Prevalence of single umbilical artery, clinical outcomes and its risk factors: A cross-sectional study

Background

Single umbilical artery (SUA) is found in 0.5–6% of all pregnancies worldwide. Although the association of SUA with some congenital malformations is mainly accepted, its effect on pregnancy/neonatal outcomes is still controversial.

Objective

This is the first study aimed to approximate the SUA prevalence in southern part of Iran. SUA epidemiologic features accompanied by some of its effects on pregnancy/neonatal outcomes are investigated as well.

Materials and Methods

In this cross-sectional study, data from two referral centers in Southern Iran were analyzed. In total, 1,469 pregnancies, fetuses, and neonates were examined for epidemiological features associated with SUA. SUA was confirmed by pathological examination, while congenital anomalies were diagnosed by clinical, ultrasound, and echocardiographical examinations. Data on pregnancy outcome were recorded based on the patients' medical records.

Results

The prevalence of SUA was 3.47% (95% CI: 2.6–4.6%). Fetal anomalies including renal, cardiac, and other congenital anomalies, intrauterine fetal death, early neonatal death, low birth weight, low placental weight, and preterm birth were significantly higher in the SUA group (OR = 68.02, 31.04, 16.03, 3.85, 11.31, 3.22, 2.70, and 2.47, respectively). However, the maternal multiparity was lower in the SUA group (OR = 0.65; 95% CI: 0.44–0.98).

Conclusion

A significant association was observed between SUA and increased risk of intrauterine fetal death and early neonatal death, as well as low birth weight and preterm birth. Obstetrical history of the mother like parity was identified as an important predictor of SUA. Further investigations are suggested on risk stratification of neonates in this regard.

Conjunctival Lesions; a Histopathologic Review in Fars Province, Iran

Purpose:

To determine the prevalence of various types of conjunctival lesions, at a tertiary ophthalmic center in Fars Province, South of Iran.

Methods:

Histopathologic slides and medical records of conjunctival lesions submitted to the pathology department of Khalili Hospital, Shiraz, Iran were reviewed from April, 2009 to July, 2013. The histopathologic diagnoses were categorized into benign, pre-malignant, and malignant lesions. The prevalence of various types of conjunctival lesions was calculated.

Results:

Histologic sections of 631 conjunctival lesions were reviewed. Benign lesions were most prevalent (81.8%), followed by premalignant (10.8%) and malignant (7.4%) lesions. Pterygia were the most common benign lesions (69.2%), intraepithelial dysplasia constituted most cases of premalignant lesions (94.1%), and squamous cell carcinoma was the most frequent malignant lesion (93.6%). Benign lesions were the most common type of lesions in all age groups, however the prevalence of malignant lesions increased significantly with age (P < 0.001).

Conclusion:

Benign lesions were the most common conjunctival lesions with pterygia on top of the list, while intraepithelial neoplasia and squamous cell carcinoma were the most common premalignant and malignant lesions, respectively. Conjunctival malignant lesions were more prevalent with older age.

A survey on rectal bleeding in children, a report from Iran

Background/aim: Studies on the epidemiology of rectal bleeding in children are limited in Iran. Our aim was to assess etiologies of rectal bleeding in children in Iran. Materials and methods: We enrolled 730 children with rectal bleeding. All the patients underwent colonoscopy, and 457 were further evaluated with histopathology. Results: According to colonoscopy and histopathology, respectively, inflammatory bowel disease (IBD) (29.4%, 15.8%), nodular hyperplasia (NH) (24.9%, 10%), and juvenile polyposis (JP) (12.6%, 9.9%) were the most common causes of rectal bleeding. Other conditions were solitary rectal ulcer (5.3%), chronic colitis (4.6%), allergic colitis (3.3%), focal colitis (1.3%), and infectious colitis (1.1%). In colonoscopy, there were no significant differences in the distribution of pathologies regarding sex, while the youngest and oldest mean ages were found for patients with NH (4.6 ± 3.9 years, P < 0.0001) and those with normal appearance (8.1 ± 4.4 years, P < 0.0001) respectively. Based on histopathologic reports, the youngest patients were diagnosed with infectious colitis (4.6 ± 2.8 years), while patients with chronic colitis were the oldest (9.2 ± 4.6 years, P = 0.003). Conclusion: JP, NH, and IBD constituted the most common etiologies of rectal bleeding in our patients. It is recommended to perform a complete diagnostic approach to accurately assess rectal bleeding in children.

Organochlorine pesticides and epigenetic alternations in unexplained female infertility

Epigenetic alterations could potentially have a significant impact on the adverse reproductive consequences in connection with exposure to environmental contaminants. In this study, the changes in Thyroid Stimulating Hormone Receptor (TSHR) and Ataxia Telangiectasia Mutated (ATM) genes methylation related to exposure to certain Organochlorine Pesticides (OCLs) in women with unexplained female infertility (UFI) were investigated. Promoter methylation of TSHR and ATM genes was conducted using methylation specific PCR in blood from 113 UFI and 103 controls. The methylation percentage of the TSHR was 48 % in UFI and 50 % in controls and the difference was statistically insignificant. But, promoter methylation of ATM was significantly higher in UFI than controls (67.9 % and 43.3 % respectively, p = 0.042). Logistic regression analysis also revealed that some OCLs (2,4-DDE, γ-HCH, 2,4-DDT, β-HCH, 4,4-DDT, and 4,4-DDE) affected methylation of ATM promoter. Among total OCLs, there were significant correlations between the ATM promoter methylation and Ʃ3 HCH, Σ2 DDE, and Ʃ7 OCLs in an adjusted model. The study posits that OCLs could modify epigenetic markers, thereby impacting gene function. Hypermethylation of the ATM gene in UFI cases, and its association with selected and total OCLs, underscores the detrimental effects of the accumulation of environmental stressors on female reproductive health, potentially leading to UFI. Furthermore, the role of ATM-mediated DNA Double-Strand Break repair in reproductive health was highlighted. Additionally, this research underscores the need for further investigation into the relationship between ATM gene promoter methylation, pesticide exposure, and UFI across various populations.