A SYSTEMATIC REVIEW OF MEDICINAL PLANTS AND PLANT DERIVATIVES AFFECTING INCREASE IN ENDOMETRIAL THICKNESS

Endometrial thickness is one of the determinant factors in fertility success. This study was carried out to determine the effects of plants on increasing endometrial thickness and ultimately increasing fertility preservation. Key terms of "endometrium thickness" or "endometrial thickness" or "endometrial lining thickness" in combination with the words "Medicinal plant", "Herb" and "Phyto" were searched on the ISI, PubMed and Scopus databases. Then, the abstracts of the articles, as well as information obtained from other sources about medicinal plants and their derivatives from which their effects directly on endometrial thickness and pregnancy were studied, were selected. Besides, only clinical trials and laboratory studies between 2007 and 2017 were included. The results from this study showed that plants such as Cimicifuga racemosa and Aspalathus lineararis and plant derivatives such as Klimadynon and Icariin and plant formulations such as Xiaoyao powder, Erzhi pill and Siwu decoction can increase fertility in humans or animals by increasing endometrial thickness. Medicinal plants and their derivatives affect the thickness of the endometrium, mainly due to having phytoestrogen and can help maintain the fetus in the uterus and increase fertility preservation. The phytoestrogens available in plants are bound to ER-a receptors and mimics the function of estrogen. However, the effective dose, administration time, endogenous estrogen status and type of herbal prescription or derivatives are of important factors that should be considered in herbal therap

MEDICINAL HERBS AFFECTING GONADOTROPIN HORMONES IN WOMEN: AN UPDATED SYSTEMATIC REVIEW

Plants and their derivatives can exacerbate or relieve diseases such as infertility, puberty disorders, and menopause. The present - study examines the role and mechanism of medicinal plants or their products in reducing or increasing the levels of GnRH, FSH and LH in females. The key word "GnRH" or "FSH" or "Luteinizing Hormone" was searched in conjunction with the words Medicinal plant, Herb * and Phyto * in the ISI and PubMed databases (using Endnote software). Then articles related to herbs and products affecting the hormones of GnRH, FSH and LH, were included in the study, following inclusion and exclusion criteria. Plants and plant derivatives that affect fertility disorders and mainly increase GnRH, include Vitex agnus-castus, Thuja occidentalis L., Cimicifuga racemosa, Yucca schidigera, isoflavones and some Chinese herbal compounds. In some cases, plants such as Emilia coccinea decrease the fertility of the fetus by lowering the FSH and LH hormones. Also, some herbs and plant compounds are used for disorders and discontinuation of symptoms. These include isoflavones, Lepidium meyenii, Angelica gigas and Chinese herbal compounds. In some cases, Radix Ginseng and isoflavones also cause premature aging and puberty, which this issue should be taken into account for nutritional purposes. Plants and plant compounds, can cause hormonal changes, especially in female GnRH hormones mainly due to presence of having phytoestrogens and by inducing their estrogenic properties

Comparison of vaginal ointment of honey and clotrimazole for treatment of vulvovaginal candidiasis: A random clinical trial

BACKGROUND AND OBJECTIVE: Vulvovaginal candidiasis (VVC) is the most prevalent vaginitis in women, accounting for 10 million medical referrals a year. Vaginal clotrimazole is a drug of choice for VVC treatment. However, increased drug resistance to this microorganism has led to an interest in naturally derived antifungal drugs. This study was conducted to compare honey vaginal ointment and clotrimazole vaginal ointment for VVC treatment. METHODS: Eighty women diagnosed with VVC were assigned to two groups for honey ointment and clotrimazole ointment treatment using a simple randomization rule. The ointments were applied at night for seven days. The disease symptoms including inflammation, vaginal discharge, and irritation at baseline in the fourth and eighth days of treatment were examined and compared between the two groups. The data was analyzed by SPSS version 20 with the Friedman test, Chi-square test, and independent t-test. P<0.05 was considered as the significance. RESULTS: The two groups were similar for inflammation severity, irritation, and discharge at baseline. In both the groups, the symptoms disappeared after treatment. On the eighth day of treatment, there was a significant difference in inflammation and vaginal discharge between the two groups. Inflammation (P=0.002) and vaginal discharge (P=0.003) recovered better in the clotrimazole group. But there was no significant difference in irritation severity and satisfaction with treatment between the two groups. In the two groups, no side effects were reported. CONCLUSION: Honey contributes to treating VVC. Thanks to the popular positive attitudes of honey, its availability, no need for sterility, and its cost-effectiveness, it is a choice of treatment for VVC. Copyright © 2017. Published by Elsevier Masson SAS

The effect of local infiltration of morphine in reducing the post operative pain in soft tissue injury

زمینه و هدف: آسیب های بافت نرم از جمله آسیب تاندون ها و لیگامان ها از مشکلات شایع بوده که باعث ایجاد درد و اختلال در عملکرد فرد می شود. در این مطالعه تأثیر تزریق موضعی مورفین در کاهش شدت درد پس از اعمال جراحی بافت نرم اندام ها مورد بررسی قرار گرفت. روش بررسی: در این مطالعه کارآزمایی بالینی دو سوکور 80 نفر از بیمارانی که با آسیب بافت نرم اندام ها به بیمارستان کاشانی شهرکرد مراجعه کرده بودند به صورت تصادفی ساده، به دو گروه مورد و شاهد تقسیم شدند. در گروه شاهد 1 سی سی نرمال سالین و در گروه مورد 1 میلی گرم مورفین به ازای هر یک سانتی متر برش با آب مقطر رقیق و به صورت موضعی تزریق شد. سپس شدت درد با استفاده از مقیاس سنجش درد (VAS) در ساعات 3، 10 و 24 پس از عمل جراحی اندازه گیری گردید. داده ها با استفاده از تست های تی مستقل، تحلیلی کای دو و تست دقیق فیشر مورد تجزیه و تحلیل قرار گرفت. یافته ها: میانگین سنی بیماران در گروه شاهد 34/6±5/32 و در گروه مورد 70/7±6/30 سال بود. میانگین طول برش در گروه شاهد 06/1±5/5 سانتی متر و در گروه مورد 8/1±57/5 سانتی متر بود (05/0P>). شدت درد در گروه شاهد در همه زمان های بررسی شده به طور معنی داری کمتر از گروه مورد بود (01/0

Effect of oral capsule of Peganum harmala seeds on bone density in menopausal women prone to osteoporosis

Background and aims: Osteoporosis is one of the most common metabolic bone diseases with systemic involvement of the body skeleton. The Peganum harmala seed contains high amounts of carboline alkaloids, which have been shown to have positive effects on bone formation in animal studies. In the present study, the effect of an oral capsule of P. harmala seed on bone density was evaluated in menopausal women prone to osteoporosis. Methods: In this randomized controlled clinical trial, 100 women referring to the orthopedic clinic with a diagnosis of osteoporosis were included and divided into the intervention group treated with calcium D (500 mg) twice a day, Osteofos (70 mg) per week, and P. harmala (500 mg) twice‐a‐day, and the control group treated with calcium D and Osteofos. Before and three months after the intervention, patients were evaluated for osteoporosis using bone densitometry. Finally, independent t-test, paired t-test, and repeated measures ANOVA were used for statistical analysis. Results: The mean bone mineral density (BMD) of the femur before and after the intervention showed significant improvements in the intervention and control groups (P<0.001). The mean differences in BMD before and after the intervention were significant in both control and intervention groups with higher improvements in the intervention group (P<0.001). Although the mean BMD of the spine before the intervention was not significantly different between the two groups (P=0.167), it was better in the intervention group after the intervention (P=0.030). Conclusion: The findings of the present study confirmed the beneficial effects of P. harmala on osteoporosis while the lack of any changes in liver enzymes. Keywords: Peganum harmala, Bone mineral density, Osteoporosis, Liver enzyme, Calcium, Vitamin

Evaluation and comparison of sensitivity and specificity of ultrasonography in placenta accreta diagnosis in the second and third trimesters

Background: Ultrasound is the selected technique for the detection of placenta accreta spectrum (PAS). This method can detect PAS in 80%-50% of cases. This study aimed to assess and compare the sensitivity and specificity of ultrasonography in the diagnosis of PAS after the first trimester. Materials and Methods: In this prospective study that was performed in 2020-2021 on 79 patients at high risk of PAS, all cases underwent ultrasonography in both 18-22 weeks of gestational age (GA) and 32-34 weeks of GA for evaluation of accreta. As per the risk factors, the delivery plan for all mothers was cesarean section. During the cesarean section, the placenta was examined for accreta, and if it was attached to the uterus, a diagnosis of placenta accreta was ascertained and a total abdominal hysterectomy was performed if the patient's bleeding was not controlled during the operation. The final diagnosis of PAS was made based on the pathology report. Results: Ultrasound evaluation for PAS in 18-22 weeks of GA had 79.17% specificity, 51.61% sensitivity, 61.54% positive predictive value, and 71.70% negative predictive value. Ultrasound imaging for PAS in 32-34 weeks of GA had 60.8% specificity, 90% sensitivity, 62.52% positive predictive value, and 90.33% negative predictive value. Conclusion: It should be concluded that PAS is a critical condition and if the patient is diagnosed in the second or third trimester, special strategies should be applied

Effect of Alkaline Drinking Water on Bone Density of Postmenopausal Women with Osteoporosis

Objectives: Postmenopausal women are predisposed to osteoporosis, and those on acidic diets are at a higher risk, because it has been demonstrated that such diets have adverse effects on bone health. In this study, the effect of alkaline drinking water on bone mineral density was evaluated in postmenopausal women with osteoporosis. Methods: One hundred postmenopausal women with osteoporosis (T-score ≤ -2.5) were equally divided into an intervention group and a control group (n = 50 each). The intervention group received calcium D (daily), alkaline drinking water (1.5 L daily with pH 8.6 ± 0.3), and Osteofos tablet (70 mg weekly), whereas the control group received only calcium D and Osteofos tablet for 3 months. T-scores of the femur and spine bones were obtained using bone densitometry before and 3 months after the intervention. Results: After the intervention, the mean T-scores of the femur and spine bones significantly increased in both the control and intervention groups (P < 0.05). However, the mean changes in the spine T-score were significantly higher in the intervention group (0.39 ± 0.07) than in the control group (0.08 ± 0.01) (P < 0.05). No significant differences were observed in the mean changes in the femur T-score between the two groups. Conclusion: Our findings demonstrate that drinking alkaline water improves spine T-scores in postmenopausal women with osteoporosis. Hence, alkaline water can be used to treat osteoporosis due to increased bone density in postmenopausal women. Long-term interventions are necessary to confirm the effects of alkaline water on femur density. Keywords: Alkaline water; Bone mineral density; Postmenopausal osteoporosis

Evaluation of the relation between cerebroplacental ratio, umbilical-cerebral ratio, and cerebro-placental-uterine ratio with the occurrence of adverse perinatal outcomes in pregnancies complicated by fetal growth restriction

Introduction: Fetal growth restriction (FGR) is a major obstetric complication associated with an increased risk of adverse perinatal outcomes. Objectives: This study aimed to evaluate the relationship between Doppler parameters, including the cerebroplacental ratio (CPR), umbilicocerebral ratio (UCR), and cerebro-placental-uterine ratio (CPUR), with adverse perinatal outcomes in singleton pregnancies complicated by FGR. Patients and Methods: This was a prospective study of 100 women with a singleton pregnancy 28 and 36.8 weeks of gestation was complicated by FGR and mild abnormalities. Feto-maternal Doppler examinations were conducted by the CPR, UCR, and CPUR parameters. Adverse outcomes were defined as Apgar score <7 at 5 minutes, preterm birth <37-week, neonatal intensive care unit (NICU) admission, fetal distress, and emergency cesarean section.These outcome parameters were checked with the results of the last ultrasound which performed 1-2 weeks before delivery. Results: Mean umbilical artery pulsatility index (UA-PI) (1.18±0.31 versus 1.04±0.21, P=0.010) and mean uterine arteries (UtAs)-PI (1.18±0.45 versus 0.96±0.36, P=0.20) were significantly higher in pregnancies that experienced adverse perinatal outcomes than those that did not experience them. Mean CPUR (1.82±1.03 versus 2.25±0.83, P=0.039) was significantly lower in pregnancies that experienced adverse perinatal outcomes versus those that did not. In binary multivariate logistic regression analysis, CPR, UCR, and CPUR parameters were evaluated with adverse perinatal outcomes. Only CPUR had a significant relationship with adverse perinatal outcomes. CPUR had a substantial relationship with Apgar score [removed

Evaluation of the relationship between pregnancy-associated plasma protein A (PAPP-A) and pregnancy outcomes

Background: In the current study, we aimed to evaluate the association between pregnancy-related plasma protein-A (PAPP-A) levels measured in the first trimester and pregnancy outcomes. Materials and Methods: This is a descriptive-analytical study that was performed in 2019--2021 on 1061 pregnant women in their first trimester. Demographic and basic information of all women were collected. These data included age, weight, parity, and date of delivery. Then the quantity of PAPP-A was recorded in three groups including less than 0.5 MOM, 0.5 to 2.5 MOM, and more than 2.5 MOM. Results: Data of 1061 women were analyzed. 900 women (84.8%) had term delivery and 155 women (14.6%) had pre-term deliveries. PAPP-A levels were normal in 83.4% of women. BMI and number of pregnancies had significant relationships with PAPP-A (p < 0.001, P = 0.03 respectively). The mean BMI in mothers with PAPP-A higher than 2.5 was significantly more than mothers with normal or lower PAPP-A levels (26.2 ± 31, P = 0.04). The frequency of term labor in mothers with normal PAPP-A was higher than other mothers (86.3%, P = 0.04). The frequency of preeclampsia in recent pregnancies in mothers with normal PAPP-A was significantly lower than other mothers (p < 0.001) and the frequency of abortions in recent pregnancies in mothers with PAPP-A less than 0.5 was significantly higher than mothers with normal or elevated PAPP-A (p < 0.001). Conclusion: Mothers with low PAPP-A levels are more likely to have poor pregnancy outcomes such as abortion, pre-term labor, and preeclampsia

Comparison of renal artery Doppler parameters of monochorionic diamniotic twin pregnancies with and without twin-to-twin transfusion syndrome

Background: Monochorionic diamniotic (MCDA) twin pregnancies are considered high-risk for several reasons, especially the risk of twin-to-twin transfusion syndrome (TTTS). Renal artery Doppler (RAD) is reported as a useful tool for predicting oligohydramnios in singleton pregnancies. We aimed to compare the RAD indices between MCDA twins with and without TTTS. Materials and Methods: In this case–control study, all pregnant women aged 18–38 years, with gestational age ≥ 18 weeks, who were referred to two Prenatal Clinics, Alzahra and Beheshti Educational Hospitals, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, October 2020–March 2022 were enrolled; the women with MCDA twin pregnancies complicated by TTTS (case group, n = 12) and without TTTS (control group, n = 24). For each twin, biometric analysis, fetal weight, and Doppler study of fetal arteries, including RAD, middle cerebral artery (MCA), umbilical artery, and ductus venosus were performed. Peak systolic velocity, Pulsatility index (PI), resistance index (RI), and systole/diastole (S/D) were measured for all arteries. Results: The donors of the case group had a lower mean MCA S/D (4.48 ± 1.89) than the control group (6.48 ± 1.97) (P = 0.01) and higher mean umbilical parameters, including PI, RI, and S/D (P < 0.05). The recipients of the case group had a lower mean renal PI than the control (P = 0.008) and lower mean MCA PI, RI, and S/D (P < 0.05). The donor group had a higher mean umbilical RI and S/D than the recipient twin, while the mean fetal weight of the recipient group was higher (P < 0.05). Conclusion: Comparing the RAD parameters between the twins with and without TTTS in the present study did not identify significant results, which rejected the primary hypothesis. Among all RAD parameters, the only significant difference observed in the present study was the lower RAD PI in RT, which cannot suggest this measurement as a valuable tool for the prediction of TTTS in MCDA twins. Therefore, the results of the present study failed to show the additional value of RAD, compared with the conventional Doppler examination of fetal arteries. Further studies are required to prove this conclusion