[Comparison of the diagnostic accuracy of pipelle biopsy, dilatation and curettage and hystrectomy in detection of endometrial lesions]

The current study has been designed to compare the diagnostic value of pipelle sampling as a simple and cost effective method with that of more complicated and expensive methods in the detection of pathologies in abnormal uterine bleedings. In 60 patients scheduled for hysterectomy due to persistent uterine bleeding, endometrial sampling was done twice, once with pipelle and then by D and C prior to the hysterectomy. First the pathological reports of pipelle and D and C specimens were compared with each other and then both were compared with hysterectomy as the gold standard. In all cases pipelle was passed to the uterine cavity without any need for cervical dilatation and anesthesia. The most frequent results in all tree kinds of sampling were proliferate endometrium and early secretary phase respectively. According to the pathological reports, pipelle and D and C in 89% of the cases, pipelle and hysterectomy in 80% of the cases and D and C and hysterectomy in 90% of the cases showed agreement, that shows so significant difference in diagnostic accuracy among three methods. Considering high agreement between pathological reports of pipelle biopsy as an outpatient method and those of D and C and hysterectomy, pipelle sampling is suggested as the first diagnostic procedure, while D and C and hysterectomy that necessitate anesthesia and take more time and expense should be reserved for just special cases

Prevalence of migraine headache and effective environmental factors in Kerman a population based survey

The aim of the present study was to estimate the prevalence of migraine headache among Kermanian adults [aged >12 years], and analyse variation by age, gender, occupation and educational level. A population-based survey was undertaken using questionnaire interviews with 1,488 adults, who were randomly selected from households across, Kerman by cluster regional sampling. There are questions about frequency and characteristics of headaches experienced and other symptoms in the questionnaire. The diagnostic criteria of the international headache society were used to classify people as migraineurs [with or without aura]. Of 1,488 random selected adults, 427 were headachers and 30 were migraineurs. The prevalence of migraineurs among males was 0.8% and among females was 3.4%. For females, prevalence appears to increase with age, peaking of 26-41 years and declining thereafter. Sex specific prevalence females and males was controlled for age, was significantly lower in males. We found no association between migraine prevalence and educational level or occupation. We found association between migraine prevalence and environmental factors, anxiety, insomnia, light, sound, fatigue, activity, smoking, menstruation, which was significant