نفیسه ثقفی

Sexual satisfaction is a person's positive evaluation of the sexual relationship. Decrease in sexual satisfaction is one of the common complaints of the postmenopausal period. Flaxseed is a phytoestrogen and contains lignan. The present study was conducted with aim to investigate the effect of vaginal cream of flaxseed and conjugated estrogen on sexual satisfaction in postmenopausal women.

This single-blind randomized clinical trial study was conducted in 2018-2019 on 60 married postmenopausal women aged 40 to 65 years referred to the clinics of Qaem and Imam Reza hospitals in Mashhad, Villa Shahr Health Center and the health center of Khalilabad city of Kashmar. The research units were randomly assigned in two groups of 30 people, vaginal cream of flaxseed and conjugated estrogen for 8 weeks. The intervention group received 4% vaginal gel in the form of one gram per day, and the flaxseed group received one gram per day for up to 8 weeks. Sexual satisfaction was calculated based on Larson's questionnaire before, 4 and 8 weeks after the study. Data analysis was done using SPSS statistical software (version 22) and Independent t-test, Friedman and Mann-Whitney tests. P<0.05 was considered statistically significant.

The mean sexual satisfaction 4 weeks after the intervention was 24.2 ± 10.4 in the flaxseed group and 23.4 ± 12.1 in the conjugated estrogen group (P=0.576), and after 8 weeks, it was 37.7 ± 18.2 in the flaxseed group and 37.8 ± 18.3 in the conjugated estrogen group, which did not show a significant difference between the two groups (P=0.638).

Vaginal cream of flaxseed without any side effects compared to the side effects of hormone therapy can be as effective as conjugated estrogen vaginal cream in increasing sexual satisfaction.

Dural arteriovenous fistula is a rare neurological disease. In this study, a case of maternal death due to dural arteriovenous fistula was reported. 

The patient was a 19-year-old woman, G2 P2 who complained of memory impairment (forgetfulness) and headache 38 days after cesarean section and referred on outpatient basis, while she could not remember the names of her husband and child, and saw the lines but was not able to read. According to the results of the CT scan and the urgent need for intensive care, she was transferred to the ICU with the diagnosis of a neurologist. On the sixth day of hospitalization, the patient suffered from generalized tonic-clonic seizures and loss of consciousness. Initial drug therapy was performed and emergency CT scans were requested. Severe cerebral edema was reported on CT, which could be due to subarachnoid or pseudo-subarachnoid hemorrhage. CT angiography, MRI and MRV revealed a dural arteriovenous fistula. The patient underwent surgery the same day. Three days after the surgery, the patient suffered a cardiac arrest, which was immediately followed by CPR, cardiac massage, and medication, which unfortunately was not successful after 45 minutes of CPR, and the patient died.

Women who suffer from postpartum headaches should be evaluated accurately and quickly. In addition, the occurrence of seizures in pregnant women and the initial diagnosis of eclampsia should not prevent the physician from paying attention to other important and deadly differential diagnoses.

Nonpuerperal uterine inversion is a rare medical condition that many gynecologists might not be encountered even with one case during their entire medical practice. It refers to the expulsion of uterine corpus from the dilated cervix resulting in uterus being turned inside out. There are two kinds of uterine inversion, puerperal and non-puerperal, which the second condition is less common. Acute uterine inversion usually presented by crampy abdominal or pelvic pain, vaginal bleeding, anemia, and even symptoms of severe sepsis. We describe a case of uterine inversion in a postmenopausal woman.

A 66 years old grand multiparous woman (6 normal vaginal delivery) who was menopause since 15 years ago, was referred to the emergency unit of an academic hospital of Mashhad University of Medical Sciences at October 2016 due to postmenopausal uterine bleeding, cramp-like abdominal pain and mass protrusion from the vagina. The vital sign was stable at the first visit but a big non-necrotizing red vaginal mass was protruded from vaginal opening that connected to other soft intravaginal mass. Abdominal ultrasonography revealed the dilated vaginal cuff and some air-fluid levels in the uterine cavity. The patient referred to the operative room and vaginal myomectomy was done with diagnosis of pedunculated submocusal leiomyoma. Then, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed after the correction of uterine inversion by abdominoperineal approach.

Acute uterine inversion is a potentially dangerous condition (due to vaginal bleeding, severe abdominal or pelvic pain, and the possibility of uterine necrosis and even systemic infection). This condition should be considered as an important differential diagnosis as a vaginal mass in the post-menopausal period.

  Postpartum hemorrhage is associated with highest rate of mortality and has many known etiologies. Inner myometrial laceration is one of the rare etiologies that lack of diagnosis can lead to maternal mortality. This report introduced a rare case of postpartum hemorrhage due to inner myometrial laceration. The patients were a 35-year-old woman (gravida 3 and live 2) referred to the hospital due to term pregnancy and premature rupture of membrane for pregnancy termination. Normal vaginal delivery was done following labor induction. After delivery of a 3700 gr neonate, severe postpartum hemorrhage occurred which was unresponsive to medical treatment and uterotonic drugs; she was transferred to operating room and hysterectomy was performed. Then, she was transferred to ICU. On the first day of Intensive Care Unit admission, the patient was complicated by ventricular tachycardia and bradycardia, and finally cardiopulmonary arrest. CPR was done, but it was unsuccessful, and the patient was expired. Pathological assessment revealed inner myometrial laceration at the posterior uterine wall. Considering inner myometrial laceration as one of the important and controllable causes of postpartum hemorrhage can lead to the diagnosis of this complication

One of the most important etiologies in pretermpremature rupture of membranes (PPROM) is cervical bacterial colonization.

This study evaluated cervical bacterial colonization in women with PPROM and the pregnancy outcomes.

In this cohort study, 200 pregnant women with PPROM at 27-37 wk of gestation who were admitted in an academic hospital of Mashhad University of Medical Sciences from March 2015 to July 2016 were studied. samples were obtained from endocervical canal for detection of routine bacteria and Gram staining. Also, we obtained one blood culture from neonates. Maternal endocervical culture, chorioamnionitis, neonatal intensive care unit admission, neonatal positive blood culture, neonatal sepsis, and mortality were documented.

Most common isolated microorganism of endocervical culture were Escherichia coli (24.2%), Coagulase negative Staphylococci (27.2%), Enterococcus and candida each one (11.7%). The prevalence of GBS was only 2.2%. Simultaneous positive blood cultures were seen in 3% of neonates. Among them, Gram-negative bacilli accounted for (66.6%), while Gram-positive cocci and candida made up only (16.7%). Endocervical colonization was associated with a higher admission rate (p=0.004), but there was no significant correlation between endocervical colonization and chorioamnionitis, positive blood culture and neonatal mortality rate.

With regard to low GBS colonization rate, appropriate antibiotic regimens should be considered in PPROM cases according to the most prevalent micro organisms of endocervical bacterial colonization. Maybe cervical bacterial colonization had some effects on neonatal outcomes. There was no significant association between endocervical bacterial colonization and chorioamnionitis, positive neonatal blood culture and neonatal mortality.

Preeclampsia, a severe complication of human pregnancy is one of the main causes of maternal, fetal, and neonatal morbidity and mortality with unclear pathogenesis. Heat shock protein 70 (HSP70) is one of the factors that can mediate cytoprotective, antiapoptotic, and immune regulatory effects.

This meta-analysis was performed with aim to evaluate HSP70 in preeclampsia and normal pregnancy.

The original publications reporting the serum HSP70 levels in preeclampsia and normal pregnancies published before November 2015 were identified by searching PubMed Central, Scopus, and ISI Web of Knowledge databases by two researchers, separately. The keywords were” preeclampsia” and “HSP70” or “Heat shock protein 70” Statistical analyses were performed using STATA software (version 11).

Out of 127 studies, seven eligible case-control studies were identified which consists of 350 preeclampsia and 429 normal pregnancies. Our pooled analysis of data from 7 studies which met the inclusion criteria, provides evidence that there is a significant association between HSP70 and preeclampsia. Cochran's test results showed the heterogeneity of the studies (p

The results showed that serum HSP70 concentration was significantly higher in preeclamptic patients than the control group. Therefore HSP70 may be identified as a diagnostic factor.

Children are important component of future society and providing their health care is a national investment. With regard to close contact between mother and child, so, improving the mothers’ knowledge about neonatal care and the risk factors can be effective to prevent neonatal mortality and morbidity. This study was performed with aim to evaluate mothers’ knowledge about neonatal care in three educational hospitals of Mashhad University of Medical Sciences.
This cross-sectional study was conducted in 2014 on 784 pregnant women referred to maternity wards of Omolbanin, Emam reza and Ghaem hospitals. The data collection tool was a researcher-made questionnaire on neonatal care. Data were analyzed by SPSS software (version 16) and using t-tests, Chi-square and ANOVA. P The knowledge of 50 mothers (6.4%) about neonatal care was poor, 430 (54.8%) moderate and 295(37.6%) good. The mothers with diploma level education had the highest level of knowledge than other mothers. There was significant relationship between mother's level of education, job and mode of delivery with mother's knowledge about neonatal care (P=0.005).
Due to the effect of mother's knowledge in the prevention of neonatal disease and mortality, it is better to focus more on educating mothers, especially in the field of mother’s diet and exercise, nipple cracking, and safe drugs during breastfeeding for all mothers.

Iron deficiency anemia is defined as hemoglobin < 11g/dl in the first and third trimesters، and < 10. 5 g/dl in the second trimester of pregnancy. Iron deficiency anemia is the most common cause of anemia during pregnancy and leads to important complications such as low birth weight، preterm birth and so on during pregnancy. This study was performed with aim to determine the prevalence of iron deficiency anemia in pregnant women and evaluation of its relationship with some variables.

This cross-sectional study was conducted on 600 pregnant women referred to morning Clinic of Ghaem Hospital in 2010. Data collection tool was a researcher-made questionnaire in which required information including gestational age، gravidity and parity، number of abortions، educational level and household income were recorded. Data analysis was performed by SPSS software (version 16).

In this study، the prevalence of anemia was 11. 2% in the subjects. There was significant relationship between age of pregnant women and anemia (P≤0. 001)، anemia and age during the first pregnancy (P=0. 001) and anemia and the time interval between the current and the previous pregnancies (P=0. 001). In addition، there was a significant relation between the prevalence of anemia and gestational age (P=0. 0005)، parity (P≥0. 005)، gravidity (P=0. 001)، educational level (p≥0. 0001) and income (p≥0. 0001).

Increased parity and gravidity leads to an increase in the prevalence of iron deficiency anemia. Regarding the fact that iron deficiency anemia is a preventable complication، specific attention to prevention programs pregnant women and empowering health care policies during pregnancy can be one of the most important priorities in the country.

Ovarian cancer is the most common cancer of the female genital tract which is often advanced at the diagnosis. Neoadjuvant chemotherapy is used in advanced cases، but is associated with several side-effects. Propolis is a substance made by bees. Recent studies show that propolis with chemotherapy has therapeutic effect and reduces chemotherapy side-effects and toxicity. This study was performed aimed to comparatively evaluate the efficacy and side-effects of propolis with chemotherapy and chemotherapy alone for neoadjuvant therapy of ovarian cancer.

This double-blind randomized clinical trial study was performed on the women with advanced stages of epithelial ovarian cancer who required neoadjuvant chemotherapy at the department of gynecology oncology of Ghaem and Omid hospitals، Mashhad University of Medical Sciences from 2013 to 2014. The subjects were randomly divided into two groups. In addition to the usual chemotherapy، one group randomly received Propolis tablet and other group received placebo. Two groups were compared in terms of reduced tumor volume and tumor marker of CA125 and nausea، vomiting، cytopenia، liver dysfunction and possibility of optimal cytoreductive surgery after treatment. Data analysis was performed using SPSS statistical software (version 16) and Mann-Whitney، Exact fisher test and Kruskal-Wallis tests.

In both groups، reduced tumor volume and tumor marker of CA125 had a significant decrease، but no significant difference was observed between the two groups (P=….). The rate of leukopenia، nausea، and vomiting was not significantly different between the two groups (P=…). No cases had liver dysfunction. All cases underwent cytoreductive surgery in Propolis group، but optimal cytoreductive surgery was not performable in 2 patients (25%) in the placebo group.

Propolis administration along with chemotherapy improves the efficacy of common chemotherapy without adverse therapeutic effect.

P53 is mutated in more than 50% of solid tumors and has been changed in 30-40% of endometrial cancer which is the most common malignancy of the genital tract of women and this change is associated with papillary serous cell type and advanced stage and poor prognosis. In addition، the overexpression of BCL2 and tumor angiogenesis is important in the prognosis of patient. Therefore، this study was performed with aim to evaluate the expression of BCL2 and P53 and angiogenesis in endometrial cancer and its relationship with clinicopathological characteristics and the factors affecting the prognosis of disease.

In this retrospective longitudinal study which was performed during 2005-2014، 30 files of patients with endometrial cancer in three different hospitals (Imam Reza، Ghaem، Omid) were collected. The pathology samples were immunohistochemical staining in terms of Bcl2 and P53 markers and angiogenesis and the association of these markers with factors affecting the prognosis and recurrence of disease were investigated. Log rank، t-test and Chi-square tests were used to analyze the data and P.

P53 expression was positive in 9 cases of 10 patients (90%) with non-endometrial cancer and all patients (100%) were negative in terms of Bcl2 and angiogenesis was severe in 8 cases of 10 patients (80%) with non-endometrial cancer and in 6 cases of 20 patients (30%) with endometrial cancer. There was significant relation between tumor histology and tumor grade and stage of the disease and survival (P = 0. 002).

Since there is relationship between genetic markers with stage and grade of disease and also survival of the patients، it is better that the related block be evaluated in terms of these markers at the time of pathological diagnosis of endometrial cancer.

uretero pelvic junction obstruction (UPJO) is partial or complete obstruction of urine flow that occurs at the site where the ureter enters to the renal pelvis. UPJO occurs in 22-37% of ectopic kidneys. In pelvic ectopic kidney in young adults, UPJO protests with clinical symptoms of intermittent pain in the side or abdomen that may be similar to the symptoms of pelvic mass. The aim of this report is to introduce a rare case of a pelvic mass protest. Case Report: A 18-year-old virgin woman referred with complain of menstrual irregularities that has performed ultrasound one last year and diagnosed with an ovarian cyst at ultrasound. Early ultrasound reported a cyst with size of about 2 × 12 cm in right ovary that after 3 months consumption of contraceptive pills, a cyst 98 × 95 × 68 mm with possible origin of right adnexal was reported. Due to abdominal pain and large size of cyst, the patient was candidate for laparotomy. The origin of cyst was diagnosed as the renal pelvis. The right kidney was ectopic and contained UPJO. Pyeloplasty was conducted by Anderson Hys method and Double-J Stent was inserted.

In the cases of pelvic mass, it is very important to consider the possible non-gynecologic origin of the mass, especially when there is no possibility of a full gynecological examination because the patient was Virgin. All differential diagnosis of pelvic masses, especially with urologic and gastrointestinal origin should be considered and diagnostic procedures should be performed before the surgery.

Gynecologic cancers can have profound effects on function of women''s life. In women with ovarian cancer، treatment leads to changes in the anatomy and function of the vagina. This study was performed with aim to evaluate sexual dysfunction in women with ovarian cancer.

This cross-sectional study was performed on 210 women with ovarian cancer admitted to Mashhad Ghaem and Omid hospitals and 130 healthy women who were matched with our patients in terms of age from 2009 to 2013. The subjects completed the form of sexual function questionnaire (FSFI) through an independent inquiry. Data was analyzed by SPSS software (version 16. 5).

31. 9% of patients were within 5 decades of life and had mean age of 48. 15 years. According to Pearson test، the prevalence of sexual dysfunction was 85. 7% in patients with ovarian cancer and 52. 9% in healthy women that the difference was significant (P< 0. 001).

Sexual dysfunction is more prevalent in patients with cancer compared to healthy subjects. Disorders were highly prevalent in the excitement and libido، vaginal moisture، orgasm and pain during intercourse.

63TPreeclampsia63T is one of the 63Tcommon complications63T 63Tduring63T 63Tpregnancy with63T 63Tconsiderable maternal and fetal63T 63Tmortality63T 63Tand63T 63Tmorbidity63T. 63THypercoagulability63T 63Tdue to63T 63Tthrombophilic63T 63Tfactors63T 63Tis63T 63Tdiscussed as the etiology involved in63T 63Tthis disease63T.

63TThe aim of this study63T was to evaluate 63Tselected thrombotic factors among pregnant women with preeclampsia and normal pregnant women63T.

63TThis63T 63Tcase-control63T 63Tstudy63T was performed 63Ton63T 63T200 pregnant women63T 63Tat63T 63Tthird trimester63T 63Tof pregnancy between 2012 and 2013.63T 63T100 pregnant women63T 63Tadmitted to63T Qaem and Imam Reza hospitals of Mashhad, due to preeclampsia, were selected as 63Tcase group63T 63Tand63T 63T10063T 63Tpregnant women63T 63Twithout preeclampsia63T referred to OB/GYN 63Tclinic63T of these hospitals as 63Tcontrol group. Blood samples63T were taken from two groups for evaluation of the 63Tcoagulation factors63T including 63Tfactor V63T 63TLeiden63T, 63Tprotein63T 63TC,63T 63Tprotein63T 63TS,63T 63Tantithrombin63T 63TIII,63T 63Tanti-63Tcardiolipin 63Tantibodies63T, and lupus 63Tanticoagulant63T 63Tantibodies63T.

63TTwo groups were not significantly different63T 63Tin63T 63Tterms of63T 63Tmaternal age and63T 63Tparity63T 63T(p>0.05).63T 63TLevels of factor63T 63TV63T 63TLeiden63T, 63Tprotein63T 63TC,63T 63Tprotein63T 63TS, antithrombin63T 63TIII,63T 63Tanti-63Tcardiolipin 63Tantibodies63T and lupus 63Tanticoagulant63T 63Tantibodies63T 63Twere63T 63Tcompared between63T 63Ttwo groups63T. The 63Tnumber63T 63Tof patients with abnormal factor V Leiden and63T 63Tprotein63T 63TC63T 63Twas63T 63Tsignificantly higher63T 63Tin63T 63Tcase group than63T 63Tin63T 63Tthe control63T 63Tgroup63T 63T(63Tp<0.01 respectively), but other 63Tfactors63T 63Twere63T not 63Tsignificant different between two groups.63T 63TThrombophilia63T 63Tdisorders63T 63Twere significantly63T 63Tmore in case group63T compared to control 63T(p<0.001)63T.

63TThe63T 63Trisk of63T 63Tthrombophilia63T 63Tdisorders63T is higher 63Tin63T 63Tpreeclamptic63T 63Tpatients than63T 63Tnormal63T 63Tpregnant women63T

Premature rupture of membranes (PROM) may have serious problems for mother، fetus and baby. Determining antibiotic use is various in mothers with these problems due to common causes of maternal vaginal colonization. The aim of this study was comparing the efficacy of cefotaxime and ampicillin on neonatal infection after premature rupture of membranes. This clinical trial was conducted on 200 women with premature rupture of membranes who required to use antibiotics in Ghaem hospital، Mashhad، Iran in 2010-2012. Women were divided randomly into two groups: group A received conventional therapy (ampicillin) and group B received cefotaxime. Status of mothers and her fetus until birth and neonates in neonatal ward or neonatal intensive care unit (NICU) until discharge or death was controlled. White blood cell and platelet count، erythrocytes sedimentation rat (ESR)، C-reactive protein (CRP)، blood cultures، cytology of cerebral spinal fluid، cerebral spinal fluid culture and mortality rates were compared in neonates of both groups. All statistical analyses were performed using SPSS software version 14. 5 and chi-square، t-test and Mann-Whitney tests. P value less than 0. 05 was considered significant. The mean length of PROM until delivery (p=0. 78)، parity (p=0. 46)، gestational age (p=0. 150)، birth weight (0. 147) and sex (p=0. 431) were homogeneous between two groups. Definite infection (p=0. 034)، high ESR (p=0. 003)، CRP positive (p=0. 049)، require hospitalization (p=0. 001) and mortality (p<0. 05) was higher in neonates who received ampicillin. The risk of neonatal infection in mothers with PROM who receive cefotaxime is clearly less than mothers who receive ampicillin.

In this study we performed linkage analysis on a large X linked RSA pedigree to find a novel susceptibility locus for RSA. A linkage scan using 11 microsatellites was performed in 27 members of a large pedigree of hereditary X-linked RSA. Two point parametric Linkage was performed using Superlink v 1.6 program. Evidence of linkage was observed to markers at Xq23, DXS7133 and at Xq22.1 DXS101, with LOD score of 3.12 and 1.60, respectively. Identified locus in this study may carry a responsible gene in RSA. Narrowing down of this region may leads to identification of this gene Recurrent spontaneous abortion (RSA) is one of the most common health complications with a strong genetic component. Several genetic disorders were identified as etiological factors of hereditary X linked RSA. However, more genetic factors remain to be identified.

Heat shock proteins (HSPs) are intracellular proteins which are expressed in cell during stress responses. In normal pregnancy، circulating HSP70 levels are decreased and it was suggested to be elevated in several pregnancy complications. The role of circulating HSP70 in normal and pathological pregnancies is not fully known. The aim of this study was to investigate the association between serum HSP70 levels and preeclampsia.

This cross sectional study was conducted on 41 preeclamptic women and 39 healthy pregnant women in third trimester of pregnancy who admitted to Qaem hospital of Mashhad، Iran in 2010-2011. All subjects were in their first pregnancy. The two groups were followed until delivery in terms of maternal and fetal complications. Serum HSP70 levels were measured using ELISA method in patients. Data were analyzed using SPSS software (version 16)، independent t-test، Fisher''s exact and Mann-Whitney tests. P value less than 0. 05 was considered significant.

The two groups were not significantly different in terms of maternal age، gestational age and body mass index (p>0. 05). Serum HSP70 levels in patients with preeclampsia were significantly higher than those with normal pregnancies (p<0. 001). There was no significant relationship between HSP70 and body mass index as well as between HSP70 and maternal age and gestational age (p>0. 05). There was no correlation between HSP70 and maternal systolic blood pressure (p<0. 001).

Serum HSP70 levels in patients with preeclampsia was higher than those with normal pregnancy. Serum HSP70 is not only be a marker for these conditions، it may also play an important role in pathogenesis of preeclampsia.

Publication of articles about problems and setbacks against medical careers has been of less interest in Iran. The aim of this study was to present the viewpoints of medical experts about the journal format, contents and quality of the articles that will be published in the Journal of Mashhad Medical Council.

This descriptive qualitative study was conducted during a meeting in May 2013. A focus group comprised of academic staff of Mashhad University of Medical Sciences (MUMS) and members of the Medical Council of Mashhad (MMC) participated in this meeting. The participants presented their views with lectures and also wrote their views by answering to a pre-designed questionnaire.

In total, opinions of 45 medical experts were collected. 85% of participants were male with a mean (SD) age of 49 (7) years old. 76% of the participants were academic staff of MUMS. Participant's opinions were categorized in two areas: (a) the structure of the journal, (b) the scope of the journal. For improvement of the journal structure, using professional editorial team, reducing printing costs, establishment of the journal website (22%), obtaining feedback of the MMC members (22%), and publication of scientific articles (22%) were the most frequent recommendations. Most recommended topics for the articles were: teaching medico-legal laws (60%), providing practical and educational articles about medical professionalism (56%), and educating medical ethics (31%).

Medical careers are involved with high loads of work. Hence, they have less time to read and update themselves about their job related issues including medico-legal issues. They may also be less updated about new findings in medical science. Journal of Mashhad Medical Council should work as a scientific platform with collaboration of medical staffs and MMC members to disseminate necessary knowledge for medical community. Furthermore, it should address occupational problems of medical community with research-based perspective.

Nausea and vomiting are the second most common complaints reported in the postoperative period and can lead to rare but serious medical complications. The aim of this study was better prevention of postoperative nausea and vomiting following gynecologic laparoscopic surgeries. This clinical trial was done in Qhaem and Emam Reza hospital of Mashhad، Iran during 2010 and 2012. 150 patients who were candidate for gynecologic laparoscopic surgeries were divided randomly into three groups. All patients received Dexamethasone immediately after anesthesia. 15 minutes before extubation، one group were given Granisotron and second group were given Ondostron and the third group (control) were given normal saline as placebo. The patients who had postoperative nausea and vomiting were treated with the same antiemetic drugs that they were given preopertively but with reduced dose of 25%. All patients were assessed for signs of nausea and vomiting. Data were analyzed using SPSS software version 11 and one-sample kolmogorov-Smirnov، one-way ANOVA and Kruskal-Wallis tests. P value less than 0. 05 was considered significant. Vomiting in the first one hour and 1-6 hours after operation was more in Granisetron-Dexamethasone group than Ondansetron-Dexamethasone group. The difference was statistically significant between two groups (p<0. 019) and the difference of vomiting was statistically significant between two groups and control group (p<0. 045) Granisetron-Dexamethasone is more effective than Ondansetron-Dexamethasone and or placebo in control of postoperative nausea and vomiting after gynecologic laparoscopic surgeries، 1 hour and 1-6 hours after operation. It is recommended to use these drugs pre-operatively.

Hypertension is one of the most common complications of pregnancy which is the main reason of both maternal and perinatal morbidity. Labetalol (both beta and alpha – receptor inhibitor) is an important drug in controlling blood pressure that is rarely used in Iran''s gynecology ward of university hospitals. This research was held with the aim of comparing the effects of two medications: hydralazine and Labetalol، in treatment of hypertension in patients with severe preeclampsia. This clinical trial study was performed on two hundred women with severe hypertension in pregnancy and gestational age of 28 to 40 weeks from March to December in 2011. They were randomly classified into two groups: receiving hydralazine (5 mg as a slow bolus dose given intravenously، and repeated every 20 min up to a maximum of five doses) and receiving labetalol (20 mg intravenous bolus dose followed by 40 mg if not effective within 20 min، followed by 80 mg every 20 min up to a maximum dose of 300 mg). The main aim was successful lowering of diastolic blood pressure 90 to 100 mm Hg and preventing maternal hypertension. Collected data were analyzed by using SPSS software version 13، chi-square and Mann Whitney Test. P value less than 0. 05 was considered statistically significant. Multivariate analysis revealed no significant differences between two groups (hydralazine and labetalol) in systolic (p=0. 619) and diastolic (p=0. 888) blood pressure after receiving medications، time of delivery (p=0. 903)، Apgar score 1minute (p=0. 681)، Apgar score 5 minute (p=0. 639)، cesarean section (p=0. 659) and abnormal bleeding after delivery (p=0. 998) respectively. Labetalol can be used alternatively instead of hydralazine to control blood pressure in severely hypertensive pregnant women.

Preterm delivery accounts for preterm labor or birth before 37th weeks of gestation that is the cause of two third of prenatal mortality and one of the problems in obstetrics and hormonal factors are reported to be effective. Progesterone is a placental hormone and effective in maintaining pregnancy. The aim of this study was to evaluate the efficacy of 17α-hydroxyprogesterone caproate in preterm delivery prevention.

This interventional clinical trial was performed on 100 pregnant women who referred to obstetrics clinic of Ghaem hospital affiliated to mashhad university of medical sciences during 2007 to 2008. They were randomly divided into two groups of 50 cases and 50 controls. The case group received intramuscular 250 mg 17α-hydroxyprogesterone caproate injection weekly at 16th up to 37th week of gestational. In control group, routine prenatal cares was performed and then pregnancy outcomes were compared in two groups. Data was analyzed using student t-test and chi square test by SPSS 11 software.

Mean gestational age was 36 weeks in case group and 32 weeks in control group. Mean birth weight was 2299 grams in case group and 2695 grams in control group. Ggestational age and birth weight had significant difference in two groups (p<0.05).

Weekly administration of 17α-hydroxyprogesterone caproate in pregnant women with history of preterm delivery decrease preterm labor and induced improvement of birth weight.

Assisted reproduction treatment (ART) entails a risk of ectopic pregnancy and early pregnancy loss. Serum ß-human chorionic gonadoropin (ß-hcg) has been found to be predictive of pregnancy outcome. Our aim was to determine whether serum ß-hcg levels obtained 16 days after ovulation are reliable predictors of pregnancy outcome. Subjects and In this retrospective study, 200 women who have achieved a pregnancy through ART treatment at the infertility clinic of Mashhad Medical Sciences University were evaluated. The treatment included IUI in 196 (98%), ICSI in 2 (1%) and IVF in 2 (1%). Serum samples were obtained on days 16 and serum ß-hcg concentration was measured by immune-radiometric assay. The mean age at treatment was 29 (range 19–35 y). One hundred and sixty women aged above 30 y and 40 cases aged below 30 y. Out of 200 patients with ART cycles 175 cases were found to be viable pregnancies (live fetus at 20 weeks gestation) and 25 patients resulting in spontaneous abortion. A statistically significant difference was found between the mean ß-hcg value of the non-viable and viable pregnancies (P<0.001). A single serum ß-hcg level 16 days after ovulation provides a useful predictor of pregnancy outcome.

Testicular feminization is a rare X linked syndrome with 46 XY karyotype. The aim of this report was to present the role of laparoscopy in the diagnosis and treatment of this syndrome.Materials & Patients: Two women referred to us with a history of amenorrhea. They were 23 and 19 years olds. Physical examination showed normal pubic hair and normal development of external genitalia and breasts. Ultrasonography of abdomen showed; agenesis of the uterus and existence of two gonads near the internal inguinal rings. Hormonal assays were done and karyotype study showed 46XY. In order to confirm the diagnosis by laparoscopy, under general anesthesia and by using Hasson technique, a 10Fr trocar was inserted and totally the four Testes were seen in the abdomen of two patients. Because of the risk of gonadoblastoma, two 5F trocars were introduced in midclavicular lines (below the umbilicus), the gonads were released from the surrounding tissues, and after ligating the vascular attachments the gonads were excised and removed through the trocar incision sites. Post laparoscopy course was uneventful and both patients discharged home after two days. Histopathologic study of the removed gonads confirmed testicular features. Having considered the minimal morbidity and complications in this two cases and report the experience of other authors, it seems that, laparoscopic gonadectomy might be a suitable option in managing patients with testicular feminization.Key Words: