Report of a Complicated Case of Couvelaire Uterus.

Couvelaire uterus (CU) is a rare complication in the life-threatening placental abruption (PA) that consists of a state of blood infiltration of the uterine myometrium and serosa. The incidence is around 1% and the treatment of choice is obstetric hysterectomy, however, in some cases, close monitoring and timely decision-making can prevent hysterectomy. Herein, we present a rare and serious case of CU with uterus preservation in a young multiparous with a high-risk pregnancy.

The Effect of Zinc Supplementation on the Improvement of Premenstrual Symptoms in Female University Students: a Randomized Clinical Trial Study.

Zinc is an essential microelement that plays many important functions in the body. It is crucial for the regulation of cell growth, hormone release, immunological response, and reproduction. Thus, this trial aimed to evaluate the effects of zinc supplementation in comparison with placebo on the improvement of premenstrual symptoms in female university students. This triple-masked, randomized, placebo-controlled, parallel trial was conducted among 69 female students aged 18-35 with premenstrual syndrome that living in dormitories of Hamadan University of Medical Sciences, in west of Iran. Participants were randomly assigned to two groups of equal number; one group received 220 mg of elemental zinc (n = 33) and the other group received placebo (n = 36) on a regular daily for 24 weeks. The premenstrual syndrome was assessed by Premenstrual Symptoms Screening Tool-Adolescent (PSST-A) questionnaire for all participants. Chi-square and t-student tests were used to compare the percentage or mean of parameters between two groups. All statistical analysis conducted by SPSS version 16. The mean age in the intervention group was 25.64 [Formula: see text] 0.53 years, and in the control group was 24.38 [Formula: see text] 0.51 years (P = 0.087). After 24 weeks of intervention, PMS physical and psychological symptoms such as anger, anxiety, depressed mood, overeating, breast tenderness, headaches, muscle pain, bloating, and weight gain significantly decreased in zinc group compared to placebo group (P < 0.001). We observed a significant increase in relationship with friends, classmates, and coworkers (p = 0.003) after 24 weeks of intervention with zinc compared to placebo. In conclusion, zinc, as a simple and inexpensive treatment, was associated with improvement of PMS symptoms. Given that this is among the first studies to evaluate the effect of zinc supplementation on PMS, additional studies are warranted to confirm these findings.

Factors Associated with Breast Cancer Mammographic Screening Behavior among Iranian Women.

Breast cancer is one of the most common diseases of women, which can increase the survival of patients with its early diagnosis. Despite the existence of relatively sensitive methods of early detection of breast cancer, such as mammography, statistics show that a small number of women perform mammography according to the recommended clinical guidelines. Using the health belief model, this study aims to determine the factors affecting mammography among women teachers in Hamedan. METHODS: This study was conducted on 458 female teachers aged 40 years and older of Hamadan city, in western part of Iran, during October to December of 2019. The participants were asked about the factors affecting mammography based on the health belief model. Questionnaires were completed by self-reported method and analyzed by SPSS software at 95% confidence interval. RESULTS: The average age of the study participants was 46±4.1 years. Among the participants, about 41.5% had performed mammography at least once. In univariate analysis, the constructs of the health belief model generally predicts performing mammography between 35 and 49 percent. In multivariate analysis, age 46 to 50 years, having supplementary insurance, history of breast disease, perceived barriers with odds ratio of 3.4, 3.4, 10.6 and .89, respectively, were significantly related to mammography. CONCLUSIONS: Female teachers over 45 years of age with a history of breast disease, if they do not have financial or other barriers to do mammography, perform breast cancer screening.

Maternal death due to COVID-19 and high BMI: A case report from Hamadan, Iran.

Pregnant women suffering chronic illness or obstetric complications such as obesity are prone to severe pneumonia and COVID-19. Obesity in pregnancy is associated with many complications for both mother and fetus. Here, we report the death of an obese mother with COVID-19.

Association of serum vitamin D levels with ectopic pregnancy.

Background and Aim: A few studies have addressed the possible role of vitamin D in decrement of ectopic pregnancy. Therefore, because of the widespread of vitamin D deficiency, especially among Iranian women, in this study, the association of serum vitamin D levels and ectopic pregnancy in pregnant women during the first trimester of pregnancy was investigated. Methods: This study is a cross-sectional study that has a control group. The cases group consisted of 51 pregnant women with ectopic pregnancies, and the control group consisted of 51 pregnant women with normal pregnancies. From all pregnant women participating in the study, 5 cc of blood samples were taken to determine the concentration of vitamin D serum. Serum vitamin D level was measured using enzyme-linked immunosorbent assays. The collected data were statistically analyzed using SPSS Statistical Software Package Version 16.0. P value less than 0.05 was considered as statistically significant level. Results: The differences between the two groups based on the demographic characteristics, including mean age, body mass index, and number of deliveries, were not statistically significant. The level of vitamin D in blood (ng/ml) was significantly higher in the control group (34.31 ± 7.32) compared to the participants with ectopic pregnancy (20.95 ± 20.68) (<0.001). Based on the results of the present study, women with inadequate serum levels (less than 30 ng/ml) are 6.40 times more likely to have an ectopic pregnancy than normal pregnant women (OR = 6.40; 95% CI; 3.260-15.834). Conclusion: Based on the results of this study and considering the association of serum vitamin D levels and ectopic pregnancy, it seems necessary to measure the level of serum vitamin D in women before their pregnancy.

Comparison of the Effects of Nika Vaginal Cream with Clotrimazole Cream on Vaginal Candidiasis Symptoms: A Randomized Single-Blind Clinical Trial.

BACKGROUND: The prevalence of vaginal candidiasis is high in women and proper treatment is essential in this regard. MATERIALS AND METHODS: This single-blind randomized controlled clinical trial was conducted on 120 women who were referred to Hamadan health centers in 2019. The patients were randomly divided into Clotrimazole cream and Nika vaginal cream groups each including 60 cases. The intervention group received Nika vaginal cream once a day for a week and those in the control group were given Clotrimazole vaginal cream in the same way. The clinical symptoms were studied by clinical examinations and the culture of vaginal discharge before and 7 days after the treatment to confirm the diagnosis of Candida albicans. The results were analyzed by SPSS 21.0 using an independent t test, Mann-Whitney U test, and Chi-square, Fisher's exact, and McNemar's tests, the significance level was set at 0.05. RESULTS: Most patients in both groups reported no clinical symptoms after the intervention, and no significant difference was observed between the two groups in this regard (χ2 = 2.23, p = 0.566). Conversely, a significant difference was found in Nika and Clotrimazole groups before and after the intervention regarding improving Vulvovaginal Candidiasis (VVC) symptoms χ2 = 86.01, χ2 = 99.41, respectively (p < 0.001). Finally, 84.48% and 75.86% of women in the Nika χ2 = 45.02 (p < 0.001) and Clotrimazole cream χ2 = 40.02 (p < 0.001) groups had negative culture results after the intervention. CONCLUSIONS: In general, the Nika and Clotrimazole vaginal creams have the same effects concerning improving the symptoms of vaginal candidiasis and thus can be used to treat VVC.