Tehran University Medical Journal

Background: Nowadays, Human adipocyte-derived stem cells (hADSCs) has been widely used in tissue engineering because of its unique features such as extraction from more sources, more easily and non-invasive extraction methods. In order to increase cell-cell interactions, similar to embryonic pre-cartilage condensation, the use of three dimensional (3D) high-density cell culture systems such as Pellet and Micromass that simulates optimal condensation in chondrogenesis in vivo is necessary. Also, these culture systems provide the proper diffusion of nutrients. Aggrecan is a proteoglycan and one of the important components of extracellular matrix of cartilage tissue that plays an important role in the organization of the extracellular matrix. The high concentrations of aggrecan produces the osmotic properties that is necessary to normal tissue function of cartilage. In current study, Aggrecan gene expression was investigated during chondrogenesis of hADSCs in two Pellet and Micromass culture systems.
Methods: This experimental study was done in Department of Anatomical Sciences Department of Faculty Medical in Isfahan University of Medical Sciences, Iran, from April 2013 to January 2015. First, the abdominal adipose tissue was obtained from three patients after obtaining written consent during their liposuction surgeries. ADSCs were extracted by mechanical and enzymatic methods and were cultured in monolayer culture. Then, in order to induction of chondrogenic differentiation, 5×105 cells of third passage (P3) were transferred to three-dimensional culture systems Pellet and Micromass containing chondrogenic mediums in experimental groups of 7 and 14 days. The evaluation of aggrecan gene expression was performed by real-time PCR technique.
Results: Gene expression analysis revealed that aggrecan was significantly increased in micromass culture at day 14 compared to Pellet culture at days 14 and 7 (P≤0.01). Also, aggrecan was significantly increased in Micromass culture at day 7 compared to Pellet culture at day 7 (P≤0.05).
Conclusion: Due to higher expression of aggrecan gene in Micromass culture compared to Pellet culture, this system may be more efficient than Pellet culture in synthesis of aggrecan in chondrogenic differentiation of ADSCs.

Background: One of the main causes of maternal death in developing countries is postpartum hemorrhage. Cesarean section is one of the most common surgeries all around the world. In comparison with normal vaginal delivery, cesarean section is a greater risk factor for postpartum hemorrhage and need for blood transfusion. The risk of postpartum hemorrhage will increase when other risk factors such as multiple pregnancies, polyhydramnios, severe preeclampsia, peripartum hemorrhage, protracted labor, labor induction, and obesity are present. Oxytocin is conventionally used for the prevention of uterine atony during the cesarean section. The aim of this study was the evaluation of the effect of sublingual misoprostol in combination with oxytocin in reducing blood loss during and after cesarean delivery.
Methods: This randomized clinical trial was performed in Ommolbanin hospital; an academic hospital that is affiliated to Mashhad University of medical sciences from September 2016 to January 2018. The subjects were 90 pregnant women with a term pregnancies who were candidates for emergent cesarean delivery under spinal anesthesia and were at high risk for postpartum hemorrhage. All participants received 40 IU oxytocin in 1 liter of normal saline after delivery, and then they were randomly assigned to the intervention group who received 400 μg sublingual misoprostol in combination with oxytocin infusion, and the control group who received only oxytocin infusion without adding misoprostol.

Background: The present study was performed to evaluate carboxytherapy as an outpatient and non-hormonal strategy for the treatment of a number of pelvic floor disorders.
Methods: This randomized block controlled clinical trial study was performed on 60 women aged 35-65 years in 1399-1400 to evaluate the effect of carboxytherapy on the treatment of stress urinary incontinence and sexual dysfunction in comparison with the control group. At the beginning of the study, vaginal examination, cough test and POP-Q test were performed for all patients. Eligible individuals were randomly assigned to either carboxytherapy or control groups. Stress urinary incontinence was assessed using the ICIQ-UI SF questionnaire and sexual dysfunction was assessed using the PISQ-12 questionnaire. In the intervention group, 30 cc of CO₂ gas with a 90-degree angle was injected in three areas of the bladder neck with the help of a needle gauge 30 with a length of 12 mm, so that each person underwent carboxytherapy twice a week for one month. The control group received the same protocol but without CO₂ injection. The results were assessed both at the beginning of the study and one month and three months after the intervention through physical examination and two questionnaires.

Results: The results of the present study showed that the mean of general sexual function index and also the mean index of sexual function of patients in the physical dimension and in the dimension related to sexual partner in the intervention group was significantly different during the two stages of measurement but no significant difference was observed in the control group. The overall score of urinary function, frequency of leakage and the effect of leakage on the quality of life of women in both control and intervention groups were significantly different between the three stages of measurement. While the rate of urine leakage in the intervention group was significantly different between times, no difference was observed in the control group.

Background: The success of labor induction depends on the condition of the cervix at the time of delivery. This study examines the effect of labor induction with an intra-cervical Foley catheter and oxytocin compared to a Foley catheter and misoprostol on cervical preparation and delivery rate in the first 24 hours after induction.
Methods: In a randomized clinical study, pregnant women with a singleton pregnancy and a gestational age of more than 40 weeks, with a Bishop score less than 4 and an intact amniotic sac referred to Umm al-Binin Hospital in Mashhad from 2017 to 2018 were included in the study. They were randomly divided into two groups of Foley catheter and oxytocin (1) or Foley catheter and misoprostol (2). In the first group, immediately after placing the Foley catheter; Oxytocin was started with a dose of 2 milliunits per minute, and every 20 minutes, 2 milliunits were added to reach the maximum dose of 30 milliunits per minute (induction method with a low dose). In the second group, after Foley catheter insertion, sublingual misoprostol was prescribed at a dose of 25 micrograms every 4 hours up to a maximum of 6 doses.

Results: 74 pregnant women were randomly evaluated in two groups of 37 people. There is no statistically significant difference in the demographic variables in the two groups. There was a significant difference in the labor rate in the first 24 hours, and it was higher in the oxytocin group (P=0.009). Bishop's score after 24 hours of induction was not significantly different in the two groups. Reaching the active phase was significantly shorter in the oxytocin group. (P=0.01). The time of catheter removal in both groups and the rate of cesarean section and the occurrence of complications were the same in both groups. Conclusion: The use of oxytocin with a Foley catheter inside the cervix can accelerate the preparation of the cervix and increase the chance of labor in the first 24 hours, but it does not affect labor complications.