International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 10 (6), pp. 001-05, June, 2022. © International Scholars Journals

Full Length Research Paper

Body mass index (BMI) related insulin resistance in polycystic ovarian syndrome among patients referred to gynecology clinic of Imam Reza Hospital, Tehran, Iran

Khayyat Khameneie Maryam¹, Nahid Arian pour²*, Aghdas Safari¹ and Rasool Roozegar³

¹Department of Obstetrics and Gynecology, Imam Reza Hospital, Tehran, Iran.

²Department of Microbiology, AJA University of Medical Sciences, Tehran, Iran.

³Department of Statistics, Yazd University, Yazd, 89195-741, Iran.

Accepted 18 September, 2021

Abstract

Polycystic ovarian syndrome (PCOs) is one of the commonest endocrinopathies of women. The present work has been undertaken with an aim to study insulin resistance rate among army personnel families. Out of 108 women suffering from oligomenorrhea and hirsutism referred to gynecology clinic of Imam Reza hospital from 2009 to 2010, 58 patients with PCOs were evaluated for insulin resistance. Their disease was diagnosed clinically and confirmed by laboratory findings. The patients fasting blood sugar (FBS) was measured to be 81 to 103 with mean of 91.44 ± 6.52. Insulin level of their fasting blood (FBI) was 3.1 to 33 with mean of 10.95 ± 7.53. FBS/FBI ratio ranged from 2.87 to 31.6 with mean of 12.54 ± 7.98. The co-relational analysis reveals a positive relationship between insulin resistance and body mass index (BMI; normal, overweight and obese). There was a significant association between these two ordinal variables (Spearman’s Correlation Coefficient is 0.59, P < 0.01). Leutinizing hormone/follicle stimulating hormone (LH/FSH) ratio is not significantly related with BMI (P = 0.65) and no significant relationship was observed between age groups and LH/FSH ratio (P = 0.76). The results achieved by two-way analysis of variance (ANOVA), that is, the F-values given in the Tests of Between-Subjects Effects indicate that the contribution of age group to ANOVA is not significant (F = 0.160, P = 0.852). The level of significance between BMI and FBS/FBI is 0.699 (F = 0.360). In addition to the main effects of both variables, there is no significant interaction. 6% of overweight and 39% of our obese patients were resistant to insulin, while no resistance to insulin was observed among cases with normal BMI.

Key words: Polycystic ovarian syndrome (PCOs), insulin resistance, diabetes, body mass index (BMI), infertility.

International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 10 (5), pp. 001-05, May, 2022. © International Scholars Journals

Full Length Research Paper

Combined oral and vaginal misoprostol use in therapeutic terminations at 14 to 28 weeks of gestation

Murat Bozkurt

Taksim Education and Research Hospital, Gynecology and Obstetrics Department. Sıraselviler Cad No. 112 Beyoğlu, 34433. Istanbul, Turkey. Tel: 902122524300-1204 -905322279072, Fax: 902122497804 E-mail: [email protected]

Accepted 19 November, 2021

Abstract

This study involved an investigation of the effectiveness and complications of oral and vaginal misoprostol use on the termination of second trimester pregnancies. A total of 103 cases were recruited from the medical records of the Gynecology and Obstetrics Clinic of Taksim Research and Training Hospital and Şırnak İdil State Hospital. Women underwent therapeutic termination of pregnancy between the 14 to 28th week of gestation using the defined combined misoprostol regimen. After the women were admitted, 200 μg vaginal (100 μg intracervical, 100 μg into the posterior fornix), 200 μg oral doses and 200 μg of sequential doses were administered in the 2nd and 4th hour. Subjects were excluded from the study if they were out of the defined gestational weeks using additional drugs with misoprostol; their data has not been recorded in detail. Of the 103 cases, 86 had an abortion within 24 h and the mean expulsion time was calculated as 15.42 ± 7.14 h (min 6.39 to max 20.03) in this group. The success rate for the 24 h was found to be 83.4%. Six more cases had an abortion when the second dose was given. The mean expulsion time was found to be 9.31 ± 3.26 h (min 6.45 to max 13.21) for the second 24 h. The success rate over 48 h rose to 89.3%. The total expulsion time was 18.30 ± 8.74 h. There was a history of previous caesarean sections in 2 out of 11 cases that did not have an abortion and one of these cases underwent a hysterotomy. The pregnancy was terminated by evacuation and curettage, as abortion did not occur despite 3 different high dose misoprostol regimens as in the other cases. Pregnancies of the remaining 9 cases were terminated with different misoprostol doses, oxytocin infusion and the evacuation and curettage method. When complication rates were evaluated, analgesic requiring pain (18.4%) was the leading complication, followed by nausea (11.6%), fever (7.7%), headaches and dizziness (5.8%), transfusion-requiring haemorrhage (3.8%) and diarrhea (1.9%). Uterine rupture or death did not occur. A combined misoprostol regimen is relatively safe with acceptable side effects when used carefully for the termination of second trimester pregnancies.

Keyword: Misoprostol, Pregnancy Trimester. Second, Termination of Pregnancy, Mean Expulsion Time, Medical Termination, Vacuum Curettage, Side Effects

International Journal of Obstetrics and Gynecology ISSN: 2736-1594 Vol. 10 (4), pp. 001-004, April, 2022. © International Scholars Journals

Short Communication

Brief Communication: Antenatal glucocorticoids and neonatal outcomes in type 1 diabetes pregnancy

Claire L. Meek [ORC ID 0000-0002-4176-8329] ^1,2,3*, Zoe Stewart⁴, Samuel Furse¹, Jennifer Yamamoto⁵, Catherine E. Aiken^1,6, Denice S. Feig⁷, Albert Koulman¹, Helen R. Murphy^2,8,9

¹The Wellcome Trust-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Addenbrookes’s Hospital, Box 289, Hills Road, Cambridge, CB2 0QQ, United Kingdom. ²Wolfson Diabetes and Endocrinology Clinic, Cambridge University Hospitals, Addenbrookes’s Hospital, Box 289, Hills Road, Cambridge, CB2 0QQ, United Kingdom. ³Department of Clinical Biochemistry, Cambridge University Hospitals, Addenbrookes’s Hospital, Box 281, Hills Road, Cambridge, CB2 0QQ, United Kingdom. ⁴Academic Clinical Lecturer in Obstetrics and Gynaecology, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. ⁵Department of Medicine, University of Manitoba, Winnipeg, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada. ⁶Department of Obstetrics, Cambridge University Hospitals, Addenbrookes’s Hospital, Box 281, Hills Road, Cambridge, CB2 0QQ, United Kingdom. ⁷Mount Sinai Hospital, Department of Medicine, University of Toronto; Lunenfeld-Tanenbaum Research Institute, Toronto, Canada. ⁸Norwich Medical School, University of East Anglia, Norwich, UK. ⁹Department of Women and Children’s Health, King’s College London, London, UK.

Accepted 17 December, 2021

Abstract

Rationale: Antenatal glucocorticoids are associated with improved outcomes in preterm infants, but their role is unclear in term offspring of high-risk pregnancies. For example, antenatal glucocorticoid administration in mothers with type 1 diabetes (T1D) in pregnancy has been reported to increase neonatal hypoglycemia risk, a common complication in this population. Both neonatal hypoglycemia and its cause, neonatal hyperinsulinism, may have chronic consequences on offspring neurological and cardiometabolic function. Objective: We aimed to assess the impact of antenatal glucocorticoid administration upon neonatal hypoglycemia risk and hyperinsulinism (assessed using cord blood C-peptide) in T1D pregnancy. Methods: We used data from the CONCEPTT randomized controlled trial of continuous glucose monitoring in pregnant women with T1D. Antenatal glucocorticoid administration was not randomised but given according to local protocols for perceived clinical need. C-peptide was measured in cord blood using an immunoassay. Results: Infants exposed to antenatal glucocorticoids had increased rates of neonatal complications, as expected, which were mostly explained by differences in gestational age at delivery. However, associations with elevated cord blood C-peptide, a marker of offspring hyperinsulinism, remained significant despite adjustment for gestational age and maternal hyperglycemia. Conclusions: Further assessment of risks and benefit of antenatal glucocorticoid administration in T1D pregnancy is warranted.

Keywords: Type 1 diabetes; pregnancy; antenatal glucocorticoids; neonatal hypoglycemia; Cord C-peptide; hyperinsulinism; perinatal complications.

International Journal of Obstetrics and Gynecology ISSN: 2736-1594 Vol. 10 (4), pp. 001-007, April, 2022. © International Scholars Journals

Full Length Research Paper

Ultrasound image acquisition by a personal computer-Application of artificial neural network

Mitra Ahmad Soltani-MD, MS

Lutalo Medical Research Corporation 15- Shariaty all- Kord St- Ressalat HW- Tehran –Iran. E-mail: [email protected]. Tel: 00989127964990.

Accepted 20 January, 2022

Abstract

Traditional probes consist of 40 to 60 crystals each attached to a pin attached to a specialized cable of minimum 2 to 3 m. Each crystal has piezoelectric properties. To capture images by personal computers to improve accessibility and reduce the cost of having ultrasonic image with special reference to obstetrics and gynecology emergency settings, a probe was designed consisting of three Doppler transducers (each with 4 pins hence generating 4 signals, altogether 12 signal) that by an analog switching with micro (1000 HZ per second) can generate 12000 signals per second changing the scan line form linear into a plane. The signals are translated into WAV sound format file that can be displayed by a Windows-based program of a personal computer. The pattern produced is created by the sound of blood flow in an organ. This vascular pattern was matched with traditional sonography of the organ. By training the network, the resolution of images can be improved further based on the formula: output = 0.77*target + 38. The probe can capture images 1/6 resolution of a traditional probe, deeper penetration (19 cm depth), 1/34 price and weight of a traditional ultrasound equipment.

Key words: Doppler transducers, scan line, artificial neural network, ultrasound, obstetrics and gynecology.

International Journal of Obstetrics and Gynecology ISSN: 2736-1594 Vol. 10 (4), pp. 001-005, April, 2022. © International Scholars Journals

Full Length Research Papers

Evaluation of the fallopian tubes in infertile women by hysterosalpingography in Tikur Anbessa Hospital, Addis Ababa, Ethiopia

Daniel Admassie and Yewebdar Negatuy

Department of Radiology, Addis Ababa University, Medical Faculty, Addis Ababa, Ethiopia Med J 46:391-5. 2008

Accepted 09 November, 2021

Abstract

Infertility is a common public health problem especially in sub-Saharan Africa. Hysterosalpingography (HSG) has for many years been employed in the evaluation of infertility for assessment of tubal patency and tubal or intrauterine lesions. The objective of this paper is to evaluate the structural abnormality of the fallopian tubes in infertile women with hysterosalpingography in Tikur Anbessa Hospital (TAH). Retrospective analysis of clinical records of 331 women with infertility problem who underwent HSG in TAH from March 1, 2003 to March 31, 2006 was done. Infertility unit in the Obstetrics and Gynecology Department in collaboration with Radiology Department compiled the data. Primary infertility is more common (60%) than secondary infertility (40%). Tubal pathologies accounted for 261 (78.9%) of the total sample. The age group of 23 to 27 years and 33 to 37 years accounted for the majority of cases of primary and secondary infertility respectively. Tubal pathology accounted for 78.9% of infertility in this study. HSG should continue serving as a valuable means of investigation (imaging modality) in infertile women of reproductive age group related to tubal pathology.

Key words: Infertility, hysterosalpingography, tubal pathologies.

International Journal of Obstetrics and Gynecology ISSN: 2736-1594 Vol. 10 (3), pp. 001-006, March, 2022. © International Scholars Journals

Full Length Research Paper

Dramatic scenario of urogenital Candida albicans in presence of Lactic acid bacteria (LAB)

Mohammed Sh. Jebur

Institute of Medical Technology, Foundation of Technical Education, Babalmuaathem Square, Baghdad, Iraq. E-mail: [email protected]. Tel: (00964) 416-9844. Fax: (00964) 415-0010.

Accepted 05 September, 2021

Abstract

Yeast infections of the vagina are more prevalence and frequently recurring problem of women. Such infections are caused primarily by Candida albicans and apparently occur when the environmental balance in the-vagina is disturbed. Lactobacillus acidopbilus restricts the growth of pathogenic microorganisms per se displayingwide inhibitory spectrum substances. Fifteen (30%) C. albicans isolates were obtained through 50 vaginal swabs from patients who visited the obstetrics and Gynecology clinic departments of hospitals in Baghdad city during the period of March to July 2010. Local isolates of L. acidophilus was evaluated as antifungal activity against vaginal isolates of C. albicans. Such activity was comprised with common four antifungal agents (Nystatine, Fluconazol, Griseofulvin and Amphotricin B). Susceptibility of C. albicans isolates to L. acidophilus bacteria were determined by means of disc diffusion assay. Results of susceptibility were showed in-vitro that all isolates 15 (100%) sensitive to Nystatine after cultivation on ESDA agar at 37°C for 24 h. Sensitivity of C. albicans to L. acidophilus suspension was less than Nystaine but still high with 13 sensitive isolates (86.6%). Fluconazol and Griseofulvin antifungal agents were showed same susceptibility of 10 sensitive isolates (66.6%) against C. albicans growth, while Amphotricin B had relatively low sensitivity with 7 isolates (46.5%). All results of susceptibility are being detected by the importance of L. acidophilus bacteria in re equilibrium normal flora of vagina that prevent or reduce the chances of vaginal infection especially recurrent vaginal candidiasis (RVC) cases. Also the findings of the study suggest that using of yoghurt as local application can be an important role to reduce or prevent RVC cases, and this can be verify by continuous efforts to make sure of probiotic effects of lactobacilli species.

Key words: Lactobacillus acidophilus, Candida albicans, vaginitis.