Vasopressin effect on operation time and frequency of electrocauterization during laparoscopic stripping of ovarian endometriomas: a randomized controlled clinical trial

The purpose of this study was to assess the vasopressin effect on operation time and the need for electrocauterization frequency and ovarian reserve during laparoscopic stripping of ovarian endometriomas. This was a randomized prospective clinical trial, in which twenty patients between 18-35 years with unilateral endometriomas were randomly divided in two groups of cases and controls. Laparoscopic cystectomy was performed by hydrodissection and stripping method in both groups with diluted vasopressin injected in cases, in comparison to only saline injection in controls. Ovarian hemostasis was achieved by bipolar electrocoagulation. The operation time and frequency of electrocoagulation were compared between two groups. The ovarian reserve was determined by ultrasound examination and laboratory assessment one month before and two months after surgery in two groups. Non parametric data was analyzed by Mann-Whitney test. The p-value less than 0.05 was considered statistically significant. The operation time was less in cases than control group, but the difference was not statistically significant [p=0.065]. The frequency of electrocoagulation for hemostasis was less in cases than controls but this difference was not statistically significant [p=0.132]. The antral follicle count decreased in both groups two months later, while no significant difference was found between two groups. This study shows that diluted vasopressin decreases operation time and electrocauterization frequency during laparoscopic stripping of ovarian endometriomas; however, the difference between case and control group is not statistically significant

[Ovarian response during IVF cycle following laparascopic cystectomy of ovarian endometrioma]

Endometrioma of ovary is one of the common diseases during reproductive age and the effect of laparoscopic cystectomy of endometrioma on infertility is still matter of debate. We designed this case control study to evaluate the ovarian response to controlled ovarian hyperstimulation during IVF [In vitro fertilization] cycle following laparoscopic unilateral cystectomy of endometrioma. In a case control study, we enrolled 30 women with history of unilateral laparoscopic cystectomy of ovarian endometrioma in stripping method who underwent IVF cycle in women Hospital, 2009-2012. The numbers of follicles in response to controlled ovarian hyperstimulation during IVF cycle in the ovary with history of unilateral laparoscopic cystectomy of endometrioma were compared with those from the contralateral ovary. The mean age [ +/- SD] of patients was 32.3 [ +/- 3.4]. The mean [ +/- SD] diameter of excised ovarian endometrioma was42.4 [ +/- 10.4] mm. Interval since ovarian surgery to induction ovulation was2.7 [ +/- 2.6] years. Mean number of follicles in the ovary with history of unilateral laparoscopic cystectomy of endometrioma was2.5 [ +/- 1.2] with the range of1 to 5 and in the control ovary 3.9 [ +/- 1.4] with the range of 1 to 6. There was significant difference in the number of follicles in the ovary with laparascopic cystectomy of endometrioma compared with opposite one [P<0.001]. Laparoscopic cystectomy for unilateral endometrioma is associated with a reduced ovarian response to controlled ovarian hyperstimulation during IVF cycle. We did not find any statistically significant difference in reduced ovarian response with regard to patients age, body mass index, size and location of the cyst, and time duration since ovarian cystectomy.

Goiter Frequency Is More Strongly Associated with Gastric Adenocarcinoma than Urine Iodine Level

PURPOSE: We designed our study to evaluate the hypothesis that gastric cancer is correlated with iodine deficiency or thyroid dysfunction. MATERIALS AND METHODS: We investigated the total body iodine reserve, thyroid function status and autoimmune disorder in 40 recently diagnosed gastric adenocarcinoma cases versus 80 healthy controls. The participants came from a region with high gastric cancer rate but sufficient iodine supply due to salt iodination. The investigation included urine iodine level, thyroid gland clinical and ultrasonographic examination, and thyroid function tests. RESULTS: Goiter was detected more frequently in the case group (P=0.001); such a finding, however, was not true for lower than normal urine iodine levels. The free T3 mean level was significantly lower in the case group compared to the control group (P=0.005). CONCLUSIONS: The higher prevalence of goiter rather than low levels of urinary iodine in gastric adenocarcinoma cases suggests that goiter, perhaps due to protracted but currently adjusted iodine deficiency, is more likely to be associated with gastric adenocarcinoma compared to the existing iodine deficiency itself.

Prediction of fetal anemia by different thresholds of MCA-PSV and delta-OD in first and second intrauterine transfusions

Our aim was to compare different thresholds of middle cerebral artery peak systolic velocity [MCA-PSV] and amniotic fluid delta optical density [Delta-OD] with fetal hemoglobin [Hb] during first and second intrauterine transfusions [IUT]. We determined serial MCA-PSV and Delta-OD in 27 red blood cell alloimmunized fetuses who needed IUT. Before the second IUT, MCA-PSV was measured. The sensitivity and specificity of MCA-PSV and Delta-OD were calculated and compared with fetal hemoglobin levels. From 27 fetuses, first time IUT MCA-PSV with a normal median value [MOM] cutoff of > 1.29 detected 60% of the moderate and 100% of the severe anemia cases. MCA-PSV of MOM > 1.5 detected none of the moderate and 93% of severe anemia cases. Delta-OD detected 50% of moderate anemic and 80% of severe anemic cases. At the second IUT, 91% of severe anemia cases were confirmed by MCA-PSV with MOM > 1.5 whereas MCA-PSV with MOM > 1.29 confirmed all cases. One case of moderate anemia was detected by MCA-PSV of MOM > 1.29 and none were detected by MCA-PSV with MOM > 1.5. Different thresholds of MCA-PSV have higher sensitivity and specificity for detecting moderate and severe fetal anemia compared with Delta-OD. It also has a high sensitivity at the second IUT