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Showing 6 results for Ghadami
Vaginal misoprostol for cervical priming before hysteroscopy
Valadan M, Rezaee Z, Mohammadpour J, Moghadami Tabrizi N,
Volume 66, Issue 8 (5 2008)
Abstract

Background: As an important diagnostic and therapeutic procedure for patients with intrauterine diseases, hysteroscopy permits a good view of the uterine cavity, thereby increasing diagnostic accuracy. Complications often encountered during hysteroscopy primarily concern problems with cervical dilatation and include uterine perforation, cervical tears, and the creation of false tracts. In this study, we investigate the utility of vaginal misoprostol for cervical dilatation in women undergoing hysteroscopy.

Methods: This triple-blind, randomized, placebo-controlled study was carried out at Mirza Khoochak Khan Hospital, Tehran, Iran. We excluded women who were pregnant, had genital tract infection, or history of cervical trauma. We randomly assigned 80 women with abnormal uterine bleeding or intrauterine lesions to receive either 200 μg vaginal misoprostol or placebo. Ten to twelve hours prior to hysteroscopy, the placebo or misoprostol was administered to the posterior vaginal fornix. Data regarding cervical response and outcome of operative hysteroscopy, as well as complications, were analyzed.

Results: The mean cervical width, as estimated by Hegar dilator, was significantly greater in the treated group (7.8±1.6mm) than that in the control group (5.6±2.2mm, p<0.001). In the misoprostol group, 28 (70%) patients required cervical dilatation, compared with 38(95%) in the placebo group (p=0.001). A significantly shorter median time of cervical dilatation to Hegar number 9 was found in the treated subjects than in the controls (60 vs. 180 seconds, p<0.001). The mean operative time was significantly shorter in the treated group (8.8±8.7 minutes) compared with that of the control group (13.1±10.1 minutes, p=0.043).

Conclusions: Vaginal misoprostol before operative hysteroscopy lessens the need for cervical dilatation, facilitating hysteroscopic surgery.


The effect of maternal body mass index on spontaneous versus induced preterm birth: a prospective study
Moghadami N, Aminikhah B, Davari Tanha F,
Volume 67, Issue 3 (5 2009)
Abstract

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 B ackground: Preterm birth which is defined as delivery before 37 completed weeks was implicated in approximately two thirds of neonatal death. Also preterm labors are the most common cause of mortality and morbidity of infants in recent years and it costs high prices for health system. We evaluate the relationship between prepregnancy maternal body mass Index (BMI) and spontaneous and indicated preterm birth.
Methods: This study included 250 healthy pregnant women, without any risk factors of preterm birth, were classified into categories that were based on their body mass index. Association between BMI, weight gain and rout of delivery were examined. Rates of indicated and spontaneous preterm birth were compared.
Results: Obese women delivered at a more advanced gestational age. (38/34±1/66 weeks vs 37/61±2/44, p=0/006). Obese patients had significantly lower incidence of spontaneous preterm birth at < 37 weeks of gestation (16/8% vs 31/2% p=0/008). Obese women had larger infants (3354/95±596/75 vs 311.24±558/357 p=0/001), and had more frequent cesarean delivery (69/6% vs 52/8%, p=0/006). Weight gain during pregnancy is poorly correlated with prepregnancy BMI (14/41±7/93 kg vs 13/78±4/94kg, p=0/4) and preterm birth.
Conclusion: In this survey, there was adverse correlation between body mass index (BMI) before pregnancy and preterm labor less than 37 completed weeks and we suggest more study for evaluation between spontaneous and induced preterm labor mechanism and in obese and non obese women. However according to this survey obesity before pregnancy is associated with a lower rate of spontaneous preterm birth.


Ovarian response during IVF cycle following laparascopic cystectomy of ovarian endometrioma
Nasrin Moghadami Tabrizi , Khadijeh Adabi , Azra Azmoodeh , Sepideh Nekuei, Babak Dabirashrafi, Kamyar Dabirashrafi, Batool Ghorbani Yekta,
Volume 71, Issue 4 (July 2013)
Abstract

Background: Endometrioma of ovary is one of the common diseases during reproductive age and the effect of laparoscopic cystectomy of endometrioma on infertility is still matter of debate. We designed this case control study to evaluate the ovarian response to controlled ovarian hyperstimulation during IVF (In vitro fertilization) cycle following laparoscopic unilateral cystectomy of endometrioma.
Methods: In a case control study, we enrolled 30 women with history of unilateral laparoscopic cystectomy of ovarian endometrioma in stripping method who underwent IVF cycle in women Hospital, 2009-2012. The numbers of follicles in response to controlled ovarian hyperstimulation during IVF cycle in the ovary with history of  unilateral laparoscopic cystectomy of endometrioma were compared with those from the contralateral ovary.
Results: The mean age (±SD) of patients was 32.3 (±3.4). The mean (±SD) diameter of excised ovarian endometrioma was 42.4 (±10.4) mm. Interval since ovarian surgery to induction ovulation was 2.7 (±2.6) years. Mean number of follicles in the ovary with history of unilateral laparoscopic cystectomy of endometrioma was 2.5 (±1.2) with the range of 1 to 5 and in the control ovary 3.9 (±1.4) with the range of 1 to 6. There was significant difference in the number of follicles in the ovary with laparascopic cystectomy of endometrioma compared with opposite one (P<0.001).
Conclusion: Laparoscopic cystectomy for unilateral endometrioma is associated with a reduced ovarian response to controlled ovarian hyperstimulation during IVF cycle. We did not find any statistically significant difference in reduced ovarian response with regard to patients age, body mass index, size and location of the cyst, and time duration since ovarian cystectomy.


The relationship between CRL and PAPP-A measurements in first trimester fetuses with low birth weight
Nasrin Niromand , Fereshteh Gharib Pour , Nasrin Moghadami , Farahnaz Sadat Ahmadi , Batool Ghorbani Yekta ,
Volume 71, Issue 5 (August 2013)
Abstract
Background: Recent studies have suggested that impaired fetal growth are indicators that may be present in the first trimester. The aim of this study was to investigate the relationship between crown-rump length (CRL) and pregnancy associated plasma protein-A (PAPP-A) measurements in first trimester for low birth weight (LBW).
Methods: This prospective cohort study were on 120 pregnant women in first pregnan-cy trimester, in Women's Hospital Mirza Kochak Khan in 2011-2012. Gestational age according to crown-rump length and gestational age according to last menstrual period (LMP), neonatal weight, small for gestational age, pregnancy associated plasma protein-A and low birth weight were recorded. Main outcome measures was weight and gestational age at birth. Statistical tests used included descriptive statistics, t-test, χ² and all tests were two-tailed and differences with P<0.05 were considered to be statistically significant.
Results: Our findings showed that a total of 120 cases were included CRL Z-score and log 10 (MOM PAPP-A) were positively correlated with fetal birth weight. The mean Crown-rump length Z-score was significantly can be reduced in LBW in first trimester pregnancy. (P<0.001) Mean PAPP-A in low birth weight was (0.4±0.11 MOM), but in normal weight infants was (1.04±0.7 MOM). (P=0.011) also mean PAPP-A in pregnant women with SGA infants is significantly less than other pregnant women (0.5±0.2 versus 1.1±0.7) (P<0.001).
Conclusion: Our data suggest that crown-rump length and maternal levels of PAPP-A measured during the first trimester are independent factors that influence fetal birth weight. But their predictive powers are not sufficiently good for them to be used alone for low birth weight screening.

Correlation of liver enzymes and sonographic findings with pulsatile index of middle cerebral and basilar arteries in nonalcoholic fatty liver
Gholamreza Rezamand , Mojdeh Ghabaee , Naser Ebrahimi Daryani , Hoda Ghadami ,
Volume 72, Issue 1 (April 2014)
Abstract
Background: Nonalcoholic Fatty Liver Disease (NAFLD) is one of the most wide-spread human diseases that can impair liver function and sometimes progresses to cir-rhosis. Recently NAFLD has been identified as an independent risk factor for cardio-vascular disease. The aim of this study was to investigate the correlation of fatty liver disease and its sonographic severity on the resistance of the intracranial arteries. Methods: This study was a cross-sectional study of 55 patients referred from Gastroen-trology clinic with diagnosis of NAFLD to Sonodoppler department of Iranian Center of Neurological Research. Pulsaltile index as a Hemodynamic parameter of Middle Cerebral (MCA) and basilar Arteries of NAFLD Patients was measured by Trans Cra-nial Doppler (TCD) sonography and the measurements were compared with normal values. Also the association of these indices with serum liver enzymes and sonographic grading of liver involvement was assessed. The analysis was done by SPSS 16. Fre-quency distribution, mean and standard deviation were used in descriptive analysis and statistical test 2 to compare qualitative variables. Results: Pulsatile Index (PI) were normal (MCA, P= 0.166, Basilar, P= 0.053) and there was no significant difference with relation to severity of fatty liver based on so-nography findings (P= 0.789), but serum liver enzyme levels were inversely correlated with basilar artery PI (P= 0.014). Conclusion: Considering the increase of cerebral arteries PI in advanced liver disease, absence of increase in vascular PI of patients in the present study could be attributed to the short duration of disease from diagnosis to perform TCD, lack of advanced liver involvement (absence of liver dysfunction) and the response effect to treatment before the TCD. Therefore, to assess vascular changes over time, repeating the TCD with assess other parameters such as Fibroscan and K18 factor that has more compatibility of liver function, could help to understand the pathophysiology of liver diseases and its effect on vascular resistance.
An accreditation model for children friendly hospitals: brief report
Zahra Imanian, Ali Mohammad Mosadeghrad, Mojtaba Amiri , Mohsen Ghadami , Robert McShery,
Volume 77, Issue 1 (April 2019)
Abstract
Background: Hospital accreditation is an external evaluation of a hospital’s structures, processes and results by an independent professional accreditation body using pre-established optimum standards. Hospital accreditation has an important role in improving quality, safety, effectiveness and efficiency of hospital services. A generic questionnaire is usually used to accredit all hospitals. However, specific instruments should be used for evaluation and accreditation of specialized hospitals considering their unique nature and specific requirements. Thus, this study aimed to develop an accreditation model for children hospitals.
Methods: A mixed method approach was used for such a descriptive and cross-sectional study. First, using a comparative study, accreditation standards and measurement criteria of children friendly hospitals were extracted from 10 well-known hospital evaluation and accreditation models and initiatives. Second, complementary interviews with 57 hospitals senior, middle and front line managers and pediatrics doctors and nurses were conducted to identify more children friendly hospital accreditation standards and measurement criteria. Third, children friendly hospital accreditation standards and criteria were modified considering the Iranian context. Finally, five pediatrics doctors reviewed, modified, finalized and confirmed accreditation standards and criteria.
Results: The Iranian framework for accreditation of children-friendly hospitals was consisted of ten standards covering management and leadership, planning and policy making, education, patient management, employee management, resource management, process management, patients’, employees’ and organization results and 132 measuring criteria. Such a systemic framework covers pediatrics hospitals’ structures, processes, outputs and outcomes. A children friendly hospital achieves better results for employees and patients through strong management and leadership, proper planning and policy making, continuous education and training staff and patients and effective management of employees, patients, resources and processes.
Conclusion: The proposed children-friendly hospitals accreditation model can be used for evaluation and accreditation of children hospitals and provide a clear picture of the performance of these hospitals.

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