ladan ajori

The aim of this study was to describe the female to male (FTM)transgenders demographic, epidemiologic characteristics and outcomes after laparoscopic hysterectomy and bilateral oophorectomy surgery by one surgeon in FTM transgender people.

This retrospective cohort study on FTM patients that referred to one of the referral centers for transgender surgeries in the capital of Iran (Tehran) since 2016 and 2022. Consecutive method used for sampling method. Data analyzing was done by SPSS, descriptive statistical, Pearson correlation coefficient and t-test.

We identified 105 FTM transgender patients undergoing laparoscopic hysterectomy and bilateral oophorectomy. The mean age was 24.74±5.41 years, and the mean age of first experience of transgender was10.51±3.68 years. There was a significant correlation between transgender and marital status (P<0.04, r= 0.2) and unemployment (P<0.05, r= 0.5). There was a significant correlation between age of first experiences of transgender and educational status (P<0.05, r= -0.1).49.5%of patients have complications after surgery.

Hysterectomy and bilateral oophorectomy by laparoscopic approach may have appropriate outcomes for reassignment surgery. Also, this study suggests that probably less educational, occupational problems occur for transgender patients if they undergo gender reassignment surgery at a younger age.

This study aimed to compare pregnancy outcomes in pregnant women in the third trimester with and without anemia.

A case-control study was conducted, involving 144 pregnant women with anemia (case group) and 144 pregnant women without anemia (control group) receiving prenatal care in the third trimester between April 2021 and March 2022. Various maternal and neonatal clinical outcomes, such as response to iron intake, incidence of preeclampsia during delivery, rates of cesarean section, postpartum infections, small for gestational age (SGA) infants, Apgar scores at 1 and 5 minutes, and birth weight, were recorded and compared between the two groups.

Mean hemoglobin and hematocrit levels were significantly lower in women with anemia compared to those in the control group (p<0.001). The response rate to iron supplementation was 21.5% in anemic women and 97.2% in non-anemic women (p<0.001). SGA incidence in the case group was 7.6% (11 cases), while it was 2.1% (3 cases) in the control group (p=0.028). Although pre-eclampsia, cesarean section rates, and infant birth weights were lower in the case group compared to the control group, these differences were not statistically significant. No significant differences were observed in the rates of cesarean section, episiotomy site infections, Apgar scores at 1 and 5 minutes between the two groups.

The results of this study indicate a correlation between maternal anemia and adverse neonatal and maternal outcomes, with a significantly higher incidence of SGA among anemic women. Therefore, healthcare providers in preconception care settings should identify anemic women prior to pregnancy initiation and provide appropriate interventions through dietary adjustments and supplements to mitigate adverse pregnancy outcomes.

Although the safety of cesarean sections has increased, there are still considerations, especially for women with a history of repeated cesarean sections. This study was conducted with the aim of investigating maternal and neonatal outcomes in candidates for cesarean sections due to repeat cesarean sections according to the number of previous cesarean sections.

This prospective descriptive study was conducted from April 2020 to June 2022 at Taleghani Hospital. All candidates for cesarean sections due to repeated cesarean sections were included in the study. According to the number of previous cesarean sections, they were divided into three groups. Statistical analysis was performed with Kruskal-Wallis, Chi-squared and Fisher’s exact tests. A P value < 0.05 indicated statistical significance.

 A total of 345 women were included in the study. The results of this study showed that these three groups were significantly different in terms of duration of surgery (P<0.001), abnormal placental adhesion (0.012), and the presence of intraperitoneal adhesions (P<0.001), but there was not a significant difference in terms of other maternal and neonatal outcomes (P<0.05).

The results of this study showed that an increase in the number of previous cesarean sections does not increase most maternal and neonatal complications during a current cesarean section. Of course, it should be noted that the number of women with a history of three or more previous cesarean sections was small in this study, and for this reason, more studies are needed.

 Adnexal torsion is a complete or incomplete twisting of the ovary, fallopian tubes, or ovarian cyst around its vascular axis, which can cause blood flow disruption. This disorder is rare but serious and accounts for about 3% of women's emergency surgeries. Early diagnosis of this disease and the necessary surgeries are very important to preserve fertility. The purpose of this study is to investigate the epidemiology, clinical symptoms, imaging and pathology of patients with torsion of the adnexa referred to the emergency rooms of Mahdiyeh and Shohadaye Tajrish hospitals.

 This study is a retrospective cross-sectional study. In the present study, 190 patients with torsion of the adnexa were examined in the period 2011–2021, in Mahdiyeh and Shohadaye Tajrish hospitals. Demographic, clinical and surgical information about patients was extracted from medical records. Data analysis was done using SPSS version 22 statistical software.

 The average age of 190 patients was 29.2. Most of the ovarian torsion patients had a history of more than one previous delivery (57.9%) and also, an ovarian mass was observed in 157 patients, and the ovarian mass of 146 patients was larger than 5 cm. The rate of ovarian preservation in this study was 61%. Hemorrhagic cysts were the most common type of cyst in patients and were reported in 37 patients.

 It is necessary to identify effective diagnostic methods. Therefore, it may be useful to investigate more serum biomarkers for early detection of adnexal torsion and to reduce diagnostic errors.

Emotional divorce is the first stage of divorce in which the marital relationship deteriorates andthe couple’s relationship lacks love and affection. Given that the family is one of the foundations of the society,emotional divorce can have devastating effects on society and negative effects on family members. Therefore, itis essential to study this issue.

Patients with Pelvic Fracture Urethral Distraction Defect (PFUDD) admitted consecutively toShohada-e-Tajrish Hospital (Tehran, Iran) from May 2020 to May 2021 were enrolled in the study. In this study allpatients were evaluated by two questionnaires: Gottman emotional divorce questionnaire to assess the patient’smarital status, and the International Index of Erectile Function (IIEF-5) questionnaire to assess the patient’s sex-ual situation.

The mean score for the IIEF-5 scores in the case and control groups were 18.32 and 21.04, respectively.The mean Gottman Scores in the case and control groups were 3.84 and 2.12, respectively. There was no signifi-cant difference between IIEF-5 and Gottman Scores between the two groups.

Considering the lack of differences between the two groups, it can be inferred that the effect of thespiritual and emotional dimension in strengthening marriage was more than the physical dimension. When aman encounters a physical problem, his wife will play a supportive role and seek to strengthen relationship andsolve problems.

More than %40 of pregnant women worldwide have anemia that can have significant side effects for both mother and baby. The claim that the implementation of a family medicine program can be effective on anemia or not is an important question that was targeted in the present study.

An experimental community trial was conducted to compare the prevalence of anemia in the second half of pregnancy between urban women (intervention group) and rural women (control group) (who had family medical coverage and active health care) before and after the intervention of "urban family medicine". The study was conducted once before the implementation of the urban family physician plan in July 2015 and then 2.5 years after the implementation of the plan in March 2016 for the second time. The results were analyzed using Chi2 test and Fisher's exact criteria.

All pregnant women, including 927 people, were included in the study without sampling,and the relevant information was studied in the two time periods mentioned. The prevalence of anemia at 10-6 weeks of gestation before and after the intervention was almost similar in rural and urban pregnant women (10.1 to 7.8 before the intervention and 11.4 to 9.5 after the intervention).Therefore, the causes of anemia other than pregnancy did not interfere with our study. Anemia of 30-24 weeks of gestation in urban pregnant women before family medicine (2015) was %33.3, which was reduced to 21.7 after the intervention in 2019 (P = 0.027).

Implementation of "family medicine/active health care" significantly reduced gestational anemia in the intervention group.

 The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation and perinatal outcomes after COVID-19 infection during pregnancy or the puerperium.

 In this case series study, since February 2020, 25 pregnant women with a definitive diagnosis of the COVID-19 infection were registered. Their clinical signs and symptoms, laboratory findings, CT manifestations, pregnancy status, were recorded at the first visit, and they were followed six months after diagnosis.

 The most common symptoms were cough, feeling feverish, and dyspnea. Twenty mothers required hospitalization, 5 out of 20 monitored in COVID-ICU. The chest CT scan demonstrated a grand glass appearance in 77% of cases among admitted patients. The total mortality rate in C-ICU (COVID-19 ICU) admitted patients were 80%.

 In this case series, among 25 pregnant women with confirmed COVID-19, the most vulnerable patients were in the early third trimester and twin pregnancy.

Adding magnesium sulfate (MgSO4) to opioid receptor agonists increases the opioid analgesiceffects via blocking this receptor. The current study aimed to evaluate the effectiveness of adding MgSO4 totincture of opium (TOP) and buprenorphine (BUP) on pain and quality of life (QOL).

In prospective, randomized, double-blind, placebo-controlled clinical trial, one hundred andsixty-three women with secondary dysmenorrhea caused by endometriosis were selected using a respondentdriven sampling (RDS) and assigned into six groups using block randomization. Patients received 50 mg/kgMgSO4 in 100 ml saline by micro set in six monthly menstrual periods and completed the visual analoguescale (VAS) and QOL Questionnaire (QOLQ). Data were analyzed by repeated measures analysis of variance(ANOVA) and hierarchical regression.

The primary outcomes showed that pain scores in magnesium (MAG) + opium tincture (OT)[F = 5.7(1,162), P = 0.004] and MAG+ BUP [F = 4.5(1,162), P = 0.006] groups showed a significant decreasecompared with control group. Also, QOL scores in MAG + OT [F = 4.8(1,162), P = 0.005] and MAG + BUP[F = 5.9(1,162), P = 0.003] showed a significant increase. However, there was no significant differencebetween the two groups (P = 0.140) and the changes did not persist until follow-up (P = 0.810). Secondaryoutcomes indicated that the low scores of the two components of QOL including physical and psychologicalcomponents were predictors of pain (P = 0.011, Beta > 3.09).

Simultaneous use of MAG with opioids is associated with pain reduction and the improvement ofQOL. However, this hypothesis requires careful handling in a randomized controlled trial.

Repeated implantation failure (RIF) is a major challenge in reproductive medicine and despite several methods that have been described for management, there is little consensus on the most effective one.

This study was conducted to evaluate the effectiveness of platelet-rich plasma in improvement of pregnancy rate in RIF patients.

Twenty women with a history of RIF who were candidates for frozen-thawed embryo transfer were recruited in this study. Intrauterine infusion of 0.5 ml of platelet-rich plasma that contained platelet 4-5 times more than peripheral blood sample was performed 48 hrs before blastocyst transfer.

Eighteen participants were pregnant with one early miscarriage and one molar pregnancy. Sixteen clinical pregnancies were recorded and their pregnancies are ongoing.

According to this study, it seems that platelet-rich plasma is effective in improvement of pregnancy outcome in RIF patients.

Ureteralstump’s metastasis of renal cell carcinoma is rare. We report a32-year-old femalewith a huge metastatic involvement of the ureteralstump and utero-cervical structures about 2 years after a left radical nephrectomy. She underwent en-bloc resection of the massin conjunctionwith total ureterectomy, bladder cuff excision and hysterectomy.The patient was referred to oncology department for additional treatment.

Tubo-ovarian abscess, a serious complication of pelvic inflammatory disease is usually caused by sexually transmitted microorganisms. We report a case of tubo-ovarian abscess containing taenia saginata proglottids.