The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysis.

INTRODUCTION: The number of patients desiring fertility-preserving treatment for endometrial cancer rather than standard surgical management continues to increase. OBJECTIVE: We aimed to evaluate the efficacies of fertility-preserving treatments on the live birth rate, remission and relapse rates for women with stage 1a grade 1 endometrial carcinoma to support patient counselling. METHODS: We performed a meta-analysis for our primary outcomes of overall remission and relapse rate, and for secondary analysis, we divided papers into treatment type: systemic progestins, intrauterine progestins or hysteroscopic resection and adjuvant hormonal treatment. RESULTS: Thirty-five observational studies met inclusion criteria, with a total of 624 patients. Overall, conservative treatment of endometrial cancer showed a remission rate of 77% (95% CI: 70-84%), a relapse rate of 20% (95% CI: 13-27%) and a live birth rate of 20% (95% CI: 15-25%) with more favourable outcomes for the hysteroscopic resection group. CONCLUSIONS: Hysteroscopic resection and adjuvant hormonal treatment had the most favourable fertility and oncological outcomes. Further high-quality prospective multi-centre trials are warranted to determine the optimal treatment regimen and dosage and risk stratification for these patients

Effect of Storage Conditions on the Quality Attributes of Shell (Table) Eggs

In tropical countries like Nigeria, egg preservation is a serious problem. The common practice is to store under ambient condition due to lack of refrigeration facilities and erratic power supply. Four crates of fresh table eggs were bought from the University of Agriculture, Makurdi farm and preliminary investigations of egg weights, Haugh unit, pH and yolk index were carried out before storage and found to be within standard. Thirty eggs were stored under ambient condition with and without application of oil respectively. The other group of thirty eggs was refrigerated. The initial weights were in the range of 60 – 69 g which reduced drastically. All other quality indices like the Haugh unit, the yolk index and pH declined drastically within the four weeks of the storage especially those that were stored under the ambient conditions. Those stored under refrigeration and those that were oiled and stored under ambient conditions (32 + 2oC) maintained high quality standards in all the quality indices evaluated. The microbiological result also showed higher bacteria, yeast and mould count on those stored under ambient condition with the initial count of 5.0 x 103 at first week and 2.8 x 107 at the fourth week while the oiled and  refrigerated eggs had values of 5.0 x 103 at week zero and 7.2 x 104 at week four of storage respectively. It is suggested that application of oil on eggs before storage can be practised to ensure retention of good quality eggs especially in the tropics and most developing nations of the world.Keywords: Ambient, oiled, refrigerated, eggs, yolk index and Haugh units