normal sperm in zinc group versus the placebo group. Blood serum zinc concentration increased in the interventional group significantly (P = 0.000), and also semen plasma zinc concentration increased significantly (P = 0.000).

Normal sperm percentage and total sperm concentration increased after zinc sulfate treatment. The beneficial effect of zinc and all results of the current study opened new way to medical purposes and public health researches.

Anemia is prevalent in 32% to 60% of patients with cancer due to an underlying disease, nutritional deficiencies and complications of medication used in chemotherapy. National Comprehensive Cancer Network (NCCN) recommends the use of oral or intravenous iron supplementation in patients with iron deficiency anemia.

The current study aimed to determine the effectiveness of ferric carboxymaltose to improve the chronic iron deficiency anemia in patients with stage III/IV colon cancer compared with that of oral iron therapy.

The study was a controlled randomized clinical trial performed on patients with stage III/IV colon cancer referred to the Rasoul-Akram hospital in Tehran, Iran, in 2015. Hemoglobin levels less than 13 g/dL in males and less than 12 g/dL in females, ferritin levels less than 30 µg/L, serum iron levels less than 50 µg/dL and total iron binding capacity (TIBC) levels less than 360 µg/dL are considered as chronic iron deficiency anemia. Patients with stage III/IV colon cancer and chronic iron deficiency anemia were enrolled. Non-compliance with the treatment regimen, intolerable side effects and lack of follow-up were the measures of exclusion from the study. Patients were selected based on the block balanced randomization and divided into two groups. The first group received the standard treatment of oral ferrous sulfate (65 mg three times a day for two months), and the second group received injection vials of ferric carboxymaltose (1500 mg for patients weighing less than 70 kg, 2000 mg for more than 70 kg).

Ten patients (five in the first group and five in the second group) were excluded due to lack of follow-up tests. In each group, 30 patients were considered in the final analysis. Analysis showed that patients who received ferric carboxymaltose had higher levels of hemoglobin and ferritin compared to patients who received ferrous sulfate (P = 0.000). The results showed that increased levels of hemoglobin in iron sulfate had no significant differences regarding gender (male or female) and the stage of the disease; although in the carboxymaltose group, improved levels of hemoglobin were significantly better in females than males (P = 0.034). Also, the level of ferritin in iron sulfate group showed a better increase in females compared to males (P = 0.007).

Findings of the study showed that using the parenteral iron formulation of carboxymaltose had an excellent efficacy in improving iron deficiency anemia in patients with high rates of colon cancer compared with that of oral ferrous sulfate. This effect is mostly related to the proper formulation of ferric carboxymaltose, which results in a stable and continuous increase in the levels of ferritin and hemoglobin in patients.

Background:

 Gestational trophoblastic neoplasm (GTN) during pregnancy includes an associated heterogeneous group of lesions that originates from abnormal proliferation of placenta. It includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor.

Objectives:

 The aim of this study was to predict the risk of invasive mole in patients with a molar pregnancy in association with β-hCG level after the evacuation of molar pregnancy. Methods: The current study was a prospective cross-sectional cohort research conducted as a diagnostic study on 110 patients with molar pregnancy referring to Department of Gynecology and Oncology of Vali-Asr, Imam Khomeini Hospital of Tehran between the years of 2015 and 2016. Patients with molar pregnancy, who were hospitalized with a diagnosis of hydatidiform mole by transvaginal ultrasonography, were examined in the study. The ability to perform ultrasonography before and after evacuation as well as the consent to participate in the study was among the inclusion criteria for patients. The patients were studied for invasive mole followed by two ultrasonography examinations, one 48 hours and the other 21 days after evacuation. β-hCG levels were also measured in successive periods of one week to six months. The association of sonography findings 48 hours and 21 days after evacuation with post-evacuation β-hCG levels was investigated using Chi-square test and multinomial regression.

Results:

 In the current study conducted on 110 patients with hydatidiform mole, the results showed that 46 patients (41.8%) suffered from invasivemole. In 23 patients (50%) with invasivemole, the results of both ultrasonography 48 hours and 21 days after evacuation were positive. There was a significant correlation between ultrasonography after evacuation (positive and negative results) and the progress of β-hCG after evacuation in women with invasive mole (P = 0.001); this means that in 73% of women with invasive mole, the positive β-hCG results corresponded with positive 21-day sonography after evacuation, and in 41% cases, ultrasound results on day 21 were reported positive before the results of β-hCG.

Conclusions:

 Positive results of sonography accompanied with positive results of β-hCG have a high efficiency in the diagnosis of invasive mole; therefore, more definitive studies with a larger sample size are suggested to confirm this hypothesis.

Determining the necessity of cesarean section (C/S) due to failure of induction of labor (IOL) is essential to avoid fetus distress. In this study, the performance of the Bishop score and trans-vaginal ultrasound measurements were compared to predict successful IOL, and the most useful cut-off points were estimated.

Nulliparous women with gestation age of > 37 weeks with a live fetus in cephalic presentation were invited to participate in this study. Bishop score was assessed by digital examination, and trans-vaginal ultrasound was used to measure cervical length. Trans-abdominal ultrasound was utilized to determine the fetal head position.

One hundred women entered the study. Multiple regression analysis revealed that the Bishop score and cervical length had a reliable predictive value in determining successful IOL. The cut-off points for predicting successful induction were 16 mm for cervical length and 5 for the Bishop score, using receiver operating characteristic curves (ROC). Both cervical length and Bishop score were good predictors for vaginal delivery (sensitivity and specificity of 85% and 67%, respectively for cervical length; and 84% and 70%, respectively for Bishop score).

Cervical length is a good predictor of successful IOL. Considering the painful process of digital exam, implementing trans-vaginal ultrasound is preferred.

Human papillomavirus (HPV) is thought to be the most common sexually transmitted viral disease. This infection continues to be an important topic. One of the most important conferences on human papillomavirus infection and related cancers is EUROGIN. The program also includes state of the art science on anogenital and head and neck cancer, inspiration, cooperation, and forums to share expertise and learn from leading experts in the field.

We reported an abstract of important articles and researches presented in this congress.

HPV had rolled in oropharyngeal cancer. KI67/P16 is important for deciding on treatment of patients with HPV high-risk positive. Methylation can be used in the management of HPV high-risk patients. 9-valent HPV vaccination can prevent different anogenital cancers.

HPV has important role in different cancers. HPV vaccination can prevent a variety of anogenital cancers related to HPV.

Peritoneal tuberculosis (PTB) and ovarian cancer have overlapping nonspecific symptoms and signs. No pathognomonic clinical features or imaging findings can help to distinguish definite diagnosis of extra pulmonary TB. Peritoneal TB can be easily confused with peritoneal carcinomatosis or advanced ovarian carcinoma; therefore, it is difficult to distinguish these two entities. The current study described two cases of peritoneal tuberculosis mimicking advanced ovarian cancer.

In the first case, the initial manifestation was lower abdominal pain. The imaging indicated ovarian mass, ascites and hepatic surface nodularity, omental and peritoneal thickening. Also, titer of tumor marker CA-125 was more than 600 units. In laparoscopy, disseminated peritoneal seeding was observed. Frozen section of sampling these lesions reported tuberculosis. Biopsy of ovarian mass reported fibrothecoma. Concurrent with this patient, the second case referred to the same center, Department of Gynecology Oncology at Ghaem Hospital, Mashhad University, Iran, in 2015. Her presentation was fever and remarkable weight loss during the last three months. She had a multiloculated pelvic mass with septation in sonography and peritoneal seeding with pleural effusion in computed tomography (CT) scan. Peritoneal tuberculosis was recognized through laparotomy and both patients received anti-TB treatment and now they are in good health status.

Peritoneal tuberculosis should always be considered in differential diagnosis of patients with evidences suggesting advanced ovarian cancer.

Embryonal (Botryoid) Rhabdomyosarcoma (RMS) is an aggressive malignancy that arises from embryonal rhabdomyoblasts. It is commonly seen in the genital tract of female infants and young children. The primary site of these tumors is closely related to the age of the patient. Embryonal Rhabdomyosarcoma has a marked tendency for local recurrence after excision. Due to young age of affected patients who desire fertility, the management of this rapidly growing malignancy is very critical and poses challenges.

We report on two cases embryonal rhabdomyosarcoma of uterine cervix, who were referred to Imam Khomeini hospital during year 2014. Both of them were young virgin females. The presenting symptom for both was vaginal bleeding and protrusion of polypoid mass from the hymen. After neoadjuvant chemotherapy, radical hysterectomy was offered to them. One of them refused, thus local excision was done. Both patients received adjuvant chemotherapy yet in the patient with local excision, the tumor recurred with multiple metastases.

There are several methods of surgical approach and variation in adjuvant therapy in the management of embryonal rhabdomyosarcoma. If we choose a conservative approach for surgery of early stage, surgical margin should be negative and in other cases doing radical surgery is the best.