Uterine fibroids (UF), most prevalent gynecological disorder, require surgery when symptomatic. It is estimated that between 25 and 35 percent of women wait until the symptoms have worsened like extended heavy menstrual bleeding and severe pelvic pain. These UF may be reduced in size through various methods such as medical or surgical intervention. Progesterone (prog) is a crucial hormone that restores the endometrium and controls uterine function. In the current study, 28 plant-based molecules are identified from previous literature and docked onto the prog receptors with 1E3K and 2OVH. Tanshinone-I has shown the best docking score against both proteins. The synthetic prog inhibitor Norethindrone Acetate is used as a standard to evaluate the docking outcomes. The best compound, tanshinone-I, was analyzed using molecular modeling and DFT. The RMSD for the 1E3K protein–ligand complex ranged from 0.10 to 0.42 Å, with an average of 0.21 Å and a standard deviation (SD) of 0.06, while the RMSD for the 2OVH protein–ligand complex ranged from 0.08 to 0.42 Å, with an average of 0.20 Å and a SD of 0.06 showing stable interaction. In principal component analysis, the observed eigen values of HPR-Tanshinone-I fluctuate between −1.11 to 1.48 and −1.07 to 1.25 for PC1 and PC2, respectively (1E3K), and the prog-tanshinone-I complex shows eigen values of −38.88 to −31.32 and −31.32 to 35.87 for PC1 and PC2, respectively (2OVH), which shows Tanshinone-I forms a stable protein–ligand complex with 1E3K in comparison to 2OVH. The Free Energy Landscape (FEL) analysis shows the Gibbs free energy in the range of 0 to 8 kJ/mol for Tanshinone-I with 1E3K and 0 to 14 kJ/mol for Tanshinone-I with the 2OVH complex. The DFT calculation reveals ΔE value of 2.8070 eV shows tanshinone-I as a stable compound. 1E3K modulates the prog pathway, it may have either an agonistic or antagonistic effect on hPRs. Tanshinone-I can cause ROS, apoptosis, autophagy (p62 accumulation), up-regulation of inositol requiring protein-1, enhancer-binding protein homologous protein, p-c-Jun N-terminal kinase (p-JNK), and suppression of MMPs. Bcl-2 expression can change LC3I to LC3II and cause apoptosis through Beclin-1 expression. 

https://doi.org/10.1016/j.jsps.2023.05.002

Tanshinone-I for the treatment of uterine fibroids: Molecular docking, simulation, and density functional theory investigations

The state of the reproductive system by women with uterine fibroids is considered as a part of this literature review. The main clinical manifestations of myomatous nodes were identified by writing the review: abnormal uterine and heavy menstrual bleeding, infertility, miscarriage, chronic pelvic pain, dysfunction of adjacent organs, which are indications for surgical treatment. It is noted that approximately 30 % of women with uterine fibroids suffer from abnormal uterine bleeding, leading to anemia and reduced quality of life. Chronic pelvic pain significantly reduces the quality of life of patients, worsening their functional and mental state and disrupting sexual function. This review focuses on reproductive problems in women with leiomyoma. Taking into consideration the high prevalence of this nosology and the need to preserve the fertility of patients, the review describes modern methods of treating patients with uterine myoma, including drug therapy surgical treatment and alternative methods. Currently, in order to stop the symptoms of uterine fibroids, as well as for preoperative preparation, conservative therapy is used, which allows to reduce pain, restore hemoglobin levels, reduce intraoperative blood loss and reduce surgery time. Reproductive disorders associated with uterine fibroids, such as infertility, recurrent miscarriage, and adverse obstetric outcomes, are a significant reason to improve organ-preserving therapies or develop new ones. Although hysterectomy is a radical treatment for uterine fibroids, it is unacceptable for patients who have not realized their reproductive function. Therefore, the most justified intervention is myomectomy with various surgical approaches, and as an alternative treatment, uterine artery embolization, radiofrequency ablation or high-intensity focused ultrasound treatment of uterine fibroids. These data allow us to conclude that the high prevalence and versatility of symptoms of uterine fibroids among patients of reproductive age determine the relevance of searching for optimal methods of treatment.

Uterine fibroids: modern methods of treatment, advantages and complications

Background Myomectomy is often the preferred treatment for symptomatic patients with myomas who wish to preserve their fertility, with a shift from open surgery towards minimally invasive techniques. Objectives Retrospective study assessing patient and surgery characteristics, follow-up, and outcomes of robot-assisted myomectomy (RAM) and abdominal myomectomy (AM) in women treated between January 1, 2018, and February 28, 2022, in a Belgian tertiary care hospital. Materials and Methods A descriptive analysis was conducted on consecutive patients who underwent myomectomies. 2018 was considered the learning curve for RAM. Main Outcome Measures We assessed rate of open surgery, operation time, postoperative hospital stay, and operative complications. Results In total, 94 RAMs and 15 AMs were performed. The rate of AMs was 56.5% in 2018 versus 2.3% after the learning curve. The median operation time for RAM was 136.5 minutes and 131 minutes for AM. Conversion rate for RAM was 0%. The median postoperative hospital stay after RAM was 1 night and 4 nights for AM. Postoperative complication rate was low, with only 14.9% and 33.3% of patients requiring pharmacological treatment of complications after RAM or AM, respectively. No surgical re-intervention was needed in any group. Conclusions Implementation of RAM at our centre resulted in a significant reduction of open surgery rate. RAM demonstrated shorter hospital stays and a lower incidence of complications compared to AM. What is new? Our study highlights the successful adoption of RAM, showcasing its potential to replace AM even in complex cases. The findings affirm the safety and feasibility of RAM, supporting its use as a valuable technique for minimally invasive myomectomy.

Implementation of robot-assisted myomectomy in a large university hospital: a retrospective descriptive study

- Uterine fibroids (UFs) are the most common tumours of the female reproductive system and represent a significant health issue worldwide. UFs develop during reproductive span and often shrink after menopause.UFs affect over 70% of women by the onset of menopause. Uterine fibroids arise from myometrial smooth muscle cells. UFs can be solitary or multiply and their size varies from microscopic to giant. Nowadays the exact cause of UFs remains unknown, but it is assumed that genetic abberations along with steroid hormones and growth factors play a pivotal role in thetumour development. In most cases UFs are asymptomaticand therefore it is difficult to estimate their actual prevalence. Symptomatic UFs present with abnormal menstrual bleeding, pelvic and low back pain, bulk symptoms, infertility and have a strong impact on health-related-quality-of-life (HRQL). Early diagnosisand treatment of UFs as well as preventive measures, especially for patients from high-risk groups, should be a priority. This article presents current data about pathophysiology, diagnosisandmanagement of UFs. Abstract- Uterine fibroids (UFs) are the most common tumours of the female reproductive system and represent a significant health issue worldwide. UFs develop during reproductive span and often shrink after menopause. UFs affect over 70% of women by the onset of menopause. Uterine fibroids arise from myometrial smooth muscle cells. UFs can be solitary or multiply and their size varies from microscopic to giant. Nowadays the exact cause of UFs remains unknown, but it is assumed that genetic abberations along with steroid hormones and growth factors play a pivotal role in the tumour development. In most cases UFs are asymptomaticand therefore it is difficult to estimate their actual prevalence. Symptomatic UFs present with abnormal menstrual bleeding, pelvic and low back pain, bulk symptoms, infertility and have a strong impact on health-related-quality-of-life (HRQL). Early diagnosis and treatment of UFs as well as preventive measures, especially for patients from high-risk groups, should be a priority. This article presents current data about pathophysiology, diagnosis andmanagement of UFs.

Uterine Fibroids. What We Know and What We Need to Know

Unveiling the advantages of laparoscopic myomectomy: A comprehensive systematic review and meta-analysis of outcomes and complications compared with traditional open surgery

Laparoscopic myomectomy versus open myomectomy in uterine fibroid treatment: A meta-analysis

Introduction: Incidence of ectopic pregnancy can be an acute or chronic condition. The condition of chronic ectopic pregnancy itself is unique, arises from a minor rupture, and then develops into a hematocele. Chronic ectopic pregnancy is quite complicated to diagnose because it usually has a prolonged clinical course and can disappear spontaneously.
Case Presentation: A woman aged 31-32 weeks, aged 24 years, complained of right abdominal pain accompanied by nausea and vomiting. Examination of vital signs was 120/80 mmHg, pulse 84 x/min, RR 20x/min, temperature 36.70C, and SpO2 of 98% with pale conjunctiva and abdominal tenderness in the right upper quadrant. On laboratory examination, the patient found severe microcytic normochromic anemia (Hb 4.5 mg/dl; MCV 96.6 Fl; MCH 30.2 pg), thrombocytopenia (platelets 133,000 L) and hypoalbumin (albumin 2.82 L). Ultrasound examination showed a mass in the right adnexa accompanied by intrauterine pregnancy. The patient underwent a laparotomy and found a mass in the form of a blood clot (hematocele) of 30x20x20 cm.
Conclusion: Chronic ectopic pregnancy is a rare condition, especially in developed countries. A clinician should be more detailed in diagnosing and considering the ultrasound, an amorphous mass with avascularity to amass with complex vascular formation. This is very necessary considering that this hematocele mass can develop progressively to cause fetal growth disorders.

Case Report: Massive Hematocel with An Intrauterine Pregnancy

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Halida Nelasari

Author Tools

Chat about Author

Papers

Laparoscopic myomectomy versus open myomectomy in uterine fibroid treatment: A meta-analysis

Case Report: Massive Hematocel with An Intrauterine Pregnancy