Application of autologous platelet-rich plasma (PRP) on wound healing after caesarean section in high-risk patients

Background: Platelet-rich plasma (PRP) is ahumanplasma product enriched by platelets, growth factors, and fibrinogen with high hemostatic and healing properties. Objectives: The aim of this study was to evaluate the effect of autologous PRP on wound healing in high-risk women undergoing cesarean sections. Patients and Methods: In this balanced, randomized, and controlled trial, 140 patients were admitted to Arash women�s hospital, Tehran, Iran from May of 2013 to November of 2014 for elective cesarean surgery. The patients were randomly assigned into two groups. The intervention group received PRP after surgery, whereas the control group received the usual care. All patients were evaluated at baseline, five days, and eight weeks after the cesarean section. The primary endpoint used the REEDA scale for assessing the changes in wound healing. The secondary outcome measures used were the Vancouver scar scale (VSS) and the visual analog scale (VAS). All scale scores were analyzed using a repeated measures test for variance. Results: At the end of study, the PRP group showed a greater reduction in the edema ecchymosed discharge approximation (REEDA) score compared to the control group (85.5 reduction in the PRP group; 72 in the control group) (P < 0.001). Compared with the control group, the PRP group had a significantly greater reduction in the VANscore, beginning on the fifth day after the cesarean section (-0.7, 38 reduction in PRP group;-0.8, 33 in control group) (P < 0.001), and this trend was stable at the end of the eighth week (-0.6, 54 reduction in PRP group;-0.3, 18 in control group). Furthermore, patients treated with PRP experienced a 93 reduction in the VAS score at the end of follow-up, but the control group only observed a 79 reduction (P < 0.001). Conclusions: It seems that applying PRP is an effective therapeutic approach for wound healing, and faster wound healing is expected due to the presence of more platelets and growth factors. © 2016, Iranian Red Crescent Medical Journal

Diagnostic accuracy of body mass index and fasting glucose for the prediction of gestational diabetes mellitus after assisted reproductive technology

Background: The aim of the present study was to determine the maternal pre-pregnancy body mass index (BMI), first-trimester fasting blood sugar (FBS), and the combination of (BMI+FBS) cut-points for at-risk pregnant women conceived by assisted reproductive technology (ART) to better predict the risk of developing gestational diabetes mellitus (GDM) in infertile women. Materials and Methods: In this nested case-control study, 270 singleton pregnant women consisted of 135 (GDM) and 135 (non-GDM) who conceived using ART were assessed. The diagnosis of GDM was confirmed by a one-step glucose tolerance test (O-GTT) using 75 g oral glucose. BMI was classified base on World Health Organization (WHO) criteria. The relationship between BMI, FBS, and BMI+FBS with the risk of GDM development was determined by logistic regression and adjusted for confounding factors. Receiver operating characteristic (ROC) curve analysis was performed to assess the value of BMI, FBS, and BMI+FBS for the prediction of GDM. Results: The GDM group had significantly higher age, BMI, family history of diabetes, and history of polycystic ovary syndrome in comparison with the non-GDM group (P&lt;0.05). Overweight and obese women had 3.27, and 5.14 folds increase in the odds of developing GDM, respectively. There was a 17 increase in the risk of developing GDM with each 1 mg/dl increase in fasting glucose level. The cut points for FBS 84.5 mg/dl (72.9 sensitivity, 74.4 specificity), BMI 25.4 kg/m 2 (68.9 sensitivity, 62.8 specificity), and BMI+FBS 111.2 (70.7 sensitivity, 80.6 specificity) was determined. Conclusion: The early screening and high-quality prenatal care should be recommended upon the co-occurrence of high FBS (�84.5 mg/dl) in the first-trimester of the pregnancy and the BMI (�25.4 kg/m2) in pre-pregnancy period in women undergone ART. The combination of BMI and FBS is considered a better prediction value. © 2019, Royan Institute (ACECR). All rights reserved

Mothers and their children�s health (MATCH): a study protocol for a population�based longitudinal cohort

Background: The quality of prenatal care is critical for the prevention of adverse pregnancy outcomes. However, according to the World Health Organization (WHO), only 64 of women worldwide have access to over four sessions of prenatal care throughout their pregnancy. Thus, studies that address factors affecting maternal and child health status before and after pregnancy are of immense importance. The primary aim of the mothers and their children�s health (MATCH) cohort study is to evaluate the effect of nutrition, sleep quality, and lifestyle on maternal and neonatal outcomes. Methods: A prospective cohort of > 2500 pregnant women in the first trimester (before 12 weeks� gestation) will be recruited at Arash Women�s Hospital in Tehran, Iran between February 2020 and August 2021. All eligible pregnant women will be followed from their first trimester of pregnancy until delivery at four time points and assessed through a series of in-person visits with interviewer-administered questionnaires and telephone interviews. Detailed data will be collected on maternal demographics, lifestyle, medical history, reproductive history, obstetric history, dietary intake, sleep pattern, blood specimens, and anthropometric measurements, alongside paternal demographics, lifestyle, and family history. The outcomes will include antenatal, peripartum, and postnatal maternal complications and infant growth and neurodevelopment. Discussion: The results of the MATCH cohort study will support the development of contextual interventions that can enhance antenatal, peripartum, and postnatal status, neonatal outcomes, and longevity mother and child. © 2021, The Author(s)

Hand eczema and related factors in patients referred to Razi Hospital, Spring, 1376

Introduction: Hand eczema is one of the most common causes of disabiliting dermatoses. Objective: Our purpose was to determine the frequency of hand eczema in out patients seen in Razi hospital (university medical center). Design: Of 3754 patients with skin problems, 206 were investigated for hand eczema and the study was carried out with regard to age, sex, occupation, exposure to chemical and physical irritants and predispositional factors. Results: The prevalence of hand eczema was 5.48%. The mean age was 30.8 years. The female: male ratio was 1.6. The highest number of patients were in the occupational group with exposure to reegents and water (we couldn&apos;t do patch test because it was not available). The most common complaint was itching (85.5%) and the fingers were the predominant affected sites. Conclusion: The major cause of hand eczema in contact dermatitis (Irritant and Allergic) and patch testing in necessary to determine the allergic agent, that can be helpful in allergic contact dermatitis (ACD) but are sometimes discouraged because of high false-positive rate and also in many instances, simultaneous exposure to irritant factors plays an essential role in the development of ACD

ACE gene rs4343 polymorphism elevates the risk of preeclampsia in pregnant women

The multifactorial basis of preeclampsia (PE) implies that there are several genes and risk factors that are important in the development of the disease. Therefore, the exact etiology and pathogenesis of preeclampsia remains unclear. It is suggested that inappropriate regulation of the renin�angiotensin system (RAS) is a risk factor for hypertension during pregnancy. The angiotensin I-converting enzyme (ACE) serum level, a key component of the RAS, affects the blood pressure. It is hypothesized that the ACE gene polymorphisms contribute to preeclampsia development. In a case�control study containing 296 subjects (165 PE patients and 131 normotensive controls), we aimed to examine the association of the ACE gene I/D and rs4343 polymorphisms with preeclampsia in Iranian women. Genotyping for rs4343 and ACE I/D polymorphisms was performed by using TP-ARMS-PCR and conventional PCR, respectively. The rs4343 G allele frequency was higher in the case group (OR = 1.90, 95 CI, 1.37�2.65; P = 0.0001). Besides, a significant difference was detected for the genotype frequencies between the studied groups under dominant (OR = 3.94, 95 CI, 2.05�7.56; P < 0.0001) and recessive (OR = 2.21, 95 CI, 1.22�4.01; P = 0.009) inheritance models. For the I/D polymorphism, no significant differences were detected in the genotype and allele frequencies or any of the inheritance models between PE patients and controls. To verify the current results and validate the significance of the studied genetic variations, additional studies in diverse ethnic populations are required. © 2018, Springer Nature Limited

Predictive factors of gestational diabetes in pregnancies following assisted reproductive technology: a nested case�control study

Purpose: To evaluate predictive factors for gestational diabetes mellitus (GDM) in singleton pregnancy following assisted reproductive technology (ART). Methods: This nested case�control study was performed during October 2016�June 2017. Pregnant women who conceived following ART procedures referred to infertility clinic were selected and categorized into GDM and non-GDM based on ADA/IAPDSG criteria. The study variables including age, educational status, first-degree family history of chronic diseases, systolic and diastolic blood pressure, previous obstetric and perinatal outcomes, infertility history, and ART cycle characteristics were collected from medical records. Prediction model to develop GDM was employed by binary logistic regression analysis after adjustment for age and body mass index, family history of diabetes, and gravidity. Results: In total, 270 women with singleton pregnancies (consisted of 135 GDM and 135 non-GDM women) conceived were studied. According to the final model, significant predictors of GDM were history of polycystic ovarian syndrome (PCOS), previous ovarian hyper-stimulation syndrome (OHSS) risk and progesterone injections. Administration of injectable progesterone during the first 10�12 weeks of pregnancy was associated with an approximately twofold increased risk of developing GDM odds ratio (OR) 2.28, 95% confidence interval (CI) 1.27�4.09) compared to vaginal progesterone. In addition, the regression analysis revealed that previous OHSS risk (OR 2.40, 95% CI 1.34�4.31) and history of PCOS (OR 2.76, 95% CI 1.26�6.06) were other most important predictors of GDM. Conclusions: The route of progesterone administration, previous OHSS risk and history of PCOS seem to be putative risk factors for GDM in women conceived by ART. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature

Predictive factors of gestational diabetes in pregnancies following assisted reproductive technology: a nested case�control study

Purpose: To evaluate predictive factors for gestational diabetes mellitus (GDM) in singleton pregnancy following assisted reproductive technology (ART). Methods: This nested case�control study was performed during October 2016�June 2017. Pregnant women who conceived following ART procedures referred to infertility clinic were selected and categorized into GDM and non-GDM based on ADA/IAPDSG criteria. The study variables including age, educational status, first-degree family history of chronic diseases, systolic and diastolic blood pressure, previous obstetric and perinatal outcomes, infertility history, and ART cycle characteristics were collected from medical records. Prediction model to develop GDM was employed by binary logistic regression analysis after adjustment for age and body mass index, family history of diabetes, and gravidity. Results: In total, 270 women with singleton pregnancies (consisted of 135 GDM and 135 non-GDM women) conceived were studied. According to the final model, significant predictors of GDM were history of polycystic ovarian syndrome (PCOS), previous ovarian hyper-stimulation syndrome (OHSS) risk and progesterone injections. Administration of injectable progesterone during the first 10�12 weeks of pregnancy was associated with an approximately twofold increased risk of developing GDM odds ratio (OR) 2.28, 95% confidence interval (CI) 1.27�4.09) compared to vaginal progesterone. In addition, the regression analysis revealed that previous OHSS risk (OR 2.40, 95% CI 1.34�4.31) and history of PCOS (OR 2.76, 95% CI 1.26�6.06) were other most important predictors of GDM. Conclusions: The route of progesterone administration, previous OHSS risk and history of PCOS seem to be putative risk factors for GDM in women conceived by ART. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature

Tehran environmental and neurodevelopmental disorders (TEND) cohort study: phase I, feasibility assessment

Purpose To advance knowledge about childhood neurodevelopmental disorders and study their environmental determinants, we conducted a study in Tehran, Iran to assess the feasibility of prospective birth cohort study. Methods We evaluated participation of pregnant women, feasibility of sampling biological material, and health care services availability in Tehran in four steps: (1) first trimester of pregnancy; (2) third trimester of pregnancy; (3) at delivery; and (4) two to three months after delivery. We collected related data through questionnaires, also various biological samples were obtained from mothers (blood, urine, milk and nails-hands and feet) and newborns (umbilical cord blood, meconium, and urine samples) from February 2016 to October 2017. Results overall 838 eligible pregnant women were approached. The participation rate was 206(25%) in our study and about 185(90%) of subjects were recruited in hospitals. Out of 206 participants in the first trimester, blood, urine, hand nail, and foot nail samples were collected from 206(100%),193(93%), 205(99%), and 205(99%), respectively. These values dropped to 65(54%), 83(69%), 84(70%), and 84(70%) for the remaining participants 120(58%) in the third trimester, respectively. Also, we gathered milk samples from 125(60%) of mothers at two to three months after delivery. Conclusion Our findings suggest that hospitals were better places for recruitment of subjects in a birth cohort in Tehran. We further concluded that birth cohort study recruitment can be improved by choosing appropriate gestational ages. Obtaining the newborn's urine, meconium, and umbilical cord blood were challenging procedures and require good collaboration between hospital staff and researchers