Tehran University Medical Journal

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Introduction: Thyroid diseases are one of the most common endocrine diseases. Incidence of thyroid diseases in women is ten times more than men. Menstrual irregularities and fertility is occasionally the first sign of thyroid diseases.

Materials and methods: In a prospective study, 325 thyroid patients were evaluated in Emam hospital. Incidence and type of menstrual irregularities were evaluated in these patients.

Results: 55.8 percent of hypothyroid patients had normal pattern ob bleeding. 44.2 hyper thyroid patients had menstrual irregularities which were in the form of oligomenorrhea and 41.7 percents of hypo-thyroid patients were irregular in the form of polymenorrhea, oligomenorrhea and menorrhagia.

Conclusion: In these patients, menstrual irregularities cured by treatment of thyroid diseases and reduced surgical interventions.

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Background and Aim: This study was conducted to evaluate the safety and efficacy of Tension-free Tape for the surgical treatment of female stress urinary incontinence.

Materials and Methods: In a prospective open study for pre and post operative, we followed 36 patients at least 1.5 years after surgery (18-28 months) all patients underwent the operation under local anesthesia, allowing the surgeon to check intra-operatively that continence has been obtained.

Results: Mean operation time was 36 minutes (range 20-45 minutes). 32(89%) of the patients was cured according to the protocol, another 3(8.3%) were significantly improved and there was 1(2.7%) failure. Mast of patients (about 91%) were operated on a one day-care basis, which implies that they were released from the hospital the day after the procedure, and no post operative catheterization, defect healing and tape rejection occurred. Pain free recovery time without any analgesic was another benefit. Five patients needed an indwelling catheter for 3 days and two uncomplicated hematoma occurred.

Conclusion: Based on the results, we conclude that Tension-free Vaginal Tape is a safe and effective ambulatory procedure for surgical treatment of genuine stress urinary incontinence, which allows the majority of the women to be discharged from the clinic the day after the procedure and start their works in the second week.

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Background: Abnormal uterine bleeding (AUB) is a common presenting symptom indicative of abnormal menstrual bleeding patterns that may occur in anovulatory or ovulatory women.There are different ways to diagnose AUB, all requiring much time and energy. The purpose of this study was to evaluate and compare the value of endometrial biopsy, transvaginal ultrasonography with dilation and curettage (D&C) which is the current gold standard procedure.

Methods: A prospective-descriptive study was conducted on fifty patients referred to our center for refractory abnormal uterine bleeding who were candidates for hysterectomy. All patients underwent endometrial biopsy and transvaginal ultrasonography , followed by D&C as a Gold standard procedure in operating room just before surgery.

Results: Mean age of patients was 46.62 years. Transvaginal utrasonography offered a sensitivity of 70% and specificity of 68% demonstrating the lowest numbers compared to D&C. Endometrial biopsy had a sensitivity of 70% and specificity of 75% that was better than sonography alone.

Conclusion: D&C was the most useful and valuable procedure and addition of endometrial biopsy with transvaginal ultrasonography will not be of high value in diagnosis.

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Background: To evaluate long-term outcome and satisfaction of MacIndo surgery with and without amnion graft.

Methods: This is a historical cohort study of patients who were treated with the McIndo procedure for vaginal agenesis. Participants answered a structured questionnaire to describe outcome in sexual function and satisfaction. Patient characteristics along with short and long-term endings were abstracted from the medical records.

Results: Thirty-five patients responded to the questionnaire. Average age (±SD) at surgery was 28.4 ± 3 years (range 17- 48 years). The mean number of years (±SD) since surgery was 7 years (range 2-12 years). In 15 patients (42.8%) amniotic graft were amniotic graft were used only in is patients (42.8%). There was no relation between two types of surgery (long-term outcome and satisfaction with p-values of 0.346 and 0.758 respectively).

Conclusions: Since there was not a statistical difference between these two types of McIndo methods, it is recommended to apply the procedure in which amnion is not used. This procedure (without amnion graft), is an easier method with less operation time and reduced viral (HIV…) transmission.

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Background: Vaginal vault prolapse is a significant longer-term complication in patients undergoing hysterectomy. An important cause is generally acknowledged to be weakness in the uterosacral and cardinal ligaments. Vaginal delivery is known to be a risk factor, and obesity and menopause are predisposing factors. Urogynecologists are constantly looking for simple, safe and effective ways to cure vaginal apex prolapse. Infracoccygeal sacropexy, also known as posterior intravaginal slingplasty, is a useful and less-invasive procedure, with low morbidity. The aim of this study is to confirm the efficacy, safety and long-term outcome of infracoccygeal sacropexy for the treatment of vault prolapse.
Methods: In a prospective observational study, we performed infracoccygeal sacropexy to treat 26 patients who had at least grade 3 symptomatic vault prolapse secondary to transvaginal hysterectomy. Data collection included anatomic outcome, and intra- and post-operative complications.
Results: The mean patient age was 67 years. The mean operation time was 30 minutes and mean blood loss was 130 ml. No intraoperative rectal perforation was seen, and all patients were discharged within 24 hours of surgery. The symptomatic cure of prolapse rate, urgency, nocturia and pelvic pain was 96.2%, 88.8%, 92.6% and 77% orderly. Only one tape rejection occurred in one of the 26 patients.
Conclusion: Our initial experience with infracoccygeal sacropexy shows an efficacy similar to other more established surgical techniques for the cure of vault prolapse, but with less surgical morbidity. Therefore, the procedure is found to be efficient and safe, with shorter operation times, reduced postoperative complication and shorter hospital convalescence.

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Background: Abdominal hysterectomy is one of the therapeutic options in treatment of gynecologic diseases. The most common methods are total and subtotal abdominal hysterectomy. The effect of hysterectomy on sexuality is not fully understood and, until recently, total and subtotal abdominal hysterectomies have been compared only in observational studies. In this study, we compare total vs. subtotal abdominal hysterectomy in terms of surgical complications and postoperative sexual function of patients.

Methods: In a single-blinded randomized clinical trial, we enrolled 25 patients who underwent subtotal abdominal hysterectomy (STAH), and 25 patients who underwent total abdominal hysterectomy (TAH). All patients were followed for 24 months after surgery. Three, six, 12 and 24 months after the procedures, all variables were compared between these two groups.

Results: The duration of operation (p=0.007), volume of bleeding (p=0.0007) and duration of hospital stay after surgery (p=0.03) were less in the STAH group than the TAH group. No complications were experienced during the operation, nor excessive post-operative pain or infection for either group. No significant differences were seen between the two groups with regard to dyspareunia, sexual satisfaction of the patients and their partners were. Spot bleeding in the STAH group was significantly more frequent than in the TAH group.

Conclusion: TAH and STAH do not have significantly different outcomes with regard to sexual satisfaction and function and surgical complications.

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Background: The aim of this study was to assess the efficacy and safety of a new minimally-invasive surgical procedure using trans-obturator Tape (TOT) to treat female stress urinary incontinence.

Methods: This clinical trial study was performed from 2003 to 2004 in the Gynecology Department of Imam Hospital, Vali-e-Asr, Tehran, Iran. A total of 35 women with stress urinary incontinence underwent the TOT procedure. All patients underwent pre-operative clinical examination, cough-stress test (full bladder), uroflowmetry and post-voiding residual volume assessment.

Results: The mean age of patients was 50 years, ranging from 26 to 74 years, with an average urinary stress incontinence duration of six years. The mean time of follow-up was 14 months (at 1, 6, 12 and 24 months) and the average duration of surgery was about 20 minutes. The perioperative complication rate was 9% with no vascular, nerve or bowel injuries. The rate of hemorrhagic side effects (spontaneously-absorbed hematoma and blood loss not requiring blood transfusion) was 2.9%. Post-operative urinary retention and vaginal erosion occurred in one case each the former was treated by intermittent self-catheterization. In total, 91.4% of patients were completely cured and 8.6% were improved without failure of treatment.

Conclusions: The present study confirms the results obtained by Delorme and coworkers, and allows us to consider TOT as a safe, minimally invasive and efficient short-term surgical technique for the treatment of female stress urinary incontinence, alone or in combination with prolapse repair. Following this study, a randomized control trial is recommended to compare TOT with the gold standard surgery for women with urinary incontinence.

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Background: Neural Tube Defect (NTD) characterized by failure of neural tube to close properly be the second most common born defect after congenital heart disease. The most prevalent forms of NTD are Anencephaly and Spinal-bifida. Many factors are involved in this anomaly. New researches suggest environmental factors like radiation, hyperthermia, Vitamin A and acid folic deficiency, anti epileptic drug like Carbamazepine, Phenobarbital, phenytoin, Folic acid antagonist like Sulfasalazine, Triametherine and systemic disease like diabet mellitus, obesity, genetic factors, the most schance 40 to 70 percentages.
Methods: In this survey cross sectional study was conducted in five hospitals depend to Tehran university during three years. Study subject identified through review of admission and discharge at major hospital through regular contact with newborn nurseries and birth hospital.
Results: In 38473 reported cases, 143 cases have neural tube defect. Among NTD cases, 11.9% of mothers had medical diseases in their previous history such as diabetes mellitus, epilepsy-psychiatric, and disorder-heart diseases. In this study group, 5.6% have preclampsia during pregnancy period. The most common NTD anomaly in this study was anencephaly and meningomyelocele that was different from studies in literature.
Conclusion: NTD result from failure of neural tube close threats fetus health up to 28 days after conception. When is often prior to the recognition of pregnancy since many pregnancy are unplanned NTD prevention is best achieve by adequate daily folic acid intake thought of reproductive ages .educational effort to promote daily intake of folic acid supplemental by women of reproductive age and NTD risk factor should be done. Early diagnostic procedure for high risk pregnancy advised.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Macrosomia is a term applied to newborns with a birth weight of >4000g. This condition leads to several maternal and fetal complications including maternal traumas as well as newborn injury. This study was designed to evaluate the risk factors of macrosomia among Iranian women.
Methods: This cross-sectional study performed between July 2001 and July 2002, included 2000 term deliveries involving newborns with birth weights of >2500g. The records of 77 mothers of live born infants weighing >4000g were compared to those of the control group (231 women). Stillborn and neonates who were <2500g were excluded from the study.
Results: Among the 2000 deliveries performed in Imam Hospital, 77(3.8%) of the newborns weighed >4000g and 12(0.6%) weighed >4500g. The mean age of the mothers, maternal BMI, history of diabetes mellitus, multiparity, fetal sex and underling maternal disease were found to be associated with increase risk of fetal macrosomia. There was no significant relationship between prolonged gestation, weight gain more than 16kg during pregnancy and past history of macrosomic delivery and macrosomia.
Conclusions: It is possible to prevent macrosomia by weight and diabetes control before the decision to become pregnant. To prevent pregnancy among multipara mothers aged >35 years old, highly protective contraceptive methods should be used. Furthermore, if a mother is diagnosed with a macrosomic fetus by sonography or other imaging methods, more care should be taken during the delivery to decrease the risk of fetal injury, such as asphyxia and brachial plexus palsy.  

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Background: Chronic Pelvic Pain (CPP), a common health problem in women, characterized by lower abdominal pain that has lasted at least for six months. Although, it's annual prevalence estimated 3.8 to 49%, there is no data in Iranian society. This study was aimed at gathering comprehensive and reliable data regarding the prevalence of CPP in female employees at two university hospitals in Tehran in 2006-2007.

Methods: A cross-Sectional study was conducted to determine the CPP prevalence on 303 volunteer females aged 19-63(34.7±9.2) years, working in two university hospitals, Tehran. A designed questionnaire with four parts containing questions regarding demographic information, gynecological, urinary and gastrointestinal symptoms was used. The ethical committee of the Shaheed Beheshti Medical University approved the study.

Results: The prevalence of present pelvic pain unrelated to menstrual cycle was 22.3% and totally 10.2% subjects suffered from CPP during the last 6-12 months. Our data showed a significant difference in prevalence of CPP between women with and without vaginal delivery (37% VS. 24 P=0.036%). There was a significant relationship between incomplete and hard defecation and occurrence of CPP (p<0.001). The prevalence of LBP & PPD in women with CPP was higher than women with no CPP (p<0.001).

Conclusions: Regarding to the prevalence of CPP and its relationship with gynecological, urinary, musculoskeletal and gastrointestinal factors, we emphasize on a multidisciplinary approach for management of CPP, also recommend performing further community-based epidemiological studies.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Mood disturbances, such as anxiety, depression and psychological distress, are common among women in menopausal period. Effect of long term estrogen replacement on post menopausal  mood disturbances is curative but specifical studies has not done on the effects of vaginal hormonal therapy in mood disturbances in menopause. The aim of this study was objectives to clarify the effect extended by Hormon Replacement Therapy (HRT) in improving post menopausal mood disturbances.
Methods: In a single blinded clinical trial, the effects of a four months application of vaginal esterogen (premarin) versus placebo (n=20) in each groups were evaluated on mood status and sexual satisfaction, using the Hamilton depression score (HDS score), and self assessment of sexual function and pleasure. Four months after treatment completion (half applicator of nightly vaginal premarin or lubricant vaginally) collected and analyzed with Statistical tests.
Results: Decline of the mean HDS scores (depression score) was observed in the premarin group. The mean HDS score (depression) after vaginal premarin decreased from (14.6±4.7) to (3.4±2.3). (p≤0.001) also, The HDS score in placebo group increased from (10.6±3.1) to (11±3.3), that significant difference between two groups before and after treatment is seen. (p≤0.01). Vaginal premarin induced a greater improvement of HDS score (p≤0.006). Mean anxiety score decreased after vaginal premarin (p≤0.000), but is not significant difference in placebo group. (p=0.08). Sexual Satisfaction in Vaginal premarin group is significantly higher (p≤0.001).
Conclusions: Vaginal Estrogene directly or indirectly improved menopausal related mood and sleep disturbances, increased and sexual satisfaction.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: The abdominal sacrocolpopexy is the gold standard method of vaginal prolapse correction and posterior intra- vaginal slingplasty (posterior IVS) is a newer procedure with minimal invasion. This study is going to compare the effectiveness and complications of these two surgical methods.
Methods: In this study, 51 patients with prolapse admitted to vali-e-asr Hospital of Tehran University of medical science were evaluated during years 2001-2004. 26 patients were operated by posterior IVS method (the first group) and 25 of them had undertaken sacrocolpo-pexy (the second group). Data were primarily gathered from patients' folder and further complimentary information were achieved by two years follow-up and inviting patients to interview or exam.
Results: Eighty percent of women with abdominal sacrocolpopexy were cured compared to 96.2 percent with posterior IVS. Surgery complications was reported in one patient (4%) of second group while none of patients in first group experience this and the difference was not statistically meaningful. Short-term post surgical complications (hemorrhage-perforation fever and abdominal distention) were also negative in first group (posterior intra vaginal slingplasty) but these problems such as fever and abdominal distention were positive in 36% of second group (abdominal sacrocolpopexy) which was evidently statistically meaningful (p=0.001). Long- term post surgical complication (tape and mesh disfunction) were seen in 7.7% of first group while none of second group patients showed these complications.
Conclusion: According to shorter operating time, lower complications and efficient response to therapy in posterior IVS method, it can be an alternative in prolapse surgery it is preferred in elderly patients with medical problems.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stress incontinence is the most common type of urinary incontinence which has been treated by different surgical techniques. The objectives of our study were to compare the laparoscopic Burch colposuspension with Trans- obturator Tape (TOT) procedure.
Methods: This randomized clinical trial was conducted on 40 patients with stress incontinence referred to Arash hospital from 2007 to 2009. All patients were randomly divided in two groups (laparoscopic Burch and TOT). Patient information was using obtained demographic, I-QOL (Which contained 22 questions), UDI-6 (urinary symptoms), ISI (Severity of urinary incontinence) questionnaires and urodynamic test.
Results: The data collected from 19 patients in TOT group and 16 patients in laparoscopic Burch groups. The objective cure rate which was determined by no urinary leakage during stress and were analyzed urodynamic evaluation was 75% in laparoscopic and 84.2% in TOT (p=0.53). Result of ISI questionnaire with showing the subjective cure rate following surgery had no significant difference between two groups (p=0.23). UDI-6 questionnaire was used to compare the result of both groups before and after surgery and showed that the improvement in Urgency was significant in TOT in compare to Burch (p=0.04). I-QOL score significantly increased in both groups after six months of operation (p<0.05). But the differences were not statistically significant.
Conclusion: Based on our results subjective and objective cure rate were not significantly different between TOT and laparoscopic Burch colposuspension.

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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.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stress urinary incontinence is a major confounding factor which impairs health quality in women. Some procedures cannot resolve it&aposs impact on life quality. This study aims to assess a less common and newly method use of transobturator tension- free vaginal tapes (TOT) in regard to short- term and long-term morbidity and impact on patient&aposs quality of life (QOL).

Methods: Fifty four patients diagnosed with urinary stress incontinence, underwent a transobturator tension free vaginal tape procedure with or whitout prolapse surgery. Pre and post operative quality of life assessed with Incontinence- specific Quality of Life questionnaire (I-QOL), and objective and subjective cure rate according to patients signs and symptoms before operation, early and late surgical complications like hemorrhage, Injury and/ or perforation of bladder, intestine, urethra and infection were mentioned.

Results: The overall intraoperative and early post-operative complication rates were 5.5% and 3.7%, respectively. No case of hematoma, bladder or bowel injury was seen.   I-QOL scores were significantly higher after surgery. The mean I-QOL score were 23.6 and 64 before and after surgery respectively (p<0.0001). This improvement was independent of the concomitant pelvic floor repair surgery, menopause, underlying diseases, number of parity, body mass index (BMI) and age. The global rate of objective cure was 94.4% (p<0.0001). The majority of women were satisfied with the outcome. (subjective cure was 90.7%- p<0.001).

Conclusions: This study demonstrates that the TOT approach in the treatment of stress urinary incontinence is a safe and effective procedure which promotes health quality of life.

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800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Psoriasis is a chronic, inflammatory disease of the skin. Recently, nicotinic cholinergic receptors have been demonstrated on keratinocytes, stimulating calcium influx and accelerating cell differentiation. Therefore, smoking and nicotine seem to influence inflammatory processes in psoriatic skin. The aim of this study was to determine the frequency of cigarette smoking as an independent risk factor in patients with psoriasis who attended the department of dermatology at Razi Hospital in Rasht during the years 2008 and 2009.
Methods : In this descriptive-inferential study, we recruited 96 patients with psoriasis vulgaris and 96 individuals as the controls. The participants were adjusted for sex, age and body mass index. The collected data related to smoking status, duration of smoking habit, smoking intensity, pack-year smoking history, and passively exposure to smoking were documented in a researcher-devised questionnaire. Subsequently, the data were analyzed by descriptive and inferential statistics such as χ², t-test and Mann-Whitney U test by SPSS software.
Results : The smoking rate was 33.3% in the patients and 19.4% in the controls. Pack-year history, regarded as the intensity and duration (years) of smoking, significantly increased the risk of psoriasis vulgaris (P<0.05, OR=2.07, 95% CI=1.17-3.68). Being a passive smoker did not make significant differences between the cases and the controls.
Conclusion: Our study demonstrated that psoriasis vulgaris had a relationship with duration and intensity of cigarette smoking and revealed the importance of smoking cessation, particularly among patients with psoriasis.

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Background: Overactive bladder (OAB) is one of the most prevalent diseases of lower urinary system. OAB disease is defined by the Standardization Subcommittee of the International Continence Society as urinary urgency, with or without urge incontinence, usually with frequency and nocturia with no proven infection or other obvious pathology. Treatment with the antimuscarinic agents tolterodine and oxybutynin is the mainstay of therapy for overactive bladder. The study was undertaken to compare the efficacy and side-effects of tolterodine and oxybutynin in a number of Iranian women.

Methods: This study consisted of two trials and done in Imam Khomeini Hospital in 2009 in one trial, 50 patients with overactive bladder were randomized to 4 weeks of treatment with 2 mg of twice-daily tolterodine, and in the other to 5 mg of three times a day oxybutynin. Urodynamic investigations, Episodes of urge urinary incontinence and adverse events were also evaluated.

Results: The results showed a good association between the questionnaire and cystometry data but urodynamic studies showed significant differences in efficacy. Tow groups showed significant improvements in all Symptoms, but The results showed that the two drugs had no significant differences in efficacy.

Conclusion: The data obtained by questionnaire indicated that both drugs increased quality of life but there were no significant differences between the two in symptom cure. Dry mouth was the most common side-effect in the two groups but unlike other studies it was higher in the tolterodine group. Therefore, our study did not show any preference between oxybutynin and tolterodine.

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Background: Pseudomonas aeruginosa is a gram-negative pathogens opportunism which causes severe infections in human beings. The most common infection include: endocarditis, meningitis, septicemia and chronic lung infections in cystic fibrosis pa-tients. This bacterium has many pathogenic factors including exotoxin A, lipopoly-sacharide, phospholipase C, pili, elastase and alkaline protease. The purpose of this study was to evaluate the frequency of exotoxin A gene (ETA) as a strong virulence factor and sensitivity determination of polymerase chain reaction (PCR) in pseudomonas aeruginosa isolated from second and third-degree burn patients. Methods: This study has performed in Besat University Hospital in Hamadan from January to December 2012. We used 170 isolated samples. The samples were isolated from blood and skin biopsy in second and third-degree burn patients. We had 79 strains positive culture of pseudomonas aeruginosa. Forward and reverse primers used for PCR were designed by DNASIS and Oligo software. Then genomic of known strains were extracted by DNA purification kit and indentified by PCR. The quality and quantity of the extracted DNA was determined using spectrophotometry. For determination of PCR sensitivity was used culture test as gold standard. DNA of pseudomonas aeruginosa (ATCC 27853) was used as a positive control. Finally data was analyzed using SPSS software. Results: Out of 170 isolated samples, 79 strains of pseudomonas aeruginosa isolated from burn patients had positive culture. PCR of isolated positive culture demonstrated that 5 strains (6.33%) were with out this virulence factor and 74 strains (93.67%) had ETA gene. So the sensitivity of test based on sensitivity formula was 94.04%. Conclusion: Our results showed that sensitivity of PCR mediated ETA gene in detection of pseudomonas aeruginosa strains is considerable and this factor can be used as a good factor identifying of pseudomonas aeruginosa. It seems more studies with larger sample size is necessary in this area.

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Background: To examine the association among pelvic girdle pain (PGP), urinary incontinence (UI) and pelvic floor muscle (PFM) function in pregnant women in second and third trimester.

Methods: 300 pregnant women who admitted for standard pregnancy care were enrolled in the study. Urinary incontinency was measured via the international consultation on incontinence questionnaire short form. Pelvic girdle pain was diagnosed according to existing guidelines. Vaginal examination assessed pelvic muscles contract- relax patterns and muscle strength. The software stata version 13 (Stata Corp., TX, USA) was used for data analysis.

Results: Overall 300 women (150 with PGP and 150 without PGP) were included in final analyses. There was not significant differences between the demographic data including, body mass index before pregnancy, maternal age, mode of delivery. Prevalence of urinary incontinence in women with pelvic girdle pain was 41.5 percent (CI 95%: 32.01- 51.48) while the prevalence of urinary incontinence in women without pain was 21.9 percent (CI 95%: 14.99-30.03). Using logistic regression, the relationship between urinary incontinence and pelvic girdle pain was significant. (CI 95%: 1.07-3.31, P=0.02). Multivariate logistic regression analysis was used to evaluate the relationship between PGP and pelvic floor muscle function and results showed that pelvic floor muscle strength in women with PGP was significantly lower than women without PGP. (CI 95%: 0.24-0.68, OR= 0.4, P<0.001). The duration of the contraction of the pelvic floor muscles in patients with PGP was significantly shorter than women without PGP. (CI 95%: 0.21-0.60, OR =0.35, P<0.001).

Conclusion: There was a significant association between pelvic girdle pain and urinary incontinence during the second and third trimesters of pregnancy and also the pelvic floor muscle strength and duration of the contraction of the pelvic floor muscles in women with pelvic girdle pain was significantly lower than those without PGP.

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Background: The purpose of the current study was to investigate the effect of a high- intensity running (12 weeks) with bee pollen on gastrocnemius muscle ABCA1 and apoA1 mRNA expression in male rats.

Methods: In the present semi-experimental study, 24 white male Wistar rats aged 8 weeks with an average weight of 90±20 were prepared from the Pasteur Institute of Amol, Iran. The rats were kept in a room with dimensions of 6×5 meters under controlled conditions of light (12 hours light, 12 hours darkness, light began at 6 am, and the darkness began 6 pm), temperature (22±3 ºC) and moisture content (about 45%) from November to the end of February 2013. After a week of familiarity with laboratory space and manipulation by human, the rats were divided with simple random sampling into four groups matched by weight: saline-control, bee pollen-control, saline-training and bee pollen-training. Rats were sacrificed 48 h after the last training session. Data were analyzed statistically using two-way ANOVA and a significance level of 0.05.

Results: The results of the present study showed that intense endurance training decreased non-significantly in the gastrocnemius muscle. In addition, the bee pollen caused a significant increase in ABCA1 gene expression in the gastrocnemius muscle of male rats (P< 0.0001). while apoA1 not expressed in the gastrocnemius muscle.

Conclusion: The results of this study showed that high-intensity running reduces ABCA1 gene expression is severe. In addition, consumption of bee pollen can increase ABCA1 gene expression in the gastrocnemius muscle. According to the results of the present research, the bee pollen intake is more effective than intense endurance training on ABCA1 gene expression in gastrocnemius muscle of male rats and plays an important role in reverse cholesterol transport.