O dispositivo "antes e depois" nas cirurgias estéticas íntimas: novas formas de materialização das normas de gênero / The "before and after" dispositive in intimate aesthetic surgeries: new ways of materializing gender norms / El dispositivo "antes y después" en las cirugías estéticas íntimas: nuevas formas de materializar las normas de género

Resumo Este artigo tem como ponto de partida uma reflexão sobre a produção de imagens e narrativas circunscritas em torno do dispositivo antes e depois. Argumenta que a divulgação de padrões estéticos, especialmente nas redes sociais, opera de modo a prescrever uma necessária transformação e aprimoramento de si. Analisa relatos de experiências de mulheres que realizaram a chamada cirurgia íntima (ninfoplastia ou redução dos pequenos lábios vaginais) com a intenção de melhoria estética. Os depoimentos provêm de um grupo de discussão em torno desses procedimentos na internet. Nos casos em que as intervenções cirúrgicas são avaliadas negativamente, o antes e depois não se realizam da forma prevista. Nesse cenário, as mulheres tendem a ressignificar a necessidade da cirurgia e a reconhecer a imposição, por parte da sociedade, de padrões corporais idealizados. Este processo é discutido por meio do debate acerca do pós-feminismo e constrangimentos de gênero.

Abstract This article analyzes the production of images and narratives circumscribed around the dispositive before and after. It argues that the dissemination of aesthetic standards, especially on social networks, operates in order to prescribe a necessary transformation and improvement of the self. It analyzes reports of experiences of women who underwent the so-called intimate surgery (nymphoplasty or reduction of the labia minora) with the intention of aesthetic improvement. The testimonies come from a discussion group around these procedures on the internet. In cases where surgical interventions are negatively evaluated, the before and after are not performed as expected. In this scenario, women tend to resignify the need for surgery and recognize the imposition, by society, of idealized body standards. This process is discussed through the debate about post-feminism and gender constraints.

Resumen Este artículo tiene como punto de partida una reflexión sobre la producción de imágenes y narrativas circunscritas en torno al dispositivo antes y después. Argumenta que la difusión de normas estéticas, especialmente en las redes sociales, opera para prescribir una necesaria transformación y mejora del yo. Analiza relatos de experiencias de mujeres que se sometieron a la llamada cirugía íntima (ninfoplastía o reducción de labios menores) con la intención de mejorar estéticamente. Los testimonios provienen de un grupo de discusión sobre estos procedimientos en Internet. En los casos en que las intervenciones quirúrgicas son evaluadas negativamente, el antes y el después no se realizan como se esperaba. En ese escenario, las mujeres tienden a resignificar la necesidad de la cirugía y reconocen la imposición, por parte de la sociedad, de patrones corporales idealizados. Este proceso se discute a través del debate sobre el posfeminismo y las restricciones de género.

Gender-based violence in a rural Nigerian community during the COVID-19 era: a call for policy action

Introduction: gender-based violence (GBV) is a global pandemic which is deeply rooted in culture, hence the need to contextually understand its occurrence and patterns in rural settings. The objective of this study assessed respondents´ attitude, prevalence, the perceived risk factors, patterns and predictors of GBV in Ife-Odan, Osun State, Nigeria. Methods: cross-sectional study design was used and multi-stage sampling method employed to recruit 450 consenting adults. A pretested interviewer-administered, semistructured questionnaire was used for data collection. Both descriptive and inferential statistics were carried out. Results: mean age (±SD) of the respondents was 30.73±7.0, 58.7% of them were females and 88.0% had negative attitude to GBV. Prevalence of any form of GBV was 16.2%. Predominant GBV types included intimate partner violence (IPV) (58.3%), female genital mutilation (FGM) (31.1%), Sexual violence (6.9%) and incest (3.4%). Perceived risk factors of GBV included cultural acceptance, substance abuse, lack of punishments for GBV offenders, indecent female dressing styles, social media influences, effects of COVID-19 lockdown and male dominance. However, gender (AOR=7.82; 95%CI=2.35-8.17), marital status (AOR=3.23;95%CI=1.82-3.78), religion (AOR=5.02;95%CI=1.78-9.63) and attitude (AOR=4.23; 95%CI=2.267-5.82) were the significant predictors of past GBV experiences in the study setting. Conclusion: gender-based violence (GBV) is prevalent in the study setting, with IPV being the most common. There is need for policymakers to focus on cultural transformation by designing a robust awareness campaign against GBV in rural Nigerian communities. Traditional and religious leaders should be sensitized and involved in the campaign programs using all available channels of communication. Laws prohibiting perpetration of GBV need to be fully implemented.

Vulvar ulcerative cutaneous tuberculosis secondary to genital tract tuberculosis

Abstract Tuberculosis is a chronic infectious disease that gradually poses a certain threat to public health and economic growth. Tuberculosis typically affects the lungs, pleura, and lymph nodes and rarely the skin. Cutaneous tuberculosis manifesting as ulcerated lesions is also rare and often misdiagnosed and missed by clinicians. Here, the authors report a 29-year-old female patient presenting a vulvar ulcer for 10 months, accompanied by irregular menstruation and increased vaginal secretions. After a skin biopsy and endometrial PCR testing, it was finally diagnosed as vulvar ulcerative cutaneous tuberculosis secondary to genital tuberculosis. Antituberculosis treatment was effective. Cutaneous tuberculosis is called a great imitator. In order to facilitate the diagnosis and treatment of tuberculosis by clinicians, the authors systematically reviewed this disease as well.

Abordaje biopsicosocial de la mutilación genital femenina en la Gambia / Biopsicosocial boarding of the feminine genital mutilation in the Gambia

RESUMEN En el presente trabajo de revisión se expone cómo, según los últimos datos de UNICEF, alrededor de tres millones de niñas y mujeres cada año son sometidas a algún tipo de mutilación genital femenina en África, lugar en el que el arraigo social y cultural sobre el que se sustenta y retroalimenta esta práctica se debe a la experiencia de sus mayores, a la de sus propias madres y abuelas, con mensajes religiosos confusos y leyes poco rigurosas. El proceso de socialización que moldea las actitudes de las niñas y las mujeres las prepara para aceptar el dolor y el sufrimiento como parte inevitable de la vida de una mujer y como una obligación a cumplir para ser aceptadas en la sociedad. Sin embargo, las mujeres que lo practican no necesitan una justificación y cuando se les pregunta, remiten a la tradición, a la religión y a cuestiones estéticas, sanitarias o de protección. Es necesario contar con una mirada antropológica del fenómeno para obtener una comprensión de su significación que permita abordar el tema con conocimiento y respeto y así trabajar para conseguir un cambio en la sociedad que conduzca a la eliminación de las causas de vulneración del derecho a la salud y para que se luche por terminar con esta práctica. Por ello, el objetivo del presente estudio es exponer elementos inherentes a la mutilación genital femenina en la República de la Gambia, desde la perspectiva biopsicosocial, de manera que los resultados del estudio se conviertan en una herramienta útil para los profesionales en contacto con la población en riesgo. El estudio se desarrolla en el contexto de la Universidad durante el período noviembre 2020-febrero 2021.

ABSTRACT This review work shows how, according to the latest UNICEF data, around 3 million girls and women each year are subjected to some type of Female Genital Mutilation (FGM) in Africa where the social and cultural roots on which FGM is supported and fed back, it is due to the experience of their elders, their own mothers and grandmothers, with confusing religious messages and lax laws. The socialization process that shapes the attitudes of girls and women prepares them to accept pain and suffering as an inevitable part of a woman's life, and as an obligation to fulfill in order to be accepted in their respective societies. However, the women who practice it do not need a justification and when asked, they refer to tradition, religion and aesthetic, health or protection issues. It is necessary to have an anthropological view of the phenomenon to obtain an understanding of its significance that allows to approach the subject with knowledge and respect and thus work to achieve a change in society that leads to the elimination of the causes of violation of the right to health and fight to end the practice of FGM. Therefore, the objective is to expose the practice of Female Genital Mutilation from a biopsychosocial perspective in the Republic of the Gambia, so that it is a useful tool for professionals in contact with the population at risk. The study is developed in the context the University during the period November 2020-February 2021.

Pregnancies in anomalous uterus: series of three cases

Uterine malformations can result from various alterations in the normal development of Mullerian ducts that make up a diverse category of congenital anomalies. In most cases, the defect remains undiagnosed and exhibits the normal number of chromosomes. Very few malformations require any intervention after thorough investigations. The most frequently used classification by the American Society for Reproductive Medicine is comprehensive, but does not include cervical or vaginal malformations. The European Society of Human Reproduction and Embryology has postulated a consensus that precisely shows independent cervical malformations.

Clinicopathological characteristics and prognostic analysis of patients with female genital tract diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective:To investigate the clinicopathological characteristics, gene mutation profile, and prognostic factors of diffuse large B-cell lymphoma (DLBCL) in female genital tract.Methods:A retrospective analysis was performed on the clinicopathological data of 30 patients with female genital tract DLBCL who were admitted to Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from October 2003 to October 2021. Targeted sequencing was used to detect 55 lymphoma-related genes, and the gene mutation status of patients was evaluated. Kaplan-Meier method was used for survival analysis, and prognostic factors were analyzed by Cox proportional hazards model.Results:The median age of 30 female genital tract DLBCL patients at diagnosis was 58 years old (23-77 years old). The initial symptoms mainly included abdominal pain, distension, and masses (8 cases, 32%). Tumors most commonly located in the adnexal region (including ovaries and fallopian tubes) (13 cases, 45%), of which 9 cases were unilateral. Twenty-one cases (70%) had multiple extra-nodal involvements, 22 cases (73%) had Ann Arbor stage Ⅲ-Ⅳ, 8 cases (27%) had Eastern Cooperative Oncology Group (ECOG) score of ≥2, and 22 cases (73%) had elevated lactate dehydrogenase (LDH), 21 cases (70%) had International Prognostic Index (IPI) score of 3-5. Within 30 patients, 11 patients (37%) received surgery, and all patients received R-CHOP regimen-based chemotherapy. All 30 cases were evaluated for efficacy, the complete remission rate was 83% (25/30), the 5-year progression-free survival (PFS) rate was 69.7%, and the 5-year overall survival (OS) rate was 79.6%. Univariate analysis showed that ECOG score ≥2 was associated with worse OS ( P = 0.048). Among the 30 patients, 7 patients (23%) were primary and 23 patients (77%) were secondary. The proportions of patients with Ann Arbor stage Ⅲ-Ⅳ, IPI score 3-5 and elevated LDH in secondary patients were higher than those in primary patients (all P < 0.001), but there were no significant differences in PFS and OS between the two ( P values were 0.261 and 0.671). The targeted sequencing results of 16 patients showed that the mutation rates of PIM1, MYD88, KMT2D, TP53, CARD11, CCND3 and GNA13 were all > 20%, and TP53 mutation was associated with poorer PFS and OS ( P values 0.012 and 0.002). Conclusions:Female genital tract DLBCL is a rare invasive extranodal DLBCL with similar survival prognosis in primary and secondary patients. High-frequency mutations of PIM1, MYD88 and TP53 genes may provide new directions for treatment.

Female genital mutilation and male involvement: Insights of men and women in two counties in Kenya

This qualitative study, conducted in Meru and Kajiado counties in Kenya, explored the perceptions and attitudes of men and women regarding male involvement in FGM in order to inform the design of male involvement strategies in FGM abandonment. We used focus group discussions to collect the data which was then subjected to thematic analysis. Three main themes emerged from the data: i) culture and the role of men; ii) perceived awareness and knowledge of FGM among men, and iii) credible and customised education and engagement. The study found widespread agreement on the importance of male involvement in FGM abandonment. Culture played an important role in determining the extent of involvement, or lack thereof. We conclude that while culture needs to be respected it ought to be challenged to avoid the continued harm to girls. The potential of men as a collective to bring about change was evident, and policy makers and NGOs should utilise the power of male collectives to support efforts to abandon FGM

Progress of imaging examination, serum carbohydrate antigen 125 and human epididymal protein 4 in the differential diagnosis and prognostic evaluation between ovarian epithelial carcinoma and pelvic tuberculosis / 肿瘤研究与临床

Epithelial ovarian cancer (EOC) is the most common ovarian malignancy. Because the early lesions are not easy to be found and the advanced cases lack effective treatments, the fatality rate ranks the first among all kinds of gynecological malignant tumors. Pelvic tuberculosis is a specific inflammation of female genitalia. The long incubation period makes the primary tuberculosis foci heal completely, and then presents the clinical "triad" similar to ovarian cancer, namely: abdominal distension, ascites and pelvic mass, accompanied by an abnormal increase in serum carbohydrate antigen 125. For the differential diagnosis of the two diseases, imaging examination combined with laboratory examination is widely used in clinical practice, but the evaluation effect of the two diseases is different to some extent. This paper reviews the progress of the significance of imaging examination and laboratory examination in differential diagnosis and prognosis evaluation of EOC and pelvic tuberculosis.

Plasmacytoma of the cervix / Philippine Journal of Obstetrics and Gynecology

@#Plasmacytoma is a rare disease entity that represents only 5%‒10% of all plasma cell neoplasms. It is rarely found in the female genital tract. There are 8 identified case reports on plasmacytoma of the cervix. The clinical symptoms are nonspecific and biopsy with immunohistochemistry is used to diagnose. Due to the paucity of cases, there is no standard treatment modality. We present a case of a 34-year-old patient who had a history of postcoital bleeding. Biopsy and immunohistochemistry were done which confirmed the diagnosis of plasmacytoma. Total abdominal hysterectomy, bilateral salpingectomy with transposition of ovaries was the chosen treatment option.

Mulheres com câncer ginecológico: significado da braquiterapia / Mujeres con cáncerginecológico: significado de la braquiterapia / Women with gynecological cancer: meaning of brachytherapy

RESUMO Objetivo: conhecer o significado da braquiterapia em mulheres com câncer ginecológico. Métodos: pesquisa qualitativa, descritiva e exploratória realizada com 32 mulheres, submetidas à braquiterapia em instituição oncológica de Santa Catarina, Brasil. Na coleta de dados, entre setembro de 2017 e julho de 2018, aplicou-se entrevista semiestruturada. As comunicações foram submetidas à análise de conteúdo, incluindo regras de enumeração para análise dos dados sociodemográficos, clínicos e para quantificação dos relatos agrupados. Publicações relacionadas com o tema e a Teoria do Conforto sustentaram teoricamente a inferência dos dados. Emergiram cinco categorias temáticas, neste artigo apresentam-se três. Resultados: a categoria "O medo e as crenças pessoais no enfrentamento do câncer ginecológico e da braquiterapia" destaca o medo da morte, o desejo pela cura e o apego à família e à religiosidade; "Medo do tratamento e desconfortos relacionados" retrata as alterações relacionadas aos contextos físico, psicológico e ambiental; "Dor como significado" revela a percepção dolorosa sentida pelas mulheres em decorrência da doença ou da braquiterapia. Conclusão: conhecer o significado da braquiterapia permite que os enfermeiros possam repensar a coleta de dados e o planejamento de enfermagem para melhor educação em saúde e redução dos desconfortos.

RESUMEN Objetivo: conocer el significado de la braquiterapia en mujeres con cáncer ginecológico. Métodos: investigación cualitativa, descriptiva y exploratoria realizada con 32 mujeres, sometidas a la braquiterapia en institución oncológica de Santa Catarina, Brasil. En la recolección de datos, entre septiembre de 2017 y julio de 2018, se aplicó entrevista semiestructurada. Los relatos fueron sometidos al análisis de contenido, incluyendo reglas de enumeración para análisis de los datos sociodemográfico, clínicos y para cuantificación de los relatos agrupados. Publicaciones relacionadas con el tema yla Teoría del Confort basaron teóricamente la inferencia de los datos. Surgieron cinco categorías temáticas, en este artículo se presentan tres. Resultados: la categoría "El miedo y las creencias personales en el enfrentamiento del cáncer ginecológico y de la braquiterapia" destaca el temor a la muerte, el deseo por la cura y el apego a la familia y a la religiosidad; "Miedo al tratamiento y las molestias relacionadas" retrata las alteraciones relacionadas a los contextos físico, psicológico y ambiental; "Dolor como significado" revela la percepción dolorosa sentida por las mujeres debido a la enfermedad o la braquiterapia. Conclusión: conocer el significado de la braquiterapia permite que los enfermeros puedan repensar la recolección de datos y la planificación de enfermería para una mejor educación en salud y reducción de las molestias.

ABSTRACT Objective: to know the meaning of brachytherapy in women with gynecological cancer. Methods: qualitative, descriptive and exploratory research conducted with 32 women who underwent brachytherapy at an oncology institution in Santa Catarina, Brazil. Data collection took place between September 2017 and July 2018 through semi-structured interviews. Communications were submitted to content analysis, including enumeration rules for the analysis of sociodemographic and clinical data and for the quantification of grouped reports. Publications related to the theme and the Comfort Theory theoretically supported the inference of the data. Five thematic categories emerged; in this article three are presented. Results: the category "Fear and personal beliefs in coping with gynecological cancer and brachytherapy" highlights the fear of death, the desire for healing and attachment to family and religiosity; "Fear of treatment and related discomforts" depicts changes related to physical, psychological and environmental contexts; "Pain as meaning" reveals the painful perception felt by women as a result of illness or brachytherapy. Conclusion: knowing the meaning of brachytherapy allows nurses to rethink data collection and nursing planning for better health education and reduction of discomfort.

Anatomia do sistema reprodutor feminino de Alouatta belzebul (Linnaeus, 1766) / [Anatomy of the female reproductive system of the Alouatta belzebul (Linnaeus, 1766)]

O conhecimento da anatomia de qualquer animal silvestre é de fundamental importância para sua preservação e proteção. Neste contexto, o presente estudo objetivou descrever a morfologia do sistema reprodutor feminino de Alouatta belzebul. Foram utilizados seis espécimes de A. belzebul, fêmeas, adultas, e livres de lesões. Observou-se macroscopicamente que os ovários têm características morfológicas em formato ovoides, com superfície lisa, e, na análise histológica na região de córtex, evidenciou-se folículos ovarianos em diferentes estágios de desenvolvimento. As tubas uterinas anatomicamente são finas e curvilíneas, apresentando uma camada mucosa, uma muscular e outra serosa. O útero possui formato simples, com fundo globoso, com um miométrio altamente vascularizado, sendo organizado em feixes de fibras musculares lisas. A estrutura anatômica da vagina apresentou-se como um tubo muscular longo de paredes finas, onde, na região vestibular, o óstio externo da uretra é marcado por uma papila uretral bilobada e, na região de vulva, em sua porção caudal, contatou-se um clitóris bem desenvolvido. No que concerne à análise histológica da vagina, verificou-se, em região de mucosa vaginal, um extrato basal composto por epitélio estratificado pavimentoso não queratinizado atrófico. As descrições morfológicas fornecem, de forma inédita, informações importantes relativas à anatomia macroscópica e microscópica do sistema reprodutor feminino dessa espécie.(AU)

Knowledge of the anatomy of any wild animal is of fundamental importance for its preservation and protection. In this context the present study aimed to describe the morphology of the female reproductive system of A. belzebul. We used 6 specimens of A. belzebul, female, adult and free of lesions. It was macroscopically observed that the ovaries are ovoid with smooth surface and the histological analysis in cortical region showed ovarian follicles in different stages of development. The fallopian tubes are anatomically thin and curvilinear, with one mucous layer, one muscular and one serous layer. The uterus was presented in a simple format with a globular fundus, with a highly vascularized myometrium, being organized in bundles of smooth muscle fibers. The anatomical structure of the vagina presented itself as a long thin-walled muscular tube where in the vestibular region the external orifice of the urethra is marked by a bilobed urethral papilla and in the caudal portion in its caudal portion a well-developed clitoris. Regarding the histological analysis of the vagina, a basal extract composed of atrophic non-keratinized stratified squamous epithelium was found in the vaginal mucosa region. The morphological descriptions provide important information regarding the macroscopic and microscopic anatomy of the female reproductive system of this species in an unprecedented way.(AU)

Desgarro perineal con mucosa vaginal íntegra tras primera relación sexual / Perineal tear with intact vaginal mucosa after first sexual intercourse

RESUMEN Las lesiones del tracto genital femenino tras relaciones sexuales son un problema frecuente en las urgencias de ginecología, pero poco estudiado salvo su aspecto médico-legal. Su incidencia es desconocida ya que muchas mujeres no llegan a consultar por miedo o pudor. El reconocimiento precoz de estas lesiones y su correcto tratamiento puede evitar la parición de secuelas que acompañarán a nuestra paciente durante el resto de su vida. Presentamos el caso de una paciente de 18 años con un desgarro perineal con mucosa vaginal íntegra tras su primera relación sexual.

ABSTRACT Injuries to the female genital tract after sexual intercourse are a frequent problem in gynecological emergencies, but little studied except for their medico-legal aspect. Its incidence is unknown since many women do not go to their specialist out of fear or embarrassment. Early recognition of these injuries and their correct treatment may prevent the appearance of sequelae that will accompany our patient for the rest of her life. We present the case of an 18-year-old patient with a perineal tear with intact vaginal mucosa after her first sexual intercourse.

The correlation between colposcopy, cervical cytology and histopathology in the diagnosis and management of cervical lesions: a cross sectional study

Background: The study was undertaken to see the correlation between cervical cytology, histopathology and colposcopy in the diagnosis and management of various cervical lesions.Methods: It is a cross sectional study conducted at a tertiary care hospital in Mumbai, in the department of obstetrics and gynecology from February 2007 to March 2008. A total 55 sexually active women were enrolled for the study who belonged to age group greater than 20 years with history of chronic leucorrhoea or post-coital bleeding/spotting, intermenstrual bleeding/spotting or examination findings of erosion, an unhealthy cervix, a lesion bleeding on touch or an abnormal or suspicious Papanicolaou smear. These women then underwent cytology, colposcopy and cervical biopsy.Results: The accuracy of cytology when compared to colposcopy was 81.82%. The accuracy of colpo-histopathology was 83.6%. The combined accuracy was 76.36%.Conclusions: The simultaneous use of cytological studies and screening colposcopy has been shown to increase the cervical cancer detection. Colposcopy offers an excellent tool in the hands of a gynaecologist to evaluate the uterine cervix and it is not possible to develop this kind of perspective by any other method.

A prospective study of outcome in infertility patients diagnosed with genital tuberculosis

Background: Tuberculosis is an increasing health problem worldwide with around 9.6 billion new cases reported every year. Female genital tuberculosis (FGTB) has a varying incidence ranging from a very low of 0.69% in developed nations to as high as 19% in developing nations like India. The average incidence of infertility due to tuberculosis is 5-10% worldwide.Methods: The study was a hospital based prospective clinical study, from September 2014-2017 with sample size of 355 infertility cases. Endometrial sampling and diagnostic hystero-laparoscopy were used for diagnosis. Endometrial sample subjected for both the test CBNAAT and HPR was used for confirmation of positive patients. Inclusion criteria were, infertile patients diagnosed with genital tuberculosis who were then given treatment. Patients diagnosed to have infertility due to causes other than TB were excluded from the study. Highly suspected cases and those who were willing underwent diagnostic laparoscopy.Results: Out of 355 cases of infertility, 83 were because of genital TB, received treatment out of which 32 conceived.  CBNAAT was very sensitive than histopathology or laparoscopy. The live birth rate and conception rate were 20.24% and 38.09 % respectively.Conclusions: CBNAAT is OPD based economical test (free by GOI), very sensitive and picked up more cases than histopathology or laparoscopy. The live birth rate and conception rate were found to be higher than other studies possible due to intervention at an earlier stage of the disease process. This test should be widely used by gynecologist for early detection of genital tuberculosis.

Extrarenal angiomyolipoma in uterine cervix: rare presentation in unusual site

Angiomyolipoma is a benign neoplasm composed of variable admixture of blood vessels, smooth muscle cells and adipose tissue. Cervical angiomyolipoma are extremely rare and to the best of our knowledge only five cases of angiomyolipoma in cervix have been reported in the literature till date. Authors are presenting a case of angiomyolipoma arising from the uterine cervix. 43 years old female presented with mass descending per vagina for 6 months. This case had no association with tuberous sclerosis. Microscopic examination showed an ill-defined polypoidal, non-encapsulated lesion covered by keratinized stratified epithelium. The lesion is made up of three components, predominantly by fascicles of spindle shaped cells, varying sized blood vessels and multiple foci of mature adipocytes with no evidence of atypia or increased mitotic activity. Smooth muscle component showed strong immunoreactivity to SMA and absence of elastic fibres in the blood vessels were confirmed by histochemistry. Non-vascular smooth muscle cells were negative for HMB-45 in contrast to renal and other extra-renal angiomyolipoma in which HMB-45 immunoreactivity in seen in these cells. To conclude, the differential diagnosis of lower abdominal mass and dysfunctional uterine bleeding should include the angiomyolipoma, even though the uterine cervix is an extremely rare location where they occur.

Progress on diagnosis and treatment of primary non- Hodgkin lymphoma in the female genital tract / 中国肿瘤临床

Primary lymphoma of female genital tract (PLFGT) is uncommon, and its etiology is unclear. It can present with pain, distention, vaginal bleeding, or discharge or be found as an incidental finding at a routine pelvic examination or surgery for other indications. PLFGT can be diagnosed with imaging, with pathomorphology being the key to diagnosing this disease. Further diagnosis and typing are needed with flow cytometry and immunohistochemistry. PLFGT should be differentiated from secondary genital lymphoma and other primary malignant tumors of the reproductive system. Preoperative diagnosis can be challenging due to its rarity. In addition, there is a lack of experience in treating PLFGT. Based on the pathological classification, staging, and non-Hodgkin lymphoma (NHL) guidelines, an individualized approach should be determined. R-CHOP has been found to significantly improve the survival of patients with NHL. However, the efficacy and safety of chemotherapy as the standard treatment for PLFGT still needs to be confirmed. Prognosis was evaluated according to the international prognostic index (IPI).

Validação de um manual de orientações para pacientes submetidas à braquiterapia ginecológica / Validación de un manual de orientaciones para pacientes sometidas a braquiterapia ginecológica / Validation of a guidance manual for patients undergoing brachyterapy for gynecologic cancer

RESUMO Objetivo: validar o conteúdo de manual de orientações direcionado a mulheres com câncer ginecológico submetidas à braquiterapia. Método: pesquisa metodológica, realizada por 15 peritos na área temática do manual, entre enfermeiras, médicos, psicólogas e nutricionistas. Para que o manual fosse considerado válido, era necessário atingir Índice de Concordância mínimo de 80% entre os peritos. Resultados: dos 21 itens avaliados, três não alcançaram o índice mínimo estabelecido, e foram reformulados com base nas sugestões dos participantes e literatura atual. Todos os outros itens foram considerados adequados e/ou totalmente adequados nos três domínios avaliativos: objetivos - 81,3%, estrutura e apresentação - 86,6%, e relevância - 94,6%. Conclusão: o manual educativo foi validado quanto ao conteúdo, podendo ser utilizado como complemento às orientações verbais fornecidas durante a consulta de enfermagem para promoção do autocuidado, e facilitar a comunicação entre profissional de saúde e paciente, no que concerne ao seu tratamento.

RESUMEN: Objetivo: validar el contenido de manual de orientaciones para mujeres con cáncer ginecológico sometidas a braquiterapia. Método: investigación metodológica, hecha por 15 expertos por área temática, entre enfermeras, médicos, psicólogas y nutricionistas. Para que el manual fuera válido, se necesita alcanzar el Índice de Concordancia mínimo de 80% entre los expertos. Resultados: de los 21 ítems evaluados, tres no obtuvieron el índice mínimo establecido, siendo reformulados con base en las sugerencias de los participantes y de literatura actual. Todos los demás ítems se los consideraron adecuados y/o totalmente adecuados en los tres ámbitos evaluativos: objetivos - 81,3%, estructura y presentación - 86,6%, y relevancia - 94,6%. Conclusión: se validó el manual educativo en cuanto al contenido y éste se puede utilizar como complemento a las orientaciones verbales fornecidas durante la consulta de enfermería para promoción del autocuidado y facilitar la comunicación entre profesional de salud y paciente acerca del tratamiento.

ABSTRACT Objective: to validate the content of a guidance manual for women undergoing brachytherapy for gynecologic cancer. Method: methodological research conducted by 15 experts in the topic addressed in the manual, including nurses, doctors, psychologists and nutritionists. A minimum level of agreement of 80% between the experts was required for the validation of the manual. Results: Of the 21 items assessed, three did not reach the minimum level of consensus established and were reformulated based on the suggestions of the participants and on the current literature. All other items were considered appropriate and/or totally appropriate in the three assessment domains: objectives - 81.3%, structure and presentation - 86.6%, and relevance - 94.6%. Conclusion: the educational manual was validated for its content and can be used as a complement to the verbal guidelines provided during nursing consultations to promote self-care, and to facilitate communication between healthcare professionals and patients regarding the treatment.

Primary vaginal malignant melanoma: A rare entity with review of literature

Primary vaginal malignant melanoma (PVMM) is an extremely rare tumor of the female genital tract, accounting for only 3% of melanomas of the female genital tract and 0.3%–0.8% of all melanomas in females. Vaginal melanoma is a very aggressive tumor with a 5-year survival rate of 5%–25%. High incidence of recurrence, spread to regional lymph nodes, and distant metastasis are responsible for poor prognosis of PVMM. Grossly, amelanotic melanoma of the vagina may be mistaken for other primary vaginal malignancies. Differentiation of malignant melanoma from other primary vaginal melanomas is essential because of better prognosis of most of other vaginal malignancies as compared to melanoma. Despite having poor prognosis, early detection and early treatment of PVMM may improve the prognosis.

Congenital Absence of the Cervix - Its Place in the Present Classification of Female Genital Tract Malformations

Aims and Objective: To outline and group cases of cervical agenesis / dysgenesis according to the associated uterine and vaginal abnormalities, as per the proposed ESHRE/ESGE CONUTA classification. Methods: The study was conducted in a tertiary care hospital and involved a total of 93 young girls diagnosed as having an absent cervix. Patients with utero-vaginal anomalies alone, with a patent cervix - such as uterine septae, uterus didelphys, bicornuate uterus; or transverse vaginal septae, imperforate hymen and complete or partial vaginal atresia, were excluded. All cases were subjected to specific clinical and local examination. Detailed 2 D Ultrasound was done to study the uterus. Identification of the cervix, its presence or absence, length of the cervical canal, hemato-cervix or hematocolpos was done by trans-abdominal route. All the cases were operated by the same team of surgeons, with the first author as the chief surgeon, to confirm and make a final diagnosis. They were then tabulated as per the CONUTA classification. Result: There was absence of the cervix (aplasia / dysplasia) in 93 cases as per the clinical examination, ultrasound, MRI and operative findings. There was complete or partial vaginal atresia (aplasia) in 69 (74.19%) cases and a normal vagina in 22(23.65%) cases. There were 33 cases (35.4%) with a normal uterus, with no cases of T-shaped uterus. There were 29/33 cases (87.89%) without vagina. There was one case with septate uterus and complete cervical and vaginal aplasia. Cases with two Bicornuate uteri with a common aplastic/dysgenetic cervix was seen in 4 cases. In 3 cases the cervix was partially patent in the upper side and obstruction was present only in the lower 4-5mm, causing ‘hemato-cervix’. There were 14 cases (15.1%) with unilaterally formed uterine horn, with the non-communicating rudimentary horn. There were 13 cases (13.9%) of cervical aplasia of the unilateral formed uterine horn. In 11 out of 93 cases (11.8%) of cervical aplasia, uterine aplasia / dysplasia and rudimentary horns with cavity were present. Conclusion: Our findings underscore the fact the patients with congenital absence of the cervix present a diagnostic challenge and that this entity should be thoroughly evaluated. The new ESHRE/ESGE classification system has the potential to overcome the limitations of the previous classification systems as it provides an effective and comprehensive categorization of almost all the currently known anomalies of the female genital tract.

Prevalence of Genital Tuberculosis in Infertile Women; a Study from a Tertiary Care Center in North India

Introduction: Female genitourinary tuberculosis (FGTB) is an important cause of infertility in women of reproductive age group. The disease remains undetected due to its asymptomatic nature and lack of sensitive tests. This study was conducted with the aim of detecting the prevalence of genital tuberculosis in infertile women. Material and methods: Endometrial curetting of 193 infertile women suspected of genital tuberculosis were taken laparoscopically and sent for histopathological examination, ZN staining, culture on LJ media and GeneXpert testing. Results: Out of 193 women, 13 were positive for Mycobacterium tuberculosis making the overall prevalence of FGTB in infertile women to the extent of 6.73%. Of these 11 presented with primary infertility while 2 patients presented with secondary infertility. The histopathological examination of all the samples was non-specific. No case of positive acid fast bacilli on ZN staining was observed. Comparison of culture and GeneXpert revealed that Xpert assay was more sensitive in detecting the positive cases. Conclusion: Our study concluded that FGTB is common in our population and women presenting with infertility should be evaluated for genital tuberculosis. A high degree of suspicion and combination of histopathological and microbiological tests are important methods for the detection of genital tuberculosis