Heterotopic pregnancy following ovulation induction by Clomiphene and a healthy live birth: a case report

<p>Abstract</p> <p>Introduction</p> <p>A heterotopic pregnancy is defined as the presence of a combined intrauterine and ectopic pregnancy. Its estimated incidence is accepted as between 1/7000 and 1/30,000 pregnancies. It is also reported to be as high as 1% after the use of assisted reproductive technology, but Clomiphene Citrate which increases the rate of twinning, could be associated with a heterotopic pregnancy rate of 1/900, which is much less than using assisted reproductive technology. Heterotopic pregnancies are diagnostic and therapeutic challenges for obstetricians. If they continue without diagnosis, a life-threatening situation may occur even when surgical intervention with laparotomy is performed.</p> <p>Case presentation</p> <p>We present the case of a 22-year-old Iranian woman who developed a simultaneous extra -and intrauterine pregnancy after the induction of ovulation with Clomiphene. In this case, there was a delay in the detection of the ectopic pregnancy component resulting in an emergency laparotomy being performed. Fortunately after the laparotomy, the intrauterine pregnancy was not affected and it progressed satisfactorily until 37 weeks. A healthy male baby was delivered by caesarean section.</p> <p>Conclusion</p> <p>This case suggests that a heterotopic pregnancy must always be considered in patients presenting with pelvic pain even in a confirmed intrauterine pregnancy, particularly after the induction of ovulation by Clomiphene Citrate or assisted reproductive technology. Every clinician treating women of reproductive age should keep this diagnosis in mind. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.</p

The relationship between body mass index, body image, and sexual function: A survey on Iranian pregnant women

Background: The prevalence of sexual problems is high during pregnancy. Despite this, there are limited data about the impact of physical and psychological factors such as body weight and body image on sexual function in pregnant women. Objective: To investigate the relationship between body mass index, body image, and sexual function among pregnant women. Materials and Methods: In this cross-sectional study, a total of 206 Iranian pregnant women (106 with normal weight and 100 overweight women) in their 2nd and 3rd trimesters of pregnancy were surveyed. Survey instruments included the Female Sexual Function Index and Multidimensional Body-Self Relations Questionnaire. Results: The prevalence of female sexual disorder was 72.3% in this survey. Diminished sexual desire/appetite was the most common problem reported by the participants (37.9%). The mean score of sexual problem and body image were not significantly different among overweight and normal weight women in the 2nd (p = 0.945 and p = 0.800, respectively) and 3rd trimesters of pregnancy (p = 0.310 and p = 0.507, respectively). Further, there were no relationships between the body mass index plus body image and the total female sexual function score (p = 0.44 and p = 0.837, respectively). However, the relationship between the appearance evaluation with lubrication (p = 0.043) and subjective weight with two subscales of sexual satisfaction (p = 0.005) and orgasm (p = 0.019) were significant. Conclusion: The findings from this study revealed that there were no relationships between body mass index plus body image score and the sexual function in pregnancy. Therefore, a further research is recommended to study other potential factors affecting sexual function during pregnancy

A declustered earthquake catalog for the Iranian Plateau

A unified catalog of earthquakes in Iran and adjacent regions (the area bounded in 22º-42ºN and 42º-66ºE) covering the period of 4th century B.C. through 2012 with Mw≥4 is provided. The catalog includes all events for which magnitude have been determined by international agencies and most reliable individual sources. Since the recurrence time of maximum credible earthquake cannot be directly estimated from the mb, empirical formulae are established to convert mb to Ms, mb to Mw and Ms to Mw for each major seismotectonic province separately. The unified catalog is declustered using conjugated distance-time windows. In order to estimate completeness thresholds, magnitude-time (M-T) diagram and Stepp’s method are applied on the declustered catalog for each seismotectonic province. The magnitude of completeness (Mc) decreases with development of local and regional seismic stations. The results of present study are particularly important in seismic hazard analysis in Iran

Specification and Implementation of Workflow Control Patterns in Reo

Abstract Coordination models and languages are relatively new methods in modeling component-based software systems. These models and languages separate the communication aspect of systems from their computation aspect, and hence enable the modeling of concurrent, distributed, and heterogeneous systems. In this thesis, our goal is to show that Reo, a channel-based exogenous coordination language, is powerful enough to be used in the area of workflow management. In order to achieve this goal, we consider a set of workflow control patterns. We implement each of these patterns in terms of a Reo circuit and show that these Reo circuits capture the behavior of the corresponding workflow control patterns. We believe that the patterns we choose in this thesis are enough to show the strength of Reo as a workflow language. We explain our approach in four steps. In the first step, we specify the general definition of workflow control patterns in terms of some Point Interval Temporal Logic formulas. In the second step, we convert each PITL formula to a constraint automaton. In the third step, we implement each workflow control pattern by a Reo circuit; each Reo circuit consists of a set of components and a set of connectors that connect and coordinate those components and provide its behavior as a relation on timed data streams; a timed data stream is a twin pair of a data stream and a time stream. In the forth step, we compositionally derive the constraint automata of that Reo circuit and finally, in the fifth step, we show the equivalence of the two constraint automata

Cardiovascular Complications of Acute Amphetamine Abuse : Cross-sectional study

Objectives: This study aimed to evaluate cardiovascular complications among patients who abuse amphetamines. Methods: This cross-sectional study took place between April 2014 and April 2015 among 3,870 patients referred to the Toxicology Emergency Department of Baharlou Hospital, Tehran University of Medical Sciences, Tehran, Iran. Those with clinical signs of drug abuse and positive urine screening tests were included in the study, while cases of chronic abuse were excluded. Cardiac complications were evaluated via electrocardiography (ECG) and transthoracic echocardiography. Results: A total of 230 patients (5.9%) had a history of acute amphetamine abuse and positive urine tests. Of these, 32 patients (13.9%) were &lt;20 years old and 196 (85.2%) were male. In total, 119 (51.7%) used amphetamine and methamphetamine compounds while 111 (48.3%) used amphetamines with morphine or benzodiazepines. The most common ECG finding was sinus tachycardia (43.0%), followed by sinus tachycardia plus a prolonged QT interval (34.3%). Mean creatine kinase-MB and troponin I levels were 35.9 ± 4.3 U/mL and 0.6 ± 0.2 ng/mL, respectively. A total of 60 patients (26.1%) were admitted to the Intensive Care Unit. The majority (83.3%) of these patients had normal echocardiography results. The mean aortic root diameter (ARD) was 27.2 ± 2.8 mm. Abnormalities related to the ARD were found in 10 patients (16.7%), three of whom subsequently died. Conclusion: According to these findings, cardiac complications were common among Iranian patients who abuse amphetamines, although the majority of patients had normal echocardiography and ECG findings

Breast Cancer: Genetics, Risk factors, Molecular Pathology and Treatment

Breast cancer within incident of one million new cases each year has become one of the most common malignancies and leading cause of death among females. This disease is comprised of about 18% of women cancers. The availability of early detection and improved treatments may decrease the mortality rates which reflected in the United States and many other western countries. Breast cancer in over the past 20 years may also have contributed to the Increasing age, nulliparity, positive family history of breast cancer, and use of menopausal hormone therapy were positively risk factors associated with breast cancer. Therefore, studying this malignity is prominent due to its mortality world wild. Evaluation and study of different aspects of breast cancer have been established during past decays which, in this review, it is presented and discussed

Location of Public Places “Bazaar” as a Commercial Case and “Square” as a Social one (Case Study: Abpakhsh City)

In spite of the fact that the need to public places for social interactions and activities is expressly felt recently, the importance of their existence in cities (studied case: Abpakhsh) has reduced or they are just found in some parts of the cities in the last decades. Attempts for solving this problem have been either descriptive or lacked consideration of geographical factors. This research is carried out to locate the public places of the Abpakhsh city by combination of Iranian-Islamic urbanizing pattern with the western pattern in order to keep the Islamic-Iranian identity of the public places with respect to the current needs of citizens. Therefore, the descriptive-analytic approach and AHP method through GIS are used in two phases. At first the per capita and the demanded lands for responding the needs of Abpakhsh citizens is measured by the 2021. Then, for better evaluation, two public places (“bazaar” as a commercial case and “square” as a social one) are located in the city with a combined Iranian-Islamic approach. The results of this evaluation in the first step show the lack of land for public places by the 2021, while the second step reveal the perfect conditions of eastern and western lands respectively for construction of a bazaar and a local square. Results generally represent the prosperous combination of the Iranian-Islamic norms with the western ones in order to maintain the Iranian-Islamic identity of Abpakhsh city without causing any obstacle for satisfying the citizen’s needs

An investigation on the effects of justice on customer’s trust in insurance firms

This paper presents an investigation on the effects of various components of justice including distributive justice, interactional justice and procedural justice on building a mutual trust among customers in insurance firms. The proposed study of this paper uses a questionnaire originally developed by Daniels [Daniels, N. (1996). Justice and justification: Reflective equilibrium in theory and practice (Vol. 22). Cambridge: Cambridge University Press.] and designs a questionnaire for measuring trust. The study was performed among 384 people who had used insurance services in city of Tehran, Iran. Cronbach alphas for two questionnaires of justice and trust are 0.799 and 0.935, respectively, which are well above the minimum acceptable level. Using Spearman correlation test, the study has detected that two justice components, interactional justice and procedural justice, positively influence on customers’ trust, significantly

Graphite Application and Different Powers of Neodymium-Doped Yttrium Aluminium Garnet (Nd:YAG) Laser on Dentin Surface Changes: A Scanning Electron Microscopy Study

INTRODUCTION: Various methods have been used for the treatment of dentine hypersensitivity such as dentifrices, sealants and different types of lasers. The aim of this study was to evaluate the effect of Neodimium:Yttrium-Aluminium-Garnet (Nd:YAG) laser in association with graphite on the dentin morphologic changes.METHODS: In this experimental in vitro study, 16 freshly extracted third molars were selected. 5 specimens with the dimensions of 2×2×1 mm from root trunk were prepared. Specimens were randomly divided into five groups: group 1 (control, no laser irradiation). Group 2, 3 irradiated by Nd:YAG laser 0.5 and 1W, output power respectively. Group 4, 5 smeared with graphite and then irradiated by Nd: YAG laser 0.5 and 1W output power. Samples were prepared for scanning electron microscopy. Number and diameter of dentinal tubules were determined in different groups and analyzed with the Kruskal-wallis and Mann-Whitney tests (SPSS 16).RESULTS: The number of tubules had significant difference between all groups (P&lt;0.001), except group 1 in comparison with group 2 (P&gt; 0.05), and group 3 in comparison with group 4 (P&gt; 0.05). Micro-cracks and rupture of melted dentin materials were seen in group 4 and 5.CONCLUSION: According to the findings of this study, smearing with graphite on dentin surface increase the absorption of Nd:YAG laser energy and reduced the diameter and number of open dentinal tubules