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M Hashemipoor , R Klishadi , N Sarrafzadegan , N Bashardoost ,
Volume 55, Issue 6 (1 1997)
Abstract

A case-control study was performed by the Research Center of Isfahan University, to determine the predisposing factors of early atherosclerosis. Children of cases admitted to a university hospital in Isfahan with early myocardial infarction (MI) were considered for the study. The affeckted cases (n=116), had 120 children aged 2-14 years. The control group were selected from children of the neighbors of the cases. The two groups were similar in age of parents, children and socio-economic status. Mean cholesterol and triglyceride levels and the frequency of hypercholesterolemia and hypertriglyceridemia were significantly higher in the children of MI cases. The mean lipid concentration of the controls was significantly higher than standard levels. These results emphasize the importance of evaluating children of high risk cases for risk factors of MI.
N Sarrafzdegan , N Mohammadifard , M Rafiy ,
Volume 56, Issue 2 (30 1998)
Abstract

Regarding the importance of cardiovascular disease in the health of societies, Hyperlipidemia is considered as an important risk factor. One of the case recently put forward in the fat profile, is high TG (triglycerides) and low HDL-C (High Density Lipoprotein). Nowadays, we believe that TG without the presence of low HDL-C is not considered as a risk factor for cardiovascular disease. So it was decided to perform a descriptive study to define the prevalence of this syndrom, like other risk factors, in urban population of Isfahan. Samples were selected by random sampling method and the sample size, to have reliability of 95%, was about 1200 from the people over 20 year old in 6 age groups and 2 sexes. After inviting the people while going fast (about 14 hours), a questionnaire including perfect identifications was filled and blood factors include total cholesterol, TG, LDL-C (LOW Density Lipoprotein), HDL-C and F.B.S (Fasting Blood Sugar) were measured. Then the statistical analyzing of data was done to define the relation between TG and HDL-C. Regarding the coefficient of correlation and P.value <0.05 in different age and sex groups (except over 70 years old group which was not significant) was defined that TG has an inverse relation to HDL-C and the prevalence in the urban population of Isfahan is 19.7%. Results got from studying the relation between TG serum level and high LDL/HDL fraction (equal or more than five) showed that the more TG gets, the more the fraction is and regarding to its prevalence (11.6%) in Isfahan. It can be a risk factor for cardiovascular disease. So regarding the high prevalence of High TG and low HDL-C syndrome, treating this syndrome can be considered as one of the primary prevention methods. To fufil the latter goal firstly the syndrome must be identified and the related patients must be treated. So the patients with high TG must be tested for HDL-C and LDL-C too. And secondly therapeutic actions to increase HDL-C and to decrease TG level must be done.
Arab M R, Sharifzadeh A, Sargolzaie Aval F, Talaei Khoozani,
Volume 63, Issue 4 (13 2005)
Abstract

Background: Fumes generated during electric welding are one of air pollutants of working place in industrial companies, which can cause some clinical signs and diseases in worker, including mucosal irritation, changing of semen quality and cancer. Chronic exposure of workers with these fumes can cause reduce sperm motility and forward penetration and decrease in normal sperm count. Although a lot of researches were done in this field up to now, there is little information about histopathological effects of these fumes on germinal epithelium. The aim of this study was to identify structural changes of germinal epithelium in Rat as an experimental model after exposure to fumes of electric welding in exposure chamber.
Material and Methods: A total number of 60 Sprague Dawley Rats were chosen and divided into experimental (40) and control (20) groups. Each of groups was subdivided into 2, 4, 6 and 8-week subgroups. The number of Rat in each subgroup of experimental and control group was 10 and 5 respectively. Animals were housed in standard situation. After adaptation experimental group were exposed to fumes of electric welding (AMA 2000 electrode, 100 Ampere, 0.1 cm/s speed of electrode welding) for 2 hour/day and 5 day/week. The rate of air turn over in exposure chamber was fixed to 12-15/hour. The amount of O3, CO, CO2, NO + NO2 and particulate matter were measured by Galtec detectors and Cellulose acetate filter respectively. According to time table animals were killed and specimens from testis were taken and fixed in formaline buffer solution and processed routinely. Sections with 5-7 micrometer in thickness were stained by H-E, PAS, PNA and Alcian blue pH=2.5. The thickness of germinal epithelium was measured and data were analyzed by Kruskall Wallis test.
Results: The results of this study showed a few quantitative and qualitative changes in germinal epithelium. Vasodilatation of vessels in tunica albuginea and interstitial tissue, decreasing of eosinophilia in myoid cells, increase in size of spermatogonia especially dark type, disorganization of association between sertoli and spermatogenic cell lineage and spermatogenic arrests in spermatocyte I period. There were significant difference between experimental and control group for thickness of germinal epithelium (p<0.001).
Conclusion: It seems that although some adaptation response was appeared in experimental group, a lot of structural changes also appeared in germinal epithelium. The amount and severity of these changes were dependent to 3 factors include the amount of fumes, the variety of it and the duration of exposure.
Sarrafzadeh J, Ebrahimi Takamjani A, Khosravi A, Haery F, Seyed Hosseini L,
Volume 64, Issue 12 (6 2006)
Abstract

Background: There is considerable professional debate over which technique is the best for lifting. The aim of this study is to compare three static lifting styles, the stoop, semi-squat and arm lift, using maximum isometric voluntary contraction (MIVC) as one indicator for recommending a lifting style.
Methods: Thirty healthy women (mean age: 22.37 years) participated in this quasi-experimental study. They performed the tests in static postures by standing on the platform of the Lift TrackTM and pulling the dynamometer of the instrument with maximum effort in three lifting styles: the stoop, semi-squat and arm lift. The subjects warmed-up by practicing the lifts first. The mean MIVC from the two other sets of lifts were used for statistical analysis by repeated measurements and SPSS (ver.10) software.
Results: There were significant differences between the MIVC of the three lifting styles in this study. The largest MIVC was for the semi-squat lift and was the least was for the arm lift (p<0.001). The MIVC of the stoop lift was larger than that of the arm lift (p<0.001).
Conclusion: The largest MIVC for the semi-squat lift suggests that this style is useful for lifting objects from the floor. The differences in biomechanical and muscle pattern activity changes could explain these results. It seems that activation of the quadriceps muscles in the semi-squat lift was a main factor for producing more MIVC, so when this style is recommended for lifting, attention to the power of the quadriceps is important.
Madani A, Pournasiri Z, Kajbafzadeh A.m, Attaee N, Mohseni P, Esfehani T,
Volume 65, Issue 6 (3 2007)
Abstract

Background: Impairment in the function of the lower urinary tract can be the cause of recurrent urinary tract infections (UTI) and vesico-ureteral reflux (VUR) in children. The purpose of our research was to evaluate the frequency of occurrence of bladder instability in children with UTI.

Methods: The research involved 133 children (11 boys, 122 girls), ranging in age from seven months to 14 years. Group A consisted of 78 children with a history of recurrent UTI, while Group B included 55 children with recurrent UTI and VUR. Urodynamic tests (cystometry) were performed on all the children.

Results: Abnormal functioning of the lower urinary tract was found in 98 children (73.1%) from Group A and 41 children (78.8%) from Group B. The most common dysfunction was detrusor-sphincter dyssynergia (DSD), which was found in 54% of all subjects, 46.2% of patients in Group A and 60% of patients in Group B (p<0.05). Unstable bladder was found in 42 (33%) children with no significant difference between the two groups. In 17 children (12.6%) DSD was accompanied by bladder instability. In both groups about 20% of the children did not present with symptoms indicative of urination dysfunction, where as 80% reported various symptoms, of which the most common were constipation and urinary urgency. In half of the children from Group A and one-fourth of the children from Group B there were several co-occurring symptoms: frequency, urgency, intermittent voiding, incontinence, dribbling and retention, and constipation.

Conclusions: The most common disturbance of lower urinary tract function in these children with recurrent UTI was DSD, which occurred more often in children with VUR.


Ramezanzadeh F, Noorbala Aa, Malak Afzali H, Abedinia N, Rahimi A, Shariet M, Rashidi B, Tehraninajad A, Sohravand F, Bagheri M,
Volume 65, Issue 8 (3 2007)
Abstract

Background: Considering the psycho-social model of diseases, the aim of this study was to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples.

Methods: In a randomized clinical trial, 638 infertile patients referred to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were included in this substudy. These couples were divided randomly into two groups. The patients in the case group received 6-8 sessions of psychotherapy before starting infertility treatment and were given fluoxetine 20-60 mg per day during the same period. The control group did not receive any intervention. Three questionnaires including the Beck Depression Inventory (BDI), Holmes-Rahe stress scale and a socio-demographic questionnaire were applied for all patients. The clinical pregnancy rates of the two groups, based on sonographic detection of the gestational sac six weeks after LMP, were compared. The data were analyzed by paired-T test, T-test, χ2 and the logistic regression method.

Results: The pregnancy rate was 47.1% in the case group and 7.1% in the control group. The pregnancy rate was significantly related to the duration and cause of infertility and the level of stress in both groups (p< 0.001). The pregnancy rate was shown to be higher in couples in which the male has a secondary level of education (p< 0.001).

Conclusions: Psychiatric interventions greatly improve pregnancy rates, and it is therefore crucial to mandate psychiatric counseling in all fertility centers in order to diagnose and treat infertile patients with psychiatric disorders and help couples deal with stress.


Akrami S M, Yousefzadeh G R,
Volume 65, Issue 9 (3 2007)
Abstract

Background: Hutchinson-Gilford Progeria Syndrome (HGPS) is a very rare genetic disorder with a frequency of 1 in 8 million live births. It is characterised by premature aging phenotype. The median age at death is 13.4 years. It is an autosomal dominat disease due to a de novo point mutation in the Lamin A gene exon 11 in the majority of cases. More than 100 cases have been reported world wide.
Case report: We describe here an exceptionally long-lived patient with HGPS, who is alive at age 36. She was referred by a cardiologist to our endocrinology clinic to be worked up for presence of a metabolic or genetic disorder before a heart surgery.
Results: Having more attention of clinicians about very rare diseases and referring the patients to geneticist are the main goals of this case report as well as describing the disease.


Jafari A, Zahmatkesh M, Sadeghiour Hr, Kajbafzadeh Am, Sarrafnejad Af,
Volume 67, Issue 2 (5 2009)
Abstract

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Varicocele is a major cause of male infertility, but its pathophysiology is unclear. Recent studies declare that fertile varicocele people with normal semen analysis are also at risk of loss of infertility. The exact mechanism by which varicocele damages spermatogenesis is still unknown. Some studies have reported increased Reactive Oxygen Species (ROS) is a major factor in semen of men with varicocele. The aim of this study was to investigate whether the source of elevated ROS is intracellular or not. In addition, we studied Mitochondrial Membrane Potential (MMP), viability, antioxidant activity, sperm count and motility in these rats.
Methods: The study group consisted of 28 male rats divided in four groups: control, sham, varicocele 1, varicocele 2, Experimental varicocele was established by partial ligation of the left renal vein in last two groups. Animals were sacrificed two and six months after surgery and dilation of the internal spermatic veins was observed. Then, superoxide anion production and Mitochondrial Membrane Potential were evaluated by Flow cytometry sperm characteristics were evaluated by Flow cytometry. Sperm superoxide anion production was assessed by the dihydroethidium and Mitochondrial Membrane Potential with rhodamin 123.
Results: Our results showed intracellular superoxide anion production significantly increased and Mitochondrial Membrane Potential, viability, sperm count and motility significantly decreased in rats with experimental left varicocele. However, there was no significant difference for seminal plasma antioxidant activity between all groups.
Conclusions: Consequently, our findings suggest that one of the main sources of ROS production is intracellular and we must consider it in treatment.


Ghanbari Z, Rostaminia Gh, Kajbafzadeh Ab, Pirzadeh L, Haghollahi F, Naghizadeh Mm, Pirooz E, Jabbari Z,
Volume 67, Issue 9 (6 2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Pelvic Organ Prolapse (POP) and related urinary symptoms are frequent disorders in elderly women and their management improves life expectancy and quality of life. Urodynamic tests applied in pathophysiologic diagnosis and treatment of urinary disorders are not always cost effective. This study aims to evaluate the results of Urodynamic tests in patients with pelvic organ prolaps.
Methods: This case- control study was done using UDI-6 questionnaire during 18 months in vali-e-asr clinic of Imam Khomeini Hospital, Iran with 105 cases of POP the cases were divided into two groups: group one (66 cases with urinary incontinency) and group two (39 without incontinency) and assessed with urodynamic tests.
Results: Based on UDI-6, the patients of group one had more clinical symptoms (frequency, urine leakage, urge incontinence and stress incontinence). (p<0.001). Except for first desire to voide and normal voided volume indices, there were no significant differences in the other urodynamic parameters in two groups. Sensitivity and specificity of urgency leak in group one was 22 and 68/8% and in group two was 30 and 65/5% respectively. Stress leak sensitivity and specificity in group one were 25/4% and 100% and in group two were 57/1% and 71/9% respectively.
Conclusion: In this study, considering sensitivity and specificity of symptoms and urodynamic test for urinary incontinency assessment is advised in patients with POP who need surgery.


Mowla K, Zakerkish M, Samarbafzadeh A, Moravej Aleali A,
Volume 68, Issue 2 (5 2010)
Abstract

Background: Behcet’s disease (BD) is a multisystemic inflammatory disease with unknown origin characterized by recurrent oral aphtous ulcers, genital, ocular and skin lesions. A single point mutation 1691G to A in the factor V gene increases the risk of venous thrombosis. This study designed to determine factor V Leiden mutation in Behcet’s disease, and to find out it's relationship with the clinical manifestations in Khuzestan province, Iran. Methods: One hundred patients with Behcet's Disease (44 males and 56 females) based on international diagnostic criteria and 70 healthy subjects were included in the study.Patients and controls were tested for the presence of factor V Leiden mutation using polymerase chain reaction method. Results: The prevalence of factor V Leiden mutation was significantly higher in BD (10 out of 100, 10%) compared with healthy control subjects (1 out of 70, 1.4%), (p=0.025). Vascular lesions in this study were deep vein thrombosis (DVT) (7%), subcutaneous thrombophlebitis (5%), stroke (1%) and retinal vasculitis (39%). It was found that there was no association between venous thrombosis and the factor V Leiden mutation in Khuzestanian patients. Also, no association between other vascular lesions and the factor V Leiden mutation was recognized. On the other hand there was a significant association between DVT and anterior uveitis (p=0.033). Conclusion: In this study we did not find any association between clinical manifestations in BD patients and factor V Leiden mutation in Khuzestan province, Iran but in BD patients with DVT, factor V Leiden mutation might be a risk factor for the development of anterior uveitis.
Abdollahi A, Hallaji Z, Ghiasi M, Afzal Zade A,
Volume 68, Issue 11 (4 2011)
Abstract

Background: Vitiligo is a common acquired disorder characterized by depigmented cutaneous patches devoid of melanocytes. The disease carries a risk for ocular abnormalities. Few reports are available about the ocular findings and their possible association with the disease in patients with vitiligo in the literature.

Methods: A total of 72 patients with previously documented cutaneous vitiligo were examined for ocular findings and 50 healthy individuals were enrolled as the control group in Razi Hospital in Tehran, Iran during years 2007-2008. Demographic features including age, gender, duration of the disease, presence of any accompanying autoimmune diseases, type of vitiligo and its anatomical distribution were recorded to investigate a possible association between the disease and the ocular findings.

Results: Amongst 72 patients with vitiligo, 11 (15.3%) had ocular findings including retinal pigment epithelium hypopigmentation, posterior pole pigment changes, peripheral iris atrophy, atrophy of retinal pigment epithelium and iris hyperpigmentation. Amongst the controls, only two cases (4%) had ocular findings which consisted of iris hyperpigmentation. The relationship between ocular findings and vitiligo was statistically significant (p= 0.04). No other remarkable features, such as age, gender, age at the onset of the disease, type of vitiligo, presence of priorbital lesions or body surface area involvement by the disease, were suggestive of an association or presenting a risk factor for vitiligo.

Conclusion: Although the sample size and prevalence of ocular findings were not satisfactory enough to make a definite conclusion, we found a higher occurrence of ocular findings in patients with vitiligo than the control group.


Hajighasemi F, Resvan Madani Fz,
Volume 69, Issue 11 (4 2012)
Abstract

Background: Isosorbide dinitrate has been broadly used in the treatment of various ischemic heart diseases. Isosorbide is a nitric oxide donor which increases blood flow to tumors through vasodilatation and consequently accelerates the access of chemo-drugs to them. Furthermore, this drug has inhibitory effects on angiogenesis, tumor growth and metastasis in vivo. Moreover, its ant-inflammatory effects have also been reported. In the present study we evaluated the effects of isosorbide on the proliferative activity of fibrosarcoma WEHI-164 cell line and peripheral blood mononuclear cells (PBMCs).

Methods: WEHI-164 fibrosarcoma cells and human PBMCs were cultured in complete Roswell Park Memorial Institute (RPMI) 1640 medium with 10% fetal bovine serum and 2×104 cells/mL for WEHI-164 and 2×105 cells/mL for PBMCs. The cells were then incubated at the exponential growth phase with different concentrations of isosorbide (4×10-6-1.6×10-3 M) for 24, 48 and 72 hours. Subsequently, isosorbide effects on proliferation of the cells were evaluated by trypan blue dye exclusion (TB) test and MTT assay. Statistical comparisons between groups were made by analysis of variance.

Results: The proliferative activity of WEHI-164 fibrosarcoma cells and human PBMCs treated with different concentrations of isosorbide, did not show any significant difference with untreated control cells.

Conclusion: The results of this study showed that isosorbide neither had any significant effects on the proliferative activity of fibrosarcoma WEHI-164 cells nor on human PBMCs. Our findings suggest that anti-tumoral effects of isosorbide reported by other investigators may be mediated through non-cytotoxic mechanisms.


Mehrafza M, Raoufi A, Abdollahian P, Nikpouri Z, Shadmani K, Najafi M, Vojoudi E, Hosseini A,
Volume 70, Issue 6 (5 2012)
Abstract

Background: Anti-Müllerian Hormone (AMH) is secreted from granulosa cells of growing follicles and is a useful marker of ovarian reserve. Fertility in women is determined by the quality and quantity of follicle pool and ovarian follicular reserve positively correlates with AMH. In this study we aimed to determine if AMH can predict ovarian response in IVF treatments.
Methods: In this retrospective observational study undertaken in Mehr Institute during 2010 to 2011, we studied the medical records of 101 patients and recorded the concentrations of AMH, day two or three FSH, LH, basal estradiol (E2), E2 on day of HCG administration and the number of metaphase II oocytes. Having undergone ovarian hyperstimulation, the women were divided into three groups: poor responders (retrieved oocytes ?3), normal responders (retrieved oocytes 4 to 15) and high responders (retrieved oocytes ?16).
Results: Overall, 20% of patients were defined as poor responders, 71% as average responders and 10% as high responders. There were significant differences in the concentration of AMH, E2 on day of HCG administration, FSH, the number of metaphase II oocytes and age between the three groups. MII oocyte count correlated positively with AMH (r=0.487), basal E2 (r=0.275) and LH (r=0.07) but it did negatively with FSH (r=-0.26) and age (r=-0.04). The areas under curve for AMH, FSH, LH, E2 and age were 0.799, 0.32, 0.429, 0.558 and 0.304, respectively. We determined the 0.85 ng/ml AMH concentration as the cut-off point with 71% specificity and 79% sensitivity for the prediction of poor responders. 
Conclusion: anti-müllerian hormone is an appropriate predicator of ovarian response following induction of ovulation.


R Afzalipour, Sr Mahdavi, H Khosravi, A Neshasteh-Riz, A Fatemeh Hosseini,
Volume 71, Issue 2 (5 2013)
Abstract

Background: Today, a CT scan examination play an important role in disease diagnosis and thus allocates a significant dose of medical X-ray examinations. One of the important principles in the use of ionizing radiations is to observe radiation protection principles. Evaluating patient's absorbed dose and implementing the strategies for reducing dose are prior in safety issues. To achieve this purpose, sufficient studies should be performed in this regard. Therefore, patient's absorbed dose and the factors affecting have been studied in this research. This study aims to present and develop an acceptable level of absorbed dose in CT scan examinations.
Methods: Diagnostic reference dose level in the adult age group (older than 15 years) has been studied in eleven CT scan centers in Tehran. For this purpose, CT scan examinations prevalent in above-mentioned centers were chosen and Weighted Computed Tomography dose index (CTDIw) and dose length product (DLP) parameters were studied. Standard phantoms with 16 and 32 diameters of Polymethylmethacrylate (PMMA) origin have been used in the centers for CT scan calibration process. CTDIw third quartile has been considered as the diagnostic reference dose level (DRL).
Results: Rate of diagnostic reference dose in the adult age group (older than 15 years) for the head, sinus, lungs, abdomen and pelvis are 50.87, 38.27, 8.05 and 9.11 mg, respectively. Dose measurements made in this survey have been used to set up local DRLs and can be used as a template for national DRLs.
Conclusion: Value of diagnostic reference dose for the head examinations is more than the other parts and diagnostic reference dose in Tehran city in the Adult age group and the protocols compared is less than national reference dose.


Marzieh Mehrafza, Azadeh Raoufi, Parvaneh Abdollahian, Zahra Nikpouri, Mehri Nasiri, Ahmad Hosseini,
Volume 71, Issue 8 (November 2013)
Abstract

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrinological disorders that affect approximately 5-7% of women in reproductive age. There is not any consensus about the efficient in vitro fertilization (IVF) protocol for patients with PCOS. The aim of the present study was to compare the half and one-third dose depot gonadotropin-releasing hormone (GnRH) agonist protocols versus the GnRH antagonist protocol in PCOS patients.
Methods: In the present study, we retrospectively evaluated 119 infertile women with PCOS. The patients entered in the study in accordance with Rotterdam criteria. According to GnRH analogue used for pituitary suppression, patients were divided into three groups: half and one-third dose depot GnRH agonist protocols and GnRH antagonist protocol. In GnRH agonist protocol, half or one-third dose depot Decapeptyl (1.875 mg, 1.25 mg) was injected on 21st day of previous cycle. In GnRH antagonist cycles, cetrotide 0.25 mg were administered daily when the leading follicles reached 14 mm. All basal and controlled ovarian hyperstimulation (COH) characteristics were analyzed.
Results: Basal characteristics including: age, FBS, prolactin, hirsutism, length of menstrual cycle were similar between 3 groups. Statically significant decreases in days of stimulation, number of gonadotrophin ampoules and metaphase II (MII) oocytes were found in GnRH antagonist protocol (P<0.001, P<0.001 and P=0.045), while the decrease in biochemical pregnancy (P=0.083) and live birth rate (P=0.169) wasn't significant. Number of embryos transferred were similar in the half and one-third dose depot GnRH agonist and GnRH antagonist cycles (P=0.881). The incidence of OHSS weren't significantly different between 3 groups (5%, 4.9% and 12.8%, P=0.308).
Conclusion: Our study suggest that one-third dose depot GnRH agonist protocol could be a suitable choice for treatment of PCOS because of lower incidence of ovarian hyperstimulation syndrome (OHSS) as compared with half dose depot GnRH agonist and higher pregnancy rate as compared with GnRH antagonist.

Marzieh Mehrafza , Azadeh Raoufi , Talieh Rahimian , Parvaneh Abdollahian , Zahra Nikpouri , Rahim Tavakkolnia , Abolfazl Golmohammadi , Ahmad Hosseini ,
Volume 72, Issue 4 (July 2014)
Abstract

Background: With introduction of intracytoplasmic sperm injection with testicular sperm extraction or precutaneouse epididymal sperm aspiration, effective treatment was provided for azoospermic men. The aim of present study was to compare clinical outcome following intracytoplasmic sperm injection using extracted testicular/epididymal sperm or ejaculated severe oligoasthenoteratozoospermic sperm. Methods: After retrospective evaluation of more than four hundred medical records of patients undergoing intracytoplasmic sperm injection Mehr medical institute (between 2011-2012), 45 cycles with severe eligoasthenoteratozoospermia and 34 cycles with azoospermia were included. Patients were treated with gonadotropin releasing hormone agonist. The clinical characteristics and intracytoplasmic sperm injection outcome such as the rate of fertilization, implantation and clinical pregnancy were compared between the two groups. Results were presented as mean±standard deviation and number (percent). Differences between variables were analyzed using student's t test and the chi-square test was used to examine differences between categorical variables. P value less than 0.05 were considered as statistically significant. Results: Mean of female age (29±4.9 vs. 30.2±5.8), body mass index (26.9±5.3 vs. 26.9±3.8), estradiol level on human chorionic gonadotropin administration day (1375.6±843.9 vs. 1181.8±673.1), total number of retrieved oocytes (9.7±5.3 vs. 9.2±5.9) and metaphase II oocytes (7.7±5.1 vs. 7.5±5.4) were similar between the two groups. Of 436 and 313 retrieved oocytes, respectively 232 and 163 oocytes were ferti-lized in oligoasthenoteratozoospermic and azoospermic groups (53.2% vs. 52.1%, P=0.214). There were not statistical differences between groups in number of trans-ferred top quality embryos (1.5±1.2 vs. 1±1.2, P=0.09), implantation rate (22.7% vs. 16.9%, P=0.238) and clinical pregnancy rate (21 (47.7%) vs. 11 (35.4%), P=0.199). Conclusion: Intracytoplasmic sperm injection with precutaneouse epididymal sperm aspiration and testicular sperm extraction are effective methods to treat azoospermic men and its clinical outcome were comparable to ejaculated sever oligoasthenoterato-zoospermic cycles. It can be concluded that the influence of sperm quality and origin on intracytoplasmic sperm injection outcome are the same.
Soror Roozafzay , Khadijeh Hekmat , Kobra Shojaei , Pourandokht Afshari , Mohammad Bahadoram ,
Volume 72, Issue 5 (August 2014)
Abstract

Background: Bacterial vaginosis (BV) is the most prevalent causes of abnormal secre-tion in women at fertility age. Also, Bacterial vaginosis is one of the most common dis-eases in women who refer to gynecology clinic. The main cause of the pathogenesis is increasing pH of vagina due to reduced number of lactobacillus and growth of anaero-bic bacteria. Prevalence of BV varies between 10 to 30 percent in different societies. Amsel criteria is used as diagnostic test in BV. This interventional study was designed to assess the impact of vaginal lactobacillus suppository and metronidazole compared to metronidazole alone on the recovery and recurrence of bacterial vaginosis. Methods: This study was a prospective, randomized, double-blind clinical trial which was conducted on 130 women with bacterial vaginosis to compare the effects of vagi-nal lactobacillus suppository and metronidazole. Bacterial vaginosis was diagnosed us-ing Amsel criteria that based on some clinical symptoms. Patients were divided into two groups, first group were treated with oral metronidazole plus lactobacillus and second group were treated with metronidazole alone. Patients were followed-up one week and four weeks after initiation of the treatment. Results: One hundred and thirty women completed the study. Patients were followed at one and four weeks after initiation of intervention. Amsel criteria and recovery rate in both groups compared before treatment one and four weeks after treatment. The crite-ria and treatment were significantly improved, but this improvement was higher and statistically significant in the metronidazole plus Lactobacillus group compared to sec-ond group (P< 0.0001). Conclusion: The protective effects of lactobacillus in dealing with anaerobic patho-gens as well as the negative impact of metronidazole on lactobacillus of vaginal flora, use of lactobacillus along with metronidazole especially in patients with recurrent infec-tions is recommended. In other words, using lactobacillus with metronidazole for treatment of bacterial vaginosis is more effective than metronidazole alone.
Fatemeh Homaee , Malihe Hasanzadeh Mofrad, Masoumeh Mirtaymoore , Monavar Afzal Aghaee, Babak Eslame ,
Volume 73, Issue 7 (October 2015)
Abstract

Background: Ovarian sex cord-stromal tumors (SCST) account for rare ovarian malignancy. These tumors are 5-8% of all ovarian neoplasms. The most common type of sex cord ovarian tumors is granulosa cell tumor (GCT). In this study our purpose was to have a look at some of clinicopathologic aspects and treatment results of these tumors. Methods: In a retrospective study, all documents of patients with SCST was referred to tumor clinics of Ghaem and Omid Hospitals, from 1998 to 2008. The data of patients were collected and analyzed. Results: In 39 (5.9) of the 398 cases, ovarian malignancies was present in SCST. Eight Patients omitted from the study because there were not enough data for them. The commonest pathology was adult granulosa cell tumor in 25 patients (80.6%). Two patients (8.33%) had juvenile granulosa cell tumor, they were 25 and 38 years old. At time of diagnosis, 27 cases (87.1%) were in early stages (stage I). Mean age of patients was 41 years (range 16-76 years) at time of diagnosis of disease. Surgical staging of cancer was performed in 14 patients (46.7%). We did fertility sparing surgery in 12 patients (40%). Two patients were pregnant after surgery. 17 patients (54.80%) did not receive chemotherapy. Three patients (9.7%) received radiotherapy. Overall survival rates were 95% at both 2 years and 5 years. Longer survival had correlation with early stages of disease (P= 0.002). Age, conservative surgery and chemotherapy had no correlations with survival. Conclusion: The prognosis of SCST is almost good. Most of the patients were diagnosed in early stage of disease. In sex cord ovarian tumor, the only factor that have a full effect on survival, is stage of the disease. If the patients desire to preserve fertility, we can do fertility sparing surgery with minimal effect on survival.


Zohreh Yousefi , Sima Kadkhodayan , Maliheh Hasanzadeh Mofrad , Behroz Davachi , Mansoureh Mottaghi , Elham Hoseini , Monavar Afzalaghaee , Asieh Maleki ,
Volume 74, Issue 9 (December 2016)
Abstract

Background: Surgical staging is the standard treatment of ovarian cancer. Pelvic and para-aortic lymphadenectomy is the important part of the surgery. The aim of this study was to evaluate the effect of para aortic lymph node dissection in early stage of patients with ovarian cancer.

Methods: This descriptive cross-sectional cohort study was performed on all stage I of ovarian cancer patients admitted in department of gynecology oncology of Ghaem Hospital, Mashhad University of Medical Sciences in November 2012 to March 2014. Every patient with clinical early stage of ovarian cancer candidate to surgical treatment selected. All cases underwent surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy. In laparotomy after identification of left and right iliac artery, all lymph nodes have been properly exposed and dissected as a part of a staging laparotomy. The dissection was continued up to the nodal tissues surrounding the aorta, and inferior vena cava, until inferior mesenteric artery lymphadenectomy level. The procedure performed only by gynecologist oncologist. In addition, we assessed other parameters such as operation time, estimated blood loss, associated mortality and morbidity and vascular injuries. Finally, the effect of para aortic lymph node dissection in early stage of ovarian cancer evaluated.

Results: Among a total of 57 ovarian cancer patients, 27 of them apparent stage I disease cases were selected. Surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy was carried for all of them. Positive para-aortic lymph node was found only in one case. The average number removed para-aortic lymph nodes in the pelvis was 9 and in para aortic was 7, respectively. In addition, 20 minutes increase in total length of operation time was observed duo to para-aortic lymphadenectomy. Also the rate increase in intra-abdominal hemorrhage rate was estimated 60 ml.

Conclusion: Lymph node dissection will produce a significant benefit in accurate and complete surgical staging. Staging surgery in addition to systematic pelvic and para aortic lymph adenoctomy in early stage ovarian cancer is preferred in gynecologic oncology centers.


Siamak Naji , Kambiz Diba , Rasoul Yosefzadeh , Fatemeh Mansouri ,
Volume 75, Issue 4 (July 2017)
Abstract

Background: Looking at the increased incidence of recurrent vulvovaginal candidiasis and refractory resulting from such non-albicans Candida species in recent decades, this study was performed aiming the use of rapid biochemical and molecular detection of drug-resistant Candida species in response to fluconazole in patients with vulvovaginal candidiasis and recurrent vulvovaginal candidiasis.
Methods: The cross-sectional study was performed at Kowsar Gynecology Center, Motahhari educational hospital and Medical Mycology Center, Faculty of Medicine, Urmia, Iran, from October 2013 to July 2015. Those patients referred to the clinic with symptoms of vaginal discharge, itching or burning that swab samples from endo-exocervix and distal fornix discharge were taken. The vaginal discharge samples submitted to Medical Mycology Center, Urmia School of Medicine for the direct microscopic examination and cultures. Identification at the level of species was performed using CHROMagar Candida and Corn meal agar media. The molecular test polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) used for confirming culture results. For the susceptibility assay, disc diffusion method was performed with fluconazole and clotrimazole.
Results: In these study 198 samples collected from patients with symptoms of vulvovaginal candidiasis, 77 vulvovaginal candidiasis cases were identified. Candida species are common in primary and recurrent cases in terms of frequency, Candida albicans (85.7%), Candida krusei (10.2%) and Candida glabrata (4.1%) were identified respectively. Total of 27 cases of recurrent vulvovaginal candidiasis, 10 cases were resistant to both clotrimazole and fluconazole (37%) was observed that the most common species are resistant to treatment were Candida albicans by (82.1%), Candida krusei (14.3%) and Candida glabrata (3.6%) respectively. Drug resistance in Candida albicans, Candida krusei and Candida glabrata causing recurrent vulvovaginal candidiasis included 69.1%, 75% and 100% respectively.
Conclusion: Our findings have shown frequency of resistant non-albicans Candida species to fluconazole and clotrimazole is increasing. There is a considerable difference between Candida albicans and non-albicans species, Candida glabrata for the resistance to fluconazole and clotrimazole.


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