Monitoring the utilization and effectiveness of Iron and Vitamin D supplementations program and its predictive factors in high schools' girls in Qom, Iran.

Background: Iron and Vitamin D3 deficiency is one of the major global health problems in teenagers and adolescent population. This study was aimed to monitor the utilization and predictive factors of Iron and Vitamin D Supplementations Program (IVDSP) in high schools' girls. Methods: In a cross sectional study, the pattern of Iron and D3 consumption based on IVDSP on 400 high schools' girl in Qom, Iran assesses. Data collection was used by a reliable and standard researcher based questionnaire and daily, weekly, monthly and seasonally consumption of complementary minerals in schools were gathered. Data analysis conducted using SPSS version 20 (SPSS Inc., Chicago, IL, USA) by chi square, independent t-test and multivariate logistic regression. Results: The mean age of subjects was 15.14 ± 1.52 years and ranged from 12 to 18 years old. The total weekly prevalence of D3 and Iron consumption in high schools' girls was calculated 36.73% and the weekly prevalence of Iron and monthly prevalence of Vitamin D3 consumption was 33.75% and 40.5%, respectively. The most common causes of non-consumption were bad taste 49.31%, Iranian made drug 20.27%, drug sensitivity 19.82% and drug interaction 10.60%, respectively. Conclusions: The inadequate and incomplete rate of IVDSP in Qom was high and more than 60% of distributed supplementations have been wasted. Results showed that students who were participated in educational orientation classes were more successful and eager in Iron and Vitamin D3 consumption. Therefore, more educational explanatory interventions for both students and her parents recommended to increase the efficiency of the program.

Cultural Beliefs and Practices in Postpartum Women in Iran: A Qualitative Study.

Background: Cultural differences can be seen in the birth and postpartum period, where some traditional practices are used to protect the postpartum women and their newborns. The aim of this study was to investigate the cultural beliefs and practices of postpartum women. Materials and Methods: This was a qualitative study. Data were collected through semistructured in-depth interviews with a purposive sample of 20 mothers in Qom hospitals, Iran from 2019 to 2020. Interviews were transcribed verbatim and finally analysed through conventional content analysis. Results: Five themes of postpartum women's cultural beliefs and practices emerged from the data analysis including beliefs and practices related to public communications, women's postnatal care beliefs and practices, nutritional beliefs and practices, beliefs and practices pertaining to breastfeeding and infant care, as well as religious and traditional beliefs and practices. The most common cultural beliefs among women were beliefs related to public communications. Conclusion: Cultural and traditional postpartum beliefs and practices are common among postpartum women in Iran. To change postpartum behaviours, it is necessary to identify beliefs and practices first and then plan to correct wrong beliefs to achieve women's health in postpartum period.

Severe Acute Respiratory Syndrome Coronavirus 2 Infection Symptoms in Pregnancy and Maternal and Neonatal Complications Due to COVID-19: A Systematic Review.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women is associated with severe maternal and neonatal complications including maternal and newborn death. Aims: This review aimed to assess the SARS-CoV-2 infection symptoms during pregnancy as well as maternal and neonatal complications in Iran. Settings and Design: A developing and low-income country and a systematic review. Materials and Methods: International scientific databases including PubMed, Web of Science, Scopus and Google Scholar were searched in a systematic review manner. Two independent researchers were checked and identified articles from September 2019 to September 2022 based on eligibility criteria and quality appraisal. The results of review were reported in two sections including maternal and neonatal outcomes. Statistical Analysis Used: Descriptive statistics was used for statistical analysis. Results: Seventeen studies including 870 pregnant mothers with COVID-19 met the eligibility criteria and were reviewed. The main maternal consequences of COVID-19 were intensive care unit (ICU) admission, pre-term delivery, maternal death, pre-mature rupture of membranes, pre-eclampsia, intrauterine growth retardation and stillbirth. Neonatal ICU admission, newborn death, neonatal sepsis, low birth weight and respiratory distress syndrome, tachypnoea, asphyxia and pneumothorax were the most common outcomes of COVID-19 infection in offspring of pregnant subjects. Conclusion: Pregnant mothers with COVID-19 infection are at higher risk of being admitted to the ICU and mechanical ventilation and consequently maternal and neonatal death. Comparing the maternal and foetal consequences in different ethnicities, regions and countries may be related to the socioeconomic status of people and should be considered with respect to different determines. Moreover, the maternal and neonatal complications due to COVID-19 infection in Iran and other developing countries seem to be higher than other countries.

Can Coronavirus Disease 2019 Effect on Human Reproduction?

Since the main role in the pathogenesis of the coronavirus is attributed to the angiotensin-converting enzyme (ACE) receptor, it could possibly be a hypothesis in the differential sex-based pathogenesis of the coronavirus. The virus inserts its genetic material into the cell through its ACE2 receptors and replicates it by intracellular proteins. ACE2 receptors are highly expressed in cell membranes of various tissues in the body, including cardiovascular, gastrointestinal, renal, macrophage cells, and especially on the surface of type 2 pneumocytes in the lungs, ovaries, uterus, vagina, placenta, and testes. Therefore, cells having a higher expression of the ACE2 may be a specific target for coronavirus binding and infectivity. Due to the increase of infections in males, concerns have been appeared about the potential impact of coronavirus disease 2019 (COVID-19) on their fertility and reproductive organs. Thus, it is necessary to investigate if COVID-19 disturbs female and male fertility, so this review aimed to study the comprehensive evidences on the association of COVID-19 with human reproduction.

Plasma Levels of miR-27a, miR-130b, and miR-301a in Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a gynecological endocrine disorder in women of reproductive age. There is adequate evidence that suggests several microRNAs (miRNAs) are of great importance for PCOS. It seems that dysregulated expression of miR-27a, miR-130b, and miR-301a are associated with PCOS. The aim of this study was to investigate whether plasma levels of these miRNAs are different between patients with PCOS and healthy controls. Fifty-three women with a definite diagnosis of PCOS, and 53 healthy controls were enrolled. MiRNAs expression levels in plasma were evaluated by real-time PCR. The diagnostic values of each miRNA were calculated by the receiver operating characteristic (ROC) curve and areas under the curves (AUC). The main clinical characteristics were not significantly different between the two groups. The circulating plasma expression levels of miR-27a and miR-301a had a significant increase (P = 0.0008 and P <0.0001, respectively) but miR-130b expression level decreased in the patient group (P <0.0001). The AUC for miR-27a, miR-130b, and miR-301a were 0.71, 0.77, and 0.66, respectively. A positive exponential was observed for miR-27a and miR-301a in multiple logistic regression. Changes in the plasma expressions of the studied miRNAs are likely to be associated with PCOS phenotypes. MiR-27a has a potential to serve as a diagnostic biomarker of PCOS.

Healing effect of Quercus persica and Lawsonia inermis ointment on episiotomy wounds in primiparous women.

BACKGROUND: Episiotomy is one of the most common surgical interventions performed to facilitate delivery. Anti-inflammatory and antibacterial effects of Persian oak (Quercus persica) and henna (Lawsonia inermis) have been proved in previous studies. The aim of this study is to evaluate the effect of Q. persica and L. inermis ointment on episiotomy wound healing in primiparous women and comparing it with placebo group. MATERIALS AND METHODS: This was a double-blind clinical trial conducted on 160 primiparous women who underwent episiotomy. The cases were randomly selected and divided into four groups of forty patients including control, placebo, those who consume topical henna, and those who consume topical Persian oak ointment. Pain and recovery assessment was done at baseline and 7th, 10th, and 14th days after birth and measured by Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA scale) and patients' pain intensity was also measured by a visual analog scale (VAS). The collected data were analyzed using Chi-square test, one-way ANOVA, and repeated measures ANOVA test by SPSS (version 22). RESULTS: The results revealed that according to the reduced score of REEDA till the 14th day after the delivery, the wound healing in the henna group and the oak group (-2.58 ± 0.29 and - 2.04 ± 0.31, respectively) was higher than the control and placebo groups (-1.62 ± 0.34 and - 1.95 ± 0.32, respectively) (P < 0.05). Furthermore, on the 14th day, the mean VAS score was not significantly different between henna and oak groups (henna group: 2.58 ± 0.25 and oak group: 2.23 ± 0.18); however, both intervention groups had a significant difference with the placebo and control groups (P < 0.05). CONCLUSION: The findings showed that the use of henna and oak ointment improves episiotomy wound healing process, so it is recommended for primiparous women.

Effect of Olive Oil in Preventing the Development of Pressure Ulcer Grade One in Intensive Care Unit Patients.

BACKGROUND: Detecting pressure ulcer is an important nursing diagnostic care required for the patients hospitalized in ICU. The purpose of this study is to examine the effect of olive oil in preventing the development of pressure ulcer grade one in ICU patients. METHODS: In this clinical trial, 72 patients eligible for hospitalization in hospitals of Isfahan University of Medical Sciences were divided randomly into two groups; control and intervention (receiving olive oil). The standard program of skincare was implemented on both the groups; in addition, olive oil was applied topically in the intervention group. The data was collected on the first day through demographic information and Braden pressure ulcer risk assessment scale. An infrared thermometer was used to record the local temperature of the ulcers daily. Assessments were made based on pressure ulcer scale for healing (PUSH) tool and the pressure ulcer area was examined per square cm on the first, fourth, and seventh day. The data collected was analyzed by Fisher's exact test, independent sample t-test and repeated measure analysis using SPSS (version 22). RESULTS: On the fourth and seventh day, the PUSH score was lower in the olive oil group (7.50 ± 2.823 and 5.44 ± 3.806) than in the control group (9.50 ± 1.732 and 8.83 ± 2.864) (P-value <0.001). Also, a significant improvement of ulcer was observed in the olive oil group (mean difference = 3.56; P value <0.001) but no change was observed in the control group (mean difference = 0.75; P value = 0.052). CONCLUSIONS: Based on the effect of olive oil in the reduction of ulcer area and the average PUSH score obtained in ICU patients, the application of olive oil is recommended for healing grade one pressure ulcers.

The effect of Aloe vera gel and sweet almond oil on striae gravidarum in nulliparous women.

BACKGROUND AND OBJECTIVE: Striae are linear depressions of the skin and causes psychological and sexual problems in person. Different methods are used to prevent and treat them but there is no definitive method. We compared the effect of Aloe vera gel and sweet almond oil on striae gravidarum. MATERIALS AND METHODS: In this double-blind clinical trial, 160 nulliparous women were enrolled and randomly divided into three case groups and one control group. The four groups were given 700 g Aloe vera, sweet almond oil, and base cream to use topically on the abdominal skin and forth group don't receive any medication as control group in five steps, they were examined study's variables (itching, erythema, and spread of striae) using statistical tests in SPSS. RESULT: The findings showed that Aloe vera and sweet almond oil creams are more effective than the base cream and the control group to decrease itching and erythema and to prevent the spread of striae on the surface of abdomen (p < .05); however, all three creams had a similar effect on the diameter and the number of striae (p > .05). CONCLUSIONS: Aloe vera and sweet almond oil creams reduce the itching of striae and prevent their progression.

Final follicular maturation by administration of GnRH agonist plus HCG versus HCG in normal responders in ART cycles: An RCT.

BACKGROUND: Gonadotropin-releasing hormone agonists (GnRH-a) was increasingly used for triggering oocyte maturationfor the prevention of ovarian hyperstimulation syndrome. Studies suggest that GnRH-a might be used as a better trigger agent since it causes both Luteinizing hormone and follicle stimulating hormone release from a physiologic natural cycle. OBJECTIVE: The aim of this study was to evaluate the effect of dual-triggering in assisted reproductive technology outcomes. MATERIALS AND METHODS: 192 normal responder women aged ≤42 years and 18< Body Mass Index <30 kg/m2 enrolled in this single-blind randomized controlled trial. All participants received antagonist protocol. For final triggering, women randomly were divided into two groups. Group, I was triggered by 6500 IU human chorionic gonadotropin (hCG) alone, and group II by 6500 IU hCG plus 0.2 mg of triptorelin. The implantation, chemical, clinical and ongoing pregnancy, and abortion rates were measured. RESULTS: The mean of retrieved oocytes and obtained embryos were statistically higher in the dual-trigger group (group I), but the implantation and pregnancy rates were similar in two groups. CONCLUSION: The results of our study did not confirm the favorable effect of dual-triggered oocyte maturation with a GnRH-a and a standard dosage of hCG as an effective strategy to optimize pregnancy outcome for normal responders in GnRH-antagonist cycles. We think that this new concept requires more studies before becoming a universal controlled ovarian hyperstimulation protocol in in vitro fertilization practice.

The Impact of Silymarin on Improvement of Hepatic Abnormalities in Patients with Severe Preeclampsia: A Randomized Clinical Trial.

BACKGROUND: Preeclampsia is a pregnancy-specific disorder, associated with increased blood pressure and proteinuria, and in extreme cases it can also cause liver and kidney problems. OBJECTIVE: To determine the impact of silymarin on the improvement of severe preeclampsia. METHODS: This randomized clinical trial was conducted at Hajar Hospital in Shahrekord, Iran, from April 2014 to September 2015. Sixty patients whose pregnancy had ended as a result of severe preeclampsia, were entered into the study. Patients were randomly divided into two groups of thirty study and control groups. In addition to current treatment for preeclampsia, case groups were administered 70 mg of silymarin, three and twenty four hours after the termination of pregnancy. The control group received placebo at the same time. The blood pressure and AST, ALT, ALP, LDH, uric acid, bilirubin and kidney tests were compared at the baseline and 12, 36 and 60 hours post-measurements in two groups by SPSS software, version 22, by the ANOVA test, and by the independent-samples t-test. RESULTS: AST and ALT liver enzyme levels decreased significantly 36 and 60 hours after the termination of pregnancy in the study group compared to the control group (p <0.01). CONCLUSION: Silymarin is used to treat liver disorders, and has beneficial results. It seems that this drug can be used for accelerating improvement of liver disorders in severe preeclampsia. However, adjusting the dose of the drug for the treatment of liver disorders in severe preeclampsia requires further studies. CLINICAL TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT201509042388/N1. FUNDING: Shahrekord University of Medical Sciences supported this research (project no. 2006).

A comparison of the efficacy of metronidazole vaginal gel and Myrtus (Myrtus communis) extract combination and metronidazole vaginal gel alone in the treatment of recurrent bacterial vaginosis.

OBJECTIVE: Due to the high incidence of bacterial vaginosis (BV) and its resistance to chemical medications and considering the anti-bacterial and anti-fungal effects of Myrtus communis, the present study aimed to compare the therapeutic effects of the vaginal gel of M. communis 2% (in metronidazole base) with metronidazole vaginal gel 0.75% alone on BV. MATERIALS AND METHODS: This research was a randomized controlled clinical trial conducted on 80 women of 18-40 years old with BV. Patients were divided into two groups of 40 women. Diagnostic criteria were Amsel's criteria and Gram staining. The first group received vaginal gel of metronidazole plus M. communis 2% and the second group received metronidazole vaginal gel alone for five consecutive nights. Therapeutic effects and Amsel's criteria were assessed after one week. Finally, the data were analyzed by SPSS 16 using t-test and Chi square tests. RESULTS: There was a significant difference in the therapeutic response between the two groups. The results demonstrated that the combination of metronidazole and M. communis had a higher efficiency (p<0.05). The patients receiving M. communis in metronidazole gel base did not experience any recurrent BV, but 30% of patients taking metronidazole alone faced recurrent BV after three weeks of follow up. CONCLUSION: Findings of the study suggested that adding M. communis extract to metronidazole increases the efficiency of BV treatment.

Efficacy of Intrauterine infusion of granulocyte colony stimulating factor on patients with history of implantation failure: A randomized control trial.

BACKGROUND: Although pregnancy rate in in vitro fertilization-embryo transfer (IVF-ET) cycles has been increased over the preceding years, but the majority of IVF-ET cycles still fail. Granulocyte colony stimulating factor (GCSF) is a glycoprotein that stimulates cytokine growth factor and induces immune system which may improve pregnancy rate in women with history of implantation failure. OBJECTIVE: The aim of this study was to evaluate GCSF ability to improve pregnancy rate in women with history of implantation failure. MATERIALS AND METHODS: 0.5 ml (300 µg/ml) GCSF was infused intrauterine in intervention group. Pregnancy outcomes were assessed based on clinical pregnancy. RESULTS: The mean age of participants was 31.95±4.71 years old. There were no significant differences between demographic characteristics in two groups (p>0.05). The pregnancy outcome in GCSF group was improved significantly (p=0.043). CONCLUSION: GCSF can improve pregnancy outcome in patients with history of implantation failure.

Comparison between the efficacy of metronidazole vaginal gel and Berberis vulgaris (Berberis vulgaris) combined with metronidazole gel alone in the treatment of bacterial vaginosis.

BACKGROUND: Bacterial vaginosis is one of the most prevalent complications among reproductive-aged women. Antibacterial and antifungal effects of Berberis vulgaris have been demonstrated in vitro and in vivo. OBJECTIVES: This study aimed to compare the therapeutic effects of the vaginal gel of Berberis vulgaris 5% (in metronidazole base) with metronidazole vaginal gel 0.75% on bacterial vaginosis on 80 patients referred to the Hajar Hospital from January 2012 to April 2013. METHODS: This study was a randomized clinical trial research on 80 women affected by bacterial vaginosis, who were randomly divided into two groups of 40 participants. Diagnostic criteria were Amsel's criteria and Gram stain. Berberis vulgaris 5% (in metronidazole gel base) or metronidazole vaginal gel for five-night usage was prescribed to each group, and after two to seven days therapeutic effects and Amsel criteria were assessed. Data analysis was performed by SPSS 16 using Student t-test, chi-square, and ANOVA tests. RESULTS: Findings of the study showed a statistically significant difference with regard to treatment response between the study groups (p<0.001), and the Berberis vulgaris group had a better response than the metronidazole gel group. The patients in groups of Berberis vulgaris in a metronidazole gel base did not experience any relapse, but, in the metronidazole group, 30% of patients experienced relapse during three weeks' follow-up. CONCLUSIONS: Findings of the study showed that adding Berberis vulgaris fruit extract on metronidazole improve the efficacy of bacterial vaginosis therapy. CLINICAL TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT201411102085N13. FUNDING: Shahrekord University of Medical Sciences supported this research.

The effect of luteal phase gonadotropin-releasing hormone antagonist administration on IVF outcomes in women at risk of OHSS.

BACKGROUND: Gonadotropin-releasing hormone (GnRH) plays essential roles in embryo implantation, invasion of trophoblastic tissue, and steroid synthesis in the placenta. OBJECTIVE: The aim of this study was to evaluate the effect of GnRH antagonist administration on pregnancy outcomes in early implantation period. MATERIALS AND METHODS: In this retrospective study, 94 infertile women undergoing GnRH antagonist protocol who were at risk of ovarian hyperstimulation syndrome (OHSS) were included. Sixty-seven patients (group I) received Cetrorelix 0.25 mg/daily in the luteal phase for 3 days while in 27 participants (group II), it was not administered. Pregnancy outcomes were assessed based on chemical and clinical pregnancy rates. RESULTS: The pregnancy outcomes were not significantly different between two groups (p=0.224). CONCLUSION: The present study proposed that luteal phase GnRH antagonist administration does not influence the chance of successful pregnancy outcomes.

The Abortificient Effects of Hydroalcoholic Extract of Lawsonia Inermis on BALB/c Mice.

INTRODUCTION: According to the traditional beliefs of certain cultures, Lawsonia inermis has been reported to cause the abortion or termination of an undesirable pregnancy. The present study was undertaken with the goal of studying the effect of Lawsonia inermis extract on abortion in pregnant BALB/c mice in 2013 in Shahrekord, Iran. METHODS: This research study used an experimental methodology and was conducted in 2013 in Shahrekord, Iran. Forty female BALB/c mice (30-40 gm, 8-12 weeks old) were randomly assigned to 4 groups. One male mouse was included for each two female mice (1:2) and they were maintained in a protective cage habitat. Pregnancy of the mice was confirmed by means of a vaginal smear. The doses of 1 mg/kg and 10 mg/kg of the hydroalcoholic extract of Lawsonia inermis were injected intraperitoneally into pregnant mice beginning on the first day and continuing through the seventh day of pregnancy. The control group did not receive any treatment, but was left completely unadministered. On the eighteenth day of pregnancy, the uterine tubes of mice were removed. The subsequent embryonic absorption is considered to be an abortion. The data were analyzed using SPSS software version 22 using Fisher's exact test and the Kruskal-Wallis H tests. RESULTS: Abortions were observed more often in the experimental groups (p< 0.01). The mean of the serum estrogen level was significantly higher in the case control groups (p< 0.01) and the mean of progesterone level was also significantly lower in the experimental groups (p< 0.01). CONCLUSION: The use of Lawsonia inermis during pregnancy may cause abortion and therefore it should be considered as contraindication or use with caution.

Comparison of the Effects of Vaginal Royal Jelly and Vaginal Estrogen on Quality of Life, Sexual and Urinary Function in Postmenopausal Women.

INTRODUCTION: Several causes can disturb the quality of life in postmenopausal women. Stress, urinary incontinence is one of the factors that can influence the quality of life of women, since they evade social activities and limit their behavior. Vulvovaginal disorders adversely impacts sexual action, psychosocial health, and partner relationships. AIM: The aim of this study was to examine the therapeutic properties of vaginal cream of royal jelly and estrogen on quality of life, sexual and urinary problems in postmenopausal women. MATERIALS AND METHODS: This study was a randomized controlled clinical trial that was done on 90 married postmenopausal women 50 to 65-year-old. A total of 90 women were randomly distributed to three groups and were treated with vaginal cream of royal jelly 15%, lubricant, and conjugated estrogens for three months. Before and after intervention, quality of life and vaginal cytology were evaluated. Data was analysed by SPSS 16 using ANOVA and Tukey tests. RESULTS: The results expressed that vaginal royal jelly is considerably more effective than conjugated estrogens and lubricant in the improvement of quality of life, sexual and urinary function in postmenopausal women (p<0.05). Results of Pap smear showed that improvement of vaginal atrophy in conjugated estrogens group was better than other groups (p<0.001), and there was no significant difference between lubricant and royal jelly groups (p=0.89). CONCLUSION: The effectiveness of vaginal royal jelly in treatment of sexual and urinary problems of postmenopausal women is related to its estrogenic properties and could be suitable in promotion of life quality in postmenopausal women.

The impact of Silymarin on improvement of platelet abnormalities in patients with severe preeclampsia.

BACKGROUND: Preeclampsia is a pregnancy-specific disorder that is associated with an increase in blood pressure and proteinuria; in severe cases, it can cause platelet abnormalities. Silymarin is the extract of Silybum marianum, which is recognized as a safe antioxidant drug. OBJECTIVE: To determine the impact of Silymarin on the improvement of severe preeclampsia in 60 patients with severe preeclampsia. METHODS: In this double-blind clinical trial study, This study included 60 patients whose pregnancies were terminated because of severe preeclampsia and who were referred to Hajar Hospital in Shahrekord, Iran, from April 2014 to September 2015. The patients were divided randomly into two groups, i.e., a group of 30 patients and a control group of 30 patients. In addition to the current treatments for preeclampsia, The members of the study group were administered 70 mg of Silymarin at three hours and 24 hours after the termination of their pregnancies. The control group received a placebo at the same times. Platelet count tests were compared at the baseline and at 12, 36, and 60 hours post-measurements in the two groups by SPSS software, version 22, by the ANOVA test, and by the independent-samples t-test. RESULTS: At the baseline, the two groups were not significantly different in terms of various criteria, such as age, BMI, and platelet counts. There were no significant differences between the two groups regarding the number of platelets at 12, 36, and 60 h after their pregnancies were ended (p > 0.01). CONCLUSIONS: The results of this study indicated that, although oxidative factors are involved in the incidence of complications of preeclampsia, e.g., thrombocytopenia, merely using an oxidative agent does not alleviate this effect. This indicated that other factors likely are involved in the pathogenesis of this disease. Additional studies are needed to prove the beneficial effects of this drug in the treatment of preeclampsia. CLINICAL TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT201509042388/N1. FUNDING: Shahrekord University of Medical Sciences supported this research (project no. 2006).

Comparison of the Effects of Myrtus Communis L, Berberis Vulgaris and Metronidazole Vaginal Gel alone for the Treatment of Bacterial Vaginosis.

INTRODUCTION: There is a growing tendency towards herbal medicines for treatment of vaginitis. Antibacterial and antifungal effects of Myrtus communis L and Berberis vulgaris have been demonstrated invitro and invivo. AIM: This study aimed to compare the therapeutic effects of the vaginal gel of Berberis vulgaris 5% (in metronidazole base) and Myrtus communis L 2% (in metronidazole base) with only metronidazole vaginal gel 0.75% on bacterial vaginosis. MATERIALS AND METHODS: This study was a randomized clinical trial research on 120 married women aged 18-40 years affected by bacterial vaginosis attended for treatment to gynaecology clinic of Hajar Hospital (Shahrekord, Iran). They were randomly divided into three groups of 40 participants. Diagnostic criteria were Amsel's criteria. Myrtus communis L, Berberis vulgaris vaginal gel or metronidazole vaginal gel for five-night usage were prescribed to each group, and after 7 days therapeutic effects were assessed. Data analysis was performed using ANOVA and Chi-square tests. RESULTS: A statistically significant difference was observed with regard to treatment response among the study groups (p<0.001), with Myrtus communis L and Berberis vulgaris groups having a better response than metronidazole gel alone. Moreover, there was no significant difference between Myrtus communis L and Berberis vulgaris groups (p= 0.18). The patients in groups of Myrtus communis L or Berberis vulgaris in metronidazole base did not experience any relapse, but in metronidazole group, 30% of patients experienced relapse during three weeks follow up. CONCLUSION: Findings of the study showed that treatment with a combination of Myrtus communis L or Berberis vulgaris in metronidazole base improve the efficacy of bacterial vaginosis therapy.

Effect of adding human chorionic gonadotropin to frozen thawed embryo transfer cycles with history of thin endometrium.

BACKGROUND: Embryo implantation process is a complex phenomenon and depends on fetal and maternal factors interaction. Endometrial thickness is needed for successful implantation. OBJECTIVE: We designed this study in order to assess adding human chorionic gonadotropin (HCG) to the conventional protocol in endometrial preparation in women with thin endometrium and a history of in vitro fertilization-embryo transfer (IVF-ET) failure. MATERIALS AND METHODS: The non-randomized clinical trial study (quasi experimental design) was performed on 28 patients. Participants were women who were candidate for frozen-thawed (ET) and had two previous failed ET cycles because of thin endometrial. HCG was administrated (150 IU, intramuscular) from the 8th day of cycle and when endometrial thickness reached at least 7mm HCG was discontinued and frozen thawed ET was done. RESULTS: Totally 28 patients were included. The mean ± SD age of participants was 30.39±4.7. The mean of endometrium thickness before and after HCG were 5.07±0.43 and 7.85±0.52, respectively p<0.001. Also, there were five clinically and chemically pregnant women. CONCLUSION: The findings of the study suggested that adding HCG to the conventional preparation method was an effective protocol and significantly improved endometrial thickness and pregnancy outcomes in women with previous embryo transfer failure because of thin endometrium.

Comparison between vaginal royal jelly and vaginal estrogen effects on quality of life and vaginal atrophy in postmenopausal women: a clinical trial study.

OBJECTIVE: This study was conducted to evaluate the therapeutic effects of vaginal royal jelly and vaginal estrogen on quality of life and vaginal atrophy in postmenopausal women. METHODS: This double-blind randomized controlled clinical trial was carried out at gynecology and obstetrics clinics of Hajar Hospital of Shahrekord University of Medical Sciences (Iran) from January 2013 to January 2014. The study was conducted on married postmenopausal women between 50 and 65 years old. Of 120 patients, 30 individuals were excluded based on the exclusion criteria, and 90 women were randomly distributed into three groups of 30 royal jelly vaginal cream 15%, vaginal Premarin, and placebo (lubricant), for three months. At the beginning and the end of the study, quality of life and vaginal cytology assay were evaluated. Data were analyzed by SPSS Version 11. RESULTS: Vaginal cream of royal jelly is significantly more effective than vaginal cream of Premarin and lubricant in improvement of quality of life in postmenopausal women (p<0.05). Moreover, Pap smear results showed that vaginal atrophy in vaginal Premarin group was lower than the other groups (p<0.001), and there was no significant difference between lubricant and royal jelly groups (p=0.89). CONCLUSION: Administration of vaginal royal jelly was effective in quality-of-life improvement of postmenopausal women. Given to the various properties of royal jelly and its effectiveness on quality of life and vaginal atrophy in postmenopausal women, further studies are recommended for using =royal jelly in improving menopausal symptoms. CLINICAL TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT code: 2014112220043n1. FUNDING: Shahrekord University of Medical Sciences supported this research (project no. 1440).