فصلنامه علوم پزشکی دانشگاه آزاد اسلامی مشهد
سال هفتم شماره 1 (پیاپی 25، بهار 1390)

Polycystic Ovary Syndrome is the most common cause of ovulatory infertility. So, physicians concerned about infertile couples should be completely aware of its numerous cases and limitations such as risks and costs. This study intended to compare the effects of two drugs, i. e. Clomiphene Citrate (CC) and Letrozole in an attempt to investigate ovulatory stimulation among sixty infertile PCOS patients who underwent IUI. During a Randomized clinical trial in a private professional clinic of gynecology and infertility, Sixty infertile patients with PCOS, eligible for the Induction of ovulation and IUI were randomly divided into two groups. The first group received two tablets of clomiphene citrate (100mg) daily on day 3 to day 7 of their menstrual cycles whereas the second group received two Letrozole tablets (5mg) daily on day 3 to day 7 of their periods. ALL patients were injected with two ampoules of HMG (350IU) daily on day 8 to day 10 of their menstrual cycles. Then, the test of trans-vaginal ultrasonography was done for the patients on the 11th day of their menstrual cycle, and the number of mature follicles, the size of dominant follicle and endometrial thickness were measured. The dose of HMG, required by the dominant follicle to approach the appropriate size (18-20mm), was determined according to the ultrasonography outcomes. Accordingly, two HCG Ampoules (100LU) were administered in the appropriate time and IUI was performed 36 hours later. The number of mature follicles, the size of dominant follicle, endometrial thickness, the number of consumed HMG ampoules, ease of performing IUI, incidence rate of OHSS, the rate of pregnancy and miscarriage. Numbers of mature follicles (9.5±6.88 vs. 8.79±5.53), the size of dominant follicle (16.09±2.86 vs. 15.27±1.77), easy performance of IUI (90.5% vs. 89.7%), incidence rate of OHSS (19% vs. 13.8%) and the rate of pregnancy (14.28% vs. 6.9%) were found to be higher in Letrozole group. However, endometrial thickness (8.64±1.72 vs. 7.82±1.85), numbers of consumed HMG (10.75±2.02 vs. 10.57±2.01) and the rate of miscarriage (6.9% vs. 4.76%) were higher in clomiphene group. But, according to statistical examinations performed on these outcomes, none of these differences were statistically meaningful. According to the insignificant effect of Letrozole found in this study and the reported warnings against its use for the risk of teratogenicity, using this drug should be limited.

Intraocular pressure (IOP) is the pressure in the orbit originating from the balance of aqueous secretion and absorption. A decrease of intraocular pressure during pregnancy has been reported by some previous studies; but, it has not been yet evaluated in each one of the trimesters of pregnancy. The goal of our study was to investigate the intraocular pressure in each trimester of pregnancy in women referring to the gynecological clinic and the welfare center of Bahman 22nd Hospital. This observational study was conducted on 50 pregnant women aged 15 to 40 years. IOP measurements were taken with tonometer during each trimester of pregnancy. Using statistical tests, the data were compared in terms of age, the trimester of pregnancy and the number of pregnancies the patient had experienced. The mean age of the subjects was 25.8 years. A significant decrease in the IOP values was reported during pregnancy. There was a statistically meaningful relationship of the IOP value with the age of the mothers and also the trimester of pregnancy (P<0.05). As the stage of trimester of pregnancy increased, the mean amount of IOP decreased. There was no statistically significant relationship between the number of pregnancies and IOP. IOP was reduced during pregnancy; it can be explained by the hormonal changes during pregnancy. More studies evaluating the effects of these hormonal changes on the IOP reduction are recommended. Maybe, it would help with producing some agents to reduce the rate of IOP in nonpregnant glaucomatous patients in future.

Refractive power of the eye is affected by many factors including the status of visual system'' components such as anteroposterior diameter، cornea، lens status، and certain drugs such as thiazides، or certain systemic diseases such as diabetes Mellitus and some eye diseases such as keratoconus. The purpose of this study was to investigate the correlation between refractive errors، corneal dioptric power and axial length (AL). Observational study was done on 100 medical students aged 21 to 31 years in outpatient ophthalmic clinic of Ghaem Hospital، Mashhad. Corneal dioptric power was measured by Javal - Schiotz keratometry device power in two main axes. Anterior–posterior eye diameter was evaluated by Ascan ultrasonography. All evaluation was done by one examiner. In this study AL was found to be the main factor of development of myopia less than six diopter. The detailed findings are summarized as follows: 1. Corneal dioptric power in myopia less than (2D) was 42. 99  1. 18 D; in myopia (2-4D) = 44/05  1. 62D; in myopia more than (4D) = 43. 5  0. 89 D. There was no statistically significant difference between these types of myopia (P=0. 143). 2. AL in myopia less than (2D) was 23. 85  1. 23 mm; in myopia (2-4D) = 24. 06  1. 03mm; in myopia more than (4D) = 25. 39  0. 62 mm. There was statistically a difference between these types of myopias (P<0. 00006). There is statistically a significant relation between Axial Length (AL) and myopia less than 6D. There is no statistically significant relation between corneal dioptric power and myopia.

Headache is a side effect of spinal anesthesia that is caused by an exit mechanism of CSF through needle-done penetration. This study was done to evaluate the incidence of post dural puncture headaches comparing the use of Quincke needles No.26 and No.25 during a course of 24 hours. This study was planned as a randomized, double-blind, clinical trial on 200 women aged 20 to 35years old who were candidates for caesarean section or appendectomy under spinal anesthesia. Spinal anesthesia was done using intrathecal injection of 2 cc (100 mg) of Lidocaine solution. Having been justified, the patients signed the informed consent forms. They were randomly divided into two groups (Group I and Group II) who underwent the spinal anesthesia. For Group I, Dr. J, Quincke needle No. 25 was used whereas Group II used Dr. J, Quincke needle No.26. The patients were checked for the incidences of headache, nausea and vomiting, backache, dyspnea, and vital symptoms including blood pressure and pulse rate. The patients were checked twice; i.e. one hour and 24 hours after the surgery. The headache intensity was evaluated using the method of VNRS (verbal numerical rating scale). Finally, the collected data were analyzed using SPSS 11. The mean intensity rate of headache in group I was significantly higher than group II for both intervals; i.e. one hour and 24 hours after the surgery. Blood pressure was decreased one hour after inducing the anesthesia, but there was no significant difference between the two needle kinds. There were no significant differences in terms of dyspnea, backache, nausea, vomiting and respiratory rate. The use of smaller needles (No. 26 instead of No. 25) has a statistically significant effect on decreasing post Dural puncture headache; thus, increasing patients’ satisfaction.

The potential effects of fasting and exercise has been of interest to athletes, coaches and researchers in different fields of sports. Some researchers have investigated the effects of exercise and fasting on blood physiological factors, diabetes, obesity and some hormones. They have found conflicting results. Hormonal changes in training and fasting condition can be important for athletes. The purpose of this study was to investigate the effects of resistance exercise on the rates of catabolic hormones (cortisol, growth hormone and thyroxin) and to compare the results in fasting and non-fasting conditions. 13 students of physical education at Islamic Azad University, Mashhad Branch were selected randomly and participated in this study as a sample. Blood samples were taken from the subjects before and after the exercise, once one week before Ramadan, and for the second time, in the fourth week of Ramadan (the twenty-eighth day). The subjects actively participated in one session of resistance training (stationary weight training). F-test and two-factor ANOVA were used to analyze the data (P≤0.05). 1. Fasting had significant effect on fasting blood glucose and hormone thyroxin. 2. Training had significant effect on growth hormone and cortisol. 3) Fasting and training had no significant mutual effect on any of the variables. Training in fasting condition, probably due to the decreased blood sugar and energy, can create more variation in the levels of catabolic hormones. But, these changes are mostly evident in thyroxin. It is recommended to have more control over the intensity of such trainings during fasting conditions in order to prevent the incidences of hypoglycemia, energy deficit and the hypotrophy of muscle tissues.

Refractive errors are one of the most common causes of ophthalmology clinic visits, and among them myopia is the most prevalent one. Laser eye surgery is a very common therapeutic method which is performed for the treatment of refractive errors, but like any other surgical method it has its own complications. In this study we tried to assess these complications. The objective of this study is to assess the ophthalmologic complications of laser eye surgery for the treatment of refractive errors. All of the patients who visited the ophthalmology clinic for laser eye surgery were included in this cohort study. Using questionnaires, the data were gathered on the degree of refractive error, the duration of the history of using glasses or contact lenses, the history of ocular trauma and finally lasik complications. The complications were assessed in 2 weeks for the early complications and in 3 months for the late ones. Then, the classified and described data were presented via tables and graphs, At the end, the data were analyzed, using SPSS software and other statistical methods. 640 eyes with refractive errors in 320 patients who underwent laser eye surgery were included in our study. Dry eye was diagnosed in 35% of the eyes; 2.2% of the eyes had conjunctivitis. The incidence of dry eye was more frequent in women than men (P<0.05), especially in women aged 18-27 years old (18.1%). In our study on 320 cases (640 eyes), the incidence of dry eye was diagnosed as the most prevalent complication of laser eye surgery (35% of the eyes).

Sexual dysfunction is a common problem in women that, in turn, may negatively impact on their quality of life. Several factors, including depression may affect sexual function. The aim of this study was to determine the correlation between depression and sexual function index among married women. This is a descriptive- correlational study that was conducted on 200 women in the health clinic of Hazrat-e Ali Hospital in Karaj in 2009. The sampling method used in this study was simple randomized sampling. The data were collected by interviewing the subjects. The instruments used include: demographic data form, the Center of Epidemiologic StudiesDepression Scale (CES-D) and Female Sexual Function Index (FSFI). The collected data were analyzed by SPSS software using descriptive statistics, t-test, ANOVA and coefficient Pearson correlation. The findings indicate that the mean score of female Sexual Function Index was 20.59±5.10 (1.2-36 range) and the mean score of depression was estimated 17.61±11.63 (0-60 range). 31.5% of the women had mild to moderate depression, and 98.5% of them were identified with sexual dysfunction. The most sexual problems were found to be sexual arousal disorder (36%), sexual dissatisfaction (20%) and orgasm disorder (16.5%). There were significant negative correlations between depression and sexual arousal (P=0.037), orgasm (P=0.046), sexual satisfaction (P=0.003), sexual pain (P=0.012) and total score of female sexual function index (P=0.011). Sexual function associates with the person’s mental status. So, paying special attention to sexual problems among depressed patients and also the assessment and treatment of depression in patients with sexual disorders are recommended.

Sialorrhea causes a condition of discomfort for patients suffering from neurological complications, in particular, and their families. Among the current treatments are the use of Scopolamines and Anticholinergics. Recently, Butolism Toxin has been used to reduce the amount of saliva glands secretion. In this article, we present a report on the injection of Butolism Toxin into a 14-month baby’s saliva gland to control the secretion. This is a case of primary drooling.