Objective: The aim of this work is to compare between intraoperative frozen section and scrape smear cytology in the diagnosis of ovarian neoplasm. Method: This study was performed between March 2011 and March 2012, o...Objective: The aim of this work is to compare between intraoperative frozen section and scrape smear cytology in the diagnosis of ovarian neoplasm. Method: This study was performed between March 2011 and March 2012, on 50 patients presented with ovarian mass. Gross examination of the tumor removed was done by inspection and palpation. The specimen was then cut with a sharp knife into two halves. The area was scraped with a sharp scalpel or the end of a glass slide, depending upon the type of tissue. A semifluid drop thus obtained was spread over a glass slide. One to four slides per case were taken from different representative areas. The slides were labelled and immediately put into 95% ethyl alcohol and stained with hematoxylin-eosin. The specimens were then fixed in formalin. Paraffin blocks of the sections were processed in the routine way and sections were stained with hematoxylin and eosin (H and E). Assessment of the overall accuracy of the intraoperative diagnosis was classified as concordant or discordant. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of benign ovarian masses were 100%, 95.2%, 96.7%, 100% and 98% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of border line ovarian masses were 100%, 93.4%, 25%, 100% and 94% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of malignant ovarian masses were 80%, 100%, 100%, 88.2% and 92% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of benign ovarian masses were 100%, 100%, 100%, 100% and 100% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of borderline ovarian masses were 100%, 95.9%, 33.3%, 100% and 96% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of malignant ovarian masses were 90%, 100%, 100%, 93.8% and 96% respectively. Conclusion: Frozen section is more accurate than smear preparations in the intraoperative assessment of ovarian tumors in this study. However, the cytology preparations were helpful in supporting the histological diagnoses, and in some cases, provided additional useful information. Thus, cytology has a complementary role to frozen section in the intraoperative assessment of ovarian lesions. At the centers where the facilities of frozen section are not available, intraoperative scrape cytology is a useful tool for intraoperative diagnosis of tumor.展开更多
Objective: The aim of the work is to evaluate the accuracy of intraoperative frozen section in the diagnosis of ovarian neoplasms in Zagazig University. Design: A prospective cross sectional cohort study. Method: This...Objective: The aim of the work is to evaluate the accuracy of intraoperative frozen section in the diagnosis of ovarian neoplasms in Zagazig University. Design: A prospective cross sectional cohort study. Method: This study was performed between March 2011 and March 2012, on 50 patients presented with ovarian mass. Gross examination of the tumor removed was done by inspection and palpation. The specimen was then cut with a sharp knife into two halves. The most appropriate area thought to be representative of lesion was chosen. The number of sections frozen was depended on the type and size of the tumor. Seven to eight μm sections were obtained and stained with hematoxylin-eosin. The specimens were then fixed in formalin. Paraffin blocks of the sections were processed in the routine way and sections were stained with hematoxylin and eosin (H and E). The diagnosis obtained by intraoperative frozen section based on cellularity and cell morphology was compared with final histopathological diagnosis in terms of diagnostic sensitivity, to differentiate between benign and malignant lesions. Assessment of the overall accuracy of the intraoperative diagnosis was classified as concordant or discordant. Results: There was no statisticaly significant differencre in the studied patients as regard the clinical data, macroscopic and intraoperative picture, while there was statisticaly significat association as regard the laterality of the ovarian masses. The validity of frozen section in the diagnosis of benign tumour was 100% with 100% accuracy, specificity, positive predictive value, negative predictive value, while sensitivity & negative prediction for borderline tumour and specificity & positive prediction of malignant tumour were 100%, specifecity for borderline tumours was 95% while the positive predictive value was 33.3% with 96% accuracy for both malignant and borderline tumours. Conclusion: Intraoperative frozen section is accurate for rapid diagnosis of ovarian tumors. It can help surgeons avoid under-treatment or overtreatment of patients. Our study was designed prospectively using a small number of patients. The door is open to larger studies using a larger number of patients to be performed in order to substantiate our results.展开更多
Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D trans...Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D transvaginal power Doppler ultrasonography.?Design: A prospective cross sectional cohort study. Method: This is a prospective cross-sectional cohort study of 90 stimulated IUI treatment cycles. Selected women were prescribed clomiphene citrate combined with highly purified urinary follicle stimulating hormone. All patients underwent serial transvaginal ultrasound scans starting from day 6 to 7 of the cycle. Perifollicular Doppler blood flows were assessed in dominant follicles ≥18 mm. The patients then were categorized into 3 groups (high vascularity group {G3 & G4}, low vascularity group {G1 & G2} and mixed grades group). Other parameters measured included number of follicles ≥ 18 mm in both ovaries, endometrial thickness and estradiol (E2) level . Human chorionic gonadotropin (hCG) injection 10,000 IU IM was given to the patient when the dominant follicle reached 18 mm in diameter. At that time, the endometrium was evaluated as regards endometrial thickness. IUI was carried out using prepared/“washed” semen (husband). All patients received luteal support in the form of progesterone from day of IUI for 14 days. Serum Β-hCG was estimated 2 weeks after insemination. Results: In this study, from all 90 cases only 8 cases got pregnant with pregnancy rate of 8.88% (6 cases got pregnant in high grade vascularity group;2 cases in mixed grades group and no cases got pregnant?in low grade group). There was statistically significant difference among the 3 groups as regarding?the pregnancy rate (P value = 0.02). There is statistically significant difference in perifollicular resistance index (RI) and pulsatility index (PI) between pregnant and non pregnant cases (P value = 0.016 and 0.047 respectively). In this study, there is no statistically significant difference between pregnant and non pregnant cases as regarding endometrial thickness and E2 level at the day of hCG administration (P value = 0.39 and 0.76 respectively). Conclusion: Perifollicular blood-flow assessment by 2D transvaginal power Doppler is a good predictive for the outcome of stimulated IUI cycles.展开更多
Objective: The aim of this study is to evaluate the acute and long-term effects of female genital mutilation (FGM) among women in Sharkia Governorate. Method: This was a cross-sectional descriptive study carried out i...Objective: The aim of this study is to evaluate the acute and long-term effects of female genital mutilation (FGM) among women in Sharkia Governorate. Method: This was a cross-sectional descriptive study carried out in Zagazic University Hospital (ZUH) over a two years period from January 2012 to January 2014. The overall sample consisted of 1500 women. An interview was utilized to collect the necessary data. The questionnaires were administered face to face, in Arabic language. Four open and 25 close-ended questions were used to collect socio-demographic data of the sample: women’s experience about the circumcision, occurrence of health hazards after circumcision, and sexual effects on married women. Intention of all women (circumcised or not) to circumcise?their daughters was also documented. Results: This study revealed that the prevalence of FGM in?Sharkia Governorate was about 85.5%. The majority of circumcised women were Muslims (94.4%), married (87.9%), housewife (81.4%), illiterate or with low education level (45.5% and 38.5% respectively) and from rural areas (82.2%). The most common types of FGM were type I (49.2%) and type II (50.8%). The most common motive of FGM was the religious cause (46.6%). The majority of circumcised women (59%) denied the occurrence of any acute complication. The reported acute complications in this study were bleeding (19.6%), urine retention (2.3%), infection (6.3%) and difficult walking (12.8%). The majority of circumcised women (86%) denied the occurrence of any problems at labor related to circumcision. The reported problems at labor in this study were narrowing of introitus (8.4%), laceration (0.7%) and bleeding (4.9%). In this study, 74.6% of circumcised women believed that there was no effect of circumcision on their sexual satisfaction and 92.1% of circumcised women believed that there was no effect of circumcision on their husband’s sexual satisfaction. Approximately 16% of circumcised women complained of dyspareunia and believed that it was related to circumcision. Conclusion: Female circumcision is deeply rooted in our community and laws alone will not eradicate it. Moreover, this approach may drive it underground. Increased media coverage, statements by ministers, religious leaders and non-governmental organizations may lead to increased discussion of the topic at a local level. Spreading the message by means of pictures, song and drama as well as economic development will be more effective.展开更多
文摘Objective: The aim of this work is to compare between intraoperative frozen section and scrape smear cytology in the diagnosis of ovarian neoplasm. Method: This study was performed between March 2011 and March 2012, on 50 patients presented with ovarian mass. Gross examination of the tumor removed was done by inspection and palpation. The specimen was then cut with a sharp knife into two halves. The area was scraped with a sharp scalpel or the end of a glass slide, depending upon the type of tissue. A semifluid drop thus obtained was spread over a glass slide. One to four slides per case were taken from different representative areas. The slides were labelled and immediately put into 95% ethyl alcohol and stained with hematoxylin-eosin. The specimens were then fixed in formalin. Paraffin blocks of the sections were processed in the routine way and sections were stained with hematoxylin and eosin (H and E). Assessment of the overall accuracy of the intraoperative diagnosis was classified as concordant or discordant. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of benign ovarian masses were 100%, 95.2%, 96.7%, 100% and 98% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of border line ovarian masses were 100%, 93.4%, 25%, 100% and 94% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of malignant ovarian masses were 80%, 100%, 100%, 88.2% and 92% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of benign ovarian masses were 100%, 100%, 100%, 100% and 100% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of borderline ovarian masses were 100%, 95.9%, 33.3%, 100% and 96% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of malignant ovarian masses were 90%, 100%, 100%, 93.8% and 96% respectively. Conclusion: Frozen section is more accurate than smear preparations in the intraoperative assessment of ovarian tumors in this study. However, the cytology preparations were helpful in supporting the histological diagnoses, and in some cases, provided additional useful information. Thus, cytology has a complementary role to frozen section in the intraoperative assessment of ovarian lesions. At the centers where the facilities of frozen section are not available, intraoperative scrape cytology is a useful tool for intraoperative diagnosis of tumor.
文摘Objective: The aim of the work is to evaluate the accuracy of intraoperative frozen section in the diagnosis of ovarian neoplasms in Zagazig University. Design: A prospective cross sectional cohort study. Method: This study was performed between March 2011 and March 2012, on 50 patients presented with ovarian mass. Gross examination of the tumor removed was done by inspection and palpation. The specimen was then cut with a sharp knife into two halves. The most appropriate area thought to be representative of lesion was chosen. The number of sections frozen was depended on the type and size of the tumor. Seven to eight μm sections were obtained and stained with hematoxylin-eosin. The specimens were then fixed in formalin. Paraffin blocks of the sections were processed in the routine way and sections were stained with hematoxylin and eosin (H and E). The diagnosis obtained by intraoperative frozen section based on cellularity and cell morphology was compared with final histopathological diagnosis in terms of diagnostic sensitivity, to differentiate between benign and malignant lesions. Assessment of the overall accuracy of the intraoperative diagnosis was classified as concordant or discordant. Results: There was no statisticaly significant differencre in the studied patients as regard the clinical data, macroscopic and intraoperative picture, while there was statisticaly significat association as regard the laterality of the ovarian masses. The validity of frozen section in the diagnosis of benign tumour was 100% with 100% accuracy, specificity, positive predictive value, negative predictive value, while sensitivity & negative prediction for borderline tumour and specificity & positive prediction of malignant tumour were 100%, specifecity for borderline tumours was 95% while the positive predictive value was 33.3% with 96% accuracy for both malignant and borderline tumours. Conclusion: Intraoperative frozen section is accurate for rapid diagnosis of ovarian tumors. It can help surgeons avoid under-treatment or overtreatment of patients. Our study was designed prospectively using a small number of patients. The door is open to larger studies using a larger number of patients to be performed in order to substantiate our results.
文摘Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D transvaginal power Doppler ultrasonography.?Design: A prospective cross sectional cohort study. Method: This is a prospective cross-sectional cohort study of 90 stimulated IUI treatment cycles. Selected women were prescribed clomiphene citrate combined with highly purified urinary follicle stimulating hormone. All patients underwent serial transvaginal ultrasound scans starting from day 6 to 7 of the cycle. Perifollicular Doppler blood flows were assessed in dominant follicles ≥18 mm. The patients then were categorized into 3 groups (high vascularity group {G3 & G4}, low vascularity group {G1 & G2} and mixed grades group). Other parameters measured included number of follicles ≥ 18 mm in both ovaries, endometrial thickness and estradiol (E2) level . Human chorionic gonadotropin (hCG) injection 10,000 IU IM was given to the patient when the dominant follicle reached 18 mm in diameter. At that time, the endometrium was evaluated as regards endometrial thickness. IUI was carried out using prepared/“washed” semen (husband). All patients received luteal support in the form of progesterone from day of IUI for 14 days. Serum Β-hCG was estimated 2 weeks after insemination. Results: In this study, from all 90 cases only 8 cases got pregnant with pregnancy rate of 8.88% (6 cases got pregnant in high grade vascularity group;2 cases in mixed grades group and no cases got pregnant?in low grade group). There was statistically significant difference among the 3 groups as regarding?the pregnancy rate (P value = 0.02). There is statistically significant difference in perifollicular resistance index (RI) and pulsatility index (PI) between pregnant and non pregnant cases (P value = 0.016 and 0.047 respectively). In this study, there is no statistically significant difference between pregnant and non pregnant cases as regarding endometrial thickness and E2 level at the day of hCG administration (P value = 0.39 and 0.76 respectively). Conclusion: Perifollicular blood-flow assessment by 2D transvaginal power Doppler is a good predictive for the outcome of stimulated IUI cycles.
文摘Objective: The aim of this study is to evaluate the acute and long-term effects of female genital mutilation (FGM) among women in Sharkia Governorate. Method: This was a cross-sectional descriptive study carried out in Zagazic University Hospital (ZUH) over a two years period from January 2012 to January 2014. The overall sample consisted of 1500 women. An interview was utilized to collect the necessary data. The questionnaires were administered face to face, in Arabic language. Four open and 25 close-ended questions were used to collect socio-demographic data of the sample: women’s experience about the circumcision, occurrence of health hazards after circumcision, and sexual effects on married women. Intention of all women (circumcised or not) to circumcise?their daughters was also documented. Results: This study revealed that the prevalence of FGM in?Sharkia Governorate was about 85.5%. The majority of circumcised women were Muslims (94.4%), married (87.9%), housewife (81.4%), illiterate or with low education level (45.5% and 38.5% respectively) and from rural areas (82.2%). The most common types of FGM were type I (49.2%) and type II (50.8%). The most common motive of FGM was the religious cause (46.6%). The majority of circumcised women (59%) denied the occurrence of any acute complication. The reported acute complications in this study were bleeding (19.6%), urine retention (2.3%), infection (6.3%) and difficult walking (12.8%). The majority of circumcised women (86%) denied the occurrence of any problems at labor related to circumcision. The reported problems at labor in this study were narrowing of introitus (8.4%), laceration (0.7%) and bleeding (4.9%). In this study, 74.6% of circumcised women believed that there was no effect of circumcision on their sexual satisfaction and 92.1% of circumcised women believed that there was no effect of circumcision on their husband’s sexual satisfaction. Approximately 16% of circumcised women complained of dyspareunia and believed that it was related to circumcision. Conclusion: Female circumcision is deeply rooted in our community and laws alone will not eradicate it. Moreover, this approach may drive it underground. Increased media coverage, statements by ministers, religious leaders and non-governmental organizations may lead to increased discussion of the topic at a local level. Spreading the message by means of pictures, song and drama as well as economic development will be more effective.
