SAREM JOURNAL OF MEDICAL RESEARCH (SAREM JOURNAL OF REPRODUCTIVE MEDICINE)
Year:2020 | Volume:4 | Issue:4|Papers Count:7

Introduction: Vasa previa is a very dangerous variation in which the vessels present inside the amniotic curtains are located on the cervical hole. These vessels may be located between the cervix and the fetus. As a result, the vessels are susceptible to compression, as well as tear or rupture, which results in rapid discharge of the blood fetus, and this state is associated with fetal mortality in 6% unidentified conditions. The present study is a case report of pregnancy with a velamentous variate cord that prevented the subsequent tragic events by early diagnosis and timely cesarean section. Patient Information: A 31-year-old pregnant woman with fetal developmental disorder was examined for Doppler ultrasonography and due to increased umbilical cord vessel resistance, at 37 weeks of pregnancy, became cesarean which was observed during operation velamentous variate cord. Conclusion: IUGR and fetal growth retardation can be associated with placental disorders. Therefore, in cases where we have fetal developmental disorder, closer examination of the placenta can lead to early termination of labor and choice of delivery method to prevent neonatal mortality and morbidity.

Introduction: Despite vaginismus is a relatively common sexual dysfunction in Iranian women, rare examinations have reported its roots. Therefore, this study was carried out to examine the link between phobia history and vaginismus in women. Methodology: The statistical population of this descriptive-correlational study comprises of married women who refer to Agape Sexual Disorders Center and the offices of gynecologists in Tehran. Of the 168 patients who were sampled, 102 had primary vaginismus and 128 had a history of animal, natural environment, blood, and injections phobia. Evaluation tools involved: 1-A blood test to check for anemia and thyroid problems, 2-Physical and genitals examination by a gynecologist 3-Clinical interview by a psychiatrist based on DSM5 for mental disorders and phobia 4-A 20-Questions Questionnaire on Female Sexual Function Index (FSF1) for sexual evaluation and diagnosis of vaginismus. 5-A researcher-made questionnaire for demographic characteristics. The data were examined by statistical correlation and logistic regression tests. Results: The results reveal a significant relationship between phobia and vaginismus (p = 0. 001). Therefore, the impact of phobia on the probability of vaginismus is positive. Conclusion: Based on the findings, we can conclude that women with a history of phobia can be prevented from developing vaginismus by phobia therapy and required training, thus leading to sexual satisfaction in couples.

Introduction: The pelvic floor muscles are normally active in erectile function. Therefore, it is assumed that weak pelvic floor muscles cause erectile dysfunction and on the other hand, normal function of pelvic floor muscles in penile blood supply and erectile function plays an important role. Aim: The aim of the present study was to compare the efficacy of oral Tadalafil and neuromuscular biofeedback of pelvic floor muscles along with oral Tadalafil in the treatment of erectile dysfunction in men. Methodology: The sample consisted of 60 men with erectile dysfunction, with a mean age of 43. 66 years, referred to the Agape Sexual Disorders Center in Tehran and Sarem Hospital. Of these, 30 patients were randomly assigned to the intervention group and were treated with neuromuscular biofeedback for 5 weeks and took 5 mg of Tadafil daily, and 30 patients as a control group used 5 mg of Tadafil daily. Evaluation was performed by interview and clinical examination, as well as International Erectile Performance Index Questionnaire (IIEF5). Results: In the fifth week after treatment, both intervention and control groups showed a significant difference (P<0. 001) in increasing the score of the International Erectile Performance Index (IIEF5) from pre-test to post-test. But only in the intervention group, the increase in pelvic floor muscle strength was significant (P<0. 001). On the other hand, there was a significant difference between the two groups in erectile function and pelvic floor muscle strength. Conclusion: Based on the findings of the study, it can be concluded that neuromuscular biofeedback in combination with Tadalafil is an effective treatment for men with erectile dysfunction.

Background and Objective: Infertility is a major health problem affecting 10-15% of couples globally. Genetic factors such as chromosomal abnormalities are one of the major causes of infertility and spontaneous abortions. The aim of this study was to establish the chromosome abnormality and chromosomal variants' rate amongst couples referred for reasons of infertility and subfertility to the Cytogenetics laboratory of Sarem Women’ s hospital in Tehran between 2006 and 2017. Material and methods: In this study, a total number of 6514 patients were referred for chromosomal investigation. The mean age of referral female and male patients were 30 and 34 years, respectively. Referral reasons included infertility, recurrent abortions, and unsuccessful Assisted Reproductive Technologies (ARTs). Heparinized peripheral blood was obtained. Cytogenetic investigation was carried out using standard techniques. GTG high resolution banding technique was used and 20-50 metaphase spreads were studied. CBG, NOR banding, and FISH investigation were carried out if necessary. Results: The overall chromosome abnormality rate was 5. 28 percent (344 out of 6514). The cytogenetic results for these referral couples are as follows: 66 (19. 1%) patients had a numerical chromosome abnormality including sex chromosomes and marker chromosomes. 120 (34. 9%) patients had structural chromosome abnormalities. 158 (46%) patients had mosaicism with different cell lines. 70 (1. 07%) patients had an inversion of chromosome 9. Discussion and Conclusion: Cytogenetic investigation in patients with infertility and subfertility is critical as a first line genetic investigation. The findings of chromosome abnormality are of great value in the better management of the patients.

Introduction: Aarskog-Scott syndrome is a rare X-linked disorder, charecterized by facial, skeletal and genital anomalies. It is also known as faciogenital dysplasia (FGDY, OMIM NO: 305400) and facio-digito-genital syndrome. Patient Information: 7 years old boy with the same features, whom had been referred for genetic counseling, diagnosis, knowing the recurrence risk and seeking advice. Conclusion: The main features are short stature, hypertelorism, short hands and feet, and shawl scrotum.

Background and Aims: Breast cancer is the most common cancer in women. Screening, early detection, and prediction of the susceptibility are very important in drug response and choosing the appropriate treatment. Due to the limitations of conventional screening methods, such as low sensitivity and specificity, pain and anxiety, and radiation hazards of imaging techniques, use of biomarkers that can overcome these limitations would be important. Tumor markers (Protein and nucleic acid) are the most important molecular markers involved in cancer progression. About half of all hereditary breast cancers are caused by germline mutation in tumor suppressor genes and genes involved in mismatch repair, cell cycle control, steroid hormone metabolism, and cell signaling. Therefore, quantitative study of these genes can be used as a possible indicator in early detection of breast cancer. In this study, we introduce the genes involved in inherited breast cancer and the role of the main molecular techniques of its diagnosis in comparison with traditional methods. Conclusion: Various techniques such as IHC, FISH, CGH, Micro array, etc. and Molecular techniques such as RT-PCR, MLPA, QPCR, and NGS are used to measure tumor markers. Today, these techniques promise to improve diagnosis and help to select an appropriate treatment for patients and find specific mutations such as BRCA1 and BRCA2, HER3, etc.

Aim: This study was performed to compare the effectiveness of radical surgery and combination therapy (Sarem's Women Hospital protocol) and their costs in patients with grade IV (Severe) endometriosis. Material and methods: In this randomized clinical trial, 44 patients with grade IV endometriosis were randomly divided into two groups. In the first group (n=19), all endometriosis lesions were completely removed by radical surgery. In the second group (n=25) no therapeutic surgery (except diagnosis) was performed and patients were included in the combination therapy treatment protocol. In this protocol (combination therapy), patients received 12 months of drug treatment with GnRH agonist (Decapeptyl 3. 75 mg, IM Inj. ) every 28 days. The fine adhesions or very poor remnants of endometriosis lesions removed by second-look laparoscopy. The severity of pelvic pain and dysmenorrhea was analyzed according to the VAS scale, one month and two years later, along with treatment costs in both groups. Results: One month after the end of treatment, pelvic pain and dysmenorrhea were significantly lower in the combination therapy group, and on the other hand, two years after treatment, recurrence of dysmenorrhea and pelvic pain were significantly higher in the radical surgery group than in the combination therapy group. There were no post-treatment complications in the combination therapy group, while some patients in the radical surgery treatment group developed complications. Also in this study, it was shown that the cost of treatment in the radical surgery group was significantly higher than the combination therapy group. Discussion and Conclusion: Combination treatment of endometriosis (Sarem's Women Hospital protocol) is more effective in reducing dysmenorrhea and pelvic pain one month and two years after treatment and with much fewer complications and is superior to radical surgery in terms of treatment costs.