1
|
Zare M, Hesampour F, Poordast T, Valibeigi M, Enayatmehri M, Ahmadi S, Nasri F, Gharesi-Fard B. Association between gene polymorphisms of IL-12, IL-12 receptor and IL-27 and organ involvement in Iranian endometriosis patients. Int J Immunogenet 2023; 50:24-33. [PMID: 36328955 DOI: 10.1111/iji.12606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
Endometriosis is an inflammatory disease characterized by the presence of ectopic endometrial tissue, immune cell dysfunction and abnormal cytokine secretion. In addition to immunological factors, genetic variations that influence endometriosis severity and cytokine expression levels play important roles in the pathogenesis of this disease. Interleukin-12 (IL-12), specifically its p40 subunit encoded by IL-12B gene and the interleukin-12 receptor β1 (IL-12Rβ2) chain of its receptor, as well as interleukin-27 (IL-27) are important in the establishment of endometriosis. So, in this study, we measured IL-12 and IL-27 serum levels and investigated the possible links between IL-12B rs3212227, IL-12Rβ2 rs3790565 and IL-27 rs153109 polymorphisms and the risk of developing endometriosis in a group of Iranian women. In this case-control study, 162 endometriosis patients and 151 healthy women were included and tested for the aforementioned polymorphisms using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The enzyme-linked immunosorbent assay (ELISA) method was also used to measure IL-12 and IL-27 serum levels. Although there was no statistically significant association between the genotypes and alleles of the studied polymorphisms and the development of endometriosis in general, the AA genotype of IL-12B rs3212227 showed a significant association with uterine endometriosis when compared to AC+CC genotypes (p = .04, CI = 0.270-0.988, OR = 0.517). Indeed, the AA genotype of the IL-12B rs3212227 single nucleotide polymorphism (SNP) may be linked with a lower risk of developing uterine endometriosis. There was no significant difference in IL-27 levels between the two studied groups (p = .49), and IL-12 levels were undetectable in both groups. In conclusion, the AA genotype of IL-12B rs3212227 might be associated with a decreased risk of uterine involvement in endometriosis patients.
Collapse
Affiliation(s)
- Maryam Zare
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Faculty of Medicine, Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada
| | - Fatemeh Hesampour
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Rady Faculty of Health Science, Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, R3E0T5, Canada
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Valibeigi
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maliheh Enayatmehri
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sahar Ahmadi
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Nasri
- Department of Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behrouz Gharesi-Fard
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
2
|
Alborzi S, Najarkolaee EH, Askary E, Alborzi S, Chamanara K, Zahiri Z, Poordast T. Successful laparoscopic sigmoid transposition for cervicovaginal agenesis in the presence of a functioning uterus: A case series. Int J Gynaecol Obstet 2023; 160:271-279. [PMID: 35810397 DOI: 10.1002/ijgo.14342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/25/2022] [Accepted: 07/07/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study investigated the long-term outcomes of laparascopic sigmoid cervicovaginoplasty in patients with congenital cervicovaginal atresia with a functioning uterus. METHODS In this case series study, seven patients with cervicovaginal atresia with a functioning uterus underwent laparoscopic sigmoid cervicovaginoplasty surgery between 2016 and 2020. Mean follow-up duration was 25.9 months (2-48 months). All of the patients had regular menstrual cycles. The average length of the vagina was 8.9 cm (7.6-10.5 cm). In one patient, proximal stenosis of neovagina was observed 12 months after surgery. RESULTS The mean age and body mass index of the patients were 18 years (12-27 years) and 19.7 (17.6-22.4), respectively. The average time period between the initiation of disease symptoms and the operation was 52.28 months (2-156 months). There were no postoperative short-term complications. We did not perform hysterectomy in our patients. None of our patients complained of signs of low anterior resection syndrome. Two patients had sexual activities without dyspareunia, postcoital bleeding, or malodorous vaginal discharge. CONCLUSION Sigmoid cervicovaginoplasty is a safe and effective procedure with satisfactory long-term outcomes. This surgery eliminates the psychological burden of hysterectomy in these patients. Through preserving the uterus, patients may have a chance of possible future pregnancy if abdominal cerclage is performed.
Collapse
Affiliation(s)
- Saeed Alborzi
- Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elnaz Hosseini Najarkolaee
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Askary
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soroush Alborzi
- Student Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kefayat Chamanara
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ziba Zahiri
- Department of Obstetrics & Gynecology, Alzahra Hospital, School of Medicine, Reproductive Health Research Center, Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
3
|
Alborzi S, Askary E, Poordast T, Alborzi S, Abadi AKH, Shoaii F. Approach to ureteral endometriosis: A single-center experience and meta-analysis of the literature. J Obstet Gynaecol Res 2023; 49:75-89. [PMID: 36268633 DOI: 10.1111/jog.15449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/03/2022] [Accepted: 09/19/2022] [Indexed: 01/19/2023]
Abstract
AIM To report single-center outcomes of laparoscopic management of patients with ureteral endometriosis and perform a meta-analysis in order to select the best approach for these patients. METHODS The cross-sectional study was conducted during a 6-year period (2015-2021) in the referral endometriosis center on 353 patients with ureteral endometriosis. For the meta-analysis, 10 articles, including 505 patients, were found to be eligible. In our meta-analysis, as well as our study, all endometriosis-related pain symptoms and complications of surgery were evaluated, analyzed, and reported. RESULTS Of the 326 patients whose ureteral involvement was confirmed in pathology, hydronephrosis and intrinsic ureteral lesions were detected in only 10.76% and 3.1% of the patients. Mean operating time and hospitalization were 3.25 ± 1.83 h and 86 ± 2.58 days, respectively. The most common site of concomitant involvement with endometriosis was uterosacral ligament (92.9%) and rectosigmoid (70.53%). Type II and III of Cliven-Dindo complications were seen in 5.66% and 1.13% of patients, respectively. During a follow-up period, no evidence of bladder or ureteral re-involvement was observed. Similar to our meta-analysis, all endometriosis-related pain decreased significantly following operation (p ≤ 0.001). In our meta-analysis, the rate of ureteral endometriosis recurrence, stenosis/stricture, bladder atonia, urinary tract infection, hematuria, and fistula formation after surgery were: 2.0% (I2 : 50.42%), 15.0% (I2 : 0.00%), 14.0% (I2 : 8.76%), 6.0% (I2 : 0.00%), 7.0% (I2 : 79.28%), and 2.0% (I2 : 0.0%), respectively. CONCLUSION The laparoscopic resection of the UE could be suggested as a feasible and safe method associated with favorable functional outcomes.
Collapse
Affiliation(s)
- Saeed Alborzi
- Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Askary
- Department of Obstetrics and Gynecology, School of Medicine, Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University Of Medical Sciences, Shiraz, Iran
| | - Soroosh Alborzi
- Student Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alimohammad K H Abadi
- Clinical Research Development Center of Nemazee Hospital, Department of Statistics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Shoaii
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University Of Medical Sciences, Shiraz, Iran
| |
Collapse
|
4
|
Poordast T, Alborzi S, Askary E, Tavabe MS, Najib FS, Salehi A, Vardanjani HM, Haghighat N, Leilami K. Comparing the quality of life of endometriotic patients' before and after treatment with normal and infertile patients based on the EHP30 questionnaire. BMC Womens Health 2022; 22:553. [PMID: 36577953 PMCID: PMC9795634 DOI: 10.1186/s12905-022-02052-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/07/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE This study aimed to determine the quality of life (QOL), in patients with endometriosis ± infertility (B and C groups) and compare those to healthy women, and also infertile groups without endometriosis as a control groups (A and D), considering the fact that endometriosis and infertility reduces the quality of life in patients. METHODS The present prospective comparative study was carried out between January 2018 and September 2020. A total of 400 women were included (100 women in each group). The participants filled in a validated questionnaire of quality of life, Endometriosis Health Profile-30 (EHP-30), and a visual analog scale of pain used, at the first visit, and 3 months after the medical or surgical treatment in the endometriosis group without infertility, additionally. RESULTS The majority of the patients were married, categorized in the middle-class of socio-economic state and housewives. They were of Persian descent. BMI was high in the infertile groups; however, the time of infertility was not different between the two groups of B and C (P = 0.054). The mean score of QOL was significantly lower in B, C, and D groups in comparison to the healthy women as the control group (A) (P < 0.001). Moreover, the infertile group (B), in comparison to endometriosis ± infertility groups (C and D), had the lowest mean score of QOL (P < 0.001). In each group, those who were older and had better educational level reported a better quality of life than other participants in that group. Social support plays a very important role in reducing the endometriosis related pain symptoms both before and after treatment. Three months after the treatment of endometriosis (D), a significant improvement was observed in all the aspects of QOL-related endometriosis. Nonetheless, the improvement of the quality of life in the surgical group was significantly higher than that in the medical treatment. The mean visual analog score of pain decreased from 62.22 ± 22.78, to 5.15 ± 2.73 following the surgical treatment (P < 0.001). CONCLUSION The lowest quality of life belonged to the infertile group, followed by the endometriosis group. The quality of life of the endometriosis group improved after the treatment. Thus, endometriotic patients' treatment in terms of improvement of quality of life should be considered by all professional health care teams.
Collapse
Affiliation(s)
- Tahereh Poordast
- grid.412571.40000 0000 8819 4698Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University Of Medical Sciences, Shiraz, IR Iran
| | - Saeed Alborzi
- grid.412571.40000 0000 8819 4698Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Elham Askary
- grid.412571.40000 0000 8819 4698Department of Obstetrics and Gynecology, School of Medicine, Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Malihe Sousani Tavabe
- grid.412571.40000 0000 8819 4698Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Fatemeh Sadat Najib
- grid.412571.40000 0000 8819 4698Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University Of Medical Sciences, Shiraz, IR Iran
| | - Alireza Salehi
- grid.412571.40000 0000 8819 4698Department of MPH, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Hossein Molavi Vardanjani
- grid.412571.40000 0000 8819 4698Department of MPH, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Neda Haghighat
- grid.412571.40000 0000 8819 4698Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Kimia Leilami
- grid.412571.40000 0000 8819 4698Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| |
Collapse
|
5
|
Alborzi S, Poordast T, Askary E, Javedanmehr M, Hamedi Shahraki M, Alborzi S, Keshtvarz Hesam Abadi A. Evaluation and Comparison of the Accuracy of Transvaginal ultrasound and
MRI
for the diagnosis of deep rectal endometriosis:A cross‐sectional study. Int J Gynaecol Obstet 2022; 161:586-593. [PMID: 36333881 DOI: 10.1002/ijgo.14554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/15/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine and compare the value of magnetic resonance imaging (MRI) and transvaginal sonography (TVS) in the diagnosis of rectal endometriosis. METHODS In this cross-sectional study, 555 patients with rectal endometriosis, who had undergone MRI and TVS before laparoscopic operation, were included. The sensitivity, specificity, and accuracy of these two imaging modalities were evaluated and compared based on histopathologic reports and three different kinds of rectal endometriosis surgeries (shaving as a first group and disk and segmental resection methods combined as a second group). RESULTS Sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of ultrasound in the diagnosis of rectal endometriosis were, respectively, 69.55% (65.4%-73.4%), 91.30% (72%-98.9%), 70.4% (66.4%-74.17%), 11.48% (9.77%-13.43%), 99.46% (98%-99.86%), 8.0 (2.12-30.1), and 0.3 (0.28-0.4). These values were 51.37% (47.1%-55.6%), 79.17% (57.8%-92.9%), 52.53% (48.3%-56.6%), 6.64% (5.39%-8.16%), 98.26% (96.26%-99.2%), 2.47 (1.13-5.4), and 0.6 (0.49-077) for MRI. Even though ultrasound had better accuracy for detection of superficial rectal endometriosis (Group 1) (P < 0.001), the sensitivity, specificity, and accuracy of both imaging modalities in diagnosis of deep rectal lesions (Group 2) were almost identical. CONCLUSION TVS should be considered as a first-line modality for diagnosis of rectal endometriosis, mainly because of its greater availability, lower cost, and higher accuracy.
Collapse
Affiliation(s)
- Saeed Alborzi
- Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center Shiraz University Of Medical Sciences Shiraz Iran
| | - Elham Askary
- Department of Obstetrics and Gynecology, School of Medicine, Maternal‐Fetal Medicine Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Masoomeh Javedanmehr
- Department of Obstetrics and Gynecology, Maternal‐fetal medicine Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Mahboobeh Hamedi Shahraki
- Department of Obstetrics and Gynecology, Maternal‐fetal medicine Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Soroosh Alborzi
- Cardiologist Student Research Center, School of Medicine Shiraz University of Medical Sciences Shiraz Iran
| | - Alimohammad Keshtvarz Hesam Abadi
- Master of Biostatistics in Clinical Research Development Center of Nemazee Hospital Department of Statistics Shiraz University of Medical Sciences Shiraz Iran
| |
Collapse
|
6
|
Alborzi S, Roman H, Askary E, Poordast T, Shahraki MH, Alborzi S, Hesam Abadi AK, Najar Kolaii EH. Colorectal endometriosis: Diagnosis, surgical strategies and post-operative complications. Front Surg 2022; 9:978326. [PMID: 36268216 PMCID: PMC9577108 DOI: 10.3389/fsurg.2022.978326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/29/2022] [Indexed: 11/05/2022] Open
Abstract
Objective The present work aimed to investigate the feasibility, complications, recurrence rate, and infertility outcomes of the radical and conservative surgical methods for colorectal endometriosis in short- and long-term follow-ups. Methods In this prospective study, the patients with confirmed diagnosis of colorectal DIE were included from March 2015 to March 2021, who were referred to an Endometriosis Surgery Center affiliated with Shiraz University of Medical Sciences (SUMS). Information on demographics, surgical approaches, intra-operative, and post-operative findings as well as complications were collected and compared. Six- and 12-month interviews were conducted to evaluate the functional outcomes of all the procedures. Results Out of 3,111 patients who underwent endometriosis surgery, 837 (28.19%) with the average age of 34.2 ± 5.9 years and average ASRM score of 102.1 ± 36.8 had rectosigmoid endometriosis. Laparoscopic rectal shaving was performed in 263(30.0%) patients while 326 (37.2%) underwent segmental bowel resection, and 248 (28.30%) were treated with disc excision. Prophylactic ileostomy was performed in six (0.68%) patients and peritonitis was reported in four (0.45%). Five (0.58%) subjects developed rectovaginal fistula and one (0.11%) was diagnosed with bladder atonia. The recurrence rate was 3.8%, 1.2%, and 0.3% in rectal shaving, disc, and segmental bowel resection techniques, respectively. Dysmenorrhea, dyspareunia, and dyschezia were improved after surgery by 7.3, 9.4, and 12.5 times, respectively. We observed 25.2% of total pregnancy following the operation, the majority of which occurred in the first year after the surgery. Conclusion There were very few short-term or long-term complications in the three different techniques when the choice was correct.
Collapse
Affiliation(s)
- Saeed Alborzi
- Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Horace Roman
- Department of Gynecology and Obstetrics, Clinique Gynécologique et Obstétrical, Rouen University Hospital, Rouen, France
| | - Elham Askary
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence: Elham Askary
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Soroush Alborzi
- Cardiologist, Student Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alimohammad Keshtvarz Hesam Abadi
- Master of Biostatistics in Clinical Research Development Center of Nemazee Hospital, Department of Statistics, Shiraz University of Medical Sciences, Shiraz, Iran
| | | |
Collapse
|
7
|
Najib FS, Poordast T, Mahmudi MS, Shiravani Z, Namazi N, Omrani GR. Does Vitex Agnus-Castus L. Have Deleterious Effect on Fertility and Pregnancy Outcome? An Experimental Study on Rats for Prediction of Its Safety. J Pharmacopuncture 2022; 25:106-113. [PMID: 35837144 PMCID: PMC9240410 DOI: 10.3831/kpi.2022.25.2.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 11/03/2021] [Accepted: 02/04/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives Herbal medicine is a worldwide health topic. Vitex agnus–castus L. (VAC) is a popular plant used for gynecologic problems due to its hormonal effects. The aim of this study is to reveal VAC extract effect on fetus when this herb is used started from antenatal period or during pregnancy. Methods Performed from starting day of January 2019 till February 2019, 48 rats were assigned in randomly divided eight-member six groups control (C1), treated group with 365 mg/kg VAC from initiation of insemination (T1) and 30 days prior to pregnancy (T2), control that underwent caesarean section on 15th day of gestational age (C2) and treated group with 365 mg/kg VAC from initiation of insemination (T3) and 30 days prior to pregnancy (T4) that underwent caesarean section. Weight, sex and number of fetuses, abortion and still birth rate and estradiol level were evaluated using t-test by SPSS software. Results We showed increased weight among T1 group considering totally and sex-dependent which is significant (all p-value < 0.05). We also detected significantly decreased weight in T2 in total (p-value < 0.0001) and when considering female fetuses (0.043) but not males (0.17). Although the results showed slightly non-significant increased weight among fetuses of T3 (totally or based on the fetus sex) compared to the control group (C2), T4 group had statistically decreased weight compared to control group. Pregnancy rate and pregnancy outcome were affected by VAC usage. The time of VAC initiation also affected live birth and abortion rates. Conclusion VAC extract may affect pregnancy rate, live birth rate, abortion and stillbirth rates. Its effect on the weight and the sex showed dual pattern depends on the time of initiation and pregnancy trimester of evaluation. Prescribing this medicinal plant for patients being prone to pregnancy should be with caution. Further study is recommended.
Collapse
Affiliation(s)
- Fateme Sadat Najib
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Monireh Sufi Mahmudi
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shiravani
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloofar Namazi
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | |
Collapse
|
8
|
Shiravani Z, Atbaei S, Namavar Jahromi B, Hajisafari Tafti M, Moradi Alamdarloo S, Poordast T, Noori A, Forouhari S, Sabetian S. Comparing four different methods for the management of ectopic pregnancy: A cross-sectional study. Int J Reprod Biomed 2022; 20:177-184. [PMID: 35571502 PMCID: PMC9099365 DOI: 10.18502/ijrm.v20i3.10709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/12/2020] [Accepted: 06/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background Ectopic pregnancy (EP) is one of the major causes of maternal mortality
during the first trimester of pregnancy. Objective Four treatment methods for EP including single-dose methotrexate (SD-MTX),
double-dose methotrexate, expectant and surgical management were
considered. Materials and Methods In this cross-sectional study, the clinical characteristics of 365 women
aged 15-44 yr who had been diagnosed with EP were reviewed from March 2017
to March 2019 in hospitals affiliated to Shiraz University of Medical
Sciences, Shiraz, Iran. Receiver operating characteristics curves were
plotted to determine the cut-off points for size of ectopic mass and
beta-human chorionic gonadotropin (β-hCG) that suitably discriminated
between double-dose methotrexate and surgery management. Results The most common site of EP was adnexa. According to the receiver operating
characteristics analysis, surgery was the best plan for the women with an
ectopic mass > 34.50 mm in diameter or with an initial β-hCG level > 6419 mIU/ml. The β-hCG levels in the women successfully
treated with SD-MTX were significantly lower than in those with failed
treatment (p = 0.02). The SD-MTX group had a higher success rate and
significantly shorter duration of hospitalization, and so this was a more
effective medical treatment in comparison with the double-dose protocol. Conclusion Surgery is proposed as the best option for the cases with large ectopic mass
or high β-hCG level. SD-MTX had a higher success rate and shorter hospital
stay than the double-dose protocol, and so was found to be an efficient and
safe alternative. Further randomized clinical trials with larger sample
sizes are recommended to validate the current results.
Collapse
Affiliation(s)
- Zahra Shiravani
- Gynecology Oncology Division, Department of Obstetrics and Gynecology,
School of Medicine, Shiraz University of Medical Science, Shiraz, Iran
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical
Sciences, Shiraz, Iran
| | - Sana Atbaei
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
| | - Bahia Namavar Jahromi
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
- Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran
| | - Mojgan Hajisafari Tafti
- Department of Obstetrics and Gynecology, School of Medicine, Shahid
Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shaghayegh Moradi Alamdarloo
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
| | - Adel Noori
- Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedighe Forouhari
- Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran
| | - Soudabeh Sabetian
- Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran
| |
Collapse
|
9
|
Ashraf MA, Shokouhi N, Shirali E, Davari-Tanha F, Shirani K, Memar O, Kamalipour A, Azarnoush A, Mabadi A, Ossareh A, Sanginabadi M, Azad TM, Aghaghazvini L, Ghaderkhani S, Poordast T, Pourdast A, Nazemi P. COVID-19, An early investigation from exposure to treatment outcomes in Tehran, Iran. J Res Med Sci 2022; 26:114. [PMID: 35126577 PMCID: PMC8765513 DOI: 10.4103/jrms.jrms_1088_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/30/2020] [Accepted: 05/31/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is a growing need for information regarding the recent coronavirus disease of 2019 (COVID-19). We present a comprehensive report of COVID-19 patients in Iran. MATERIALS AND METHODS One hundred hospitalized patients with COVID-19 were studied. Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and postdischarge follow-up were analyzed. RESULTS The median age of the patients was 58 years, and the majority of the patients (72.7%) were above 50 years of age. Fever was present in 45.2% of the patients on admission. The most common clinical symptoms were shortness of breath (74%) and cough (68%). Most patients had elevated C-reactive protein (92.3%), elevated erythrocyte sedimentation rate (82.9%), and lymphocytopenia (74.2%) on admission. Lower lobes of the lung were most commonly involved, and ground-glass opacity (81.8%) was the most frequent finding in computed tomography scans. The administration of hydroxychloroquine improved the clinical outcome of the patients. Lopinavir/ritonavir was efficacious at younger ages. Of the 70 discharged patients, 40% had symptom aggravation, 8.6% were readmitted to the hospital, and three patients (4.3%) died. CONCLUSION This report demonstrates a heterogeneous nature of clinical manifestations in patients affected with COVID19. The most common presenting symptoms are nonspecific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. Hydroxychloroquine and lopinavir/ritonavir (in younger age group) can be potential treatment options. Finally, patients discharged from the hospital should be followed up because of potential symptom aggravation.
Collapse
Affiliation(s)
- Mohammad Ali Ashraf
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasim Shokouhi
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shirali
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Davari-Tanha
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiana Shirani
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omeed Memar
- Academic Dermatology and Skin Cancer Institute, Chicago, IL, USA
| | - Alireza Kamalipour
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA, USA.,MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ayein Azarnoush
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Avin Mabadi
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Adele Ossareh
- Department of Statistics, Shahid Beheshti University, Tehran, Iran
| | - Milad Sanginabadi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Talat Mokhtari Azad
- The National Influenza Centre, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ghaderkhani
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alieh Pourdast
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Research Center for HIV/AIDS (IRCHA), Tehran, Iran
| | - Pershang Nazemi
- Department of Infectious Diseases, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Poordast T, Naghmehsanj Z, Vahdani R, Moradi Alamdarloo S, Ashraf MA, Samsami A, Najib FS. Evaluation of the recurrence and fertility rate following salpingostomy in patients with tubal ectopic pregnancy. BMC Pregnancy Childbirth 2022; 22:2. [PMID: 34979988 PMCID: PMC8721972 DOI: 10.1186/s12884-021-04299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 11/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background Ectopic pregnancy is one of the leading causes of pregnancy-related mortality; the treatment strategies associated with this condition entail complications, such as recurrence of ectopic pregnancy or infertility. The objective of this study was to evaluate the recurrence and fertility rate after salpingostomy in patients with tubal ectopic pregnancy. Methods This cross-sectional retrospective study was conducted at four referral centers of Obstetrics and Gynecology, under the supervision of Shiraz University of Medical Sciences (Iran). The medical records of 125 patients with tubal pregnancy were reviewed. These patients underwent laparoscopic salpingostomy from April 2009 to March 2016.Data on maternal age, BMI, history of previous EP, genital tract infection, IUD insertion, history of previous surgery, and infertility were further obtained. The patients were followed up for approximately 1 to 7 years. The recurrence of EP and subsequent pregnancy rate were assessed during the follow-up period. Results There was no statistically significant relationship between post-salpingostomy recurrence and maternal age, previous abdominopelvic surgery, and history of infertility(P = .425); however, the post-salpingostomy recurrence of EP was correlated with BMI (P = 0.001), previous history of EP (P = 0.001), genital tract infection (P = 0.001), and IUD insertion (P = 003). Among 95 women who had no contraception, pregnancy occurred in 51 cases (53.6%) and recurrence of EP was observed in 16 patients (12.8%). Conclusions Our results suggest that salpingostomy is a safe method with a low risk of recurrence and good fertility outcomes for women who consider future pregnancy.
Collapse
Affiliation(s)
- Tahereh Poordast
- Infertility Research Center, Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Naghmehsanj
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Razie Vahdani
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Ali Ashraf
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Almtaj Samsami
- OB & GYN Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Sadat Najib
- Infertility Research Center, Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
11
|
Bahmanpour S, Keshavarz M, Koohpeyma F, Badr P, Noori A, Dabbaghmanesh MH, Poordast T, Najib FS, Zare N, Namazi N, Jahromi BN. Preserving effect of Loboob (a traditional multi-herbal formulation) on sperm parameters of male rats with busulfan-induced subfertility. JBRA Assist Reprod 2022; 26:574-582. [PMID: 34995049 PMCID: PMC9635600 DOI: 10.5935/1518-0557.20210099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Male infertility secondary to exposure to gonadotoxic agents during reproductive age is a concerning issue. The aim of this experimental study was to determine the effect of Loboob on sperm parameters. METHODS 55 healthy rats were selected, weighted and divided into five groups consisting of 11 rats each. The control group received no medication. Rats in Treatment Group 1 received 10mg/kg Busulfan and rats in Treatment Groups 2, 3, and 4 received 35,70 and 140 mg/kg Loboob respectively in addition to 10mg/kg Busulfan. Finally, the sperm parameters and weights of the rats were compared using the Kolmogorov-Smirnov, non-parametric Kruskal-Wallis, and Dunn-Bonferroni tests. RESULTS All sperm parameters and weights were significantly decreased among rats receiving Busulfan. All dosages of Loboob were effective to enhance the motility of slow spermatozoa, while only in the rats given 70 and 140 mg/kg of Loboob saw improvements in progressively motile sperm percentages (0.024 and 0.01, respectively). Loboob at a dosage of 140mg/kg improved sperm viability. It did not improve normal morphology sperm or decrease immotile sperm counts. Loboob did not affect mean rat weight. CONCLUSIONS Loboob offered a dose-dependent protective effect on several sperm parameters in rats with busulfan-induced subfertility.
Collapse
Affiliation(s)
- Soghra Bahmanpour
- Anatomy Department, School of Medicine, Shiraz University of
Medical Sciences, Shiraz, Iran , Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran
| | - Mojtaba Keshavarz
- Endocrine and Metabolism Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran
| | - Farhad Koohpeyma
- Endocrine and Metabolism Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran
| | - Parmis Badr
- Pharmaceutical Sciences Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran , Phytopharmaceutical Technology and Traditional Medicine Incubator,
Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adel Noori
- Student Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran , Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
| | | | - Tahereh Poordast
- Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran , Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
| | - Fateme Sadat Najib
- Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran , Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
| | - Najaf Zare
- Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran , Department of Biostatistics, School of Medicine, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Niloofar Namazi
- Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran , Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
| | - Bahia Namavar Jahromi
- Infertility Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran , Department of Obstetrics and Gynecology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran ,Corresponding author: Bahia Namavar Jahromi Department
of OB-GYN School of Medicine Shiraz University of Medical Sciences Shiraz, Iran.
E-mail:
| |
Collapse
|
12
|
Shiravani Z, Poordast T, Alamdarloo SM, Najib FS, Hosseinzadeh F, Shahraki HR. Chamomile Extract versus Clotrimazole Vaginal Cream in Treatment of Vulvovaginal Candidiasis: A Randomized Double-Blind Control Trial. J Pharmacopuncture 2021; 24:191-195. [PMID: 35028170 PMCID: PMC8716701 DOI: 10.3831/kpi.2021.24.4.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/10/2020] [Accepted: 12/02/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives Vulvovaginal candidiasis (VVC) treatment is advised for all women due to its symptoms and complications. In this study, the standard treatment, clotrimazole, was compared with chamomile extract cream in outpatient clinics. Methods We recruited 73 women with VVC, who were randomly allocated into two groups, clotrimazole versus chamomile extract cream. After two weeks of treatment with the same criteria, cheese-like vaginal discharge, itching and burning sensations, strawberry cervix, and recovery percentage was evaluated. Results Thirty patients in each group were analyzed. There was no significant difference in age and number of pregnancies between groups (p = 0.85 and 0.09, respectively). Comparing before and after treatment, cheese like discharge (p < 0.001), itching (p < 0.001), burning (p < 0.001) had significantly improved in both groups. Further, the recovery percentage was not significantly different between groups (88.9% vs 75% in the chamomile vs clotrimazole groups, respectively). Conclusion Chamomile is as effective as clotrimazole in VVC treatment; a higher percentage of women who used this medication recovered, although this did not reach significance. In addition, no complications were reported in either group.
Collapse
Affiliation(s)
- Zahra Shiravani
- Infertility Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Infertility Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shaghayegh Moradi Alamdarloo
- Department of Perinatology, Maternal-fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Sadat Najib
- Infertility Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Hosseinzadeh
- Department of Midwifery, School of Nursing and Midwifery, Estahban branch, Islamic Azad University, Estahban, Iran
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| |
Collapse
|
13
|
Alborzi S, Poordast T, Askary E, Chamanara K, Sorouri ZZ, Kellaii EHN, Nahooji SP. The effect of vasopressin injection on ovarian reserve in patients who had cystectomy for ovarian endometrioma; a randomized controlled trial. Reprod Biomed Online 2021; 44:651-658. [DOI: 10.1016/j.rbmo.2021.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
|
14
|
Tavana Z, Askary E, Poordast T, Soltani M, Vaziri F. Does laparoscopic hysterectomy + bilateral salpingectomy decrease the ovarian reserve more than total abdominal hysterectomy? A cohort study, measuring anti-Müllerian hormone before and after surgery. BMC Womens Health 2021; 21:329. [PMID: 34507569 PMCID: PMC8434747 DOI: 10.1186/s12905-021-01472-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Decreased ovarian function and reserve is one of the complications of hysterectomy. In this study, we aimed to compare anti-müllerian hormone (AMH) levels between total abdominal hysterectomy (TAH), and total laparoscopic hysterectomy (TLH). METHODS In this prospective cohort study, serum levels of AMH were compared between the groups undergoing TAH + bilateral salpingectiomy and TLH, in 66 patients (33 in each group) who referred to the hospitals of Shiraz University of Medical Sciences for hysterectomy during one years of work. The collected information included age, weight, gravidity, parity, regularity of menstrual cycle, uterine weight, blood loss during surgery, and serum levels of AMH before and 6 months after surgery, compared between groups. RESULTS Most patients (88% in TAH and 73% in TLH group) aged 40-50 years. Mean age, weight, parity of patients was similar in both groups, while blood loss was significantly less in TLH group (P < 0.01). Median (IQR) of pre-surgical AMH values were 0.40 (0.55) ng/ml in the TLH group and 0.92 (1.23) ng/ml in the TAH group (P = 0.12) that decreased to 0.29 (0.44) ng/ml in the TLH group and 0.15 (0.31) ng/ml in the TAH group (P = 0.02). Also Median (IQR) of the difference between pre and post-surgical AMH values were 0.12 (0.31) and 0.58 (1.17) in TLH and TAH group, respectively (P = 0.003). CONCLUSION The serum levels of AMH decreased significantly after both methods of hysterectomy (laparoscopy and laparotomy), while this decrease was greater in TAH group that shows.
Collapse
Affiliation(s)
- Zohreh Tavana
- Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Askary
- Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. .,Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. .,Department Of Obstetrics and Gynecology, Shahid Faghihi Hospital, Zand Street, 7134846114, Shiraz, , Iran.
| | - Maryam Soltani
- Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farideh Vaziri
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Midwifery, Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
15
|
Alborzi S, Askary E, Keramati P, Moradi Alamdarloo S, Poordast T, Ashraf MA, Shomali Z, Namavar Jahromi B, Zahiri Sorouri Z. Assisted reproductive technique outcomes in patients with endometrioma undergoing sclerotherapy vs laparoscopic cystectomy: Prospective cross-sectional study. Reprod Med Biol 2021; 20:313-320. [PMID: 34262399 PMCID: PMC8254172 DOI: 10.1002/rmb2.12386] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 12/02/2022] Open
Abstract
PURPOSE The authors compared assisted reproductive technique (ART) outcomes and the recurrence rate of endometrioma in the infertile patients undergoing sclerotherapy vs laparoscopic ovarian cystectomy. METHODS In this prospective cross-sectional study, a total of 101 infertile patients, with unilateral endometriomas, were divided into two groups. The first group (n = 57) underwent ART after 1 year of unsuccessful spontaneous pregnancy after laparoscopic ovarian cystectomy; the second group (n = 44) had ethanol sclerotherapy (EST) at the time of oocyte retrieval. The authors measured the number of oocytes, clinical pregnancy rate (CPR), live birth rate (LBR), complication, and recurrence of endometriomas as the primary and secondary outcomes. RESULTS The two groups had no significant differences in baseline characteristics and ovarian stimulation markers and also total number of oocytes. 42.1% and 34.1% of the patients (n = 24 and 15) had clinical pregnancy, and 38.6% and 29.5% (n = 22 and 13) had live birth following ART cycles in the surgery group and sclerotherapy group (P = .41, 0.34). The recurrence rates were 14.0% and 34.1% in the surgery and sclerotherapy groups (P = .017, X 2 = 5.67). CONCLUSIONS Ethanol sclerotherapy can be a good alternative to surgery concerning the treatment of endometrioma; however, the recurrence of the disease in this group is significantly higher.
Collapse
Affiliation(s)
- Saeed Alborzi
- Department of Obstetrics and GynecologyLaparoscopy Research CenterSchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Elham Askary
- Department of Obstetrics and GynecologyInfertility Research CenterSchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Pegah Keramati
- Department of Obstetrics and GynecologySchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Shaghayegh Moradi Alamdarloo
- Department of Obstetrics and GynecologyInfertility Research CenterSchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Tahereh Poordast
- Department of Obstetrics and GynecologyInfertility Research CenterSchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Mohammad Ali Ashraf
- Department of Obstetrics and GynecologySchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Zahra Shomali
- Department of Obstetrics and GynecologySchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Behieh Namavar Jahromi
- Department of Obstetrics and GynecologyLaparoscopy Research CenterSchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Ziba Zahiri Sorouri
- Department of Obstetrics and GynecologyLaparoscopy Research CenterSchool of MedicineGuilan University of Medical SciencesRashtIran
| |
Collapse
|
16
|
Poordast T, Ghaedian L, Ghaedian L, Najib FS, Alipour S, Hosseinzadeh M, Vardanjani HM, Salehi A, Hosseinimehr SJ. Aloe Vera; A new treatment for atrophic vaginitis, A randomized double-blinded controlled trial. J Ethnopharmacol 2021; 270:113760. [PMID: 33383112 DOI: 10.1016/j.jep.2020.113760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
AIM OF THE STUDY Vaginal atrophy is of the most common problems during menopause with significant psychosocial and medical consequences. Estrogen as an approved therapy for vaginal atrophy can be associated with adverse effects and several contraindications in menopause patients. The aim is to compare the effect of Aloe Vera vaginal cream with commercially available estrogen vaginal cream for management of vaginal atrophy in menopause females. MATERIALS AND METHODS This is a double-blinded randomized controlled trial on 60menopause female with complaints of vaginal atrophy symptoms. Subjects were randomly allocated in two groups of 30 patients, named as estrogen and Aloe Vera groups. Vaginal health index (VHI), maturity value (MV), vaginal cytologic smear, transvaginal sonography (TVS) and severity of symptoms related to vaginal atrophy were assessed before and after 6-weeks of vaginal cream administration. RESULTS Comparison of MV before and after treatment revealed that superficial cells were significantly increased after administration of both vaginal cream (6.67 VS 54.33 in Aloe Vera group; 4.33 VS 59.67 in estrogen group). In addition, VHI (13.83 vs 20.13 in Aloe Vera group; 13.97 vs 19.93 in estrogen group) and symptoms of vaginal atrophy (3.63 vs 1.10 in Aloe Vera group; 3.90 vs 0.66 in estrogen groups) were also significantly improved after treatment in both groups. There was no significant difference between groups after treatment except for fluid volume with a superiority in Aloe Vera group (P-value = 0.004) CONCLUSION: Aloe Vera vaginal cream can be as effective as estrogen vaginal cream in the management of vaginal atrophy in menopause females.
Collapse
Affiliation(s)
- Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Lida Ghaedian
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Ghaedian
- Department of Obstetrics and Gynecology, Kosar Hospital, Shiraz, Iran
| | - Fatemeh Sadat Najib
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shohreh Alipour
- Department of Quality Control, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Massood Hosseinzadeh
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Alireza Salehi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Seyed Jalal Hosseinimehr
- Department of Radiopharmacy, Faculty of Pharmacy, Pharmaceutical Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
17
|
Jamali N, Zal F, Mostafavi-Pour Z, Samare-Najaf M, Poordast T, Dehghanian A. Ameliorative Effects of Quercetin and Metformin and Their Combination Against Experimental Endometriosis in Rats. Reprod Sci 2021; 28:683-692. [PMID: 33141412 DOI: 10.1007/s43032-020-00377-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/26/2020] [Indexed: 12/31/2022]
Abstract
Endometriosis, as the leading cause of infertility, is attributed to oxidative stress, inflammation, and autophagy dysregulation. This study was conducted to evaluate the effect of quercetin and metformin, alone or in combination, on the ectopic and eutopic endometrial tissues in a rat model of endometriosis. We divided 60 female rats into 6 groups, including SH, Endo, Endo + Oil, Endo + Q, Endo + M, and Endo + Q + M. The last five groups underwent a surgery, so that we could induce endometriosis, and after 4 weeks, daily treatment began, lasting for a month. Subsequently, the size and histoarchitecture of the endometrial implants, serum levels of 17β-estradiol, progesterone and tumor necrosis factor (TNF)-α, and markers of oxidative stress and autophagy were assessed utilizing ELISA and gene expression analysis. Our results shed light to the fact that serum TNF-α and 17β-estradiol levels significantly increased in endometriosis rats. Moreover, NADPH: quinone oxidoreductase (NQO1) enzyme activity and gene expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and autophagy markers significantly decreased; meanwhile, mammalian target of rapamycin (mTOR) gene expression increased in the ectopic endometrial tissues, as compared with eutopic ones. Surprisingly, our results demonstrated that the treatment in which we applied the combination of quercetin and metformin significantly reversed these changes and had a pronounced effect on the endometrial implant size and gene expression levels of mTOR and autophagy markers in ectopic endometrium. The findings of the present study suggest that quercetin, metformin, and their combination were of potential therapeutic effects on the rat model of endometriosis.
Collapse
Affiliation(s)
- Navid Jamali
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Zal
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zohreh Mostafavi-Pour
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Samare-Najaf
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirreza Dehghanian
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
18
|
Jamali N, Mostafavi-Pour Z, Zal F, Kasraeian M, Poordast T, Nejabat N. Antioxidant ameliorative effect of caffeic acid on the ectopic endometrial cells separated from patients with endometriosis. Taiwan J Obstet Gynecol 2021; 60:216-220. [PMID: 33678318 DOI: 10.1016/j.tjog.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Considering the role of oxidative stress in the development and progression of endometriosis, the ameliorative effect of caffeic acid treatment on ectopic, eutopic endometrial cells enzyme activities was investigated. We also determined the underlying cellular mechanisms. MATERIALS AND METHODS Ectopic endometrial specimens were collected from women with confirmed cases of endometriosis (n = 10) and eutopic specimens from (n = 10) controls. Following endometrial cell isolation and culture, eutopic and ectopic endometrial cells were treated with caffeic acid. Then, reactive oxygen species (ROS) level, NAD(P)H quinone oxidoreductase 1 (NQO1), and Heme oxygenase 1 (HO-1) enzyme activities, nuclear factor erythroid 2-related factor 2 (Nrf-2) gene expression were measured. RESULTS In ectopic endometrial cells, caffeic acid caused a significant elevation in Nrf-2 gene expression level, NQO1, and HO-1 enzyme activities. In addition, reduced ROS level was observed in caffeic acid-treated ectopic endometrial cells in comparison with the control. On the contrary, we did not observe any significant changes in caffeic acid-treated eutopic endometrial ones. CONCLUSION Caffeic acid can protect the endometrial cells against oxidative stress and might be able to prevent the progression of endometriosis and its related complications, such as pain and infertility.
Collapse
Affiliation(s)
- Navid Jamali
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Mostafavi-Pour
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fatemeh Zal
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kasraeian
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Nejabat
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
19
|
Askary E, Poordast T, Shiravani Z, Ali MA, Hashemi A, Naseri R, Moradialamdarloo S, Karimi Z, Izanloo E, Najib FS. Coronavirus disease 2019 (COVID-19) manifestations during pregnancy in all three trimesters: A case series. Int J Reprod Biomed 2021; 19:191-204. [PMID: 33718763 PMCID: PMC7922300 DOI: 10.18502/ijrm.v19i2.8477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/23/2020] [Accepted: 12/05/2020] [Indexed: 12/15/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) pandemic has raised concerns about the susceptibility amongst different groups of the population. Pregnant women are one such group. This study was conducted to investigate the effect of COVID-19 on pregnancy and maternal/neonatal outcomes. Case presentation This case series was conducted on 16 pregnant women with COVID-19 from March 21 to May 11, 2020. Clinical characteristics, pregnancy complications, medication used, maternal/neonatal outcomes, and fatality rate were investigated through this study. The mean age of the patients was 30.06 yrs. Patients from all three trimesters were included (1 in first, 5 in second, and 10 in the third trimesters). The most common clinical symptoms were shortness of breath (n = 10), dry cough (n = 10), myalgia (n = 8), and chills (n = 7). Also, three cases had papulosquamous skin lesions with fissuring. The most common laboratory results were leukocytosis (n = 8), increased liver enzymes (n = 6), elevated CRP (n = 5), and thrombocytopenia (n = 4). There was one case of maternal mortality, five of premature labor pain (PLP), two of preeclampsia, and two of placenta accreta. Twelve pregnancies were terminated (nine cesarean sections, three vaginal deliveries). Among neonates, we had 6 cases of preterm labor. All neonates had negative PCR results. Conclusion Clinical manifestations and paraclinical results were similar to non-pregnant patients. There was no evidence of vertical transmission. PLP and premature rupture of membranes (PROM) were the most common complications in the second and third trimesters of pregnant COVID-19 women, which can lead to rupture of the uterus. Termination and delivery should be planned individually.
Collapse
Affiliation(s)
- Elham Askary
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shiravani
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ashraf Ali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Atefeh Hashemi
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Razieh Naseri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shaghayegh Moradialamdarloo
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zinat Karimi
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Izanloo
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Sadat Najib
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
20
|
Abstract
Sexual dysfunction is more common among the people with human immunodeficiency virus (HIV) infection than in those without it. The sexual dysfunction in HIV-infected people is associated with adverse outcomes such as reduced quality of life, unprotected sexual activities, and reduced adherence to highly active antiretroviral therapy. Therefore, the present study was designed to investigate a potential predictor role of some variables such as socioeconomic status, hormonal and HIV disease profile, type of treatment, depression, anxiety, stress, domestic violence, and status of partner infection for sexual function in people with HIV infection. This descriptive cross-sectional study was conducted on 40 HIV-infected women with medical records in behavioral disease counseling centers of Shiraz University of Medical Sciences. The required data were collected using the Female Sexual Function Index (FSFI), Depression‚ Anxiety‚ Stress Scale (DASS-21), and Domestic Violence Questionnaire. To examine the CD4 cell levels and hormonal profiles, 5cc blood was taken from the patients simultaneously on days 3 - 5 of their menstrual cycles. The data were analyzed using the SPSS18 software. The mean age of the participants was 38.2 ± 5.2 years, and the frequency of sexual dysfunction was 100%. There was a statistically significant difference in the levels of the elevated variables such as estradiol, stress, anxiety, and depression. The multivariate analysis showed that only the increased estradiol level (P = 0.005, B = 0.06) was a predictor factor of sexual dysfunction. All the HIV-infected women had sexual dysfunction. The results of this study showed that in those women the increased levels of estradiol could be a predictor of sexual dysfunction.
Collapse
|
21
|
Ashraf MA, Keshavarz P, Hosseinpour P, Erfani A, Roshanshad A, Pourdast A, Nowrouzi-Sohrabi P, Chaichian S, Poordast T. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Pregnancy and the Possibility of Vertical Transmission. J Reprod Infertil 2020; 21:157-168. [PMID: 32685412 PMCID: PMC7362089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a growing need for information regarding maternal and neonatal outcomes during coronavirus pandemic. In this study, a comprehensive investigation was done regarding the possibility of vertical transmission using the available data in the literature. METHODS A systematic search was conducted using electronic databases, including PubMed, Scopus, Web of Science, Embase, and Scholar. All studies containing infected COVID-19 pregnant women who had given birth were included, and the search was done up to April 14, 2020. RESULTS Overall, 21 articles were reviewed, and clinical characteristics of 90 pregnant patients and 92 neonates born to mothers infected with COVID-19 were reviewed. The most common symptoms included fever, cough, and dyspnea. The main laboratory findings included leukocytosis, lymphopenia, thrombocytopenia, and elevated C-reactive protein. The most commonly reported complications were preterm labor and fetal distress. Three mothers were admitted to ICU and required mechanical ventilation; among them, one died, and one was on extracorporeal membrane oxygenation. Overall, 86 neonates were tested for the possibility of vertical transmission and 82 cases were negative in RT-PCR, while 4 were positive. Out of 92 neonates, one died, and one was born dead. Nineteen patients reported having no symptoms, while breathing problems and pneumonia were reported as the most common neonatal complications. CONCLUSION There were no differences in the clinical characteristics of pregnant women and non-pregnant COVID-19 patients. COVID-19 infection has caused higher incidence of fetal distress and premature labor in pregnant women. Although the possibility of vertical transmission in infected pregnant women is rare, four neonates' test results for COVID-19 infection were positive in this review.
Collapse
Affiliation(s)
- Mohammad Ali Ashraf
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pedram Keshavarz
- Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Hosseinpour
- School of Medicine, Islamic Azad University, Kazeroun branch, Kazeroun, Iran
| | - Amirhossein Erfani
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Alieh Pourdast
- Department of infectious diseases, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Research Center for HIV/AIDS (IRCHA), Tehran, Iran
| | - Peyman Nowrouzi-Sohrabi
- Department of Biochemistry, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahla Chaichian
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
22
|
Najib FS, Hashemi M, Shiravani Z, Poordast T, Sharifi S, Askary E. Diagnostic Accuracy of Cervical Pap Smear and Colposcopy in Detecting Premalignant and Malignant Lesions of Cervix. Indian J Surg Oncol 2020; 11:453-458. [PMID: 33013127 DOI: 10.1007/s13193-020-01118-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 06/01/2020] [Indexed: 12/19/2022] Open
Abstract
The objective of this study was to determine the diagnostic accuracy of pap smear and colposcopy in detecting the premalignant and malignant lesion of the cervix. In this cross-sectional study, a total number of 160 women who presented with abnormal clinical problem or routine checkup during a 6-month period were included. All the patients underwent pap smear and colposcopy by the same gynecologists team, and finally, cervical biopsy was performed in all the individuals. The demographic and clinical characteristics as well as the obstetrics history were recorded. The diagnostic accuracy of each test was calculated according to the biopsy as gold standard. The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were recorded and compared between two modalities. Overall, we included a total number of 160 patients with mean age of 37.6 ± 7.32 (ranging from 24 to 63) years. The sensitivity and specificity of pap smear were found to be 47.19% and 64.79%, respectively. The PPV and NPV of the pap smear were calculated to be 88.69% and 38.46%, respectively. The sensitivity and specificity, PPV, and NPV of the colposcopy were calculated as 64.72%, 52.74%, 76.32%, and 95.41%, respectively. The overall diagnostic accuracy of the pap smear and colposcopy was reported to be 82.2% and 96.3%, respectively. The results of this study demonstrate that colposcopy has a higher diagnostic accuracy in detecting cervical premalignant and malignant lesions compared to the pap smear.
Collapse
Affiliation(s)
- Fatemeh Sadat Najib
- Infertility Research Center, Obstetrics and Gynecology Department, Division of Oncology Gynecology, Shiraz University of Medical Sciences, OB & GYN ward, Faghihi Hospital, Zand Blvd, Shiraz, Iran
| | - Masooumeh Hashemi
- Fellowship of Oncology Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shiravani
- Infertility Research Center, Obstetrics and Gynecology Department, Division of Oncology Gynecology, Shiraz University of Medical Sciences, OB & GYN ward, Faghihi Hospital, Zand Blvd, Shiraz, Iran
| | - Tahereh Poordast
- Infertility Research Center, Obstetrics and Gynecology Department, Division of Oncology Gynecology, Shiraz University of Medical Sciences, OB & GYN ward, Faghihi Hospital, Zand Blvd, Shiraz, Iran
| | | | - Elham Askary
- Infertility Research Center, Obstetrics and Gynecology Department, Division of Oncology Gynecology, Shiraz University of Medical Sciences, OB & GYN ward, Faghihi Hospital, Zand Blvd, Shiraz, Iran
| |
Collapse
|
23
|
Balaghi Z, Azima S, Motamedifar M, Kaviani M, Poordast T, Zare N. The Effect of Lactofem Oral Probiotic Capsule on Lactobacilli Colonization and Some Vaginal Health Parameters. Gynecol Obstet Invest 2020; 85:245-251. [DOI: 10.1159/000506802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 02/26/2020] [Indexed: 11/19/2022]
|
24
|
Poordast T, Askari E, Najib FS, Moradialamdarloo S, Naghizadeh N. Investigation of the Necessity of Urodynamic Test in Patients with Urinary Stress Incontinence for TOT Surgery. Int J Epidemiol Res 2020. [DOI: 10.34172/ijer.2020.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims: Stress urinary incontinence is one of the most common diseases which can reduce the quality of life in women. Urodynamic test is a common method of diagnosis of this disease. This study is designed for investigating the necessity of urodynamic test in patients with urinary stress incontinency before transobturator tape (TOT) surgery. Urodynamic test before surgery can affect the quality of life in patients. Methods: This study was a randomized clinical trial. The sample size was 48 patients divided into two groups of 24 women in January 2018. Women with urinary incontinence complaints were randomly divided into two groups. For the first group, the urodynamic test was done. Both groups were evaluated one month and six months after TOT surgery based on the results of the I-QOL questionnaire. Results: The mean I-QOL score was 83.9±3.3 in questionnaire group and 81.6±4.6 in urodynamic group one month after surgery with no statistically significant (P=0.052) difference. The quality of life score after 6 months was 87.2±4 in the questionnaire group and 85.4±3 in the urodynamic group with no statistically significant differences with each other (P=0.084). Conclusion: In this study, the urodynamic test only had additional information related to lower urinary tract symptoms and it did not have effects on improving the outcome of the surgery. The test only imposes economic burden. Therefore, the urodynamic test is not required before surgery in patients with urinary stress incontinence
Collapse
Affiliation(s)
- Tahereh Poordast
- Assistant professor of Obstetrics and Gynecology Infertility Research Center, Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Askari
- Assistant professor of Obstetrics and Gynecology Infertility Research Center, Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Sadat Najib
- Assistant professor of Obstetrics and Gynecology Infertility Research Center, Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shaghayegh Moradialamdarloo
- Assistant professor of Obstetrics and Gynecology Infertility Research Center, Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Naghizadeh
- Gynecologist, Department of Obstetrics and Gynecology, Shiraz Medical School, University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
25
|
Sadat Najib F, Poordast T, Rezvan Nia M, Hossein Dabbaghmanesh M. Effects of selenium supplementation on glucose homeostasis in women with gestational diabetes mellitus: A randomized, controlled trial. Int J Reprod Biomed 2020; 18:57-64. [PMID: 32043072 PMCID: PMC6996124 DOI: 10.18502/ijrm.v18i1.6201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 06/02/2019] [Accepted: 08/14/2019] [Indexed: 12/17/2022] Open
Abstract
Background There is limited evidence about the anti-diabetic effects of selenium supplementation in women with gestational diabetes mellitus (GDM). Objective This study investigates the effects of selenium supplementation on glucose homeostasis in women with GDM. Materials and Methods A total of 60 pregnant women with GDM were enrolled in this prospective randomized, double-blind, and placebo-controlled clinical trial. They were randomly assigned to take either 100µg selenium supplements as tablet or a placebo daily for 12 wk since 24-28 wk of gestation. The primary outcomes were changes in the glucose homeostasis, including fasting plasma glucose, the 2-hr post prandial blood glucose, serum insulin level, glycosylated hemoglobin (Hb A1C), and the homeostasis model assessment of insulin resistance(HOMA_IR) at the initial period and 3 months after intervention. Results The mean maternal age of the patients who took selenium supplements was 29.19 ± 6.16 (range 18-41) years. In the placebo group, the mean maternal age was 31 ± 4.43 (range 24-39) years. Compared with the placebo group, fasting plasma glucose, 2-hr post-prandial blood glucose, glycosylated hemoglobin(Hb A1C), serum insulin level, and homeostasis model of assessment-estimated insulin resistance(HOMA_IR) were not significantly changed in the selenium group at the end of study (p = 0.25, p = 0.87, p = 0.34, p = 0.57, and p = 0.31, respectively). Conclusion The results of this trial suggest that supplementation with 100µg of selenium does not modulate glucose homeostasis in women with GDM.
Collapse
Affiliation(s)
- Fatemeh Sadat Najib
- Infertility Research Centere of Obstetrics and Gynecology Ward, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Infertility Research Centere of Obstetrics and Gynecology Ward, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Rezvan Nia
- Infertility Research Centere of Obstetrics and Gynecology Ward, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Dabbaghmanesh
- Endocrin and Metabolic Research center of Internal Medicine Ward, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
26
|
Tarokh M, Ghaffari Novin M, Poordast T, Tavana Z, Nazarian H, Norouzian M, Gharesi-Fard B. Serum and Peritoneal Fluid Cytokine Profiles in Infertile Women with Endometriosis. Iran J Immunol 2019; 16:151-162. [PMID: 31182689 DOI: 10.22034/iji.2019.80258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Endometriosis is a chronic inflammatory disease with the growth of endometrial cells out of uterus and in the peritoneal cavity. T cell subsets participate in the establishment and progress of the disease by producing different cytokines. OBJECTIVE To investigate a group of cytokines related to Th1/Th2/Th17/Treg subsets within both peripheral blood and peritoneal fluid (PF) samples from infertile endometriosis women. METHODS Peripheral blood and PF samples were collected from 30 infertile endometriosis and 30 non-endometriosis fertile women during laparoscopy. Concentration of cytokines, including TNF-α, IFN-γ, TGF-β1, IL-4, IL-10, IL-17 and IL-23 were evaluated using ELISA method. RESULTS Results indicated that the concentration of IFN-γ within serum was significantly reduced in endometriosis group (p=0.001). Regarding PF cytokines, TGF-β1 was increased in endometriosis group (p=0.030). Furthermore, the ratios of IFN-γ/TGF-β1 and IL-17/IL-23 were significantly different between endometriosis and non-endometriosis women in serum samples (p<0.001 and p<0.01 respectively). The ratios of TNF-α/IL-10 and IL-17/IL-10 were also significantly different regarding PF samples between the two studied groups (p<0.04 and p<0.03 respectively). Finally, significant correlations were observed between the levels of IL-17 and IL-23, inflammatory and anti-inflammatory cytokines, in both samples and serum to PF inflammatory cytokines. CONCLUSION Based on the results of the present study, in women with endometriosis, the disturbance of cytokines network might gradually activate the inflammatory responses and tissue repair, resulting in endometriosis development after several years.
Collapse
Affiliation(s)
- Majid Tarokh
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran,Iran
| | | | | | | | | | | | | |
Collapse
|
27
|
Alborzi S, Zahiri Sorouri Z, Askari E, Poordast T, Chamanara K. The success of various endometrioma treatments in infertility: A systematic review and meta-analysis of prospective studies. Reprod Med Biol 2019; 18:312-322. [PMID: 31607791 PMCID: PMC6780037 DOI: 10.1002/rmb2.12286] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/15/2019] [Accepted: 06/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Endometriosis is seen in 0.5%-5% of fertile and 25%-40% of infertile women. To investigate this conflict between gynecologists that ovarian endometriomas should be removed or not before making any decision about pregnancy among infertile women, the authors decided to carry out a systematic review and meta-analysis to compare the effect of various available therapeutic methods and notice the impact of these options on women's pregnancy rate. METHODS This review is based on PRISMA recommendations with an electronic search using the following databases: PubMed, Scopus, Google scholar, etc, from 2000 to 2018, in the English language. The studies compare pregnancy rate based on four different treatment types of OMAs between infertile women: (surgery + ART, surgery + spontaneous pregnancy, aspiration ± sclerotherapy + ART, and ART alone). MAIN FINDINGS At least eight prospective studies were included, in which 553 infertile women were compared in terms of treatment methods of OMAs before trying to become pregnant. CONCLUSION Treatments are usually based on the patient's clinical condition and must be individual, with the purpose of relieving pain, improving fertility, or both. The authors do not have not any significant difference between our four groups of study; however, the success of surgical procedure compared to other methods was higher and the success of ART alone was the least.
Collapse
Affiliation(s)
- Saeed Alborzi
- Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research CenterShiraz University of Medical SciencesShirazIran
| | - Ziba Zahiri Sorouri
- Department of Obstetrics & Gynecology, School of Medicine, Reproductive Health Research Center, Alzahra HospitalGuilan University of Medical SciencesRashtIran
| | - Elham Askari
- Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research CenterShiraz University of Medical SciencesShirazIran
| | - Tahereh Poordast
- Department of Gynecology and ObstetricsShiraz University of Medical SciencesShirazIran
| | - Kefayat Chamanara
- Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research CenterShiraz University of Medical SciencesShirazIran
| |
Collapse
|
28
|
Mostafavi-Pour Z, Jamali N, Zal F, Kasraeian M, Poordast T. In vitro analysis of antioxidant and heme oxygenase-1 enzymes activity in ectopic and eutopic cells from patients with endometriosis treated with caffeic acid. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
29
|
Alborzi S, Poordast T, Askary E, Dorniani G. Effects of clarithromycin on inflammatory markers and clinical manifestations in postsurgical follow-up of patients with endometriosis: a double-blinded randomized placebo-controlled clinical trial. Arch Gynecol Obstet 2019; 299:1305-1312. [PMID: 30888478 DOI: 10.1007/s00404-019-05057-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 01/18/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Studies showed anti-inflammatory and immunomodulatory effects of macrolide antibiotics such as clarithromycin in endometriosis. Therefore, the present study aims to investigate the therapeutic efficacy of clarithromycin in patients with endometriosis. METHODS This was a double-blinded randomized placebo-controlled trial conducted on endometriotic women during March 2016-2017 in Dena Hospital, Shiraz, Iran. Immediately after surgery, the patients were randomly divided into clarithromycin (real) (n = 120) and placebo group (n = 169). The real group received 500 mg of clarithromycin everyday for 6 months and the placebo group received the placebo. The serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), Erythrocyte sedimentation rate (ESR) and C-reactive protein as well as clinical symptoms at baseline and 3 and 6 months of post-surgery were compared within and between groups. RESULTS The scores of dysmenorrhea, dyschezia, dyspareunia, and non-menstrual pain significantly decreased in both real and placebo groups compared with the baseline values. However, the real group showed greater reductions compared with the placebo group (p < 0.001). Similarly, the serum levels of CRP, TNF-α, and IL-10 decreased in both groups compared with the baseline values, but the real group showed greater reductions. Interestingly, the reductions in the clinical symptoms and serum levels did not significantly differ between the real and placebo groups. Moreover, the reductions in the studied variables showed no dependence on the time. CONCLUSION Clarithromycin may be an appropriate treatment in endometriotic patients. However, the non-significant differences between the real and placebo groups necessitate further studies on the therapeutic efficacy of clarithromycin.
Collapse
Affiliation(s)
- Saeed Alborzi
- Department of gynecology and obstetrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Department of gynecology and obstetrics, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Elham Askary
- Department of gynecology and obstetrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gita Dorniani
- Department of gynecology and obstetrics, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
30
|
Moshfeghy Z, Asadi K, Akbarzadeh M, Zare A, Poordast T, Emamghoreishi M, Najib FS, Sayadi M. Quercus Brantii Lindl. Vaginal Douche Versus Clotrimazole on Vaginal Candidiasis: A Randomized Clinical Trial. J Pharmacopuncture 2018; 21:185-194. [PMID: 30283706 PMCID: PMC6168190 DOI: 10.3831/kpi.2018.21.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 07/11/2018] [Accepted: 08/02/2018] [Indexed: 11/22/2022] Open
Abstract
Objectives Vaginal Candidiasis with an approximate prevalence of 30% is the second cause of vaginal infections. Antifungal azole is the first treatment for Vaginal Candidiasis; however, some side effects have been reported for this chemical medicine. Based on the antifungal activity of Inner Stratum of Quercus Brantii (Q. Brantii), the aim of our study was to compare the effects of vaginal douche of Q. Brantii extract and clotrimazole on vaginal candidiasis symptoms before and after the treatments, in women. Methods 89 non-pregnant women with positive KOH test which is capable of identifying the presence of hyphae and mycelium by adding KOH (10%), and a positive vaginal candidiasis culture were randomly divided into two experimental groups, using permuted block randomization method. One group received clotrimazole vaginal cream (1%) and the other group received vaginal douche of Q. Brantii extract. Groups were treated for 7 days and KOH tests and cultures were evaluated again. Data were analyzed via chi-square and independent t-test, using SPSS software. Results According to the results, there were no significant differences between experimental groups for demographic characteristics like age (p=0.403), BMI (p=0.911), educational levels (p=0.862) and contraceptive methods (p=0.702). Moreover, significant differences were seen in vaginal discharge between the groups after the treatments (P=0.043). Conclusion The results suggested that the therapeutic effect of vaginal douche of Q. Brantii extract was approximately similar to that of clotrimazole vaginal cream.
Collapse
Affiliation(s)
- Zeinab Moshfeghy
- Community Based Psychiatric Care Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khadegeh Asadi
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Akbarzadeh
- Maternal-Fetal Research Center, Department of Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Atefeh Zare
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Infertility Research Center, Shiraz University of Medical Science, Shiraz, Iran.,Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Emamghoreishi
- Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh S Najib
- Infertility Research Center, Shiraz University of Medical Science, Shiraz, Iran.,Department of OB/GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrab Sayadi
- Cardio-vascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
31
|
Abstract
OBJECTIVES The aim of the present study was to review 6 year experience on the surgical outcomes of laparoscopic endometriosis surgery. METHODS A cohort study was performed in Shiraz University of Medical Sciences using data from medical records of 1315 cases of patients with endometriosis undergoing laparoscopic surgery with follow-up of 6 to 72 months. RESULTS This study concerned a cohort of 1315 patients diagnosed with endometriosis operated between April 2010 and April 2016, 1086 (82.5%) of whom were in stage III and IV; 968 (73.61%) had endometrioma (regardless of having deep infiltrative endometriosis [DIE] or peritoneal involvement) and 347 (26.39%) of patients had either DIE or peritoneal involvement without endometrioma. Regarding the patients, unilateral endometrioma was statistically significant in the left ovary (p = .002). One hundred and thirty-three (10.7%) rectal wall, 7 (0.32%) sigmoid colon, 4 (0.18%) vagina, 125 (5.6%) ureter and 33 (1.52) bladder involvements were detected. Prior to operation, the pain VAS score was 8.23 ± 2.03, which decreased to 4.46 ± 2.47 in 93.07% of patients. Fifty-three patients (6.56%) needed reoperation. Sixty-six (33.1%) infertile women had spontaneous pregnancy and 15 (25%) became pregnant using intrauterine insemination (IUI) or assisted reproductive technique (ART) post-operatively. CONCLUSION Surgical treatment of endometriosis seems to be an effective treatment. DIE can be present in the absence of endometrioma. The rate of left endometrioma is higher due to the pressure effect of the sigmoid colon. Nonetheless, if an expert surgeon performs this procedure, not only the rate of post-operative complications, but also the possibility of recurrence would decrease.
Collapse
Affiliation(s)
- S Alborzi
- a Department of Obstetrics and Gynecology , Shiraz University of Medical Sciences , Shiraz , Iran
| | - A Hosseini-Nohadani
- a Department of Obstetrics and Gynecology , Shiraz University of Medical Sciences , Shiraz , Iran
| | - T Poordast
- a Department of Obstetrics and Gynecology , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Z Shomali
- a Department of Obstetrics and Gynecology , Shiraz University of Medical Sciences , Shiraz , Iran
| |
Collapse
|