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Introduction@#Among women with Polycystic Ovarian Syndrome (PCOS), obesity is one of the diagnosis criteria and it is evaluated by waist circumference. We aimed to determine the measurement of waist circumference in women with PCOS. Obesity and PCOS tend to increase throughout the world. In 1994, leptin was discovered to be directly related to body mass index in obesity. Ovarian cystic syndrome has been shown to be associated with leptin levels and also that indicating the need for prevention of obesity in women.@*Objective@#Clinical and medical determination for the waist circumference of women with PCOS and comporation study to leptin and comparative study to leptin levels.@*Мaterial and Methods@#This research included a total of 86 women aged 18-35 in Ulaanbaatar city. We took a permission to start the research at the meeting of the Research Ethics Council of the Mongolian National University of Medical Sciences on March 22, 2019. Statistical analysis of this study results was performed using SPSS 19.0, text recording using Microsoft Office 2018 software, T-test to exclude group differences, ANOVA test for differences between more than two groups, and p<0.05 statistical probability difference.@*Results@#The research of the 56 women tested for leptin in the serum of women with PCOS, 28 (32.5%) had a normal BMI with PCOS and 28 (32.5%) had an excess of BMI with PCOS, respectively. The mean levels of leptin was 13.86±11.40 kg/ml for people with normal BMI, PCOS and 33.78±17.63 kg/ml for people with excess BMI, PCOS. Leptin is higher in women with BMI, PCOS and this result is statistically significant (P-value 0.000).@*Conclusion@#Leptin levels are higher during PCOS, and leptin levels increase as the number of risk factors increases. Leptin secretion is affected by BMI and waist circumference.
ABSTRACT
About 10-15% of infertility among reproductive aged couples. According to the Centers for Disease Control, 1/3 of the women among 30 over aged, ½ of the women among 40 over aged women have infertility. Infertility rate is in Europe 10%,in USA 15%, in Russia 17 % (Speroff L. Endocrinology and Infertility. 2005). Female infertility is 45.6%, caused by damage to fallopian tubes is 61%, hormonal causes infertility is 30-40%. In Mongolia the report of study in 1997, infertility rate was 13.06%, report of IVF laboratory of Bayangol hospital infertility rate was 8-10% in 2010, the female infertility was 40-60%. We have first time to study female infertility risk factor among our gynecological department. Aim of study is to identify the some risk factor of female infertility We separated the women into 2 groups by fertile (normal 48 women and infertility 48 women). Hormonal findings was obtained from all women and had survey of questionnaire to risk factor. Statistical analysis did SPSS 20, data were given as mean±SD, the frequencies of the alleles and genotypes in patients and controls were compared with X2 analysis. Odds ratio (OR) and 95% confidence intervals were calculated.The mean age was 33.4±6.1 and mean years of infertility was 7.0±4.5. The primary infertility was 27.1% (n=13), secondary infertility was 72.9% (n=35). The 1.2% (n=15) were given birth, the 33.3% (n=16) had miscarriage and 58.3% (n=28) had abortion of total women. The mean BMI was 24.7±4.6 and 23% were overweight and 13% women were obesity among infertility women. The mean length of uterus was 5.1±1.1 sm, width was 4.0±0.8 sm, mean length of ovaries was 3.1±0.6 sm, mean width was 2.3±0.6 sm among infertility women. Also estradiol mean level was 41.6±22.1 pg/ml, FSH was 15.6±6.1mIU/ml, LH 5.5±1.7mIU/ml, and prolactin 14.4±10.6 ng/ml, progesteron mean level was 0.6±0.1 ng/ml among infertility women. These hormonal level was same in normal women. The risk factor of infertility were sexually transmitted disease (p=0.007, OR=7.667, CI 1.612-36.455), and curettage of uterus (p=0.024, OR=1.357, CI 1.156-1.1819). Secondary female infertility rate was (72.9%) and the women with STD 7.6 hold and women with previous had curettage of uterus will get 1.3 hold the risk of infertility.
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Cervical cancer is commonly caused by infection with human papilloma virus(HPV) and some risk factors are involved in the etiology of it.1 All over the world 437000 people are diagnosed with cervical disorders and half of them die due to cervical cancer.2 Annually 12000 new cases of cervical cancer are detected and 5000 women die because of it. In Spain about 2000 women are determined in the 3rd and 4th stage of the disease per year.3 Over the period 2000-2008 cervical cancer rate is 8 %among all cancers in Mongolia. Approximately 16 % of women’s cancer is cervical cancer. 4 In developing nations prevalence rate of cervical cancer is higher because of malnutrition, quality and framework for early detection are not satisfying and some reproductive risk factors also influence on it. 5 Worldwide diagnosing early and rapid management of precancerous condition and cervical abnormalities turn into main issue. Therefore based on these detection of premalignant lesion of cervix by colposcopy the main objective of the study. The overall goal of the study is to detect the premalignant lesion of cervix by colposcopy and determine of some risk factors and study the results.A total of 71 women, who are treated in Women’s inflammatory disease unit, Infertility and Women’s endocrine disorder unit are recruited for the cross sectional study. The women, who conducted the study were selected by accidently and colposcopy was done. They also have completed special questionnaires. The data were analyzed using the SPSS 19.0, Windows Office. The average age of the women was 38±9.4. Colposcopy was done 90.1% (n=64) of women, 9.9% (n=7) of women had not colposcopy. Among the women who had colposcopy, biopsies were taken 56.3% (n=36). During colposcopy we analyzed condition of cervix then we took biopsy from suspected areas and sent it histology laboratory. We compared predictive diagnosis, histology results after colposcopy and 33.3% (n=12) were identified as normal, CIN I was 52.7%, (n=19), CIN II was 5.5% (n=2), CINIII was 2.7% (n=1), cervical cancer is confirmed in 5.5% (n=2). We studied risk factors that can influence the cervical disorders among the women recruited in the study and age of first sexual intercourse (r=0.356, p=0.033), number of abortion (r=0.412, p=0.029) were statistically significant. However age of the women, parity, usage of contraceptive pills, smoking, number of sexual partners were statistically not significant.(p>0.05) When women’s age of first sexual intercourse is younger, cervical cancer disorder occurs30% greater comparing to women having first sexual intercourse later, (p<0.05, R=0.3), when number of abortion increases cervical cancer disorder increases 40%(p<0.05, R=0.41).F-1 to recruit osteoprogenitor /mesenchymal stem cells in the bone regeneration process.
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Benign ovarian pathology remains a significant disorder in women who are in reproductive age in the world. During the last decades laparoscopic treatment has been established as a routine method of benign ovarian masses. Adhesion prevention, less operative pain and cosmetic better results are some of the most important advantages of this proceed. Since 2010, laparoscopic surgery has been implemented in our hospital, and it is necessary to expand in the future. In 2014 total of 286 cystectomy were done and 50 cases from them were held by laparoscopy at First Maternity Hospital. In Mongolia laparoscopic surgery cases are few and there is no study relating to this situation. Purpose of this study was to investigate whether laparoscopy could replace safe and effective surgical treatment of benign ovarian pathology. 50 women with benign adnexal cysts, laparoscopically treated in the Department of Gynecologic surgery of First Maternity Hospital in 2014 were included. This is a prospective study which used questionnaire with 24 questions.The mean age of presentation was 31 years. Ovarian cysts were more commonly seen in the age group 18-35 years. The diagnosis in 28 (56%) cases was endometriosis of the ovary, 1 (2%) serous cystadenomas, 9 (18%) dermoid ovarian cyst, 9 (18%) follicular cysts and 6 (12%) paraovarian cysts. Serum level of CA-125 measured before the surgery : high- 7(14%), normal- 26(52%) and 17(34%)- cases not measured. Pain improvement after surgery- 90% of the patients had no pain, 4% were with wound pain, and 6% were with pelvic pain. It was proven the advantage of the laparoscopic surgery Patients hospital stay: 72%-1 day, 24%- 2 days and 4%- 3 days. Laparoscopic surgery seems to offer significant advantages such as reduced hospital stay, less adverse effects, better quality of life, and superior vision especially on surgical treatment of cases like endometriosis.
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Hysterectomy is still the most common major operation performed by gynecologists. Having said that the incidence of hysterectomy has increased last 20 years with new minimally invasive technique. Laparoscopy assisted vaginal hysterectomy has advantage like small incision, less operative pain, quicker recovery, less hospital stay comparing to the abdominal open surgery. Objective: To compare the outcome of abdominal hysterectomy and laparoscopic vaginal hysterectomy.The study population comprised all patients who had LAVH and abdominal hysterectomy at First Maternity Hospital, from June 2013 to December 2014.The mean age of both group is same (46.2±5.3). Duration time of LAVH is approximately 2.30±-5.9minutes and of total abdominal hysterectomy is a 1.41±2.7 minute. The general blood loss during LAVH is 74.4±19 ml and during total abdominal hysterectomy is 185.2 ± 67 ml. After LAVH any patient had no complaints. After LAVH the patient stayed at the hospital for 3 days. LAVH took significantly longer operating time than TAH. Blood loss was jess during LAVH. Hospital stay after LAVH was less than TAH. Drug cost is more case LAVH.
ABSTRACT
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-age women, affecting an estimated 5-8% of all women in this age group. Clinically, hyperandrogenism, chronic amenorrhea, central obesity and polycystic ovary can all occur in women with PCOS and may cause of infertility. Dehydroepiandrosterone sulfate is an androgenic hormone produced inadrenal cortex and recently, there is no any data determined DHEA-S in patients with PCOS.Our study was designed to evaluate obesity, central obesity, hirsute grade and infertility and to determine serum DHEA-S hormone in women with PCOS and healthy non-PCOS women.We have used a cross-sectional study design and the study included reproductive-age 36 women, of whom 18 were diagnosed with PCOS and 18 were non-PCOS. Anthropometric components were measured and ELISA test to determine serum DHEA-S hormone was analyzed for all of these women. When we analyzed ELISA test to determine serum DHEA-S hormone, DHEA-S level was2.9±2.0 µg/ ml in non-PCOS reproductive-age women and 8.0±2.1 µg/ml in women with PCOS, respectively (р=0.01). Among the women diagnosed with PCOS had higher incidence of central obesity and grade II hirsute and infertility than healthy women (p=0.001). By the result, higher level of serum DHEA-S in women diagnosed with PCOS may cause of sign of hyperandrogenism such as central obesity, infertility and hirsute.
ABSTRACT
Endometriosis is described as a chronic inflammatory disease, characterized by endometrial-like tissue, found outside the uterine cavity which cause chronic pelvic pain, infertility,dysmenorrhea. The prevalence of endometriosis is difficult to determine accurately but in asymptomatic women, the prevalence of endometriosis ranges from 2- 22 %, depending on the population studied , in infertile women 20-50 % and in those with pelvic pain, between 40-50% (Balasch, 1996; Eskenazi, 2001; Meuleman, 2009).Endometriosis is found 7-10% of reproductive agewomen and 20-90% in with chronic pelvic pain, infertility cases. Pathogenesis of endometriosis is not yet fully understood but one potential cause of the disease is retrograde menstruation which results in the deposition of endometrial tissue into the peritoneal cavity. Today a composite theory of retrograde menstruation with implantation of endometrial fragments in conjunction with peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Susceptibility to endometriosis is thought to depend on the complex interaction of genetic, immunologic, hormonal and environmental factors. To determine prevalence and severity of clinical symptoms, compare meta-analysis to changes the clinical value of serum CA-125 and peritoneal fluid cytology in women with endometriosis of Ulaanbaatar city. We had selected total of 60 woman with endometriosis which were registered from January to December 2014 in gynecologic clinic of First Maternity Hospital. The research group registered in questionnaire with 28 questions. During the inspection laboratory analysis of serum CA-125, ultrasound analysis and peritoneal fluid cytology were done. Assessment of pelvic pain by means of a 10-point linear analog scale / pain score/ which provided by International Pain Association. The research result was worked out by prospective method. Average age of patients 33.4±8.9. Pain location: Chronic pelvic pain 30%; Dysmenorrhea 28.3%; Dysparunea 10%; Pain during defecation 6,7%; Without pain -25%. Average level of Serum СА125 was 38.13±20.6. Location of endometriosis: adenomyosis - 8.4%, endometrioma-15% endometriotic lesion at cul de suc 68.3%, rectal involment 1.7%, tubal lesion-3.3%, combined 3,3%. 76.7% of surgery for endometriosis have done by laparoscopy and 23.3% by laparotomy. Ultrasound examination result: endometrioma d=0-2cm-1.7%, d= 3-5cm-36.2%, d=6-8cm-10.3%, d=9cm<-12.1%. Cytology result: Peritoneal fluid contains 75% of erythrocytes, mesothelial cells and it needs to further study.CONCLUSION:Most of patient /58.3%/ had chronic pelvic pain and dysmenorrhea. The severity of pain was significantly improved after operative laparoscopy. /p<0.05%/51,7% of patient had infertility problem.Value of serum CA-125 was higher in study group with large sized and not clear content ovarian endometrioma by ultrasound examination. /p<0.05%/The local environment of peritoneal fluid surrounding the endometriotic implant is immunologically dynamic and links the reproductive and immune systems. Peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Peritoneal fluid contains a variety of free floating cells, including macrophages, mesothelial cells, lymphocytes, erythrocytes, eosinophils and mast cells. In our cytology results: peritoneal fluid contains 75% of erythrocytes, mesothelial cells.