Publications by authors named "Kobra Tahermanesh"

14 Publications

  • Page 1 of 1

Babu and Magon uterine closure technique during cesarean section: A randomized double-blind trial.

J Obstet Gynaecol Res 2021 Sep 15;47(9):3186-3195. Epub 2021 Jun 15.

Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Aim: We compared the effectiveness of the Babu and Magon uterine closure technique and unlocked double-layer uterine closure on the integrity and thickness of the uterine scar.

Methods: A randomized double-blind trial was performed at Hazrat-e Rasoul -e-Akram Hospital, Tehran, Iran, from March 2018 to December 2019, in 72 pregnant women who were candidates for cesarean section for the first time. Women were randomly assigned to the Babu and Magon uterine closure technique (intervention group, n = 34) or double-layer closure of the uterine incision (control group, n = 38). The primary outcome of the study was the frequency of myometrial defects at the site of the scar (niche), and a large niche. Secondary outcomes, including the time taken for uterine closure and postpartum hemorrhage (early and late), were compared between groups.

Results: Adjacent myometrium thickness (AMT) between the two groups was not statistically significant. A niche was reported in 23.5% (8/34) and 50% (19/38) of women in the intervention and controls, respectively (p = 0.02). A large niche was reported in 2.9% (1/34) and 23.7% (9/38) of women in the intervention and controls, respectively (p < 0.01). The duration of uterine closure was not statistically significant between the two groups. Hemoglobin levels did not differ significantly between groups during the first 24 h post-surgery.

Conclusion: The results of the study showed that the technique of uterine closure is one of the main potential determinants of myometrial healing. The Babu and Magon uterine closure technique seems to lead to tissue alignment during suturing and consequently cause better myometrial healing, although this issue calls for well-founded longer studies of appropriate design.
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http://dx.doi.org/10.1111/jog.14889DOI Listing
September 2021

The blooming phenomenon: a rare but a dilemma in hysteroscopic resection of myomas.

J Turk Ger Gynecol Assoc 2021 Jun 4. Epub 2021 Jun 4.

Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Modern surgical technologies allow gynecologists to treat most submucosal myomas by some form of resection hysteroscopically. What appears on imaging or direct visualization to be a submucosal myoma can be a single tumor, or may represent multiple smaller myomas appearing as one, compacted together in a typical pseudo capsule. During myoma resection, the effect of the distending media can be different depending on the morphology of the myomas. After starting resection, the power of distending media can push truly solitary myoma to somewhat flatten against the uterine wall. However, in the second type of myoma, the fluid can push the myomas into the uterine cavity, similar to the blooming of a flower. The tip of the hysteroscope may enter the dissected spaces between the myomas, impairs the panoramic view. This event can be a cause of failure of hysteroscopic myomectomy to adequately treat the myomas encountered. In this study, blooming phenomenon is introduced, the problems created by this phenomenon and solutions for its management are considered.
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http://dx.doi.org/10.4274/jtgga.galenos.2021.2021.0006DOI Listing
June 2021

The Impact of COVID-19 Pandemic on Stress and Anxiety of Non-infected Pregnant Mothers.

J Reprod Infertil 2021 Apr-Jun;22(2):125-132

Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: The newly emerging COVID-19 has caused severe anxiety around the world and it is infecting more people each day since there is no preventive measure or definite therapy for the diseases. The present study aimed to evaluate its effect on anxiety and stress of pregnant mothers during perinatal care.

Methods: Three-hundred pregnant mothers without COVID-19 infection who were referred to the hospitals affiliated to Iran University of Medical Sciences for delivery during April 2020, based on negative clinical symptoms and the results of polymerase chain reaction (rt-PCR) for COVID-19, were recruited by census method and asked to complete the Persian version of the perceived stress scale (PSS); participants views about their anxiety level and the role of COVID-19 as the source of their stress and worries were recorded. Women who refused to continue the study were excluded. The frequency of variables and mean scores were calculated using SPSS v. 21.

Results: Mean age of mothers was 30.20±16.19 years; 31.3% were primigravida and mean gestational age was 38.00±4.14 weeks. Moreover, 16.3% asked for earlier pregnancy termination and 39% requested Cesarean section (C/S). Assessing the mothers' anxiety revealed a high/very high level of anxiety in 51.3%. The majority felt worried and frustrated because of COVID-19 (86.4%). Social media had a great impact on the level of stress among these mothers (60.3%).

Conclusion: COVID-19 pandemic is an important source for the increased anxiety and stress among healthy pregnant mothers.
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http://dx.doi.org/10.18502/jri.v22i2.5801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143014PMC
May 2021

Broad ligament pregnancy in the presence of an intrauterine contraceptive device: A case report.

Int J Surg Case Rep 2021 Feb 27;79:421-423. Epub 2021 Jan 27.

Department of Obstetrics & Gynecology, Emam Complex, Vali-e-Asr Hospital, Tehran University of Medical Science(TUMS), Tehran, Iran. Electronic address:

Introduction: Abdominal pregnancy though scarce is associated with considerable morbidity and mortality. Few cases till now have been diagnosed or managed by laparoscopy.

Case Presentation: In this study, a case of an abdominal pregnancy in a woman with intrauterine contraceptive device (IUD) in situ and a history of cesarean section is described.

Clinical Discussion: Our case was a brief description of a broad ligament pregnancy as a subcategory of abdominal pregnancy .It was located medial to the pelvic sidewall, lateral to the uterus, inferior to the fallopian tube and superior to the pelvic floor.

Conclusion: The pregnancy was in the location of the left broad ligament which was diagnosed on laparoscopic evaluation.
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http://dx.doi.org/10.1016/j.ijscr.2021.01.080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851414PMC
February 2021

The effect of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis.

Gynecol Endocrinol 2021 Jul 29;37(7):640-645. Epub 2021 Jan 29.

Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: To our knowledge, data on the effects of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis are limited. This study was conducted to determine the effects of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis.

Methods: The current randomized, double-blind, placebo-controlled trial was conducted among 60 patients (aged 18-40 years old) with endometriosis. Participants were randomly allocated into two groups (30 participants each group) to receive either 50,000 IU vitamin D or placebo each 2 weeks for 12 weeks.

Results: Vitamin D supplementation significantly decreased pelvic pain ( - 1.12; 95% CI, -2.1, -0.09; =.03) and total-/HDL-cholesterol ratio ( - 0.29; 95% CI, -0.57, -0.008; =.04) compared with the placebo. Moreover, vitamin D intake led to a significant reduction in high-sensitivity C-reactive protein (hs-CRP) ( - 0.64 mg/L; 95% CI, -0.97, -0.30; <.001) and a significant increase in total antioxidant capacity (TAC) ( 47.54 mmol/L; 95% CI, 19.98, 75.11; =.001) compared with the placebo.

Conclusions: Overall, our study demonstrated that vitamin D intake in patients with endometriosis resulted in a significant improvement of pelvic pain, total-/HDL-cholesterol ratio, hs-CRP and TAC levels, but did not affect other clinical symptoms and metabolic profiles.
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http://dx.doi.org/10.1080/09513590.2021.1878138DOI Listing
July 2021

Uterine Isthmus Tourniquet during Abdominal Myomectomy: Support or Hazard? A Randomized Double-Blind Trial.

Gynecol Obstet Invest 2020 16;85(5):396-404. Epub 2020 Sep 16.

Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran,

Background And Objectives: A tourniquet has been suggested as a useful means of reducing massive hemorrhage during myomectomy. However, it is not clear whether the restricted perfusion affects the ovaries. In the present study, we examined the effect of a tourniquet on ovarian reserve and blood loss during myomectomy.

Materials And Methods: In a randomized double-blind clinical trial, fertile nonobese patients scheduled for abdominal myomectomy at Rasool-e-Akram Hospital from February 2018 to June 2019 were randomized to a tourniquet (n = 46) or a non-tourniquet group (n = 35). Serum levels of anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) were measured before and 3 months after surgery, blood loss was recorded during surgery, and serum levels of hemoglobin (Hb) were recorded before surgery, 6 h and 3 days after surgery. SPSS version 21 was used for statistical analysis.

Results: Demographic, obstetric, and myoma characteristics were similar in the 2 groups (p > 0.05). The mean baseline values of AMH and FSH did not differ between groups (p > 0.05). After surgery, only FSH was higher in the control group (p = 0.043). Despite the time taken to fasten and open the tourniquet, the mean operating time was shorter in the tourniquet group (p < 0.001). Blood loss was higher in the control group (p = 0.005). The drop in Hb levels at 6 h after surgery was higher in the non-tourniquet group (p = 0.002). Blood loss was significantly associated with the duration of surgery (r = 0.523, p < 0.001).

Conclusion: The use of a tourniquet during abdominal myomectomy significantly reduced the mean volume of blood loss compared to the non-tourniquet group, while it did not prolong the duration of surgery, nor reduced the ovarian reserve. A tourniquet is a safe and efficient measure during abdominal myomectomy.
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http://dx.doi.org/10.1159/000510512DOI Listing
April 2021

Uterine intracavitary angioleiomyoma.

J Obstet Gynaecol 2020 Nov 18;40(8):1186-1188. Epub 2020 Feb 18.

Department of Biomedical Engineering, Materials and Biomaterials Research Center (MBMRC), Tehran, Iran.

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http://dx.doi.org/10.1080/01443615.2019.1705775DOI Listing
November 2020

Mesenteric ischemia in pregnant woman: a case report.

J Obstet Gynaecol 2019 Oct 4;39(7):1012-1014. Epub 2019 Jun 4.

Endometriosis Research Center Iran University of Medical Sciences , Tehran , Iran.

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http://dx.doi.org/10.1080/01443615.2019.1572077DOI Listing
October 2019

Endometriosis of Diaphragm: A Case Report.

Int J Fertil Steril 2018 Jun 20;12(3):263-266. Epub 2018 Jun 20.

Pain Research Center, Iran University of Medical Science, Tehran, Iran.

Endometriosis affects about 10% of women of reproductive age. Its main feature is the presence of stroma and endometrial glands in sites other than the uterus, mainly in pelvis. Pelvic peritoneum, ovaries, uterine ligaments, bladder, intestines, andcul-de-sac are among the affected areas. Sometimes endometriosis can be found outside of the pelvis and even above abdominal cavity, like indiaphragm.Herein, we present a case of an asymptomatic diaphragmatic endometriosis that was discovered incidentally during laparoscopy of pelvic endometriosis, as well as our appropriately proposed treatment protocol.
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http://dx.doi.org/10.22074/ijfs.2018.5379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018178PMC
June 2018

B-Lynch plus technique for uterine conservative surgery in an asymmetric atonic uterus.

Int J Gynaecol Obstet 2018 09 25;142(3):370-371. Epub 2018 Jun 25.

School of Medicine, Yasuj University of Medical Sciences (YUMS), Yasuj, Iran.

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http://dx.doi.org/10.1002/ijgo.12562DOI Listing
September 2018

Author's Reply.

J Minim Invasive Gynecol 2018 02 6;25(2):344-345. Epub 2017 Dec 6.

Tehran, Iran.

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http://dx.doi.org/10.1016/j.jmig.2017.10.031DOI Listing
February 2018

Ultrastructural Investigation of Pelvic Peritoneum in Patients With Chronic Pelvic Pain and Subtle Endometriosis in Association With Chromoendoscopy.

J Minim Invasive Gynecol 2017 01 29;24(1):114-123. Epub 2016 Sep 29.

Endometriosis and Gynecologic Disorders Research Center, Department of Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Study Objective: To evaluate the pelvic peritoneum under chromoendoscopy by scanning electron microscopy (SEM) as well as light microscopy with hematoxylin and eosin staining and immunohistochemistry (IHC) assays in patients with chronic pelvic pain (CPP) associated with subtle endometriosis.

Design: Case series study (Canadian Task Force classification II).

Setting: A referral academic community tertiary medical center.

Patients: Three women aged 29 to 37 years were referred to the obstetrics and gynecology clinic of the tertiary university hospital with CPP. They were suspicious for endometriosis, were not responding to medical treatments, and had undergone previous pelvic laparoscopy to determine the stage of endometriosis and preparation of peritoneal samples under the guidance of staining with methylene blue in 0.25% dilution.

Interventions: Comparison of stained and unstained pelvic peritoneal samples after the instillation of 0.25% methylene blue into the pelvic cavity.

Measurements And Main Results: In 3 patients, laparoscopic examination showed minimal endometriosis. A total of 18 samples (9 stained and 9 unstained) from the 3 patients were prepared for SEM. Ten of the samples (55.6%) showed microstructural peritoneal destruction (7 of 9 stained [77.7%] and 3 of 9 [33.4%] unstained). Eighteen samples (9 stained and 9 unstained) from the 3 patients were also prepared for IHC. Six of these samples (33.3%) were S-100-positive, including 4 of 9 (44.4%) stained samples and 2 of 9 (22.2%) unstained samples.

Conclusions: In general, in the context of CPP and endometriosis, there is no established relationship between the severity of pain and stage of endometriosis. In the pathophysiology of CPP associated with endometriosis, ultrastructural changes can play a significant role. Under methylene blue staining, some destroyed areas were detected, but the stained areas do not necessarily correlate with increased microstructural peritoneal destruction.
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http://dx.doi.org/10.1016/j.jmig.2016.09.013DOI Listing
January 2017

Cytotoxicity assessment of adipose-derived mesenchymal stem cells on synthesized biodegradable Mg-Zn-Ca alloys.

Mater Sci Eng C Mater Biol Appl 2016 Dec 7;69:584-97. Epub 2016 Jul 7.

Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences (SUMS), Shiraz, IR, Iran.

Magnesium (Mg)-based alloys have been extensively considered as biodegradable implant materials for orthopedic surgery. Mg and its alloys are metallic biomaterials that can degrade in the body and promote new bone formation. In this study, the corrosion behavior and cytotoxicity of Mg-Zn-Ca alloys are evaluated with adipose-derived mesenchymal stem cells (ASCs). Mg-2Zn and Mg-2Zn-xCa (x=1, 2 and 3wt.%) alloys were designated. Mg alloys were analyzed with scanning electron microscopy and potentiodynamic polarization. To understand the in-vitro biocompatibility and cytotoxicity of Mg-2Zn and Mg-2Zn-xCa alloys, ASCs were cultured for 24 and 72h in contact with 10%, 50% and 100% extraction of all alloys prepared in DMEM. Cell cytotoxicity and viability of ASCs were examined by MTT assay. Alloying elements including Zn and Ca improved the corrosion resistance of alloys were compared with pure Mg. The cytotoxicity results showed that all alloys had no significant adverse effects on cell viability in 24h. After 72h, cell viability and proliferation increased in the cells exposed to pure Mg and Mg-2Zn-1Ca extracts. The release of Mg, Zn and Ca ions in culture media had no toxic impacts on ASCs viability and proliferation. Mg-2Zn-1Ca alloy can be suggested as a good candidate to be used in biomedical applications.
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http://dx.doi.org/10.1016/j.msec.2016.07.016DOI Listing
December 2016

Leiomyosarcoma of the Broad Ligament With Fever Presentation: A Case Report and Review of Literature.

Iran Red Crescent Med J 2016 Apr 12;18(4):e33892. Epub 2016 Mar 12.

Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran.

Introduction: Leiomyosarcoma is a rare gynecologic malignancy that accounts for less than 1% of gynecological malignancies. Leiomyosarcoma of the broad ligament is an even rarer condition. According to Gardner's criteria, the diagnosis is made when the mass is completely separated from the uterus and adnexa. So far, 23 cases of primary leiomyosarcoma of the broad ligament have been reported in the literature published in English.

Case Presentation: In September 2014, a 55-year-old, gravida 3, para 3 woman with a BMI of 30 and a chief complaint of fever and dizziness was admitted to the infectious-diseases ward of the Pars general hospital affiliated with Iran University of Medical Sciences in Tehran, Iran. Her symptoms had begun two weeks before. The results of a fever workup and examination for infectious, metabolic, and immunologic problems were all negative. Imaging modalities revealed an endometrial polyp, two calcified myoma in the body of the uterus, and a solid, heterogeneous 70-mm mass in the right para-cervical space, posterior to the broad ligament, and far from the ovary. After surgery, a histologic report revealed leiomyosarcoma.

Conclusions: Although a leiomyosarcoma of the broad ligament is rare, practitioners should consider it when dealing with masses in the region of the broad ligament. If there is any suspicion of malignancy, especially in the presence of fever, it is recommended to avoid morcellation during laparoscopy.
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http://dx.doi.org/10.5812/ircmj.33892DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913035PMC
April 2016
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