Nonobstetric lacerations of the vagina

Although obstetrically related trauma remains the most common cause of injury to the female genital tract, trauma of nonobstetric origin is not uncommon. Reports of traumatic injuries to the vagina, especially lacerations, have been infrequent in the literature and offer only a generalized approach to this problem. Severe vaginal lacerations may result in life-threatening blood loss. The authors report their recent experience with treating patients who have this type of trauma, review mechanisms of injury, and provide an organized treatment protocol for the nonobstetric patient with suspected vaginal laceration. Preparation for these emergencies circumvents dangerous delays and inadequate examination and treatment.     

Association of C3953T transition in interleukin 1β gene with idiopathic male infertility in an Iranian population

In this study we investigate the association of C3953T transition single nucleotide polymorphism in the fifth exon of the interleukin 1β gene with idiopathic male infertility. In a case-control study, blood samples were collected from 230 fertile and 207 infertile men who referred to the Kashan IVF centre. Genotypes of samples at the C3953T location were determined by polymerase chain reaction-restriction fragment length polymorphism. The data showed a significant association of TT genotype (OR?=?2.49, 95%CI?=?1.02–6.10; p?=?0.0452) and T allele (OR?=?1.46, 95%CI?=?1.07–1.99; p?=?0.0174) with male infertility. In a subgroup analysis, we found that the TT genotype (OR?=?3.28, 95%CI?=?1.16–9.26; p?=?0.0249) and T allele (OR?=?1.63, 95%CI?=?1.10–2.41; p?=?0.0142) were associated with oligozoospermia. Our findings suggest that the C3953T polymorphism could be considered as a potential biomarker for a genetic diagnosis of male infertility.     

Synthetic hemoglobin‐based oxygen carriers are an acceptable alternative for packed red blood cells in normothermic kidney perfusion

Normothermic machine perfusion presents a novel platform for pretransplant assessment and reconditioning of kidney grafts. Maintaining the metabolic activity of a preserved graft at physiologic levels requires an adequate oxygen supply, typically delivered by crystalloid solutions supplemented with red blood cells. In this study, we explored the feasibility of using a synthetic hemoglobin‐based oxygen carrier (HBOC) in human kidney normothermic perfusion. Fourteen discarded human kidneys were perfused for 6 hours at a mean temperature of 37°C using a pressure‐controlled system. Kidneys were perfused with a perfusion solution supplemented with either HBOC (n = 7) or packed red blood cells (PRBC) (n = 7) to increase oxygen‐carrying capacity. Renal artery resistance, oxygen extraction, metabolic activity, energy stores, and histological features were evaluated. Throughout perfusion, kidneys from both groups exhibited comparable behavior regarding vascular flow (P = .66), oxygen consumption (P = .88), and reconstitution of tissue adenosine triphosphate (P = .057). Lactic acid levels were significantly higher in kidneys perfused with PRBC (P = .007). Histological findings were comparable between groups, and there was no evidence of histological damage caused by the HBOC. This feasibility experiment demonstrates that a HBOC solution can offer a logistically more convenient off‐the‐shelf alternative to PRBC in normothermic machine perfusion of human kidneys.     

Randomized Controlled Trial of a Prenatal Breastfeeding Self-Efficacy Intervention in Primiparous Women in Iran

Objective

To determine the effects of a prenatal breastfeeding self-efficacy intervention on breastfeeding self-efficacy and breastfeeding outcomes.