Enhancing endometrial receptivity in FET cycles: exploring the influence of endometrial and subendometrial blood flow along with endometrial volume

Introduction

Fetal health and a receptive and healthy endometrium are two essential factors in achieving successful implantation. If the endometrium is unreceptive, postponing the transfer cycle to a suitable time can enhance the chances of pregnancy. This study aims to assess the impact of endometrial and sub-endometrial blood flows measured by Doppler ultrasound, as well as endometrial volume, on endometrial receptivity in frozen embryo transfer (FET) cycles.

Methods

112 patients with a mean age of 33.93 ± 4.93 years underwent in vitro fertilization (IVF). Serum β-hCG level was used to confirm pregnancy, and among the participants, 50 (44.6%) achieved pregnancy after IVF.

Results

The study results revealed a significant difference in endometrial blood flow between the pregnant and non-pregnant groups, with a higher pregnancy rate observed in participants exhibiting multi-focal and spare endometrial blood flows (p < 0.05). Furthermore, there was a notable association between endometrial blood flow and pregnancy outcome, as indicated by higher ongoing pregnancy rates in those with multi-focal and spare endometrial blood flows (p < 0.05). However, no significant differences were observed in endometrial variables such as volume, length, width, thickness, and pattern between the pregnant and non-pregnant groups. Additionally, contextual parameters showed no significant relationship with pregnancy outcome (p > 0.05). The study also found that endometrial measurement indices did not have a significant impact on pregnancy outcomes, with no significant differences observed between the groups (p > 0.05).

Conclusion

In conclusion, endometrial blood flow is crucial for a successful pregnancy after IVF, while the predictive value of the endometrial volume is limited for pregnancy outcomes.

The effect of Pilates exercises on sleep quality and fatigue among female students dormitory residents

BACKGROUND

This study aims to investigate the effect of Pilates exercises on sleep and fatigue among female college students residing in the dormitory.

METHODS

This quasi-experimental study, two parallel groups was performed on 80 single female college students (40 per group), between 18 to 26 years old who lived in the two dormitories. One dormitory was considered as the intervention group and another as the control group. The Pilates group received three one-hour Pilates exercise sessions per week for eight weeks and the control group maintained their routine activities. The Pittsburgh Sleep Quality Index (PSQI) and the Multidimensional Fatigue Inventory (MFI-20) were used respectively to assess sleep quality and fatigue levels, at three time points: baseline, end of week four, and eight follow-ups. Fisher's exact, Chi-square, independent sample t-test and repeated measurements were used.

RESULTS

Overall, 66 participants completed the study (32 and 35 participants in the Pilates and control groups, respectively). After four and eight weeks of intervention, the overall mean score of sleep quality improved significantly (p < 0.001). At week four of the intervention, the Pilates group had a significantly lower mean score for subjective sleep quality and daytime dysfunction than the control group (p < 0.001 and p < 0.002, respectively), although sleep duration and habitual sleep efficiency improved after eight weeks of intervention (p < 0.04 and p < 0.034, respectively). Additionally, the overall mean score of fatigue and its dimensions in weeks four and eight of the intervention in the Pilates group were significantly lower compared to the control group (p < 0.001).

CONCLUSION

After eight weeks of Pilates exercises implementation, most components of sleep quality significantly improved; however, the effect of Pilates exercises on fatigue was evident from week four onward. Trial registration This trial was registered on 2/6/2015 in the Iranian Registry of Clinical Trials with the IRCT ID: IRCT201412282324N15. URL of registry: https://www.irct.ir/trial/1970 .

The effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss: a randomized clinical trial

BACKGROUND

Primary dysmenorrhea is considered as one of the women's main problems during reproductive age. The present study aimed to investigate the effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss.

METHODS

This double-blind, randomized, placebo-controlled trial, was performed on 84 single female college students between 18 and 25 years old who living in dormitories. Students with primary dysmenorrhea and vitamin D deficiency were divided into experimental (n = 42) and control (n = 42) groups. Five days before the putative beginning of their next menstrual cycle, the experimental group received 300,000 IU vitamin D (50,000 IU, two tablets every 8 h), and the control group received a placebo (oral paraffin). The effects of the supplement on the severity of dysmenorrhea and menstrual blood loss were evaluated one cycle before and during two successive cycles. Using the visual analog scale (VAS), verbal multidimensional scoring system (VMS), and pictorial blood assessment chart (PBLAC) questionnaires. Fisher's exact, Chi-square, independent sample t-test and repeated measurements were used.

RESULTS

In total, 78 of the 84 students completed the study (39 students per group). The intervention resulted in a significant reduction in the mean scores of both the VAS and VMS in the experimental group, in the first and second menstrual cycles (p < 0.001, p < 0.001, respectively), but not in the means score of PBLAC. Mefenamic acid consumption at the first and second menstruation period, in the experimental group was lower than the control group (p = 0.009, p < 0.001, respectively).

CONCLUSIONS

The results indicate that vitamin D supplementation could decrease the severity of primary dysmenorrhea and the need to consume pain-relief medications. Contrariwise vitamin D supplementation had no significant effect on menstrual blood loss.

TRIAL REGISTRATION

This trial was registered in the Iranian Registry of Clinical Trials with code IRCT201305212324N on 18/1/2014. URL of registry: https://en.irct.ir/trial/1964 .

The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND

Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally.

METHODS

The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented.

FINDINGS

Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]).

INTERPRETATION

The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden.

FUNDING

Bill & Melinda Gates Foundation.

Occupational exposure to BTEX and styrene in West Asian countries: a brief review of current state and limits

The aim of introducing occupational exposure limits (OELs) is to use them as a risk management tool in order to protect workers' health and well-being against harmful agents at the workplace. In this review we identify OELs for benzene, toluene, ethylbenzene, xylene (BTEX), and styrene concentrations in air and assess occupational exposure to these compounds through a systematic literature search of publications published in West Asian countries from 1980 to 2021. OELs for BTEX and styrene have been set in Iran and Turkey to levels similar to those in European countries and the US. The search yielded 49 full-text articles that cover studies of exposure assessment in six countries, but most (n=40) regard Iran. Average occupational exposure to benzene of workers in oil-related industries is higher than recommended OEL, while average occupational exposure to other compounds is lower than local OELs (where they exist). Currently, information about levels of occupational exposure to BTEX and styrene is insufficient in West Asian countries, which should be remedied through OEL regulation and application. Furthermore, coherent research is also needed to determine actual levels of occupational exposure, dose-responses, and the economic and technical capacity of local industries to address current issues.

Geographic Distribution and Estimating the Childhood Cancer Incidence in Iran: Three-Source Capture –Recapture Analysis on National Registries Data

Background: Cancers seldom happen in childhood age and awareness of accurate cancer incidence is essential in order to preventive programs. This study aimed to estimate the childhood cancer incidence in Iran using the three-source capture -recapture method. Methods: Total new cases of childhood cancer reported by three national data sources of MAHAK charity database, pathology reports and clinical records in Iran were enrolled in this study. The common cases among three sources were determined using data linkage method. The childhood incidence rate per 1 million populations was estimated based on three-source capture-recapture method. We used BIC, G2 and AIC statistics to select the best-fit model. Arch GIS was used to determine geographic distribution. Results: Overall, 2567 childhood cancer was included by three sources of registries. The total estimated number of childhood cancer was 5388 (95% CI: 4742.15-6228,14). The higher estimated incidence rate was Leukemia, Lymphoma by 94.91 and 24.80 per 1 million populations and the lower incidence was liver and retinoblastoma with 2.35 and 7.01 per 1 million populations. Provinces of Ardabil and Kohgiluyeh with an incidence rate of 420.01 and 404.61 per 1 million populations had a higher incidence rate and Mazandaran and Ilam with an incidence rate of 60.87 and 66.88 per 1 million populations had the lowest incidence. The overall completeness of the childhood cancer registry based on three-source was 48%. Conclusion: The low-quality childhood cancer registration system highlights the needs for urgent screening programs for early detection in the high prevalent area in Iran.

Prevalence of cigarette smoking among college students in Iran: An updated systematic review and meta-analysis of observational studies

Background: Cigarette smoking is known as a gateway drug for illicit drug use in youth. The objective of this study is to assess the prevalence of cigarette smoking in the college students in Iran.

Methods: We searched electronic databases including Scopus, Medline/PubMed, Google Scholar and Web of Science, and national databases such as Magiran, Scientific Information Database, Iranmedex, Medlib, Irandoc, and IranPsych from 1946 to 21st July 2018 without any language restriction using a proper search strategy. We used a random effect model to calculate the pooled prevalence of cigarette smoking in college students in Iran. Chi-square test and I2 index were used to evaluate the heterogeneity between the studies. We used the meta-regression and subgroup analysis to assess the potential source of heterogeneity. Stata software, version 11 (StataCorp, TX) was used for all statistical analysis.

Results: We included 60 eligible articles in our study. The pooled prevalence of cigarette smoking at least once in the lifetime was 19% (95%CI: 17-22). The I2 index indicated considerable between-study heterogeneity (I2 =98%, p<0.001). The pooled prevalence of cigarette smoking at least once in the lifetime in males and females was 28% (95% CI: 23-34) and 9% (95% CI: 6-13), respectively. In multivariable meta-regression, a significant association was shown between the year of study (β=-13.1, p=0.011) and sampling method (β=-12.8 p=0.017) and daily use in the last month.

Conclusions: Increasing prevalence of smoking among Iranian university students is an important health priority. Increasing preventive and health education programs are recommended.

The Prevalence and Incidence of Hemolytic Uremic Syndrome in Iran, a Systematic Review and Meta-analysis

HUS is a leading cause of AKI in infants. Though new classification of HUS is based on underlying disease, it traditionally defines as diarrhea positive (typical) and negative (atypical). We have no figure of the incidence and prevalence of HUS, the underlying disease and the outcome in Iranian patients. This meta-analysis of Iranian studies deals with this matter. We used relevant medical search engines and national databases from 1985 to 2019. We searched manually to detect admissible cross references. All studies assessed for the aspects and the risk of distort by three appraisers. Metaprop package of STAT applied to calculate point prevalence, proportion, and incidence with 95% confidence intervals. A total of 27 articles and one abstract of congress containing 7084 cases met all the inclusion criteria and qualified for the final analysis. Considering 1397 patients with HUS over 33 years of study, the pooled prevalence was 28% (95% CI: 15 to 44) and 18.38 pmp (0.55 pmp/y). In children less than 15 years, the prevalence was 79.82 pmp (2.41 pmp/y). Between 1985 and 2019, atypical HUS was identified in 488 patients with the prevalence of 27.88 pmp (annual prevalence of 0.84 pmp/y of children aged less than 15 years old). The incidence was 9.4 pmp (0.28 pmp/y), contributed to 9.9% (95% CI: 3 to 20) of AKI, and 5.48% (95% CI: 3.5 to 7.9) of CKD and ESRD. The rate of HUS diagnosis was increasing during the previous four decades. HUS consists of a significant number of AKI and ESRD. It needs further prospective longitudinal study.

Accuracy of oxygen saturation index in determining the severity of respiratory failure among preterm infants with respiratory distress syndrome

BACKGROUND

To evaluate the severity of respiratory failure among newborns with respiratory distress syndrome (RDS), oxygenation index (OI) has been implemented. In the present study, we assessed the accuracy of oxygen saturation index (OSI) in determining the severity of respiratory failure.

METHODS

A cross-sectional study was carried out in the NICUs of two Iranian Hospitals (Tehran, Iran) in 2018. Preterm neonates with RDS entered the study. Immediately after admission, the severity of RDS was determined based on RDS scoring system. Then, 2 CC of arterial blood was withdrawn and sent to laboratory determining blood gases. Simultaneously, the level of peripheral capillary oxygen saturation (SpO₂) was read using pulse oximeter and recorded. OI and OSI were measured using the formulae. Receiver Operating Characteristic curve, Kappa agreement coefficient and accuracy, sensitivity and specificity was used to compare the OI and OSI results.

RESULTS

In the study, 95 neonates were considered. Based on ROC curves, the appropriate cut off with AUC = 0.99 for severe respiratory failure was OSI >8. The sensitivity, specificity, negative predicted value, and positive predicted value for the OSI Cut off >8 were 100, 98, 0.97 and 100%, respectively. The overall accuracy and Kappa agreement between OSI and OI was 0.96 and 0.98%, respectively.

CONCLUSION

Our results showed that OSI with high sensitivity, specificity values could predict the severity of respiratory failure in preterm neonates with RDS.

Validity and reliability of the Persian version of the Dutch musculoskeletal questionnaire

Background: Dutch Musculoskeletal Questionnaire (DMQ) is used to examine physical and environmental risk factors and to identify high-risk groups for exposure to the risk factors of musculoskeletal disorders at workplace. The aim of this study was to develop the Persian version of the DMQ and to assess its psychometric properties.

Methods: This study was conducted on 212 employees of Gas Transmission Company. Using a standard forward-backward translation procedure, the English version of the questionnaire was translated into Persian and culturally adapted. Content validity was established by 10 expert opinions. The intraclass correlation coefficient (ICC) was used for the statistical analysis of reproducibility. Kuder-Richardson-20 was used for internal consistency and confirmatory factor analysis for structural validity.

Results: This study revealed high internal consistency and good test-retest reliability for the Persian version of the questionnaire. The means of the content validity ratio (CVR) and content validity index (CVI) for the total 35 items of the questionnaire were 0.96 and 0.91, respectively. The internal consistency of the factors was satisfactory, ranging from 0.83 to 0.88. Confirmatory factor analysis confirmed the existence of 7 factors in the questionnaire and an acceptable fit for the Persian version of the DMQ.

Conclusion: The Persian version of the DMQ has acceptable psychometric properties. Thus, it can be used as a valid instrument to assess workload and to identify high-risk groups of musculoskeletal disorders at workplace.

Psychometric properties of the Persian version of the Patient Measure of Safety (PMOS)

Background: Patient safety practice reduces the adverse events that may occur in the health care system during procedures, diseases, and diagnoses. Failure and negligence in identifying and resolving health care system errors may result in financial and physical harm. Thus, this study aimed to investigate the psychometric properties of the Patient Measure of Safety in Hospitals (PMOS). Methods: This study was conducted on 264 patients in 4 hospitals. The patient measure of safety questionnaire has 44 items and 9 domains. To translate the PMOS questionnaire, standardized forward-backward procedure was used, and a panel of experts assessed the face and content validity of the Persian version. Internal consistency, confirmatory factor analysis (CFA), and test-retest method were used to test the validity and reliability of the instrument. Also, AMOS (version 23) and SPSS (version 16) software were used for data analysis and modeling. Results: The average CVI score was 0.85, indicating well results in the Persian context. CVR score was 0.65. The indices of goodness of fit were acceptable for Iranian sample (CFI=0.91, TLI=0.89, RMSEA=0.063, relative/normal Chi-Square Statistic (X2/df)=2.85). All items were significantly loaded on the domains, except the 33rd and 38th items that were related to the eighth domain. Thus, the final Persian version was developed with 8 domains and 42 items. Internal consistency was acceptable for these domains, and test-retest method showed a good reliability (r=0.984). Conclusions: The Persian version of PMOS is an appropriate instrument to assess the safety of patients in Persian language communities. Also, PMOS is an optimal tool to identify and avoid preventable errors.

Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data

OBJECTIVES

Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran.

METHODS

This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages.

RESULTS

The risk of mortality from TB was found to increase with the unemployment rate (β^=0.02), illiteracy (β^=0.04), household density per residential unit (β^=1.29), distance between the center of the county and the provincial capital (β^=0.03), and urbanization (β^=0.81). The following other risk factors for TB mortality were identified: diabetes (β^=0.02), human immunodeficiency virus infection (β^=0.04), infection with TB in the most recent 2 years (β^=0.07), injection drug use (β^=0.07), long-term corticosteroid use (β^=0.09), malignant diseases (β^=0.09), chronic kidney disease (β^=0.32), gastrectomy (β^=0.50), chronic malnutrition (β^=0.38), and a body mass index more than 10% under the ideal weight (β^=0.01). However, silicosis had no effect.

CONCLUSIONS

The results of this study provide useful information on risk factors for mortality from TB.

Natural cycle versus artificial cycle in frozen-thawed embryo transfer: A randomized prospective trial

Objective:

To investigate whether there was a difference in pregnancy outcomes between modified natural cycle frozen-thawed embryo transfer (NC-FET) cycles and artificial cycles (AC)-FET in women who all had regular menstrual cycles.

Materials and Methods:

One hundred seventy patients who met the inclusion criteria and had at least two cryopreserved embryos were included in a prospective randomized controlled trial. Eighty-five patients were randomized based on Bernoulli distribution into the following two groups: 1) Modified NC-FET using human chorionic gonadotropin for ovulation induction and 2) AC-FET, in which endometrial timing was programmed with estrogen and progesterone. The main studied outcome measure was the clinical pregnancy rate per cycle.

Results:

No significant differences were found between the two groups with regard to the chemical, clinical, and ongoing pregnancy rates (48.2% vs 45.9%, p>0.05; 38.9% vs 35.3%, p>0.05; and 37.6% vs 34.1%, p>0.05, respectively), as well as the live birth or miscarriage rates per cycle (35.3% vs 31.8%, p>0.05; and 1.2% vs 1.2%, p>0.05, respectively).

Conclusion:

These findings suggest that although both FET protocols are equally effective in terms of pregnancy outcomes in women with regular menstrual cycles, NC-FET is more favorable because it requires no medication, has no adverse events, and has a significant cost reduction.

The Association between Lifestyle, Occupational, and Reproductive Factors and Colorectal Cancer Risk

Objective: Association of lifestyle, reproductive and environmental factors has been investigated with increased risk of colorectal cancer in different studies. We explored evidence and investigated association between various risk factors and colorectal cancer. Methods: This case- control study was conducted 155 colorectal cancer patients and 150 hospital-controls. We obtained detailed lifestyle, occupational, reproductive information from both groups. Chi-Square test and Logistic regression model were used to evaluate the risk factors of colorectal cancer. Results: The results showed that frequent intake of fruits, chicken, fish and alcohol drinking were associated with risk for colorectal cancer. Agricultural occupation (OR=7.003, 95% CI=2.19-22.38) and industrial exposure (OR=1.97, 95% CI=0.91-4.22) were associated significantly with risk for colorectal cancer. Regarding reproductive factors, women who reported less than 3 pregnancies was associated with an increased risk of colorectal carcinoma (OR=2.88, 95% CI=1.15-7.17). We did not find significant association between other reproductive factors and colorectal cancer risk in women after adjusting for demographic factors. Conclusion: In this case-control study we observed that agricultural occupation, industrial exposure and high consumption of fish and less than 3 pregnancies in women were associated with an increased risk of colorectal carcinoma.

Hysteroscopy: A necessary method for detecting uterine pathologies in post-menopausal women with abnormal uterine bleeding or increased endometrial thickness

Objective:

To investigate the histologic and hysteroscopic findings of post-menopausal women with uterine bleeding and asymptomatic women with increased endometrial thickness equal or more than 5 mm.

Materials and Methods:

This cross-sectional study was performed between May 2014 and June 2015 on 110 post-menopausal women aged 40-82 years. The women were divided into two groups: Women with abnormal uterine bleeding (AUB group) and asymptomatic women with increased endometrial thickness (asymptomatic group).

Results:

Among the participants, 67 women had AUB and 43 women were asymptomatic. In the AUB group sensitivity, specificity, and positive and negative predictive values of hysteroscopy for normal findings were 98%, 100%, 100% and 90%, respectively. In the asymptomatic group, the same parameters were 98%, 100%, 100% and 85%, respectively. The sensitivity, specificity, and positive and negative predictive values of hysteroscopy for polyps and myomas were 100%. Also, the sensitivity, specificity, and positive and negative predictive values were 100% in hyperplasia cases found during hysteroscopy in both groups.

Conclusion:

Increased endometrial thickness in postmenopausal women with or without AUB is mostly due to benign lesions such as polyps and submucosal myomas. Hysteroscopy is a safe and reliable method for evaluating and treating these lesions.

The examination of relationship between socioeconomic factors and number of tuberculosis using quantile regression model for count data in Iran 2010-2011

BACKGROUND

Poverty and low socioeconomic status are the most important reasons of increasing the global burden of tuberculosis, not only in developing countries but also in developed countries for particular groups. The purpose of this study was to assess the association between socioeconomic factors and the number of tuberculosis patients using quantile regression for count data.

METHODS

This cross-sectional study was conducted on 11,320 tuberculosis patients from March 2010 to March 201 in Iran. Data was gathered from the 345 sections of Iran by Ministry of Health and Medical Education and Statistical Center of Iran. The jittering method was applied for smoothing, and then, the quantile regression for count data was fitted. The AIC was used to compare the fitness of quantile regression for count data model and Poisson log-linear model. The R (3.0.1) software and Quantreg and AER packages were used for all analysis and modeling of the data.

RESULTS

The results of fitting the quantile regression for count data showed that in all percentiles, the more increase in immigration rate, illiteracy rate, unemployment and urbanization rates, the more tuberculosis morbidity rate was increased. The maximum increase of tuberculosis due to immigration rate, urbanization rate, unemployment rate, and illiteracy rate was in 95th percentile (β^=0.315), 85'Th percentile (β^=0.162), 75'Th percentile (β^=0.114 ), and 95'Th percentile (β^=0.304), respectively. For 50th percentiles and higher percentiles, with increasing the sum of physicians to the number of population, the tuberculosis morbidity rate was decreased, and the maximum decrease was in 95'Th percentile ( β^=-0.1). For all percentiles, the AIC showed that quantile regression for count data had been a better fit to data.

CONCLUSION

With respect to the relationship between socioeconomic factors and TB rate, health care observers should pay close attention to improving these factors in Iran to reduce the TB mortality and morbidity.

Estimating the Esophagus Cancer Incidence Rate in Ardabil, Iran: A Capture-Recapture Method

Background:

Accurate cancer registry and awareness of cancer incidence rate is essential in order to define strategies for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increase the accuracy of cancer incidence estimation.

Objectives:

This study aimed to estimate the esophagus cancer incidence by capture-recapture method based on Ardabil population-based cancer registry data.

Patients and Methods:

Total new cases of esophagus cancer reported by three sources of pathology reports, medical records, and death certificates to Ardabil province cancer registry center in 2006 and 2008 were enrolled in the study. All duplicated cases between three sources were identified and removed using Excel software. Some characteristics such as name, surname, father’s name, date of birth and ICD codes related to their cancer type were used for data linkage and finding the common cases among three sources. The incidence rate per 100,000 was estimated based on capture-recapture method using the log-linear models. We used BIC, G² and AIC statistics to select the best-fit model.

Results:

After removing duplicates, total 471 new cases of esophagus cancer were reported from three sources. The model with linkage between pathology reports, medical record sources and independence with the death certificates source was the best fitted model. The reported incidence rate for the years 2006 and 2008 was 18.77 and 18.51 per 100,000, respectively. In log-linear analysis, the estimated incidence rate for the years 2006 and 2008 was 49.71 and 53.87 per 100,000 populations, respectively.

Conclusions:

Based on the obtained results, it can be concluded that none of the sources of pathology reports, death certificates and medical records individually or collectively were fully covered the incidence cases of esophagus cancer and need to apply some changes in data abstracting and case finding.

Estimating the Completeness of Lung Cancer Registry in Ardabil, Iran with a Three-Source Capture-Recapture Method

Cancer registration is an important component of a comprehensive cancer control program, providing timely data and information for research and administrative use. Capture-recapture methods have been used as tools to investigate completeness of cancer registry data. This study aimed to estimate the completeness of lung cancer cases registered in Ardabil Population Based Cancer Registry (APBCR) with a three-source capture-recapture method. Data for all new cases of lung cancer reported by three sources (pathology reports, death certificates, and medical records) to APBCR for 2006 and 2008 were obtained. Duplicate cases shared among the three sources were identified based on similarity of first name, last name and father's names. A log-linear model was used to estimate number of missed cases and to control for dependency among sources. A total of 218 new cases of lung cancer was reported by three sources after removing duplicates. The estimated completeness calculated by log-linear method was 26.4 for 2006 and 27.1 for 2008. The completeness differed according to gender. In men, the completeness was 26.0% for 2006 and 28.1 for 2008. In women, the completeness was 36.5% for 2006 and 46.9 for 2008. In conclusion, none of the three sources can be considered as a reliable source for accurate cancer incidence estimation.

The Value of Routine Hysteroscopy before the First Intracytoplasmic Sperm Injection Treatment Cycle

BACKGROUND/AIMS

To assess uterine cavity with office hysteroscopy in order to diagnose and treat pathologies in patients who have started their first intracytoplasmic sperm injection (ICSI) cycles and evaluate its impact on pregnancy rate.

METHODS

A number of 220 infertile women scheduled for ICSI participated in this prospective randomized study. They were randomly divided into 2 equal groups. Group I (intervention) underwent office hysteroscopy before starting assisted reproductive techniques (ART) cycle. Group II (control) started ART cycles without office hysteroscopy. All women had normal transvaginal ultrasonography and hysterosalpingography. The detected intrauterine abnormalities were treated during hysteroscopy. Four weeks after embryo transfer, ultrasonography was done for detecting clinical pregnancy.

RESULTS

Abnormal findings were seen in hysteroscopy in 22.7% of the intervention group. The pregnancy rate in the intervention group (48.20%) was significantly higher than that in the control group (38.60%; p = 0.004).

CONCLUSION

Routine office hysteroscopy before ICSI cycles provides direct evaluation of uterine cavity. Also, pregnancy rate improves after correction of endometrial cavity abnormalities.

Estimating the completeness of gastric cancer registration in Ardabil/Iran by a capture-recapture method using population-based cancer registry data

BACKGROUND

Knowledge of cancer incidences is essential for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increasing the accuracy of cancer incidence estimations. This study aimed to estimate the completeness of gastric cancer registration by the capture-recapture method based on Ardabil population-based cancer registry data.

MATERIALS AND METHODS

All new cases of gastric cancer reported by three sources, pathology reports, death certificates and medical records that reported to Ardabil population-based cancer registry in 2006 and 2008 were enrolled in the study. The duplicate cases based on the similarity of first name, surname and fathers names were identified between sources. The estimated number of gastric cancers was calculated by the log-linear method using Stata 12 software.

RESULTS

A total of 857 new cases of gastric cancer were reported from three sources. After removing duplicates, the reported incidence rates for the years 2006 and 2008 were 35.3 and 32.5 per 100,000 population, respectively. The estimated completeness calculated by log-linear method for these years was 36.7 and 36.0, respectively.

CONCLUSIONS

These results indicate that none of the sources of pathology reports, death certificates and medical records individually or collectively fully cover the incident cases of gastric cancer. We can obtain more accurate estimates of incidence rates using the capture-recapture method.

Cardiogenesis of embryonic stem cells with liquid marble micro-bioreactor

A liquid marble micro-bioreactor is prepared by placing a drop of murine embryonic stem cell (ESC) (Oct4B2-ESC) suspension onto a polytetrafluoroethylene (PTFE) particle bed. The Oct4B2-ESC aggregates to form embryoid bodies (EBs) with relatively uniform size and shape in a liquid marble within 3 d. For the first time, the feasibility of differentiating ESC into cardiac lineages within liquid marbles is being investigated. Without the addition of growth factors, suspended EBs from liquid marbles express various precardiac mesoderm markers including Flk-1, Gata4, and Nkx2.5. Some of the suspended EBs exhibit spontaneous contraction. These results indicate that the liquid marble provides a suitable microenvironment to induce EB formation and spontaneous cardiac mesoderm differentiation. Some of the EBs are subsequently plated onto gelatin-coated tissue culture dishes. Plated EBs express mature cardiac markers atrial myosin light chain 2a (MLC2a) and ventricular myosin light chain (MLC2v), and the cardiac structural marker α-actinin. More than 60% of the plated EBs exhibit spontaneous contraction and express mature cardiomyocyte marker cardiac troponin T (cTnT), indicating that these EBs have differentiated into functional cardiomyocytes. Together, these results demonstrate that the liquid-marble technique is an easily employed, cost effective, and efficient approach to generate EBs and facilitating their cardiogenesis.

In vitro fertilization outcome following embryo transfer with or without preinstillation of human chorionic gonadotropin into the uterine cavity: a randomized controlled trial

BACKGROUND

Intrauterine injection of human chorionic gonadotropin (hCG) at embryo transfer (ET) has been shown to improve the outcome of assisted reproductive techniques. The aim of this study was to confirm previous findings.

METHODS

In this randomized controlled trial, 483 infertile women who were candidates for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) for the first time were randomly assigned to receive an intrauterine injection of 500 IU hCG or placebo (tissue culture media) before ET. The main outcome measures were implantation and clinical pregnancy rates.

RESULTS

Both the hCG-treated group (n = 240) and control group (n = 243) were similar at baseline in terms of demographic and obstetrical characteristics. There were significant differences between the two groups regarding the implantation rate (23.6 vs. 12.2%, p < 0.001), pregnancy rate (54.6 vs. 35.8%, p < 0.001), clinical pregnancy rate (50 vs. 32.1%, p < 0.001), ongoing pregnancy rate (15.3 vs. 9.2%, p < 0.001) and live delivery rate (14.3 vs. 8.4%, p < 0.001). The rate of fertilization and abortion rates were not statistically different.

CONCLUSION

Intrauterine injection of hCG before ET improves implantation and pregnancy rates and may be considered an adjuvant in IVF/ICSI.

Thermoresponsive cellulosic hydrogels with cell-releasing behavior

Here we report the preparation and characterization of thermoresponsive cellulosic hydrogels with cell-releasing behavior. Hydroxypropyl cellulose (HPC) was modified with methacrylic anhydride (MA). The resultant macromonomer, HPC-MA, retains the characteristic thermoresponsive phase behavior of HPC, with an onset temperature of 36 °C and a lower critical solution temperature (LCST) of 37-38 °C, as determined by turbidity measurement. Homogenous HPC-MA hydrogels were prepared by UV-cross-linking the aqueous solutions of the macromonomer at room temperature, and characterized by water contact angle and swelling ratio measurements, and dynamic mechanical analysis. These hydrogels exhibit temperature-dependent surface hydrophilicity and hydrophobicity, equilibrium water content as well as mechanical properties. Cell-releasing characteristics were demonstrated using African green monkey kidney cell line (COS-7 cells) and murine-derived embryonic stem cell line (Oct4b2). By reducing temperature to 4 °C, the cultivated cells spontaneously detached from the hydrogels without the need of trypsin treatment. These unique properties make our HPC-MA hydrogels potential substrates for cell sheet engineering.

The effect of progesterone supplementation on pregnancy rates in controlled ovarian stimulation and intrauterine insemination cycles: a randomized prospective trial

OBJECTIVE

To evaluate the effect of vaginal progesterone as luteal phase support on pregnancy rates in controlled ovarian stimulation and intrauterine insemination cycles in couples with unexplained or mild male factor infertility.

STUDY DESIGN

290 Patients who met the inclusion criteria were included in a prospective randomized controlled trial. All patients underwent controlled ovarian stimulation and intrauterine insemination: 148 patients were randomized to start with a supported cycle and 142 patients with an unsupported cycle. In supported cycles, patients received vaginal progesterone once daily from the day after insemination until 12 weeks of pregnancy or, in non-pregnant women, for 14 days. No progesterone was given during unsupported cycles. The main outcome measures were clinical pregnancy rates per cycle.

RESULTS

In total, 148 cycles with luteal phase support and 142 cycles without luteal phase support were performed. The clinical pregnancy rates per cycle were higher for cycles with luteal phase support than for the unsupported cycles (24.3% vs. 14.1% respectively, p=0.027).

CONCLUSION

The use of vaginal suppositories as luteal phase support significantly improved clinical pregnancy rates in controlled ovarian stimulation and intrauterine insemination in patients with unexplained or mild male factor infertility.

Tumor inside a pearl drop

The confined internal space of a liquid marble, as well as its porous and non-adhesive shell, offers an attractive application possibility - accommodating living cells inside liquid marbles. Cancer cells in suspension may aggregate to form three dimensional structures, also known as cancer cell spheroids (CCS). In this study, CCS formation inside liquid marble is investigated. This liquid marble application opens significant and novel avenues for biomedical applications and cancer research.

Successful pregnancy after localized resection of perforated uterus in choriocarcinoma and a literature review

Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. Rapid growth and myometrial invasion may be followed by uterine perforation. In this study, we present the cases of two young patients (18 and 19 years of age) with acute abdominal pain and shock, while they were under chemotherapy due to persistent trophoblastic disease. During emergent exploratory laparotomy, localized resection of uterus was performed. They had their first successful term pregnancy 5 and 4 years after surgery, respectively. Uterine perforation following choriocarcinoma is a rare event. Hysterectomy is recommended in emergency conditions, but localized resection of uterus should be considered in women who are desirous of future fertility.

Successful pregnancy after localized resection of perforated uterus in choriocarcinoma and a literature review

Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. Rapid growth and myometrial invasion may be followed by uterine perforation. In this study, we present the cases of two young patients (18 and 19 years of age) with acute abdominal pain and shock, while they were under chemotherapy due to persistent trophoblastic disease. During emergent exploratory laparotomy, localized resection of uterus was performed. They had their first successful term pregnancy 5 and 4 years after surgery, respectively. Uterine perforation following choriocarcinoma is a rare event. Hysterectomy is recommended in emergency conditions, but localized resection of uterus should be considered in women who are desirous of future fertility.

The effect of HMG and recombinant human FSH on oocyte quality: a randomized single-blind clinical trial

OBJECTIVE

To compare the effect of HMG and rhFSH on oocyte quality in ICSI cycle.

SETTING

Vali-e-Asr university teaching hospital.

METHOD

Prospective single-blind randomized clinical trial.

SUBJECTS

Sixty women undergoing ovarian stimulation for ICSI were randomized to receive a standard protocol of either HMG or rhFSH in down-regulation cycles.

INTERVENTIONS

Prior to microinjection, each oocyte was assessed regarding the nuclear maturity, morphology of zona plucida, cytoplasmic appearance and polar body morphology. Fertilization rate was followed.

MAIN OUTCOME

The percentage of metaphase II oocytes in HMG and rhFSH groups.

STATISTICAL ANALYSIS

Statistical analyses were carried out by the Mann-Whitney, Fisher's exact, chi2 tests and Student's t-test.

RESULTS

No significant differences were found between two groups in regard to the demographic data, the ovarian response and pregnancy/implantation rates (P>0.05). The percentage of metaphase II oocytes in HMG and rhFSH groups were 81.3% versus 80.6%, respectively.

CONCLUSIONS

There were no significant differences between parameters such as, oocyte quality and percentage of metaphase II oocytes between these two groups.