مجله زنان مامائی و نازائی ایران
سال هجدهم شماره 148 (هفته دوم خرداد 1394)

Stress Urinary Incontinence (SUI) is a very common problem in adult women and its etiology is multifactorial. Due to different viewpoints in the prevalence and causes of SUI in previous studies، this study was performed with aim to compare the prevalence of SUI four months after vaginal delivery and elective cesarean section and the effective factors. This analytical study was conducted on 1520 primiparous women in Kermanshah medical-health centers in 2010. The first group had normal vaginal delivery four months ago and the second group underwent elective cesarean section. Sandvik questionnaire and medical records were used to evaluate the severity and factors effective on SUI. Data analysis was performed using SPSS statistical software (version 16) and Kolmogorov-Smirnov test، Levene test، independent t-test، Mann-Whitney and chi square-test. The prevalence of stress urinary incontinence four months after vaginal delivery was 3%. After vaginal delivery and elective cesarean section، the prevalence was 4. 3%، and 1. 87%، respectively، significant difference was observed between the two groups (P = 0. 006). There was a significant relationship between SUI with maternal age (P=0. 001)، maternal BMI (P=0. 043) and neonatal weight (P=0. 042)، but there was no significant relationship with head circumference (P=0. 943) and episiotomy (P=1. 0). The two groups of vaginal delivery and elective cesarean section were not significantly different in terms of severe SUI (P=1. 0). Mode of delivery، neonate''s weight، maternal age and BMI increase the prevalence of stress urinary incontinence four months after delivery، but normal vaginal delivery does not cause severe SUI.

Bacterial vaginosis، vulvovaginal candidiasis، and trichomoniasis are the most common vaginal infections among women of childbearing age. This study was performed with aim to investigate the relationship between various individual characteristics and above mentioned infections using newly developed polymerase chain reaction assay and gram staining. This cross-sectional study was conducted on 250 women referred to Payambar Azam gynecology clinic، Kerman، Iran from 2012 to 2013. The data related to individual characteristics were obtained by applying a researcher–made questionnaire. The patients underwent gynecological examination. Then، samples from posterior fornix discharges were collected using two vaginal swabs that were placed in two microtubes containing 1ml of sterile saline. Polymerase chain reaction assay and gram staining examination were done to diagnose vaginal infections. Data were analyzed by minitab statistical software (version 16)، using chi-square test. P< 0. 05 was considered statistically significant. A significant relationship was found between common vaginal infections and educational level of women (P= 0. 0001)، and their husbands (P= 0. 0001)، and also family income (P= 0. 001)، while no significant relationship was shown between vaginal infections and age، the subject and her husband''s job، family size، duration of marriage، parity and frequency of monthly intercourse، breast feeding status، smoking by the husband and a history of exposure to these infections (P>0. 05). There is a positive correlation between suffering from common vaginal infections (Bacterial vaginosis، candidiasis، and trichomoniasis) and educational level of couples and also family income.

Fertility and having healthy child is one of the valuable indexes in people''s health. Incidence of infertility in the world has a treatment economic load and also causes significant psychiatric complications for the infertile couples and threats the health of family. Given the importance of the issue، attention to complementary medicine and use of Iranian traditional medicine can be useful and helpful. This study was performed with aim to evaluate the causes of infertility from Iranian traditional Medicine (ITM) point of view according to the valuable Exir book of Hakim Mohammad Azam Khan. This study was performed as library based on reference availabe and reliable books of traditional medicine such as law in medicine، store of Kharazmshahi، Aghili''s Kholasah al-Hekmah and Moalejat with a focus on Azam Exir، and finally، what Hakim Azam Khan explained about the causes of infertility was stated. Iranian medicine Hokama have suggested various reasons as the causes of infertility in men and women، separately، and stated different treatment methods such as single plants، combined drugs and method performed manually including bloodletting، cupping، and massage، and at the end of the treatment method in food section explained the type of food that is useful for disease. They divided causes of infertility into two groups of male and female factors and emphasized on the existence of semen in men and women and the role of each one in fertility. Sufficient production of semen in males and ovum in females depends on the health of body''s main and vital members (including the heart، brain and liver). They reported fertility was possible through the health of genital system and production of reproductive semen in both and simultaneous orgasm of man and woman when having sex. According to the careful viewpoint of Hakim Azam Khan in explaining the causes of infertility and accurately classifying them، as well as description of how to diagnose and treatment courses of each of the infertility causes، it seems that today by relying on their views on empirical research، we can achieve more effective treatments for infertility.