effect of vitamin E and aspirin on the uterine artery blood flow in women with recurrent abortion: a single-blind randomized controlled trial

Background: Recurrent spontaneous abortion has high incidence rate. The etiology is unknown in 30-40%. However high uterine artery resistance is accounted as one of the recurrent abortion reasons

Objective: The objective of the current study was to determine the impacts of vitamin E and aspirin on the uterine artery blood flow in women having recurrent abortions due to impaired uterine blood flow

Materials and Methods: This randomized clinical trial was conducted on 99 women having uterine pulsatility index [PI] more than 2.5 and the history of more than two times abortions. The candidates were categorized into three groups; receiving aspirin, only vitamin E, and aspirin+vitamin E. After 2 months, uterine PIs were compared with each other

Results: All drug regimens caused an enhancement in uterine perfusion with a significant decline in uterine artery PI value. The women receiving vitamin E in accompanied with aspirin had the least mean PI of the uterine artery [p<0.001]. The total average PI score of the right and left uterine arteries in groups receiving vitamin E in accompanied with aspirin was lower than the two counterparts significantly [p<0.001]

Conclusion: Vitamin E, aspirin and especially their combination are effective in improving uterine artery blood flow in women with recurrent abortion due to impaired uterine blood flow. More well-designed studies are needed to find out whether the enhancement of uterine perfusion may lead to a better pregnancy outcome

role of spiritual attitude in child-rearing in predicting the psychological hardiness of mothers with handicapped children

Objective: Providing care to children who have disability is often a stressful experience, yet spiritual beliefs may help mothers to be patient, tolerant and hard in coping with child-rearing difficulties. This study examined the relationship between the spiritual attitudes of mothers of handicapped children to child-rearing and psychological hardiness

Methods: In a descriptive correlational study, 120 mothers of handicapped children who were referred to the rehabilitation clinics of the University of Social Welfare and Rehabilitation Sciences [Rofeideh, Akhavan and Sina clinics] were selected through purposeful sampling and answered the Sanctification of Parents Scale [SPS], and Personal Views Survey [PVS]. Data were analyzed by SPSS-20 software and statistical procedures including Pearson correlation and multiple regression analysis were used

Results: Results showed that spiritual attitudes to child-rearing are significant predictors of hardiness in mothers

Discussion: It seems like having spiritual attitudes in difficult situations such as providing care for disabled children plays a significant role in mother's patience and hardiness

relation between deterministic thinking and mental health among substance abusers involved in a rehabilitation program

Objective: The current research is to investigate the relation between deterministic thinking and mental health among drug abusers, in which the role of cognitive distortions is considered and clarified by focusing on deterministic thinking

Methods: The present study is descriptive and correlative. All individuals with experience of drug abuse who had been referred to the Shafagh Rehabilitation center [Kahrizak] were considered as the statistical population. 110 individuals who were addicted to drugs [stimulants and Methamphetamine] were selected from this population by purposeful sampling to answer questionnaires about deterministic thinking and general health. For data analysis Pearson coefficient correlation and regression analysis was used

Results: The results showed that there is a positive and significant relationship between deterministic thinking and the lack of mental health at the statistical level [r=%22, P<0.05], which had the closest relation to deterministic thinking among the factors of mental health, such as anxiety and depression. It was found that the two factors of deterministic thinking which function as the strongest variables that predict the lack of mental health are: definitiveness in predicting tragic events and future anticipation

Discussion: It seems that drug abusers suffer from deterministic thinking when they are confronted with difficult situations, so they are more affected by depression and anxiety. This way of thinking may play a major role in impelling or restraining drug addiction

Anti-HLA antibodies and kidney allograft outcomes in recipients with donor bone marrow cell infusion

Anti-HLA-antibodies are known to affect the allograft survival in transplant recipient patients. The aim of this study was to evaluate the association between anti-HLA antibodies and kidney allograft outcomes, particularly in recipients with concurrent donor bone marrow cell infusion [DBMI]. Between June 2006 and May 2007, forty living unrelated donor kidney transplants consisting of 20 recipients with DBMI and 20 without infusion entered into the study and were monitored prospectively for one year. Pre-and post-transplant [days 14, 30, and 90] sera were screened for the presence of anti-HLA class-I and II antibodies, and subsequently positive sera retested with ELISA specific panel for antibody specification. Of 40 patients, 9 [22.5%] experienced acute rejection episodes [ARE] [6/20 cases in non-infused versus 3/20 in DBMI patients]. The prevalence of anti-HLA antibodies before and after transplantation were higher in patients with ARE compared to non-rejecting ones [88.8% vs. 38.7%, p=0.01 and 66.6% vs. 25.8%, p=0.04, respectively]. A total of 10% [4/40] of patients developed donor specific anti-HLA antibodies [DSA] and in this regard 2 patients from the control group experienced ARE. All 3 rejecting patients in DBMI group were negative for DSA and positive for non-DSA. The lower titer of post-transplant anti-HLA antibodies were shown in DBMI patients compared to pre-transplantation titer. Additionally, the average serum creatinine levels during one year follow up and even in those patients with ARE were lower compared to controls. Our findings reveal an association between pre-and post-transplant anti-HLA antibodies, and ARE and also early allograft dysfunction. It suggests that lower incidence of ARE, undetectable DSA, lower titer of antibodies concomitant with a decrease in serum creatinine level, better allograft function and lower percentages of PRA in DBMI patients, could be the probable manifestations of partial hypo-responsiveness against allografts

Evaluation of subtypes of peripheral blood lymphocytes in patients with vitiligo

Vitiligo is characterized with white patches on the skin and alteration of melanocytes in dermoepidermal junction. Autoimmune mechanisms with an underlying genetic predisposition are the most likely causes of vitiligo. This study was performed to evaluate immune disturbance in vitiligo and clarify its more details. A total of 29 vitiligo patients and 21 healthy controls were included in this case control study. Complete blood count was measured and peripheral blood samples were evaluated floweytometrically for surface antigenic markers including CD3, CD4, CD8, CD19, CD16, CD56 and CD25 for determining the percentage and total number of various lymphocyte subgroups. Patients with different clinical subtypes were compared with each other and controls in terms of the flowcytometry results. Obtained information was assessed by SPSS statistical software. Total numbers of CD3+, CD8+ T cells, B cells and CD25+ cells were significantly increased in generalized type vitiligo patients in comparison with localized type. CD25+ cells were also increased significantly in generalized and stable types of vitiligo compared with healthy controls and finally the total number of lymphocytes was significantly decreased in localized type vitiligo patients in comparison with healthy controls.. Our data indicate cellular immune disturbance in vitiligo. Disorders of immune regulatory system may play a major role in this context. Significant CD25+ or regulatory T cells increment in different clinical subtypes of the disease is in favor of the above hypothesis. Later and larger studies may result in new and effective routs of treatment for vitiligo acting through regulating immune system

Treatment of vitiligo with blister grafting technique

Surgical treatments of vitiligo are punch grafting, blister grafting, flip-top transplantation, split skin grafting, etc aiming at rebuilding of melanocytic population in those patients who do not respond to medical treatment The objective of this study was determination of efficacy of blister grafting technique in the treatment of vitiligo. This study was done on 10 patients with vitiligo of face and /or distal extremities who had received different medical treatments including PUVA and had not responded, and their diseases were stable. Blister in recipient site was created by cryotherapy and in donor site by using vacuum device. Then donor site blister was transferred to the recipient site and bath sites were covered by dressing. 10 patients [8 females and 2 males] with mean age of 31.2 +/- 11.4 years entered the study. After 1-6 weeks, first signs of repigmentation were observed and after 4 months complete repigmentation occured in 7 patients [70%] In two patients, a repigmentation of more than 50% was observed while in one patient no pigmentation was seen which was related to errors in surgical technique. Blister grafting surgery in limited patches of vitiligo which have not responded to medical treatments gives excellent results of prolonged repigmentation without any scar formation