The effect of Achillea Millefolium L. on vulvovaginal candidiasis compared with clotrimazole: A randomized controlled trial.

INTRODUCTION: Vulvovaginal candidiasis is the second most common cause of vulvovaginal infections. The aim of this study is to evaluate the effectiveness of vaginal cream of Achillea millefolium extract in women with vulvovaginal candidiasis in comparison with vaginal clotrimazole. MATERIALS AND METHODS: This double-blind randomized clinical trial study was conducted on 80 women diagnosed with vulvovaginal candidiasis clinically and by laboratory test; 40 women received vaginal cream clotrimazole 1 % and 40 received vaginal cream containing the aqueous extract of A. millefolium for 7 days. Clinical and laboratory assessments were performed before and after the intervention. Minimum inhibitory concentration of the extract was evaluated with Broth micro-dilution procedure. RESULTS: The Dermatology life quality index score showed significant reduction in both groups after treatment, but it was significantly more reduced in control group (p < 0.05). Improvement in vulvar erythema was observed in both groups with no statistically difference (p = 0.1). Vaginal culture was negative in term of Candida in 28(77 %) patients of control group and in 18(53 %) patient of experimental group (p < 0.05). The Minimum inhibitory concentration of the extract was 37.5 mg/mL for the standard strain. DISCUSSION AND CONCLUSION: Study results showed that vaginal cream containing A. millefolium could reduce the complaints of vulvovaginal candidiasis. But, future studies with a larger sample size and different dosages are recommended to assess the outcomes of this new treatment.

Investigating the Relationship between Magnesium levels and Diabetes Mellitus in Pregnant Women.

Gestational diabetes mellitus (GDM) is defined as one of the three main types of diabetes mellitus (DM). It is established that GDM is associated with exceeding nutrient losses owing to glycosuria. Magnesium (Mg), as one of the essential micronutrients for fetus development, acts as the main cofactor in most enzymatic processes. The aim of this study was to measure serum and cellular levels of Mg, albumin, creatinine, and total protein to further clarify the relationship between these components and DM in pregnant women. Blood samples were obtained from 387 pregnant women. The participants were classified into four groups based on their type of diabetes, namely GDM (n=96), DM (n=44), at high-risk of DM (n=122), and healthy controls (n=125). All participants' fasting blood sugar (FBS), creatinine, albumin, Mg, and total protein in the serum levels and red blood cell Mg (RBC-Mg) were measured during 24-28 weeks of gestation. Groups were compared for possible association between DM and abortion, gravidity, and parity. The serum levels of creatinine, FBS, albumin, Mg, and RBC-Mg were statistically different among four groups (P =0.001). Significant lower levels of RBC- Mg was observed in all studied groups in comparison with controls. Given a positive correlation between DM and abortion, it seems that decreased levels of RBC-Mg and serum albumin can increase the risk of abortion in pregnant women. Our data demonstrated significant alterations in albumin, Mg, and creatinine concentrations in women with DM or those at high risk of DM during their gestational age. It seems that the measurement of these biochemical parameters might be helpful for preventing the complications, and improving pregnancy outcomes complicated with DM.

Association between endometriosis and hyperprolactinemia in infertile women.

BACKGROUND: The association of endometriosis with hyperprolactinemia is controversial. OBJECTIVE: The present study aimed to determine the frequency of endometriosis and association of prolactin with endometriosis in infertile women. MATERIALS AND METHODS: 256 infertile women who underwent diagnostic laparoscopy for the evaluation of infertility, referred to Fatemezahra Infertility and Reproductive Health Research Center were included in a cross-sectional study. The presence of endometriosis was evaluated. To investigate the association of endometriosis with hyperprolactinemia, the patients whose infertility was not caused by endometriosis were included as control group. Serum prolactin (PRL) level was measured in both groups. The comparison of basal serum PRL levels between the two groups was performed, using independent t-test. One way ANOVA was used to determine PRL association with endometriosis stages. RESULTS: The frequency of endometriosis was found to be 29%. PRL levels were significantly higher in endometriosis group compared to control group (23.02±1.25 vs. 17.22±1.22 respectively, p=0.004). Statistically significant associations were found between staging of endometriosis and prolactin levels (p=0.01). CONCLUSION: Hyperprolactinemia may be associated with endometriosis and its progression.

Prevalence of Varicocele among Primary and Secondary Infertile Men: Association with Occupation, Smoking and Drinking Alcohol.

BACKGROUND: Existing data suggests that varicocele plays a central role in progressive infertility. AIMS: This study was designed to assess the occupational and lifestyle factors of development of varicocele among male infertile, for a better prevention and management of the varicocele. MATERIALS AND METHODS: All males with infertility, who presented at Fatemezahra Infertility and Reproductive Health Research Center between April 2010 and February 2011, were examined. Their occupations, smoking, and drinking alcohol, presence or absence of varicocele were evaluated. The lifestyle factors associated with varicocele were analyzed. RESULTS: The data of 816 men, aged 21-71 years, were included in the study. Two hundred and sixty-one men (32%) with varicocele and 555 (68%) without varicocele were found. Percentage of varicocele was significantly higher in smokers compared with non-smokers (P = 0.035). The adjusted OR for varicocele in smokerswas significantly higher than that in non-smoker (OR = 2.420; 95% CI = 1.04, 5.61). No significant differences were seen between varicocele and occupation or alcohol drinking for the prevalence of varicocele. CONCLUSIONS: The findings of the present study indicated that a high frequency of varicocele was indentified among male infertile. Therefore, it is necessary for those male cigarette-smokers to evaluate their possibilities of infertility and varicocele.

Effect of medicinal herbs on primary dysmenorrhoea- a systematic review.

Conventional treatment for primary dysmenorrhoea has a failure rate of 20% to 25% and may be contraindicated or not tolerated by some women. Herbal medicine may be a suitable alternative. To determine the efficacy and safety of Iranian herbal medicine for primary dysmenorrhea when compared with placebo, no treatment, and other treatment. Electronic searches of the Cochrane Menstrual Disorders and Dysmenorrhoea Group Register of controlled trials, Scopus, Google Scholar, Medline, Pubmed were performed to identify relevant randomized controlled trials (RCTs). The study abstraction and quality assessment of all studies were undertaken following the detailed descriptions of these categories as described in the JADAD Criteria for Systematic Reviews of Interventions. 25 RCTs involving a total of women were included in the review. The review found promising evidence in the form of RCTs for the use of herbal medicine in the treatment of primary dysmenorrhoea compared with pharmacological treatment. However, the results were limited by methodological flaws. Further rigorous no penetrating placebo-controlled RCTs are warranted. The review found promising evidence supporting the use of herbal medicine for primary dysmenorrhoea; however, results are limited by the poor methodological quality of the included trials.

Polycystic ovary syndrome in Iranian adolescents.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is linked with metabolic syndrome, which includes obesity, insulin resistance, dyslipidemia, and endocrine function in patients with PCOS. The aim of this study was to determine the prevalence of adolescent PCOS and characteristics associated with PCOS in adolescents in Babol, Iran. MATERIALS AND METHODS: A cross-sectional study was conducted on 1549 girl high school students aged 16-20 years who were living in Iran. After overnight fasting, blood samples were collected to determine hormones and lipid levels in PCOS patients between the first and fifth days of their menstrual period or withdrawal bleeding. RESULTS: The overall prevalence of adolescent PCOS was 129 (8.3%) (95% CI; 4.0, 12.0). Irregular menstruation was observed in 24.1% of adolescents. A total of 68% of PCOS adolescents had insulin resistance. Compared with non-PCOS adolescents, the OR of adolescent PCOS for family history of hirsutism was 1.53 (95% CI, 1.06-2.20; p=0.024), family history of irregular menstrual cycle was 2.27 (95% CI, 1.56-3.30; p<0.001), menarche age <13 years was 1.95 (95% CI, 1.36-2.81; p<0.001), hirsutism was 1.14 (CI 95%, 1.10-1.17; p<0.001), acne was 5.10 (CI 95%, 3.52-7.40; p<0.001), and wrist circumference was 1.28 (CI 95%, 1.07-1.54; p=0.007). CONCLUSION: The presenting findings showed the high prevalence of PCOS among Iranian adolescents. Emphasis should be placed on clinical screening in adolescents with high-risk factors, including irregular menstrual, menarche <13 years, hirsutism, acne, high wrist circumference, and paternal obesity to help reduce the risk of developing metabolic disturbance and to find ways to improve long-term health.

Reproductive outcome following hysteroscopic treatment of uterine septum.

BACKGROUND: Septate uterus is the most common uterine anomaly and a cause for miscarriage and infertility. Existing data suggested a better reproductive outcome of uterine septum following hysteroscopic septum resection. OBJECTIVE: Current study was administered to share our experience in hystroscopic septum resection for reproductive outcome following hysteroscopic treatment of uterine septum and specifically focusing on different treatment protocols after hysteroscopic septum resection. METHODS& MATERIALS: This study was a cross-sectional study based on secondary data that was obtained from medical records of infertile women who had undergone transvaginal hysteroscopy and used different treatment protocols after hysteroscopic correction of uterine septum in Infertility and Reproductive Health Research Center between April 2005 and February 2014. RESULTS: The total number of infertile women underwent hysteroscopy uterine septoplasty was 106. The hysteroscopy septoplasty resulted in an overall pregnancy rate of 67% and a live birth 57.5%. Pregnancy rate for patients who had not male infertility was 92.1%. The chi-square test did not reveal any statistically significant difference in side affect, pregnancy, live birth, abortion, preterm deliveries, and term deliveries rate between these patients either with consistent hormone therapy plus IUD insertion or with alternate hormone therapy plus IUD after hysteroscopic metroplasty. CONCLUSION: The findings of the present study indicated hysteroscopic septum resection to remove a uterine septum in women with infertility is safe and may be an efficacious procedure. Treatment following hysteroscopic septum resection, either the consistent or the alternate protocol is both beneficial to improve pregnancy rate.

Body mass index and gonadotropin hormones (LH & FSH) associate with clinical symptoms among women with polycystic ovary syndrome.

UNLABELLED: To evaluate the relevance of body mass index (BMI), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and LH/FSH ratio with clinical symptoms in polycystic ovary syndrome (PCOS) women. METHODS: We reviewed the medical records of all women visited in the PCOS Clinic of Babol (Iran) from 2008 to 2012. A retrospective cross-sectional study was conducted on 175 PCOS women; aged 18-38 years diagnosed based on the Rotterdam criteria. Among the PCOs women, the prevalence of oligomenorrhea, acne, and hirsutism were found to be 92.0%, 31.4%, and 78.9%, respectively. Positive finding of polycystic ovaries was observed in 89.1% of PCOS women with by using sonography. A total of 69.2% overweight/obesity patients had polycystic ovary morphology on ultrasound image. Compared with non- overweight/obesity, the adjusted OR of PCOS women for sonographic view of polycystic ovaries was 4.33 (95% CI, 1.42-13.15, p=0.001), Nevertheless, the adjusted odds ratio (OR) showed no significant associations between LH, FSH, and LH/FSH ratio with clinical symptoms in these women. The findings of this study indicated that the overweight/obese women with PCOS are at an increased risk for sonographic view of polycystic ovaries. Therefore, it is suggested that successful weight loss is the most effective method of restoring ovulation, menstruation that should be used as major advice in obese PCOS patients.

Physical activity and body mass index among women who have experienced infertility.

INTRODUCTION: The experience of infertility is a common medical condition in the developing countries. The aim of this retrospective epidemiologic study was to determine fertility status and parity in Babol, Iran and then identify physical activity and body mass index (BMI) among women who have experienced infertility. MATERIAL AND METHODS: A total of 1,081 women aged 20-45 years were selected using cluster sampling. The current physical activity was measured using the original International Physical Activity Questionnaire short form. Lifestyle factors were compared between those who had experienced infertility (n = 168) and the rest of the women. A face-to-face household interview was conducted using a specially designed interview questionnaire. RESULTS: After adjusting for suspected confounding factors, women with infertility experience had a 4.8-fold increased risk of obesity (OR = 2.02, CI = 0.70, 5.84) and almost a 3.8-fold increased risk of being overweight (OR = 2.11, CI = 0.72, 6.17) compared to women without infertility. No significant differences were found in Met-minutes of sedentary activity, intensity of walking, moderate, vigorous, and total physical activity, self-reported dietary intake, exercise, and level of physical activity between women with and without experience of infertility. CONCLUSIONS: Since both obesity and infertility are increasing public health issues in Iranian women, more attention should be paid to lifestyle behaviors, especially gaining weight in women who have experienced infertility.

Assess quality of life among Iranian married women residing in rural places.

It is important how women describe their quality of life. The aim of this study was to evaluate the effects of rural residence on quality of life of the married women. The Wellness and Quality of Life Questionnaire (WHOQOL) was used to assess QOL rural residence in Iranian married women. A total of 1,140 (577 urban and 563 rural) women aged 20-45 years were selected using standard cluster sampling technique in Babol, Iran. The questionnaire with 55 items consists of five domains: physical state, mental/emotional state, stress evaluation, life enjoyment, and overall quality of life. Lower scores in three domains: physical state, mental/emotional state, and stress evaluation mean better QOL. Higher scores in life enjoyment and overall quality of life mean better QOL. Rural residences smoke more and have a lower level of education, higher level physical activity, higher level of good self reported dietary, and lower long term health problems than urban residents. After adjusting confounding variables, logistic regression indicated living in rural settings statistically decrease the probability of having worse quality of life related to physical health (OR 0.67; CI 0.50-0.91), higher life enjoyment (OR 0.44; CI 0.32-0.61), and better overall QOL (OR 0.44; CI 0.37-0.61). The results have been suggested to be useful in order to anticipate greater health care needs of the rural married women and improve their quality of life by providing more opportunities for rural women.

Epidemiology of infertility: a population-based study in Babol, Iran.

The aim of researchers in the present study was to determine the prevalence of infertility and self-reported cause of infertility in Babol, Iran and then identify the factors associated with infertility. A retrospective epidemiologic study was conducted of characteristics of urban and rural women related to infertility. A total of 1,140 women aged 20-45 years were selected using cluster sampling. Of these 1,140 women, 59 (5.2%) (CI 4.2, 6.2) were voluntarily childless. Of the remaining 1,081 women, 913 (84.5%) (CI 82.5, 86.5) reported no difficulties in having children, and the remaining 168 (15.5%) (CI 13.5, 17.5) experienced difficulty conceiving at some stage in their lives. The prevalence of ever having primary infertility was 4.3% (CI 2.3, 6.3). The most frequently self-reported causes of infertility in this study were ovulation problems (39.2%). Infertile women were significantly more likely to have a higher age at marriage (p = 0.001), lower education (p = 0.006), higher body mass index (p = 0.0001), long-term health problems (p = 0.0001), a partner who smoked (p = 0.029), and past history of tubal or ectopic pregnancy (p = 0.002). These risk factors may help inform reproductive health clinics and primary healthcare centers about factors associated with infertility.

Does Adding Dexamethasone to Clomiphene Citrate Improve Ovulation in PCOS Patients? A Triple - Blind Randomized Clinical Trial Study.

BACKGROUND: A common cause of anovulation is polycystic ovarian syndrome (PCOS). Clomiphene citrate (CC) is the first line of treatment in PCOS patients however approximately 25% of patients may be CC-resistant. This study aimed to evaluate the efficacy of adding dexamethasone (dex) to CC in CC-resistant PCOS patients with the intent to improve ovulation. MATERIALS AND METHODS: This randomized controlled trial study was performed on 60 infertile PCOS patients referred to our infertility research center from 2007 to 2009. Patients were randomly divided in two groups and stimulation performed with dex+CC or CC+placebo. Rates of ovulation, pregnancy and number of mature follicles were evaluated. RESULTS: Ovulation rate in the dex+CC group was 21 out of 30 (70%) and in the CC+placebo group it was 17 out of 30 (56.7%). The pregnancy rate was 5 (16.7%) in the dex+CC group and 3 (10%) in the CC+placebo group. There was no significant difference between rates of ovulation and pregnancy in both groups, but the number of follicles ≥18 mm were significant in the dex+CC group (p<0.05). CONCLUSION: Our results showed that addition of dex to cc significantly increased the number of matured follicles, however the ovulation and pregnancy rates were comparable between the two groups (Registeration Number: IRCT 138807041760 N2).