Journal of Obstetrics, Gynecology and Cancer Research
Volume:7 Issue: 4, Jul - Aug 2022

Receptor tyrosine kinase (RTK) signaling is a crucial pathway in the development of many cancers. KIT, PI3K, and AKT are the major genes in this pathway. KIT RTK functions in cell signal transduction in various cell types, such as cancer cells. A central element of RTK signaling is phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit A (PIK3CA), involved in cell proliferation, survival, and growth. AKT is a serine/threonine-specific protein kinase that has an important role in several processes, such as apoptosis and cell proliferation. The importance of mutations and overexpression of KIT, PI3K, and AKT genes in breast cancer has been previously demonstrated. This review investigated the relationship between gene mutations and overexpression and clinicopathological variable of KIT, PI3K, and AKT in breast cancer. Finally, the role of inhibitor drugs of these genes in breast cancer treatment. These data were collected from PubMed and Google Scholar databases from 2000 to 2021. The expression of KIT, PI3K, and AKT genes in normal breast tissues has been observed. However, mutations and overexpression of these genes are associated with malignancies. The mutations in KIT, PI3K, and AKT genes are different from those found in other malignancies. Also, most of the drugs that inhibit the RTK signaling are being tested in clinical trials for the treatment of breast cancer. Monitoring and timely management of adverse effects are critical to minimize toxicities and optimize the efficacy of this targeted therapy. Therefore, further development of predictive biomarkers can better select patients who will benefit from RTK inhibitors.

Diagnosis of endometriosis according to TVS may be an appropriate alternative method for laparoscopy. Hence in this study, the role of TVS was investigated compared with laparoscopic assessment in cases with pelvic endometriosis attending to imaging center of Imam-Khomeini and Yas Hospital in Tehran in 2018. In this diagnostic study, 69 patients with pelvic endometriosis were assessed. The results of TVS were compared with laparoscopic assessment, and the sensitivity, specificity, and congruence rate were determined. According to the obtained results, it may be concluded that most sensitivity of TVS is related to the torus uterinus and dome of the bladder. Also, the most specificity is related to bladder, sigmoid colon, and peritoneal cyst. The most congruence rate between U/S and laparoscopy is at bladder trigon and sigmoid colon. However, in the end, multicenter studies with more cases and comparisons with the results of other diagnostic methods are recommended to achieve more accurate results.

Cervical cancer is one of the most preventable malignancies that can also be diagnosed in the early stages through screening tests. The Papanicolaou test (Pap smear) is the most conventional means for screening, while studies represent acceptable and more accurate outcomes of colposcopy in contrast to Pap smear. The current study aims to assess the values of colposcopy for cervical cancer diagnosis.

This is a cross-sectional study conducted on 94 patients diagnosed with high-grade squamous intraepithelial lesion (HSIL). After that, colposcopy was performed for all patients, and findings were presented as normal, chronic cervicitis, the thin acetowhite lesion (AWL), dense/thick AWL, AVP, pilling, and cauliflower-like mass. The biopsies were taken and pathological studies, as the gold standard was interpreted as normal, cervicitis, atypical squamous cells of undetermined significance (ASCUS), cervical intraepithelial neoplasia-1, -2 or -3 (CIN-1, -2 or -3), carcinoma-in-situ (CIS), adenocarcinoma and invasive squamous cell carcinoma (SCC).

The pap-smear results were significantly associated with the biopsy reports (P<0.001; kappa=0.225). Besides, significant concordance was found between colposcopy and biopsy (P<0.001; kappa=0.247). The total sensitivity and specificity of colposcopy were based on the biopsy findings as the gold standard was 97% and 41%, respectively (P<0.001).

Colposcopy was significantly sensitive and specific for diagnosing both non-malignant CIN-1 and malignant cervical lesions, but not for CIN-2, -3, and CIS lesions. Further evaluations are strongly recommended.

 The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation and perinatal outcomes after COVID-19 infection during pregnancy or the puerperium.

 In this case series study, since February 2020, 25 pregnant women with a definitive diagnosis of the COVID-19 infection were registered. Their clinical signs and symptoms, laboratory findings, CT manifestations, pregnancy status, were recorded at the first visit, and they were followed six months after diagnosis.

 The most common symptoms were cough, feeling feverish, and dyspnea. Twenty mothers required hospitalization, 5 out of 20 monitored in COVID-ICU. The chest CT scan demonstrated a grand glass appearance in 77% of cases among admitted patients. The total mortality rate in C-ICU (COVID-19 ICU) admitted patients were 80%.

 In this case series, among 25 pregnant women with confirmed COVID-19, the most vulnerable patients were in the early third trimester and twin pregnancy.

Pelvic floor dysfunctions (PFD) are common disorders among women and affect about 50% of them over 50. About 400,000 American women undergo surgery due to the severity of these disorders. The aim of this study was to investigate the correlation of patients' symptoms with both static and dynamic MRI findings.

In this study, we performed MRI on 60 women suspected of pelvic floor disorders in the Imam Khomeini Hospital complex. Following rectal enema of 60-120 cc sonography gel and vaginal enema of 5-10 cc gel, we performed MRI with 3 Tesla equipment (Siemens Magnetom Trio) utilizing multichannel (16 rows) surface coil on the supine position. Static MRI was performed with high-resolution T2 FSE sequences in sagittal, axial, and coronal planes. Dynamic imaging was done using mid-sagittal T2 HASTE or true FISP in 3 different phases (rest, squeeze, strain and defecogram). The radiologists were blinded to the clinical data of patients.

Our study included 60 patients with a mean age of 52.7±14.3 years. Regarding the MRI findings in patients with urinary symptoms, except for the level I fascial defect, the other findings were not related to the patients' symptoms. Among patients with defecation symptoms, other MRI findings did not have a significant relationship with the patient's symptoms except for severe rectal descent. The association between endopelvic fascial defects and levator muscle injury with sexual complaints was not statistically significant.

 In conclusion, these results suggest that the patients' symptoms are not good predictors for MRI findings and are limited in reliability. Thus, MRI must be counted necessary to further evaluate patients with pelvic floor abnormalities. Other studies regarding MRI findings' correlation with different symptoms in these patients are required.

Breast cancer is the most common type of cancer and about one-third of all cancers in women. Within the case of early detection, more than 90% of the patients are treated. However, most women do not perform breast self-examination as a simple, effective, and inexpensive way to prevent cancer deaths. Therefore, this study aimed to inform and educate women to promote self-efficacy and encourage individuals to self-care.

 This study is quantitative research and was conducted on 80 women aged 20-60 years old in health centers of the city of Some Sara. The data collection tool was a researcher-made questionnaire designed based on the Extended Parallel Process Model. The educational intervention was conducted using lecture, question and answer, movie screening, and practical presentation using Moulage. The health behaviors and performance of the participants before and immediately after the intervention, and two months later, were compared within the intervention and control groups. Data were analyzed by repeated-measures test, chi-square, Mann -Whitney, Exact Fisher's test.

The study results showed that educational intervention based on the Extended Parallel Process Model had increased self-efficacy within the intervention group compared with the control group. The intervention increased the average score of individuals from model structures. So that before the educational intervention, the average perceived susceptibility and severity score, perceived self-efficacy and response efficacy, perceived threat, and perceived efficacy was moderate. After the intervention, the average score of all model components increased (P<0/05). The mean score of the performance checklist was 14 before the intervention, which was upgraded to 20 after the intervention (P<0/05).

The results of this study supported the effectiveness of the Extended Parallel Process Model in preventing breast cancer.

This study was performed to determine and compare the ED90 of prophylactic oxytocin (OX) infusion after delivery of the placenta during cesarean section (CS) in low- and high-risk parturients for uterine atony.

This experimental study was a single-blind and dose-response study using a 9:1 biased-coin sequential allocation method to estimate the ED90 of prophylactic infusion of OX in women with high and low risk for uterine atony who underwent CS. The total administrated OX dose of each patient was determined in the two study groups. The primary outcome was the ED90 for desirable uterine tone based on the opinion of the in-charge obstetrician. The number of subjects receiving supplemental uterotonics was compared.

In the low-risk group, three (3.7%), out of the 41 parturients, did not achieve a satisfactory suitable response to OX dose of 9; on the other hand, 24 high-risk parturients (58%) did not achieve a satisfactory and reasonable response to OX dose of 9. The OX ED90 was significantly greater for the high risk-group (11.55 units, 10.39-14.86) than the low-risk group (8.13 units, 8.31-9.56). Fisher’s exact probability test showed a significant difference in ED90 of OX between the two groups (P=0.02).

The present study results showed that the mean ED90 of OX in low-risk parturients was significantly lower than that of high-risk ones. We suggest differentiation between low-risk and high-risk parturients in the guidelines of OX administration.

The effect of storage time and temperature on the prepared semen sample was evaluated, but the optimal condition is unclear. The aim of this study was to assess the effect of long-term incubation of prepared sperm at testicular temperature versus room temperature on semen parameters and DNA fragmentation index (DFI).

Sperm samples were collected from 40 patients between 2019 and 2020. Each sample was separated into two parts and underwent a non-direct swim-up method. One group was placed in a 35°C incubator, and the other group was kept at room temperature (26°C) in the dark. Both groups were evaluated at intervals of 45 minutes, 24 hours and 48 hours after sampling in terms of sperm concentration, motility, morphology, and DFI. Student t-test and repeated measures analysis of variance were used.

Sperm count (P=0.007) and motility (P<0.001) at 26°C in three-time intervals of 45 minutes, 24 hours and 48 hours were significantly higher than 35°C. The proportion of normal morphology spermatozoa at 26 and 35°C at 45 min, 24 h, and 48 h did not show a significant difference (P=0.08). DFI at 26°C in three-time intervals was significantly lower than 35°C (P=0.008).

 The results of this study indicated that when the prepared sperm samples are incubated for 24 h at 26°C compared to 35°C, they show significantly better quality and good quality of sperm can be retained for several hours if stored at room temperature.

This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond 38 weeks.

This retrospective cohort study was recruited in an academic hospital affiliated with Tehran University of Medical Sciences between June 2018 and June 2020. The subjects of the study were the women who were scheduled for elective CS and divided into 3 groups according to the gestational age (38 0/7 to 38 6/7 as group A, 39 0/7 to 39 6/7 as group B, and 40 0/7 to 40 6/7 as group C). The neonatal outcomes and the growth and development status were evaluated by ages and stages questionnaires® (ASQ) after 12 months and compared between groups.

Totally, 952 neonates were eligible for this study. In groups A, B, and C, CS was performed in 314, 409, and 229 neonates, respectively. The first minute Apgar was significantly lower in the neonates with lesser gestational age at delivery (P=0.026). Indeed, neonatal hospitalization, hypoglycemia, and jaundice in group A were significantly higher than in other groups (P<0.001). Regarding psychomotor development, the scores related to gross motor and problem-solving abilities in group A were significantly lower than those in other groups (P<0.05).

It is suggested to plan elective CS beyond 39 weeks of gestation to decrease prenatal morbidities and improve psychomotor development one year after birth.

Conflicting results have been reported about the association between vitamin D and preeclampsia. The aim of the current study is to compare the serum levels of vitamin D in preeclamptic, and non-preeclamptic pregnant women admitted to the Ayatollah Mousavi Hospital in Zanjan.

In this case-control study, 120 pregnant women were selected using convenience sampling in Zanjan in 2018-2019. Then they were divided into two groups, preeclampsia and non- preeclampsia. Both groups were matched one by one. The data were collected using a demographic information questionnaire and a researcher-made checklist. After obtaining consent from participants, blood samples were collected using the peripheral venous catheter. Then the ELISA test was used to measure vitamin D in participants. Data were analyzed by SPSS version 16 using, independent t-test, and Chi-square test (P≤0.05).

Of the participants, 64 (53.4 %) were between 20-35 years old, 48 (40%) were older than 35 years, and 8 (6%) were younger than 20 years. Most of the participants' gestational age was between 34 and 39 weeks (89.1%). The Mean (SD) of serum level of vitamin D was significantly higher in healthy pregnant women (19.06 (7.48)) than women with preeclampsia (16.60 (5.87)) (P<0.01). Among those with preeclampsia, the highest vitamin D level (17.17) was observed at 37-39 weeks of gestation. The lowest level (10.8) was for those with less than 34 weeks gestational age.

This study demonstrated that vitamin D could be a protective factor for preeclampsia in pregnant women. However, further studies are recommended.

 Fertility is important in developing personality, and infertility is a disorder that often bears unintended and sometimes untreatable consequences for couples. As an element of personal features, mental health is often related to marital satisfaction. In this study, the correlation between mental health and marital satisfaction is investigated in infertile couples referring to the Kosar Infertility Center of Urmia, Iran.

This cross-sectional study was performed on 186 infertile couples referred to Kosar Infertility Center, Iran. They were randomly selected in 2018. The data were collected using General Health Questionnaire and Enrich Marital Satisfaction Questionnaire completed by the participants. In the present study, to conduct data analysis, SPSS version 25.0 was used along with inferential and descriptive statistics.

Idealistic distortion had a significant relationship with mental health in infertile couples (P=0.015). Moreover, leisure activities (P=0.043) and financial management (P=0.017) had a significant inverse relationship with mental health in infertile couples.

According to the findings, based on the association between marital satisfaction and mental health, mental health can be improved by solving marital problems and enhancing the satisfaction of infertile couples. Hence, the health status of families is improved, denoting the considerable contribution of family counseling centers.

Perivascular epithelioid cell tumors (PEComas) are a group of mesenchymal neoplasms with different biological presentations from benign to malignant types. Hence, we report the first description of PEComa presenting with an acute surgical abdomen. Her definite diagnoses were made based on the histomorphology results at Imam Khomeini Hospital, Tehran University of Medical Sciences, in 2020.
Considering different clinical presentations, unknown characteristics of imaging, and rarity of PEComa, preoperative diagnosis of it seems impossible. However, IHC can play an important role in its diagnosis.

The most common form of structural uterine anomaly is the septate uterus, which has the highest rate of reproductive failure. An uncommon type of development is a septate uterus with cervical duplication and a complete longitudinal vaginal septum. We report a 26-year-old woman with infertility complaints. We performed diagnostic procedures and noticed that the patient had a septate uterus and cervical duplication with a longitudinal vaginal septum. It is an uncommon Mullerian anomaly that does not fit into the current assortment system of Mullerian anomalies by the American Fertility Society (AFS).

Infertility is the failure of the male or female reproductive system to conceive after 12 months or more of regular unprotected sexual intercourse (1). Failure to ovulate, problems in the menstrual cycle, infections, inadequate egg maturation, ejaculation problems, antibodies that attack sperm and tumors are some of the reasons that can make a man or a woman infertile. COVID-19 is a disease caused by a new type of coronavirus; it is an infectious disease caused by the acute respiratory syndrome of coronavirus 2 (SARS-CoV-2). This article is about the fact that patients with COVID-19 are more prone to infertility than other normal people. There is a possibility that this coronavirus could have a pathophysiological effect on the testes. Additional data have shown that active COVID-19 infection significantly reduces the ratio of testosterone to LH, showing a significant effect on the response of Leydig cells to LH stimulation (2). Men are said to be more likely to get COVID-19 than women; even the mortality rate is higher (3). The testes can be a potential target for the SARS-CoV-2 virus, and testicular damage and subsequent infertility after COVID-19 infection can be explained theoretically (4). It was only in May that six semen samples were positive for SARS-CoV-2 (5).

Dear Editor- in –Chief of Journal of Obstetrics, Gynecology and Cancer Research (JOGCR), I write to you regarding the published article in The Journal of Obstetrics, Gynecology, and Oncology research titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy” by Aminimoghaddam et al that was published on 27th of September, 2019 [1]. The article was revised with interest and raised for me some serious concerns.

Response to the editor letter Dear Professor Behtash, I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy,” published in 2019 in your journal. I want to first thank Professor Hemida for reading my paper carefully and sharing his comments. I highly believe that sharing comments and raising scientific questions could benefit our society. I hope that the responses that the co-authors have provided be helpful and to the point. As he suggested, I am willing to let the journal publish the responses in the next issue.

In the version of this article initially published, the name of author Mina Bakhshali-Bakhtiari was incorrectly written as Mina Bakhtiari.