Zahra SHAHRAKI, Yasin GANJALI and Mahsa GHAJARZADEH

ABSTRACT

Background: Hysteroscopy is a diagnostic and therapeutic modality, while cervical ripening before hysteroscopy is an issue of concern and different agents have been used for this purpose. The goal of this study is to compare the effectiveness of misoprostol and isosorbide mononitrate (IMN) for cervical ripening before hysteroscopy.
Methods: In this randomized clinical trial, 56 women who were candidates for hysteroscopy were randomly assigned to misoprostol or isosorbide mononitrate groups. During the early follicular phase of the cycle, a gynecology expert performed the hysteroscopies. Cervical dilation was measured by insertion of Hegar dilators up to size 9 without force. Vaginal bleeding, headache, abdominal pain, nausea, and vital signs were recorded by a specialized nurse.
Results: There was no significant difference regarding age, systolic and diastolic blood pressure in the two groups. Heart rate was significantly higher in the IMN group. Bleeding rate was not significantly different between the two groups (25.8% in the misoprostol group and 24% in the isosorbide mononitrate group, p=0.8). Headache was significantly more frequent in the isosorbide group, while abdominal pain, nausea, vomiting were significantly prevalent in the misoprostol group. The mean Hegar number used in the misoprostol and IMN groups was 7.3±1.1 vs 6.7±0.8 (p=0.03).
Conclusion: Isosorbide mononitrate (IMN) is more effective than misoprostol for cervical ripening before hysteroscopy and complications are more frequent in the misoprostol group.
Keywords: misoprostol, cervical ripening, hysteroscopy, isosorbide mononitrate

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Mahsa GHAJARZADEH, Rozita JALILIAN, Mohammad Ali SAHRAIAN, Abdorreza Naser MOGHADASI, Amirreza AZIMI, Mehdi MOHAMMADIFAR and Sepehr AZIZI

ABSTRACT

Background: Multiple sclerosis is a chronic inflammatory disease which affects the central nervous system. Many patients with multiple sclerosis suffer from persistent pain during the disease course. In Iranian cases, pain has not been regarded as it should be.
Objective: The goal of this study was to determine the prevalence and types of pain in Iranian multiple sclerosis patients.
Material and methods: This cross sectional study was conducted in the multiple sclerosis clinic of Sina Hospital between October 2014 and August 2015. Eighty eight multiple sclerosis patients were enrolled. Participants were asked to fill a valid and reliable Persian version of the Brief Pain Inventory. Demographic data (sex, age), disease duration and disease course were extracted from patients’ medical files. All patients were examined by an expert neurologist to obtain Kurtzke Expanded Disability Status Scale (EDSS).
Results: The mean age and mean duration of disease were 30.4±7.6 years and 5.9±4 years, respectively. Median EDSS was 1. All patients reported pain. The most common sites of pain were upper extremities (52.3%). Higher the EDSS score, higher pain interference with the evaluated items. By using the worst pain intensity as a dependent variable, and age, sex, EDSS, disease duration and type of disease as independent variables, regression analysis showed that the EDSS score was an independent predictor for the intensity of pain in this group of patients.
Conclusion: Pain is a common symptom found in patients diagnosed with multiple sclerosis. Thus, an accurate and thorough assessment of pain should be integrated in the routine evaluation of patients diagnosed with multiple sclerosis
Keywords: multiple sclerosis, pain, Iran.

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Ali Akbar RAHBARIMANESH, Anahita IZADI, Zahra ESKANDARIZADEH and Mahsa GHAJARZADEH

ABSTRACT

One of the causes of infants’ hospitalizations is bronchiolitis, while different viral agents could be causative agents. As there is little information regarding the common agents of bronchiolitis in Iranian infants, we designed this study to determine which agents were responsible for hospitalization due to bronchiolitis among infants in an Iranian tertiary center. Two hundred and three infants with bronchiolitis who were hospitalized in Bahrami hospital were enrolled. Data regarding age, sex, duration of hospitalization, exposure to smoking, previous antibiotic usage and fever were collected for all enrolled cases. Throat sample by means of soap was collected and rapid test with immunochromatography (IC) test was performed. Rapid test was positive in 59 (29%) cases and three cases had concomitant infection with two viruses. The most common viral agent was RSV (Respiratory Syncytial Virus). Mean age was significantly lower in cases with RSV or RSV+ adenovirus infectious in comparison with other two groups (adenovirus or influenza only), while mean duration of hospitalization was significantly longer in RSV/RSV+ adenovirus group. RSV is the most common viral etiology of bronchiolitis in Iranian infants less than one year old, which is related with younger age and longer duration of hospitalization.
Keywords: bronchiolitis, infants, Iran.

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Fariba ASKARI, Mahsa GHAJARZADEH, Rozita JALILIAN, Amirreza AZIMI, Mansoureh TOGHA, Mohammad Ali SAHRAIAN and Mehdi MOHAMMADIFAR

ABSTRACT

Migraine and multiple sclerosis (MS) are two neurologic disorders that influence different aspects of women who are affected. Sexual function is one of the co-morbidities that are not considered well in such cases. The goal of this study to evaluate sexual function in women experiencing either migraine or MS. Eighty six married migraineus patients and 86 age- matched married MS cases were asked to fill out valid and reliable Beck depression inventory (BDI) and FSFI (Female Sexual Function Index ) questionnaires. BDI score was higher in women with migraine than MS cases and BDI scores in both groups were high in cases with sexual dysfunction. BDI score was significantly correlated with total FSFI and its subscales in both groups. Multiple linear regression analysis between the FSFI as a dependent variable and age, BDI and education level as independent variables showed that age and BDI are independent predictors of FSFI in both groups.

Sexual dysfunction should be considered in women with either MS or migraine.

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Mahsa GHAJARZADEH, Roshanak HABIBI, Neda AMINI, Abbas NOROUZI-JAVIDAN and Seyed Hassan EMAMI-RAZAVI

ABSTRACT

Objective: To study the attitudes of Iranian medical students towards the do-not-resuscitate (DNR) decision.

Methods: In this cross-sectional study, 220 medical students (110 interns and 110 residents) of Tehran University of medical sciences were selected. They asked to answer to the questionnaire which included two items: first item consisted of demographic questions (age, sex, and level of education); second item included questions about DNR Orders which derived from a previous study conducted by Hosaka et al.

Results: A total of 185 questionnaires returned (Response rate (RR=84%)). Ninety five were residents and ninety were interns. Seventy four percent of residents and 53% of interns felt that DNR order is sporadically necessary. Near 30% of interns and 40% of residents had participated in DNRs in their study period and the most case was the patient with terminal cancer. The most common person who decided DNR orders were physicians. Most participants believed that DNR cards are useful for establishing in clinical settings.

Conclusion: As DNR is definitely a medical decision, it should be clearly discussed with patients and their families. So, it should be provided in standard format in medical situations.

Keywords: DNR, Iran, medical students, attitude

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Seyed Hasan Emami RAZAVI, Mahsa GHAJARZADEH, Alireza ABDOLLAHI, Saeed SHOAR and Ramesh OMRANIPOUR

ABSTRACT

Background: Breast cancer is the most common cancer in women. Prostrate-specific antigen (PSA) is a marker of prostate gland malignancy which has been considered in cases with breast cancer in recent years. The goal of this study was to determine total and free PSA levels in cases with malignant and benign breast lesions.

Method: Ninety women with histological proved malignant breast masses and 90 with benign breast masses were enrolled. Total and free PSA levels along with histological grade and conditions of vascular and perinural invasion, status of hormonal tumor receptors, immune-histo-chemistry markers recorded for all cases. Total and free PSA levels were assessed after treatment in cases with malignant masses.

Results: Total and free PSA levels were significantly higher in cases with malignant masses. The best cut off point for total PSA to differentiate benign and malignant masses was 0.31 and the best cut off point for free PSA to differentiate benign and malignant masses was 0.19. After treatment, mean free PSA level was significantly lower than free PSA before treatment (0.23 vs 0.3, p<0.001).

Conclusion: serum PSA level could be applied for differentiating benign and malignant breast masses.

Keywords: PSA, breast, diagnosis

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