role of colposcopy in the diagnosis and management of chronic vulvar pain [vulvodynia]

Fifty women complaining of chronic vulvar pain and 22 age-matched patients without pain were selected for this study. After full gynecological examination, a histopathologic analysis was carried out and biopsy was taken from any detected lesion. The results showed that vulvodynia was found to be either primary or secondary; the primary is the commonest and may be diffuse or localized and the secondary may be associated with lower genital infection, rectal and/or urethral lesions. The characteristic colposcopic lesion was the acetowhite area with or without the associated micropapillary lesion detected in 24% of the cases. Cases having such lesion showed epithelial koilocytosis by a histopathological examination and it indicated chronic HPV infection. It was concluded that chronic HPV infection is definitely a cause of vulvodynia. Colposcopy examination is essential in these cases as well as histopathology and bacteriology are essential for the confirmation of the diagnosis and planning the management

Effect of adjuvant chemotherapy on ovarian function in young women with breast cancer

In the present study the ovarian function in 32 premenopausal women treated with adjuvant chemotherapy for carcinoma of the breast was evaluated. All patients answered a series of questions about their menstrual cycle and fertility before, during and after chemotherapy. Thereafter, they were subjected to full gynecologic examination and hormonal assays. While receiving chemotherapy, the majority of patients [72%] maintained regular periods. Moreover, 56% of those who developed amenorrhoea during chemotherapy restored regular cycles after a median period of 4 months. After a median period of 23 months, 17 patients [53%] had regular periods without any sexual or gynecologic problems. two patients conceived after 14 and 19 months after the last cycle of chemotherapy. The amenorrhoea group had high gonadotrophin levels and low estradiol levels consistent with ovarian failure as the cause of amenorrhoea in these patients. Patients with regular menses had significantly lower median gonadotrophin levels and a higher median estradiol level [P< 0.001]

Altered prostaglandin metabolism as a cause of pre-eclampsia: an implication on therapy

In a trial to declare the possible role of altered prostaglandin metabolism in the pathogenesis of pre-eclampsia, the plasma levels of 2 major antagonistic compounds have been estimated using enzyme immunoassay method; namely thromboxane A2 and prostacyclin, along with estimations of platelet count and ADP induced platelet aggregation. The study comprised 10 normal pregnant and 10 pre eclamptic females of comparable parity and gestational periods, as well as 10 normal age matched non-pregnant females for comparision. Mean platelet count was significantly lower in pre-eclamptic cases as compared to both normal pregnant and control groups, with no significant difference between the later 2 groups. Mean platelet aggregation percent was only significantly higher in normal pregnant females as compared to both pre-eclamptic and non-pregnant controls, using either low or usual doses of ADP. A significantly higher mean plasma thromboxane-B2 and a significantly lower mean plasma prostacyclin levels were observed in both normal pregnant and pre-eclamptic groups as compared to controls, with no significant difference in the level of either compound between the former 2 groups. A significant positive correlation between TXB2 level and each of systolic and diabolic blood pressures was observed in pre-eclamptic patients. A significant positive correlation was similarly observed between TXB2 level and ADP induced aggregation percent using both low and usual doses, only in non-pergnant controls. Moreover the levels of both TXB2 and PCI2 showed a direct significant correlation in both pregnant groups. The ratio of thromboxane B2/prostacyclin was however, significantly highrt in both pregnant groups as compared to controls as well as in pre-eclamptic patients as compared to normal pregnant females. A disturbed prostaglandin metabolism, with unchecked thrombogenic effect of thromboxane A2 was suggested as a potential mechanism for pre-eclampsia. The therapeutic use of low dose asprin as a selective cyclo-oxygenase inhibitor might be of help in prevention of the microcirculatory complications observed in this condition