Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 12 3 2018 12 15 121 128 EN Reza Heidari Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Mostafa Akbariqomi Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Elaheh Motevaseli Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Mir Davood Omrani Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hamid Kooshki Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Ahmad Reza Shamshiri Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Shilan Shafei Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Moloud Absalan Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad Ali Mazlomi Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Soraya Saleh Gargari Department of Gynecology & Obstetric, Shohada Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Gholamreza Tavoosidana Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran 2018 06 20 2019 01 15 Objective: To investigate the performance of first trimester Down syndrome (DS) screening markers in Iranian pregnancies.Although sonographic and serum markers are currently recommended for the first trimester screening of Down syndrome, the screening performance of the markers depends on the race and ethnicity. Materials and methods: A retrospective case-control study using first trimester screening results recorded with the prenatal diagnostic multi-centers in Iran. A total of 6,384 pregnant women were examined from March 2012 to February 2017. Totally 100 Down syndrome cases and 266 matched controls were selected and the maternal characteristics, sonographic and biochemical screening data were collected. Statistical analysis was performed using logistic regression and descriptive statistics. A decision tree model was designed using the chi-squared automatic interaction detection method based on serum markers. Results: For screening of DS pregnancies, PAPP-A (cut-off 0.795 MoM) yielded the highest sensitivity (86%) and NB marker presented highest specificity (96.24%). combination of the biochemical markers PAPP-A and β-hCG (cut-off: 1.55 MoM) showed the highest sensitivity over other combined markers. The decision-tree model based on serum markers improved (91% DR For a 5% FPR) first trimester screening performance. Conclusion: The novel decision-tree model base on serum markers revealed a better predictive value to achieve high sensitivity and specificity of first trimester Down syndrome screening in Iranian population. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/906 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/906/458

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 12 3 2018 12 15 169 172 EN Salmeh Dadgar Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Seyedeh Azam Pourhosseini Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2018 08 28 2019 01 15 Spontaneous uterine inversion rarely occurs in times other than the postpartum period. This condition is usually associated with the presence of a polypoid mass in the fundus, which is often a uterine leiomyoma or, in rare cases, a uterine sarcoma. Herein we report a case of a multipara, 51-year-old woman, presented with pelvic pain and vaginal bleeding. On the speculum examination, a circular mass of about 10 Cm, was observed in the vagina. In an ultrasound, a 55×62 mm intramural fibroid was observed. the patient was scheduled for surgery. After accessing the abdominal cavity, the patient was diagnosed with the uterine inversion. A longitudinal incision was made on the retraction ring. The base of the prolapsed mass was clamped at the incision site, and the mass was driven up into the vaginal canal and a total hysterectomy was performed. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/952 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/952/462

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 12 3 2018 12 15 129 133 EN Fatemeh Mostajeran Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Hatav Tehrani Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Elham Ghoreishi Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 2018 08 24 2019 01 15 Objective: The fertility potential of women declines with aging and the likelihood of infertility and stillbirth increase. Treatment protocols involving dehydroepiandrosterone (DHEA) provide pathways on improving fertility and live birth rate. This randomized clinical trial aimed to evaluate the effect of DHEA on In Vitro Fertilization (IVF) outcomes in women over 35 years and normal ovarian reserve. Materials and methods: One hundred and six consecutive women with advanced reproductive age undergoing IVF due to infertility were enrolled in the study. Participants in the intervention group received 75 mg/day of DHEA orally 8 weeks before starting the cycle of ovulation induction. Participants in placebo group received placebo tablets during the same period. After 8 weeks, routine procedure of IVF was initiated then Clinical pregnancy, Miscarriage, Endometrial thickness and Duration of stimulation were evaluated for all the participants in both groups. Results: There is no significant difference between groups in terms of age and BMI. Mean endometrial thickness was significantly lower in DHEA group (9.63 ± 0.70vs.8.05 ± 0.70; p < 0.001) while Duration of stimulation was higher (8.98 ± 1.29vs.10.59 ± 1.43; p < 0.001). There was no significant difference between pregnancy rate, and miscarriage rate of the groups. Conclusion: According to the result of this study, DHEA supplementation may improve IVF outcomes in infertile women. Although additional larger and placebo-controlled studies using different DHEA protocols are required to support our present findings.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/951 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/951/459

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 12 3 2018 12 15 173 176 Leili Hafizi Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Elham Rezaii Asgarieh Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Nayereh Taheri Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Nayereh Ghomian Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2018 09 09 2019 02 05 Objective: Triplet or higher-order multiple pregnancies are often caused due to ovulation induction. Spontaneous quadruplet pregnancy is a rare phenomenon which is associated with maternal and fetal complications. Here in, we report a spontaneous quadruplet pregnancy with no family history and as a result of an unwanted pregnancy. Case report: The patient was a 34-year-old, G4 L2 Ab1. She noticed being pregnant during breastfeeding, a spontaneous quadruplet pregnancy. There was no case of multiple pregnancies in her or her husband's family. In week 29 she was hospitalized due to the diagnosis of preterm labour. At 32 weeks and 4 days of gestation, because of the restart of labour contractions and dilatation development, she underwent a cesarean section. The outcome was the birth of 4 healthy neonates weighing between 1800 to 2100 gram and normal Apgar score. Conclusion: Quadruplet pregnancy can rarely occur spontaneously even unintentionally, and can reach the third trimester without prophylactic cerclage. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/966 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/966/463

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 12 3 2018 12 15 134 141 EN Farahnaz Rostami Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Lida Moghaddam Banaem Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Sedigheh Hantoushzadeh Maternal, Fetal & Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran 2018 09 07 2019 01 15 Objective: To compare administration of weekly high dose versus daily low dose vitamin D3 in treatment of vitamin D3 deficiency in pregnancy. Materials and methods: A randomized controlled clinical trial was performed between July 2016 until 2 July 2017 on 215 pregnant women with vitamin D3 deficiency (serum levels < 30 ng/ml) and gestational age less than 14 weeks. The participants were randomly assigned to 2 treatment groups of A: receiving 1000 unit vitamin D3 daily, and B: 50,000 units weekly for 10 weeks. At 24-28 weeks of gestation, serum levels of vitamin D3 were measured again. Data entry and statistical analysis were performed by SPSS software v. 20 and P value less than 0.05 was considered as statistically significant level. Results: Primary mean serum vitamin D3 level in group A was: 17.3 ± 6.8 and in group B: 15.2 ± 7.3 ng/ml while mean serum vitamin D3 level after treatment in group A was significantly lower than group B (31.9 ± 118 B vs. 42.9 ± 15.5, p-value: < 0.001); both groups were successfully treated, no remarkable side effects were observed in either groups. Conclusion: As both regimens treat vitamin D deficiency successfully and consuming weekly high dose vitamin D3 makes more acceptable serum levels for mothers with no apparent side effects weekly high dose vitamin D3 can be safely administered for vitamin D3 deficiency in pregnancy, if further studies show similar results. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/965 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/965/460

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 12 3 2018 12 15 142 147 EN Masomeh Mousavi Nursing and Midwifery Care Research Center, Faculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Mokhtar Mahmoudi School of Nursing and Midwifery, Iran University of Medical science, Tehran, Iran Mohamad Golitaleb School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran Mohammad Goodari School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran Davood Hekmatpou Department of Nursing, Faculty of Nursing, Arak University of Medical Sciences, Arak, Iran Parya Vakilian Department of Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran 2018 09 02 2019 01 15 Objective: Andropause syndrome is caused due to the deficiency in sex hormones and brings about symptoms of physical, psychological, and sexual nature. This study aims at investigating the prevalence of andropause syndrome in 40-65-year-old men in the central city of Iran (Arak). Materials and methods: This study is a descriptive cross-sectional research conducted on 600 men living in the city of Arak in 2017. The subjects were selected through cluster sampling and qADAM was used for collecting data including three areas (level of energy, psychological and sexual). The data were analyzed through descriptive and inferential statistics (independent t-test and ANOVA) and using SPSS 16. Results: The results showed that the average questionnaire score increased with an increase in age up to 50 years and above. Correlation test for the three subscales of physical, psychological, and sexual showed that the psychological subscale had the highest correlation with andropause score (p < 0.05). Among the items related to the subscales, the statement” I feel my sex drive has decreased” with mean and standard deviation of 3.62 ± 1.06 had the highest correlation with andropause and the statement “I feel I have no value for society” with mean and standard deviation of 1.7 ± 0.86 had the lowest correlation with andropause.   Conclusion: Andropause age in Arak is 50 years and above. Average questionnaire score showed a positive direct relation with age. Decreased sex drive had the highest correlation and losing social value had the lowest correlation with andropause state. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/958 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/958/465

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 12 3 2018 12 15 148 159 EN Sunday Adelakun Department of Human Anatomy, School of Health and Health Technology, Federal University of Technology, Akure, Ondo State, Nigeria AND Department of Anatomy, Faculty of Basic Medical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Oyo state, Nigeria Busuyi Akinola Department of Human Anatomy, School of Health and Health Technology, Federal University of Technology, Akure, Ondo State, Nrsicum Boiss) on Early Return of Bowel Motility After Caesarean Section: Double-Blind, Randomized, Placebo-Controlled Trial 35 41 Seyde Sedighe Yousefi Asistant Professor, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran AND Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran Omid Sadeghpour The Research Institute for Islamic & Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran Zeinab Hamzehgardeshi Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran AND Sexual and Reproductive Research Centre, Mazandaran University of Medical Sciences, Sari, Iran Farnaz Sohrabvand Department of Obstetrics, Gynecology & Infertility, School of Medicine, Tehran University of Medicine Sciences, Tehran, Iran 2019 01 11 2019 07 28 Objective: To investigate the effect of the Carumcarvi (BuniumpersicumBoiss) plant, a gas solvent, on resumption of bowel motility after caesarean section. Materials and methods: A randomized controlled trial was done on a group of 98 women undergoing elective caesarean section under general anesthesia in a university hospital. Patients in the intervention group (Group A) drank 10 ml of a syrup containing 8 g of BuniumpersicumBoiss in 20 ml of syrup 6 to 7 hours after surgery. The control group (Group B) comprised 10 patients who drank 10 ml of placebo syrup 6 to 7 hours after surgery. Demographic characteristics, time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement, and length of hospital stay were compared between the two groups. Results: Compared with the control group, the intervention group had a significantly shorter mean time to hearing the first intestinal sounds (10.66 ± 2.38 vs. 19.54 ± 3.85 h), mean time to first flatus (13.91 ± 3.73 vs. 24.82 ± 5.83 h), mean time to first bowel movement (19.31 ± 4.63 vs. 30.70 ± 10.21 h), and mean length of hospitalization (31.70 ± 7.70 vs. 49.20 ± 10.16 h) (p < 0.05). No patients developed serious side effects associated with consumption of the syrup. Conclusion: The use of a gas solvent such as BuniumpersicumBoiss after caesarean section can speed the resumption of postoperative bowel motility. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1041 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1041/478

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 13 1 2019 07 28 42 46 EN Jayran Zebardast Institute for Cognitive Science Studies (ICSS), Tehran, Iran Nikzad Eisazadeh Quran, Hadith and Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran Khorshid Vaskooi Treatment Vice Chancellor, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Mirbazegh Treatment Vice Chancellor, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran 2018 05 16 2019 07 02 Objective: The purpose of this study was to investigate the status of knowledge, attitude and practice of medical team about suitable " Healthcare personnel (HCP) attire". Materials and methods: This is a descriptive study that was approved by the Research Ethics Committee of Tehran University of Medical Sciences, and evaluated knowledge, attitude and performance of physicians and nurses about "Health care personnel (HCP) attire" by a questionnaire. In order to create the questionnaire a panel of experts&#x