Introduction: Paget’s disease of the vulva (PDV) is a very rare malignancy originating in vulvar apocrinegland-bearing skin cells. Based on multi centric nature of Paget’s disease, it’s a chronic and relapsing course. The aim of this report is to introduce a case of multi centric Paget’s disease and review of literature. Case report: A 62-year-old woman with complaints of vulvar pruritus, painful vulvar lesion for 4 years was referred to oncology department of Ghaem hospital, Mashhad University of Medical Sciences in 2016. Pathological results of erythematous and exfoliated lesion of the major and minor labia extend to anus was reported as PDV with full-thickness involvement. In investigations, she had persistent hematuria. Pelvis and abdomen investigation revealed irregularity in the posterior wall of the bladder and biopsy detected urothelial carcinoma in the bladder. Radical cystectomy was performed subsequently. In addition, complete response of vulvar lesion to imiquimod cream was seen after 6 weeks of therapy. The patient is free of disease and now she is under serial follow-up. Conclusion: Generally standard treatment modality in patients who experienced multicenteric Paget’s disease is surgical resection, also topical 5% imiquimod cream may be considered as an alternative option in setting metastatic vulvar Paget.

Stem cells isolated from menstrual fluid have mesenchymal stem cell like properties and have multi lineage differentiation capacity. Menstrual fluid has ease of access in collection and repeated sampling is possible in a noninvasive manner. Also, rapid culture of these is possible in numbers that are sufficient for therapeutic use. They are, hence, looked upon as a novel innovation and are finding a place in the current medicine practice

Introduction: Paget’s disease of the vulva (PDV) is a very rare malignancy originating in vulvar apocrinegland-bearing skin cells. Based on multi centric nature of Paget’s disease, it’s a chronic and relapsing course. The aim of this report is to introduce a case of multi centric Paget’s disease and review of literature. Case report: A 62-year-old woman with complaints of vulvar pruritus, painful vulvar lesion for 4 years was referred to oncology department of Ghaem hospital, Mashhad University of Medical Sciences in 2016. Pathological results of erythematous and exfoliated lesion of the major and minor labia extend to anus was reported as PDV with full-thickness involvement. In investigations, she had persistent hematuria. Pelvis and abdomen investigation revealed irregularity in the posterior wall of the bladder and biopsy detected urothelial carcinoma in the bladder. Radical cystectomy was performed subsequently. In addition, complete response of vulvar lesion to imiquimod cream was seen after 6 weeks of therapy. The patient is free of disease and now she is under serial follow-up. Conclusion: Generally standard treatment modality in patients who experienced multicenteric Paget’s disease is surgical resection, also topical 5% imiquimod cream may be considered as an alternative option in setting metastatic vulvar Paget.

Background: The aim of this study was to evaluate ovarian damage following laparoscopic endometrioma cystectomy using ultrasound and pathologic samples. Materials and Methods: This is a prospective cohort study in General Women Hospital affiliated to Tehran University of Medical Sciences. 40 patients with endometrioma, total of 44 cysts including bilateral cysts, underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound. Results: Mean antral follicle count (AFC) before the operation was 4 ± 1.29 and after operation was1.64 ± 1.03. The reduction in AFC after cystectomy was statistically significant (P <0.000), and with each 1 centimeter increase in cyst diameter a reduction of AFC averaging 0.421 was observed. On pathological examination, it was shown that every millimeter of inadvertently excised ovarian tissue and cyst wall fibrosis thickness leads to reduction of 1.06 and 1.2 in AFC respectively. Conclusion: Laparoscopic cystectomy for endometrioma is associated with reduction in ovarian reserve and this reduces proportionally with cyst diameter, amount of normal ovarian parenchyma excised and cyst wall fibrosis.

Objective: The primary goal of this study was to assess the G-CSF effects on IVF outcomes in women with normal endometrial thickness. Patients and Methods: This was a randomized controlled study performed at Assisted Reproductive Techniques Center of Ain Shams University Maternity Hospital, over a 2-year period, between Jan 2014 and Jan 2016, and included 60 infertile women with normal endometrial thickness. Women were scheduled for IVF and randomized into two groups. Exclusion criteria were positive history of repeated implantation failure (RIF), endocrine disorders, severe endometriosis, congenital or acquired uterine anomaly and contraindication for G-CSF (renal disease, sickle cell disease, or malignancy). In G-CSF group (n=30), 300 µg trans-cervical intrauterine of G-CSF was administered at the oocyte retrieval day. Controls (n=30) were treated with standard protocol. Chemical, clinical and ongoing pregnancy rates, implantation rate, and miscarriage rate were compared between groups. Results: Biochemical pregnancy had occurred in 27.3% of participants in group I and 21.3% of women in group II with a significant difference between the two groups. The clinical pregnancy rate was 22% and 16% in group I and II respectively with no significant difference between the two groups. The acceptability of women in group I was 68%, mild discomfort occurred in 44.7%, moderate discomfort was in 28.7%, severe discomfort was in 11.3% and 15.3% of women in group I had no discomfort at all. Difficult flushing had occurred in 14.7% of women.

Background: Antepartum fetal death (AFD) contributes significantly to stillbirths (SB) in low- and middle-income countries (LMIC). Modifying locally-prevalent demographic risk factors could lessen the burden of SB in the region. Objective: This study seeks to identify the prevalence and modifiable socio-demographic risks for antepartum fetal death (AFD) in a Nigerian setting with the aim of recommending appropriate interventions to reduce the burden. Method: Hospital-based 6 year (2009-2014) review of obstetric records at Ekiti State University Teaching Hospital (EKSUTH), Nigeria. Results: Stillbirth (SB) rate was 29/1000 births and AFD rate was 22.5/1000 birth. AFD was more among women with age =20 years (93.8%), who had no antenatal care (83.2%), single (92.3%), with no formal education (95.6%), unskilled occupation (81.1%), parity = 5 (92.3%), those with prior history of SB (81.0%) and Muslims (81.8%). Logistic regression analysis showed that absence of antenatal care (AOR: 3.32, 95% CI: 1.80-6.21, P<0.001) and lack of formal education (AOR: 0.18, 95% CI: 0.03-0.64, P= 0.005) significantly predict likelihood of AFD.