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

Sexual Health and Relationship Education and Supporting Services Available to Young People in Tehran; Needs Assessment and Programme Design

Abstract Background: Sexual Health and Relationship Education ( provides individuals with the knowledge and skills set which helps them to manage risky behaviours and make informed decisions and to protect themselves against STIs, risky behaviour, and unintended pregnancy. Such education is minimally provided in Iranian schools and universities; and previous research has indicated a demand and the need for SHRE among young people across the social spectrum (Chapter 1). Aim: The overall aims of this project were to ( conduct a needs assessment of the SHRE and sexual health service needs of young adults living in Tehran, ( investigate how such provision could be improved or augmented, taking the account of the views of health professionals and policymakers, and ( design a tailor-made SHRE programme for the future development of improved provision to be delivered in Tehran. Methods: This PhD project explored Iranian young adults’ sexual health education, training, and service needs and ways to improve or augment the existing provision (Chapter 3). This was followed by an investigation of Iranian healthcare professionals’ assessments of, and recommendations for, sexual health education and service provision for young people in Tehran (Chapter 4). Both of these studies employed detailed thematic analyses of interview transcripts. Finally, a tailor-made programme outline for an improved SHRE provision for young adults in Tehran was developed based on the findings of the first two studies, recommendations made in international guidance on the optimal content of SHRE programmes, and further stakeholder consultations using a public involvement methodology (Chapter 5). Results: Young adults in Tehran expressed their need and demand for enhanced sexual health education and healthcare. They highlighted existing barriers such as almost non-existent official education and the lack of reliable resources, taboo and cultural barriers, and lack of trust and confidentiality when seeking sexual health information, advice, and healthcare. This has resulted in ambiguities and misconceptions, including those regarding the cause and transmission of STIs and the correct use of contraception methods. They unanimously expressed their dissatisfaction with available sexual health education and provided recommendations for an improved provision, including holding mixed-gender extracurricular workshops with a comprehensive approach to sexual health and relationship education (Chapter 3). Validating young adults’ views, healthcare professionals emphasised the need for improved SHRE and service provision for young adults. They also confirmed the barriers highlighted by young Tehranians and collectively supported the augmentation of educational provision and healthcare services and provided recommendations on how this could be achieved (Chapter 4). A bespoke SHRE programme was then developed based on the aforementioned needs assessments, in addition to comments from the programme’s stakeholders and best practice guidelines published by six national and international organisations. The programme provides content and delivery recommendations, along with objectives and deliverables for each content category. The final programme outline is intended as a blueprint for improved SHRE provision in Tehran, and potentially Iran (Chapter 5). Conclusion: This PhD project has generated two novel in-depth needs assessments complemented by a theory- and evidence-informed, tailor-made SHRE programme outline which has the potential to augment the currently minimal SHRE provision in Tehran. This enhanced programme will have the capacity to provide young adults with reliable and non-judgmental sexual health and relationship knowledge and skills, which can result in improved sexual health and confidence in managing healthy relationships. Overall, this research demonstrates the unmet needs and desires of Tehranian young adults and healthcare professionals concerning sexual health and relationship education. It provides several recommendations for the future development and implementation of SHRE programmes in Tehran

Health-Care Professionals\u27 Assessments of, and Recommendations for, Sexual-Health Education and Service Provision for Young People in Tehran

Background: Only limited Sexual Health and Relationships Education (SHRE) is provided in Iranian schools and universities while research has highlighted demand and need for improved SHRE among young adults. We explored health-care professionals' (HCPs) assessments of, and recommendations for, SHRE and service provision for young people in Tehran. Design and Methods: Semi-structured interviews were conducted with a sample of 17 HCPs based in Tehran and verbatim transcripts were analyzed using thematic analysis. Results: Participants confirmed the need for improved SHRE and service provision for young adults. HCPs described how a lack of reliable educational resources for young adults, taboo and cultural barriers, and a lack of trust and confidentiality prevented young people from accessing information and services. They unanimously supported education and services to be augmented, and provided recommendations on how this could be achieved. Conclusions: A number of positive suggestions for the improvement of SHRE and Iranian sexual health services in Iran were identified

A comparison between the effects of metformin and N -acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome

Objective: To compare N-acetyl cysteine (NAC) and metformin on polycystic ovary syndrome (PCOS).Method: Study was performed as a randomized double-blind clinical trial on women with diagnosis of PCOS without additional complications. In one group, oral NAC 600 mg, three times a day and in the other group, 500 mg oral metformin, three times a day were prescribed. Duration of treatment was 24 weeks, and after finishing this period of treatment, fasting blood glucose (FBS) and insulin, lipid profile and Homeostasis Model Assessment (HOMA) index were measured (all the blood samples were taken while fasting) and were compared in the two groups.Results: Forty-six women in NAC group and 48 women in metformin group finished the study. The two groups did not show significant difference according to age, body mass index (BMI) of more than 30; mean BMI, AUB, FBS, fasting blood insulin, lipid profile and HOMA index before treatment. After 24 weeks of treatment; BMI >30 17 (35.4%) versus 7 (15.2%), p = 0.033, mean BMI (28.36 ± 2.27) versus (27.11 ± 3.55), p = 0.44, number of women with the complain of abnormal uterine bleeding (AUB) 24 (50%) versus 13 (28.3%), p = 0.037, FBS (90.02 ± 6.24) versus (86.61 ± 7.81), p = 0.021, fasting insulin (10.40 ± 2.64 versus 8.89 ± 2.20, p = 0.004), HOMA Index (2.09 ± 0.69 versus 1.71 ± 0.45, p = 0.001), low density lipoprotein (LDL) (141.83 ± 26.98 versus 127.89 ± 28.70, p = 0.017) were less in NAC group. Triglyceride (TG) and total cholesterol did not show significant difference between the two groups after treatment. High-density lipoprotein (HDL) was higher in NAC group.Conclusion: NAC can improve lipid profile and fasting blood sugar (FBS) and fasting blood insulin better than metformin. © 2015 Taylor & Francis

Comparison between two doses of betamethasone administration with 12�hours vs. 24�hours intervals on prevention of respiratory distress syndrome: a randomised trial

The purpose of the present study was to compare the effect of a two-dose administration of betamethasone with 12�hours interval vs. 24�hours interval on neonatal respiratory distress syndrome (RDS). The study was performed as a randomised clinical trial on 201 pregnant women with a gestational age of 26�34�weeks. In one group 12�mg of betamethasone every 12�hours for two doses and in the other group 12�mg of betamethasone every 24�hours for two doses were prescribed intramuscularly. There were no significant differences between the two groups according to maternal age, parity, gravidity, BMI, neonatal sex, need to surfactant, NICU admission, NICU stay, neonatal death, neonatal sepsis and Apgar score at minutes 1 and 5, but the gestational age at the beginning of the study and delivery receiving complete course of betamethasone and neonatal weight were lower in 24�hours group. RDS, necrotising enterocolitis, intra-ventricular haemorrhage and chorioamnionitis were more in the 24�hours� group. Multiple regression analysis showed that RDS and IVH (p�=�.022, RR�=�0.07, CI95 0.006�0.96 and p�=�.013; RR�=�0.9, CI95 0.1�0.89, respectively) were more in the 24�hours group and neonatal death (p�=�.034, RR�=�4.7, CI95 1.07�16.2) and NEC (p�=�0.038, RR�=�2.5, CI95 1.7�3.7), were more in the 12�hours group. In conclusion, it seems that 12�hours interval betamethasone therapy may be considered as an alternative treatment in the case of preterm labour for acceleration of lung maturity; however, it is suggested that more studies should be performed on this issue and various morbidities.IMPACT STATEMENTWhat is already known on this subject: Administration of a single course of corticosteroids in all women with a gestational age of 24�34 weeks of pregnancy who are at risk for preterm labour and delivery has been recommended. The accepted regimen by National Institutes of Health (NIH) is an injection of betamethasone for two doses with 24�hours interval.What do the results of this study add: Twelve hours interval betamethasone therapy may be considered as an alternative treatment in the cases of preterm labour for acceleration of lung maturity.What are the implications of these findings for clinical practice and/or further research: Prescription of two doses (complete regimen) is more important than the interval between two doses for obtaining the maximum effect in a preterm birth. © 2018 Informa UK Limited, trading as Taylor & Francis Grou

A comparative study on the efficacy of nifedipine and indomethacin for prevention of preterm birth as monotherapy and combination therapy: a randomized clinical trial

Introduction: Preterm delivery is an important issue in obstetrics, which is the most common cause of neonatal mortality and morbidity. Therefore, finding a way to prevent it is always under serious concern. Objective: The study aimed to compare the efficacy of two tocolytic agents, nifedipine and indomethacin, for inhibiting preterm uterine contractions as monotherapy and combination therapy. Materials and methods: A double-blind randomized clinical trial was performed on pregnant women with gestational age of 26�34 weeks of pregnancy who referred to hospital for preterm labor. They were randomly assigned to three groups. Indomethacin plus placebo, nifedipine plus placebo, and a combination of indomethacin and nifedipine were administered to the three groups. Inhibiting contractions for 2 hours and prevention of delivery for 48 hours and 7 days were evaluated. Also, duration of pregnancy, the number of preterm births, and the interval between entering the study and delivery were compared between three groups. Results: One hundred fifty women were eligible for the study. Two women in the nifedipine group and one woman in the combined group were excluded from the study because of hypotension. The women of the three groups did not have significant difference according to age, BMI, gravidity, parity, Bishop score, gestational age, and the number of contractions at entering the study. Thirty-six women (72) in the indomethacin group, 36 women (72) in the nifedipine group, and 41 women (89.4) in the combination group had stopped contractions within the first 2 hours of intervention (p =.002). Inhibiting contractions for 48 hours (p =.003), inhibiting contractions for 7 days (p =.021), gestational age at birth (p =.001), number of pregnancies more than 37 weeks (p =.007), and neonatal weight (p =.020) were significantly more in the combination group. Conclusion: Combination therapy with nifedipine and indomethacin was more effective than monotherapy with either of these two medications for inhibiting preterm labor, delaying delivery, and prolongation of the duration of pregnancy. © 2019 Informa UK Limited, trading as Taylor & Francis Group

Evaluation of the effects of cabergoline (Dostinex) on women with symptomatic myomatous uterus: a randomized trial

Objective Myoma is one of the most common benign tumors of uterus and one of the most common causes of vaginal bleeding in women. The purpose of the present study is to evaluate the effect of dopamine receptor agonist cabergoline on the size of myoma and the amount of bleeding in the women with myoma of the uterus. Study design The study was performed as a single blind randomized clinical trial on the women with symptomatic myoma. The women were randomly assigned in 2 groups. In the case group, 0.5 mg cabergoline was prescribed weekly for three months, and in the control group, nothing was prescribed and the women only had close observation for symptoms. The reduction in symptoms including pelvic pain and duration and amount of uterine bleeding, and the size of myoma, were compared between the 2 groups. Results 51 women finished the study (26 women in the case group and 25 women in the control group). There was no significant difference between the 2 groups according to age, gravidity, parity, history of abortion, having living children, pretreatment hemoglobin, pain and amount of uterine bleeding, uterine size, and the size of myoma. After treatment, hemoglobin levels had dropped in the control group but not in the case group (p = 0.004). On the other hand, pain had also decreased significantly in the case group in comparison with the control group (p = 0.001). Also, the amount of menstrual bleeding (p = 0.004), uterine size (p = 0.001) and the size of the largest myoma (p = 0.013) showed significant reduction in the case group. Conclusion Cabergoline can decrease the amount of bleeding and pain in the cases of myomatous uterus and can be used for the symptomatic women who want to preserve uterus for a certain period of time. � 2016 Elsevier Ireland Lt

Woman�s perceived stress during pregnancy; stressors and pregnancy adverse outcomes

Background: Stress perceived by mothers during pregnancy is dependent on several factors and can lead to adverse pregnancy outcomes threatening mother and child physical and mental health. Objective: The purpose of the present study is measuring perceived stress of pregnant women by 14 items Cohen�s perceived stress scale (PSS), detecting stressors surrounding pregnant women including male partner�s role, intimate violence, socioeconomic situation, etc., as well as investigate the effect of perceived stress on pregnancy adverse outcomes. Method: Two hundred first gravid pregnant women between 18 and 35 years old at post labor ward entered our cross-sectional study. They were asked to fill out the PSS questionnaire and an information gatherer filled out the checklist for exposures and baseline characteristics. Result: Mean ± SD of participants� PSS was 25.5 ± 8.6. Mothers� PSS was significantly higher in group reported father�s verbal aggression against mother (N = 71, 38) (23.7 ± 9 versus 28.2 ± 7.2; p <.001) and father�s physical aggression against mother (N = 28, 15) compared to nonexposed one (24.9 ± 7.7 versus 28.4 ± 8.7; p:.04). Mothers� PSS score was significantly correlated with mothers� satisfaction from both fathers� emotional (r: �0.30, p:.001) and financial support (r: �0.34, p <.001) during pregnancy. Moreover, the mother�s satisfaction from father�s concomitance in prenatal care (PNC) visits was significantly correlated with the mother�s perceived stress (r: 0.24, p:.001). Conclusion: Male partner�s role during pregnancy directly affects the pregnant woman�s perceived stress. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Comparison between two doses of betamethasone administration with 12 hours vs. 24 hours intervals on prevention of respiratory distress syndrome: a randomised trial

The purpose of the present study was to compare the effect of a two-dose administration of betamethasone with 12 hours interval vs. 24 hours interval on neonatal respiratory distress syndrome (RDS). The study was performed as a randomised clinical trial on 201 pregnant women with a gestational age of 26�34 weeks. In one group 12 mg of betamethasone every 12 hours for two doses and in the other group 12 mg of betamethasone every 24 hours for two doses were prescribed intramuscularly. There were no significant differences between the two groups according to maternal age, parity, gravidity, BMI, neonatal sex, need to surfactant, NICU admission, NICU stay, neonatal death, neonatal sepsis and Apgar score at minutes 1 and 5, but the gestational age at the beginning of the study and delivery receiving complete course of betamethasone and neonatal weight were lower in 24 hours group. RDS, necrotising enterocolitis, intra-ventricular haemorrhage and chorioamnionitis were more in the 24 hours� group. Multiple regression analysis showed that RDS and IVH (p =.022, RR = 0.07, CI95 0.006�0.96 and p =.013; RR = 0.9, CI95 0.1�0.89, respectively) were more in the 24 hours group and neonatal death (p =.034, RR = 4.7, CI95 1.07�16.2) and NEC (p = 0.038, RR = 2.5, CI95 1.7�3.7), were more in the 12 hours group. In conclusion, it seems that 12 hours interval betamethasone therapy may be considered as an alternative treatment in the case of preterm labour for acceleration of lung maturity; however, it is suggested that more studies should be performed on this issue and various morbidities.IMPACT STATEMENTWhat is already known on this subject: Administration of a single course of corticosteroids in all women with a gestational age of 24�34 weeks of pregnancy who are at risk for preterm labour and delivery has been recommended. The accepted regimen by National Institutes of Health (NIH) is an injection of betamethasone for two doses with 24 hours interval. What do the results of this study add: Twelve hours interval betamethasone therapy may be considered as an alternative treatment in the cases of preterm labour for acceleration of lung maturity. What are the implications of these findings for clinical practice and/or further research: Prescription of two doses (complete regimen) is more important than the interval between two doses for obtaining the maximum effect in a preterm birth. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group

A qualitative assessment of the sexual-health education, training and service needs of young adults in Tehran

BACKGROUND: Sexual Health and Relationships Education (SHRE) provides individuals with knowledge and skills to manage risky behaviors and take informed decisions to protect themselves against STIs, and unintended pregnancy. Only minimal SHRE is provided in Iranian schools and universities and previous research has highlighted needs and demands for improved SHRE and sexual services in Iran. This study explored young, Iranian adults’ experience of, and need for sexual health education, sexual skills training and sexual healthcare services, as well their views on how to augment and improve existing provision. DESIGN AND METHODS: Semi-structured interviews were conducted with a sample of 25 young adults who lived in Tehran, Iran and had volunteered to participate in the study. Transcripts were analyzed using thematic analysis. RESULTS: Participants explained their needs and demands for sexual health education and sexual healthcare. They unanimously expressed their dissatisfaction with available SHRE and sexual health care provision. They highlighted barriers to gaining sexual health information and seeking advice and healthcare, including a lack of reliable resources, taboo and cultural barriers, lack of trust and protected confidentiality. This has resulted in ambiguities and misconceptions, including those regarding the cause and transmission of STIs and correct use of contraceptives. Participants recommended improvements, including holding mixed-gender extracurricular workshops with a comprehensive approach to sexual health and relationships education. CONCLUSIONS: There is a clear need and demand for provision of relevant and reliable sexual health and relationships education for young adults in Tehran. This should be addressed to empower young people to make informed choices and avoid risky sexual behavior. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11371-x