Tehran University Medical Journal

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder and one of the main reasons of infertility in women. PCOS causes many symptoms in women, one of the most important of them is ovulation failure. It affects the women at the age of fertility. Many factors are detected to exacerbate PCOS including insulin, anti-Mullerian hormone, obesity and androgen. The aim of this study was to evaluate endocrine and metabolic factors and its relation with obesity in patients with polycystic ovary syndrome in exacerbation of disease.
Methods: This cross-sectional study was carried out at the Caucasus Infertility Treatment Center of Ardabil from July 2015 to March 2016 and on 321 patients with polycystic ovary syndrome. Blood samples were investigated to measure serum levels of fasting insulin, dehydroepiandrosterone sulfate (DHEAS), 17OHP, fasting blood sugar, sex hormone binding globulin (SHBG), anti-Mullerian hormone, vitamin D, total testosterone, free testosterone, prolactin, FSH, LH and TSH. Also, body mass index (BMI), duration of infertility and age were measured. BMI was evaluated to measure the obesity of patients.
Results: We were able to demonstrate significantly high level of total testosterone and fasting insulin in PCOS women by having weight gain (P< 0.05). Response to drug was significantly increased with reduced weight of these patients (P= 0.02). The level of fasting blood sugar (P= 0.01) and anti-Mullerian hormone (P< 0.05) were increased significantly with access in PCOS. On the other hand, our data showed that duration of infertility was increased by growing the age of patients (P< 0.05).
Conclusion: Insulin resistance, obesity, hyperandrogenism and metabolic syndrome are very important factors in pathogenesis of PCOS. These factors could affect the fertility of women by effecting the reproductive processes. Therefore, it is better in the patients who are older, treatment strategies further underline on reduce these factors (insulin resistance, obesity and hyperandrogenism) to prevent disease progression and increase duration of infertility.

Background: Psychosocial issues and quality of life are important components at the patients diagnosed with chronic hepatitis B and C. Hepatitis is a chronic liver disease that can affect quality of life of patients. In this study, we compared the quality of life between patients with hepatitis B and C and finally presented a structural model about it.
Methods: In a prospective analytic study, 86 patients with hepatitis B and 86 with hepatitis C who referred to the Rasoul-e-Akram Hospital in Tehran from April 2015 to April 2018 were compared regarding the quality of life and health-related quality of life. The clinical and radiographic data of patients were extracted from their medical records. The 36-item short-form health survey (SF-36) was used for the evaluation quality of life and health-related quality of life. The questionnaire consisted of 36 questions in eight sub-scales (physical performance, physical role, physical pain, general health, vitality, social role, emotional role, and mental health).
Results: Generally, the quality of life score was significantly lower in patients with hepatitis C (34.13±9.37) than patients with hepatitis B (51.5±10.5) (P=0.001). Except for the physical role and vitality, all other SF-36 subscales were significantly lower in the HCV patients group (P>0.05). Based on the results of logistic regression, the emotional dimension of patients was reported as most important effect on the quality of life in patients [(OR=9.15, 95% CI=(4.11-15.41), P=0.001)]. Based on the results of linear analysis, hepatitis type [(B=4.21, P=0.001)], patient income [(B=2.57, P=0.001)], the level of education [(B=2.9, P=0.014)] and the gender of patients [(B=2.77, P=0.023)] were reported as most important factors affecting the quality of life of patients, respectively. There was no significant difference between age, body mass index and smoking reported in patients' quality of life (P>0.05).
Conclusion: According to the results of this study, the quality of life in patients with hepatitis C was significantly lower than the quality of life in patients with hepatitis B.