سال:1400 | دوره: | شماره: |تعداد مقالات:14

The coronavirus disease 2019 (COVID-19) pandemic has represented a major impact to health systems and societies worldwide (1). Pregnant women do not appear to be more susceptible to infection or to serious complications compared to non-pregnant women (2). Presence of comorbidities may increase the risk for presenting with more severe clinical manifestations. Inflammation and host immune response lead to cytokine storm which results in organ dysfunction in COVID-19 with the lung as the most important organ and acute respiratory distress syndrome (ARDS) as the most severe form of complication resulting in intubation (3). Pregnant women are more prone to difficult airway management because of the physiologic changes (4). COVID-19 transmission is person to person by respiratory droplets after contact with an infected person. As these patients may need operations during their pregnancy, management of airway can be important and sometimes problematic in some cases (5, 6). Since the COVID-19 pandemic, face-to-face consultations have not been recommended and many interactions are now virtual. This has the potential to interact for accurate planning for airway assessment, in particular of pregnant women...

Objectives: To determine the status of primary osteoporosis and evaluate the effects of curcumin nanomicelles, Nigella sativa oil, and curcumin nanomicelles plus N. sativa oil compared to placebo on cellular-molecular and clinical outcomes. Materials and Methods: The study protocol will be implemented in two phases. The first phase is a cross-sectional study aiming at determining the prevalence of primary osteoporosis and its risk factors, especially cellular-molecular factors in 528 postmenopausal women aged 50-65 years in Tabriz, Iran through simple random sampling. The second phase is a triple-blind factorial randomized controlled clinical trial. In this phase, patients with primary osteoporosis, identified with dual-energy X-ray absorptiometry, will be randomly divided into equal four groups of 30 individuals in a triple-blind factorial randomized controlled trial. The four group included N. sativa oil soft capsules (one capsule 1000 mg/d) and placebo-curcumin nanomicelles, curcumin nanomicelles soft capsules (one capsule 80 mg/d) and placebo-N. sativa, N. sativa oil, and curcumin nanomicelles soft capsules, and both placebos for six months. Results: The prevalence of primary osteoporosis and its relationship with several parameters will be determined in phase 1, including socio-demographic-obstetric-medical characteristics, anthropometric indices, body composition, lifestyle, osteoporosis-related microRNAs, inflammatory and oxidative biomarkers, bone turnovers, and some gene polymorphisms. Finally, changes in mean bone mineral density (BMD), bone turnovers, inflammatory and oxidative biomarkers, and osteoporosis-related microRNAs will be evaluated in phase 2. Conclusions: The present study can significantly contribute to the prognosis of the disease and the selection of an appropriate herbal supplement given the cost-effectiveness of herbal compounds as pharmaceutical adjuvants.

Objectives: Constipation is one of the most common issues at the time of pregnancy. Traditional Persian medicine (TPM) has always emphasized the use of safe laxatives to relieve constipation during pregnancy. The present study aimed to investigate the effect of Rosa damascena Mill. products on constipation and the quality of life during pregnancy. Materials and Methods: This is a single-arm clinical trial study on 35 pregnant women (14-34 weeks) with constipation diagnosed on the basis of Rome IV criteria in Tehran and Qom, Iran during 2018-2019. The consumption of R. damascena products was recommended daily for 4 weeks. Then, the severity of constipation and the quality of life were assessed via the Rome IV criteria and the World Health Organization (WHO) quality of life questionnaires (WHOQOL-BREF), respectively. Results: This study was performed on 35 pregnant women (14-34 weeks). The consumption of R. damascena products decreased the score of Rome IV criteria (Mean9. 4 to 1. 1) while increasing the frequency of bowel movements and improving the overall quality of life (P < 0. 001). The predominant constipation signs, including straining, lumpy and hard stools, a sensation of incomplete evacuation, a sensation of anorectal obstruction, manual facilitation maneuvers, and less than 3 spontaneous bowel movements per week significantly improved after the consumption of R. damascena products (P < 0. 001). Conclusions: Rosa damascena products can effectively treat constipation and enhance the quality of life.

Objectives: Human papillomavirus (HPV) infection is the leading sexually-transmitted infection (STI) worldwide and the main etiology of cervical cancer. HPV infection rates are important in directing vaccination policies and screening for cervical cancer. Unfortunately, no recent reports have evaluated the prevalence of this infection among Jordanian women despite major globalization-driven changes in sexual behavior. Accordingly, this study aimed to determine the prevalence of HPV infection and its genotypic distribution in the cervical samples of Jordanian women. Materials and Methods: The study was carried out at Prince Hamza Hospital (Amman, Jordan) during 2016-2017. Women (15-75 years old) were randomly selected for cervical cell collection. DNA was extracted and then amplified using MY09/11 and GP5+/6+ consensus primers. Finally, positive samples were genotyped by applying real-time-polymerase chain reaction and reverse line blotting. Results: Fourteen out of 348 women tested positive for HPV with a prevalence rate of 4%. In addition, multiple HPV genotypes were observed in 36% (5/14) of infected women while single HPV genotype infection was found in 64% (9/14) of infected women. Further, high-risk (HR), potential high-risk (pHR), and low-risk (LR) HPV genotypes were detected in most cases with a 78. 6% (11/14) infection rate, 42. 9% (6/14), and 7. 1% (1/14) of infected women, respectively. Eventually, 10 different genotypes were detected in infected women and HPV 16 was the most common type (42. 9%, 6/14). Conclusions: Our data suggest that the prevalence of HPV infection among Jordanian women is below the global and regional rates. It is hoped that these data should facilitate the implementation of appropriate cervical cancer screening and future HPV vaccination programs.

Objectives: To compare the demographic, anthropometric, and biochemical characteristics between women with polycystic ovary syndrome (PCOS) and healthy women and to identify the independent biochemical markers of PCOS. Materials and Methods: A case-control study was conducted on 77 women with PCOS and 73 healthy controls aged between 18 and 49 years. Blood samples were obtained for the determination of plasma total homocysteine (tHcy), total cholesterol (TC), triglycerides (TG), low-and high-density lipoprotein, TC/high-density lipoprotein ratio, total testosterone (TT), sex hormone-binding globulin, and free androgen index (FAI). Finally, multivariable logistic regression analysis was performed to identify the independent biochemical markers of PCOS. Results: The mean differences between cases and controls in tHcy, TG, and sex hormone-binding globulin were statistically significant. tHcy and TG were elevated in cases while sex hormone-binding globulin demonstrated a reduction. All three markers were identified as independent predictors of PCOS in multivariable analysis in addition to a fourth, TT. tHcy is an independent biomarker of PCOS despite a relationship with TG and TC, the former of which is itself an independent biomarker. Conclusions: In general, overweight women with PCOS had higher levels of tHcy and TG and a lower level of sex hormone-binding globulin compared with healthy controls. The level of tHcy is a marker of PCOS independent of the lipid profile. The differential biochemical profile of women with PCOS and healthy women provides useful hints for the diagnosis of PCOS and thus must be addressed in relation to the risk of cardiovascular disease.

Objectives:Research on understanding the pathogenesis of preeclampsia and its alternative management is still not optimal,resulting in high morbidity and mortality,especially in developing countries.Therefore,this study aimed to understand the L-arginine effect on placental endoglin,transforming growth factor-ß, 1 (TGF-ß, 1) expression and blood pressure in preeclampsia.Materials and Methods:Using a post-test control group design,this randomized experimental study was carried out on an anti-Qa2 preeclampsia mice model,in which the treatment group (n=9) was given L-arginine orally.Blood pressure was measured on day 15 and mice were terminated at day 16 to evaluate endoglin and TGF-ß, 1 placenta expression through immunohistochemistry.Results:Based on the results,lower systolic and diastolic blood pressure (P < 0.05) and significantly lower endoglin and higher TGF-ß, 1 placental expression were found in the L-arginine treatment group compared with the control (the preeclampsia mice model) group (P < 0.05).Conclusions:In general,L-arginine can ameliorate systemic blood pressure and locally in the placenta by providing lower expression of endoglin while higher TGF-ß, 1 in the preeclampsia mice model.

Objectives: Abnormally invasive placentation (AIP) is a challenging situation capable of complicating childbirth that has recently arisen, imposing a risk on maternal lives and well-being. The optimal management of this complication requires a valid antenatal diagnostic tool other than Doppler ultrasound (US). Of these, a handful of laboratory markers have been so far used for the antenatal detection of invasive placentation. This study sought to establish whether low maternal serum zinc (Zn) is related to AIP in women with placenta previa. Materials and Methods: Over a period of six years, a prospective study was performed, including 168 pregnant ladies with placenta previa of whom, 72 cases were diagnosed with placenta accrete (PA) spectrum using Doppler US. The serum Zn was measured in all participants, and each individual was followed up regarding intraoperative and postoperative outcomes. Results: A significantly lower serum Zn level was found in women having the PA spectrum (P < 0. 001). At a level of 68 μ, g/dL, serum Zn was 79. 2% sensitive, 95. 8% specific, and had a comparable accuracy (88. 7% vs. 89. 3%) to color Doppler US in the identification of cases with PAS spectrum among those with placenta previa. Conclusions: Low maternal serum Zn level is associated with AIP among placenta previa cases. Thus, more studies are needed in the future to support the use of this technique in the antenatal detection of the PAS.

Objectives: This study aimed to determine the utilization of pre-pregnancy care services and their associated factors among women with high-risk pregnancy in the northern part of Peninsular Malaysia. Materials and Methods: This cross-sectional study commenced in 2017 among women diagnosed as high-risk pregnancy in governmental health clinics in the state of Perak, Malaysia. Stratified random sampling was applied and interviewer-guided questionnaires were administered in this regard. A proforma and the validated Pre-pregnancy Care Knowledge and Practice Questionnaire were used, consisting 21 items on knowledge and 16 items on practice. The utilization of pre-pregnancy care services was defined if someone had attended the service at least once prior to the current pregnancy. Finally, logistic regression analysis was conducted using SPSS software. Results: Of 490 women with high-risk pregnancies, 23. 9% (n=117) utilized pre-pregnancy care services. Only one-third of them were aware of the offered services (33. 1%), received advice to seek these services (30. 4%), and were referred to the services (27. 3%). There were four significant associated factors for the utilization of pre-pregnancy care services, including maternal age (P = 0. 016), planned pregnancy (P < 0. 001), family planning practice (P < 0. 001), and pre-pregnancy care knowledge (P = 0. 030). Conclusions: The utilization of pre-pregnancy care services among women with high-risk pregnancy in this study was low. An increase in maternal age, a planned pregnancy, history of practicing family planning, and women with good pre-pregnancy care knowledge were more likely to utilize pre-pregnancy care services.

Objectives: Different types of gonadotropin-releasing hormone (GnRH) agonist protocols are used in assisted reproductive technology (ART) cycles although the role of every other day GnRH agonist administration is not well understood. Thus, this study compared the effectiveness of different ways of the administration of GnRH agonists in the ovarian stimulation long protocol and their effects on in vitro fertilization (IVF) outcomes. Materials and Methods: In a randomized controlled trial (RCT), 138 patients were randomly assigned to 3 groups with 46 patients. In group A, patients were treated with daily buserelin 0. 5 mg subcutaneously and those in group B were treated with triptorelin 0. 1 mg daily, and finally, patients in group C received triptorelin 0. 1 mg every other day (all under a long protocol). Eventually, controlled ovarian stimulation was performed with the follicle-stimulating hormone (FSH). Results: There was no significant difference in biochemical and clinical pregnancy, along with abortion and twin rates between the comparison groups. Meanwhile, the number of gonadotropin injections was significantly lower in group C (P = 0. 033). Moreover, the number of follicles and days of ovarian stimulation did not have a significant difference between study groups. Finally, the number of metaphase 2 oocytes and embryos was significantly higher in group A (P = 0. 001). Conclusions: In general, pregnancy and abortion rates did not significantly differ between the comparison groups and, the number of gonadotropin injections was significantly lower in the triptorelin 0. 1 mg every other day group. Thus, our finding revealed that every other day use of triptorelin 0. 1 mg, comparing its daily use or daily buserelin, might be cost-benefit.

Objectives: Women with breast cancer spinal metastases are highly prone to coronavirus disease 2019 (COVID-19), resulting in the incidence of stress in these women. The present study aimed to investigate the perceived stress and its effect on the quality of life (QoL) and coping strategies of female chemotherapy patients with breast cancer spinal metastases during the COVID-19 pandemic. Materials and Methods: This descriptive-correlational study was conducted during February 20, 2020 and May 21, 2020 at Tabriz University of Medical Sciences during the COVID-19 pandemic. A total of 61 female chemotherapy patients with breast cancer spinal metastases completed the Perceived Stress Scale (PSS) and Billings, SF-36 questionnaire, and Moos’,Coping Checklist. The data were analyzed in SPSS using the Pearson correlation coefficient test at the significance level of P < 0. 05. Results: The overall perceived stress level of the participants was high (51. 10 ±,2. 45). The overall score of coping strategies was 46. 10 ±,1. 15 while the scores of problem-and emotion-focused subscales were 22. 25 ±,1. 41 and 30. 42 ±,01. 30, respectively. The perceived stress level had a significant correlation with overall coping (P = 0. 009, r=0. 8), emotion-focused coping (P = 0. 04, r = 0. 5), and problem-focused coping (P = 0. 02, r = 0. 6) strategies. Finally, the results showed poor relationships between problem-focused and physical health (P = 0. 009, r = 0. 4), problem-focused mental health (P = 0. 01, r = 0. 4), emotion-focused and physical health (P = 0. 02, r = 0. 3), and emotion-focused and mental health (P = 0. 03, r = 0. 3). Conclusions: Based on the findings, there are direct correlations between the perceived stress (strong) and QoL (poor) levels of female chemotherapy patients with breast cancer spinal metastases and their coping strategies during the COVID-19 pandemic.

Objectives: Radiofrequency (RF) and laser are minimally invasive methods that are used to treat mixed urinary incontinence (MUI) and vulvovaginal atrophy (VVA). The purpose of this study was to compare the effect of RF and laser on UI and VVA in Iranian menopausal women. Materials and Methods: Two hundred and forty women participated in this randomized clinical trial, including those who referred to Valiasr hospital, Tehran, Iran and underwent MUI and VVA treatments in 2018. Participants were randomly divided into the RF (n = 80), laser (n = 80), and placebo (n = 80) groups. Before and after the intervention, UI was assessed using the International Consultation on Incontinence. Finally, pelvic organ prolapse/urinary incontinence sexual questionnaire, vaginal health index (VHI), and visual analog score were used to determine sexual satisfaction. Results: VVA symptoms decreased in RF and laser groups after the intervention although changes in the RF group were more compared to the laser group (15. 813 vs. 10. 075, P < 0. 001). Contrarily, VHI improved in RF and laser groups after the intervention although changes in the RF group were more remarkable in comparison with the laser group (10. 425 vs. 2. 231, P < 0. 001). Based on the results, MUI symptoms decreased after the intervention in RF and laser groups although changes in the laser group were not significant (P <0. 149). Eventually, emotional behaviors in the RF group improved after the intervention (P = 0. 04) although changes in the laser group were not significant. Conclusions: In general, a greater reduction was observed in the RF group regarding MUI and VVA symptoms compared to the laser group. In addition, using the RF method for the treatment of the genitourinary syndrome of menopause (GSM)symptoms had significantly greater effects on the improvement of the quality of life and sexual satisfaction of menopausal women compared to laser therapy. Thus, RF seems to be an effective and acceptable non-surgical method for the treatment of UI and VVA.

Objectives: Menopause is one of the risk factors for deep vein thrombosis (DVT) that may increase its likelihood after coronary artery bypass graft surgery (CABG). Hence, it is essentially advised to prevent DVT. In this regard, the purpose of this study was to investigate the effects of simple exercise with and without physiotherapy on DVT prevention in postmenopausal women requiring CABG. Materials and Methods: This quasi-experimental study was carried out on 34 patients in Tabriz Shahid Madani hospital from 1 March to the end of July 2019. It is noteworthy that participants were selected based on a random sampling method. The experimental group, namely, the exercise group (n=17) did cardiovascular exercises for 40 minutes the day before the surgery. However, the other group received physiotherapy for each leg for 15 minutes in addition to cardiovascular exercise. Then, DVT diagnosis blood tests, clinical examinations, and Doppler sonography were performed and recorded in all participants’,portfolios. The obtained data were analyzed using SPSS software, and the SPSS tests included Kolmogorov-Smirnov, paired t test, and independent t-test at the significance level of 0. 05. Results: The results of intra-group DVT and blood tests before and after the intervention revealed a statistically significant difference in terms of complete blood count, hemoglobin, hematocrit (P ≤,0. 05). However, no statistically significant differences were reported considering the other variables (P ≥,0. 11). Finally, in the case of inter-group variations, a comparison of the results of the two groups represented no statistically significant difference in any of the studied variables (P ≥,0. 15). Conclusions: In general, a light exercise session either with or without physiotherapy did not have any positive effects on DVT prevention in postmenopausal women in need of CABG.

Objectives: Different drugs are prescribed for the induction of ovulation in patients with polycystic ovary syndrome (PCOS). The aim of this study was to compare the effect of letrozole alone with letrozole plus N-acetyl cysteine (NAC) on the pregnancy rate in patients with PCOS. Materials and Methods: This clinical trial studyincluded317 patients with PCOS in the infertility clinic of Zahedan in 2018. Patients were randomly divided into letrozole and NAC plus letrozole groups. Then, several parameters were evaluated in both groups, including the pregnancy rate, number of follicles larger than 18 mm, endometrial thickness, and the endometrial pattern. Finally, data were analyzed using SPSS 25, and t-test and chi-square tests were used for statistical analysis. Results: The mean age of study participants was 28. 5 ±,4. 9 years old. The mean duration of infertility in the intervention group was 4. 5 ±,3. 8 years. The mean anti-Mü, llerian hormone and the mean endometrial thickness of patients in the intervention group were 4. 4±,3. 6 ng/mL and 7. 6 ±,2. 5 mm, respectively. Eventually, the pregnancy rate was 14. 6% (n = 23) and 7. 5% (n = 12) in the intervention and control groups, respectively (P = 0. 046). Conclusions: The results of this search revealed that the number of follicles with the size of 18 mm in the control group was higher compared to the intervention group, but the fertility rate in patients with PCOS receiving letrozole plus N-acetylcysteine was significantly higher.

Objectives: Premature rupture of membrane (PROM) refers to the spontaneous rupture of fetal membranes prior to delivery and the initiation of the labor. In addition, the early rupture of membranes can lead to several adverse complications for both the mother and the fetus. Therefore, the present study aimed to investigate the association between the platelet-to-lymphocyte ratio (PLR) and the premature rupture of the membrane in pregnant women. Materials and Methods: This retrospective case-control study reviewed the files of 150 women with PROM matched with 150 spontaneous preterm labor (SPL) women at Al-Zahra hospital of Rasht during 2017-2018. Demographic data, complete blood cell count, PLR, maternal age, gestational week, gravida, parity, and birth weight were recorded, and finally, the obtained data were analyzed by SPSS, version 19. Results: Based on the results, there was a statistically significant difference between maternal platelet count and PLR in these two groups (P = 0. 0001). However, no significant difference was observed regarding maternal age, gravida, parity, and maternal lymphocytes count in PROM and control groups (P > 0. 05). According to logistic regression analysis, a negative association was found respecting gestational age and PLR in the PROM group while a positive association was observed in the group without PROM regarding birth weight and PRL. In the receiver-operator curve diagram, the appropriate cut-off point for the PLR index for detecting PROM was determined as 142. 2 with a sensitivity of 62. 7% and a specificity of 63. 3%. Conclusions: In general, a significant association was found between PLR and PROM. Therefore, well-planned cohort studies are welcomed to find any prognostic role for this marker.