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Maternal age-specific motorists associated with severe maternal morbidity.
The first case of Middle East respiratory syndrome coronavirus (MERS-CoV) was identified in the year 2012, which spread rapidly and increased to more than 2200 in 2018. This highly pathogenic virus with high mortality rate is among one of the major public health concerns. Saudi Arabia remains to be the most affected region with the majority of MERS-CoV cases, and currently, no effective drugs and vaccines are available for prevention and treatment. A large amount of information is now available regarding the virus, its structure, route of transmission and its pathophysiology. Therefore, this review summarizes the current understanding of MERS-CoV's pathogenesis, treatment options and recent scientific advancements in vaccine and other therapeutic developments, and the major steps taken for MERS prevention control. © 2019 Future Medicine Ltd.The onset of psoriasis collides with women's reproductive timeframe, and pregnancy brings challenges to its treatment. Indeed, the health of both mother and foetus must be considered. When choosing to treat pregnant women affected by psoriasis with pharmacological therapy, it is important to be aware of all possible options and their repercussions. Although there are several pharmacological therapies available, pregnancy brings ethical concerns and any pharmacological approach must be well thought out. The data available in humans are limited, and further investigation on this matter is needed. Within biological therapies, certolizumab pegol has recently been identified as a promising approach during pregnancy because it has been shown to have no late active placental transfer and no clear signs of foetal harm. This article aims to review the impact of psoriasis during pregnancy, how the disease can be managed pharmacologically during this period according to the available armamentarium, and the possible effects of the therapeutic options for the mother and the foetus. Copyright © 2020 Ferreira C, Azevedo A, Nogueira M, Torres T.Objective To report the neglected pessary in a patient with pelvic organ prolapse. Pelvic organ prolapse (POP) is one of the most important medical challenges in women especially elderly. One of the conservative treatments of symptomatic POP is pessary placement. Case report A 84-year-old woman, para 10 was referred to female pelvic floor clinic of an academic hospital for vaginal bleeding and neglected vaginal pessary. Vaginal examination in the pelvic floor clinic revealed an entrapped ring pessary in severely atrophic vaginal mucosa with purulent discharge. Conclusion Although pessary is the first choice and one of the best conservative treatment for pelvic organ prolapse, it shouldn't be used for poor cooperative patient who cannot comply with regular follow-up visits which may cause harmful complications. Copyright © Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences.Objective To compare the difference in Vitamin D level between women with ectopic pregnancy and control group. Materials and methods In the present case-control study, 150 patients with ectopic pregnancy were included as case group and 150 women with normal pregnancy as a control group. Then, serum vitamin D levels were measured in both groups and they were then compared with each other. P less than 0.05 was considered statistically significant. Results The mean age in ectopic pregnancy group was 28.12 ± 5.91 and 27.35 ± 6.21 years old in control group; the difference between two groups was not statistically significant (p = 0.43). The vitamin D level in control group was higher than that of ectopic pregnancy group (p = 0.002). Of all patients, 182 patients (60.66%) had vitamin D deficiency and 64 patients (21.33%) had vitamin D insufficiency. Conclusion Serum vitamin D level among patients with ectopic pregnancy was statistically lower than women with normal pregnancy. Copyright © Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences.Objective Women frequently experience perineal damage after a vaginal delivery. This study aimed to investigate the effect of perineal massage (PM) during labor on the need for episiotomies. Materials and methods The study is a double-blind randomized clinical trial conducted with 99 patients (n=49 controls; n=50 cases). Participants comprised of nulliparous pregnant women aged from 18 to 35 years in the 37th-42nd week of gestation, who referred to the Um-al-Banin Hospital of Mashhad from July to October 2018, for vaginal delivery and were in the active stage of labor. Allocation to study groups was based on a random allocation list generated by a software application. PM was performed for the cases in the active stage four times, each lasting for two minutes at intervals of half an hour. Dibutyryl-cAMP The massage was continued at the beginning of the second stage of labor for ten minutes. Control women received routine care. The delivery was practiced by a midwife who was blinded to the study groups and the performance orificant (p = 0.002), and the median time of completion of the active stage until delivery in the PM group had reduced. Conclusion PM had a significant impact on the reduction of the need for episiotomies and the duration of the second stage of labor. Thus, it can be suggested as a safe, simple, low-cost, and effective technique to reduce the perineal damage during delivery. Copyright © Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences.Objective To assess the correlation between the levels of BPA in the serum and follicular fluid (FF) using oocyte morphology. Materials and methods In this cross-sectional research, oocyte, FF, and serum samples were obtained from a sample population consisting of 90 women undergone in vitro fertilization in Ganjavian Hospital in Dezful, Iran during October 2017-March 2018. The ELISA kit was utilized for the measurement of the BPA levels. In addition, oocyte morphology simultaneous with inverted optical microscopy. Results Follicular fluid BPA levels had no significant effect on MII oocytes (p ≥ 0.05). However, the mean levels of degenerated oocytes and germinal vesicle (GV) were significantly higher in the women with high BPA levels in the FF (p ≤ 0.05). Moreover, the mean counts of MII oocytes and oocytes were significantly higher in the women with serum BPA levels of ≤ 50 ng/ml (p ≤ 0.05), while the mean count of GV oocytes was significantly higher in the women with serum BPA levels of ≥ 150 ng/ml (p ≤ 0.05).
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