[Effect of heat therapy on pain severity and the end of labor in primigravida women]

Pain is a common phenomenon and is an inevitable part of process of childbirth. Continuous labor pain is effective on respiratory system; blood circularly; endocrine glands and other activity of body. Heat as a non pharmacological method of pain relief helps reduce the pain severity. The aim of this study was to determine the effect of heat therapy on labor pain and the end of labor in prime gravid women who referred to the hospitals of Babol University of medical sciences in Babol in 2006-2007. In this clinical trial study, 64 low risk nullparous women were randomly divided into two groups [heat therapy and routine care groups]. The control group got routine cares in obstetrics ward and heat therapy group in addition ot these cares used warm bag for the low back from cervix dilatation of 3-4 cm to the end of first stage of labor and for perinea at the second stage. The intensity of pain was determined in dilatation of 3-4, 6-6 and 9-10 cm and at the end of second stage of labor by Mc Gill pain scale. Data was analyzed with t-test and chi square and ManWitney tests by using SPSS Software statistical. Comparing two groups showed a significant decrease in the intensity of pain in heat therapy group in the first stage, in the second stage of labor [p<0.001]. Also, in heat therapy group duration of the first and third stage of labor with p<0.001 decreased but duration of second stage of labor showed no significant difference between two groups. The mean of APGAR score of neonates type of delivery and perineum tear, height of fundus an hour after delivery showed no significant difference between two groups. According to the results of this study, it seems that heat affects on the pain severity in first and second stages of labor and duration of first and third stages in labor without any negative effect after delivery on neonate and mother

effect of heat therapy on labor pain severity and delivery outcome in parturient women

Pain relief for labor, as an acute and severe pain, has been considered for many years. The aim of this study was to determine the effect of heat therapy on labor pain and the time of labor in primigravida women referring to the affiliated hospitals of Babol University of Medical Sciences during 2006-2007. In this study, 64 nulliparous women were randomly divided into two groups [heat therapy and routine care group]. The control group received routine care in the obstetrics ward but the heat therapy group used warm bag for the low back since the cervix dilated about 3-4 cm to the end of the first stage of labor and for perinea at the second stage as well as the routine cares. The severity of pain was determined on dilatation of 3-4, 6-7 and 9-10 cm and at the end of the second stage of labor by Mc Gill pain questionnaire. Comparison of the two groups showed a significant decrease in the intensity [severity] of pain in the heat therapy group in the first stage, and on dilatation of 6-7 cm and 9-10 cm, and in the second stage of labor. Also, in the heat therapy group duration of the first and third stages of labor decreased but that of the second stage of labor showed no significant difference between the two groups. According to the results of this study, it seems that heat affects the intensity of pain in the first and second stages of labor and shortens the first and third stages of labor

Evaluation of preoperative elevation of serum C-Reactive protein as an indicator for prognosis in Colorectal Cancer

The C-reactive protein [CRP] is a product synthesized in hepatocytes and has been reported to be up-regulated by such proinflammatory cytokines as interleukin-1 [IL-1], interleukin-6 [IL-6], and tumor necrosis factor [TNF]. The significance of a preoperative serum elevation in CRP as a predictive indicator for the malignant potential and prognosis in colorectal cancer has not been elucidated. Forty consecutive patients with colorectal cancer, whose local lesions were resected in our department, plus forty volunteer healthy persons, were selected. Any patient with inflammatory diseases such as infection or collagen disease was excluded from the current study. Then preoperative serum CRP level were measured, and also from the control group. The relationships between the serum elevation of CRP and both the clinicopathologic factors and prognosis of the patients was investigated. The rate of patients with elevated serum CRP level was significantly higher in colorectal cancer patients in comparison with the control group [55% versus 2.5%]. Furthermore the incidence of liver metastasis, peritoneal carcinomatosis, histopathologic lymph nodes metastasis, and tumor invasion in colorectal cancer patients with a preoperatively elevated serum CRP level were significantly more frequent than in those with a negative serum CRP level. The survival rates of colorectal cancer patients without a preoperative elevation of serum CRP proved to be significantly more favourable than what in colorectal cancer patients with such an elevation [94.4% versus 59.1%; P < 0.001]. A preoperative serum elevation of CRP was thus found to be an indicator of malignant potential of the tumor as well as a predictor for the prognosis of patients with colorectal cancer

Comparison of embryo quality cultured in Ham's F-10+%10 maternal serum and GI[III]

Appropriate culture media and environment for embryonic cell growth considered to be major factors for generation of an embryo in vitro. In this study two embryonic growth condition of Glm and Ham's F-10 + Maternal Serum [MS]%10 were compared. This investigation was prospectively performed on 100 infertile couples that were treated by IVF-iCSL The participants were divided into two equal groups. Ovules obtained from first group were treated with Ham's F[10] + Maternal Serum%10 culture media and the second group with Gl[III]. The variables affecting ovule and embryonic growth were measured, and collected data were analyzed by SPSS. The mean of age for tested ladies was 28.01 and the mean for duration of infertility was 6.87 years. The number of pronucleous with moderate quality were 2.14 in-group I and 3.22 in-group 11 [P=0.023]. The number of embryo with three cells were 1.26 and 0.54 and for grade B embryonic cell were 1.18 and 1.78 and grade C embryonic cell were 1.08 and 0.56 in group I and II respectively [p=0.29]. The mean of grade B blastomer in GI[III] media was more than Ham's F[10]+ Maternal Serum 10%. Compairing the means; the mean of grade B blastomers in Glm media was shown to be more than Ham's F[10] + Maternal Serum 10%. All of the findings showed that Gl[III] cultural condition is more effective than Ham's F[10] and the maternal serum as a supplement has no considerable impact

[Comparing AVF ligature and transvenous endorrhaphy for AVF closure in hemodialysis patients]

Arteriovenous fistulae are the principal chronic hemodialysis access in patients with end stage renal disease. There is an increasing number of patients who need AVF closure because of serious complications or renal function retrieval by transplantation. Multiple open and endovascular techniques have been proposed for AVF closure. In this study, we are going to compare two surgical methods and select the preferred one as the standard technique for closure. A randomized controlled clinical trial was designed. 140 patients were randomly assigned into two matched groups. 70 patients underwent AVF ligature and the other 70 subjects underwent transvenous endorrhaphy. Each patient was followed for at least 6 months to monitor surgical results. Of 140 patients, 26 [18.6%] AVF closures were failed during 6 months of follow up. Of 26 failed cases, 24 had undergone AVF ligature. Thrill recurrence and closure failure was 37.1% in the ligature group and 2.9% in the endorrhaphy group. Transvenous endorrhaphy is associated with better AVF closure results. Therefore, we recommend this procedure as the standard technique of AVF closure

Correlation between basal antral follicle count and mean ovarian diameter with ovarian responsiveness in ART cycles

Since, ovarian response during assisted reproductive technology [ART] depends on ovarian reserve so it is important to evaluate ovarian reserve before the ART cycle. The purpose of this study was to determine correlation between basal antral follicle count and mean ovarian diameter before treatment with ovarian responsiveness. This study was performed on 94 infertile women who consecutively underwent ART in Fatemeh Zahra Center in Babol for one year. FSH, LH and FSH/LH were measured on day 3 of cycle, and basal antral follicle count and mean ovarian diameter were determined by vaginal sonography. GnRH Agonist was administered for hypophysial down regulation and then gonadotropin was administered for induction of ovulation. Ampules of gonodotropin, days of stimulation, numbers of oocytes, pregnancy rate and cycle cancellation were recorded. A positive linear correlation was seen between basal antral follicle count with recovered oocytes [p<0.05]. Also, pregnancy rate had a positive linear correlation with recovered oocyte, fertilized ovum and basal antral follicle count [p< 0.05]. A negative linear correlation was observed between basal antral follicle count with ampules of gonadotropin, days of stimulation that was not statistically significant [p>0.05]. It was not seen a significant correlation between mean ovarian diameter and pregnancy rate, recovered oocytes, days of stimulation and ampules of gonodotropin. The results show that antral follicle count on cycle day 3 has positive correlation with oocyte count and pregnancy rate. It is an easy and reliable method to predict ovarian responsiveness that allows physicians to evaluate patients immediately before ART stimulation and to optimize stimulation protocols

Effect of xylocaine on human normal sperm motility

Infertility as an obvious problem causes different social problems in family. One of the most common methods to solve the problem of infertile couples with azoospermia is capture via testis or epididymo biopsy. Use of anesthetic drugs is unavoidable for pain relief. Since these drugs can cause the reduction of sperm motility so it is necessary to determine the concentration of drugs that used for topical anesthetic. In this experimental study, semen samples of 30 men were studied. Post swim up samples [65ml] in Ham's F10 culture were put in six separated tubes and 10% of semen was mixed with xylocaine [20%, 40%, 60%, 80% and 100%]. Sample one was considered as control group and sperm motility and grading at 3 different times [0, 2, and 24 hours] were recorded. Data was statistically analyzed. Mean of sperm motility in control group was 63.20 +/- 5.31 and in test group decreased from 45.50 +/- 11.54 [xylocaine 20%] to 4.9 +/- 5.72 [xylocaine 100%] [p= 0.000]. Prolonged contact causes more decrease in motility and grading of sperm [p=0.001]. Increase of xylocaine concentration caused a decrease in sperm motility, so the effect of xylocaine on sperm parameters depends on dosage and duration of contact

[Comparison of the effectiveness of double IUI versus single IUI in pregnancy rate in infertility]

In infertility without suffering tubal factor, WI is the choice therapeutic method. Some studies recommended double IUI for every cycle. Since double IUI needs more laboratory materials and more expenses, so in this study it was tried to evaluate pregnancy rate in infertile couples after single and double IUI. This clinical trial study was performed on infertile couples referred to Fatemeh Alzahra or Babol Clinic hospital for IUI cycles. Patients divided into two groups. In the first group, 36 hours after HCG injection, IUI was done as a single protocol and in the other group; IUI was done 24 and 72 hours after HCG injection as double protocol. Then data were analyzed by fisher's exact test. Two hundred and fifteen women participated in our study and their mean age was 26.02 +/- 5.5 and the mean [ +/- SD] duration of infelicity was 3.73[ +/- 2.75] years. In the first group, pregnancy rate was 16.9% and in second group it was 19.6% without any significant difference between two groups. Also, there was no significant difference between groups in pregnancy rate with different etiology of infertility. Some studies recommended that double IUI is more successful than single IUI. But present findings suggest that there is no difference in pregnancy rate between single IUI and double IUI

Pregnancy rate following Metformin consumption in patients with PCOS under ART treatment

Infertility with an incidence of about 15% has mainly been one of the community burdens that have even been threatening to the continuity of the family life. One of the most prevalent causes of women infertility is ovarian causes particularly PCOS. Since Metformin may improve quality and increase the number of ova, and likewise increase fertilization rate via reducing the level of insulin, this study was conducted with aim of investigating responses of patients with PCOS in the cycle of ART. This was a randomized clinical trial on 100 infertile patients with PCOS who referred to Shariati Hospital in Tehran during 1999-2000. The subjects were randomly categorized in to 2 groups [A=44 and B=46 women]. Ten patients were eliminated from study due to ignoring the treatment plan. Group A received Metformin at a dose of 500 mg t.i.d in addition to induction of ovulation with long protocol. The results were analyzed using t-test and X2 and P<0.05 was considered as significant. Results showed that average level of estradiol in group A was 2159_1056pg/ml and 2842 +/- 1050 pg/ml in group B, with a significant difference [P=0.002]. We administered 23 +/- 7.6 ampules of HMG for the subject's in group A and 31.34 +/- 8.12 ampules for those in group B [P = 0.001]. The difference in number of oocytes was not significant, where as we found a significant difference in the number of germinal vesicle [P = 0.047]. There were no significant differences in course of treatment, numbers of oocytes and the number of pregnancy between 2 groups. Considering the findings of this study by using Metformin, we improve the quality of ova in patients with PCOS. This happens due to the effect of Metformin through reducing insulin resistance and hyperandrogenism in patients with PCOS leading to a prominent drop in estradiol levels in serum that in turn lowers the need for administration of HMG and result in improving oocyte quality

Comparison of hysterosonography and hysterosalpangiography in the diagnosis of intrauterine abnormalities in infertile women

Uterine abnormalities are found in approximately 34-62% of infertile women. Because of this relatively high prevalence of uterine abnormalities, evaluation of uterine cavity is performed in the primary evaluation of infertility. The purpose of this study was to compare the diagnostic accuracy of hysterosonography with that of hysterosalpangiography for the evaluation of abnormalities of uterine cavity of infertile women. Sixty six infertile women were prospectively evaluated with hysterosalpangiogram [HSG] and hysterosonogram [H/S] as a part of their infertility workup. The result of each examination was compared with what was obtained by hysteroscopy as a golden standard. The results of H/S agreed with hysteroscopy in 95.5% [K=0.86] while HSG agreed with hysteroscopy in 87.9% [K=0.64] of cases. Sensitivity of H/S was 85.7% and its specificity 98.1%, while sensitivity of HSG was 71.4% and its specificity 92.3%. Hysterosonography was in general more accurate test and appeared to be an acceptable first-line evaluation for intrauterine structure. We recommend use of hysterosonography as a noninvasive, easy, inexpensive, effective and well-tolerated method of investigating the intrauterine cavity in infertile women instead of hysterosalpangiography