Paratubal cysts can become extremely big before causing symptoms. Torsion is another urgent issue regarding PTCs, necessiating urgent surgery for preservation of the ovary and the tube. Although malignancy is rare, borderline paratubal tumors have been reported in the literature.

Melatonin is a neurohormone secreted mainly by the pineal gland that controls circadian rhythm, which is primarily regulated by light. Although melatonin levels are known to be altered in individuals with sleep disorders, melatonin also has modulatory effects on other body systems, including the skeletal and immune systems. In addition, melatonin has been shown to interfere with carbohydrate and lipid metabolism and to have significant antioxidant effects, both directly and via its metabolites. Melatonin levels vary throughout human life and are known to decrease with age but the effects of declining melatonin levels are poorly understood. In women, this age-related decrease in melatonin levels coincides with the menopause. This review aims to summarize the impact of altered melatonin levels in aging women and the outcomes of exogenous replacement therapies.

Background: Our aim was to compare the therapeutic efficacies of norethisterone acid (NETA), tranexamic acid and levonorgestrel-releasing intrauterine system (LNG-IUS) in treating idiopathic heavy menstrual bleeding (HMB). Methods: Women with heavy uterine bleeding were randomized to receive NETA, tranexamic acid or LNG-IUS for 6 months. The primary outcome was a decrease in menstrual bleeding as assessed by pictorial blood loss assessment charts and hematological parameters analyzed at the 1st, 3rd and 6th months. Health-related quality of life (QOL) variables were also recorded and analyzed. Results: Twenty-eight patients were enrolled in each treatment group, but the results of only 62 were evaluated. NETA, tranexamic acid, and LNG-IUS reduced menstrual blood loss (MBL) by 53.1, 60.8, and 85.8%, respectively, at the 6th month. LNG-IUS was more effective than NETA and tranexamic acid in decreasing MBL. LNG-IUS was also more efficient than tranexamic acid in correcting anemia related to menorrhagia. Satisfaction rates were comparable among the NETA (70%), tranexamic acid (63%) and LNG-IUS (77%) groups. QOL in physical aspects increased significantly in the tranexamic acid and LNG-IUS groups. Conclusion: The positive effect of LNG-IUS on QOL parameters, as well as its high efficacy, makes it a first-line option for HMB.

Abstract:Objective: C-reactive protein (CRP) is a well-known marker of infl ammation and infection in clinical practice. This study is designed to evaluate CRP levels in diff erent phases of menstrual cycle, which might end up with misleading conclusions especially when used for cardiovascular risk assessment. Methods: Twenty-seven women were eligible for the cross-sectional study. Venous blood samples from each participant were collected twice during the menstrual cycle. The fi rst sampling was held at 2nd to 5th days of the menstrual cycle for FSH, estradiol, CRP, and sedimentation, and the second was done at 21st to 24th days of the menstrual cycle for measurement of progesterone, CRP, and sedimentation values. Results: CRP values were signifi cantly higher in the early follicular phase compared to luteal phase (1.8 mg/L [0.3-7.67] vs. 0.7 mg/L [0.1-8.3], p < 0.001, respectively). In both phases of the menstrual cycle, sedimentation rate was similar (12.1 ± 6.7 vs. 12.3 ± 7.7; p = 0.717, respectively). Conclusions: CRP levels in early follicular phase of the menstrual cycle (menstruation) are signifi cantly higher than CRP levels in luteal phase of the same cycle. In reproductive age women, detection of CRP for cardiovascular risk assessment during menstruation might not be appropriate.

The purpose of this study was to investigate whether levels of fetal hypoxia markers, S100 and ischaemia modified albumin (IMA) change in cases of intrauterine growth restriction (IUGR). This case-control study included 15 intrauterine growth restricted fetuses and 20 age-matched controls. During delivery of the fetuses, cord blood and maternal blood S100 and IMA levels were studied. The fetal weight and umbilical cord pH values of IUGR fetuses were significantly lower than the control group. The mean maternal and umbilical cord blood values of S100 and IMA were similar in the two groups. IMA levels in cord blood of the IUGR group were significantly higher than maternal levels, whereas umbilical and maternal levels of IMA did not differ among control cases. In cases without brain sparing effect in Doppler ultrasonography, umbilical cord S100 and IMA levels do not change significantly in IUGR when compared with appropriate-for-gestational-age (AGA) fetuses.