Hysteroscopic and Pathologic Evaluation of Chronic Endometritis in Patients with Unexplained Recurrent Spontaneous Abortion

BACKGROUND AND OBJECTIVE: Chronic endometritis is one of the most specific, but not the most common causes of infertility, which reduces the amount of pregnancy and poor results of pregnancy, such as preterm labor and abortion. The aim of this study was to evaluate the role of chronic endometritis in recurrent spontaneous abortions (RSA) and to determine the bilateral relationship between the histological and pathological findings of this inflammation. METHODS: A case controlled-prospective observational study was performed on one hundred women 20-35 years in the Fatemeh Zahra infertility center and Rohani hospital. Patient group include forty patients with unexplained RSA and control group include 60 women that underwent hysteroscopy due to vaginal bleeding or other causes except RSA. All of the women underwent endometrial biopsy and examined by pathologist for presence plasma cells in stroma. FINDINGS: In all patients endometritis rate was 8%. Patients with RSA had a significantly higher incidence of CE both hysteroscopically (30% vs. 6.7%; p<0.005) and pathologically (27.5% vs. 6.7%; p < 0.005). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of hysteroscopy in the diagnosis of CE were 93.3%, 97.6%, 87.5% and 98.8% respectively. Also the PPV and NPV of hysteroscopy, sensitivity, specificity in the diagnosis of endometrial polyp were 100%, 87.3%, 76.3% and 100% respectively. CONCLUSION: Based on the results, there was a significant association between CE and unexplained RSA. Due to high sensitivity and acceptable specificity of hysteroscopy in diagnosis of CE and endometrial polyp, we recommended hysteroscopic evaluation of patients with unexplained RSA

Assessment of Effective Factors In Recurrent Implantation Failure (RIF) Following Assisted Reproductive Technology (ART)

BACKGROUND AND OBJECTIVE: Despite many advances have been made in the assisted reproduction techniques (ART), implantation rate after embryo transfer has not increased significantly. Therefore, this study aims to determine the factors involved in recurrent implantation failure (RIF) following ART. METHODS: In this retrospective study, 80 infertile patients with a history of at least 3 recurrent implantation failure (RIF) following assisted reproductive technology (ART) were referred to Fatemezahra Infertility Center in Babol from March 2006 to March 2013 were selected. The control group also included 80 women who became pregnant following the first IVF. Associated factors of infertility, endocrine disorder and endometriosis were recorded and their effect on RIF was assessed in both groups. FINDINGS: The mean BMI was 26.39±3.63 in the case group and 26.77±4.49 in the control group. Body mass index (BMI) >30 increased the risk of RIF significantly (p=0.001). After adjusting for the effects of other possible confounding factors, the odds ratio of obesity on RIF was 1.09(0.91-1.19) 95% CI which was not significant (p=0.06). There were no significant differences among type and cause of infertility, endocrine abnormalities, uterine malformations, endometriosis and polycystic ovary with RIF. CONCLUSION: According to our findings, BMI, type and cause of infertility, endocrine disorders, uterine abnormalities, endometriosis, and polycystic ovary were not effective on recurrent implantation failure

Preferential Paths of Air-water Two-phase Flow in Porous Structures with Special Consideration of Channel Thickness Effects.

Accurate understanding and predicting the flow paths of immiscible two-phase flow in rocky porous structures are of critical importance for the evaluation of oil or gas recovery and prediction of rock slides caused by gas-liquid flow. A 2D phase field model was established for compressible air-water two-phase flow in heterogenous porous structures. The dynamic characteristics of air-water two-phase interface and preferential paths in porous structures were simulated. The factors affecting the path selection of two-phase flow in porous structures were analyzed. Transparent physical models of complex porous structures were prepared using 3D printing technology. Tracer dye was used to visually observe the flow characteristics and path selection in air-water two-phase displacement experiments. The experimental observations agree with the numerical results used to validate the accuracy of phase field model. The effects of channel thickness on the air-water two-phase flow behavior and paths in porous structures were also analyzed. The results indicate that thick channels can induce secondary air flow paths due to the increase in flow resistance; consequently, the flow distribution is different from that in narrow channels. This study provides a new reference for quantitatively analyzing multi-phase flow and predicting the preferential paths of immiscible fluids in porous structures

Comparison of anti Chlamydia antibodies in tubal and non-tubal infertile patients

Background and purpose: Chlamydia trachomatis infection is one of the most prevalent bacterial sexually transmitted infection in most countries. This organism may stay in genital tract for long time and cause subtle yet progressive damage in fallopian tubes. In this study we evaluate the correlation between chlamydia antibodies and tubal and other factors of infertility.Materials and Methods: In this case control study, 28 patients with tubal factor infertility, 28 patients with non tubal factor infertility and 30 normal patients were enroled. Presence or absence of tubal factor was assessed by direct vision via laparscopy, then titres of IgA and IgG were evaluated in all of them using ELISA method in the same labratory. Data were recoded and analyzed using SPSS software and chi-square, Fisher's exact, T-test and Mann- Whitney test.Results: Positive titre of IgG was higher in tubal factor infertility but it was not statistically significant between three groups (p>0.294). Positive titres of IgA were more common in non tubal factor infertility (p=0.007). Though positive and negative titres of IgA (P=0.224) and IgG (P=0.273) were not statistically different in fertile and infertile patients. Positive and negative titres of IgA and IgG were also not statistically different in patients with or without PID (p>0.05).Conclusion: No correlation was found between the positive titres of IgG and IgA against Chlamydia and tubal factor infertility

Peripartum Cardiomyopathy: A Case Report

ABSTRACT: Introduction & Objective: Peripartum cardiomyopathy is a rare but sometimes fatal form of heart failure during the period of 1 month antepartum to 5 months postpartum. The aim of this report is to assess the clinical presentation, management and crucial role of echocardiography in women with peripartum cardiomyopathy. Case: A 22 year-old woman, with previously healthy primipara, was admitted to the emergency ward with sever dyspnea, cough, and bloody hemoptesis and a preliminary diagnosis of pulmonary embolism (PE) two weeks after cesarean section. Neither perfusion scintigaphy nor Doppler sonography test of lower extremities and pelvis showed any evidence of PE or deep venous thrombosis. Echocardiography revealed features of left ventricular failure. A diagnosis of peripartum cardiomyopathy was made, appropriate treatment was administered and the patient improved. Conclusion: It is possible to misdiagnose peripartum cardiomyopathy with PE. Echocardiography is a valuable tool in the differential diagnosis. As a noninvasive procedure, it should be performed at the bedside as soon as possible to introduce proper treatment and to avoid potentially fatal errors

Comparing the effects of prednisolone and promethazine in the treatment of hyperemesis gravidarum: a double-blind, randomized clinical trial

Background: Nausea and vomiting during pregnancy is one of the most frequent obstetric problems of unknown etiology and there is no definitive treatment for it. The purpose of this study was to compare the effects of prednisolone and promethazine in the treatment of hyperemesis gravidarum. Materials and Methods: This double-blind clinical trial study was conducted on 70 pregnant women, with a singleton pregnancy at less than 16 weeks of gestation, with hyperemesis gravidarum. Women were randomly divided into two groups to receive either prednisolone (5mg) or promethazine (25mg) three times daily they received capsules with similar shapes but different codes. The dose of medication was tapered down after the first week and it was discontinued after two weeks. Finally, women were studied for relapse symptoms during the treatment and two weeks post-treatment. Results: There was a significant difference in the improvement of symptoms between the two groups during the course of treatment and also two weeks post-treatment (P=0.001). Moreover, there was no significant difference between the two groups in the frequency of nausea and vomiting during the first 4 days, in the 14th day of the treatment and 2 weeks post-treatment (P=0.07). Conclusion: Results show that both prednisolone and promethazine are effective to control hyperemesis gravidarum

Relationship between the serum B-HCG and preeclempsia and itsseverity

Background and purpose: Preeclampsia as the most common complication of pregnancies has unknown physiopathology. Because the role of serum Beta-human Chorionic Gonadotropin (B-hCG) in pathophysiology of preeclampsia is not well known, we decided to determine the correlation between serum concentration of B-HCG and preeclampsia .Materials and Methods: This case-control study performed on two groups of 40 preeclamptic nulliparous and 40 healthy term pregnant women at obstetrics and gynecology ward of Sh. Yahyanejhad Hospital in Babol during 2003-4 . Serum B- hCG concentration was measured in all patients. Patients with chronic hyprtension, diabetes, multiple pregnancies or medial diseases were excluded. The data were analyzed using Chi-square, T-Test and ANOVA, Mann-Whitney and Kruskall-Wallis tests.Results: The maternal serum Beta hCG levels in patients with preeclampsia were (39840±24630) IU/L which is higher in comparison with healthy ones (27460±25862) IU/L (P=0.031). The mean of serum beta hCG levels were 31991±16758 and 84312±9257 in mild and severe preeclampsia (P<0/0001).Conclusion: Serum Beta hCG level is higher in preeclamptic women than normal pregnancies. It is also noticed that the higher the levels of serum Beta hCG the more severe the preeclampsia. This finding, in turn, reinforces the association between elevated HCG concentrations and placental damage

Outcomes of total versus subtotal abdominal hysterectomy ‫البطن‬ ‫طريق‬ ‫عن‬ ‫للرحم‬ ‫الكامل‬ ‫غري‬ ‫االستئصال‬ ‫مقابل‬ ‫الكامل‬ ‫االستئصال‬ ‫حصائل‬

ABSTRACT There is still controversy about the best technique for hysterectomy to reduce postoperative adverse effects. This randomized clinical study in Babol, Islamic Republic of Iran, compared some clinical complications and sexual functioning following subtotal (SAH) and total abdominal hysterectomy (TAH). A total of 150 women (50 allocated to SAH and 100 to TAH) were followed up at 6 months postoperatively. Length of hospitalization was 4.40 (SD 1.90) days after SAH and 4.48 (SD 1.67) days after TAH. Haemoglobin level, postoperative fever, symptoms of dyspareunia and frequency of sexual intercourse were not significantly different between the 2 groups of women. SAH did not show any significant benefits over TAH. Comparaison des résultats de l&apos;hystérectomie subtotale et de l&apos;hystérectomie abdominale totale RÉSUMÉ Il existe toujours une controverse quant à la technique d&apos;hystérectomie permettant le mieux de réduire les effets indésirables postopératoires. Une étude clinique randomisée réalisée à Babol, en République islamique d&apos;Iran, a comparé les complications cliniques et la fonction sexuelle après une hystérectomie subtotale et une hystérectomie abdominale totale. Un groupe de 150 femmes (50 ayant subi la première et 100 la seconde) a été suivi pendant six mois après l&apos;opération. La durée d&apos;hospitalisation était de 4,40 jours (écart type 1,90) après une hystérectomie subtotale et de 4,48 jours (écart type 1,67) après une hystérectomie abdominale totale. Le taux d&apos;hémoglobine, la fièvre postopératoire, les symptômes de dyspareunie et la fréquence des rapports sexuels ne présentaient pas de différence significative entre les deux groupes. L&apos;hystérectomie subtotale n&apos;a pas apporté d&apos;avantage important par rapport à une hystérectomie abdominale totale

Thermo-mechanical modeling of turbulent heat transfer in gas-solid flows including particle collisions

A thermo-mechanical turbulence model is developed and used for predicting heat transfer in a gas-solid flow through a vertical pipe with constant wall heat flux. The new four-way interaction model makes use of the thermal kθ-τθ equations, in addition to the hydrodynamic k-τ transport, and accounts for the particle-particle and particle-wall collisions through a Eulerian/Lagrangian formulation. The simulation results indicate that the level of thermal turbulence intensity and the heat transfer are strongly affected by the particle collisions. Inter-particle collisions attenuate the thermal turbulence intensity near the wall but somewhat amplify the temperature fluctuations in the pipe core region. The hydrodynamic-to-thermal times-scale ratio and the turbulent Prandtl number in the region near the wall increase due to the inter-particle collisions. The results also show that the use of a constant or the single-phase gas turbulent Prandtl number produces error in the thermal eddy diffusivity and thermal turbulent intensity fields. Simulation results also indicate that the inter-particle contact heat conduction during collision has no significant effect in the range of Reynolds number and particle diameter studied. © 2002 Elsevier Science Inc. All rights reserved.The work of GA was supported by the U.S. Department of Energy, National Energy Technology Laboratory (NETL).Peer Reviewe