A randomized, double-blind, placebo-controlled pilot study of the comparative effects of dienogest and the combined oral contraceptive pill in women with endometriosis.

OBJECTIVE: To compare the effects of dienogest and a combined oral contraceptive pill (COCP) after laparoscopic surgery on pain and quality of life in women with severe endometriosis. METHODS: A randomized double-blind pilot study was conducted from March 2018 to March 2020 in women with severe endometriosis confirmed by laparoscopic surgery. A total of 108 patients who had undergone laparoscopic surgery received dienogest, COCP, or placebo daily for 6 months. Primary and secondary outcomes were compared between the three groups. RESULTS: Treatment with dienogest or COCP was associated with improved self-reported pain after 6 months of treatment, as evidenced by significantly lower scores for pelvic pain and dyspareunia compared with placebo (P < 0.05). Significant differences in overall quality of life score were observed over 6 months in the dienogest, COCP, and placebo groups (mean difference 22.00, 23.45, and 6.45 points, respectively; P < 0.001). Post-hoc analysis revealed a significant difference in overall quality of life score between the placebo group and the dienogest (P < 0.001) and COCP groups (P = 0.004). CONCLUSION: Postoperative administration of dienogest or COCP reduced endometriosis-associated pain and improved quality of life in women with severe endometriosis. CLINICAL TRIALS REGISTRATION: https://en.irct.ir/trial/43070.

Comparing the Effect of Dienogest and OCPS on Pain and Quality of Life in Women with Endometriosis: A Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Endometriosis is an estrogen-dependent disease that adversely affects women's quality of life (QOL). We aimed to compare the effect of dienogest and oral contraceptive pills (OCPs) on pain and QOL in women with endometriosis. METHODS: This randomized double-blind trial was conducted at Rasoul-e-Akram hospital, affiliated to Iran University of Medical Sciences, Tehran, Iran, from March 2018 to March 2020, on women with severe endometriosis confirmed by laparoscopic surgery. Ninety patients were randomly given either dienogest (Vissane 2 mg tablet; n = 30), or OCPs (LD; n = 30), or placebo (n = 30) daily for 12 weeks. The primary objective of this study was to evaluate the patient's pain including dyspareunia, dysuria, dyschezia, and pelvic pain. The secondary outcome was considered as a change in patients' QOL score. RESULTS: The mean age of population was 32.99 ± 7.1 years. There was no significant difference in the three groups regarding baseline characteristics. Pelvic pain was significantly reduced, while the effect of medication on dysuria and dyschezia was not significant. The overall QOL score between the control and dienogest (P = 0.02) and OCPs groups (P = 0.001) was significantly different; however, the difference was not significant between the two intervention groups. CONCLUSION: The finding of the present study revealed that there is no difference in the efficacy of dienogest and OCPs in management of pain and the QOL. But there was a significant difference between the placebo and intervention groups.

A systematic review of prevalence of Depression in Iranian patients.

BACKGROUND: Depression is a common mental health disorder which has become a global public health issue. It constitutes around 35 to 45% of mental health problems in Iran and covers 8% to 20% of population of Iran. Therefore, the present study aimed to determine the prevalence of depression among the Iranian patients through systematic review and meta-analysis. METHOD: For the present study information were searched in Web of Science, Scopus, PubMed, Google Scholar, and in Iranian databases including Iran Medex, SID, MedLib, Scientific Information Database, MagIran, using the following keywords: "depression", "prevalence" and Iran. The data from these databases were analyzed through meta-analysis (random effects model). Heterogeneity among the results of the studies was examined by I2 index. Beck Depression Inventory (BDI), Depression Anxiety and Stress Scale-21 (DASS-21), General Health Questionnaire-28 (GHQ-28), and Geriatric Depression Scale (GDS) were used in this study, and statistical analyses were performed using STATA Ver.16. RESULTS: A total of 46 studies conducted in Iran based on a sample size of 2960 individuals was found during the time period of 2010 and 2018. Prevalence of depression among Iranian patients was estimated to be 34.26 (95% CI, 24.12% - 44.10%). Thus, the findings indicated that there exists a moderate prevalence of depression which is continuously growing. CONCLUSION: The prevalence of depression in Iran is moderate and growing which is alarming as it may turn out to be a massive increase in incidence rate of depression in coming years. This indicates a greater risk for Iranian population and calls for effective measures to be taken to control the mental health problems among Iranian patients.

A robust PID controller based on imperialist competitive algorithm for load-frequency control of power systems.

A new PID controller for resistant differential control against load disturbance is introduced that can be used for load frequency control (LFC) application. Parameters of the controller have been specified by using imperialist competitive algorithm (ICA). Load disturbance, which is due to continuous and rapid changes of small loads, is always a problem for load frequency control of power systems. This paper introduces a new method to overcome this problem that is based on filtering technique which eliminates the effect of this kind of disturbance. The object is frequency regulation in each area of the power system and decreasing of power transfer between control areas, so the parameters of the proposed controller have been specified in a wide range of load changes by means of ICA to achieve the best dynamic response of frequency. To evaluate the effectiveness of the proposed controller, a three-area power system is simulated in MATLAB/SIMULINK. Each area has different generation units, so utilizes controllers with different parameters. Finally a comparison between the proposed controller and two other prevalent PI controllers, optimized by GA and Neural Networks, has been done which represents advantages of this controller over others.