Obstetrics and Gynecology
Madhubala Manickavasagam
Volume 6, Issue 2 , March 2021, , Pages 57-64
Abstract
Background and Objective: Anemia in Pregnancy (AIP) causes many obstetric complications. Pregnant women’s awareness and knowledge play a pivotal role in management and prevention of AIP.Methods: The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics ...
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Background and Objective: Anemia in Pregnancy (AIP) causes many obstetric complications. Pregnant women’s awareness and knowledge play a pivotal role in management and prevention of AIP.Methods: The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics and gynaecology department for antenatal care on their first appointment. The diagnosed participants’ knowledge, awareness and management potential about AIP was assessed.Results: The mean age was 26.9 and 24.2 years in AIP and non-anemia in pregnancy NAIP groups, respectively. First trimester early week’s appointment was 38.3% and 37.6% of AIP and NIAP groups, respectively. AIP compared to parity (χ2 = 3.0739) and gestation age (χ2 = 0.8435) was not significant at P-value<0.05. According to WHO definition, AIP was reported in 49.2% of the study population involving 30.4% of urban and 18.8% of rural population. The knowledge and awareness of pregnant women towards anemia in pregnancy was not significant with eleven predictor’s odds ratio. However, both of the groups, 60.3% of the AIP and 46.2% of the NAIP cases were aware of the anemia-related complications during pregnancy.Conclusions: First trimester anemia in pregnancy was a prominent health burden in spite of available resources and awareness programmes. There was a sensitization lacunae to rule out the misconception and the belief. A healthy state of mind and practice among women shall be instrumental in bringing about an improved perception of AIP and its prevention.
Obstetrics and Gynecology
Mahbod Kaveh; Venus Hajaliakbari; Fateme Davari-Tanha; Shokoh Varaei; Mahsa Ghajarzadeh; Elham Feizabad; Mohammad Ali Ashraf; Zahra Kaveh
Volume 7, Issue 2 , September and October 2021, , Pages 69-76
Abstract
Background & Objective: The recent surge in coronavirus disease 2019 (COVID-19) cases has exposed health care workers (HCWs) to a wide range of psychological stressors and predisposed them to anxiety-related disorders. In this study, we observed the anxiety level in this population.Materials & ...
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Background & Objective: The recent surge in coronavirus disease 2019 (COVID-19) cases has exposed health care workers (HCWs) to a wide range of psychological stressors and predisposed them to anxiety-related disorders. In this study, we observed the anxiety level in this population.Materials & Methods: This multicenter, cross-sectional study was performed on 1,038 HCWs in 14 hospitals of Tehran during the COVID-19 pandemic. In May 2020, Beck Anxiety Inventory (BAI) was used to measure the level of anxiety in this population.Results: The mean±SD age of participants was 36.30±8.23 years old. Most participants were 31 to 40 years old (43.2), female (87.6%), and nurses (49.5%). The BAI scores of the participants were in a positive skew distribution, with a score range of 0-63, a median of 12, and a mean value of 15.30±11.43. Out of 1,038 hospital staff, 411 (39.6%) had moderate to severe anxiety. The anxiety level was significantly higher in HCWs ≤40 years old, women, and nurses. However, there was no significant relationship between stress levels among frontline workers compared to second-line workers (P < /em>=0.82).Conclusion: It seems that HCWs experienced a high level of anxiety in the COVID-19 outbreak. One of the critical measures in every epidemic is to provide supportive care to maintain the mental well-being of HCWs, especially in high-risk groups, including younger HCWs, women, and nurses.
Reproductive Medicine
Zahra Rezaei; Mehrnaz Valadan; Pooneh Shojaee Asl
Volume 5, Issue 3 , November 2020, , Pages 84-87
Abstract
Background & objective: Insulin resistance can be seen in most overweight women with polycystic ovary syndrome (PCOS). Insulin resistance seems to play a key role in the pathophysiology of PCOS and infertility. This study aimed to evaluate the effects of insulin resistance on pregnancy rate ...
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Background & objective: Insulin resistance can be seen in most overweight women with polycystic ovary syndrome (PCOS). Insulin resistance seems to play a key role in the pathophysiology of PCOS and infertility. This study aimed to evaluate the effects of insulin resistance on pregnancy rate and regulation of the menstrual cycle following laparoscopic ovarian electrocautery (LOE).Materials & Methods: This prospective cohort study was conducted on 54 infertile metformin- and clomiphene citrate-resistant women with PCOS at Yas Hospital in 2007. These patients initially took a glucose tolerance test and then classified into two groups (i.e., insulin-resistant and non-insulin-resistant) based on the obtained results. Both groups, then, underwent LOE. Patients were evaluated for pregnancy rate and regulation of the menstrual cycle up to six months.Results: Out of 54 patients, 37 patients (68.5%) were non-insulin-resistant, and 17 patients (31.5%) were insulin-resistant. In the insulin-resistant group, after six months, menstrual cycles were less regular than those of the non-insulin-resistant group (OR=0.2; 95%CI, 0.07-0.87). Fifteen (40.5%) women in the non-insulin-resistant group became pregnant; in contrast, three (17.6%) women in the insulin-resistant group became pregnant. In the logistic regression analysis, the results demonstrated that age, duration of infertility, body mass index (BMI), and insulin resistance had no significant effects on pregnancy rate.Conclusion: Insulin resistance can be an important marker of the poor outcomes of PCOS infertility treatment, and LOE significantly improves insulin resistance in women with PCOS.
Hassan Boskabadi; Maryam Zakerihamidi; Fatemeh Bagheri
Volume 4, Issue 3 , September and October 2019, , Pages 93-98
Abstract
Background & Objective: Caesarean sections without indication, compared to normal vaginal deliveries, bring about many consequences for the mother and her fetus. Therefore, this study aimed at comparing the characteristics of neonates born by normal vaginal deliveries and caesarean sections.
Materials ...
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Background & Objective: Caesarean sections without indication, compared to normal vaginal deliveries, bring about many consequences for the mother and her fetus. Therefore, this study aimed at comparing the characteristics of neonates born by normal vaginal deliveries and caesarean sections.
Materials & Methods: In this cross-sectional study conducted from 2015 to 2019, 736 term neonates aged 3 to 12 days old with a weight > 2.5 kg and a gestational age > 37 weeks referred to a neonatal clinic were studied after obtaining their parents’ full consent. A researcher-made questionnaire examining maternal personal information, neonate’s characteristics, breastfeeding status, and the type of delivery was completed. The obtained data were analyzed via SPSS 22, using a t-test and Chi-square test.
Results: In the present study, out of the 736 term neonates, 409 neonates (55.6%) were born by normal vaginal deliveries and 327 neonates (44.4%) were born by caesarean sections. There were statistically significant differences between the two methods of delivery in terms of the frequency of breastfeeding per day (P < /em>=0.002), the frequency of urination per day (P < /em>=0.007), the first postpartum defecation time (P < /em>=0.027), and neonates’ chief complaint (P < /em>=0.004).
Conclusion: The results of the current study showed that the neonates born by normal vaginal deliveries, compared to those delivered by caesarean sections, had a more favorable status, regarding the frequency of breastfeeding, the frequency of urination per day, and the first postpartum defecation time. Moreover, the level of weight loss (g) per day and the percentage of daily weight loss were higher in the neonates born by caesarean sections compared to the other neonates.
Forough Javanmanesh; Maryam Kashanian; Vajihe Zamani; Narges Sheikhansari
Volume 3, Issue 3 , September and October 2018, , Pages 99-103
Abstract
Aims: Pain is the main concern after surgery. Gabapentin was recently suggested as a pain killer to be used after various surgeries. The purpose of the present study was to evaluate the effects of gabapentin on pain relief and need for opiates after total abdominal hysterectomy.
Materials & Methods: This ...
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Aims: Pain is the main concern after surgery. Gabapentin was recently suggested as a pain killer to be used after various surgeries. The purpose of the present study was to evaluate the effects of gabapentin on pain relief and need for opiates after total abdominal hysterectomy.
Materials & Methods: This randomized double-blind placebo-controlled clinical trial was performed on 85 women who underwent total abdominal hysterectomy from March 2014 to March 2016 in Akbarabadi teaching hospital and Firoozgar teaching hospital in Tehran, Iran. Samples were selected using consecutive sampling method and were randomly assigned into the 2 groups. In case group (n=44) gabapentin (800mg) was orally administered one hour before surgery and in the placebo group (n=41) placebo which was similar to gabapentin administered. The pain score was assessed in 2, 6, 12 and 24 hours after surgery. Nausea and vomiting were also compared between the 2 groups. Data were analyzed by SPSS 19 software using statistical tests.
Findings: The two groups did not have significant differences according to pain score in the recovery room (point 0). Mean score of pain was lower in the case group in 2, 6, 12 and 24 hours after surgery (p=0.005). Meperidine (pethidine) use was less in the case group (p=0.003). There was no difference between the 2 groups for nausea and vomiting.
Conclusion: Using gabapentin before surgery can lower the pain after surgery and reduces the need for opiates. However, it doesn’t have an effect on nausea and vomiting.
Obstetrics and Gynecology
Khor Chun Kit; Christine Na Sin Ee; Jackie Wong Kee Hung; Aiswaryaa Devi A/P Tambi Selvam; Chan Sue Vern; Lee Lionel; Hussein Akl; Kavitha Nagandla
Volume 8, Issue 2 , March and April 2023, , Pages 105-112
Abstract
Background & Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy; however, medical treatment is an option for those who wish to preserve fertility. ...
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Background & Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy; however, medical treatment is an option for those who wish to preserve fertility. This systematic review aims to assess the efficacy of levonorgestrel-releasing intrauterine device as medical management in women who have adenomyosis.Materials & Methods: We searched PubMed, Cochrane and Scopus databases from January 2000 to November 2019 for relevant studies containing the use of levonorgestrel-releasing intrauterine device (LNG-IUD) in managing patients with ultrasonographic diagnosis of adenomyosis. Main outcome measures in the study are menstrual blood loss (milliliters), pain score measured in 10 cm-visual analogue scale, and uterine volume.Results: Pooled results from meta-analysis showed that after LNG-IUD treatment for adenomyosis, there is significant reduction in dysmenorrhoea, measured using Visual Analogue Scale after 6 months (Standardized Mean Difference (SMD): 3.68; Cl: 2.11-5.25) , 12 months (SMD: 4.23; CI: 2.99-5.48), 24 months (SMD: 4.69; CI: 3.40-5.97) and 36 months (SMD: 4.01; CI: 3.57-4.45); significant reduction in menstrual bleeding after 6 months (SMD: 2.52; CI: 1.15-3.89), 12 months (SMD: 3.43; CI: 1.64-5.22) and 24 months (SMD: 3.57; CI: 1.88-5.26); significant reduction in uterine volume after 6 months (SMD: 0.49; CI: 0.04-0.93), 12 months (SMD: 0.80; CI: 0.11-1.48) and 24 months (SMD: 0.86; CI: 0.15-1.58).Conclusion: LNG-IUS is an effective method in alleviating the symptoms of adenomyosis. It is a valuable long-term alternative for the treatment of adenomyosis for young and perimenopausal women in terms of dysmenorrhoea and heavy menstrual bleeding.
Obstetrics and Gynecology
Khadije Rezaie Keikhaie; Mania Kaveh; Fatemeh Bahrami; Kambiz Sadegi; Atefeh Kamali; Mahdi Afshari
Volume 6, Issue 3 , June 2021, , Pages 110-115
Abstract
Background & Objective: Anti-mullerian hormone indicates ovarian reserve. The objective of this study was to compare the changes of AMH level following two methods of laparoscopic cystectomy in order to evaluate ovarian reserve in patients with endometrioma.Materials & Methods: To this end, ...
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Background & Objective: Anti-mullerian hormone indicates ovarian reserve. The objective of this study was to compare the changes of AMH level following two methods of laparoscopic cystectomy in order to evaluate ovarian reserve in patients with endometrioma.Materials & Methods: To this end, 86 patients with endometrioma were selected on the basis of inclusion and exclusion criteria, divided into two groups, and subjected to laparoscopic cystectomy. The mean hormone levels were measured before and after surgery and the changes were compared between the two groups using the repeated measures tests. The data were also analyzed using the SPSS 22.Results: The mean number of childbirth was 2.06 in patients with a standard deviation of 1.64. Out of 86, 42 patients (48.8%) were treated with complete removal of cysts and the rest underwent partial removal. The length of cysts in patients undergoing complete removal was significantly larger than that in patients with partial removal (P < /em>=0.011), while the width of cysts was not significantly different between the two groups of patients (P < /em>=0.084). The AMH levels in patients undergoing complete removal significantly decreased from 2.22 before surgery to 1.96 after surgery (P < /em><0.001). The AMH levels in patients undergoing partial removal was also decreased from 2.47 before surgery to 2.14 after surgery, representing a statistically significant difference (P < /em><0.001).Conclusion: Regarding the results of the study, the type of ovarian cyst removal has not any effect on after-surgery consequences.
Maternal Fetal Medicine
Maryam Kashanian; Nooshin Eshraghi; Majid Kalani; Arash Bordbar; Nasim Eshraghi; Mahnaz Kalati; Sara Norouzi; Amir Hossein Kashanian
Volume 9, Issue 2 , March and April 2024, , Pages 125-130
Abstract
Background & Objective: Preterm birth is the most important cause of neonatal mortality and morbidity. Finding the best treatment regimen, of antenatal corticosteroids, has been under serious concern. To compare the efficacy of intravascular versus intramuscular betamethasone phosphate ...
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Background & Objective: Preterm birth is the most important cause of neonatal mortality and morbidity. Finding the best treatment regimen, of antenatal corticosteroids, has been under serious concern. To compare the efficacy of intravascular versus intramuscular betamethasone phosphate on neonatal outcomes in the cases of imminent preterm birth.
Materials & Methods: A double-blind randomized clinical trial was performed on 136 eligible pregnant women with gestational age of 26- 34 weeks and imminent preterm birth (delivery within 24 hours). They were randomly assigned into two groups. Group A received intramuscular betamethasone phosphate, and group B received a similar dose of betamethasone phosphate intravenously. Women were followed up to delivery, and their neonatal outcomes were compared.
Results: Women of the two groups (68 women in each group), did not show a significant difference in maternal age, BMI, gravidity and parity, gestational age at the time of admission and delivery, history of miscarriage and assisted reproductive techniques, delivery route, sex and weight of newborns, and Apgar score in minutes 1 and 5. The need for NICU admission, duration of hospitalization, neonatal respiratory distress syndrome, surfactant requirement, and intubation were lower in the IV betamethasone group. There were no significant differences between the two groups according to necrotizing enterocolitis, intraventricular hemorrhage, and neonatal death.
Conclusion: Using IV betamethasone, in cases where there is no enough time to complete the 24-hour betamethasone course due to the possibility of impending delivery, may reduce neonatal complications due to quicker onset of action.
Faramarz Karimian; Setareh Akhavan; Ali Marzoughi; Mohammad Reza Keramati; Mohammad Ashouri
Volume 4, Issue 4 , September and October 2019, , Pages 135-140
Abstract
Background & Objective: Cyclic mastalgia is clinically related to alterations in sex hormone levels during the menstrual cycle. A derangement in normal menstrual cycle leads to exacerbated mastalgia; which can also cause menstrual irregularities and abnormal uterine bleeding (AUB). A decrease in ...
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Background & Objective: Cyclic mastalgia is clinically related to alterations in sex hormone levels during the menstrual cycle. A derangement in normal menstrual cycle leads to exacerbated mastalgia; which can also cause menstrual irregularities and abnormal uterine bleeding (AUB). A decrease in severity of mastalgia is observed in patients with simultaneous cyclic mastalgia and menstrual irregularities/AUB, following correction of menstrual irregularity. This study was designed and conducted to investigate the possibility of whether correction of menstrual irregularities can diminish cyclic mastalgia.
Materials & Methods: This case-control study was carried out on women suffering from simultaneous mastalgia and menstrual irregularity. One-hundred and fifty patients were randomly distributed between case and control groups, each including 75 patients. Patients in both groups took 100 mg vitamin E oral tablet daily for 3 months. Patients in case group also received low-dose oral contraceptive pills (OCP-LD) to correct menstrual irregularity. Patients recorded the severity of mastalgia in Cardiff breast pain chart using Visual Analogue Scale (VAS).
Results: At the beginning of study, there was no significant difference in the number of days suffering from mild and severe mastalgia between two groups. However, at the end of the study, mild and severe mastalgia reduced significantly in the case group compared to the control group (P < /em>=0.003 and P < /em>=0.045, respectively).
Conclusion: In women with cyclic mastalgia, correction of menstrual irregularity leads to significant pain relief. Correcting menstrual irregularity is suggested as a first-line treatment in women with mastalgia.
Gynecology Oncology
Maryam Rahimi; Elahe Keyhani; Farkhondeh Behjati
Volume 5, Issue 4 , December 2020, , Pages 137-148
Abstract
Background & Objective: As the most common cancer type, breast cancer has been recognized as the second mortality cause among women. The KIT proto-oncogene is one of the important factors involved in tumor development. The previous findings have demonstrated an increased copy number and overexpression ...
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Background & Objective: As the most common cancer type, breast cancer has been recognized as the second mortality cause among women. The KIT proto-oncogene is one of the important factors involved in tumor development. The previous findings have demonstrated an increased copy number and overexpression of this gene under the influence of breast cancer development.Materials & Methods: This study aimed to investigate the relationship between the copy number variation (CNV) of all exons of KIT gene and estrogen receptor (ER), progesterone receptor (PR), HER2, P53, stage, tumor size, Ki67, Annexin V, histological type, age, molecular subtype, and node status by surveying breast cancer tissues collected from 64 patients. The CNV exons and clinicopathological variables were assessed by multiplex ligation-dependent probe amplification (MLPA), hematoxylin and eosin (H&E) staining, and immunohistochemistry techniques.Results: Sixty percent of cases in exon 17, 60% in exon 18, and nearly 67% in exon 19 with increased CNVs had a tumor size of 2-5 cm; these results were significant. Also, patients with an increased exon 7 CNV were significantly in stage 3. Other exons did not exhibit significant relation to other clinicopathological variables (P < /em>>0.05).Conclusion: Exons 7, 17, 18, and 19 are the key coding domains of tyrosine kinase, involving the activation of various upstream transcription factors that regulate apoptosis, cell differentiation, proliferation, and angiogenesis. Variation in exons can influence drug resistance. The results of this study can contribute to the diagnosis and treatment of breast cancer, although their confirmation requires further examinations.
Shayesteh Parashi; Vahideh Astaraei; Mansoureh Vahdat; Parisa Dini; Mahdis Mohammadianamiri
Volume 3, Issue 4 , November and December 2018, , Pages 143-147
Abstract
Background & Objective: Postoperative hemorrhage is one of the most frequently cited complications of total abdominal hysterectomy (TAH). This study aimed to investigate the effect of a single preoperative dose of sublingual misoprostol on reducing blood loss during total abdominal hysterectomies.
Materials ...
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Background & Objective: Postoperative hemorrhage is one of the most frequently cited complications of total abdominal hysterectomy (TAH). This study aimed to investigate the effect of a single preoperative dose of sublingual misoprostol on reducing blood loss during total abdominal hysterectomies.
Materials & Methods: This study was a single-blind randomized controlled trial (RCT). The statistical population included all women who were candidates of hysterectomy in 2017 and 2018. A total of 132 patients were randomly selected and classified into two groups of misoprostol (N=66) and placebo (N=66). Examining intraoperative blood loss was considered a primary outcome. Moreover, levels of hemoglobin before and 24 hours after the surgery, the need for a blood transfusion, febrile morbidity, and the duration of hospitalization were regarded as secondary outcomes. The means of bleeding in the two groups were compared using a t-test.
Results: There were no significant differences between the two groups in the baseline characteristics (P < /em><0.05). After the surgery, the mean of hemoglobin values was lower in the placebo group compared to the misoprostol one, and this difference was statistically significant (P < /em><0.001). There was a significant difference in intraoperative blood loss between the two groups, and it was significantly higher in the placebo group (P < /em><0.001).
Conclusion: Taking a single preoperative dose of sublingual misoprostol is effective in reducing intraoperative blood loss after total abdominal hysterectomies. Additionally, this intervention led to a decline in hemoglobin.
Maternal Fetal Medicine
Sedigheh Borna; Vida Radi; Maasoumeh Saleh; Mina Ataee; Hanieh Feizmahdavi; Zohreh Salari; Mamak Shariat
Volume 7, Issue 3 , January and February 2022, , Pages 144-150
Abstract
Background & Objective: This study assessed the relationship between the ratio of fetal lung volume to head circumference and amniotic fluid index (AFI) in the third trimester of pregnancy.Materials & Methods: This prospective study was performed on low-risk pregnant women in their third trimester ...
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Background & Objective: This study assessed the relationship between the ratio of fetal lung volume to head circumference and amniotic fluid index (AFI) in the third trimester of pregnancy.Materials & Methods: This prospective study was performed on low-risk pregnant women in their third trimester of pregnancy. Fetal lung volume was determined separately using the lung-to-head ratio (LHR) for the right and left lungs. Moreover, the AFI was evaluated, and the Pearson correlation coefficient between LHR for both lungs and AFI was investigated.Results: Overall, 112 pregnant women were included in the study. The mean ± standard deviation (SD) of fetal Observed/Expected Right LHR (O/E RLHR) and O/E Left LHR (O/E LLHR) were 113.9±0.36 and 97.13±27.87, respectively. The mean ± SD of AFI was 12.5±4.96 cm. Pearson correlation coefficient did not show a significant relationship between AFI and the left and right LHR (P < /em>>0.05). However, O/E RLHR was significantly correlated with abdominal circumference (P < /em>=0.02, r=0.2), gestational age (P < /em>=0.21, r=0.27), and fetal weight (P < /em><0.001, r=0.27). There was a positive correlation between the number of days the infant was admitted to the neonatal intensive care unit and the volume of the right lung of the fetus (P < /em>=0.03, r=-0.2). No correlation was observed between fetal parameters and the volume of the left lung of the fetus.Conclusion: The results of this study showed that AFI in the third trimester of pregnancy was not significantly correlated with LHR.
Obstetrics and Gynecology
M. Madhubala; Mansi Shukul; C. Kasthuri
Volume 6, Issue 4 , August 2021, , Pages 167-173
Abstract
Background & Objective: Uterine fibroids (UF) in pregnancy is a condition, where symptomatic or asymptomatic fibroids in the uterine cavity may cause complications in pregnancies. Placental abruption and preterm labor, occurs in late pregnancy, postpartum hemorrhage, caesarean section and retained ...
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Background & Objective: Uterine fibroids (UF) in pregnancy is a condition, where symptomatic or asymptomatic fibroids in the uterine cavity may cause complications in pregnancies. Placental abruption and preterm labor, occurs in late pregnancy, postpartum hemorrhage, caesarean section and retained placenta in perinatal period. This study aimed to reckon whether the surgical Caesarean myomectomy is still a gold standard in myoma removal in pregnant women.Materials & Methods: This study was retrospectively conducted in pregnant women deliveries with uterine fibroids who underwent Myomectomy with lower segment caesarean section (LSCS). The caesarean myomectomy cases were compared with LSCS alone controls in 1:2 ratio. The primary outcome is to minimize blood loss and need for blood transfusion. The secondary outcome is the length of surgery duration and hospital stay.Results: The outcome of case and control compared was 43 caesarean myomectomy with LSCS as case group and 86 LSCS Alone as control group. The incidence of hemorrhage in case group was 10 out of 43 while control was 2 out of 86 (2.32%) with P-value of 0.0017. The secondary outcome was the length of surgery duration and hospital stay which were found statistically significant between the case and control groups, with P-value = 0.0001 and 0.0072, respectively.Conclusion: Caesarean Myomectomy can be the effective surgical option to enucleate uterine myoma, and preserve uterus and jettison from eventful or symptomatic uterine fibroids. To have the chances for prevention of immediate or interval - myomectomy / hysterectomy and control of post-partum menstrual over bleeding.
Obstetrics and Gynecology
Maliheh Arab; Nafiseh Poorzad; Giti Noghabaei; Ghazaleh Fazli; Behnaz Ghavami; Tayebeh Jahed Bozorgan
Volume 8, Issue 3 , May and June 2023, , Pages 204-209
Abstract
Background & Objective: Gynecological cancer survivors have been growing, as a result of advancements in national cancer screening strategies, resulting in early-stage diagnosis, and cancer treatments developments. Lack of a valid documented assessment tool to measure their requirements for ...
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Background & Objective: Gynecological cancer survivors have been growing, as a result of advancements in national cancer screening strategies, resulting in early-stage diagnosis, and cancer treatments developments. Lack of a valid documented assessment tool to measure their requirements for supportive care is detected. The aim was to develop a comprehensive scale that comprises all features of gynecologic cancer survivors` requirements in Iranian population.Materials & Methods: The Cancer Survivors Assessment Questionnaire NCCN2.2020 (National comprehensive cancer network) was translated including the instructions, and the answer choices by two native translators, including one fluent translator and one linguist. For qualitative face validity of the questionnaire at the disposal of 10 specialists were delegated to make the necessary changes. Content validity and content validity index were evaluated in terms of qualitative face validity and quantitative face validity. Necessary changes were applied.Results: The original Cancer Survivors Assessment Questionnaire NCCN2.2020 (National comprehensive cancer network) was condensed from 27 to 24 questions during the customization process. Questions related to lymphedema, and immunization were eliminated from the survey, as a result of low content validity index and scores. According to the panel of experts, ten questions including number 3, 5, 6, 9, 10, 13, 17, 18, 19, and 25 of the questionnaires were changed to a more suitable and comprehensible ones in Persian language.Conclusion: We suggest that the Persian version of cancer survivors’ assessment questionnaire be applied in populations with Persian language and that its sensitivity to variation be measured.
Radiology
Behnaz Moradi; Masoumeh Gity; Fatemeh Davari Tanha; Masoumeh Golestani Jahromi; Shahrzad Fayyazi
Volume 7, Issue 4 , March and April 2022, , Pages 272-278
Abstract
Diagnosis of endometriosis according to TVS may be an appropriate alternative method for laparoscopy. Hence in this study, the role of TVS was investigated compared with laparoscopic assessment in cases with pelvic endometriosis attending to imaging center of Imam-Khomeini and Yas Hospital in Tehran ...
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Diagnosis of endometriosis according to TVS may be an appropriate alternative method for laparoscopy. Hence in this study, the role of TVS was investigated compared with laparoscopic assessment in cases with pelvic endometriosis attending to imaging center of Imam-Khomeini and Yas Hospital in Tehran in 2018. In this diagnostic study, 69 patients with pelvic endometriosis were assessed. The results of TVS were compared with laparoscopic assessment, and the sensitivity, specificity, and congruence rate were determined. According to the obtained results, it may be concluded that most sensitivity of TVS is related to the torus uterinus and dome of the bladder. Also, the most specificity is related to bladder, sigmoid colon, and peritoneal cyst. The most congruence rate between U/S and laparoscopy is at bladder trigon and sigmoid colon. However, in the end, multicenter studies with more cases and comparisons with the results of other diagnostic methods are recommended to achieve more accurate results.
Obstetrics and Gynecology
Poorya Davoodi; Delaram J. Ghadimi; Malihe Rezaei; Mohammad Amin Khazei Tabari; Aryan Shirani; Behnaz Nouri; Noosha Samieefar; Meisam Akhlaghdoust
Volume 8, Issue 4 , July and August 2023, , Pages 315-326
Abstract
Background & Objective: Endometriosis, a common disease of the female reproductive system, could affect many aspects of women’s lives. Along with many other diseases, COVID-19 has affected the diagnostic or treatment approaches towards endometriosis. This systematic review aims to investigate ...
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Background & Objective: Endometriosis, a common disease of the female reproductive system, could affect many aspects of women’s lives. Along with many other diseases, COVID-19 has affected the diagnostic or treatment approaches towards endometriosis. This systematic review aims to investigate COVID-19 in endometriosis patients in terms of prognosis, diagnosis, treatment, and quality of life during the pandemic.Materials & Methods: Relevant studies were identified through searching for endometriosis and COVID-19 in different databases, including PubMed, Medline, Scopus, and Web of Science, on 17 January 2022. Peer-reviewed published articles evaluating COVID-19 and endometriosis written in English were included.Results: Out of 115 articles, 9 manuscripts met our criteria. Endometriosis does not intensify the risk of COVID-19 infection. However, COVID-19 has changed the health care of endometriosis patients.Conclusion: COVID-19 has affected endometriosis patients’ life in many aspects, including their job, lifestyle, and health care. Further studies are recommended to evaluate how the pandemic has affected endometriosis patients.
Reproductive Medicine
Adeola Oluboyo
Volume 7, Issue 5 , July and August 2022, , Pages 374-381
Abstract
Infertility is an important world-wide reproductive disorder and some couples are being affected everyday as the population increases. The study aimed to evaluate the levels of selected trace elements (zinc, magnesium, selenium) and glutathione peroxidase in female subjects diagnosed with infertility. ...
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Infertility is an important world-wide reproductive disorder and some couples are being affected everyday as the population increases. The study aimed to evaluate the levels of selected trace elements (zinc, magnesium, selenium) and glutathione peroxidase in female subjects diagnosed with infertility. The study investigated a total of 90 subjects; 25 subjects diagnosed of primary infertility, 25 subjects diagnosed with secondary infertility and 40 apparently healthy individuals which served as the control group within the age range of 20-45years. Samples were obtained from the patients who attended the obstetrics and gynecology department, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria. Zinc (Zn) and selenium (Se) were estimated using atomic absorption spectrophotometer (AAS), magnesium (Mg) was estimated spectrophotometrically, while glutathione peroxidase (GPx) was evaluated using enzyme linked immunosorbent assay (ELISA) technique. Zinc (Zn), magnesium (Mg) and glutathione peroxidase (GPx), were significantly lower (P < /i>>0.05) in subjects with infertility in relation to the control subjects, while selenium (Se) was found to be significantly higher (P < /i><0.05) in subjects with infertility compared with control subjects. Selenium (Se) and magnesium (Mg) were significantly lower (P < /i><0.05) in subjects diagnosed with primary infertility compared with subjects diagnosed with secondary infertility. No significant difference (P < /i><0.05) was found in serum zinc (Zn) levels and glutathione peroxidase (GPx) between subjects with primary and secondary infertility. The study concluded that the parameters are useful and should be included in the routine assessment, diagnosis and monitoring of cases of infertility.
General Gynecology and Pelvic Floor
Zinat Ghanbari; Leila Pourali; Tahereh Eftekhar; Maryam Deldar Pesikhani; Soudabeh Darvish; Elnaz Ayati; Zahra Lotfi
Volume 8, Issue 5 , September and October 2023, , Pages 431-437
Abstract
Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could ...
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Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could negatively affect the quality of life in these patients. This study aimed to assess the surgical outcomes of native-tissue apical suspension by sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS).Materials & Methods: This prospective cohort study was conducted to evaluate the outcomes of native-tissue apical suspension for pelvic organ prolapse within one year after the surgery from March 2017 to July 2019 at Imam Khomeini hospital, an academic hospital of Tehran University of Medical Sciences, Tehran, Iran. Inclusion criteria were patients with uterine prolapse at Stage 2 or 3 according to the Pelvic Organ Prolapse Quantification System (POP–Q) who planned for total vaginal hysterectomy and apical suspension using uterosacral ligament suspension (ULS) or sacrospinous ligament fixation (SSLF) with no history of pelvic organ prolapse surgery. The main outcome was surgical consequences within 1 year after surgery.Results: There was no significant difference between the two groups in terms of relapse of anterior, posterior, or apical compartment prolapse. According to the clinical recurrence, although vaginal bulging and pressure were more common in sacrospinous ligament fixation (SSLF) group, the difference was not significant. The number of patients with severe buttock and pelvic pain was significantly higher in the sacrospinous ligament fixation (SSLF) group.Conclusion: sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are both optimal procedures with the same complications and similar surgical outcomes; however, uterosacral ligament suspension (ULS) had lower post-operative pelvic pain, and also the number of retreatment was lower in this group.
Obstetrics and Gynecology
Maryam Moradi; Azin Niazi; Melissa Parker; Anne Sneddon; Violeta Lopez; David Ellwood
Volume 7, Issue 6 , September and October 2022, , Pages 479-488
Abstract
Background & Objective: The aim of this study was to determine the endometriosis-associated symptoms and diagnostic delay through an online survey.Materials & Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered into and analyzed ...
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Background & Objective: The aim of this study was to determine the endometriosis-associated symptoms and diagnostic delay through an online survey.Materials & Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered into and analyzed using the STATA software (version 14.1). A total of 903 respondents completed an online survey from September 2013 to October 2015.Results: Out of 903, 71.10% were Australians and 28.90% were Non-Australian, with a self-reported diagnosis of endometriosis confirmed by surgery. Out of the participants, 86.5% completed the online survey. Delay in diagnosis was 8.1±6.2 years. There was no difference in the age range (P < /i> = 0.35), mean age of onset of the first symptoms (P < /i> = 0.93), and delay in diagnosis (P < /i> = 0.11) between both groups. Most common endometriosis-related symptoms that all respondents had experienced in their lifetime were period pain (98.1%), fatigue (94%), bloating (90.7%), ovulation pain (88.7%), pelvic pain (87.3%), pain during and before/after sexual activity (82.7%), and heavy bleeding (82.2%). Treatments used by affected women included: pain killers (96%), hormonal medication (84.7%), surgical treatments (84.5%), and delayed fertility (37.1%). Conclusion: Vast similarities in demographics and endometriosis-associated symptoms among the Australian and non-Australian women with endometriosis support the universality of the disease characteristics. Delay in diagnosis of endometriosis is a problem and the reasons for delayed diagnosis must be understood to try to shorten this delay. Besides pain, patients with endometriosis suffer from a variety of other symptoms; hence, any treatment must take into account the most prominent symptoms.
Obstetrics and Gynecology
Ali Massoudifar; Nozhan Alimi; Ainaz Boostan; Atoosa Etezadi; Ezzatalsadat Haji Seid Javadi; Misa Naghdipour Mirsadeghi
Volume 8, Issue 6 , November and December 2023, , Pages 549-555
Abstract
Background & Objective: Because childbirth is a natural process, pain is therefore part of the process. The amount of labor pain is probably directly related to the pregnant woman's mood, familiarity, awareness and self-confidence. Therefore, it is illogical to accept the complications of surgery ...
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Background & Objective: Because childbirth is a natural process, pain is therefore part of the process. The amount of labor pain is probably directly related to the pregnant woman's mood, familiarity, awareness and self-confidence. Therefore, it is illogical to accept the complications of surgery and anesthesia and harm to the baby in order to escape the pain. Therefore, the aim of current study was investigating the relationship between the perception of labor pain and the number of deliveries.Materials & Methods: This study is descriptive-analytical correlational study. Two questionnaires were used for gathering information: one on personality traits and the other on labor pain. One hundred participants were chosen according to their demographic information, from a pool of pregnant women at maternal ward of the Persian Gulf Hospital in Bandar Abbas City, Iran. The data was analyzed by means of descriptive_ analytical measures such as Pearson Factor.Results: The mean age of women was 27.15±4.6. Collected data showed that 31% of women were gravida 1, 33% gravida 2, 15% gravida 3, 10% gravida 4, 5% gravida 5, 4% gravida 6, and 2% were gravida 7. a significant relationship was found between pain in the first delivery and pain in the second, third, fifth and sixth deliveries, so that the pain in the first delivery was more than the pain in the second, third, fifth and sixth deliveries.Conclusion: According to the results of this study the severity of labor pain in primiparous and multiparous women was not statistically significant and the intensity of reported pain level was high in all mothers.
Masoumeh Fallahian; Shahrzad Tavana
Volume 1, Issue 1 , May and June 2016
Abstract
Abortion is desperately selected by some females who cannot continue their unintended pregnancies in all societies, some will suffer complications and some will die. Annual number of induced abortion has increased in the developing countries but the maternal death related to unsafe abortion has declined ...
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Abortion is desperately selected by some females who cannot continue their unintended pregnancies in all societies, some will suffer complications and some will die. Annual number of induced abortion has increased in the developing countries but the maternal death related to unsafe abortion has declined in the world since 2003. Medical abortion has contributes to this decline. In Iran, abortion rate of one per four female is estimated. The current study evaluated the technique of induced abortion among mothers with parity score of 0 - 1 (0.49), who attempted abortion; approximately 65 females performed induced abortion medically by misoprostol in 50.7%, surgically by curettage in 28% and manual vacuum aspiration (MVA) or vacuum curettage in 18% of the cases at the gestational age of six weeks. Since previously mentioned technique of abortion was surgical; the unsafe and clandestine abortions with 1.35% maternal death in the 1990s later changed to medical abortion by dinoprostone (prostaglandin E2) in the 2000s and now medical abortion is replaced by misoprostol (prostaglandin E1) in the 2010s. Complete abortion occurred in approximately 60% of the misoprostol cases. The parity score and gestational age in abortion cases have declined. Failure of withdrawal method of contraception (57%) and unmet need to modern effective contraception are contributing factors in these abortions. The trends in abortion are replaced by medical abortion with less morbidity at earlier stages of pregnancy. Traditional contraception and lack of effective contraceptive facilities and accessibilities are likely to increase unintended pregnancies and consequently abortions as well.
Setare Akhavan; Afsaneh Tehranian; Akram Ghahghaei Nezam Abadi
Volume 1, Issue 2 , September and October 2016
Abstract
Introduction: Embryonal (Botryoid) Rhabdomyosarcoma (RMS) is an aggressive malignancy that arises from embryonal rhabdomyoblasts. It is commonly seen in the genital tract of female infants and young children. The primary site of these tumors is closely related to the age of the patient. Embryonal Rhabdomyosarcoma ...
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Introduction: Embryonal (Botryoid) Rhabdomyosarcoma (RMS) is an aggressive malignancy that arises from embryonal rhabdomyoblasts. It is commonly seen in the genital tract of female infants and young children. The primary site of these tumors is closely related to the age of the patient. Embryonal Rhabdomyosarcoma has a marked tendency for local recurrence after excision. Due to young age of affected patients who desire fertility, the management of this rapidly growing malignancy is very critical and poses challenges.
Case Presentation: We report on two cases embryonal rhabdomyosarcoma of uterine cervix, who were referred to Imam Khomeini hospital during year 2014. Both of them were young virgin females. The presenting symptom for both was vaginal bleeding and protrusion of polypoid mass from the hymen. After neoadjuvant chemotherapy, radical hysterectomy was offered to them. One of them refused, thus local excision was done. Both patients received adjuvant chemotherapy yet in the patient with local excision, the tumor recurred with multiple metastases.
Conclusions: There are several methods of surgical approach and variation in adjuvant therapy in the management of embryonal rhabdomyosarcoma. If we choose a conservative approach for surgery of early stage, surgical margin should be negative and in other cases doing radical surgery is the best.
Setare Nasiri; Shahrzad Sheikh Hasani; Azamosadat Mousavi; Mitra Modarres Gilani; Setare Akhavan; Mohammad Rahim Vakili
Volume 1, Issue 3 , November and December 2016
Abstract
Introduction: One of the rare ovarian neoplasms is sclerosing stromal tumor (SST). The most common age at presentation of sclerosing stromal tumor is the second and third decades of life. Usually this tumor presents with menstrual irregularity and pelvic pain as reported previously. Surgery is mandatory ...
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Introduction: One of the rare ovarian neoplasms is sclerosing stromal tumor (SST). The most common age at presentation of sclerosing stromal tumor is the second and third decades of life. Usually this tumor presents with menstrual irregularity and pelvic pain as reported previously. Surgery is mandatory for diagnosis because there is not any distinctive feature to diagnose by imaging techniques.
Case Presentation: Our case in this report is a 26-year-old woman presented with pelvic pain. We conducted routine laboratory tests and checked ovarian mass tumor markers preoperatively. Due to her normal hormonal status in physical examination, we did not request more hormonal laboratory tests. However on imaging, we did not suspect benign tumor. Doppler sonography showed low resistance flow in peripheral and center of the mass. Right ovarian mass was resected and diagnosed as ovarian stromal tumor compatible with sclerosing stromal tumor. Unexpectedly at operation, we encountered severe hemorrhage from peritoneal surface so that conservative management such as packing and suturing or cauterization was not helpful. Finally, argon coagulation stopped bleeding. All coagulation laboratory tests requested by a hematologist were normal.
Conclusions: In conclusion, we believe that vascular endothelial growth factor (VEGF) production of tumor is responsible for massive bleeding.
Shilan Amir Hosseini; Bakhtiar Piroozi; Mohammad Amerzade; Hooman Ghasri; Salah Aldin Farshadi; Hossein Safari; Seyfollah Moradi
Volume 2, Issue 1 , March and April 2017
Abstract
Background: Since April 22, 2014, the natural childbirth promotion package has been implemented in the form of the Health Transformation Plan (HTP) to decrease the cesarean section rate in Iran. This study aimed to determine the amount of subsidy allocated to the natural childbirth package and to examine ...
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Background: Since April 22, 2014, the natural childbirth promotion package has been implemented in the form of the Health Transformation Plan (HTP) to decrease the cesarean section rate in Iran. This study aimed to determine the amount of subsidy allocated to the natural childbirth package and to examine its effects on the cesarean section rate in hospitals affiliated with Kurdistan University of Medical Sciences (KUMS), Kurdistan Province, Iran.
Methods: This is a descriptive study implemented by retrospective and longitudinal design. The population in this study to determine the budget amount allocated to “childbirth promotion package” and all mothers that had natural childbirth deliveries from May 5, 2014 (beginning of HTP) to September 2015 in hospitals affiliated with KUMS. Study populations to determine the C-section ratio included all mothers who had deliveries in hospitals affiliated with KUMS from December 2012 to May 4, 2014 (before HTP) and from May 5, 2014 to September 2015 (after HTP). Using a checklist, the required data was collected from the Statistics and Health Economics Department of Treatment Deputy of KUMS. Afterwards, the obtained data were described using the descriptive statistical indicators including frequency, percent, and mean via Microsoft Excel 2013 (Microsoft Corp., Redmond, WA, USA).
Results: Since the beginning of implementing the natural childbirth promotion package until September 21, 2015, a total of 23 566 mothers had natural childbirth deliveries in the hospitals affiliated with KUMS. These mothers benefited from a total amount of 23 939 046 090 IRR provided by the natural childbirth package. In addition, the cesarean ratio has decreased 7% after implementing HTP.
Conclusions: It seems that HTP caused for the cesarean ratio to decrease in hospitals affiliated to KUMS. Further studies are recommended to determine the causality between a decrease in cesarean rate and HTP.
Bouhlol Ghorbanian; Yousef Saberi
Volume 2, Issue 2 , May and June 2017
Abstract
Background: Atherogenic indices are among risk factors of diabetes which can cause cardiovascular diseases. The purpose of this study was to examine the effect of a 10-week aerobic training on atherogenic indices, lipid profile, and body composition in women with type II diabetes.
Methods: In this ...
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Background: Atherogenic indices are among risk factors of diabetes which can cause cardiovascular diseases. The purpose of this study was to examine the effect of a 10-week aerobic training on atherogenic indices, lipid profile, and body composition in women with type II diabetes.
Methods: In this quasi-experimental study, 40 postmenopausal women with type II diabetes (aged 40 to 60 years) were selected using convenience sampling method and were randomly assigned to experimental (n = 20) and control (n = 20) groups. The exercise protocol included a 10-week aerobic training [aerobic exercise and walking for 3d/wk, 45 to 60 min/d with 45 to 60% heart rate reserve (HRR)]. The atherogenic indices of non-HDL cholesterol (non-HDL-c), atherogenic index of plasma (AIP), low-density lipoprotein cholesterol to high-density lipoprotein ratio (LDL-c/HDL-c ratio), total cholesterol to high-density lipoprotein ratio (TC/HDL-c), lipid product index (LPA), lipid profile, and body composition were measured before and after the intervention. The obtained data were analyzed using t-test. The statistical significance criterion was set at P < 0.05.
Results: The results showed that the levels of TG, LDL-c/HDL-c, and TC/HDL-c significantly decreased as a result of the intervention. However, the changes of LPA, AIP, HDL-c, LDL-c, TC, non-HDL-c, and body composition indices were not significant.
Conclusions: Considering the results of the current study, it seems that aerobic exercise and walking with appropriate volume and intensity can affect atherogenic indices, lipid profile, and body composition in diabetic patients and can reduce the risk of cardiovascular diseases, especially atherosclerosis, among these patients. Further studies are needed to achieve more accurate results.
