Evaluation of expression of biomarkers of PLAGL1 (ZAC1), microRNA, and their non-coding RNAs in patients with endometriosis.

Since the PLAGL1 (ZAC1) gene is expressed in the human endometrium. It may be involved in the etiology of endometrial disorders by its abnormal regulation and expression. This study aimed to investigate the Zac1 gene and related microRNA and LncRNA and its alterations in patients with endometriosis. Blood plasma, ectopic (EC) and eutopic (EU) endometrial samples were gathered from 30 patients with endometriosis and 30 healthy fertile women, and the Q-PCR technique was used to determine the expression level of Zac1 mRNA and microRNAs (miR-1271-5p, hsa-miR-490-3pin) and LncRNAs (TONSL-AS1 TONSL, KCNQ1OT1 KCNQ1). According to the results, the Zac1 gene and KCNQ1OT1 KCNQ1, TONSL-AS1 TONSL LncRNA expression were significantly decreased in the endometriosis group versus the control group (P < 0.05). MiR-1271-5p and hsa-miR-490-3pin microRNA expression were significantly raised in the endometriosis group as opposed to the control group (P < 0.05). In summary, this research for the first time revealed that identifying Zac1 expression provides us with new indicators for evaluating endometriosis.

Surviving surgery; succumbing to pharmacotherapy: A case report underscoring the importance of PRN order clarification for patient safety.

"Pro re nata" (PRN) or "as needed" medicine administration and usage is a relatively neglected area in medication management (pharmacotherapy/pharmaceutical care) which contributes to error-prone use of medications and is unsafe for patients. In this case, we report the incident of diclofenac toxicity in a 51-year-old woman due to a prescription of 100 mg diclofenac suppositories PRN, or as needed, for postoperative pain control without explanation of the maximum daily dose (150 mg daily), which led to arbitrary consumption of 3 g of diclofenac over 5 days (600 mg daily) by the patient, and subsequent development of metabolic acidosis, acute kidney injury, and sudden cardiac arrest. The implementation of practical guidelines and training programs for health care workers to appropriately prescribe, dispense, and administer PRN medicines are necessary, and should at least include providing clarification for their indication, dose and frequency, as well as any cautionary instructions to ensure safe and effective use of such medicines.

A rare case of primary ovarian mesenchymal chondrosarcoma in pregnancy.

Mesenchymal chondrosarcoma is a rare tumor that is more common in young people; it is an uncommon type of chondrosarcoma with a poor prognosis. In two-thirds of cases, it affects the bone, especially the spine. However, parts of the body other than the skeletal system are occasionally involved. These rarer types have a worse prognosis, with a high likelihood of metastasis and death. Due to the possible misdiagnosis of mesenchymal chondrosarcoma, the integrated use of imaging, immunohistochemistry, and pathology can be helpful.

Evaluation of the diagnostic accuracy of the cervical biopsy under colposcopic vision.

This study was conducted to evaluate the diagnostic accuracy of the cervical biopsy under colposcopic vision. This retrospective study was performed on 190 women, who were selected from a total of 412 cases referring for colposcopy in one year. All patients underwent colposcopy and loop electrosurgical excision procedure (LEEP). After the investigation of demographic characteristics and data confirmation, colposcopic characteristics were examined. Then, the diagnostic indicators and diagnostic accuracy of the cervical biopsy under colposcopic vision were determined. The mean age of patients was 35.51± 5.91 years. In smokers, the percentage of cancer and CIN3 cases was higher than in normal individuals, and this difference was statistically significant in terms of the frequency of cancerous lesions (P = 0.2). A comparison of colposcopic biopsy with LEEP has shown that the frequency of advanced cases in LEEP has been detected more, and the correlation coefficient (kappa) indicated the weak agreement between the findings of colposcopically directed biopsy (CDB) and LEEP methods. (k = 0.23). The diagnostic accuracy of the cervical biopsy under colposcopic vision for cervical cancer is effectively high. It is recommended that this procedure be performed to diagnose cancerous lesions; however, contrary to what is seen in colposcopy, malignant cases may be spreading and follow-up of patients can affect therapeutic performance.

Predicting value of HE4 and CA125 markers for optimal cytoreductive surgery in ovarian cancer patients.

We conducted a cross-sectional study to evaluate the role of serum levels of CA125 and HE4 in predicting optimal cytoreductive surgery. Eligible women who had been diagnosed with ovarian cancer based on both clinical and imaging criteria were enrolled in this study. Serum levels of CA 125 and HE4 were checked before surgery and all patients underwent complete surgical staging. After completion of the pathological evaluation, data were entered in SPSS version 23. One hundred and ten individuals were enrolled in our study. We divided cases between two groups: stage I to III b and stage IIIc to IV. Serum level of HE4 >170 pmol/L can predict optimal cytoreductive surgery before operation. (sensitivity:80% and specificity 70%) and serum level of CA 125 > 320 UI/mL can predict optimal cytoreductive surgery before operation. (sensitivity:80% and specificity 70%). Our data demonstrated a negative predictive value of about 80% for both HE4 and CA125. Based on these cut-off, unnecessary surgery can be avoided in many cases, however, it is unwise to ignore clinical performance and radiological findings. Nevertheless, we can say the evaluation of tumor markers is feasible and helpful in predicting optimal surgery.

The effect of N-acetyl cysteine on the volume of uterine leiomyoma: A randomized clinical trial.

OBJECTIVE: To conduct a clinical trial to investigate the effect of N-acetyl cysteine (NAC), a non-hormonal drug, on the volume of leiomyoma, the most common benign tumor in women. METHODS: This study is a randomized clinical trial, which was performed in Semnan, Iran. Eligible women who were diagnosed with uterine leiomyoma using vaginal ultrasound were randomly assigned to receive NAC or placebo for 12 weeks. The change in the volume of Leiomyoma was considered to be the main variable in the efficacy evaluation. Reduction in the leiomyoma volume was calculated after intervention and data were entered in SPSS version 23. RESULTS: Fifty individuals were enrolled in our study. 25 women received NAC, while 25 women took placebo. The mean volume of leiomyoma in group A was 5.71 cm3 and in group B was 6.56 cm3 . The mean rate of volume reduction in the A and B groups was 25.25 % and 1.08 %, respectively, which demonstrated a significant difference between the two groups (P < 0.004). CONCLUSION: Although this trial recommends the use of NAC as a non-hormonal drug in the treatment of leiomyoma of the uterus, the possibility of treatment failure in controlling abnormal uterine bleeding cannot be ignored. Nevertheless, we can say it is feasible and effective in the reduction of leiomyoma volume.