Leila Bayani - Academia.edu (original) (raw)

Papers by Leila Bayani

PubMed, Jul 1, 2015

Background: Treatment of cesarean scar pregnancy (CSP) is controversial. The objective of this st... more Background: Treatment of cesarean scar pregnancy (CSP) is controversial. The objective of this study was to report our successful experience in the medical treatment of CSP with potassium chloride (KCl) and methotrexate. Case: This is a case series of six patients between 6-12 gestational weeks with the diagnosis of CSP. In five cases the fetus was alive and in one case, despite being at a gestational age of 12 weeks based on CRL, there was no fetal heart activity. In four of these cases, an ultrasound- guided KCl injection in the heart was performed on four living fetuses and then systemic methotrexate was administered. In two other cases, methotrexate was injected into the gestational sac and subsequently the systemic methotrexate was administered. During follow-up, the patients were stable and no complications occurred. Additionally, serum beta human chorionic gonadotropin (β-hCG) was negative between five to 11 weeks later. One of the patients became pregnant one year later. Her pregnancy continued without any complication and she was delivered by cesarean section at the gestational age of 38 weeks. During caesarean section, it was noticed that the appearance of previous cesarean scar was normal and there was no scar. Conclusion: Based on our experience, the combination of systemic Methotrexate with local Methotrexate or KCl is feasible and can be performed as an outpatient procedure and is successful in the treatment of CSP.

Nutrition and Cancer, Mar 12, 2018

The aim of this study was to determine the effect of supplementation with 50,000 IU/monthly vitam... more The aim of this study was to determine the effect of supplementation with 50,000 IU/monthly vitamin D for 1 yr on breast density in Iranian women. Methods: This double-blind, placebo-controlled, single center clinical trial was conducted among 400 women aged 40 yr and older. Participants were allocated to 2 groups. Group 1 received vitamin D (Cholecalciferol) 50,000 IU in tablet form, monthly, for 1 yr. Group 2 received vitamin E 400 IU in tablet form, monthly, for the same period of time. Participants had follow-up clinic visits every 6 mo and received an annual mammogram. Results: Final data were evaluated based on 216 and 194 women in the vitamin D and control groups. The mean decrease in mammographic density was ¡5.01%(95% CI, ¡9.9% to ¡0.01%) and ¡2.34 %(95% CI, ¡6.84% to ¡2.15%) in the vitamin D and control groups, respectively. There was no significant association between vitamin D consumption and breast density after 1 yr (OR D 0.7, 95% CI, 0.46 to 1.06; P D 0.1).Similar results were observed when multivariate model of logistic regression analysis was performed. Conclusions: This study showed that monthly consumption of 50,000 IU of vitamin D supplementation for 1 yr did not affect breast density.

PubMed, Jul 1, 2012

Background: To determine whether the phosphodiesterase type 5 inhibitor, Sildenafil citrate, affe... more Background: To determine whether the phosphodiesterase type 5 inhibitor, Sildenafil citrate, affects uteroplacental perfusion. Materials and methods: Based on a randomized double-blinded and placebo-controlled trial, forty one pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were evaluated for the effect of a single dose of Sildenafil citrate on uteroplacental circulation as determined by Doppler ultrasound study of the umbilical and middle cerebral arteries. Statistical analysis included χ(2)-test to compare proportions, and independent-samples t-test and paired student's t-test to compare continuous variables. Results: Sildenafil group fetuses demonstrated a significant decrease in systolic/diastolic ratios (0.60 [SD 0.40] [95% Cl 0.37-0.84], P=0.000), and pulsatility index (0.12 [SD 0.15] [95% Cl 0.02-0.22], P=0.019) for the umbilical artery and a significant increase in middle cerebral artery pulsatility index (MCA PI) (0.51 [SD 0.60] [95% Cl 0.16-0.85], P=0.008). Conclusion: Doppler velocimetry index values reflect decreased placental bed vascular resistance after Sildenafil. Sildenafil citrate can improve fetoplacental perfusion in pregnancies complicated by intrauterine growth restriction. It could be a potential therapeutic strategy to improve uteroplacental blood flow in pregnancies with fetal growth restriction (FGR).

Ultrasonography, 2023

Compared to the risk-oriented approach to ovarian lesions that is presented in the Ovarian-Adnexa... more Compared to the risk-oriented approach to ovarian lesions that is presented in the Ovarian-Adnexal Reporting and Data System (O-RADS) US Risk Stratification and Management System as a guideline, a lesion-oriented flowchart is more user-friendly for radiologists. In the present article, the O-RADS guideline has been depicted in the form of a single flowchart to explain how to approach ovarian lesions in an algorithmic manner. In addition to providing a practical flowchart, this pictorial article contains some images of the related ovarian lesions.

Current Women's Health Reviews, Jan 20, 2023

Background: Since breast cancer is increasing worldwide and previous risk factors cannot justify ... more Background: Since breast cancer is increasing worldwide and previous risk factors cannot justify such an increasing trend, investigating new environmental factors is necessary for each population. Mammographic breast density (MBD) is a strong risk factor for breast cancer as well as a biomarker for the effect of chemicals on breast tissue. Objective: Given limited data about the association between breast density and cosmetic products containing endocrine-disrupting chemicals (EDCs), the purpose of this study was to evaluate the effects of cosmetic products on MBD in Iranian women. Methods: In this cross-sectional study, women who attended two university hospitals for breast screening mammography and who had been living in the capital city of Iran for the last 3 years or more were recruited. We asked women to fill out a questionnaire containing two parts; the first part was about the women's characteristics and medical history and the second part consisted of cosmetic use. The frequency of cosmetic use was measured using the Likert scale in four scales. One expert radiologist in each center reported the MBD on a four-category scale. Results: The mean age of 813 participants was 50.16 ± 7.65. Three hundred-seven (37.8%) women had low breast density and 506 (62.2%) had high breast density. Based on our results, heavy use of moisturizers, sunscreen, nail polish, eye products, makeup products, and lipstick was associated with increased breast density. In multivariable analysis after adjusting for menopause, excessive use of nail polish, sunscreen, and moisturizing cream was associated with increased MBD. Conclusion: Our study shows a probability of an increased MBD with the excessive use of cosmetic products. Since a small increase in the risk of breast cancer may lead to a considerable public health impact, thus further studies are needed to find new prevention strategies.

Journal of Clinical Ultrasound

Breast conservative treatment (BCT) is currently accepted as the standard treatment option for br... more Breast conservative treatment (BCT) is currently accepted as the standard treatment option for breast cancer. Targeted ultrasound helps detect recurrent lesions, postoperative changes, and scarring tissue. In this pictorial essay, we review the ultrasound features of benign (seroma, hematoma, fat necrosis, traumatic neuroma, fibrosis/scarring) and malignant (recurrence, new primary cancer) causes of palpable lumps after BCT and provide images from our patients to illustrate some typical findings of common pathologies. Ultrasound, especially as an adjunct to mammography, can make a specific diagnosis in most cases.

Current Women s Health Reviews

Journal of Diagnostic Medical Sonography, Mar 14, 2022

Objective: The aim of this study was to suggest a new sonographic sign, which could be helpful in... more Objective: The aim of this study was to suggest a new sonographic sign, which could be helpful in the determination of chorionicity in twin pregnancies, during the second and third trimesters. Materials and Methods: This was a retrospective study evaluating the sonographic images of 50 women with twin pregnancy. Out of 50 twin pregnancy case reviewed, only 27 were included. Those patient cases that were included were scanned by a single radiologist. The presence of a hypoechoic cleft, in the thickness of placental bulk, could be detected in all of the dichorionic pregnancy cases. This sonographic appearance was referred to as the “cleft sign.” Results: The “cleft sign” was present in all the dichorionic diamniotic (DC-DA) twin pregnancy cases, but no similar appearance was seen in the monochorionic diamniotic (MC-DA) twins. Considering this sign, the radiologist was able to correctly diagnose the chorionicity of all 24 patients in the second and third trimester. Conclusion: The findings of the present study suggest a possible role for this newly identified “cleft sign.” This sonographic appearance is a hypoechoic cleft in the thickness of placenta, of dichorionic pregnancies, as an indicator of DC twin pregnancy. In this retrospective case analysis, the “cleft sign” was diagnostically significant in the second and third trimesters.

Environmental Health and Preventive Medicine

Background: Air pollution is one of the major public health challenges in many parts of the world... more Background: Air pollution is one of the major public health challenges in many parts of the world possibly has an association with breast cancer. However, the mechanism is still unclear. This study aimed to find an association between exposure to six criteria ambient air pollutants (PM 2.5 , PM 10 , SO 2 , NO 2 , O 3 , and CO) and mammographic breast density (MBD), as one of the strongest predictors for developing breast cancer, in women living in Tehran, Iran. Methods: Participants were selected from women attending two university hospitals for screening mammography from 2019 to 2021. Breast density was rated by two expert radiologists. Individual exposures to 3-year ambient air pollution levels at the residence were estimated. Results: The final analysis in 791 eligible women showed that low and high breast density was detected in 34.8 and 62.2 of participants, respectively. Logistic regression analysis after considering all possible confounding factors represented that an increase in each unit of NO 2 (ppb) exposure was associated with an increased risk of breast density with an OR equal to 1.04 (95CI: 1.01 to 1.07). Furthermore, CO level was associated with a decreasing breast density (OR = 0.40, 95CI = 0.19 to 0.86). None of the other pollutants were associated with breast density. Conclusion: Higher MBD was associated with an increased level of NO 2 , as a marker of traffic-related air pollution. Furthermore, CO concentration was associated with a lower MBD, while other criteria air pollutants were not related to MBD. Further studies are needed to evaluate the association between ambient air pollutants with MBD.

Successful local and systemic medical treatment of cesarean scar pregnancy and a subsequent term ... more Successful local and systemic medical treatment of cesarean scar pregnancy and a subsequent term pregnancy after treatment: a case series

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

Background: Severe early-onset fetal growth restriction can lead to a range of adverse outcomes i... more Background: Severe early-onset fetal growth restriction can lead to a range of adverse outcomes including fetal or neonatal death, neurodisability, and lifelong risks to the health of the affected child. Sildenafil, a phosphodiesterase type 5 inhibitor, potentiates the actions of nitric oxide, which leads to vasodilatation of the uterine vessels and might improve fetal growth in utero. The objective is to evaluate effectiveness and safety of Sildenafil citrate for treatment of Doppler velocimetry of uterine, umbilical artery for systolic/diastolic ratio (S/D ratio) at first visit, after 2 hours and then after 12 weeks of treatment.Methods: A case control study was carried out in 96 antenatal women with fetal growth restriction over a period of twelve months. A written informed consent was obtained. Out of 96, 12 were lost to follow up. Of remaining 84 women, 42 were included in the study group and 42 in the control group. First group (case) received Sildenafil citrate 50 mg stat fol...

Ultrasonography

Ultrasonography. 2022 May 30. Epub ahead of print Compared to the risk-oriented approach to ovari... more Ultrasonography. 2022 May 30. Epub ahead of print Compared to the risk-oriented approach to ovarian lesions that is presented in the Ovarian-Adnexal Reporting and Data System (O-RADS) US Risk Stratification and Management System as a guideline, a lesion-oriented flowchart is more user-friendly for radiologists. In the present article, the O-RADS guideline has been depicted in the form of a single flowchart to explain how to approach ovarian lesions in an algorithmic manner. In addition to providing a practical flowchart, this pictorial article contains some images of the related ovarian lesions.

Journal of Diagnostic Medical Sonography, 2022

European Journal of Breast Health, 2021

Objective: Breast ultrasound (BUS) is often performed as an adjunct to mammography in breast canc... more Objective: Breast ultrasound (BUS) is often performed as an adjunct to mammography in breast cancer screening or for evaluating breast lesions. Our aim was to design a practical and user-friendly format for BUS that could include the details of the Breast Imaging Reporting and Data System. Materials and Methods: As a team of radiologists and surgeons trained in the management of breast diseases, we gathered and carried out the project in four phases-literature search and collection of present report formats, summarizing key points and preparing the first draft, seeking expert opinion and preparing the final format, and pilot testing-followed by a survey was answered by the research team's radiologists and surgeons. Results: It produced a list of items to be stated in the BUS report, the final BUS report format, and the pilot format guide. Then, the radiologists used the format in three active ultrasound units in university-affiliated centers, and reports were referred to the surgeons. At the end of the project, the survey showed a high degree of ease of use, clarity, conciseness, comprehensiveness, and well-classified structure of the report format; but radiologists believed that the new organization took more time. Conclusion: We propose our design as a user-friendly and practical format for BUS reports. It should be used for a longer time and by various ultrasound centers in order to ascertain its benefits.

Copyright © 2014 Sadaf Alipour et al. This is an open access article distributed under the Creati... more Copyright © 2014 Sadaf Alipour et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Mammographic density is a risk factor, for breast cancer and its association with various factors is under investigation; we carried out a study to assess its relationship with daily dairy intake, sun exposure, and physical activities. Patients and Methods. Women ≥40 years of age were interviewed about habits of dairy product consumption, daily sun exposure and physical activity. Exclusion criteria consisted of history of breast cancer, consumption of calcium and vitamin D supplements, hormone replacement therapy, or renal disease. Mammographic densities were classified according to the classification system of the American College of Radiologists into 4 classes.Results. Overall 703 cases were entered in the study.Themean ...

Diagnostic accuracy of sonohysterography compared to endometrial biopsy in pre-menopausal women w... more Diagnostic accuracy of sonohysterography compared to endometrial biopsy in pre-menopausal women with abnormal uterine bleeding

Iranian Journal of Public Health, 2018

Background: Phytoestrogens treatment to relieve hot flushes in menopausal women was considered re... more Background: Phytoestrogens treatment to relieve hot flushes in menopausal women was considered recently. However, the actual effectiveness and safety are not clear. Methods: Randomized clinical trial (IRCT#20100706004329N5) was performed in 204 patients who complained of hot flushes in Arash Women’s Hospital, Tehran, Iran from 2013–2015. The first group received 50 mg isoflavone (group A) once daily and the second group received placebo (group B) in the same regimen. Patients were evaluated for breast examination (BE) and breast sonography (BS) as well as vaginal sonography at initial presentation and at 6th and 12th week follow-ups. Patients were educated to record frequency and severity of hot flushes. Results: Group A experienced less hot flushes attack (6 vs 9 patients with 5< attacks in 6 wk (P= 0.05), 7 Vs 13 patients with 5< in 12 wk (P=0.01)) which was also less severe (8 vs 12 patients with severe symptoms in 6 wk (0.04) and 3 Vs 10 patients with severe symptoms in 12...

Background Endometriosis is a common benign but painful gynecologic condition. Studies suggest th... more Background Endometriosis is a common benign but painful gynecologic condition. Studies suggest that the risk of some types of malignancies such as breast cancer is higher in women with endometriosis. Mammographic breast density (MBD) is known as an important predictor for breast cancer. The present study aimed to investigate the potential relationship between endometriosis and MBD. Methods This cross-sectional study was conducted on 370 women over 40 years of age. Laparoscopic surgery was carried out for the diagnosis of endometriosis. MBD was classified into four categories according to the ACR BI-RADS classification. Statistical analysis was performed using SPSS software to evaluate the potential association between variables. Results The mean age of all participants was 47.2±6.4 years, and most participants (76.8 %) were premenopausal. Multivariate analysis of the potential predictors of MBD, including age, body mass index, oral contraceptive consumption, progesterone consumption...

Archives of Breast Cancer, 2020

Background: Inflammatory breast cancer is a very aggressive type of breast cancer which invades s... more Background: Inflammatory breast cancer is a very aggressive type of breast cancer which invades skin lymphatics. The standard treatment includes neoadjuvant chemotherapy followed by modified radical mastectomy and postsurgical radiation. Preserving the skin or nipple are not considered reasonable due to the involvement of the dermal lymphatics and therefore skin sparing or nipplesparing mastectomy are not usually carried out for this type of breast cancer. Case presentation: In this article, we present a case of inflammatory breast cancer in a very young woman who was positive for BRCA2 genes. Question: The possibility to perform nipple sparing or skin sparing mastectomy and immediate breast reconstruction, and the indication for prophylactic contralateral mastectomy as discussed in the tumor board are presented in this article. Conclusion: Neither of the more conservative techniques of mastectomy was appropriate for this case. Also, the prognosis of the patient mostly depends on th...