Background: polycystic ovarian syndrome (PCOS) is a common cause of infertility and is associated with chronic anovulation and hyperandrogenemia. Clomiphene citrate (CC) is still the first-line therapy for ovulation induction in these patients. Metformin, a biguanide, has been used to treat insulin resistance in women with PCOS. Furthermore, many reports confirmed that the addition of metformin to CC in the CC-resistant PCOS was highly effective in achieving ovulation. Letrozole, an aromatase inhibitor, has attracted attention for a long time to induce ovulation. Aim of the work: In the current study, we aimed to compare the effect of administration of combined metformin–Clomiphene Citrate to that of combined metformin–letrozole in the induction of ovulation in infertile overweight women with PCOS. 40 infertile overweight cases with PCO were included. Methods: Sixty participants had received metformin in aggregate with both CC (100 mg) or and similar number received letrozole (5 mg) plus metformin for 5 days starting from the 3rd day of their menstrual cycle. Results: The cumulative pregnancy rate of CC-metformin was 21.66% and letrozole-metformin was 25%, the difference is insignificant. Conclusion: CC and letrozole are similarly viable in the treatment of overweight women with PCOS when joined with metformin treatment.

FDA approval of CDK4 / 6 inhibitors (Palbociclib, Ribociclib and Abemaciclib) for metastatic and advanced breast cancer, in combination or not with Fulvestrant or Letrozole, has improved the prognosis of this type of patient population. Palliative radiotherapy with antalgic purpose in most of the cases is often part of the multidisciplinary treatment of bone involvement metastatic breast cancer. In the context of the approval of these innovative therapies and of the development of radiotherapy techniques, including stereotactic radiosurgery, it is necessary to identify the best therapeutic sequence and parameters (dose, volume, fraction size) to obtain a synergistic effect. Considering the toxicity profiles of new therapies (especially lymphopenia and neutropenia) and the different mechanisms of the induction of these toxicities towards radiotherapy and chemotherapy, it is also necessary to demonstrate the safety profile of concomitant or sequential irradiation with the administration of CDK4 / 6 inhibitors in combination with radiation therapy.

Agni karma refers to the use of heated metals by traditional physicians. Endometriosis is defined as implantation of endometrial cells outside the endometrial cavity. Presenting symptoms are dyspareunia and dysmenorrhea. Recognition and awareness of such disorder are vital to avoid skin damage. A 31 years old nulliparous presented with dysmenorrhea and dyspareunia after unsuccessful attempts to alleviate symptoms by heated metals. Stage 4 endometrioses was diagnosed via laparoscopy and bilateral ovarian cystectomy was done for endometriomas. Agni karma is an unacceptable treatment for endometriosis as it results in avoidable body damage. Using heated rods is contraindicated in endometriosis, as it does neither alleviate symptoms nor treat the condition. It is used due to its lower cost, rapidity to treat the illness and non-complex equipment. To prevent unnecessary body damages, awareness is crucial along with consulting legal healthcare centers where medical and surgical treatment from qualified healthcare professionals is provided.

Purpose: To investigate the postoperative outcomes regarding bowel functions in women and the pattern of symptoms after surgical treatment for deep infiltrating endometriosis in comparison with healthy subjects. Methods: This cross-sectional study was designed as a single tertiary-level academic center. We included 130 female adult patients who had undergone (recto) sigmoid resection for deep infiltrating endometriosis between January 2005 and December 2015. Patients were randomly age-matched to two controls derived from the general population in the Netherlands. We measured the prevalence of constipation, fecal incontinence, Irritable Bowel Syndrome and the Low Anterior Resection Syndrome Score. Results: The prevalence of constipation, fecal incontinence, and irritable bowel syndrome in the patients was significantly higher than in the controls (50.8% versus 26.2% and 15.4% versus 5.4%, and 14.6% versus 5.4%, respectively, P < 0.05 for each). The prevalence of constipation and fecal incontinence was lower in the patients who had undergone surgery longer than 24 months ago, in comparison with those who had undergone surgery less than 24 months ago (46.7% versus 69.9% and 15.0% versus 17.4%), which was still significantly higher in comparison to the control group. The low anterior resection syndrome score was significantly higher in the patients than in the controls. Conclusion: The postoperative outcomes in patients treated for deep infiltrated endometriosis regarding constipation, fecal incontinence, and irritable bowel syndrome are suboptimal and do not come close to outcomes in the general female population in the Netherlands. These patients should be screened postoperatively and if necessary, treated for bowel functions.