BackgroundNutritional status of women has been considered an important prognostic indicator of pregnancy outcomes. Few studies have evaluated patterns of weight gain and pre-pregnancy body mass index in developing regions where malnutrition and poor weight gain as well as maternal obesity have significant influences on the pregnancy outcome. This study aims to show effect of pregnancy body mass index and the corresponding gestational weight gain on the outcome of pregnancy.MethodsOn a prospective cross sectional study, two hundred and seventy women from urban areas of Northwest Iran were recruited for participation during their first eight weeks of pregnancy. Body mass index (BMI) was categorized and gestational weight gain was divided into two groups of normal and abnormal based on recommendations of Institute of Medicine (IOM) published in 1990. Chi square and one way ANOVA were used in the univariate analysis of the association between weight gain and corresponding adverse outcomes including cesarean, preterm labor and low neonatal birth weight. Adjusted odds ratios for adverse outcomes were determined by multiple logistic regression models, while controlling for the following factors: maternal age, parity, and education.ResultsBoth pre-pregnancy BMI < 19 and abnormal weight gain during pregnancy were found to be associated with low neonatal birth weight defined as < 2500 g. Abnormal weight gain, during pregnancy was not related to an increased risk of preterm labor or cesarean delivery but it was highly associated with low birth weight (LBW)(P < 0.05).ConclusionLow pre-pregnancy BMI is an established risk factor for LBW. Abnormal gestational weight gain may further complicate the pregnancy as an additional risk factor for neonatal LBW. All women, regardless of their pre-pregnancy BMI may be at risk for abnormal weight gain and hence low birth weight. Pre-pregnancy and gestation nutritional assessments remain significant part of all prenatal visits.

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Induction of labor is conducted in special fetal or maternal conditions. Labor is induced in about 20% of women. The aim of this study was realizing the relationship between some factors including cervical ripening and also response to induction so we could predict the induction outcome better. Material and methods: The present prospective study was based on 101 pregnancy cases admitted to the labor ward in Urmia from March 2010 until December 2010. Maternal age ranged from 17 to 41 years and the gestational age between 37 to 42 weeks according to an ultrasound or reliable last menstrual period, as criteria of study inclusion. After admission, patients had a vaginal speculum for Preterm Premature Rupture of Membranes (PPROM), Abdominal ultrasonography for biometry and Amniotic Fluid Index (AFI), transperineal ultrasonography for measuring fetal head distance to maternal perineum, and vaginal ultrasonography for measuring cervical length and posterior angle of fetal head with cervix were undergone. Bishop score was assigned to another person. Labor was induced by administering either intravaginal misoprostol (25 microgram every six hours for a Bishop score lower than 7) or intravenous oxytocin (low dose regimen for a Bishop score equal to or more than 7). Results: Misoprostol was used for 75 patients and 26 patients had induction of labor with low dose oxytocin. Eighty one patients had Normal Vaginal Delivery (NVD) while 20 were delivered via Cesarean Section. For cervical ripening, Bishop Score (p<0.001), cervical length (p=0.04) and parity (p=0.06) were predicting factors. The cervical posterior angle p=0.02 had a predicting role in natural delivery. Conclusion: The cervical posterior angle was a predicting factor for natural delivery. Although cervical length, Body Mass Index (BMI), and parity were not predicting factors for natural delivery; these factors were good predictors for cervical ripening.

Objective:There are two basic ways to analyze survival data including nonparametric and parametric methods. Considering that cervical cancer is the fourth most common cancer among women, this study was conducted using a suitable regression model for survival data for patients with cervical cancer in Urmia.Material and Methods:In this historical retrospective study, all patients with cervical cancer who referred to Motahhari Hospital of Urmia during 2004 and 2015 were included in the study and consisted of 109 women with cervical cancer. The data were collected using checklist which filled with records of patients. The data were described with percent, mean and standard deviation. The survival function was computed with the Kaplan-Meier method. The adjusted Hazard Ratio for variables were estimated after fitting the Cox proportion hazard model using Forward Stepwise Likelihood Ratio method with PE=0.1, PR=0.15.Results:Of the 109 patients, the mean (SD) time of diagnosis was 50.1% (11.7) years. The mean (SD) and median of follow-up time was 38.23 (32.50) and 27.1 months (Mim: 2 months and Max: 132 months). Ninty-Three of patients (88.7%) were in urban area. Using Log-Rank test, the mean score of survival in patients with recurrence of 38.8 months was significantly lower than those without recurrence (102.5 months) (P <0.001). The results of the COX model showed that the adjusted relative risk of mortality with a diagnostic age of 50 years or more compared to those under 50 years of age was 1.978. The risk for marriage under age 20 was 3.189 compared to the marriage age of 20 years or more.Conclusion:According to results, the low age of marriage increases the occurrence of advanced stages of cancer in older ages and as a social and cultural factor has a significant effect on the survival of patients with cervical cancer.

ObjectiveThe objective of this study was to determine if second curettage was associated with a decreased need for the number of chemotherapy treatments compared to usual care.MethodsA pilot randomized controlled clinical trial was designed at Motahhari Referral Hospital in 2014. Fifty-two patients with low risk, nonmetastatic gestational trophoblastic neoplasm were assigned randomly to two arms. The interventional arm included a repeat uterine curettage, and the control group received standard care (chemotherapy). All participants were followed periodically over 6 months. Primary outcome was defined as the number of chemotherapy courses in each arm. Student’s t-test and receiver operator characteristics (ROC) curve were applied for statistical analysis as appropriate.ResultsFifty percent of participants who underwent re-curettage did respond to intervention with no further chemotherapy after 6 months of follow-up. The intervention arm had higher number of remissions without chemotherapy compared to those who received usual care. In the subgroup analysis, the ROC curve could predict the re-curettage treatment response by beta human chorionic gonadotropin (BhCG) level significantly. No complications were reported in the intervention arm.ConclusionSecond curettage is an alternative effective procedure to decrease the need for chemotherapy among patients with low risk, nonmetastatic gestational trophoblastic neoplasm. Further clinical trials with larger sample size may be needed to determine the effective role of second curettage among patients.

Background: This study has evaluated urinary tract injuries and dysfunction after Radical Hysterectomy (RH) performed in patients with cervical cancer and has compared the cystometric parameters and urinary complications occurring in these patients with those occurring in patients who had undergone Simple Hysterectomy (SH).

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Introduction: Several studies have been carried out in the field of traffic collisions in Iran. However, few studies have used the victims' medical records as a source of information. This study aimed to use the data collected from the medical records and a geographic information system to show the epidemiology of urban traffic collisions to be used in injury prevention strategies.Methods: This was a descriptive, cross-sectional study which was completed in 2013. The sample consisted of 1240 medical records of the people injured in the urban traffic collisions in the capital city of Iran between October 2010 and April 2011. Data were analyzed by using SPSS 18.0 and ARC GIS 10.0.Results: According to the results, motorcyclists were the main group of victims, and most collisions occurred in the afternoon between 12:00 and 18:00 pm. Moreover, the findings showed that the frequency of collisions was higher in District five (16.7%), District six (13.7%), and District 12 (8.3%) of the city. Conclusion:In most traffic collisions, motorcyclists were involved and victims mainly suffered from injuries in the lower limbs. Therefore, training in the use of safety equipment, setting collision prevention strategies, and controlling the risky behavior of motorcyclists may help to reduce the number of collisions.