[Outcome of malignant vulvar tumors]

Vulva anatomy - FIGO classification- Vulva tumors anatomopathology - Treatments of vulva cancers. Our study is a retrospective, longitudinal and continuous one. It concerns 11 malignant vulva tumors which were treated in the d‚partement "C" of the centre of maternity of Tunis. The period of study is fifty four months [2002-2006]. The aim of our study is to analyse the characteristics of the vulva cancer and to compare our results to litterature. Mean age of our patients is 67 years old. They are all menaused. The principal signs are vulva tum‚faction in 72,7% of the cases, vulva pruritis in 27,3% of the cases and genital bleeding in 27,3% of the cases. The mean period of consultation is of 14 months. We have ten cases of vulvar epidermoid carcinoma and one melanoma. The treatment was surgical in the eleven cases [10 total vulvectomy and one hemivulvectomy] They all benefited of an inguinal bilateral curage. The adjuvant radioth‚rapie was indicated in 3 cases. A patient was classed stage lb of FIGO, 7 stage II, one stage III and one stage IVA. Nine patients are in remission, 3 are dead: 2 because of their cancer and one due to a pulmonar embolism. The survival of 6 month is 72, 2%.The prevention of this cancer passes by the close follow of dystrophic states and viral pathologies of the vulva

Usefulness of colposcopy in inflammatory vagin frottis

The cervical cancer is the second most frequent cancer of the woman in Tunisia. It is considered as a sexual transmissive desease due to the involvement of the HPV. The purpose of our study is to proove that an inflammatory cervical smear should be considered as a positive test and must lead to other investigations. It is a prospective study over 140 cases of inflammatory cervical smears [without atypical cells] diagnosed during a year period from June 2001 to June 2002. These patients had a systematic colposcopy with the biopsy of suspicious lesions. The mean age of our patients is 42 years. 68.57% of them are in active genital period. The colposcopy was normal in 10% of our patients. It showed benign lesions such as: ectropion in 22.85%, colpitis in 14.28%, cervical polypus in 5%, normal transformation zone in 8.57%, but also suspicious lesions such as: atypical transformations grade I [ATGI] in 25.71% and atypical transformations grade II [ATGII] in 13.57%. The biopsies made on 89 patients showed dysplasia and carcinoma in 18.57% of them. A case of in situ carcinoma, a microinvasif epidermoid carcinoma and an invasif glandular carcinoma were diagnosed. Colposcopy is an ambulatory investigation. It makes a minutious study of the cervix and diminishes the rate of false negative made by the cervical smear

[Inaugural diabetic acido-ketosis during pregnancy]

Ketoacidosic decompensation is still an important cause of morbidity, and mortality in diabetic patients. This complication may inaugurate the disease and its occurrence in pregnancy is a medical and obstetrical emergency that puts both mother's and foetus' life at risk. We report two cases of inaugural ketoacidosis in patients 27 and 14 years old, at 36 and 25 weeks of amenorrhea [WA]. With reanimation and insulinotherapy, evolution was favorable with a cesarean section delivrery at 36WA+3d and 35WA+3d of healthy children who weighed 2900g and 1970g. Persistance of high glucose values in postpartum required continuance of insulinotherapy for one patient and oral antidiabetic agents for the second