Differential diagnosis of benign ovarian cysts using tumor markers in serum and cyst fluid

Background: Differentiating the type of benign ovarian cyst can result in better care. Aims: To measure CA-125, CA 19-9, Carcinoembryonic Antigen (CEA) and Alpha-fetoprotein (AFP) in serum and cyst fluid of patients with benign ovarian cysts and whether these biomarkers can be used to identify the type of the cyst. Methods and materials: Patients with benign ovarian cysts undergoing laparoscopic cystectomy were included. Cyst types were determined histologically. Levels of CA 125, CA 19-9, CEA and AFP were measured in serum and cyst fluid. Results: 98 cysts (25 functional, 12 endometrioma, 15 dermoid, 28 mucinous cystadenoma, 18 serous cystadenoma) were evaluated. There was a significant difference in levels of CA 125 and CA 19-9 in serum and CA-125, CA 19-9 and CEA in cyst fluid. For diagnostic purposes, a value of ≥35 IU/mL for serum CA 125 predicted endometriomas with a sensitivity of 91.7% and a specificity of 91.9%. A value of ≤22.5 IU/mL for cyst fluid CA 19-9, predicted functional cysts with a of sensitivity of 92% and specificity of 95.2%. A value of ≥100 ng/mL for cyst fluid CEA, predicted mucinous cysts with a sensitivity of 96.4% and specificity of 96.7%. Conclusion: Levels of CA-125, CA 19-9 and CEA in serum and cyst fluid of patients with benign ovarian cysts can be used as a diagnostic tool in patient evaluation with acceptable sensitivity and specificity. This finding can be used in conjunction with other methods such as ultrasound, especially in cases that are harder to diagnose

Differential diagnosis of benign ovarian cysts using tumor markers in serum and cyst fluid

Background: Differentiating the type of benign ovarian cyst can result in better care. Aims: To measure CA-125, CA 19-9, Carcinoembryonic Antigen (CEA) and Alpha-fetoprotein (AFP) in serum and cyst fluid of patients with benign ovarian cysts and whether these biomarkers can be used to identify the type of the cyst. Methods and materials: Patients with benign ovarian cysts undergoing laparoscopic cystectomy were included. Cyst types were determined histologically. Levels of CA 125, CA 19-9, CEA and AFP were measured in serum and cyst fluid. Results: 98 cysts (25 functional, 12 endometrioma, 15 dermoid, 28 mucinous cystadenoma, 18 serous cystadenoma) were evaluated. There was a significant difference in levels of CA 125 and CA 19-9 in serum and CA-125, CA 19-9 and CEA in cyst fluid. For diagnostic purposes, a value of ≥35 IU/mL for serum CA 125 predicted endometriomas with a sensitivity of 91.7% and a specificity of 91.9%. A value of ≤22.5 IU/mL for cyst fluid CA 19-9, predicted functional cysts with a of sensitivity of 92% and specificity of 95.2%. A value of ≥100 ng/mL for cyst fluid CEA, predicted mucinous cysts with a sensitivity of 96.4% and specificity of 96.7%. Conclusion: Levels of CA-125, CA 19-9 and CEA in serum and cyst fluid of patients with benign ovarian cysts can be used as a diagnostic tool in patient evaluation with acceptable sensitivity and specificity. This finding can be used in conjunction with other methods such as ultrasound, especially in cases that are harder to diagnose

Acute Poisoning in Children; a Population Study in Isfahan, Iran, 2008-2010

Objective: Acute accidental poisoning in children is still an important public health problem. The epidemiological investigation specific for each country is necessary to determine the extent and characteristics of the problem. The aim of our study was to elucidate the current pattern of acute poisoning among children. Methods: The present retrospective study describes the epidemiology of acute accidental poisoning in children (less than 10 years old) admitted to the Emergency Department of two teaching hospitals during a period of two years. Findings: Three hundred and forty four children under 10 years old were admitted to emergency department of two teaching hospitals due to acute accidental poisoning. Drugs were the most common agents causing the poisoning (58.1%), followed by Hydrocarbons (13.1%), and opioids (9.3%). Common signs were neurological (42.6%) with lethargy being the most common (39.1%). 50.6% of cases were discharged from hospital within 6-12 hours, 91.6% of them without any complication. Conclusion: Accidental poisonings are still a significant cause of morbidity among children in developing countries. Regarding the high prevalence of pharmaceutical drug poisoning and because lethargic was the most frequent neurological sign, comprehensive toxicology screen tests should be included as part of the routine evaluation of children presenting to an ED with an apparent life-threatening event

In vitro fertilization outcome in frozen versus fresh embryo transfer in women with elevated progesterone level on the day of HCG injection: An RCT

Background: The effect of elevated progesterone level on human chorionic gonadotropin (HCG) day in in vitro fertilization cycles is controversial. Some suppose that rise in progesterone level seems to have a negative impact on implantation and pregnancy by desynchronizing the endometrium, while others disagree. Objective: To evaluate the superiority of the frozen cycle over fresh cycle on live birth in patients with elevated progesterone level on HCG day. Materials and Methods: In this double-blind, randomized clinical trial, 72 women undergoing assisted reproductive technology with elevated progesterone level (≥1.8 ng/dl) on HCG day were included. The participants were grouped by fresh versus frozen embryo transfer, randomly. Finally, the clinical pregnancy and live birth rate were compared. Results: The implantation rate was 21.51%. The clinical pregnancy rate was 47.22% in fresh embryo transfer group (17/36) and 41.66% in frozen group (15/36) (p=0. 40). The live birth rate was not significantly difference between two groups (p=0.56). Conclusion: None of the fresh and frozen cycles are superior to the other and we recommend individualizing the decision for each patient. The frozen cycle may impose more emotional stress on patient