Clients' viewpoints about the quality of services in the premarital counseling classes in Tabriz health centers

Premarital counseling equips couples with information about all aspects of sexuality and the related health issues. This study was aimed to assess the quality of premarital counseling services in health care centers in Tabriz. A cross-sectional study was conducted on 236 randomly selected women from premarital counseling centers in Tabriz was carried out and a self-structured instrument including items on demographic characteristics, the quality of counseling condition and providers, family planning, genetic and thalassemia counseling and sexual health was used for data gathering. The results showed that the viewpoint of clients about relationship with health care provider and condition of consultation was suitable in 75.8% and 85.2% of women, respectively. It was found that in 72.5%, 38.1% and 49.6% of clients the counseling areas were in moderate level respectively for counseling about importance of family planning, genetic counseling and thalassemia. It was indicated that 58.5% of participants expressed the sexual health aspect of the premarital classes as poor or completely poor. Our study results can provide suitable information for health policy providers to improve the quality of premarital counseling classes. In order to develop a relatively stable behavior in young couples, it is recommended that the quality of the classes would be overemphasized

[Intravenous leiomyomatosis of the uterus with extension to the right heart: a case report]

Intravenous leiomyomatosis is an uncommon non-malignant tumor which originates from the smooth muscle cells. It is usually confined to the pelvic venous system. Rarely it can afflict intracaval and intracardiac extension. We report a case of young 25 years old woman, G2/P2; with intravenous leiomyomatosis originate from the uterus and extending into right atrium. It was successfully treated through a two-stage surgical approach. In conclusion, we should consider intravenous Ieiomyomatosis with cardiac extension in patient with uterus leiomyoma, hysterectomy, cardiac symptoms, and cardiac mass

effect of oxygenation technique in general anesthesia on postoperative nausea and vomiting

To evaluate the effect of routine positive pressure mask ventilation [PPV] for preoxygenation on the occurrence of postoperative nausea and vomiting [PONV]. Double-blind randomized clinical trial. Teaching Hospital of Birjand University of Medical Sciences, Iran. One hundred sixty elective surgical patients undergoing general, urologic, and orthopedic surgeries between 2007 and 2008. Patients were divided into two groups [A and B]. All patients underwent the same method of general anesthesia using sodium thiopental, fentanyl and suxamethonium. Both groups received 100% oxygen for three minutes before induction of anesthesia. Patients in group A received positive pressure oxygenation for 30 seconds after induction of anesthesia whereas group B patients did not. The incidence of PONV and decrease in SPO[2] [saturation <89%] was compared in the two groups. Out of 160 patients, 20 patients were excluded [abdominal and laparoscopic surgeries or operation time >1 h]. Group A had 73 and group B had 67 patients. There was no decrease in SPO[2] saturation observed in the two groups. The prevalence of PONV was significantly higher in group A [45.2 Vs 28.4% for group A and B, respectively, p<0.05]. Thirty seconds of additional oxygenation with PPV after induction of anesthesia resulted in a higher incidence of PONV. There was no de-saturation in group B patients. Therefore, in non-emergency cases when a short- acting muscles relaxant drug [e.g., suxamethonium] is used, PPV before intubation can be avoided

[ value of Pap smear in detecting cervical neoplasia compared with histopathologic findings in patients referred to Taleghani Hospital, Tehran 2007-2009]

Although the Pap smear screening test has showed a great success in early diagnosis of cervical cancer in different countries over the past 60 years, cervical cancer has remained the fifth most common cancer among Iranian women. The diagnostic value of Pap smears which are done in health centers around the country compared with international standards for cervical cancer screening requires further consideration. The purpose of this study was to compare Pap test's findings with colposcopic biopsies as the gold standard. In this cross-sectional study, all non-pregnant women attended to Taleghani hospital gynecology clinic between 2007 and 2009 for routine Pap smear and were volunteer to participate in this research, and based on clinical findings as well as colposcopist's opinion had an indication for colposcopy, were included. Eligible women had a Pap test as well as colposcopy and cervical biopsy thereafter. Sensitivity, specificity, positive and negative predictive value [PPV and NPV] of Pap test was calculated compared with cervical biopsy as the gold standard. Overall,%67 of women had abnormal biopsy [mostly HPV appearance], whereas only%21 of Pap smear results indicated abnormal cervical screening test results. The sensitivity, specificity, PPV, and NPV of Pap smear for detecting cervical neoplasia in our study was%23.9,%84.8,%76.2, and%35.4, respectively. The sensitivity of Pap smear was less than other reports. It needs more quality control, including sampling, sample preparation and interpretation in this center. Studies with more samples in other hospitals and particularly in different health care centers in Iran are highly recommended

Knowledge and Attitude of Women Regarding the Human Papillomavirus (HPV) Infection, Its Relationship to Cervical Cancer and Prevention Methods

This study aimed to determine knowledge and attitude of women to HPV and its association with cervical cancer and prevention methods. In a cross-sectional study, 500 women, aged between 20 and 50 presenting to local health centers in Tehran, were asked about demographic factors and questioned about cervical cancer, HPV, and prevention methods. Responses were tabulated and summarized. Although knowledge of HPV, its relation to cervical cancer and prevention methods among Iranian women is not enough, their attitude towards education in this regards is extremely high. The results reflect the need of advertising and educational programs for public about HPV prevention methods, to reduce the prevalence of this infection and its severe consequences.

Hypotension in spinal and epidural anesthesia

Hypotension occurs during spinal block and may be associated with serious complications. The blood pressure decreases by 39-45% after intrathecal and epidural anesthesia. To evaluate intrathecal and epidural anesthesia in patients with gynecological surgery and compare hypotension in both methods. Randomized clinical trial. Sina Hospital, Tehran, Iran. Sixty patients were evaluated for hypotension induced by Lidocaine used intrathecally or epidurally. The patients were randomly assigned in the two groups; all the patients had gynecological surgery. Intrathecal anesthesia was administered using 75mg [1.5ml] of Lidocaine 5% in the first group and epidural anesthesia was administered using 300mg [20ml] of Lidocaine 1.5% in the second group. The injections were done in L4 -L5 space. The decrease in systolic blood pressure was faster and significantly more in intrathecal than in the epidural group [p<0.05]. The decrease in blood pressure is less seen in epidural anesthesia. Cardiovascular conditions are more stable during epidural anesthesia