accuracy of placental alpha-microglobuline-1 test in diagnosis of premature rupture of the membranes

Premature rupture of membranes [PROM] is a common obstetric issue during pregnancy which might lead to serious fetal or maternal problems. Therefore, an appropriate diagnosis and management of PROM are of significant importance in patients. The aim of this study was to determine the accuracy of placental alpha microglobuline-1 [PAMG-1] test in PROM diagnosis and compare this diagnostic method with other standard tests in diagnosis of PROM. In this prospective diagnostic accuracy study, patients with symptoms of membrane rupture in 16-39 weeks of gestation were involved. Three tests including Fern, Nitrazine and PAMG-1 were performed at the same time. PROM was confirmed in 86 patients out of 100. The sensitivity and specificity were respectively 81.3% and 100% for Fern test, 93% and 92.8% for Nitrazine test, 98.9% and 92.8% for PAMG-1 test. PAMG-1 test showed higher sensitivity [98.9% with p<0.001] and accuracy [98%] compared with conventional tests. Although PAMG-1 showed a lower positive predictive value [PPV] compared to conventional tests such as Fern test [100%], it was shown to be more accurate. The accuracy of PAMG-1 test was superior to both Fern and Nitrazine test in PROM diagnosis

Comparison of 25-hydroxyvitamin D and calcium levels between polycystic ovarian syndrome and normal women

Given the relationship of vitamin D deficiency with insulin resistance syn-drome as the component of polycystic ovary syndrome [PCOS], the main aim of this study was to compare serum level of 25- hydroxyvitamin D [25[OH]D] between PCOS patients and normal individuals. A cross sectional study was conducted to compare 25[OH]D level between117 normal and 125 untreated PCOS cases at our clinic in Arash Hospital, Tehran, Iran, during 2011-2012. The obtained levels of 25[OH]D were classified as follows: lower than 25 nmol/ml as severe deficiency, between 25-49.9 nmol/ml as deficiency, 50-74.9 nmol/ml as insufficiency, and above 75 nmol/ml asnormal. In addition, endocrine and metabolic variables were evaluated. Among PCOS patients, our findings shows 3[2.4%] normal, 7[5.6%] with insufficiency, 33[26.4%] with deficiency and 82[65.6%] with severe deficiency, whereas in normal participants, 5[4.3%] normal, 4[3.4%] with insufficiency, 28[23.9%] with deficiency and 80[68.4%] with severe deficiency. Comparison of 25[OH]D level between two main groups showed no significant differences [p= 0.65]. Also, the calcium and 25[OH]D levels had no significant differences in pa-tients with overweight [p=0.22] and insulin resistance [p=0.64]. But we also found a relationship between 25[OH]D level and metabolic syndrome [p=0.01]. Furthermore, there was a correlation between 25[OH]D and body mass index [BMI] in control group [p=0.01], while the C-reactive protein [CRP] level was predominantly higher in PCOS group [p<0.001]. Although the difference of 25[OH]D level between PCOS and healthy women is not significant, the high prevalence of 25[OH]D deficiency is a real alarm for public health care system and may influence our results

Association of reproductive and menstrual characteristics with mammographic density

Background: Mammographic density has been recognized as a risk factor for breast cancer, but the association between potential effective factors and mammographic density has not been fully studied in Asian women. We conducted a study to investigate the association of mammographic breast density with several menstrual and reproductive characteristics. Methods: Screening mammography was performed in women above 40 years attending the breast clinic of Arash Women's Hospital, Tehran, Iran, for breast cancer screening. The densities were classified by two expert radiologists according to the parenchymal mammographic classification system of the American College of Radiologists. Those with a history of breast cancer or renal disease, recent hormone replacement therapy, or consumption of vitamin D supplements were excluded. Results: Overall, 823 patients were assessed. Mammographic density was associated with higher age at first birth [P < 0.001], lower parity [P < 0.001], BMI [P < 0.001], and premenopausal status [P < 0.001]. However, no associations were observed with age at menarche [P = 0.057] and menstrual pattern [P = 0.973]. Conclusions: Our study showed an association between mammographic density and age, parity, BMI, and age at first birth, and no association with menstrual pattern in terms of regularity and age at menarche. In addition, mammographic density was significantly higher in premenopausal women

α:Non-α and Gγ:Aγ globin chain ratios in thalassemia intermedia patients treated with hydroxyurea

<p><b>OBJECTIVES</b>To elucidate the possible ways by which hydroxyurea molecules affect globin chain (α or β-like) synthesis.</p><p><b>METHODS</b>A total of 23 thalassemia intermedia patients (13 male and 10 female) aged between 5 and 26 years were treated for five months with 15 mg/(kg·day) of hydroxyurea. Hemoglobins electrophoresis and globin chain electrophoresis was performed on each sample at different time points before and during the treatment.</p><p><b>RESULTS</b>Fetal hemoglobin increased significantly in most patients and average episodes of transfusion decreased. Both Gγ and Aγ-globin chains increased significantly and α-globin:Nonα-globin chain as well as Gγ-globin:Aγ globin chains ratios decreased.</p><p><b>CONCLUSIONS</b>Improvement in α:non-α ratio and consequent decrease of free α-globin chain might be the cause of beneficial effects of hydroxyurea therapy. Two patients who felt better didn't show significant increase in their fetal hemoglobin level, and this is in contradiction with the hypothesis claiming that the HbF level increase is the cause of such therapeutic effect. In spite of the unclear mechanism of action of this drug, hydroxyurea therapy had noticeable impacts on thalassemia intermedia and also sickle cell disease and even patients suffering from thalassemia major.</p>

[Common techniques for preserving fertility in girls and young women undergoing cancer treatment]

Current protocols for cancer treatment could lead to the failure of ovarian function and subsequent infertility in women. Therefore, utilizing ways to preserve fertility in these individuals seem to be essential. In this review, the full-text of articles which were accessible and had been published during 1976 to 2009 about different methods of female fertility preservation were collected and studied through various online databases such as PubMed, Science Direct, etc. According to the reviewed articles, there are several methods for fertility preservation in women, including ovarian transposition and oocyte, embryo and ovarian cortex cryopreservation. Ovarian transposition is not useful for preserving fertility in women who undergo chemotherapy. Embryo and oocyte cryopreservations require a delay before starting treatment. Metaphase II oocytes are high-volume and fully-differentiated cells which may sustain injury due to the freezing process restricting the number of collected oocytes and reducing the chances of fertility. On the other hand, ovarian stimulation and oocyte collection are not practical in young patients, especially in underage girls. In addition to the restrictions on the number of collected embryos and the raised legal and ethical issues, embryo crypreservation is limited to adults and married women. In comparison to other methods, cryopreservation of the ovarian cortex seems to be more appropriate as ovarian tissue is resistant to cryopreservation and it is easy to be collected by laprascopy, making it practical for use in premature girls. Furthermore, the large number of follicles in the ovarian tissue increases the chances of fertility preservation in women. In general, several parameters including the type, time and duration of treatment, cancer type, age and marital status determine the efficacy of each method