PCOS is the commonest endocrinopathy in women and the commonest cause of unovutation in infertile couples.The role of endoscopy in the diagnosis and treatment of PCOS is well known. With laparoscopy we can see PCOS ovaries, differentiate other causes of infertility such as tubal problems or pelvic adhesion.With hysteroscopy we can see abnormal endometrial growth or polyps and we can do endometrial biopsy.Beside diagnostic aid, endoscopy can be used in the treatment of PCOS.In these cases we can do ovarian drilling with diathermy, Laser, crayon or hot water. And with this technic we induce ovutation, regulate the menstrual periods and increase the pregnancy rate.

Background and Study Aims: Patients with chronic renal failure may demonstrate a number of gastrointestinal lesions and suffer subsequent complications. Our aim was to investigate the ENDOSCOPE findings in these patients and identify the predisposing factors.Patients and Methods: During a 1-year period (February 2000 to January 2001), we studied consecutive patients with chronic renal failure who were undergoing routine endoscopy before renal transplantation. The rapid urease test was also performed to detect Helicobacter pylori infection. Demographic and clinical data were collected. Logistic regression analysis was used to determine the risk factors for important endoscopic lesions, including esophagitis, gastroduodenal erosions, and peptic ulcers.Results: We studied 206 patients (124 male, 82 female, mean age 38.9). Of the patients 73.8% were asymptomatic but some patients experienced nausea (12.6 %), heartburn (8.7 %), and abdominal pain (7.3 %). Endoscopy was normal in 74 patients (35.9%). Abnormal endoscopic findings were duodenal erosions (32.0 %), antral erosions (22.8 %), diffuse antral erythema (27.8%), duodenal ulcer (7.3 %), esophagitis (5.8 %), angiodysplasia (4.4 %), nodular duodenum (2 %), and inflammatory gastric polyps (1.5 %). The rapid urease test was positive in 58.8 % 01 patients. Important endoscopic lesions were more common in men and in H. pylori-infected patients. Age, duration 01 dialysis, cause of the chronic renal failure, presence of any symptoms, and hemoglobin levels were not found to be related to these lesions. Most patients with peptic ulcers were asymptomatic.Conclusions: Duodenal erosions (32.0 %), gastric erosions (22.8 %), diffuse antral erythema (27.8%) and duodenal ulcer (7.3%) are common lesions in patients with end-stage renal disease. Male gender and H. pylor infection are associated with a higher risk of these lesions As there is no association between patients symptoms and gastroduodenal lesions, which may increase the risk of post-transplant complications, the development of diagnostic strategies for the detection of these lesions is recommended.

Background and Aim: Transcranial endoscopic surgeries are mainly limited to intraventricular lesions. This study aims to elaborate on the various benefits of transcranial endoscopic surgeries in extraventricular regions of the brain. Methods and Materials/Patients: It is a retrospective study of transcranial extraventricular endoscopic surgeries (TEESs) operated between June 2022 to May 2023. The authors described the surgeries done for brain lesions other than intraventricular lesions as extraventricular surgeries. Access to the intracranial region was obtained through the transcranial approach. The transnasal rigid ENDOSCOPE was used for the surgeries. The surgery was performed as either pure endoscopic surgery or endoscopic-assisted microscopic surgery. Results: The authors have performed 6 microvascular decompressions using an ENDOSCOPE. Three pineal tumors, 3 craniopharyngiomas, 1 cerebellopontine angle epidermoid cyst, and 1 petrous neurenteric cyst were excised using an ENDOSCOPE by transcranial approach. One internal carotid artery bifurcation aneurysm was clipped using an ENDOSCOPE. All patients improved in the postoperative period. Surgeries were done using the 0-degree and 30-degree ENDOSCOPEs. The endoscopic eye was able to reach the deep-seated area of surgical interest and authors were able to visualize the structures in a wide panoramic view with good illumination and magnification. There was no misinterpretation of structures. Conclusion: ENDOSCOPE can reach the deep-seated extraventricular areas of the brain with a narrow corridor, giving good illumination and magnification at the site of surgery. An ENDOSCOPE can reach beyond the obstructing anatomical structure and visualize the area behind it. It is used as a complimentary to microscope to access the microscopic invisible areas. It has increased the ease of doing surgery, decreased tissue dissection, decreased complications, and improved surgical results. TEES improves the hand-eye coordination of surgeons in transcranial surgeries and it will help in adapting to exoscope easily

Tranexamic acid (TA) is an antifibrinolytic agent which reduces bleeding following certain surgical procedures. The present study was performed on 56 patients, scheduled for elective endoscopic sinus surgery under general anesthesia, to examine the effects of topical TA on providing a bloodless surgical field and evaluate the bleeding volume. The study comprised 26 patients who received topical TA and 30 patients used placebo. The homodynamic endpoints were to maintain the mean arterial blood pressure at 30% bellow its preoperative level. Intraoperative bleeding was assessed using a six point scale. There was less bleeding volume in the TA group than in the placebo group (174.0±10.6 vs 229.1±23.8 ml; P<0.05). The frequency of score 3 was 26% in TA group which was significantly lower than of placebo group (70%).The bleeding score of TA group was significantly lower than of placebo group (2.3±0.2 vs. 2.5±0.15). In conclusion it seems that topical application of tranexamic acid reduces intraoperative bleeding in endoscopic sinus surgery.

Background: Various systems of Computerized Tomographic (CT) staging and scoring have been applied to define the extent of sinus abnormality and the degree of mucosal thickening. Functional Endoscopic Sinus Surgery (FESS) has been used with considerable success rate to treat chronic sinonasal patients unresponsive to medical therapy. This study was designed to investigate the relationship between the result of CT scoring and staging and the outcome of surgery.Methods: The one year outcome of FESS together with preoperative CT staging and scoring were determined and compared with each other.Results: Compared to those with higher stages (III and IV), patients with lower preoperative CT stages (I and II) had a significantly higher successful outcome of surgery. CT staging and scoring were obviously correlated. Conclusions: The results of this study show that preoperative CT staging and scoring are two useful means for better prediction of the long-term outcome of surgery one year after FESS.

Introduction: Nasocomial infection is one of the biggest complications of health care facilities all over the world which involves two millions people with nearly 9 billion dollar in cost in addition to therapeutic expenses each year. This study was carried out in order to determine the application of infection control methods by staff working in ENDOSCOPE centers affiliated to Tehran University of Medical Sciences in 2004-2005. Methods: This research is a descriptive study. All ten ENDOSCOPE centers staff totally 54 physicians,27 nurses and 14 workers were chosen for the survey. Data gathering instruments consisted of a questionnaire bout demographic characteristic of the participants, 6 checklists for evaluating the characteristics of disinfection solutions that workers used for disinfecting ENDOSCOPE set, the characteristics of ENDOSCOPE unit environment, the process of disinfecting the set and its environment, as well as the methods used to protect nurses, physicians and associate nurses. The data were gathered by the researchers using observation. Laboratory kits also were another way of data gathering used to get microbial culture from operating room; ENDOSCOPE tubes and disinfecting solutions which were handed in to the hospitals laboratory centers to be analyzed. The gathered data were analyzed via SPSS computer software, and descriptive statistics.Results: The study findings related to the application of disinfecting method in the units show that in 30% percent of hospitals were desirable, 50% semi-desirable and 20% undesirable. Results about the method of reprocessing of ENDOSCOPEs through staffs showed that only one hospital (10%) was desirable, also 30% semi-desirable and 60% undesirable. About the application of disinfection or sterilization in ENDOSCOPEs through nursing staff the results showed that 20% of hospitals were desirable, 70% semi-desirable and one hospital (10%) undesirable. Also the way used for protecting staff were shown as undesirable in all hospitals. About the kinds of microorganisms grown in the environment, on the equipments as well as disinfection solution it was shown that that the majority of the growth was for Bacillus (3.6%) and minimum for pseudomonas and staphylococci (%1.8).Conclusion: Totally the results of this study showed that the application of infection control methods through staff of ENDOSCOPE centers is not suitable. It can result in infectious diseases. Therefore prevention from nosocomial infections in ENDOSCOPE units based on frequent emphasizes by articles in this regard needs a precise and yearly supervision.

Introduction: This study aims to report a rare case of a respiratory epithelial adenomatoid hamartoma (REAH) of the lateral nasal wall that had initially presented as a fungating mass, similar to that of a sinonasal malignancy, and its complete removal from the lateral nasal wall. Case Report: We report the case of a 58-year-old woman who presented to us with a chief complaint of recurrent right-sided epistaxis and nasal blockage for the past 4 months, which was progressively worsening. Histopathological examination confirmed the presence of a REAH instead of a sinonasal malignancy. The tumor was surgically excised from the lateral nasal wall using electrocautery under endoscopic guidance. The patient was then carefully followed-up after surgery, and the wound was successfully healed 3 months after the initial surgery. There was no evidence of recurrence 6 months after the initial surgery Conclusion: This case demonstrates the rare presentation of a REAH, which had arisen from the lateral nasal wall. Clinically, it is difficult to distinguish a REAH from a more notorious mass such as a sinonasal malignancy. Therefore, biopsy is mandatory in all cases of lateral nasal mass in order to rule out malignancy before confirming nasal REAH. Fortunately, as seen in this case, a lateral nasal REAH, once diagnosed, can be safely and easily removed from the lateral nasal wall using electrocautery with good surgical outcomes and a low rate of recurrence.