Prompt action is needed to reduce the unacceptably high rate of unwarranted cesarean deliveries. Improving women's knowledge about the risks and benefits of different modes of delivery can lead to a positive maternal attitude towards vaginal delivery.

Background: Adequate endometrial growth is principal for implantation and pregnancy. Thin endometrium is associated with lower pregnancy rate in assisted reproductive technology. Some frozen-thawed embryo transfer cycles are cancelled due to inadequate endometrial growth. Objective: To assess the effectiveness of autologous platelet-rich plasma (PRP) intrauterine infusion for the treatment of thin endometrium. Materials and Methods: A total of 72 patients who had a history of cancelled frozen-thawed embryo transfer cycle due to the thin endometrium (< 7mm) were assessed for the eligibility to enter the study between 2016 and 2017. Twelve patients were excluded for different reasons, and 60 included patients were randomly assigned to PRP or sham-catheter groups in a double-blind manner. Hormone replacement therapy was administered for endometrial preparation in all participants. PRP intrauterine infusion or sham-catheter was performed on day 11-12 due to the thin endometrium and it was repeated after 48 hr if necessary. Results: Endometrial thickness increased at 48 hr after the first intervention in both groups. All participants needed second intervention due to an inadequate endometrial expansion. After second intervention, endometrial thickness was 7.21 ± 0.18 and 5.76 ± 0.97 mm in the PRP group and sham-catheter group, respectively. There was a significant difference between the two groups. (p < 0.001). Embryo transfer was done for all patients in PRP group and just in six cases in the sham-catheter group. Chemical pregnancy was reported in twelve cases in the PRP group and two cases in the sham-catheter group. Conclusion: According to this trial, PRP was effective in endometrial expansion in patients with refractory thin endometrium.

Potentially pathogenic Free-Living Amoebae include members belonging to Naegleria genus. The species N. fowleri is known worldwide as the causative agent of the lethal Primary Amoebic Meningoencephalitis (PAM). Only one clinical case of N. fowleri has been reported in Iran. Several species of Naegleria have been reported to be natural carriers of other potentially pathogenic microbial agents. The thermotolerance properties of this genus facilitates their presence in geothermal water sources including hot springs and spas. In the current study water samples were collected from 22 therapeutic hot springs, Northern Iran and investigated for the presence of Naegleria spp. using morphological keys and PCR/DNA sequencing based methods. Incubation of collected samples were done at both 30°C and 45°C in order to detect Naegleria spp. and N. fowleri, respectively. Thermotolerance assay and flagellation tests were also performed. The obtained results revealed that 54% of the investigated water samples were positive for Naegleria spp. including N. australiensis, N. americana, N. dobsoni, N. pagei, N. polaris and N. fultoni. The pathogenic N. fowleri was not detected. The most detected Naegleria was belonged to N. australiensis. This is the first report on the Naegleria spp. occurrence in hot springs in Northern Iran showing that most of the surveyed hot spring sources were contaminated with non-pathogenic Naegleria spp. However, due to the recent report of PAM in the country, further studies to investigate the presence of pathogenic N. fowleri in the environment and clinical samples is needed in the region and worldwide.

Background: Intestinal parasitic infections (IPIs) are confirmed as major public health problems, worldwide. Northern Iran is highly endemic area for such infections. This research aimed to study on the prevalence of IPIs among people referred to the health care centers in Mazandaran Province, Northern Iran. Methods: In this descriptive cross-sectional survey, 984 stool samples were collected during 2015-2016. Fresh stool samples were collected from all individuals and examined by direct slide smear, formalin-ether concentration, trichrome and modified Ziehl-Neelsen staining techniques. The results were analyzed using SPSS version 16 and Chi-square test. Results: Out of 984 participants, the overall prevalence of IPIs was 12.1% (95 CI, 11.4-12.7; 119/984). The prevalence of protozoa and helminthes infections were 7.9% (95 CI, 7.4-8.3; 109/984) and 5.3% (95 CI, 4.9%-5.5%; 69/984), respectively. The most prevalent protozoan IPs were include Giardia lamblia (3.3%), Entamoeba coli (2%), Blastocystis hominis (1.3%), Entamoeba histolytica/dispar (1.1%), Entamoeba hartmanni (1.1%) and Cryptosporidium spp. (0.6%). Also major helminthic infections were include Trichostrongylus spp. (2.6%), Hookworms (1.7%), Strongyloides stercoralis (1.1%), Hymenolepis nana (0.6%) and Dicrocoelium dendriticum (0.6%). The results of the univariate analysis revealed that residence (rural being [P = 0.017]) and occupation (farmers [0.033]) were statistically significant risk factor for IPIs. Conclusion: In conclusion, we have found, despite persistent improvement in sanitary conditions over the recent years in northern part of Iran, IPIs are still among the main public health problems in this area. Moreover, helminths infection in our study were considerable. Thus, effective control programs are essential to reduce the incidence of IPIs.

Background: Telomeres are evolutionary, specialized terminal structures at the ends of eukaryotic chromosomes containing TTAGGG repeats in human. Several human diseases have been known to be associated with dramatic changes in telomere length. The aim of the present study was to assess the correlation between the relative leukocyte telomere length (LTL) and infertility in a group of Iranian azoospermic males. Methods: In this casecontrol pilot study, relative telomere length (RTL) of peripheral blood leukocytes from a total of 30 idiopathic nonobstructive azoospermic males and 30 healthy fertile males was evaluated using real-time PCR. RTL was calculated as T (telomere)/S (single copy gene) ratio and compared between infertile and fertile groups. Results: Patients with azoospermia showed significantly shorter RTL than fertile males (0.54 vs. 0.84, p < 0.05). The area under the receiver operating characteristic (ROC) curve was estimated to be 99.8%, suggesting LTL as a potential marker for the diagnosis of azoospermia. Conclusion: Our findings demonstrated a probable association between telomere shortening and azoospermia in a population of Iranian infertile men affected by idiopathic azoospermia.