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Objective(s): Sexual satisfaction and sexual assertiveness are both considered to be the most important factors in maintaining a successful, healthy and happy married life. The aim of this study was to investigate the relationship between sexual assertiveness and sexual satisfaction of married women of reproductive age in Qom province in 2021. Methods: 100 married women who referred to health centers in Qom, Iran participated in this cross-sectional study. Health centers were selected by clustering and a convenience sample was entered into the study from April to October 2023. The questionnaire of Hulbert's sexual assertiveness index and Larson Sexual Satisfaction were used. Data analysis was done by SPSS-22 software. Pearson's correlation coefficient and one-way analysis of variance were used to analyze the data. Results: The results showed that the mean of sexual satisfaction score (SD) was 99.40 (15.41), the mean of sexual assertiveness was 56.19 (20.04), and there was a high correlation between sexual assertiveness and sexual satisfaction r=0.74 (P

Objective(s): Sexual satisfaction and sexual assertiveness are both considered to be the most important factors in maintaining a successful, healthy and happy married life. The aim of this study was to investigate the relationship between sexual assertiveness and sexual satisfaction of married women of reproductive age in Qom province in 2021. Methods: 100 married women who referred to health centers in Qom, Iran participated in this cross-sectional study. Health centers were selected by clustering and a convenience sample was entered into the study from April to October 2023. The questionnaire of Hulbert's sexual assertiveness index and Larson Sexual Satisfaction were used. Data analysis was done by SPSS-22 software. Pearson's correlation coefficient and one-way analysis of variance were used to analyze the data. Results: The results showed that the mean of sexual satisfaction score (SD) was 99.40 (15.41), the mean of sexual assertiveness was 56.19 (20.04), and there was a high correlation between sexual assertiveness and sexual satisfaction r=0.74 (P <0.001). There was a significant difference between the averages of sexual assertiveness and age of women and spouses (P <0.001). A significant difference was found between the average sexual self-expression of women with the number of children (P=0.03) and between the average sexual assertiveness and the education groups of spouses (P=0.04). Conclusion: Considering the positive correlation between sexual assertiveness and sexual satisfaction, it is suggested that in order to increase women's sexual satisfaction, service providers should increase their sexual assertiveness through various counseling and educational methods. [ABSTRACT FROM AUTHOR]

Introduction: Interstitial pregnancy is a dangerous and challenging ectopic pregnancy. Despite different diagnostic methods, the early detection of interstitial pregnancy is very difficult and misleading. Interstitial ectopic pregnancy tends to severe bleeding, so that incorrect diagnosis leads to life threatening of patient. The aim of this study was to introduce a case of interstitial ectopic pregnancy (Corneal) with placenta Increta in the second half of pregnancy. Case Report: A 23-year-old woman G2 with history of previous cesarean section, at 23 weeks of pregnancy with complaints of abdominal pain, nausea and vomiting after sexual intercourse referred to Izadi educational Hospital. Regarding drop in vital signs, oliguria, generalized tenderness and ultrasound reports of abdominal blood, the patient was transferred to the operating room. On the left, interstitial ectopic pregnancy was torn with placenta Increta. The embryo was removed, but the placenta was placed in the cornea to the cervix and to the broad ligament. Hysterectomy was performed due to the placenta Increta. Ultimately, the diagnosis and immediate treatment saved the patient's life. The pathological study showed placenta Increta. Conclusion: Intrauterine ectopic pregnancy is one of the rare diseases. Since interstitial pregnancy is located in a place full of vessels, any rupture can lead to catastrophic and life threatening bleeding. Interstitial pregnancy requires accurate diagnosis and immediate treatment. Proper and timely intervention therapy can prevent serious complications and reduce maternal mortality and mortality.

Background and purpose: Influenza is an acute respiratory disease with annual epidemics which can cause life-threatening complications in people with underlying illnesses such as diabetes, hypertension, kidney and respiratory diseases, and obesity. The aim of this study was to evaluate the risk factors and the underlying factors causing Influenza complications. Materials and methods: This descriptive cross-sectional study was performed using the medical records of 459 patients with influenza in Ghaemshahr Razi Hospital between May 2015 and March 2016. Results: The patients were 49.5% females (n=227) and 50.5% males (n= 232) whose median age was 43.6±18.5 years (5-89 years of age). The duration of hospitalization varied from 1 to 43 days (SD= 3.27). The most common findings in chest CT scans were grand glass. Among the patients, 23 (5%) needed special care. The most common underlying illnesses were diabetes and hypertension and the most common complaints were fever and cough, followed by fever and chills. Conclusion: This study showed that influenza is not limited to a specific sex and age, and some underlying factors such as obesity, chronic pulmonary diseases, heart disease, and taking corticosteroids, and the time interval between the onset of symptoms and hospital arrival are amongst the major risk factors for its complications. More attention on these factors could be of great benefit in reducing the complications of Influenza.

Background: Colorectal carcinoma is a common malignancy, in treatment of which pelvic radiotherapy plays an important role. But this may lead to azospermia. We designed a study to determine the delivered dose to the testis with thermoluminescence dosimetry (TLD) and compare it to the dose calculated by the Three-dimensional planning software. Methods: We measured the testicular doses by TLD; the TLDs were fixed to the scrotum in six points anteriorly and posteriorly in two random fractions of the radiation course. All patients received a 50-50.4 Gy radiation dose to the pelvis in a prone position with standard fractionation and 3-dimensional planning, through three or four fields. The average dose of the TLD measurements was compared to the average of 6 relevant point doses calculated by the planning software. Results: In 33 patients with a mean age of 56 years, the mean testis dose of radiation measured by TLD was 3.77 Gy, equal to 7.5% of the total prescribed dose. The mean of point doses calculated by the 3-dimensional planning software was 4.11 Gy, equal to 8.1% of the total prescribed dose. A significant relationship was seen between the position of the inferior edge of the fields and the mean testis dose (P= 0.04). Also body mass index (BMI) was inversely related with the testicular dose (P= 0.049). Conclusion: In this study, the mean testis dose of radiation was 3.77 Gy, similar to the dose calculated by the planning software (4.11 Gy). This dose could be significantly harmful for spermatogenesis, though low doses of scattered radiation to the testis in fractionated radiotherapy might be followed with better recovery. Based on above findings, careful attention to testicular dose in radiotherapy of rectal cancer for the males desiring continued fertility seems to be required.

Background: The high number of breast cancer patients who receive radiation therapy after surgery has caused many to think about a shorter period of radiotherapy, which can significantly reduce the radiotherapy machine time, labor hours, and fewer patient visits. This study was designed to evaluate the acute skin effects and cosmetic outcomes of short course radiotherapy in early-stage breast cancer in comparison with the conventional treatment method.Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy by either receiving conventional treatment (dose: 50 Gy in 25 fractions) with subsequent electron boost or a short-course hypofractionated radiotherapy (dose: 42.5 Gy in 16 fractions) and a subsequent electron boost.Results: There were no skin changes during the first or the second week of treatment in the two groups. Cutaneous complications began after the third week as grade 1 skin toxicity after termination of the short-course radiotherapy but there were no difference in complication rate after four weeks of treatment. Six months and one year after treatment, there were no differences in terms of skin complications or cosmetic outcomes between the two groups.Conclusion: Although the use of a whole-breast irradiation with a hypofractionated schedule was associated with desirable outcomes, in term of skin toxicity and cosmetics, but longer follow-up periods with larger sample sizes are needed to confirm these results.

Background: More than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard of treatment for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultaneously with radiation.Methods: Thirty Women with untreated invasive squamous-cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in Radiation Oncology department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty mg/m2 gemcitabine followed by 35 mg/m2 cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment.Results: The mean age of the participants was 58.13±11.83 (29-78) years. After 3 months of treatment, 73.3% had complete and 26.7% had partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients.Conclusion: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation by gemcitabine in advanced cervical cancers.

Introduction: Tremendous efforts towards the elimination of Iodine Deficiency Disorders (IDD) during the last two decades have controlled these disorders in most of the provinces in Iran. This study was performed to evaluate the adequacy of iodine supplementation after 17 years of universal salt iodization in Yazd province. Methods: In a cross-sectional study, 1200 schoolchildren (600 girls and 600 boys) aged 8 to10 year-olds, randomly selected from Yazd province were evaluated in 2007. Goiter prevalence, urinary iodine excretion and iodine content of household salts were measured and the obtained data were compared to those obtained in 1996 and 2001. Results: Total prevalence of goiter was 6.3% and no grade II goiter was seen. The median urinary iodine in 120 schoolchildren was 248 µg/L, with 5.8% (95% CI= 1.6-10) having urinary iodine excretion less than 50µg/L. Eighty six percent of households were using purified iodized salt, 48% of households had appropriate salt storage, and 5% of the household salts contained less than 15 µg iodide. Conclusion: Goiter prevalence has significantly decreased in the Yazd province, 17 years after universal salt iodization. The median urinary iodine of schoolchildren was adequate as that reported in 1996 and 2001, indicating a well established sustainable IDD program in Iran.

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Breast conservative therapy is associated with similar outcomes in comparison with mastectomy. The aim of this study is assessment of local recurrence rate and related risk factors in patients who have been treated with radiotherapy after conservative surgery for breast cancer."n"nMethods: This is a cohort study which data of all breast cancer patients who have visited in follow up clinic in radiation oncology department of cancer institute of Imam Khomeini Hospital complex in Tehran, Iran, during years 2007-2009 were collected. All of the patients were investigated for local recurrence and the possible risk factors."n"nResults: Two hundred and seventy seven patients have entered the study and all have followed for at least one year since data entry. Median follow-up time from the start of radiotherapy were 35 months (12-148 mo). We had seven cases (2.5%) with local recurrences (2.5%) which most of them occurred in first year after treatment. Because of low rate of recurrence none of the variables such as margin and nodal status has significant correlation with local recurrence which this should be due to small number of patient and short time of follow up."n"nConclusions: At median follow up of 35 months from the beginning of radiation therapy, local recurrence rate was 2.5% which is similar to the literature. We recommend to follow a larger group of patients for longer times to estimate recurrence risk after breast conservative therapy.

"nBackground: Treatment of cervical carcinoma is routinely performed with Low Dose Rate (LDR) brachytherapy, but Brachytherapy in our department is done with Medium Dose Rate (MDR) due to the technical characteristics of the machine available here. Thus we decided to evaluate the results of this treatment in our department in a prospective study. "nMethods: Between March 2006 and July 2008, 140 patients with histologic diagnosis of cervical carcinoma referred to Tehran Cancer Institute; were treated with external beam radiotherapy (44-64 Gy to whole pelvis) and MDR brachytherapy (8-30 Gy to Point A) with a dose rate of 2.2±0.3 Gy/h. "nResults: 121 patients were followed up for a median time of 18 months (range: 9-39 m). There were 11%(6/54) local recurrence for surgery and adjuvant radiotherapy group; 25%(16/65) for radical radiotherapy group, and 19%(23/121) for all patients. Rectal and bladder complications incidence for all patients were 10%(12/121) and 13%(16/121) respectively. High grade complication was shown only in one patient in radical radiotherapy group. In this study 3-years disease free survival and overall survival were 73% and 92% respectively, and disease stage (p=0.007) and overall treatment time (p=0.05) were the significant factors affecting disease free survival. "nConclusions: Results of this series suggest that the use of external beam radiotherapy and MDR brachytherapy with about 20% dose reduction in comparison with LDR can be an acceptable technique with regard to local control and complications.

Background: Carcinoma of the uterine cervix is the sixth most common malignant neoplasm in women. Early stage diagnosis of uterine cervix carcinoma increases the cure rate of disease. Radiotherapy, with or without concurrent chemotherapy, is one of the most effective treatment modality in cervical carcinoma. After radiotherapy, accurate and regular follow-up results in early diagnosis and effective treatment of recurrence. The aim of this study is the assessment of the pathologic characteristics, setting and indications for postoperative radiotherapy and outcome of patients at the last follow-up.Methods: In this retrospective study, we evaluated 346 cases of cervical carcinoma had received radiotherapy in radiation oncology department of the Cancer Institute of Imam Khomeini Hospital, Tehran, Iran, from 1995 to 2001.Results: The age of the study group ranged from 26 to 78 years (mean=50.5, SD=11). Of these patients, 30.4% were in the early stage and 69.6% had advanced stage disease. Squamous cell carcinoma comprised 92.2% of the cases and 6.4% adenocarcinoma. Radical radiotherapy was the most frequent radiotherapy setting and adjuvant radiotherapy (post-op) was the second. A considerable number of patients did not come back for follow-up, and 43.7% were followed for a short time.Conclusion: Accurate presurgical clinical staging and surgical treatment by an expert gynecologic oncologist can reduce expose the patients to risks of two modality treatments (surgery and radiotherapy). According to our results, patients do not pay enough attention to disease follow-up. An acceptable training plan with emphasis on regular follow-up, is recommended.

Background: The standard treatment for high-grade astrocytoma (grades 3 and 4) is surgery followed by radiotherapy (post-op RT). Adjuvant chemotherapy increases disease-free survival (DFS) and overall survival (OS). There are several drugs used for this purpose, each of which have shown benefits and shortcomings. The superiority of combination therapies such as PVC (procarbazine, CCNU and vincristine) over single agents such as BCNU (carmustine) and CCNU (lumostin) has not been definitively established. Single agent CCNU could be a very convenient treatment, as it only involves oral prescription every six weeks. Thus, in this study, we compare CCNU alone with PCV to establish any potential superiority with regard to DFS and OS."nMethods: From 2003-2006, patients with high-grade astrocytoma who had undergone surgery and radiotherapy in the Cancer Institute of Imam Khomeini Hospital, Tehran, Iran, were randomized to CCNU alone or PCV. Chemotherapy was repeated every six weeks for six cycles. Six weeks after the end of sixth cycle, a CT scan was performed. New neurologic signs and symptoms or increases in the previous signs and symptoms and/or new masses in imaging and/or growth of the residual tumor (> 25%) and/or enhancement of any inactive mass from the previous imaging was considered a recurrence. DFS was considered to be the duration from the end of RT to the date of recurrence or last follow-up. OS was taken as the duration from the end of RT to date of death or last follow-up."nResults: After informed consent, of the 70 patients included in this study, 38 were treated with PCV and 32 were treated with CCNU. The mean age was 44 years, ranging from 16 to 78 years, and 51 of the patients were male. Nineteen patients had grade 3 anaplastic astrocytoma and 51 patients had grade 4 glioblastoma multiforme. There were no significant differences with regard to patient age, gender and pathology between the CCNU and PCV groups. DFS and OS were 26 and 27 months, respectively, in the CCNU group and 29 and 34 months, respectively, in the PCV group. By log-rank test, the difference between CCNU and PCV was not statistically significant with regard to the length of DFS and OS."nConclusion: Although no significant differences were found, a trend toward better survival could be seen in patients treated with PCV. Further studies with more patients and longer follow-up are needed to definitively resolve this issue.

Introduction: Using logbooks in different sections of medical education has been helpful in investigating the educational status of medical students. In order to identify the educational status of clerkship students in pediatric ward, this study was designed to determine the condition of education as well as practical works of clerkship students based on their logbooks in Shiraz University of Medical Sciences. Methods: In this descriptive cross-sectional study, medical students’ logbooks of a three month pediatric clerkship filled by 45 students in 2005, were studied and statistically analyzed. Clerkship students in pediatric ward received a handbook containing a list of diseases and procedures, and reported them based on their exposure as observation in morning classes or having a role in the treatment of the disease. The Mean of the frequency of observations in each part was analyzed by SPSS software. Results: In pediatric ambulatory clinic, neonates emergency, pediatric emergency and pediatric general ward, 60.73% of the diseases mentioned in the list, were observed by students. In subspecialty wards, 18.16% of diseases were observed by students. Almost 59% of all procedures had been performed by each student. Conclusion: logbooks are suitable means for evaluation of educational status and are able to determine the acquired experiences in educational courses and reveal the deficiencies in learning process. In this study there was a major difference between students’ familiarity with educational subheadings in specialty and subspecialty wards which is necessary to consider. Applying this method in evaluation of medical students’ educational status is recommended.

Background: Colorectal carcinoma is a common malignancy, in treatment of which pelvic radiotherapy plays an important role. But this may lead to azospermia. We designed a study to determine the delivered dose to the testis with thermoluminescence dosimetry (TLD) and compare it to the dose calculated by the Three-dimensional planning software. Methods: We measured the testicular doses by TLD; the TLDs were fixed to the scrotum in six points anteriorly and posteriorly in two random fractions of the radiation course. All patients received a 50-50.4 Gy radiation dose to the pelvis in a prone position with standard fractionation and 3-dimensional planning, through three or four fields. The average dose of the TLD measurements was compared to the average of 6 relevant point doses calculated by the planning software. Results: In 33 patients with a mean age of 56 years, the mean testis dose of radiation measured by TLD was 3.77 Gy, equal to 7.5% of the total prescribed dose. The mean of point doses calculated by the 3-dimensional planning software was 4.11 Gy, equal to 8.1% of the total prescribed dose. A significant relationship was seen between the position of the inferior edge of the fields and the mean testis dose (P= 0.04). Also body mass index (BMI) was inversely related with the testicular dose (P= 0.049). Conclusion: In this study, the mean testis dose of radiation was 3.77 Gy, similar to the dose calculated by the planning software (4.11 Gy). This dose could be significantly harmful for spermatogenesis, though low doses of scattered radiation to the testis in fractionated radiotherapy might be followed with better recovery. Based on above findings, careful attention to testicular dose in radiotherapy of rectal cancer for the males desiring continued fertility seems to be required. [ABSTRACT FROM AUTHOR]

Background: The high number of breast cancer patients who receive radiation therapy after surgery has caused many to think about a shorter period of radiotherapy, which can significantly reduce the radiotherapy machine time, labor hours, and fewer patient visits. This study was designed to evaluate the acute skin effects and cosmetic outcomes of short course radiotherapy in early-stage breast cancer in comparison with the conventional treatment method. Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy by either receiving conventional treatment (dose: 50 Gy in 25 fractions) with subsequent electron boost or a short-course hypofractionated radiotherapy (dose: 42.5 Gy in 16 fractions) and a subsequent electron boost. Results: There were no skin changes during the first or the second week of treatment in the two groups. Cutaneous complications began after the third week as grade 1 skin toxicity after termination of the short-course radiotherapy but there were no difference in complication rate after four weeks of treatment. Six months and one year after treatment, there were no differences in terms of skin complications or cosmetic outcomes between the two groups. Conclusion: Although the use of a whole-breast irradiation with a hypofractionated schedule was associated with desirable outcomes, in term of skin toxicity and cosmetics, but longer follow-up periods with larger sample sizes are needed to confirm these results [ABSTRACT FROM AUTHOR]

Background: More than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard of treatment for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultaneously with radiation. Methods: Thirty Women with untreated invasive squamous-cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in Radiation Oncology department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty mg/m2 gemcitabine followed by 35 mg/m2 cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment. Results: The mean age of the participants was 58.13±11.83 (29-78) years. After 3 months of treatment, 73.3% had complete and 26.7% had partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients. Conclusion: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation by gemcitabine in advanced cervical cancers. [ABSTRACT FROM AUTHOR]

Background: Breast conservative therapy is associated with similar outcomes in comparison with mastectomy. The aim of this study is assessment of local recurrence rate and related risk factors in patients who have been treated with radiotherapy after conservative surgery for breast cancer. Methods: This is a cohort study which data of all breast cancer patients who have visited in follow up clinic in radiation oncology department of cancer institute of Imam Khomeini Hospital complex in Tehran, Iran, during years 2007-2009 were collected. All of the patients were investigated for local recurrence and the possible risk factors. Results: Two hundred and seventy seven patients have entered the study and all have followed for at least one year since data entry. Median follow-up time from the start of radiotherapy were 35 months (12-148 mo). We had seven cases (2.5%) with local recurrences (2.5%) which most of them occurred in first year after treatment. Because of low rate of recurrence none of the variables such as margin and nodal status has significant correlation with local recurrence which this should be due to small number of patient and short time of follow up. Conclusions: At median follow up of 35 months from the beginning of radiation therapy, local recurrence rate was 2.5% which is similar to the literature. We recommend to follow a larger group of patients for longer times to estimate recurrence risk after breast conservative therapy. [ABSTRACT FROM AUTHOR]