Application of the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) to patients with endometriosis

OBJECTIVE: Endometriosis, a common hormone-dependent chronic inflammatory disease causes various symptoms including pelvic pain, which affect the physical and psychological quality of life in women of reproductive age. The present study aimed to assess the quality of life of Iranian women with endometriosis using the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) questionnaire. METHODS: This cross-sectional study performed in Tehran between October 2014 and July 2016 included 70 Iranian women with endometriosis. The Iranian version of the WHOQOL-BREF questionnaire was used to measure quality of life in these women. The Pearson's correlation coefficient, the paired and the independent t-tests, and a linear regression model were used to statistically analyze the data using the SPSS software version 16.0. RESULTS: The total mean score of the WHOQOL-BREF questionnaire was 80.58. The highest and the lowest mean scores were observed in the environmental (28.15) and the physical health domains (10.59), respectively. A multiple linear regression model (backward method) showed that insurance coverage was associated with the total WHOQOL-BREF score, whereas age, insurance coverage, and income level were associated with domains 1 through 4, respectively (P < 0.05). CONCLUSION: Endometriosis affects various aspects of the quality of life of Iranian women who therefore require holistic management focused on both, the physical and psychological aspects of treatment.

Conservative management of ovarian fibroma in a case of Gorlin-Goltz Syndrome comorbid with endometriosis

Ovarian fibromas are the most common benign solid ovarian tumors, which are often difficult to diagnose preoperatively. Ovarian fibromas, especially in bilateral cases, may be cases of Gorlin-Goltz syndrome [GGS], a rare autosomal dominant disorder with predisposition to basal cell carcinomas [BCCs] and other various benign and malignant tumors. This case report describes a 25 year-old female with GGS, bilateral ovarian fibroma, endometriosis and septated uterus, which was referred to the Gynecology Clinic of Rasoul-e-Akram Hospital in October 2016. This patient had facial asymmetry due to recurrent odontogenic keratocysts. In young cases of ovarian fibromas as reported here, conservative surgical management can preserve ovarian function and fertility. These patients must be followed up by a multidisciplinary team and submitted to periodic tests

[Prevalence of hymenal damage during operative hysteroscopy in Hazrat Rasool e Akram Hospital between 2004 and 2014]

Background: The virginity is a matter of concern in many eastern countries, especially Muslim societies. In some cultures, integrity of hymen before marriage causes deprivation of social rights for the females; even in some cases an honor killing is plausible

Materials and methods: In this descriptive cross-sectional study, total records of all virgin patients who underwent hysteroscopy for medical reasons in Hazrat Rasool Hospital between 2004 and 2014 were studied. Data were analyzed by SPSS version 19 using descriptive scales and simple proportion and ratios

Results: 400 women with AUB [abnormal uterine bleeding] were referred to Hazrat Rasool Hospital for the diagnosis and treatment. 12 cases [3%] were virgin and 388 [97%] were non-virgins. In 12 Virgin patients admitted for hysteroscopy, 3 [25%] hymenal damage were reported, and in 9 virgin patients hymen remained intact postoperatively

Conclusion: Regarding the high prevalence of congenital and acquired uterine diseases and successful treatment of these problems by hysteroscopy, it seems prudential to focus on more comprehensive teaching programs in the gynecologic endoscopic field. This will help better and earlier diagnosis and treatment of virgin patients, due to seeking earlier medical care

[Evaluation of the factors influencing endometriosis in reproductive age women]

Background: Endometriosis is one of the most common diseases with high socio- economic burden in women. The aim of this study was to investigate the factors influencing on endometriosis by logistic regression

Materials and methods: In this case- control study, data were collected from patients records in Hazrat Rasoole Akram Hospital in Tehran. The patients who suffered from endometriosis [250], and their disease was diagnosed by laparoscopy, were selected as case group, and 250 patients with gynecologic disorder, other than endometriosis, confirmed by laparoscopy were chosen as control group. Factors affecting endometriosis were evaluated by logistic regression using the software SPSS. P- value <0.05 was considered significant

Results: Mean age [ +/- standard deviations] of women in case group [34.84 +/- 0.62] was significantly higher than control group [33.75 +/- 0.55] [P=0.02]. Single variable logistic regression for independent variables candidate age, irregular menses, the duration of menstrual cycle, the duration of bleeding, the number of pregnancies, the number of live births, infertility, speck before menstrual bleeding to enter into multi variable logistic regression at error level of 0.2. Variables of age, the number of live births, and premenstrual spotting were predicted as factors influencing endometriosis

Conclusion: According to the result of present study, age, the number of live births, premenstrual spotting were predicted as effective factors for endometriosis. As we know, increasing awareness of women about factors influencing endometriosis may help timely diagnosis and treatment of this important disease

Laparoscopic approach to a large ovarian fibroma: a case report

Ovarian fibroma is the most common benign solid tumor of the ovary, which is often difficult to diagnose preoperatively. The choice treatment for ovarian fibroma is surgical removal, but discussions for the operative approach, laparoscopic or open, in the literature seem to be scant. Case Presentation: We presented a unique clinical experience of laparoscopic approach to a case of 15 cm unilateral ovarian fibroma in a 24 year old patient, with a successful and complete resection of the tumor beside ovarian tissue preservation in December 2012 in Rasoul-e-Akram hospital, Tehran, Iran. In conclusion, we should not forget the role of laparoscopy as a diagnostic procedure even in suspicious cases of ovarian fibroma with solid tumor, ascites, and pleural effusion

Assessment of C-reactive protein and C3 as inflammatory markers of insulin resistance in women with polycystic ovary syndrome: a case-control study

Polycystic ovary syndrome [PCOS], a common endocrine disorder, is associated with infertility, menstrual dysfunction, hirsutism and frequent miscarriages. Insulin resistance, as a major cause of PCOS, represents a disorder with increase in inflammatory markers and risk of type 2 diabetes. We aimed to investigate whether inflammatory markers, including C-reactive protein and C3 [Complement], are related and altered in polycystic ovary syndrome. A case-control study including forty-two women diagnosed with PCOS, according to Rotterdam criteria, and forty-two healthy controls, matched for body mass index [BMI] and age, was conducted in 2012. C-Reactive protein [CRP] and C3 were assessed as possible determinants of the homeostasis model assessment [HOMA] index. Independent-sample t-test was used to compare the means of the groups in age, BMI, C3, FBS and BS 2hpp [2 hr postprandial glucose] and for CRP, Fasting Insulin and 2 hr Plasma Insulin and HOMA index. Mann-Whitney test and Pearson correlation were used for analyzing the data. The p<0.05 was considered as statistically significant. Levels of plasma CRP [p=0.039], 2 hr pp [p=0.045], Fasting Insulin [p=0.002], 2 hr Plasma Insulin [p=0.002] and HOMA index [p=0.002] were significantly higher in PCOS patients. But C3 was not significantly higher in cases [p=0.885; CI: 95%]. There was no significant correlation between C3 and CRP with HOMA index. CRP increased significantly in patients with PCOS and was associated with insulin resistance, the most probable cause of PCOS. However, such an association was not found in C3