The Effect of the CO2 Fractional Laser or Premarin Vaginal Cream on Improving Sexual Function in Menopausal Women: A Randomized Controlled Trial

Introduction:Sexual dysfunction is a complex problem in postmenopausal women with a prevalence rate of 68 - 86 %. This study aimed to evaluate the effect of a fractional CO2 laser or vaginal cream on the improvement of sexual function in menopausal women. Methods:This is a two-group clinical trial study.   Postmenopausal women with the inclusion criterion were enrolled and randomly divided into two groups of intervention (n=25) and control group (n=25). In the intervention group, the CO2 laser therapy was performed every month for three months, and in the control group, Premarin vaginal cream was applied (0.625 mg  )، 1 gr, three nights a week for 3 months. Vaginal Health Index scoring( VHI)  and Female Sexual Function Index( FSFI) questionnaires were completed before and after three months of treatment.Results:The effects of the laser treatment was greater than the Premarin group with respect to improvement in sexual desire, orgasms, sexual satisfaction, less pain during sexual relations, and overall sexual function. ( P<0.05)Conclusion:It seems that the fractional CO2 laser may be more effective than hormonal therapy in improving sexual function in postmenopausal women

The prophylactic effect of date palm (Phoenix dactylifera L.) fruit extract on testicular toxicity induced by formaldehyde: An experimental study

Background: Formaldehyde (FA) is one of the most widely used materials in industries and in sciences. Prolonged contact with FA might have harmful effects on fertility due to the increase in the reactive oxygen species level. On the other hand, date palm (Phoenix Dactilifera L.) fruit extract (DPFE) contains a high concentration of natural antioxidants that could scavenge free radicals. Objective: The aim was to investigate the prophylactic effects of DPFE, with strong antioxidant properties, on FA-induced testicular toxicity in male mice. Materials and Methods: Thirty-two adult NMRI male mice with a weight range of 25- 35 gr (9-10 wk old) were randomly divided into four groups: control group (distilled water, orally for 35 days), FA group (FA; 0.25 mg/kg intraperitoneally (i.p.) for 20 days), treatment group (Date (DT) + FA; DPFE, 4 mg/kg for 35 days followed by FA administration, 0.25 mg/kg, i.p., for 20 days), date fruit extract group (DT; DPFE, 4 mg/kg, orally for 35 days). After this, blood was collected and left epididymis and testis tissues were isolated to evaluate the sperm parameters and histological examination, respectively. Results: The FA administration increased the sperm morphological anomalies and reduced the sperm count, viability and motility, and also testosterone compared to the control group (p ≤ 0.001). In addition, histological studies of the testes showed that FA causes changes in the testis seminiferous tubules such as destruction of germinal epithelium and vacuolization of the tubules. The DPFE consumption before FA administration could partially ameliorate the reduced testosterone, sperm, and testicular parameters due to FA. Conclusion: The DPFE use might have discount effects on FA-induced testicular toxicity. Key words: Formaldehyde, Date fruit, Testis, Toxicity, Sperm, Testosterone

Effects of Melatonin Supplementation on Hormonal, Inflammatory, Genetic, and Oxidative Stress Parameters in Women With Polycystic Ovary Syndrome

Purpose: The aim of the current study was to evaluate the effect of melatonin administration on clinical, hormonal, inflammatory, and genetic parameters in women with polycystic ovarian syndrome (PCOS).Methods: The present randomized, double-blinded, placebo-controlled clinical trial was conducted among 56 patients with PCOS, aged 18–40 years old. Subjects were randomly allocated to take either 5 mg melatonin supplements (n = 28) or placebo (n = 28) twice a day for 12 weeks.Results: Melatonin administration significantly reduced hirsutism (β −0.47; 95% CI, −0.86, −0.09; P = 0.01), serum total testosterone (β −0.11 ng/mL; 95% CI, −0.21, −0.02; P = 0.01), high-sensitivity C-reactive protein (hs-CRP) (β −0.61 mg/L; 95% CI, −0.95, −0.26; P = 0.001), and plasma malondialdehyde (MDA) levels (β −0.25 μmol/L; 95% CI, −0.38, −0.11; P < 0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (β 106.07 mmol/L; 95% CI, 62.87, 149.28; P < 0.001) and total glutathione (GSH) (β 81.05 μmol/L; 95% CI, 36.08, 126.03; P = 0.001) compared with the placebo. Moreover, melatonin supplementation downregulated gene expression of interleukin-1 (IL-1) (P = 0.03) and tumor necrosis factor alpha (TNF-α) (P = 0.01) compared with the placebo.Conclusions: Overall, melatonin administration for 12 weeks to women with PCOS significantly reduced hirsutism, total testosterone, hs-CRP, and MDA, while increasing TAC and GSH levels. In addition, melatonin administration reduced gene expression of IL-1 and TNF-α.Clinical Trial Registration:www.irct.ir, identifier IRCT2017082733941N9, Available online at: https://www.irct.ir/trial/2605

Effect of Adding Human Chorionic Gonadotropin to The Endometrial Preparation Protocol in Frozen Embryo Transfer Cycles

Background: Human chorionic gonadotropin (HCG), one of the initial embryonic signals, isprobably a major regulator of the embryo-endometrial relationship. This study aims to assess theadvantage of HCG supplementation during the secretory phase of hormonally prepared cycles forthe transfer of cryopreserved-thawed embryos.Materials and Methods: This study was a randomized clinical trial. Infertile women who werecandidates for frozen-thawed embryo transfers entered the study and were divided into two groups,HCG and control. The endometrial preparation method was similar in both groups: all women receivedestradiol valerate (6 mg) po per day from the second day of the menstrual cycle and progesteronein oil (100 mg) intramuscular (I.M.) when the endometrial thickness reached 8 mm. Estradiol andprogesterone were continued until the tenth week of gestation. In the HCG group, patients received anHCG 5000 IU injection on the first day of progesterone administration and the day of embryo transfer.Results: In this study, 130 couples participated: 65 in the HCG group and 65 in the control group.There was no statistically significant difference between groups regarding basic characteristics.Implantation rate, chemical pregnancy, clinical pregnancy, ongoing pregnancy, and abortion rateswere similar in both groups.Conclusion: Although HCG has some advantages in assisted reproductive technology (ART)cycles, our study did not show any benefit of HCG supplementation during the secretory phase offrozen cycles (Registration Number: IRCT201107266420N4)

Vaginal Symptoms after Reconstructive Surgery for Prolapsed Pelvic Organ

Objective: Pelvic organ prolapse is a common disorder in women over the world and its general treatment is surgery. Therefore it is important to consider if vaginal symptoms, quality of life and sexual function after surgery improve. The purpose of this study was to assess vaginal symptoms in women 3 months after surgery for pelvic organ prolapse. Materials and methods: In this study 50 eligible women were evaluated between March 2007 and May 2008. These women underwent physical examination for prolapse staging and medical status and completed the ICIQ–VS questionnaire pre– and post operation 3 months later). Results: Mean age was 44.86 (31–74) years and %72 were premenopausal. Vaginal symptoms, sexual function and quality of life scores improved in order (8.88 Vs 18.04, 17.16 Vs 34.48, 2.76 Vs 4.8, all P<0.05). Conclusion: Vaginal symptoms, sexual function and quality of life after surgery improved. It appears that in Iranian patients, the performance of reconstruction surgery alone results in satisfaction

Posterior Intravaginal Slingplasty for Vaginal Prolapse

Objective: Urogynecologists are constantly looking for simple, safe and effective ways to cure vaginal apex prolapse. The aim of this study was to evaluate the results of posterior intravaginal slingplasty (PIVS). Materials and methods: A total of 38 patients with advanced vaginal apical prolapse underwent posterior intravaginal slingplasty in Vali-e-Asr hospital in Tehran. In this clinical trial (before-after study), demographic, pre-operative, operative details and post-operative follow-up data were collected for all patients. The data were analyzed using SPSS software and Mac Nemar test.  P<0.05 was considered for statistical significance. Results: The mean for patients' age was 67 (50-81) years, for operation time was 35 (25-45) minutes and for blood loss was 125 (70-300) ml. No intraoperative rectal perforation was observed and there was a significant difference in patients' symptoms such as pelvic pain, nocturia, urgency and urinary tract infection before and after the surgery (p < 0.001). Conclusion: PIVS had similar efficacy with other studies in the treatment of vaginal vault prolapse. The procedure reduces the complication rate and shortens the rehabilitation period with a satisfying result

High Transverse Vaginal Septum with Vaginal and Cervical Agenesis in a 13-Year-Old Female: A Case Report

Background & aim: A vaginal septum is a condition in which the wall of the tissue dividing vagina does not resolve completely. This complication can be transverse and longitudinal. Although the occurrence of a transverse vaginal septum is 2 per 100,000 births, the exact etiology of this anomaly remains still unidentified. In this study, a case of high transverse vaginal septum with vaginal and cervical agenesis is reported.Case report: A 13-year-old single and virgin girl presented with cyclic abdominal pain. On examination and magnetic resonance imaging, vaginal and cervical agenesis was diagnosed. Surgical therapy included an incision in the lower part of the uterus at the site of the bulging and the use of a hysterometer passing down the uterus. The cervix was not touched, cervical agenesis was diagnosed, and the patient underwent abdominal hysterectomy and bilateral tubal salpingectomy. The pathological results confirmed the cervical agenesis.Conclusion: It is recommended that in patients with high transverse vaginal septum, hysterectomy be performed for the treatment of cervical and vaginal agenesis. However, it may not be a suitable treatment choice for some cases, and it is better to decide based on the patient's condition

Inter-relationships between inflammatory biomarkers and severity of angiographically verified coronary artery occlusion

Background and Aim: Growing clinical evidence suggests that inflammation is the hallmark of the initiation, progression and extent of occlusion by atherosclerosis plaques, but biochemical data are still controversial. The aim of the present cross-sectional investigation was to evaluate the relationship between the severity of coronary artery occlusion (CAO), serum amyloid A (SAA), and interleukin -6 (IL-6) Materials and Methods: The subjects assessed were165 having stable coronary artery disease, but without left main artery lesion. Angiographic examination revealed that 37 subjects had minimal CAO (control group), 41 one CAO, 41 two CAO , and 47 three CAO. The Subjects’ SAA and IL-6 were assessed by means of ELISA.The level of fibrinogen was estimated using coaglumetry. The obtained data was analysed by means of SPSS (v: 13). Results: Fibrinogen concentrations were significantly higher in subjects with 1, 2 or 3 CAO compared to the controls. SAA levels in the subjects were higher than those in the controls, but the differences were not statistically significant. On the other hand, IL6- concentrations in patients with a varying degree of CAO were similar but slightly lower than those in the controls. Significant correlations were distinguished between SAA, IL-6, and fibrinogen in the patients as a whole (p=0.05). Fibrinogen levels in the patients were significantly correlated with HDL and LDL. Conclusion: It was found that fibrinogen estimation is .superior to IL-6 and SAA in examining the interrelationship between inflammation and progression of CAO

Posterior Tibial Nerve Stimulation for Treating Neurologic Bladder in Women: a Randomized Clinical Trial

Overactive bladder (OAB) is a disabling disorder. Treatment of cases with OAB includes behavioral, pharmacological, surgical interventions and peripheral electrical stimulation. The goal of this study was to determine effects of posterior tibial nerve stimulation on sexual function and pelvic disorders in women with Overactive bladder (OAB). Fifty women were randomly assigned to PTNS (posterior tibial nerve stimulation) plus tolterodine or tolterodine alone treatment. Tolterodine group received 4 mg tolterodine daily for three months while the other group received this treatment plus percutaneous tibial nerve stimulation for 12 consequence weeks. Two in PTNS group and 8 in the control group withdrew from the study. Age, education level, and occupation status were not significantly different between two groups. Mean total FSFI and its subscales were not significantly different before and after treatment between two groups. Urine leakage associated with a feeling of urgency and loss of stool or gas from the rectum beyond patient's control became significantly different after treatment between two groups. Posterior tibial nerve stimulation could help urinary problems in women with a neurologic bladder