ABSTRACT
We aimed to perform a systematic review and meta-analysis of all randomized placebo-controlled trials (RCTs) that examined the analgesic benefits of preemptive pregabalin among patients undergoing minimally invasive hysterectomy. Five major databases were systematically screened from inception until August 29, 2021 Relevant studies were evaluated for risk of bias. Endpoints were analyzed using the random-effects model and pooled as the mean difference or risk ratio with a 95% confidence interval. Four studies with seven treatment arms met the inclusion criteria. The total sample size was 304 patients: 193 and 111 patients were allocated to the pregabalin and placebo groups, respectively. Overall, the included studies revealed a low risk of bias. The summary results revealed that the mean postoperative pain scores at rest were significantly lower in the pregabalin group than in the control group at 0, 2, 4, 6, 12, and 24 hours. Moreover, the mean postoperative pain scores on movement/coughing were significantly lower in the pregabalin group than in the control group at 12 and 24 hours. The rate of patients who were opioid-free postoperatively was significantly higher in the pregabalin group than in the control group. There was no significant difference between the groups in terms of the mean postoperative time to first rescue analgesic and the rates of adverse events. Compared with placebo, preemptive pregabalin was largely safe, and was correlated with superior analgesic effects in terms of lower postoperative pain scores and higher opioid-sparing effects. Additional RCTs are needed to confirm these findings.
ABSTRACT
Endometrial stromal sarcoma [ESS] is an extremely rare neoplasm accounting for only 0.2% of all uterine malignancies and for 15-26% of primary uterine sarcomas. The annual incidence of ESS is 1-2 per million women. Herein, to the best of our knowledge, we present the first reported case of ESS of the vulva in a 50-year-old female presenting with per vaginal spotting over a period of three months. Her past surgical history included a subtotal hysterectomy and left salpingo-oophorectomy for uterine fibroids ten years previously. On examination, a 3.5 x 3 x 2 cm cystic mass was found in the right labia majora. The mass was excised and the diagnosis of endometrial stromal sarcoma was made. Subsequent metastatic workup was negative and the patient was started on megestrol acetate. She has remained disease free with no signs or symptoms of recurrent or advanced disease for 28 months
ABSTRACT
Incidence of malignant ovarian germ cell tumors [MOGCTs] in the Saudi Arabian population has not been studied before. Therefore, the primary objective of this study was to define the population-based incidence rates and histopathological types of MOGCTs in the Saudi Arabian population from 1999 to 2008. Our study showed that MOGCTs are a common type of ovarian tumors in the Saudi Arabian population, and the incidence rates and histopathological types are relatively comparable to the international populations with few differences.
ABSTRACT
There are only a few reports of uterine cancers in women with Down syndrome, whose tumor profile is marked by a reduced risk for solid neoplasms. There are no reports of a uterine carcinosarcoma arising in a woman with Down syndrome. In our case, a delayed diagnosis of uterine carcinosarcoma was confirmed on a 38-year-old, nulliparous, single, obese women with Down syndrome, who presented with irregular vaginal bleeding. Although uterine cancers are underrepresented in women with Down syndrome, uterine malignancy should be considered in the differential diagnosis of abnormal vaginal bleeding. A timely and complete gynecological examination will preclude a delay in diagnosis