[Survey the amnion graft in treatment of congenital absence of the vagina]

Vaginalatresia can be congenital or acquired. Absence of a functional vagina can lead to primary or secondary amenorrhea and haematometra. Survey the Amnion Graft in Treatment of Congenital Absence of the Vagina. In this study, 14 cases of vaginal agenesis between 1997 until 2008 years were analyzed. The amnion membrane of elective cesarean section was kept in new space using a 20ml syringe covered by sponge or elastic band as a mould. Patients with vaginal agenesis underwent vaginoplasty using amniotic membrane grafts according to Frank method. Twelve patients had Mayer-von-Rokitansky-Kuster-Hauser syndrome [MRKHS] and others [2] had vaginal agenesis with normal functional uterus. All patients were between 20 and 26 years old. Regular menstrual periods were observed in two patients that had normal uterus one month after operation. The follow-up pelvic ultrasonography was normal. After operation one of the 14 patients [7.1%] developed vaginal stenosis; that were corrected with sexual intercourse. All of married patients were satisfied of sexual function. The incidences of urologic abnormalities were [21.4%]: congenital horseshoe kidney found in two patients and one patient had only one kidney. Stenosis of the vagina was reported in one patient. All patients achieved a good outcome. Using amniotic membrane as an allograft for vaginal reconstruction showed very good outcome with a resultant good caliber new vagina

[Effect of cervical cleaning with cotton on quality of Pap smear]

Introduction: Today, cancer of the cervix has been considered a preventable cancer due to its long pre- invasive state, availability of cervical cytology screening programs, and effectiveness of the treatment of preinvasive lesions. Due to slow progression of cervical cancer lesions, Pap smear is an efficient procedure for cancer detection and decreases mortality

Objective: The objective of this study is to compare the quality of Papsmear before and after cervical cleaning in females referred to Alzahra Hospital

Materials and Methods: This is a before - after clinical trial. Subjects were sampled by nonprobability convenience method. Inclusion criteria were absence of vaginal bleeding, infection, pregnancy, coitus and vaginal douching during past 48 hrs. After obtaining informed consent, two cytologic smears were taken by cytobrush [Cervex-Brush] before and after cervical cleaning by sterile cotton. Both smears were fixed, Coded and send to a special laboratory immediately. They were taken by a resident and were reported by a pathologist. After data collection analysis carried out with X[2], X[2] Mantel Hanszell, statistical software SPSS.10 was used

Results: In this study, 152 patients had met inclusion criteria .The mean age of women was 39.6 +/- 11.2yrs [range 17-65 yr]. Before cleaning, there were 39[25.7%] satisfactory versus 101 [66.4%] after cleaning [P<0.0001]. There were 22 [14.5%] unsatisfactory smears before cleaning versus 10 [6.6%] after it [P=0.0025]. Before cleaning 15 [9.9%] of smears were poor cellular although 4 [2.6%] of smears was poor cellular after procedure [P= 0.009]. Before cleaning, we had 1 [0.7%] smear with epithelial abnormality, which were increased by 7 [4.6%] after [5 ASCUS-1 AGUS-1 CIN-I] [P=0.032]

Conclusion: Pap smear sampling after cervical cleaning increases the quality of smear and is recommended. Due to similar standard results in other sites of the world, we advocate this procedure for accuracy improvement

[Assessment of women's knowledge regarding postpartum complications and cares]

Introduction: Mother and child health is one of the major concerns of public health throughout the world. Health education and increased knowledge of mothers in relation to their health is an important strategy for improving maternal and child health

Objective: The aim of this study was the survey of postpartum women's knowledge about complications and cares after delivery

Materials and Methods: This is a descriptive, cross-sectional study that assesses postpartum women's knowledge about postpartum complications and cares in Alzahra hospital in spring of 2003. The subjects were selected with convenience sampling method [non-probability] from women with the same case. A standard questionnaire [designed by ministry of health] was used to collect the data. This questionnaire consisted of a two-part questionnaire which included: [1] the demographics [2] assessment of knowledge level. After data collection, analysis was carried out with chi-square test by spss.10 software

Results: In this study, 384 women were assessed. Data showed that the mean age of the women was 26.5 +/- 0.3 yrs. Only 10 cases [2.6%]of women had university education. The majority of subjects were housewives 389[95.8%]. An evaluation of their knowledge about postpartum complications and cares showed that 360 [93.8%] of them had very poor and 22[5.7%] of them had poor and 2[0.5%] of them had intermediate knowledge. The results indicated that there weren't statistically significant relationship between age, parity and information source with level of knowledge [P>0.05] but there were significant correlations between education level and job with knowledge level.[p<0.05]

Conclusion: Regarding the low level of the women's knowledge about postpartum cares and complications, the researchers suggest on increasing knowledge levels by means of holding different classes and counseling sessions and also continuous visiting of the patients which can help them to reach this goal

[Relative frequency of gonococcal endocervisitis and some associated factors in reproductive age women]

Introduction: Gonorrhoeae is one of the sexual transmitted diseases. It is often asymptomatic in women and can cause a variety of complications and sequelaes, if it is left untreated

Objective: The goal of this study was to determine the relative frequency of gonococcal endocervisitis and some associated factors in women in reproductive age referring to Alzahra hospital in Rasht from 2002 to 2003

Materials and Methods: This is a cross-sectional study. In this study, all the women who referred to Alzahra maternity hospital for family planning and gynecologic disease in 2002-3 were assessed with sequential non-probability sampling .All of the women, who had inclusion criteria, were examined for cervical mucus assessment [for kind and amount]. Culture of cervical mucus is a standard method for diagnosis of gonorrhea infection. So they were referred to a specific laboratory for providing samples of cervical mucus to culture in Thayer-Martin medium. After this procedure, one pathologist evaluated smears. Data gathering form included demographics variables like age, education and …also cause of referring ,kind of vaginal discharge, history of vaginal infection and treatment, contraceptive methods and results of culture. Analysis carried out with chi–square test by spss.10 software

Results: In this study, 1951 women were enrolled. Most of patients 1488 [76.3%] were 21-40 years old. The first coitus age in majority of cases was 20-34 years old. 1136 cases [58.2%] had a history of vaginal infection, 1167 women [59.8%]were in middle class socio-economic status. Neisseria gonorrhea revealed in 11 cases [0.6%] of cultures. There weren't significant correlation between variations like age, first coitus age, parity, education level, socio- economic level, contraceptive methods and gonococcal infection. There was a significant statistical difference between muco-purulent vaginal discharge and gonococcal infection [P<0.004]

Conclusion: Nevertheless, culture of the samples have sensitive, frequency of gonorrhea was similar to research that was carried out in Tehran [diagnosed with smear]. In comparison with the prevalence of gonococcal infection in Asia, it was 4% and was limited to 0.6% in our study. It appears that the condition of cultural values in sexual relations, rate of gonococcal infection had decreased

[Homocysteinaemia and degenerative complications in non insulin dependent diabetes mellitus]

Type 2 diabetes mellitus [non insulin-dependent diabetes mellitus: NIDDM] is known to be associated with degenerative complications. Although, the pathophysiology of such complications is well known, the role of homocysteine [Hey] is still discussed.The aim of the present study was to evaluate the relationship between the homocysteine levels and the NIDDM related complications in a group of NIDDM patients. Our study population consisted of 41 NIDDM patients including 13 subjects [G1] without complications [group controls], 17 patients [G2] with microangiopathy and 11 patients [G3] with coronary deficiency. Plasmatic homocysteine, glycemia, glycated haemoglobin [HbAIC] and lipid parameters were assessed in all patients. Our results showed that mean levels of plasmatic homocysteine were within the normal range [10.4 +/- 3.3 micro mol/l, 9.9 +/- 5.5 micro mol/l and 14.8 +/- 10.4 micro mol/l in G1, G2 and G3 respectively]. Nevertheless, moderate hyperhomocysteinaemia was found in 36% in the coronary group [G3], 17.3% in patients with microangiopathy [G2] and 7.7% in controls.These preliminary results showed that cardiovascular complications in NIDDM patients may be related to high levels of homocysteine

[Investigation of the pregnancy rate after intracytoplasmic sperm injection in patients with obstructive and non-obstructive azoospermia]

In 10-20% of men with abnormal semen, azoosperima, the absence of sperm in ejaculation is common. Up to now, there has been no chance of pregnancy for couples in which the male partner had permanent azoospermia except by the use of donor insemination treatment but intracytoplasmic sperm injection [ICSI] has initiated a new era for azoospermic patients. The present study assessed the outcome of 50 consecutive ICSI cycles with spermatozoa surgically retrieved from azoospermic patients. In a male infertility center, 50 ICSI using precutaneouse epididymal sperm aspiration [PESA] or testicular sperm extraction [TESE] was carried out in 30 obstructive and 20 non-obstructive azoospermic patients, respectively. Fertilization and pregnancy rates were compared in two groups. One hundred and seventy two and 116 MII oocyte were injected with motile or shaking sperm, which 69.2% and 64.6% were fertilized in obstructive and non-obstructive group, respectively. The clinical pregnancy rates were 23.3% and 25% in obstructive and non-obstructive group, respectively. The ongoing pregnancy rates were similar in two groups [20%]. It seems that by using ICSI with a new sperm retrieval technique, the azoospermic patients could be potentially fertile

[Survey of attitude and knowledge about tubal ligation and its complications in women residing in Rasht]

Introduction: contraception is a major component of preventive health care for women. Several methods are used for familly planning but tubal ligation [TL] is different from other contraceptives because often it isn't reversible.Recently,due to decrease in acceptability of TL in women,there are questions on saftey of this method

Objective: the purpose of this stuy was to investigate attitudes and knowledge about tubal ligation and possibility of Post Tubal Ligation Syndrome in women residing in Rasht

Materials and Methods: in this study, 403 women were collected with stratified randomized sampling. The data collection instrument consisted of a three-part questionnaire which included:[1] the demographics [2] knowledge level and [3] questions concerning the attitude. We applied the SPSS.9 statistical analysis software and Chi-square tests, pearsonian coefficient. P<0.05 was determined as statistical significance

Results: the research showed that 45/9% of women have poor knowledge and 21% have negative attitudes about tubectomy. There were significant correlations between the number of children, education level, and information source with level of knowledge [P<0.05]. Also, there were significant correlations between variations like education level, information source and contraception methods with level of attitude [P<0.05]. Our results showed that 82/1%,41/5% and 21/8% of women believed that Pelvic and Lumbar pain, Menstrual disorders and Ovarian cyst might occur after tubal ligation respectively

Conclusion: our research showed that many of women due to fear of tubal ligation complications [Post Tubal Ligation Syndrome] had a negative attitude. It seems that increasing the knowledge of women and more comprehensive studies are necessary for Post- Tubal Ligation syndrome about which there is no consensus yet