Does transcutaneous electrical nerve stimulation reduce the laparoscopic related shoulder pain?

Objective Although laparoscopic surgery is a good substitute for laparotomy in reducing postsurgical pain, many patients complain of shoulder pain after laparoscopic surgery and require pain-relief. Post-operative pain management leads to increased patient satisfaction. Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological, non-invasive modality that reduces pain by activating the descending inhibitory systems in the central nervous system. Given the importance of decreasing shoulder pain after gynecological laparoscopy, the current study aimed to investigate the management of shoulder pain in these patients using TENS. Methods This was a retrospective case-control study. A total of 112 women aged 18–45 years who experienced shoulder pain due to gynecologic laparoscopic surgery were included in the study. Patients were divided into TENS and control groups. In the TENS group, TENS was used twice for 20 minutes each, but in the control group, the patients received regular treatment. Patients were evaluated at intervals of 2, 4, 8, 24, 48, and 72 hours after laparoscopy for shoulder pain score. Results The results showed a significant decrease in visual analog scale scores at 2, 4, and 8-hour in the TENS group compared with the control group. At 24 hours evaluation, although the pain was reduced, the difference was not significant. At 48- and 72-hour assessment, all patients in each group reported zero score for severity of pain. Conclusion The findings suggest that TENS significantly reduces postoperative shoulder pain

Royan Institute First Attempts: Autotransplantation of Vitrified Human Ovarian Tissue in Cancer Patients

Today, timely diagnosis and therapeutic progress open a road of hope for survival in cancerous patients. Increasedknowledge about the various cytotoxic treatment's impacts on ovarian function and fertility has resulted in a surgein the number of patients seeking to preserve their fertility before starting the anti-cancer treatment process. In thisregard, embryo cryopreservation can be recommended for fertility preservation when the woman is married and hasadequate time for ovarian stimulation. If patients are prepubertal girls or not married women, oocytes or ovarian tissuecan be frozen instead to be used in the future. In this regard, the first attempts for ovarian tissue transplantations wereconducted in 2016 and in 2019 for two cancerous patients whose ovarian tissue was cryopreserved in the RoyanHuman Ovarian Tissue Bank (Tehran, Iran). Unfortunately, the transplantations did not result in a live birth

Increased risk of endometriosis by long term exposure to xenoestrogens: A case control study in Iranian women

Aims of the study: Endometriosis is a prevalent gynecologic disorder in young women at reproductive age but the underlying risk factors have not identified yet in Iran and other neighboring countries. Persistent exposure to environmental endocrine disrupting chemicals (EDCs) in particular dioxins, PAHs and polychlorinated biphenyls (PCBs) with xenoestrogenic potentials have been hypothesized in the etiopathogenesis of endometriosis .We aimed in the present study to investigate the joint effects of endogenous and exogenous sources of estrogens on the incidence of endometriosis in Iranian women who born and lived in Tehran .Methods: The age matched study population consisted of 34 women with endometriosis and 100 healthy women who underwent surgery from March 2009 to March 2012 . Results: Out of evaluated exogenous sources of estrogen exposure, living near xenoestrogen producing factories (p<0.001*, OR= 16.8, CI 95%5-56.8) in women with lower economical status (p= 0.001, OR=8.29 Cl95%, 3.37-20.37) was identified as the most important risk factor of endometriosis. The prevalence of this phenomenon was higher in women with histories of malignancy in their first degree family (P=0.014, OR=3.08, CI95% 1.23-8.53), infertility (p<0.001, OR=13.07, Cl95%, 5.14-33.23), hormonal dysregulations (p=0.003, OR=8.38, CI95%, 2.03-34.61) and bipolar disorders (p=0.046, OR=3.44, CI95%, 1.11-10.68). Conclusion: Incidence and development of endometriosis is dependent on long term exposure to environmental xenoestrogens especially in women with lower economical status which may affect the endogenous levels of estrogen in women with background factors

Treatment of Ovarian Hyperstimulation Syndrome in a Mouse Model by Cannabidiol, an Angiogenesis Pathway Inhibitor

Studies suggest that ovarian hyperstimulation syndrome (OHSS) can be treated by reducing the level of vascular endothelial growth factor (VEGF). However, due to the side effects of commercially available VEGF-reducing drugs, they can be ruled out as a suitable treatment for OHSS; therefore, researchers are looking for new medications to treat OHSS. This study is aimed at investigating the effects of cannabidiol (CBD) in an OHSS model and to evaluate its efficacy in modulating the angiogenesis pathway and VEGF gene expression. For this purpose, 32 female mice were randomly divided into four groups (eight mice per group): control group, group 2 with OHSS induction, group 3 receiving 32 nmol of dimethyl sulfoxide after OHSS induction, and group 4 receiving 30 mg/kg of CBD after OHSS induction. The animals’ body weight, ovarian weight, vascular permeability (VP), and ovarian follicle count were measured, and the levels of VEGF gene and protein expression in the peritoneal fluid were assessed. Based on the results, CBD decreased the body and ovarian weights, VP, and corpus luteum number compared to the OHSS group (p<0.05). The peritoneal VEGF gene and protein expression levels reduced in the CBD group compared to the OHSS group (p<0.05). Also, CBD caused OHSS alleviation by suppressing VEGF expression and VP. Overall, CBD downregulated VEGF gene expression and improved VP in OHSS

The Diagnostic Accuracy of Combined Enolase/Cr, CA125, and CA19-9 in the Detection of Endometriosis

Background. The present study was designed to verify the accuracy of the noninvasive biomarkers enolase/Cr, CA125, and CA19-9 as a clinical diagnostic tool for the detection of endometriosis. Methods. A cross-sectional study was performed at Rasool-e-Akram Hospital affiliated to Iran University of Medical Sciences, Tehran, Iran, from April 2015 to April 2018. Eighty-six women were scheduled to undergo laparoscopy due to chronic pelvic pain, infertility, pelvic mass, and abnormal uterine bleeding. Serum and urine samples of all patients were collected preoperatively. Serum levels of CA125 and CA19-9, and urine levels of enolase-1 were measured. Serum levels of CA125 and CA19-9 were determined by the electrochemiluminescence method (ECL). Urinary enolase-1 was measured by the ELISA method. Result. Serum levels of CA125 and CA19-9 were significantly higher in the endometriosis group than in controls (p<0.001, p=0.004, respectively). Levels of enolase I and enolase/Cr were higher in patients with endometriosis, but the differences were not statistically significant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of combined enolase/Cr, CA125, and CA19-9 were 65%, 66.6%, 71%, and 60.1%, respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of combined enolase/Cr, CA125, and CA19-9 was 1.94 and 0.52, respectively. The area under the ROC curve for enolase/Cr+CA125+CA19−9 was 0.675 (95% confidence interval 0.573-0.710). Conclusion. The present study revealed that concurrent measurement of enolase-1, CA125, and CA19-9 might be a valuable noninvasive test for the identification of endometriosis