INFLUENCE OF THE NUMBER OF PREVIOUS CAESAREAN SECTIONS ON LOWER UTERINE SEGMENT STATE

Determining the lower uterine segment (LUS) state before vaginal delivery and after Caesarean section, including pregnant women with more than one Caesarean section, may be an important step towards prevention from still high maternal and neonatal morbidity and mortality that follow uterine rupture. In pregnant women with one or more previous Caesarean sections, ultrasonic measuring of thickness and estimating the LUS integrity can objectively show the state of uterine scars. The aim of this study was to determine the influence of several previous Caesarean sections on the LUS state in term pregnant women. The prospective study included 62 pregnant women with one or more previous Caesarean sections – the examined group, and 50 pregnant women without Caesarean section – the control group, that after the 37th week of pregnancy had undergone the transvaginal ultrasonic measuring of the thickness of the LUS muscular tissue. In 57 pregnant women from the examined group delivered with another Caesarean section, we estimated, intraoperatively, the LUS integrity in the scar area. On the same occasion, in the scar area, the presence of defect – partial or complete was detected. The research pointed out that the average LUS thickness in the examined group – 1.92±0.95mm was statistically significantly lower compared to the control group – 2.68±0.97mm (p<0.001). The average LUS thickness in 52 examined women with one Caesarean section was 1.92±0.97mm, and in 9 women with two Caesarean sections the average thickness was lower – 1.78±0.82mm, which does not represent a statistically significant difference (p=0.85). In one pregnant woman with three Caesarean sections, the LUS thickness was 3.30mm. We registered the total of 13 pregnant women with a defect in the Caesarean section scar area (12 partial and 1 complete defects), in 12 women after one Caesarean section and in 1 woman after two Caesarean sections. The research results show that women with previous Caesarean section have significantly thinner LUS, compared to the group of pregnant women without scars. With the increasing number of previous Caesarean sections, the LUS thickness decreases, but the difference is not statistically significant. Intraoperatively, the presence of certain LUS classes compared to the number of previous Caesarean sections is not significantly different. Furthermore, the increase in the number of Caesarean sections does not involve a statistically significant increase in the frequency of Caesarean section scar defects, which is in accordance with other authors’ results

Acute abdomen in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome

Background. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a malformation of female genital tract (incidence 1 in 4000 female newborn children). It appears as a result of a disorder in the development of Millerian cannals. Etiology is unknown. Syndrome MRKH is the most frequent cause of primary amenorrhoea (90%). Patients with MRKH have a normal female phenotype, with normal pubic hairness and thelarche, and female karyotype (46XX) followed by primary amenorrhoea. Hormonal status corresponds to healthy women, where the appearance of ovarian tumors and tumors on rudiment parts of uterus is possible. Case report. We presented a case of acute abdomen in a patient with previously not diagnosed MRKH. The diagnosis was done during the operation. Small pelvis and an abdominal part were filled with torquated tumor lump, where ovaries, oviducts, uterus or something resembling rudiment of uterus were not recognized through careful examination. Furthemore, the patient had a short, dead-end vagina. Tumorectomy was done and hystopathological finding showed the presence of vascular leiomyoma. Conclusion. The diagnosis of complex syndromes, such as MRKH, can, despite modern diagnostics, be absent for non-medical and psycho-social reasons. We can expect ovarian and uterine pathology on hypoplastic structures in these patients, as well as in healthy women. Vascular leiomyoma in the patients with MRKH was not found in the available literature

Bezbednost primene lekova koji se koriste u terapiji HIV infekcije

Human immunodeficiency virus (HIV), isolated in 1983 by Paster Institute researches, has been recognised as the cause of million fatalies in 21st century. Initial monotherapy failed to show promising results, however, with the development of highly active antiretroviral therapy new era of HIV treatment has started. This new approach resulted in extended life time, reduced development of virus resistance as well as morbidity and mortality of HIV patients. Antiretroviral therapy is longlife and connected with serious adverse and toxic effects. Mitochondrial toxicity can be manifested as periferal lipoathrophy, hepatic steatosis, lactic acidosis, neuropathy and miopathy. Metabolic features associated with lipodystrophy include hypertriglyceridaemia, hypercholesterolaemia, insuline resistance and abnormal glucose tolerance. Hepatotoxicity, nephrotoxicity, osteopenia, rash and gastrointestinal symptoms can also occur during antiretroviral therapy. The aim od this work was to present the most important adverse and toxic effects of drugs used in HIV therapy.Virus humane imunodeficijencije, izolovan zahvaljujući istraživačima Paster Instituta 1983. godine, uzročnik je milionskih žrtava u XXI veku. Kako inicijalna monoterapija nije uspela da pokaže zavidne rezultate, razvojem visoko aktivne antiretrovirusne terapije započeta je nova era HIV terapije. Nov pristup lečenju produžio je životni vek obolelih, smanjio pojavu rezistencija kao i stopu morbiditeta i mortaliteta obolelih. Antiretrovirusna terapija je doživotna i nosi sa sobom ozbiljne neželjene i toksične efekte. Mitohondrijska toksičnost može se ispoljiti kao periferna lipoatrofija, hepatična steatoza, laktična acidoza, neuropatija i miopatija. Metabolički poremaćaji udruženi sa lipodistrofijom uključuju hipertrigliceridemiju, hiperholestirolemiju, insulinsku rezistenciju i abnormalnu glukoznu toleranciju. Hepatotoksičnost, nefrotoksičnost, ostepenija, pojava raša i smetnje na nivou gastroinestinalnog trakta takođe se mogu javiti pri primeni antiretrovirusne terapije. Cilj ovoga rada je bio da da prikaz najznačajnijih neželjenih i toksičnih efekata lekova koji se koriste u terapiji HIV-a

The value of Pap test in women with endometrial cancer

Introduction: Endometrial cancer is the second most common gynecological tumor. There is still no recommended screening method for endometrial cancer. The application of transvaginal sonography, hysteroscopy and Pap test may prove useful in screening for this disease. Atypical glandular cells represent an important finding in Pap tests and they are related to histopathological verification of the endometrium. The aim of the study was to determine the usefulness of the Pap test in assessing the cervical infiltration, as well as to determine the significance of hormonal status and histopathological type of tumor in a pathological Pap test in patients with endometrial cancer.Methods: The study was retrospective. The analysis included the data obtained from 62 operated patients diagnosed with enometrial cancer, medical history (menopausal status), histopathological findings after surgery (type and stage of the disease) and a preoperative Pap smear. The chi squared and Fisher’s test were used.Results: The difference in the prevalence of pathological Pap test in premenopausal and postmenopausal group of patients was not statistically significant. The difference in the prevalence of pathological Pap test in the group of endometrioid and non-endometrioid tumours of the uterine corpus had statistical significance. The difference in the prevalence of pathological Pap test compared to the present stage (I and II) was not statistically significant.Conclusion: Pap smear does not correlate with menopausal status in women with endometrial carcinoma. Abnormal Pap test is more commonly found in cases of non-endometroid tumours. Pap smears cannot beused to assess cervical involvement

PROLACTIN AND HYPERPROLACTINAEMIA IN FEMALE REPRODUCTIVE ENDOCRINOLOGY – AN UPDATE

Hyperprolactinaemia is one of the most frequent causes of anovulation, resulting in infertility and hypoestrogenic  state with consequences on overall women’s health. Recent investigations on biological actions of prolactin, especially prolactin of extrapituitary origin, expand our knowledge  on prolactin role in the human organism and open new questions connected with female reproductive function and treatment of female infertility. This article represents the review of current knowledge on prolactin physiology, etiopathogenesis, clinical features, assessment , differential diagnosis ,and teatment of hyperprolactinaemia in the female patient

Antimicrobial activity of plant secondary metabolites

Sekundarni metaboliti biljaka odgovorni su za širok dijapazon aktivnosti biljnih droga. Ciljevi istraživanja sekundarnih biljnih metabolita, odnose se i na potrebe pronalaska novih antimikrobnih materija s obzirom na globalnu pojavu otpornosti bakterija na antibiotike. U ovom radu, razmatra se antimikrobna aktivnost sekundarnih biljnih metabolita.Plant secondary metabolites are responsible for a wide range of herbal drug activities. The objectives of the research of secondary plant metabolites also relate to the needs of the invention of new antimicrobials due to the global appearance of bacteria resistance to conventional antibiotic agents. In this paper, the antimicrobial activity of secondary plant metabolites is considered

Significance and efficacy of triterpene saponin herbal drugs with expectorant action in cough therapy

Medicinal plants, about 10,000 species, are used in medicine to treat diseases or preserve human health because they are rich in the content of alkaloids, glycosides, resin, essential oils, etc. Phytopreparations are very important in the treatment of productive cough, both in self-medication and on the recommendation of health professionals. Medicinal preparations containing saponosides stimulate the glands to secrete bronchial secretions through a gastropulmonary reflex mechanism, which results in the production of rarer, watery mucus in the bronchial glands. They act on thick mucus as surfactants, reduce its viscosity and facilitate expectoration. Among triterpene saponosides used as expectorants, ivy leaf extract has proven therapeutic efficacy based on in vitro and in vivo studies. For other saponin expectorants (primrose root and flower, liquorice root (radix dulcis = sweet root), senega root, grindelia herb, common polypody rhizome), only the traditional application has been documented, which is confirmed by many studies. Due to the increased application, as well as the necessary confirmations of efficacy, there is a need for future research to analyze in more detail the pharmacological effects of triterpene saponins of expectorant action and their effect on the human organism

The possibility of application of plants in the prevention and treatment of diabetes

Dijabetes melitus spada među najčešće bolesti endokrinog tipa i u stalnom je porastu. U lečenju šećerne bolesti, koristi se nekoliko pristupa; insulin u kombinaciji sa dijetom, lekovi i medicinska sredstva, promene životnih navika. Važnu ulogu u prevenciji i lečenju dijabetesa, imaju i brojne biljne vrste, za koje je potvrđeno da poseduju hipoglikemijsko dejstvo.Diabetes mellitus is one of the most common endocrine diseases and is on the rise. In the treatment of diabetes, several approaches are used; insulin in combination with diet, medicines and lifestyle changes. Numerous plant species, which have been confirmed to have hypoglycemic activity, also play an important role in the prevention and treatment of diabetes

Safety of antiretroviral drugs

Human immunodeficiency virus (HIV), isolated in 1983 by Paster Institute researches, has been recognised as the cause of million fatalies in 21st century. Initial monotherapy failed to show promising results, however, with the development of highly active antiretroviral therapy new era of HIV treatment has started. This new approach resulted in extended life time, reduced development of virus resistance as well as morbidity and mortality of HIV patients. Antiretroviral therapy is longlife and connected with serious adverse and toxic effects. Mitochondrial toxicity can be manifested as periferal lipoathrophy, hepatic steatosis, lactic acidosis, neuropathy and miopathy. Metabolic features associated with lipodystrophy include hypertriglyceridaemia, hypercholesterolaemia, insuline resistance and abnormal glucose tolerance. Hepatotoxicity, nephrotoxicity, osteopenia, rash and gastrointestinal symptoms can also occur during antiretroviral therapy. The aim od this work was to present the most important adverse and toxic effects of drugs used in HIV therapy