Neonatal Ovarian Cyst: A Case Report

Background: Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts. Prenatal ultrasonography allows diagnosis of ovarian cysts and may suggest antenatal complications. The management of fetal ovarian cysts is still controversial despite the improvement in prenatal diagnosis with ultrasonography. Some studies suggest an aggressive management, while others plead for a conservative one. Case report: We report on the first successfully treated large neonatal ovarian cyst from Iran. She was a normal-term infant with respiratory distress due to the large size of the ovarian cyst diagnosed prenatally. We didn’t find any other related anomaly in the neonate. Conclusion: Neonatal simple ovarian cysts are rare, but may cause complications. Most small simple cysts regress spontaneously; surgical intervention is reserved for complicated or large size ovarian cysts

Study of 4G/5G Mutations Prevalence in Plasminogen Activator Inhibitor-1 (PAI-1) Gene in Iranian Women with Ectopic Pregnancy

Abstract Background: Ectopic pregnancy is a type of pregnancy in which implantation of zygote occurs out of the uterine cavity. One of the most important problems is bleeding. On the other hand, Plasminogen Activator Inhibitor-1(PAI-1) gene is one of the involved factors in unsuccessful pregnancies, and 4G/5G polymorphism is the most common changes of this gene. So, it is important to study the prevalence of these changes in this gene in women with ectopic pregnancy. Materials and Methods: In this case-control study, 100 Iranian women with ectopic pregnancy and 101 Iranian women with the normal pregnancy were selected. After blood sampling, ARMS PCR method has been used for detection 4G/5G polymorphism and data were analyzed by statistical analysis. Results: In this study, 4G allele with 70.79% prevalence and 5G allele with 63.5% prevalence are the most common alleles for the control and case group, respectively. 4G/4G and 4G/5G genotypes in the control group and 4G/5G and 5G/5G genotypes in the case group are prevalent. An Armitage test found p<0.05 for both alleles, showing 4G allele (p= 1.524e-10; OR= 0.262) has decreasing effect and 5G allele (p= 1.524e-10; OR= 3.822) has increasing effect in ectopic pregnancy. Conclusion: According to the findings, 5G allele and 4G/5G and 5G/5G genotypes have increasing effect, 4G allele and 4G/4G genotype have decreasing effect in ectopic pregnancy. So, we could consider 5G allele as a risk factor of ectopic pregnancy in this study

Comparison between Preoperative Rectal Diclofenac Plus Paracetamol and Diclofenac Alone for PostoperativePain of Hysterectomy.

Objective: To detect whether the preoperative combined administration of rectal diclofenac and paracetamol is superior to placebo or rectal diclofenac alone for pain after abdominal hysterectomy. Materials and methods: Ninety female patients (American Society of Anesthesiologists (ASA) physical status I-II), scheduled for abdominal hysterectomy were recruited to this double blind trial and were randomized to receive one of three modalities before surgery: rectal combination of diclofenac and paracetamol, rectal diclofenac alone or rectal placebo alone which were given as a suppository one hour prior to surgery. The primary outcomes were visual analogue pain scores measured at 0, 0.5, 2, 4, 8, 16 and 24 hours after surgery and the time of first administration and also total amount of morphine used in the first 24 hour after surgery. A 10 cm visual analog scale (VAS ) was used to assess pain intensity at rest. Results: In patients receiving the combination of diclofenac and paracetamol total dose of morphine used in the first 24 hour after surgery was significantly lower (13.9 ± 2.7 mg) compared to diclofenac group (16.8± 2.8 mg) and placebo group (20.1 ± 3.6 mg) (p < 0.05). VAS pain score was significantly lower in combination group compared to other groups all time during first 24 hours (p < 0.05). There had been a significant difference between combination group and the two other groups in terms of the first request of morphine (p < 0.05). Conclusion: According to our study Patients who receive the rectal diclofenac-paracetamol combination experience significantly a lower pain scale in the first 24 hour after surgery compared with patients receiving diclofenac or placebo alone. Their need to supplementary analgesic is significantly later and lower compared to placebo and diclofenac alone

High plasma homocysteine and insulin resistance in patients with polycystic ovarian syndrome

Background: Polycystic ovarian syndrome (PCOS) is a common disease among women in fertility ages and cause severe insulin resistance. Hyperhomocysteinaemia is said to be among the features of PCOS that could influence its outcome.Objective: This study aimed to investigate whether hyperhomocysteinaemia exists in PCOS and if it is related to insulin resistance in the affected patients.Materials and Methods: This prospective study was carried out in a university based fertility clinic. Sixty four PCOS patients and 50 normo ovulatory controls were reviewed for fasting glucose, insulin, homocysteine, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) plasma levels in the blood sample of the 3rd day of their menstrual cycle. Insulin resistance was determined with the fasting glucose (mmol/L) to insulin (mIU/L) ratio and HOMA-IR (Homeostasis model assessment-Insulin resistance). Independent-samples T-test and linear regression test were utilized to analyze the obtained data.Results: Homocysteine levels compared between PCOS patients and control group showed a significant difference. PCOS group was divided into insulin resistant (IR) (LogHOMA-IR≥0.57) and non insulin resistant (NIR) patients. The IR group had significantly higher homocysteine (p-value=0.02), fasting insulin and glucose levels (p-value<0.001) rather than NIR group.Conclusion: PCOS patients have a leaning toward hyperhomocysteinaemia and insulin resistance. Insulin resistant patients are found to have higher homocysteine leve

High plasma homocysteine and insulin resistance in patients with polycystic ovarian syndrome

Background: Polycystic ovarian syndrome (PCOS) is a common disease among women in fertility ages and cause severe insulin resistance. Hyperhomocysteinaemia is said to be among the features of PCOS that could influence its outcome. Objective: This study aimed to investigate whether hyperhomocysteinaemia exists in PCOS and if it is related to insulin resistance in the affected patients. Materials and Methods: This prospective study was carried out in a university based fertility clinic. Sixty four PCOS patients and 50 normo ovulatory controls were reviewed for fasting glucose, insulin, homocysteine, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) plasma levels in the blood sample of the 3rd day of their menstrual cycle. Insulin resistance was determined with the fasting glucose (mmol/L) to insulin (mIU/L) ratio and HOMA-IR (Homeostasis model assessment-Insulin resistance). Independent-samples T-test and linear regression test were utilized to analyze the obtained data. Results: Homocysteine levels compared between PCOS patients and control group showed a significant difference. PCOS group was divided into insulin resistant (IR) (LogHOMA-IR≥0.57) and non insulin resistant (NIR) patients. The IR group had significantly higher homocysteine (p-value=0.02), fasting insulin and glucose levels (p-value<0.001) rather than NIR group. Conclusion: PCOS patients have a leaning toward hyperhomocysteinaemia and insulin resistance. Insulin resistant patients are found to have higher homocysteine level

The effect of meperidine on peripartum breastfeeding and neonatal weight.

Objective: To evaluate the effect of Meperidine, commonly administered for labor analgesia, on newborn weight and peripartum breastfeeding during two months after delivery. Materials and methods: This pilot cohort study was conducted between October 2010 and October 2011 at the Women Hospital of the Tehran University of Medical Sciences. In this study, we examined the effects of meperidine on breastfeeding and neonatal weight. A total number of 184 full term pregnant women, planned to deliver at this center (normal vaginally delivery or cesarean), participated in this study. The study group included the women who received meperidine in peripartum time to be compared with a control group who did not receive any opioid. Meperidine was administrated to them based on their peripartum breastfeeding behaviour and baby weight, two month after delivery. Results: Of the 184 woman recruited to the trial, 38 women had normal vaginal delivery and 146 had ccesarean. Within the first two-month, 4% of mothers in control group and 11% of meperidine group used formula. However, this differences were not statistically significant (p value= 0.07). Furthermore, baby weight distribution was not statistically different between two groups. Conclusion: The inhibitory effect of using Meperidine on peripartum breastfeeding and weight of newborn in the first two months was not statistically significant in this study. More research is needed to clarify the association between meperidine and peripartum breastfeeding

Direct Proportional Relationship between Histopathologic and Sonographic Analysis of Laparoscopic Removal Ovarian Endometriotic Cyst: Evaluating the Effects on Ovarian Reserve

Background: The aim of this study was to evaluate ovarian damage following laparoscopic endometrioma cystectomy using ultrasound and pathologic samples.&nbsp;Materials and Methods: This is a prospective cohort study in General Women Hospital affiliated to Tehran University of Medical Sciences. 40 patients with endometrioma, total of 44 cysts including bilateral cysts, underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound.Results: Mean antral follicle count (AFC) before the operation was 4 ± 1.29 and after operation was1.64 ± 1.03. The reduction in AFC after cystectomy was statistically significant (P &lt;0.000), and with each 1 centimeter increase in cyst diameter a reduction of AFC averaging 0.421 was observed. On pathological examination, it was shown that every millimeter of inadvertently excised ovarian tissue and cyst wall fibrosis thickness leads to reduction of 1.06 and 1.2 in AFC respectively.&nbsp;Conclusion: Laparoscopic cystectomy for endometrioma is associated with reduction in ovarian reserve and this reduces proportionally with cyst diameter, amount of normal ovarian parenchyma excised and cyst wall fibrosis.&nbsp;</p