زینت قنبری

Given the significance of patient care in obstetrics and gynecology, we aimed to assess the satisfaction of Tehran University of Medical Sciences residents with their training program in this field.

In this cross-sectional descriptive study, 77 obstetrics and gynecology residents from the first to fourth year at Tehran University of Medical Sciences participated with informed consent, adhering to ethical principles, from April to October 2023 across four teaching hospitals: Imam Khomeini, Shariati, Mohib Yas, and Arash.The researcher developed a questionnaire consisting of 62 online questions, including 15 demographic questions and 47 related to satisfaction. Most of the questions are statements with five response options: strongly agree, agree no opinion, disagree, and strongly disagree. Each criterion was assessed and classified on a scale from one to five. The assistants' satisfaction levels were assessed in various areas, yielding an overall score of 47-235. Scores above 70% indicate high satisfaction, 50-69% reflects average satisfaction, and below 50% signifies dissatisfaction. It's important to clarify that the areas include clinics, with specific focus on rotation shifts for assistants in gynecology, oncology, prenatal care, and infertility. Data analysis was conducted using SPSS software, Version 22. Descriptive statistics included the median and range for continuous variables (number of surgeries and satisfaction scores) and frequency and percentage for nominal variables (quality of satisfaction) across three defined levels of desirability: appropriate, relatively appropriate, and unfavorable.

Satisfaction with the number of surgeries and educational quality at Imam Khomeini Hospital was higher than at other hospitals (P=0.07). Significant differences were noted in the gynecology and pelvic surgery departments, with residents at both Imam Khomeini and Arash hospitals reporting greater satisfaction in gynecology (P=0.018) and pelvic surgery (P=0.036). Additionally, regarding the conference program and educational mornings, Shariati Hospital reported a higher level of satisfaction in this area (P=0.47).

The satisfaction scores in various areas indicate that 64.5% of assistants at Imam Khomeini Hospital rated their educational status as appropriate, while 60% at Arash Hospital rated it as relatively good, and 25% at Yas Hospital found it unfavorable.

Pelvic organ prolapse (POP) is the descent of pelvic organs beyond the vaginal walls which is associated with bothersome urinary, defecatory, sexual and vaginal mass protrusion symptoms. The present study was performed aimed to investigate the correlation of the symptoms and POP-Q stage.

This cross-sectional study was performed on 335 women with pop symptoms referred to the pelvic floor clinic of Tehran Imam Khomeini hospital in 2018-2019. A checklist of detailed medical history which contains urinary, defecatory, sexual and bulging symptoms due to pelvic organ prolapse was completed by a gynecologist (fellowship of pelvic floor disorders) and the stage of POP was evaluated according to pelvic organ prolapse quantification (POPQ) system. The relationship between clinical symptoms and the stage of POP was assessed. Data were analyzed by SPSS software (version 23) and Chi-square, Fisher's exact test and multivariate regression. P<0.05 was considered statistically significant.

Among women with pelvic organ prolapse symptoms, there was significant correlation between stress and urgency urinary incontinence and lower stage of anterior compartment prolapse (p=0.002, p=0.043, respectively). Also, significant correlation was observed between urgency urinary incontinence and lower stage of posterior compartment prolapse (P=0.04), but there was no correlation between defecatory symptoms and stage of anterior, posterior or apical compartment prolapse (P>0.05). There was significant correlation between vaginal noise and sexual dissatisfaction with lower stage of anterior compartment prolapse (p=0.014, p=0.025, respectively).

Urinary symptoms especially stress and urgency urinary incontinence and sexual dissatisfaction were correlated with lower stage of POP. Also, due to the lack of relationship between defecation symptoms and prolapse stage, complaints of pelvic organ prolapse symptoms may not be related to the severity and stage of prolapse in clinical examination.

Obstructive vaginal anomalies such as transverse septum and vaginal agenesis usually present with primary amenorrhea and pelvic pain. This study was performed with aim to evaluate the results of vaginal reconstructive surgery (vaginoplasty) in patients with vaginal agenesis (Rokitansky syndrome) and transverse vaginal septum.

This cohort study was performed on all patients with vaginal agenesis and transverse vaginal septum who had underwent vaginoplasty in the pelvic floor disorders department of Imam Khomeini Hospital ,Tehran in 2014-2019. Basic information, clinical symptoms at admission, type of Mullerian anomaly, type of surgery, complications during surgery, vaginal re-stenosis and pregnancy were collected from patients' files and by phone calls and follow up visits after surgery. Central and dispersion indices were used to describe the data. Frequency distribution was presented in the form of tables.

33 patients had transverse vaginal septum and 35 cases had vaginal and uterine agenesis (Rokitansky syndrome). In terms of early symptoms at admission, the most common symptoms were amenorrhea, pelvic pain, and inability to sexual intercourse or dyspareunia. In 11 cases (33.33%), vaginal re-stenosis occurred after correction of transverse vaginal septum, all of which occurred in the first 3 months after surgery due to incorrect use of vaginal dilator. Laparotomy was performed in 2 cases (6%) due to severe abdominal pain after initial surgery that was diagnosed as pelvic endometriosis. In the vaginal agenesis group, vaginal re-occlusion occurred in5 cases (14.28%) after the surgery.

The most common complication after surgery was vaginal re-obstruction, so training the patient and emphasizing on the regular use of vaginal dilator is very important to prevent this complication.

Uterine prolapse has been traditionally treated with vaginal hysterectomy and cuff suspension. Recently there is renewed interest in uterine conservation during prolapse surgeries. This study was performed with aim to evaluate the success rate and quality of life in women following one of three types of uterine sparing prolapse surgery.

This retrospective study was performed in Tehran Imam Khomeini Hospital in 2019. The data of 99 patients with uterine prolapse who underwent one of three types of uterine sparing surgery (Manchester, Sacrospinus Hysteropexy, Abdominal sacral Hysteropexy) during three years were reviewed and compared in terms of success rate and quality of life. 99 patients completed a valid questionnaire of quality of life after prolapse surgeries (Pelvic Floor Distress Inventory-20). The success rate after 12 months was evaluated as a primary outcome and the complications such as repeat surgery, using pessary  and feeling mass were evaluated as secondary outcomes. Data were analyzed by SPSS software (version 22) and ANOVA, Kruskal-Wallis and Chi-square tests were used. P < 0.05 was considered statistically significant.

The success rate of sacral hysteropexy was higher than two other groups (about 94%).The highest recurrence was in sacrospinous, in the Ba point ( -2.06± 0.506) and C point (-2.1±1.084) (p<0.01). The quality of life was similar in the Manchester and sacral hysteropexy group and was higher than sacrospinous group. Early complications after sacral hysteropexy were ileus and defecatory disorder.

All three uterine sparing prolapse surgeries had success rate of higher than 60%. All three surgical groups had a good quality of life and satisfaction 12 months after the procedure. The highest recurrence was in sacrospinous in Ba and C points. Finding mesh complications following sacral hysteropexy surgery requires long-term follow-up.

Urinary incontinence is a common disorder in women. Pelvic floor muscle exercise is one of the effective treatment methods. Self-efficacy is considered an effective and strong predictor of willingness to perform and continue these exercises. In Iran, there is no appropriate tool for assessing self-efficacy. So this study was performed to determine the psychometric properties of the Broome scale in women with urinary incontinence.
Methods & Materials: A psychometric study of the Broome scale was conducted on women with urinary incontinence who referred to health centers affiliated to Tehran University of medical sciences in 2015.In this study, following processes were implemented: translation, back translation, face validity, content validity using CVR and CVI, reliability using Cronbach’s α coefficient, and construct validity using explanatory factor analysis.

The face validity was confirmed through the modification of ambiguous items based on the patients’ views. Content validity (CVR= 0.8 and CVI= 0.8 to 0.9) and reliability (Cronbach’s α= 0.96) were also confirmed. Explanatory factor analysis showed two factors with eigen value more than 1 including pelvic floor exercise self-efficacy in usual and special situations. These factors explained 82.08 percent of the total variance.

The reliability and validity of the Broome scale were confirmed for using by Iranian women with urinary incontinence, and this scale can be used to measure these women's self-efficacy in performing pelvic floor exercises.

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.
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.
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 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.

ICS (International continence society) has explained urinary incontinence as any loss of urine involuntarily. UI (urinary incontinence) is not a mortal condition but has many adverse effects on patients’ quality of life. Studies have shown a high prevalence of UI among women, especially in older ages and higher body mass index. Due to intervention of UI with religious activities, demand for treatment of UI is more serious in our country. It is believed that all the kinds of drug therapy and surgeries have many side side effects especially in old patients. On the other hand it seems that Iranian Traditional Medicine can manage this disease as a hypothesis. So a plan was programmed as a first step to review philosopher’s approach to diseases specially UI. Terms "salasolbol" and "bolfelferash" which mean loss of urine involuntarily and enuresis respectively, were considered equivalent for UI. Causes and treatments of these conditions were excluded and written in this review article. Based on ancient’s opinion, the most causes of UI is "cold" and "wet" of bladder and "esterkha" of external sphincter which make them be weak and lost their internal natural powers specially "maseke" which is bladder’s power for holding urine. Signs and symptoms of patients who suffer from UI, even their laboratories studies on the basis of traditional medicine, confirm this idea. It seems new view from an old but original frame of traditional medicine to UI can introduce effective way for treating urinary incontinence.

Stem cells are undifferentiated cells able to self-renew as well as to produce more differentiated daughter cells. In this study, stem cells were isolated from the endometrium and were then compared with the mesenchymal stem cells for their nature to be determined. Endometrial samples from healthy donors with informed consent after laparoscopy were collected by a gynecologist. The bone marrow samples were aspirated from femur by a hematologist. At least 5 mL of blood was removed and the tissue is at least one square centimeter. After three successive passages, the stem cell surface markers of CD90, CD105, CD146, CD34, CD73, CD44, CD133, and CD45 were analyzed using flowcytometry. The karyotype analysis was also performed for the adherent cells. Endometrial stem cells were successfully isolated from the five samples. Adherent cells in flowcytometric analysis showed the positive expression of surface markers to be CD146: 59.3%, CD105: 98.3%, CD90: 95.8%, CD34: 0.9%, CD 45: 1.1%, CD73: 96%, CD44: 84%, and CD133: 1.4% while in bone marrow mesenchymal stem cells the expression of markers were CD105: 98.6%, CD90: 98.4%, CD34: 0.5%, CD73: 97.9%, CD44: 89.3%, CD146:13%, CD45: 0.3%, and CD133: 0.6%. The morphology of endometrial cells, spindle-like mesenchymal cells, the mode of application, and 44XX karyotype were normal. Stem cells isolated from the endometrial tissue had a heterogeneous population of the cells and high levels of expression of specific surface markers of stem cells especially the mesoderm lineage.

Chronic Pelvic Pain (CPP), a common health problem in women, characterized by any lower abdominal pain that lasted at least six months or more, with no relation to pregnancy, menstruation and intercourse. The pain can affects on activities of daily living negatively and lead to medical or even surgical treatment. According to our knowledge, there are limited studies related to CPP in Iran. Therefore, present study was aimed to survey on CPP in women attending Pelvic Floor Clinic at the Imam Khomeini University Hospital. Methods and materials: This cross-sectional study was conducted on 516 married women (who were not virgin). Participants completed a designed questionnaire, which included demographic information and questions regarding involvement of gynecologic, urinary, gastrointestinal, musculo - skeletal and psychological systems. After collecting data, binary logistic regression was used to analysis the data. Values of p<0.05 were considered to be significant. 27/9% of women reported current pain in the pelvic area unrelated to menstruation and sexual intercourse, while totally 17/6% suffered from pain over the past 6-12 months or CPP. There were a significant relationship between CPP, chronic low back pain and dyspareunia (p=0.04 and p=0.03 respectively). Our data did not show significant difference between the prevalence of CPP, types of delivery and history of having trauma to the spine and pelvis. This comprehensive study provided an extensive and multidimensional approach regarding to CPP in our society. As for to estimation 27.9% pelvic pain and 17.6% CPP and their relationship with gynecological, urinary, musculoskeletal and gastrointestinal systems, we suggest doing more population-based epidemiological studies, also emphasis on multidisciplinary approach for managing these patients.

The effect of interventions in forms of changing body posture on Pelvic Floor Muscles (PFM) function is discussed in recent years. The present study was aimed to investigate the effects of changes in pelvic posture, also PFM and Transversus Abdominis Muscle (TrA) contractions on some continence ultrasonic parameters in women with and without Stress Urinary Incontinence (SUI). Twenty-one women with SUI and twenty matched incontinent women, (mean age 42.7 and 39.2 years, respectively) were recruited to the study. We assessed some continence ultrasonic parameters via Trans Labial Ultrasonography (TLUS) in neutral standing position, during anterior and posterior pelvic tilt, PFM and TrA contractions. Shapiro-Wilk, Student t-test, Repeated measures ANOVA, Bonferroni post hoc paired comparisons, and Pearson tests were performed to analyze the data. The significance level was set as P < 0.05. Regarding ultrasonic assessment, the main effect of intervention was significant on the angels of Alpha, Gamma and Levator plate (P < 0.05) with no significant effect on the Beta angle (P > 0.05). There was a significant difference in effect, of posterior pelvic tilt on Gamma and Levator plate angles between the two groups (P < 0.05). Anterior pelvic tilt resulted in an increase in Gamma angle in both groups ((P < 0.05). Posterior pelvic tilt results in changes in ultrasonic parameters towards increasing pelvic floor stability in comparison to the anterior pelvic tilt.

In thepast two decades،numerous studies using ultrasonographicimagingandindicatorssuch asthebladderorurethramobility were conducted to assess thepelvic floorstructure and morphology، alsoto diagnosedisorders likeurinary incontinenceas well as prolapsed and their severities. Regarding the Rehabilitative UltrasoundImaging (RUSI) andtheimportance of studyingpelvic floormuscle function for physiotherapists، thisarticleaimed to review practical aspects of two common ultrasonographic imaging methods for assessment of pelvic floor muscles’ function. Trans-abdominal andTrans-labial have been introduced astwo commonultrasonographicmethodstoevaluatepelvic floor musclefunction. However،Trans-labial method is more sensitive withlessmeasurement error. Noneed togetdressed، quickimaging andviewingthepatient''sbladderareconsidered as advantagesofTrans-abodominal approach.

Bladder base movement (BBM) reflects the level of pelvic floor (PF) stability and responds with mechanical load induced changes of PF or body position. Adoption of proper body position during pelvic floor muscle (PFM) training for management of Stress Urinary Incontinence (SUI) is very important. This study was performed aimed on investigating BBM while performing different postural interventions in women with and without SUI using Trans Abdominal Ultrasonography (TAUS). This clinical trial was conducted on 41 women referred to Vali Asr hospital of Imam Khomeini Hospital in Tehran during 2008-2009. After collecting demographic information، Trans Abdominal Ultrasonography was done at rest، during Crook lying and Straight Leg Raising (SLR)، cough and Valsalva maneuvers، during PFM and Transversus Abdominis (TrA) contractions and BBM was assessed. Data were analyzed using SPSS software (version 16)، Kolmogorov-Smirnov test، independent T-test، repeated measures ANOVA test، Bonferroni post hoc test and Pearson’s correlation test. P less than 0. 05 was considered statistically significant. Regarding ultrasonic assessment، only the main effect of intervention was significant (p=0. 0001). Adopting crook lying position affected BBM more positively in continent women compared with incontinent women (mean 6. 3 vs. 2. 5 mm; P<0. 05). There were no differences in effects of cough، Valsalva maneuvers، TrA and PFM contractions on BBM between two groups (P>0. 05). Changing patient position from straight leg raising to crook lying causes upward movement of bladder base. Comparing the two groups was shown that the effect of crook lying on elevation of bladder base in control group was significantly more than patients.

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.

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.

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.

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.

Aplasia of the uterus and upper two-thirds of the vagina due to Mayer–Rokitansky–Kuster–Hauser syndrome prevents normal coitus which may lead to anxiety and other psychiatric problems in these women. Vaginal reconstruction improves the patients’ quality of life. This study intends to compare sexual function in normal women and women having undergone vaginoplasty for Mayer–Rokitansky–Kuster–Hauser syndrome. This descriptive and analytical study was carried out in the gynecologic clinic of Imam Khomeini Hospital in 2004 to 2008. Nineteen female patients with Mayer–Rokitansky–Kuster–Hauser syndrome and a history of vaginoplasty were compared to 30 women without any anatomical malformations in their genitalia. The female sexual function index (FSFI) was used to evaluate the problem in the two groups. The calculated scores of the two groups were compared and statistically analyzed. The mean age of the patients was 29.57 (SD = 6.11) years. The mean score for sexual desire in individuals with a history of vaginoplasty was 22.84 (SD = 2.5) compared to 24.63 (SD = 2.94) in the healthy women (p = 0.033) and the mean score for sexual arousal in women having undergone vaginoplasty was 13.89 (SD = 2.47) compared to 15.27 (SD = 3.41) in the healthy individuals. Sexual arousal, orgasm and pain were not different between the two groups. Sexual arousal and satisfaction were not different in women having undergone vaginoplasty and women with normal sexual function. It seems that the surgery offers a better quality of life and is acceptable to women with Mayer–Rokitansky–Kuster–Hauser syndrome.

Stress urinary incontinence is a major confounding factor which impairs health quality in women. Some procedures cannot resolve it's 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's quality of life (QOL). Fifty four patients diagnosed with urinary stress incontinence, underwent a transobturator tension free vaginal tape procedure with or whitout prolapse surgery

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. 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, UDI-6, ISI questionnaires and urodynamic test

Given high prevalence of pelvic organ prolapse in female, and necessity of effect assessment of it's risk factors in various societies, this study was aimed to investigate the correlation of thoracic and lumbar spinal curvature as well as pelvic tilt changes with pelvic organ prolapse. In this cross-sectional and case-control study, fifteen females with pelvic organ prolapse, on the basis ofAWT IMAGE inclusion criteria were selected by simple and convenient sampling from Imam Khomeini and Akbar abadi hospitals patients as case group. Also, fifteen females with zero or first degree of prolapse were selected by matching with cases as control group. Prolapse condition of both groups participants was assessed by pelvic organ prolapse qualification (POP-Q) system and spinal curvature of thoracic and lumbar as well as pelvic tilt were assessed by flexicurve ruler and pelvic inclinometer, respectively. Data were analyzed by Kolmogroff-Smirnoff, Independent T and Multiple Logistic Regression tests. There was no significant difference between two groups in kyphosis (P=0.26), lordosis (P=0.52) and pelvic tilt (P=0.41). Although the results of study do not show significant correlation between kyphosis, lordosis and pelvic tilt with pelvic organ prolapse occurrence but similar direction of changes in the variables with our hypothesis and other studies preserve the likelihood of relationship between the increasing of kyphosis and decreasing of lordosis in pelvic organ prolapse in a large statistic society.

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. 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.

The abdominal sacrocolpopexy is the gold standard method of vaginal prolapse correction and posterior intra-vaginal slingplasty is a newer procedure with minimal invasion. This study is going to compare the effectiveness and complications of these two surgical methods. 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 patient's folder and further complimentary information were achieved by two years follow-up and inviting patients to interview or exam

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. 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

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. 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

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. 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.

The Premenstrual Syndrome (PMS) is a combination of distress, physical, psychological and behavioral changes that occurs in the luteal phase of the menstrual cycle. Although, the etiology of the PMS is not clear, to relief from the symptoms of this syndrome different methods including, safe exercise are recommended. The aim of this investigation was to determine the effects of a three-month regular aerobic exercise on the PMS symptoms. Ninety one women aged 16-48 years (31.6±8) with regular menstrual cycle accepted to participate in this quasi-experimental study. A Modified Menstrual Distress Questionnaire (MMDQ) was used. Participants were divided into two groups: 1- Fourty eight women who did not have any past experience of regular experience and also did not have any form of aerobic exercise in the duration of this study, 2- Fourty three women who accepted to have regular aerobic exercise for a duration of three months. Twenty two women in the second group had a history of regular exercise and aerobic exercise program was only prescribed for this group. The exercise program consisted of a five-minute warming up, 45 minutes limbs and trunk fast exercise and a ten-minute stage for cooling down. Each exercise session time was an hour and was carried out three times per week during three months. Data were analyzed using SPSS and parametric tests (ANOVA, paired t-test and Pearson correlation) were used where appropriate. Among women with aerobic exercise the severity of electrolytic, neurovegititive and cognitive symptoms was significantly decreased after the 3 months. Furthermore, the skin and neurovegatitive symptoms were also changed in experimental group who had a history of regular exercise. There were no correlation between age, education, marital status and severity of premenstrual syndrome symptoms. Based on the results of this study it can be concluded that a three-month regular aerobic exercise could reduce the severity of physical symptoms of premenstrual syndrome.

Neural Tube Defect 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. In this survey cross sectional study was conducted in five hospitals depend to Tehran university during three years.

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. 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. The mean age of patients was 50 years, ranging from 26 to 74 years, with an average urinary stress incontinence duration of six years.