[Efficacy of uteral injection of GCSP in repeated implantation failure: a clinical trial study]

Background: despite advances in clinical and laboratory techniques, including stimulating ovulation and transferring embryo, success rate of pregnancy remains is about 30%. The aim of this study was to assess the effect of intra uterine G-CSF on implantation and clinical pregnancy rate in patients with implantation failure in IVF

Methods: this study was a randomized clinical trial on patients undergoing in vitro fertilization within an age range of 45-18 years and a history of failure in implantation for two or more times. A total of 34 patients receiving G-CSF in the intervention group and 38 patients in the control group were enrolled

Results: mean age of the participants was 34.1 years with a standard deviation of 6.4 years. The average number of years of fertility was 10 years with a standard deviation of 5.2 years. The average number of embryos implanted in the intervention group was 2.88 with a standard deviation of 0.33. The figures for the control group were 2.97 and 0.37, respectively. The two groups did not differ significantly. With respect to the potential clinical and laboratory fertility outcomes, including existing gestational sac with observed heart rate and positive serum betaHCG, no statistically significant difference was observed between the two groups

Conclusion: it seems that the effect of G-CSF on improving fertility outcomes inpatients with implantation failure does not exist and more related studies are recommended in this regard

[Comparison between preventive antibiotic regimes of cefazolin with or without Azithrornycin in cesarean surgical site infection]

Background: wound infection is not uncommon after cesarean sections. Using a first-generation cephalosporin [cefazolin] has been recommended for antibiotic prophylaxis in patients, but according to few reports, extending the spectrum of antibiotic prophylaxis by adding azithromycin to the standard cephalosporin may lead to extra protection, against postcesarean infections. The relevant available data are not enough to draw a solid conclusion. This study aimed to compare the effectiveness of conventional antibiotic prophylaxis using cefazolin with a combination of cefazolin and azithromycin in reducing wound infection

Methods: in this randomized clinical trial, candidates of cesarean section were categorized in two groups; cases [n=85] who received intraoperative cefazolin plus postoperative oral azithromycin [500 gr] and controls [n=86] who received intraoperative cefazolin only. The incidence rate of surgical wound infection by 30 days postoperation was compared between the two groups

Results: cesarean sections were emergency in 80% of cases and 89.5% of controls [p=0.08]. Postcesarean incisional wound infection developed in 4.7% of controls, whereas no patient in the case group had such infection [p=0.12]

Conclusion: compared to cefazolin alone, a combination of azithromycin and cefazolin was more effective in preventing postcesarean incisional wound infection, the difference was not significant. Nonetheless, owing to this advantageous clinical consequence using a combination of these two antibiotics instead of cefazolin alone is recommended

Urinary incontinence during pregnancy and postpartum incidence, severity and risk factors in Alzahra and Taleqani hospitals in Tabriz, Iran, 2011-2012

This is a cohort study that investigated the incidence, severity and risk factors of Urinary Incontinence during pregnancy and postpartum in nulliparous women. In this cohort study, 441 nulliparous women were studied. The women were followed up from the beginning of pregnancy until the postpartum period. The prevalence of urinary incontinence was determined among them. Risk factors that could play a significant role were analyzed using questionnaires. In this study, 441 nulliparous women with an average age of 28.1 +/- 3.7 years were studied. The prevalence of urinary incontinence in the third trimester of pregnancy was 39.4% and it was 31% in the postpartum period. Vaginal delivery, maternal weight, and fetal weight [> 4 kg] were the most important risk factors for increasing the incidence rate of urinary incontinence. In this study, age had no role in incontinence. The severity of incontinence in 26.6% of the participants over 5 was based on visual analogue scale [VAS] scoring. Urinary incontinence is one of the common disorders during pregnancy and postpartum period that can affect quality of women life significantly. Type of delivery and maternal and fetal weights are the most important risk factors for increasing this disorder. Unlike previous studies, age did not play any role in incontinency in this study

Comparing therapeutic effects of Metformin and Pioglitazone in Polycystic ovary syndrome [PCOS]

To compare therapeutic effects of Metformin and Pioglitazone in Polycystic ovary syndrome [PCOS]. In a randomized clinical trial, 100 women with PCOS were recruited during a one year period in Al-Zahra Hospital of Tabriz. These patients were randomized into two groups of 50 patients receiving either Metformin 500 mg[TDS], or Pioglitazone 15 mg[BID], for six months. Clinical and laboratory findings were compared between the two groups at the baseline and end of the study. Pregnancy frequency was higher in Metformin group. Amelioration of menstrual cycles, hirsutism, and laboratory tests, including FBS, Hyperinsulinemia, oral glucose tolerance test, 2hpps and insulin, free testosterone and prolactin was significant in both groups. The change of serum total cholesterol and HDL was not significant in the Pioglitazone group. According to our results, Metformin is superior to Pioglitazone due to better influence on pregnancy and lipid profile