Social determinants and reproductive factors of the menopausal symptoms among women in Tabriz-Iran

Background: Menopause is a natural event in which different degrees of psychosomatic changes occur. The social, demographic and behavioral factors in different nations have a significant effect on symptoms of menopause. The aim of this study was to determine the relationship between the personal, demographic, social and reproductive factors with symptoms of menopause and the frequency of the mental and physical symptoms of menopause among women in Tabriz, Northwest of Iran

Methods: A cross-sectional study was conducted in the clinics and health centers of Tabriz, East Azerbaijan and Iran. A total of 300 women aged 40-60 years filled a questionnaire on the socio demographic variables, reproductive history and symptoms checklist

Results: Among the symptoms, muscle and joint pain [68.7%], and increased facial hair [20.5%] were the most and the least common ones respectively. According to participants, as age increases, the symptoms worsen [p=0.003]. The frequency of the symptoms of the employed women was less than those of retired ones and housewives [p=0.001]. The physical and mental symptoms had negative relation with educational status [p<0.05]. An increase in the number of the children, the history of the oral contraceptive use and dysmenorrhea had positive relation with the frequency of the symptoms

Conclusion: The quality of life of the women during menopause worsens with an increase in age and number of children, whereas it improves with higher educational levels and employment

Primary retroperitoneal mucinous tumor; report of two cases and review of literature

Primary retroperitoneal mucinous tumors are rare neoplasms and almost exclusively seen in women. In this case report we present two cases of this entity with their clinicopathologic features. The first patient was a 32 years old unmarried woman presented with abdominal pain. Ultrasound imaging demonstrated a solid and thick walled ovarian mass m. 105* 70*80 mm. At laparotomy a large retroperitoneal mass with extention to pelvis, dome of urinary bladder and upper abdomen was found and omentum was involved by the tumor. Histopathological examination revealed a mucinous adenocarcinoma with mural nodule contained high-grade anaplastic carcinoma in retroperitoneal space. The second case was a 36 years old woman with retroperitoneal mucinous cystadenoma. The first case died of disease at first month of her diagnosis. Primary retroperitoneal mucinous tumors that containing anaplastic carcinoma or sarcomas are highly aggressive tumors with poor prognosis showing metastasis by high-grade component

randomized clinical trial to compare immediate versus delayed removal of foley catheter following abdominal hysterectomy and laparotomy

Indwelling urinary catheters are frequently used after surgery to prevent urinary retention. There is controversy about the ideal time to remove the catheter after surgery. This study compares the early and late Foley catheter removal following hysterectomy and laparotomy. In a clinical trial, 200 women candidate for hysterectomy or laparotomy were randomized to early removal of Foley catheter immediately or 24 hours after surgery. Early and late outcomes such as pain, fever, symptomatic urinary tract infection [UTI], the rate of recatheterization and patients' satisfaction were compared in two groups. There were no significant differences between two groups in symptomatic UTI, recatheterization rate and reinsertion of Foley catheter. The mean time of hospital stay were lower in the early removal group [P< 0.05]. The patients were more satisfied when the catheter was removed early. Immediate removal of Foley catheter seems to be more beneficial and satisfying for the patients than delayed removal

effect of supplemental iron elimination on pregnancy outcome

To assess the effect of eliminating supplemental iron on pregnancy outcome. A clinical trial was conducted at Alzahra hospital from 2007 to 2009. Nine hundred sixty healthy women at first trimester of pregnancy with Hb>12 gr/dl and BP<140/90 mmHg were randomized into receiving daily one multivitamin+30 mg elemental iron or multivation + placebo tablet from 13 weeks of pregnancy. Iron parameters were analyzed at the 1st trimester and before delivery by using ELISA. Monthly Hb and Hct checkup was performed for placebo group and whom with Hb < 10.5 gr/dl at the end of 2nd trimester or Hb < 11 at 3rd trimester, excluded from the study. Finally 410 women in iron group and 372 in placebo group accomplished the study. The mean weight gain of mothers in iron group was significantly greater than placebo group. [11.57kg vs. 11.09kg, p=0.018]. Iron parameters at delivery time decreased, in two groups and were meaningful in placebo group. Neonatal complications were not significantly different between groups. The rate of preterm labor, IUGR, PROM, placental abruption, gestational diabetes and preeclampsia were not significantly different between groups except for pregnancy induced hypertension [6.7% in iron group vs. 3.4 in placebo group, p=0.04]. Considering iron is a possible source of producing free radicals which has ability of oxidative damage, it is recommended that in iron-replete non anemic women at beginning of pregnancy especially who are at high risk for hypertension, iron should not be prescribed until Hb falls below normal level

Comparison of the effect of gonadotropin-releasing hormone agonist and dopamine receptor agonist on uterine myoma growth. Histologic, sonographic, and intra-operative changes

To investigate the effect of 2 medications; Diphereline and Cabergoline, on uterine leiomyoma growth, and its histologic, sonographic, and intra-operative changes. In an effort to treat large uterine leiomyoma in symptomatic patients in the Gynecology Clinics of the Alzahra Teaching Hospital of Tabriz University of Medical Sciences, Tabriz, Iran, from September 2007 to November 2008, 60 candidates randomized to receive Diphereline 3.75 mg, 4 times every 28 days [group I], and Cabergoline 0.5 mg, once a week for 6 weeks [group II], were included in this study. Clinical symptoms, feasibility of intra-operative dissection, intraoperative complications, sonographic, and pathologic characteristics of the tumor were evaluated. Thirteen patients from group I, and 10 patients from group II underwent surgery. There was a significant difference between the groups in the rate of lymphocyte infiltration [p=0.003], but not in other pathologic features. In both groups, the mitotic index was between 0-10. While there was no significant difference between the groups in the number [p=0.30], and volume of leiomyomas [p=0.65], however, changes in the uterine artery circulation was significant [p=0.001 [group I], p=0.026 [group II]]. In addition, there was a significant difference between the groups for intra-operative hemorrhage and adhesion of leiomyomas to the uterine wall. This study found that Cabergoline is as effective as Diphereline in the shrinkage of myomas, accompanied by improvement in the sonographic, clinical, and intra-operative outcomes without any adverse pathological changes, and could be a good medical regimen as an adjunct to surgical management