Intrauterine synechiae after myomectomy; Laparotomy versus laparoscopy: non-randomized interventional trial

Leiomyomata is the most frequent gynecological neoplasm. One of the major complications of myomectomy is intrauterine adhesion [synechiae]. To evaluate and compare the rate and severity of synechiae formation after myomectomy by laparotomy and laparoscopy. In this non-randomized interventional trial, hysteroscopy was performed in all married fertile women who had undergone myomectomy [type 3-6 interamural and subserosal fibroids] via laparotomy and laparoscopy in Tehran's Arash Hospital from 2010 to 2013. Three months after the operation, the occurrence rate and severity of intrauterine synechiae, and its relationship with type, number and location of myomas were investigated and compared in both groups. Forty patients [19 laparoscopy and 21 laparotomy cases] were studied. Both groups were similar regarding the size, type [subserosal or intramural], number and location of myoma. The occurrence rate of synechiae in the laparoscopy and laparotomy group was 21% and 19%, respectively; showing no significant difference [p=0.99]. Among all patients, no significant relationship was found between the endometrial opening [p=0.92], location [p=0.14] and type of myoma [p=0.08] with the occurrence rate of synechiae. However, a significant relationship was observed between myoma's size [p=0.01] and the location of the largest myoma with the occurrence of synechiae [p=0.02]. With favorable suturing methods, the outcome of intrauterine synechiae formation after myomectomy, either performed by laparotomy or laparoscopy, is similar. In all cases of myomectomy in reproductive-aged women, postoperative hysteroscopy is highly recommended to better screen intrauterine synechiae

Evaluating success of curettage in the surgical treatment of endometrial polyps

To determine treatment efficacy of curettage on endometrial polyp. The quasi-experimental pre-and-post study was conducted in 2011-12 at the gynaecology department of Imam Reza Hospital, Mashhad, Iran, and comprised patients who underwent hysteroscopy for endometrial polyp. Location, size, number and base condition of the polyps were recorded before the patient underwent curettage. Hysteroscopy was then performed and the condition of the remaining polyps was compared with initial findings. Also, the remaining polyps were resected. SPSS 13 was used for statistical analysis. There were 51 patients in the study with a mean age of 33.14 +/- 8.19 years [range: 23-59 years]. Besides, there were 82 polyps; 38[46.3%] having a narrow base, and 44[53.7%] having a wide base. The mean polyp size was 2.39 +/- 2.63cm.After performing curettage, 23[28.0%] polyps were removed completely, 39[47.6%] had size reduction, and 20[24.4%] had no change in size. Curettage could not significantly remove polyps [p<0.001].Polyps smaller than 2cm were more likely to have been removed compared to the bigger ones [p=0.003].Polyps with wide base were more significantly removed than those with narrow base [p<0.001].Further, those with wide base and also smaller than 2cm were removed more significantly than others [p<0.001].The location of polyps had no effect on removal probability by curettage [p=0.114]. Curettage was not found to be a reliable method for endometrial polyp removal. If hysteroscopy is not accessible, the size of the polyp should be determined by vaginal sonograghy to estimate the probability of its removal by curettage

Effects of magnetized water on ovary, pre-implantation stage endometrial and fallopian tube epithelial cells in mice

Magnetized water has made many improvements in industry, agriculture and medicine. However its utilization in medicine still remains controversial. In this study we aimed to investigate the effects of magnetized water on height of epithelial cells in pre-implantation stage endometrium and fallopian tube and number of corpus lutea in female mice. Eighty female NRMI mice were recruited to this experimental study and randomly divided into two groups: the control group which drank normal water and the experimental [case] group which drank magnetized water for 2 weeks. Super-ovulation was induced in these mice and then they were mated with male mice as well. Samples of ovary, uterus and fallopian tube were obtained at the pre-implantation stage. Then, after preparation, the number of corpus lutea in each ovary was counted and the height of fallopian and endometrial epithelial cells was measured by light microscopy. Data analysis showed a significant increase in the mean number of corpus lutea and the height of epithelial cells in fallopian tube comparing the case with the control group [p=0.01, p=0.002 respectively] whereas uterus epithelial cells of the case group showed insignificant increase in height, in compare with the control group [p=0.052]. Our results suggest that magnetized water intake increases the number of corpus lutea and the height of fallopian tube epithelial cells. Further research is needed to determine whether this will increase in the success rate of fertility

effect of extremely low frequency pulsed electromagnetic field on in vitro fertilization success rate in NMRI mice

The effects of exposure to electromagnetic fields [EMF] on reproduction systems have been widely debated. In this study, we aimed to investigate whether low frequency EMF could ameliorate the in vitro fertilization success rate in Naval medical research institute [NMRI] Mice. In this randomized comparative animal study, ten NMRI mice were randomly divided into 2 equal groups [control and experimental].10 IU of human chorionic gonadotropin [hCG] was injected intraperitoneally to both groups in order to stimulate ovulating, and ovums were then aspirated and kept in KSOM [modified version of sequential simplex optimization medium with a higher K+ concentration] culture medium. Metaphase II ovums were separated, and sperms obtained by "swim out" method were added to metaphase II ovums in the culture medium. The experimental group was exposed to 1.3 millitesla pulsed electromagnetic field at 4 kilohertz frequency for 5 hours. To assess the efficacy, we considered the identification of two-pronuclear zygote [2PN] under microscope as fertilizing criterion. Total number of collected ovums in the control and experimental groups was 191 and 173, respectively, from which 58 [30.05%] and 52 [30.36%] ovums were collected from metaphase II, respectively. In vitro fertilization [IVF] success rate was 77% in extremely low frequency- pulsed electromagnetic field [ELF-PEMF] for exposed group [experimental], whereas the rate was 68% for control group. Despite increased percentile of IVF success rate in exposed group, there was no statistically significant difference between 2 groups, but this hypothesis has still been stated as a question. Further studies with larger sample sizes and different EMF designs are suggested

[Relationship between job stress with menstrual bleeding pattern among midwives]

Job stress can interfere with endocrine function and result in dysfunctional menstrual bleeding patterns. The aim of this study was to assess the relationship between job stress with menstrual bleeding pattern among midwives. In this cross-sectional study, we recruited 150 midwives working in hospitals and health centers of Mashhad using two-stage sampling. Data were collected using a questionnaire including demographic characteristics, Karazek Job Content, a daily diary for menstrual periods to record duration and interval of periods, and the Higham Chart for recording the bleeding amount. The diary was completed for three menstrual periods. Collected data were analyzed using independent t-student, one way ANOVA, Mann-Whitney U, Chi-squared test, correlation test and linear regression in the SPSS-14. The findings showed that 21.3% of the midwives reported mild job stress, 19.3% had moderate stress and 59.3% reported severe job stress. Mean of the duration of the periods was 7.06 days, the mean interval of the periods was 27.9 days and the mean amount of bleeding was 79.72 cc. There was a significant relationship between job stress and the duration and interval of periods [P<0.001]. There was not any significant relationship between job stress with the amount of bleeding. Our study showed that job stress was related to menstrual bleeding patterns among midwives. It is necessary introduce strategies to decrease job stress and provide professional support for midwives