Prevalence and Risk Factors of Urinary/Anal Incontinence and Pelvic Organ Prolapse in Healthy Middle-Aged Iranian Women

Objectives@#Urinary incontinence (UI) and anal incontinence (AI) cause concern, social exclusion, and ultimately reduced quality of life in women. The aim of present study was to assess the prevalence and related risk factors of UI, AI, and pelvic organ prolapse (POP). @*Methods@#The present study recruited 340 menopausal women living in Tabriz in northwest Iran. The data collection tools included the Pelvic Floor Distress Inventory-20 and a personal and social information questionnaire. POP was diagnosed via clinical examination using the simplified pelvic organ prolapse quantification system. @*Results@#The prevalence of UI and POP was approximately 50%, and approximately 16% of participants reported AI. Based on the odds ratios, the most remarkable risk factor of urinary stress incontinence was the number of vaginal deliveries, whereas that of urinary urge incontinence was obesity. Episiotomy and age were the most major risk factors of AI and POP, respectively. @*Conclusions@#The results of the present study showed that the prevalence of POP, UI, and AI is remarkably high among postmenopausal women, warranting the need to prioritize the assessment of POP and various incontinences in middle-aged women in the primary health care system. Furthermore, increased emphasis should be put on modifiable risk factors.

The Effect of Flaxseed Enriched Yogurt on the Glycemic Status and Cardiovascular Risk Factors in Patients with Type 2 Diabetes Mellitus: Randomized, Open-labeled, Controlled Study

Flaxseed is one of the rich sources of α-linolenic acid and lignan. Flaxseed and its components have antioxidant, hypolipidemic and hypoglycemic effects. The study aimed to investigate the effect of flaxseed enriched yogurt on glycemic control, lipid profiles and blood pressure in patients with type 2 diabetes. A randomized, open-labeled, controlled clinical trial was conducted on 57 patients with type 2 diabetes. Participants were assigned to receive 200 g 2.5% fat yogurt containing 30-g flaxseed or plain yogurt daily for 8 weeks. Anthropometrics and biochemical parameters were evaluated at the beginning and end of the study. After 8 weeks of supplementation, Hemoglobin A1c was significantly decreased in the intervention group compared to control (p = 0.007). Also, at the end of the study, significant differences were seen between the flaxseed enriched yogurt and control groups in triglycerides and total cholesterol concentrations (p = 0.04 and p = 0.01), systolic blood pressure and diastolic blood pressure (p = 0.02 and p = 0.002, respectively). However, we did not find any difference between 2 groups in low-density lipoprotein, high-density lipoprotein, body weight and waist circumference (p > 0.05). Our results showed that the addition of flaxseed to yogurt can be effective in the management of type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02436369

Effects of Resistant Starch Supplementation on Glucose Metabolism, Lipid Profile, Lipid Peroxidation Marker, and Oxidative Stress in Overweight and Obese Adults: Randomized, Double-Blind, Crossover Trial

Obesity is a substantial public health challenge across the globe. The use of resistant starch has been proposed as a probable management strategy for complications of obesity. We investigated the effects of resistant starch intake on lipid profiles, glucose metabolism, antioxidant status, lipid peroxidation marker, blood pressure, and anthropometric variables in subjects with overweight or obesity. In this 12-week, randomized, double-blind, placebo-controlled, 2 × 2 crossover trial, 21 Participants (mean age, 35 ± 7.0 years; body mass index, 32.4 ± 3.5 kg/m²) were given 13.5 g Hi-Maize 260 or placebo daily for 4 weeks, separated by a 4-week washout period. Changes in total antioxidant status (p = 0.04) and serum concentrations of insulin in 52.4% participants with insulin levels above 16 µIU/mL at the baseline (p = 0.04) were significantly different in the three phases. In addition, the mean of serum high-density lipoprotein cholesterol after the intervention was significantly higher than after baseline value (p = 0.04). We found no significant differences in serum concentrations of total cholesterol, triacylglycerol, low-density lipoprotein cholesterol, fasting blood sugar, insulin, homeostatic model assessment of insulin resistance, quantitative insulin sensitivity check index, superoxide dismutase activity, malondialdehyde, blood pressure, and anthropometric variables in the three phases of baseline, after intervention with resistant starch and after placebo. Resistant starch consumption improved serum insulin concentrations, lipid profiles, and antioxidant status in subjects with overweight or obesity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01992783

TGF-beta1 polymorphisms -509 C>T and +915 G>C and risk of pancreatic cancer

Aim: Our aim was to determine the association between TGF-beta1 polymorphisms at position -509 C>T [rs1800469] and +915 G>C [rs1800471] and pancreatic cancer susceptibility in Iranian population

Background: Ninety percent of pancreatic cancer patients have less than 5-year overall survival and approximately 50% of cases were diagnosed with metastasis in the time of admission. Previous evidences have demonstrated the strong association between TGF-beta1 variations and cancer susceptibility so far

Methods: A total of 78 patients with pancreatic cancer and 94 healthy controls were enrolled in this case control study from 2007-2012. Genomic DNA was isolated from peripheral blood samples according to phenol chloroform extraction. The genotypes of TGF-beta1 rs rs1800469 and rs1800471 were determined using the polymerase chain reaction-restriction fragment length polymorphism method

Results: The mean age of cases and the control group were 64.50 +/- 13.718 and 40.12 +/- 16.001, respectively. For polymorphism-509 C>T, the frequency of TT genotype were 31 [33.0], CT, 47[50] and CC, 16 [17] in control and 19 [24.4], 45 [57.7] and 14 [17.9] in cases respectively. In position +915 G>C, the frequency of GG genotype was 84 [89.4] and GC, 10 [10.6] in control and 71 [91.0] and 7 [9] in cases, respectively. We did not observe any significant differences in the genotype and allele frequencies of the TGF-beta1-509 C>T [rs1800469] and codon +915 G>C [rs1800471] between the two study groups [P>0.05]

Conclusion: we found that TGF-beta1 gene polymorphisms rs1800469 and rs1800471 might not play a role in pancreatic cancer susceptibility in Iranian population

[Determine effect of weight loss on serum level of inflammatory cytokines IL-1beta, IL-6, CRP andTNF-alpha in obese patients with fatty liver disease]

Background: Obesity results in a chronic inflammatory state leading to long term adverse effects. The aim of this study is to evaluate effect of low calorie diet and weight loss on serum level of inflammatory markers in patients with fatty liver disease in Iranian population

Methods: In a clinical trial, 40 patients with fatty liver disease in Gastro-hepathology clinic of Tabriz Imam Reza hospital were introduced to receive a low calorie diet. Serum level of proinflammatory factors [IL-1, IL-6, TNF-alpha and Hs-CRP] were measured and compared before and after an 8 week trial of diet

Results: The mean age of the patients was 45.36+/-10.51 years [range: 23-70]. Nine [22.5%] patients were male and 41 [77.5%] was females. The mean value of weight and body mass index of participants decreased significantly after 8 weeks [a mean decrease of 6.47+/- 3.40 percent in weight]. Weight loss in men was significantly more than women. The mean level of IL-1, IL-6, TNF-alpha and Hs-CRP was significantly decreased after weight loss in both men and women. There was no correlation between amount of weight loss with degree of decrease in inflammatory markers. Decrease of TNF-alpha was significantly more in younger patients

Conclusion: Weight loss with low calorie diet can decrease the level of IL-1, IL-6, TNF-alpha and Hs-CRP of patients with fatty liver during 8 weeks independent from gender and degree of weight loss

Pathological and clinical correlation between celiac disease and pathological and clinical correlation between celiac disease andpathological and clinical correlation between celiac disease and helicobacter pylori infection; a review of controversial rep

There are overwhelming reports and descriptions about celiac associated disorders. Although there is a clear genetic association between celiac disease [CD] and some gastrointestinal disorders, there are controversial reports claiming an association between CD and Helicobacter pylori [H. pylori] infection. Different studies indicated the possible association between lymphocytic gastritis and both CD and H. pylori infection, although this evidence is not consistently accepted. Also it was shown that an increase in intraepithelial lymphocytes count is associated with both H. pylori infection and celiac disease. Therefore the following questions may raise: how far is this infection actually related to CD?, which are the underlying patho-mechanisms for these associations? what are the clinical implications? what is the management? and what would be the role of gluten free diet in treating these conditions? PubMed [PubMed Central], Ovid, ISI of web knowledge, and Google scholar were searched for full text articles published between 1985 and 2015. The associated keywords were used, and papers described particularly the impact of pathological and clinical correlation between CD and H. pylori infection were identified. In this review we tried to answer the above questions and discussed some of the recent developments in the pathological and clinical aspects of CD and H. pylori infection

Prevalence of inflammatory bowel disease among patients with primary sclerosing cholangitis in Iran

Background and study aims: In Iran, the epidemiology of primary sclerosing cholangitis [PSC] and its association with inflammatory bowel disease [IBD] have not been studied thoroughly. This study investigates the epidemiology and prevalence of IBD among patients with PSC

Patients and methods: A retrospective study of 154 patients with PSC was conducted. The demographic and clinical data were collected, and the variables were analysed in the following two patient groups: patients with both PSC and IBD, and patients with PSC and without IBD

Results: A total of 154 patients with a mean age of 40.3 years [range 20-81 years] were included, of whom 57 [37%] were female and 97 [63%] male. Ninety-six patients [62.3%] were diagnosed with IBD, 92 [59.7%] with ulcerative colitis, and four [2.6%] with Crohn's disease. In this study, elevated alkaline phosphatase levels were found in 90.8% of patients. The intra-hepatic duct [IHD] and extrahepatic duct [EHD] were involved in 70.5% of patients, isolated intrahepatic bile duct in 24.4%, and isolated extrahepatic duct in 3.8%. Small-duct PSC [normal results of imaging and PSC proved by histology of liver biopsy] was observed only in 1.3% of patients

Conclusion: PSC has become increasingly diagnosed in Iran. This is possibly because of better diagnostics and the increasing prevalence of IBD in this country. For diagnosing PSC and identifying the presence of IHD strictures, the results of both magnetic resonance cholangiopancreatography [MRCP] and endoscopic retrograde cholangiopancreatography [ERCP] showed good interobserver agreement, but the ERCP results could be used to evaluate the presence and severity of EHD strictures

comparison of the effects of acute and repeated morphine administration on fast synaptic transmission in magnocellular neurons of supraoptic nucleus, plasma vasopressin levels, and urine volume of male rats

The activity of the magnocellular neurons [MCNs] of supraoptic nucleus [SON] is regulated by a variety of excitatory and inhibitory inputs. Opioids are one of the important compounds that affect these inputs at SON synapses. In this study, whole-cell patch clamp recording of SON neurons was used to investigate the effect of acute and repeated morphine administration on spontaneous inhibitory and excitatory post synaptic currents [sIPSCs and sEPSCs] in MCNs. While acute bath application of morphine to brain slice of intact rat produced an increase in sEPSCs frequency and a decrease in sIPSCs frequency, repeated in vivo administration of morphine produced opposite effect. Moreover, repetitive i.c.v. administration of morphine for three consecutive days caused significant increase in urine volume, but had no significant alteration in water consumption compared to control group. The increase in urine volume was consistent with a significant decrease in plasma arginine vasopressin [AVP] levels after repetitive i.p. morphine administration. The results suggest that acute administration of morphine stimulates whereas repeated administration of morphine inhibits the MCNs. Morphine-induced MCN inhibition could result in diminished plasma AVP levels and eventually an increase in urine volume of rats

effects of legumes on metabolic features, insulin resistance and hepatic function tests in women with central obesity: a randomized controlled trial

The effect of high-legume hypocaloric diet on metabolic features in women is unclear. This study provided an opportunity to find effects of high-legume diet on metabolic features in women who consumed high legumes at pre-study period. In this randomized controlled trial after 2 weeks of a run-in period on an isocaloric diet, 42 premenopausal women with central obesity were randomly assigned into two groups: [1] Hypocaloric diet enriched in legumes [HDEL] and [2] hypocaloric diet without legumes [HDWL] for 6 weeks. The following variables were assessed before intervention and 3 and 6 weeks after its beginning: Waist circumference [WC], systolic blood pressure [SBP], diastolic blood pressure [DBP], fasting serum concentrations of triglyceride [TG], high density lipoprotein cholesterol, fasting blood sugar [FBS], insulin, homeostasis model of insulin resistance [HOMA-IR], alanine aminotransferase [ALT] and aspartate aminotransferase [AST]. We used multifactor model of nested multivariate analysis of variance repeated measurements and t-test for statistical analysis. HDEL and HDWL significantly reduced the WC. HDEL significantly reduced the SBP and TG. Both HDEL and HDWL significantly increased fasting concentration of insulin and HOMA-IR after 3 weeks, but their significant effects on insulin disappeared after 6 weeks and HDEL returned HOMA-IR to basal levels in the subsequent 3 weeks. In HDEL group percent of decrease in AST and ALT between 3[rd] and 6[th] weeks was significant. In HDWL group percent of increase in SBP, DBP, FBS and TG between 3[rd] and 6[th] weeks was significant. The study indicated beneficial effects of hypocaloric legumes on metabolic features

Practice of Iranian adolescent girls regarding puberty and menstrual hygiene and its predictors, 2013

Adolescence is a unique period in life cycle. During this period, adolescents face with many behavioural challenges. This study aimed to determine adolescent girls' practice regarding puberty and menstrual hygiene, as well as its relationship with socio-demographic characteristics. This cross-sectional study was conducted on 1017 female students who were studying at second and third grade of secondary schools in Tabriz, 2013. Samples were selected randomly. Questionnaires used in the study were the practice and socio-demographic questionnaires. General linear model was used to determine predictors of practice. Mean [SD] of practice score in adolescent girls was 64.2 [12.1] from attainable score of 0-100. More than half of students [56.7%] had moderate practice. According to adjusted general liner model, variables of being in second class, having a father with elementary education or illiterate, living in undesirable economic status, having peer groups and friends as main source of information, having insufficient information about puberty had negative relationships with practice score. While, there was a positive relationship between age at menarche and practice score [P<0.05]. The findings show that the practice of adolescents about puberty and menstrual hygiene is moderate. Thus, it is necessary to educate the girls about puberty and menstrual hygiene to enable them to have a healthy reproductive life in future

[Knowledge and Practice of the students in Tabriz about iron deficiency and iron supplementation]

Iron supplements, is the most cost effective and common strategy used in developed countries for the control of iron deficiency. Weekly iron supplementation programs in high schools and middle schools for girls in 2006, has been carried out. This study aimed to determine the status and practice of female students about iron deficiency and iron supplementation and its relation to personal and social factors. In this cross-sectional study in 2012, 920 pupils from 10 schools were questioned. The questionnaire included demographic information and questions about knowledge and practice. School choice as a quota of five school districts in Tabriz took place. Collected data was analysed by SPSS 13, using inferential statistics methods. The mean [SD] scores of students was 52.4 [13] and practice score was 63.4 [11.3], respectively. 61.6% of the students stated that they "often or always" use tablet distribution. 8% of the sample stated that they had "never" iron distribution in their schools. The most common reason for not taking the tablets was expressed color and taste of the tablets. For better and more effective implementation of iron supplementation programs in schools, iron supplementation and nutrition education classes for students or their mothers and distribution of quality iron tablets are required

[Efficacy of hop [Humuluslupulus L.] on early menopausal symptoms in perimenopausal women: a randomized double blind placebo-controlled trial]

Nowadays, because of the concern about risks of hormone-therapy, many physicians and women prefer phyto-estrogens for the treatment of menopausal symptoms. Hop is a plant with potent phyto-estrogenic ingredients. However, its effect on the symptoms has been evaluated only in one clinical trial. The purpose of this study was to evaluate the efficacy of hop [Humuluslupulus L.] in the treatment of early menopausal symptoms and hot flashes [primary outcomes]. In this randomized, double-blind, placebo controlled trial, 60 perimenopausal women were randomly assigned to two equal groups [n=30]. One group received hop tablets, 500 mg/day and other group received placebo tablets 500 mg/day, for 90 days. Early menopausal symptoms were assessed by means of Greene Scale [0-63] before and at the 4[th], 8[th] and 12[th] weeks after intervention. ANOVA was used for data analysis. There was no loss to follow-up during the 12 weeks of intervention. The mean Greene total score was significantly lower in the hop group in comparison to the placebo group at the 4[th] [adjusted difference: -8.3, 95% confidence interval: -9.7 to -6.9],8[th] [-14.6, -16.5 to -12.7] and 12[th] [-18.2, -20.5 to -16.0] weeks after intervention. No side effects were reported in this study. Hop effectively reduced the early menopausal symptoms and the number of hot flushes in perimenopausal women. Therefore, phytoestrogens can be used for the treatment of climacteric symptoms in the perimenopausal women

Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial / 中西医结合学报

Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area.

Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial / 中西医结合学报

<p><b>BACKGROUND</b>Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area.</p><p><b>OBJECTIVE</b>The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>In this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratified block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d.</p><p><b>MAIN OUTCOME MEASURES</b>Perineal pain and wound healing were assessed using visual analogue scale (0-10) and Redness, Edema, Ecchymosis, Discharge, Approximation scale (0-15), respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors.</p><p><b>RESULTS</b>Follow-up rate was 100% up to the 8 h time point in both groups, and 86% (62 of 72) in the cinnamon group and 85% (61 of 72) in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was significantly lower than that in the placebo group at (4±1) h (adjusted difference: -0.6, 95% confidence interval: -1.0 to -0.2) and (8±1) h (-0.9, -1.4 to -0.3) after intervention, and on the 10-11th day after delivery (-1.4, -2.0 to -0.7). Also the cinnamon group showed significantly more improvement than the control group in healing score at (8±1) h (-0.2, -0.4 to -0.04) and the 10-11th day after delivery (-1.6, -2.0 to -1.1).</p><p><b>CONCLUSION</b>Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.</p>

Effect of Hypericum perforatum L. compared with metronidazole in bacterial vaginosis: A double-blind randomized trial

Objective: To compare effect of Hypericum perforatum (H. perforatum) vaginal gel with metronidazole on bacterial vaginosis (BV) in terms of initial response to treatment and preventing recurrence (primary outcomes) and also patient complaints (secondary outcomes). Methods: In this double-blind, double dummy trial, married women aged 18-49 with BV were randomized into two groups and administered 5 g of 3% H. perforatum and placebo of metronidazole (n=82), or 5 g of 0.75% metronidazole and placebo of H. perforatum (n=80) vaginally for 5 d. Amsel criteria were used for diagnosis and assessing cure and recurrence of BV. The comparisons was done using Chi-square, Fisher's exact and logistic regression. Results: At 10-12 d, cure rate was 82% in the H. perforatum and 85% in metronidazole group (risk ratio 0.9, 95% confidence interval 0.6 to 1.3). Among the cured women, recurrence rate was 9% in the H. perforatum and 13% in the metronidazole group at the 30-35 d visit (risk ratio 0.8, 95% confidence interval 0.4 to 1.3). There was no statistically significant difference between the groups regarding any patient complaints, except itching which was less in H. perforatum group (5% vs. 16%, P=0.018 at the first and 13% vs. 43%, P < 0.001 at the second follow-up). No significant adverse event was reported at any groups. Conclusions: H. perforatum could be a good option for treatment of BV. However, further studies are needed for its public use.

[ anti proliferative and anticancerogenic effects of nano-curcumin in rat colon cancer]

Curcumin, the active ingredient of turmeric, has the ability to inhibit the carcinogenic pathways, and thus can prevent or postpone the carcinogenic process in different animal species. Retention time of curcumin is short due to the quick excretion of the body, so, the therapeutic effects of curcumin are restricted resulting in short-term retention in the plasma. Therefore, several methods are used for increasing the efficiency of curcumin in plasma and tissues. The present study is designed to evaluate the effects of the anti-proliferative and anti-carcinogenic of nano-curcumin in rat colon cancer. In this study which was performed in Cancer Research Center of Tehran University of Medical Sciences in 2012. Thirty rats have divided into control, curcumin and nano-curcumin groups. All animals received azoxymethane [15 mg/kg, s.c] as a carcinogen, once a week for two consecutive weeks. Animals received curcumin 0.2% and nano-curcumin 2 weeks before azoxymethane injection up to 14 weeks after the last injection of azoxymethane in curcumin and nano-curcumin groups, respectively. At the end of experiment, the colorectal specimens from all mucosal lesions were obtained for histo-and-immunohistochemical [Ki-67 and COX-2] studies. The cytological and morphological changes of the cells in nano-curcumin group were significantly lower compared to other groups [P<0.05]. In addition, the Ki- 67 and COX-2 proteins expression was lower in the nano-curcumin group in compareson with the curcumin and control groups [P<0.05]. The results indicate that the using a suitable nanoparticle can be appropriately resolved the low bioavailability of curcumin. This can be an important method to use of natural products in the prevention and/or treatment of cancer.

NMR based metabonomics study on celiac disease in the blood serum

The aim of this study is to look for the proper methods that would be a major step towards untreated CD diagnosis and seek the metabolic biomarkers causes of CD and compare them to control group. Celiac disease [CD] is a common autoimmune disorder that is not easily diagnosed using the clinical tests. Thirty cases and 30 controls were entered into this study. Metabolic profiling was obtained using proton nuclear magnetic resonance spectroscopy [HNMR] to seek metabolites that are helpful for the detection of CD. Classification of CD and healthy subject was done using random forest [RF]. The obtained classification model showed an 89% correct classification of CD and healthy subject for the external test set. The metabolites that caused changes in people with CD were identified using RF; these metabolites include lactate, valine and lipid. The findings of the present study reveal serum lactate, valin and lipid levels in CD patient are lower than healthy cohorts. This metabolite may provide diagnostic tools as well as insight into potential targets for disease therapy

Determining appropriate strategies for improving women's health promoting behaviours: using the nominal group technique

Women's health constitutes a major aspect of development in societies and is considered a health-related priority. The aim of the present study was to determine appropriate strategies for improving health promoting behaviours in women of reproductive age in the Islamic Republic of Iran. Using the nominal group technique, a panel discussion was held in October 2011 with 12 health specialists who were selected through purposive sampling. In the first round, panel members generated 81 strategies; after eliminating irrelevant items and merging items with similar concepts, 44 strategies remained. After group discussion and voting, the following 4 items had the highest scores: improving physical activity, with a social support approach; empowering women; promoting and improving men's role in women's health; and promoting social support. The strategies presented in this study may be utilized by policy-makers, managers and health care providers to improve women's health promoting behaviours, and thus contribute to their wellbeing

Facilitators and inhibitors of health promoting behaviors: the experience of Iranian women of reproductive age

There is scant information on the facilitators and inhibitors of health promoting behaviors among reproductive aged Iranian women. This study aims to explore the experience of factors influencing health promoting behaviors among Iranian women of reproductive age from a qualitative perspective. This study was performed in Tehran in 2011, over about 8 months. Qualitative methods, specifically in depth interviews, were used to gather data on 15 women of reproductive age. Data continued to be collected until introduction of new information ceased. The interviews were recorded, transcribed verbatim, and analyzed by conventional content analysis. The reported factors were categorized into four main groups and 12 subgroups: [1] personal barriers [lack of time, school or work duties, lack of preparation or motivation, physical disability]; [2] socio environmental barriers [family responsibilities, environmental pressures, high costs and financial pressures]; [3] personal facilitators [personal interest and motivation, experience of disease]; and [4] socio environmental facilitators [family and social support networks, encouraging and motivating environment, media, and public education]. In these women's experience, factors influencing health promoting behaviors were either facilitators or inhibitors; most were inhibitors. The findings of this study show that, in addition to personal factors, the pursuit of health promoting behaviors is affected by socio environmental factors. These results will be useful in designing interventions and plans for women's health promotion that focus on the improvement of their environment and the modification of social factors

Effect of cervical wiping with sterile cotton on the quality of pap-smear

There are conflicting reports about the effect of wiping cervix with cotton on Pap-smear results. Therefore, we aimed to do a research about this subject. 234 eligible women attended to have Pap-smear at an educational hospital in Rasht, Iran, from July to September 2011, were allocated by block randomization into two groups. In the intervention group, we cleaned cervix with a sterile cotton rotating 360 degrees and obtained samples using spatula for exocervix and cytobrush for endocervix. This method was performed without cleaning the cervix on the control group. Data collection, vulvovaginal examination, laboratory assay were done by investigators masked to the group allocation. Participants were also blind. The data were analyzed using logistic regression in SPSS-13. Rate of sufficient endocervical cell of the slides in the intervention group was significantly higher than in the control group [70.3% vs. 57.8%, p=0.03]. In the intervention group 42.4% of the slides were satisfactory and 57.6% had limited quality for interpretation. These figures in the control group were 37.1% and 62.9%, respectively. This difference was not statistically significant. Also, there was no significant difference between the groups on rate of slides with inadequacy of squamous cells and obscuring 75% or more of the slides with inflammatory exudate or blood [p>0.05]. There were no significant differences between the groups on some quality indicators of the smears. However, frequency of smears with sufficient endocervical cells was higher in the group with cervical wipping. Therefore, it is recommended to clean cervix before obtaining the smears