The magnitude of the problem, he’s focused on empty follicles always facing the IVF  specialist  at the end of ivf procedures and so all financial factors has been spent and so prediction and management of such cases will prevent loss of the cycle and its impact on the patient and subsequently  losing a huge budget.

Types: Genuine EFS due to failure to retrieve oocytes despite optimal hCG surge and so will not respond to rescue protocol.  

False type which occurs due to presence of low hCG level due to an error in the administration or bioavailability of hCG. 

Prevention: Prevention of such cases is done by assessment of serum HCG the day after the trigger and if  hCG concentration is < 100 miu then second bolus of hCG should be given then reschedule OR 24 to 36 hours later.

Management: If the patient doesn’t get any eggs after flushing three mature follicles so stop the procedure ensure the patient has taken the trigger injection at the right time rapid home pregnancy test if it is positive this rolls out diagnosis of empty follicle syndrome and so proceed in egg collection. If pregnancy test is negative this will confirm his diagnosis of empty falcon syndrome so stop the procedure leave the rest of the follicles intact will the patient out of operative room give the patient an addition of those of which imagery injection to support follicular growth.

Introduction: Autoimmune Hepatitis (AIH) occurs when the Liver is attacked by immune cells that mistake it for foreign tissue or pathogen, causing inflammation. Treatment with prednisone is generally used initially and a second medication, azathioprine may be recommended as well. Prednisone, especially when taken long term, can cause a wide range of serious side effects, including diabetes, thinning bones (osteoporosis) and osteonecrosis.  Most people need to continue taking the prednisone for at least eighteen to twenty-four months, and many remain on it for life. The disease often returns if the drug is discontinued. In Traditional Chinese Medicine (TCM), Yin deficiency plays a central role in Autoimmune Disease. Purpose: The purpose of this study is to demonstrate that Autoimmune Hepatitis can be treated without the use of corticosteroids or immunosuppressive drugs. Methods:  A case report of a female patient who had severe headache in the parietal region, as a symptom. According to TCM, this region corresponds to Liver meridian disharmony. Auricular acupuncture sessions were started, as well as dietary counselling according to the teachings of TCM. Laboratory tests revealed low prothrombin time and the presence of antinuclear antibody. Results: After one month of treatment, the exams were repeated and the antinuclear antibody was negative. Conclusion: The conclusion of this study is that Autoimmune Hepatitis can be treated without the use of corticosteroids and Immunosuppressive drugs according to the teachings of Traditional Chinese Medicine, reducing the side effects caused by these drugs.

A retrospective and prospective study of breast lump was carried out-in BSMMU during January 2000 to July 2003 to determine the distribution of disease patterns, accuracy of FNAC diagnosis and its correlation with histodiagnosis. A total of 878 patients underwent FNAC examination and cytodiagnosis was available for 868 cases. Cytohisto correlation was found in 76 cases. All cytologically diagnosed benign breast lesions (43) correlated with histodiagnosis as benign’; false negative diagnosis was made in 3 patients. Cytological and histological study was proven malignant (32); one case constitute false positive. Most of the breast lumps were benign lesions (78.7%) of which fibroadenoma was the commonest (64.6%). Incidence of malignancy was 10.5%; Duct cell carcinoma is the most common one (89.01%). Breast lumps were frequent in left breasts (Upper and outer quadrant). Incidence of benign diseases was common in less than 29 years and malignant diseases were high in 4^th and 5^th decades. Accuracy of FNAC to diagnose the breast lump was 94%.

Objective: To compare the effects of electrical bipolar vessel sealing and conventional suturing on postoperative pain, operative time, blood loss, and costs, in women undergoing vaginal hysterectomy.

Methods: 20 women scheduled to undergo vaginal hysterectomy for benign conditions. Women was randomized to vessel sealing or conventional surgery, and divided into 2 groups, A and B, 10 for each group. Vaginal hysterectomy using vessel sealing Erbe machine for Group A and traditional vaginal hysterectomy for group B. For each woman, general, abdominal and pelvic examination was done preoperatively, also pelvic ultrasound and routine preoperative investigations was performed. After vaginal hysterectomy, assessment of blood loss, post-operative pain, operative time and costs was evaluated.

Result: The evening after surgery, women in the vessel‐sealing group reported significantly less pain (5.7 versus 4.5 on a scale of 0–10, P= 0.03), but after that pain scores were similar. Operation duration was shorter for vessel sealing (39 versus 61 minutes=P<0.05). Blood loss was less in group A. We observed no major difference in costs between the two interventions (2903 versus 3102, P=0.26).

Conclusion: Using vessel sealing machine during vaginal hysterectomy resulted in less pain on the first postoperative day, shorter operating time, less operative blood loss, but no major differences in costs were found between the two interventions.

Introduction: The tendinitis is commonly defined as an inflammation of the tendon, which is what connects bones to muscle. On the major literature, tendinitis is usually caused by repetition of movements and lack of stretching. However, the cause was never before associated to a disease in the liver, such as Autoimmune Hepatitis. According to Traditional Chinese Medicine (TCM), tendons are governed by the energy of the Gallbladder meridian, which is attached to the Liver energy.  Purpose: The aim of this study is to demonstrate that tendinitis may be an early manifestation of Autoimmune Hepatitis. Methods:  Through a clinical case report of a female patient, M.C., 42 years old, with chronic pain in shoulder and elbow, resistant to conventional treatments with anti-inflammatories and physiotherapy. She sought acupuncture treatment, and even so, the improvement presented was scarce. In her physical examination, a bulging was detected in the right ear, on the area that corresponds to the Liver, according to Auricular Medicine. Laboratory tests were requested to see if there could be any undiagnosed liver disease until then. The only exam that was initially altered was the prothrombin time of 89%. More tests were ordered to see whether anti-bodies were present. Anti-nuclear, anti-smooth muscle, anti-microsomal. Results: To the physician's surprise, the patient had a 1:160 anti-nucleus reagent. Conclusion: The conclusion of this study is that tendinitis may be the initial manifestation of an Autoimmune Hepatitis.

Pre-eclampsia is a serious medical condition if left untreated can develop into eclampsia, which is yet a left threatening complication. It remains one of the most common reasons for women to die during pregnancy in developing countries like Bangladesh. A total of 50 patients suffering from severe pre-eclampsia were studied to find out the relationship and risk factors among age, parity, antenatal care and mode of delivery in department of obstetrics and gynaecology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, during the period of study, September 2013 to March 2014. Prospective type of cross-sectional study was done on pregnant women with severe pre-eclampsia in labour and in antenatal ward admitted in the hospital during the study period. In the present study, Majority of pre-eclamptic patients in this study was found to be primigravida (60%) and only 40% of the patients were multigravida with age ranging between 15-35 years. A positive family history of hypertension (48%) was found in patients with severe pre-eclampsia. Most of the patients (66%) had no regular antenatal care, only 22% of patients received regular antenatal care. Various symptoms of severe pre-eclamptic patients were studied which revealed swelling of both leg was the most common symptom of all patients (78%), headache(34%), epigastric pain (30%), insomnia (26%), blurring of vision (18%), oliguria (6%). Obstetrical intervention was observed, showing greater incidence of caesarean section (70%) in comparison to vaginal delivery (22%) in severe pre-eclamptic patients.  Overall outcome of neonates showed as healthy, premature, intra-uterine growth retardation (IUGR), stillbirth, and neonatal death as 52%, 18%,12%,10%,8% respectively. Pre-eclampsia contributes to high mortality and morbidity of both mother and the neonates in our country. Therefore, proper health education and regular antenatal care must be provided to all pregnant women in order to prevent and screen pre-eclampsia. Measures must be taken to control this condition through Behavioral Change Communication (BCC) regarding antenatal care, danger signs, delivery plan, involving both private and public awareness.

The purpose of this study was to estimate the prevalence of possible related factors associated with symptomatic pelvic organ prolapse (POP) among Japanese women 20 to 90 years of age. The cross-sectional study evaluated 8,407 randomly selected women who were employed at the Japanese Agriculture Group. The participants were asked to provide information regarding their demographic characteristics and symptoms of POP or urinary incontinence (UI). The potential risk factors included age, body mass index, self-reported conditions or comorbid diseases, parity, heavy lifting at work, perceived health status, and occupation. The weighted prevalence of POP was 5.64%. The proportion of women who reported having symptomatic POP generally increased with age and peaked at the age of 70–79 years old. In multivariate analysis revealed age, parity, heaving lifting, perceived health status, comorbid diseases were significantly and independently associated with presence of prolapse, whereas the woman’s BMI and weight were not. The present study provided the first population-based estimate of the prevalence of POP among Japanese women. The prevalence of symptomatic POP increased with age and peaked at 70–79 years old. Advancing age, parity, parity, heaving lifting, perceived health status, comorbid diseases increasing have the strongest correlations with prolapse.

Unicornuate uterus is rare (6.3%) and is usually associated with endometriosis and renal abnormalities. We present a case of a 22 years old, unmarried girl, with dysmenorrhoea since menarche which was progressively increasing for 1 year. Menstrual cycle was regular, flow average. Secondary sexual characteristics were normal. Abdomen was soft with no mass. USG showed normal size uterus and a right sided haemorrhagic cyst (?)/endometriotic cyst (3x4 cm). With the probable diagnosis of endometrioma, oral progesterone was given continuously for three months. Then she had regular menstrual cycle without dysmenorrhoea for 3 months and got married. Three months later she had severe unilateral dysmenorrhoea and dyspareunia. Abdomen was tense and tender. Uterus was normal size and a soft, severely tender ill defined mass felt through the right fornix. TVS revealed normal size uterus with a rudimentary horn on right side (?haemorrhagic cyst, 5x5 cm). MRI revealed unicornuate uterus with a rudimentary horn on right side with right sided hematosalpinx. There was no renal abnormality. By this time she became pregnant. Her pregnancy was in normal uterine cavity. At her 10 weeks of gestation she had incomplete abortion, and E&C was done. After three months on laparoscopy and hysteroscopy, uterus was found unicornuate with right sided non-communicating rudimentary horn with hematometra and hematosalpinx. Left fallopian tube and both ovaries were normal. Right sided salpingectomy with excision of the rudimentary horn was done. She had no complaints in subsequent follow up for 6 months and was advised to conceive.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.

Objective: Sentinel lymph node (SLN) mapping with indocyanine green injection has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy. The aim of this study was to measure the predictive value of sentinel-lymph-node mapping in small cohorts of patients.

Methods: In this prospective study we analyzed the results of surgery treatment of 8 patients with the first clinical stage of endometrial cancer (T1a Nx Mx). Morphological examination was a highly differentiated endometrial adenocarcinoma G1 in all cases. We carried out an injection of the indocyanine green into the cervix uteri, mapping of the SLN with an infrared video endoscopic device, selective lymphadenectomy of the SLN (with a note about the accumulation of contrast), total laparoscopic hysterectomy and total pelvic lymphadenectomy (reference standard) all patients.

Results: In all 8 cases the SLN was intraoperative successfully mapped. In 5 cases we found Positive sentinel lymph nodes out of which in 3 cases; metastases were not detected. After the examination of all nodes removed after total lymphadenectomy in 5 women with positive SLN, metastases were also detected in other lymph nodes. In other group (3 patients with negative SLN) metastases were also not found.

Conclusions: This method application makes easier and more accurate to find regional nodes. The use of cervical injection techniques with indocyanine green can be favored. Sentinel lymph mapping may be considered an alternative standard of care in the staging of women with endometrial cancer.