Background: We aimed to investigate the accordance of Critical Organ Scoring Index (COSI), Conformity Index (CI) and Normal Tissue Complication Probability (NTCP) parameters with Dose Volume Histograms (DVH) used for evaluation of 3 different pelvic radiotherapy plans. Materials and Methods: Ten gynecologic carcinoma patients who underwent adjuvant radiotherapy were enrolled in this study. Treatment plans were created with conformal treatment planning (3DCRT) and intensity modulated radiation therapy (IMRT) to a total dose of 50. 4 Gy in 28 fractions. Initially, volume related dose evaluation was done via DVH. Subsequently, HI, CI, COSI and NTCP for selected normal tissues were calculated for each plan and compared with DVH parameters. Finally, a graphical demonstration was evaluated to see if the results were in accordance with DVH. Results: CI results were statistically significant in favor of IMRT (p<0. 001). Rectum V40Gy decreased with 9IMRT compared to 3DCRT and 7IMRT (p=0. 013 and p=0. 013). V40Gy for bladder was also lower with 9IMRT compared with 3DCRT and 7IMRT (p=0. 005 and p=0. 012). COSI calculations revealed better small intestine protection in IMRT plans similar with DVH (p=0. 005 and p=0. 022). Femoral heads were better protected with IMRT plans were better compared to 3DCRT in NTCP calculations (p=0. 002). Normal tissue protection was worst with 3DCRT via both DVH and COSI evaluations (p=0. 001 and p<0. 001 respectively). Conclusion: Using the indexes in this study to decide the most appropriate plan among multiple treatment plans in gynecologic cancer patients will be timesaving and easier in comparison with evaluating the DVH of every alternative plan.

An early diagnosis of Gynecological caner is a life saving measure in ensuring a woman's health. It is important that the current knowledge about screening and timely diagnosis of premalignant and malignant conditions are ensured for physicians, the necessity of widespread use of screening is due to its high sensitivity, specificity, low cost and its non invasiveness. Cervical cancer is one of the Gynecological cancers where screening programs have resulted in a reduction in morbidity and mortality secondary to this disease, in endometrial cancer, as the patient usually reports during the initial phase of the disease; screening is only useful in the high risk group. Ovarian cancer is another Gynecological caner in which considerable research is going on to find an appropriate screening Techniques. In this article we would discuss the varying screening techniques available for Gynecological caners.

Background: To investigate the effects of different radiotherapy regimens on the prognosis of patients with brain metastases. Materials and Methods: Patients with brain metastases undergoing radiotherapy from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into a whole-brain radiotherapy (WBRT) group, stereotactic ablative radiotherapy (SABR) group, and WBRT+SABR group, and overall survival (OS) and progression-free survival (PFS) were analyzed. Results: Forty patients were candidates for the analysis, with a median age of 57. 5 years and a median follow-up time of 27. 4 months. The median OS and PFS were 35. 7 and 13. 5 months, respectively, and the median radiotherapy dose was 41. 7 Gy. The median OS times for patients who received WBRT (n = 12), SABR (n = 21), and WBRT+SABR (n = 7) were 41. 8, 70. 6, and 56. 8 months, respectively (p = 0. 7). The median PFS times were 10. 2 months, 34. 3 months, and 25. 9 months, respectively (p = 0. 322). Subgroup analysis indicated that the OS times were 25. 4 months after WBRT (n = 7), 79. 1 months after SABR (n = 11), and 65. 9 months after WBRT+SABR (n = 5) among patients with brain metastases from lung cancer (p = 0. 028). The patients had PFS times of 7. 1, 33. 4, and 29. 1 months after irradiation with WBRT, SABR, and combination therapy, respectively (p = 0. 009). Conclusion: The three different radiotherapy regimens had no significant effects on the prognosis of patients with brain metastases. SBAR was superior to WBRT and WBRT+SABR with respect to the prognosis of patients with brain metastases from lung cancer. The sample size of this retrospective study was small,therefore, larger, prospective studies are needed.

Background: Gastrointestinal Injuries (GI) during Gynecological operation are uncommon but proper management of these injuries is very important. Objectives: The aim of this study was to review the causes and management of gastrointestinal injuries during Gynecological and obstetrical operations.Patients and Methods: In this descriptive retrospective study, 25 patients with gastrointestinal injuries during Gynecological and obstetrical operation at Shabihkhani Maternity Hospital in Kashan city were reviewed. Demographic data such as age, gravid, parity, type of surgery or procedure, history of laparotomy, the surgical operation, injury site, time of diagnosis and method of treatment were extracted from medical records.Results: The mean age of women was 33.2±7.57 years. Fourty-four percent of the patients had a history of abdominal scar. Thirty-two percent of all GI injuries occurred during total abdominal hysterectomy (TAH). The small bowel was injured in 36% of cases. Fifty-two percent of injuries were diagnosed during the operation and the mean time of injury diagnosis was 2.8±0.9 days. Conclusions: All of the gynecologic surgeons must be aware of gastrointestinal injuries and should anticipate injury to these organs, especially in high-risk patients for decreasing patient morbidity.

Celiac disease (CD) shows an increased prevalence in female, particularly during the fertile period. Celiac disease should be researched in infertility, spontaneous and recurrent abortions, delayed menarche, amenorrhea, early menopause, and children with low birth-weight. Celiac disease is still little considered during the evaluation of infertility. Up to 50% of women with untreated CD refer an experience of miscarriage or an unfavorable outcome of pregnancy. Celiac patients taking a normal diet (with gluten) have a shorter reproductive period. Women with undiagnosed CD had a higher risk of small for gestation age infants very small for gestational age infants and preterm birth when compared with women with noted CD. The link between NCGS and infertility is actually unknown. The goal of our work is to perform an actual review about this topic and to increase the awareness in the medical population to research celiac disease in selected obstetric and Gynecological disorders.