Survey of sexual dysfunction in women with cervical cancer and a history of pelvic radiation therapy in 2009 to 2013 in Ghaem and Omid hospitals, Mashhad

Introduction: Cervical cancer is the second most common cancer in women and one of the leading causes of cancer-related death in developing countries. In cervical cancer patient, both surgery and radiation therapy can cause sexual dysfunction. Therefore, this study was performed with aim to survey sexual dysfunction in women with cervical cancer and a history of pelvic radiation therapy. Methods: This study was performed on 176 women with cervical cancer and a history of pelvic radiation therapy referred to Ghaem and Omid hospitals in Mashhad who were selected using convenient sampling from 2009 to 2013. Research tools consisted of personal information form and ROSEN Female Sexual Function Index (FSFI). Data was analyzed by SPSS software (version 16.5) and Spearman and Pearson correlation coefficient tests. PResults: 53(30%) of women with cervical cancer and a history of pelvic radiation therapy had low sexual desire, 86 (49%) undesirable sexual arousal, 62 (35%) low lubrication, 74 (42%) undesirable orgasm. 70 (40%) of women complained of dyspareunia and 42 (24%) of Women were dissatisfied from sexual function. There was a significant correlation between sexual function with staging of cervical cancer (P= 0.001, r= - 0.25). There was a significant correlation between sexual desire (P= 0.04), sexual arousal (P= 0.008), lubrication (P= 0.001), orgasm (P= 0.004), sexual satisfaction (P= 0.009) and dyspareunia (P= 0.000) with staging of cervical cancer. Conclusion: Sexual disorders in women with cervical cancer and a history of pelvic radiation therapy and correlation between sexual function with stage of cervical cancer reflects the fact that treatment, education and counseling programs is necessary for these women

Perforated Gastric Diverticulum in a Preterm Newborn: A Case Report

Gastric diverticulum in newborn infants is the rarest (0.04%) of gastrointestinal diverticula. Most of them especially in this age group are asymptomatic or cannot be diagnosed based on examinations and symptoms. However, if it becomes symptomatic, the symptoms can range from vague abdominal pain to bleeding, perforation or torsion. The present case report discusses a preterm newborn with a perforated gastric diverticulum. &nbsp

Effects of Changing GnRH Agonist to Antagonist or Vice Versa on M2 Oocytes, Clinical Pregnancy and Live Birth Rates in Two Consequent IVF Cycles

Objectives: The objective of this study was to investigate the impact of changing the ovarian stimulation protocol from gonadotropinreleasing hormone (GnRH) agonists to antagonists, or vice versa, on the outcomes of in vitro fertilization (IVF) in the same groups of patients. Materials and Methods: This study was a cohort study of women with infertility who had a history of two consequent IVF cycles due to an unsuccessful previous attempt and were recruited between 2016 and 2019. The patients were treated with either an agonist or antagonist protocol in the first or second round. They were categorized into two groups based on whether the second round was the same as the first one or different. The primary outcomes included the number of M2 oocytes, the number of transferred embryos, the chemical pregnancy rate, and the clinical pregnancy rate. The secondary outcome was the live birth rate. Statistical analyses were performed using SPSS version 26 software. Results: A total of 39 women and 78 cycles with a history of infertility, with a mean age of 29.72 (5.36, SD), were evaluated in two groups: same (17, 43.6%) and different (22, 56.4%) protocols. Primary infertility was the most frequent type of infertility, recorded in 31 (79.6%) individuals. No significant differences were found between the two groups in terms of mean endometrial diameter (P=0.820), HCG administration (P=0.069), mean stimulation duration (P=0.931), mean total dose of administered gonadotropins (P>0.05), and embryo transfer types (P= 0.051). Also, no significant differences were found in the primary outcomes between the same and different protocol groups (P>0.05). The live birth rate also showed no significant difference as a secondary outcome (P = 0.954). Conclusions: This study found no significant difference in IVF outcomes when switching between GnRH agonist and antagonist protocols or using the same protocol for consecutive rounds

Partial molar ectopic pregnancy: A case report

Partial or complete mole affects one in 1000  pregnancies.Partial mole is a rare form of ectopic pregnancy. There was a married woman,gravid 4,parity 1,abortion 1,and she had past medical history 0f right ectopic pregnancy.she had left ectopic pregnancy and was treated by laparascopic left salpyngectomy after failure of intramascular methotrexate treatment.After surgery  the pathology exam showed partial mol

Safety of Uterine Compression Suture in the Management of Postpartum Hemorrhage: A Case Report

Uterine atony is the main cause of postpartum hemorrhage (PPH). Uterine compression suture is a common technique to control PPH in caesarean delivery. This article aimed to report a complication of this method for post-delivery atony. A 27-year-old primigravida woman with term pregnancy underwent caesarean delivery and was unresponsive to medical therapy and uterine artery ligation due to uterine atony. Two compression sutures were placed on her uterus. However, after 11 days, the patient underwent surgery again due to severe fever, infection, and a necrotic mass in the uterine cavity. The necrotic mass was we removed during the surgery. Although uterine compression suture is an effective method for the treatment of PPH, we witnessed some side effects in the patient, especially myometrium necrosis

Misoprostol versus High Dose Oxytocin and Laminaria in Termination of Pregnancy in Second Trimester Pregnancies

Background: In 2 recent decades, found drug regimen to induce abortion that are more effective than surgery. Prostaglandins especially misoprostol, oxytocin and osmotic dilators such as laminaria use for termination but the best method is unknown. Therefore we aimed to assess the comparison between the Misoprostol regimen and the highly concentrated oxytocin with laminaria regimen in second trimester of pregnancy termination. Methods: In this randomized clinical trial, 100 women with gestational age 14 to 24 week coming to hospital due to termination of pregnancy in the absence of uterine contractions and items of exclusion criteria enrolled to study and randomly assign to 2 groups and received misoprostol (group 1) or oxytocin (group 2). Data collected with use of observation, examination and demographic checklist. In group 1, in admission time and then every 6 hour patients received 200 µgr misoprostol until start the pain or vaginal bleeding or abortion in 48 hr. in group 2, patients first received laminaria in cervix with duration of 6 hr and then oxytocin 50 unit in 500 cc normal saline in 3 hr. after 1 hr rest, oxytocin dosage elevated as multiple into 2 and continue until termination or maximum dose of 300 u in 500 cc normal saline. Data entered to SPSS software version 16 and analyzed with use of descriptive methods and also Chi- square and T-test. Results: In each group enrolled 50 women that approximately no different in baseline characteristic. Number of abortion in misoprostol group was more than oxytocin group (P<0.001) and duration of abortion also was shorter than oxytocin in misoprostol group (P<0.001). Side effects in 23 (46%) women in misoprostol group were seen but no side effect seen in oxytocin group. Complementally interventions was seen in 31 women (60%) in misoprostol group versus 32 women (62%) in oxytocin group but this difference was not significant (P>0.05). Conclusion: This study demonstrated that misoprostol is effective than oxytocin in termination of pregnancy but with attention to limitation of this study include of limited abortion causes due to legal laws, additional studies on different doses of misoprostol and oxytocin due to achieve to suitable regimen with lower side effects recommended

Effectiveness of infertility counseling on pregnancy rate in infertile patients undergoing assisted reproductive technologies: A systematic review and meta-analysis

Background: Psychological interventions such as counseling for infertile patients seem to increase pregnancy rate. Objective: The aim of this systematic review and meta-analysis was to examine if counseling improves pregnancy rate among infertile patients. Thus, randomized controlled trials investigating the effect of counseling on pregnancy rate in infertile patients undergoing ART were pooled in a meta-analysis. Materials and Methods: The databases of PubMed, Scopus, Cochrane, Google Scholar, and Persian databases including SID, Iran Medex, and Magiran were searched from 1997 to July 2016 to identify relevant articles. Included studies were trials on infertile patients (women or couples) receiving counseling independent of actual medical treatment. The outcome measure was pregnancy rate. Out of 620 relevant published trials, a total of nine RCTs were ultimately reviewed systematically and included in a meta-analysis to measure the efficacy of counseling on pregnancy rate. Odds ratio and Risk difference were calculated for pregnancy rate. All statistical analyses were done by Comprehensive Meta-analysis Version 2. Results: Nine RCTs involving 1079 infertile women/couples were included in the study. The findings from RCTs indicated significant effect of counseling on pregnancy rate so that there was a positive impact of counseling on pregnancy rate (OR= 3.852; 95% CI: 2.492-5.956; p=0.00) and (RD= 0.282; 95%; CI: 0.208-0.355; p=0.00). Conclusion: Counseling was found to improve patients&rsquo; chances of becoming pregnant. So counseling represents an attractive treatment option, in particular, for infertile patients who are not receiving medical treatment

Sexual dysfunction in infertile women

Background: Sexual problems have different effects on the life of people by influencing their interpersonal and marital relationships and satisfaction. Relationship between sexual dysfunctions and infertility can be mutual. Sexual dysfunction may cause difficulty conceiving but also attempts to conceive, may cause sexual dysfunction. Objective: This paper compares sexual dysfunction in fertile and infertile women. Materials and Methods: In this cross-sectional study, 110 infertile couples referring to Montasarieh Infertility Clinic and 110 fertile couples referring to five healthcare centers in Mashhad were selected by class cluster sampling method. Data collection tools included demographic questionnaire and Glombok-Rust Inventory of Sexual Satisfaction. Data were analyzed through descriptive and analytical statistical methods by SPSS. Results: There was no significant difference in total score of sexual problems and other dimensions of sexual problems (except infrequency) in fertile 28.9 (15.5) and infertile 29.0 (15.4) women. Fertile women had more infrequency than infertile women (p=0.002). Conclusion: There was no significant difference between fertile and infertile women in terms of sexual problems. Paying attention to sexual aspects of infertility and presence of programs for training of sexual skills seem