BackgroundPatients with pelvic mass are the most referred patients to gynecologist. The aim of this study was to evaluate the ability of three malignancy risk indices (RMI 1, RMI 2 and RMI 3) and CA-125 to discriminate a benign from a malignant pelvic mass in our region (North of Iran).MethodsThis retrospective study was performed on 182 women with pelvic masses referred to Yahyanejad Hospital from 2007 to 2009. Ultrasound scans were scored as one point for each of the following characteristics: multilocular cyst, solid areas, intra-abdominal metastases, ascites, and bilateral lesions. For each patient a total ultrasound score (U) was calculated. The difference of the three RMI was based on the allocation of the U and M scores. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of level of serum CA-125, the RMI 1, 2 and 3 were compared.ResultsMean age of the patients was 39.9 ± 9.3 years. Most of them were premenopausal (161 women or 88.4%). A significant linear trend for malignancy was found by increasing age, ultrasound score, and serum CA-125. The best performance of CA125 was at a cut-off 88 U/ml, with a sensitivity of 88%, a specificity of 97%, a positive predictive value of 84%, and a negative predictive value of 99%. RMI 1 and 3 at the optimal cut off point of 265 and RMI2 at the optimal cut off point of 355, had a sensitivity of 91%, specificity of 96%, a positive predictive value of 78%, and a negative predictive value of 99%.ConclusionIn our population we found that there is no statistically significant difference in the performance of three malignancy risk indices (RMI 1, RMI 2, and RMI 3) and CA125 in differentiating between benign and malignant pelvic masses.

These findings show that adding 3 weeks of psychological intervention to medical therapy may appear to produce positive therapeutic outcomes upon conclusion of treatment, and 1 month after treatment. This suggests that psychotherapy should be considered as an adjunctive treatment option for women with moderate NVP. In future studies, however, a group of patients who are receiving placebo psychotherapy along with medical treatment should be included. Furthermore, an economic evaluation of the addition of psychological intervention to standard medical therapy would be useful.

BackgroundGum chewing after cesarean section may stimulate bowel motility and decrease duration of postoperative ileus.ObjectivesThe current study assessed the effect of chewing sugar-free gum on the return of bowel function, where cesarean section had been performed in nulliparous women.Materials and MethodsIn a randomized clinical trial, 60 patients, scheduled for cesarean section were randomly divided in to 2 groups gum-chewing group (n = 30) and control group (n = 30) postoperatively. The patients in the gum-chewing group postoperatively chewed sugar free gum 3 times daily each time for 1 hour until discharge. The patients' demographic characteristics, duration of surgery, mean hunger time, flatus and bowel motility were compared in the two groups.ResultsThere was no significant difference between the 2 groups regarding patient demographics, intraoperative, and postoperative care. In the gum-chewing and the control group there was a significant difference in the mean postoperative interval of the first bowel movement (20.89 ± 8.8 versus 27.93 ± 9.3 hours, P = 0.004), the first feeling of hunger (10.37 ± 6.0 versus 16.33 ± 9.3 hours, P = 0.005), the first passage of flatus (25.02 ± 5.8 versus 31.08 ± 9.7 hours, P = 0.003), and the first defecation (31.17 ± 5.3versus 40.08 ± 8.8 hours, P = 0.000) respectively, which were significantly shorter in the gum-chewing group compared to those of the control group. There were no major complications in either group. All patients in the gum-chewing group tolerated it without any major complications and side effects.ConclusionsThe study results demonstrated that bowel motility after cesarean section in nulliparous women can be accelerated by gum chewing which is a useful, inexpensive and well-tolerated method for mothers in post-cesarean section.

The aim of study was to investigate the effect of postoperative gum chewing on the recovery of bowel function after cesarean section. Total 100 women delivered by lower uterine segment section cesarean under local anesthesia (spinal). Eligible patients were randomly allocated into two groups: a gum-chewing group (n=50) or a control group (n= 50). The gum-chewing group participants who received one stick of sugarless gum for one hours, three times daily immediately after recovery from anesthesia and the control group had the usual postoperative care until being discharged. All women were followed up regularly until discharge from hospital, and recorded the times to the first bowel sounds of normal intestinal sounds, the time to the first passage of flatus, the time to the first feeling of hunger, and the time to the first defecation. The operative data, postoperative tolerance of gum chewing, and postoperative complications were documented. There was no statistically significant difference between the two groups in terms of demographic characteristics such as age, body mass index, parity, duration of surgery, number of miscarriages and curettages, time to the first feeding, the amount of serum intake, and type of cesarean section. The mean average postoperative interval of the first bowel sounds (21.9 versus 26.1 hours, p= 0.016), the first feeling of hunger (11.8 versus 14.5 hours, p= 0.050), the first passage of flatus (24.8 versus 30.0 hours, P=0.002), the first defecation (30.6 versus 38.4 hours, P= 0.0001) was significantly shorter compared to the control group.

BackgroundThe purpose of this study was compare of daily iron supplementation in three time frames- daily, weekly and three time weekly supplementation in preventing anemia in healthy pregnant women.MethodThe present study was a prospective simply randomized clinical trial. During January 2006- January 2008, 150 healthy pregnant women without anemia, in their 16th week of pregnancy were randomly allocated into three equal groups. The first group (n = 50) received a 50 mg-ferrous sulfate tablet daily, second group (n = 50) received a 50 mg-ferrous sulfate tablet three times a week, and the third group (n = 50) received two 50 mg-ferrous sulfate tablets (100 mg) weekly, respectively for 12 consecutive weeks. Serum hemoglobin, ferritin, and iron were measured before and after the supplementation. Paired t and ANOVA tests were used as appropriated.ResultsThere were no significant differences between the pre- and post-treatment hemoglobin levels with iron supplementation in the three group (P = 0.518, P = 0.276, respectively). The mean serum iron level before and after treatment with iron supplementation in the three groups was not statistically significant (P = 0.962, P = 0.970, respectively). Although the mean serum ferritin level before and after treatment with iron supplementation was statistically significant in the three groups, no significant differences were found comparing the three groups (P = 0.827, P = 0.635 respectively).ConclusionsThis results suggested, three times a week or weekly iron supplementation is as effective as daily supplementation for healthy pregnant women without anemia.Trial RegistrationISRCTN: IRCT201101093820N1

Purpose This study investigated the optimal cutoff points of three psychological tools for screening psychiatric disorders in women with high‐risk pregnancy. Design and Methods In this cross‐sectional study (N = 155), sensitivity/specificity of the Edinburgh Postnatal Depression Scale (EPDS), the Brief Symptom Inventory 53‐items (BSI‐53), and the BSI‐18 were computed with respect to having a psychiatric diagnosis based on the clinical interview. Results The usual cutoffs (≥13 for EPDS, T‐score of 63 for BSI‐53) demonstrated poor diagnostic accuracy. The optimal thresholds were computed for EPDS cutoff of 6.5, GSI = 0.47 for BSI‐53, and GSI = 0.5 for BSI‐18. Practice Implications The use of psychological tools among pregnant women with high‐risk pregnancy may need to be modified in order to accurately identify psychiatric disorders.

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