Mojgan Akbarzadeh-Jahromi

Introduction Human papillomavirus (HPV) is the most common sexually transmitted infection and a major cause of genital warts and anogenital cancers in both sexes. This study assessed HPV genotype distribution in a large outpatient population in southwestern Iran to inform preventive strategies. Materials and methods In this cross-sectional study, 10,739 outpatient samples were collected from 2018 to 2023. Specimens included urine from men and vaginal swabs from women with normal cytology. HPV genotypes were assessed using DNA extraction, PCR and Direct Flow Chip method. Results HPV prevalence was 41.6% (94.8% in females, 5.2% in males). Women had a higher positivity rate (42.0%) than men (34.2%). The highest prevalence (44.3%) occurred in the 31–40 age group. High-risk types were present in 65.8% of positive cases. Women were more affected by high-risk genotypes, while low-risk types predominated in men. The most frequent high-risk genotypes were HPV-16, -53, -52, -66, and − 39; the most common low-risk types were HPV-6, -54, -42, -62, and − 44. Most individuals had a single infection. Mixed infections, more common in women, often involved both high- and low-risk types and showed greater diversity with age. Conclusion HPV prevalence, particularly of high-risk types, is notably high among women in southwestern Iran. The peak age of infection is higher than in developed countries. Differences in genotype distribution compared to American and other Iranian studies highlight the need for region-specific vaccination strategies targeting locally prevalent genotypes.

Introduction: Actinomycosis is a rare, chronic bacterial infection caused by the genus Actinomyces. The cervicofacial form is most common, while gallbladder involvement is exceptionally uncommon, with fewer than 50 cases reported in the literature. Case Report: A 21-year-old diabetic woman presented with one day of nausea, vomiting, and persistent right upper quadrant abdominal pain. Ultrasonography and computed tomography scan revealed an enlarged gallbladder with biliary sludge and a single gallstone. A preoperative diagnosis of acute cholecystitis was made, and cholecystectomy was performed. Histopathological examination confirmed acute cholecystitis and demonstrated numerous filamentous, gram-positive bacteria, consistent with actinomycosis. Following 6 months of penicillin therapy, the patient remains well with no clinical or radiological evidence of recurrence. Conclusion: This case underscores the importance of routine histopathological evaluation of gallbladder specimens. Although rare, gallbladder actinomycosis should be considered in the differential diagnosis of gallbladder disease, particularly in immunocompromised individuals.

Background : Inflammatory lesions and cysts are the most common Bartholin glands pathologic diagnoses. There have been very few reports of benign solid lesions of Bartholin glands such as nodular hyperplasia. Materials and methods : Thirty-two lesions diagnosed as Bartholin duct cyst in the gynecologic specialized institute were reviewed by two expert gynecological pathologists. Results : Using specific criteria, 7 qualified as nodular hyperplasia, 25 as Bartholin duct cyst. The average age of the patients with nodular hyperplasia was 31 years (range, 24 to 43). These lesions were solid, solid and cystic or purely cystic, had a mean maximal dimension of 3.3 cm, and were frequently thought to be Bartholin cysts on clinical examination. Four lesions were diagnosed as Bartholin duct cysts, while in the review they were considered as nodular hyperplasia. Conclusion : Nodular hyperplasia of Bartholin gland may be more common than is reported in the literature. This study showed that the diagnosis of nodular hyperplasia has been overlooked due to limited literature sources.

Background. Vascular subinvolution of the placental bed is one of the uncommon but life-threatening forms of secondary postpartum hemorrhage. Studies on subinvolution of the implantation site are sparse and there is a scarcity of practice-based literature for this diagnosis. Case presentation. A 40-year-old woman with vaginal bleeding and light-headedness was admitted a few days after spontaneous abortion. Based on her unstable condition, hysterectomy was done. Pathologic gross evaluation of the uterus identified multiple large and dilated blood vessels, and microscopically, the myometrium showed thrombosis with scattered extravillous trophoblastic cells within the vessel walls. Conclusions. We described this rare case and explored the literature focusing on the pathophysiology and helpful ancillary studies for diagnosing this situation.

Pyoderma gangrenosum (PG) is a rare dermatological disease characterized by the rapid development of painful skin ulcers. While systemic infliximab is considered a standard treatment for patients with PG, herein, we report our success with the use of intralesional infliximab in a 40-year-old woman with systemic lupus erythematosus (SLE) and PG.

Introduction: Gestational trophoblastic disease (GTD) includes hydatiform mole, choriocarcinoma, placental site trophoblastic tumor, and epithelial trophoblastic tumor. Also, molar pregnancy can happen as an ectopic pregnancy. The coincidence of these complicated pregnancies seems to occur extremely rarely. Case presentation: Here, we presented a 26-year-old woman, nulli gravida with the first presentation of intrauterine complete molar pregnancy; she underwent suction curettage but was prompted to Gestational Trophoblastic Neoplasm (GTN) and she received chemotherapy. During chemotherapy, she had severe abdominal pain and underwent laparotomy, and found an ectopic molar pregnancy in the fallopian tube. Salpingectomy was done and followed up with serum human chorionic gonadotropin (hCG) level and again due to improper decrease of hCG levels, she was diagnosed as a heterotopic post-molar GTN and received methotrexate (MTX) in multiple doses, but she did not respond to MTX, so we started actionomycine-D (Act-D) for her. She was cured after receiving 5 courses of Act-D and now she is on her monthly follow-up with an hCG level. Conclusions: It is important to notice the likelihood of ectopic molar pregnancy or a heterotopic molar pregnancy in the case of managing molar pregnancy, especially when we encounter a case’s poor response to medical or surgical therapy.

Objective: beta-thalassemia is a prevalent disease in Iran. The adverse effects of anemia on placental and neonatal outcomes have previously been shown. Women require additional iron during pregnancy and the anemia of women with beta-thalassemia may adversely affect the neonatal outcome and increase placental abnormalities. In this study, we compared the placental histology and neonatal outcomes among pregnant women with and without beta-thalassemia. Material and methods: In this population-based cross-sectional study, 144 pregnant women with beta-thalassemia minor (case group) were compared to 142 women without beta-thalassemia (control group). Women with singleton pregnancies over 20 weeks of gestation without pregnancy complications, anemia, collagen vascular diseases, or other hemoglobinopathies, all referred to hospitals affiliated to Shiraz University of Medical Sciences from March 2014 to February 2016, were included and maternal and neonatal data were extracted from medical records. After child birth, the placenta was evaluated for macroscopic and microscopic changes. Results: The frequency of LBW was significantly higher in the case group than that in the control group (19.7 vs. 9.7%, respectively) (p = .019). Six in the case group had gross abnormalities of placenta, while none in the control group (p = .03) and the case group had a higher frequency of chorangiosis, calcification, syncytial knot, and umbilical cord position (p < .05). Conclusion: As beta-thalassemia increases the chance of placental abnormalities, it is recommended to pay more attention to patients with beta-thalassemia, especially during pregnancy, to prevent placental and neonatal adverse outcomes.

This study aimed to assess the maternal features, Vascular Endothelial Growth Factor (VEGF) and Placenta Growth Factor (PLGF) in the Placenta Accreta Spectrum (PAS); then, to determine a predictive value of VEGF and PLGF in the PAS. This prospective case-control study was conducted on 90 pregnant women including 45 PAS, and 45 Normal Placenta (NP). Maternal age, gravidity, C/S, and serum levels of VEGF and PLGF were assessed between NP and PAS, and among NP and PAS sub-groups, including Placenta Accreta (PA), Placenta Increta (PI), and Placenta Percreta (PP). The Multi-gravidity, previous C/S, maternal age, and serum level of PLGF were significantly higher in the PAS group compared to the NP group OR = 42, 8.1, 1.17, and 1.002 (p-value <.05 for all); however, there was no difference regarding serum level of VEGF (p-value >.05). The same differences were seen among NP with PA, PI, and PP sub-groups (p-value <.05 for all, but p-value >.05 for VEGF). Placenta Previa was uniformly distributed across the PAS sub-groups (p-value >.05), also the VEGF and PLGF serum levels did not differ between PAS with Previa and PAS without Previa groups (p-value >.05). A valid cut-off point for PLGF was reported at 63.55. A predictive value of PLGF for the PAS patients is presented enjoying high accuracy and generalisability for the study population.

Background: Single umbilical artery (SUA) is found in 0.5–6% of all pregnancies worldwide. Although the association of SUA with some congenital malformations is mainly accepted, its effect on pregnancy/neonatal outcomes is still controversial. Objective: This is the first study aimed to approximate the SUA prevalence in southern part of Iran. SUA epidemiologic features accompanied by some of its effects on pregnancy/neonatal outcomes are investigated as well. Materials and Methods: In this cross-sectional study, data from two referral centers in Southern Iran were analyzed. In total, 1,469 pregnancies, fetuses, and neonates were examined for epidemiological features associated with SUA. SUA was confirmed by pathological examination, while congenital anomalies were diagnosed by clinical, ultrasound, and echocardiographical examinations. Data on pregnancy outcome were recorded based on the patients’ medical records. Results: The prevalence of SUA was 3.47% (95% CI: 2.6–4.6%). Fetal anomalies including renal, cardiac, and other congenital anomalies, intrauterine fetal death, early neonatal death, low birth weight, low placental weight, and preterm birth were significantly higher in the SUA group (OR = 68.02, 31.04, 16.03, 3.85, 11.31, 3.22, 2.70, and 2.47, respectively). However, the maternal multiparity was lower in the SUA group (OR = 0.65; 95% CI: 0.44–0.98). Conclusion: A significant association was observed between SUA and increased risk of intrauterine fetal death and early neonatal death, as well as low birth weight and preterm birth. Obstetrical history of the mother like parity was identified as an important predictor of SUA. Further investigations are suggested on risk stratification of neonates in this regard. Key words: Umbilical cord, Single umbilical artery, Pregnancy outcome, Congenital abnormalities.