Effects of oral contraceptives on serum concentrations of adipokines and adiposity indices of women with polycystic ovary syndrome: a randomized controlled trial.

PURPOSE: To compare the effects of oral contraceptives (OCs) with different progestins, including Levonorgestrel (LNG), Desogestrel (DSG), Cyproterone Acetate (CPA), and Drospirenone (DRSP) on adipokines levels and adiposity indices in women with polycystic ovary syndrome (PCOS). METHODS: In this parallel randomized clinical trial, 120 women with PCOS randomly assigned to intervention with OCs containing LNG, DSG, CPA, or DRSP. Outcomes of interest, including serum concentrations of adiponectin, leptin, and resistin, and adiposity indices, i.e., body mass index (BMI), waist circumference (WC), obesity, central obesity, waist to hip ratio (WHR), waist to height ratio (WHtR), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), and visceral adiposity index (VAI), and lipid profiles were assessed at baseline, and 6 months of treatment. RESULTS: This study showed no significant differences in serum concentrations of adipokines between the four study groups after 6 months of treatment. Our results also showed that patients treated with various compounds of OC for 6 months had no significant differences in their adiposity indices, except for LAP (p = 0.04), and VAI (p = 0.03). PCOS patients treated with OCs containing CPA had significantly a higher mean LAP, compared to those using products containing LNG. Besides, patients treated with OCs containing CPA had significantly a higher mean VAI, compared to those treated with OCs containing DRSP. CONCLUSION: This study demonstrated that OCs with low androgenic and antiandrogenic activities had identical effects on serum concentrations of adipokines, and adiposity indices, except LAP, and VAI parameters. REGISTRATION NUMBER: IRCT20080929001281N3.

An Exploration of the Maternal Experiences of Breast Engorgement and Milk Leakage after Perinatal Loss .

INTRODUCTION & PURPOSE: Perinatal loss is one of the toughest events of life. Physiological milk secretion after perinatal loss adds to complicacy of the hardships of the event. The present study is aimed at exploring women's experience with breast problems and milk leakage after perinatal loss. METHODS: The Study was carried out through explorative quality approach with 18 participants. Sampling method was purposeful and selecting the participants from widest variety was ensured. Data gathering was through deep semi-structured interview and data analyses were done by conventional content analysis. Reliability and validity of the data were ensured by collecting data from a wide range of participants and frequent revisions. FINDINGS: Data analysis indicated four themes including beyond pain, longing being mother, insufficiency of provided information and coping Strategies, and beliefs and values regarding milk leakage and breast engorgement. CONCLUSION: The findings suggested that health care givers needed to inform the patients about probability milk leakage and breast engorgement and remedies to reduce pains and problems of breast engorgement.

Relationship between air pollution and pre-eclampsia in pregnant women: a case-control study.

Pre-eclampsia is the main cause of maternal and fetal death and disability worldwide. Its incidence in the Islamic Republic of Iran is 5%-12%. Air pollution has been reported to be one of the causative factors, and this case-control study determined its effect on pre-eclampsia in 195 pregnant women (65 with pre-eclampsia and 130 without) admitted to hospitals in Tehran. Women were divided into high and low exposure groups according to the mean density of exposure to pollutants during pregnancy. There was no statistically significant relationship between exposure to air pollutants including CO, particulate matter, SO2, NO2 and O3 and pre-eclampsia. The combined effect was also not significant. Air pollution is one of the problems of modern society and its avoidance is almost impossible for pregnant women. This study should reduce concern about pregnant women living in polluted cities.

Educational needs assessment for men's participation in perinatal care.

To assess men's educational needs to improve their involvement in perinatal care we carried out a descriptive, cross-sectional study on 400 women seeking perinatal care in Shahid Beheshti University of Medical Sciences hospitals and 400 men who were accompanying them. Participants were recruited using a quota sampling method. A questionnaire was used to collect information on demography, men's educational needs and attitude assessment. The mean attitude score was 79.13% (SD 10.5%). More than 95% of participants agreed with perinatal care education for men and the content most required was "Signs of risks during the perinatal period" and "Mothers' nutrition". The majority of participants preferred the face-to-face couples' counselling method, at home as the best place, evening and weekends as the best time and marriage classes as the best time for initiation. Men's education is necessary to promote male involvement in perinatal care.

Educational needs assessment for men's participation in perinatal care

To assess men's educational needs to improve their involvement in perinatal care we carried out a descriptive, cross-sectional study on 400 women seeking perinatal care in Shahid Beheshti University of Medical Sciences hospitals and 400 men who were accompanying them. Participants were recruited using a quota sampling method. A questionnaire was used to collect information on demography, men's educational needs and attitude assessment. The mean attitude score was 79.13% [SD 10.5%]. More than 95% of participants agreed with perinatal care education for men and the content most required was "Signs of risks during the perinatal period" and "Mothers' nutrition". The majority of participants preferred the face-to-face couples' counselling method, at home as the best place, evening and weekends as the best time and marriage classes as the best time for initiation. Men's education is necessary to promote male involvement in perinatal care

Comparing the complications of 2 copper intrauterine devices: T380A and Cu-Safe 300.

This single-blind case-control study compared the complications of 2 intrauterine devices in consecutive referrals for device insertion in clinics of Shaheed Beheshti University of Medical Sciences, Islamic Republic of Iran. Women who met the inclusion criteria (n = 110) were randomly allocated to receive copper T380A (controls) or Cu-Safe 300 (cases). Moderate or severe pain during the device insertion was reported in 69.1% of controls and 47.3% of cases. Bleeding, vertigo and crampy pain at insertion were not significantly different between the groups. After 3 months follow-up, blood spotting was reported in 16.3% and 32.7% of controls and cases respectively. The Cu-Safe-300 group had less pain and menstrual bleeding but copper T380A had less spotting after 3 months. Studies on longer term complications are strongly recommended.

Comparing the complications of 2 copper intrauterine devices: T380A and Cu-Safe 300

This single-blind case-control study compared the complications of 2 intrauterine devices in consecutive referrals for device insertion in clinics of Shaheed Beheshti University of Medical Sciences, Islamic Republic of Iran. Women who met the inclusion criteria [n = 110] were randomly allocated to receive copper T380A [controls] or Cu-Safe 300 [cases]. Moderate or severe pain during the device insertion was reported in 69.1% of controls and 47.3% of cases. Bleeding, vertigo and crampy pain at insertion were not significantly different between the groups. After 3 months follow-up, blood spotting was reported in 16.3% and 32.7% of controls and cases respectively. The Cu-Safe-300 group had less pain and menstrual bleeding but copper T380A had less spotting after 3 months. Studies on longer term complications are strongly recommended

Comparison of fern and evaporation tests for detection of ruptured fetal membranes.

Timely diagnosis of ruptured fetal membranes during the pregnancy is important. This study in the Islamic Republic of Iran compared the sensitivity and specificity of the evaporation test that requires no special equipment with the standard fern test requiring a microscope. Two groups of 50 pregnant women were studied: 1 with artificially ruptured membranes (gold standard) and 1 with intact membranes. The positive and negative predictive values of the fern test were 92% and 96% and for the evaporation test were 89% and 98%. The evaporation test is a simple, easy and non-expensive diagnostic test for ruptured membranes.

Comparison of fern and evaporation tests for detection of ruptured fetal membranes

Timely diagnosis of ruptured fetal membranes during the pregnancy is important. This study in the Islamic Republic of Iran compared the sensitivity and specificity of the evaporation test that requires no special equipment with the standard fern test requiring a microscope. Two groups of 50 pregnant women were studied: 1 with artificially ruptured membranes [gold standard] and 1 with intact membranes. The positive and negative predictive values of the fern test were 92% and 96% and for the evaporation test were 89% and 98%. The evaporation test is a simple, easy and non-expensive diagnostic test for ruptured membranes

Prevention of early islet graft failure by selective inducible nitric oxide synthase inhibitors after pig to nude rat intraportal islet transplantation.

BACKGROUND: Clinical and experimental data indicate that early failure of intraportally grafted islets is caused by inflammation including secretion of cytokines and nitric oxide. Direct inducible nitric oxide synthase suppression may avoid detrimental effects associated with steroid administration. We compared the efficiency of selective and unselective inducible nitric oxide synthase inhibitors with dexamethasone to suppress nitric oxide generation after intraportal islet xenotransplantation into nude rats. METHODS: Nonfasting serum glucose levels were daily evaluated after intraportal transplantation of 4000 freshly isolated pig islets into diabetic nude rats (85 mg/kg streptozotocin) either sham-treated with saline (n=21) or continuously infused for 7 days with L-NG-monomethyl-arginine (n=7), S-methyl-isothiourea (n=15), or S-(2-aminoethyl)-isothiourea (n=19) in a dosage of 240, 100, or 50 mg/kg/day, respectively. Dexamethasone was injected i.p. twice as a daily bolus of 20 mg/kg (n=10) starting 1 day pretransplant. The nitrate/nitrite serum level was quantified colorimetrically 0, 24, and 48 hr posttransplant. RESULTS: Saline treatment partially resulted in graft function (4/21) throughout the observation period (21 days). L-NG-monomethyl-arginine-treated rats showed sustained hyperglycemia (0/7) not different from diabetic controls. Normoglycemia was observed after treatment with dexamethasone (6/10, P<0.05 versus saline and L-NG-monomethyl-arginine), S-methyl-isothiourea (10/15, P<0.01), or S-(2-aminoethyl)-isothiourea (15/19, P<0.001). Graft function was associated with complete suppression of nitric oxide generation after S-methyl-isothiourea and S-(2-aminoethyl)-isothiourea treatment (P<0.001 versus saline) and partial suppression after dexamethasone treatment (P<0.05). CONCLUSIONS: Our observation of long-term function of xenogeneic islets in an inflammatory environment without interference of reactive T cells revealed the potency of highly selective isothioureas to completely suppress inducible nitric oxide synthase making reduction of islet-toxic immunosuppression feasible.

Pretransplant induction of HSP-70 in isolated adult pig islets decreases early islet xenograft survival.

The heat-induced HSP-70 expression protects rat islet single cells against lysis mediated by nitric oxide (NO), reactive oxygen, and streptozotocin. The present study was performed to investigate the potential antiinflammatory effect of pretransplant heat shock in adult pig islets for subsequent early islet xenograft survival. Maximum HSP-70 expression in freshly isolated pig islets was induced by hyperthermia at 43 degrees C for 90 min prior to islet regeneration at 37 degrees C for 4-6 h. Heat-stressed and sham-treated islets were incubated in 0.6 mM H2O2 or 1.5 mM Na-nitroprusside at 37 degrees C for 20 h. Early graft survival was evaluated in normoglycemic Lewis rats after simultaneous, contralateral transplantation of heat-shocked islets and sham-treated islets into the renal subcapsular space of the same recipient. Prior hyperthermia significantly reduced specific lysis of islets exposed to NO or H2O2, although protection was only marginal. No differences were observed between viability of heat-shocked and sham-treated islets after NO exposure. In contrast, prior heat shock increased islet viability after H2O2 treatment. The finding that hyperthermia reduced recovery of initially grafted pig insulin 48 h after transplantation by 30% compared to controls contrasted significantly with an increased insulin recovery in heat-exposed islets at the end of simultaneous 37 degrees C culture. The observation, that the heat-induced HSP-70 expression decreases early islet xenograft survival as reflected by recovery of grafted insulin, implies an enhancement of islet immunogenicity and the induction of apoptosis. Future experiments aiming at augmentation of intrinsic defense mechanisms should consider detrimental effects associated with induction of heat shock proteins.

[Graft rejection in experimental xenogenic transplantation of isolated islands of Langerhans of the pig]. / Abstossungsreaktionen bei der tierexperimentellen xenogenen Transplantation von isolierten Langerhansschen Inseln des Schweins.

Prevention of the occurrence of diabetes-specific vascular complications is the final aim of clinical islet transplantation. Pancreatic islets isolated from adult pigs may be a suitable tissue source to transplant a large number of type 1 diabetic patients. Acute cellular rejection may be finally overcome by clinically applicable protocols for tolerance induction. However, primary nonfunction of the graft, as regularly observed in the porcine islet-to-rat xenotransplantation model, may be an additional problem. In this paper, species-specific inflammatory and immunological mechanisms are discussed which prevent early porcine islet graft function in rats but not in mice.