International Journal of Women's Health and Reproduction Sciences
Year:2019 | Volume:7 | Issue:3|Papers Count:31

Endometrial carcinomas which account for more than 90% of uterine cancer cases are the most common gynecologic malignancies of the female reproductive organs. Thanks to the recent molecular studies, genomic alterations leading to the pathogenesis of these types of cancers have been revealed extensively. Nowadays, conventional pathologic diagnoses of them do not seem to be able to sufficiently guide the optimal clinical managements and therefore, efforts to develop a new classification system based on their molecular-morphologic features is highly encouraged (1). Publication of the Cancer Genome Atlas (TCGA) report on a genomic analysis of 373 endometrial carcinomas (2) forced the efforts to incorporate molecular testing into routine histologic evaluation (3). Although DNA polymerase epsilon, catalytic subunit (POLE), mismatch repair (MMR), and human epidermal growth factor receptor 2 (HER2) are highly evaluated molecular tests due to potential efficacy of immune checkpoint inhibitors and other targeted therapies, the data is not sufficient to attain a clear consensus on which tests to perform...

Objectives: Hyoscine butylbromide is one of the drugs that is used to shorten prolonged labor and helps to decrease the complications and pain related to prolonged labor. To prescribe this drug, understanding its effect on the duration of labor is important through summarizing the available primary study results. Therefore, the present study aimed to determine the effect of hyoscine butylbromide in shortening the duration of labor through summarizing the available primary evidence. Materials and Methods: To this end, different electronic databases were searched including the International Scientific Indexing Web of Science, PubMed/Medline, and Scopus in order to find English published articles during 2000-2017. The obtained data were by Stata software. Finally, the effect of hyoscine butylbromide was estimated by the mean difference (MD) and CI as the summary measures using a random-effects meta-analysis model. Results: Based on the results, hyoscine butylbromide significantly reduced the duration of labor in the intervention group when compared to the placebo group in the first (MD =-67. 77 minutes, 95% CI,-90. 98 to-44. 56) and second stages of labor (MD=-2. 76 minutes, 95% CI,-4. 79 to-0. 74). However, it failed to significantly decrease the duration of labor in the third stage (MD =-0. 45 minutes, 95% CI,-1. 45 to 0. 56) in the intervention group. Conclusions: In general, hyoscine butylbromide led to a significant reduction in the duration of labor in the first and second stages while it caused no significant decrease in its duration in the third stage. Thus, hyoscine butylbromide could be used for reducing labor duration in the first and second stages of delivery.

Objectives: Teenage marriage results in social, cultural, and economic problems including domestic violence. Based on research evidence, the present study attempted to provide a documentary image of domestic violence in early marriages. Materials and Methods: This study was conducted by searching different databases such as Web of Science, Cochrane Library, Science Direct, PubMed, Scientific Information Database, Google Scholar, Magiran, Irandoc, and Iranmedex for articles which were published during 2000-2018. To this end, MeSH keywords like “ dating violence” , “ intimate partner violence (IPV)” , “ teenage marriage” , and “ domestic violence” were utilized and thus a total of 176 articles were obtained and selected for review. Finally, the “ Grading of Recommendations, Assessment, Development, and Evaluations” (GRADE) approach was used to order the quality of evidence. Results: Based on the findings, the general prevalence of domestic violence varies from 7% to 48% in the world and from 10. 7% to 93% in Iran. IPV is more prevalent in younger women and psychological and physical violence is higher in this group. In addition, the prevalence of domestic violence in pregnancy varies from 2% to 43. 5%. Women experience more violence in three months pre-pregnancy, during the first six months of pregnancy, and three months after childbirth. During pregnancy, domestic violence is related to the complications of preterm labor, low birth weight, vaginal bleeding, and hospitalization. Eventually, depression, panic attacks, excessive alcohol use, eating disorders, and suicidal thoughts are mental health disorders resulted from domestic violence. Conclusions: Overall, young women are the sacrifice of violence in their most active years of life, which is along with the most harm in society concerning health, economics, cultural, and social issues. Considering its high rate, teenage marriage can be prevented by increasing public awareness and the cooperation of related organizations.

Objectives: High-risk pregnancies can affect the quality of life (QOL) of pregnant women due to their complications. QOL involves different dimensions including physical, psychological, and social health of the individuals. Assessing the QOL, especially in mothers with gestational diabetes is important in planning for maternal and newborn care and understanding the need for care for policymakers and the health care association. Therefore, the present study aimed to review the effects of gestational diabetes on QOL during pregnancy. Materials and Methods: In this study, articles indexed in several databases such as PubMed, Science Direct, Scopus, Google Scholar, SID, and Magiran were obtained among which, those related to the QOL of mothers with gestational diabetes were extracted and evaluated based on the aim of the study. Results: The series of the reviewed studies included 10 articles on the physical, psychological, and social dimensions of the QOL of mothers with gestational diabetes. Most of the examined articles failed to find any significant change in the physical dimension of QOL of mothers with gestational diabetes. The psychological effects of gestational diabetes were diverse and less understandable, therefore, different studies obtained contradictory results in this regard. Three out of four studies examining the social dimension of QOL of women with gestational diabetes showed that mothers’ QOL could be jeopardized by social dimension. Conclusions: In general, the results revealed that gestational diabetes could affect various physical, psychological, and social dimensions of the QOL of mothers. In addition, adequate education should be provided for mothers with diabetes in order to reduce their fear, anxiety, and depression concerning gestational diabetes.

Objectives: Menopause is a naturally occurring event in which there is a failure of a woman’ s ovarian function, thus ending her ability to bear children. However, the attitude of women about menopause and its treatment vary in different societies. The present study assessed postmenopausal women’ s attitude and knowledge about menopause and hormone treatment (HT) in a private specialist clinic in Enugu, Nigeria. Materials and Methods: This descriptive cross-sectional survey was conducted on 400 consecutively selected women at the gynecologic clinic of a specialist hospital in Enugu through a structured questionnaire. Descriptive statistics were applied to investigate women’ s attitudes using SPSS software. The level of significance was estimated by the chi-square test and P<0. 05 was considered statistically significant. Results: The mean age of the respondents at menopause was 48. 4 (± 5. 2) years, and their ages ranged between 38 and 52 years. A total of 300 (75%) women had at least primary education. In addition, the hot flush was the most common symptom. Further, 236 (59%) of the respondents obtained their information based on experiences and older women while 64 (16%) of them received such information from books and the internet. Totally, 148 (37%) of women sought treatment in the hospital and 196 (49%) of them had heard of HT mostly from their physician. Even though they were aware that HT relieves hot flushes, they were afraid of the perceived side effects like cancer and heart disease. However, 10. 3% remained as the current users. Given adequate information, 37% of the respondents would like to use HT. Conclusions: In general, an increased number of postmenopausal women in Enugu, Nigeria seek relief in the hospital and are becoming aware of HT.

Objectives: The present study aimed to evaluate the effects of granulocyte colony-stimulating factor (G-CSF) as an adjunct to in vitro fertilization (IVF). In other words, it delved into the influence of G-CSF on the endometrium and the achievement of pregnancy. Materials and Methods: This retrospective cross-sectional study was conducted on a subgroup of women with two or more previously failed IVFs, who attended a fertility clinic in Johannesburg. These women underwent a procedure of transvaginal infusion of G-CSF in addition to their IVF protocol although endometrial thickness was not a criterion for G-CSF use. Results: The group included 49 women with a mean age of 38. 9 years (SD ± 6. 11). The mean number of previous IVFs was 3. 1 (SD ± 1. 76). The mean endometrial thickness pre-G-CSF and post-G-CSF was 7. 53 mm (SD ± 2. 69) and 9. 11 mm (SD ± 2. 12), respectively. The clinical pregnancy rate was 34. 69%. Univariate analysis between the groups of women who achieved or failed to achieve pregnancy showed that the age difference between the two groups was statistically significant (P = 0. 0005). Further, G-CSF use was associated with increased pregnancy rates in younger women. Finally, although the mean endometrial thickness pre and post-G-CSF were not statistically significant between the two groups (P > 0. 05), the mean change in endometrial thickness was statistically significant in all women regardless of pregnancy outcome (P = 0. 0029). Conclusions: In general, G-CSF is considered as a useful adjunct for the treatment of women with recurrent failed IVFs and aged less than 38 years. Based on the findings, a statistically significant overall expansion of endometrial thickness was reported by using G-CSF. However, it failed to show any association between endometrial expansion and pregnancy outcome.

Objectives: The aim of this study was to identify the effect of socio-economic factors such as family income, employment, housing education, and tobacco smoke exposure on spontaneous preterm birth (SPTB) in Saudi women. Materials and Methods: A matched case-control study was conducted on 150 women with SPTB delivery and 150 women with spontaneous full-term delivery, in three hospitals in Riyadh. Cases and controls were matched in terms of age and parity. Then, information on maternal socio-economic risk factors was obtained through face-to-face interviews. The odds ratio (OR) for risk factors and a 95% confidence interval (CI) were calculated as well. Finally, a multiple logistic regression model was used to control potential confounding factors. Results: Based on the results, factors including first-degree consanguinity (adjusted OR [AOR] =3. 72, 95% CI=1. 52-9. 12), exposure to tobacco smoke (AOR=2. 62, 95% CI=1. 03-6. 66), and low family income (AOR=4. 63, 95% CI=1. 62-13. 27) were all associated with an increased risk of SPTB. Conclusions: Overall, SPTB in Saudi Arabia was found to be correlated with first-degree consanguinity, low family income, and exposure to tobacco smoke. Therefore, public health interventions conducted to address these associated factors may contribute to the reduction in the prevalence of PTB.

Objectives: Physical activity is considered as an essential component of a woman’ s ability to maintain or improve her level of wellness. Nevertheless, women, particularly young girls, usually pay less attention to health-promoting behaviors such as regular physical activity. Given the significance of physical activity in woman’ health status, the present study aimed to determine the influence of such activity and body mass index (BMI), especially on menstrual characteristics and menarche age among young females according to their socioeconomic status (SES). Materials and Methods: Data collection included two parts. First, a cross-sectional study was conducted on 1000 healthy and young females aged 11-28 years and standardized self-reporting questionnaires were used to obtain relevant information. Then, purposive sampling technique was utilized to compare the information pertinent to physically active and inactive females or those with sedentary behavior. The data were later analyzed using the chi-square test by SPSS 16. Results: Based on the results, the majority of the young female population were physically inactive and only 121 women (12. 1%) enjoyed exercising at least for 30 minutes three times a week or more. In addition, there was a significant correlation between BMI, SES, and physical activity involvement. The cycle length, the regularity of periods, and the severity of dysmenorrhea exhibited a positive association with involvement in physical activity. Conclusions: Overall, physical activity had a positive influence on menstrual characteristics in young females. Therefore, it is important to educate women for regular physical activity in order to modify or reduce menstrual cycle disturbances.

Objectives: Total fertility rate (TFR) in Iran is declining to the lowest low level over the past 30 years. In order to increase the TFR, the influencing factors for willingness to have child should be identified. The aim of this study was to identify the factors that influence the willingness of Iranian men and women to have child. Materials and Methods: This cross-sectional study was conducted on married Iranian men and women through an online survey. A questionnaire consisting of demographic characteristics, including age of subject, age of spouse, duration of marriage, number of children, education level of subjects and his/her spouse, current pregnancy status of subject or spouse, contraception use and type of contraception, and a validated questionnaire to identify the factors affecting willingness to have child in 4 domains (inter family factors, social factors, medical and parental factors and emotional and child related factors) were filled by subjects. Results: A total of 731 subjects (23. 1% male and 66. 9% female) answered the online questions. Mean age of subjects was 31. 80 ± 6. 83 years. Willingness to have child was significantly related to spousal age difference (P = 0. 002, odds ratio [OR] =0. 90), number of children (P < 0. 001, OR=0. 21), being pregnant (P < 0. 001, OR=82. 91), level of education in spouse (P = 0. 03, OR=2. 18), inter family factors score (P < 0. 001, OR=1. 14), social factors score (P < 0. 001, OR=0. 87) and emotional and child related factors (P < 0. 001, OR=1. 52). Conclusions: This study revealed that willingness to have child in Iranian men and women is mostly influenced by personal and spousal factors.

Objectives: Women’ s reproductive empowerment is an essential issue for good reproductive health which is affected by various socioeconomic and cultural factors. This study was designed to compare women’ s reproductive empowerment in urban and rural areas. Materials and Methods: In this descriptive-analytical and correlational-type study, 810 women referring to health care centers in Sari were recruited through proportional cluster sampling method. Data were collected using a questionnaire on women’ s reproductive empowerment including cultural, individual-family, social, and family planning domains. Finally, the obtained data were analyzed using descriptive and analytical tests. Results: The mean (standard deviation) of women’ s reproductive empowerment score was 91. 46± 13. 14 (a 95% CIof 90. 55-92. 36) and no statistical difference was observed between the urban and rural women in this respect (P = 0. 59). In addition, cultural and family planning domains obtained the highest 29. 12 (5. 80) and the lowest 17. 55 (4. 25) scores concerning reproductive empowerment, respectively. Therefore, women’ s reproductive empowerment score was significantly correlated with the females’ employment status (P = 0. 006) and their husbands’ levels of education (P < 0. 001). Conclusions: Overall, the finding contributes to the discourse on women’ s reproductive empowerment based on their residential area and thus adds to the limited literature on this issue in developing countries and Iran, in particular. Therefore, appropriate planning is required for women with various employment statuses and their spouses with different educational levels in order to improve their empowerment in terms of reproductive issues.

Objectives: Childbearing is considered as a great event in the lives of many women while the effect of pain on this event is undeniable. Thus, the think of pain and how to overcome it has engaged the minds of women, their family, and health-care providers. The birth ball is one of the non-invasive methods of pain control. Therefore, the present study aimed to evaluate the effect of the birth ball on the pain and self-efficacy of pregnant women during the childbirth process. Materials and Methods: This study was a randomized clinical trial. A total of 178 participants were selected based on the specific selection criteria and randomly allocated to control and intervention groups. The women in the intervention group were asked to join a planned exercise with the birth ball including a 20-minute well-defined exercise three times a week for 6– 8 weeks at home whereas those in the control group followed up the routine prenatal cares. The questionnaires were completed by the participants at the four and eight-centimeter cervical dilations. Results: Based on the results, birth ball exercises could significantly improve childbirth self-efficacy and pain so that labour pain was lower in this group of women as compared to the other group (P < 0. 001 in both cervical dilatations). In addition, the score of self-efficacy was higher in the intervention group compared to the control group (P < 0. 001). Further, the result of generalized estimating equation model showed that birth ball exercise can decrease the childbirth pain. However, part of this effect may be related to an increase in the patients’ self-efficacy (30%-40%). Conclusions: In general, although birth ball exercise could decrease the childbirth pain, part of this effect was probably associated with an increase in self-efficacy of the patients.

Objectives: The aim of this study was to evaluate the perception and experience of recurrent pregnancy loss through the perspective of women in the United Arab Emirates (UAE). Materials and Methods: This qualitative study was conducted in 2017 and 12 women with recurrent miscarriage were interviewed, using purposive sampling method, in the Medical and Health Clinic of the Department of Obstetrics and Gynecology under the supervision of the UAE Medical University. Transcribed interviews were analyzed using conventional content analysis. Results: Data analysis led to the extraction of three main themes, including endless pregnancy, thirst for support and affirmation, and religious beliefs. Conclusions: Overall, the experience of recurrent miscarriage means endless pregnancy from Arab women’ s perspective, which awakened a thirst for support and affirmation. In this regard, the utilization of religious beliefs greatly reduced their pain. Therefore, knowing the dangers and consequences of recurrent miscarriages in Arab women, adopting preventative measures, and improving the quality of care in these vulnerable women require special attention.

Objectives: Inability to have a child is stressful and affects all aspects of couples’ lives. Infertility diagnosis, duration and reason of infertility, treatment failure, and frequent pregnancy tests are among the stress-inducing factors in couples. The current study aimed to compare infertility-related stress among couples and evaluate its relationships with infertility factors. Materials and Methods: This cross-sectional study was performed on 150 infertile couples (300 individuals) visiting infertility centers of Tehran. The data were collected using the Fertility Problem Inventory (FPI) and fertility and demographic characteristics form. The subjects were selected through convenience sampling method. The data were analyzed through inferential statistics, including paired samples t-test, independent samples t test, ANOVA, and linear regression. Results: According to the results, the mean stress score of women was significantly higher than that of the men (P = 0. 007). There was a significant difference between males and females regarding the mean scores of social concern and need for parenthood (P = 0. 005). The mean score of infertility-related stress was also significantly higher in women with treatment failure than in men (P = 0. 01). Conclusions: Based on the findings of the present study, infertile women experienced greater stress than males. Furthermore, infertility-related stress increased in women due to treatment failure. Therefore, it is recommended that women who have experienced treatment failure be subjected to precise psychological evaluations before undergoing the treatment process.

Objectives: Unintended pregnancy, as one of the main issues in reproductive health, is defined as a mistimed or unwanted pregnancy all over the worlds. This study aimed to determine the prevalence and risk factors of unintended pregnancy among Iranian women. Materials and Methods: As part of a survey on twin or multiple pregnancies in Tehran, Iran, this cross-sectional study considered a total of 5152 deliveries in 103 hospitals during 2015. The required data were gathered at the time of delivery or within the next 2-3 days from physically unstable women. The sampling was carried out within two weeks. All women, regardless of method of delivery, being primiparous or multiparous, and pregnancy outcome were included in the study. Results: According to the results, the prevalence of unintended pregnancy in Iran was estimated 19. 81%. Based on univariate analysis, the mean age of mothers, the mean age of fathers, number of pregnancies, and number of deliveries in unintended pregnancies were significantly higher than those in intended pregnancies. In addition, the prevalence of unintended pregnancy among housewives, as well as women with low levels of education and income was high. According to multiple logistic regression analysis, economic status and number of deliveries were the main predicting factors of unintended pregnancy. Conclusions: In general, the prevalence of unintended pregnancy in Iran is lower than that in other countries. However, preventive actions and health education programs still should be undertaken for mothers in order to minimize the prevalence of unintended pregnancies, thereby reducing the consequences for mother and baby.

Objectives: Osteoporosis is one of the major problems of the healthcare system and is a common debilitating metabolic disease among women. Pender’ s health promotion model which is a conceptual framework and describes a wide range of health behavior was selected to assess the behavioral changes in this study. Materials and Methods: A total of 122 women aged between 30 and 45 were selected to take part in this quasi-experimental study. The samples were split into experimental and control groups using the block randomization method (block size of 4). The educational program, based on Pender’ s model, was performed weekly. Pender’ s questionnaire on preventive behaviors of osteoporosis was filled out before and two months after interventions by both groups. SPSS software version 18. 0 was used for data analysis. Results: In terms of qualitative and quantitative data (demographic characteristics), there was no meaningful difference between the two groups (P > 0. 05). The mean difference (MD) in the score of the perceived benefits and barriers, perceived self-efficacy, programming, competing demand, and their commitment to a plan of actions increased in the experimental group after the intervention (P < 0. 001). However, there was no significant increase in the mean score of social support in the experimental group after the intervention (P > 0. 05). Conclusions: It can be assumed that teaching preventive behaviors of osteoporosis through Pender’ s health promotion model was effective. Considering the findings, it is obvious that continuing this program can maintain and consolidate the changes which have been made in behaviors.

Objectives: Assisted reproductive technologies (ARTs) give hope to some infertile couples; however, in vitro fertilization (IVF) is expensive and not subsidized by the Iranian state. More than 75% of IVF cycles in Iranian couples are unsuccessful. The aim of this study is to describe the challenges experienced by infertile couples after unsuccessful treatment. Materials and Methods: In this descriptive qualitative study, 36 participants including 29 Iranian infertile couples recruited after unsuccessful ART treatments, five infertility treatment team members and 2 relatives of infertile couples were interviewed at an Infertility Center in Northeastern Iran from April 2016 to June 2017. Data were collected using semi-structured, face-to-face interviews. Data analysis was carried out following Sandelowski. Results: Iranian infertile couples’ experiences following failed ART cycles are described. The findings presented here show that Iranian infertile couples experience stressors during treatment cycles and systemic challenges which may be unique to the Iranian cultural context. Conclusions: Iranian infertile couples face particular challenges related to the cultural context in which ARTs are delivered. Further exploration of the effects of culture on the experiences of failed ARTs needs to be considered by infertility clinics in Iran.

Objectives: Violence against women is one of the most serious social problems in any cultures and communities, affecting the reproductive health of this gender. Accordingly, this study aimed to determine the reproductive health needs of violent women. Materials and Methods: This qualitative study was conducted on 19 domestically abused women and 9 key informants. The study population was selected through purposive sampling technique and the data were collected to the point of saturation using unstructured individual interviews, observation, and field notes. Eventually, data were analyzed by MAXQDA software using conventional content analysis. Results: The main concepts obtained from the data were categorized into 5 major themes, including the need for motivating self-care, empowering women against oppression, having a safe sex life, promoting the capacity of the reproductive health system in the support of domestically abused women, and training males to involve in reproductive health issues. Conclusions: According to the results of the study, domestic violence is probably related to specific reproductive health needs among females at individual, family, and society levels. Therefore, it is essential to determine the needs of domestically abused women in order to improve their general and reproductive health.

Objectives: Infertility is one of the important complications in gynecology and the aim of the present study was to investigate the etiology and risk factors associated with infertility in the southern region of Iran. Materials and Methods: This cross-sectional study was conducted in infertility centers of Hormozgan University of Medical Science (HUMS). Totally, 250 infertile couples were included. The variables including socio-demographic characteristics, smoking, body mass index (BMI), and infertility status (e. g., type of fertility, duration, etc. ) were assessed by a self-administered and validated questionnaire. Data analysis was carried out using SPSS version 22. 0. Results: The most common causes of male and female infertility were varicocele (49. 4%) and ovulation disorders (57. 5%), respectively. There was a significant association between female factor infertility and level of education, age of women, women’ s age at marriage, number of abortions, alcohol consumption, presence of an underlying disease, and BMI (P < 0. 005). There was also a significant relationship between male factor infertility and men’ s job, addiction, smoking, and presence of an underlying disease (P < 0. 005). Conclusions: Considering various risk factors for infertility, an important step forward can be taken towards reducing the incidence of these risk factors by providing different education classes during pre-marriage, pre-partum, pregnancy and postpartum periods so as to inform couples of controllable risk factors.

Objectives: Preeclampsia is considered as one of the most important causes of death among pregnant women all around the world. This study aimed to study the predictive value of uterine artery Doppler ultrasonography in the incidence of preeclampsia and the intrauterine growth restriction (IUGR) in pregnant women who attended Fatemieh hospital. Materials and Methods: This study was performed by the prospective cohort method and the statistical population included 108 pregnant women, in their 18-22 weeks of pregnancy, with a singleton pregnancy who referred to the prenatal Fatemieh Hospital of Hamadan during 2013-2016. The uterine artery Doppler ultrasonography was performed and the incidence of IUGR and the occurrence of preeclampsia in the followed pregnancy was evaluated in these patients. Data were analyzed by SPSS 16. 0 using the chi-square and Mann-Whitney U statistical tests. Results: The mean difference of pulsatility index (PI) in patients with preeclampsia was statistically significant compared to healthy individuals (P = 0. 001). In addition, the mean difference of PI in individuals with infants suffering from IUGR was statistically significant compared with the infants not suffering from the IUGR (P = 0. 001). Further, the incidence of preeclampsia and IUGR in women with a bilateral notch in ultrasonography was significantly greater than those of the women with no report of a bilateral notch in ultrasonography (P = 0. 001). Conclusions: Therefore, Doppler ultrasonography of the uterine artery has a predictive value in preeclampsia among pregnant women.

Objectives: miRNAs comprise a group of master gene expression regulators, exerting their effects after transcription through targeting specific mRNAs, hence, influencing cellular processes. A considerable number of miRNAs are known to affect cell proliferation and migration in breast cancer, one of which is hsa-miR-330, a key player in various types of cancers. The purpose of this study was to evaluate the anti-proliferative and anti-migrative effects of hsa-miR-330 on MCF-7 cell line. Materials and Methods: MCF-7 cells were transfected with pCMV-miR-330 vector and cell selection was performed in media containing Geneticin (G418). Subsequently, MTT assay was performed to evaluate the effect of hsa-miR-330 on proliferation and scratch wound healing assay was employed to evaluate cellular migration. Finally, using real-time PCR, the expression of hsa-miR-330 as well as the repressive impact on the expression of E2F was investigated. Results: Upon confirmation of hsa-miR-330 induction in MCF-7 cells via GFP channel imaging system, miR-330 expression was demonstrated to be increased 10 folds in stable cells. The results of MTT and wound-healing assays demonstrated an inhibitory role for hsa-miR-330 in proliferation and migration of stable hsa-miR-330-transfected MCF-7 cancer cells compared to controls. In addition, after transfecting cells with hsa-miR-330, E2F1 was down-regulated in comparison with controls. Conclusions: Based on the results of the current study, we suggest a potential inhibitory role for hsa-miRNA-330 in cell proliferation as well as cell migration in breast cancer by targeting E2F1 mRNA. Additionally, a therapeutic role can be suggested for hsa-miR-330 in terms of target therapy for breast cancer.

Objectives: The present study aimed to determine the unfulfilled needs of patients with breast cancer and the predictors of this disease in order to plan for appropriate interventions based on these needs. Materials and Methods: This cross-sectional study was conducted on 190 females with breast cancer in Arak-Iran, who were selected by the convenience sampling method. Patients were evaluated by Socio-demographic and Disease Questionnaire, Perceived Illness Questionnaire, and Supportive Care Needs Survey Short Form. Data were analysed using SPSS, one-way ANOVA, chi-square, independent t test, the Pearson correlation coefficient, and multivariate linear regression. Results: Based on the results, the average number of supportive care needs was 100 (31. 9). In addition, the greatest needs of patients were related to psychological, health-information, and physical sub-scales with a mean of 31. 3 (12. 5), 36. 0 (12. 5), 14. 9 (5. 8), respectively. Finally, multivariate linear regression analysis showed that family income and the perception of illness were among the predictors of supportive care needs. Conclusion: In general, health attention providers are required to pay particular attention to the psychological, health, witting, and physical needs of females with mamma cancer and the related predictive factors of this disease.

Objectives: Several factors, including pregnancy which is associated with physical, psychological, and hormonal changes, affect females and their sexual partners’ relation and function. This study aimed to investigate the effect of “ permission, limited information, specific suggestions, intensive therapy” (PLISSIT)-based sexual counseling on the sexual function of pregnant women. Materials and Methods: The present randomized controlled trial was performed on 70 pregnant women who had a sexual function score of less than the cut-off point within a gestation period of 16-20 weeks. The participants were randomly divided into intervention and control groups by the blocking method. The intervention group received individual counseling based on the PLISSIT model by a well-trained midwife while the control group only received the usual care for pregnancy. The primary outcome measures were the total score of female sexual function four weeks after the intervention. Finally, the data were collected using a questionnaire of personal and midwifery information, as well as the female sexual function index in previous stages and four weeks after the intervention. All analyses were based on the intention to treat the approach. Results: There was a significant difference between the mean total score of sexual function (adjusted mean difference: 9. 07; 95% CI: 7. 24 to 10. 90) and all the sub-scales that intervention and control groups adjusted for baseline scores four weeks after the intervention (P < 0. 05). Consultation significantly reduced the frequency of sexual dysfunction and there was a significant difference between the 2 groups in this regard (P < 0. 001). Conclusions: Given the effect of sexual counseling on the improvement of sexual function of pregnant women based on the PLISSIT model, this approach is recommended during pregnancy.

Objectives: Infertility is considered as a major issue all over the world. All the studies in this field focus on how to develop successful methods of turning infertile couples into fertile ones. Endometrial mechanical injury in order to augment the probability of implantation of embryo and pregnancy rate has been particularly noted in recent years. Considering the controversies in the use of methods and results of the previous studies, we decided to compare the pregnancy and abortion rates in the intrauterine insemination (IUI) cycles with and without intervention, by employing a new method. Materials and Methods: This interventional study was performed on 150 infertile couples who referred to the infertility treatment clinic of Al-Zahra hospital, Tabriz (from April 2016 to March 2017) and were randomly divided into two groups. The IUI procedure was carried out in the first group after the endometrial scratch on the first to fifth days of the menstrual cycle, while the control group underwent only IUI without any intervention. The pregnancy and abortion rates were compared in study groups. Results: Pregnancy rate in the intervention group was significantly higher compared to the control group. No relationship was observed between the abortion rate and the intervention. There was no statistically significant difference between type and cause of infertility, maternal age and body mass index (BMI), duration of infertility, number of dominant follicles and pregnancy or abortion rates. Conclusions: The endometrial scratching performed on the first to fifth days of the menstrual cycle, preceding IUI procedure, leads to a significant increase in pregnancy rate. On the other hand, this method can be employed with lower costs in comparison to other fertilization methods.

Objectives: Considering the prevalence of sexual problems in postmenopausal women as well as complications of hormone therapy, the tendency to use complementary medicine has increased. The present study was conducted to evaluate the efficacy of combined herbal drug on the sexual function of postmenopausal women. Materials and Methods: The present triple-blinded randomized controlled trial was done on 64 Iranian women in 2017. The women were randomly allocated to 2 groups of intervention (combined herbal capsules users) and control (placebo users). Herbal capsules contained carnation, Anise, Anison, violets, Terminalia chebula, fresh green raisins, Senna leaves, Tangerine and Golqand. Participants in both groups took 2 capsules twice a day (before lunch and before dinner) for 4 weeks. The Female Sexual Function Index (FSFI) was filled out before the intervention and 4 weeks after the intervention. Results: No statistically significant difference was observed between the study groups in terms of socio-demographic properties, the total mean score of sexual function and its sub-domains before the intervention. Four weeks after the intervention, the total mean (SD) sexual function score was 26. 99 (5. 31) in the combined herbal capsule group and it was 18. 35 (4. 51) in the placebo group, so it was significantly higher in the combined herbal capsule group compared to the placebo group (adjusted mean difference=8. 70; 95% CI=6. 58-10. 82). Moreover, there was a significant difference in the mean score of desire, arousal, lubrication, orgasm, satisfaction, and pain subscales between study groups after the intervention. Conclusions: The results of the study show that taking combined herbal capsules improved sexual function in postmenopausal women. However, further studies are necessary to decide on its use as an alternative medication for the improvement of sexual function.

Objectives: The shortened duration of labor without creating major complications is considered ideal for the mother and infant while prolonged labor is accompanied by maternal and fetal consequences. Considering its importance, the purpose of this study was to compare the effects of acupressure at the Hugo point and hyoscine on the duration of labor stages and fetal-neonatal outcomes in nulliparous women. Methods: This controlled randomized clinical trial was conducted on 162 nulliparous women who referred to Ardabil Sabalan Hospital in 2017. Participants were divided into Hugo acupressure, hyoscine, and control groups by means of randomized blocks, each containing 54 nulliparous women. In the Hugo group, the pressure exerted on the Hugo point at 5 cm dilatation and in the hyoscine group, the hyoscine was injected intramuscularly at 5 cm dilatation. Data were analyzed using one-way ANOVA, Kruskal-Wallis, Fisher exact, and chi-square tests. Results: The mean (SD) duration of the active phase of labor was 137. 0 (15. 1), 143. 3 (172), and 187. 7 (24. 7) minutes in the Hugo, hyoscine, and control groups, respectively. In addition, the mean (SD) duration of the second stage of labor in the above-mentioned groups was 39. 5 (8. 5), 52. 4 (15. 0), and 58. 3 (8. 7) minutes, respectively (P < 0. 001). Conclusions: Overall, the implementation of acupressure at the Hugo point led to a greater reduction in the duration of labor stages compared to hyoscine infusion without imposing the side-effects on mother.

Objectives: Infertility is defined as the lack of pregnancy after one year of sexual contact without using any contraception. The aim of this study was to investigate the association between endometrial thickness (ET) and endometrial pattern with beta-human chorionic gonadotropin (B-HCG) test in women undergoing the induction of ovulation who referred to the infertility clinic of Ali ibn-e Abitalib hospital in Zahedan. Materials and Methods: This cross-sectional study was conducted at Ali ibn-e Abitaleb hospital in Zahedan (Iran) in 2017. The ET and endometrial pattern were estimated using transvaginal sonography and the pregnancy rate was determined based on B-HCG test. Finally, the data were analyzed by SPSS using the Chi-square test and independent t-test. Results: A total of 200 individuals with a mean age of 29. 6 ± 5. 6 years were evaluated in this study. The negative or positive B-HCG distribution was significantly different in terms of the endometrial pattern (P=0. 001) so that 35. 3% of women had B-HCG positive cases in the three-line pattern of ET while in the homogenous pattern, 3. 3% had B-HCG positive cases. In addition, the pregnancy rate in women with ET greater than 7 mm was significantly higher compared to those women with ET less than 7 mm thickness (35. 1% vs. 12. 8%, P<0. 001). Conclusions: Overall, the results of this study showed a significant correlation between the endometrial pattern and ET and pregnancy rate based on positive B-HCG test.

Objectives: Miscarriage is defined as the loss of pregnancy before the 20 weeks of gestational age. This study was conducted to compare the induction abortion in the first trimester using misoprostol alone and misoprostol with estrogen priming. Materials and Methods: This clinical trial was conducted in Ali ibn-e Abitalib hospital of Zahedan in 2017. A total of 100 women with missed abortions under 14 weeks of gestational age were evaluated. The women were randomly assigned into the misoprostol alone and misoprostol with estrogen priming groups. Ultrasound was done to evaluate the presence of remnants 4 hours after the abortion. If it was less than 10 mm, the abortion was considered successful. Results: The success rate was 38% in the misoprostol group and 86% in the misoprostol with estrogen priming group. Conclusions: Overall, this study showed that estrogen increases the success rate of abortion and reduces the time to abortion.

Objectives: Monozygotic triplet pregnancy very rarely occurs in assisted reproductive technology (ART) treatment. The present study reported two cases of trichorionic triplet pregnancies after single embryo transfer (SET) and reviewed the literature in this regard. Case Presentation: In the first case, a 29-year-old female underwent the long protocol using gonadotropin-releasing hormone analogue and one full blastocyst was transferred in a fresh cycle. At 6 gestational weeks, three gestational sacs were clearly observed, while only one fetus with fetal heart beat was found after one week. In the second case, a 39-year-old female underwent intracytoplasmic sperm injection treatment and seven embryos were frozen accordingly. After assisted hatching, one completely expanded blastocyst was transferred during a hormone replacement cycle. Three gestational sacs with three yolk sacs were observed at 6 gestational weeks. Finally, two fetuses with fetal heart beat were found after one week. Conclusions: Overall, although the developmental mechanisms of monozygotic triplets are unknown, clinicians should be aware of the possibility of multiple pregnancies under SET.

Objectives: Leiomyosarcoma (LMS), which arises from the uterine cervix, is an extremely rare neoplasm and is presented with vaginal bleeding and discharge. In our case report, we intended to highlight the role of polypectomy as a practical option for routine hysterectomy and the surgical cure of cervical LMS. Case Report: A 50-year-old woman (Para 8+0, 6A) presented to the Gynecological Clinic of ATB University Teaching Hospital with vaginal discharge and fleshy mass protruding from the vulva. Examination revealed a cervical polyp on the anterior lip of the cervix. Polypectomy was performed subsequently, and histologic examination including immunohistochemical staining confirmed LMS of the uterine cervix. The patient underwent hysterectomy with bilateral salpingo-oophorectomy with the histological confirmation of a complete excision. Conclusions: Generally, no specific management option is taken for this tumor due to its rare occurrence. However, polypectomy with a wide excision of tumor margin could result in a complete cure, and prolonged survival as in the case presented. Accordingly, histological studies including special stainings may play a vital role in cancer diagnosis.

Background: Infertility is commonly treated through intrauterine insemination (IUI). However, a limited number of reports are available regarding the infectious complications including IUI. Case Report: This study presented the cases of bilateral tubo-ovarian abscesses after IUIs in a 40-year-old woman with secondary infertility. In addition, salpingectomy and hysterectomy were needed despite treatment with triple antibiotic. Moreover, the diagnosis of tubo-ovarian abscesses was confirmed by means of pathological evaluations. Further, the patient responded well to antibiotic therapy following the surgery. Conclusions: Given the ascending trend of pelvic infections, the IUI-assisted violation of the natural cervical barrier can theoretically pose higher risks of this complication to the patients. Therefore, pelvic infections are highly recommended to be rejected before IUI. Finally, the diagnosis and intervention are necessary for minimizing morbidity and optimize treatment as well.

Medicalization is regarded as a form of social control and a process through which problems or non-medical experiences are defined and managed as medical problems or diseases. Furthermore, medicine is increasingly dominating the everyday life of individuals (1), thereby resulting in the social acceptance of the medicalized form of human experiences. Via attaching a disease label to natural phenomena, medical professionals expand the scope of their authority, regardless of whether they have the capacity to effectively manage these phenomena (2). The current paper did not intend to undervalue medical achievements, especially in the area of maternity care, but rather, to depict the overmedicalization of the experience of pregnancy and childbirth...