Comparison of 1 versus 3 Days Post-operative Catheterization after Anterior Colporrhaphy

With attention to the fact that after anterior colporrhaphy surgery and stitches on vaginal mucus, inserting urinary catheter is requested, according to scientific references and in order to prevent from urinary retention, it has been said that the catheter should be inserted for 3 days. But inserting the catheter leads to infections of bladder and pain. So, in the present study, we compared the removal of the catheter 24 hours versus 72 hours after the surgery, considering urinary infections, urinary retention, patient’s ease and hospitalization. Within two groups of 70 patients, which has been assimilated based on basic factors (devided into two groups accidently with excel table) urinary catheter fixed for 1 and 3 days. After that, patients were compared considering urinary retention, urinary infections and the rate of patient satisfaction. Urinary retention was 28.6% in the test group and 22.9% in a controlling group which was not statistically meaningful (P=0.78). Urinary infections were 22.9% in the test group and 34.3% in the controlling group (P=0.42) and the rate of patient’ssatisfactions was 57.1% in the test group and 40% in controlling group (P=0.23). The hospitalization period in the test group and in the control group was 2.91±0.61 and 3.94± 0.59 days respectively with a significant difference (P=0.001). The results showed that short time catheterization is more satisfactory in comparison long catheterizations

Dosage Optimization for Letrozole Treatment in Clomiphene-Resistant Patients with Polycystic Ovary Syndrome: A Prospective Interventional Study

Objective. Dose adjustment for induction of ovulation is one of the most important problem. Methods. In a prospective interventional study, 44 clomiphene-resistant infertile patients (113 cycles) were selected from the Abolfazl Infertility Clinic of Bushehr University of Medical Sciences. Letrozole was given orally in a dose of 2.5 mg, 5 mg, and 7.5 mg, respectively. If the patient displayed no response, the dosage was increased. Results. In this patients ovulation occurred in 50 cycles (44.24%), clinical pregnancy rate according to number of cycles was 23.89% (27 of 113 cycles) and according to the number of patients was 61.36% (27 of 44 patients). In the 2.5, 5, and 7.5 groups, follicles occurred in 22.9%, 42.1%, and 85.18% of cycles, and pregnancy rate was 14.58%, 28.94% and, 33.33%, respectively. Conclusions. It is better to administer Letrozole at a lower dosage to prevent complications and increase the dose based on sonographic results antral follicular count, anti-Müllerian hormone, LH/FSH, and estradiol

Comparison the Effect of Letrozole Versus Medroxy Progesterone Acetate on Premenopausal Patients With Endometrial Hyperplasia: An Randomized clinical trial

Objective: The assessing the effect of letrozole and medroxyprogesterone acetate on women with simple endometrial hyperplasia without atypia in reproductive age. Material and Methods: Eighty patients of Abolfazle clinic in Bushehr with abnormal uterine bleeding and simple endometrial hyperplasia enrolled in this study. The patients were randomized in 2 groups: group A included 40 patients who received 10 mg medroxyprogesterone acetate for 10 days in each month during 3 months and group B included 40 patient that received 2.5 mg letrozole for 3 months. Serial transvaginal sonography and estradiol were checked basically and repeated after 3 months of treatment. Main outcome measures were endometrial thickness and estradiol level in serum. Results: In 2 groups A & B, there were no significant differences in the base variables. The level of estradiol in groups A and B before treatment was similar in the 2 groups. Endometrial thickness in groups A and B was not statistically significant. The difference between these 2 groups from the endometrial thickness reduction viewpoint, is not significant (P value = 0.445). The level of decline estradiol in serum in the groups A&B was significant, Conclusion: Letrozole is an acceptable drug for treatment of simple endometrial hyperplasia especially in the patients who did not tolerate medroxyprogesterone

Dosage Optimization for Letrozole Treatment in Clomiphene-Resistant Patients with Polycystic Ovary Syndrome: A Prospective Interventional Study

Objective. Dose adjustment for induction of ovulation is one of the most important problem. Methods. In a prospective interventional study, 44 clomiphene-resistant infertile patients (113 cycles) were selected from the Abolfazl Infertility Clinic of Bushehr University of Medical Sciences. Letrozole was given orally in a dose of 2.5 mg, 5 mg, and 7.5mg, respectively. If the patient displayed no response, the dosage was increased. Results. In this patients ovulation occurred in 50 cycles (44.24%), clinical pregnancy rate according to number of cycles was 23.89% (27 of 113 cycles) and according to the number of patients was 61.36% (27 of 44 patients). In the 2.5, 5, and 7.5 groups, follicles occurred in 22.9%, 42.1%, and 85.18% of cycles, and pregnancy rate was 14.58%, 28.94% and, 33.33%, respectively. Conclusions. It is better to administer Letrozole at a lower dosage to prevent complications and increase the dose based on sonographic results antral follicular count, anti-M¨ullerian hormone, LH/FSH, and estradiol

Comparison the effects of oxytocin and methylergonovine in elective caesarean section under spinal anesthesia

Purpose In order to prevent postpartum hemorrhage in caesarean section under spinal anesthesia, patients routinely receive oxytocin. In this study we compared the efficacy of Methylergonovine and Oxytocin on hemodynamic stability and bleeding amount in caesarean section. Materials and methods In this randomised controlled trial study, 80 patients candidate for elective caesarean section under spinal anesthesia divided to two groups: 40 patients in control group received oxytocin and 40 ones in case group received methylergonovine. Results There was no differences between groups in Mean age, baseline hemodynamic values, after spinal anesthesia and recovery (except diastolic blood pressure min 20), time of uterine atony, dizziness; nausea and vomiting. After drug administration (oxytocin and methylergonovine), systolic blood pressure in minutes 1, 10, 15 and diastolic blood pressure in minutes 1, 3, 20 increased in case group statistically more than control group. In control group, heart rate in minutes 1, 5 increased significantly more than the other group. Mean arterial blood pressure in minutes 1, 3, 5, 10, 15 reduced significantly more than in control group. Need to vasoconstrictor drug statistically was less in case group (p\0.0001). Conclusion Methylergonovine induced significantly more hemodynamic stability. Adverse effects were similar between two groups. We recommend the use of methylergonovine in patients with caesarean section under spinal anesthesia because of its hemodynamic stability and low need to vasoconstrictor drugs

Design and psychometric measurement of the questionnaire on attitude, knowledge and utilization of self-care for patients undergoing coronary artery bypass graft surgery based on Waltz model

Background. Self-care behaviors in cardiac patients are one of the essential factors in their treatments. The failure to apply proper self-care behaviors reduces their recovery and imposes high costs on the health care system. Aim. This study aimed for design and psychometric measurement of the questionnaire on attitude, knowledge and utilization of self-care for patients undergoing coronary artery bypass graft surgery based on Waltz model Method. In this methodological study, the following four steps were conducted for design and psychometric measurement of the questionnaire: 1) defining the theoretical and practical self-care concept for patients undergoing coronary artery bypass graft surgery in the domains of physical activity, sexual activity, social activity, mental state, and smoking; 2) designing the items of the questionnaire using other instruments which are being used in heart diseases; 3) determining the face validity (the assessment of facility, difficulty, and ambiguity of the items and their importance for patients) and content validity of the questionnaire (the assessment of appropriateness and necessity of items by experts opinions and measuring CVR and CVI; 4) the internal consistency of the questionnaire was evaluated by determining the Cranach's alpha coefficient. Findings. The first version of this questionnaire was produced with 56 items, of which 15 items were deleted during the process of validity and reliability confirmation. The final version of the questionnaire was provided with 41 items in three domains; knowledge domain with 14 items, attitude domain with 7 items and utilization domain with 20 items. The results of the psychometric procedure for the questionnaire was the content validity index of 0.99, the content validity ratio of 0.96 and the internal consistency of the questionnaire with Cronbach's alpha coefficient of 0.7 representing appropriate validity and reliability of the questionnaire. Conclusion. This 41-item questionnaire can be utilized in the assessment process of these patients. Measuring construct validity is recommended for the validity of the domains of the present questionnaire

Body Mass Index Before and After Pregnancy Associated With Maternal and Neonatal Complications

Objective: The aim of this study is evaluate the effects of weight before and during pregnancy on maternal and neonatal complications. Materials and Methods: In this cohort study, the statistical population was pregnant women. After collecting all the primary information, the relationship between pre-pregnancy body mass index (BMI) and weight gain during pregnancy with preterm delivery and maternal complications such as diabetes and pre-eclampsia were studied. Results: From a total of 1400 pregnant women, who were recruited for this study, 897 were referred to Bushehr’s Persian Gulf Martyrs Hospital; statistical analysis was performed on the participants. BMI before pregnancy had no significant relationship with the number of previous abortions (P = 0.3). No significant relationship was found between BMI before pregnancy and gestational diabetes during pregnancy (P = 0.53), preeclampsia (P = 0.26), or preterm delivery (P = 0.55). Weekly weight gain was significantly less in mothers without preterm birth than mothers with preterm birth (P = 0.002), but there was no significant difference in overall weight (P = 0.99). BMI had a significant impact on low birth weight (LBW) in infants (P = 0.003). The impact of pre-pregnancy BMI on Apgar scores was significant (P = 0.043). The mother’s BMI and weekly weight gain (without adjusting for confounding variables) as well as weight gain after adjusting for confounding variables had no significant effect on the mother’s risk of developing gestational diabetes. The mother’s age was the only confused variable (adjusted odds ratio [OR] = 1.09, P = 0.004). Pre-pregnancy BMI had a significant impact on the chances of Small for gestational age (SGA) infants (P = 0.03), but no significant effect on the chance of large for gestational age (LGA) births (P >0.05). Conclusion: High BMI during pregnancy has an adverse outcome in pregnancy

Epidemiological features of children mortality in the area covered by Shahid Beheshti university of medical sciences in 2012

Background and Aim: Under 5-years mortality year is one of the most important indicators of development and health in the countries. Therefore, generating accurate picture of child mortality in order to evaluate the death causes and identifying the avoidable factors for designing the interventions and preventing similar death is necessary. The present study aimed to investigate the causes of deaths in 1 to 59 months children in the area covered by Shahid Beheshti University of Medical Sciences in 2012. Methods: In this descriptive cross-sectional study that conducted from March 2012 to March 2013, all of 1 to 59 months children deaths in the area covered by Shahid Beheshti University of Medical Sciences were investigated. Required data was extracted from registration forms of the child health office of ministry of health and medical education. Results: The total number of deaths in 1 to 59 months children was 383. The highest frequency of death was observed in the children who aged between 1 to 12 months (57.8%). More than half of the children who died were boy (52.5%). Totally, the most common causes of death were congenital and chromosomal abnormalities (17.5%), injuries (15.4%) and cancers (11.2%). Conclusion: Based on the results, designing interventions such as genetic counseling in high risk couples, training of the parent and children for prevention of injuries and public awareness about the warning symptom of the cancers and respiratory system disease in order to reduce the children deaths is essential

The effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein(a) and oxidized low-density lipoprotein, lipid profiles and biomarkers of oxidative stress in patients with polycystic ovary syndrome

This study was conducted to determine the effects of omega-3 fatty acids and vitamin E cosupplementation on gene expression of lipoprotein(a) (Lp[a]) and oxidized low-density lipoprotein (Ox-LDL), lipid profiles and biomarkers of oxidative stress in women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was done on 68 women diagnosed with PCOS according to the Rotterdam criteria aged 18e40 years old. Participants were randomly assigned into two groups to receive either 1000 mg omega-3 fatty acids from flaxseed oil containing 400 mg a- Linolenic acid plus 400 IU vitamin E supplements (n ¼ 34) or placebo (n ¼ 34) for 12 weeks. Lp(a) and Ox-LDL mRNA levels were quantified in peripheral blood mononuclear cells of PCOS women with RT-PCR method. Lipid profiles and biomarkers of oxidative stress were quantified at the beginning of the study and after 12-week intervention. Quantitative results of RT-PCR demonstrated that compared with the placebo, omega-3 fatty acids and vitamin E co-supplementation downregulated expressed levels of Lp(a) mRNA (P < 0.001) and Ox-LDL mRNA (P < 0.001) in peripheral blood mononuclear cells of women with PCOS. In addition, compared to the placebo group, omega-3 fatty acids and vitamin E cosupplementation resulted in a significant decrease in serum triglycerides (�22.1 ± 22.3 vs. þ7.7 ± 23.6 mg/dL, P < 0.001), VLDL- (�4.4 ± 4.5 vs. þ1.5 ± 4.7 mg/dL, P < 0.001), total- (�20.3 ± 16.6 vs. þ12.2 ± 26.1 mg/dL, P < 0.001), LDL- (�16.7 ± 15.3 vs. þ11.9 ± 26.1 mg/dL, P < 0.001) and total-/HDLcholesterol (�0.5 ± 0.6 vs. þ0.4 ± 0.8, P < 0.001). There were a significant increase in plasma total antioxidant capacity (þ89.4 ± 108.9 vs. þ5.9 ± 116.2 mmol/L, P ¼ 0.003) and a significant decrease in malondialdehyde levels (�0.3 ± 0.4 vs. -0.008 ± 0.6 mmol/L, P ¼ 0.01) by combined omega-3 fatty acids and vitamin E intake compared with the placebo group. Overall, omega-3 fatty acids and vitamin E cosupplementation for 12 weeks in PCOS women significantly improved gene expression of Lp(a) and Ox- LDL, lipid profiles and biomarkers of oxidative stress

Cloning and expression of human vasohibin1 gene in E. coli

Background: Angiogenesis is an important process in various physiologic and pathologic states. The most significant stimulator of angiogenesis is vascular endothelial growth factor (VEGF). In contrast, vasohibin1 acts as an angiogenesis inhibitor which specifically inhibits new vessels formation. The aim of the present study was cloning and expression of vasohibin1 gene in E. coli as well as purification of recombinant vasohibin1 protein. Methods: Total RNA was extracted from human umbilical vein endothelial cells and cDNA was synthesized by RT-PCR. cDNA was amplified using a specific designed primer set. The PCR product was evaluated by electrophoresis and then cloned in pET28a expression vector which transformed into E.coli BL21 (DE3) as a host. IPTG is used as an expression inducer in media. Alternatively, PCR products were analyzed by sequencing and double digestion with EcoRI and HindIII restriction endonuclease. The expressed protein was purified by Ni-NTA column and confirmed by SDS Page and western blotting. Evaluation of gene inhibition was carried out through western blottting and RT-PCR. Results: No mutation or sequence variants were found in PCR products as a result of sequencing analysis. Moreover, the quantity and quality of expressed recombinant protein in the presence of IPTG with selected vector in E. coli was approximately high. VASH1 significantly prevented the receptor expression. The quality and level of expressed protein in pET28 expression vector indicated the efficacy of the applied system in vasohibin1 production. Conclusions: The produced vasohibin1 protein probably can be used as an angiogenesis inhibitor in further studies on retinopathies