Anthropometric, clinical and biochemical comparison of the four polycystic ovarian syndrome phenotypes

Objectives: Polycystic ovarian syndrome [PCOS] phenotypes in different races and ethnicities present with various features. This study aimed to investigate the anthropometric, clinical and biochemical differences according to the four Rotterdam phenotypes of PCOS

Design: A cross-sectional study was conducted

Setting: Two private infertility clinics and a public endocrinology clinic in Rasht, Iran

Subjects: One hundred and sixty one women with PCOS aged between 15 and 41 years from March 2010 to July 2012 were included. Polycystic ovarian syndrome was diagnosed by irregular menstruation [IM], polycystic ovary [PCO] and hyperandrogenism [HA]

Intervention: Demographic data, and fertility features were collected and anthropometric, clinical and biochemical characteristics were measured

Main outcome measures: There were significant differences in mean levels of 17-hydroxyprogesterone [P = 0.010], luteinizing hormone [P = 0.047], and ratio of luteinizing hormone / follicle stimulation hormone [P = 0.017] among the four phenotypes

Results: Most of the subjects were categorized into the IM + PCO + HA phenotype [54%], followed by IM + HA [28%], IM + PCO [13%], and PCO + HA [5%]. Among the four phenotypes, there were no significant differences in terms of demographic characters, fertility features and anthropometric measurements [P > 0.05], but there were significant differences in the prevalence of hirsutism, alopecia and morphology of PCO [P < 0.05]

Conclusion: Phenotypes of PCOS in women from Rasht are similar in most anthropometric, clinical and biochemical features

Midwives' educational needs and knowledge about sexually transmittable infections in the Islamic Republic of Iran

This study aimed to evaluate the educational needs and knowledge about sexually transmittable infections [STIs] demonstrated by midwives. In a cross-sectional study in 2014, 144 midwives in Rasht, Islamic Republic of Iran, were surveyed. The Persian version of the Sexually Transmitted Disease Knowledge Questionnaire [STD-KQ] and a researcher-made questionnaire to evaluate educational needs and profile were used. The participants obtained 74% of the total score of STD-KQ. Thirty-one percent of participants were categorized in high or very high need of education. Seventy percent of midwives mentioned they were trained on all STIs at university. However, only 6.3% of midwives were aware of existing STIs guidelines. Participants reported that in the last two years they were only educated about HIV/AIDS and hepatitis B at their workplace. Thus, a comprehensive educational programme to empower midwives for complete STIs control is recommended

Metabolic syndrome in patients with Polycystic Ovary Syndrome in Iran

Background: The prevalence of metabolic syndrome [MetS] in polycystic ovary syn-drome [PCOS] has been studied in different populations, but their results were so con-troversial regarding Iranian women. These controversial data indicated the need for more investigation of MetS characteristics in PCOS patients in our population. So this study aimed to evaluate the clinical and laboratory characteristics and metabolic features of patients with PCOS in Rasht

Materials and Methods: This prospective cross sectional study was conducted on 215 PCOS women who lived in Rasht, north of Iran, from March 2010 to July 2012. The participants were then divided into two groups of women with MetS [n=62] and women without MetS [n=153]. The diagnosis of PCOS and MetS were based on the Rotterdam 2003 criteria and the Adult Treatment Panel III [ATP III] criteria, respectively. Demographic characteristics, fertility characteristics, family history and laboratory findings were assessed

Results: The prevalence of MetS in women with PCOS was 28.8%. In PCOS women of both groups, the waist circumference [WC] exceeded 88cm in 72.6%, hypertension [systolic blood pressure [SBP] and/or diastolic blood pressure [DBP] >/= 130/85mm Hg] was prevalent in 9.3%, fasting blood sugar [FBS] level was >/= 110 mg/dl in 6%, triglycerides [Tg] level were >/= 150 mg/dl in 47%, and high-density lipoprotein [HDL] level was <50 mg/dl in 86%. The values of WC, SBP, DBP, body mass index [BMI], ovarian size, Tg, cholesterol, FBS, 2-hour blood sugar, aspartate aminotransferase [AST], and alanine aminotransferase [ALT] were significantly greater in PCOS women with MetS than women without MetS. Also HDL and luteinizing hormone [LH] levels in women with MetS were significantly lower than women without MetS

Conclusion: Prevalence of MetS in PCOS women was 28.8%, indicating that this value is higher than other studies conducted on PCOS women in Iran and other studies conducted on general population in Iran. PCOS women are considered as a high-risk population for MetS. The special strategies are required to prevent MetS and its associated complications in PCOS women

relationship between vaginal bleeding in the first and second trimester of pregnancy and preterm labor

Vaginal bleeding is a common complication during pregnancy, which is observed in about 1/4 of pregnancies and in half of cases can lead to abortion. If vaginal bleeding happens during pregnancy some adverse pregnancy outcomes, including perinatal mortality and morbidity, low birth weight and preterm delivery will be increased. The aim of this study was to determine the relationship between vaginal bleeding and its characteristics in the first and second trimester of pregnancy and preterm labor. This is a case-control study conducted on 440 pregnant women referred to Al-Zahra Hospital in Rasht, Iran. Data were collected by a form. The form included demographic characteristics and confounding factors, the occurrence of bleeding during pregnancy and its features. Data were analyzed by T test, chi square and logistic regression in SPSS 16. Findings showed that vaginal bleeding was associated with 3 times increased risk of preterm delivery [OR: 3, 1.84-4.89]. Also, findings showed that bleeding characteristics including bleeding time, frequency, severity and intensity was significantly associated with preterm labor. According to significant association between vaginal bleeding and preterm delivery, it seems that performing some interventions to prevent preterm labor could be appropriate.

Seasonal variation of the onset of preeclampsia and eclampsia

Preeclampsia is one of the three leading causes of maternal mortality. Studies have suggested that the incidence of preeclampsia may be partially dependent on the month or season of delivery. This study was conducted to evaluate whether seasonal variation has any effect on the incidence of eclampsia or preeclampsia. From 1999 to 2001, a cross-sectional study in Alzahra Hospital was performed using all deliveries with gestational age more than 20 weeks. Variables of maternal age, parity, occurrence of preeclampsia and eclampsia, and season were evaluated and analyzed by chi-square test in SPSS 10. During the period of the study, there were 12,142 deliveries at Alzahra Hospital in Rasht. There were 2,579 [21.3%] deliveries in spring, 2,696 [22.2%] in summer, 3,645 [30%] in autumn, and 3,222 [26.5%] in winter. There was no statistically significant relationship between the age, parity and season. Hypertensive disorder was reported in 609 pregnancies [5%], with 11,533 [95%] having no hypertensive disorder. Data showed that 397 patients [3.3%] had preeclampsia and eclampsia. The highest rate of preeclampsia was in spring [3.6%], and the lowest rate was in summer [3%], but it revealed no statistical difference in the incidence of preeclampsia with season. We found no correlation between preeclampsia or eclampsia and season. It may be due to relative similarities between seasons in North of Iran. For example, there are relative similarities between spring and summer, and between autumn and winter

comparison between suppository diclofenac and pethidine in post-cesarean section pain relief: a randomized controlled clinical trial

Narcotic drugs are usually used for postoperative pain control which could cause several complications such as respiratory depression and apnea. Therefore, replacement of these drugs with safer analgesics is recommended. The aim of this study was to compare the analgesic effects of suppository diclofenac and pethidine in post-cesarean section [C/S] patients. In this clinical trial, pregnant women who were admitted to Alzahrah Hospital, Isfahan, Iran, between August and February 2004 and met the inclusion criteria were recruited. After obtaining informed consent, the patients were randomly assigned [block randomization] to two groups. In group A, 100 mg rectal suppository diclofenac was used after operation at four time points: at the end of operation and 8, 16 and 24 hours after the operation. Group B received pethidine 1 mg/kg intramuscularly at similar time points. The pain scores were assessed at 2, 10, 18 and 26 hours after C/S using the Visual Analogue Scale [VAS]. Age, gestational age, parity, history of previous abortion, C/S and abdominal surgery, level of education, pain score, side effects and satisfaction level were assessed. Analysis was carried out with ANCOVA model and X[2] Mantel Haenszel tests by SPSS.10 software. P<0.05 was considered significant. Two hundred forty patients met inclusion criteria. Age, parity, history of previous abortion, history of previous C/S and abdominal surgery, level of education and satisfaction level were similar in the two groups [P>0.05]. There was no significant difference between side effects in the two groups except for dizziness in 11 cases in group B. There were significant statistical difference between pain intensity in 10, 18 and 26 hours after C/S in group A and group B [2.05 +/- 2.07, 1.4 +/- 1.6 and 0.5 +/- 1.1 vs. 2.6 +/- 2.2, 2.3 +/- 2.2 and 1.3 +/- 1.9] respectively. The results of the present study showed that the use of suppository diclofenac is an appropriate replacement therapy for pain relief after C/S