comparison of the effects of transdermal estradiol and estradiol valerate on endometrial receptivity in frozen-thawed embryo transfer cycles: a randomized clinical trial

Background: The purpose of this study was to determine the optimal endometrial preparation protocol by comparing the clinical outcome of two methods of endometrial preparation in frozen-thawed embryo transfer [FET] cycles, including that is, oral estradiol and 17 beta-estradiol transdermal patch

Methods: In this randomized controlled trial, women underwent either conventional IVF or intracytoplasmic sperm injection [ICSI] who had at least two top-quality embryos appropriate for cryopreservation and frozen embryos from previous cycles. In the study group [n=45], 17-B estradiol transdermal patches 100 microg were applied from the second day of the cycle and continued every other day. Then, each patch was removed after four days. In the control group [n=45], oral estradiol valerate 6 mg was started at the same time and continued daily

Results: There was a significant difference in estradiol level on the day of progesterone administration and the day of embryo transfer between the two groups [p=0.001 in both], but no significant difference was observed between them in biochemical and clinical pregnancy rates [32.6% vs. 33.3%, p=1.000 and 30.2% vs. 33.3%, p=0.810, respectively]

Conclusion: It is suggested that estradiol transdermal patches be used instead of oral estradiol in FET cycles. Due to the reduced costs, drug dose, and emotional stress as well as the simplicity of the protocol for patients

Trend in cataract surgical rate in Iran provinces

The aim of this study was to determine the trend of changes in Cataract Surgical Rate [CSR] in the provinces of Iran during 2006 to 2010 and identify high risk areas. This report is part of the national Iranian CSR Study. The percentage change in CSR in 2010 compared to 2006 was conducted in each province, retrospectively. One hundred and ten centers were chosen from all provinces, to determine CSR in each, the weight of major [>3,000 annual surgeries] and minor [3,000 annual surgeries or less] centers was calculated based on the number of selected centers, and multiplied by the number of surgeries in each province. In eight provinces, CSR was decreased by 1-60%. One province [Booshehr] showed no change. Eighteen provinces had 2-79% increase. No 2006 data was available in three provinces. North Khorasan had the most decrease while Kerman had the most increase in CSR. Six of these 8 provinces had CSR>3,000 despite a decrease in 2010, but North Khorasan had CSR<3,000 over the whole 5 year period. In 4 provinces, CSR had a gap from 3,000 despite anascending trend, and in two, the gap was quite considerable. Although CSR has an improving trend in most provinces in Iran, it is decreasing in some provinces, and despite an already low CSR, the exacerbation continues. The growing population of over 50 year olds calls for prompt measures in such provinces. Even in improving provinces, some lag behind the minimum recommended by WHO, and the growth rate of the over 50 population reveals the necessity of immediate planning

Effect of anterior chamber depth on the choice of intraocular lens calculation formula in patients with normal axial length

To compare the accuracy of Sanders-Retzlaff-Kraff II [SRK II] and 3[rd] and 4[th] generation intraocular lens [IOL] formulas and to compare the effect of different anterior chamber depths among the IOL formulas in cataract patients with normal axial length [AL; 22.0-24.5 millimeters, mm]. A retrospective chart review was performed of patients with normal AL who underwent cataract surgery. The SRK II and 3[rd] generation IOL formulas [Hoffer Q, SRK T, Holladay l] were compared to the 4[th] generation Haigis formula. For analysis, preoperative anterior chamber depth [ACD] was divided into three subgroups- =/<3, 3-3.5, and >/= 3.5 mm. The mean error [ME] and mean absolute error [MAE] of each formula was compared for each subgroup against the total. The difference between the ME and MAE of the formulas were compared for each ACD subgroup. P< 0.05 was considered statistically significant. The study sample was comprised of 309 eyes. The MAE were 0.56 D, 0.52 D, 0.51 D, 0.50 D, and 0.50 D with Haigis, Hoffer Q, SRK T, Holladay 1, and SRK II formulas, respectively The Haigis formula was a significantly weaker predictor than the SRK T [P < 0.00l] and Holladay 1[P= 0.035]formulas. The ME with Haigis formula was -0.23 D which changed to -0.06 D with ACD >/= 3.5 mm [P = 0.002]. The ME was -0.24 D with SRK II and changed to -0.09D with ACD 0.05, all comparisons]. The SRK II formula can predict refraction in patients with normal AL and ACD less than 3 mm with less error and is preferred over other formulas. The Haigis formula is the preferred choice in patients with a normal AL and ACD longer than 3.5 mm. The prediction accuracy of Hoffer Q, SRK T, and Holladay 1 is comparable in normal AL

Barrier and facilitators of HIV related risky sexual behavior

This study was conducted to identify the determinants of protective behavior in relation to HIV transmission. Since the risk of transmission is higher among those who have extramarital intercourse, the study sample constituted of such people. We started this study in 2010 and finished it in 2011. Participants were divided into low-risk and high-risk groups. High-risk people included sex workers and those who presented at drop- in centers. interviewers were 18 men and women in low-risk group and 12 men and women in the high-risk group. Data were collected through in-depth interviews and were analyzed using the thematic framework method. In both groups, protective behavior was influenced by willingness to protect, intention or decision to protect, and personal, social, and environmental barriers and facilitators. In terms of willingness, behavior was influenced to preserve sexual pleasure by avoiding condoms. In terms of barriers and facilitators, trust in partner, misperceptions, condom inaccessibility, unplanned sex, fear of contracting the disease, partner's wish, ethical commitments were mentioned by both groups, stigma of condom possession by the low-risk group, and partner's force was mentioned by the high-risk group. Educational programs need to focus on changing the concept that "condoms reduce sexual pleasure". In addition, interventional programs to strengthen factors such as self-efficacy, ethical commitments, faithfulness, and correct beliefs such as undue trust in partner, misconception of being safe, unplanned sex, and the stigma of possessing condoms can be very effective in changing high-risk sexual behavior

Classical and molecular methods for evaluation of Chlamydia trachomatis infection in women with tubal factor infertility

Chlamydia trachomatis is the most reported bacterial sexually transmitted disease, especially among young women worldwide. The aim of this study was comparison to evaluate the prevalence of Chlamydia trachomatis infection in woman with tubal infertility by means of PCR and cell culture techniques. Fifty-one women with confirmed TFI were enrolled in this study in [avicenna infertility Clinic] between January 2010 and January 2011. Cervical swab and cytobrush specimens were collected from each patient by gynecologists and sent to laboratory in transport media. Detection of Chlamydia trachomatis in samples was performed using PCR and bacteria culture in MacCoy cell line. The data were analyzed by Fisher's exact test and independent t-test. Statistical significance was established at a p-value <0.05. A significant relation was observed between increased the age of first intercourse and chlamydial infection. Six [11.7%] samples had positive PCR result, whereas cell culture results were positive in only 2 [3.9%] samples. A significant relation was also identified between the duration of infertility and infection [p<0.05] by PCR versus cell culture method. The results showed that PCR is a rapid method, compared to cell culture for detecting Chlamydial organism. It also became clear that the age at first intercourse is important to predict the likelihood of Chlamydia trachomatis

Effects of Chlamydia trachomatis infection on fertility; a case-control study

Nowadays, Chlamydia trachomatis is known as a causative agent of infertility. Because of, asymptomatic nature of infection, many may suffer from its lasting complications such as infertility. This study was performed in Tehran during April 2007 to April 2008 to compare the prevalence of Chlamydia trachomatis infection in fertile and infertile women using ELISA and PCR methods. Overall, 234 infertile and 223 pregnant women, as the fertile group, participated in this hospital-based case-control study. After completing an informed consent form and the questionnaire, first catch urine and blood sample were obtained for PCR and ELISA [IgG, IgM] tests, respectively. Logistic regression analysis was used to control possible confounding factors, and determine adjusted odds ratio of infertility due to the infection. PCR results revealed that 29 [12.4%] of the infertile and 19 [8.5%] of the fertile women were positive for C. trachomatis infection [p=0.440]. IgG was positive in 21 [9.0%] of the infertile and 11 [5.0%] in the fertile group [p=0.093]. IgM assays identified that 2 [0.9%] of the infertile and 4 [1.8%] of the fertile women were positive for the micro-organism [p=0.375]. We found no significant differences among fertile and infertile women for Chlamydia trachomatis infection. Nevertheless, molecular techniques which are more sensitive, more specific and non-invasive can be used to detect C. trachomatis infection

[Detection of Chlamydia trachomatis and Mycoplasma genitalium in semen samples of infertile men using multiplex PCR]

Chlamydia trachomatis is the most common bacterial sexually transmitted infection in the world, but the effect of this infection on male fertility is still controversial. Despite reports of interaction between Mycoplasma genitalium and sperm, this pathogen in semen samples of infertile men is less studied. We studied, the prevalence of Chlamydia trachomatis and Mycoplasma genitalium infection in infertile men. Among attending Avicenna Infertility Center, 120 men who had abnormal semen analysis tests were selected and the samples were taken. After detailed analysis of semen quality, DNA was extracted from each sample by chelex. Samples were evaluated for these two pathogens by multiplex PCR. Results were statistically analyzed. Chlamydia trachomatis and Mycoplasma genitalium was detected in 23/3% and 12/5% of the samples, respectively. Although, Mycoplasma genitalium infection rises by increasing [P=0.640] and decreasing in age of first sexually activity [P=0.203], and also positive cases of Chlamydia trachomatis infection showed increase regarding age increase [P=0.619] and age decrease in first sexually activity [P=0.511], but these differences were not statistically significant. All in all, regarding to the increased prevalence of Chlamydia trachomatis infection compared with the only similar study in Iran and high prevalence of Mycoplasma genitalium infection in infertile men, this assessment was done. A multiplex PCR protocol rapidly and simultaneously identify these organisms in comparison with uniplex from clinical samples. Based on our results screening for Chlamydia trachomatis and Mycoplasma genitalium infection among infertile men seems to be valuable

Urogenital chlamydia trachomatis infection among prisoner men

Chlamydia trachomatis [C.trachomatis] is one of the most common curable STDs. Little information is available on its incidence among prisoner men. This study aimed to investigate the frequency of urogenital infection with C.trachomatis among imprisoned men as a high risk group. In this cross-sectional study, 130 imprisoned men aged 16-49 years in one of Tehran prisons were randomly selected. After completing informed consent, each volunteer dedicated a urine sampler and a completed questionnaire. DNA extraction and PCR assay were performed in Avicenna Research Institute. Among the 130 prisoner men, only 3 [2.3%] had positive PCR test results. Mean age of participants was 28.00 +/- 4.58 and the mean age at first sexual contact was 20.33 +/- 3.51. All had at least elementary education while 66.7% were unmarried and 33.3% were unemployed and had less than 1000000 Rails per month. Moreover, 33.3% were homeless and others living in rental houses. Furthermore, 66.6% had more than 4 sexual partners. There was no difference in condom use and none of them mentioned urinary discharge or dysuria. Additionally, 66.6% were IVDU and had more than 3 prison admissions. There was no report of HIV, HCV or HBV infection among them. The low incidence of C.trachomatis in this study showed that screening of asymptomatic men by PCR is not cost-effective and in order to obtain more epidemiological information, low-cost techniques such as serological methods can be recommended. Moreover, studies with broader distribution and higher sample size should be performed to determine real prevalence of chlamydia infection and make a definite decision about screening

Comparative molecular and microbiologic diagnosis of vaginal colonization by group B streptococcus in pregnant women during labor

Rapid tests for detection of Streptococcus agalactiae or Group B Streptococci [CGS] at the onset of labor are needed to permit early intrapartum antibiotic prophylaxis. This study aimed to evaluate the PCR assays targeting the 16S ribosomal RNA gene [16S rDNA] for detection of the GBS in comparison with a specific culture method. Two swabs were used to obtain vaginal specimens from the 330 pregnant women attended delivery room at Hedayat hospital, Tehran, Iran. One swab was analyzed by direct plating onto selective GBS agar medium [ISLAM] and the other swab was used for a PCR assay, which amplified the 16S rDNA of S.agalactiae. Comparative study between the selective culture and the PCR assay was done among the 330 tested women. The GBS colonization rate based on the culture results was 20.6% [68/330]. Both culture and PCR methods were positive for 56 and negative for 253 women. The culture method was positive and PCR was negative in 12 women. The culture was negative and the PCR positive for 9 women. Sensitivity of the PCR assay was 82.3% and specificity was 96.5%. The positive predictive value was 86.15% and negative predictive value was 95.4%. ISLAM diagnostic procedure and PCR are rapid and reliable analyzing methods, which might be useful for accurate diagnosis of GBS colonization in pregnant women at the time of delivery

Preventing mother-to-child transmission of HIV/AIDS: do Iranian pregnant mothers know about it?

Nowadays, HIV is mostly spreading in Asian countries. One of the important routes for HIV transmission in these countries is the vertical route which infects 35% to 45% of newborns. Mother's education, drug prophylaxis and Cesarean section, accompanied by banning breastfeeding will decrease this rate to 2%. Therefore, mothers' knowledge about Prevention of Mother to Child Transmission [PMTCT] has a great role in HIV/AIDS prevention. This study was designed to evaluate knowledge of pregnant women about HIV, its vertical transmission and prevention in Tehran, Iran. This cross-sectional study was conducted on 1577 pregnant women aged 15-46 years who were attending prenatal care clinics in Tehran, Iran. The research material was a questionnaire which was completed daily by trained midwives. The data were statistically analyzed by ANOVA, independent sample t-test, Pearson correlation and linear regression with a significance level of p = 0.05. About 16.5% of the participants had good knowledge about HIV/AIDS and 54.1% about its transmission routes but awareness about its prevention was only 5.7%. Fifty-seven percent of the participant had not been tested for HIV earlier and 20.2% were not willing to undergo such tests. About 86.2% of the participants had no idea about the availability of drug prophylaxis in Iran for PMTCT. The fact that 28.2% of the participants were not willing to undergo HIV testing reflects negative attitude about HIV infection. Although the overall awareness about the infection and its transmission was good but knowledge about its prevention especially by PMTCT and its availability in Iran was low. Educational programs through mass media or prenatal care programs by focusing on HIV/AIDS prevention maybe useful

[ level of knowledge among Shahid Beheshti University students about genital herpes]

Genital herpes is increasing in Asia and the world. Based on other studies, knowledge has an important role in reducing high risk sexual behavior. In this study we evaluated knowledge among Shahid Beheshti University students as a sample of young and educated population of Iran. This cross-sectional study carried out on 409 of Shahid Beheshti University students in Tehran - Iran at Autumn 2004. Research material was questionnaire and data analyzed by SPSS-13, T-student, Chi-square, Mann-Whitney, Kruskal-Wallis Tests. Mean +/- SD of level of knowledge, nature and transmission of genital herpes was 26.5 +/- 26%, 23.7 +/- 24.2% and 30.56 +/- 36.8%, respectively. The level of knowledge about signs, treatment and prevention of disease was 18.8%, 16.4% and 46.2%, respectively. There was a significant relation between age, marital status and education with knowledge [P < 0.05]. The level of knowledge among engineering students was higher than humman sciences students [P < 0.05]. Based on our study, most of participants had no enough knowledge about genital herpes. Most of participants were willing to know more about it as they obviously welcomed to our pamphlets. It seems that educations about genital herpes should be added to educational programs