An Overview of The Available Methods for Morphological Scoring of Pre-Implantation Embryos in In Vitro Fertilization

Assessment of embryo quality in order to choose the embryos that most likely result in pregnancy is the critical goal in assisted reproductive technologies (ART). The current trend in human in vitro fertilization/embryo transfer (IVF/ET) protocols is to decrease the rate of multiple pregnancies after multiple embryo transfer with maintaining the pregnancy rate at admissible levels (according to laboratory standards). Assessment of morphological feathers as a reliable non-invasive method that provides valuable information in prediction of IVF/intra cytoplasmic sperm injection (ICSI) outcome has been frequently proposed in recent years. This article describes the current status of morphological embryo evaluation at different pre-implantation stages

Downregulation Of Extracellular Matrix And Cell Adhesion Molecules In Cumulus Cells Of Infertile Polycystic Ovary Syndrome Women With And Without Insulin Resistance

Objective The extracellular matrix (ECM) of the cumulus oocyte complex (COC) is composed of several molecules that have different roles during follicle development. This study aims to explore gene expression profiles for ECM and cell adhesion molecules in the cumulus cells of polycystic ovary syndrome (PCOS) patients based on their insulin sensitivity following controlled ovarian stimulation (COS). Materials And Methods In this prospective case-control study enrolled 23 women less than 36 years of age who participated in an intracytoplasmic sperm injection (ICSI) program. Patients were subdivided into 3 groups: control (n=8, fertile women with male infertility history), insulin resistant (IR) PCOS (n=7), and insulin sensitive (IS) PCOS (n=8). We compared 84 ECM component and adhesion molecule gene expressions by quantitative real-time polymerase chain reaction array (qPCR-array) among the groups. Results We noted that 21 of the 84 studied genes differentially expressed among the groups, from which 18 of these genes downregulated. Overall, comparison of PCOS cases with controls showed downregulation of extracellular matrix protein 1 (ECM1); catenin (cadherin-associated protein), alpha 1 (CTNNA1); integrin, alpha 5 (ITGA5); laminin, alpha 3 (LAMA3); laminin, beta 1 (LAMB1); fibronectin 1 (FN1); and integrin, alpha 7 (ITGA7). In the IS group, there was upregulation of ADAM metallopeptidase with thrombospondin type 1 motif, 8 (ADAMTS8) and neural cell adhesion molecule 1 (NCAM1) compared with the controls (P<0.05). Conclusion Downregulation of ECM and cell adhesion molecules seem to be related to PCOS. Gene expression profile alterations in cumulus cells from both the IS and IR groups of PCOS patients seems to be involved in the composition and regulation of ECM during the ovulation process. This study highlights the association of ECM gene alteration as a viewpoint for additional understanding of the etiology of PCOS

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Case report - Non-puerperal uterine inversion in a virgin woman

Background: Inversion of the uterus is very uncommon. Patients may present with pelvic pain, vaginal discharge, or hemodynamic shock. Case: We report a case of 35 years old women (virgin) who was admitted with profuse vaginal bleeding and cramps of uterus. In the vaginal examination at litothomy position a mass of 5x8 cm in size was protruded from the vagina. At first myomectomy was performed and after that laparotomy with total abdominal hysterectomy was done. Conclusion: Early diagnosis, immediate treatment of shock, and replacement are essential in uterine inversion

Gorlin syndrome: A case report

Gorlin syndrome is a rare autosomal dominant disorder which characterize by multi-organ abnormities such as odontogenic keratocysts in the jaw, skeletal abnormities and multiple basal cell carcinoma etc. We report a case of this syndrome in a young man with palmar pits, multiple facial BCC, clacifications of the falx cerebri and bifid rib

Assessing the risk of industrial dyes on life of aquatic plant Ceratophyllum demersum

Azo group dyes are the most important group of commercial dyes and the widest dyes which are used in various industries. The release of effluents containing these compounds into the environment leads to several problems such as reduced photosynthesis and plant growth, and reduced water quality. In the present study, the effect of three different concentrations (0, 10, 20 mg / L) of Acidic Blue dye 92 (AB92) on the physiological characteristics of aquatic plant Ceratophyllum demersum such as photosynthetic pigments, cyanidin glycoside concentration, the ability to scavenging free radicals and lipid peroxidation were investigated during 7 days. According to results, the amount of chlorophyll a, chlorophyll b, total chlorophyll, and total carotenoid decreased in the concentration of 20 mg / L compared to the control by 15.38, 18, 16.88, and 45.1%, respectively. The concentration of cyanidin glycoside, lipid peroxidation, and antioxidant activity increased in both 10 and 20 mg / L, since at 20 mg / L concentration so that these parameters were increased in comparison with control by 81.8%, 69.5 %, and 14.29 %, respectively. Thus, the presence of both 10 and 20 mg / L of Acidic Blue dye 92 induced antioxidant activity and the risk of oxidative stress for Ceratophyllum demersum

Extramammary Paget's Disease Associated With Genital Wart and Lichen Sclerosus

Extramammary Paget’s disease is an uncommon intraepithelial adenocarcinoma in genital and perianal regions. Genital wart is the most common sexually transmitted disease caused by human papilloma viruses and vulval lichen sclerosus is chronic pruritic dermatitis in genital area which could be able to change to invasive squamous cell carcinoma. We report a patient who had simultaneous lichen sclerosus, genital wart and extramammary Paget’s disease of the vulva. We could not find any significant association between them in literature

New Methods of Evaluation for Postgraduate Training in Kermanshah University of Medical Sciences (2014)

Revered editor evaluation of medical students in specialized medical fields has great importance in determining the necessary competence to learning clinical environments and necessary ability for functioning in the real environment (1). New specialized medical evaluation focuses on ways that confirm the clinical competence assistant that can point to the students’ experience booklet (log book); assay exams; Multiple Choice Question (MCQ); Objective Structural Clinical Examination (OSCE); observation with check list or rating scale; self-assessment and assessment by peers rating scale general; Portfolio; Direct Observation of Procedure Skill (DOPS); Mini Clinical Evaluation Exercise (Mini-CEX); 360-degree comprehensive assessment of Clinical Skills based on Records assistants (CSR); Objective Structural Practical Examination (OSPE) (2). This descriptive-analytical study was performed to evaluate the use of modern methods of evaluation among eleven postgraduate departments in Kermanshah University of Medical Sciences in 2015. Data collection tool was a checklist that was prepared by researchers and was completed by clinical group managers. Data were analyzed with SPSS-16 software, Chi-square test and analysis of variance. In total of 11 studied groups, 106 full-time board faculty members, 14 co-education, 221 residents were working. The most modern methods to evaluate in %100 of groups were OSCE and MCQ, DOPS in %80 of groups, and Mini-CEX and CSR in% 27 of groups. Assay exams were used in infectious and pathology groups as the use of other modern methods of evaluation was not observed in all groups. Statistically, the most important reasons for the lack of significant new methods of evaluation were: internal decision of the department (P=0.002), unfamiliarity of team members with modern methods of evaluation (P=0.06), and the adequacy of other methods of evaluation according to the decision of the department (P<0.001). Other cited reasons such as lack of necessary accuracy of other methods to evaluate assistants and cost of time and money for the groups were not statistically significant. There is an extended use of the OSCE and MCQ in Kermanshah University of Medical Sciences in evaluating education assistants (3) and evaluation of five-year period of residency MCQ both quantitatively and qualitatively represents designer's assistant to the quality of exam questions in this type of methods (4). But considerable point in this study is lack of attention and unwillingness among faculty members in departments to use other new methods in evaluating the residents. This finding has also been reported in other universities of medical sciences (5), and it is proposed to hold effective and useful workshops to train and change point of views of faculty members about the new methods of evaluation practices

Increased Carotid Artery Intima-Media Thickness in Pregnant Women with Gestational Diabetes Mellitus

Background: Pregnant women with previous gestational diabetes mellitus are at increased risk of progressive carotid artery disorders. The current study evaluated carotid intima-media thickness (IMT) in pregnant women with gestational diabetes at two time points of mid-term and full-term pregnancy to determine whether gestational diabetes mellitus causes increased IMT. Methods: This cross-sectional study carried out at Afzalipour Hospital (Kerman, Iran) between 2009 and 2010, recruited 50 women who were at high risk of gestational diabetes during pregnancy and had an oral glucose challenge test (OGCT) as screening for gestational diabetes. B-mode ultrasound scans were performed at baseline and at two time points of mid- term pregnancy (20 to 24 weeks) and full-term pregnancy (36 to 38 weeks) on all the participants. The mean IMT of common carotids and internal carotid arteries from two walls (near and far walls) at four different angles was assessed. Results: An overall comparison between the impaired OGCT test group and the control group revealed significant differences in carotid IMT in the mid-term (0.65 ± 0.07 vs. 0.59 ± 0.06 mm; p value = 0.002) and full-term (0.65 ± 0.05 vs. 0.59 ± 0.04 mm; p value 0.05). Conclusion: Carotid IMT was significantly higher in the women with gestational diabetes than that in the normoglycemic group in different trimesters. This finding denotes that atherosclerosis might start years before the diagnosis of gestational diabetes in vulnerable women