Background: The etiology of End Stage Renal Disease (ESRD) in every community differ according to genetic, nutrition, and public health status. ESRD,the terminal stage of chronic renal failure,needs replacement therapy otherwise could lead to death. The aim of the study is to determine the relative frequency of ESRD etiology in hemodialysis patients of Gilan province.
Methods:This descriptive study was performed on 407 patients who were being hemodialysis in all hemodialysis centers of the Gilan province from September 2002 to September 2003. The original data was collected from the medical records of patients.
Results: The most prevalent causes were: hypertension 35.4% unknown etiology 16.2% diabetes melitus 13.8% , glomerulopathies 9.6% , urologic causes 9.1%, cystic kidney diseases 7.6 % other causes 5.9 % congenital 2.5%.
Conclusion: In our study hypertension was the first etiology of ESRD, followed by unknown causes, however nephrology textbooks indicate diabetes melitus as the primary and hypertension as the secondary etiology of ESRD,.
Background: Sexual function in women may be affected by their menstrual cycle. Lack of sexual drive is a deficiency or absence of sexual fantasies and desire for sexual activity. This study aims at determining the changes in sexual desire during the menstrual cycle and those associated with premenstrual syndrome (PMS) and evaluates sexual desire during the menstrual cycle and the associated changes with PMS.
Methods: The sample for this cross-sectional study includes 150 women employed in factories in Tehran. The instruments for data collection were questionnaires and journals of premenstrual experiences.
Results: Analysis of the data showed that the mean age of the subjects was 31 years )standard deviation = 8.46(. The most frequent decrease in sexual desire was during the week prior to the start of menstrual bleeding (27.3%) and the least frequent was from the end of bleeding to one week before the next period of menstrual bleeding (5.3%). In 24.7% of the cases, an increase in sexual desire occurred during the middle of the menstrual cycle and 27.3% during the course of menstrual bleeding. Moreover, 10.7% of the subjects had an increase in sexual desire during the week before bleeding. Furthermore, a positive correlation was found between changes in sexual desire and PMS (p<0.001). In addition, a positive correlation was found between changes in sexual desire and breast tenderness, joint and muscle pain.
Conclusions: The sexual desire of women, with or without PMS, changes during the menstrual cycle. The greatest decrease in sexual desire occurs during the first week before menstrual bleeding in women with PMS. Such information can greatly help toward understanding and treatment in sexual therapy for couples.
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.
Background: The value of the mandibulo-canine index (MCI) in gender identification has been proved in some studies in various countries. The goal of our study was to determine the utility of MCI in gender identification in Iran.
Methods: This descriptional survey was performed on a group of 18- to 25-year-old Iranian students at the Tehran University of Medical Science. We included 50 males and 50 females that were selected using a single sampling method. Data were statistically analyzed by SPSS (v. 13) and t-test.
Results: No statistically significant difference was found between the mean ages of the two groups. Among men, the MCI ranged from 0.209 to 0.293, with a mean of 0.252. Among women, the MCI ranged from 0.202 to 0.276, with a mean of 0.245. There was significant statistical difference between the two means, (0.007 P value = 0.04). The standard MCI of 0.247 was compared to that of each gender, after which no significant statistical difference was found between the two genders (P value = 0.8).
Conclusions: Despite some studies performed in other countries displaying the usefulness of MCI in sex determination, our data did not support this conclusion. Perhaps this difference can be explained because of the variety ethnic groups from various cities of Iran represented in this research had some influence on the results.
Background: The perception of impairment of sexual function after childbirth in vaginal delivery (as a complication) makes pregnant women to request elective cesarean section. But this conception is more related to culture. Therefore we studied women's sexual health after childbirth to assess whether women who underwent cesarean section experienced better sexual health in the postnatal period than women with vaginal births.
Methods: A cohort study was conducted on 303 primiparous women who had delivered vaginaly and 315 primiparous delivered by elective cesarean section in seven private hospitals in Tehran, employing data of demographic characteristics like age, education, BMI, obstetric history (weight gain in pregnancy, history of pelvic pain and vaginal discharge), stress incontinence history (prepregnancy and during pregnancy) and effect of delivery on sexual satisfaction in several follow-ups until 12 months after delivery.
Results: Sexual satisfaction after delivery in vaginal group was significantly more than cesarean group. (76% vs 60%, p<0.0001). There was no relation between pelvic pain & delivery type (in several follow- up).
Conclusions: Instead of social conception of have more sexual satisfaction after cesarean delivery, outcomes from this study provide no basis for advocating cesarean section as a way to protect women's sexual function after childbirth. Therefore Request of cesarean section by mother for having more sexual satisfaction after childbirth is not logic.
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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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MicrosoftInternetExplorer4
Background: One of the major
problems in the medicine is personal identification in cases of skeletal
remains. The first step is determination of sex. One of the elements that
recently paied more attention to it is the patella. Since the measurements are
population specific, so we measured the patellas of Iranians to determine their
patellas dimensions for sex prediction.
Methods: In this
study three metrical characteristics of patella were measured from 67 corps
between 20-64 years refered to the autopasy hall of forensic medicine center in
Tehran (L.M.O). For statistical analysis of datas, the statistical product and
service solution (SPSS version 16) program was used and unvariate and multivariate discriminant
function analysis were performed to indicate the efficiency of each variable
for sex determination.
Results: The mean of
patella height in male was 4.46 cm and in female was 3.87, the mean
of patella width in male was 4.60 and in female was 4.03cm and the
mean of patella thickness in male was 2.25 and in female was 2.07cm. Among
these measurements maximal width with average accurancy of 94% and then
maximal height with 91% and finally maximal thickness with 71.6-73.1%
respectively were better variables for sex determination. Also in multivariate
discriminant analysis, combination of all three measurements with average
accuracy of 94% was the best function for sex determination.
Conclusion: The
results of this study revealed that we can determine sex with high confidence
in situations such as explosions, air crashes and etc, just by using the
patella measurement.
Background: Although sexual dysfunction is a common problem in patients with obsessive-compulsive disorder (OCD), there are sparse clinical research on the study of the correlation between OCD subtypes and different phases of sexual response cycle. This study was undertaken to assess sexual function and its different phases in a group of Iranian patients with OCD. Methods: This was a descriptive cross-sectional study. The subjects consisted of 56 married OCD patients (36 female, 20 male) who suffered from OCD according to a psychiatric interview and DSM-IV questionnaire based on structured clinical interview for DSM (SCID). Patients were between 18 to 50 year age that had been referred to the outpatient clinic of Roozbeh Psychiatric Hospital and three private psychiatric clinics in Tehran (from September 2011 to February 2013). Five Questionnaires were used in this study: Iranian validated form of Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF), Maudsley Obsessional Compulsive Inventory (MOCI), Obsessive Compulsive Inventory-Revised (OCI-R) and a questionnaire which has provided demographic data and other relevant information regarding sexual function and OCD. Results: The prevalence of sexual dysfunction among female was 80.6% and the frequency of disorders in different subscales of FSFI including sexual desire, sexual arousal, lubrication, orgasm, satisfaction and sexual pain were 50%, 58.3%, 36.1%, 44.4%, 41.7% and 52.8% respectively. Sexual disorder is reported in 25% of male OCD patients which subscales' evaluation of IIEF shows low sexual desire in 10%, erectile disorder in 20%, orgasmic disorder in 25%, sexual dissatisfaction in 40% and 50% decreased in the total sore of IIEF. Moreover, the correlation coefficients between the total score of OCI-R with erectile and satisfaction subscales of IIEF were statistically significant. The score of washing subscale in OCI-R and sexual satisfaction was significantly correlated. Conclusion: High prevalence of sexual dysfunction in OCD women and significant correlation between male sexual dysfunction and OCD (r= -481.0 between total score of OCI-R with erectile dysfunction and r= -458.0 between total score of OCI-R and sexual satisfaction) could confirm a relation between OCD and sexual disorders. So, evaluation of sexual function in all patients with OCD is recommended.
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.
Background: Sexual dysfunction could be under the influence of some underlying medical problems. The purpose of this study is to examine the relationship between medical problems and sexual function in post-menopausal women.
Methods: This is a community-based, descriptive-correlation study of 405 post-menopausal women residing in Chalus and Nowshahr cities, North of Iran, aged 40 to 65 years old from October 2013 to May 2014. A multistage, randomized sampling was conducted. The data was acquired through interviews using the Female Sexual Function Index (FSFI) questionnaire and a researcher-made questionnaire, and was analyzed using descriptive and analytical tests such as multiple linear regression and logistic regression models.
Results: 51.4% of the subjects had medical conditions. Cardiovascular disorders were the most common diseases among the subjects. 61% of the women were suffering from female sexual dysfunction (FSD). Sexual dysfunction in patients with medical conditions was significantly higher (P= 0.037). Scores of arousal (P= 0.000), orgasm (P= 0.018), and satisfaction (P= 0.026), as well as the FSFI total score (P= 0.005), were significantly lower in subjects with cardiovascular disorders. Scores of desire (P= 0.001), arousal (P= 0.006), lubrication (P= 0.010), orgasm (P= 0.004), and satisfaction (P= 0.022), as well as the FSFI total score (P= 0.017), were significantly lower in subjects with diabetes. Scores of pain were significantly lower in subjects with musculoskeletal disorders (P= 0.041), they experienced more pain during intercourse. In domains of arousal (P= 0.030), satisfaction (P= 0.040), and pain (P= 0.044), the scores of those taking antihypertensive medications were significantly lower than the scores of the rest of the subjects. Scores of desire (P= 0.001), arousal (P= 0.006), orgasm (P= 0.006), and satisfaction (P= 0.048), as well as the FSFI total score (P= 0.006), were significantly lower in those taking antidiabetic drugs. And lastly, the mean satisfaction score in women whose spouse had medical conditions was significantly lower (P= 0.040).
Conclusion: Cardiovascular disorders, diabetes, and musculoskeletal disorders could have a negative impact on sexual function in post-menopausal women. Thus, these diseases must be considered and treated in order to improve women’s health, particularly their sexual function.
Background: Dyspareunia is a pain that is occurs in the genital area before, during or after intercourse and is an important factor for sexual dysfunction. The aim of this study was to evaluate the effect of pelvic floor physical therapy on sexual function and muscle strength and endurance of pelvic floor (as a non-invasive therapy) in women with dyspareunia.
Methods: In this clinical trial study, 32 women in the age range of 20-50-year-old and sexually active with complaints of dyspareunia, before the investigation were examined in terms of genital health and strength and endurance of the pelvic floor muscles. After the confidence of mental health, patients underwent pelvic floor rehabilitation for 10 sessions during 3 months. After assessment, myofascial release techniques and progressive pelvic floor muscles exercise was performed for patients based on their primary strength. Finally, patients were compared in terms of the severity of dyspareunia, sexual performance status (by using female sexual function index questionnaire), improvement of symptoms, pelvic floor muscle strength and endurance before (first session of physiotherapy) and after (after 3 months) investigation.
Results: In the remaining 32 patients with dyspareunia with a mean age of 38±1.24 years, desire index score 0.95 unit, arousal index score 1.01 unit, lubrication index score 0.67 unit, orgasm index score 0.71 unit, satisfaction index score 1.03 unit, pain index score was increased 1.05 unit, strength index score 2.44 unit, endurance index score 7.06 unit were increased in comparison to before the investigation that showed a significant different with P< 0.0001.
Conclusion: According to obtained results, pelvic floor physical therapy had a significant effect in women with dyspareunia. So that the severity of dyspareunia, pelvic floor muscle strength and endurance had clinically significant improvement after pelvic floor physiotherapy.
Results: The study was performed on patients 20 to 50 years, mainly in patients aged 35 to 45 years (51.8%). The average age was 41.44±5.87 years. In our study, the most dysfunction was in sexual desire (57.6%), vaginal moisture (53.1%), sexual excitement (48.2%), orgasm (44.1%), and dyspareunia (52.2%) in breast cancer patients. There was significant difference between two group (P<0.001).There is no difference about sexual satisfaction between two groups (P=0.262). Conclusion: Sexual dysfunction is common in breast cancer patients compared to healthy women. Dysfunction in orgasm, dyspareunia, reducing vaginal moisture and sexual desire were common in the breast cancer patient. The results of this study should be used to inform patients and physician about sexual problems. |
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