Effect of oral evening primrose capsules on ripening of the cervix in nulliparous Iranian pregnant women (A randomized trial)

Introduction: Ripening of the cervix and uterine contractions are two basic factors of a successful delivery. Lack of ripening of the cervix is considered to be one of the problems of delivery. Thus, the present research was designed to determine the effect of oral evening primrose capsules on the ripening of cervix in nulliparous women. Materials and methods: This research has been conducted with the triple-blind randomized trial method on 80 nulliparous women in the 40th week of pregnancy (6th day + 40 weeks) visiting the prenatal clinic Prenatal clinic Shahid Akbarabadi educational and medical center of Iran University of Medical Sciences in 2015. Samples were divided into two equal groups of medicine and placebo with the randomized allocation method. Each of the participants took a bottle containing 14 1000mg oral evening primrose capsules (2 capsules per day, each 12 twelve hours for a week) or the placebo containing 14 1000mg oral capsules of paraffin in similar bottles. Data collecting tools include: demographic specifications questionnaire and the form of the records of the examinations. Data was analyzed through statistical tests and SPSS software version 16 using descriptive inferential statistic. Findings: Similarity of the two groups in terms of individual specifications and Bishop Score before the intervention were reviewed in the two groups and no significant statistical difference was seen between the two groups. The mean of the Bishop score for those who had taken 10 or more capsules after the intervention did not show a statistically significant difference (p=0.110). Conclusion: Consumption of evening primrose did not show a considerable improvement in the score. It is recommended to do more comparative studies in this field in later weeks of pregnancy due to the conflicts of the studies

A comparison between serum levels of interleukin-6 and CA125 in patients with endometriosis and normal women

Background: The purpose of the present study was to compare the serum levels of IL6 and CA125 in women with and without endometriosis. They were also compared in mild, moderate and severe cases. Methods: In this case-control study, CA125 and IL6 levels in 76 women with laparoscopic proven endometriosis were compared with 76 women without evidence of endometriosis. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were then calculated for each test. Results: Both groups did not show significant difference in their age, BMI, ESR and gravidity. Mean serum levels of IL-6 and CA125 were significantly higher in the case group (30.4±6.43 vs 13.9±3.17 Pg/ml and 62.6±10.69 vs 16.6±1.79 IU/ml respectively). Considering a cutoff point of 30 Pg/ml for IL-6, sensitivity, specifically, PPV and NPV value of 21.1, 66.6, 86.8 and 23.37 were obtained, respectively. Considering a cutoff point of 35 IU/ml for CA125, sensitivity, specifically, PPV and NPV were 44.76, 94.73, 89.47 and 63.15, respectively. Area under the ROC curve was 0.69 for CA125 and 0.54 for IL6, which showed a low value for these tests. Conclusion: Although CA125 and IL-6 were higher than normal controls in endometriosis, area under the ROC curve, did not show significant any diagnostic value for these tests

The Effects of Calcium, Vitamins D and K co-Supplementation on Markers of Insulin Metabolism and Lipid Profiles in Vitamin D-Deficient Women with Polycystic Ovary Syndrome

Background Data on the effects of calcium, vitamins D and K co-supplementation on markers of insulin metabolism and lipid profiles among vitamin D-deficient women with polycystic ovary syndrome (PCOS) are scarce. Objective This study was done to determine the effects of calcium, vitamins D and K co-supplementation on markers of insulin metabolism and lipid profiles in vitamin D-deficient women with PCOS. Methods This randomized double-blind, placebo-controlled trial was conducted among 55 vitamin D-deficient women diagnosed with PCOS aged 18–40 years old. Subjects were randomly assigned into 2 groups to intake either 500 mg calcium, 200 IU vitamin D and 90 µg vitamin K supplements (n=28) or placebo (n=27) twice a day for 8 weeks. Results After the 8-week intervention, compared with the placebo, joint calcium, vitamins D and K supplementation resulted in significant decreases in serum insulin concentrations (−1.9±3.5 vs. +1.8±6.6 µIU/mL, P=0.01), homeostasis model of assessment-estimated insulin resistance (−0.4±0.7 vs. +0.4±1.4, P=0.01), homeostasis model of assessment-estimated b cell function (−7.9±14.7 vs. +7.0±30.3, P=0.02) and a significant increase in quantitative insulin sensitivity check index (+0.01±0.01 vs. −0.008±0.03, P=0.01). In addition, significant decreases in serum triglycerides (−23.4±71.3 vs. +9.9±39.5 mg/dL, P=0.03) and VLDL-cholesterol levels (−4.7±14.3 vs. +2.0±7.9 mg/dL, P=0.03) was observed following supplementation with combined calcium, vitamins D and K compared with the placebo. Conclusion Overall, calcium, vitamins D and K co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on markers of insulin metabolism, serum triglycerides and VLDL-cholesterol levels

Effects of Long-Term Vitamin D Supplementation on Regression and Metabolic Status of Cervical Intraepithelial Neoplasia: a Randomized, Double-Blind, Placebo-Controlled Trial

We are not aware of any study examining the effects of long term vitamin D administration on regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1). This study was performed to evaluate the effects of long-term vitamin D administration on regression and metabolic status of patients with CIN1. This randomized, double-blind, placebo-controlled trial was performed among 58 women diagnosed with CIN1. CIN1 diagnosis was performed based on specific diagnostic procedures of biopsy, pathological diagnosis, and colposcopy. Patients were randomly allocated into two groups to take 50,000 IU vitamin D3 supplements (n = 29) or placebo (n = 29) every 2 weeks for 6 months. Fasting blood samples were taken at the beginning of the study and end-of-trial to measure related markers. After 6 months of vitamin D administration, greater percentage of women in the vitamin D group had regressed CIN1 (84.6 vs. 53.8%, P = 0.01) than those in the placebo group. Long-term vitamin D supplementation increased serum-25(OH) vitamin D levels in the intervention group compared to the placebo group (+12.3 ± 11.4 vs. -0.1 ± 3.7 ng/mL, P < 0.001). In addition, vitamin D intake led to significant decreases in serum insulin levels (−5.3 ± 7.3 vs. +2.4 ± 5.9 μIU/mL, P < 0.001), homeostasis model of assessment-insulin resistance (−1.2 ± 1.6 vs. +0.5 ± 1.2, P < 0.001), homeostatic model assessment-Beta cell function (P = 0.005) and a significant elevation in quantitative insulin sensitivity check index (+0.03 ± 0.04 vs. -0.007 ± 0.02, P < 0.001) compared with the placebo group. Additionally, significant increases in plasma nitric oxide (NO) (+15.5 ± 10.3 vs. +4.0 ± 13.4 μmol/L, P = 0.001), total antioxidant capacity (TAC) (P = 0.04), total glutathione (GSH) (+11.8 ± 153.5 vs. -294.2 ± 595.1 μmol/L, P = 0.01) and a significant reduction in plasma malondialdehyde (MDA) levels (−0.8 ± 1.0 vs. -0.03 ± 1.4 μmol/L, P = 0.03) were observed following the administration of vitamin D supplements compared with the placebo group. In conclusion, vitamin D3 administration for 6 months among women with CIN1 resulted in its regression and had beneficial effects on markers of insulin metabolism, plasma NO, TAC, GSH and MDA levels. Clinical trial registration numberwww.irct.ir: IRCT201412065623N30

Effect of vaginal misoprostol on cervical priming in diagnostic dilatation and curettage

Introduction:Dilatation of cervix is essential for dilatation and curettage and hysteroscopy as well. Complications encountered during the procedure are partly related to difficulties in cervical dilatation. Finding the materials which can cause cervical dilatation more easily is important. The purpose of the present study is to evaluate the effect of vaginal Misoprostol on priming the cervix before dilatation in patients who are candidate for this procedure. Methods: A randomized clinical trial was performed on 60 women who were candidated for D&C. In 30 patients (case group), 200 mg Misoprostol (one tablet) was administered in posterior fornix of vagina 4 hours before operation, whereas in other 30 patients (control group), placebo was used. Then the two groups were compared according to their need to Hagar dilatator thinner than number 5 for dilatation of cervix and the duration of dilatation and curettage. Results: It was revealed that measures like age, parity and previous delivery methods did not show a statistically significant difference between two groups. 6 patients (20), in the case group, and 26 (87) in the control group needed the Hager dilatator number 5 to dilate the cervix (P<0.005) which their difference was statistically significant. The mean duration of D&C in the control group was 19±4 minute versus 12.7±2.8 minute in case group which showed a statistically significant difference (P<0.001). Conclusion: Vaginal misoprostol is a suitable agent for priming the cervix in order to dilate more easily before D&C