Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2021 | Volume:24 | Issue:1|Papers Count:12

Introduction: The report of fallopian tube obstruction in hysterosalpingography in infertile patients should be confirmed by laparoscopy. This study was performed with aim to assess the value of hysteroscopy in cases of fallopian tubes obstruction during laparoscopy. Methods: This interventional study was performed on 54 infertile women who were candidates for laparoscopy due to fallopian tube obstruction in Hysterosalpingography (despite normal uterine cavity) in the gynecology ward of Mashhad Imam Reza Hospital in 2014-2016. Patients were included in the study if tube obstruction was observed during laparoscopy. At the same stage, the hysteroscopy was performed, and then the status of the tubes was again checked through laparoscopy. The value of performing hysteroscopy was evaluated in terms of detecting the uterus pathology, opening of the tubes or both. Data were analyzed by SPSS software (version 20) and student t-test, Q2, and Mc-nemar tests. P<0. 05 was considered statistically significant. Results: In this study, 54 patients with 74 blocked fallopian tubes were included. Hysteroscopic findings indicated intrauterine pathology in 30 cases (55. 6%) and after performing hysteroscopy, at least one tube was opened in 25 cases (46. 3%). 38 patients (70. 4%) benefited from hysteroscopy (opening of tube or intrauterine pathology diagnosis). In the study of the relationship between hysteroscopic evidence (normal or pathologic) and consequent tube opening, the probability of tube opening was significantly higher in the pathologic cases (p<0. 001). Conclusion: In the cases of observation of tube obstruction in diagnostic laparoscopy in infertile women (despite normal endometrial cavity in HSG), hysteroscopy was helpful and in many cases lead to detection of unknown uterine pathologies or help to tubal opening.

Introduction: Exercise can play a supportive role in the improvement of breast cancer by regulating and modulating cytokines. Interleukin 10 is an anti-inflammatory and anti-tumor cytokine that plays an important role in inhibiting tumor growth. This study was performed with aim to evaluate the effect of 12 weeks of combined exercise (aerobic_pilates) on the serum level of interleukin 10 and blood platelets in women with breast cancer. Methods: This experimental study was performed on 30 women with breast cancer who had undergone at least 6 months of surgery and had received chemotherapy and were under treatment with medication in Azarbaijan Shahid Madani University in 2019. The subjects were divided into experimental and control groups. The experimental group performed 3 sessions of exercise each week (aerobic-pilates) for 12 weeks. During this time, the control group did not participate in any exercise or physical activity program. Blood samples were obtained before and 48 hours after exercise intervention to extract the variables. Data were analyzed by SPSS software (version 20) and independent and correlated t-test. P<0. 05 was considered statistically significant. Results: The results of correlated t-test showed that the serum level of interleukin 10 (P =0. 001) and the number of blood platelets (P =0. 041) significantly increased in the experimental group after 12 weeks of combined training (aerobic-Pilates) compared to the pre-test, while this change was not significant in the control group (p> 0. 05). Conclusion: Performing combined exercises (aerobic_Pilates) by improving the status of interleukin 10 as an anti-inflammatory and anti-tumor cytokine can be useful in improving the health status of women with breast cancer. Therefore, designing and performing such exercises in this population can solve many problems of these loved ones.

Introduction: Despite the positive evidence on the effect of progesterone on protection of pregnancy in patients with threatened abortion, the results of studies regarding its drug type have been controversial. This study was performed with aim to compare the effect of vaginal progesterone and dydrogesterone on pregnancy outcome in cases with threatened abortion. Methods: In this single-blind randomized clinical trial, 160 pregnant women with threatened abortion who referred to Qazvin Kowsar Hospital in 2018 were randomly assigned to receive dydrogesterone (Duphaston) 10 mg twice daily or vaginal progesterone (Cyclogest) 400 mg daily. Finally, pregnancy outcomes were compared between the two groups. Data were analyzed by SPSS software (version 18) and Chi-square, independent t-test and Mann-Whitney tests. P<0. 05 was considered statistically significant. Results: Frequency of cesarean section was 27 (33. 7%) in the dydrogesterone group and 25 (31. 2%) in the vaginal progesterone group (P = 0. 736). In general, the incidence of preterm labor was 97 (60. 6%) and there was no significant difference between the two groups (P >0. 05). In addition, incidence of preeclampsia, gestational diabetes mellitus, placenta previa and intrauterine fetal death as well as neonatal weight were not significantly different between the two groups (P >0. 05). Finally, maternal and neonatal complications showed no significant difference between the two groups (P = 0. 675). Conclusion: Pregnancy outcomes after administration of dydrogesterone are not different with vaginal progesterone in the treatment of threatened abortion.

introduction: Chronic inflammation can be the main cause of many common diseases in old age. Elevated level of CRP and proinflammatory cytokines such as TNF-α is positively associated with fibroblast growth factor 23 (FGF23). Therefore, considering the potentially beneficial effect of elastic band resistance training (EBRT) on these variables, this study was performed with aim to investigate the effect of 12 weeks of selected EBRT on serum levels of FGF23, TNF-α and hsCRP in overweight elderly women. Methods: This clinical trial study was performed in 2017 on 28 elderly women in Shahrekord. The subjects were randomly divided into experimental and control groups. EBRT was performed for 12 weeks. Fasting blood samples were taken 24 hours before the first training session and 48 hours after the last training session to measure serum levels of FGF23, TNF-α and hsCRP. Data were analyzed by SPSS software (version 25) and repeated measure two-way ANOVA test. P<0. 05 was considered statistically significant. Results: EBRT had no significant effect on serum FGF23 levels, BMI, and Waist-to-hip ratio in elderly women (P>0. 05); but serum levels of TNF-α (P=0. 046), hsCRP (P=0. 037), and also body fat percentage (P=0. 023) significantly decreased after EBRT. Conclusion: Regardless to no significant changes in FGF23 levels, it seems that 12 weeks of EBRT can have a significant effect on reducing chronic inflammation in the elderly by reducing the levels of hsCRP and proinflammatory cytokine TNF-α .

Introduction: Menopause is one of the risk factors for knee osteoarthritis which causes complications such as pain and movement restriction. Involving people in treatment programs such as self-care interventions has been associated with beneficial results. This study was performed with aim to evaluate the effects of water exercise training on motor symptoms and physical pains in postmenopausal women with knee osteoarthritis. Methods: This randomized clinical trial study was performed with participation of 42 women in Tabriz University of Medical Sciences in 2019. After random assignment of the subjects to the intervention and control groups, the intervention group performed simple water exercises for 12 sessions (50 minutes each session). Data were collected using Knee injury and osteoarthritis outcome score questionnaire. Data were analyzed by SPSS software (version 20) and Kolmogorov-Smirnov, Fisher exact, Chi-square and independent t-test. P<0. 05 was considered statistically significant. Results: The mean total score of osteoarthritis in the intervention group before the intervention was 121. 15 ± 12. 90 and in the control group was 129. 19 ± 11. 49, which was not significantly different (p= 0. 209), but after receiving the intervention, statistically significant difference was observed between the intervention group (74. 81 ± 5. 55) and the control group (127. 12 ± 11. 89) (p= 0. 0001). Conclusion: Simple water exercises improve physical pain and osteoarthritis symptoms in postmenopausal women.

Introduction: Considering that ethnicity is one of the influential factors in choosing the contraceptive method, and the social, cultural and religious factors affecting this choice vary among different ethnic groups, therefore, this study was performed with aim to identify differences in contraceptive methods in a multi-ethnic mosaic community. Methods: This cross-sectional study was performed in 2017 on 1000 married women at reproductive age (15-49 years) from five ethnic groups of Fars, Turk, Kurd, Turkman and Tat in North Khorasan. Data were collected using a researcher-made questionnaire of fertility behavior (using deductive method based on literature review and compilation of existing questionnaire questions). Data were analyzed by SPSS software (version 21) and t-test and bilateral variance analysis. P<0. 05 was considered statistically significant. Results: The first priority of contraceptives was pills in all ethnic groups (most frequently in the Kurdish ethnicity). In Fars, Kurds and Turks, with slight differences between condoms and IUDs, they are the second priority of contraceptive methods. In the Tat and Turkmen ethnicity, with the clear distinction, condom was the second and IUD was the third priority of in choosing a contraceptive method. Conclusion: The choice of contraceptive methods is influenced by the characteristics of individuals. Therefore, all planning, especially family planning programs which are directly related to fertility, should be based on specific cultural and social conditions and understanding the conditions of that community.

Introduction: Regarding the increasing prevalence of polycystic ovarian syndrome (PCOS) in young women and the side effects of existing medication regimens, this study was performed with aim to evaluate the antioxidants and clinical effects of oral Curcumin Nanomicell capsule with the approach to improve the women's quality of life. Methods: This cross-sectional interventional open label study was performed on 20 patients with PCOS in Tehran from April 2018 to September 2019. The subjects received 50 mg Nanomicell capsule for 90 days every other day. Quantitative indexes of oxidative stress (serum level of Malondialdehyde, Superoxide dismutase, and Catalase) were analyzed at baseline and after the end of intervention; the patients' quality of life was evaluated as monthly. Data were analyzed by SPSS software (version 24) and paired t-test and U Mann-Whitney test. P<0. 05 was considered statistically significant. Results: Continuous 3-month oral intake of Curcumin Nanomicell reduced the menstrual pain scores (p=0. 003), anxiety and depression levels (p=0. 007) and hirsutism (p<0. 0001), but no significant relationship was observed between the use of 80 mg Curcumin Nanomicell as monthly and every other day and reduced serum level of oxidative stress factors and other factors related to the patients' quality of life (p>0. 05). Conclusion: Curcumin Nanomicell improved some clinical signs of PCOs but antioxidant effect was not observed according to the serum biomarkers. However this pilot study on a small sample size opened up a new insight for future therapy of PCOs patients, further research in larger groups in longer time periods seems necessary.

Introduction: Cervical ripening and induction of labor is necessary before the spontaneous onset of labor. In traditional medicine, rose-water has been used as an effective factor in the onset of labor contractions. However, clinical studies on its efficacy are very rare. This study was performed with aim to determine the effect of oral rose-water on cervical ripening in primiparous women. Methods: This randomized clinical trial study was performed in 2019 on 60 primiparous women with 40 weeks of gestation in the maternity of Tabas hospital. The subjects were assigned to two groups of intervention and control (n=30 in each group). The intervention group consumed five ml of oral rose-water daily since 40 week of gestation for one week and the control group received routine care. Bishop score was measured at days one, three, seven and entering the labor. Data collection tools were the forms of questionnaire, physical examination, observation and counting fetal movement and the checklist of rose-water consumption. Data were analyzed using T-tests, Chi-square, and analysis of variance with repeated measures. P<0. 05 was considered statistically significant. Results: The mean age of mothers in the intervention and control groups was 26. 53± 5. 16 and 26. 53± 5. 28, respectively. The onset of labor did not show a significant difference in two groups (p=0. 303). Analysis of variance with repeated measures showed that the mean of Bishop score on the third and seventh days after beginning of the intervention was not significantly different between the two groups (p =0. 160). The results of this test showed that the trend of bishop score changes in both groups was incremental. Conclusion: According to the results of the study, daily consumption of 5 ml rose-water (with concentration of 24% rose water essential), had no significant effect on cervical ripening in primiparous women had no side-effects. It is recommended that future research be done with higher dose of rose-water with safe dose range on cervical ripening.

Introduction: Cesarean section is performed with two technique of closure or non-closure of the peritoneum, but there is disagreement about the advantages and disadvantages of these techniques. Accordingly, this study was performed with aim to compare the early maternal complications of cesarean section in two technique of closure or non-closure of the parietal peritoneum. Methods: This double-blind randomized clinical trial study was performed on 120 patients undergoing cesarean section at Hamadan Fatimah Hospital in 2019. Samples were randomly divided into two groups: closure of the peritoneum (n=60) and non-closure of the peritoneum (n=60). The maternal complications during and after surgery were recorded. Data were analyzed by SPSS software (version 21) and Chi-square, independent t-test and repeated measures. Results: The results showed that operative time and bleeding during surgery were significantly fewer in patients receiving non-closure technique (p<0. 05). Also, the duration of ileus, the amount of received analgesic, and pain 12 and 24 hours after the surgery were significantly lower in patients receiving non-closure technique (p <0. 05). However, there was no significant difference between the two groups in terms of pain after 6 hours of the surgery and the symptoms of surgical wound infection (p> 0. 05). Conclusion: The complications such as bleeding during surgery, the duration of surgery, ileus after surgery, pain, and consumption of analgesic will occurs with less intensity in patients receiving non-closure technique than patients with closure technique; however, these two methods were not different in terms of surgical wound infection.

Introduction: Fertility means the ability to have a child that is one of the causes of family formation. Several factors can affect fertility. Micronutrients are essential for the body's anabolic and catabolic activities, so they may be effective factors on fertility. Therefore, this study was conducted with aim to determine the role of micronutrients in male and female fertility. Methods: In this review study, the Persian databases of Magiran, SID and the English databases of Pubmed, Scopus, SID, Elsevier, Web Of Sciences and the Google Scholar search engine were searched using the English keywords of Infertility, fertility Infertility, Fertility, Male Infertility, Semen, Semen Parameters, Systematic Review, Clinical Trial, Case-Control, Female Infertility, Micronutrients, Vitamin A, Vitamin B, Vitamin C, Ascorbic Acid, Vitamin D, Vitamin E, Antioxidants, Folic Acid, Zinc and their Persian equivalents in the period of 1990-2020. Numerous quantitative and qualitative studies that were similar to the present study in terms of content were selected and evaluated. Results: Among 1052 articles, 22 studies which were more related to the aim of the present study were selected and evaluated. The results of reviewing the studies showed that the consumption of micronutrients including vitamins D, E, C, A, zinc, iodine, selenium, folate and omega-3 fatty acids can play a role in improving male and female fertility parameters. Deficiency of each of them has been seen in infertile men and women. Conclusion: Since nutrition has moved towards ready meals and lifestyle has moved towards a sedentary life and as a result, the body does not meet the essential needs for basic activities, it seems that the recommendation to consume micronutrients in men and women can prevent many fertility problems and reduce the cost of infertility treatment.

Introduction: COVID-19 infection is a progressive disease that is associated with a rapidly increasing in global mortality. With the prevalence of COVID-19 infection, its prevention and control among pregnant women, and the potential risk of transmission to the fetus has become a main concern. The present study, while introducing evidence for SARS and MERS in pregnant women, examines some physiological changes in this population and the possible treatment strategies. Methods: In this review article, 147 related articles up to September 1, 2020 from the Persian and English language databases of Google, Google Scholar, Web of Science, Pubmed, and Scopus were extracted using the keywords of infection, COVID-19, pregnancy, fetus, and physiology. The articles which did not serve the purpose of this study were excluded from the study process. Finally, the information of 66 articles was used to write the present article. Results: Despite the lack of vertical transmission of the virus from mother to fetus during the previous outbreak of SARS-CoV and MERS-CoV coronaviruses, a case of vertical transmission of SARS-COV-2 to the placenta and fetus in late pregnancy has been reported. Changes in ACE2 receptor expression, respiratory-vascular changes, and changes in the immune system are some of the reasons for pregnant women's sensitivity to the SARS-COV-2. The management and control of COVID-19 infection include screening and intensive care, medication, and guided therapy. Conclusion: Given the immunological and physiological changes during pregnancy and limited information about COVID-19 infection, pregnant women are at-risk populations and have identified as high-risk groups.

Introduction: Granular cell tumor (GCT), formerly known as granular cell myoblastoma, is an uncommon soft tissue neoplasm that may be of neural or neuroectodermal origin. For a long time, this neoplastic lesion was considered to be of striated muscle origin. This type of tumor can be found anywhere in the body, but rarely in the abdominal wall. In this study, we report a granular cell tumor in abdominal wall. Case presentation: We report a 54-year-old woman with relatively painful and rigid abdominal wall lesion in the suprapubic area from 20 days before admission. Ultrasound and CT scan were performed and the patient underwent abdominal wall mass excision surgery in the suprapubic region. Surgical resection was performed extensively with the removal of adjacent muscles and fascia. Preoperative histopathologic diagnosis is important because one of the therapeutic targets of GCT is extensive excision to obtain tumor-free margins, as in the case of margin involvement, the chance of recurrence is high. Then, the sample was sent to the pathology department for further examination, and immunohistochemistry study with CK, chromogranin, S100, and CD68 markers was done for final diagnosis. Since abdominal wall GCT is a very rare clinically and radiologically finding and can mimic malignant symptoms, it is important to correctly diagnose it. Conclusion: Due to the numerous reported cases of this lesion in women and the possibility of more encountering of gynecologists with this case, the need for accurate knowledge of this lesion in the gynecological surgery group is of greater importance to prevent the consequences of improper treatment.