Comparative Effects of Exercises Combined With Kinesio Taping and Electrotherapy in Women with Primary Dysmenorrhea: A Randomized Controlled Clinical Trial.

Background: Primary dysmenorrhea is a common gynecological problem characterized by menstrual pain without any pelvic pathology. It affects a significant portion of women of reproductive age, impacting their quality of life and daily activities. Physiotherapy interventions such as therapeutic exercise, manual therapy, electrotherapy, and kinesio taping reduce menstrual pain and symptoms. However, there is no study investigating the effects of combined physiotherapy interventions. Primary Study Objective: This study aimed to evaluate and compare the effects of exercises combined with either kinesio taping or electrotherapy on reducing menstrual pain and associated symptoms in women suffering from primary dysmenorrhea. Methods: The randomized controlled clinical trial. Setting: Biruni University Department of Physiotherapy and Rehabilitation Laboratory. Participants: Thirty-six women diagnosed with primary dysmenorrhea by a Gynecologist and Obstetrician were randomized into the kinesio-taping group (n=19) and the electrotherapy group (n=17). Intervention: A similar exercise program was carried out in both groups for eight weeks, two days a week and 40 minutes a day. To increase blood flow in the pelvic region and reduce pain mediators, taping was applied to the sacral and pubic regions using the ligament technique in the kinesio taping group, and a vacuum interferential current was applied to the lumbar and gluteal regions in the electrotherapy group. Primary Outcome Measures: The menstrual pain intensity and menstrual symptoms were assessed with valid and reliable the Visual Analogue Scale (VAS) and the Menstrual Symptom Questionnaire (MSQ). Results: The VAS (kinesio taping and electrotherapy group: P < .001), MSQ-pain symptoms (kinesio taping group: P = .014, electrotherapy group: P = .032), and MSQ-coping methods scores (kinesio taping group: P = .001, electrotherapy group: P = .005) decreased both statistically and clinically in both groups. In addition, a statistically significant improvement in MSQ-negative effects/somatic complaints (P = .047) and MSQ total scores (P = .030) was observed in the electrotherapy group. There was no statistically significant difference between the two groups regarding substantial changes (P > .05). Conclusion: The exercises combined with either kinesio taping or electrotherapy effectively reduced menstrual pain intensity and menstrual symptoms related to pain and coping methods in women with primary dysmenorrhea. Notably, exercises combined with electrotherapy also improved menstrual symptoms related to negative effects and somatic complaints. These findings suggest that both kinesio taping and electrotherapy, when combined with exercises, are viable options for managing primary dysmenorrhea, potentially offering clinicians flexible treatment approaches.

Comparison of metabolic profile and abdominal fat distribution between karyotypically normal women with premature ovarian insufficiency and age matched controls.

OBJECTIVE: We designed a prospective case-control study in order to investigate the lipid profiles, insulin sensitivity, presence of metabolic syndrome (MetS) and the abdominal fat distribution in karyotypically normal women with premature ovarian insufficiency (POI). METHODS: Anthropometric measurements, FSH, estradiol, total testosterone (T), sex hormone binding globulin (SHBG), free androgen index (FAI), fasting glucose and insulin, homeostatic model for insulin resistance (HOMA-IR), lipid profile, the prevalence of MetS and ultrasonographic abdominal fat measurements were assessed in 56 women with POI and 59 healthy controls at the same age range. RESULTS: Serum levels of T, SHBG and FAI were not significantly different between both groups. Total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were higher in women with POI. There were no differences in glucose, insulin, HOMA-IR, low-density lipoprotein cholesterol (LDL-C), triglyceride levels between the two groups. A significant positive correlation was identified between T and TG and also between FAI and LDL-C; SHBG levels were correlated inversely with FSH, and positively with HDL-C in women with POI. The presence of MetS was significantly higher in women with POI. The subcutaneous, preperitoneal and visceral fat thicknesses were not significantly different between the groups. CONCLUSIONS: Early cessation of ovulatory function may associated with higher levels of serum TC and HDL-C, but does not seem to cause differences in abdominal fat distribution in women with POI. POI is associated with higher risk of MetS.

Hydrosonographic assessment of the effects of 2 different suturing techniques on healing of the uterine scar after cesarean delivery.

OBJECTIVE: To compare the effects of 2 suturing techniques (single versus double layer) on healing of the uterine scar after a cesarean delivery. METHODS: In the present randomized, prospective study, 36 women with a term pregnancy who had an elective cesarean delivery were randomly assigned to closure of the uterine incision with a single-layer locked suture or with a double-layer locked/unlocked suture. Six months after the operation, the integrity of the cesarean scar at the uterine incision site was assessed by hydrosonography. The healing ratio and the thickness of the residual myometrium covering the defect were calculated as markers of uterine scar healing. RESULTS: There were no significant differences between the groups in terms of estimated blood loss, operation time, or additional hemostatic suture. However, the mean thickness of the residual myometrium covering the defect was 9.95 ± 1.94 mm after a double-layer closure and 7.53 ± 2.54 mm after a single-layer closure (P = 0.005). The mean healing ratio was significantly higher after a double-layer closure (0.83 ± 0.10) than after a single-layer closure (0.67 ± 0.15; P = 0.004). CONCLUSION: A double-layer locked/unlocked closure of the uterine incision at cesarean delivery decreases the risk of poor uterine scar healing.

Is methotrexate administration needed for the treatment of caesarean section scar pregnancy in addition to suction curettage?

OBJECTIVE: This study evaluated the clinical outcomes and safety of treating caesarean scar pregnancy (CSP) by means of suction curettage followed when required by Foley tamponade, with or without methotrexate (MTX) therapy preceding the curettage. METHODS: Twenty-five patients with CSP were identified between August 2008 and April 2012. The first team of doctors treated Group A patients (n = 11) with systemic MTX followed by dilatation and suction curettage whereas the second team of doctors carried out only a suction curettage on women of Group B (n = 14). If uncontrolled vaginal bleeding occurred in either group during or after the operation, a Foley catheter, guided by real time transabdominal ultrasound, was placed in the uterine cavity against the site where the CSP had been implanted. RESULTS: Clinical outcomes in the two groups - including mean estimated blood loss, major complication rate, and hospital length of stay - were comparable. Surgeons used Foley catheter balloons for tamponade in six of the 11 patients in Group A and in seven of the 14 patients in Group B. Treatment was successful in ten of 11 cases in group A and 13 of 14 cases in group B. Group B's mean duration of treatment (2.36 ± 0.49 days) was significantly shorter than that of Group A (14.45 ± 4.96 days; p < 0.001). CONCLUSION: Suction curettage, followed when needed by Foley catheter tamponade, is an effective treatment for CSP.

To evaluate the prevalence and clinical outcomes using a one-step method versus a two-step method to screen gestational diabetes mellitus.

OBJECTIVE: The goal of this study is to compare the prevalence and clinical outcomes of a one-step with a two-step screening method, both of which are commonly used for the diagnosis of gestational diabetes mellitus (GDM). METHODS: Women who presented for GDM screening and who consented to participate in this study were randomized into two groups. The women in Group 1 (n = 386) were screened using a one-step method (2-h, 75 g oral glucose tolerance test (OGTT)) and in Group 2 (n = 400) by a two-step method (the 50 g glucose challenge test (GCT) followed by the 100 g OGTT). The pregnancies were then classified into three subgroups as follows: women who had negative 2-h 75 g OGTT results according to IADPSG criteria (IADPSG-negative), women with negative 50 g GCT results (GCT-negative) and women with positive 50 g GCT results but negative 3-h 100 g OGTT results according to C&C criteria (C&C-negative). RESULTS: The prevalence of GDM using the one-step and two-step methods was 14.5% and 6%, respectively. In adjusted multivariable regression models, women in the GCT-negative and the C&C-negative groups had greater risk of polyhydramnios than women in the IADPSG-negative group [adjusted prevalence risk ratios (aPR), 1.40; 95% confidence intervals (CI), 1.03-1.91; aPR, 2.76; 95% CI, 1.27-6.02, respectively]. Women in the C&C-negative group had greater risk of pre-eclampsia than women in the IADPSG-negative group (aPR, 3.30; 95% CI, 1.57-6.91). CONCLUSIONS: Women who were defined as having normal glucose tolerance by IADPSG had better perinatal outcomes than women who were defined as having normal glucose tolerance by GCT and women who were GCT-positive with a negative OGTT.

The effects of ranibizumab on surgically induced endometriosis in a rat model: a preliminary study.

OBJECTIVE: To examine the effect of ranibizumab on surgically induced endometriosis in rat models. STUDY DESIGN: Endometrial tissue was implanted onto the abdominal peritoneum of 20 rats that were randomized into 2 groups. The rats in group 1 (n = 9) were given 0.6 mg/kg ranibizumab on the 1st and 14th days after the second operation. The rats in group 2 (control group, n = 9) received no medication. All the rats were observed for a total of 28 days. RESULTS: At the end of the treatment, the mean volume and weight of the explants in group 1 (11.49 ± 6.87 mm(3) and 36.61 ± 17.84 mg) were significantly lower than that of the control group (190.6 ± 177.4 mm(3) and 187.3 ± 174.5 mg; both Ps < .01). Mean epithelial histologic scores were significantly lower in group 1 (1.11 ± 0.78) than that of the control group (2.33 ± 0.71; P < .01). When compared with the control group, vascular endothelial growth factor (VEGF) immunoreactivities in group 1 showed statistically significant reductions (1.67 ± 0.50; 2.67 ± 0.50; P < .01). CONCLUSION: Ranibizumab has significantly regressed the size of the endometriotic implants and caused atrophy of these lesions in rats by decreasing explant levels of VEGF.

Pregnancy Outcome of Multiparous Women Aged over 40 Years.

Objective. The aim of this study was to evaluate the effect of maternal age on prenatal and obstetric outcome in multiparaous women. Materials and Methods. A retrospective case control study was conducted, including women aged 40 years and over (study group, n = 97) who delivered at 20 week's gestation or beyond and women aged 20-29 years (control group, n = 97). Results. The mean age of women in the study group was 41.2 ± 1.7 years versus 25.4 ± 2.3 years in the control group. Advanced maternal age was associated with a significantly higher rate of hypertension, diabetes mellitus, fetal complication, and 5-minute Apgar scores <7 (P < 0.05). Caeserean section rate, incidence of placental abruption, preterm delivery, and neonatal intensive care unit admission were more common in the older group, but the differences were not statistically significant. Conclusions. Advanced maternal age is related to maternal and neonatal complications.

Somatostatin analogs regress endometriotic implants in rats by decreasing implant levels of vascular endothelial growth factor and matrix metaloproteinase 9.

OBJECTIVE: To examine the effect of somatostatin analogs on surgically induced endometriosis in rat models. STUDY DESIGN: Endometrial tissue was implanted onto the abdominal peritoneum of 26 rats that were randomized into 3 groups. The rats in group 1(n = 9) were subcutaneously administered with 0.02 mg/kg/d of octreotide (a short-acting analog)for 28 days . The rats in group 2 (n = 8) were subcutaneously injected with 20 mg/kg of a single dose of a long-acting analogue lanreotide The rats in group 3 were given no medication and served as controls (n = 9). RESULTS: Mean volume and histologic score of implants in groups 1 (P < .01 and P < .05, respectively) and 2 (P < .01and P < .05, respectively) were significantly lower than that in group 3. There were significant reductions in vascular endothelial growth factor (VEGF) and matrix metalloproteinase 9 (MMP-9) immunoreactivities in group 1 (0.67 ± 0.50 and 1.22 ± 0.44, respectively; both P < .01) and group 2 (0.71 ± 0.48 and 0.86 ± 0.69, respectively; both P < .01) when compared with the control group (1.78 ± 0.83 and 2.11 ± 0.78, respectively). CONCLUSION: Somatostatin analogs has regressed significantly the size of the endometriotic implants and caused atrophy of these lesions in rats by decreasing explant levels of VEGF and MMP-9.