[Evaluation of the risk factors related to dysfunctional uterine bleeding in peri-menopausal women in Sanandaj]

Dysfunctional uterine bleeding [DUB] is one of the common problems in peri-menopausal women that can affect their physical, emotional and social conditions. In addition DUB is one of the main causes of hysterectomy. The aim of this study was to investigate risk factors associated with DUB in peri-menopausal women in Sanandaj. This case-control study included 62 women with DUB[case group] and 124 women without DUB[control group]. We used a questionnaire consisted of different items which was completed for every subject after clinical interview. Using SPSS software, data analysis was performed by chi-square, Fisher exact test and logistic regression. DUB showed significant relationships with type of delivery [p=0.015] and age [p=0.045]. DUB had no significant relationship with diabetes [p=0.095], hypertension [p=0.917] and type of contraceptive methods [p=0.906]. Analysis by logistic regression revealed that women over 50 years of age and women with history of Cesarean section [C/S] had a respective risk of 2.284 [p=0.021] and 2.493 [p=0.009] times greater to develop DUB than women without these factors. The age over 50 years and C/S was suggested as risk factors which can be related to DUB. Attention to the advantages of vaginal delivery and complications of C/S is necessary and reduction of C/S rate can be effective in decreasing the incidence of DUB

[Comparative efficacy of 2% hydroquinone and melfade in treatment of melasma]

Melasma is an acquired hypermelanosis disease and can cause superficial problems in women if left untreated. The objective of this study was to compare the efficacy of 2% hydroquinone and Melfade in the treatment of Melasma. This is a randomized clinical trial study conducted at Kurdistan University of Medical Sciences in 2008. Sixty two women with Melasma disease were recruited and randomly assigned to two groups. Two percent hydroquinone was prescribed for the first group [n=31] and Melfade for the second group. After 12 weeks of daily drug consumption by the patients, they were examined by a dermatologist for assessment of recovery. The collected data was analyzed by the SPSS software. Response to treatment with hydroquinone and Melfadewas the same and no significant differences were found between the two groups. [P>0.05] Results of this study demonstrated that topical Melfade is as effective as 2% hydrquinone in treatment of Melasma, Therefore it can be considered as an alternative drug in the treatment of Melasma

[Effect of supplemental oxygen on the incidence and severity of nausea and vomiting in the patients after cesarean surgery under spinal anesthesia]

Nausea and vomiting are common complications after surgery occurring in 20-70 percent of total surgeries and depends on factors such as anesthesia method and hemodynamic status, oxygen concentration, pain, etc. In some studies use of higher concentrations of oxygen prior to surgery has resulted in decreased incidence of nausea and vomiting and in some other studies such results had not been verified. In the present study, the effects of supplemental oxygen has been assessed on the incidence and severity of nausea and vomiting in the patients after cesarean surgery under spinal anesthesia. This study was a randomized clinical trial and 122 women who were candidate for cesarean surgery were assigned randomly into intervention and control groups. Intervention group received 80 percent O2equivalent to 12 liter per minute, continuously during surgery and after surgery in recovery room, and alternatively 6 hours by use of ventury mask in the ward. The control group received 30 percent O2, equivalent to 3-5 liters per minute with a regular mask as a routine measure. The incidence and severity of nausea and vomiting was recorded during surgery, up to 6 hours after surgery, in the recovery room and in the postpartum ward. According to the results, the incidence of nausea during surgery showed no significant relationship but it showed a significant difference in the recovery room and at the postpartum ward in the intervention and control groups [p<0.01]. Incidence of vomiting during surgery and at the postpartum ward in the intervention and control groups had no significant difference but it revealed a significant difference in the recovery room [p<0.001]. There was a significant difference in the severity of nausea in the intervention and control groups during surgery, in recovery room and after 6 hours of surgery in the postpartum ward and the severity of nausea was higher in the control group [p<0.05]. This study demonstrated that supplemental oxygen therapy during and after surgery by spinal anesthesia technique was not effective for the prevention of nausea. There was only a significant statistical difference in the rate of vomiting in the recovery room between the two groups. Use of supplemental oxygen decreased the need for analgesic drugs in these patients

[Bilateral twin ectopic pregnancy with simultaneous intra uterine pregnancy]

Unilateral Twin Ectopic Pregnancy is very rare and only 100 cases have been reported till now. Bilateral Twin Ectopic pregnancy is the rarest type of Dizigotic twin pregnancy. We have reported a case of Bilateral Twin ectopic pregnancy with live simultaneous Ilntra Uterine Pregnancy that its prevalence is unclear. We didn't find any similar cases in the literature. The patient was a 34-year-old woman with intermittent crampic pain in both abdominal owe' quadrants for 2 days. The patient had a history of abortion and also a secondary infertility and HMG Injection. The ultra-sonography showed a 12 week pregnancy uterus with bilateral ovarian cyst where one of them was ruptured and a large amount of fluid in pelvic cavity was seen. Therefore, a decision was made for surgery During operation, two much dilated non ruptured area in left falopian tube and two ectopic pregnancies in the right fallopian tube were seen which one of them was ruptured. Considering the ectopic pregnancy, when encountering women in reproductive age, is necessary and any pregnant woman with abdominal pain must be considered for

Evaluation of impaired glucose tolerance test in patients with polycystic ovarian syndrome

Disorders of carbohydrate metablolism are among metabolic disorders which can be encountered in patients with PCO syndrome. The present study was designed to assess the relationship between PCOS and glucose intolerance in patients referring to obstetric clinic in Sanansaj in 2004. This study was a descriptive case-control study. The case group included 126 women at reproductive age with PCOS, confirmed with clinical, sonographic and laboratory data. Control group consisted of 126 women without any evidence of PCOS that were matched with the case group for age, weight, height, pregnancy number, method of contraception, history of abortion and still birth. Oral glucose tolerance test [GTT] using a st and ard 75 g glucose was performed and LH and FSH were checked for all subjects. Using SPSS win soft ware, data were analyzed by means of chi-square [lamda[2]] and T-tests. According to the results of this study the mean level of blood glucose, fasting and after 1 hour, did not show any significant differences; but after 2 and 3 hours we found remarkable differences in the glucose values between the two groups. Impaired glucose tolerance test was significantly higher in the case group. [17 vs. 2 and p=0.001 OR=9.67 Cl 2.08

Epidemiological survey of gestational trophoblastic disease in Besat Hospital in Sanandaj from 1373 to 1382

Gestational trophoblastic diseases are among the cases of high risk pregnancies. Lack of timely diagnosis may lead to complications such as high morbidity and mortality, HTN and hyperthyroidism. The aim of this study was to assess the incidence and epidemiologic status of gestational trophoblastic diseases in Besat Hospital in Sanandaj from 1373 to 1382. This descriptive study included all normal deliveries, cesarean sections, and curettages of the moles in Beast Hospital from 1373 to 1382. The sampling method was census. Data were analyzed by means of descriptive statistical methods using SPSS win 11 program. The results of this study showed that the incidence of trophoblastic diseases was 2.02 per 1000 pregnancy, namely 81 cases out of 39979. 78 [96.3%] patients had hydatidiform mole, 2 cases [2.5%] invasive mole and 1 case [1.2%] choriocarcinoma. The mean age of the patients was 27.2 +/- 5.2 years. 30 cases [38%] had history of abortion. The incidence of gestational trophoblastic diseases and the mean age of these patients in Sanandaj are the same as those of others regions of Iran. Therefore routine sonography in the first trimester, for rapid diagnosis of gestational trophoblastic diseases is recommended

Randomized control trial investigation of the effect of high-dose versus low-dose oxytocin regimens in induction of labour

Induction of labour means stimulation of uterus to increase the frequency, duration and strength of contractions. There are numerous methods for induction of labour, but use of synthetic oxytocin is the most common method. In the academic hospitals, approximately 20-30 percent of labours are induced by use of oxytocin. There are two regimens for oxytocin administration i.e. low-dose and high-dose oxytocin. This study was performed to determine the effect of high-dose versus low-dose oxytocin regimens to induce labour in post-term pregnancies in primigravid women. sixty pregnant women were entered into this prospective, randomized, double blind clinical trial. The patients were assigned into two groups by randomized block sampling. Our study included primigravid pregnant women for whom the only indication for induction of labour was post-term pregnancy. Patients were randomly assigned into two groups [n=30] and received oxytocin according to either a low-dose or high-dose protocol. The required Data were extracted by observation, patient interview and also patients records. Statistical analysis was performed by means of X[2] and Mann-Whitney U tests. P value of <0.05 was considered statistically significant. There was no significant difference in the mean cervical dilatation, gestational age and maternal age before induction of labour in the 2 groups. Mean durations of active phase were 249.29 minutes and 191.91 minutes in the low-dose and high-dose groups respectively [p>0.05]. The mean values for hospitalization time from admission to complete dilatation of cervix were 512.47 and 449.95 minutes in the low-dose and high-dose groups correspondingly. The mean time from admission to delivery was 552.9 minutes in the low-dose group versus 512.16 minutes in the high-dose group. Lack of response to induction encountered in 20% and 33.3% of the cases of high-dose and low-dose groups accordingly [p>0.05]. The most common cause of cesarean section in the two groups was unresponsiveness to induction [46.1% in low-dose and 42.7% in high dose groups]. We faced 2 cases of neonatal death [6.7%] in the low-dose group. We conclude that high-dose oxytocin regimen shortens labour time. Therefore fewer cesarean sections are required and neonatal outcome will be better. Nonetheless the rate of hyperstimulation is more when high-dose oxytocin regimen is used