Comparison of closure of subcutaneous tissue versus non-closure in relation to wound infection and disruption after cesarean section delivery in obese patients.

چکیده: زمینه و هدف: باز شدگی زخم یکی از عوارض مهم بعد از سزارین است و چاقی یکی از ریسک فاکتورهای عفونت زخم به همراه سایر عوارض می باشد. این مطالعه با هدف مقایسه اثر دوختن یا ندوختن بافت زیر جلد در ایجاد عفونت و باز شدگی زخم بعد از عمل سزارین در افراد چاق انجام شده است. روش بررسی: در یک مطالعه کارآزمایی بالینی در شهرستان یزد 100 نفر از زنان چاقی (که بافت زیر جلد آنها حداقل cm2 بود) و با روش سزارین زایمان می کردند به دو گروه 50 نفری تقسیم شدند، در گروه مورد بعد از دوختن فاشیای شکم بافت زیر جلد با نخ ویکریل 2/0 سوچور شد و گروه شاهد بعد از دوختن فاشیا، زیر جلد را باز گذاشته و جلد ترمیم شد. بیماران هر دو گروه از نظر ترشحات عفونت و باز شدگی زخم بررسی شدند. نتایج مطالعه با تست های آماری t-student و کای دو بررسی شد. یافته ها: هر دو گروه از نظر سن، تعداد زایمان، نوع بیهوشی و نوع انسزیون یکسان بودند. عفونت چرکی (کشت مثبت) در 2 نفر ازگروه مورد و 5 نفر از گروه شاهد مشاهده شد (05/0

Accuracy of the Triple Test Versus Colposcopy for the Diagnosis of Premalignant and Malignant Cervical Lesions

Background: Despite the World Health Organization (WHO) recommendations concerning the use of alternative tests for the detection of cervical cancer precursor lesions in low-income countries, the accuracy of these tests is a debated issue. In the present study we compare the diagnostic accuracy of the triple test with that of colposcopy for the diagnosis of premalignant and malignant cervical lesions. Methods: A cross-sectional study was performed in 328 women referred to the gynecology clinic at Shahid Sadoughi Hospital, affiliated to Yazd University of Medical Sciences (SSUMS), Yazd, Iran, from March 2016 to June 2018. As the first step, a Pap smear was obtained from all participants. Visual inspection with acetic acid (VIA) and Lugol�s iodine (VILI) was performed in accordance with the known protocol. A colposcopy was then conducted in all participants, biopsy samples were obtained, and histological features studied. Finally, the results were compared by statistical analysis. Results: The age range of the participants was 30 - 50 years. Of 328 women, 60 (18.3 ) were postmenopausal. Two-hundred and five patients (62.5 ) had an abnormal Pap smear, 165 (50.3 ) had abnormal results on colposcopy, and 141 (43 ) had abnormal histopathology reports. The VIA was positive in 129 patients (39.3 ) and the VILI in 177 (54 ). The results of the triple test were reported to be positive in 205 cases (51.52 ). The sensitivity of the triple test in the detection of premalignant and malignant cervical lesions was 78.7 and 69 , respectively. The sensitivity and specificity of colposcopy in the detection of premalignant and malignant cervical lesions was 80.1 and 72.2 , respectively. The diagnostic accuracy of the triple test and colposcopy in the detection of premalignant and malignant cervical lesions was 73 versus 75 . Conclusion: Since the results of the study showed that the diagnostic accuracy of the triple test is equivalent that of colposcopy, the former may be used in low-income countries and areas lacking access to colposcopy. © 2020. All rights reserved

Dietary phytochemicals, HDAC inhibition, and DNA damage/repair defects in cancer cells

Genomic instability is a common feature of cancer etiology. This provides an avenue for therapeutic intervention, since cancer cells are more susceptible than normal cells to DNA damaging agents. However, there is growing evidence that the epigenetic mechanisms that impact DNA methylation and histone status also contribute to genomic instability. The DNA damage response, for example, is modulated by the acetylation status of histone and non-histone proteins, and by the opposing activities of histone acetyltransferase and histone deacetylase (HDAC) enzymes. Many HDACs overexpressed in cancer cells have been implicated in protecting such cells from genotoxic insults. Thus, HDAC inhibitors, in addition to unsilencing tumor suppressor genes, also can silence DNA repair pathways, inactivate non-histone proteins that are required for DNA stability, and induce reactive oxygen species and DNA double-strand breaks. This review summarizes how dietary phytochemicals that affect the epigenome also can trigger DNA damage and repair mechanisms. Where such data is available, examples are cited from studies in vitro and in vivo of polyphenols, organosulfur/organoselenium compounds, indoles, sesquiterpene lactones, and miscellaneous agents such as anacardic acid. Finally, by virtue of their genetic and epigenetic mechanisms, cancer chemopreventive agents are being redefined as chemo- or radio-sensitizers. A sustained DNA damage response coupled with insufficient repair may be a pivotal mechanism for apoptosis induction in cancer cells exposed to dietary phytochemicals. Future research, including appropriate clinical investigation, should clarify these emerging concepts in the context of both genetic and epigenetic mechanisms dysregulated in cancer, and the pros and cons of specific dietary intervention strategies

Maternal Serum Triglycerides at Midpregnancy and Term Neonate Weight in Non-Diabetic Women with Normal Body Mass Index

Context: Fetal macrosomia is one of the major complications of pregnancy.Objective: To determine whether elevated midpregnancy (24 -28 Gestational weeks) maternal serum lipid levels predict the riskmacrosomia in non-diabetic women.Study Design: 190Nondiabetic pregnant women (who had negative diabetic screens) in Shahid Sedughi Hospital Of Shahid Sedughi universitywere enrolled.Methods: Fasting serum triglyceride, and total cholesterol levels were measured at 24-28 weeks gestation. We tested the association between maternal variables and birth weight by univariable analysis. We also used multiple logistic regression analysis to determine whether maternalhyperlipidemia,is arisk factor for having an LGA infant.Results: We enrolled 190 subjects. Among measured maternal lipids, only triglyceride levels correlated 2 with birth weight in univariable analysis (r = 0.40, P = .000). Logistic regression analysis showed that fasting maternal hypertriglyceridemia was the significant predictor of macrosomia,  independent of maternal weight gain and fasting plasma glucose levels. (odds ratio 11.2; 95% confidence interval 1.5, 31.2; P= .01).Conclusion: In nondiabetic women, fasting triglyceride levels at midpregnancy correlatedpositively with newborn weight at term

Comparison of Serum CA-125 Level in Ruptured and Unruptured Tubal Pregnancies in Yazd/Iran during 2001-2006

Abstract: Background & Aims: This study aimed to determine if serial measurement of serum CA-125 level could be used as a useful test in the differential diagnosis of intact and ruptured tubal pregnancies. Methods: In a single-blind prospective controlled clinical study, 59 women with tubal pregnancy of 6–12 weeks (26 women with ruptured tubal pregnancy, 33 women with intact tubal pregnancy and 59women with normal intrauterine pregnancy of the same gestational age as control group) were studied prospectively. Serum CA-125 levels were measured in all women and compared among three groups. Results: Demographic features (age, gestational age, parity and educational level) were not significantly different in three groups. CA-125 level in ruptured tubal pregnancy group was significantly higher than that in control group (P = 0.04). Both these two groups had higher levels of CA-125 comparing to the intact tubal pregnancy group (P = 0.001, P = 0.006, respectively). Conclusion: In intact tubal pregnancies managed with medical treatment, serial measurements of CA-125 could be a supplementary test for an early diagnosis of tubal rupture. Keywords: CA-125 antigen, Tubal pregnanc

Effect of hyoscine butylbromide first stage of labour in multiparus women

Background: Prolonged labor is one of the most important risk factors for perinatal compromise and, if caused by obstructed labor, it carries the risk of uterine rupture, postpartum hemorrhage (PPH), puerperal sepsis, and maternal death. Objective: To determine whether or not hyoscine butylbromide shortens the stages of labor, without an increase in maternal or neonatal complications. Method: In single-blinded randomized clinical trial study , 188 multiparas women in active phase of labor who were admitted to Shahid Sadoughi Hospital from October 2006 to April 2007 in Yazd - Iran , were evaluated . They were divided hyoscine group (n = 94) received 20mg (1ml) of hyoscine and control group (n = 94) received 1 ml of normal saline was given as placebo, intravenously. The effects of hyoscine in shortening labor time; and neonatal Apgar score was compared. Results: Duration of the first (mean± SD: 186.8 ± 125.6 minutes vs. 260.4 ± 120.9 minutes, p= 0.00 1) and second stage of labor (mean± SD: 20.0 ± 8.1minutes vs. 25.8 ± 9.4 minutes, p= 0.03) was shorter in hyoscine group. Frequency of cesarean section and mean of neonatal Apgar score at minutes of one and 5 were not different in both groups. No serious adverse events were seen in the two groups. Conclusion: Injection of hyoscine in active phase of labor can be effective in shortening of labor without any adverse effect on mother and fetus