Long term remission of metastatic placental site trophoblastic tumor (PSTT): Case report and review of literature

BACKGROUND: Placental site trophoblastic tumor (PSTT) is a rare and unique form of gestational trophoblastic disease (GTD). This tumor represents a neoplastic transformation of intermediate trophoblastic cells. We document a case of long term remission in a patient with metastatic PSTT. CASE PRESENTAION: A 27-year-old patient with metastatic PSTT was treated with combination therapy (chemotherapy and surgery). Patient is alive after 10 years without any evidence of recurrence. Literature on PSTT was searched using Medline and cross references, and pertinent articles were reviewed. CONCLUSION: With surgery and chemotherapy it is possible to achieve long-term remission in metastatic PSTT. Only a handful of previously reported cases with prolonged remission had been treated with the described combined chemotherapy and surgical approach. We suggest that this approach may be recommended for metastatic PSTT

Survey of sexual dysfunction in women with cervical cancer and a history of pelvic radiation therapy in 2009 to 2013 in Ghaem and Omid hospitals, Mashhad

Introduction: Cervical cancer is the second most common cancer in women and one of the leading causes of cancer-related death in developing countries. In cervical cancer patient, both surgery and radiation therapy can cause sexual dysfunction. Therefore, this study was performed with aim to survey sexual dysfunction in women with cervical cancer and a history of pelvic radiation therapy. Methods: This study was performed on 176 women with cervical cancer and a history of pelvic radiation therapy referred to Ghaem and Omid hospitals in Mashhad who were selected using convenient sampling from 2009 to 2013. Research tools consisted of personal information form and ROSEN Female Sexual Function Index (FSFI). Data was analyzed by SPSS software (version 16.5) and Spearman and Pearson correlation coefficient tests. PResults: 53(30%) of women with cervical cancer and a history of pelvic radiation therapy had low sexual desire, 86 (49%) undesirable sexual arousal, 62 (35%) low lubrication, 74 (42%) undesirable orgasm. 70 (40%) of women complained of dyspareunia and 42 (24%) of Women were dissatisfied from sexual function. There was a significant correlation between sexual function with staging of cervical cancer (P= 0.001, r= - 0.25). There was a significant correlation between sexual desire (P= 0.04), sexual arousal (P= 0.008), lubrication (P= 0.001), orgasm (P= 0.004), sexual satisfaction (P= 0.009) and dyspareunia (P= 0.000) with staging of cervical cancer. Conclusion: Sexual disorders in women with cervical cancer and a history of pelvic radiation therapy and correlation between sexual function with stage of cervical cancer reflects the fact that treatment, education and counseling programs is necessary for these women

The Effect of Muscular Fatigue on Neck Proprioception Performance between Elite Athletes and Non-Athletes

Introduction: The poor performance of neck proprioception is a risky factor for athlete’s head and neck injury. Muscle fatigue as an inevitable factor of any physical activity can cause disorder in proprioception performance. This study intends to investigate the effect of cervical muscular fatigue on neck proprioception performance in elite karate athletes in comparison to non-athletes. Materials and Methods: Sixteen professional karate athletes and sixteen non-athletes participated in this study. Cervicocephalic relocation test measuring angle repositioning error during active cervical extension and rotation movements was used to assess neck proprioception ability, before and after isotonic muscular fatigue. Data were analyzed by independent T-test and paired T-test with SPSS (version 20) and alpha level set at 0/05. Results: There is no significant difference in neck sense status before and after neck muscular fatigue in both groups. Also, there is significant difference in neck proprioception performance between karate athletes and non-athletes following extension (P<0.05). In addition, athletes had greater joint position errors than non-athletes. Discussion: Although muscular fatigue did not affect proprioceptive neck performance, probably the effects of degenerative changes in neck proprioception and the acceleration repeated movements in karate athletes weaken their neck proprioception function in some direction in comparison to non-athletes. Therefore, it is important to improve the performance of neck proprioception in karate athlete's trough special neck proprioception training.Key words: Martial Arts, Proprioception, Muscle Fatigu

Clinical significance of circulating tumor cell related markers in patients with epithelial ovarian cancer before and after adjuvant chemotherapy

Acknowledgment This study was financially supported by grants from Mashhad University of Medical Sciences (No. 961802) and National Institute for Medical Research Development (NIMAD) (No. 973128).Peer reviewedPublisher PD

Effect of garlic (Allium sativum) on male fertility: a systematic review

Introduction: Fertility in men mainly depends on the number, quality, motility, and morphology of the sperms, and disruption of each of these factors leads to infertility. A large number of couples suffer from infertility problems. Among the various therapies, medicinal herbs are used in many countries to treat male infertility. Current systematic review was conducted to study the effects of garlic on male fertility. Methods: The information of this systematic review was collected by searching the key words: treatment, fertility, infertility, male, herbal medicine, garlic, Allium sativum, medicinal plant, sperm, sex hormones, testis and spermatogenesis in international databases such as: Web of Science (ISI), PubMed, Scopus and Embase until March 2018. This study was conducted in accordance with the PRISMA statement for systematic reviews and meta- analysis. and the SYRCLE risk of bias tool was used for qualitative assessment. Results: A total of 18 experimental studies were included in the study. Thirteen studies evaluated garlic and 5 studies compared garlic effect with adriamycin, titanium dioxide, furan, vitamin E, N-acetylcysteine and cadmium. All studies were conducted in in vivo condition. The results of the studies indicated the potential effect of garlic on enhancing fertility and spermatogenesis, increasing the level of testosterone and improving the testicular structure. Conclusion: Garlic can increase fertility probably due to its antioxidant properties. However, more clinical trials are recommended

Lymphatic mapping and sentinel node biopsy in endometrial cancer — a feasibility study using cervical injection of radiotracer and blue dye

BACKGROUND: The aim of this study was to evaluate the feasibility and accuracy of sentinel lymph node (SLN) detection using preoperative lymphoscintigraphy and intra-operative gamma probe/blue dye for endometrial cancer patients. MATERIAL AND METHODS: Twenty four consecutive patients with endometrial cancer were recruited. All patients underwent lymphatic mapping and sentinel node biopsy using combined intracervical radiotracer and blue dye injections. Pelvic lymph node dissection was performed for all patients. Para-aortic lymphadenectomy was done in high risk patients. All SLNs were examined by frozen section and Hematoxylin and Eosin (H&E) permanent sections. RESULTS: Pre-operative lymphoscintigraphy showed at least one SLN in 21/24 patients. Intra-operatively, at least one SLN could be harvested by gamma probe and/or blue dye methods. A total of 95 SLNs were detected. Four SLNs were detected only by blue dye, 42 only by radiotracer, and 49 were hot/blue. Median number of SLN per patient was 3. Three patients had positive pelvic lymph nodes. All of them had positive SLN (no false negative case). Frozen section could identify SLN involvement in two of three patients with positive pathology. CONCLUSION: Lymphatic mapping and sentinel node biopsy is feasible and accurate in endometrial cancer patients using combined radiotracer and blue dye methods. Frozen section accuracy was lower and underscores the importance of expert pathologists for SLN mapping technique.

Leiomyosarcoma with Unusual Macroscopic Features: A Case Report

Uterine sarcoma is a rare tumor of mesodermal origin, accounting for 2-6% of uterine malignancies. Leiomyosarcoma (LMS) has been reported in only 1% of all uterine malignancies and is regarded as the most common primary uterine sarcoma. Herein, we present a case of LMS with unusual macroscopic features. The patient was a 61-year-old woman with LMS, which consisted of a large cystic mass (88×136 mm), containing six liters of brownish fluid on the right side of the pelvis and abdomen. The fundus of the uterus was ruptured by the solid part of the tumor. For treatment, total hysterectomy, salpingo-oophorectomy and the optimal resection of tumoral parts were carried out. Overall, the distinctive biological behavior and poor overall survival of uterine sarcoma challenge the post-operative management of this tumor. According to the one-year follow-up, the patient was disease-free. Unfortunately, no further information is at hand beyond this period

The potential prognostic and therapeutic application of tissue and circulating microRNAs in cervical cancer

Cervical cancer (CC) is a common malignancy in women and a major cause of cancer- related mortality globally. Some novel biomarkers may enable the early diagnosis and monitoring of CC. MicroRNAs are small noncoding RNAs that control gene translation at a post transcriptional level. Hence the deregulation of these molecules can cause many diseases. There appears to be an association between aberrant miRNA expression and CC, but the molecular mechanisms involved in the development of CC remain unknown. The upregulation of some circulating miRNAs, e.g. miRNA-20a, miRNA-203, miRNA-21, miRNA-205, miRNA-218, and miR-485-5, as well as tissue specific-miRNAs, e.g. miR-7, miR-10a, miR-17-5p, miR-135b, miR-149 and miR-203 has been found in patients with CC. There is also growing evidence for the importance of miRNAs in the development of drug-resistance. This review therefore highlights recently published preclinical and clinical investigation performed on tissue-specific and circulating miRNAs, as potential biomarkers for the detection of patients at early stages of CC, in the prediction of prognosis, and monitoring of their response to therapy. Key word: cervical cancer, CIN, MiRNA, circulating biomarker, tissue-specific biomarker, HP

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Partial molar ectopic pregnancy: A case report

Partial or complete mole affects one in 1000  pregnancies.Partial mole is a rare form of ectopic pregnancy. There was a married woman,gravid 4,parity 1,abortion 1,and she had past medical history 0f right ectopic pregnancy.she had left ectopic pregnancy and was treated by laparascopic left salpyngectomy after failure of intramascular methotrexate treatment.After surgery  the pathology exam showed partial mol