Sima Giti; Khadijeh Abadian
Volume 4, Issue 2 , May and June 2019, , Pages 75-77
Abstract
Background & Objective: Despite the rarity of head and neck squamous cell carcinoma during pregnancy, the outbreak of its various malignant types is probable during pregnancy due to the increased maternal age and decreased age of cancer occurrence. Therefore, paying attention to any abnormal symptoms ...
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Background & Objective: Despite the rarity of head and neck squamous cell carcinoma during pregnancy, the outbreak of its various malignant types is probable during pregnancy due to the increased maternal age and decreased age of cancer occurrence. Therefore, paying attention to any abnormal symptoms in any period, such as pregnancy, seems necessary. This study aimed to report a case of tongue cancer diagnosed during pregnancy.
Case Report: A 31-year-old woman who was at 18 weeks of her first pregnancy noticed an Aphthous stomatitis on her tongue. Since the routine Aphthous stomatitis treatment failed to treat the lesion and it developed and swelled in the neck and mouth region, the patient referred to her physician again. After carrying out a biopsy of the lesion, squamous cell carcinoma of the tongue was diagnosed. The patient underwent chemotherapy and radiotherapy after terminating the pregnancy by a cesarean section, and the malignant tumor shrank.
Conclusion: It seems that a complete multidisciplinary study is needed to minimize fetal health risks and to optimize maternal treatment outcomes.
Shahrzad Sheikhhasani; Azamsadat Mousavi; Monireh Mirzai; Mitra Modares Gilani; Setareh Akhavan
Volume 3, Issue 2 , May and June 2018, , Pages 79-82
Abstract
Introduction: Timely diagnosis of gestational trophoblastic neoplasia (GTN) is essential for successful management of the condition and preservation of fertility. The aim of the present study was to describe a case of misdiagnosis GTN with brain and lungs metastasis.
Patient information: The present ...
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Introduction: Timely diagnosis of gestational trophoblastic neoplasia (GTN) is essential for successful management of the condition and preservation of fertility. The aim of the present study was to describe a case of misdiagnosis GTN with brain and lungs metastasis.
Patient information: The present case study was conducted in Imam Khomeini hospital, Tehran, Iran, in 2017. A 35-year-old woman presented with acute headaches and left hemiplegia one month after the conclusion of her term pregnancy. The patient was previously diagnosed as a case of subarachnoid hemorrhage and inferior sagittal sinus thrombosis and was unsuccessfully treated with anticoagulant drugs leading to worsening signs and symptoms. Her initial β-hCG at admission to the hospital was 22,000,000IU/L, which lead to diagnosis of GTN with extensive metastatic lesions in the lungs and brain. Due to extensive intracranial hemorrhage, the patient was first treated with whole brain radiation therapy for 10 sessions daily (Total Dose=3000cGy). EMA-EP treatment was initially withheld due to concern for bleeding during concurrent radiation therapy. Following the brain radiation therapy, the chemotherapy was started for the patient. Upon completion of 3 cycles of EMAEP, the patient’s hCG was lowered to 5IU/L. The treatment was continued for 5 more cycles and resulted in hCG reading of under 2IU/L at her last visit.
Conclusion: This case highlights the variable presentation of GTN which might easily cause misdiagnosis and delayed treatment and shows excellent response to treatment despite late treatment and massive tumor burden with some modifications to plan of treatment
General Gynecology and Pelvic Floor
Behnaz Nouri; Ahmad Reza Baghestani; Paricheher Pooransari
Volume 6, Issue 2 , March 2021, , Pages 87-94
Abstract
Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial ...
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Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial (RCT) aimed to compare the effect of EPO and misoprostol on cervical ripening/dilatation.Methods: In this double–blind RCT study, women of reproductive age without history of normal vaginal delivery (NVD) and menopause women (age range: 20–75 years) were enrolled. The subjects who were candidates of hysteroscopy, dilatation, and curettage were randomly assigned into two groups. In one group, 2 capsules of 500 mg EPO (N=81) and in the other group 2 capsules of 200 µg misoprostol (N=84) were placed in posterior fornix 2 hours before surgery. The time to reach complete dilatation (Hegar 3 to 10 mm), size of the first Hegar used to apply force, bleeding volume, and cervical laceration were compared between the groups using the IBM SPSS Statistics for Windows, Version 21.0 (Armonk, NY: IBM Corp).Results: The two study groups had similar demographic information, number of pregnancies, cesarean sections, and NVDs (P < /em>>.05), but had different frequency of surgical types (P < /em>=.018). EPO group had a larger mean size of the Hegar (7.32 vs. 6.58 mm; P < /em>=.004) and shorter time to reach complete dilatation (242.35 vs. 331.79 min; P < /em>=.002); however, bleeding volume and frequency of cervical laceration were not different between the groups (1.41 vs. 2.00 cc and 8.6% vs. 14.3%, respectively; P < /em>>.05).Conclusion: The superiority of EPO capsules to misoprostol for cervical ripening before gynecologic procedures in women of reproductive age without history of normal NVD and menopause women suggests it as an appropriate alternative to misoprostol.
Reproductive Medicine
Ayman Dawood; Mohamed Elnamoury; Walid Atallah
Volume 7, Issue 2 , September and October 2021, , Pages 99-104
Abstract
Background & Objective: Multifetal reduction not only lowers the number of fetuses but also improves pregnancy outcomes. A great conflict emerges when obstetrician faces triplet or higher order multifetal pregnancies. Decision-making is so difficult whether to continue pregnancy as such with ...
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Background & Objective: Multifetal reduction not only lowers the number of fetuses but also improves pregnancy outcomes. A great conflict emerges when obstetrician faces triplet or higher order multifetal pregnancies. Decision-making is so difficult whether to continue pregnancy as such with its risks or reduce the number of fetuses to improve outcomes. This study aimed to assess the obstetrical outcomes of Embryo Reduction to Twins (ERTT) procedures in IVF/ICSI centers in Egypt.Materials & Methods: This retrospective cross-sectional study was conducted from June 2017 to December 2020. Data of the patients in five IVF/ICSI centers were accessed using the computer-stored patients' files. Patients who got pregnant spontaneously or after IVF/ICSI procedures with 3 or more embryos were recruited in the study. The patients were counseled for ERTT and those who accepted the procedure were included. The measured obstetrical outcomes were abortion rate, preterm labor, and preeclampsia, premature rupture of membranes, and neonatal morbidity and mortality.Results: One hundred and twenty four cases were included in this study from 5 IVF/ICSI centers. Most cases (83.87%) of multifetal pregnancies were due to IVF/ICSI procedures. The mean age was 28.3 ± 2.5 years and the mean gestational age at reduction was 8.4 ± 0.6 weeks. The great majority of cases (72.58%) were operated by aspiration. The abortion rate was 29.84%. The mean gestation age at delivery was 34.51 ± 1.82 weeks. The incubator admission rate was 41.93% and the overall postoperative complication was 9.68%.Conclusion: Embryo Reduction to Twins in triplets or higher order pregnancies was considered feasible, safe and linked to minimal complications. The ERTT procedure improved obstetrical and neonatal outcomes.
Pathology
Zahra Shahi; Mohammad Amin Edalatmanesh; Babak kheirkhah
Volume 5, Issue 3 , November 2020, , Pages 110-114
Abstract
Background & Objective: Cervical cancer is the fourth most common cancer in women worldwide. HPV is a heterogeneous virus, and a persistent high-risk HPV infection contributes to cancer development. This study aims to determine the relative frequency of HPV genotypes in Kerman, Iran.Materials & ...
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Background & Objective: Cervical cancer is the fourth most common cancer in women worldwide. HPV is a heterogeneous virus, and a persistent high-risk HPV infection contributes to cancer development. This study aims to determine the relative frequency of HPV genotypes in Kerman, Iran.Materials & Methods: This cross-sectional study was conducted on 50 women with Pap smear samples, referring to a general laboratory in Kerman, Iran. Detecting two HPV genotypes was carried out using Multiplex Polymerase Chain Reaction (PCR) technique. The sociodemographic survey was conducted for each HPV-positive woman. Results: Out of 50 cervical cancer patients, 33 women (66%) were HPV 16, 18-positive. HPV 16 (38%) was the most rampant type, followed by HPV 18 (14%) and HPV 16, 18 (14%).Conclusion: Studying the prevalence of HPV genotypes and their respective risk factors can lead to efficient vaccine development against the virus in each geographical area. It can also be beneficial for illness management and high sensitivity diagnosis of cervical intraepithelial neoplasia.
Elham Shirali; Fariba Yarandi; Mostafa Safavi; Omid Hemmatian; Marjan Ghaemi
Volume 4, Issue 3 , September and October 2019, , Pages 117-119
Abstract
Background & Objective: Primary vaginal sarcomas are extremely rare and counts about 2-3% of all vaginal malignancies. We report a case with vaginal leiomyosarcoma which was treated by radical hysterectomy.
Case Report: A 46 year old woman from Iraq, referred to Yas Hospital by chief complaint of ...
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Background & Objective: Primary vaginal sarcomas are extremely rare and counts about 2-3% of all vaginal malignancies. We report a case with vaginal leiomyosarcoma which was treated by radical hysterectomy.
Case Report: A 46 year old woman from Iraq, referred to Yas Hospital by chief complaint of post-coital bleeding and a vaginal mass with pathology report of vaginal leiomyosarcoma. She underwent radical hysterectomy with bilateral salpingo-oophorectomy and partial vaginectomy (2/3 upper of the vagina). She refused to receive chemotherapy after surgery. In 3 years follow up, she did not have any recurrence.
Conclusion: Experiences about vaginal leiomyosarcoma are not sufficient due to rarity of the disease. However, based on review of the literature surgery is still the first choice followed by both chemotherapy and radiotherapy that are preferred based on current reports.
Soheila Aminimoghaddam; Nastaran Abolghasem; Tahereh Ashraf- Ganjooie
Volume 3, Issue 3 , September and October 2018, , Pages 123-128
Abstract
Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients ...
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Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients have metastatic disease when Gestational trophoblastic neoplasia (GTN) is diagnosed. GTN is unique in women malignancies because it arises from trophoblast but not from genital organs. It is curable with chemotherapy, low-risk GTN completely response to single-agent chemotherapy and does not require histological confirmation. In persistent GTN, clinical staging and workup of metastasis should be performed. The aim of the present study was to review the new management of GTD.
Conclusion In the case of brain, liver, or renal metastases, any woman of reproductive age who presents with an apparent metastatic malignancy of unknown primary site should be screened for the possibility of GTN with a serum HCG level. Excisional biopsy is not indicated to histologically confirm the diagnosis of malignant GTN if the patient is not pregnant and has a high HCG value. Given the vascular nature of these lesions, a biopsy can have significant morbidity. In every woman with abnormal bleeding or neurologic symptom without documented reason, the probability of malignant GTN should be in mind and determination of HCG titer is recommended. In selected cases with low-risk GTN, repeat curettage is done to reduce the need for chemotherapy courses. In recent years personalized medicine is encouraged for treatment of GTN.
Maternal Fetal Medicine
Tajossadat Allameh; Zahra Allameh; Zahra Javanmardi; Elham Moazam; Maryam Dehghan
Volume 8, Issue 2 , March and April 2023, , Pages 131-136
Abstract
Background & Objective: Due to the uncertainties of maternal and neonatal complications after delivery and the lack of similar studies in this regard, this study aimed to compare the maternal and fetal complications of vaginal birth after C-Section (VBAC), natural delivery and repeat Cesarean ...
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Background & Objective: Due to the uncertainties of maternal and neonatal complications after delivery and the lack of similar studies in this regard, this study aimed to compare the maternal and fetal complications of vaginal birth after C-Section (VBAC), natural delivery and repeat Cesarean section in Isfahan province.Materials & Methods: In this one-year descriptive cross-sectional study, 49889 pregnant women who had the natural childbirth (29631 deliveries), elective repeat Cesarean section (20148 deliveries) and VBAC delivery (110 deliveries) were enrolled, then maternal and neonatal complications were compared in three groups.Results: There was a significant difference between the three groups based on the maternal and neonatal outcome, Apgar scores in the first and fifth minutes after delivery and the need for resuscitation at birth (P <0.05). Neonatal outcome was better in natural delivery and then VBAC compared to repeat C-section, respectively. Maternal outcome was better in VBAC and then repeat C-section than the natural childbirth. Apgar scores in the first and fifth minute were better in VBAC, and later natural delivery than repeat C-section. Resuscitation at birth demonstrated better results for natural delivery and then VBAC than repeat C-section.Conclusion: Utilizing VBAC and natural delivery have better maternal and fetal outcomes compared to C-section, along with being more satisfactory and safer.
Obstetrics and Gynecology
Majid Zare-Bidaki; Mohammad Nadjafi Semnani; Ali Nadjafi Semnani; Nahid Ghanbarzadeh
Volume 6, Issue 3 , June 2021, , Pages 134-142
Abstract
Background & Objective: Urinary incontinence (UI) is a common disease that affects millions of people throughout their lives. It is reported that UI has a considerable economic burden on patients and communities. The aim of this study was to find out the prevalence of urinary incontinence (UI) and ...
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Background & Objective: Urinary incontinence (UI) is a common disease that affects millions of people throughout their lives. It is reported that UI has a considerable economic burden on patients and communities. The aim of this study was to find out the prevalence of urinary incontinence (UI) and its related factors among women living in Birjand city, Iran.Materials & Methods: A cross-sectional study from September 2020 to December 2020 was conducted on women 15 to 70 years living in nine areas of Birjand city. Data were gathered by researcher-made questionnaire and in-person interviews about demographic, obstetrics, and UI (stress, urge, and overflow UI) characteristics. Chi-square test was applied to analyze differences between women with and without UI about risk factors.Results: Of 3028 women (mean age 32.70±11.49 years), 828 (27.3%) reported to have UI. The rate of stress, urge, and mixed UI was 18.1%, 3.4%, and 5.9%, respectively. All types of UI were associated with age, education, BMI, chronic cough / dyspnea, constipation, diabetes mellitus, and smoking.Conclusion: Women should be continuously educated by health care providers on the risk factors and activities which can reduce their risk for UI. Further studies on women across the country may help decision makers to measure the regional burden of disease and to plan population-level interventions.
Gynecology Oncology
Pegah Sasanpour; Marzieh Ghasemi; Maryam Nazemian; Narjes Noori; Hossein Ansari
Volume 9, Issue 2 , March and April 2024, , Pages 150-153
Abstract
Background & Objective: Endometrial cancer is the most prevalent type of genital system cancers. It is needed to assess discrimination power of CEA, CA 15-3, CA 125 tumor markers in endometrial cancer patients and moreover in cases with abnormal uterine bleeding. We examined tumor markers (CA 15-3, ...
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Background & Objective: Endometrial cancer is the most prevalent type of genital system cancers. It is needed to assess discrimination power of CEA, CA 15-3, CA 125 tumor markers in endometrial cancer patients and moreover in cases with abnormal uterine bleeding. We examined tumor markers (CA 15-3, CA 125, CEA) in differentiating endometrial cancer and unusual uterine bleeding.
Materials & Methods: The present case-control study was conducted on 60 women with endometrial cancer and evidence of abnormal uterine bleeding who referred to Ali Ibn Abitaleb Hospital in Zahedan in 2021. The sampling method was easy and accessible and was used to collect observation information, examination, and data form data. For data analysis, SPSS software version 26, statistical graphs and independent t-test were used.
Results: The difference in serum levels of CEA marker tumor in patients of case (endometrial cancer patients) and control (abnormal uterine bleeding patients) was statistically significant. Differences in serum levels of CA 15-3 tumor marker in patients between case group (endometrial cancer patients) and control (patients with abnormal uterine bleeding) and difference in serum levels of CA 125 tumor marker in patients between case (endometrial cancer patients) and control groups (bleeding patients) uterine abnormalities were not statistically significant.
Conclusion: Serum level of CEA tumor marker has a statistically significant relationship with endometrial cancer patients and abnormal bleeding patients, but serum tumor marker level CA 15-3 and serum tumor marker CA 125 and with endometrial cancer patients and abnormal bleeding patients do not have.
Abed Ebrahimi; Frogh Pourgholam; Mahbobeh Rostami; Farzad Abaszadeh; Behzad Gholamveisi
Volume 4, Issue 4 , September and October 2019, , Pages 155-159
Abstract
Background & Objective: Mature cystic teratomas are rare neoplasms and consist of at least two to three embryonic layers. While these tumors are most commonly seen in the testes and ovaries, they have been reported elsewhere.
Case Report: A 22-year-old female patient referred to Mehr Hospital in ...
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Background & Objective: Mature cystic teratomas are rare neoplasms and consist of at least two to three embryonic layers. While these tumors are most commonly seen in the testes and ovaries, they have been reported elsewhere.
Case Report: A 22-year-old female patient referred to Mehr Hospital in Mashhad with symptoms of pelvic pain, tympanites, altered bowel habits, nausea, and vomiting. According to the performed examinations and evaluations, a mass of 37 × 20 mm was found in the retroperitoneum between the vagina and rectum. The patient underwent laparoscopic surgery and the cyst was completely resected. The patient was discharged a day after the surgery and no surgical complications were reported in conducted follow-ups. The pathologic finding also reported a dermoid cyst.
Conclusion: Resection surgery is the mainstay in the treatment of mature retroperitoneal teratomas. Although tumor characteristics can be diagnosed preoperatively by imaging modalities, a definitive diagnosis can only be made by histologic evaluations.
Nafiseh Faghih; Maliheh Arab
Volume 3, Issue 4 , November and December 2018, , Pages 169-171
Abstract
Background & Objective: Endometrial cancer is one of the most common gynecologic malignancies in developed countries. Survival rate in metastatic endometrial adenocarcinoma recurrence is reduced, and treatment in these patients is mostly palliative. One of the therapeutic options in the endometrial ...
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Background & Objective: Endometrial cancer is one of the most common gynecologic malignancies in developed countries. Survival rate in metastatic endometrial adenocarcinoma recurrence is reduced, and treatment in these patients is mostly palliative. One of the therapeutic options in the endometrial adenocarcinoma recurrence is hormone therapy. The expected response to the hormonal treatment is about 10-20%.
Case Report: This is a case report from 57-year-old woman suffering from stage IA - Grade 1 endometrial cancer, who had vaginal carcinoma recurrence with liver and pulmonary metastasis 5.5 years after the initial treatment. Due to positive hormone receptor and the pathological profile of the tumor, hormone therapy with tamoxifen and megestrol was started. The treatment evaluation revealed complete response within five months with clearance of lung and liver metastatic lesions. There is no evidence of disease and metastases in the patient's examination and imaging after 3 years of starting hormone therapy.
Conclusion: In the case of well-differentiated recurrent and metastatic endometrial cancer, good response to the hormone therapy by the least complications might be achieved.
Obstetrics and Gynecology
Nahid Zirak; Leila Mashhadi; Elaheh Jajarmi; Negar Morovatdar; Parisa Mohebbi; Nahid Javdani Haji; Shahrzad Maraghehmoghaddam; Leili Hafizi
Volume 7, Issue 3 , January and February 2022, , Pages 171-176
Abstract
Background & Objective: This study aimed to investigate the relationship between the level of high-sensitivity C-reactive protein (hs-CRP; as an indicator of inflammatory response) and shoulder tip pain (STP) following cesarean section (C-section).Materials & Methods: In this cohort study, a ...
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Background & Objective: This study aimed to investigate the relationship between the level of high-sensitivity C-reactive protein (hs-CRP; as an indicator of inflammatory response) and shoulder tip pain (STP) following cesarean section (C-section).Materials & Methods: In this cohort study, a total of 120 pregnant women who were candidates for elective C-section at Imam Reza Hospital were included. The level of hs-CRP was measured perioperatively. STP was measured after the operation.Results: Mean hs-CRP was significantly higher in females with STP compared to counterparts (19±13.1 vs. 7.2±4.5; P < /em><0.001). There was a positive and strong correlation between STP and postoperative hs-CRP (P < /em><0.001).Conclusion: The release of acute-phase proteins (such as hs-CRP) plays a significant role in STP after C-section; the intensity of STP is associated with the level of hs-CRP.
Obstetrics and Gynecology
Hana Sohrabi; Seyedeh Reyhaneh Yousefi-Sharmi; Rozbeh Sohrabi
Volume 5, Issue 4 , December 2020, , Pages 172-174
Abstract
Aplasia cutis congenita (ACC) is a rare congenital disorder characterized by localized or widespread skin absence. The most common site is the scalp and the main cause is unknown. Here we report a case of extensive ACC with scalp involvement. A female infant with an Apgar score of 9 and weighing 3406 ...
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Aplasia cutis congenita (ACC) is a rare congenital disorder characterized by localized or widespread skin absence. The most common site is the scalp and the main cause is unknown. Here we report a case of extensive ACC with scalp involvement. A female infant with an Apgar score of 9 and weighing 3406 gr was born by cesarean section in Besat Hospital, Sanandaj, Iran. A lesion measuring 5×10 cm with highly prominent vessels was on the forehead and parietal bone without scalp, skull, or bone tissue leading to the brain tissue being covered with a thin membrane. Other clinical examinations were normal. The newborn suffered from a ruptured aneurysm and intracerebral hemorrhage and underwent pharmacologic treatment. She died after 21 days of hospitalization. In order to prevent mortality in infants with skin defects, infection control is a priority. Antibiotics could be administered in cases with extensive lesions to prevent neonatal sepsis and improve scar tissue formation. Moreover, restorative measures should be taken if necessary.
Obstetrics and Gynecology
Zahra Naeiji; Saleheh Heydari; Melina Bahaar; Masoomeh Mirzamoradi; Atefeh Moridi; Marzieh Fathi
Volume 6, Issue 4 , August 2021, , Pages 195-201
Abstract
Background & Objective: Pessary is a silicone, rubber or plastic device, available in different shapes and sizes, which may prevent preterm labor in some pregnant women.Materials & Methods: We enrolled >18-year-old women with gestational age between 24 weeks and 0 days to 34 weeks ...
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Background & Objective: Pessary is a silicone, rubber or plastic device, available in different shapes and sizes, which may prevent preterm labor in some pregnant women.Materials & Methods: We enrolled >18-year-old women with gestational age between 24 weeks and 0 days to 34 weeks and 0 days, admitted to hospital with signs/symptoms of preterm labor (threatened preterm labor) and shortened cervical length (<25 mm in ultrasound measurement). Included subjects were randomly allocated to 2 groups. In first group a cervical pessary was placed for patient in lithotomy position. In second group no pessary was inserted and patients received only the routine standard institutional treatments.Results: Demographic characteristics, Body Mass Index, mean cervical length, parity status, fertilization type (natural, assisted) and route of delivery had no statistically significant difference in 2 studied groups. Although gestational age at which patient had experienced her first preterm labor episode was similar in 2 groups, gestational age at delivery was higher in pessary group compared with expectant management group (38.64 weeks versus 35.80 weeks which was statistically significant). Neonatal outcome measures (like rate of respiratory distress, orotracheal intubation, low birth weight, NICU admission, fetal death, etc.) were better (statistically significant) in pessary group.Conclusion: Using cervical pessary after successful control of a threatened preterm labor episode in women with short cervix can postpone the labor significantly, leading to increased gestational age and improved neonatal outcome.
Obstetrics and Gynecology
Dhai Abdulalazize Rashid; Fadia Jassim Alizzi
Volume 8, Issue 3 , May and June 2023, , Pages 233-239
Abstract
Background & Objective: Infertility that cannot be explained by anovulation, poor sperm quality, tubal disease, or any other recognized cause of infertility is referred to as unexplained infertility. The aim of this study is to assess the correlation between integrin alpha-v beta-3 expression, ...
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Background & Objective: Infertility that cannot be explained by anovulation, poor sperm quality, tubal disease, or any other recognized cause of infertility is referred to as unexplained infertility. The aim of this study is to assess the correlation between integrin alpha-v beta-3 expression, endometrial thickness and subendometrial blood flow resistance index in unexplained infertility.Materials & Methods: The study carried out on Kamal – Al-Samurai fertility center in the period from October 2020 - September 2021. Six days after detecting urinary Luteinizing Hormone (LH) surge, all the women were asked to come to do two-dimensional (2D) transvaginal ultrasound to assess endometrial thickness and subendometrial blood flow color Doppler resistance index and endometrial samples was taken and examined immunohistochemically to detect alpha-v beta-3 integrin. The cut-off value of integrin and subendometrial blood flow resistance index, sensitivity and specificity were calculated by applying Receiver Operative Characteristics (ROC) curve.Results: The endometrial thickness was lower and resistance index was higher in case group (P < 0.001). The expression of integrin alpha-v beta-3 in infertile group was significantly low (P < 0.001) with significant positive correlation between integrin score and endometrial thickness (r= -0.708 & P < 0.001) and significant negative correlation between integrin score and subendometrial resistance index (r= -0.786 & P <0.001).Conclusion: Alpha-v beta-3 integrin expressions and endometrial thickness are reduced significantly in mid-luteal phase while the subendometrial blood flow color Doppler resistant index significantly increased, and using them together can possibly be used as a diagnostic predictor of unexplained infertility.
Obstetrics and Gynecology
Atefeh Mousavi; Sharareh Jannesari; Sepideh Hajian; Mahnaz Solhi; Mehdi Khabaz Khoob; Malihe Nasiri; Aryan Sadeghyan
Volume 7, Issue 4 , March and April 2022, , Pages 304-313
Abstract
Background & Objective: Breast cancer is the most common type of cancer and about one-third of all cancers in women. Within the case of early detection, more than 90% of the patients are treated. However, most women do not perform breast self-examination as a simple, effective, and inexpensive way ...
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Background & Objective: Breast cancer is the most common type of cancer and about one-third of all cancers in women. Within the case of early detection, more than 90% of the patients are treated. However, most women do not perform breast self-examination as a simple, effective, and inexpensive way to prevent cancer deaths. Therefore, this study aimed to inform and educate women to promote self-efficacy and encourage individuals to self-care.Materials & Methods: This study is quantitative research and was conducted on 80 women aged 20-60 years old in health centers of the city of Some Sara. The data collection tool was a researcher-made questionnaire designed based on the Extended Parallel Process Model. The educational intervention was conducted using lecture, question and answer, movie screening, and practical presentation using Moulage. The health behaviors and performance of the participants before and immediately after the intervention, and two months later, were compared within the intervention and control groups. Data were analyzed by repeated-measures test, chi-square, Mann -Whitney, Exact Fisher's test.Results: The study results showed that educational intervention based on the Extended Parallel Process Model had increased self-efficacy within the intervention group compared with the control group. The intervention increased the average score of individuals from model structures. So that before the educational intervention, the average perceived susceptibility and severity score, perceived self-efficacy and response efficacy, perceived threat, and perceived efficacy was moderate. After the intervention, the average score of all model components increased (P < /em><0/05). The mean score of the performance checklist was 14 before the intervention, which was upgraded to 20 after the intervention (P < /em><0/05).Conclusion: The results of this study supported the effectiveness of the Extended Parallel Process Model in preventing breast cancer.
Obstetrics and Gynecology
Roya Kaboodmehri; Seyedeh Hajar Sharami; Sodabeh Kazemi; Mandana Mansour Ghanaei; Seyedeh Fatemeh Dalil Heirati; Zahra Pourhabibi; Sina Montazeri
Volume 8, Issue 4 , July and August 2023, , Pages 350-356
Abstract
Background & Objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluate the relationship between AMH levels and demographic factors.Materials & Methods: In this ...
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Background & Objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluate the relationship between AMH levels and demographic factors.Materials & Methods: In this cross-sectional study, conducted in Al-Zahra hospital Rasht in the north of Iran, 234 patients, 18-45 years old, were enrolled. The demographic parameters (e.g. age, education, habitat and etc.) and AMH levels were recorded for each patient. The patients were divided into two groups based on their AMH levels [group 1: less than 1.1 (ng/ml) vs. group 2: more than (1.1 ng/ml)]. The data was analyzed by SPSS-21 software.Results: The mean AMH level was 2.66 ng/ml. Age, education status and habitat showed significant differences among subjects with AMH levels, so that with aging the AMH levels decreased. Patients living in villages or the ones with low educational degrees and those with higher parities also revealed lower levels of AMH (p<0.05).Conclusion: There was a significant relationship between age, educational status and habitat with AMH values. Similar to other studies, we believe that with aging the AMH levels decrease. Furthermore, the other two aforementioned demographic features could affect a woman’s ovarian reserve and fertility status, too.
Gynecology Oncology
Mohammad Pouryasin; Azam-Sadat Mousavi; Jalil Pakravesh; Delaram Zare Kamel; Shahla Nooriardabili; Shakiba Khodadad; Soheila Aminimoghaddam; Mehran Ghazimoghadam; Yasaman Farbod; Ali Pouryasin
Volume 7, Issue 5 , July and August 2022, , Pages 405-413
Abstract
Background & Objective: Persistent infection with some types of Human papillomavirus (HPV), which are high-risk genotypes, can lead the patients toward cervical cancer and, finally, death. Recent studies showed HPV co-infection with non-HPV sexually transmitted infections (non-HPV STIs) could increase ...
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Background & Objective: Persistent infection with some types of Human papillomavirus (HPV), which are high-risk genotypes, can lead the patients toward cervical cancer and, finally, death. Recent studies showed HPV co-infection with non-HPV sexually transmitted infections (non-HPV STIs) could increase the persistency rate of HPV infections. This study aimed to estimate the prevalence of STIs and assess the association of HPV/non-HPV STIs co-infection on cervical cell changes based on cytological findings.Materials & Methods: In this cross-sectional study, in addition to the routine cervical screening, including HPV testing and cytological assessment, non-HPV STI testing was performed on 1065 Iranian women. To assess the HPV and non-HPV STIs, commercial kits were used.Results: 964 (90.5%) women had normal cytology (NILM) results. The overall prevalence of HPV and non-HPV STIs were 39.1% and 68.5%, respectively. HPV-53 (6.5%), -16 (6.1%) and -31 (5.5%) were found as the most prevalent genotypes. Ureaplasma Parvum (UP) (42.7%), Group B Streptococcus (GBS) (23.7%), Candida Species (CS) (23.6%), Ureaplasma Urealyticum (UU) (9.6%), and Mycoplasma Hominis (MH) (7.1%) were found as the most prevalent non-HPV STIs. The co-infection of HPV with GBS played an important role in developing the cervical lesion (P < /i><0.05). Conclusion: In the present study, the STIs, including HPV, UP, GBS, CS, UU, and MH, were prevalent among the study participant, and it was found that the HPV/GBS co-infection played a significant role in the development of LSIL or worse cytological grades. To clarify this issue, further studies will be conducted.
Reproductive Medicine
Sayedeh Elham Sharafi; Marzieh Hajibabaei; Fatemeh Keikha; Ali Montazeri
Volume 8, Issue 5 , September and October 2023, , Pages 464-471
Abstract
Background & Objective: Oocyte donation is an assisted reproductive technique. The infertile couples' demand for using this technique has increased in recent years. This study aimed to evaluate psychiatric disorders, personality characteristics and intelligence quotient among women who are candidates ...
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Background & Objective: Oocyte donation is an assisted reproductive technique. The infertile couples' demand for using this technique has increased in recent years. This study aimed to evaluate psychiatric disorders, personality characteristics and intelligence quotient among women who are candidates for oocyte donation.Materials & Methods: This was a cross-sectional study. Thirty-nine parous women were entered into the study. A psychiatrist interviewed participants regarding the psychiatric axis I disorders. Also, participants were asked to answer the Millon Clinical Multi axial Inventory (MCMI III) and Raven’s Standard and Progressive Matrices (RSPM).Results: The mean age of participants was 28.79 (SD = 4.1) years and it was 11.17 years (SD = 2.6) for education. The mean of donation frequency was 1.35 (SD =0.6). Twenty-one donors (53.8%) had only financial motivation and eleven (28.2%) had only altruist object. Twenty-eight (71.8%) women did not have any psychiatric axis I disorders while eight women (20.5%) had at least one disorder. Eleven participants (28.4%) suffered from at least one personality disorder. The mean intelligence quotient was 99.3 (SD =14.2).Conclusion: The results showed that oocyte donors might suffer from mental disorders and intelligence quotient problems irrespective of age, education, job status and motivation for donation. In conclusion, it seems that psychological assessment and help service is necessary for oocyte donors before any donation procedure.
Obstetrics and Gynecology
Neda Hashemi; Zahra Soleimani
Volume 7, Issue 6 , September and October 2022, , Pages 513-517
Abstract
Background & Objective: The association of Trichomonas vaginalis (T. vaginalis) and infertility is controversial. There is a doubt regarding the relation between T. vaginalis infection and female infertility. This study is the first meta-analysis that investigated the association between T. vaginalis ...
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Background & Objective: The association of Trichomonas vaginalis (T. vaginalis) and infertility is controversial. There is a doubt regarding the relation between T. vaginalis infection and female infertility. This study is the first meta-analysis that investigated the association between T. vaginalis infection and risk of female infertility.Materials & Methods: Web of Science, PubMed and Scopus were searched using appropriate keywords as major international electronic bibliographic databases up to January 2020. Q-test and I2 statistic were used for evaluating heterogeneity between studies as well as Begg's and Egger's tests for exploring publication. Results were reported by pooled odds ratio (OR) estimate from individual studies by choosing random-effects model.Results: In total, 650 articles were obtained by initial search until January 2020 with 9779 women. Results of the pooled OR estimates showed a significant association between T. vaginalis and infertility in adjusted studies (OR=1.95; 95% CI: 1.46, 2.43). Based on Begg's and Egger's tests, there was no evidence of publication bias (P < /i>=0.532 and P < /i>=0.896, respectively).Conclusion: There was a significant association between T. vaginalis and female infertility. However, more evidence is necessary to prove the potential association of T. vaginalis with an increased risk of female infertility.
Obstetrics and Gynecology
Nahla W. Shady; Amed A. Taha; Hany F. Sallam
Volume 8, Issue 6 , November and December 2023, , Pages 579-586
Abstract
Background & Objective: To determine the safety and adequacy of intravenous (IV) carbetocin compared to IV tranexamic acid (TA) plus sublingual misoprostol in reducing hemorrhage during and following cesarean delivery (CD) in women with at least one risk factor for postpartum hemorrhage.Materials ...
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Background & Objective: To determine the safety and adequacy of intravenous (IV) carbetocin compared to IV tranexamic acid (TA) plus sublingual misoprostol in reducing hemorrhage during and following cesarean delivery (CD) in women with at least one risk factor for postpartum hemorrhage.Materials & Methods: This clinical study was randomized. We randomly assigned 400 term pregnant women who were candidates for elective CD to receive either a 100 μg intravenous infusion of carbetocin or 1gm. IV TA along with 400 μg of sublingual misoprostol after delivery. Comparing the quantity of blood loss at and six hours following a CD was the primary result. We also disclosed the necessity for any extra medications and any adverse drug reactions.Results: When compared to the misoprostol plus tranexamic acid group, the carbetocin group's total mean blood loss was considerably higher (829.7 293.3 mL vs. 609.33 211.5 mL; P = 0.0001). Following the administration of carbetocin and misoprostol with TA, respectively, 9.5% and 26.5% of patients required further uterotonics treatment (P = 0.0001). When compared to the carbetocin group, the misoprostol group's side effects, such as a bad taste in the mouth and fever, were much greater (P = 0.0001).Conclusion: When it comes to minimizing overall blood loss during and after CD, IV tranexamic acid combined with sublingual misoprostol is superior to IV carbetocin.
Mahboobeh Shirazi; Behzad Abdollah Pour; Parisa Ghaffari; Fereydoun Jahangir; Esmaeil Daryaee; Zivar Abdollah Pour; Mehrnoosh Bagheryan; Fatemeh Shahbazi
Volume 1, Issue 1 , May and June 2016
Abstract
Background: As the use of computers and the Internet by adolescents and young adults continues to grow, it appears to be essential to study the relationship between the consumption of electronic media and mental health.
Objectives: The aim of this study was to investigate the relationship between depression ...
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Background: As the use of computers and the Internet by adolescents and young adults continues to grow, it appears to be essential to study the relationship between the consumption of electronic media and mental health.
Objectives: The aim of this study was to investigate the relationship between depression and Internet addiction in nursing students of Hazrat Zainab school of nursing (Larestan University of Medical Sciences) and Gerash Paramedical School, located in the southern part of the Fars province.
Materials and Methods: This was a descriptive correlation study, in which a questionnaire, including the beck depression inventory (BDI) and the young’s internet addiction test (IAT), were distributed among a total 150 volunteer students of Larestan Faculty of Medical Sciences. Statistical analysis was performed using the SPSS software, version 19 (SPSS, Inc., Chicago, IL, USA).
Results: The results showed that four percent of the participants of this study had Internet addiction and this dependency on the Internet, as according to the t-test, was not significantly different between males and females. However, the current results showed a significant association between depression and Internet addiction (P = 0.024, r = 0.222).
Conclusions: Technology plays an important role in our everyday lives and the identification of its dimensions is crucial.
Setareh Akhavan; Azamsadat Mousavi; Mitra Modaresgilani; Abbas Alibakhshi; Maryam Rahmani; Nasrin Karimi
Volume 1, Issue 2 , September and October 2016
Abstract
Background: Gestational trophoblastic neoplasm (GTN) during pregnancy includes an associated heterogeneous group of lesions that originates from abnormal proliferation of placenta. It includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor.
Objectives: ...
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Background: Gestational trophoblastic neoplasm (GTN) during pregnancy includes an associated heterogeneous group of lesions that originates from abnormal proliferation of placenta. It includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor.
Objectives: The aim of this study was to predict the risk of invasive mole in patients with a molar pregnancy in association with β-hCG level after the evacuation of molar pregnancy.
Methods: The current study was a prospective cross-sectional cohort research conducted as a diagnostic study on 110 patients with molar pregnancy referring to Department of Gynecology and Oncology of Vali-Asr, Imam Khomeini Hospital of Tehran between the years of 2015 and 2016. Patients with molar pregnancy, who were hospitalized with a diagnosis of hydatidiform mole by transvaginal ultrasonography, were examined in the study. The ability to perform ultrasonography before and after evacuation as well as the consent to participate in the study was among the inclusion criteria for patients. The patients were studied for invasive mole followed by two ultrasonography examinations, one 48 hours and the other 21 days after evacuation. β-hCG levels were also measured in successive periods of one week to six months. The association of sonography findings 48 hours and 21 days after evacuation with post-evacuation β-hCG levels was investigated using Chi-square test and multinomial regression.
Results: In the current study conducted on 110 patients with hydatidiform mole, the results showed that 46 patients (41.8%) suffered from invasive mole. In 23 patients (50%) with invasive mole, the results of both ultrasonography 48 hours and 21 days after evacuation were positive. There was a significant correlation between ultrasonography after evacuation (positive and negative results) and the progress of β-hCG after evacuation in women with invasive mole (P = 0.001); this means that in 73% of women with invasive mole, the positive β-hCG results corresponded with positive 21-day sonography after evacuation, and in 41% cases, ultrasound results on day 21 were reported positive before the results of β-hCG.
Conclusions: Positive results of sonography accompanied with positive results of β-hCG have a high efficiency in the diagnosis of invasive mole; therefore, more definitive studies with a larger sample size are suggested to confirm this hypothesis.
Sedigheh Borna; Hajiehe Borna; Fahimehe Gotbizadeh; Mahnaz Jahani
Volume 1, Issue 3 , November and December 2016
Abstract
Background: Progesterone is a smooth muscle relaxant and also has a vasodilator effect on human placental arteries and veins.
Objectives: The aim of this study was to evaluate the effect of progesterone therapy on fetal Doppler velocimetry in intrauterine growth retardation (IUGR) and preterm fetuses.
Methods: ...
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Background: Progesterone is a smooth muscle relaxant and also has a vasodilator effect on human placental arteries and veins.
Objectives: The aim of this study was to evaluate the effect of progesterone therapy on fetal Doppler velocimetry in intrauterine growth retardation (IUGR) and preterm fetuses.
Methods: Thirty pregnant females with IUGR and thirty pregnant females with threatened preterm labor at 28 to 37 weeks of gestation were enrolled in the clinical trial study. Fetal Doppler velocimetry was investigated before, 24 hours and two weeks after progesterone therapy. Seven patients with IUGR and 9 patients with preterm labor were excluded from the study before completion of the survey due to the termination of pregnancy.
Results: Following progesterone treatment, middle cerberal arterypulsatility index (MCA_PI) significantly decreased after 24 hours in patients with IUGR and after two weeks in patients with preterm labor (P < 0.001). There was not a statistically significant decrease in the pulsatility index of the fetal umbilical artery (UmA) after 24 hours in the IUGR fetuses (P = 0.18). Umbilical artery pulsatility index (UmA_PI) significantly decreased after two weeks in IUGR fetuses (P < 0.004).
Conclusions: Progesterone led to a reduction in the MCA_PI and UmA_PI in IUGR and preterm fetuses. Vasodilatory effect of pro gesterone on the umbilical artery is mediated by multiple doses in IUGR fetuses.
