pISSN: 1735-8949
eISSN: 1735-9392
Editor–in–Chief:
Fatemeh Davari Tanha, MD.
Vol 12, No 1 (March 2018)
Original Articles
-
Objective: To assess the relationship between free testosterone level and components of MS in women with PCOS.
Materials and methods: This is a cross-sectional study which was conducted on 215 women with PCOS. PCOS was diagnosed based on the Rotterdam criteria. Patients were divided into two subgroups of patients with and without MS based on ATP III criteria. In each subgroup, the association between individual components of MS with free testosterone was measured. Data were analyzed using SPSS software.
Results: The prevalence of MS was 28.8% (n = 62). The mean level of free testosterone in patients with blood pressure ≥ 130/85 was significantly higher than those with blood pressure < 130/85 mm/hg. (p = 0.029) Also, in patients with diastolic blood pressure ≥ 85, the level of free testosterone was significantly higher than patients with diastolic blood pressure < 85. (p = 0.026). Results showed significant positive correlation between the level of free testosterone and cholesterol (p = 0.024). But no significant correlation was noted between levels of free testosterone and other variables.
Conclusion: Regarding the relationship between blood pressure and high levels of free testosterone, it seems that regular blood pressure screening has a higher priority of concern comparing other complications for preventing cardiovascular adverse effects in women with PCOS and hyperandrogenism. -
Objective: To determine the role of aqueous crude leaf extract of Seneciobiafrae (SB) combined with Zinc (Zn) on Testicular function of Adult Male Sprague dawley Rats.
Materials and methods: Twenty-four adult males praguedawley Rats weighing 180-200g, aged 10-12 weeks, were randomized into four groups (A,B,C,D) of six rats each (n = 6) and were given 2mls of distilled water; 500 mg/kg of SB ; 500 mg/kg of SB and 0.5 mg/kg Znsulfate; 500 mg/kg of SB and 1mg/kg of Zn. The administration was done daily via gastric gavage for 28 days. Parameterstested include: testicular histology, sperm parameters, haematological parameters and Testosterone assay.
Results: There was observed no significant (p > 0.05) increased in testis, epididymal, seminal vesicle, vas deference and prostate gland weight of animals across the group receiving the Seneciobiafrae extract combine with Zn. Testis and serum testosterone levels, sperm count, percentage of sperm viability and motility was higher in the rats administered a combination of Seneciobiafrae extract and Zn compared with controls (p < 0.05). Conversely the percentage of abnormal sperm morphology was decreased (p < 0.05). Histological analysis showed normal spermatogenesis, better association and high density of spermatogenic cells and lumen contains full mature spermatozoa.
Conclusion: Aqueous extract of Seneciobiafrae combined with Zn, potentially enhance testicular function including steroidogenesis and spermatogenesis in male rats. -
Objective: To evaluate association between polymorphism rs1670533 in RNF212 gene with the risk of Down syndrome in young women.
Materials and methods: In a case control study, one hundred pregnant women were evaluated in both group. The case group consisted pregnancy with diagnosis of Down syndrome in women younger than 35 years old. The control group consisted pregnancy with normal neonate. Fifty pregnant women in each group were allocated.one hundred blood samples were collected. Genomic DNA was extracted by salting – out method and polymorphism of rs1670533 were detected by PCR.PCR products were detected on 2% agarose gel electrophoresis.
Results: The TTrs1670533 haplotype was present in 36% of pregnant women with Down syndrome versus 14% of normal pregnant women, (p = 0.003 e-12; CI 95%1.665-5.305, OR = 3.107); TC haplotype was present in 56% of normal pregnancy regarding of16% of pregnancy with Down syndrome (p = 4.288 e = 12; CI 95%: 0.145-0.25; OR = 0.126).
Conclusion: It seems that TTrs1670533 haplotype is a risk factor for pregnancy with Down syndrome in young women and TC haplotype has protective effect. -
Objective: Even though cervical length is considered as predictor of timing and mode of delivery, it is not used as a screening tool in low risk asymptomatic population. This study was carried out with the intention to know the timing and mode of delivery in asymptomatic low risk women using second trimester ultrasonographic cervical length measurement and predict the risk of pretermlabor, prolonged pregnancy and need for caesarean section. 1) To determine the association between cervical length at mid-pregnancy and timing of delivery. 2) To determine the usefulness of mid-pregnancy ultrasonographic cervical length measurement in predicting mode of delivery.
Materials and methods: Transvaginal sonography was performed to measure the cervical length between 20-24 weeks of gestation. These patients were followed till delivery to assess the gestational age at delivery and mode of delivery.
Results: Totally 237 patients were recruited of which 173 satisfied the inclusion criteria. Out of 15 patients with cervical length less than 3cm, 14(93.33%) had preterm delivery. Postdated pregnancy was observed in 45(90%) out of 50 patients with cervical length more than 4cm. In the group with cervical length less than 3cm, 12 (80%) delivered vaginally. Among cervical length more than 4cm group 24 (48%) required cesarean section.
Conclusion: Cervical length of less than 3cm measured between 20-24 weeks of gestation is associated with preterm births and favours vaginal birth whereas, cervical length of more than 4cm is associated with postdated pregnancy and increased incidence of cesarean section. -
Objective: To evaluate the effect of letrozole plus misoprostol to terminate non-viable pregnancies in first trimester compared with the use of misoprostol alone.
Materials and methods: In a single-blind clinical trial, 128 women over 18 years old referred to Educational-Medical centers of Tabriz University of Medical Science (Tabriz, Iran), for abortion in first trimester of non-viable pregnancies, were randomly selected in two intervention and control groups using Rand list (version 1.2) software. To complete abortion both groups received 600 mcg of misoprostolorally. The intervention group received letrozole 10 mg daily for 3 days before receiving misoprostolorally. Complete abortion rate and the side effects of both groups were recorded.
Results: Mean pregnancy age based on LMP in intervention group and control group were 7.74 ± 0.95 and 8.52 ± 1.29 weeks respectively. Complete abortion rate in the intervention group was 93.7%, and in control group was 68.7% which was significantly higher in intervention group (p = 0.001). Abdominal pain in the intervention group is also significantly lower than that of the control group (p = 0.013). Intervention group also had significantly lower duration of bleeding rather than control group (p = 0.006).
Conclusion: Based on the findings of this study, letrozole pretreatment with misoprostol for first-trimester medical abortion can increase complete abortion rate significantly without increasing side effects compared to use of misoprostol alone. -
Objective: To assess reproductive health needs in men and women as the first and basic step in educational planning.
Materials and methods: The study was qualitative. Participants were Postmenopausal women and men over 60 years. Data gathering was done by semi structured interviews. Analysis of the qualitative data was conducted during a multi-step process according to the assessment method of Altschuld et al needs analysis.
Results: Two general themes were considered in categorizing codes extracted from interviews: 1) Problems, 2) Demands. Women’s reproductive health problems were Problems associated with menopause, Related to family planning, sexual problems, and diseases and cancers. Reproductive health problems in men were in two main subthemes Urinary-reproductive problems and sexual dysfunction. Their main demand was for establishing a health center for geriatric reproductive health.
Conclusion: Aging has severe effect on men’s and women’s reproductive health and elderly peoples need health services to cope with changes, therefore these needs should be considered in medical curriculums. -
Objective: We aimed to determine the effect of psychoeducation on women’s anxiety in subsequent pregnancy following stillbirth.
Materials and methods: This two-arm, semi-experimental study was conducted on 100 women with subsequent pregnancy after stillbirth who visited the healthcare centers affiliated to a university of medical sciences in southeast of Iran in 2017. The eligible women were selected by using the convenience sampling method and were randomly divided into the intervention and control groups. The intervention group attended four psychoeducation sessions during four weeks according to the determined content. On the other hand, the control group received the routine care education. After eight weeks, data were collected using Pregnancy Related Anxiety Questionnaire (PRAQ). To analyze the data, independent t-test, Paired t-test and Chi-square U test, were run in SPSS, version 21.
Results: No significant differences were observed between the study groups in terms of demographic characteristics (p > 0.05). Although the mean score of anxiety was not significantly different in the intervention and control groups prior to the psychoeducation sessions (p = 0.83), it was significantly lower in the intervention group after the psychoeducation intervention, compared to the control group (50.64 ± 20.05 vs. 63.54 ± 22.90; p = 0.0001).
Conclusion: Psychoeducation intervention could diminish anxiety in women with subsequent pregnancy after stillbirth. Therefore, we recommend incorporating the components of psychoeducation related to the special needs of this group of women as a part of the routine prenatal care and educating healthcare providers to use these interventions. -
Objective: To correlate the Magnetic Resonance Imaging findings and clinical presentation in patients of eclampsia.
Materials and methods: This one year prospective study was conducted in the HDU of Department of Obstetrics and Gynecology, PT.B.D.Sharma, PGIMS, Rohtak .A total of 50 women with eclampsia (both antepartum and postpartum) were divided into two groups: a) study group patients with abnormal MRI
b) control group: b) control group: patients with normal MRI.Comparison was done using chi-square test and unpaired student ‘t’ test.
Results: MRI revealed abnormal findings in 24% of women, commonest diagnosis being CVT without infarct (10%) followed by infarct (8%), PRES (4%) and HLE (2%).Totally 66% (n = 33) of the women presented with postpartum eclampsia while 34% (n = 17) had antepartum eclampsia.96%(n = 48) were unbooked cases. Unconsciousness, altered sensorium, headache, blurring of vision, seizures, GCS < 3 correlated well with MRI findings (p = 0.000, p = 0.027, p = 0.001, p = 0.007, p = 0.005, p = 0.000 respectively) whereas fundoscopic changes did not (p = 0.520). The mean uric acid and serum creatinine levels was higher (0.41 ± 0.11 mmol/ L vs 0.26 ± 0.10 mmol/ L and 80 ± 18 µmol/ L vs
71 ± 9 µmol/ L) in the study group and this was statistically significant (p = 0.003, p = 0.04 respectively).There was no statistically significant difference between blood pressure values of cases with or without MR imaging evidence of brain lesions. There was no maternal mortality among 50 cases. The sensitivity, specificity, positive predictive value and negative predictive value of neurological findings for abnormal MRI in patients with eclampsia was found to be 91.7%, 73.7%, 52.4%, 96.6% respectively.
Conclusion: Unconsciousness, altered sensorium, headache, blurring of vision,seizures, GCS < 3, elevated uric acid and serum creatinine levels in the follow-up of pregnant patients with preeclampsia/eclampsia should be a warning for possible brain lesions whereas booking status, mean BP, fundoscopy, platelet, hemoglobin, liver enzymes were not significantly associated with positive MRI findings in patients of eclampsia.
