Tehran University Medical Journal

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Background: The aim of this survey was to evaluate the prevalence of some perinatal complications in birth weight discordance (BWD) among twin pregnancies.
Methods: In a descriptive analytical cross-sectional study, 490 twin neonates (245 twin pregnancies) born at Mirzakoochakkhan Hospital from 1999 to 2003 were evaluated. Maternal and neonatal data of each delivery were collected for BWD, gestational age, maternal age, parity, infant gender, neonatal death, neonatal septicemia, mode of delivery, hyperbilirubinemia, blood transfusion and duration of hospitalization.
Results: The average age of the mothers was 26±4.78 years, of which 51.8% were nullipara. The average gestational age was 35.02±2.73 weeks, with 15.9% before 32 weeks of gestation. The neonatal death rate was 7.8%, the majority of which involved male neonates and multiparas. The average duration of hospitalization was 6.07±4.45 days, 8.5 days for those twins with BWD≥20%, and longer (9.14 days) for neonates with mothers younger than 20 years old. Septicemia was most frequent (31.3%) in twins with BWD of 30-34%, as was hyperbilirubinemia requiring blood transfusion (25%). Hyperbilirubinemia was more common in neonates with mothers aged less than 20 years and more than 35 years..
Conclusions: BWD in twins is a predictive factor for septicemia and hyperbilirubinemia requiring transfusion. Therefore, healthcare workers and hospital wards dealing with twins with BWD should be especially ready and equipped to provide the additional care needed for these patients.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Increased total plasma homocysteine (Hcy) is an accepted risk factor of cardiovascular disease (CVD), stroke, preclampsia, recurrent abortion and diabetes type I and II. The aim of the current study was to assess serum homocysteine and its relation with serum folat, vitamine B12 and lipid profile in gestational diabetes mellitus and to compare these with those of pregnant women.
Methods: In a prospective controlled survey 80 pregnant women (24-28 weeks) with uncomplicated pregnancies were evaluated. They were assigned to one of two groups according to the results of 100g-OGTT. In the case group there were pregnant women with gestational diabetes mellitus according to the OGTT and in the control group women who had normal OGTT results were put. Levels of fasting glucose, homocysteine, vit B12, and folic acid, uric acid, total cholesterol, triglyceride, Low Density Lipoprotein cholesterol (LDL) and High Density Lipoprotein cholesterol (HDL) were measured in both groups.
Results:  The mean level of homocysteine in GDM group was significantly higher than control group (p=0.000). The mean level of folic acid and vit B12 was significantly lower than the level in control group (p=0.001, p=0.004 respectively). Body mass index (BMI) in GDM group was higher (p=0.000) and HDL level was lower (p=0.006) than control group. There were no significant differences among the groups with respect to levels of total cholesterol and triglyceride.
Conclusion: We found that patients with gestational diabetes have higher homocysteine level than normal pregnant women. This increased level seems to be related to an abnormal OGTT. Further investigations are needed to follow up these patients in the postpartum period and later on.

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Background: Infertility is defined as failure to achieve pregnancy after one year of unprotected sexual intercourse. Infertility can be related to male or female factors. Varicocele is the most common cause of infertility in men that is correctable with surgery. The purpose of this study was to determine the effects of recombinant follicle-stimulating hormone (rFSH) on semen parameters in infertile men.

Methods: This randomized clinical trial was done on 96 infertile men admitted to the Women's General Hospital Mohebe-Yas from September 2014 to September 2015. Inclusion criteria were to include varicocelectomy for unilateral idiopathic varicoceles and consent to participate in the study. Allergy to the drug combination and patient dissatisfaction were exclusion criteria. Patients participating in the study were divided into two groups randomly, one group received recombinant FSH three times a week and the other group received a placebo (normal saline) in the same way. After three months, the improvement of semen parameters, including motility, morphology and sperm count as well as the complications were determined in both groups. The data were analyzed with statistical software SPSS version 13 (Chicago, IL, USA).

Results: A total of 96 patients were enrolled in two groups of 48 men and women both groups were matched in terms of underlying factors. The rate of improvement in the morphology and motility of sperm in the treated group was significantly more than the placebo group (P= 0.0001) but the changes in sperm count were not significantly different between the groups (P= 0.495).

Conclusion: In summary, based on the results obtained in this study, it can be concluded that recombinant FSH is effective on improving semen parameters in infertile men after varicocelectomy compared with a placebo group and its major impact is on the morphology and motility of sperm.