Menstrual Disorders in Nongenital Tuberculosis

Menstrual patterns differ even in nongenital tuberculosis. Our objective is to determine whether nongenital tuberculosis makes menstrual dysfunction, before and sustain after treatment. Menstrual patterns were compared in women with pulmonary or extrapulmonary but nongenital tuberculosis with healthy nursing students and also with themselves, before and after treatment in a retrospective cohort study. Subjects were selected by convenient nonrandomized sampling but control groups were selected by random allocation among volunteers of nursing students. Case and control subjects were matched in age group. Menstrual patterns including amount, duration, interval, cessation of period, any menstrual irregularity, and pelvic pain were evaluated. Among 100 cases of proven tuberculosis, 90 patients had pulmonary and 10 cases had extrapulmonary tuberculosis. Secondary amenorrhea (P ≤ .001, RR: 22), spotting during menstrual period (P ≤ .0001, RR: 4.5), decreasing in amount (P ≤ .001, RR: 7.8), shorter duration of menstrual period (P ≤ .001, RR: 12), and pelvic pain (P ≤ .001, RR: 8.6) were more prevalent and significantly different in the cases compared to control subjects (with CI:95% and P < .001), but excessive or prolong vaginal bleeding was not observed. Menstrual disorders occur even in nongenital tuberculosis, but it is manifested with cessation or decrease in menstrual bleeding flow and period

Comparison of callus induction and somatic embryogenesis of some Iranian cottons (Gossypium Spp.) with Coker 312 and histology of somatic embryogenesis

Callus induction and somatic embryogenesis from hypocotyl explants of some Iranian cottons spp. (Hashem abad, Kerman, Termez and Sepid) were compared with Coker 312 through induction and formation of embryogenic calli on medium of Murashige and Skoog (MS) with Gamborg vitamins (B5) supplemented with the following compositions: MSB1 (0.5 mg/l zeatin), MSB2 (1 mg/l zeatin), MSB3 (0.5 mg/l 2,4-dichlorophenoxyacetic acid, 0.1 mg/l kinetin), MSB4 (1 mg/l 2,4-D, 0.5 mg/l kinetin, 0.5 mg/l zeatin) and MSB5 (2 mg/l α-naphtalene-3-acetic acid, 1 mg/l kinetin, 0.75 mg/l MgCl2). The optimum medium for the proliferation of embryogenic calli was MS medium containing B5 vitamins, 1 mg/l 2,4-D, 0.5 mg/l kinetin and 0.5 mg/l zeatin and the optimum medium for the development of somatic embryos was MS medium (NH4NO3 was removed and KNO3 amount doubled) containing B5 vitamins, 40 g/l sucrose and without hormone. Media MSB1, MSB2 and MSB4 gave the highest percentage (100%) of calli induction in Coker 312 but the lowest induction (46.66%) was observed when Hashem abad explants were cultured in the MSB3 medium. Embryogenesis percentage of Termez (2.22  to 24.40%), Hashemabad (1.85 to 9.73%) and Sepid (9.06 to 22.28%) genotypes were significantly lower than that of Coker 312 (66.66 to 94.33%). The Kerman genotype did not show embryogenesis. In the histological studies, the different development stages of the embryos (globular, heart, torpedo and cotyledonary) together with callus cells were showed.Key words: Hypocotyl explants, somatic embryo, in vitro regeneration, germination, somatic embryogenesis histology

Immediate dilation of a tight or stenotic cervix by intra-procedural administration of hyoscine butylbromide: A clinical trial

Background: Cervical dilation is indicated prior to performing various gynecological procedures. However, gynecologists are at times confronted with a stenotic or tight cervix, resistant to dilation. This can be problematic particularly when cervical ripening has not been attempted hours before the start of the procedure. Objective: The objective of this study is to investigate the efficacy of administration of hyoscine butylbromide for cervical dilation for immediate dilation of the tight or stenotic cervix. Materials and Methods: In this clinical trial study, a population of 40 women, aged 20-70 yr with stenotic cervix, evidenced by resistance to pass dilator #2 through their cervical canal were compared. Cervical patency was assessed 10 min following intracervical canal instillation of hyoscine butylbromide. Results: Cervical width of 57.5% of patients became wider, as evidenced by passage of the number 4 Hegar dilator through the cervical canal without resistance. Independent T-tests did not reveal any statistically significant difference between the two groups based on their age. Fisher Exact test revealed a statistically significant difference between the two groups based on the prior route of delivery, with a more statistically significant response in patients who had vaginal deliveries. Conclusion: Intra-cervical canal instillation of hyoscine butylbromide is effective in immediate dilation of the tight or stenotic cervix during intra-uterine procedures

Struma ovarii associated with Pseudo-Meig's syndrome and high serum level of CA 125; a case report

Struma ovarii is a rare form of ovarian neoplasm in a form of mature teratoma and is composed predominantly of thyroid tissue. In the literature review, there has only been 10 cases of this tumor, associated with ascites and pleural effusion (Meig's Syndrome) and increased CA125 so far. In such cases, the tumor mimics malignant ovarian tumor. In this article, the case of a 72-year-old symptomatic woman with a pelvic mass, pleural and peritoneal effusion and high level of serum CA125 is presented. Cytological evaluation for the pleural fluid was performed. She underwent hysterectomy and bilateral salpingo-oophorectomy. The result of pathologic diagnosis is presented in this paper. The patient was well in postoperative period and paraclinical tests including CA 125 were normal as well

Hepatitis B vaccine: Immunity, efficacy and types

Current issues that are associated with the development of hepatitis B vaccine, combination vaccines, modes of administration, immunogenicity, and efficacy of different types of hepatitis B vaccines are reviewed. Hepatitis B viral mutants can emerge as a result of either immune response or treatment options. Several studies are in progress on treatment of chronic hepatitis B infection by immunization with multiple antigenic components; DNA vaccines alone or with DNA encoded immunomodulatory cytokines; combination of vaccine with antiviral drugs and cytokines; and genetic manipulation of antigen presenting cells. Integrating hepatitis B vaccine doses into the global infant immunization program is not sufficient for hepatitis B virus (HBV) infection eradication. Implementing HBV schedule to high risk groups such as injection drug users, inmates of correctional centers, and persons at risk for sexually transmitted diseases, surveillance of hepatitis B infected subjects and refugees, access to immunization services and treatment is necessary. Further investigation is needed to assess factors that can impede an adequate antibody response, HBV variants, and the need for booster doses to preserve vaccine-induced immunity, vaccinating schedule for older children, evaluation of those vaccinated but in persistent contact in HBV-endemic areas. Copyright © 2010, Shiraz E Medical Journal. All rights reserved

Lamivudine resistance in Iranian chronic hepatitis B patients

Background and objectives: Lamivudine therapy for chronic hepatitis B (CHB) is associated with resistance. This study aimed to analyze the response, the incidence of LAM resistance, and different viral mutational patterns of Lamivudine therapy. Study design: CHB patients (n=31) who had not previously received interferon or a nucleoside analogue, received Lamivudine once daily for a minimum of E12 months and followed. All patients were tested for presence of mutation in YMDD motif of viral polymerase gene at the end of the first year of treatment, and if indicated in rising alanine aminotransferase (ALT) or HBVDNA titer. Polymerase chain reaction along with restriction fragment length polymorphism (PCR-RFLP) method was used to detect mutations in YMDD motif. Results: The mean age of patients was 45.2 (SD 13.5) years. The mean follow-up period of patients was 45.5 (21.9) months. Seventeen patients (54.8) had mutations, and 45.2 of subjects were sensitive to LAM. Mean time of mutation detection after treatment was 45.5 (SD 25.3) months. The distribution of YMDD status was: 32.3 YIDD, 3.2 YSDD, 12.9 YVDD, and 6.5 YVDD/ YIDD. The mean age, pretreatment HBeAg negativity, and high HBVDNA titer at time of mutation had significant statistical association with occurrence of YMDD mutants (PV= 0.009, 0.032, 0.049), respectively. Conclusions: Lamivudine-resistant mutation is common in CHB patients. Regarding different mutant strains as identified in this study, is necessary for develop more useful treatment strategies, especially in patients without YMDD mutation and high HBVDNA titer, analysis for possible new mutants should be performed. Copyright © 2010, Shiraz E Medical Journal. All rights reserved

Asymptomatic Bacteriuria in Users of Intrauterine Devices

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Introduction: The aim of this study was to compare the frequency of asymptomatic bacteriuria in women who use intrauterine devices (IUDs) as a contraceptive method with subjects who use tubal ligation (TL). Materials and Methods: A cohort study was conducted on women who were candidates for IUD insertion or TL (control). The patients were followed for 3 months, and urine cultures were assessed for bacteriuria at the end of the study. Results: Overall, 131 women (mean age, 31.9 ± 4.25 years) in the IUD group and 78 (mean age, 32.1 ± 4.0 years) in the control group were studied. The parity score was 2 or more in 72% of the women in the IUD group and in 74% of the controls. The average intercourse frequency was twice per week in 82% of IUD users and 80% of controls. Fifty-seven percent of the women in the IUD group and 55% of the women in the control group had graduated secondary school (high school). Asymptomatic bacteriuria was detected in 13 IUD users (9.9%) and in 1 woman (1.3%) in the control group (risk ratio = 7.74, confidence interval: 1.03 to 58.03; P = .019). The detected microorganism in the urine culture was Escherichia coli in 12 IUD users and in 1 patient in control group. Klebsiella was found in 1 IUD user. Conclusion: Use of an IUD is a risk factor for urinary tract infection and should be considered, especially in women with recurrent urinary tract infections.</p

Comparing the adverse outcomes of contraception failure between IUD and withdrawal methods

Background: Objective of current study was to compare the adverse outcomes of pregnancy after failure of IUD (Intrauterine device) with the withdrawal method of contraception in order to predict and prevent such outcomes.Methods: In a retrospective cohort study, the adverse outcomes of 224 pregnancies (2 groups, 112 women each) were assessed following failure of the IUD or withdrawal methods of contraception (coitus interruptus). Data were analyzed and P values ≤0.05 were considered statistically significant.Results: Rates of spontaneous and induced abortion, ectopic pregnancy, and vaginal bleeding during second half of pregnancy were more common in the removed IUD group compared to the withdrawal method, differences however not significant. No fetal abnormality was observed in IUD group. Preterm birth (p= 0.045), preterm premature rupture of membrane (p= 0.01), and vaginal bleeding during pregnancy (p= 0.01), were more prevalent in the IUD group (retained and removed) compared to those using the withdrawal method.Conclusions: Considering the adverse outcomes, we knew women with pregnancy after failure of IUD were at an increased risk for such outcomes, compared to those using the withdrawal method; however the results of this research showed these adverse effects are not significant when pregnancy with IUD is detected earlier and IUD is removed during the early stage(s) of pregnancy

The presence of anti thyroid and anti ovarian auto-antibodies in familial premature ovarian failure

Background: Premature ovarian failure (POF) is a disorder of multi causal etiology. Autoimmunity has been proposed as a mechanism for some cases of ovarian follicle dysfunction which is evident in POF. The aim of this study was to identify the level of auto-antibodies in POF and familial POF patients. Materials and Methods: In this study, auto-antibodies including anti-ovarian antibody (AOA), anti thyroid peroxidase (TPO) and anti thyroglobulin (TG) antibodies were assessed in the sera of 43 cases with spontaneous POF including 12 cases affected by familial POF. The control samples were obtained from sera of 39 women with normal ovulatory or post menopause women. Results: AOA were detected in 46.5 of the POF group, 41.7 of the familial POF group and 41 of the control group without significant statistical difference between the three groups. Thyroid peroxidase (TPO) antibody was found in 32.6 of the POF group, 41.6 of the familial POF group and 10.3 of the control group. Anti TPO was detected significantly high in both POF and familial POF groups (p<0.02 and p<0.01, respectively). Thyroglobulin (TG) antibody was found in 48.8 of the POF group, 75 of the familial POF group and 23.1 of the control group with meaningful difference (p<0.02 and p<0.001, respectively). TG antibody was significantly higher in familial POF group in comparison to POF group (p<0.03). Conclusion: Although measurement of AOA is not a reliable method for diagnosis of auto-immune POF, but existence of anti thyroid antibodies in familial POF (mainly anti TG) can potentially represent an autoimmune mechanism. It is possible to propose a genetic component for developing autoimmune POF supported by presence of anti thyroid antibodies in familial POF