Publications by authors named "Shirin Niromanesh"

6 Publications

  • Page 1 of 1

Comparison of umbilical artery Doppler and non-stress test in assessment of fetal well-being in gestational diabetes mellitus: A prospective cohort study.

Electron Physician 2017 Dec 25;9(12):6087-6093. Epub 2017 Dec 25.

Ph.D. of Reproductive Health, Assistant professor, Department of Midwifery, School of Nursing & Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.

Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is related to poor perinatal outcomes. Reduction of neonatal complications of GDM is feasible by assessment of fetal well-being. Both fetal Doppler and NST are used for the screening of high-risk pregnancies.

Objective: We aimed to compare the non-stress test (NST) and umbilical artery (UA) Doppler assessments for evaluation of the adverse perinatal outcomes in GDM.

Methods: We conducted a prospective cohort study on 50 pregnant women with GDM in Jame Zanan Hospital, Tehran, Iran, from Oct 2014 to Sep 2015. A convenient sampling method was used for patient recruitment. Inclusion criteria were women with GDM, singleton pregnancies, and gestational age>32 weeks who had neither medical conditions nor fetal anomalies. Adverse perinatal outcomes were defined as Apgar scores at 1-min and 5-min <7, hypoglycemia (blood glucose <45 mg/dl), neonatal acidosis (PH<7.2), hypocalcemia (Ca<8 mg/dl), admission to the NICU for more than 24 hours, and perinatal death. Statistical analyses were performed with SPSS version 16 using Chi-square, Fisher's exact test, and independent-samples t-test. The significance level was considered at 0.05.

Results: Totally, 22% and 12% of women had an abnormal UA Doppler and a non-reactive NST respectively. Poor outcomes were detected in 13 women. The most frequent poor outcomes were hypoglycemia (n=9), Apgar 1-min <7 (n=8), neonate admitted in NICU (n=6), and respiratory distress syndrome (n=6). Poor outcome was more prevalent in women with non-reactive NST (p<0.001), abnormal UA Doppler (p=0.033), and those with infant birth weight >4000 gram (p=0.033). Sensitivity and specificity of the NST in predicting different poor outcomes were 76.9% and 97.3% respectively. Sensitivity and specificity of UA Doppler in predicting different poor outcomes were 30.8% and 94.6% respectively.

Conclusion: NST is a better predictor of adverse perinatal outcomes in GDM patients.
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December 2017

Effects of cinnamon supplementation on antioxidant status and serum lipids in women with polycystic ovary syndrome.

J Tradit Complement Med 2018 Jan 19;8(1):128-133. Epub 2017 May 19.

Physiology Center Research, Kerman University of Medical Sciences, Kerman, Iran.

Background: The objectives of study were to investigate the effects of cinnamon supplementation on antioxidant status and serum lipids in women with polycystic ovary syndrome (PCOS).

Methods: This double-blind randomized controlled clinical trial was conducted on 84 overweight or obese PCOS patients; aged 20-38 years. Subjects in cinnamon (n = 42) and placebo (n = 42) groups were given 3 cinnamon capsules (each one contained 500 mg cinnamon) or placebo daily for 8 weeks. Fasting blood samples, anthropometric measurements and dietary intake data were gathered at the beginning and at the end of the study. Independent t test, paired t test and analysis of covariance were used to analyze of data.

Results: Cinnamon significantly increased serum total antioxidant capacity (P = 0.005). Malondialdehyde was significantly decreased compared with placebo (P = 0.014). Cinnamon supplementation significantly improved serum level of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol (all P < 0.05). No significant effect was detected on serum triglyceride level.

Conclusions: Cinnamon supplementation improved antioxidant status and serum lipid profile in women with PCOS and may be applicable for reducing PCOS risk factors.
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January 2018

Variable Number Tandem Repeat (VNTR) Genotyping of Hydatidiform Mole in Iranian Patients.

Avicenna J Med Biotechnol 2014 Oct;6(4):246-53

Mirza Koochak Khan Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Classification of molar gestation into Complete Hydatidiform Mole (CHM) and Partial Hydatidiform Mole (PHM) is done according to clinical, ultrasonographic, histologic and genetic criteria. However, making a distinction between CHM and PHM using histologic criteria alone may be difficult and several studies have shown that misclassifications are frequent, even for experienced pathologists. CHM is the most common precursor to choriocarcinoma and heterozygous moles carry an increased predisposition to transformation.

Methods: Formalin-fixed, paraffin-embedded tissue sections of patients as well as peripheral blood of patients and their partners' were collected in EDTA tubes. Tissue samples were obtained by curettage. Histological evaluation was performed on routine section stained with Hematoxylin and Eosin. Variable Number Tandem Repeats (VNTRs) genotyping was performed for 30 cases in two groups of CHM (n=21) and PHM (n=9), with Polymerase Chain Reaction (PCR) amplification of 2 different polymorphic loci, namely the Col2A1 and D1S80.

Results: The results of DNA analysis by VNTR genotyping showed that in 16 cases of CHM, amplification of the VNTR polymorphic loci showed androgenetic mono-spermic moles (homozygote) and in 5 cases of CHM androgenetic dispermic moles (heterozygote) in molar tissue. In cases of PHM, 6 samples were triploid dispermic and 3 samples were diploid biparental.

Conclusion: This study confirmed that VNTR genotyping can identify the parental source of polymorphic alleles in hydatidiform mole. Compared to STR genotyping, VNTR genotyping was performed by PCR amplification of several minisatellite markers of DNA. This method significantly requires less time and is cost-effective.
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October 2014

Metformin compared with insulin in the management of gestational diabetes mellitus: a randomized clinical trial.

Diabetes Res Clin Pract 2012 Dec 12;98(3):422-9. Epub 2012 Oct 12.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Women Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Aims: To evaluate the effect of metformin and insulin in glycemic control and compare pregnancy outcome in women with gestational diabetes mellitus (GDM).

Methods: This randomized controlled trial was conducted in GDM women with singleton pregnancy and gestational age between 20 and 34 weeks who did not achieve glycemic control on diet were assigned randomly to receive either metformin (n=80) or insulin (n=80). The primary outcomes were maternal glycemic control and birth weight. The secondary outcomes were neonatal and obstetric complications.

Results: Two groups were comparable regarding the maternal characteristics. Two groups were similar in mean FBS (P=0.68) and postprandial measurements (P=0.87) throughout GDM treatment. The neonates of metformin group had less rate of birth weight centile >90 than insulin group (RR: 0.5, 95% CI: 0.3-0.9, P=0.012). Maternal weight gain was reduced in the metformin group (P<0.001). Two groups were comparable according to neonatal and obstetric complications (P>0.05). In metformin group 14% of women needed to supplemental insulin to achieve euglycemia.

Conclusion: Metformin is an effective and safe alternative treatment to insulin for women with GDM. This study does not show significant risk of maternal or neonatal adverse outcome with the use of metformin.
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December 2012

The application of low-level laser therapy after cesarean section does not compromise blood prolactin levels and lactation status.

Photomed Laser Surg 2009 Jun;27(3):509-12

Department of Medical Laser, Milad Hospital, Tehran, Iran.

Objective: This study evaluates the systemic effect of low-level laser therapy (LLLT) on blood prolactin levels and lactation status when it is used to hasten surgical wound healing in women having undergone a cesarean section.

Background Data: LLLT has been used in parturient patients for postpartum mastitis and nipple soreness. However, previous studies have revealed hormonal and physiological effects of LLLT on the lactation status.

Materials And Methods: Twenty healthy women scheduled for cesarean section were randomly divided into two groups: an LLLT group and a control group. LLLT was delivered as follows: (1) irradiation with 980 nm (100 mW, 3.3 J/cm(2), total energy 60 J), and 650 nm (30 mW, 1.5 J/cm(2), total energy 27 J) to the incision line, and (2) intravenous laser irradiation at 2.5 mW and 650 nm for 15 min on three consecutive postoperative days. Except for LLLT, all the therapeutic conditions in both groups were identical. Blood prolactin levels were measured in the groups on the third postoperative day, and tissue samples were taken from the wound margins for histological evaluation on the 10th postoperative day.

Results: Although there was a difference between blood prolactin levels in the two groups, the difference was not statistically significant (p = 0.205). However, there was a statistically significant difference in the mean lymphocyte counts and number of vessel lumina, with higher numbers seen in the LLLT group.

Conclusion: LLLT after cesarean section has no serious deleterious effects on lactation, and it helps to modulate metabolic processes and thus promotes wound healing post-surgery.
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June 2009

Rh alloimmunization and term delivery.

Arch Iran Med 2007 Jan;10(1):111-3

Department of Obstetrics and Gynecology, Mirza Kochak Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Nowadays management of severe Rh alloimmunization consists of serial determination of middle cerebral artery peak systolic velocity, amniocentesis, cordocentesis, and in many instances intrauterine transfusion. We present a case of severe Rh alloimmunization who, for the first time in Iran, was delivered at term after several intrauterine transfusions.
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January 2007