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Abstract: Neuroendocrine neoplasms (NENs) are a diverse group of tumors that express neuroendocrine markers and primarily affect the lungs and digestive system. The incidence of NENs has increased over time due to advancements in imaging and diagnostic techniques. Effective management of NENs requires a multidisciplinary approach, considering factors such as tumor location, grade, stage, symptoms, and imaging findings. Treatment strategies vary depending on the specific subtype of NEN. In this review, we will focus on treatment strategies and therapies including the information relevant to clinicians in order to undertake optimal management and treatment decisions, the implications of different therapies on imaging, and how to ascertain their possible complications and treatment effects., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Neuroendocrine neoplasms (NENs) may be challenging to diagnose due to their small size and diverse anatomical locations. Hybrid imaging techniques, specifically positron emission tomography/computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI), represent the current state-of-the-art for evaluating NENs. The preferred radiopharmaceuticals for NEN PET imaging are gallium-68 (68Ga) DOTA-peptides, which target somatostatin receptors (SSTR) overexpressed on NEN cells. Clinical applications of [68Ga]Ga-DOTA-peptides PET/CT include diagnosis, staging, prognosis assessment, treatment selection, and response evaluation. Fluorodeoxyglucose-18 (18F-FDG) PET/CT aids in detecting low-SSTR-expressing lesions and helps in patient stratification and treatment planning, particularly in grade 3 neuroendocrine tumors (NETs). New radiopharmaceuticals such as fluorine-labeled SSTR agonists and SSTR antagonists are emerging as alternatives to 68Ga-labeled peptides, offering improved detection rates and favorable biodistribution. The maturing of PET/MRI brings advantages to NEN imaging, including simultaneous acquisition of PET and MRI images, superior soft tissue contrast resolution, and motion correction capabilities. The PET/MRI with [68Ga]Ga-DOTA-peptides has demonstrated higher lesion detection rates and more accurate lesion classification compared to PET/CT. Overall, hybrid imaging offers valuable insights in the diagnosis, staging, and treatment planning of NENs. Further research is needed to refine response assessment criteria and standardize reporting guidelines., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Recent advances in molecular pathology and an improved understanding of the etiology of neuroendocrine neoplasms (NENs) have given rise to an updated World Health Organization classification. Since gastroenteropancreatic NENs (GEP-NENs) are the most common forms of NENs and their incidence has been increasing constantly, they will be the focus of our attention. Here, we review the findings at the foundation of the new classification system, discuss how it impacts imaging research and radiological practice, and illustrate typical and atypical imaging and pathological findings. Gastroenteropancreatic NENs have a highly variable clinical course, which existing classification schemes based on proliferation rate were unable to fully capture. While well- and poorly differentiated NENs both express neuroendocrine markers, they are fundamentally different diseases, which may show similar proliferation rates. Genetic alterations specific to well-differentiated neuroendocrine tumors graded 1 to 3 and poorly differentiated neuroendocrine cancers of small cell and large-cell subtype have been identified. The new tumor classification places new demands and creates opportunities for radiologists to continue providing the clinically most relevant report and on researchers to design projects, which continue to be clinically applicable., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Neuroendocrine neoplasms are a heterogeneous group of gastrointestinal and lung tumors. Their diverse clinical manifestations, variable locations, and heterogeneity present notable diagnostic challenges. This article delves into the imaging modalities vital for their detection and characterization. Computed tomography is essential for initial assessment and staging. At the same time, magnetic resonance imaging (MRI) is particularly adept for liver, pancreatic, osseous, and rectal imaging, offering superior soft tissue contrast. The article also highlights the limitations of these imaging techniques, such as MRI's inability to effectively evaluate the cortical bone and the questioned cost-effectiveness of computed tomography and MRI for detecting specific gastric lesions. By emphasizing the strengths and weaknesses of these imaging techniques, the review offers insights into optimizing their utilization for improved diagnosis, staging, and therapeutic management of neuroendocrine neoplasms., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The microbiota in the oral cavity has a strict connection to its host. Its imbalance may determine oral diseases and can also have an impact on the systemic health. Probiotic strains may help in the restoration of a balanced condition. For this purpose, we screened the antibacterial and antiadhesive activities of many viable probiotic strains ( Lactobacillus acidophilus PBS066, Lactobacillus crispatus LCR030, Lactobacillus gasseri LG050, Lactiplantibacillus plantarum PBS067, Limosilactobacillus reuteri PBS072, Lacticaseibacillus rhamnosus LRH020, Bifidobacterium animalis subsp. lactis BL050, Lacticaseibacillus paracasei LPC 1101, L. paracasei LPC 1082, and L. paracasei LPC 1114) against two main oral pathogens, Streptococcus mutans and Aggregatibacter actinomycetemcomitans , involved in dental caries and periodontal disease development and progression. Considering both the agar overlay preventive and treatment models, seven probiotics determined greater inhibition zones against the tested pathogens. This behavior was further analyzed by the plate count method and scanning electron microscope imaging. L. plantarum PBS067, L. rhamnosus LRH020, L. paracasei LPC 1101, L. paracasei LPC 1082, and L. paracasei LPC 1114 prevent the growth and adhesion of oral pathogens in a strain-specific manner ( p < 0.0001). These probiotics might be considered as an alternative effective adjuvant to improve oral and systemic well-being for future personalized treatments.

In this study, a recently reported Ti-based metallic glass (MG), without any toxic element, but with a significant amount of metalloid (Si-Ge-B, 18 atom %) and minor soft element (Sn, 2 atom %), was produced in ribbon form using conventional single-roller melt-spinning. The produced Ti 60 Zr 20 Si 8 Ge 7 B 3 Sn 2 ribbons were investigated by differential scanning calorimetry and X-ray diffraction to confirm their amorphous structure, and their corrosion properties were further investigated by open-circuit potential and cyclic polarization tests. The ribbon's surface was functionalized by tannic acid, a natural plant-based polyphenol, to enhance its performance in terms of corrosion prevention and antimicrobial efficacy. These properties can potentially be exploited in the premucosal parts of dental implants (abutments). The Folin and Ciocalteu test was used for the quantification of tannic acid (TA) grafted on the ribbon surface and of its redox activity. Fluorescent microscopy and ζ-potential measurements were used to confirm the presence of TA on the surfaces of the ribbons. The cytocompatibility evaluation (indirect and direct) of TA-functionalized Ti 60 Zr 20 Si 8 Ge 7 B 3 Sn 2 MG ribbons toward primary human gingival fibroblast demonstrated that no significant differences in cell viability were detected between the functionalized and as-produced (control) MG ribbons. Finally, the antibacterial investigation of TA-functionalized samples against Staphylococcus aureus demonstrated the specimens' antimicrobial properties, shown by scanning electron microscopy images after 24 h, presenting a few single colonies remaining on their surfaces. The thickness of bacterial aggregations (biofilm-like) that were formed on the surface of the as-produced samples reduced from 3.5 to 1.5 μm.

Prosthetic liners are mainly used as an interface between residual limbs and prosthetic sockets to minimize physical and biological damage to soft tissue. However, the closed and moist conditions within liners and the amputee's skin provide a suitable environment for bacterial growth to cause infections. This study aimed to coat a comprehensive variant material with copper oxide nanoparticles (CuO NPs) and compare their surface analysis and antibacterial properties. These materials were covered with CuO NPs solution at a concentration of 70 μg mL -1 to achieve this purpose. After drying, their surface characteristics were analyzed by measuring zeta potential, contact angle, surface roughness, and fiber arrangement. Cu-released concentration from the coatings into the acetate buffer solution by inductively coupled plasma mass spectrometry indicated that lycra and nylon quickly released Cu ions to concentrations up to ∼0.2 μg mL -1 after 24 h, causing low metabolic activity of human bone-marrow mesenchymal stem cells (bMSC) in the indirect assay. Antibacterial activity of the coated specimens was evaluated by infecting their surfaces with the Gram-positive bacteria Staphylococcus epidermidis, reporting a significant ∼40 % reduction of metabolic activity for x-dry after 24 h; in addition, the number of viable bacterial colonies adhered to the surface of this material was reduced by ∼23 times in comparison with non-treated x-dry that were visually confirmed by scanning electron microscope. In conclusion, CuO NPs x-dry shows optimistic results to pursue further experiments due to its slow speed of Cu release and prolonged antibacterial activity, as well as its compatibility with human cells., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

In this study, a bio-based acrylate resin derived from soybean oil was used in combination with a reactive diluent, isobornyl acrylate, to synthetize a composite scaffold reinforced with bioactive glass particles. The formulation contained acrylated epoxidized soybean oil (AESO), isobornyl acrylate (IBOA), a photo-initiator (Irgacure 819) and a bioactive glass particle. The resin showed high reactivity towards radical photopolymerisation, and the presence of the bioactive glass did not significantly affect the photocuring process. The 3D-printed samples showed different properties from the mould-polymerised samples. The glass transition temperature T g showed an increase of 3D samples with increasing bioactive glass content, attributed to the layer-by-layer curing process that resulted in improved interaction between the bioactive glass and the polymer matrix. Scanning electron microscope analysis revealed an optimal distribution on bioactive glass within the samples. Compression tests indicated that the 3D-printed sample exhibited higher modulus compared to mould-synthetized samples, proving the enhanced mechanical behaviour of 3D-printed scaffolds. The cytocompatibility and biocompatibility of the samples were evaluated using human bone marrow mesenchymal stem cells (bMSCs). The metabolic activity and attachment of cells on the samples' surfaces were analysed, and the results demonstrated higher metabolic activity and increased cell attachment on the surfaces containing higher bioactive glass content. The viability of the cells was further confirmed through live/dead staining and reseeding experiments. Overall, this study presents a novel approach for fabricating bioactive glass reinforced scaffolds using 3D printing technology, offering potential applications in tissue engineering.

Boswellia serrata Roxb. extract (BSE), rich in boswellic acids, is well known as a potent anti-inflammatory natural drug. However, due to its limited aqueous solubility, BSE inclusion into an appropriate carrier, capable of improving its release in the biological target, would be highly desirable. Starting with this requirement, new hybrid composites based on the inclusion of BSE in a lamellar solid layered double hydroxide (LDH), i.e., magnesium aluminum carbonate, were developed and characterized in the present work. The adopted LDH exhibited a layered crystal structure, comprising positively charged hydroxide layers and interlayers composed of carbonate anions and water molecules; thus, it was expected to embed negatively charged boswellic acids. In the present case, a calcination process was also adopted on the LDH to increase organic acid loading, based on the replacement of the original inorganic anions. An accurate investigation was carried out by TGA, PXRD, FT-IR/ATR, XPS, SEM, and LC-MS to ascertain the nature, interaction, and quantification of the active molecules of the vegetal extract loaded in the developed hybrid materials. As a result, the significant disruption of the original layered structure was observed in the LDH subjected to calcination (LDHc), and this material was able to include a higher amount of organic acids when its composite with BSE was prepared. However, in vitro tests on the composites' bioactivity, expressed in terms of antimicrobial and anti-inflammatory activity, evidenced LDH-BSE as a better material compared to BSE and to LDHc-BSE, thus suggesting that, although the embedded organic acid amount was lower, they could be more available since they were not firmly bound to the clay. The composite was able to significantly decrease the number of viable pathogens such as Escherichia coli and Staphylococcus aureus, as well as the internalization of toxic active species into human cells imposing oxidative stress, in comparison to the BSE.

Endometriosis is a prevalent condition that affects millions of individuals globally, leading to various symptoms and significant disruptions to their quality of life. However, the diagnosis of endometriosis often encounters delays, emphasizing the pressing need for non-invasive screening. This retrospective cross-sectional study aimed to evaluate the utility of the Endometriosis Risk Advisor (EndoRA) mobile application in screening for endometriosis in patients with chronic pelvic pain and/or unexplained infertility. The study consisted of 293 patients who met specific criteria: they were English-speaking individuals with chronic pelvic pain and/or unexplained infertility, owned smartphones, and had no prior diagnosis of endometriosis. The results demonstrated that the EndoRA score exhibited a high sensitivity of 93.1% but a low specificity of 5.9% in detecting endometriosis. The positive predictive value was 94.1%, while the negative predictive value was 5.0%. Although the study had limitations and potential selection bias, its findings suggest that EndoRA can serve as a valuable screening tool for high-risk individuals, enabling them to identify themselves as being at an increased risk for endometriosis. EndoRA's non-invasive nature, free access, and easy accessibility have the potential to streamline evaluation and treatment processes, thereby empowering individuals to seek timely care and ultimately improving patient outcomes and overall well-being.

Purpose: To externally validate an algorithm for non-invasive differentiation of hepatic mucinous cystic neoplasms (MCN) from benign hepatic cysts (BHC), which differ in management., Methods: Patients with cystic liver lesions pathologically confirmed as MCN or BHC between January 2005 and March 2022 from multiple institutions were retrospectively included. Five readers (2 radiologists, 3 non-radiologist physicians) independently reviewed contrast-enhanced CT or MRI examinations before tissue sampling and applied the 3-feature classification algorithm described by Hardie et al. to differentiate between MCN and BHC, which had a reported accuracy of 93.5%. The classification was then compared to the pathology results. Interreader agreement between readers across different levels of experience was evaluated with Fleiss' Kappa., Results: The final cohort included 159 patients, median age of 62 years (IQR [52.0, 70.0]), 66.7% female (106). Of all patients, 89.3% (142) had BHC, and the remaining 10.7% (17) had MCN on pathology. Agreement for class designation between the radiologists was almost perfect (Fleiss' Kappa 0.840, p < 0.001). The algorithm had an accuracy of 98.1% (95% CI [94.6%, 99.6%]), a positive predictive value of 100.0% (95% CI [76.8%, 100.0%]), a negative predictive value of 97.9% (95% CI [94.1%, 99.6%]), and an area under the receiver operator characteristic curve (AUC) of 0.911 (95% CI [0.818, 1.000])., Conclusion: The evaluated algorithm showed similarly high diagnostic accuracy in our external, multi-institutional validation cohort. This 3-feature algorithm is easily and rapidly applied and its features are reproducible among radiologists, showing promise as a clinical decision support tool., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To determine the risk factors of osteoporosis and osteopenia of the spine in postmenopausal women., Method: An analytical cross-sectional study was performed on postmenopausal women. The T-score of the lumbar spine (L2-L4) was measured by densitometry and compared between osteoporotic, osteopenia, and normal women., Results: One thousand three hundred fify-nine postmenopausal women were evaluated. The prevalence of osteopenia and osteoporosis was 58.2% and 12.8% respectively. Age, BMI, parity, total breastfeeding years, dairy use, calcium-D supplements, and regular exercise were significantly different in women with osteoporosis, osteopenia, and normal women. Ethnicity, diabetes, and previous fracture history were only other among women with osteoporosis (not osteopenia) and normal women. For osteopenia of the spine, age [AOR 1.08 (1.05-1.11; p  < .001)] was the risk factor, and BMI = >30 [AOR 0.36 (0.28-0.58; p  < .001)] and BMI 25-<30 [AOR 0.55 (0.34-0.88; p  = .012)] were protective factors. Hyperthyroidism (AOR 23.43, p  = .010), Kurdish ethnicity (AOR 2.96, p  = .009), not having regular exercise (AOR 2.22, p  = .012), previous fracture history (AOR 2.15, p  = .041)], and age (AOR 1.14, p  < .001)], were risk factors for osteoporosis, while BMI ≥30 [AOR 0.09, p  < .001], BMI 25-<30 [AOR 0.28, p  = .001], and diabetes [AOR 0.41, p  = .038] were protective factors for osteoporosis of the spine., Conclusion: Hyperthyroidism, low BMI <25, parity ≥ 6, Kurdish ethnicity, not having regular exercise, history of previous fracture, and age, were risk factors for osteoporosis of the spine respectively, while low BMI and age were risk factors for osteopenia.

Background: Some recent trials have reported high efficacy for nonsteroidal anti-inflammatory drugs (NSAIDs) in relieving medical abortion-related pain. The aim of this study was to determine the beneficial effect of oral NSAIDs (ibuprofen lysine) in reduction of pain and hemorrhage in first-trimester medical abortion., Methods: This randomized triple-blinded clinical trial was performed on 98 pregnant women who were candidate for medical abortion within the first-trimester period (gestational age<12 weeks). The participants were randomly assigned to receive ibuprofen lysine (684 mg orally every 4 hours) or placebo. All patients were initially treated with misoprostol (800 µg every 3 hours). Pain intensity and rate of hemorrhage were assessed every hour up to 15 hours after receiving the first dose of misoprostol by visual analogue scaling (VAS) and pictorial blood loss assessment chart (PBAC), respectively., Results: Assessing the mean pain score within 15 hours of receiving misoprostol showed significantly lower pain intensity within the first 10 hours of assessment in the group receiving NSAID in comparison with the control group ( P <0.001). The bleeding rate was also significantly lower in the NSAID group at the fifth ( P =0.013) and ninth ( P =0.040) hour of receiving misoprostol compared to the control group. We found no difference in abortion-related complication rate between the NSAID and placebo groups (8.3% versus 8.0%, P =0.952)., Conclusion: The use of NSAIDs (ibuprofen lysine) is a good pharmacological analgesic option for relieving medical abortionrelated pain and hemorrhage., (© 2023 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Strawberries and raspberries are susceptible to physiological and biological damage. Due to the consumer concern about using pesticides to control fruit rot, recent attention has been drawn to essential oils. Microbiological activity evaluations of different concentrations of tested EOs (cinnamon, clove, bergamot, rosemary and lemon; 10% DMSO-PBS solution was used as a diluent) against fruit rot fungal strains and a fruit-born human pathogen ( Escherichia coli ) indicated that the highest inhibition halos was found for pure cinnamon and clove oils; according to GC-MS analysis, these activities were due to the high level of the bioactive compounds cinnamaldehyde (54.5%) in cinnamon oil and eugenol (83%) in clove oil. Moreover, thermogravimetric evaluation showed they were thermally stable, with temperature peak of 232.0 °C for cinnamon and 200.6/234.9 °C for clove oils. Antibacterial activity evaluations of all tested EOs at concentrations from 5-50% ( v / v ) revealed a concentration of 10% ( v / v ) to be the minimum inhibitory concentration and minimum bactericidal concentration. The physicochemical analysis of fruits in an in vivo assay indicated that used filter papers doped with 10% ( v / v ) of cinnamon oil (stuck into the lids of plastic containers) were able to increase the total polyphenols and antioxidant activity in strawberries after four days, with it being easier to preserve strawberries than raspberries.

Implant-associated infections are a severe global concern, especially in the case of orthopedic implants intended for long-term or permanent use. The traditional treatment through systemic antibiotic administration is often inefficient due to biofilm formation, and concerns regarding the development of highly resistant bacteria. Therefore, there is an unfulfilled need for antibiotic-free alternatives that could simultaneously support bone regeneration and prevent bacterial infection. This study aimed to perform, optimize, and characterize the surface functionalization of Ti6Al4V-ELI discs by an FDA-approved antimicrobial peptide, nisin, known to hold a broad antibacterial spectrum. Accordingly, nisin bioactivity was also evaluated by in vitro release tests both in physiological and inflammatory pH conditions. Several methods, such as X-ray photoelectron spectroscopy (XPS), and Kelvin Probe atomic force microscopy confirmed the presence of a physisorbed nisin layer on the alloy surface. The functionalization performed at pH 6-7 was found to be especially effective due to the nisin configuration exposing its hydrophobic tail outwards, which is also responsible for its antimicrobial action. In addition, the first evidence of gradual nisin release both in physiological and inflammatory conditions was obtained: the static contact angle becomes half of the starting one after 7 days of soaking on the functionalized sample, while it becomes 0° on the control samples. Finally, the evaluation of the antibacterial performance toward the pathogen Staphylococcus aureus after 24 h of inoculation showed the ability of nisin adsorbed at pH 6 to prevent bacterial microfouling into biofilm-like aggregates in comparison with the uncoated specimens: viable bacterial colonies showed a reduction of about 40% with respect to the un-functionalized surface and the formation of (microcolonies (biofilm-like aggregates) is strongly affected.

The purpose of this trial was to compare extra-amniotic saline infusion (EASI) and intravaginal isoniazid (INH) for cervical ripening. This randomised clinical trial included 150 pregnant women who were undergoing induction of labour and who required pre-induction cervical ripening. Patients were randomly assigned to receive EASI or intravaginal INH. Bishop's score at the beginning of the study and before oxytocin infusion was not significantly different between INH and EASI groups. However, the time from first intervention to the beginning of the induction and also to the beginning of the active phase were significantly shorter in EASI group ( p value ≤.001). Moreover, INH did not influence the labour process after the beginning of the active phase of labour. In conclusion, INH could be used for cervical ripening especially in the outpatient setting; however, it is a slower ripening agent compared to EASI.Impact Statement What is already known on this subject? To date there has been only one study about the safety and effectiveness of isoniazid (INH) in cervical ripening at term pregnancy which has compared INH with misoprostol. What do the results of this study add? The results of this study showed that vaginal INH is an effective agent for cervical ripening at term but in comparison to extra-amniotic saline infusion (EASI) it takes a longer time. What are the implications of these findings for clinical practice and/or further research? INH can be used in outpatient settings for cervical ripening at term pregnancy which makes it convenient for patient and cost effective for both patient and health system. Further studies are needed to discover the clinical efficacy of INH in comparison to other ripening methods and also the best dosage of INH for cervical ripening.

This paper envisions Ti 40 Zr 10 Cu 36 Pd 14 bulk metallic glass as an oral implant material and evaluates its antibacterial performance in the inhabitation of oral biofilm formation in comparison with the gold standard Ti-6Al-4V implant material. Metallic glasses are superior in terms of biocorrosion and have a reduced stress shielding effect compared with their crystalline counterparts. Dynamic mechanical and thermal expansion analyses on Ti 40 Zr 10 Cu 36 Pd 14 show that these materials can be thermomechanically shaped into implants. Static water contact angle measurement on samples' surface shows an increased surface wettability on the Ti-6Al-4V surface after 48 ​h incubation in the water while the contact angle remains constant for Ti 40 Zr 10 Cu 36 Pd 14 . Further, high-resolution transmission and scanning transmission electron microscopy analysis have revealed that Ti 40 Zr 10 Cu 36 Pd 14 interior is fully amorphous, while a 15 ​nm surface oxide is formed on its surface and assigned as copper oxide. Unlike titanium oxide formed on Ti-6Al-4V, copper oxide is hydrophobic, and its formation reduces surface wettability. Further surface analysis by X-ray photoelectron spectroscopy confirmed the presence of copper oxide on the surface. Metallic glasses cytocompatibility was first demonstrated towards human gingival fibroblasts, and then the antibacterial properties were verified towards the oral pathogen Aggregatibacter actinomycetemcomitans responsible for oral biofilm formation. After 24 ​h of direct infection, metallic glasses reported a >70% reduction of bacteria viability and the number of viable colonies was reduced by ∼8 times, as shown by the colony-forming unit count. Field emission scanning electron microscopy and fluorescent images confirmed the lower surface colonization of metallic glasses in comparison with controls. Finally, oral biofilm obtained from healthy volunteers was cultivated onto specimens' surface, and proteomics was applied to study the surface property impact on species composition within the oral plaque., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Background: This study aimed to compare the effect of ovarian suspension and hyaluronic acid gel to prevent re-adhesions after laparoscopic endometrioma surgery., Methods: This randomized clinical trial was conducted at Rasoul-e-Akram and Pars Hospitals, Tehran, Iran, 2016-18. Fifty patients with bilateral endometrioma and pelvic adhesions, the candidates of laparoscopic surgery, were included. In each patient, at the end of ovarian cystectomy and adhesiolysis, one of the ovaries was randomly sutured to the abdominal wall, and the HYAcorp Endogel covered the other; the adhesion rate was compared between the groups by ultrasonography, three-month after surgery., Results: Mean age of patients was 32.6 years. Presurgical variables were similar between right and left ovaries and the study groups (P > 0.05). Postsurgical ultrasonography showed that ovarian soft markers, including < 1/3 ovarian adhesions (minimal adhesions) in 80.5% of ovaries of the Endogel group and 35.5% of the ovarian suspension group (P < 0.001) with higher ovarian mobility in the Endogel group (65% vs. 22%) (P = 0.001). In addition, site-specific tenderness and ovarian fading margin were lower in the Endogel group (P < 0.001). Trial registration Clinical trial registry number: IRCT2015081723666N1, 12.19.2015, Date of registration: 01/02/2016; https://en.irct.ir/trial/20174?revision=20174 . Date and number of IRB: 2015, I.R.IUMS.REC.1394.24703., Conclusion: Hyaluronic acid gel can be more effective than ovarian suspension in preventing ovarian adhesions after laparoscopic treatment of endometriosis., (© 2022. The Author(s).)

Zirconium-Copper-based metallic glass thin films represent promising coatings in the biomedical sector for their combination of antibacterial property and wear resistance. However, finding a Zr-Cu metallic glass composition with desirable cytocompatibility and antibacterial property is extremely challenging. In this work, we have created a cytocompatible and (super-)hydrophobic Zr-Cu-Ag metallic glass coating with ≈95% antifouling properties. First, a range of different chemical compositions were prepared via Physical Vapor Deposition magnetron by co-sputtering Zr, Cu, and Ag onto a Polybutylene terephthalate (PBT) substrate among which Zr 93·5 Cu 6·2 Ag 0.2 , Zr 76·7 Cu 22·7 Ag 0.5, and Zr 69·3 Cu 30·1 Ag 0.6 were selected to be further investigate for their surface properties, antibacterial activity, and cytocompatibility. Scanning electron microscopy (SEM) images revealed a micro-roughness fibrous structure holding superhydrophobic properties demonstrated by specimens' static and dynamic contact angle measurements ranging from 130° to 150°. The dynamic contact angle measurements have shown hysteresis below 10° for all coated samples which indicated the superhydrophobicity of the samples. To distinguish between antifouling and bactericidal effect of the coating, ions release from coatings into Luria Bertani Broth (LB), and Dulbecco's Modified Eagle Medium (DMEM) solutions were evaluated by inductively coupled plasma mass spectrometry (ICP-MS) measurements after 24 ​h and 5 days. Antifouling properties were evaluated by infecting the specimens' surface with the Gram-positive Staphylococcus aureus and the Gram-negative Escherichia coli strain reporting a ≈95% reduction of bacteria adhesion as visually confirmed by FESEM and fluorescent live/dead staining. Human mesenchymal stem cells (hMSC) were used for direct cytocompatibility evaluation of coated samples and their metabolic activity was evaluated via relative fluorescence unit after 24 ​h and 5 days confirming that it was comparable to the controls (>97% viable cells). The results were further visualized by FESEM, fluorescent staining by Live/Dead Viability/Cytotoxicity Kit and confirmed the cytocompatibility of all coated samples. Finally, hMSC' cytoplasm was stained by May Grunwald and Giemsa after 5days to detect and visualize the released ions which have diffused through the cells' membrane., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Background & Objectives: Endometriosis is one of the causes of female infertility, but the prevalence of endometriosis is not exactly known. We conducted a systematic review and meta-analysis to provide an estimate of the prevalence of endometriosis in women considering the stage of disease, diagnostic method, geographical distribution, clinical symptoms and sample size., Methods: MEDLINE, Web of Science, Google Scholar, Scopus and Cumulative Index of Nursing and Allied Health were searched to identify peer-reviewed studies published from January 1990 to December 2018 reporting the prevalence of endometriosis. Relevant additional articles were identified from the lists of the retrieved articles. Studies with cross-sectional design were included in the meta-analysis., Results: The overall prevalence of endometriosis was 18 per cent [95% confidence interval (CI): 16-20] and the prevalence of endometriosis by stage ranged from two per cent (95% CI: 1-4) for stage 4 to 20 per cent (95% CI: 11-28) for stage 1. The prevalence levels of endometriosis in women with infertility, chronic pelvic pain and asymptomatic were 31 (95% CI: 15-48), 42 (95% CI: 25-58) and 23 per cent (95% CI: 19-26), respectively., Interpretation & Conclusions: The results of this study showed that the prevalence of endometriosis in developing countries was high. Future studies are needed to explore other factors affecting the prevalence of endometriosis worldwide, which may help develop future prevention programmes.

Objective: The aim of this systematic review and meta-analysis study was to determine the pooled estimate of the effect of antenatal magnesium sulfate (MgSO4) on intraventricular hemorrhage (IVH) in premature infants., Methods: Two review authors independently searched all randomized clinical trials from international databases, including Medline (PubMed), Web of Sciences, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Research Registers of ongoing trials (ClinicalTrials.gov), from January 1989 to August 2017. Two independent review authors were responsible for data collection. After extracting the necessary information from the evaluated articles, metaanalysis of the data was performed using Stata version 14. Also, sources of heterogeneity among studies were determined by Meta regression., Results: In this study, among 126 articles that were extracted from primary studies, 7 papers that evaluated the effect of MgSO4 on IVH were eligible for inclusion in the meta-analysis. The results of the meta-analysis showed that pooled relative risk (95% confidence interval [CI]) was 0.80 (95% CI, 0.63 to 1.03) for the effect of MgSO4 on IVH., Results: of this study showed that although MgSO4 had a protective effect on IVH in premature infants, this effect was not statistically significant. Further studies are needed to determine the best dosage, timing, and gestational age to achieve the optimum effect of MgSO4 on IVH., Systematic Review Registration: International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42019119610.

Objective: The aim of the present study was to compare the efficacy of vaginal isoniazid (isonicotinic acid hydrazide [INH]) and vaginal misoprostol in cervical ripening before hysteroscopic surgery., Methods: This randomized controlled trial included patients scheduled for hysteroscopic surgery during April 2016 and June 2017. The inclusion criteria were as follows: postmenopausal women or those at premenopausal age who had not had a vaginal delivery and candidate for diagnostic or operative hysteroscopy with closed cervix before intervention. The INH group (intervention group) received 900 mg of vaginal isoniazid (three 300-mg pills) 6-8 hours before hysteroscopic surgery. The misoprostol group (control group) received 400 micrograms of vaginal misoprostol 6-8 hours before hysteroscopic surgery. Finally, the efficacy of the 2 agents was comparatively analyzed., Results: Baseline characteristics were comparable between the groups. In 67 cases in the INH group (95%) and 45 in the misoprostol group (50%), hysteroscopic entry was successful without additional mechanical dilation, and this difference was statistically significant (P=0.001). The odds ratio (OR) obtained in this study was 0.57 for both INH and misoprostol groups (OR, 0.57; 95% confidence interval, 0.43-0.75). Further, 19 cases in the INH group vs. 45 cases in the misoprostol group did not respond to the intervention, indicating statistically significance (P=0.001)., Conclusion: Vaginal INH is more effective than misoprostol in cervical ripening before hysteroscopic surgery and can be a good alternative to misoprostol., Trial Registration: Iranian Registry Clinical Trial (IRCT) Identifier: IRCT2015112821506N4.

Cartilage repair still represents a challenge for clinicians and only few effective therapies are nowadays available. In fact, surgery is limited by the tissue poor self-healing capacity while the autologous transplantation is often forsaken due to the poor in vitro expansion capacity of chondrocytes. Biomaterials science offers a unique alternative based on the replacement of the injured tissue with an artificial tissue-mimicking scaffold. However, the implantation surgical practices and the scaffold itself can be a source of bacterial infection that currently represents the first reason of implants failure due to the increasing antibiotics resistance of pathogens. So, alternative antibacterial tools to prevent infections and consequent device removal are urgently required. In this work, the role of Nisin and LL-37 peptides has been investigated as alternative to antibiotics to their antimicrobial performances for direct application at the surgical site or as doping chemicals for devices aimed at articular cartilage repair. First, peptides cytocompatibility was investigated toward human mesenchymal stem cells to determine safe concentrations; then, the broad-range antibacterial activity was verified toward the Gram-positive Staphylococcus aureus and Staphylococcus epidermidis as well as the Gram-negative Escherichia coli and Aggregatibacter actinomycetemcomitans pathogens. The peptides selective antibacterial activity was verified by a cells-bacteria co-culture assay, while chondrogenesis was assayed to exclude any interference within the differentiation route to simulate the tissue repair. In the next phase, the experiments were repeated by moving from the cell monolayer model to 3D cartilage-like spheroids to revisit the peptides activity in a more physiologically relevant environment model. Finally, the spheroid model was applied in a perfusion bioreactor to simulate an infection in the presence of circulating peptides within a physiological environment. Results suggested that 75 μg/ml Nisin can be considered as a very promising candidate since it was shown to be more cytocompatible and potent against the investigated bacteria than LL-37 in all the tested models., (Copyright © 2020 Najmi, Kumar, Scalia, Cochis, Obradovic, Grassi, Leigheb, Lamghari, Loinaz, Gracia and Rimondini.)

Fetal Alcohol Spectrum Disorders (FASD) represent a worldwide problem. The severity and types of symptoms of FASD vary, which may be due to the genotype of the fetus and the developmental stage at which the fetus is exposed to alcohol. The most prevalent forms of FASD present less severe symptoms, including behavioral and cognitive abnormalities, and arise from exposure to low amounts of alcohol consumed infrequently. Treating or diagnosing FASD patients has been difficult because we do not understand the mechanisms underlying FASD. Animal models, including the zebrafish, have been suggested to answer this question. Here, we present a proof of concept analysis studying the behavioral effects of embryonic alcohol exposure in one-week old juvenile zebrafish. We exposed zebrafish embryos at one of five developmental stages (8, 16, 24, 32, or 40 hour post-fertilization) to 0% (control) or 1% (vol/vol) ethanol for 2 h, and tested the behavior of these fish at their age of 7-9 days post-fertilization. We employed two genetically distinct zebrafish populations, a quasi-inbred AB derivative strain, and a genetically variable WT population. We report significant developmental time and genotype dependent effects of alcohol on certain measures of motor function and/or anxiety-like responses. For example, we found embryonic alcohol exposed AB fish to swim faster, vary their speed more, stop moving more often and turn less compared to control fish, alcohol induced changes that were absent or less robust in WT fish. We conclude that our results open new avenues to the identification of genetic mechanisms that mediate or influence alcohol induced developmental alteration of brain function and behavior, which, on the long run, may allow us to identify diagnostic biomarkers and treatment options for human FASD., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background and Objectives: A tourniquet has been suggested as a useful means of reducing massive hemorrhage during myomectomy. However, it is not clear whether the restricted perfusion affects the ovaries. In the present study, we examined the effect of a tourniquet on ovarian reserve and blood loss during myomectomy., Materials and Methods: In a randomized double-blind clinical trial, fertile nonobese patients scheduled for abdominal myomectomy at Rasool-e-Akram Hospital from February 2018 to June 2019 were randomized to a tourniquet (n = 46) or a non-tourniquet group (n = 35). Serum levels of anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) were measured before and 3 months after surgery, blood loss was recorded during surgery, and serum levels of hemoglobin (Hb) were recorded before surgery, 6 h and 3 days after surgery. SPSS version 21 was used for statistical analysis., Results: Demographic, obstetric, and myoma characteristics were similar in the 2 groups (p > 0.05). The mean baseline values of AMH and FSH did not differ between groups (p > 0.05). After surgery, only FSH was higher in the control group (p = 0.043). Despite the time taken to fasten and open the tourniquet, the mean operating time was shorter in the tourniquet group (p < 0.001). Blood loss was higher in the control group (p = 0.005). The drop in Hb levels at 6 h after surgery was higher in the non-tourniquet group (p = 0.002). Blood loss was significantly associated with the duration of surgery (r = 0.523, p < 0.001)., Conclusion: The use of a tourniquet during abdominal myomectomy significantly reduced the mean volume of blood loss compared to the non-tourniquet group, while it did not prolong the duration of surgery, nor reduced the ovarian reserve. A tourniquet is a safe and efficient measure during abdominal myomectomy., (© 2020 S. Karger AG, Basel.)

Background: Previous studies conducted on the association between diabetes and the risk of endometrial cancer have reported controversial results that have raised a variety of questions about the association between diabetes and the incidence of this cancer. Thus, the aim of this systematic review and meta-analysis was to more precisely estimate the effect of diabetes on the risk of endometrial cancer incidence., Methods: All original articles were searched in international databases, including Medline (PubMed), Web of sciences, Scopus, EMBASE, and CINHAL. Search was done from January 1990 to January 2018 without language limitations. Also, logarithm and standard error logarithm relative risk (RR) were used for meta-analysis., Results: A total of 22 cohort and case-control studies were included in this meta-analysis, of which 14 showed statistically significant associations between diabetes and risk of endometrial cancer. Diabetes was associated with increased risk of endometrial cancer (RR = 1.72, 95% CI 1.48-2.01). The summary of RR for all 9 cohort studies was 1.56 (95% CI 1.21-2.01), and it was 1.85 (95% CI 1.53-2.23) for 13 case control studies. The summary of RR in hospital-based studies was higher than other studies. Thirteen of the primary studies-controlled BMI as a confounding variable, and the combined risk of their results was 1.62 (95% CI 1.34-1.97)., Conclusions: Diabetes seems to increases the risk of endometrial cancer in women, and this finding can be useful in developing endometrial cancer prevention plans for women having diabetes.

Objective: Endometriosis, a common hormone-dependent chronic inflammatory disease causes various symptoms including pelvic pain, which affect the physical and psychological quality of life in women of reproductive age. The present study aimed to assess the quality of life of Iranian women with endometriosis using the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) questionnaire., Methods: This cross-sectional study performed in Tehran between October 2014 and July 2016 included 70 Iranian women with endometriosis. The Iranian version of the WHOQOL-BREF questionnaire was used to measure quality of life in these women. The Pearson's correlation coefficient, the paired and the independent t -tests, and a linear regression model were used to statistically analyze the data using the SPSS software version 16.0., Results: The total mean score of the WHOQOL-BREF questionnaire was 80.58. The highest and the lowest mean scores were observed in the environmental (28.15) and the physical health domains (10.59), respectively. A multiple linear regression model (backward method) showed that insurance coverage was associated with the total WHOQOL-BREF score, whereas age, insurance coverage, and income level were associated with domains 1 through 4, respectively ( P <0.05)., Conclusion: Endometriosis affects various aspects of the quality of life of Iranian women who therefore require holistic management focused on both, the physical and psychological aspects of treatment., Competing Interests: Conflict of interest: No potential conflict of interest relevant to this article was reported.

Background: Due to the amphipathic properties of biosurfactants which act on surfaces and interfaces interest by a variety of industries such as cosmetic, pharmaceutical, bioremediation and petroleum-related industries has recently increased., Methods: Detection of a high-efficiency biosurfactant producer using preliminary screening methods from soil contaminated with crude oil was carried at the Microbiology Laboratory at Shahid Beheshti University, Tehran, Iran in 2013. Then after characterization of some physico-chemical properties of produced biosurfactant and production optimization conditions, processes of purification and complete identification were done., Results: Pseudomonas aeruginosa sp. ZN was selected as high-efficiency biosurfactant producing strain from soil contaminated with oil from Ahvaz City, Khuzestan Province, southern Iran. The biosurfactant production in modified BH2 culture medium supplemented with 1% n-hexadecane occurred during exponential phase resulting in a reduction surface tension from 70 to 29 mN/m. Strain ZN produced biosurfactant with different properties to other Pseudomonas reported. These characterizations included continued production at C/N ratio range of 10-40; the produced biosurfactant could not separate stable emulsion of span-80-kerosene: Tween-80-distilled water (30:70) within 24 h. The produced biosurfactants were able to increase hydrophobicity of bacterial cell to 55%. Recovery of biosurfactants from cell-free supernatant was performed with acid precipitation and ammonium sulfate precipitation. Chemical analysis such as spraying techniques on developed TLC plate and staining methods of supernatant indicated that produced biosurfactants were glycolipids, characterized by ESI-MS analysis of extracted product as di-rhamnolipids., Conclusion: Ability of this strain to produce biosurfactant in the presence of cooked oil and n-hexadecane make it an optimistic candidate for biodegradation of some derivatives of crude oil and food industry., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests.

Since 60-80% of total costs of production are usually associated with downstream collection, separation, and purification processes, it has become advantageous to investigate how to replace traditional methods with efficient and cost-effective alternative techniques for recovery and purification of biosurfactants. In the traditional techniques, large volumes of organic solvents are usually used for increasing production cost and the overall environmental burden. In addition, traditional production and separation methods typically carried out in batch cultures reduce biosurfactant yields due to product inhibition and lower biosurfactants activity as a result of interaction with the organic solvents used. However, some in situ recovery methods that allow continuous separation of bioproducts from culture broth leading to an improvement in yield production and fermentation efficiency. For biosurfactants commercialization, enhancement of product capacity of the separation methods and the rate of product removal is critical. Recently, interest in the integration of separation methods with a production step as rapid and efficient techniques has been increasing. This review focuses on the technology gains and potentials for the most common methods used in in situ product removal: foam fractionation and ultrafiltration, especially used to recover and purify two well-known biosurfactants: glycolipids (rhamnolipids) and lipopeptides (surfactins)., (© 2018 International Union of Biochemistry and Molecular Biology, Inc.)

Background: Fetal male gender may affect the progression of labor and could be a risk factor for labor arrest. This study was conducted to evaluate the effect of fetus gender on labor curve. Methods: In this cohort study, 1550 singleton term pregnant women in labor phase (either spontaneous or by induction) were enrolled. Results of regular cervical examination, dilation, length of labor stages, mode of delivery, and sex of the fetus, and birth weight were recorded for all participants. Labor progression curve was compared between two sex groups with independent t test and chi2 test. Results : Finally, 1527 women completed the study (47.8% female and 52.1% male). Mean duration from beginning of the active phase up to full dilatation, from 4 to 6 cm, 6 to 8 cm, and 8 to 10 cm dilatations, were significantly longer in the male sex group compared to the female (p˂0.05). All durations were also significantly different when parity was considered (p˂0.05). We could not show fetal sex as an independent risk factor for active phase arrest (OR Adjusted: 1.18, CI 95% 1.01:1.42). Conclusion: Active phase stage was slower and longer in women who carried male fetuses compared to those carrying female fetuses; however, fetal sex did not increase the risk of active phase arrest.

Background: Threatened preterm labor (TPL) is the leading cause of hospitalization during pregnancy. Tocolytic agents are the primary therapeutic options for TPL. The aim of this study is to compare intramuscular progesterone with oral nifedipine as a tocolytic agent. Methods: This randomized controlled trial was carried out in a teaching hospital (Shahid Akbarabadi) in Tehran, Iran, from December 2011 to November 2012. Three hundred and fifteen singleton pregnant women aged >18 yrs at 26-34 weeks' gestation with the diagnosis of threatened preterm labor (TPL) were randomly received either intramuscular progesterone or oral nifedipine for tocolysis. Maternal and neonatal outcomes were then compared between the two interventions. P value less than 0.05 was considered statistically significant. IRCT registration number of this study is IRCT201112198469N1 Results: The success rate of progesterone and nifedipine in treating TPL were 83% and 82.7%, respectively. There was no significant difference between the two interventions with regard to gestational age at delivery, type of delivery, the time interval until the delivery, birth weight, NICU admission rate and hospital stays. Progesterone administration was associated with lower duration of NICU stay as compared with nifedipine (0.33±0.77 days vs.1.5±3.2 days, p<0.05). None of the two drugs caused any major side effects. Conclusion: Single dose intramuscular progesterone is as effective as oral nifedipine in treating TPL. It also significantly reduces the NICU stay.

Objective: To evaluate the effects of laparoscopic cystectomy on serum anti-Müllerian hormone (AMH) level as a marker of ovarian reserve in patients with endometrioma., Methods: A prospective observational study enrolled patients aged younger than 40 years who were referred to a tertiary center in Tehran, Iran, between January 1, 2013 and December 31, 2014 to undergo laparoscopic cystectomy for ovarian endometriomas at least 30 mm in diameter, or regardless of size for patients with infertility, dysmenorrhea, dyspareunia, or dyschezia. Baseline and 6-month post-operative AMH levels were compared., Results: Data from 70 patients were included in the analyses. Among patients with unilateral endometriomas, lower pre-operative AMH levels were observed in patients with endometriomas at least 50 mm in diameter (P=0.027), whereas cyst size was not associated with differences in pre-operative AMH level in patients with bilateral endometriomas (P=0.227). Across the entire study population, post-operative AMH levels were lower than the baseline (P=0.008). Greater post-operative decreases in AMH were associated with bilateral cysts compared with unilateral cysts (P=0.046), cysts being at least 50 mm in diameter among patients with unilateral cysts (P=0.028), and both cysts being at least 50 mm in diameter among patients with bilateral cysts (P=0.025)., Conclusion: Laparoscopic cystectomy was associated with post-operative decreases in serum AMH, particularly with bilateral involvement and endometriomas at least 50 mm in diameter., (© 2016 International Federation of Gynecology and Obstetrics.)

Due to the rapid increase of waste vulcanized rubber products, the development of low-cost, efficient, and selective devulcanization processes is needed. In this paper, the devulcanization ability of Gordonia desulfuricans DSM 44462(T) was evaluated by a design of experiments. The aim of the experimental design was to investigate the importance of parameters influencing the bacterial growth, such as the glucose concentration (C), dibenzothiophene concentration (DBT), and initial biomass (optical density, OD) in biodevulcanization process. The complex viscosity (η*) was chosen as experimental response for the experimental design. A multiple linear regression was used to model the relationship between the response and the process variables. In addition, the crosslink density and gel fraction were measured. Furthermore, the automated ribosomal intergenic spacer analysis (ARISA) as a microbiological method was performed to assess the persistence of the inoculated strain during the experiments. Reduced regression models were obtained considering only the significant variables and interactions. The glucose concentration C and OD variables and C-DBT and DBT-OD interactions resulted to the relevant parameters for the process. The fingerprinting showed the persistence of G. desulfuricans DSM 44462(T), despite the presence of other bacterial population after the VGNR sterilization. These results highlight the importance to support the physics analysis with microbiological analyses to evaluate the bacterial persistence during the treatment.

Objective: To evaluate the accuracy of protein measurement and protein-to-creatinine ratio (PCR) in 4-, 8-, and 12-h urine samples as compared with 24-h urine samples as the gold standard method for suspected pre-eclampsia., Methods: In a prospective study, 120 women at more than 20weeks of pregnancy with high blood pressure and no history of hypertension were enrolled between April 2010 and December 2012. Net protein excretion and PCR were evaluated in urine samples collected over 4h, 8h, 12h (day), and 12h (night) and compared with 24-h protein excretion as the gold standard test., Results: A significant positive correlation was found between the values of the 4-h, 8-h, 12-h (day), and 12-h (night) samples and the 24-h samples. The best cutoff point of the PCR to detect significant urine protein excretion was 0.28, 0.24, 0.25, and 0.23 for the 4-h, 8-h, 12-h (day), and 12-h (night) samples, respectively., Conclusion: Measurement of protein and PCR in 4-h, 8-h, and 12-h urine samples might provide an alternative test for detecting proteinuria among pregnant women with suspected pre-eclampsia when there is insufficient time to collect 24-h urine samples., (Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Background: Müllerian anomalies are associated with infertility. Hysteroscopy as the gold standard for evaluating Müllerian anomalies is an invasive, expensive and risky procedure which requires enough experience. Transvaginal sonography (TVS) and hysterosalpingography (HSG) are less invasive procedures, but there is little known about the accuracy of these tests. The aim of this study was to evaluate the accuracy of the combination of TVS and HSG with hysteroscopy as the gold standard., Methods: Medical records of infertile women who were undertaken all three diagnostic modalities were reviewed to analyze their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)., Results: Ninety-nine infertile women were assessed with a mean±SD age of 29.1±6.47 years, mean±SD duration of themarriage of 8.9±10.28 years, and mean±SD duration of infertility of 5.6± 4.16 years. The sensitivity, specificity, PPV, and NPV of TVS were 98.55%, 30%, 76.4%, and 90%, respectively. HSG had a sensitivity of 95.6%, specificity of 60%, PPV of 84.62%, and NPV of 85.71%.When both modalities were combined, the sensitivity, specificity, PPV, and NPV were 94.2, 66.67, 86.67, and 83.33%, respectively. The diagnostic accuracy of single TVS, HSG or combined techniques was statistically similar that was equal to 77.7, 84.8 and 85.8 % respectively., Conclusion: The accuracy of combination of two diagnostic modalities, 2D TVS and HSG is not higher than HSG alone for assessing uterine malformation in infertile women.

Background and Objective: Pelvic organ prolapse (POP) refers to drop of any pelvic organs into or outside of the vaginal canal or anus. This is a disabling condition that results in limitations in all aspects of women's lives, especially quality of life. The evaluation of quality of life in women with POP requires the use of a valid and reliable measure. An important aspect of validity is responsiveness. The aim of current study is to evaluate the responsiveness of P-QOL questionnaire in patients with prolapse., Methods: Women with confirmed diagnosed POP by gynecologist who were scheduled to undergo POP's treatment enrolled in the study. Quality of life as an outcome measure was evaluated before and six month after treatment besides assessing of physical index of treatment's effect (pelvic organ prolapse quantification; POP-Q). Responsiveness was evaluated using calculation of standardized response mean (SRM) and effect size (ES)., Results: Fifty women were evaluated in current study. Mean age was 43.5±11.8 years old. The range of Cronbach's alpha was between 0.60 and 0.89 for all domains of P-QOL. The range of SRM for all domains was between 0.60 and 0.88. The range of ES was between 0.54 and 0.96. Score of all domains of P-QOL was statistically different between pre and post-treatment (P<0.0001)., Conclusion: The findings of current study showed the P-QOL questionnaire has a good responsiveness in Persian language and could use to assess the impact of interventions on quality of life in patients with prolapse., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: Various gonadotropin preparations have been used for ovarian stimulation in intrauterine insemination (IUI). The purpose of the current study was to compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating hormone (rFSH) combined with clomiphene citrate (CC) in IUI cycles for polycystic ovary syndrome-associated infertility., Methods: In this prospective trial, couples prepared for IUI cycles were randomly allocated either to receive CC and rFSH (group A, n = 132) or CC and hMG (group B, n = 144) for ovarian stimulation. Outcomes including rates of clinical pregnancy, miscarriage, ovarian hyperstimulation syndrome, multiple pregnancy, cancellation and live birth were compared., Results: The duration of gonadotropin therapy was shorter and total doses of gonadotropins was lower in the rFSH group. The number of stimulated follicles reaching >17 mm diameter was comparable between groups, but the mean follicular diameter was significantly higher in the rFSH group. The endometrium was also significantly thicker at the time of human chorionic gonadotropin administration in the rFSH group. However, pregnancy outcomes, including the rates of clinical pregnancy, ongoing pregnancy, live birth, miscarriage, ovarian hyperstimulation syndrome and cancellation, were similar between groups., Conclusion: IUI cycles in which rFSH is administered may result in shorter duration of treatment, a lower total gonadotropin dose and better follicular and endometrial characteristics on the day of human chorionic gonadotropin injection. © 2015 S. Karger AG, Basel.