Admission test and pregnancy outcome

Background: The admission test [AT] has been carried out for many years, but there are still debates about the prognostic value of the test. Therefore, we aimed to examine the value of the AT in predicting the adverse outcome in neonates

Methods: In this cross-sectional study, 425 pregnant women with normal vaginal delivery were studied between2009 and 2014at Vali-e-Asr Hospital. Based on the results, the women were divided into 2groups of normal and abnormal ATs. All the patients were followed up until the birth of their baby, when the status of mother and neonate was determined. The main outcomes of the study were cesarean rate, neonatal intensive care unit [NICU] admission, fetus demise, neonatal acidosis, and Apgar score. The independent t-test, chi-square test, Fisher exact test, and logistic regression were used for statistical analysis. The data were analyzed using SPSS [version 17]

Results: Of 425 pregnant women studied, 142 [33.4%] had abnormal ATs with a mean age of 29 [+/-4.5] years. Multivariate analysis showed that an abnormal AT was able to predict the incidence of cesarean section, intrauterine growth restriction, turned cord, and Apgar<7, but it could not predict neonatal death and hypoxia

Conclusion: The AT was shown to be a useful screening test with risk factors such as oligohydramnios, bloody amniotic fluid, meconium amniotic fluid, intrauterine growth restriction, and turned cord. Additionally, the test was also able to predict NICU admission and the need for cesarean section, but it could not predict the occurrence of neonatal death

Vaccine candidates against nontypeable haemophilus influenzae: a review

Nonencapsulated, nontypeable Hemophilus influenzae [NTHi] remains an important cause of acute otitis and respiratory diseases in children and adults. NTHi bacteria are one of the major causes of respiratory tract infections, including acute otitis media, cystic fibrosis, and community-acquired pneumonia among children, especially in developing countries. The bacteria can also cause chronic diseases such as chronic bronchitis and chronic obstructive pulmonary disease in the lower respiratory tract of adults. Such bacteria express several outer membrane proteins, some of which have been studied as candidates for vaccine development. Due to the lack of effective vaccines as well as the spread and prevalence of NTHi worldwide, there is an urgent need to design and develop effective vaccine candidates against these strains

Evaluation of caspase 3 enzyme and TNF-alpha as biomarkers in ureteropelvic junction obstruction in children- a preliminary report

Objective: To determine the applicability of urinary caspase 3 enzyme and TNF-alpha as biomarkers in children with ureteropelvic junction obstruction [UPJO]

Methods: In this study, 31 unilateral UPJO patients and 33 age- and sex-matched healthy childrens were enrolled. The patients with UPJO consisted of 11 female and 20 male children between the ages of 2 to 62 months old. All participants were evaluated regarding anterior-posterior[AP] diameter and cortical thickness of affected kidney by ultrasonography. Technetium DTPA renal scan and voiding cystourethrogram[to assess vesicoureteral reflux] were performed, pre-operatively. Also, urinary levels of TNF-alpha and caspase 3 enzyme were checked. Follow-ups included measurement of aforementioned indices in patients: AP diameter and cortical thickness of the affected kidney, as well as TNF-alpha and caspase 3 levels in urine, three and six months after pyeloplasty

Results: The results showed highly significant decrease in urinary TNF-alpha and caspase 3 enzyme [P values < 0.01], approaching the level measured in children without UPJO after six months. Significant decrease in AP diameter and increase in cortical thickness were also noticed [P values < 0.01]

Conclusion: The results of this study strongly support that TNF-alpha and caspase 3 levels in urine can be used for improvement monitoring in follow-up of UPJO patients after pyeloplasty and can also be potentially used as determining indices for surgical plan but more studies, especially in patients who are not surgical candidates are needed to confirm our observaitons

Development and validation of attitude toward gestational surrogacy scale in iranian infertile couples

Background: Surrogacy is one of the most challenging infertility treatments engaging ethical, psychological and social issues. Attitudes survey plays an important role to disclosure variant aspects of surrogacy, to help meeting legislative gaps and ambiguities, and to convert controversial dimensions surrounding surrogacy to a normative concept that eliminates stigma. The aim of this study is to develop a comprehensive scale for gestational surrogacy attitudes

Materials and Methods: Development process of gestational surrogacy attitudes scale [GSAS] performed based on a descriptive cross-sectional study and included a rich data pool gathered from literature reviews, a qualitative pilot study on 15 infertile couples [n=30], use of expert advisory panel [EAP] consisting of 20 members, as well as use of content validity through qualitative and quantitative study by the means of content validity ratio [CVR] and content validity index [CVI]. Also internal consistence using Cron-bach's alpha and test-retest reliability using intracalss correlation coefficient [ICC] were evaluated. Application of GSAS was tested in a cross-sectional study that was conducted on 200 infertile couples [n=400] at Royan Institute, Tehran, Iran, during 2014

Results: Final version of GSAS had 30 items within five subscales including [acceptance of surrogacy], [Surrogacy and public attitudes], [Child born through surrogacy] [Surrogate mother], and "Intentional attitude and surrogacy future attempt". Content validity was represented with values of CVR=0.73 and CVI =0.98. Cronbach's alpha value was 0.91 for the overall scale, while ICC value due to test-retest responses was 0.89

Conclusion: Acceptable level of competency and capability of GSAS is significantly indicated; therefore, it seems to be an appropriate tool for the evaluation of gestational surrogacy attitudes in Iranian infertile couples

Conjoined twins in a monochorionic triplet pregnancy after in vitro fertilization: a case report

Background: Monozygotic monochorionic triplet pregnancy with conjoined twins is a very rare condition and is associated with many complications

Case: In this study, we describe a monochorionic-diamniotic triplet pregnancy after in vitro fertilization with an intracytoplasmic sperm injection. At a gestational age of 6 weeks and 4 days of pregnancy one gestational sac was observed, and at a gestational age of 12 weeks and 2 days, triplets with conjoined twins were diagnosed. After consulting with the parents, they chose fetal reduction of the conjoined twins. Selective feticide was successfully performed by radiofrequency ablation at 16 weeks of pregnancy. Unfortunately, the day after the procedure, the membrane ruptured, and 1 week later, all fetuses and placenta were spontaneously aborted

Conclusion: Monochorionic triplet pregnancy with conjoined twins is very rare. These pregnancies are associated with very serious complications. Intra cytoplasmic sperm injection increases the rate of monozygotic twinning and conjoined twins. Counseling with parents before IVF is very important

nested-splicing by overlap extension PCR improves specificity of this standard method

Background: splicing by overlap extension [SOE] PCR is used to create mutation in the coding sequence of an enzyme in order to study the role of specific residues in protein's structure and function

Objectives: we introduced a nested-SOE-PCR [N -SOE-PCR] in order to increase the specificity and generating mutations in a gene by SOE-PCR

Materials and Methods: genomic DNA from Bacillus thermocatenulatus was extracted. Nested PCR was used to amplify B. thermocatenulatus lipase gene variants, namely wild type and mutant, using gene specific and mutagenic specific primers, followed by cloning in a suitable vector. Briefly in N-SOE-PCR method, instead of two pairs of primers, three pairs of primers are used to amplify a mutagenic fragment. Moreover, the first and second PCR products are slightly longer than PCR products in a conventional SOE. PCR products obtained from the first round of PCR are used for the second PCR by applying the nested and mutated primers. Following to the purification of the amplified fragments, they will be subject of the further purification and will be used as template to perform the third round of PCR using gene specific primers. In the end, the products will be cloned into a suitable vector for subsequent application

Results: in comparison to the conventional SOE-PCR, the improved method [i.e. N-SOE-PCR] increases the yield and specificity of the products. In addition, the proposed method shows a large reduction in the non-specific products

Conclusions: by applying two more primers in the conventional SOE, the specificity of the method will be improved. This would be in part due to annealing of the primers further inside the amplicon that increases both the efficiency and a better attachment of the primers. Positioning of the primer far from both ends of an amplicon leads to an enhanced binding as well as increased affinity in the third round of amplification in SOE

Effect of orem self-care program on the life quality of burn patients referred to ghotbal-din-e-Shirazi burn center, Shiraz, Iran: a randomized controlled trial

Advances in treatment and critical care have largely improved the survival following burns; therefore, the importance of quality of life in burn patients is an issue beyond question. The aim of this study was to determine the effects of Orem self-care program on Quality of Life of burn patients. A randomized clinical trial study was conducted on 110 eligible burn patients who were selected using easy sampling method and allocated randomly into two groups of experiment and control. The instrument for data collection was a questionnaire, containing demographic and burn information and burn-specific health scale-brief [BSHS-B] questionnaire. For the experiment group, 5 sessions of theoretical training and 75-90 minutes of practical training were accomplished. The quality of life of the patients with burns was assessed in three phases by the BSHS-B questionnaire. The data were analyzed in SPSS-17 using Chi-square test, Fisher's exact test, Independent t-test and repeated measurement multivariate test. After one month and two months of the use of self-care model, the quality of life of the cases improved from 73.33% to 83.78% and 98.12%, respectively [P<0.001]. But the changes in the quality of life of the patients in the control group were not statistically significant [P>0.05]. Based on the obtained results of this study, designing and implementing a self-care program based on Orem's model and the needs of burn patients will improve their quality of life. Therefore, it is recommended that this program should be considered as a part of treatment program for these patients.

Single dose effect of diazinon on biochemical parameters in testis tissue of adult rats and the protective effect of vitamin E

Diazinon [DZN] is an organophosphate pesticide that widely used for agricultural pest control all over the world. DZN affects target organs including reproductive system by inhibiting the activity of acetylcholinesterase and inducing oxidative stress. Vitamin E [alpha-tocopherol] is a strong antioxidant which inhibits free radicals, and probably can reduce lipid perxidation effectively in biological systems. The present study, aimed to evaluate the effects of DZN on malondialdehyde [MDA] and glutathione [GSH] levels in testis of rats and protective effect of vitamin E. In this experimental study, thirty adult male Wistar rats [200-250 gr] were divided into 5 groups [n= 6]: control group [did not receive any material], sham group [received only pure olive oil], experimental group 1 [DZN, 60 mg/kg], experimental group 2 [Vit E, 200 mg/kg] and experimental group 3 [DZN+Vit E, with the same dose]. All groups were sacrificed after 6 weeks and right testis was used to measure the MDA and GSH levels. The amount of MDA was determined by the thiobarbituric acid assay and 5, 5-Dithio-bis [2nitrobenzoic acid] DTNB-recycling protocol was used for GSH assay. The results showed that DZN increased MDA level [p<0.001] and reduced GSH level [p<0.001]. Administration of DZN plus vitamin E decreased the MDA level [p<0.001] and increased GSH level [p=0.001]. DZN induced lipid peroxidation in the testis of rats. Vitamin E by its antioxidant activity was able to improve the toxic effect of DZN

Ultrasound detection of placenta accreta in the first trimester of pregnancy

Placenta accreta is considered a life-threatening condition and the main cause of maternal mortality. Prenatal diagnosis of placenta accreta usually is made by clinical presentation, imaging studies like ultrasound and MRI in the second and third trimester. To determine accuracy of ultrasound findings for placenta accreta in the first trimester of pregnancy. In a longitudinal study 323 high risk patients for placenta accreta were assessed. The eligible women were examined by vaginal and abdominal ultrasound for gestational sac and placental localization and they were followed up until the end of pregnancy. The ultrasound findings were compared with histopathological examinations as a gold standard. The sensitivity, specificity, positive and negative predictive value of ultrasound were estimated for the first trimester and compared with other 2 trimesters in the case of repeated ultrasound examination. Ultrasound examinations in the first trimester revealed that 28 cases had the findings in favor of placenta accreta which ultimately was confirmed in 7 cases. The ultrasound sensitivity and specificity for detecting placenta accreta in the first trimester was 41% [95% CI: 16.2-62.7] and 88% [95% CI: 88.2-94.6] respectively. Ultrasound screening for placenta accreta in the first trimester of pregnancy could not achieve the high sensitivity as second and third trimester of pregnancy

[Assessment of erythrocyte and serum cholinesterase activity in male rats treated with diazinon, and protective role of vitamin E]

Background: Diazinon [DZN] is an organophosphate [OP] that inhibit cholinesterase activity and induce oxidative stress in the target tissues such as the the reproductive system .The aim of present study was to evaluate the effects of diazinon on cholinesterase activity in blood serum and erythrocytes of male rats and to assess the protective role of vitamin E.

Material and Methods: In this experimental study, thirty adult male wistar rats [200 - 250 gr] were divided into 5 groups [n = 6]: control group [did not receive any material], sham group [received only pure olive oil], experimental group 1 [DZN, 60 mg/kg], experimental group 2 [received DZN+Vit E daily, with the same dose] and experimental group 3[Vit E 200 mg/kg]. DZN and solvent was injected intraperitoneally [IP] and vitamin E was administrated by gavage. After 6 weeks, 3 ml blood from the heart tissue was taken and titrimetric and Ellman's method respectively was used for serum and erythrocyte cholinesterases activity evaluation. Data were analyzed using SPSS software. P<0.05 value was taken as statistically significant.

Results: The results showed that diazinon, reduced activity of acetylcholinesterase [P= 0.000] and pseudocholinesterase [P=0.01] in experimental group 1 compared to the control group. Inhibition in erythrocyte and serum cholinesterase activity was not recovered in experimental group 2 [use of diazinon plus vitamin E diazinon].

Conclusion: According to inhibit the activity of two important enzymes of erythrocyte and serum cholinesterase in rats treated with diazinon, there are possibility of cytotoxicity at farmers and people who are in contact with these compounds. On the other hand, cholinesterase activity did not recovered by vitamin E probably due to the competitive nature of enzyme inhibition by diazinon. Therefore, care should be taken to prevent from entering toxin to the body.

Optimizing primary recovery and refolding of human interferon-beta from escherichia coli inclusion bodies

The refolding of proteins from inclusion bodies is affected by several factors, including solubilization of inclusion bodies by denaturants, removal of the denaturant, and assistance of refolding by small molecule additives. The purpose of this study was optimization of recombinant human interferon-beta purification in order to achieve higher efficiency, yield, and a product with a better and more suitable biological activity. Triton X-100 and sodium deoxycholate were used to wash the recombinant human interferon-beta inclusion bodies prior to solubilization. The inclusion bodies solubilization process was performed by denaturants and reducing agents; guanidine-hydrochloride, urea, beta-mercaptoethanol and dithiothritol. The best recovery was obtained in the presence of 0.5% TritonX-100 [v/v]. Low concentrations of urea only gave a marginal improvement on the refolding of recombinant human interferon- beta. Successful refolding was achieved by gradient elution [decreasing the guanidine-hydrochloride concentration] in the presence of L-arginine. Partial purification was also achieved continuously, and recombinant human interferon-p was recovered with 93.5% purity. The interferon prepared in this project was biologically active and inhibited the replication of vesicular stomatitis virus in Hela cells, when compared to the standard interferon. In this research, the best recovery of inclusion bodies was found at a concentration 0.5 M of Triton X-100, the maximum efficiency of solubility was found in pH 10.5 and the maximum efficiency of refolding was achieved by final buffer containing 2M urea and 0.6 M L-Arg

Caffeine consumption and incidence of hypertension in pregnancy

To study the effects of caffeine consumption on incidence of pre-eclampsia and gestational hypertension. In a case-control study, two groups of pregnant women were selected as follows: one group included 40 women suffering from hypertension in pregnancy, while the other group comprised 100 healthy pregnant women. Inclusion criteria for both groups were normal BMI [19-22] before pregnancy, no high-risk age group [18 -35 years] for preeclampsia, no underlying disease, no history of abortion, and regular prenatal care. We evaluated the amount an duration of caffeine consumption in both groups. In nine [25.5%] mothers of preeclampsia group and15 [15.8%] mothers of healthy pregnant group were observed to consume excessive amount of tea [more than four cups a day]. In the preeclampsia group, excessive consumption of tea was seen, but this difference [difference in what??] was not significant. Among 21 [51%] mothers in preeclampsia group and 64 [64.7%] mothers in the other group, there is not a significant relation in drinking different types of caffeine, like dark coca, soft drinks, or coffee with occurring of preeclampsia. After evaluation the obtained data, we did not observe any relationship between the risk of preeclampsia and consumption of different types of caffeine [tea, coffee, or soft drinks]. Perhaps, more holistic and broader studies in this area are required

[ evaluation of delayed-onset muscle soreness in luteal and follicular phases of menstrual cycle among healthy untrained female students]

Delayed-onset muscle soreness [DOMS] after eccentric exercises would limit the efficacy of athletes. This study was designed to investigate the rate of DOMS in luteal and follicular phases of menstrual cycle [an indirect assesment of possible role estrogen] among healthy untrained female students Twenty-six healthy untrained female students, ranged between 18-25 years old were assigned into two groups based on their menstrual cycle: Mid-luteal [ML] [n=14] and Mid-follicular [MF] [n=12]. To induce DOMS, all participants walked downwardly on treadmill, declined 20 degrees, 5 km/h, for 30 minutes. DOMS criteria [serum creatine kinase, pressure pain threshold, muscle soreness and thigh circumference], and average peak torque of dominant knee extensor were recorded at baseline, 24 and 48 hours post-exercise. Both groups showed significant perception of DOMS symptoms as compared to their baseline levels [p<0.05]. Although, the severity of DOMS was lower in the ML group as compared with the MF group, but the difference was not significant. The findings of this study showed that DOMS got perceived in both experimental groups with a milder severity in ML group. The milder severity in the ML group may be contributed to the higher level of estrogen

Prediction of fetal anemia by different thresholds of MCA-PSV and delta-OD in first and second intrauterine transfusions

Our aim was to compare different thresholds of middle cerebral artery peak systolic velocity [MCA-PSV] and amniotic fluid delta optical density [Delta-OD] with fetal hemoglobin [Hb] during first and second intrauterine transfusions [IUT]. We determined serial MCA-PSV and Delta-OD in 27 red blood cell alloimmunized fetuses who needed IUT. Before the second IUT, MCA-PSV was measured. The sensitivity and specificity of MCA-PSV and Delta-OD were calculated and compared with fetal hemoglobin levels. From 27 fetuses, first time IUT MCA-PSV with a normal median value [MOM] cutoff of > 1.29 detected 60% of the moderate and 100% of the severe anemia cases. MCA-PSV of MOM > 1.5 detected none of the moderate and 93% of severe anemia cases. Delta-OD detected 50% of moderate anemic and 80% of severe anemic cases. At the second IUT, 91% of severe anemia cases were confirmed by MCA-PSV with MOM > 1.5 whereas MCA-PSV with MOM > 1.29 confirmed all cases. One case of moderate anemia was detected by MCA-PSV of MOM > 1.29 and none were detected by MCA-PSV with MOM > 1.5. Different thresholds of MCA-PSV have higher sensitivity and specificity for detecting moderate and severe fetal anemia compared with Delta-OD. It also has a high sensitivity at the second IUT

Conservative management of placenta increta: case report and literature review

Placenta increta, a rare complication of pregnancy, is associated with significant postpartum hemorrhage often requiring emergency hysterectomy. We report a case of conservative management, with a combination of parenteral methotrexate, serial ultrasound and beta-hCG assessment. Serum beta-hCG levels were undetectable after 8 weeks of therapy. A scan at 6 months showed complete involution of the uterus. Review of the literature discussing the diagnostic tools, clinical features, management and outcome of pregnancies with placenta increta

Comparison of the efficacy of nifedipine and hydralazine in hypertensive crisis in pregnancy

Intravenous hydralazine is a commonly administered arteriolar vasodilator that is effective for hypertensive emergencies associated with pregnancy. Oral nifedipine is an alternative in management of these patients. In this study the efficacy of nifedipine and hydralazine in pregnancy was compared in a group of Iranian patients. Fifty hypertensive pregnant women were enrolled in the study. A randomized clinical trial was performed, in which patients in two groups received intravenus hydralazine or oral nifedipine to achieve target blood pressure reduction. The primary outcomes measured were the time and doses required for desired blood pressure achievement. Secondary measures included urinary output and maternal and neonatal side effects. The time required for reduction in systolic and diastolic blood pressure was shorter for oral nifedipine group [24.0 +/- 10.0 min] than intravenus Hydralazine group [34.8 +/- 18.8 min] [P

Effect of metformin on diabetes mellitus prevention in pregnant women with risk factors

This study evaluated the efficacy and safety of metformin on prevention of gestational diabetes mellitus in women with high risk of GDM. Total number of 189 pregnant women aged between 25 to 35, and 10 to 14 weeks pregnancy, admitted to Mirza Koochakkhan Hospital, Tehran in January 2008 - January 2009 entered to this randomized controlled clinical trial. The women had one of the three risk factors; history of GDM, family history of diabetes, or BMI >/- 30 kg/m[2], with normal results in the glucose challenge test [GCT] or the glucose tolerance test [GTT]. Subjects were randomly split to two groups; 63 women [group A] who received metformin [500 mg, twice a day] and 126 women [group B] did not use metformin. Incidence of gestational diabetes was compared between two groups. The incidence of gestational diabetes was significantly different between two groups [%1.4 in group A,%15.4 in group B] [p<0.001]. The study also showed that the insulin requirement was significantly different between two groups after developing GDM [group A%3.6, group B%9.5, p=0.001]. Using Metformin can effectively reduce the incidence of GDM in pregnant women at risk

Seat belt use during pregnancy in Iran: attitudes and practices / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Seat belt use during pregnancy reduces injury to the mother and her fetus. During recent years, the use of seat belts has been mandated by law in Iran. The purpose of this study was to determine the attitudes and practices of pregnant women regarding seat belt use.</p><p><b>METHODS</b>In this cross-sectional study, we asked 335 pregnant women at a hospital-based prenatal care clinic on the use of safety belt before and during pregnancy. SPSS version 13.0 was used for data analysis.</p><p><b>RESULTS</b>The mean age of study subjects was 27.3 years ± 5.3 years with the median of 27 years. Compared with the seat belt use before pregnancy, no change was detected in 48.7% of the women; seat belt use had increased in 17.5 % of them and decreased in 33.8 %. Eighty-one percent of women knew the correct placing of both lap belt and shoulder belt. Only 4% of women had received education on proper restraint use during pregnancy.</p><p><b>CONCLUSIONS</b>The prevalence of seat belt use during pregnancy is lower than reports which are mostly from developed nations. The fact that about one-third of women have decreased their seat belt usage during pregnancy highlights the importance of education of mothers on this topic.</p>