Enhancement of Levator Ani Muscle Strength in Postpartum Women: The Impact of Pelvic Floor Muscle Training.

BACKGROUND Levator ani muscle injuries during vaginal childbirth can lead to pelvic organ prolapse (POP). Pelvic floor muscle training (PFMT) is an effective conservative approach to alleviate these symptoms. This study aimed to compare outcomes with and without 3 months of PFMT in 34 women with levator ani muscle injury following vaginal delivery. MATERIAL AND METHODS In a quasi-experimental study, 34 postpartum women were divided into 2 groups: one received PFMT along with home-based materials and regular follow-ups, while the other served as the control. We measured basal tone and maximal levator ani muscle contraction using the Peritron perineometer and assessed changes after 3 months. RESULTS The basal tone and maximal contraction of the levator ani muscle significantly increased following a 3-month intervention period both in PFMT and control group (P=0.0001). The maximal contraction of the levator ani muscle after a 3-month intervention period was significantly higher in PFMT group compared with control group (36.59±1.45 vs 27.76±13.35, P=0.0001), respectively. A significant positive correlation was found between basal tone and maximal contraction (r=0.806, P=0.0001). CONCLUSIONS A 3-month PFMT program effectively increased levator ani muscle strength in postpartum women compared to those who did not undergo PFMT.

Predicting Chemotherapy Resistance in Gestational Trophoblastic Neoplasia: Ratio of Neutrophils, Lymphocytes, Monocytes, and Platelets.

BACKGROUND Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) have recently been used as inflammatory biomarkers for cancer patients. This study aims to determine the role of pretreatment NLR, LMR, and PLR in predicting chemoresistance in gestational trophoblastic neoplasia (GTN) patients. MATERIAL AND METHODS A total of 129 low-risk and high-risk GTN patients who had received first-line chemotherapy were enrolled in this historical cohort study. The pretreatment NLR, LMR, and PLR values were analyzed to predict the resistance to first-line chemotherapy in low-risk and high-risk GTN patients. RESULTS Chemoresistant patients had significantly higher NLR than chemosensitive patients in low-risk and high-risk GTN patients (P<0.05). In high-risk GTN, patients with lower LMR and higher PLR tended to have chemoresistance to first-line chemotherapy (P=0.008, P=0.001). Univariate analysis revealed that the NLR, LMR, and PLR cut-off points of 2.654, 3.8, and 192.174, respectively, were associated with chemoresistance in high-risk GTN (P=0.0001, P=0.011, P=0.0001). The combination of NLR, PLR, and FIGO score in high-risk GTN was the best combination among other combinations with cut-off value >17 (P=0.001). CONCLUSIONS Higher NLR, lower LMR, and higher PLR were associated with chemoresistance for high-risk GTN patients. Furthermore, NLR, LMR, and PLR can improve the accuracy of predicting resistance to first-line chemotherapy in high-risk GTN.

Nomogram development for predicting ovarian tumor malignancy using inflammatory biomarker and CA-125.

Global challenges in ovarian cancer underscore the need for cost-effective screening. This study aims to assess the role of pretreatment Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte-Ratio (LMR), Platelet-to-Lymphocyte Ratio (PLR), and CA-125 in distinguishing benign and malignant ovarian tumors, while also constructing nomogram models for distinguish benign and malignant ovarian tumor using inflammatory biomarkers and CA-125. This is a retrospective study of 206 ovarian tumor patients. We conducted bivariate analysis to compare mean values of CA-125, LMR, NLR, and PLR with histopathology results. Multiple regression logistic analysis was then employed to establish predictive models for malignancy. NLR, PLR, and CA-125 exhibited statistically higher levels in malignant ovarian tumors compared to benign ones (5.56 ± 4.8 vs. 2.9 ± 2.58, 278.12 ± 165.2 vs. 180.64 ± 89.95, 537.2 ± 1621.47 vs. 110.08 ± 393.05, respectively), while lower LMR was associated with malignant tumors compared to benign (3.2 ± 1.6 vs. 4.24 ± 1.78, p = 0.0001). Multiple logistic regression analysis revealed that both PLR and CA125 emerged as independent risk factors for malignancy in ovarian tumors (P(z) 0.03 and 0.01, respectively). Utilizing the outcomes of multiple regression logistic analysis, a nomogram was constructed to enhance malignancy prediction in ovarian tumors. In conclusion, our study emphasizes the significance of NLR, PLR, CA-125, and LMR in diagnosing ovarian tumors. PLR and CA-125 emerged as independent risk factors for distinguishing between benign and malignant tumors. The nomogram model offers a practical way to enhance diagnostic precision.

Comparison of glutaminase and cancer antigen 125 for distinguishing benign and malignant ovarian tumors.

Increasing demand for glutaminase (GLS) due to high rates of glutamine metabolism is considered one of the hallmarks of malignancy. In parallel, cancer antigen 125 (CA-125) is a commonly used ovarian tumor marker. This study aimed to compare the roles of GLS and CA-125 in distinguishing between benign and malignant ovarian tumors. The research was conducted as a comparative study, enrolling 156 patients with ovarian tumors. Preoperative serum CA-125 and GLS levels were analyzed to evaluate their effectiveness in distinguishing between benign and malignant ovarian tumors. The results revealed that the mean levels of CA-125 and GLS were significantly higher in malignant ovarian tumors compared with benign ones (389.54 ± 494.320 vs. 193.15 ± 529.932 (U/mL) and 17.37 ± 12.156 vs. 7.48 ± 4.095 (µg/mL), respectively). The CA-125 and GLS cutoff points of 108.2 U/mL and 18.32 µg/mL, respectively, were associated with malignant ovarian tumors. Multivariate analyses showed that GLS had higher predictive capabilities compared with CA-125 (odds ratio 9.4 vs. 2.1). The accuracy of using GLS combined with CA-125 was higher than using CA-125 alone (73.1% vs. 68.8%). In conclusion, higher levels of CA-125 and GLS are associated with malignant ovarian tumors. GLS outperforms CA-125 in distinguishing between benign and malignant ovarian tumors. The combination of GLS and CA-125 demonstrated improved accuracy for distinguishing benign and malignant ovarian tumors when compared with using CA-125 alone.