Background: Unopposed estrogen has a central role in development of endometrial benign, premalignant and malignant lesions. The aim of this study was to evaluate the anti-estrogenic effect of metformin on endometrial histology in comparison with progesterone. Materials and Methods: A total of 43 patients who were referred to our center for abnormal uterine bleeding and had a histologic diagnosis were disordered proliferative endometrium or simple endometrial hyperplasia were included and randomly distributed in two groups treated with metformin (500mg Bid) or megestrol (40mg daily), respectively, for three months. After this period the patients were evaluated by another endometrial biopsy to assess the impact of the two drugs in restoring normal endometrial histology. Results: Our findings revealed that metformin could induce endometrial atrophy in 21 out of 22 patients (95.5%) while this positive response was achieved in only 13 out of 21 patients (61.9%) in the megstrol group. In addition two low grade endometrial carcinomas in the metformin group responded very well. Conclusions: We conclude that metformin could be used as an effective antiestrogenic agent in control of abnormal endometrial proliferative disorders.

Article Type: Original ArticleIntroduction: Polycystic ovary syndrome (PCOS) is a disorder in women of reproductive age. Psychosocial factors can play a role in PCOS. Methods: To determine the psychosocial factors associated with PCOS in a case control study, 742 PCOS cases were compared to 798 women without PCOS for psychiatric disorders and social conditions. The data were collected using a validated questionnaire of the Minnesota Multiphasic Personality Inventory (MMPI). The Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire (DSM-IV) was used to diagnose major psychopathological disorders and other depressive and anxiety syndromes. The suspected psychopathology was evaluated by a clinical psychiatrist. Results: There was a significant difference between cases and controls in education level (71.8% vs. 80.4%; (P<0.001), and employment status (60% vs. 53%; P=0.01) (respectively). Chronic anxiety (35.7% vs. 26.8%; P<0.001), depression (18.9% vs. 7.9 %; P<0.001), anxiety disorders (7.7% vs. 3.3%; P<0.001), and personality disorders (2.9% vs. 1.7%; P=0.01), were higher in the PCOS patients compared controls, respectively. Conclusion:The results showed that chronic anxiety and depression were the most pscycologic pattern in PCO patients. Lower educational level and unemployment were higher in the cases than controls.

Pre-eclampsia is a pregnancy-related multi-systemic hypertensive disorder and affects at least 5% of pregnancies. This randomized clinical trial aimed at assessing the effect of low doses and high doses of folic acid on homocysteine (Hcy) levels, blood pressure, urea, creatinine and neonatal outcome. A randomized clinical trial was done at Alzahra Teaching Hospital, Tabriz University of Medical Sciences from April 2008 to March 2013. Four-hundred and sixty nulliparous pregnant women were randomly assigned into two groups. Group 1 (n = 230) received 0.5 mg of folic acid and group 2 (n = 230) received 5 mg of folic acid per daily. They were followed until delivery. Blood pressure and laboratory changes, including plasma Hcy levels, were measured and compared between the groups. Homocysteine concentrations were significantly higher at the time of delivery in group 1 (13.17±3.89 μmol/l) than in group 2 (10.31±3.54, μmol/l) (p<0.001). No statistically significant differences were observed in systolic and diastolic blood pressure (p = 0.84 and 0.15, respectively). Birth weight was significantly higher in group 2 (p = 0.031) and early abortion was significantly higher in group 1 than group 2 (p = 0.001). This study has provided evidence that a high dosage of folic acid supplements throughout pregnancy reduces Hcy concentrations at the time of delivery.Trial Registration: Iranian Registry of Clinical Trials IRCT201402175283N9

Background/Aims: The role of human papillomavirus (HPV) in the etiology of cervical cancer is now well established. This investigation was designed to study the prevalence of the four most common high-risk HPVs in the archival tissues with precancerous and cancerous lesions from patients from northwestern Iran. Methods: 133 formalin-fixed paraffin-embedded tissue specimens were tested for HPV DNA by using GP5+/6+-based general PCR and two type-specific PCRs. Results: In total, 84 (64%) out of 131 amplifiable samples were positive for HPV DNA. The most prevalent oncogenic HPV was type 16 (67.6%) followed by types 31 (22.8%), 18 (7.6%) and 33 (1%). Multiple HPV infections were present in 20 (15.3%) of the 131 samples. Notably, of these 20 cases with multiple infections, 15 were from patients with invasive cervical cancer. Conclusions: The multiplicity of HPV genotypes was noted in invasive cervical carcinoma samples, along with rather different circulating HPV types in the study population. Hence, relevant HPV typing information in cervical carcinoma is very important for planning more efficient screening programs and for further HPV vaccine design.

BackgroundNipple pain and damage in breastfeeding mothers are common causes of premature breastfeeding cessation. Peppermint water is popularly used for the prevention of nipple cracks in the North West of Iran. The aim of this study was to determine the effectiveness of peppermint water in the prevention of nipple cracks during breastfeeding in comparison with the application of expressed breast milk (EBM).MethodsOne hundred and ninety-six primiparous breastfeeding women who gave birth between February and May 2005 in a teaching hospital in Tabriz, Iran, were randomized to receive either peppermint water or EBM. Each woman was followed for up to three visits or telephone calls within 14 days and then by telephone call at week six postpartum.ResultsWomen who were randomized to receive peppermint water were less likely to experience nipple and areola cracks (9%) compared to women using EBM (27%; p < 0.01). Women who used the peppermint water on a daily basis were less likely to have a cracked nipple than women who did not use peppermint water (relative risk 3.6, 95%CI: 2.9, 4.3). Nipple pain in the peppermint water group was lower than the expressed breast milk group (OR 5.6, 95% CI: 2.2, 14.6; p < 0.005).ConclusionThis study suggests that peppermint water is effective in the prevention of nipple pain and damage. Further studies are needed to assess the usefulness of peppermint water in conjunction with correct breastfeeding techniques.Trial registration number: NCT00456404

Introduction Of all the female malignancies, most clinical discussions focus on ovarian cancer. It has the highest case fatality ratio and it is the fifth most common cause of malignancyrelated death among women. The cancer is associated with low parity and infertility. Early menarche and late menopause increase the risk of ovarian cancer. Ovarian cancers include epithelial and non-epithelial tumors. More than 80% of epithelial ovarian cancers are seen in postmenopausal women. The peak incidence of epithelial ovarian cancer is between 55 to 60 years of age. Data show that feature of CA125 increases if the test is performed by transvaginal ultrasound. Its symptoms include complex pelvic mass such as solid pattern, heterogeneous component with irregular thick septum, bilateral masses, and size of lesions exceeding 8 cm. The effective factors in the prognosis of ovarian cancer are divided into the 3 categories of pathological, biological and clinical factors. The pathological factors include the structure and degree of lesion. The biological factors include ploidy and proto-oncogenes such as HER-2neu. The clinical factors include the stage of tumor, the extent of residual disease after primary surgery, volume of ascites, age of the patient, and functional status of patient. Ovarian cancer treatment includes primary cytoreductive and then chemotherapy (1). Chemotherapy may be associated with the complications such as nausea and vomiting, bone marrow depression, peripheral neuropathy, weight loss, hemolytic anemia, and transient cortical blindness (2). Ginger is a plant with anti-carcinogenic and antioxidative effects and modern studies have shown other treatment effects such as the ability to inhibit formation of inflammatory products, direct anti-inflammatory effects, and anti-tumoral effects. It has been proved that the active ingredient in ginger can kill cancer cells due to apoptosis and autophagocytosis. This has also been emphasized in ovarian cancers (2). On the other hand, although chemotherapy drugs suppress inflammatory markers, cancer cells may show resistance to them. It has been proved that ginger can

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