elahe afshari

Endometriosis is a gynecologic disorder which causes dysmenorrhea and infertility. Early diagnosis of endometriosis can help prevent the necessity for invasive diagnostic procedures. Medical imaging has been widely utilized to diagnose various diseases without the need for invasive procedures. The purpose of this study was to investigate the cervical length in women with endometriosis.

In this case-control study, the case group consisted of nulliparous women with endometriosis, while the control group comprised nulliparous women without endometriosis. A total of 42 individuals were included in each group. Cervical length was measured using transvaginal ultrasound from the external os to the internal os. The patients in the case group underwent laparoscopy to confirm the diagnosis. Pearson chi-square test and Fisher’s exact test were employed to compare categorical variables with a p<0.05 considered statistically significant.

In both groups, there were no notable variations in any of the demographic characteristics. However, the severity of dysmenorrhea was significantly different between the two groups (p=0.01). The average diameter of the mediolateral cervix (29.48±6.2 and 27.14±3.8) was statistically significant between the patient group and control group, respectively (p=0.04). The mediolateral width may have a positive predictive effect on the presence of endometriosis, while cervical length appears to have a protective effect against endometriosis.

Demographic data do not predict endometriosis. This study suggests that mediolateral width in transvaginal sonography can serve as a minimally invasive diagnostic tool for endometriosis, showing correlation with endometriosis symptoms like dysmenorrhea and dyspareunia.

Emotional divorce happens when a man and a woman live coldly together but do not request a legal divorce. So the aim of this study is to investigate the impact of acceptance and commitment group therapy (ACT) on emotional divorce and self-efficacy of couples.

This was a controlled experiment. In 2020, Bu Ali town, Hamedan province, had 338 married factory workers. Authors chose 60 emotional divorce sufferers using a questionnaire. 40 persons with average self-efficacy questionnaire ratings were randomly assigned into experimental and control groups. The experimental group received 8 weeks of acceptance and commitment-based treatment, while the control group received no intervention. Gottman's 1994 Emotional Divorce Questionnaire and Scherer et al1982.’s self-efficacy questionnaire were utilized as pre- and post-test. SPSS version 23 analyzed data. Shapiro-Wilk test assessed variable distribution normality. The scores in the experimental and control groups are normal because emotional divorce and self-efficacy are significant (P < 0.05). Leven's test tested the population's two groups' variance equality.

In the post-test phase, the findings of the analysis of covariance showed that acceptance and commitment group therapy resulted in lower scores of emotional divorce (p less than 0.05) and higher levels of self-efficacy (p less than 0.05) in the experimental group in comparison to the control group. Both the emotional divorce variable (P = 0.414, F = 0.682) and the self-efficacy variable (P = 0.601, F = 0.278) were found to have identical variances according to the results of the Leven test (P = 0.601, F = 0.278).

Acceptance and commitment group therapy was able to significantly reduce emotional divorce and increase self-efficacy compared to the control group. Therefore, it is possible to prevent acceptance and commitment therapy to reduce emotional divorce and prevent psychological and social damage.

Adnexal mass is one of the most common gynecologic diseases among women of all ages.

In this cross-sectional study, we enrolled 126 patients with large adnexal masses (≥ 10 cm) managed by laparoscopic surgery during 2013 - 2020. The rates of intraoperative complications, conversion to open surgery, and incidence of cancer were assessed.

Mean mass size was 15.08 ± 5.03 in all participants without significant difference based on the tumor type (P = 0.624). Mean age and operation time were higher in the malignant type compared to the benign type (P < 0.001). Type of surgery and frequency of intraoperative complications were also different among patients with different tumor types (P < 0.001 and P = 0.816, respectively).

Our study showed that large adnexal tumors can be operated by laparoscopic approach, while the most important factor for increased surgical complications and duration was malignancy.

Preeclampsia is a specific gestational syndrome that reduces organ perfusion due to vascular spasm and endothelial activation. Despite the use of magnesium sulfate, the patient's blood pressure sometimes remains uncontrolled, and therefore, it is necessary to use other medications, especially diuretics and Methyldopa. Hence, the aim of this study was to compare Lasix and Methyldopa in controlling postpartum hypertension in preeclampsia patients after magnesium sulfate treatment.

This double-blind randomized clinical trial was carried out on 100 women with preeclampsia referred to Akbar Abadi Hospital-Iran. In the first 24 hours after the termination of pregnancy, the participants’ blood pressure was measured and those with a blood pressure of 140/90 to 160/100 were divided into two groups. In the first and second 24 hours, and then one week after the intervention, systolic and diastolic blood pressure as well as diuresis and drug complications in the two groups were assessed and compared.  The present study was registered in the Iranian Registry of Clinical Trials (IRCT) under the ID of IRCT20180114038349N1.

The mean age of individuals was 29.93 ± 6.65 in the Methyldopa group, and 32.35 ± 4.85 in the Lasix group (P = 0.479). Systolic and diastolic blood pressure had a substantial reduction in both groups, but there was no significant difference between the two groups (P> 0.05). Systolic blood pressure was reduced by 31 mmHg (reduction from 146 to 115) in the methyldopa group and 30 mmHg (reduction from 145 to 114) in the Lasix group. Furthermore, the reduction in diastolic blood pressure was 25 mmHg (from 95 to 70) in the methyldopa group, and 21 mmHg in the Lasix one (from 91 to 70).

The present study showed that using Lasix and methyldopa was effective enough in changing blood pressure in patients with preeclampsia, and the effects observed in the two groups were the same. Therefore, it could have a great impact on the wellbeing of couples.

Uterine septum is one of the most common congenital abnormalities in women that leads to numerous gynecological problems and adverse obstetrics outcomes. This study aimed to evaluate the effects of Hysteroscopic Resection on pregnancy outcomes in women undergone the surgery.

In this quasi-experimental study, 90 women were included from April 2016 to June 2018 from patients attending to Rasoul Akram hospital of Tehran. The inclusion criteria included: the age lower than 35 years old, primary infertility, idiopathic recurrent spontaneous abortion, BMI between 19 and 30, and having informed consen. Septum was resected by scissor upward and lateral. After 10 months of follow-up in average, we assessed rate of live births, abortions, birth weight and presentation.

82 individuals were assessed for occurrence of conception (response rate=91%). The mean age of patients was 30.01 ± 6.76 years and the mean BMI was 26.25 ± 4.88. Out of 82 patients, 36 patients were pregnant, of whom 16 (44.4%) had abortions. 5 (14.9%) of the pregnancies ended with preterm birth, and 6 (17%) ended with stillbirth.

The present study showed that the infertile patients with uterine septum and with no other causes of infertility were more likely to be pregnant compared to other patients with idiopathic infertility. Our study showed that post-operation fertility following Hysteroscopic Resection was lower than that in previous reports. According to the findings of this study, scissors may be safe, effective and cost-effective method for removing uterine septa.