Complications of illegal abortion in the suburbs of Tehran: A 9-year cross-sectional study.

BACKGROUND: Illegal abortion is a common way to terminate unintended pregnancy. It may be associated with severe complications and may raise maternal mortality and morbidity rate. Illegal abortion is one of the important concerns in health system. In our study, we consider illegal abortion claims in Medical Council court in the suburbs of Tehran. MATERIALS AND METHODS: A retrospective study was conducted. Data were extracted from registered judicial complainant cases of illegal abortion in Shahriyar medical court, Iran, during 2009-2017. RESULTS: There were 751 registered claims during 2009-2017. Among them, a total of 95 gynecological claims were included in the study. Four (4.2%) registered claims were illegal abortion with severe complications such as peritonitis, rupture of uterine, small intestine, rectum, and mesentery perforation. Three cases had consumed misoprostol (prostaglandin E2) and one case had used prostaglandin E1 before curettage. Misoprostol was also used significantly more frequently than other methods for abortion before curettage (P < 0.05). Minor and short-term complications did not registered. CONCLUSION: The feature of claims showed that only severe morbidity and complications were registered in medical court. The definition of illegal abortion as a criminal act can be one of the factors of decreasing of abortion's complication claims.

"Stain in life": The meaning of urinary incontinence in the context of Muslim postmenopausal women through hermeneutic phenomenology.

INTRODUCTION: UI is a worldwide chronic condition among postmenopausal women. Little is known about the meaning of lived experiences of urinary incontinence of these women's viewpoints in their context. OBJECTIVE: The aim of this study was to illuminate the experience of Muslim community-dwelling postmenopausal women who were living with urinary incontinence (UI). METHODS: Seventeen women with UI (range: 52-68 years) who had experienced it for more than ten years were interviewed. A phenomenological hermeneutic method was used to analyze and interpret the interview texts. RESULTS: The women's experiences of living with urinary incontinence have been presented in terms of three main themes: disruption of normal functioning, self-imposed restriction, and feelings of despair. Disruption of normal functioning meant emotional, spiritual, physical, and daily life disruption. Self-imposed restriction meant suppression of delights and needs and avoidance of social interactions. Feelings of despair referred to predictions of a bad and dark future of living with urinary incontinence, ambiguity, and hopelessness. The meaning of living with UI has been considered a 'stain in life'. Health care providers should be familiar with the different manifestations of urinary incontinence for early diagnosis and prevention of the negative effects of this condition to improve quality of life. In addition, symbolic interactionism theory can help health care providers to understand the meaning of urinary incontinence for women.

Comparison of osteogenic medium and uniaxial strain on differentiation of endometrial stem cells.

BACKGROUND: Mechanotransduction plays a pivotal role in remodeling and repair of skeletal tissues. This mechanism has been widely used in bone tissue engineering especially under in vitro conditions. To date, various stem cells have been used for this purpose. The present study was the first to evaluate the effect of mechanical loading on differentiation of human endometrial stem cells (hESCs) to osteoblasts. MATERIALS AND METHODS: Adhesion of endometrial stem cells after isolation and culture on a silicone membrane covered with collagen was evaluated under scanning electron microscope (SEM). Twenty-four hours after cell culture on the membrane and ensuring appropriate cell adhesion, a group of cells in a conventional culture medium received 3% static uniaxial strain. In the positive control group, cells cultured on the membrane were placed in an osteogenic medium without receiving any mechanical strain. The negative control group was placed in a regular medium and received no strain either. Two weeks later, cultured cells were evaluated for expression of osteogenic markers using immunofluorescence staining and real-time polymerase chain reaction (PCR). Data of real-time PCR was analyzed by ANOVA. P < 0.05 was considered statistically significant. RESULTS: SEM analysis revealed adequate cell adhesion to the membrane after 24 h. Two weeks after loading, expression of markers in the positive control group was significantly higher compared to test group. CONCLUSION: We can conclude that static uniaxial strain exerted on hESCs results in their differentiation to osteoblasts. However, this magnitude of static strain in the tested time period cannot yield excellent differentiation when compared to the osteogenic medium.

Clinical and ultrasonographic changes of the breast after use of soy isoflavones.

BACKGROUND: Phytoestrogens may be an alternative therapy in control of menopausal symptoms but their definite effects on breast tissue must be determined. Our study aimed to define the clinical and ultrasonographic changes of the breast after use of soy isoflavones in menopausal women. MATERIALS AND METHODS: Menopausal women with hot flashes were randomly grouped as cases and controls and cases received soy isoflavones for 12 weeks. Breast examination (BE) and ultrasonography (US) were done at 0, 6 and 12 weeks. Tenderness and nodularity on BE were graded 1-4 by breast surgeons. RESULTS: There were 30 women in the case and 26 in the control group. The mean age was 51.3 years and the mean age of menopause was 49.2 years. There was no change in the BE and US at 6 weeks in controls. In the case group, 10% had grade 1 tenderness and 13.3% grade 2 tenderness and grade 1 nodularity in BE accompanied with diffuse small cysts in US. At 12 weeks, there was no change in BE and US in the 2 groups. CONCLUSIONS: There was no statistically significant difference in the BE of the 2 groups at 6 and 12 weeks (p value=0.36 and 0.41 for nodularity and tenderness respectively) and in the US results. Although the literature contains many facts concerning PEs and the breast, further prospective studies are needed to identify structural breast changes produced by PEs in order to identify the appropriate dosage and indications of use.

Sildenafil citrate and uteroplacental perfusion in fetal growth restriction.

BACKGROUND: To determine whether the phosphodiesterase type 5 inhibitor, Sildenafil citrate, affects uteroplacental perfusion. MATERIALS AND METHODS: Based on a randomized double-blinded and placebo-controlled trial, forty one pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were evaluated for the effect of a single dose of Sildenafil citrate on uteroplacental circulation as determined by Doppler ultrasound study of the umbilical and middle cerebral arteries. Statistical analysis included χ(2)-test to compare proportions, and independent-samples t-test and paired student's t-test to compare continuous variables. RESULTS: Sildenafil group fetuses demonstrated a significant decrease in systolic/diastolic ratios (0.60 [SD 0.40] [95% Cl 0.37-0.84], P=0.000), and pulsatility index (0.12 [SD 0.15] [95% Cl 0.02-0.22], P=0.019) for the umbilical artery and a significant increase in middle cerebral artery pulsatility index (MCA PI) (0.51 [SD 0.60] [95% Cl 0.16-0.85], P=0.008). CONCLUSION: Doppler velocimetry index values reflect decreased placental bed vascular resistance after Sildenafil. Sildenafil citrate can improve fetoplacental perfusion in pregnancies complicated by intrauterine growth restriction. It could be a potential therapeutic strategy to improve uteroplacental blood flow in pregnancies with fetal growth restriction (FGR).