III.

The objective of this study was to evaluate the treatment outcomes and complications in human immunodeficiency virus (HIV)-infected women undergoing loop electrosurgical excision procedure (LEEP) for cervical neoplasia. The medical record of 60 evaluable HIV-infected women who had abnormal Papanicolaou (Pap) smear and underwent LEEP following colposcopy at Chiang Mai University Hospital between May 1998 and June 2004 was reviewed. Thirty-one (51.7%) had associated genital infection at screening. Twenty-five (41.7%) had opportunistic infection, but only 18 (30.0%) were treated with antiretroviral therapy. The most common abnormal Pap smear was high-grade squamous intraepithelial lesion (46.7%), followed by low-grade squamous intraepithelial lesion (40.0%). Forty (66.7%) women had clear surgical margins after LEEP. Only one (1.7%) woman had severe intraoperative hemorrhage. Early and late postoperative hemorrhage were noted in three (5%) women of each period. Localized infection of the cervix was detected in seven (11.7%) women. Two (3.3%) women developed cervical stenosis at 6 months after LEEP. There was no significant difference in overall complications between HIV-infected women and the control group (P= 0.24). Among 60 HIV-infected women, no statistical difference in the rate of margins involvement (P= 1.00) and complications (P= 0.85) could be demonstrated between HIV-infected women who received antiretroviral therapy and those who did not. Disease-free rate at 6 and 12 months were 97.1% and 88%, respectively. These data demonstrated that LEEP appears to be safe and effective in HIV-infected women.

OFT has high sensitivity in detection of alpha-thalassemia-1 trait or beta-thalassemia trait and due to its simplicity with very low cost it may, therefore, be considered as a screening test in a wide population.

Objective:To compare the diagnostic accuracy of International Ovarian Tumor Analysis (IOTA) simple rules and risk of malignancy index (RMI 1/RMI 2) scoring to discriminate between benign and malignant adnexal masses.Methods: Secondary analysis of a cohort of patients scheduled for surgery for adnexal masses in a tertiary center between April 2010 and March 2018. Ultrasound examinations were performed by general gynecologists within 24 hours prior to surgery to evaluate sonographic features. Demographic data and preoperative CA 125 levels were recorded. IOTA rules and RMI scoring were applied to predict malignancy and prospectively recorded. Final diagnosis was based on pathological or intraoperative diagnosis. Results:A total of 479 masses met the inclusion criteria and were retrieved from the database: 334 (69.7%) benign and 145 (30.3%) malignant. IOTA rules could be applied to 392 (81.8%) masses and were inconclusive in 87 (18.2%). Sensitivity and specificity of IOTA rules (83.8% and 92.0%, respectively) were significantly higher than RMI 1 (77.2% and 86.8%, respectively) and RMI 2 (82.1% and 82.6%, respectively).Conclusion: IOTA simple rules had higher diagnostic accuracy compared with RMI to discriminate between benign and malignant adnexal masses; however, nearly 20% of IOTA results were inconclusive and needed expert consultation. K E Y W O R D SBenign adnexal mass; International Ovarian Tumor Analysis (IOTA) simple rules; Malignant adnexal mass; Risk of malignancy index (RMI); Ultrasound

The objectives were to describe our nerve-sparing class III radical hysterectomy technique and assess the feasibility and safety of the procedure as well as its impact on voiding function. From January to August 2005, 21 consecutive patients with FIGO stage IB-IIA cervical cancer and 1 patient with clinical stage II endometrial cancer underwent nerve-sparing radical hysterectomy with systematic pelvic lymphadenectomy. The transurethral catheter was removed on the seventh postoperative day. Then intermittent self-catheterization was performed and post-void residual urine volume (PVR) was recorded. The nerve-sparing procedure was completed successfully and safely in all of the patients. Eight (36%) and 6 (27%) patients had the PVR of < 100 ml and < 50 ml respectively at the initial removal of the catheter. On the fourteenth day, 82% and 77% of the patients had the PVR of < 100 ml and < 50 ml, respectively. The mean duration before the PVR became < 50 ml was 11.27 (5-26) days. In conclusion, the technique described in this preliminary study appears safe, adequate, and feasible in our population with satisfactory recovery of voiding function. A larger comparative study is needed on long-term urinary, bowel, and sexual function as well as recurrence and survival.