Study of The Relationship Between 24-hour Urine Protein Excretion Rate and Protein/Creatinine Ratio in Random Urine Specimen of Women with Preeclampsia.

INTRODUCTION: Early diagnosis and management of preeclampsia are very important to reduce fetal and maternal complications. In this study, we examined the ratio of protein to creatinine in a random urine sample and its relationship to the rate of 24-hour urine protein excretion for quick detection and prompt management of this condition in women with preeclampsia. METHODS: In this descriptive-analytical cross-sectional study, 60 pregnant women with preeclampsia referred to the maternity ward of Ali Ebn -e Abitaleb hospital of Zahedan in 2019 were recruited. The 24-hour urine protein excretion and the ratio of protein to creatinine in a random urine sample were compared in these patients. RESULTS: The results showed that there was a positive correlation between the 24-hour urinary protein excretion and the protein to creatinine ratio of the random urine sample in preeclampsia (P < .001, r = 0.515). Women with a higher 24-hour protein excretion also had a higher urinary protein to creatinine ratio. CONCLUSION: In general, based on the results of this study, it can be concluded that the ratio of protein to creatinine in the random urine sample has a good diagnostic efficiency in suspected preeclampsia. It is a quick alternative method for detecting suspicious proteinuria and could be used as a screening test in emergency situations.  DOI: 10.52547/ijkd.7457.

Corrigendum to "The effect of topical endometrial scratching on pregnancy outcome in women with previous failure of intrauterine insemination: A non-randomized clinical trial" [Int J Reprod BioMed 2021; 19: 465-470].

[This corrects the article DOI: 10.18502/ijrm.v19i5.9256.].

Right-side inguinal canal endometriosis at ultrasound: A case report.

Background: The first case of inguinal endometriosis was described by Cullen. Endometriosis in the round ligament could be in the pelvic or inguinal area and is a rare disease occurring in 0.6% of women. Women with inguinal endometriosis have a painful inguinal mass during menstrual cycles and they mostly have a history of surgery. The right side is more commonly involved in inguinal endometriosis than the left side (90-94%). A history of gynecologic or abdominal surgery is common in women with inguinal endometriosis. Case presentation: In our case, a 39-yr-old virgin woman presented with localized pain in the right inguinal that had been present for 4 yr. She did not have any history of previous surgery, and abdominal ultrasonography showed a hypoechoic mass with minimal vascularity. Inguinal endometriosis was correctly diagnosed by two expert radiologists preoperatively, and she underwent laparoscopic surgery. Conclusion: Considering inguinal endometriosis in the differential diagnosis of women with inguinal masses is important, even if there is no history of gynecologic or abdominal surgery.

The effect of topical endometrial scratching on pregnancy outcome in women with previous failure of intrauterine insemination: A non-randomized clinical trial.

BACKGROUND: The prevalence of infertility is increasing worldwide and the treatment is one of the important issues. OBJECTIVE: This study aimed to evaluate the effect of local endometrial scratching on pregnancy outcomes in women with previous failure of intrauterine insemination. MATERIALS AND METHODS: This non-randomized clinical trial study was performed on 336 women referred to the infertility clinic of Ali ebn-e Abitaleb Hospital of Zahedan (between May and November 2019). Women were divided into two groups: endometrial scratch as case and a control group. In the case group (n = 173), endometrial scratching was performed on days 8-9 of the menstrual cycle in addition to routine infertility treatments, while in the control group (n = 163), only routine treatment was performed. Chi-square test was used to compare the frequency of male factor severity and the percentage of successful pregnancies between both groups and was used to investigate the effect of male factor on the fertility rate in each group (moderate male factor and mild male factor). RESULTS: The mean age of the women was 28.4 ± 5.2 yr. The success rate of pregnancy in the case group was 12.3% and in the control group 11%, which were not statistically significant (p = 0.697). CONCLUSION: Overall, the results of this study showed that endometrial scratching had no effect on the pregnancy rate.

Maternal and Fetal Outcomes of Pregnant Women Infected with Coronavirus Based on Tracking the Results of 90-Days Data in Hazrat -E- Rasoul Akram Hospital, Iran University of Medical Sciences.

OBJECTIVE: To evaluate the maternal and fetal outcomes of COVID-19 up to three months after the delivery in pregnant women. METHODS: This case series study was conducted on all pregnant women with COVID-19 hospitalized in Hazrat -E- Rasoul Akram Hospital, Tehran, Iran from March 8, 2020 to December 28, 2020. Data were included maternal age and gestational age (GA) which presenting signs and symptoms were collected at hospital admission. To confirm COVID-19 diagnosis, high-resolution computed tomography (HRCT) or reverse transcription-polymerase chain reaction (RT-PCR) tests were conducted. Both the mothers and the newborns were followed up to three months after delivery. RESULTS: Fourteen pregnant women with the median age of 31.5 were enrolled. HRCT was done in twelve mothers (85.7%), and eleven mothers (78.6%) were evaluated via RT-PCR; four of them (36.36%) were positive. Two mothers (14.28%) were admitted to ICU. The cesarean section (C/S) was done following fetal distress in only three mothers due to their concerns of vertical transmission. Two mothers were admitted to the intensive care unit (ICU), and one of them died of pneumomediastinum. Fortunately, no neonatal death was reported three months after the delivery. CONCLUSION: COVID-19 affects mothers more in the last trimester of the pregnancy. Although no fetal death was reported in the recent study, physicians should closely monitor pregnant women to reduce the adverse event .

Comparison of ovulation induction with letrozole plus dexamethasone and letrozole alone in infertile women with polycystic ovarian disease: An RCT.

BACKGROUND: Infertility is characterized by the inability to obtain a successful pregnancy after 6 months or more with unprotected and regular intercourse. In developing countries, the incidence of infertility is 2%. The causes of infertility could be male factor or female factor, or mixed factor. OBJECTIVE: This study was conducted with the aim of comparison the ovarian response to letrozole alone and letrozole plus dexamethasone in infertile women with poly cystic ovarian disease (PCOS). MATERIALS AND METHODS: This randomized clinical trial was conducted on 120 infertile women with PCOS referred to Ali-Ebne-Abitaleb hospital, Zahedan, Iran from February to August 2017 into two groups: group I received letrozole alone and group II recived letrozole plus dexamethasone. The endometrial thickness, follicle diameter, and ovulation were evaluated and compared by ultrasound on days 12 to 14. RESULTS: The mean thickness of endometrium was not different between two groups. Pregnancy rate was 8% in letrozole group and 23% in Letrozole plus Dexamethasone (p = 0.024). Also, the mean diameter of follicles in two groups were not statistically significant. CONCLUSION: Overall, this study showed that dexamethasone may increase pregnancy rate.

Association of ACE I/D and AGTR1 A1166C Gene Polymorphisms and Risk of Uterine Leiomyoma: A Case-Control Study.

Objective: Uterine leiomyoma (UL) can be considered as the most common benign gynecological tumors of the smooth muscle cells in the myometrium. They are likely to be associated with infertility and recurrent abortion as well as obstructed labor and post-partum hemorrhage. Moreover, altered vascular-related genes can be linked to developing leiomyoma. Polymorphisms of the angiotensin-converting enzyme (ACE) gene are associated with some vascular diseases. The present study was carried out to investigate the association of ACE I/D and AGTR1 A1166C gene polymorphisms and the risk of uterine leiomyoma in a sample of Iranian population. Methods: The study was carried out on a total of 413 women divided into 202 patients with diagnosed uterine leiomyomas and a control group of 211. Genotyping was performed using the PCR or PCR-RFLP methods. Results: The ID and DD genotypes of ACE I/D polymorphism were associated with 2 and 2.9 fold higher risk of UL compared to II genotype (OR, 2 [95% CI, 1.3 to 3.2]; P = 0.004 and OR, 2.9 [95% CI, 1.6 to 5]; P = 0.0002). The frequencies of ACE D alleles were 53.7% in women with UL and 40.3% in controls, which were observed to be statistically different (P < 0.0001). The alleles and genotypes of AGTR1 A1166C polymorphism were not different between UL and control women (P=0.9). Conclusion: The ACE ID and DD genotypes were associated with a higher risk of UL. No relationship was found between AGTR1 A1166C polymorphism and UL.

Evaluation of Prevalence of Changes in Thyroid Functional Tests in Mole Hydatiforme

Introduction: Mole hydatiforme is the most common type of gestational trophoblast disease (GTI) and the aim of this study, is evaluation the frequency of changes in thyroid function test in mole hydatidiform patients. Materials and Methods: In this retrospective study, 63 patients with mole hydatidiform who reffering to gynecolgy ward of Ali ibn Abitaleb Hospital in Zahedan from April 2016 to March 2017, were studied. Information such as age, gravidity and laboratory findings inclluding thyroid function test (TFT) and the presence or absence of clinical sympltoms were recorded in the information forms and analyzed by SPSS software. Results: In this study, 63 patients with mole hydatidiform were studied. The mean age of the patients was 26.6 ± 7.7 years. The most common clinical manifestations of hyperthyroidism in patients with mole hydatidorme was tachycardia (39.7%). There was no relationschip between age and gravidity with the hyperthyroid simptoms and thyroid function test. Conclusion: Overall, the results of this study showed ttat 67% of patients with mole hydatidiform hay reduced TSH and more than 50% of cases hay increased free T3 and T4. There was no relationship between maternal age and gravidity with changes in thyroid functional test (AU)

Prevalence of Celiac in Infertile Women Due to Unexlained Infertility

Introduction: Celiac disease is an immune response to a gluten-based diet that affects the small intestines of people with a genetic predisposition to disease. Celiac has intra intestinal and extra instestinal manifestations., In recent years, celiac and infertility have been considered. The present study examines the effect of celiac disease and its treatment on the menstrual cycle, pregnancy and menopause. In this study, we compared the prevalence of celiac disease in fertile women with infertile women in Zahedan. Materials and Methods: In this case control study, 150 patients with unexplained infertility from Febraury 2016 to 2017 referred to Infrtility Clinic of Alis ibn-Abitaleb Hospital in Zahedan (Iran), were included in the study. Total IgA and IgA TTG were evaluated. IƒTTG is positive, for confirmation of diagnosis, biopsy is performed from the distal part of the duodenum. In control group, 150 fertile women with two or more children with the same characteristics were studied. Results: Theree patients with unexlained infertility (2%) were positive for TTG. Two of them (1/3%) were positive to celiac disease in small intestinal biopsy. None of the women in the control group had TTG positive (p=0.49) Discussion and Conclusion: It seems that some infertile patients with unexplained infertility suffer from celiac disease, but with a (p=0.49), it seems that celiac screening as a cause of infertility with unexplained cause needs more studies with larger sample size in Iran (AU)

Association of HOTAIR gene polymorphisms and haplotypes with uterine leiomyoma susceptibility in southeast of Iran.

Uterine leiomyoma (UL) is the most common benign tumor of the uterus. HOX transcript antisense RNA (HOTAIR) as a lncRNAs is the product of HOXC gene that plays a major role in the invasion and development of different tumors. Several lines of evidence have been suggested the effects of HOTAIR polymorphisms on cancer risk. The aim of the present study was to analyze the effects of HOTAIR polymorphisms (rs12826786, rs920778, rs4759314 and rs1899663) on UL in southeast of Iran. A total of 152 women with UL and 182 age-matched healthy women were selected in the case-control study. The PCR-RFLP and ARMS-PCR methods were used for genotyping. HOTAIR rs920778 polymorphism was associated with a lower risk of UL in dominant [OR, 0.5 (95% CI, 0.3-0.9); P = 0.03], recessive [OR, 0.6 (95% CI, 0.4-0.9; P = 0.016] and allelic models [OR, 0.6(95% CI, 0.5-0.9); P = 0.004]. However, HOTAIR rs12826786 polymorphism was associated with a higher risk of UL in dominant [OR, 2.6 (95% CI, 1.6-4.1); P = 0.0001], recessive [OR, 1.9 (95% CI, 1-3.6); P = 0.04] and allelic models [OR, 1.8 (95% CI, 1.3-2.4); P = 0.0003]. There was no association between HOTAIR rs4759314 and rs1899663 polymorphisms and UL susceptibility. The frequency of CTGA haplotype was lower in UL women; however, the CCGA, TCGA, TTTA, and TTGA haplotypes were more frequent in UL women. Our results indicated that HOTAIR rs12826786 and rs920778 polymorphisms had a significant effect on UL susceptibility. The HOTAIR haplotypes could affect UL susceptibility.

Assessment of occurrence of preeclampsia and some clinical and demographic risk factors in Zahedan city in 2017.

Background: Blood pressure dysfunctions are one of the biggest complications and causes of maternal mortality during pregnancy. The aim of the present study is to evaluate some of the clinical and demographic risk factors in various aspects, both of which can help to better understand the causes and reduce the incidence of preeclampsia. Method: This nested case-control study was carried out on 270 pregnant women with preeclampsia as the case group and 270 pregnant women who did not have symptoms of preeclampsia at the time of referral were interviewed according to inclusion criteria as the control group. The factors studied included age, body mass index, history of hypertension in mother, history of diabetes in mother, history of lupus in mother, number of pregnancies, history of preeclampsia in previous pregnancies, twin or more pregnancies, season of occurrence, maternal educational level, maternal blood group, maternal occupation status, infant's sex and smoking status which were compared etween the  two groups. t test and Chi-square tests were used to compare the variables in both groups. Fisher's exact test or Mann-Whitney U test was used if necessary. Findings: Of the 6929 pregnant women who participated in our study, 541 (7.8%) had preeclampsia. The means of body mass index (BMI) (24.86% versus 23.52%) (P = 0.032), the history of hypertension (19.3% versus 10.7%) (P = 0.006), history of preeclampsia in previous pregnancies (60.2% versus 13.3%) (P < 0.001), low level of education and illiteracy (51.1% versus 39.6%) (P = 0.028), and twin or more pregnancies (5.6% versus 2.2%) (P = 0.045) were significantly higher in the case group when compared to the control group. There was no statistically significant difference between the mean and standard deviation of age and number of pregnancies and the frequency of diabetes and lupus, the frequency of maternal occupation, maternal smoking, maternal blood group, and season of occurrence in the two groups (P > 0.05). Conclusion: Maternal BMI, maternal hypertension, history of preeclampsia in previous pregnancies, low maternal educational status, and twin or multiple pregnancies might be the risk factors for preeclampsia during pregnancy.

Impact of Gestational Weight Gain on Cesarean Delivery Risk, Perinatal Birth Weight and Gestational Age in Women with Normal Pre-pregnancy BMI.

BACKGROUND: Gestational weight gain (GWG) proportional to body mass index before pregnancy is one of the factors on maternal and neonatal outcomes. The aim of the current study was to assess association between GWG, and cesarean section, birth weight and gestational age at birth in women with normal BMI prior to pregnancy. METHODS: This was a cross-sectional study carried out in 103 hospitals in Tehran, the capital of Iran, from July 6 to 21, 2015. The data were extracted by 103 trained midwives. Finally, 2394 pregnant women with normal BMI before pregnancy and singleton birth were examined. GWG was categorized based on Institute of Medicine (IOM) recommendations. RESULTS: Prevalence of low birth weight (LBW) was 5.41% and prevalence of macrosomia was 2.18%. The prevalence of LBW in women with GWG less than the weight gain recommended by IOM was 2.13 times [95% confidence interval (CI) 1.13-4.02, P = 0.019] more than in women with GWG equal to the weight gain recommended by IOM. There was no statistically significant difference in the prevalence of LBW between women with GWG more than recommended weight gain by IOM and women with GWG equal to the weight gain recommended by IOM (OR = 1.21, 95% CI 0.61-2.38, P = 0.580). CONCLUSION: After controlling for confounding variables, the prevalence of cesarean section and preterm birth had no significant difference at various levels of GWG. Accordingly, the prevalence of LBW among women with GWG less than the recommended weight gain by IOM was significantly 2.13 more than that among women with GWG equal to the recommended weight gain by IOM.