Successful Pregnancy and Delivery after Uterine Rupture in Previous Pregnancy: A Case Report

BACKGROUND AND OBJECTIVE: Uterine rupture in all layers is not only a serious complication of pregnancy but is also associated with maternal and fetal mortality. The usual treatment for uterine rupture is termination of pregnancy, and hysterectomy is necessary in most cases. Successful repair of uterine rupture in all layers is not only uncommon but successful subsequent pregnancy is quite rare. A successful pregnancy is reported in a woman with a history of complete uterine rupture due to intramural pregnancy. CASE REPORT: A 28 – year – old pregnant woman, gravida 4, with a history of two abortions, and one delivery (stillbirth) was admitted to the high-risk pregnancy unit of Ayatollah Rouhani Hospital (Babol, Iran). She had a history of rupture of all layers of the uterus following intramural pregnancy in her third pregnancy, and at that time, she had undergone laparotomy and repair of the uterus. In the fourth pregnancy, due to the history of uterine rupture, she was under prenatal care in high-risk pregnancy unit, and after the onset of contractions at 36 weeks and 2 days, emergency cesarean section was performed for the patient, and the neonate was born with 10/10 APGAR score and a weight of 3000 grams. CONCLUSION: In women who become pregnant after a history of rupture of all layers of the uterus and after the repair of uterine, prenatal and fetal care should be done carefully and cesarean section should be performed immediately after the onset of labor contractions

The Predictive Role of Preoperative Leukocytosis, Anemia and Thrombocytosis with the Severity of Epithelial Ovarian Tumors

BACKGROUND AND OBJECTIVE: Ovarian cancer is the sixth common cancer among women in the world. Preoperative blood cell count can be a biomarker that predicts the severity of different types of cancer and determine the type of surgery. Therefore, the present study was conducted to determine the predictive role of the three blood markers of anemia, leukocytosis and thrombocytosis in the stage and grade of epithelial ovarian cancer before the operation. METHODS: In this cross-sectional study, the data of 60 patients with epithelial ovarian cancer were evaluated. Demographic data, hemoglobin, white blood cell count and platelets were statistically compared based on the stage of disease and the grade of mass differentiation as good, moderate and undifferentiated. FINDINGS: 61.1% of patients with thrombocytosis were in stage 3 and 33.3% of patients with leukocytosis were in stage 2 (p≤0.05), while 20.5% of the patients with anemia were in stage 3 (p>0.05). Moreover, 52.4% of patients with leukocytosis and 61.1% of patients with thrombocytosis had grade 3 tumor (p≤0.05), but only 34.1% of patients with anemia were in this group (p>0.05). Based on the evaluation of the ROC curve, cut-off point of the white blood cell was calculated to be 9050/ml with a sensitivity of 64% and specificity of 65% and platelet count was calculated to be 266000/ml with a sensitivity of 88% and specificity of 53%. CONCLUSION: Based on the results of this study, preoperative leukocytosis and thrombocytosis were correlated with stage and grade of epithelial ovarian cancer and had a predictive role

The Risk Factors for Ectopic Pregnancy

BACKGROUND AND OBJECTIVE: Ectopic pregnancy is a common complication and one of the causes of pregnancy-related deaths. Considering the increased prevalence of ectopic pregnancy in recent years and the increased risk factors such as assisted reproductive treatment, the present study was conducted to investigate the risk factors for ectopic pregnancy in Babol, northern Iran. METHODS: This case-control study was performed on pregnant women who were admitted with suspicion for ectopic pregnancy or acute abdomen within a 6-year period. Patients diagnosed with ectopic pregnancy were selected in the case group and the control group was selected from among the pregnant women's medical record during the same years. Patients were examined in terms of age, parity, history of abortion, type of contraception, history of ectopic pregnancy, history of pelvic infections, history of cesarean section, infertility treatment, history of smoking, marriages within the family, medical history and underlying disease. FINDINGS: In this study, 201 patients were examined in each group. The mean age for the case group was 29.75±5.6 and for the control group was 28.62±6.4 years. Among the risk factors, assisted reproductive treatment (OR=10.24, p≤0.001), abdominal and pelvic surgery (OR=2.35, p=0.002), infertility (p=6.76, p<0.001), contraceptive pills (OR=0.61, p<0.001) and nulliparity (OR = 1.61, p=0.019) were associated with increased risk of ectopic pregnancy. CONCLUSION: According to the results of this study, the most important risk factors for ectopic pregnancy are the use of hormonal pills to prevent pregnancy and nulliparity, respectively

High frequency of SEN virus infection in thalassemic patients and healthy blood donors in Iran

<p>Abstract</p> <p>Background</p> <p>SEN virus is a blood-borne, circular ssDNA virus and possessing nine genotypes (A to I). Among nine genotypes, SENV-D and SENV-H genotypes have the strong link with patients with unknown (none-A to E) hepatitis infections. Infection with blood-borne viruses is the second important cause of death in thalassemic patients. The aim of this study was to determine the frequency of SENV-D and SENV-H genotypes viremia by performing nested-PCR in 120 and 100 sera from healthy blood donors and thalassemic patients in Guilan Province, North of Iran respectively. Also, to explicate a possible role of SEN virus in liver disease and established changes in blood factors, the serum aminotransferases (ALT and AST) and some of the blood factors were measured.</p> <p>Results</p> <p>Frequency of SENV-D, SENV (SENV-H or SENV-D) and co-infection (both SENV-D and SENV-H) viremia was significantly higher among thalassemic patients than healthy individuals. Frequency of SENV-H viremia was significantly higher than SENV-D among healthy individuals. In comparison to SENV-D negative patients, the mean of mean corpuscular hemoglobin was significantly higher in SENV-D positive and co-infection cases (<it>P </it>< 0.05). The means of AST and ALT were significantly higher in thalassemic patients than healthy blood donors, but there were not any significant differences in the means of the liver levels between SENV-positive and -negative individuals in healthy blood donors and thalassemic patients. High nucleotide homology observed among PCR amplicon's sequences in healthy blood donors and thalassemic patients.</p> <p>Conclusions</p> <p>The high rate of co-infection shows that different genotypes of SENV have no negative effects on each other. The high frequency of SENV infection among thalassemic patients suggests blood transfusion as main route of transmission. High frequency of SENV infection in healthy individuals indicates that other routes rather than blood transfusion also are important. Frequency of 90.8% of SENV infection among healthy blood donors as well as high nucleotide homology of sequenced amplicons between two groups can probably suggest that healthy blood donors infected by SENV act partly as a source of SENV transmission to the thalassemic patients. In conclusion, SENV-D isolate in Guilan Province may be having a pathogenic agent for thalassemic patients.</p

Bone mineral density in Iranian adolescents and young adults with β-thalassemia major

The authors investigated the prevalence of low bone mass in patients from Tehran, Iran, with β-thalassemia major (n = 203), aged 10-20 years, and the potential risk factors for osteoporosis in this patient population. Prevalence of osteoporosis was 50.7 in lumbar spine, 10.8 in femur, and 7.9 in both regions with no significant difference between the two genders. The following factors were associated with low BMD: height for age and weight for age below 3rd percentile, delayed puberty or hypogonadism, age when Desferal (for iron chelation) was started, duration of Desferal therapy, and serum zinc. Low serum copper and 25(OH)D were not associated with low BMD. Copyright © Informa Healthcare USA, Inc

Multifactorial anticancer effects of digalloyl-resveratrol encompass apoptosis, cell-cycle arrest, and inhibition of lymphendothelial gap formation in vitro

BACKGROUND: Digalloyl-resveratrol (di-GA) is a synthetic compound aimed to combine the biological effects of the plant polyhydroxy phenols gallic acid and resveratrol, which are both radical scavengers and cyclooxygenase inhibitors exhibiting anticancer activity. Their broad spectrum of activities may probably be due to adjacent free hydroxyl groups. METHODS: Protein activation and expression were analysed by western blotting, deoxyribonucleoside triphosphate levels by HPLC, ribonucleotide reductase activity by 14 C-cytidine incorporation into nascent DNA and cell-cycle distribution by FACS. Apoptosis was measured by Hoechst 33258/propidium iodide double staining of nuclear chromatin and the formation of gaps into the lymphendothelial barrier in a three-dimensional co-culture model consisting of MCF-7 tumour cell spheroids and human lymphendothelial monolayers. RESULTS: In HL-60 leukaemia cells, di-GA activated caspase 3 and dose-dependently induced apoptosis. It further inhibited cell-cycle progression in the G1 phase by four different mechanisms: rapid downregulation of cyclin D1, induction of Chk2 with simultaneous downregulation of Cdc25A, induction of the Cdk-inhibitor p21(Cip/Waf) and inhibition of ribonucleotide reductase activity resulting in reduced dCTP and dTTP levels. Furthermore, di-GA inhibited the generation of lymphendothelial gaps by cancer cell spheroid-secreted lipoxygenase metabolites. Lymphendothelial gaps, adjacent to tumour bulks, can be considered as gates facilitating metastatic spread. CONCLUSION: These data show that di-GA exhibits three distinct anticancer activities: induction of apoptosis, cell-cycle arrest and disruption of cancer cell-induced lymphendothelial disintegration. British Journal of Cancer (2010) 102, 1361-1370. doi:10.1038/sj.bjc.6605656 www.bjcancer.com (C) 2010 Cancer Research U

The Comparison of the Risk Factors in the Term and Preterm Delivery

BACKGROUND AND OBJECTIVE: Premature delivery is the presence of progressive uterine contractions before reaching 37 weeks of pregnancy. Since it is associated with perinatal complications and high costs, this study aimed to study the risk factors for premature delivery. METHODS: This cross-sectional study was conducted on 377 pregnant women with preterm labor (23-37 weeks) and 423 pregnant women of term delivery referring to Ayatollah Rohani Hospital of Babol city, Iran. We extracted and investigated the subjects&rsquo; demographic data, history of infertility, smoking habits, use of drugs, fast food consumption, history or presence of maternal illnesses and surgery, Urinary Tract Infections (UTI), Oligohydramnios, intrauterine growth restriction (IUGR), embryonic anomalies, premature rupture of membranes, vaginal bleeding as well as the neonatal data. FINDINGS: As observed in the two groups of preterm and term delivery respectively, there was employment during pregnancy in 83 (22%) and 51 (12%) cases, a history of preterm labor in 41 (10.9%) versus 21 (5%) cases, bleeding during the first trimester in 118 (31.3%) versus 61 (14.4%) cases, fast food consumption in 34 (9%) versus 14 (3.3%) cases, UTI in 150 (39.8%) versus 111 (26.2%) cases, anemia in 62 (16.4%) versus 29 (6.9%) cases, hypertension in 72 (19.1%) versus 13 (3.1%) cases and finally, smoking habits in 22 (5.8%) versus 5 (1.2%) subjects. There was a statistically significant association between the aforementioned variables (p<0.05). CONCLUSION: According to the results of this study, the most significant risk factors for premature delivery could be managed and controlle