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The prevalence of struma onset in uterine tube is lower than ovary’s stuma. In this report a 63 year old woman was referred to main hospital in the city of Yazd, Iran in 2008. The patient referred with abdominal swelling in pre-umbilical and supra pubic region associated with losing weight and frequent constipation since 5 years ago. After the hospitalization the patient underwent the laparatomy. in pathology report the masses was struma ovarii and mature cystic teratoma associated with struma salpingi and peritoneal steremosis. Special demonstration accompanied struma salpingi in this case are struma ovarii and multiple vesicular vegetasion in choledosac, Peritoneum and bladder. This report was a very rare case of struma salpingi accompanied with struma ovarii and steremosis.

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Vulvar melanoma is a very rare tumor with the rate of 0.1-0.19/100000. It mostly occurs during post menopausal period. In this case report, our patient was a 43 years old woman, her symptom was a small pruritic lesion noticed two months earlier when she was referred to the clinic. This lesion was a 5mm diameter dark brown and flat on her left labialis minor. Malignant melanoma with 3-5mm thickness was diagnosted following biopsy. Wide local excision with more than 2cm free margin and inguino femoral lymphadenectomy at the site of the lesion was done. The recurrence of tumor was not abserved during four months follow-up.

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Background and Objective: Respiratory distress syndrome is the most important lung problem during the neonatal period. Although the benefits of antenatal corticosteroids in neonates with a gestational age of less than 34 weeks have been demonstrated, the benefit of this treatment in neonates with higher gestational age is dubious. This study investigated the effect of Betamethasone on respiratory distress syndrome among neonates with gestational age of 35-36 weeks. Materials and Methods: This double blind randomized controlled trial study was done on 200 pregnant women who were of high risk for preterm labor in 35-36 weeks of gestation in Sanandaj city-Iran during 2007. 200 pregnant women randomly divided into treatment and placebo groups were received intramuscularly Betamethasone (12 mg/kg/BW twice) and normal saline, respectively. Data including age of mother, sex, weight, respiratory distress syndrome and newborns admission in hospital were recorded for each subject. Data was analyzed by using two-tailed T, Mann-Whitney, chi-square and Fisher exact tests. Results: There were no difference among two groups about age of mother, sex and weight of newborns. There were 8 (8%) and 20 (20%) newborns with respiratory distress syndrome in case and controls, respectively (P<0.01). Admission in hospital was 16% in Betamethasone group vs 28% in normal saline group (P<0.04). Conclusion: The study demonstrated that exposure to antenatal Betamethasone with 12mg/kg/BW twice between 35 and 36 weeks of gestation is associated with a significant reduction in the rate of respiratory distress syndrome.

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Background and Objective: Placenta previa (PP) is a common cause of pri-partum bleeding leading to high mortality and morbidity in mothers and neonates. This study was conducted to determine risk factors and outcomes of PP in Golestan province of Iran. Materials and Methods: This case-control study was done on pregnant women admitted for deliverly to the Dezyani hospital of Gorgan, Iran during 2002-07. All PP cases were recruited as case group and 251 non-PP ones were entered into the study as control group. Student t-test and Chi-Square test were used to assess the relationship between variables. Results: In this study out of 33473 pregnant cases, 82 women (0.24%) had PP. The mean (±SD) age of mothers with PP was 28.5 (±6.2) years. There was a significant correlation between PP and delivery method (P<0.05). History of cesarean section was significantly higher in cases than controls (P<0.05). The prevalence of hysterectomy due to PP was significantly higher in women with history of cesarean section (24%) than other ones (5%) (P<0.05). Conclusion: We found a significant relationship between history of cesarean section and hysterectomy due to PP. Therefore, PP should be considered in women with a history of cesarean section.

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Background and Objective: Anesthetic agents effect on pregnancy in operating room personnel is a challenge in anesthesiology. This study was carried out to determined pregnancy complications among hospital operating room personals in Fars province – Iran.

Materials and Methods: In this case-control study, 122 women working in operating rooms of governmental Fars province hospitals during their pregnancies with different jobs considered as case group. 122 women working in internal and pediatric wards considered as control group. The history of pregnancy complications including infertility, abortion, preterm labor, fetal death, neonatal death and low birth weight obtained using questionnaire. Data were analyzed using SPSS-15 software and Chi-Square test.

Results: The incidence of abortion was 19.8% and 16% in case and control group respectively, this difference was not statistically significant. Infertility was significantly higher (8.2% versus 2.5%) in case group than control group (P<0.05). No significant differences in incidence of preterm labor, fetal death, neonatal death and low birth weight were seen between two groups.

Conclusion: This study showed that the incidence of pregnancy complications is similar between women working in operating room and those working in other hospital wards but the prevalence of infertility is higher in operating room personnel than those of other wards.

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Background and Objective: Controversies results in quality of life associated with the type of delivery have been reported. This study was performed to determine the relationship between Women’s Quality of life and type of delivery.

Materials and Methods: This descriptive analytical study was conducted on 300 women that referring to health center in kashan city during 2007-08. The women were divided in two groups according to the type of delivery whether it was cesarean section or vaginal delivery. Special life quality questionnaire, 2 and 4 months after delivery was completed by women. Scores of aspects in 2 and 4 months after delivery were determined and compared between two groups. Data was analyzed by SPSS-16 software, Chi-Square, independent t- test, pair t test and Mann- U Whitey test.

Results: Findings showed no differences in aspects of quality of life between cesarean section and normal delivery groups except in “Mother's satisfaction toward delivery” that results showed  higher score 2 months (p=0.03) and 4 months (p=0.018) after normal delivery. Scores of this aspect in 2 months after normal delivery and cesarean section was (4.40±1.11, 3.76±1.16) and in 4 months after normal delivery and cesarean section was (4.13±1.40, 3.82±1.22) respectively.

Conclusion: This study showed there was not significant difference in women quality of life between cesarean section and normal delivery 2 and 4 monthes after delivery.

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Background and Objective: Menstrual disorders are including of metruragy, oligomenorrhea, polymenorrhea, dysmenorrheal and amenorrhea. Hormonal disorders can be the cause of such abnormalities. This study was designed to evaluate, the correlation between serum thyroid and sex hormones level,with menstrual disorders.

Materials and Methods: This descriptive - analytical study carried out on 110 women with menstrual disorders without anatomical disorders referred to private clinic during 2007-08. In third day of menstrual cycle, sample blood was taken for determination of LH, FSH, PRL, TSH, T3, T4 and Testosterone. Laboratory tests were performed by ELISA method.

Results: The 42.7% of women with menstrual disorders were in age group lower than 25 years. Oligomenorrhea with 42.7% was the major menstrual disorder and amenorrhea was the lowest with 4.5%. The most hormonal disorders was related to T3 (46.3%), LH (44.5%) and testosterone was the lowest with 5.4%. 11 cases (10.0%) have presented with hirsutism.

Conclusion: According to findings of this study T3 and LH are the common hormonal disorders in menstrual abnormalities.

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Background and Objective: Striae gravidarum is one of the cutaneous physiological changes during pregnancy with a high prevalence. This study was done to evaluate the effect of olive oil on prevention of striae gravidarum.

Materials and Methods: In a randomized controlled clinical trial, 100 nulliparous women referring to Tehran health ceatens were gone under investigation during 2009. Those whome had the inclusion criteria were divided to experimental group (using olive oil) and control group. The questionnaire was completed via interview and observation. Data were analyzed using descriptive statistics and Chi-Square test.

Results: Moderate striae gravidarum was seen 32% and 22% in intervention and conrtol groups, respectively. Severe striae gravidarum was 6% and 14% in intervention and control groups, respectively, but this diference was not significant.

Conclusion: This study showed that olive oil did not demonstrate to have any role in reducing of stria gravidarum.

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Background and Objective: The painful menstruation is one of the common disorders of ‎female sexual organ which is experienced by almost fifty percent of the women affected ‎by regular menstrual periods. The primary dysmenorrhea is referred to as the ‎menstrual pain in absence of undetectable pelvic disease which occurs usually during 2 years after first menstruation when ovulation is established. This study was done to investigate the effect of heat and vibration on primary dysmenorrhea. Materials and Methods: This clinical trial study carried out on 75 female students, aged 18-22 years old from Islamic Azad ‎University. Each subject evaluated for two menstrual cycles. At first cycle the participants received the routine pain-relief method. During the second cycle each of them applied combined heat-vibration device for ten minutes during ‎menstrual pain. Data collected using ‎questionnaire and pain visual analog scale and analyzed using SPSS-14, t student and Wilcoxon tests. Results: In contols, pain score was 5.34 and 4.09 prior and after routine intervertion, respectively (P<0.001). Also, in cases pain score significantly reduced from 5.34 to 3.44 after intervention by heat and vibration. In 8% of cases a slight redness was observed. Conclusion: This study showed that heat and vibration is more effective than routine intervention in pain during menstrual cycles.

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Background and Objective: Nausea and vomiting are the most frequent complications in the first trimester of pregnancy. Herbal medicine is among the traditional effective treatments. Ginger and Chamomile are hypothesized to be useful in decreasing the signs. This study was done to determine the effect of Ginger and Chamomile capsules on nausea and vomiting in pregnancy.

Materials and Methods: This triple-blind randomized placebo-controlled trial was carried out on 105 pregnant women in 6-16 weeks of gestational age with a mild to moderate nausea and vomiting, whome referred to the prenatal care clinic in Dezyani hospital and health centers, Gorgan, Northern Iran during 2009-10. Rhodes index questionnaire had been given to all participants to be completed before bed-time for two weeks. In the first week no intervention was done and prescribing the capsules was started the following week. Subjects randomly divided into 3 groups: In group 1, ginger capsules were consumped twice a day for one week, in group 2 twice daily chamomile capsule and in placebo group, glucose capsule was prescribed. Scores were calculated and all data were entered into the SPSS-16 software, analysis was done using variance analysis, Will-Cockson, paired T and Fisher-exact tests.

Results: The mean of Rhodes index before intervention in plasbo, Ginger and Chamomile groups were 12.71±5.88, 10.42±0.76 and 11.19±5.51, respectively. Also, the mean of Rhodes index after intervention in plasbo, Ginger and Chamomile groups were 11.47±6.43, 7.28±3.74 and 5.73±4.32, respectively (P<0.05). Bonferroni test indicated that there is no difference about scor chang (after and before) between Ginger and Chamomile and Ginger and plasbo, but this difference was significant between Chamomile and plasbo group (P<0.05).

Conclusion: This study showed that Chamomile capsule was more effective on nausea and vomiting during pregnancy compared to Ginger.

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Background and Objective: The incidence of ectopic pregnancy is increasing due to artificial reproductive technology and increasing rate of sexual transmitted diseases. Ectopic pregnancy is the most common cause of maternal mortality in the first trimester and it reduces the chance of future successful pregnancy. Identifying the risk factors can help to reduce the maternal mortality and morbidity due to early diagnosis and on time treatment. This study was carried out to assess the risk factors in ectopic pregnancy in northern, Iran. Materials and Methods: This case control study was carreid out on 150 patients with ectopic pregnancy as cases and 300 women with normal pregnancy as controls. The subjects were selected from teaching hospital in Babol in northern Iran, during 2005-09. The risk factors include history of tuble surgery, ectopic pregnancy, cesarean section, pregnancy with IUD, infertility, assisted fertility with IUI, multiple partener, pre-eighteen years marriages were recorded for each subject by direct interview and file. Data were analyzed using SPSS-16 and Chi-Square and exat Fisher tests. Results: Theraputic assisted fertility with IUI (95% CI: 3.02-185.09, OR: 23.6, P<0.05), previous ectopic pregnancy (95% CI: 1.90-73.94, OR: 8.19, P<0.05) and cesarean section history (95% CI: 1.1-2.6, OR: 1.7, P<0.05) increased the possibility of ectopic pregnancy. There was not significant differnces between pre- eighteen years marriages, infertility history and multiple partener in cases compared to controls. Conclusion: This study showed that assisted fertility with IUI, previous tubal surgery, pregnancy with IUD, previous ectopic pregnancy and cesarean section are the main risk factors of ectopic pregnancy in northern, Iran.

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Background and Objective: The utrine cervical cancer is the third common cancer among women word-wide. Oral contraceptives (OCs) have characterized as one of the possible risk factors for cervical cancer which are daily used by millions of women. The objective of this study was to determine the relationship between utrine cervical carcinoma and oral contraceptives. Materials and Methods: This case - control study was done on 128 patients with utrine cervical cancer as cases and 128 healthy women as controls in Tehran, Iran during 2008. The cases matched with controls according to age, history of abortion, number of deliveries, and social-economical status. Data were analyzed using SPSS-11, student’s t-test, Chi-Square, Pearson's correlation and Fisher’s exat tests. Results: Significant correlation was observed between utrine cervical cancer and the history of using and duration of oral contraceptives (P<0.05). Eighty-one (66.3%) and 46 (35.9%) of subjects in case and control groups used oral contraceptives, respectively. The possibility of utrine cervical cancer through oral contraceptives consumption was 3.072 (CI 95% 1.05-2.91) and this rate increased to 5.2 times after consuming the oral contraceptives for longer than 8 years. Conclusion: This study showed that the usage of oral contraceptives increase the possibility of utrine cervical cancer by 3 times.

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The latest reported incidence of subarachnoid hemorrhage due to aneurysms and arterio-venous malformations (AVMs) is around 15 per 100,000 pregnancies. It is also the third leading cause of maternal death from non obstetric causes accounting for 12% of total mortality. A pregnant woman with 42 years old G5P4Lch4 had vaginal delivery in 12 Aug 2009. One week after delivery she was visited by General Physician due to headache. She was admitted with signs of dizinous, vomiting projectile and painful stimuli, hospital consciousness level 5 and coma. CT scan was demonstrated a massive bleeding inside the brain. Massive hemorrhage into the ventricle was detected following neurosurgery. She was dead due to cardiac arrest after 10 days. Based on this case report, woman with headache following delivery should be recommended for cerebral aneurysm.

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Background and Objective: Menopausal symptoms influence mental, physical and emotional health, as well as social performance and family relationships. Due to the undesirable side effects of alternated hormone-therapy, tendency toward alternative treatments in relieving these symptoms have been increased, and the use of herbs like phytoestrogens seem preferable. This study was conducted to determine the effect of red clover Isoflavones extract on menopausal symptoms. Materials and Methods: This clinical randomized, triple-blind trial was conducted on 72 menopausal women who referred to Navab Safavi health care center, Isfahan, Iran during Oct-Apr 2011. After two weeks of monitoring and determination of the baseline symptoms score including hot flushes and sweating, paresthesia, insomnia, nervousness, depression, vertigo, weakness and fatigue, arthralgia and myalgia, headache, palpitation and formication, the women were randomly divided into two groups of 36 subjects: placebo and intervention (taking 45 mg of red clover Isoflavones extract capsules). The subjects were given one capsule daily for eight weeks and menopausal symptoms were recorded weekly. Data were analyzed using SPSS-18, independent t-test, ANOVA, chi-square and Mann–Whitney tests. Results: 55 women completed the study: 27 subjects in the placebo and 28 in the intervention group. The mean age of subjects in placebo and intervention group was 53.923.21 and 52.963.07 years, respectively. The mean age of menopause in the placebo and intervention groups was 51.382.63 and 50.051.17 years, respectively. The mean elapsed time since menopause was determined as 2.691.47 years in placebo and 2.661.65 years in intervention group. The average score of menopausal symptoms at the end of the 10th week was 13.877.22 and 16.4411.59 in intervention and placebo groups, this reduction was significant (P<0.05). Conclusion: This study showed that consumption of capsules containing red clover Isoflavones extract for 8 weeks, reduces menopausal symptoms in postmenopausal women.

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Background and Objective: Androgens are among the causative factors in preeclampsia. This study was done to compare the serum androgens and progesterone in preeclampsia and normal pregnancy. Materials and Methods: This case-control study was done on 30 preeclamptic and 30 healthy pregnant women in Gorgan, Iran. Higher or equal to 140/90 mmHg and proteinuria equal or more than +1 in dip stick test in the third trimester of pregnancy were considered as the diagnostic criteria of preeclampsia. Progesterone, free and total testosterone, and dehydroepiandrosterone sulphate (DHEA) were measured by ELISA method. Results: Total testosterone level was 1.8±0.3 ng/ml and 1.3±0.9 ng/ml in cases and controls, respectively. This difference was not significant. Progesterone was lower in cases (95±46.9 ng/ml) than in controls (165.4±75 ng/ml) (P<0.01). Free testosterone and DHEA were 5.6±2.3 ng/ml and 1±0.5 ng/ml in cases, respectively which was significantly higher than the controls (3.2±1.5 ng/ml and 0.7±0.4 ng/ml, respectively) (P<0.045). Conclusion: Serum level of free testosterone, DHEA and progesterone increased and reduced respectivley in preeclampsia.

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Background and Objective: Some studies have shown that pregnant women with abnormal glucose challenge test (GCT) and normal oral glucose challenge test (OGTT) have the chance of adverse pregnancy outcomes including macrosomia, pre-eclampsia and increase of cesarean section rate. This study was performed to determine the pregnancy outcomes in women with abnormal glucose challenge test. Materials and Methods: This case –control study was done on 60 pregnant women with abnormal GCT (more than 130 mg/dl) and normal OGTT and 67 pregnant women with normal GCT (less than 130 mg/dl) in Kermanshah ,Iran during September 2010-March 2011. Results: Delivery with Vacum, polyhydroamnus, pre-eclampsia pyelonephritis and low birth weight significantly was higher in cases than controls (P<0.05). But there was a non significant difference in stillbirth, neonatal abnormality, neonatal respiratory distress and shoulder dystocia between case and control groups. Conclusion: Polyhydramnious, pre‌eclampsia and pyelonephrities and low birth weight are more frequent in pregnant women with abnormal GCT and normal OGTT in compare to pregnant women with normal GCT.

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Background and Objective: Gestational diabetes is affected 3-12% of women and occurs at the final stage of second trimester. This study was done to determine the fructosamine and glycated hemoglobin level in pregnant women with abnormal glucose challenge test. Methods: This case – control study was carried out on 96 pregnant women with glucose challenge test (GCT)>140 mg/dl as cases and 96 pregnant women with GCT<140 mg/dl as controls. The serum fructosamine and glycated hemoglobin determined using ELISA and chemical methods, respectively. Results: In pregnant woman with abnormal GCT, there was a significant correlation with glycated hemoglobin and fructosamine. The glycated hemoglobin correlation was more significant compared to fructosamine (0.63 to 0.24). There was not significant correlation between GCT with fructosamine and glycated hemoglobin in individuals with normal GCT. Conclusion: The measurement of glycated hemoglobin is more accurate than fructosamine in pregnant women with abnormal glucose challenge test.

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Background and Objective: Overweight, obesity and ethnicity are effective factors on pregnancy complications. This study was conducted to determine the relationship between third tri-mester body mass index (BMI) with maternal and neonatal complications. Methods: This descriptive analytic study was conducted on 551 pregnant women in third tri-mester with Fars, Sistani and Turkman ethnicities in Sayad Shirazi teaching hospital in Gorgan, north of Iran during 2012. BMI calculated at the time of labor admission and the subjects categorized into three groups of normal / underweight, overweight and obese. Results: The mean of maternal age among Fars, Sistani and Turkman ethnic groups were 26.5±5.5, 24.6±5.3 and 26.2±5.2 years, respectively. The mean of gestational age among Fars, Sistani and Turkman ethnic groups were 38.4±2.3, 38.6±2.3 and 37.4±3.2 weeks, respectively. A significant relationship was found between BMI and cesarean section and labor dystocia in Fars and Sistani ethnic groups, respectively (P<0.05), while no relationship was found between BMI and neonatal complications. Conclusion: Overweight and obesity in Fars ethnicity are at risk of cesarean section and those with Sistani ethnicity are at risk of labor dystocia.

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Background and Objective: Due to high prevalence of pre-menstrual syndrome (PMS) and pre-menstrual dysphoric disorder (PMDD) and its effect on the educational, professional activities and familial behaviors, this study was conducted to determine the prevalence of clinical manifestations of pre-menstrual syndrome and pre-menstrual dysphoric disorder in medical students. Methods: This descriptive-analytic study was done on 162 female medical students of Golestan University of Medical Sciences in Gorgan, Iran during 2010. Demographic characteristics and PMS and PMDD clinical manifestations questionnaire based on DSM-IV-TR and ACOG criteria was filled for each subject. Results: Mean age and menarche age of subjects was 22.2±2.5 and 13.3±1.2 years, respectively. 145 students (89.5%) were single. 57.4% and 22.8% of participants fulfilled the criteria of PMS and PMDD, respectively. The most frequent affective and somatic symptom was lethargy and fatigability (57.4%) followed by sensation of bloating and weight gain (45.7%). The lowest frequent somatic and affective symptoms were dyspnea (8%) and insomnia (1.2%), respectively. There was significant correlation between the prevalence of PMDD and chronical and menarche age (P<0.05). Conclusion: Pre-menstrual syndrome is a prevalent disorder in medical students of Golestan University of medical sciences in Iran.

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Background and Objective: Thrombophilia is characterized by increasing blood coagulability. It causes preeclampsia and repeated abortions. This study was done to determine the corrolation of coagulation factors deficiency with preeclampsia. Method: This case-control study was carried out on 142 pregnant women with preeclampsia as caess and 142 pregnant women without preeclampsia as controls. Coagulation factors including Prs, prc, and anti-thrombin-3 were measured using ELISA and chromogenic methods. Results: Prs deficiency was found in 2 (1.4%) and 6 (4.2%) of cases and controls, respectively. This difference was not significant. Prc and anti-thrombin- 3 deficiencies was not found in cases and controls. Conclusion: There is not any relation between deficiencies of coagulation factors with preeclampsia.