Evaluation of secretome biomarkers in glioblastoma cancer stem cells: A bioinformatics analysis.

BACKGROUND: Glioblastoma (GBM) is a malignant brain tumor that frequently occurs alongside other central nervous system (CNS) conditions. The secretome of GBM cells contains a diverse array of proteins released into the extracellular space, influencing the tumor microenvironment. These proteins can serve as potential biomarkers for GBM due to their involvement in key biological processes, exploring the secretome biomarkers in GBM research represents a cutting-edge strategy with significant potential for advancing diagnostic precision, treatment monitoring, and ultimately improving outcomes for patients with this challenging brain cancer. AIM: This study was aimed to investigate the roles of secretome biomarkers and their pathwayes in GBM through bioinformatics analysis. METHODS AND RESULTS: Using data from the Gene Expression Omnibus and the Cancer Genome Atlas datasets-where both healthy and cancerous samples were analyzed-we used a quantitative analytical framework to identify differentially expressed genes (DEGs) and cell signaling pathways that might be related to GBM. Then, we performed gene ontology studies and hub protein identifications to estimate the roles of these DEGs after finding disease-gene connection networks and signaling pathways. Using the GEPIA Proportional Hazard Model and the Kaplan-Meier estimator, we widened our analysis to identify the important genes that may play a role in both progression and the survival of patients with GBM. In total, 890 DEGs, including 475 and 415 upregulated and downregulated were identified, respectively. Our results revealed that SQLE, DHCR7, delta-1 phospholipase C (PLCD1), and MINPP1 genes are highly expressed, and the Enolase 2 (ENO2) and hexokinase-1 (HK1) genes are low expressions. CONCLUSION: Hence, our findings suggest novel mechanisms that affect the occurrence of GBM development, growth, and/or establishment and may also serve as secretory biomarkers for GBM prognosis and possible targets for therapy. So, continued research in this field may uncover new avenues for therapeutic interventions and contribute to the ongoing efforts to combat GBM effectively.

Clean environment index: A new approach for litter assessment.

Littered waste is one of the ubiquitous problems in urban environments. In this study, urban environmental pollution was evaluated for the first time using a new developed index. The findings indicated that cigarette butts with an average 58% are the largest share in the composition of littered waste. In addition, the numbers of littered wastes throughout the study area had a spatial variation. According to clean environment index (CEI), the entire study area was found to be in a moderate status. However, 40% of the study areas were classified in a dirty and extremely dirty status. Comparison of the studied urban land-uses showed that residential land use with CEI equal to 3.38 is interpreted in the clean status, while commercial land use with CEI equal to 15.05 can be classified in the dirty status. The application of CEI has a good capability to assess littered waste; this index can be employed to evaluate the pollution of urban sidewalks and other environments such as beaches.

A Study of How Moral Courage and Moral Sensitivity Correlate with Safe Care in Special Care Nursing.

Background: Nursing is a caring profession, and nurses who have moral sensitivity and moral courage presumably can provide safe and better care for patients. This study aims at investigating how moral courage and moral sensitivity correlate with safe care in special care nursing. Methods: This study is a descriptive work of research. The participants consisted of 524 nurses who were in practice in the ICU (intensive care unit), CCU (C\coronary care unit), post-CCU (postcoronary care unit), and dialysis of four hospitals located in the south of Iran selected via census sampling. Data were collected from April to September 2020 using the moral sensitivity questionnaire (MSQ), professional moral courage questionnaire (PMCQ), and the assessment of safe nursing care questionnaire (ASNCQ). The collected data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson's correlation coefficient in SPSS v. 22. Results: The mean ± SD of the nurses' age was 33.89 ± 6.91 years, and the mean ± SD of their work experience was 9.16 ± 4.67 years. The total mean score ± SD of the nurses' moral sensitivity was found to be 93.41 ± 2.68, the total mean score ± SD of their moral courage was found to be 96.38 ± 3.63, and the total mean score ± SD of their safe care scores was found to be 321.80 ± 9.76. The values of Pearson's correlation coefficients showed significant correlations between moral courage and safe care (r = 0.54, p < 0.001), moral sensitivity and safe care (r = 0.59, p < 0.001), and moral sensitivity and moral courage (r = 0.52, p < 0.001). Conclusion: There is a positive correlation between moral sensitivity and moral courage. Both positively correlated with special care nursing. Accordingly, through effective planning, education, and giving their support, nurse administrators can promote the abovementioned ethical virtues in the nursing staff, thereby improving the quality of care.

Cigarette butts as a super challenge in solid waste management: a review of current knowledge.

Filtered cigarette is the most common type of tobacco used and cigarette butt is the most important environmental consequence of smoking. This study aimed to investigate the cigarette butt management and identify future needs to improve the current situation. The results showed that cigarette butts are the most abundant and widespread hazardous waste in the world. The current form of cigarette butt management has inferior performance that faced waste management systems with serious challenges. The results showed that reducing the littering rate and recycling are known as basic strategies in the management of this hazardous waste. Future studies should focus on reducing cigarette butt pollution and the amount of pollutant leakage from them.

Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes in Ahvaz, Iran.

BACKGROUND: Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes. The aim of this study was to investigate the relation between Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. METHODS: Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to research the effect of UTCI on adverse pregnancy outcomes. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. RESULTS: The results showed that the low values of UTCI index (11.6 °C, in lags 0-6, 0-13) caused significant increase in the risk of preterm labor. However, hot thermal stress (high UTCI) significantly increased the risk of stillbirth in lag 0-13. We did not observe any significant relation between UTCI and other pregnancy outcomes in this study. CONCLUSIONS: It seems like both hot and cold weathers can be associated with adverse pregnancy outcomes.

Scientists have found that climate change has adverse effects on human health. Because pregnant women are one of the most vulnerable groups, these negative impacts may affect their fetuses, which make up the next generation. In this study, we examined the effect of temperature on some pregnancy outcomes, including low birth weight, preterm labor, spontaneous abortion, preeclampsia and gestational hypertension in Ahvaz city, which is one of the hottest cities in the world.One way to assess temperature impact on humans is by using temperature indicators. In this study we used the Universal Thermal Climate Index (UTCI) for this purpose. The data at different time intervals were collected and evaluated with specific models.Our results showed that low values of UTCI, which is equivalent to cold weather, significantly increase the risk of preterm labor. But, high levels of UTCI, which means hot weather, significantly increase the risk of stillbirth.In conclusion; both hot and cold weather can be associated with adverse pregnancy outcomes in Ahvaz city. Therefore, pregnant women should protect themselves from exposure to hot and cold weather.

Estimation of the heavy metals released from cigarette butts to beaches and urban environments.

Cigarette butts (CB) are considered as a commonly littered waste. This hazardous waste contains a variety of pollutants. This study was developed to estimate the release of some heavy metals from CBs to the environment in different climatic conditions in different scenarios. To this end, CBs samples were obtained through artificial smoking from 10 high-consumption brands in the Iranian market, and their samples in urban areas were taken and analyzed in terms of heavy metals pollution. The results showed that the average concentrations of Lead, Cadmium, Chromium, Zinc, Copper, Nickel in the studied CBs were 1.71, 0.36, 1.59, 24.61, 12.83, and 2.66 µg/g, respectively. The long persistency of CBs in the environment leads to increased release of all heavy metals to 9.7%. In addition, the rainfall can accelerate the leaching of heavy metals to 17.7% compared to the control scenario. The total mean concentrations of the studied metals in the CBs samples collected from the urban areas in rainy and non-rainy conditions were measured to be 32.67-51.81 µg/g, respectively. According to the data obtained for the amount of each heavy metal releases in four scenarios, 147.5 kg/year and 57.3 kg/year heavy metals are released to the environment in the worst and the best-case scenarios. This study showed that CBs littering lead to the release of heavy metals into the environment; it is necessary to reduce the density of CBs in urban and public environments by training the smokers as well as increasing the efficiency of the urban cleaning system.

The effect of peer group on self-care behaviors and glycemic index in elders with type II diabetes.

BACKGROUND: Diabetes is one of the most expensive and chronic diseases of elderly age. Knowledge and self-care behaviors play an important role in treating diabetes and preventing its side effects. This study aimed to investigate the effect of peer group on self-care behaviors and glycemic index in the elderly with type II diabetes mellitus in Fasa city, Fars province. MATERIALS AND METHODS: This quasi-experimental study was conducted on 100 elderly patients with type II diabetes (50 patients in the intervention group and 50 in control group) referred to the diabetes center. Among the elderly, the intervention group was selected as a trainer based on the checklist of the peer group and was trained by the researcher. In addition to the usual care of the diabetes clinic, the patients in the intervention group received training from their peers for 8 weeks during 8-45 min of training sessions. Data were collected using a valid self-reported questionnaire including demographic variables, awareness, and diabetes self-care behaviors (Summary of Diabetes Self-care Activities), as well as free practice (fasting blood sugar [FBS] and hemoglobin A1c [HbA1c]), which was completed by both groups before and 2 months after the intervention. Then, the data were entered into the SPSS statistical software, version 22 and were analyzed using Chi-square test, independent t-test, and descriptive statistical methods. P < 0.05 was considered statistically significant. RESULTS: The results showed that the two groups of intervention and test were identical in terms of demographic information. In the intervention group, before and after 2 months of educational intervention, there was a significant difference in increasing awareness and self-care behavior in diet, physical activity, blood sugar testing, foot care, and medication (P < 0.001). However, this difference was not significant in the control group (P < 0.05). In the intervention group, the mean FBS and quarterly (HbA1c) index decreased significantly (P < 0.05). CONCLUSION: This study showed that teaching self-care program, in the same way, has been effective in improving self-care behavior and blood sugar index in the elderly with diabetes and suggested that this educational method be used in other chronic diseases.

Oligopin® Supplementation Mitigates Oxidative Stress in Postmenopausal Women with Osteopenia: A Randomized, Double-blind, Placebo-Controlled Trial.

BACKGROUND: Evidence indicates a close association between oxidative stress and the etiopathogenesis of osteopenia. In vitro and animal studies report that Oligopin®, an extract of French maritime pine bark extract, has beneficial effects on oxidative stress. PURPOSE: Here, we aimed to determine whether supplementation with Oligopin® affects bone turnover markers, antioxidant enzymes, and oxidative stress markers in these patients. METHODS: Forty-three postmenopausal women with osteopenia were randomized in a placebo-controlled, double-blind clinical trial to receive either 150 mg/day Oligopin® (n = 22) or placebo (n = 21) for 12 weeks. Plasma levels of bone turnover markers; osteocalcin (OC), type I collagen cross-linked C-telopeptide (CTX-1), OC/CTX1 ratio along with total antioxidant capacity(TAC), malondialdehyde (MDA) concentration, protein carbonyl, and total thiol contents in plasma, activities of manganese superoxide dismutase (MnSOD) and catalase in both peripheral blood mononuclear cells (PBMCs) and plasma as well as mRNA expression of MnSOD, catalase, and Nrf2 in PBMCs were measured at the baseline and the end of the intervention. RESULTS: Oligopin® supplementation significantly increased OC levels and the ratio of OC to CTX1 in women with osteopenia compared to placebo intervention after 12 weeks. Oligopin® significantly decreased plasma protein carbonyl content in postmenopausal women compared with the after placebo treatment. Moreover, Oligopin® intervention significantly increased plasma total thiol content, TAC, plasma activity of both MnSOD and catalase, and the transcript level of Nrf2, MnSOD, and catalase in comparison with the placebo group. CONCLUSION: Supplementation with 150 mg/day Oligopin® for 12 weeks exerts beneficial effects in postmenopausal osteopenia through improving the antioxidant defense system in the plasma and PBMCs that was accompanied by an increase in indicators of bone turnover.

Cardiovascular and respiratory emergency dispatch due to short-term exposure to ambient PM10 in Dezful, Iran.

Introduction: This study was conducted to determine the relation between exposure to particulate matter less than 10 microns (PM10) caused by dust storms and the risk of cardiovascular, respiratory and traffic accident missions carried out by Emergency Medical Services (EMS). Methods: This was a time-series study conducted in Dezful city, Iran. Daily information on the number of missions by the EMS due to cardiovascular, respiratory and crash problems and data on PM10 were inquired from March 2013 until March 2016. A generalized linear model (GLM) with distributed lag models (DLMs) was used to evaluate the relation between the number of EMS missions and the average daily PM10. The latent effects of PM10 were estimated in single and cumulative lags, up to 14 days. Results: In the adjusted model, for each IQR increase in the average daily PM10 concentration, the risk of EMS missions in the total population in single lags of 2 to 7 days, and the cumulative lags of 0-7 and 0-14 days after exposure had a 0.8, 0.8, 0.8, 0.8, 0.7, 0.6, 6.7 and 1.4% significant increase. Also, for each IQR increase in the daily mean concentration of PM10 in single 1 to 7, and cumulative lags of 0-2, 0-7, and 0-14 days after exposure, respectively, a 2.4, 2.7, 2.8, 2.9, 2.9, 2.7, 2.5, 7.4, 23.5 and 33. 3 % increase was observed in the risk of EMS cardiovascular missions. Conclusion: Increase in daily PM10 concentrations in Dezful is associated with an increase in the risk of EMS missions in lags up to two weeks after exposure.

The Effects of Group Play Therapy on Self-Concept Among 7 to 11 Year-Old Children Suffering From Thalassemia Major.

BACKGROUND: Children suffering from thalassemia have higher levels of depression and lower levels of self-concept. OBJECTIVES: The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012. PATIENTS AND METHODS: In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Self-concept was measured three times using the Piers-Harris children's self-concept scale: before, immediately after, and a month after the intervention. RESULTS: For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P < 0.001), going from 60.539 to 69.908. Likewise, comparing the first and third time points, the mean score significantly increased and reached 70.611 (P < 0.001). Furthermore, changes in the mean score from the second to the third time point, though non-significant (P = 0.509), followed the trend, going from 69.908 to 70.611. For the control group, comparing the first, second, and third time points did not result in any significant change in the mean score (P > 0.05). CONCLUSIONS: The results showed that group play therapy improves self-concept in children suffering from thalassemia major.

Life Satisfaction Index among Elderly People Residing in Gorgan and Its Correlation with Certain Demographic Factors in 2013.

BACKGROUND: Aging is a universal phenomenon that will present itself as a dominant social and welfare challenge. AIM: This study was to examine life satisfaction among people residing in Gorgan and its correlation with certain demographic factors in 2013. METHODS: A total of 250 elder people were selected for the study through the convenience sampling during 4 months. Data collected through life satisfaction index-A (LSIA). This instrument consists of 5 subscales, including, zest for life, resolution and fortitude, congruence between desired and achieved goals, positive self-concept and mood tone. The Multiple Linear Regression analysis was used in order to determine factors influencing the overall LSIA. RESULTS: The overall LSIA score was 22.1 ± 7.5 with the maximum and minimum mean scores pertaining to the resolution and fortitude (6.1 ± 2.5) and the positive self-concept (3.1 ± 1.2) subscales, respectively. Level of education, type of living and gender were variables influencing the overall LSIA (P<0.05). CONCLUSION: Given the overall LSIA, it appears that future plans for this age group should be seriously revised along with cultural plans for promoting reverence for old age in the general public.

Effects of Common Fig (Ficus carica) Leaf Extracts on Sperm Parameters and Testis of Mice Intoxicated with Formaldehyde.

Formaldehyde (FA) is the leading cause of cellular injury and oxidative damage in testis that is one of the main infertility causes. There has been an increasing evidence of herbal remedies use in male infertility treatment. This assay examines the role of Ficus carica (Fc) leaf extracts in sperm parameters and testis of mice intoxicated with FA. Twenty-five adult male mice were randomly divided into control; sham; FA-treated (10 mg/kg twice per day); Fc-treated (200 mg/kg); and FA + Fc-treated groups. Cauda epididymal spermatozoa were analyzed for viability, count, and motility. Testes were weighed and gonadosomatic index (GSI) was calculated. Also, histoarchitecture of seminiferous tubules was assessed in the Haematoxylin and Eosin stained paraffin sections. The findings showed that FA significantly decreased GSI and increased percentage of immotile sperm compared with control group. Disorganized and vacuolated seminiferous epithelium, spermatogenic arrest, and lumen filled with immature germ cells were also observed in the testes. However, Fc leaf extracts improved sperm count, nonprogressive motility of spermatozoa, and GSI in FA-treated testes. Moreover, seminiferous tubule with spermatogenic arrest was rarely seen, indicating that Fc has the positive effects on testis and epididymal sperm parameters exposed with FA.

Effects of family-centered empowerment model based education program on quality of life in methamphetamine users and their families.

BACKGROUND: Nowadays there are more concerns about drug treatment of methamphetamine abusers whereas quality of life (QOL) related supportive psychotherapy is less credited. OBJECTIVES: This study aimed to evaluate the effects of family-centered empowerment model on social support and QOL of methamphetamine users and their families. PATIENTS AND METHODS: This study was a randomized clinical trial; individuals were randomly allocated to three groups: a group for educating methamphetamine users in recovery (95 subjects), a group for educating a family member of methamphetamine users in recovery (95 subjects) and a control group (95 subjects). Data collecting instruments were standard questionnaires of social support and health-related quality of life (HRQOL). Data were analyzed using χ2-test, t-test, paired t-test, Pearson's correlation and ANOVA. RESULTS: Mean scores of QOL and social support dimensions changed significantly in two intervention groups (P < 0.0001), but didn't change in the control group (P > 0.05). Also, there was a positive significant relation (P < 0.05) between total social support and all dimensions of QOL for all study groups. CONCLUSIONS: Family-centered empowerment model, easily adapted to methamphetamine users and their families, leads to improved social supports and QOL.

Effects of Educational Intervention on Health-Promoting Lifestyle and Health-Related Life quality of Methamphetamine Users and Their Families: a Randomized Clinical Trial.

BACKGROUND: Family-centered empowerment of drug and stimulant users is an effective program for a better response to treatment, prevention of treatment adverse effects, and promotion quality of life (QoL) and lifestyle in the process of discontinuing drug abuse. OBJECTIVES: This study aimed to determine the effects of educational intervention, based on family-centered empowerment and Pender's health promotion models, on health-promoting lifestyle and health-related QoL among methamphetamine users and their families. PATIENTS AND METHODS: In a randomized clinical trial, methamphetamine users, who were admitted to Tehran University of Medical Sciences Substance Abuse Treatment Centers, were randomly allocated to three groups: a group for training of methamphetamine users who were in recovery phase (intervention group 1;95 subjects);a group for training of a family member of methamphetamine users who were in recovery phase (intervention group 2; 95 subjects); and a control group (95 subjects). A demographic checklist and a standard questionnaire covering health-promoting lifestyle, health-related QoL, self-efficacy, perceived affect, perceived social support, and perceived barriers dimensions were used to gather required data. Independent-samples t test, paired-samples t-test, and ANCOVA were used to analyze the data. RESULTS: Analysis of covariance showed that after adjusting for effects of pretest scores, the difference between mean post-test scores of health-promoting lifestyle scale, health-related QoL scale, and all constructs of Pender's health promotion model (self-efficacy, perceived affect, perceived social support, and perceived barriers) in the intervention group 1 and control group were significant (P< 0.0001). In addition, changes in mean scores of lifestyle scale (42.4 ± 13.6), QoL scale (29.1 ± 14.2), self-efficacy (16.1 ± 2.6), perceived affect (16.1 ± 8), social support (35.4 ± 12.4), and barriers (17.2 ± 15.8) before and after intervention were significant in the intervention group 2 (P < 0.0001). CONCLUSIONS: Application of family-centered empowerment model among methamphetamine users and their families is practically feasible and can result in enhancement and improvement of their QoL, lifestyle, and health promotion model constructs.

Osteoid osteoma of the rib presenting as thoracic outlet syndrome.

Osteoid osteoma of the rib is a rare condition mostly mentioned in case report studies as lesions involving posterior region of the rib causing scoliosis. This report presents a 22-year-old man who complained of neurologic thoracic outlet syndrome symptoms. The pathologic study of the resected mass of the first rib confirmed the diagnosis of osteoid osteoma. This unique presentation of the osteoid osteoma as thoracic outlet syndrome suggests that this pathologic involvement of the ribs is not confined to the symptoms of pain and scoliosis.

Comparison between family function dimensions and quality of life among amphetamine addicts and non- addicts.

BACKGROUND: One of the most important factors in drug abuse and drug avoidance is family and its function. OBJECTIVES: This study aimed to compare family function and quality of life dimensions among Amphetamine addicts and non-addicts. MATERIALS AND METHODS: The current study is a case-control, which assessed 95 Iranian addicts and 95 non-addicts. Sampling method in the addicts group was random clustering. The non-addicts were selected from accompanied addicts in other centers with respect to the demographic characteristics. The instruments were Family Assessment and Quality of Life (SF-36) scales. SPSS software version 11.5 was used for statistical analysis and Pearson's correlation coefficient, stepwise regression analysis, and independent samples t-test were conducted. RESULTS: The study revealed that some disorders in family function dimensions were higher in the addicts compared to non-addicts. Addicts have a quality of life lower than non-addicts (P < 0.05). There was a relationship between different dimensions of family function and the quality of life in both the addicts and non-addicts (P < 0.05). Regression analysis showed that roles dimensions and family function could roughly account for 17% of the changes in the addicts' quality of life while in the non-addicts, behavioral control dimension of family function could account for roughly 17% of the changes in their quality of life. CONCLUSIONS: Regarding the study findings, there was a significant difference between family function dimensions and quality of life among addicts and non-addicts.

Value of serum urocortin concentration in the prediction of preterm birth.

AIM: Preterm delivery is a serious problem during pregnancy with remarkable neonatal adverse effects. Prediction of preterm delivery in women with preterm uterine contractions or signs of preterm labor is critical because if these women are identified they can be referred to tertiary centers. The present study aimed to evaluate the value of maternal serum urocortin concentration for predicting preterm delivery in women with signs of spontaneous preterm labor. MATERIAL AND METHODS: A cohort study was conducted on pregnant women at a gestational age of 28-36 weeks who were admitted to the labor ward with spontaneous preterm labor. A blood sample was obtained from all participants to measure serum urocortin. The women were monitored up to delivery and serum urocortin was compared between women with preterm delivery and those who delivered at term (37 weeks of gestation). Receiver Operating Characteristic (ROC) curve analysis was used to determine sensitivity and specificity if applicable. RESULTS: One hundred and sixty pregnant women finished the study. One hundred and forty-eight (92.5%) of the women delivered preterm. Mean serum urocortin in the preterm delivery group was higher than in the term group, but without statistical significant difference (392.6 ± 29.23 vs 113.2 ± 11.0. pg/mL, respectively, P = 0.252). Area under the ROC curve was 0.6, which shows that this test is not appropriate for predicting preterm delivery in women with preterm labor. CONCLUSION: Serum urocortin could not predict women who delivered preterm among women with signs of preterm labor.

The role of infertility etiology in success rate of intrauterine insemination cycles: an evaluation of predictive factors for pregnancy rate.

BACKGROUND: The objective of this study was to identify the prognostic factors that influence the outcome of ovarian stimulation with intrauterine insemination (IUI) cycles in couples with different infertility etiology. MATERIALS AND METHODS: This retrospective study was performed in data of 1348 IUI cycles with ovarian stimulation by clomiphene citrate (CC) and/or gonadotropins in 632 women with five different infertility etiology subgroups at Akbarabbadi Hospital, Tehran, Iran. RESULTS: The pregnancy rate (PR)/ cycle was highest (19.9%) among couples with unexplained infertility and lowest (10.6%) in couples with multiple factors infertility. In cases of unexplained infertility, the best PRs were seen after CC plus gonadotropins stimulation (26.3%) and with inseminated motile sperm count>30×10(6) (21.9%), but the tendency didn't reach statistical significant. In the ovarian factor group, the best PRs were observed in women aged between 30 and 34 years (20.8%), with 2-3 preovulatory follicles (37.8%) and infertility duration between 1and 3 years (20.8%), while only infertility duration (p=0.03) and number of preovulatory follicles (p=0.01) were statistically significant. Multiple logistic regression analysis determined that number of preovulatory follicles (p=0.02), duration of infertility (p=0.015), age (p=0.019), infertility etiology (p=0.05) and stimulation regimen (p=0.01) were significant independent factors in order to predict overall clinical PR. CONCLUSION: The etiology of infertility is important to achieve remarkable IUI success. It is worth mentioning that within different etiologies of infertility, the demographic and cycles characteristics of couples did not show the same effect. Favorable variables for treatment success are as follows: age <40, duration of infertility ≤5 years and a cause of infertility except of multiple factors.

The effect of low dose human chorionic gonadotropin on follicular response and oocyte maturation in PCOS patients undergoing IVF cycles: a randomized clinical trial of efficacy and safety.

PURPOSE: To compare the efficacy of two regimens of low dose human chorionic gonadotropin (hCG) on follicular response and oocyte maturation in women with polycystic ovarian syndrome (PCOS). METHODS: Ninety women with PCOS who underwent assisted reproduction were eligible for this controlled, prospective, randomized study. Our trial was performed at Royan Institute Reproductive Research Center over a 24-month period. Ovarian stimulation in all groups was initiated with recombinant FSH, 150 IU daily. The dose and duration of FSH treatment were adjusted by monitoring follicular development with ultrasound and estradiol levels. Patients were randomized using a block randomization technique which assigned them to three groups: group A (control group) continued r-FSH until oocyte retrieval. In group B, r-FSH was reduced to 75 IU once the lead follicle reached 14 mm in mean diameter and low dose hCG (100 IU/day) was initiated. In group C, r-FSH was discontinued and low dose hCG (200 IU/day) was begun when the lead follicle reached 14 mm in mean diameter. The main outcome measure was follicular response and oocyte maturation. RESULTS: As compared to the FSH only group, groups which were given low dose hCG had lower gonadotropin consumption and fewer immature oocytes than the control group. No women in the low dose hCG groups developed severe ovarian hyper-stimulation syndrome. Fertilization, implantation and pregnancy rates were similar in the three groups. CONCLUSIONS: A combination of FSH and low dose hCG improved oocyte maturity and preserved outcomes with improved safety and lowered cost.