Survival of premenopausal breast cancer patients in relation to menstrual timing of surgery with peritumoral estrogen receptor status and angiogenesis

To define the prognostic significance of menstrual timing of breast cancer [BRCA] surgery, its interaction with estrogen receptor [ER] and angiogenesis. Prospective randomized involving 40 premenopausal BRCA patents with accurate triangulation of surgery [no multistage] in objectively defined menstrual cycle side [transvaginal ultrasound-serum progesterone], immunocytochemical stain for estrogen receptors and factor VIII, 5 years follow up with well proved finite end points./ /[ disease free survival [DFS]and disease free time [DFT]/ /]. Resected Tumors in the follicular phase had more angiogenic score [P, 0.001] plus higher micro vessel count [P, 0.001]. Patients who underwent surgery in the luteal phase had better [DFS] [P, 0.02]. On univariant analysis the menstrual timing [P, 0.01] and angiogenic score [P, 0.01] predicted the DFS, their bivariant analysis found luteal phase subset with low angiogenic score had the best prognosis [P, 0.04], but on multivariate analysis the menstrual timing was the discriminant factor [P, 0.04], the predictors for DFT were menstrual timing [P, 0.02], and ER status [P, 0.04] with insignificant difference on subset analysis. Menstrual timing represented grade II prognostic factor, with better DFS, DFT for patients operated in the luteal phase. It acts through angiogenesis modulation

Functional status of the thyroid gland in complicated versus uncomplicated pregnancies

Many Adverse pregnancy outcome have been reported in pregnant women with thyroid dysfunction. The prevalence of thyroid dysfunction and its relation to pregnancy outcome had not been studied in our locality. To assess the magnitude of thyroid disorders during pregnancy and their relation to pregnancy outcome. A prospective clinical observational study. Subjects and One-hundred-fifty four, pregnant women attending the Ante-natal Care Unit, Mansoura University Hospital. Clinical examination was undertaken. Laboratory evaluation utilizing the highly sensitive chemiluminscent serum TSH assay was performed, together with estimation of serum total T3 and total T4. Cases with abnormal TSH levels were subjected to free T4 estimation to confirm the state of thyroid dysfunction. Urine examination, blood count, liver function tests, kidney function tests and plasma glucose were carried out. Thyroid and abdominal ultrasound were performed. The studied cases were classified into two groups; group 1; 12 women having different antenatal complications and group II; 42 women having no pregnancy complications. The studied cases were also grouped into rural and urban groups, according to their residence in villages or Mansoura town respectively No hyperthyroid cases were detected in either groups. The clinical manifestations of hypothyroidism were not fulfilled, but utilizing serum TSH and FT4 testing, forty five cases out of the 154 studied cases revealed subclincial hypothyroidism [29.2%] being significantly higher among the complicated pregnancy group [33.9%] than the non complicated group [16.7%] and significantly more frequent among the rural cases than the urban group [p<0.001]. Subclincial hypothyroidism has a tendency to increase with increasing gestational age. The most prevalent complications were severe preeclamptic toxemia in 73.7% and second trimester abortion in 15.8% of cases. Subclinical hypothyroidism is common, especially in rural localities. TSH screening of pregnant women in each trimester is suggested

Preliminary uterine artery ligation versus pericervical mechanical tourniquent during abdominal myomectomy

Interventions that reduce blood loss during myomectomy are many. The effectiveness and the adverse effects of each are still under investigation. To compare preliminary uterine artery ligation versus pericervical mechanical tourniquet during abdominal myomectomy. Randomized prospective study. Two hundreds and six patients with symptomatic myomas in premenopausal and/or childbearing period attending the gynecology department, Mansoura University Hospital. Clinical examination, urine examination, blood count, liver function tests, kidney function tests and plasma glucose were carried out. Abdominal and transvaginal ultrasound were performed. The studied cases were randomly allocated into two groups; group I; 104 patients underwent preliminary uterine artery ligation and group II; 102 women underwent pericervical mechanical tourniquet during abdominal myomectomy. The operative time and operative blood loss were significantly lower in the uterine artery ligation group [P < 0.001]. Post operative reduction of haemoglobin concentrations and haematocrite values were significantly lower in uterine artery ligation group [P 0.015 for each]. Operative complications [conversion to hysterectomy, urinary tract injury, gastrointestinal were significantly lower in the uterine artery ligation group versus the touriquet [p < 0.001]. Post operative beven the need for blood transfuion and post operative analgesia were significantly highen in touriquet group [p < 0.001]

Can exercise affect reproductive and trophic hormones in girls?

To study the effect of exercise on the reproductive hormones [testosterone and estrogen] and trophic hormones [follicle stimulating hormone [FSH], luteinizing hormone [LH] and prolactin [PRL]] in girls of Sport Education at Mansoura University. Sixty students were randomized chosen from the student girls aged 18-20 years in the faculty of Sport Education at Mansoura University, Egypt, divided into 2 groups: Study group [30 students]: Control group [30 students]. The study group will practice only the physical exercises in the faculty curriculum for 2 years, 4 days/week. The control group will not practice any kind of sport. There is no significant statistical difference between the study group and the control group regarding anthropometric measurements. There is significant increase in testosterone level in the control group. Also there is significant increase in estradiol level in the study group. Regarding FSH, LU and prolactin there is no significant statistical difference in hormonal level in the study and control group. Non vigorous exercise in young girls is beneficial in decreasing testosterone level and increasing estradiol level, with no effect on trophic hormones [FSH. LH and prolactin]