Prevalence of chronic endometritis in infertile women undergoing hysteroscopy and its association with intrauterine abnormalities: A Cross-Sectional study.

OBJECTIVE: Chronic endometritis (CE) is an inflammatory condition with several different risk factors. We aimed to examine whether intrauterine abnormalities, such as endometrial polyps, submucosal myomas, intrauterine adhesions, or a septate uterus, were associated with an increased likelihood of developing chronic endometritis. METHODS: A cross-sectional study was conducted on 335 infertile women who underwent hysteroscopy surgery at the Ayatollah Taleghani Hospital Infertility Center, affiliated by Shahid Beheshti University of Medical Sciences, in 2022. All participants in the study underwent hysteroscopic surgery, which allowed for direct visualization of the intrauterine cavity, and endometrial biopsies were taken for further analysis. To characterize endometritis, plasma cell infiltration was assessed. Patients with ≥5 plasma cells observed in 10 high-power fields were defined as having chronic endometritis. RESULTS: Endometritis was observed in 51.3% of the patients, totaling 172 individuals. Logistic regression analysis revealed that patients with endometrial polyps had 5.2 times higher odds of developing endometritis compared to patients without polyps (95% CI = 2.9, 9.2) (p-value <0.001). Similarly, patients with intrauterine adhesions had a significant increase in the odds of endometritis (OR = 4.6, 95% CI = 2.1, 10.1) (p-value <0.001). CONCLUSIONS: Treatment or removal of endometrial abnormalities through hysteroscopic procedures may help to reduce the risk of chronic endometritis and improve fertility outcomes. Further research is necessary.

End-users' perspectives on factors affecting implementation and utilization of the Iranian electronic health record system: a qualitative study in a developing country.

BACKGROUND: As one of the most important information technologies for storing, managing, and exchanging health information, the electronic health record (EHR) plays a major role in the health system. However, these systems in developing countries have been associated with multidimensional issues. The purpose of the present study was the assessment of nonclinical end-users' points of view on the implementation and utilization of the Iranian electronic health record system. METHODS: This was a large qualitative study conducted in 2021 for 7 months from February to August. In this study, data were collected through in-depth semi-structured interviews with 70 non-clinical end-users in 22 public and six private hospitals of West Azerbaijan province in Iran. To analyze the data, the thematic analysis method was used. RESULTS: The study results indicated that technical, human, cultural, managerial, and financial readiness are the most important factors affecting the implementation of EHRs in Iran. Among the mentioned factors, technical and human readiness were emphasized more by the users. Also, technical, organizational, human, and managerial factors were identified as factors influencing EHRs utilization, and technical and organizational factors had a stronger role in the system utilization. CONCLUSIONS: According to the results, several factors influence EHR implementation and adequate utilization in Iran. To achieve the predetermined goals of this system, implementation issues and problems of using the system should be considered and solved.

The effect of vitamin D on urgent urinary incontinence in postmenopausal women.

INTRODUCTION AND HYPOTHESIS: Conflicting results have been reported on the effect of vitamin D supplementation on urinary incontinence (UI). Therefore, the aim of this study was to evaluate the effect of consuming vitamin D oral supplements on improving urge UI (UUI) in postmenopausal women with vitamin D deficiency. METHODS: This randomized clinical trial was conducted in 2019-2020 in postmenopausal women with UUI or nocturia more than once at night with vitamin D levels less than 30 ng/ml. After recording the severity of UI and its impact on the patient's daily life, patients were randomly divided into two groups of 45 patients: one taking vitamin D3 (50,000 IU) tablets and one taking placebo weekly for 8 weeks. RESULTS: There was no significant difference between the two groups in terms of the severity of UI and the frequency of nocturia before treatment. However, after treatment, in the vitamin D group, the severity of UI and the frequency of nocturia significantly reduced. Before treatment, the impact of UI on patients' daily life was reported to be high in more than 70% of patients in both groups, which was not significantly different; however, after treatment, its impact was significantly reduced in the vitamin D group. CONCLUSIONS: The findings of the present study showed that in postmenopausal women with UUI or nocturia, weekly use of vitamin D 50,000 IU tablets for 8 weeks can reduce the severity of UI and the frequency of nocturia, and reduce their impact on disruption in daily life.

Severe early ovarian hyperstimulation syndrome following GnRH agonist trigger and freeze-all strategy in GnRH antagonist protocol; case report and literature review.

Ovarian hyperstimulation syndrome (OHSS) is characterized by increased vascular permeability, hemoconcentration and fluid leakage to the third space. The vast majority of OHSS cases occur following ovarian stimulation for IVF. This potentially lethal iatrogenic condition is one of the most serious complications of assisted reproductive technologies. We report one case of severe early OHSS after GnRH agonist trigger in a GnRH antagonist protocol and freeze-all approach without the administration of any hCG for luteal-phase support in a 34-year-old case of PCO with 7 years primary infertility. After oocyte retrieval the patient was seen at the emergency unit of the hospital with abdominal distension, pain, anuria, dyspnea, and OHSS symptoms. The diagnosis was OHSS with severe ascitis. She was admitted to the Intensive care unit (ICU). She was managed with oxygen by mask, intravenous fluids, anticoagulant and albumen, we performed a two-time vaginal ascites puncture, resulting in the removal of 7800mL of clear fluid in Intensive Care Unit with full recovery. This case study presents the clinical manifestations, investigation, progress, management, outcome and preventive measures. The patient was managed with no complications. Clinicians have to be aware that even the sequential approach to ovarian stimulation with a freeze-all approach and GNRH analog triggering does not completely eliminate OHSS in all patients.

Docosahexaenoic acid may inhibit immune evasion of colorectal cancer cells through targeting immune checkpoint and immunomodulator genes and their controlling microRNAs.

Colorectal cancer is one of the major concerns in both developed and developing societies. Because of the serious side effects of the current treatments, novel therapy agents have been developed that target immune checkpoint and immunomodulatory molecules in the tumor environment. Therefore, this study investigates the effect of docosahexaenoic acid (DHA) fatty acid on the expression of immune checkpoint molecule, PD-L1, and immunomodulatory molecules, CD47 and CD39, and their controlling miRNAs in the colorectal cancer cell lines. Human colorectal cell lines HT-29 and Caco-2 were treated with 100 µM DHA and 50 µM LA for 24 h under the normoxic and hypoxic conditions. Total RNA was extracted and the qRT-PCR was performed to analyze the expression of the studied genes and miRNAs. The western blotting technique was also used for validation. The qRT-PCR results showed that DHA treatment decreased the expression of the PD-L1, CD47, and CD39 genes, but decreases these genes controlling miRNAs, mir-424, mir-133a, and mir-142, respectively. Western blotting analysis demonstrated that PD-L1 protein expression decreased after DHA treatment. LA administration had no inhibitory effect on the studied genes. This study showed that DHA may have anti-cancer properties by downregulation of proteins involved in the immune evasion of colorectal tumors. DHA could be used as a potential immune checkpoint inhibitor for the treatment of colorectal cancers.

Association between Fetal MTHFR A1298C (rs1801131) Polymorphism and Neural Tube Defects Risk: A Systematic Review and Meta-Analysis.

BACKGROUND: The association of the fetal MTHFR A1298C (rs1801131) polymorphism and neural tube defects (NTDs) susceptibility has been widely demonstrated, but the results remain inconclusive. Thus, we performed a meta-analysis to investigate the association between fetal MTHFR A1298C polymorphism and NTDs risk. METHODS: An electronic search of PubMed, web of science, SciELO, CNKI database for studies on the fetal MTHFR A1298C polymorphism and NTDs risk was performed up to March 30, 2020. RESULTS: A total of 22 case-control studies with 3,224 fetuses with NTDs and 3,295 controls were selected. Overall, pooled data showed that the fetal MTHFR A1298C polymorphism was not significantly associated with risk an increased risk of NTDs in the global population. When stratified analysis by ethnicity, country of origin and NTDs type, still no statistically significant association was found. CONCLUSIONS: Our pooled data emerged no evidence for significant association between fetal MTHFR A1298C polymorphism and NTDs risk.

Association of Fetal MTHFR C677T Polymorphism with Susceptibility to Neural Tube Defects: A Systematic Review and Update Meta-Analysis.

Background MTHFR gene may be a key epigenetic regulation-related factor crucial during embryogenesis. We performed a meta-analysis to determine the association of fetal MTHFR C677T polymorphism with neural tube defects (NTDs).Methods A comprehensive literature search of the PubMed, Embase, and CNKI database was performed up to April 10, 2020.Results A total of 19 case-control studies with 2,228 NTDs cases and 4,220 controls were identified. Pooled data revealed that the fetal MTHFR C677T polymorphism was significantly highly correlated with development of NTDs in the overall population. Stratified analysis showed a significant association among Caucasians and Asians, but not in mixed populations. There was a significant association between the MTHFR C677T polymorphism and spina bifida risk. No publication bias was found under any genetic model.Conclusions Our pooled data support the fetal MTHFR C677T polymorphism association with risk of NTDs, especially among Caucasians and Asians.

The effect of Triticum sativum (wheat) germ on postpartum pain: A double-blind clinical trial.

OBJECTIVE: Postpartum pain (PP pain) is a common problem after vaginal delivery. Some herbs are used to reduce PP pain. Due to the anti-inflammatory properties of Triticum sativum (wheat) germ, this study was conducted to investigate the effect of wheat germ on PP pain. MATERIALS AND METHODS: This is a randomized, double-blind, placebo-controlled clinical trial performed on 90 women who had a vaginal delivery and complained of moderate to severe PP pain. The participants were randomly divided into two groups. In the intervention group, a capsule containing 500 mg of wheat germ was taken every 6 hr for 2 days and in the control group, a placebo capsule was taken in the same order. The severity of PP pain was measured before and one hour after receiving the capsule by using the Visual Analogue Scale. RESULTS: The two groups were not different in terms of pain severity before the intervention. The PP pain in women with moderate pain was significantly reduced in both groups, the reduction was greater in the wheat germ group (GEE=0.04) but this reduction was not significant. The PP pain in women with severe pain was significantly reduced in both groups, however, the reduction was significantly greater in the wheat germ group (GEE=0.63, p=0.007). Moreover, the results showed that the use of mefenamic acid in the wheat germ group was significantly lower than the control group (p=0.04). Moreover, no side effect was reported after consuming the wheat germ. CONCLUSION: It seems that wheat germ reduces severe PP pain. Further research on this plant is recommended.

Optimization of fortified sponge cake by nettle leaves and milk thistle seed powder using mixture design approach.

Powdered nettle leaf and milk thistle (MT) seed were added to the cake batter with certain percentages selected by the Design-Expert v. 10 software (0-25, 25-0, 18.75-6.25, 6.25-18.75, and 12.5-12.5). Addition of nettle and MT seeds to the cake reduced the moisture content, volume, and springiness and increased hardness of the samples. 12.5% nettle-12.5% MT seed had the least hardness and the highest amount of springiness and cohesiveness. The highest BI, WI, SI, L*, a*, and b* and the lowest ΔE were observed in 12.5% nettle-12.5% MT seed and 25% MT seed samples, respectively. Antioxidant activity and antimicrobial properties were increased in all samples compared to the control sample, so that 6.25% nettle-18.75% MT exhibited the highest antioxidant activity and antimicrobial properties. The highest levels of quercetin and silymarin were observed in 25% nettle and 25% MT seeds, respectively. In the sensory evaluation, 12.5% nettle-12.5% MT seed took the best scores regarding flavor, texture, color, and overall acceptance. Based on the lowest hardness, 13.65% nettle-11.34% MT seed was determined as optimized points by the software, which was equivalent to desirability of 0.72. The optimum sample contained 62.90 mg quercetin and 886.70 mg silymarin. According to the HPLC analysis results, consumption of 10 optimal cakes daily could theoretically decrease the blood sugar level, which requires further studies. The remaining amount of quercetin and silymarin in 2.5 g of nettle leaves and 2.5 g of MT seeds after heating was 11 and 19 mg, respectively. In other words, heat did not have much effect on the destruction of quercetin and silymarin.

Cumulative Evidence for Association of IL-10 -1082G > A Polymorphism with Susceptibility to Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis.

BACKGROUND: The IL-10 -1082 G > A polymorphism has been reported to be associated with a risk of recurrent pregnancy loss (RPL) with inconsistent results. Thus, to clarify the effect of the polymorphism on the susceptibility to RPL, a meta-analysis was performed. Methods: A systematic literature search in PubMed, Web of Science, Scopus and SciELO was performed to identify the relevant studies published up to December 20, 2019, and related information was extracted. Results: A total of 17 case-control studies with 3,224 RPL cases and 3,295 controls were selected. Pooled data revealed that IL-10 -1082 G > A polymorphism was significantly associated with risk of RPL in the global population. Moreover, subgroup analysis indicated a significant association in Caucasians, but not in Asian or mixed populations. Conclusions: Our pooled data highlights that IL-10 -1082 G > A polymorphism is a risk factor for RPL susceptibility in the global population, especially in Caucasians.

Association of Endothelial Nitric Oxide Synthase 894G > T Polymorphism with Preeclampsia Risk: A Systematic Review and Meta-Analysis based on 35 Studies.

BACKGROUND: Several case-control studies have been performed to investigate the association between 894 G > T polymorphism in endothelial nitric oxide synthase (eNOS) gene and susceptibility to preeclampsia. However, the results were inconsistent and inconclusive. Therefore, we conducted this meta-analysis to investigate the association. Methods: All studies published up to September 30, 2019 were identified by searching electronic databases such as PubMed, EMBASE, CNKI, and WANFANG. Results: A total of 35 case- control studies with 4,254 cases and 5,801 controls were selected. There was a significant association between the eNOS 894 G > T and preeclampsia risk. When stratified by ethnicity, an increased risk of preeclampsia was found in Caucasian and Mixed populations, but not in Asians or Africans. Conclusion: Based on our meta-analysis, the eNOS 894 G > T polymorphism was associated with an increased risk of preeclampsia, especially among Caucasian and Mixed populations.

Association of MMP-2, MMP-3, and MMP-9 Polymorphisms with Susceptibility to Recurrent Pregnancy Loss.

BACKGROUND: Genetic causes that contribute to recurrent pregnancy loss (RPL) are not fully understood. The aim of this study was to evaluate the association of five polymorphisms at MMP-2, MMP-3, and MMP-9 genes with risk of RPL. Methods: The study comprised 250 women with RPL and 250 healthy controls. The MMP-2 (rs243865, rs2285053), MMP-3 (rs35068180), and MMP 9 (rs3918242, rs17576) polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Results: A significant association was found between MMP-3 rs35068180 polymorphism and RPL risk. There was no significant association between RPL and polymorphisms at MMP-2 (rs243865, rs2285053) and MMP 9 (rs3918242, rs17576) genes. Conclusion: MMP-3 rs35068180 polymorphism may modulate RPL risk in Iranian women. There is no evidence to suggest that MMP-2 (rs243865, rs2285053) and MMP 9 (rs3918242, rs17576) polymorphisms are associated with RPL risk.

Association of Insulin-like Growth Factor-II Apa1 and MspI Polymorphisms with Intrauterine Growth Restriction Risk.

BackgroundInsulin-like growth factor-II (IGF-II) has a prominent role in fetal growth and development. The aim of this study was to investigate the association of IGF-II Apa1 and MspI polymorphisms with intrauterine growth restriction (IUGR) risk. Methods: A total of 45 infants with IUGR and 45 infants appropriate for gestational (AGA) were enrolled. Genotyping of Apa1 and MspI polymorphisms was assayed by PCR-RFLP approach. Results: The heterozygote genotype (AG) of IGF-II Apa1 CT was associated with an increased risk of IUGR. Genotypes and alleles of IGF-II MspI polymorphism had no significant association with IUGR susceptibility (P > 0.05). Conclusions: The current study suggests that IGF-II Apa1 polymorphism is associated with an increased risk of IUGR, while IGF-II MspI showed no association with IUGR. Thus, IGF-II Apa1 polymorphism could be used as a relevant molecular marker to identify the fetus at risk of developing IUGR.

Cancer and Coronavirus Disease (COVID-19): Comorbidity, Mechanical Ventilation, and Death Risk.

BACKGROUND: The presence of comorbidity poses a major clinical challenge in the care and treatment of COVID-19 patients. Moreover, having one or more comorbidities could be a life-threatening situation in COVID-19 patients. Cancer is substantially associated with significant morbidity and mortality in COVID-19 patients. However, there is not sufficient data to conclude that cancer patients have a higher risk of COVID-19 infection. In this study, we reviewed cancer comorbidity and risk of mechanical ventilation or death in patients with confirmed COVID-19. METHODS: A comprehensive systematic search was performed on PubMed, Scopus, Web of Science, SciELO, and CNKI, to find articles published until August 01, 2020. All relevant case series, case reports, systematic and narrative reviews, meta-analyses, and prospective and retrospective studies that reported clinical characteristics and epidemiological information of cancer patients infected with COVID-19 were included in the study. RESULTS: A total of 12 cohort studies exclusively on cancer patients with confirmed COVID-19 were selected. CONCLUSIONS: According to the findings of this study, cancer was not among the most prevalent underlying diseases in patients with confirmed COVID-19. Moreover, cancer patients infected with COVID-19 had the lowest risk of mechanical ventilation or death than the non-cancer infected patients.

Association of IL-12B rs3212227 and IL-6 rs1800795 Polymorphisms with Susceptibility to Cervical Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND: Primary studies have shown that the IL-12B rs3212227 and IL-6 rs1800795 polymorphisms are associated with an increased risk of cervical cancer. However, conflicting results warrant a meta-analysis to obtain more precise estimates. METHODS: A comprehensive literate search on PubMed, Web of Science, Scopus, CNKI, and SciELO was performed to collect all eligible studies up to November 10, 2019. The pooled odds ratios (OR) and 95% confidence intervals (CI) were used to calculate the risk. This meta-analysis was carried out by utilizing CMA software. RESULTS: A total of eleven case-control studies including four studies on IL-12B rs3212227 and seven studies on IL-6 rs1800795 were selected. Pooled ORs revealed that the IL-6 rs1800795 polymorphism was significantly associated with an increased risk of cervical cancer (C vs. G: OR = 1.294, 95% CI 1.071-1.564, p= 0.007; CC vs. GG: OR = 1.633, 95% CI 1.059-2.520, p= 0.027; CC+CG vs. GG: OR = 1.312, 95% CI 1.048-1.643, p= 0.018; and CC vs. CG+GG: OR = 1.592, 95% CI 1.268-1.999, p≤0.001), but not IL-12B rs3212227 polymorphism. Stratified analysis by ethnicity revealed that both IL-12B rs3212227 and IL-6 rs1800795 polymorphisms were associated with risk of cervical cancer in Asian women. CONCLUSIONS: Our pooled data revealed that the IL-12B rs3212227 and IL-6 rs1800795 polymorphisms may be used to identify individuals at high risk of cervical cancer in Asian women.
.

Vertical Transmission of Coronavirus Disease 19 (COVID-19) from Infected Pregnant Mothers to Neonates: A Review.

Background: Since early December 2019, the Coronavirus Disease 19 (COVID-19) infection has been prevalent in China and eventually spread to other countries. There are a few published cases of COVID-19 occurring during pregnancy and due the possibility of mother-fetal vertical transmission, there is a concern that the fetuses may be at risk of congenital COVID-19. Methods: We reviewed the risk of vertical transmission of COVID-19 to the fetus of infected mothers by using data of published articles or official websites up to March 4, 2020. Results: A total of 31 infected pregnant mothers with COVID-19 were reported. No COVID-19 infection was detected in their neonates or placentas. Two mothers died from COVID-19-related respiratory complications after delivery. Conclusions: Currently, based on limited data, there is no evidence for intrauterine transmission of COVID-19 from infected pregnant women to their fetuses. Mothers may be at increased risk for more severe respiratory complications.

Effect of type and amount of modified corn starches on qualitative properties of low-protein biscuits for phenylketonuria.

The effect of corn starches (natural, pregelatinized, and cross-linked) in four levels on quality of low-protein biscuit was evaluated. First, the microscopic structure, thermal properties, and low-branched chains content of them were evaluated. Water absorption capacity (WAC) and gelatinization properties of combined starches and physicochemical properties of products were assessed. Cross-linked starch had the highest glass transition temperature (Tg ). The maximum and minimum WAC was observed in samples containing 100% pregelatinized and 100% cross-linked starches, respectively. An increase in the amount of pregelatinized starch was accompanied by a decrease in the maximum viscosity and gelatinization temperature. Pregelatinized starch improved sensory and textural characteristics of samples, while cross-linked starch affected baking properties of the product. The best sample containing 30% of pregelatinized and 70% cross-linked starch with 1.27 g protein and 12 mg phenylalanine in 100 g biscuit is introduced as the low protein and safe product for Phenylketonuria.

Association of XRCC3 18067 C>T (Thr241Met) polymorphism with risk of cervical and ovarian cancers: A systematic review and meta-analysis.

The 18067 C>T polymorphism of XRCC3 gene has been considered to be implicated in the development of cervical and ovarian cancers, but the results are inconsistent. Thus, we conducted a meta-analysis to assess the association of XRCC3 18067 C>T polymorphism with risk of cervical and ovarian cancers. All studies on the association of XRCC3 18067 C>T polymorphism with cervical and ovarian cancers risk were retrieved. Finally, a total of 17 studies including 10 studies with 5,637 cases and 10,057 controls on ovarian cancer and 7 studies with 1,112 cases and 1,233 controls on cervical cancer were selected. Overall, pooled results showed that the XRCC3 18067 C>T polymorphism was significantly associated with increased risk of ovarian cancer (TC vs. CC: OR = 0.904, 95% CI = 0.841-0.972, p = 0.006; TT + TC vs. CC: OR = 0.914, 95% CI = 0.853-0.979, p = 0.010) and cervical cancer (TC vs. CC: OR = 1.00, 95% CI = 1.066-1.585, p = 0.009). Further subgroup analysis by ethnicity revealed an increased risk of cervical and ovarian cancer in Asians and Caucasians, respectively. The present meta-analysis inconsistent with the previous meta-analysis suggests that the XRCC3 18067 C>T polymorphism might be implicated in the pathogenesis of cervical and ovarian cancers.

Association of Promoter Region Polymorphisms of IL-6 and IL-18 Genes with Risk of Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis.

Background: The present meta-analysis was performed to investigate the association of promoter region polymorphisms at IL-6 and IL-18 genes with recurrent pregnancy loss (RPL) risk. Methods: An electronic search of the PubMed, Embase, ISI Web of Knowledge and CNKI databases was performed to identify eligible studies up to May 30, 2019. Results: A total of 31 case-control studies were finally selected. Significant associations with the risk of RPL were detected for the IL-6 -174 G > C, -634 G > C and IL-18 -137 G > C polymorphisms in overall population. Further, subgroup analyses by ethnicity revealed that the IL-6 -174 G > C and -634 G > C polymorphisms were significantly associated with risk of RPL risk in Asians. Conclusions: Our results suggest that the IL-6 -174 G > C, -634 G > C and IL-18 -137 G > C polymorphisms may contribute to the susceptibility of RPL. The IL-18 -607 C > A polymorphism does not appear to influence the development of RPL.