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Background & Objective: Endometrial hyperplasia is the primary precursor of endometrial cancer in the female reproductive system, with abnormal uterine bleeding (AUB) being the predominant manifestation of this condition. The purpose of this study was to determine the prevalence of endometrial hyperplasia and its correlation with various factors among patients presenting with abnormal uterine bleeding. Materials & Methods: This cross-sectional descriptive-analytical study reviewed the hospital records of all patients with abnormal uterine bleeding admitted to Ali Ebn-e Abi Taleb Hospital in Zahedan from April 2015 to April 2018. Data were analyzed using the SPSS. Results: The prevalence of endometrial hyperplasia was estimated to be 20.3%. The average age of the study subjects was about 45 years. The highest number of patients (37, 52.9%) belonged to the age group of 36-50 years. Among the different types of endometrial hyperplasia observed, the most common was "simple non-atypical hyperplasia" found in 45 patients (64.3%), while the least common was "simple atypical hyperplasia" observed in three patients (4.3%). Overall, "non-atypical hyperplasia" (including both simple and complex types) was present in 58 patients (82.85%). The prevalence of infertility, obesity, hypertension, diabetes, premature menarche, late menopause, family history, oligomenorrhea, and polycystic ovary syndrome (PCOS) was reported in 7.1%, 32.9%, 24.3%, 22.9%, 8.5%, 13.6%, 7.1%, 5.7%, and 3.4% of cases, respectively. Conclusion: women with a history of diabetes, hypertension, and obesity are at an increased risk of developing endometrial hyperplasia. Therefore, it is crucial to evaluate these patients for the presence of endometrial hyperplasia. [ABSTRACT FROM AUTHOR]

Background: This study was designed to evaluate the comparison of insertion of levonorgestrel (LNG)-releasing intrauterine system versus oral medroxyprogesterone acetate on endometrial hyperplasia in a randomized controlled trial. Materials and Methods: A total of 60 women with the initial histopathological diagnosis of endometrial hyperplasia in two groups received LNG or medroxyprogesterone (10 mg/d orally) for 12 days a month for 3 months). Endometrial biopsy was obtained for all patients after 3 months of treatment. Response to treatment was defined based on the histopathology of the post treatment pipelle endometrial specimens in three categories of resolution, persistence and progression. Results: Treatment response rate in patients in the LNG group was 89.3% (25 of 28 patients), versus 70.4% (19 of 27 patients) in patients in the medroxyprogesterone group. The rate of persistence was 10.7% (3 of 28 patients) and 22.2% (6 of 27 patients) in LNG and medroxyprogesterone groups respectively. No progression of endometrial hyperplasia observed in any of the patients in LNG group, but progression of endometrial hyperplasia was observed in 7.4% (2 of 27 patients) in the medroxyprogesterone group. There was no statistically significant difference between groups regarding the response to treatment (P = 0.15). Side effects such as bloating, weight gain, fatigue and hair loss were comparable between the groups (P > 0.05). Hirsutism was significantly more in the medroxyprogesterone group than LNG group (P = 0.013). Conclusion: Results showed that the use of LNG for treating endometrial hyperplasia for 3 months was associated with high-treatment response rate and the low proportion of patients with progression compared to the use of medroxyprogesterone. [ABSTRACT FROM AUTHOR]

Background: Endometrial cancer is the most common gynecologic malignancy that has often proceeded by a premalignant phase. Modern molecular and immunostaining methods for precancerous lesions diagnosis have been expanded. One of the genetic alternations in the endometrial cancer carcinogenesis is the mutational activation of the K-ras oncogene. K-ras mutation has recognized to occur at an early stage of neoplastic progression in the endometrium. The purpose of this study is to investigate the expression pattern of K-ras gene in atypical and nonatypical hyperplastic endometrium. Methods: In a prospective study in the referral gynecologic hospital in Tehran, immunohistochemical evaluation of K-ras has performed on 72 consecutive specimens in two following groups: endometrial hyperplasia without atypia (n: 36), and endometrial hyperplasia with atypia (n: 36). Staining of cells has evaluated in arbitrary quantitative methods in regards to both slides area staining and intensity of color reaction. Results: K-ras immunoreactivity has seen in 3/36 (8.3%) cases of non atypical hyperplasia and in 2/36 (5.6%) cases of atypical hyperplasia (P: 0.64). Conclusion: We have not establish any significant differences in K-ras expression between the atypical and nonatypical hyperplastic endometrium, and our data has supported this view that K-ras mutation is a very rare event in human endometrial carcinogenesis. [ABSTRACT FROM AUTHOR]

Background: Data on the effects of folic acid supplementation on clinical symptoms and metabolic profiles of patients with endometrial hyperplasia (EH) are limited. This investigation was performed to evaluate the effects of folic acid supplementation on clinical symptoms and metabolic status of patients with EH., Methods: This randomized, double-blind, placebo-controlled trial was conducted among 60 women diagnosed with EH. Diagnosis of EH was made based on biopsy results. Participants were randomly allocated to 2 groups to take 5 mg/d folic acid supplements (n = 30) or placebo (n = 30) for 12 weeks., Results: After the 12-week intervention, folic acid supplementation significantly decreased fasting plasma glucose (β -3.99 mg/ dL; 95% CI, -7.39, -0.59; P = 0.02), serum insulin levels (β -2.82 µIU/mL; 95% CI, -4.86, -0.77; P = 0.008), homeostasis model assessment for insulin resistance (β -0.68; 95% CI, -1.20, -0.17; P = 0.009), triglycerides (β -16.47 mg/dL; 95% CI, -28.72, -4.22; P = 0.009) and very-low-density lipoprotein (VLDL) cholesterol (β -3.29 mg/dL; 95% CI, -5.74, -0.84; P = 0.009), and significantly increased the quantitative insulin sensitivity check index (β 0.01; 95% CI, 0.004, 0.03; P = 0.01) compared with the placebo. Additionally, folic acid intake resulted in a significant reduction in serum high sensitivity C-reactive protein (hs-CRP) (β -0.36 mg/L; 95% CI, -0.52, -0.21; P < 0.001) compared with the placebo. Folic acid supplementation did not affect other metabolic parameters., Conclusion: In conclusion, we found that folic acid administration for 12 weeks to subjects with EH improved glycemic control, triglycerides, VLDL-cholesterol and hs-CRP levels, but did not influence recurrence and other metabolic profiles., (© 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)