An Epidemiologic Study of Maternal Deaths in the Population Covered by Kerman University of Medical Sciences, 2010-2012

Background: Pregnancy is a physiological process in any women's life, but in some cases it might be ended in maternal death tragedy. However, most cases of maternal deaths are preventable. Reviewing maternal death cases, for the purpose of identifying the related factors is beneficial for future planning. The aim of this study was to assess the current statuses of maternal death and its causing factors in hospitals affiliated to Kerman University of Medical Sciences. Methods: In this cross-sectional study, all cases of maternal deaths during 2010 to 2012 were studied and a designed data entry form was completed for each case. Data analysis was done through SPSS17. Results: During the 3 years of study, 28 maternal deaths had occurred and the ratio of maternal death was calculated as 23.57 per 100000 live births. Preeclampsia was the most common direct cause and heart disease was the most common indirect cause of maternal deaths. Maternal deaths were related to shortcomings in all stages of before pregnancy, during pregnancy and post partum period. Conclusion: In order to minimize the number of maternal deaths, more attention should be paid to the quality of maternal care before pregnancy, during pregnancy and in post partum period. Keywords: Pregnancy, Prenatal Care, Maternal Mortalit

Predicting role of Myc-induced nuclear antigen 53 in determining the development and severity of systemic lupus erythematosus

IntroductionSystemic lupus erythematosus (SLE) as an autoimmune disease can relate to an imbalance between regulatory T cells (Tregs) and Th17 cells. Previous reports have shown that Myc-induced nuclear antigen (Mina) 53 protein is involved in the developments of Tregs and Th17 cells. Therefore, the current study focused on determining whether Mina53 level is correlated to the severity of SLE.MethodsThe blood samples were collected from 60 patients with SLE (30 cases with mild SLE and 30 cases with severe SLE) and 30 healthy subjects. The serum concentration of Mina53 was measured using enzyme-linked immunosorbent assay (ELISA). The expression of Mina53 gene was assessed using real-time PCR method after extracting RNA from isolated peripheral blood mononuclear cells and synthesizing cDNA.ResultsPatients with SLE showed significant increases in the serum level and gene expression of Mina53 compared to healthy subjects (P<0.001). Furthermore, serum level and gene expression of Mina53 showed significant effects on SLE disease and its severity (P<0.01). There was the highest sensitivity and maximum specificity in the cut-off point of Mina53 serum level equal to 125.4 (area under the curve (AUC)=0.951) and Mina53 expression level equal to 8.5 (AUC=0.88) for SLE diagnosis. The cut-off point of Mina53 serum level equal to 139.5 (AUC=0.854) and the cut-off point of Mina53 expression level equal to 8.5 (AUC=0.788) had the highest sensitivity and maximum specificity determining severe forms of SLE.DiscussionOur results showed that the changes in serum and expression levels of Mina53 have significant effects on SLE disease and its severity. These levels may be considered as diagnostic and predictive markers for SLE

Sodium dodecyl sulfate coated γ-alumina support modified by a new Schiff base for solid phase extraction and flame-AAS determination of lead and copper ions

A simple and fast approach for solid phase extraction is herein described, and used to determine trace amounts of Pb2+ and Cu2+ metal ions. The solid phase support is sodium dodecyl sulfate (SDS)-coated γ-alumina modified with bis(2-hydroxy acetophenone)-1,6-hexanediimine (BHAH) ligand. The adsorbed ions were stripped from the solid phase by 6 mL of 4 M nitric acid as eluent. The eluting solution was analyzed by flame atomic absorption spectrometry (FAAS). The sorption recovery of metal ions was investigated with regard to the effects of pH, amount of ligand, γ-alumina and surfactant and the amount and type of eluent. Complexation of BHAH with Pb2+ or Cu2+ ions was examined via spectrophotometry using the HypSpec program. The detection limit for Cu2+ was 7.9 µg L-1 with a relative standard deviation of 1.67%, while that for Pb2+ was 6.4 µg L-1 with a relative standard deviation of 1.64%. A preconcentration factor of 100 was achieved for these ions. The method was successfully applied to determine analyte concentrations in samples of liver, parsley, cabbage, and water

Interaction of triacontanol and arsenic on the ascorbate-glutathione cycle and their effects on the ultrastructure in Coriandrum sativum L.

Exogenous application of triacontanol (TRIA) has the ability to mitigate the adverse effects of abiotic stresses by modulating a number of physio-biochemical processes in different plants. However, information about how its effects may be mediated under heavy metal stress is scanty. In this study, we evaluated how TRIA exerted its role against the toxicity of sodium arsenate in coriander (Coriandrum sativum L.). The activities of enzymes, including ascorbate peroxidase (APX), glutathione reductase (GR), monodehydroascorbate reductase (MDHAR), dehydroascorbate reductase (DHAR) and glutathione-S-transferase (GST), were measured. In addition, the contents of ascorbate (ASC), dehydroascorbate (DHA), reduced glutathione (GSH) and some elements including both As and the nutrients Ca, Mg, Zn, K, P were determined. Results suggested that As decreased GSH, ASA and DHA contents, a clear indication of oxidative stress, but their amounts were raised by TRIA treatment. Also, As stress decreased plant Ca, Zn, K, Mg and P contents, while TRIA improved their uptake and inhibited As accumulation. As 200 μM treatment inhibited the activities of APX, MDHAR, DHAR, and GR, enzymes of the ascorbate-glutathione cycle (AGC). TRIA supplementation restored and even enhanced the activity of all the AGC enzymes. 10 μM TRIA treatment increased GST gene expression and activity to a greater extent than under only As treatment. TRIA-alone treatments did not change the mentioned parameters. Transmission electron microscopy (TEM) observations showed that TRIA was able to protect cells, and most of all chloroplasts, from As-induced damage. These results clearly indicate the protective role of TRIA in modulating the redox status of the plant system through the antioxidant AGC and GSH enzymes, which could counteract arsenic-induced oxidative stress

Ultrasonographic Evaluation of Bowel Wall Thickness and Intramural Blood Flow in Ulcerative Colitis

Aim. This study aimed at assessing Doppler ultrasonographic findings of gut wall vessels and thickness in active and quiescent ulcerative colitis. Methods. Fifty patients with ulcerative colitis were studied using transabdominal grayscale and Doppler sonography of sigmoid, distal and middle parts of descending colon in different stages of the disease. Thickness of colon wall in the most involved site, number of color signals in each box, resistive index (RI), and pulsatility index (PI) were evaluated. Results. The median thickness of the colon wall in the most involved sites was 4.3 mm in acute phase and 4.4 mm in the inactive phase (P = 0.47). The median number of the color signals in the active phase at the most involved site, distal part of descending colon and sigmoid was higher than that of the color signals in the inactive phase (P = 0.0001). In the most involved site, the PI and RI were undetectable in the inactive phase. The median PI was 1.4 in the mild phase, 1.3 in the moderate phase, and 1.1 in the severe phase (P = 0.002). Conclusion. In contrast to the colon wall thickness, increased intramural blood flow reflected the clinical severity in ulcerative colitis patients

An animal model study of osteochondral defect repair by human adipose stem cells and pomegranate fruit hydroalchoholic extract

Objective: Articular cartilage damages do not repair spontaneously. Tissue engineering is a promising approach to repair cartilage damage. Transforming growth factor-beta (TGF-β) members are the known induction factors in chondrogenic differentiation. However, hypertrophy of the chondrocytes resulting from mesenchymal stem cells (MSCs) induction by TGF-β is inevitable. Pomegranate fruit contains many ingredients which are useful in ensuring the health of organs. This study was designed to investigate the Pomegranate Fruit hydroalchoholic Extract (PFE) capability in human adipose derived stem cells (hASCs) differentiation into the chondrocytes on fibrin scaffold.Materials and Methods: Pomegranate fruit hydroalchoholic extract (PFE) was prepared. hASCs were isolated, expanded, labeled, and seeded on the fibrin scaffold. The constructs were divided into three groups including TGF-β3, PFE, and control. The constructs were induced for 14 days, then, the MTT assay, Real-Time Polymerase Chain Reaction (PCR), and histochemistry assessments were run, and finally, the constructs were transplanted into the knee defect of rats. The gross and histological assessments of the transplants were done after 8 weeks.Results: The viability rate, COL2A1, Aggrecan (ACAN) and COL10A1 genes expression levels, and histological criterion of the PFE samples were significantly higher than that of the control. The macroscopic grades and histological results of the PFE samples were close to that of the TGF-β3. The number of positive cells for COLІI protein were higher significantly in the PFE group than the control.Conclusion: PFE was effective in the chondrogenic induction of hASCs. Further studies are needed to find out the events of the chondrogenic induction using PFE

Does Endometrial Compaction Predict Clinical Pregnancy Rate after Cleavage Stage Frozen Embryo Transfer?

Objectives: This study aimed to determine the relationships between endometrial compaction and pregnancy outcome in patients receiving artificial endometrial preparation for frozen embryo transfer (FET) cycles. Materials and Methods: This prospective cohort study was performed in a university-affiliated fertility clinic from March 2020 to March 2021. The eligible women undergoing their first or second FET cycle and having the top grading cleavage stage embryos were enrolled. All patients received the same endometrial preparation regime. The alteration in endometrial thickness (EMT) between the day of progesterone initiation and the day of embryo transfer (ET) was measured using consecutive transvaginal sonography. The patients were divided into three groups based on the percentage of endometrial compaction (i.e., the difference of EMT at end of the estrogen-only phase and after three days of progesterone administration (ET day) divided by the EMT on the terminal day of the estrogen-only exposure). Results: Overall, 300 eligible women were evaluated and only 27.3% (82/300) of the studied cycles showed ≥5% compaction, whereas 72.6% (218/300) either expanded or showed minimal compaction. The clinical and ongoing pregnancy rates in group 2 (any expansion) were significantly higher than those in groups 1 and 3 (P=0.002 and P=0.01, respectively). Multivariable logistic regression test indicated that the cycles with any expansion in ET were independently associated with 3.1 times improvement in clinical pregnancy rate in comparison to those with any compaction (P=0.002). Conclusion: Gross endometrial compaction occurred in one-third of FET cycles with no significant positive effect on pregnancy outcomes after cleavage-stage ET

The Association of Serum Hepcidin Levels and Insulin Resistance in PCOS Patients: A Case-Control Study

Objective: To investigate the relationship between insulin resistance and hepcidin levels in patients with PCOS. Materials and methods: In this case–control study fifty- six patients with PCOS and forty – one healthy control subjects were included. Plasma levels of hepcidin, IL-6, Serum Insulin and ferritin using ELISA method, serum iron levels using a spectrophotometric method, and Insulin resistance by using HOMA  were measured in the two groups of PCOS (case group) and  healthy subjects (control group). The results were analyzed by student’s t-test, General Linear Model, Binary logistic and linear regression tests. Results: The mean hepcidin level was 1.97 ± 0.53 pg/ml and 2.40 ± 0.25pg/ml in the case and control groups, respectively. The t-test results showed a significant difference between the two groups (p = 0.0001). The mean of insulin level in case and control group was 30.65 ± 15.02g/dl and 14.71 ± 10.46g/dl, respectively. The t-test analysis indicated a significant difference between the two groups (p = 0.0001). There was an inverse relationship between the level of hepcidin with HOMA-IR (β = -0.629, p = 0.04), and IL-6 (β = -0.243, p = 0.015) in both groups. The adjusted OR proved a statistically significant association between serum hepcidin (OR = 0.063; 95 % CI: 0.01-0.385, p-value  =  0. 003) and HOMA (OR  =  1.569; 95 % CI: 1.254–1.964, p-value  =  0.001) with PolycysticOvarian Syndrome. Conclusion: There was an inverse relationship between hepcidin levels and insulin resistance in both groups meaning decrease in hepcidin levels and increase in insulin resistance may increase the risk of PCOS

Fertility Preservation in Female Cancer Patients: Our Center Experiences

Reproductive options are one of the most important issues to cancer survivors, and it is related to quality of life. Although most of young patients are interested in parenthood in future but significantly pretreatment access of patients to fertility preservation (FP) services is low, because of low referral rate and disparity. Data were retrospectively analyzed from 77 cancer patients who were referred to vali-e-asr reproductive center between March 2013 and February 2015. Their ovarian reserve was estimated with AMH test, Antral follicular count and FSH (if they were referred in first days of menstrual cycle). Embryo or oocyte cryopreservation was used based on participants’ marriage status. Of 77(mean age 30, range: 16-45) patients 29(37.2%) were declined fertility preservation and the cost was the most frequent prohibitive cause. 10(12.9%) were excluded of fertility preservation services. Of 38 patients who were recruited for fertility preservation, 28(60.5%) were married, the mean number of embryos cryopreserved were 3.9. and the mean number of oocytes cryopreserved for 10 single participant in this group was 5.7. Our results demonstrate that oncologists have essential role in improving the provision of fertility preservation services. There are different available FP options that they can be use individualize. By assessing patients’ prohibitive factor and making an attempt to diminish them such as cost of FP services, we can improve their quality of life