shohreh alimohammadi

Proprotein convertase subtilisin/kexin type 9 (PCSK9) protein is one of the factors associated with oxidative stress and dyslipidemia disorders.

This study aimed to evaluate the lipid profile, PCSK9 levels, and oxidative stress in preeclampsia.

This case-control study was conducted at Sina hospital in Hamadan University of Medical Sciences, Hamadan, Iran from August 2020-May 2021. The average maternal age of included participants was 30 yr with 30 preeclampsia and 30 healthy pregnant women. After clinical examination, the fasting blood samples were collected, and the serum PCSK9 protein concentration, superoxide dismutase, glutathione peroxidase activities, and glutathione levels were determined by enzyme-linked immunosorbent assay. Total antioxidant capacity, total oxidant status, and malondialdehyde levels were determined manually.

The average maternal age of participants were 29.97 ± 4.75 and 31.23 ± 5.85 yr, respectively. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), PCSK9, total antioxidant capacity, and malondialdehyde levels were higher in the preeclampsia group compared with control (p < 0.02). Total oxidant status, glutathione levels, superoxide dismutase, glutathione peroxidase activities were lower in the cases group compared with the control group (p < 0.01). The PCSK9 variable had a significant negative association with antioxidant parameters; however, a significant positive association was observed between PCSK9 level and parameters of LDL-C.

PCSK9 is associated with increased serum levels of LDL-C and oxidative factors in pregnant women that increase the risk of endothelial damage and hypertension in preeclampsia.

Tooth development involves reciprocal interactions between the oral epithelium and ectomesenchyme. The inner layer cells of the enamel organ (EO), known as the inner enamel epithelium (IEE), undergo differentiation into preameloblasts and subsequently mature ameloblasts. These ameloblasts play a crucial role in the secretion of enamel matrix proteins, including amelogenin. This experimental study aimed to analyze the expression profile of amelogenin in various histological structures of human primary developing teeth, employing a relatively large sample size.
This experimental study included 33 human fetuses aged between 13 and 23 weeks, with three samples obtained from each gestational age. The samples were categorized into three age groups of ≥13 and <16 gestational weeks (g.w.), <19 g.w., as well as ≥19 and ≤ 23 g.w. Hematoxylin and eosin staining, as well as immunohistochemistry staining, were performed on the samples. To assess the expression level of amelogenin in different histological structures of human primary teeth, a two-way ANOVA test was employed. The statistical significance threshold was set at P≤0.05.
There were statistically significant differences regarding the expression level of amelogenin in various histological structures of human primary teeth in different fetal ages (13-23 weeks), except for the maxillary central incisor and mandibular central incisor.
Due to the profile of expression of amelogenin, it can be concluded that amelogenin expression could be associated with ameloblast and odontoblast differentiation, as well as enamel and dentin matrix deposition. In addition, the results of this study may shed light on the role of the cervical and coronal portions of the EO as stem cell reservoirs.

Statement of the Problem:

 Enamel organ (EO) is an ectodermal derived structure, which is involved in the different aspects of tooth development. Tooth development shares the same regulatory molecules and genes expressed in other developing organs. Endothelin- 1 (ET-1) and Endothelin A receptor (ETAR), (ET-1/ETAR) axis, are involved in differentiation of embryonic stem cells and organ development.

The present study aimed to investigate the ET-1 and ETAR expression profiles during the development of human primary tooth EO with the relatively large sample size.

In this experimental study, 33 human fetuses aged from 13 to 23 weeks (3 samples from each fetal age) were collected. The samples were divided into three age groups (<16 weeks, <19 weeks, ≥19 weeks) and cut for hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining. A two-way ANOVA test was conducted to examine the expression levels of ET-1 and ETAR in different layers of human primary tooth EO. The statistical significance was assumed at p ≤ 0.05.

There were statistically significant differences between the expression levels of ET-1/ETAR axis in the four-layered human primary tooth EO in different fetal ages (13-23 weeks). Besides, there were significant differences between the expression levels of ET-1/ETAR axis in all layers of human primary enamel organ and types of teeth.

Due to the profile of expression of ET-1/ETAR axis, it can be concluded that this axis contributes to the differentiation of all human primary EO layers and secretion of enamel. ET-1/ETAR axis is one of the signaling molecules, which may have crucial roles in tooth development.

Due to the significant importance of the teeth in mastication, speech, and aesthetics, it is necessary to identify all involved genes in the tooth development. Therefore, this study aimed to evaluate the role of endothelin-1 and its A receptor in dental lamina in different stages of tooth development.

This cross-sectional study included 33 fetal samples that were divided into three groups regarding gestational age. All samples were then stained by immunohistochemistry. Subsequently, the analysis was conducted in SPSS software (version 20) through the two-way ANOVA and Tukey's tests to examine the differences between the variables.  A p-value less than 0.05 was considered statistically significant.

There was a significant difference between the gestational age and the expression level of endothelin-1 in dental lamina (P<0.001). In addition, a significant relationship was observed between age and anatomic area (P<0.001). There was also a significant difference between the gestational age and the expression level of endothelin-1 receptor (ETAR) in dental lamina (P<0.001). A significant association was found between gestational age and anatomic area (P<0.001).

The expression levels of endothelin-1 and its receptor (ETAR) in each jaw were higher in anterior dental lamina, compared to posterior dental lamina. These results may confirm the role of endothelin-1 and its receptor in cell proliferation, differentiation of dental lamina, and  calcium ion transport during tooth development

COVID-19 is a new viral disease with a rapid outbreak. Pregnant women are at a higher risk of contracting viral infections including COVID-19. We aimed to evaluate the clinical course and risk factors of pregnant women diagnosed with COVID 19 in Hamadan Province, west of Iran. Study design: A retrospective cohort study.

The convenience sampling was performed using 50 papers and electronic files of pregnant women diagnosed with COVID-19 according to the WHO’s temporary guidelines. They were hospitalized in health centers and clinics of Hamadan Province. The data-collecting tool employed was a researcher-made questionnaire. The data were analyzed via SPSS software version 19.

The mean age of pregnant women with COVID 19 was estimated to be 29.20 ± 5.8 yr and their average gestational age estimated to be 28.8 ± 8.20 weeks. About 32% of them had an underlying disease, 32% a history of influenza, and 40% recently traveled to infected areas. The most common findings were CT scans and multiple mottling and ground-glass opacity chest radiology. The most common symptoms were fever, cough, and shortness of breath. About 8% of the women required ICU hospitalization and the average length of hospital stay was 4.04 ± 2.38 and 29% had premature births. Moreover, 28% of infected mothers had a normal delivery and 20% had a cesarean section.

Early diagnosis of Covid-19 disease is essential in pregnant women. Because there is a possibility of worsening complications in the mother and fetus.

Some studies have shown that abnormal levels of biomarkers may be associated with adverse pregnancy outcomes. This study aimed to investigate the association between serum levels of Inhibin A and the outcomes of pregnancy.

This retrospective cohort study was conducted on the data obtained from the Inhibin A of 560 pregnant women at 15 to 20 weeks of gestation in Hamadan, Iran. The levels of Inhibin A less than 0.5 and higher than 2 mmol were considered below and high, respectively. The patients were assessed in terms of birth weight, gestational age, Apgar score, preeclampsia, intrauterine fetal death, and cesarean section. The receiver operating characteristic curve level was calculated to detect adverse pregnancy complications. The data were statistically analyzed in STATA software (version 14).

Out of the pregnant women eligible for the study, 33 (5.9%) cases were excluded due to incomplete medical record files and unavailability. Of the remaining 527 patients, 378 (71.7%), 26 (4.9%), and 123 (23.3%) ones had normal, low, had high Inhibin A levels, respectively. Patients with higher serum Inhibin A levels had a higher risk of preeclampsia, low birth weight, and prematurity, compared to those with normal or low levels (P˂0.05).

Based on the findings of the present study, high levels of Inhibin A at 15 to 20 weeks of gestation can be associated with the risk of preeclampsia, low birth weight, and prematurity.

Women with polycystic ovary syndrome (PCOS) are at higher risk of developing pregnancy complications including gestational diabetes and preeclampsia. This study was performed with the aim of examining the impact of metformin on incidence of gestational diabetes and preeclampsia in pregnant women with PCOS.

In this clinical trial, 88 pregnant women with PCOS with a history of taking metformin referring to Fatemieh hospital in Hamedan, Iran in 2017-18 were randomly assigned into two groups: metformin consumption (1000-2000 mg/day) continuing throughout the pregnancy and control (stopping metformin consumption immediately after detection of pregnancy). The pregnancy and fetal consequences and complications were compared in both groups. The data were analyzed by STATA software version 14.0.

In both groups, no significant difference was observed in terms of mean age, duration of infertility, body mass index, and baseline variables (p>0.05). The relative risk (RR) of incidence of gestational diabetes (RR: 1.97, 95% CI: 1.63 -2.39), preeclampsia (RR: 2.65, 95% CI:  1.95- 3.59), and abortion (RR: 2.33, 95% CI: 1.69 -3.22) was higher in the control group who did not continue metformin consumption throughout the pregnancy (p<0.05). The frequency of C-section was lower in the intervention group than in the control group (p<0.05).

Based on the results of the present study, continuation of metformin consumption in women with PCOS during pregnancy may be associated with decreased adverse consequences of pregnancy including gestational diabetes and preeclampsia.

Background Preterm birth with a prevalence of about 10% causes 75-95% of prenatal mortality, and one of the effective factors of it is hormonal factors. This study aimed to investigate the effect of oral medroxy progesterone on reducing preterm labor in women with a history of preterm labor. Materials and Methods This double-blinded clinical trial was performed on 214 pregnant women with the history of at least one preterm labor referred to midwifery clinic of Fatemieh Hospital, Shiraz, Iran, during 2017 to 2018. One hundred and seven women underwent treatment with oral medroxy progesterone (100 mg per day), and 107 individuals were prescribed placebo, and prenatal care was performed routinely. Recent pregnancy course and delivery time were compared in two groups. Data were analyzed by SPSS software version 16.0. Results Gestational age with a mean of 30 ± 3.89 and 36± 2.11 weeks, respectively in control and intervention groups differed significantly (P <0.05). The number of referrals to hospital due to preterm labor, the age of patients at first referral due to preterm labor, and age of delivery in both groups of receiving progesterone and placebo were significantly different (P <0.05). Conclusion Based on the results of the current study using 100 mg oral progesterone per day in weeks 16-36 of pregnancy was effective in reduction of preterm labor, and caused improved gestational age in mothers.

Health promoting hospitals (HPHs), in addition to their routine diagnosis and treatment services, concentrate on health enhancement and disease prevention. This study was conducted to systematically review studies conducted in the field of health promoting hospitals (HPH) in Iran to achieve HPH standards.

Electronic search was conducted from October to February 2016 in Persian and English databases. Search was done IranMedex, SID, ISI Web of Knowledge, ScienceDirect, PubMed, and Google Scholar with the following keywords: Health promotion hospital (s), health promoting hospital (s), health promotion hospitals, HPH, and Iran. Based on inclusion and exclusion criteria and the aim of the study, 10 studies were selected to be reviewed.

The results showed that HPH standards in studied hospitals were very poor in overall standard and that the standard of management policy had the lowest mean. Studies conducted in the order modeling HPH in Iran showed that factors of patient empowerment and society had the greatest impact and needs assessment had the lowest impact. The results of interventional studies were reviewed in this study and it was found that implementing standards of HPH and educational interventions increase the standard of HPH.

The review of the HPH studied indicated that the most important challenge in achieving the standards of health promotion hospitals is Iran’s hospital policy, which is more treatment-oriented.

Small supernumerary marker chromosomes (sSMC) are still a major problem in clinical cytogenetics as they cannot be identified or characterized unambiguously by conventional cytogenetics alone. On the other hand, and perhaps more importantly in prenatal settings, there is a challenging situation for counseling how to predict the risk for an abnormal phenotype, especially in cases with a de novo sSMC. Here we report on the prenatal diagnosis of a mosaic tetrasomy 18p due to presence of an sSMC in a fetus without abnormal sonographic signs. For a 26-year-old, gravida 2 (para 1) amniocentesis was done due to consanguineous marriage and concern for Down syndrome, based on borderline risk assessment. Parental karyotypes were normal, indicating a de novo chromosome aberration of the fetus. FISH analysis as well as molecular karyotyping identified the sSMC as an i(18)(pter->q10::q10->pter), compatible with tetrasomy for the mentioned region. Cordocentesis was done due to normal sonography and the results from amniocentesis were confirmed. The parents opted for pregnancy termination and post mortem examination now noted, low anterior hairline, large philtrum, low-set posteriorly rotated malformed ears with prominent antihelix, lower limbs joint contracture and digital anomalies, including long and narrow toes with clinodactyly of the 1st and 5th toes and postaxial polydactyly of one hand. De novo i(18p) can be considered as a special case in the sense that the major relevant phenotypes mentioned for it, i.e. feeding difficulties, abnormalities in muscle tone and developmental/mental retardation, cognitive and behavioral characteristics, recurrent otitis media and seizures, are mostly postnatal. This emphasizes the necessity to determine the nature of a de novo euchromatic marker chromosome, especially in cases with normal ultrasound result and the suitability of a cordocentesis in order to better predicting the pregnancy outcome and parental counseling.