[Comparing carotid intima-media thicknessin women with and without gestational diabetes mellitus]

Background and Aims: Women with history of gestational diabetes mellitus [GDM] are at risk for developing cardiovascular disease and metabolic syndrome. Carotid intima-media thickness [CIMT] is noninvasive marker of sub clinical atherosclerosis assessment. The aim of the present study was to assess relationship between GDM and increased CIMT

Methods: Twenty women with previous history of GDM and twenty women without it [as a control group] were included in the study. Two groups were matched based on their age, body mass index [BMI] and parity. CIMT was measured one year after delivery in two groups by B-mode sonography and compared with ultrasonic results of CIMT in mid- and late-gestational periods

Results: CIMT in both groups increased in gestational period and decreased after delivery and this diminution was significant at late-gestational period in both groups and also significant at mid-gestational period in women with history of GDM

Conclusion: CIMT was significantly decreased one year after delivery in women with GDM

[Frequency of dysplastic and cancerous Pap smear and genotyping of human papillomavirus by DNA probe techniques in Kerman, Iran]

Around the world, cervical cancer is the second most common cancer in women. Today, screening programs have reduced morbidity and mortality rates of this disease. Epidemiological and molecular studies have shown that certain types of the human papillomavirus are carcinogen types and the primary cause of cervical cancer. HPV type 16 and 18 are the most common high-risk types. In this study, frequency of different HPV genotypes in women who referred for a routine visit to an outpatient clinic of Kerman University of Medical Sciences, Iran, has been obtained by DNA probe technique. Our study is a cross-sectional, analytic study on 20000 Pap smear samples over four consecutive years among women in reproductive ages [15-50 years] referred to University centers and private institutions in Kerman, Iran. All samples were collected in the laboratory of Afzalipour, and Bahonar Hospitals, and private institutions. The typical samples of dysplasia and cancer were reviewed by two pathologists and a pathology assistant according to the World Health Organization standards. The samples were examined after DNA extraction and molecular DNA probe technique. 62 cases of 82 Pap smear samples were dysplastic and 20 samples were diagnosed as squamous cell carcinoma [SCC]. Moreover, 20 cases [32.2%] of dysplastic Pap smears and 12 cases [60%] of SCC samples were HPV positive. A total of 32 patients [39%] were positive for HPV. Of all samples only two were genotype 18 [25.6%], one was a mixture of 16 and 31 genotypes, and the remaining were all genotype 16 [93.75%]. In the comparison between dysplasia severity [mild, moderate, and severe] and the HPV status [+ or -], and also the relation between age and status of HPV and the severity of dysplasia no relations were found. However, there was a significant relation between detection [dysplasia, SCC] and the HPV status, and also the relation between age and type of lesion diagnosis. Based on the findings of our study and the Iranian culture, prevalence of HPV infection among women with cervical cancer is less common than in other countries. HPV type 16, which is a carcinogenic genotype, was the predominant genotype

[Comparison of the eficacy of intravenous magnesium sulfate and oral indomethcin in the management of preterm Labor]

Preterm labor is often resulted in preterm births and increased rate of neonatal morbidity and mortality. Treatment consists of bedrest, hydration, pharmacologic interventions, and combinations of these. The purpose of this study was to compare the efficacy of intravenous magnesium sulfate [MgSO4] and indomethacin in the treatment of preterm labor pains. Neonatal and maternal side effects of each method were also studied. A total of 120 women between 26 and 31 weeks' gestation admitted due to preterm labor were randomized to receive either MgSO4 [n=60] or oral indomethacin [n=60]. All women received betamethasone and prophylactic antibiotics. Data were analyzed using student t-test and 2. The two groups had no significant difference in mean gestational age and cervical dilation and effacement at enrollment. The gestational age at delivery was similar in both groups [p=0.279]. Delivery was delayed for more than 48 hours in 81% of subjects in MgSO4 group and in 87% of subjects in the indomethacin group [P=0.298]. Neonatal birth weight, type of delivery, recurrent preterm labor pain and mean time to suppress the contractions were similar in both groups. No serious side effect was seen in the two groups. Conlusion: Acute tocolysis by either IV MgSO4 or oral indomethacin can delay preterm birth for 48 hours, provide the critical period of steroid effect, arrest an episode of preterm labor, and consequently delays delivery and improves neonatal outcomes. It is therefore necessary that all Obstetricians remain up-to-date regarding the efficacy, indications, contraindications, and side effects of all tocolytics

[ prevalence rate of congenital hypothyroidism in Kerman/Iran in 2005-2007]

Congenital hypothyroidism [C.H] is one of the most common infants' endocrine diseases and the cause of mental retardation in newborns. This study was performed to determine the prevalence of C.H and it's relation with neonatal's sex, birth weight and height and mothers' age, gestational age, parents' educational level, past medical history of thyroid disease in mother and family and consumption of Iodine salt by mother. A Total of 3000 neonates aged 2-5 days were screened from November 2005 to July 2006. Specimen collection and transportation to lab were performed according to NCCLS and Wisconsin newborn screening program guidelines. Thyroid stimulating Hormone [TSH] concentration in dried blood spot was determined quantitatively using ELISA technique. From 3000 neonates, 23 cases [0.8%] had TSH >/= 20 mIU/L that were recalled for verification of C.H. Of them, 13 cases [56%] were male and 10 cases [44%] were female. All of 23 infants were detected during 1-2 months after birth and 3 of them had serum TSH >/= 10 mIU/L. According to the protocol of kit they were considered as hypothyroidism cases and were referred for treatment. Considering the importance of congenital hypothyroidism in mental retardation, neonatal screening programs are of high importance. In this study, the prevalence of the disease was 1 in 1000 that is more than that in developed countries. Therefore, it should be considered as one of the hygienic priorities in our country

[Seroepidemiology of human cytomegalovirus in pregnant women and their neonates in kerman city during 2005]

Human Cytomegalovirus [HCMV] or Human Herpes Virus Type-5[HHV-5] is a member of herpesviridae placed in subtype beta herpesvirinae. CMV is a ubiquitous pathogenic virus and can infect humans all through their life. Prevalence of CMV infection in developed countries is about 45% and in developing countries it varies up to 100%. CMV infection during pregnancy is very important, because it can threat life of both mother and her fetus, and it can cause congenital defects. Maternal infection is a determining factor in neonatal infection. The present study was conducted to determine the prevalence rate of CMV infection as well as the relationship between underlying factors of this infection in women and their neonates in Kerman. ELISA technique and Diagnostic Kits [EIA WELL, Rome, Italy] were used to determine the seroprevalence of 794 samples [397 maternal, 397 neonatal] collected from 5 delivery centers in Kerman. The frequency distributions of maternal primary infection, secondary infection, immune mothers and seronegative cases were respectively 0.76% [3 cases], 32.24% [128 cases], 59.7% [237 cases] and 7.3% [29 cases]. Seroprevalence rate for CMV-IgG and CMV-IgM of mothers were respectively, 33.8% [134 cases] and 91.94% [365 cases]. No significant relationship was found between CMV infection and factors of mother's age and occupation, husband's occupation, number of children, parity, family income, previous history of abortion, pervious history of blood transfusion and organ transplant, febrile disease during pregnancy and place of residency; however, mother's educational level showed a significant relation [P=0.38]. Due to high prevalence rate of CMV found in this study, further studies about the diagnosis, epidemiology and detection of CMV primary infections in mothers and their neonates, are highly recommended

[ comparison of total protein, albumin and phosphorus level in preeclamptic pregnant women and women with normal pregnancy]

Preeclampsia has remained one of the important obstetrical problems for which different factors have been suggested. Decrease of serum levels of albumin, total protein and phosphorous have been suggested in the pathophysiology of preeclampsia. The aim of this study was to determine serum levels of Albumin, total protein and phosphorous in normal pregnancy and preeclamptic women. In this case-control study, 100 pregnant women aged 20 to 30 years with the gestational age of 28 to 40 weeks were studied. Patients were divided into two groups: 50 women as case group [preeclampsia] and 50 women as control group [normal pregnancy]. The serum levels of Albumin, total protein and phosphorous were measured in both groups. There were no significant difference between two groups in demographic factors and mean maternal age but duration of pregnancy was significantly different in the two groups [36.29 +/- 3.2 weeks in case group and 38.19 +/- 2.5 in control group] [P<0.0001]. The mean systolic and diastolic blood pressurse and body mass index were significantly different in both groups [P<0.0001]. The mean systolic blood pressure in preeclamptic women was 149.8 +/- 13.39 and in normal group was 108.7 +/- 9.73 and the mean diastolic blood pressure in preeclamptic women was 95 +/- 8.57 and in normal group was 67.4 +/- 10.72. Body mass index was 22.84 +/- 2.07 in preeclamptic women and in normal pregnants was 21.21 +/- 2.09. There was no significant difference between the two groups in mean serum levels of albumin, total protein and phosphorous. Serum Albumin in preeclamptic women was 4.12 +/- 0.45 and in women with normal pregnancy was 4.26 +/- 0.57. Serum level of total protein was 5.95 +/- 1 and 6.03 +/- 0.92 and serum phosphorous was 3.53 +/- 0.68 and 3.35 +/- 0.82 in preeclamptics and normals respectively. There was no significant relationship serum between levels of Albumin, total protein and phosphorous and preeclampsia

[ comparison of total and ionisedserum calcium level in preeclamptic pregnant women and the women with normal pregnancy]

Preeclampsia remains one of the important obstetrical problems and changes calcium metabolism and low dietary calcium intake has been suggested in the pathophisiology of preeclampsia. The aim of this project was to determine the total and ionized calcium level in normal pregnancy and preeclamptic women.This case control study included 100 pregnant women, 20 to 30 years who were 28 to 40 weeks pregnant. Patients were divided into two groups, 50 women as case group [preeclampsia] and 50 women as control group [normal pregnancy]. The serum total and ionized calcium were measured in both groups.There were no significant differences between two groups in demographic factors. Duration of pregnancy was significantly different in two groups [36.29 +/- 3.2 weeks in case group and 38.19 +/- 2.5 in control group][p<0001]. The mean systolic and diastolic blood pressure and body mass index were significantly different in both group [p<0001]. The mean systolic blood pressure in preeclamptic women was 149.8 +/- 13.39 and in normal group was 108.7 +/- 9.73 and the mean diastolic blood pressure in preeclamptic women was 95 +/- 8.57 and in normal group was 67.4 +/- 10.72, body mass index was 22.84 +/- 2.07 in preeclamptic women and in normal pregnancy was 21.21 +/- 2.09. There was no significant differences between the two groups in mean serum level of total and ionized calcium [total calcium in preeclamptic women was 9.95 +/- 1.28 and in normotensive women was 10.13 +/- 1.11]Ionized calcium was 4.7 +/- 0.29 vs. 4.5510.54.There was no significant differences in serum total and ionized calcium between preeclampticand normotensive pregnant women

[relationship between maternal perception of decreased fetal movements and rate of fetal complications during delivery]

The maternal perception of fetal movements at term has been used as an evaluative test of fetalwellbeing since the last 30 years, but there are different reports about its value. The aim of this study wasevaluation of decreased fetal movement and relation to situation of fetus in uterus. It is significant that weunderstand the relationship between decreased fetal movement and increased fetal distress, heart decelerationand meconium.This study was carried out from 2000-2001 in Kerman Bahonar hospital. The method was a casecontrol one with 100 cases and 100 controls. Cases and controls were selected from pregnant women enteringactive phase of labor or induction of labor for causes other than perception of decreased fetal movements. Fetalheart rate was monitored in both groups during labor phase and also, color of amniotic fluid and meconiumduring rupture of membrane was recorded. Type of delivery, Apgar scores at minute 1 and 5, mortality andmorbidity were compared in both groups. In this study, amniotic fluid volume was a significant variable that waspaid special attention.After analysis, there was a significant relationship between decreased fetal movement and manyvariables, for example, gravidity, deceleration of fetal heart, 1[st] and 5[th] minutes apgar score, fetal mortality,type of delivery, amniotic fluid volume and meconium staining.We can conclude that decreased fetal movement is a significant factor in evaluation of fetal wellbeing in near-term ante partum cases