Tehran University Medical Journal

Background: Cervical cancer is one of the most common cancers in women.Conization of the cervix is one of the best diagnostic and therapeutic modality in preinvasive lesion of the cervix.

Methods: In this retrospective study we have evaluated the indications,complications, cytopathologic results, diagnostic and therapeutic value of 44 patients who underwent cervical conization.

Results: Age of the study group ranged from 18 to 75 (mean=43.18, SD=±11.4), and their parity ranged from 0 to 10 (mean 4-5, SD=±2-3). Ten cases (22.7%) were menopauses. The main indication was inability to visualize the entire T.zone (19 cases/43.2%) that was more prevalent in menopauses (50%/5cases in menopauses and 41.2% /14 cases in premenopauses). Bleeding occurred in 2 cases (4.5%) and urinary infection in 1 case (2.3%). The most common histologic result after conization was mild dysplasia in 23 cases (52.3%). The most common colposcopic biopsy result was moderate dysplasia in 16 cases (36.4%).The most common pap smear result was HSIL in 16 cases (36.4%). Two cases (4.5%) had invasive cancer in colposcopic- biopsy: one of them had ASCUS in the pap and another one had HSIL. Four cases (9.1%) had invasive cancer in histologic report: one of which had ASCUS on the pap and the others had HSIL.

Conclusion: Pap smear in screening of cervical cancer are not reliable and colposcopy is more acceptable in LSIL and ASCUS. Gynecologists should develop the skill to perform an accurate knife conization because the classical indications for conization continue to be valid and it has a low complication rate.

Background: Sleep has a major role in daily cycles and reconstruction of physical and mental abilities. Regarding the importance of this feature, we decided to determine sleep quality in medical students.

Methods: A questionnaire containing demographic data, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index was prepared. We distributed the questionnaires using a census method to every student at the Zanjan Faculty of Medicine. The completed questionnaires were collected and the data was analyzed using SPSS.

Results: A total of 224 students answered the questionnaire, with 133 (59.4%) students evaluated to have good sleep quality and 91 (40.6%) poor sleep quality. Of these 91 students, 38% were female and 44.8% were male (p=0.307). The prevalence of poor sleep quality according to the four stages of medical training was 24.6% of those in basic sciences, 42.9% of those in physiopathology, 41.7% of externs, and 53.5% of interns (p=0.008). According to residential status, the prevalence of poor sleep quality was 61.5% among students living with their spouse, 44.6% for students living in their own private homes, 37.6% among students living in the dormitory, and 20.8% for those living with their parents (p=0.024). According to marital status, 35.8% of singles and 64.9% of married students had poor sleep quality (p=0.001). According to financial status, 57.9%, 46.9%, and 33.9% of those from low, moderate and high economic classes, respectively, were sleep deprived (p=0.049). Among those with average grades of under 16 and over 16 out of 20, 47.5% and 32%, respectively, were suffering from poor sleep quality (p=0.047). There was no obvious relationship between sleep quality and BMI, sex, or history of depression or anxiety.

Conclusion: Poor sleep quality was significantly associated with lower grades, economic status, living arrangement and type of training. A large number of students quality of life and work may suffer because sleep deprivation.

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.

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Sleep and sleep deprivation plays a major role in EEG abnormalities and also idiopathic and symptomatic seizures. The aims of this study were to compare baseline EEG findings with waking and sleep EEGs after sleep deprivation in patients with sleep seizure.
Methods : In this cross-sectional study, 33 patients with sleep seizure attending the Neurology Clinic of Sina Hospital in Tehran, Iran, during year 2009 were enrolled. After a baseline EEG, patients were asked to remain awake for 24 hours before taking a waking and a sleep EEG. Finally, the baseline EEGs were compared with findings from waking and sleep EEGs after sleep deprivation.
Results : From 33 patients with sleep seizure, sixteen (48.5%) patients were female and seventeen (51.5%) were male. Patients aged from 7 to 49 years and the mean age of the participants was 26.83 (SD=10.69) years. Twenty patients had no family histories of seizure contrary to 13 patients with a positive history for the disease. There was statistically significant differences between the baseline and waking EEGs after sleep deprivation (P=0.042) as there was between baseline and sleep EEGs (P=0.041). Moreover, there was significant differences between waking and sleep EEGs after sleep deprivation (P=0.048).
Conclusion: This study demonstrated the effects of sleep deprivation on EEG findings in patients with sleep seizure. In patients with sleep seizure, waking and sleep EEGs could be better demonstrated after sleep deprivation than routine waking EEGs. According to the results of this study, waking EEGs taken after a period of sleep deprivation is superior to sleep EEGs after the deprivation.

Background: Different treatment used for resolving menopausal problems. Some studies assayed effectiveness of citalopram but it had some side effects and other studies about medicinal plants in Iran, including Melissa (combination of officinalis and foeniculum vulgare) showed improvement insomnia and anxiety. This study decided to assay effectiveness of this drug and comparison with placebo and citalopram in treatment of sleep disturbance of menopausal women.