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Background: The local application of stains or dyes during endoscopy is referred to as "chromoendoscopy" in an attempt to improve tissue identification, distinction, and diagnosis. Objectives: To judge the value of chromohysteroscopy in identifying endometrial abnormalities that are too subtle for standard hysteroscopy to detect. The histopathology from routine endometrial sampling and chromohysteroscopy was compared. Methodology: This interventional prospective study included 49 women with abnormal uterine bleeding. First of all, a 4 mm diameter hysteroscope was used to perform a diagnostic hysteroscopy. Between the 20th and 25th day of their menstrual cycle, patients were booked for blind endometrial sampling and chromohysteroscopy directed biopsies. Results: Focal staining had higher sensitivity, specificity and accuracy 65.5%, 95% and 77.6% respectively, for detection of endometrial pathologies compared with diffuse staining. Focal dark pattern was significantly associated with, submucous myoma, endometrial hyperplasia, necrotic mass, endometritis, simple and complex endometrial hyperplasia with atypia and endometrial carcinoma. Conclusion: The diagnostic precision of traditional hysteroscopy is enhanced with chromohysteroscopy. In cases of Abnormal Uterine Bleeding (AUB), it is a useful, affordable diagnostic for identifying endometrial diseases. [ABSTRACT FROM AUTHOR]

Copyright of Magyar Nőorvosok Lapja is the property of Hungarian Society of Obsterics & Gynaecology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Argonaute family genes (piwi and aub) involved in the production of small RNAs are responsible for the regulation of many cellular processes, including the suppression of genome instability, modulation of gene activity, and transposable elements. Dysfunction of these genes and the associated activation of transposable elements adversely affect reproductive development and quality of life. The role of transposons in contrast to retrotransposons and their interaction with genes of the Argonaute family in aging processes have not been studied. This study considers a scenario in which the piwi and aub genes in the presence of functional hobo transposons can modify the effects from the level of DNA damage to lifespan. The simultaneous presence of mutation (piwi or aub) and hobo (regardless of size) in the genome has practically no effect or (less often) leads to a decrease in the level of DNA damage in ovarian cells. A high level of sterility and low ovarian reserve were noted mainly with a combination of mutations and full-sized hobo elements. The combination of these two genetic factors negatively affects the fertility of young females and embryonic survival. Isolated cases of restoration of reproductive functions with age were noted but only in females that had low fertility in the early period of life. The presence of hobo transposons contributed to an increase in the lifespan of both mutant and non-mutant females. Dysfunction of the piwi and aub genes (without hobo) can reduce the lifespan of both sexes. Together, each mutation and hobo transposons act antagonistically/additively (in females) and synergistically/antagonistically (in males) to change the lifespan. In parameters of locus-specific instability, hobo activation was more pronounced in piwi gene dysfunction. The results obtained complement data on the study of new functions of Argonaute family genes and their interactions with transposable elements in the aging process. [ABSTRACT FROM AUTHOR]

Background: Abnormal Uterine Bleeding is most commonly encountered in peri-menopausal and post-menopausal women. Abnormal uterine bleeding has a negative impact on quality of life and in turn affects the efficiency of the women. As other diagnostic tools Hysteroscopy can also be used as an office procedure. Material & method: The present retrospective study analysis was conducted on 86 women attending the Gynaecology OPD at Hi-tech Medical college, Bhubaneswar, Odisha. from March 2021 to February 2023. Women attending OPD in the reproductive age group ie (20-40 years) and peri-menopausal age group ie more than 40yrs, with complaints of abnormal uterine bleeding were included. After obtaining postcounseling written informed consent, Thorough physical examination and routine pre-op blood investigations (Hemoglobin, ABO & Rh, Blood sugar, urine REME) done, which was followed by hysteroscopy an. Biopsy/gross specimen was obtained (as the case may be) and subjected to histo-pathological evaluation. Result: On hysteroscopy, a maximum number of cases (n=48, 55.81%) had no abnormal pathology (24 proliferative, 15 secretory and 9 atrophic). A total of 7 (8.13%) cases were diagnosed to have polyp, 3 (3.48%) had calcified endometrium, 11 (12.79%) had submucous myoma, 2 (2.32%) had necrotic mass, one had adhesions, and two had forgotten IUCD. However, on histopathology, 56 (65.11%) cases had normal/proliferative/atrophic endometrium, 17 (19.76%) had hyperplasia, 3 (3.48%) had calcified endometrium, and 10 (11.62%) had polyp. No significant difference between two modalities was observed with respect to number of normal/proliferative/atrophic endometrium. Statistically, no significant difference between two modalities was observed with respect to other pathologies. Overall there was 62.7% agreement between histopathology and hysteroscopy. Conclusion: The findings of the study suggested that hysteroscopy was quite useful in diagnosis of abnormal uterine bleeding. Although it had an agreement with histopathology to the extent of 62.9% only, it provided additional information for pathologies that remained undiagnosed on histopathology. Hence it is essential that it should be made essential part of diagnostic workup of cases of abnormal uterine bleeding. [ABSTRACT FROM AUTHOR]

Boron presents an important role in chemistry, biology, and materials science. Diatomic transition-metal borides (MBs) are the building blocks of many complexes and materials, and they present unique electronic structures with interesting and peculiar properties and a variety of bonding schemes which are analyzed here. In the first part of this paper, we present a review on the available experimental and theoretical studies on the first-row-transition-metal borides, i.e., ScB, TiB, VB, CrB, MnB, FeB, CoB, NiB, CuB, and ZnB; the second-row-transition-metal borides, i.e., YB, ZrB, NbB, MoB, TcB, RuB, RhB, PdB, AgB, and CdB; and the third-row-transition-metal borides, i.e., LaB, HfB, TaB, WB, ReB, OsB, IrB, PtB, AuB, and HgB. Consequently, in the second part, the second- and third-row MBs are studied via DFT calculations using the B3LYP, TPSSh, and MN15 functionals and, in some cases, via multi-reference methods, MRCISD+Q, in conjunction with the aug-cc-pVQZ-PPM/aug-cc-pVQZB basis sets. Specifically, bond distances, dissociation energies, frequencies, dipole moments, and natural NPA charges are reported. Comparisons between MB molecules along the three rows are presented, and their differences and similarities are analyzed. The bonding of the diatomic borides is also described; it is found that, apart from RhB(X1Σ+), which was just recently found to form quadruple bonds, RuB(X2Δ) and TcB(X3Σ−) also form quadruple σ2σ2π2π2 bonds in their X states. Moreover, to fill the gap existing in the current literature, here, we calculate the TcB molecule. [ABSTRACT FROM AUTHOR]

Objective: To develop a core outcome set for heavy menstrual bleeding (HMB). Design: Core outcome set (COS) development methodology described by the COMET initiative. Setting: University hospital gynaecology department, online international survey and web‐based international consensus meetings. Population or sample: An international collaboration of stakeholders (clinicians, patients, academics, guideline developers) from 20 countries and 6 continents. Methods: Phase 1: Systematic review of previously reported outcomes to identify potential core outcomes. Phase 2: Qualitative studies with patients to identify outcomes most important to them. Phase 3: Online two‐round Delphi survey to achieve consensus about which outcomes are most important. Phase 4: A consensus meeting to finalise the COS. Main outcome measures: Outcome importance was assessed in the Delphi survey on a 9‐point scale. Results: From the 'long list' of 114, 10 outcomes were included in the final COS: subjective blood loss; flooding; menstrual cycle metrics; severity of dysmenorrhoea; number of days with dysmenorrhoea; quality of life; adverse events; patient satisfaction; number of patients going on to have further treatment for HMB and haemoglobin level. Conclusions: The final COS includes variables that are feasible for use in clinical trials in all resource settings and apply to all known underlying causes of the symptom of HMB. These outcomes should be reported in all future trials of interventions, their systematic reviews, and clinical guidelines to underpin policy. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the utility of transvaginal ultrasound and hysteroscopy in diagnosing abnormal uterine bleeding in peri-menopausal women. Methods: Between September 2021 and March 2023, 176 women presenting with abnormal uterine bleeding at the Second Affiliated Hospital of Xinjiang Medical University were subjected to both hysteroscopy and transvaginal ultrasound examinations. Results: There was a significant discrepancy between the pathological diagnoses and the findings from transvaginal ultrasound (p < 0.05), with a Kappa coefficient of 0.475, indicating moderate agreement. Similarly, a significant difference was observed between the results of pathological diagnosis and those obtained via hysteroscopy (p < 0.05), with a Kappa coefficient of 0.669, suggesting substantial agreement. The combined diagnostic approach yielded a Kappa value of 0.784, demonstrating a better consistency and indicating superior diagnostic efficacy. In diagnosing peri-menopausal abnormal uterine bleeding, transvaginal ultrasound exhibited a sensitivity of 89.7%, specificity of 66.7%, and a negative predictive value of 46.7%. Hysteroscopy showed higher sensitivity and specificity at 94.8% and 76.2% respectively, but a relatively low negative predictive value of 66.7%. The combined diagnostic approach further improved the sensitivity and specificity to 97.4% and 81.0% respectively, with a negative predictive value of 81.0%, surpassing those of the individual methods. For the etiological diagnosis of abnormal uterine bleeding (AUB) caused by endometrial polyps, hysteroscopy achieved a concordance rate of 93.3%, significantly outperforming transvaginal ultrasound, which had a rate of 77.3% (χ2 = 7.670), thus demonstrating higher detection efficiency. Conclusions: Transvaginal ultrasound and hysteroscopy are valuable diagnostic tools in the etiological assessment of peri-menopausal AUB. Transvaginal ultrasound, being safe and cost-effective, is preferable for initial etiological screening of AUB, though it carries the risk of underdiagnosis and misdiagnosis. Despite the higher cost and reduced convenience of hysteroscopy, its combination with pathological examination significantly enhances the detection rates of cancerous and precancerous lesions. Consequently, the integration of transvaginal ultrasound with hysteroscopy is recommended for the comprehensive diagnostic evaluation of endometrial lesions in peri-menopausal women with AUB, facilitating early diagnosis and treatment.

Therapeutic carbohydrate restriction diets have been becoming increasingly popular over the years, resulting in dramatic weight loss and an improvement in metabolic disorders. Obesity, insulin resistance, and diabetes are the risk factors for many gynecologic morbidities such as uterine leiomyoma, endometrial polyps, and polycystic ovarian syndrome. There is evidence suggesting that the pathogenesis of cardiovascular disease is similar to that seen in many causes of abnormal uterine bleeding. We aim to explain how cardiovascular disease risk factor reduction with the use of therapeutic carbohydrate restriction may prevent and potentially treat these gynecologic disorders. [ABSTRACT FROM AUTHOR]

Introduction- Abnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. Aims And Objectives- compares the efficacy accuracy of hysteroscopy and transvaginal sonography in diagnosing the pathology of AUB. The hysteroscopic and sonographic findings are correlated with the histopathological diagnosis of endometrium obtained by curettage. Material And Methods- The present study "A comparative study of hysteroscopy and transvaginal ultra sonography in the evaluation of AUB in reproductive age group" is a prospective study which was done in the department obstetrics and gynecology, Indore. 100 patients with the complain of AUB were selected at random from the Gynecology Out Patient Department of the Institute of obstetrics and gynecology medical college and MY hospital Indore. The age group of the selected patients ranged from 20 to 40 years. All the patients underwent TVS, Hysteroscopy followed by curettage and removal of abnormal lesions like Polyps and Submucous fibroid and the material was sent for histopathological analysis. The period of study was from September 2018 to Aug-2019. Patients with age group in the range of 20 to above and parous woman with AUB and who do not have any other medical or surgical complications and who do not require any emergency management were selected for this study. Patients with severe anemia, pregnancy, nulliparous, pelvic inflammatory disease, systemic cause of bleeding, vaginal and cervical cause of bleeding, thyroid disorder and coagulation disorder, unmarried girls and medical complications like uncontrolled diabetes mellitus or hypertension were also excluded from study to preclude any anesthetic or surgical risks during hysteroscopy. After informed written consent and counselling, detailed clinical history was taken. obstetric history included parity, mode of delivery, abortion, history of IUCD, history of D and C, contraception history, detailed menstrual cycle history past and present in term duration, frequency, flow amount and type of abnormal bleeding, and duration of complain, any relevant preceding event. Results- Total number of patients selected: 100. Among the reproductive age group, patients in the age group of 26 - 30 constitute 40%. Patients having 1 - 2 children constitute the majority - 48% of cases; whereas multiparous women having more than 4 children constitute only 10%. Kumari m et al and Patil et al, 61% and 71% patient with aub were multiparous respectively. Mishra et al study 65% multiparous 30% primiparous. 80% of patients sought medical advice within 6 months of illness; whereas only 2% of patients sought the medical advice after 1 year of illness. Commonest pattern of bleeding is menorrhagia accounting for 42% of cases. By Histopathology 74 patients (74%) had normal endometrium. Histopathology diagnosed 8 cases of hyperplasia and 14 cases of endometrial polyp, 4 cases of Submucous fibroid. In the present study there were no malignancies detected. 8 out of 100 patients had simple hyperplasia, whereas in 74 out of 100 patients, endometrium was normal. Conclusion- This study confirms that hysteroscopy is superior to transvaginal sonography in evaluating abnormal uterine bleeding. Most of the patient presenting with aub are in reproductive age group. Higher incidence of intrauterine pathologies in this age group. Both tvs and hysteroscopy will diagnose the condition of uterus. but both have different accuracies. Compare to tvs, hysteroscopic is direct visualization of endometrial cavity and also a safe reliable and fast procedure in the diagnosis of cases with abnormal uterine bleeding with high sensitivity, specificity, positive predictive value, negative predictive value with minimal complication. Additional opportunity of taking biopsy. Transvaginal sonography can be used as the first line diagnostic technique but hysteroscopy followed by histopathological examination should be considered as "Gold standard" for evaluation of abnormal uterine bleeding. [ABSTRACT FROM AUTHOR]

Aim: To investigate the status of abnormal uterine bleeding (AUB) in Japan using the International Federation of Gynecology and Obstetrics (FIGO) classification (AUB system 1 and 2; PALM‐COEIN) and to clarify the relationship between AUB symptoms and the diseases causing AUB. Methods: In a nationwide study, we enrolled first‐time patients who visited target facilities during two consecutive weeks from December 1, 2019 to January 31, 2020. The FIGO classification was used to investigate patients with symptoms and causative diseases of AUB. Based on the proportion of patients in the nationwide study, 373 cases were included in the detailed survey. Survey items included symptoms of AUB according to AUB system 1, examination details, and causative diseases according to the PALM‐COEIN classification. Results: Within the study period, we encountered 61 740 first‐time patients, of which 8081 (13.1%) were diagnosed with AUB. Among them, 39.9% had abnormal menstrual cycles and 56.9% had abnormal menstrual bleeding. In the survey, PALM had the highest percentage of AUB‐L and COEIN had the highest percentage of AUB‐O. Correspondence analysis showed that COEIN was strongly associated with abnormal menstrual cycles and PALM with abnormal menstrual bleeding. Conclusion: We conducted the first nationwide survey of AUB in Japan. The FIGO classification was a useful tool for the diagnosis of AUB, with a strong correlation between symptoms of AUB by AUB system 1 and the causative disease of AUB by PALM‐COEIN. Conversely, a high percentage of AUB‐N and AUB‐E suggests that AUB system 1 and PALM‐COEIN are ambiguous as diagnostic tools. [ABSTRACT FROM AUTHOR]

The purpose of the research is to analyse the missions, key directions, and principles of work of the main world broadcasters' union as a significant institutional aspect of the TV industry development and audio-visual culture in the XXI century. Methodology of the research. In the article, firstly, a system approach is used to look at the broadcasters' union as the integral element of the TV and audio-visual industry. Secondly, a principle of the historical neoinstitutionalism is applied, in accordance to which the broadcasters' unions are accepted as the historically formed structures and institutions that condition the processes of this branch development and support, and the institutional trajectory chosen by them determines the parameters of television discourse today. Scientific novelty of the research. For the first time at the scientific article level, the position and peculiarities of the broadcasters' unions as the institutional development and support of the TV industry in the XXI century were considered. Conclusions. The significance of the role of the world broadcasters' unions was emphasized, which in the XXI century remain one of the key subjects and players in the international media market. On the example of such institutions as the European Broadcasting Union, African Union of Broadcasting, Asia-Pacific Broadcasting Union, we have proven that the world broadcasters' unions remain a powerful tool of influence on the international arena and a driver of the TV and audio-visual industries development at the modern stage. These unions provide normative and technical support of their members, exchange of technologies, programs and innovations, create conditions for learning and cooperation (through conferences, working groups, trainings), international frequency planning and coordination, promote the influence of the TV industry and audiovisual industry on the social-economic development of a region. [ABSTRACT FROM AUTHOR]

Abstract Background The overall clinical significance of the finding of endometrial abnormalities in predicting premalignant/malignant endometrial lesions is still incompletely determined. For this reason the management, surgical or expectant, of women in which an endometrial abnormality has been detected is debated. Methods This retrospective study was carried out on 1020 consecutive women, 403 premenopausal and 617 postmenopausal, who underwent operative hysteroscopy in a University Hospital for suspected endometrial abnormalities, which were detected by transvaginal ultrasound (TVS) and/or office hysteroscopy. In these women, the clinical characteristics and findings at TVS and hysteroscopy were evaluated in relation to the presence/absence of premalignant/malignant endometrial lesions at pathology report. Results The clinical characteristics considered were significantly different when the study women were compared according to their menopausal status. Premalignant/malignant lesions were found in 34/1020 (3.33%) women. Complex hyperplasia with atypia and endometrial cancer were detected in 22 (2.15%) and 12 (1.17%) cases, respectively. The postmenopausal women had a significantly higher risk of premalignant/malignant lesions than premenopausal women (O.R. = 5.098 [95% C.I.: 1.782–14.582], P

Background- Hysterectomy is one of the most frequently performed surgery by obstetrician-gynaecologists next only to caesarean section. Several routes of hysterectomy have been explored and debated in search for the optimum one which would aid in the ease of operation with minimum complications and best cosmetic results. Hysterectomies are performed vaginally, laparoscopically (total laparoscopic hysterectomy) .Objectives - 1) To compare non descent vaginal hysterectomy (NDVH) with total laparoscopic hysterectomy(TLH) in terms of duration of surgery and requirement of Oophercetomy .2) To find out the association between various intra-operative and post-operative complications, post operative pain,biochemical parameters changes and duration of hospital stay following Non-descent vaginal and total laparoscopic hysterectomy. Methodology- It was a prospective observational study conducted for a period of 2 years(October 2015-September 2017) among the patients admitted to the Dept, of O & G,VIMSAR Burla for whom hysterectomy was chosen as a mode of treatment. Total sample size was 100. Results - Most common indications for hysterectomy was AUB/DUB in both NDVH (50%) and TLH(52%) groups. Comparison of 2 groups (NDVH/TLH) for duration of surgery with unpaired t test it was revealed that there was a significant difference between groups with p value < 0.0001 which indicates that NDVH could be performed in less time compared to TLH . The accidental detection of any adnexal pathology if found then, oophorectomy could be performed easily while doing TLH as compared to NDVH. Ureteric injury was more common while performing TLH as compared to NDVH. There was no statistical significant association between the types of surgery with intra operative & post-operative complication with P value >0.05. Patients who underwent TLH experienced less pain post operatively as compared to patients of NDVH group. Mean duration of hospital stay with the types of surgery was not found to be significant. Conclusion- The route of hysterectomy must be decided by the surgeon in such a way that the patients will get maximize benefits and there will be minimum complications. [ABSTRACT FROM AUTHOR]

What happens in the brain during meditation? Neuroscientists such as Andrew Newberg, who studies religious experiences on the neural level, may provide an answer. He calls the devolution, which is similar to all mystical experiences in different faiths, self-transcendent experience (STE); in a further instance, he also calls it the feeling of Absolute Unitary Being (AUB). A more detailed consideration of related issues is done by examining the human expansion of consciousness in Islamic mysticism based on an event depicted in the Qurʾān, namely Mosesʾ desire to talk to or see God, his subsequent unconsciousness due to the awe of God, and his subsequent attainment of a new consciousness. The following paper will have a brief look at the case of Moses and aims to investigate the states of consciousness during such experiences. Here, an attempt will be made to trace and prove a connection between neuroscience and the mystical state of the feeling of union with God. In doing so, particular attention will be paid to the state of the encounter between Moses and God. From a neuropsychological point of view, the question will be investigated whether the special spiritual experiences such as those of Moses can be measured, and within this framework, different consciousness models will be presented. Can Newberg's STE or AUB theory be regarded equally with the fanāʾ state? Finally, which kind of psychological experience is applicable to Moses will be examined. [ABSTRACT FROM AUTHOR]

In 1995, Morris first described cesarean scar defect as an "isthmocele" by macroscopy following hysterectomy in women with prior cesarean delivery. Cesarean scar defect is associated with gynecological symptoms such as abnormal uterine bleeding, secondary infertility, pelvic pain, and obstetrical complications such as cesarean scar pregnancy, placenta accreta, and uterine rupture. Surgical treatment techniques include hysteroscopic resection, transabdominal repair (laparotomy, laparoscopic, and robotic), and vaginal repair. If the residual myometrial thickness is <3 mm and a patient is symptomatic, consideration is made for defect repair from above rather than hysteroscopic resection. The advantages of laparoscopic repair include anatomic restoration of myometrial thickness, correction of uterine retroflexion, exploration of other causes of infertility and pelvic pain, and pathological diagnosis of scar tissue with endometriosis. Cesarean scar defect often cannot be visualized on the side of the abdominal cavity; therefore, it is difficult to identify the extent of the defect laparoscopically. Herein, we introduce laparoscopic cesarean scar defect repair through a surgical video with narration. This technique uses a uterine manipulator to distend and help delineate the defect, and a laparoscopic support suture within the defect as a "handle" to place the scar tissue on tension to ensure complete resection of the fibrotic tissue. Temporary uterine artery occlusion can be included to reduce bleeding in the surgical field to support visualization for complete fibrotic tissue removal and to achieve good apposition with a double-layer suture to promote proper anatomic wound healing. Symptom relief was achieved, and the patient became pregnant one year postoperatively. This video demonstrated a feasible, safe, effective procedure for laparoscopic cesarean scar defect repair in the patient., (Copyright © 2024 Elsevier Inc. All rights reserved.)

To explore the reproductive endocrine feature and conception outcome of women with unknown etiological long menstrual cycle (LMC) (36–45 days) with long follicular phase. In the cohort study, we included 80 women with unknown etiological long menstrual cycle of biphasic basal body temperature (BBT) lasting for 36–45 days and 87 controls with normal cycle of biphasic BBT into LMC group and NMC group, respectively. Serum hormone levels, fasting glucose, and insulin of participants were tested, and ovulation was observed by ultrasound. The conception outcome was followed up within 12 menstrual cycles. In the LMC group, the rate of abnormality of HOMA-insulin resistance index (40.0% vs. 20.7%, p <.01), luteal phase defect (30.9% vs. 13.8%, p <.05) and abnormality of FSH/LH ratio (15.6% vs. 5.7%, p <.05) were all significantly higher, but the serum estradiol level on the day before ovulation (261.10 pg/mL vs. 320.26 pg/mL, p <.01) was lower. The rate of poor ovulation quality (31.3% vs.15.4%, p <.05) in the LMC group was significantly higher than the NMC group. In the LMC group, the natural conception rate within 12 menstrual cycles was lower (41.9% vs. 66.2%, p <.01), whereas the spontaneous abortion rate in early pregnancy (29.0% vs. 9.8%, p <.05) and the conversion rate (21.6% vs. 5.2%, p <.01) to anovulation within 12 cycles were significantly higher. Women with unknown etiological menstrual cycle (36–45 days) with long follicular phase have greater endocrine abnormality and higher risk of spontaneous abortion, infertility, and conversion to anovulation. Moderate early intervention may be advisable for these women, especially those who wish to get pregnant. [ABSTRACT FROM AUTHOR]

One of the commonest reasons for women seeking gynecological advice is Abnormal uterine bleeding (AUB). Most common anatomical causes of abnormal uterine bleeding in women are endometrial polyps, sub mucosal fibroids and endometrial hyperplasia. Hysteroscopy is an effective procedure but is more expensive than Saline Infusion Sonography (SIS). Direct visualization of uterine cavity is possible by hysteroscopy, but it does not give any information about myometrium and adnexa. Saline infusion sonography is effortlessly accepted by most patients as it can be an outpatient procedure. This article present summary of salient features of the procedure which will help the practitioner to take informed decision.

Background: The overall clinical significance of the finding of endometrial abnormalities in predicting premalignant/malignant endometrial lesions is still incompletely determined. For this reason the management, surgical or expectant, of women in which an endometrial abnormality has been detected is debated.Methods: This retrospective study was carried out on 1020 consecutive women, 403 premenopausal and 617 postmenopausal, who underwent operative hysteroscopy in a University Hospital for suspected endometrial abnormalities, which were detected by transvaginal ultrasound (TVS) and/or office hysteroscopy. In these women, the clinical characteristics and findings at TVS and hysteroscopy were evaluated in relation to the presence/absence of premalignant/malignant endometrial lesions at pathology report.Results: The clinical characteristics considered were significantly different when the study women were compared according to their menopausal status. Premalignant/malignant lesions were found in 34/1020 (3.33%) women. Complex hyperplasia with atypia and endometrial cancer were detected in 22 (2.15%) and 12 (1.17%) cases, respectively. The postmenopausal women had a significantly higher risk of premalignant/malignant lesions than premenopausal women (O.R. = 5.098 [95% C.I.: 1.782-14.582], P < 0.005). This risk was even higher when abnormal uterine bleeding (AUB) was present (O.R. = 5.20 [95% C.I.: 2.38-11.35], P < 0.0001). The most significant associations with premalignant/malignant endometrial lesions were BMI, AUB in postmenopause, overall polyp size, atypical aspect of endometrial polyps at hysteroscopy, postmenopausal status, diabetes mellitus and patient age.Conclusions: The results of the present study suggest that the proper, aggressive or expectant, management of endometrial abnormalities should take into account both ultrasonographic and hysteroscopic findings together with the specific clinical characteristics of the patients. [ABSTRACT FROM AUTHOR]

Background: Abnormal uterine bleeding (AUB) is a term used to describe any type of bleeding that does not fall within the normal range of amount, frequency, duration and cyclicity. The prevalence is 9-14% of women from menarche to menopause and also affects the quality oflife.1 ApproximatelylS-26% of menstrual disorders are attributed to thyroid dysfunction.2 Objective: To categorise the patients into four categories- euthyroid, subclinical hypothyroid, hypothyroid, hyperthyroid and determine the type of menstrual bleeding pattern in relation to different thyroid disorders. Materials and Methods: We did a prospective observational (non-interventional) study at Department of Obstetrics and Gynaecology, Kamala Nehru Memorial Hospital, Prayagraj from July 2019 to June 2020. A total of 100 patients attending the inpatient and outpatient of the department in the age group of 15-45 years with complaints of menorrhagia, oligomenorrhoea, polymenorrhoea, amenorrhoea and hypo menorrhoea fulfilling the inclusion criteria and exclusion criteria were included in the study. The patients were categorized into four groups: euthyroid, hypothyroid, subclinical hypothyroid and hyperthyroid, and then comparison among all the groups were done with respect to age, parity, BMI, TSH, FT31 FT4 levels and histopathological findings. Results: All the groups were comparable in terms of age, parity, BM I and family history although the majority of cases of AU B was found in the age group of 36-45 years. Subclinical hypothyroidism was found to be the most prevalent thyroid disorder with menorrhagia as the most common menstrual disorder. Hyperthyroid patients had oligomenorrhoea as the most common complaint. This association was not found to be statistically significant (p>0.05). Proliferative endometrium was found to be more commonly associated with euthyroidism and hypothyroidism (subclinical and overt) while secretory endometrium was seen in hyperthyroidism. This association was not found to be statistically significant (p>0.05). Conclusion: The present study reported high incidence of thyroid diseases in patients of AU B. Thyroid function evaluation she u Id be mandatory in cases of AUB to detect thyroid dysfunction and these cases should be referred to physician for further medical treatment. [ABSTRACT FROM AUTHOR]

Aims: Hysterectomy are being performed in regular basis and its aetiology and histopathological findings are watched and co-related in this study. Methods: This is an observational descriptive study carried out in the Department of Obstetrics and Gynaecology at Nobel Medical College Teaching Hospital Biratnagar for one year from 15 May 2021 to 15 may 2022. All the patients undergoing hysterectomies were analyzed for indication, type of procedure, complications and histopathological diagnosis. Results: A total of 456 hysterectomies were performed in a year. Preoperative diagnosis in most of the cases was fibroid uterus. The common surgical procedure was total abdominal hysterectomy. The most common histopathological diagnosis was fibroid uterus followed by uterine prolapse, ovarian mass, endometrial disease and adenomyosis. Conclusions: Fibroid uterus is the leading cause of hysterectomy as well as the commonest pathologic diagnosis followed by prolapsed uterus and ovarian tumor. [ABSTRACT FROM AUTHOR]

Copyright of Al-Adab / Al-ādāb is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Background: Contraceptive injection is the most common contraception used in Indonesia. Among the contraceptive injections, depomedroxy progesterone acetate (DMPA) is the most effective method with pregnancy rate of 0,3 pregnancy in 100 women annually. Abnormal uterine bleeding (AUB) is a common side effect occurred in DMPA users which leads to the discontinuation of contraception. Objective: To explore the effect of tranexamic acid on bleeding length for DMPA users with AUB who receive low dose Oral Contraceptive Pills (OCP). Methods: We performed double blind randomized control trial between two groups to investigate the effect of tranexamic in managing AUB in DMPA users who receive low dose OCP. This study was performed in Dr. Kariadi Hospital Semarang, Indonesia. Forty-four subjects were divided into two groups, equally. Group 1 received 250 mg tranexamic acid four times a day for 5 days and OCP once a day for 28 days, while Group 2 received placebo four times a day for 5 days and OCP once a day for 28 days. Both groups were evaluated for bleeding length during treatment and were analyzed using Mann Whitney for post treatment with tranexamic acid. Results: The mean bleeding length was 5.2±3.62 days and 9.2±6.16 days in group 1 and 2 respectively. These bleeding lengths were significantly different between both groups (p=0.018). The precentage of subjects in whom bleeding was stopped during the first week after initial treatment was significantly higher in group 1 than group 2 (77,3 % vs 45,5 %, p

Background: Approximately 33% of all gynaecological consultations are associated with abnormal vaginal bleeding, and this proportion increases to 70% in the peri and postmenopausal years. Aims and Objective: To compare the diagnostic accuracy of Karman's cannula endometrial aspiration histopathology versus dilatation and curettage in patients with abnormal uterine bleeding. Methodology: In total 100 women of all age groups with a clinical diagnosis of AUB were included in this prospective comparative study. Endometrial aspiration with Karman cannula was performed in the operation theatre prior to curettage to maintain synchronization during sampling. Results: In our study, no significant difference was observed between Karman and D and C regarding sample adequacy (P = 0.07), HPE findings (P = 1) and concordance rate with hysterectomy specimen (P = 1). 95% of the samples obtained by Karman and 98% of those obtained by D and C were adequate. For obtaining an adequate sample by Karman the sensitivity and accuracy was 96.94% and 96% when compared with D and C. Karman and D and C had comparable concordance rates (95% and 95%) with hysterectomy specimen. Karman endometrial sampling is an easy procedure when compared to D and C (P = 0.007). With considering D and C as gold standard Karman endometrial sampling demonstrated 100% accuracy for diagnosing adenocarcinoma, endometrial hyperplasia. Conclusion: Endometrial aspiration with Karman cannula is an easy, safe, cost-effective, accurate, convenient method of achieving histopathological diagnosis. It can be done as an outpatient procedure without analgesia and anaesthesia when compared to D and C which is expensive and invasive method and requires hospitalization and general anaesthesia.

Background Abnormal uterine bleeding constitutes a vexing issue among female patients, substantially impacting their quality of life. Surgical interventions, particularly hysterectomy, contribute to the psychological, physical, and financial burden on families and, by extension, the healthcare system. Levonorgestrel-releasing intrauterine system (LNG-IUS) represents a conservative management approach and emerges as a beneficial option for affected patients. The present study aims to elucidate color Doppler changes in the uterine artery pre- and post-LNG-IUS insertion. Objective The primary objectives encompass an investigation into the variations in Doppler indices (resistance index (RI) and pulsatility index (PI)) within the arcuate and radial branches of the uterine artery, as well as the assessment of endometrial thickness before LNG-IUD insertion, at three months, and six months post-insertion. Secondary outcomes include evaluating changes in pictorial blood assessment chart (PBAC) scores before insertion, at three months, and at six months after LNG-IUS insertion. Methods A cross-sectional study was conducted at the Department of Obstetrics and Gynecology at All India Institute Of Medical Sciences (AIIMS), Nagpur. A cohort of 25 women underwent LNG-IUS insertion. The endometrial cavity, RI, and PI of both arcuate and radial arteries were assessed before LNG-IUS insertion and at three and six months after insertion. Results The PI of the arcuate artery exhibited minimal alteration over the six-month duration, with a p-value of 0.43. Conversely, the RI demonstrated a statistically significant increase over the same period (p = 0.03). Conversely, the radial artery exhibited no statistically significant changes in either PI or RI (p = 0.39 or 0.13, respectively). Conclusion Following six months of LNG-IUS utilization, a substantial reduction in endometrial thickness and menstrual flow was observed, concomitant with an improvement in hemoglobin levels. Notably, the PI of both the arcuate and radial arteries demonstrated no significant change. Although the RI of the arcuate artery increased, its clinical relevance may be limited. Consequently, the observed reduction in menstrual bleeding cannot conclusively be ascribed to diminished blood flow in uterine arteries., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. All India Institute of Medical Sciences, Nagpur issued approval IEC/Pharmac/2021/322. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: AIIMS Nagpur has funded the study. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gupta et al.)

During the last twenty years, the diagnostic approach to endometrial pathology has radically evolved. For over a century, intrauterine blind biopsy techniques were considered the gold standard procedure for the histopathological diagnosis of intrauterine diseases. The advent of hysteroscopy, which made it possible to directly visualize the uterine cavity, and the subsequent miniaturization of the instruments allowing its use in the office setting without anesthesia are considered game-changers. To date, it is feasible to retrieve a targeted eye specimen of endometrial tissue with little or no discomfort for the patient in the office setting. To pursue this aim, several technological upgrades have improved the diagnostic accuracy of hysteroscopic endometrial biopsy. In this paper we provide an up-to-date review of the latest evidence regarding indications, instrumentations, and techniques for hysteroscopic endometrial biopsy, to help the operator in providing an adequate endometrial sampling for histopathological analysis. [ABSTRACT FROM AUTHOR]

What happens in the brain during meditation? Neuroscientists such as Andrew Newberg, who studies religious experiences on the neural level, may provide an answer. He calls the devolution, which is similar to all mystical experiences in different faiths, self-transcendent experience (STE); in a further instance, he also calls it the feeling of Absolute Unitary Being (AUB). A more detailed consideration of related issues is done by examining the human expansion of consciousness in Islamic mysticism based on an event depicted in the Qurʾān, namely Mosesʾ desire to talk to or see God, his subsequent unconsciousness due to the awe of God, and his subsequent attainment of a new consciousness. The following paper will have a brief look at the case of Moses and aims to investigate the states of consciousness during such experiences. Here, an attempt will be made to trace and prove a connection between neuroscience and the mystical state of the feeling of union with God. In doing so, particular attention will be paid to the state of the encounter between Moses and God. From a neuropsychological point of view, the question will be investigated whether the special spiritual experiences such as those of Moses can be measured, and within this framework, different consciousness models will be presented. Can Newberg’s STE or AUB theory be regarded equally with the fanāʾ state? Finally, which kind of psychological experience is applicable to Moses will be examined.

The ability of transposons to mobilize to new places in a genome enables them to introgress rapidly into populations. The piRNA pathway has been characterized recently in the germ line of the fruit fly, Drosophila melanogaster, and is responsible for downregulating transposon mobility. Transposons have been used as tools in mosquitoes to genetically transform a number of species including Anopheles stephensi, a vector of human malaria. These mobile genetic elements also have been proposed as tools to drive antipathogen effector genes into wild mosquito populations to replace pathogen-susceptible insects with those engineered genetically to be resistant to or unable to transmit a pathogen. The piRNA pathway may affect the performance of such proposed genetic engineering strategies. In the present study, we identify and describe the An. stephensi orthologues of the major genes in the piRNA pathway, Ago3, Aubergine (Aub) and Piwi. Consistent with a role in protection from transposon movement, these three genes are expressed constitutively in the germ-line cells of ovaries and induced further after a blood meal.

The ability of transposons to mobilize to new places in a genome enables them to introgress rapidly into populations. The piRNA pathway has been characterized recently in the germ line of the fruit fly, Drosophila melanogaster, and is responsible for downregulating transposon mobility. Transposons have been used as tools in mosquitoes to genetically transform a number of species including Anopheles stephensi, a vector of human malaria. These mobile genetic elements also have been proposed as tools to drive antipathogen effector genes into wild mosquito populations to replace pathogen-susceptible insects with those engineered genetically to be resistant to or unable to transmit a pathogen. The piRNA pathway may affect the performance of such proposed genetic engineering strategies. In the present study, we identify and describe the An. stephensi orthologues of the major genes in the piRNA pathway, Ago3, Aubergine (Aub) and Piwi. Consistent with a role in protection from transposon movement, these three genes are expressed constitutively in the germ-line cells of ovaries and induced further after a blood meal.

Objective: To describe the distribution of abnormal uterine bleeding (AUB) type according to the polyp (AUB-P); adenomyosis (AUB-A); leiomyoma (AUB-L); malignancy and hyperplasia (AUB-M); coagulopathy (AUB-C); ovulatory dysfunction (AUB-O); endometrial (AUB-E); iatrogenic (AUB-I); and not yet classified International Federation of Gynecology and Obstetrics classification system in a medically underserved American inner-city population. Our secondary objective was to find an association between risk factors and type of AUB. Material and Methods: We conducted a descriptive cross-sectional analysis at our outpatient women's health clinic located in the Bronx, New York City, from November 2016 to December 2019. Results: Among 390 patients, the most common AUB type was AUB-L (n=185, 47.4%), followed AUB-P (n=100, 25.6%), AUB-A (n=55, 14.1%), AUB-O (n=19, 4.9%), AUB-M (n=15, 3.8%), AUB-E (n=14, 3.6%) and AUB-I (n=2, 0.5%). Race was distributed as follows: Hispanic (68.2%), Black (25.9%), Caucasian (3.3%), and Asian (2.1%). Comorbidities included hypertension (36.4%), diabetes (15.6%), and thyroid disease (6.9%). The median age at diagnosis was significantly higher in AUB-M (59 years old, p<0.001), AUB-P (52.5 years old, p<0.001), AUB-E (51.5 years old, p=0.001) compared to AUB-L (46 years old). The median body mass index (BMI) was significantly higher in AUB-E (34.2 kg/m², p=0.048) and AUB-O (32.6 kg/m², p=0.038) compared to AUB-L (30 kg/m²). Race was equally distributed among the AUB types. AUB-M (66.6%, p=0.002), AUB-E (57.1%, p=0.022), AUB-P (47%, p<0.001), and AUB-A (30.8%, p<0.001), had statistically significantly more cases of hypertension compared to AUB-L (28.1%). AUB-P (27%, p<0.001), AUB-M (26.6%, p=0.025), AUB-E (35.7%, p=0.001) and AUB-A (9%, p<0.001) had more patients with diabetes mellitus (DM) than AUB-L (3.3%). Conclusion: In an American population of medically underserved patients, the most common cause of AUB was leiomyoma and the most common race was Hispanic. Women with AUB-L were younger, with lower BMI, and with fewer cases of hypertension and DM when compared to other types of AUB. [ABSTRACT FROM AUTHOR]

The endometrium is a dynamic target organ in a woman's reproductive life. It undergoes cyclical change regulated by the fine balance between oestrogen and progesterone. The endometrial thickness (ET) varies according to the phases of the menstrual cycle. Endometrium contains both oestrogen and progesterone receptors, which respond to above hormones, irrespective of whether the woman is in reproductive or menopausal phase. Abundance of oestrogen leads to endometrial hyperplasia, and paucity causes endometrial atrophy. The initial best modality of assessing ET or aberration is high resolution transvaginal ultrasonogram. Thickened endometrium is always a clinical conundrum. Dilemma does remain as to the thickness of endometrium which requires intervention, mostly in symptomatic pre and perimenopausal women. In post-menopausal women with bleeding, the cut-off of ET that warrants investigation is almost defined. However, the cut-off value of ET in asymptomatic postmenopausal women; beyond which intervention is required, is still debated. Dilemma also exists about the cut-off of ET in both symptomatic and asymptomatic women on HRT and Tamoxifen. This article will discuss the above issues and reach at some consensus about the cut-off of ET after critical analysis of evidence and experience and will help clinicians in arriving at a proper decision in dealing with such clinically confounding situations. [ABSTRACT FROM AUTHOR]

Heavy menstrual bleeding is common and debilitating but the causes remain ill defined. Rates of obesity in women are increasing and its impact on menstrual blood loss (MBL) is unknown. Therefore, we quantified BMI and MBL in w omen not taking hormones and with regular menstrual cycles and revealed a posit ive correlation. In a mouse model of simulated menstruation, diet-induced obesity also resulted in delayed endometrial repair, a surrogate marker for MBL. BrdU staining of mouse uterine tissue revealed decreased proliferation during menstruation in the luminal epithelium of mice on a high-fat diet. Menstruation is known to initiate local end ometrial inflammation and endometrial hypoxia; hence, the impact of body weight on these processes was investigated. A panel of hypoxia-regulated genes (VEGF, ADM, LDHA, SLC2A1) showed consistently higher mean values in the endometrium of women wit h obesity and in uteri of mice with increased weight vs normal controls, although stat istical significance was not reached. The inflammatory mediators, Tnf and Il6 were significantly increased in the uterus of mice on a high-fat diet, consistent with a pro-inflamm atory local endometrial environment in these mice. In conclusion, obesity was associate d with increased MBL in women. Mice given a high-fat diet had delayed endometrial repai r at menstruation and provided a model in which to study the influence of obesity on m enstrual physiology. Our results indicate that obesity results in a more pro-inflamma tory local endometrial environment at menstruation, which may delay endometrial repair and increase menstrual blood loss. [ABSTRACT FROM AUTHOR]

Background: Iraq still considered one of the countries in the region with high prevalence of TB, there are about 20000 patients, accounts for 3% of the total number of cases, and the estimated death from TB exceeds 4000 per year. TB in Iraq until nowadays considered a health, public and social problem, and because of the wars and political problems, many programs, campaigns, and researches were hundred by this situation Objective: To detect endometrial Tuberculosis in women complaining from AUB (abnormal uterine bleeding) using real time PCR method of assessment via taking an endocervical swab. Patients and methods: Prospective cross-sectional study carried at Department of obstetrics and gynecology in Baghdad teaching hospital /medical city over a period of eight months starting from Octuber2019, to Augest2020. A total of 60 women complaining from abnormal uterine bleeding(AUB) who were scheduled to have endometrial biopsy for histopathology by dilatation and curettage(D&C), endocervical swab assessed for female genital tuberculosis(FGTB) by real time PCR. Results: Out of 60 samples taken 6 were positive by real time PCR 10%, while there was only one case positive by histopathology 1.66% which was also positive by PCR the same patient gave history of pulmonary TB and received a nine month course of treatment, according to these findings the sensitivity of PCR found to be 100% while the specificity92% and an accuracy of 92%. Conclusion: Real time PCR considered one of the valuable diagnostic tools for mycobacterium tuberculosis, and because Iraq still showing high incidence of the disease, one should suspect mycobacterium tuberculosis in any women complaining from abnormal uterine bleeding and offer PCR in addition to other diagnostic modalities, luckily it will allow treatment at an early stage of the disease. [ABSTRACT FROM AUTHOR]

Introduction: If a woman suffers from congenital fibrinogen deficiency (CFD), she might undergo hypermenorrhea monthly and possibly to suffer from hemoperitoneum due to a ruptured follicle or corpus luteal cyst every month, which seriously threaten her health and quality of life. Here, we creatively used a combination of the levonorgestrel-releasing intrauterine system (LNG-IUS) and the combined oral contraceptives (COC) for a girl with CFD.Case presentation: A 14-year-old girl presented with no obvious cause of persistent and severe lower abdominal pain that began 8 h prior. After examination, she was diagnosed as hemoperitoneum. CFD was diagnosed when she was 2 years old and she had two hospitalizations due to hemorrhagic anemia caused by menorrhagia. Therefore, after successful conservative treatment of hemoperitoneum, a combination of LNG-IUS and COC was used for the long-term conservative management of hypermenorrhea and hemoperitoneum. During the half-year of follow-up, she had hypomenorrhea without hemoperitoneum.Conclusions: To the best of our knowledge, this was the first patient treated with such a procedure in the literature, and we recommend every woman with CFD at puberty or reproductive age receives this two-pronged treatment.

Introduction: Abnormal uterine bleeding (AUB) is one of the most common reason for visits to gynecologists. Endometrial biopsy is a routine procedure in gynecological practice to detect the etiology of AUB and to exclude precancerous and cancerous lesions of the endometrium. The aim of this study was to assess the causes of AUB among women, who had undergone invasive diagnostics due to AUB. Material and methods: This study was carried among 531 women, who had undergone invasive diagnostics due to AUB between January 2018 and December 2018. Women were divided into premenopausal (with perimenopausal) and postmenopausal groups. Transvaginal ultrasound was performed. Endometrial thickness was compared with histopathological results in each subgroup and statistically analyzed. The incidence of histopathological findings and rate of anemia were also analyzed. Results: In our series of patients the most common cause of AUB based on histopathological results was endometrial polyp, both before and after menopause. The most frequent pathologies at ultrasound findings were leiomyomas and endometrial polyps. The incidence of taken together: atypical hyperplasia and endometrial cancer was significantly higher in postmenopausal group (8.58%) than in pre- and perimenopausal (1.35%, p = 0.0001). The median endometrial thickness, both before and after menopause, was significantly greater in patients with pathological than with nonpathological endometrium. 31% of women with abnormal uterine bleeding before menopause and 10% after menopause had anemia. Conclusions: Measurements of endometrial thickness seems to be acceptable initial diagnostic tool to distinguish between benign and pathological endometrial changes both before and after menopause. [ABSTRACT FROM AUTHOR]

Background: Approximately 33% of all gynaecological consultations are associated with abnormal vaginal bleeding, and this proportion increases to 70% in the peri and postmenopausal years. Aims and Objective: To compare the diagnostic accuracy of Karman's cannula endometrial aspiration histopathology versus dilatation and curettage in patients with abnormal uterine bleeding. Methodology: In total 100 women of all age groups with a clinical diagnosis of AUB were included in this prospective comparative study. Endometrial aspiration with Karman cannula was performed in the operation theatre prior to curettage to maintain synchronization during sampling. Results: In our study, no significant difference was observed between Karman and D and C regarding sample adequacy (P = 0.07), HPE findings (P = 1) and concordance rate with hysterectomy specimen (P = 1). 95% of the samples obtained by Karman and 98% of those obtained by D and C were adequate. For obtaining an adequate sample by Karman the sensitivity and accuracy was 96.94% and 96% when compared with D and C. Karman and D and C had comparable concordance rates (95% and 95%) with hysterectomy specimen. Karman endometrial sampling is an easy procedure when compared to D and C (P = 0.007). With considering D and C as gold standard Karman endometrial sampling demonstrated 100% accuracy for diagnosing adenocarcinoma, endometrial hyperplasia. Conclusion: Endometrial aspiration with Karman cannula is an easy, safe, cost-effective, accurate, convenient method of achieving histopathological diagnosis. It can be done as an outpatient procedure without analgesia and anaesthesia when compared to D and C which is expensive and invasive method and requires hospitalization and general anaesthesia. [ABSTRACT FROM AUTHOR]

It is estimated that 19% of adolescents in Poland begin their sexual life when they are 15 years old and more than 50% of people aged 17-19 years have already had their first sexual contact. World Health Organization recommends teenagers to use the method of 'dual protection' (condom and other method of contraception, i.e. intrauterine devices). In this study, we sought to present our own experience in the field of the use of levonorgestrel-releasing intrauterine devices in adolescents and to compare it with the experience of other researchers worldwide. Low- dose levonorgestrel-releasing intrauterine device is safe and effective method of contraception in adolescents. It is also an alternative treatment used in heavy chronic abnormal uterine bleeding. It can be also used as an alternative in women with cyanotic heart disease who have contraindications for standard contraception. Gynecologists and pediatricians should be well informed in the topic of intrauterine device use among adolescents and they should provide them reliable knowledge in this field. [ABSTRACT FROM AUTHOR]

Objective: Abnormal uterine bleeding (AUB) is common gynaecological problem in women of reproductive age group. Its prevalence is approximately 19% in reproductive age women. The present study was aimed to evaluate the role of transvaginal ultrasonography and colour Doppler in diagnosing uterine pathologies and later its confirmation by histopathology. Materials & Methods: Sixty women presenting with complaint of abnormal uterine bleeding between the age group of 30-60 years were included in the study. Transvaginal ultrasound (TVS) & colour Doppler (CD) was done followed by dilatation and curettage (in premenustral phase in case of premenopausal women) in all cases and histopathological examination of tissue and specimen obtained after surgery was done in selected cases. Uterine size, endometrial thickness and blood flow indices were measured. Statistical analysis of data was done using ANOVA and Chi-square test. Results: Colour Doppler transvaginal ultrasonography (CDTU) showed abnormal studies in 39 patients (65%), D&C and tissue specimen obtained after surgery revealed abnormalities in 38 patients (63.3%). Thus CDTU has sensivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of 100%, 95.5%, 97.4%, 100% respectively. In abnormal CDTU finding, only 1.7% cases had normal histopathological examination (HPE). CDTU effectively diagnosed all malignant and potentially malignant states. Conclusion: CDTU can be used as a screening tool for malignancy. It is beer than TVS for screening endometrial pathology which can be confirmed by D&C. [ABSTRACT FROM AUTHOR]

Background: The most commonly used technique for detecting endometrial disease in women with AUB is 2D and 3D transvaginal ultrasound. Patients and Method: This study is a controlled clinical trial that was conducted in El-Minia University Maternity Hospital, Egypt. Cases were collected from the outpatient clinic and inpatient gynecological department and 132 pre- & postmenopausal women were included in this study. All cases presented by AUB. The study was conducted between August 2017 and August 2019.The study was approved by the hospital ethical committee. Results: In our study by comparing the AUCs of ET is 0.859, EV is 0.875, VI is 0.916, FI is 0.803, VFI is 0.906, PI is 0.902 and RI is 0.930, the best variable to predict malignancy is RI followed by VI followed by VFI, PI and EV. Conclusion: 3D ultrasonography and power Doppler, especially RI, may be useful for discrimination between benign and malignant endometrium in women with AUB. [ABSTRACT FROM AUTHOR]

Background: Uterine bleeding, which affects a woman between menstrual periods, indicates several hormonal phenomena, which are uterine bleeding outside regular menstrual periods, usually associated with menstruation without ovulation, which is usually the cause of uterine bleeding. The purpose of this study was to describe the prevalence of the AUB among Mosul women. Methodology: Study design: A prospective study was applied in the Mosul city, Iraq. All cases of abnormal vaginal bleeding procured between October, 2018 and October, 2019, at Al-khanssa teaching hospital, in Mosul city, Iraq. A total of 152 cases were included in the study. For each case, representative slides were reviewed and the pattern of uterine histopathological changes identified and classified according to age groups. Results: Total of (233) women abnormal uterine bleeding was studied from October 2018 to October 2019. Women’ age ranged from 15-55 years. Structural cause of chronic abnormal uterine bleeding consisted of 35.42% of cases, whereas nonstructural cause of chronic abnormal uterine bleeding consisted of 64.58% of cases. Ovulatory dysfunction was the most common finding among women with chronic AUB, accounting for (57.7%) cases. Polyp was found in (16.2%) women, Leiomyoma in (12%) patients, Adenomyosis in (4.94%) patients, Endometrial in (2%) patients, malignancy and hyperplasia in (1.9%) women, and Coagulopathy in (1%) women. The highest rate of Ovulatory dysfunction was belonged to age 25-29 years (19.9%).P prevalence was recorded at the highest rate among women belonged to age (40-44).The prevalence of A & L increased by the age. The prevalence rate was 42.3% among women aged (40-44)(45-49) years respectively. The majority occurrence of AUB found in women belonged to age group()years and those who were multiparous. Conclusion: The study concluded that our college students still need intensive training in critical thinking and problem solving techniques, and that the teachers of training and teaching should follow advanced method of teaching their students. [ABSTRACT FROM AUTHOR]

The purpose of this prospective study was to assess the effectiveness of norethisterone (NET) in the management of abnormal uterine bleeding (AUB) in adolescents in a tertiary care center. This was a prospective audit focused on administering high doses of NET in female adolescents with complaints of AUB. We included female adolescents who presented to our Emergency Gynecological Department or Adolescent Gynecological Outpatient Department from October 2016 to January 2019. The study included 29 female adolescents aged 11-17 (mean, 13.14) years. Patients were administered a daily dose of 10-30 mg, depending on the severity of the condition, bleeding duration, and patient weight. Cessation of vaginal bleeding. Mean age at menarche of our patient sample was 11.4 years (range, 10.7-14 years). AUB presented at a mean time of 24.6 months after menarche (range, 0-79 months). Blood transfusion was deemed necessary in 9 patients. Bleeding stopped at a mean of 46.1 (range, 8-120) hours after onset of treatment with NET. No serious adverse events were reported with NET administration, with only 3 cases of minor side effects. The use of NET is an effective and reliable treatment option among adolescents for whom control of AUB is desired in the acute setting. [ABSTRACT FROM AUTHOR]

Highlights • Aub overexpression enhanced mobility defects induced by the knockdown of Caz. • Caz plays a role in pre-piRNA production. • Knockdown of Caz produced abnormal abortive pre-piRNAs associated with Caz. • Aub overexpression induced the abnormal cytoplasmic localization of Caz. Abstract piRNAs, small non-coding RNAs, were considered to be restricted to germline cells. Although they have recently been detected in somatic cells including neurons, it remains unclear how piRNA biogenesis is involved in neuronal diseases. We herein examined the possible roles of Aubergine (Aub), a Piwi-family protein (PIWI) responsible for piRNA biogenesis, in the neuronal disorders, using the Cabeza (Caz) knockdown Drosophila. Caz is a Drosophila homologue of FUS , which is one of the genes causing amyotrophic lateral sclerosis (ALS). Aub overexpression enhanced the mobility defects accompanied by anatomical defects in motoneurons at neuromuscular junctions induced by the neuron-specific knockdown of Caz. In order to elucidate the underlying mechanisms, we examined pre-piRNA and mature-size piRNA levels under these conditions. qRT-PCR and RNA-seq analyses revealed that the Caz knockdown increased pre-piRNA levels, but reduced mature-size piRNA levels in the central nervous system (CNS), suggesting a role in the pre-piRNAs production. Aub overexpression did not increase mature-size piRNA levels. These results suggest that the accumulated pre-piRNAs are abnormal abortive pre-piRNAs that cannot be further processed by slicers, including Aub. We also demonstrated a relationship between Caz and pre-piRNAs in the CNS by RNA immunoprecipitation. Aub overexpression induced the abnormal cytoplasmic localization of Caz. Based on these results, we propose a model in which Caz knockdown-induced abnormal pre-piRNAs associate with Caz, then translocate and accumulate in the cytoplasm, a process that may be mediated by Aub. The novel roles for Caz and Aub demonstrated herein using the Caz -knockdown fly will contribute to a deeper understanding of the pathogenesis of ALS. [ABSTRACT FROM AUTHOR]

We conducted a prospective observational study investigating the clinical relevance of endometrial thickness (ET) and abnormal uterine bleeding (AUB) on endometrial cancer (EC) risk in a cohort of postmenopausal patients undergoing diagnostic hysteroscopy and endometrial biopsy. Patients were divided into two groups according to the indication of diagnostic hysteroscopy: ET_Group (asymptomatic patients with endometrial thickness ≥ 4 mm) and AUB_Group (patients with a history of abnormal uterine bleeding). We further divided the AUB_Group into two subgroups based on endometrial thickness (AUB_Subgroup1: ET < 4 mm; AUB_Subgroup2: ET ≥ 4 mm). The primary outcome was the risk of endometrial cancer and atypical hyperplasia according to the indications of diagnostic hysteroscopy (AUB, ET ≥ 4 mm or both). The secondary outcome was to determine the best cut-off value of endometrial thickness to predict endometrial cancer in asymptomatic postmenopausal women. The prevalence of endometrial cancer and atypical hyperplasia in AUB_Group and ET_Group was 21% and 6.7% respectively. As well as for EC alone, higher prevalence of both conditions was observed in AUB_Subgroup2 (29.3%) in comparison to AUB_Subgroup1 (10.6%; p < 0.001). In asymptomatic patients the cut-off of endometrial thickness that showed the best sensitivity and specificity to diagnose endometrial cancer (100% and 80% respectively) was 11 mm (AUC of 91.4%; Expβ: 1067; CI 95%). In conclusion, considering the high risk of neoplasia, diagnostic hysteroscopy with endometrial biopsy should be mandatory in cases of abnormal uterine bleeding in postmenopausal patients. Moreover, we want to emphasize the need for further evidence stating the clinical relevance of endometrial thickness value in asymptomatic patients and the impact of individual risk factors on endometrial cancer development.

Heavy menstrual bleeding (HMB) or abnormal uterine bleeding (AUB) is a common cause of gynecological complaints in perimenopausal women. The treatment chosen by most of the women having HMB/AUB in the perimenopausal age group when medical therapy fails is hysterectomy, which unfortunately has significant issues related to safety and long-term quality of life apart from being a burden on the health care system and cost to patients. Minimal access surgical techniques like hysteroscopic targeted therapies are available which are conservative and spare the uterus and major surgery and its complications and sequelae. Hysteroscopic management of HMB is a minimally invasive and targeted approach in diagnosing and treating the pathological lesions causing the symptoms and not radical like hysterectomy which has more chances of occurrence of adverse events both intra and postoperatively. In terms of health-related quality of life, women suffering from HMB who underwent a hysteroscopic conservative approach had better scores when compared to those with hysterectomy. The present review aims to review the evidence generated to compare the two surgical modalities, hysteroscopic targeted therapy and hysterectomy, in terms of their effectiveness, safety, and effect on the quality of life of these perimenopausal women having HMB/AUB., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Acharya et al.)