Journal of Family and Reproductive Health
Volume:2 Issue: 3, Sep 2008

Being either underweight or overweight can affect a woman's fertility. Irregular menstrual cycles, reduced spontaneous and assisted fertility and an increased risk of miscarriage are risks associated with obesity that are often overlooked. Excessive weight and central distribution of body fat are both related to an increased risk of normogonadotrophic anovulation. Weight loss can re-establish ovulation in obese anovulatory patients or improve their response to ovulation induction. However, even a small amount of weight loss (5%) may improve fertility. Men who are overweight or obese have significantly lower sperm counts than men of normal weight.

Sexually transmitted infections (STIs) remain a public health problem of major significance in most parts of the world. This study aimed to detect the most prevalent pathogens in patients with signs and symptoms of STI referring to a group of university clinics in Tehran. In this cross-sectional study using randomized cluster sampling, 507 consecutive male and female patients presenting with signs and symptoms of STI referring to selected health care centers of Shahid Beheshti University were evaluated between May 2005 and May 2007. Diagnosis was made according to WHO criteria for signs and symptoms of STI in addition to microscopic study of genital discharges. The most prevalent STI pathogens were Candida, Trichomona, Neisseria gonorrhoeae and Chlamydia with respective frequencies of 53.96%, 18.87%, 4.91% and 22.26% in women and 47.10%, 8.67%, 9.50% and 34.71% in men. Candida was detected in majority of cases. Chlamydia was the most prevalent STI in both sexes. Simple preventive care has crucial role in decreasing the frequency of STIs in society.

The aim of this study was to determine men’s knowledge, attitudes and practice towards family planning in a province of north-eastern Turkey. This descriptive research was carried on 801 volunteers amongst men of reproductive age living in a city with a total population of 80,000 men. Data were gathered using a self-administered questionnaire that addressed men’s roles, attitudes and behaviors towards family planning. The most commonly used contraceptives were condom (36.8%) and withdrawal (27.3%) methods in single men. Married men reported relying more on female methods and they were more satisfied with the method they used. The idea of shared responsibility in family planning was more appreciated by single men. The role of family as a source of knowledge about family planning was low in both groups. Married men were more against vasectomy and condom while single men had more negative attitudes towards using hormone pills for men if produced in the future. Comprehensive projects are needed to improve male participation in family planning, especially in male dominant cultures. This must be seen as a golden key in the reproductive health programs.

Preterm premature rupture of membranes (PPROM) occurs in 2% of all pregnancies. The aim of this study was to compare positive cultures of GBS in two groups of pregnant women. This case control research was conducted on 242 pregnant women: first group was consisted of 117 pregnant with PPROM and gestational ages between 26-37 weeks; second group was consisted of 125 term pregnant women with intact membranes and before onset of labor. Rectovaginal and urine samples were studied using specific culture medium of GBS, "Todd Hewitt Broth". The percentage of positive results was calculated using odds ratio and chi-square test. GBS cultures were positive in 20 cases (17%) in PPROM group and 5 cases in group of term pregnant (4%) (Odds ratio=4.95 CI= 1.79-13.67, p=0.001). Past history of preterm labor and neonate hospitalization were more common in PPROM group but without any significant relationship to positive cultures. Our study showed significant difference of GBS colonization rate between two groups (p=0.001). According to CDC and ACOG guidelines routine screening and treatment of positive cases are indicated.

The aim of this study was to determine knowledge and attitude about emergency contraception among women using condom, coitus interruptus and rhythm methods. Between April and September 2006, 400 women referring to the health centers in Shahrekord, were evaluated. They entered the study if they were using condom, coitus interruptus or rhythm methods. A questionnaire including demographic information, contraceptive method in use, and patient's awareness and attitude/practice about emergency contraception was completed for each participant. Of the 400 responders, 60.5% were using condom, 38.7% were using coitus interruptus and 0.8% were practicing rhythm method. The awareness was inadequate in 22.5% of women, moderate in 55% and adequate in 22% of them. The attitude of users was positive in more than 70% of them and only 20.5% of women had practiced emergency contraception. The relation of age and job with awareness was significant (P<0.001). A significant relation was considered between the level of education and knowledge of women (P<0.01). The women who had adequate knowledge had practiced the emergency contraception better than those with inadequate knowledge (P<0.001). However, only 27.1% of responders who reported knowing about emergency contraception knew the correct time frame in which emergency contraceptives must be used. There is a critical need to train the women about emergency contraception, emphasizing available methods and correct timing.

This study aimed to describe attributors of family stressors which cause rehospitalizations in patients with psychotic disorders. In a cross sectional study (during 2006-7) 203 randomly selected psychiatric readmitted patients with psychotic diagnosis and registered demographic and psychiatric clinical data were included. Family stressors as the possible cause of readmission were asked through a structured interview by the psychiatrist. Family factors were reported as a cause in 132 (60.6%) cases. Poor family support (n=88; 43.3%) and family conflict (n=58; 28.6%) were the two most prevalent family stressors, respectively. Bivariate analysis showed that admission due to family issues was different among men and women (79.1% vs. 38.7%, respectively p<0.001) and according to job situation (p<0.001), and literacy (p=0.036). According to logistic regression, gender (men) was the only predictor of admission due to family issues (OR=5.989, CI=3.220-11.141, p<0.001). Family factors are prevalent causes of return to hospital in patients with psychotic disorders, and this is more prevalent in men. An approach to decrease the marital stressors is needed in patients with psychotic disorders. In this approach, increasing family support and decreasing family conflict are essential.

The present study aimed to determine whether castration altered osmotically stimulated vasopressin (VP) release and urinary volume and what is the role of endocrine-stress axis in this process. Totally 108 mice were studied in two main groups of castrated (n=78) and control (n=30). Each group was extracted by acute cold stress (4◦C for 2h/day), restraint stress (by syringes 60cc 2h/day) and cold/restraint stress. The castrated group was treated in sub groups of testosterone, control (sesame oil as vehicle of testosterone). Propranolol as blocker of sympathetic nervous system was given to both groups of castrated mice and main control. Our results showed that, there is interactions between testosterone and sympathetic nervous system on vasopressin, because urine volume was decreased only in testoctomized mice with cold/restraint and cold stress (P<0.001); propranolol as the antagonist of sympathetic nervous system could block and increase urine volume in castrated mice. This increased volume of urine was due to acute cold stress, not restraint stress (p<0.001). The role of testosterone, noradrenalin (NA) and Vasopressin (VP) in the acute cold stress is confirmed, because testosterone could return the effect of decreased urine volume in control group (P<0.001). Considering the effect of cold/restraint stress on urinary volume in castrated mice shows that there is interaction between sex hormone (testosterone), vasopressin and adrenergic systems.

The goal of this study was to assess the utility of serum uric acid in preeclampsia diagnosis and its correlation with some maternal and fetal outcomes. A case-control study was performed on 26 term pregnant women with preeclampsia and 52 normal pregnant women. Serum uric acid, platelet count, hematocrit, gestational age, and birth weight of all patients were measured. Data distribution was assessed with the one sample Kolmogorov-Smirnov test. Mann-Whitney U test was used to assess differences between groups. Correlations between plasma uric acid and other parameters were evaluated with the Spearman’s Rho or Pearson correlation test, where appropriated. Receiver-operating characteristics (ROC) curves were used to assess the ability of plasma uric acid to distinguish the preeclampsia from normal subjects. Significance was set at P< 0.05. The mean level of plasma uric acid was 5.8 (+2) mg/dl in cases and 4.9 mg/dl in controls (P=0.04). ROC curve analysis demonstrates the absence of obvious cut off point for plasma uric acid to distinguish preeclampsia. Sensitivity and specificity for uric acid level of 5.5 mg/dl were 61.5% and 78.8%, respectively. There was no significant linear correlation between the plasma uric acid level and other measured parameters in each group. On the basis of our data, the clinical utility of measuring serum uric acid levels in diagnosing preeclampsia is limited.

Tuberculosis (TB) is the most common infectious cause of human death. After the lung, genitourinary tract is the most common site for TB infection. Pelvic tuberculosis should be considered in young women presented with pelvic mass, ascites, fever, an elevated CA125 level, negative cytology, and positive history of contact with affected person. A 24- year- old girl presented as stage IV ovarian cancer due to pelvic mass, ascites, bilateral multiple lung nodules is described. Further evaluation revealed inflammatory lesion of the left sacroiliac joint. Serum CA 125 was normal. PCR on tissue specimen from sacroiliac joint showed Mycobacterium Tuberculosis. Within two months after anti TB therapy pelvic mass, ascites and lung nodules resolved completely without any surgical intervention.This is the first case of active pelvic tuberculosis with normal CA125 that has been reported up to now.