International Journal of Women's Health and Reproduction Sciences
Year:2016 | Volume:4 | Issue:2|Papers Count:10

Introduction: While it is widely accepted that minimal invasive surgical techniques definitely lead to less postoperative pain, decreased morbidity and faster recovery time in comparison to open abdominal procedures the tissue retraction and in our gynecological field myoma and uterine power morcellation in order to avoid larger abdominal incisions or colpotomy has been a challenging field of discussions with many contradictory issues. Morcellation is defined as division and removal in small pieces in the Merriam Webster dictionary.

Objectives: Exposure to secondhand smoke (SHS) constitutes major health problems that threaten human health around the world; its adverse effects can lead to serious illnesses in both the pregnant women and the growing fetus. The purpose of this study was to determine the prevalence of SHS among Saudi pregnant women in King Khalid University Hospital (KKUH) and to determine the association between the socioeconomic characteristics of the pregnant women and exposure to SHS.Materials and Methods: This was a cross-sectional study conducted in the antenatal clinic, KKUH. Data were collected from consecutive women using a predesigned questionnaire addressing the participants’ demographics and exposure to SHS status.Results: The prevalence of SHS exposure among pregnant women was 24%. Low maternal education level and being unemployed were associated with more exposure to SHS (P=0.039) and (P=0.02), respectively. There was no association between maternal age, parity and monthly income and exposure to SHS (P=0.697), (P=0.420) and (P=0.543), respectively.Conclusion: Maternal educational levels and unemployment are associated risk factors for SHS exposure during pregnancy.

Objectives: Sex ratio at birth should remain constant in the absence of any manipulation. India has shown a worsening sex ratio over the years. Tamil Nadu has shown a remarkable decline in birth rate as well as infant mortality rate. Knowing trends of sex ratio over the years will help us in formulating policies to reduce discrimination.Materials and Methods: Community Health Department of the Christian Medical College has been operating a detailed demographic surveillance system in Kaniyambadi block in Tamil Nadu since 1982. Data was analyzed to provide estimates of sex ratio at birth, juvenile sex ratio and sex specific infant and perinatal mortality.Results: There has been a decline in the Infant mortality rate from 67.4 per 1000 live births in 1986 to 16.3 per 1000 live births in 2013. But the sex ratio during 2011-2014 is showing an unfavorable trend. The sex ratio for the first child was 845 females/1000 males. The second pregnancy was not unfavorable but every subsequent pregnancy showed an unfavorable sex ratio.Conclusion: The study has shown the preference for a male child in the Indian society. The sex of the pre-existing child is a powerful predictor for the next child. The role of modern technology needs to be re-examined in order to address this adverse sex ratio.

Objectives: As the technique of choice, hysteroscopy can be used in visualizing and treating intrauterine pathologies such as polyps, septa, fibroids and endometrial hyperplasia. The best visualization, however, is attained when the endometrium is flat or atrophic; or a pre-existing active bleeding is minimal or suspended during hysteroscopy. Both epsilon-aminocaproic acid (EACA) and oxytocin have been found effective against active bleeding. The present work aimed to compare the efficacy and safety of intrauterine EACA and intravenous oxytocin in the management of intractable uterine bleeding in candidates of operative hysteroscopy.Materials and Methods: In this single-center, observer-blinded clinical trial, 144 candidates of operative hysteroscopy with intractable moderate uterine bleeding were randomized in two groups, receiving either intrauterine instillation of EACA (2 g in 1 L of 5% dextrose serum, n=72) or intravenous oxytocin (10 IU/L, n=72). The operator graded the severity of intraoperational bleeding (I=no to V=most severe). Serum hematocrit and hemoglobin changes, intra- and post-operational complications, the mean operative time, and the mean volume of the employed media were also recorded and compared between the two groups.Results: The two groups were comparable in terms of age, gravidity and parity. Grades I, II and III of intraoperational bleeding were reported in 79.2%, 18.1% and 2.8% of cases in the EACA group, and 18.2%, 65.3% and 16.7% of the cases in the oxytocin group, respectively (P<0.001). While the two groups were also comparable in terms of serum hematocrit and hemoglobin changes, intra- and post-operation complications (none in both groups) and the mean volume of the media intraoperatively, the mean operative time was significantly shorter in patients who received intrauterine instillation of EACA (10.28±3.24 minutes vs.11.81±4.62 minutes, P=0.02).Conclusion: Owing to less severe intraoperative hemorrhage and shorter duration of operation in the group who received intrauterine instillation of EACA than those with intravenous injection of oxytocin, we recommend the intrauterine EACA in managing intractable uterine bleeding in candidates of hysteroscopy.

Objectives: 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.Materials and Methods: 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.Results: 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<0.05, indicating that not all groups had the same number of total number of cysts. Also, the results indicated that patients with 0-2 parity had a significantly higher total number of cysts than patients with 6 and over (P<0.05). Moreover, the results of Games-Howell post hoc procedure indicated that patients with 0-2 parity had a significantly higher number of inclusion cysts than patients with 6 and over (P<0.05).Conclusion: 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.

Objectives: Menopause with oxidative imbalance causes metabolic disorders. These disorders are involved in the pathogenesis of various diseases. Olive leaf is a rich source of phenolic compounds that are biologically active and have better antioxidant activity, anti-inflammatory and radical scavenging effect. The aim of this study was to evaluate the effects of olive leaf extract on antioxidant activity of liver tissue in ovariectomized rats.Materials and Methods: In this study, 21 male Wistar rats weighting 220±20 g were randomly selected and were divided into three groups (n=7): 1) control group (healthy animals), 2) OVX group (ovaries removed by surgery) and 3) OVX-OLE group (ovaries removed and received olive leaf extract). The third group of animals received olive leaf extract for 30 days in dose of 100 mg/kg orally and through gavages. At the end of the study, samples of liver tissue were taken and the activities of super oxide dismutase (SOD), glutathione peroxidase (GPX), malondialdehyde (MDA) and catalase were measured.Results: The results showed that ovariectomy reduced rates of SOD (P=0.001), GPX (P=0.003) and catalase (P=0.001) significantly compared to controls. It was also found that the average level of MDA in OVX group than the OVX-OLE and control group was significantly higher (P=0.001).Conclusion: This study showed that oral administration of olive leaf can increase the activity of antioxidant enzymes in the liver tissue.

Introduction: Giant condyloma of the cervix (GCC) is an uncommon entity that has been poorly characterized in the literature, being even more uncommon during the pregnancy.Case Presentation: The authors describe a case of GCC in a pregnant woman as well as reviewing the literature on the topic aiming to reach a better understanding of the natural history of this entity. Our patient is a 27-year-old primigravida of Asian origin. The patient has been diagnosed with cervical giant condyloma in a second trimester coitorrhage context.Conclusion: A conservative treatment of the giant condyloma could be preferable during pregnancy, carrying surgical excision out after birth.

Introduction: Placenta accreta (PA) is defined as the penetration of trophoblastic tissue into the myometrium. We aimed to report a case of PA which was successfully managed with partial segmental resection of uterus.Case Presentation: A 23 years old women gravida 2, parity 1, referred to our hospital for placental retention after vaginal delivery. The intraoperative exploration showed that the placenta remained in the right part of the uterine. According to these findings, the initial diagnosis was PA. The placenta and the uterine wall were removed in one piece. The uterine wall was reconstructed by vicyrl no: 1 in a three layer closure. Bilateral uterine artery ligation was performed in order to prevent excess uterus bleeding. Then, modified b-lynch suture was performed for prophylaxis of atonia.Conclusion: Nowadays, conserving the uterus, avoiding the possibility of hemorrhage and making future pregnancies possible are the main objectives of conservative treatments in PA. Partial segmental uterine resection is an alternative, conservative and acceptable management option in selected cases of PA.

Dear Editor: Recently, a case report describing a woman who had two Mirena intrauterine devices (IUDs) in uterine cavity is published (1). The patient was suffering from heavy menstrual bleeding. Clinical and ultrasound examinations, laboratory tests, cervical cytology and endometrial biopsy were normal and a Mirena IUD was inserted. Six months later, she still had the same complaints. Ultrasound scan was performed and no Mirena IUD was seen in uterine cavity. A new Mirena IUD was inserted. She did not recover and admitted to another clinic where three-dimensional (3-D) ultrasound scan revealed the presence of two Mirena IUDs.

Hypersexuality refers to a clinical diagnosis used by mental health providers and researchers to describe a suddenly increased or extremely frequent sexual activity or sexual urges. The literature defines hypersexuality as a condition where affected persons exhibit excessive or unusual indulgence or concern with sexual activity. Sexologists have reported that hypersexuality can be a primary condition, or a symptom of the underlying medical sexual condition, such as a bipolar disorder, Parkinson disease, damaged kidney or impaired adrenal functions. The objective of the current review is to explore the hypersexual behavior in females and examine the role of sexual hormone secretion in proliferating the condition. Specific focus is to discuss how a hormonal imbalance in females could lead to hypersexuality if major glands in the body become impaired, including the adrenal cortex, the thyroid glands, pancreatic glands, and how medical conditions like cancer in these organs can also trigger hypersexual behavior. The study will also seek to verify if there is a link between medical conditions on the above organs and the normal secretion of sex hormones, which when triggered can cause an imbalance in hormone secretion resulting in excessive sexual urge and fantasies.