ناهید خداکرمی

Cervical cancer is the fourth common cancer in women and human papillomavirus is the most common risk factor of it. The present study was performed aimed to determine the relationship between Vitamin D and human papillomavirus in women referring to the hospitals of Shahid Beheshti University of Medical Sciences.

This comparative study was conducted on 140 women referring to the hospitals of Shahid Beheshti University of Medical Sciences of Tehran in 2020. The case group were women with HPV infection and the control group in the same centers were the women with no HPV infection based on liquid based pap smear. Data was collected by interview and completing the questionnaire of Pap smear and measuring serum level of vitamin D. Data were analyzed by SPSS software (version 26) and Mann-Whitney test, independent t, chi-square, Fisher's exact and logistic regression. P<0.05 was considered statistically significant.

Logistic regression results and control of confounding variables of education and hookah consumption showed that 64 women (91.43%) in control group and 70 women (100%) in case group had vitamin D level less than 20 ng/ml and 6 women (8.57%) in control group had vitamin D level of 21-29 ng/ml. There was significant relationship between vitamin D and HPV infection (OR: 0.3, CI: 95%, P<0.001, 0.69-4.03). The risk of HPV infection increased as 0.3 by each 1 ng/ml reduction of vitamin D level.

In the present study, serum level of vitamin D was lower in women with HPV, but due to the limitations of the present study, more extensive research is needed in this regard.  Sufficient vitamin D level can help maintain and promote women's health.

COVID-19 pandemic caused a lot of severe problems in the world. This study investigated the epidemiology of the disease in Tehran in the first quarter of the epidemic's beginning.

The available information recorded for patients from 20 February 2020 to 20 May 2020 in Tehran was used. To prepare disease-related distribution maps, the addresses of patients' residences in Google Earth were called to ARC-GIS version 10-4. The methods used in GIS include IDW, Hotspot and also software development.

Overall, 3699 individuals whose PCR results were positive in Tehran were included in the study. Out of the total number of them, 550 people died and the fatality rate of the disease in hospitalized patients was 14.9%. One thousand five hundred thirty patients (41.4%) have recovered, and the remaining 1619 patients were under treatment until data collection. Of the total, 1479 confirmed cases were women (40%). The average age was 57.4 years (SD=16.5). The density of cases in areas 4, 8 and 13, and the existence of some cluster diseases in neighborhoods such as Tehran Pars, Ayat and Pirouzi streets are noteworthy points.

The trend of the COVID-19 epidemic is dire and requires long-term measures. Nevertheless, to control this disease, the health system, the policy of isolating patients and suspicious people, wear masks especially in densely populated areas, are the most important controlling factors.

Endometrial cancer is the most common gynecologic malignancy in developed countries. The incidence of endometrial cancer is increasing in Iran. The risk of endometrial cancer is related to estrogen levels that breastfeeding reduces it. This study was performed with aim to compare breastfeeding duration in women with endometrial cancer and women without endometrial cancer.

This retrospective case-control study was performed on 240 women referring to the hospitals of Shahid Beheshti University of Medical Sciences, Tehran in 2017. The case group included women with endometrial cancer and the control group was women without endometrial cancer. Data was collected by interview and completion of demographic and fertility characteristics, medical records and endometrial cancer information. Data were analyzed by SPSS (version 21) and Chi-Square, independent T-Test, Mann-Whitney and ROC curve. P< was considered statistically significant.

24 women (20%) in case group and 41 women (34%) in control group reported the history of breastfeeding. The mean duration of breastfeeding in the case group was 58.58±22.19 months and in the control group were 72.61±15.38 months. The duration of breastfeeding in the case group was significantly shorter than the control group (p = 0.004).

Women with endometrial cancer had shorter duration of breastfeeding, so breastfeeding training must be noticed as postpartum care.

Nipple fissure is one of the most common problems in breastfeeding women and the main reason for the early discontinuation of breastfeeding. Due to the importance of breastfeeding, the present study was performed with aim to review the clinical trials conducted on the treatment of sore nipple and nipple pain in breastfeeding women.
In this systematic review, all local databases were searched with the keywords of “sore nipple” and “clinical trial” and databases of Google Scholar, PubMed, ProQuest, Scopus, Science Direct and Medline with the keywords of “sore nipple” and “clinical trial” were searched to November 2015 with no time and language limitations. All the articles were reviewed based on the Jadad scale and those scoring ≥3 were selected. The results were reported qualitatively.
A total of 14 articles meeting the inclusion criteria were ultimately examined. Among the treatments examined in these studies, Lanolin along with a nipple shield, Aloevera gel, menthol essence and warm compress led to more decrease in severity of pain and the fastest recovery of sore nipples.
Lanolin along with a nipple shield, Aloevera gel, menthol essence and warm compress are the most effective treatments for sore nipples. Nevertheless, a definitive judgment about the effectiveness of these interventions requires more accurate studies with adequate sample sizes. Studies conducted on sore nipples and their treatment are scattered and drawing conclusions about the interventions is not possible due to the limited number of studies.

Breast cancer is always one of the most important difficulties in women''s health that causes serious physical، mental and economical harms for the patient and her family. Nowadays، molecular therapies have been considered by the researchers. Used drugs act through different molecular mechanisms and prevents from breast cancer developing; a lot of proteins play a role in these mechanisms including melatonin has a specific role. For this reason، recognizing melatonin functions and executive mechanisms، related genes and orientation with melatonin news and also its benefits in breast cancer will help us to design new and efficient molecular methods in treatment and management of breast cancer. This study was performed with the aim to review recognized mechanisms by melatonin in breast cancer treatment till now. To open access the articles، we searched from valid internal and external databases. For research formula، at first، we determine main key words، then equivalent terms were identified، and using appropriate operators، the formula was developed. The results were screened and the relevant articles were selected. Finally، 55 articles about breast cancer molecular biology and Melatonin function mechanism were selected and based on them، the review was done. The wide function domain of Melatonin in breast cancer includes induction of apoptosis، telomerase and inhibition of epidermal growth factor bridle in breast cancer، cell cycle inhibition، stimulation of immune system to destroy cancer cells، repair of damaged DNA، the regulation of daily and seasonal rhythm and also angiogenesis inhibition. The role of melatonin as an oncostatics and oncocytotoxic factor leads to believe melatonin application as a supplement factor in breast cancer treatment. The safety of Melatonin along with its benefits introduces it as a suitable candidate to improve treatment methods for breast cancer patients.

The incidence rate of cervical cancer is lower in Iran compare to other countries; however، because of higher risk of cervical cancer deaths in this region، a cervical cancer screening program seems to be required. The aim of this study was to provide an organized approach to prevention and control of cervical cancer which could be feasible in other Muslim societies. We conducted a systematic review of previous studies related to cervical cancer in Iran and reviewing the foreign country''s guidelines. 190 articles about cervical cancer in Iran from 1971 to 2013 were studied. 13 articles were related to the data that we needed for developing the recommendation questions. We also reviewed the guidelines of World Health Organization and International Agency for Research on Cancer (IARC)، GLOBOCON report، Iran Ministry of Health cancer registry report and 8 available foreign developed countries guidelines. Documents and papers with highest level and consistent with the aims of this review were selected and the Iran cervical cancer screening program was conducted by using the practical guideline development cycle. A questionnaire that included questions which have been answered in the guideline was designed. Expert panel make a decision for the necessity of cervical cancer screening program for Iran. We recommended an organized screening program with cytologic evaluation (Pap smear) that would be start at age 30، continued for every 5 years. The age for ending the screening is 69 years. There is no need to do screening for pregnant women and women who had hysterectomy. Organized cervical cancer screening is a necessity for Iran، because we could not ignore more than 500-900 new cases with invasive cervical cancer that have been diagnosed every year in Iran.

It is estimated that 80-90 % of breastfeeding women experience some nipple injury and soreness، with 26% progressing to cracking and extreme nipple pain that could lead to breastfeed failure. The aim of this study was to examine the effect of Calendit –E cream and expressed of breast milk in the treatment of nipple crack. This study is a single blind randomized clinical trial. 82 breastfeeding women with age older than 18، who suffered from nipple crack were included in the study. After explaining methods of the study and obtaining written consent، the samples randomly assigned into two groups: Calendit -E cream and expressed breast milk and they were treated for one week. The correct method of breastfeeding and using of cream or mother’s milk were instructed to both groups. The nipple crack scores were measured and recorded by the researcher before treatment and third and seventh days of the study. A questionnaire was used for collecting demographic data، the severity of crack was measured by observing the nipple using Storr score check list، and evaluation form of breastfeeding. Data were analyzed by SPSS software and t-test، paired t-test، chi-square، Mann-Whitney، Wilcoxon and repeated measurement tests. The statistical tests showed the severity of crack between the two groups، before the study was highly homogeneous the severity of cracks reduced on the third day with no significant difference between two groups (P = 0. 2). But in the seventh day this decrease was more significant in the Calendit-E group (p = 0. 006). Calendit -E cream is more effective than expressed breast milk on the nipple crack’s treatment.

Pain is a protective mechanism and it occurs when some tissues are damaged; thus, one is forced to remove the painful stimulus. Pain Intensity is closely related to the rate of tissue damage. The present research was carried out with aim of comparing the effects of Calendit- E cream and expressed breast milk in the treatment of nipple pain. This study was a single blind randomized clinical trial one in which 82 breastfeeding women aged over 18 yrs, who suffered from nipple pain, after obtaining written consent, were taken as subjects. They were randomly divided into two treatment groups; i.e. calendit-E cream and expressed breast milk groups. Both groups were instructed in the correct method of breastfeeding and using of cream or expressed breast milk and they were being treated for a week. The nipple pain scores were measured and recorded before treatment, and on the third and seventh days of the study. Data collection was done by means of a demographic questionnaire, pain assessment form, and an evaluation form of breastfeeding. The obtained data was analyzed using SPSS software, t-test, and paired t-test at the significant level P<0.05. Reduction of severity of pain after treatment was significant in both groups (P<0.001), but a significant difference in the intensity of pain between the two groups on the third (P=0.8) and seventh (P=0.22) days of intervention was not observed. Calendit-E cream and expressed breast milk is both equally effective in reducing nipple pain.

Pregnancy has many physiologic and psychologic changcs in some cases various psychosomatic issues lead to high risk pregnancy. The said study has been done with a view to determine mind’s health in pregnant mothers with high and low risk pregnancy who used to refer to the health & treatment centers of Shahid Beheshti Medical Sciences University in 2010. 392 pregnant women studied in 2 groups of high and low study pregnancy. The 3 parts questionnaire distributed between pregnant women: first personal specifications, second the questionnaire (the form for evaluation of high risk pregnancy) and third, measurement of mental health GHQ1. Then data was analyzed using descriptive and deductive tests. Of 196 pregnant mother in high-risk group with mean age of 288±5.28, %56.6 and in Low risk people with mean age of 25.36±4.58, %46.4 didn’t enjoy an acceptable mental health. (T.Test with p ≤ 0.005). mean of mental Health score of pregnant women in high-risk group is 22.37 with SD of ±11.04 and in Low-risk group is 25.73 with SD of 12±31. The result showed that high risk pregnancy may affect mental health of the mothers. It is recommended that measurement of mental health should be taken into consideration among the care program of programming period.

Human papillomavirus (HPV) infection seems to be the most common sexually transmitted infection. High-risk (HR) human papillomavirus (HPV) prevalence has been shown to correlate well with cervical cancer incidence rates. Since there is little known about the epidemiology of this infection in Tehran, we designed to estimate the prevalence of HPV in some areas in Tehran. Cervical specimens were obtained from 825 married women aged 21-59 years from the general population of Tehran, Iran according to the standardised protocol of the IARC International HPV surveys. HPV was detected using a GP5+/6+ PCR-based assay. HPV prevalence in the general population was 7.8% (5.1% of high-risk types), with no statistically significant variations by age. Cervical intraepithelial neoplasia was diagnosed in 4.1% of women, of whom 35.3% were HPV-positive. HPV16 was confirmed as the most common type among women with both normal (1.8%) and abnormal (8.8%) cytology. HPV positivity was significantly higher among divorced women, women in polygamous marriages and those reporting husband's extramarital affairs. However the prevalence of HPV seems not high in comparison with other international data, more molecular and seroepidemiological survey in national level needs to have a better perspective.

To determine sexual behavior patterns in married woman with 19-45 ages who com to Taleghani heath center, Tehran, Iran. A cross-sectional study with a total of 200, 19-45 years old women who came to Taleghani health center was performed. Sampling was as simple method. A designed questionnaire administered for data collection. Content validity and Choronbach's Alpha were utilized for examination of validity and reliability respectively. Questionnaires were completed through interview. Then the data were analyzed using SPSS 15. The mean age and marriage age in women was 34.08±7.04 and 20.73±3.9 years respectively. 24.5 % of them had anal sex and 23.5 % had oral sex. There were a significant relation between asked and acceptance of oral and anal sex (P<0.00). Most of them have more than one behavior in one sexual episode. There are Non-vaginal sex in some women of society that can lead to some physical problems such as urinary tract infections, genital infections and sexually transmitted and can had negatively psychologic load on women. Hence, advice and education on sexual health in the community seems to be necessary.

The number of cesarean sections continues to rise in developed countries. This is one of the main concerns of society, especially in obstetrics and gynecology fields. The overall goal of this research is to determine and compare the outcomes of cesarean and vaginal delivery for mothers and infants in selected hospitals in Tehran in 2009. This was a prospective population-based cohort study of 246 pregnant women who delivered in Tehran hospitals. 114 healthy women undergoing a cesarean section and their infants henceforth known as the “cesarean group” were considered for the comparison with an otherwise similar group of 132 women delivering vaginally. The data were collected in three stages (at childbirth, before discharge and 10 days after birth) and analyzed through SPSS Software V.16 at 0.05 level of significance. There was no significant correlation between early postpartum hemorrhage, PPH leading to an intervention and treatment after 10 days of postpartum, infection and postpartum urinary retention, infection leading to treatment, readmission within 10 days after delivery and postpartum blouse syndrome. In contrast, there was a significant relation between the decrease of more than 10% of hematocrit before and after delivery and type of delivery (p<0.001), and also between the type of delivery and the incision pain (Episiotomy or cesarean) (p<0.001), birth satisfaction after 10 days (p=0.001. Also, there was a significant relationship between the type of delivery and hospitalization duration (p<0.001) and also hospitalization costs (p<0.001). There was no significant correlation between type of delivery with newborn Apgar score during one minute and five minutes after birth. There was no significant relationship between newborn weight, jaundice and respiratory depression, and need to admission in NICU. There was no significant relationship between type of delivery with fever leading to treatment, infant feeding, impatience and death of newborn during 10 days after birth. The study found no statistically significant difference in maternal and neonatal outcomes between C-section and vaginal birth groups. More studies are needed to understand the short term and long term complication of the delivery mode on maternal-child outcomes.

Mean age of participants was 57.85 with standard deviation 11.02. Mean age of participants’ at the time of diagnosis was 54.83 with standard deviation of 11.33. Quality of life scores for these patients was 46.98 with standard deviation of 7.60, which is considered a moderate level of quality of life. Scores of physical functioning, emotional, and social functioning sub scales were 25±9.61 -53.8±14.53 and 61.34±18.33 respectively.Therer was a significant association between quality of life scores and socioeconomic status. A significant association was also found between quality of life scores and duration of time from diagnosis and treatment completion. Findings of this study showed that quality of life of cervical cancer survivals was affected by cancer. Improving physical function and recovery form symptoms may improve quality of life of these patients.

Miscarriage was estimated 20% of all pregnancy every year, approximately. There are different modalities, medical or surgical, to treat incomplete abortion. One of the procedures is manual vacuum aspiration (MVA). It is a new method in Iran. The aim of this study was to evaluate the efficacy of this method in Iran. This randomized clinical trial was designed to compare MVA against sharp curettage in incomplete abortion treatment. The two universities related medical centers with obstetric department were engaged. The 316 cases were elected by inclusion criteria and then allocated into MVA (156 cases) or curettage (160 cases) treatment group. They were followed up for three weeks and blood pressure, pain with visual analogue scale; patient satisfaction and bleeding were evaluated in every subject by gynecologist. At the end, data were analyzed using by SPSS15 software. Duration of surgery was significantly shorter in MVA than curettage group. Although there were no difference in pain score at admission but patients had less pain during surgery and one hour after surgery in MVA group. Patients in curettage group had more bleeding during surgery. Satisfaction score were significantly more in MVA group at discharge (96.2% against 83.3 %) but this difference was not significant between two groups, 1 and 3 weeks after surgery. Our findings showed that MVA was effective to treat incomplete abortion. It has less complication and bleeding. In addition, satisfaction is high and it consider cost effective.

The aim of this study was diagnosis of premature rupture of membranes in suspected patients by measurement of prolactin and B-hCG levels in vaginal washing in order to reduce perinatal mortality and morbidity. The study included 211 pregnant women who were referred to the emergency of Imam Hossein hospital at 28-38 weeks of pregnancy for leakage or prenatal care from April, 2007 to April, 2008. The expulsion of fluid from the cervix was evaluated and fern and nitrazin tests were done. B-hCG and prolactin levels of vaginal washing fluid were measured. The presence of 2 of 3 parameters of fern test, nitrazin and cervical fluid was defined as absolutely premature rupture of membranes. Mann-Withney U-test was used for analysis. The Roc curve was calculated. There were 132 patients in PROM group and79 patient in the control group. The average age in the PROM and control groups was 26.9‌±6.08 and 26.2±4.84 years, respectively(P=0.074). Both groups were matched for parity and gravidity. Prolactin levels in PROM group were 2930±3737mIU/l versus 23.18±120mIU/l in the control group (P=0.000). B-hCG was 439.78±1867mIU/l in PROM and 17.72±30mIU/l in control group (p=0.000). Sensitivity and specificity of prolactin according to cut-off of 16.0 mIU/l was 79.41% and 96%, respectively. Sensitivity and specificity for B-hCG with cut-off point of 12.5 was 69.85% and 69.33%, respectively. The measurement of prolactin and B-hCG levels in patients with suspected premature rupture of membranes can help in decision-making and treatment.

In most cultures, fertility has a great social value and parenting aones own biological child is considered the most basic motive in the process of human life. On the other hand, infertility could lead to a destructive emotional experience. According to the World Health Organization (WHO), about 80 million people in the world live with infertility. Infertility has a negative influence on the lives of both genders and predisposes them to emotional and psychological burdens. Physical, mental and economic challenges may affect young couples during infertility treatment. The purpose of this study was to examine the in-depth life experience of infertile couples. This qualitative, phenomenological study was conducted on 11 purposively selected couples attending the outpatient department of Reproductive Health Research Center at Taleqani Hospital on August-December 2008. The interviews were carried out to explore life experiences of the infertile couples who were under infertility treatment process. The data were generated from taped interviews and the researcher's observational field notes. The data were analyzed according to the procedure outlined by Colaizzi. Interviews were categorized by examining the participant's interview transcripts and identifying significant statements and meanings. Themes emerging from the statements were identified, and cross-case comparisons were made to confirm or modify them. Six key themes followed by eleven sub-themes emerged from the data. The results showed that infertility, affects emotional and sexual relationships of infertile couples. The couples relationship with family members and relatives is affected when they realize about their problem. Sometimes the infertile couples resort to unusual and non-medical treatment options when their expectations form the medical team are not met. Thematically, infertility could deeply affect infertile couple's entire life. More widespread use of midwifery and psychological counseling services at infertility treatment centers seem to be of help to infertile couples and their relatives.

Evaluation for STIs requires speculum examination. It is sometimes uncomfortable and rejected by many patients. Speculum examination often is impractical or not available in remote areas. Recently, it is possible to omit the speculum examination and noninvasively diagnose for Chlamydia and gonorrheal infections from urine sample. This comparison study was conducted by collected vaginal specimens directly without performing a speculum examination for the diagnosis of trichomonas infections.The aim of this study was comparison of two methods of vaginal discharge collection with and without speculum examination for diagnosis of the trichomonas infection. We examined 100 patients with vaginal discharge to the gynecology clinic of the Taleghani hospital. Two vaginal swab were collected from vaginal discharge of patients before and during speculum examination for diagnosis of trichomoniasis. Both of vaginal specimens were tested with blinded microscopic. Compared collection methods sensitivities, specificity, positive predictive value, negative predictive value and accuracy of both methods was compared. Sensitivities, specificity, positive predictive value, negative predictive value and accuracy of speculum collection methods were 69%, 99%, 92%, 94% and 93% for trichomoniasis respectively. Sensitivities, specificity, positive predictive value, negative predictive value and accuracy of nonspeculum collection methods were 62.5%, 99%, 91%, 93% and 92% for trichomoniasis respectively. The differences between methods was not statistically significant (P= NS). There was a very good agreement between both methods for diagnosis of trichomoniasis (KAPPA= o.85). We have demonstrated the benefit of nonspeculum vaginal specimens for the diagnosis of trichomoniasis. This technique has applicability for studies involving the epidemiology of vaginal infection as well as for home diagnostic testing, elder and pregnant women respectively.

Patient's satisfaction is one of the most important health indicators in health care sysytem which is used for care qualification and providing health services. Hence, a descriptive-correlative study is carried out to determine the satisfaction degree of normal delivery and its relative factors in childbearing women at “Shaheed Chamran, Borujerd” and “Madiye, Tehran” Hospitals in 1385. In this study, 360 literate Iranian childbearing mothers were chosen via a non-probable quaoto sampling. Data gathered by a questionnaire consisting of 4 parts (pain severity, personal control, environmental satisfaction, childbirth satisfaction) and two checklists of demographic features and past obststric records. Respectively, the pain ruler was used to estimate the pain severity, the questionnaire of labors Agentry Scale to personal control, 17-question Likert scale to environmental contentment and 18 questions derived from 34-item questionnaire of Mackey Childbirth satisfaction to childbirth content. Using SPSS 13, Mann-Whitney and Cruskal- Wallis non-parametric tests, Spearman’s Correlation coefficlency, one-way Anova (variance Analysis) and regression test were applied to analyze the information. Among the studied women, 72/2% were contented with their childbirth, whereas 8.4% of them were unsatisfied with their childbirth. There was a meaningfull relationship among pain severity, environmental satisfaction, personal control, childbirth factor, reserved length of the first phase of labor, pregnancy age, the conformity of newborn’s gender with father’s and with mother’s will (P<0/001), lack of problem in their second and third delivery (P=0/01), mother’s degree of education (P=0/009), economical situation (P=0/02), and spouse’s occupation (P=0/03) with childbirth gratification in “Shaheed Chamran” hospital. there was a significant relationship between pain severity, personal control, the reserved length of the first and second phase (P<0/001) in “Mahdiye” hospital. Based on regression test, the personal control varriables (P<0/001) and environmental content (P=0/005) were achieved to be the predictors of childbirth gratification. Pejuhandeh Vol.13, No 63, 2008 14 It is outstanding that the contentment with childbirth is a multi-dimensinal issue and in order to increase the mothers’ positive experiences and prevent them from side-effects of their negative experiences, all the aspects must be comprehensively, simultaneously, considered.

To study the effect of an Iranian herbal drug in the treatment of primary dysmenorrhoea a randomized, double-blind, placebo-controlled pilot trial among 180 female students settled at Isfahan University dormitory aged 18–27 years who suffered from primary dysmenorrhoea was conducted. Participants were divided into three groups randomly (herbal drug, mefenamic acid and placebo). The herbal drug (Saffron, Celery See and Anise extracts highly purified) group was given 500 mg of SCA three times a day for three days, starting from the onset of bleeding or pain was administered. Participants were followed with three cycles from beginning of menstruation and continued through the whole three days of bleeding. Main outcome measures the severity and duration of pain at two and three months. A visual analogue scale was used to record pain. Overall-pain was the average pain intensity among days in pain. There were statistically significant reductions in pain score and pain duration in SCA (p<0.01) and mefenamic acid (p<0.01) groups. The decrease in pain score was reflected by a significant reduction in another drug used among the treatment groups compared with placebo. The magnitude of the reduction was significantly greater in the SCA group than in mefenamic acid and placebo (p=0.031). Both of the drugs relieved menstrual pain effectively in compare with placebo. So more clinical trials are need for efficacy of this herbal drug.