Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 2 2022 05 24 93 101 Hadi Tehfe Faculty of Medicine, University of Ottawa, Ottawa, Canada Ryan Chow Faculty of Medicine, University of Ottawa, Ottawa, Canada Sophie Li Faculty of Medicine, University of Ottawa, Ottawa, Canada Patrick Kim Faculty of Medicine, McMaster University, Hamilton, Canada Saif Samari Faculty of Medicine, McMaster University, Hamilton, Canada Lamia Hayawi Clinical Research Unit, Children's Hospital of Eastern Ontario, Ottawa, Canada Richard Webster Clinical Research Unit, Children's Hospital of Eastern Ontario, Ottawa, Canada Nadya Ben Fadel Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada 2021 07 27 2022 04 03 Objective: Premenstrual syndrome (PMS) is a very prevalent condition that affects premenopausal women and can result in monthly debilitating emotional and physical symptoms. The objective of this systematic review was to determine which predictive factors were associated with an increased amount of bias in non-randomized studies (NRSs) of PMS. Materials and methods: A search of the EMBASE and Medline electronic databases was completed from January 1, 2010 to December 2021. The methodological quality of the included studies was independently evaluated and critically appraised using the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-1) tool. Associations of different factors with the risk of bias levels were assessed using a univariate logistic regression. Odds ratio and 95% confidence interval (CI) were reported. Results: Of the 1668 studies, 38 were determined to be eligible for inclusion. The ROBINS-1 tool identified that 12 studies were of low/moderate risk of bias (31.6%) and 26 were of serious/critical risk (68.4%). Evidence of relationships between the ROBINS-1 score and impact factor (OR=0.20; 95% CI, 0.07 to 0.57; p= 0.003) and number of authors (OR=0.65; 95% CI, 0.43 to 0.99; p= 0.046) were identified, whereas no relationships were found with the number of citations, the sample size, the funding type, or the conflict-of-interest statement. Conclusion: The systematic review concludes that the methodological rigor of non-randomized studies of PMS can vary, with fewer authors and a lower impact factor showing evidence of association with a decreased quality of evidence. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1865

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 2 2022 05 24 106 115 Zohreh Halvaiepour Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran Hamid Reza Oreyzi Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran Mehdi Nosratabadi Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Fariba Yazdkhasti Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran 2021 11 29 2022 01 23 Objective: Psychological perceptions are concerned with how a person perceives and psychologically frames life with an illness. The current study sought to examine the psychological perceptions of women suffering from Female Sexual Interest/Arousal Disorder in the setting of Isfahan, Iran. Materials and methods: The study was done according a qualitative design, and it was conducted in Isfahan, Iran, from July 2018 to February 2019. Twenty in-depth interviews were performed with 20 patients who were recruited on the purposeful method. The thematic analysis approach was used to analyze the data. The data were organized using MAXQDA software (version 12). Results: The following four themes were extracted: (i) Dysfunctional cognition, which includes five sub-themes: attention bias, belief bias, memory bias, perceptual bias, and cognitive distortion; and (ii) Relationship and partner factors, which include four sub-themes: psychological maltreatment, aggression, deception, and betrayal.; (iii) lack of life skills, which includes four sub-themes: poor problem-solving, poor sexual knowledge, poor understanding and intimate relationships, and immature defense mechanisms; and (iv) lack of motivation and genuine interest, which includes two sub-themes: forced marriage and lack of initial affection and attraction to the husband. Conclusion: Internal and interpersonal factors were shown to have a role in the creation of sexual arousal disorder in Iranian women, according to the study. As a result, designing scenarios for cognitive bias modification and educational programs for improving interpersonal skills would be beneficial. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1962

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 2 2022 05 24 155 160 EN Ruchi Nagpal Department of Pathology, Bhaskar Medical College and General Hospital, Hyderabad, Telangana, India Hari Vanam Department of Microbiology, Bhaskar Medical College and General Hospital, Hyderabad, Telangana, India Harshi Dhingra Department of Pathology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India Ravali Banswada Department of Obstetrics and Gynaecology, Bhaskar Medical College and General Hospital, Hyderabad, Telangana, India 2021 11 01 2022 01 23 Objective: Surgical site infections (SSIs) owing to nontuberculous Mycobacteria (NTM) have emerged as an important cause of hospital-acquired SSI leading to great morbidity and mortality. Among NTM, Mycobacterium abscessus is reported in these sites. Epidemiology and transmission of M. abscessus in humans is noticing crux changes. Case report: We hereby describe a case of SSI after lower segment cesarean section (LSCS), presenting as a skin and soft tissue infection (SSTI) owing to a NTM. Conclusion: Clinicians should be aware of the possibility of infections caused by M. abscessus in patients who develop SSIs, particularly if they do not respond to conventional first-line antimicrobial therapy. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1927

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 2 2022 05 24 1960 1960 Pathum Sookaromdee Private Academic Consultant, Bangkok Thailand Viroj Wiwanitkit Honorary Professor, Dr DY Patil University, Pune, India 2021 11 26 2022 02 01 No Abstract No Abstract No Abstract No Abstract No Abstract https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1960

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 2 2022 05 24 102 105 EN Gary Ventolini Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA Kushal Gandhi Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA Nathan Manales Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA John Garza Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA AND The University of Texas Permian Basin, Odessa, Texas, USA Asley Sanchez Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA Brianna Martinez Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA 2021 11 29 2022 04 09 In women’s health, clinicians are often faced with diagnosing and administering treatment to patients who present with an increased vaginal discharge without much other information to work with. It’s only once a patient’s background is reviewed and lab work is completed that two common reasons behind vaginal discharge with similar symptoms, Lactobacillosis and Cytolytic Vaginitis, can be differentiated and a proper diagnosis can be reached. Now, we understand that Lactobacillosis and Cytolytic Vaginitis are symptomatically confused by patients as well as inexperienced clinicians. Lactobacillosis involves the presence of abnormal, extremely long Lactobacilli, a keystone species for vaginal health, while Cytolytic Vaginitis mainly involves, increased Lactobacilli, pH between 3.5 and 4.5, presence of cytolysis, and a lowered white blood cell count. Both present with similar discharge, leading to their conflation. A microscopic examination of the discharge using a wet mount with normal saline can provide 80% diagnostic sensitivity until further testing can be completed. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1964

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 2 2022 05 24 116 123 Sepideh Peivandi Department of Obstetrics and Gynecology, School of Medicine, Sexual and Reproductive Health Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran Alireza Razavi Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Shervin Shafiei Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Marzieh Zamaniyan Department of Obstetrics and Gynecology, School of Medicine, Diabetes Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran Asma Orafaie General Practitioner, Mazandaran University of Medical Sciences, Sari, Iran Hamed Jafarpour Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 2021 07 05 2022 04 03 Objective: The coronavirus disease 2019 (COVID-19) pandemic affected the continuation of all non-emergency medical treatment and patients potentially suffer from restrictions including patients under infertility treatment. This study aimed to evaluate the knowledge and attitudes of infertile couples about continuing assisted reproductive technologies (ARTs) therapy during the COVID-19 outbreak, in Sari, Iran. Materials and methods: We conducted a prospective longitudinal investigation on potential infertile couples for treatment with ARTs referred to our infertility clinic from March 2020 to June 2020. Ninety-two patients were studied voluntarily and anonymously in this study. A self-developed structured questionnaire was used to assess the attitude towards continuing infertility treatment. A P-value of less than 0.05 was considered statistically significant. Results: Thirty-two patients (33.33%) had decreased motivation to continue treatment during the COVID-19 pandemic. Fear of transmission to the fetus (28.13%) had the highest frequency among the causes of decreased motivation to continue treatment (P-value = 0.011). Trust on the support of the treatment team (56.67%) was the most common reason for not reducing motivation in patients without decreased motivation (P <0.001). Conclusion: Despite the COVID-19 pandemy, in Iran most infertile patients tended to continue ARTs. Although many patients had passable knowledge on COVID-19, the stress of infertility and the high desire of infertile couples to have children did not deter them from continuing their therapy. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1840

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 2 2022 05 24 124 131 Marzieh Vahid Dastjerdi Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran Akram Ghahghaei-Nezamabadi Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran Afsaneh Tehranian Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahbobeh Mesgaran Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran 2021 10 23 2022 04 03 Objective: Borderline oligohydramnios always produces a dilemma of management and counseling among obstetricians. This study was designed to compare the effect of sildenafil plus fluid therapy versus fluid therapy alone on pregnancy outcomes and AFI improvement in pregnant women complicated by idiopathic borderline oligohydramnios. Materials and methods: This randomized clinical trial was conducted in Arash Women’s Hospital, Tehran, Iran from 2017 to 2020.  Fifty-one pregnant women with idiopathic borderline oligohydramnios were allocated to two groups. Group 1 received fluid therapy and Group 2 received fluid therapy and Sildenafil 25 mg three times daily for six weeks. AFI was measured at the time of randomization, 24 h after treatment and then weekly for six weeks. The changes in AFI, type of delivery, gestational age at delivery, and neonatal outcomes were compared between the two groups. Results: After the intervention, the change in AFI between two groups was not statistically significant. Maternal and fetal outcomes are compared between two groups and there was no significant difference between them. The median (Inter-quartile range) AFI after intervention, in Sildenafil group compared with hydration group, were in 24 hours (8.5 vs. 8, p=0.27), first (9.5 vs. 9.1, p=0.74), second (9 vs 10, p=0.12) third (10.4 vs. 9.4, p=0.33), fourth (10.8 vs 9.1, p=0.1) and Fifth week (10 vs 9.3, p=0.5) of follow-up respectively, but none of them were statistically significant. Conclusion: The findings showed that sildenafil plus fluid therapy do not improve the pregnancy outcomes in women with isolated borderline oligohydramnios compared to fluid therapy alone.   https://jfrh.tumomen’s Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Afsaneh Tehranian Department of Obstetrics and Gynecology, Arash Women’s Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Elham Feizabad Department of Obstetrics and Gynecology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Parvin Nikabadi Department of Obstetrics and Gynecology, Arash Women’s Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2024 03 01 2024 05 12 Objective: This study aimed to evaluate the effect of random biopsy and endo-cervical curettage (ECC), alone and together, in the diagnosis of high-grade cervical lesions in women with normal colposcopy. Materials and methods: This cross-sectional study was conducted on 356 women who underwent colposcopy examination in the gynecology-oncology clinic of Roointan-Arash Women’s Hospital, affiliated with Tehran University of Medical Sciences. All eligible women underwent colposcopy. In colposcopy examination, up to four biopsy samples were randomly taken for each quartile of the cervix and ECC was performed. Finally, the rate of intraepithelial neoplasia (CIN) and the relation between random biopsy and ECC and CIN diagnosis was determined. Results: In total, 27 (7.6%) low-grade squamous intraepithelial lesions (LSIL) and 19 (5.3%) high-grade squamous intraepithelial lesions (HSIL) were detected in cases that underwent random biopsy. There was a significant association between the abnormal random biopsy results and having multiple sexual partners (p=0.001), cigarette (p=0.041), and hookah (p=0.033) smoking. Furthermore, 31 (8.7%) LSIL and 42 (11.8%) HSIL were reported in women who underwent ECC. There was a significant relation between the abnormal results of ECC and hookah consumption (p=0.008) and human papillomavirus (HPV) infection (p=0.011). The concordance (p=0.001) between random biopsy and ECC result was 71.2% and only in 28.8% of the cases one of the methods was normal and the other was abnormal. Conclusion: The present study showed that the simultaneous use of ECC and random biopsy in women with normal colposcopy increases the detection rate of precancerous lesions by up to 28.8%.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2649 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2649/683

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 2 2024 06 30 115 121 Zinat Ghanbari Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Asadi Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Shahrzad Amirlatifi Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mamak Shariat Maternal, Fetal & Neonatal, Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Tahereh Eftekhar Department of Obstetrics and Gynaecology, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Maryam Deldar Department of Obstetrics and Gynaecology, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Razieh Vahdani Maternal-fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2024 02 18 2024 06 05 Objective: Voiding Dysfunction (VD) is one of the most common disorders among women, which is characterized by a disorder in urination. Pelvic organ prolapse is one of the factors that can affect VD. In this study, the relationship between prolapse in the anterior, posterior, and apical areas and VD has been evaluated. Materials and methods: This is a cohort retrospective study. The participants in this study were women with VD, who referred to the pelvic floor disorders clinic of Imam Khomeini Hospital in Tehran in 2018-2020. Clinical information was obtained retrospectively from the hospital's electronic data system, also symptoms (intermittent stream, incomplete voiding, poor flow, post void dribble, straining to void, stage anterior, posterior and apical) and urodynamic parameters (including EMG, PVR100, Qmax12, and pdet20) were evaluated, which included detailed questionnaires (Urinary Distress Inventory 6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7)), pelvic examination, and complete urodynamic evaluation. Results: There was a direct relationship between the age of the patients and the stage of prolapse (p<0.001). So that, the stage increased with age. In addition, it was found that the severity of urinary symptoms is related to the stage of prolapse in the apical area (p=0.001). Also, the results showed that intermittent stream symptoms and the symptoms of staining to void had a significant relationship with the stage of prolapse (III and IV) in the apical and anterior areas. Also, it was shown that only PVR > 100 had a significant relationship with the stage of prolapse in the apical area (p=0.001). Conclusion: Intermittent stream and straining to void were related to the stages of prolapse in the apical and anterior regions. It was also concluded that the greater the prolapse, the higher the value of PVR > 100.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2631 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2631/684

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 2 2024 06 30 122 128 EN Mahbod Ebrahimi Department of Gynecology and Obstetrics, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran AND Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Firoozeh Akbari Asbagh Department of Gynecology and Obstetrics, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mojgan Tavakoli Department of Gynecology and Obstetrics, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Nasim Eshraghi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Naghmeh Poormand Department of Gynecology and Obstetrics, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Marjan Ghaemi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran 2023 12 25 2024 06 05 Objective: This study aimed to measure the correlation of sperm DNA fragmentation with semen parameters, lifestyle, and fertility outcomes after intracytoplasmic injection (ICSI). Materials and methods: The partners who were candidates for ICSI with a history of one In vitro fertilization (IVF) failure or male factor were recruited in the study. Semen parameters including sperm count, motility, and morphology as well as DNA fragmentation index (DFI) (that were divided into 2 groups as high (>15%), and low (≤15%) fragmentation scales) were evaluated either. The correlation of DFI with semen parameters, lifestyle, and clinical pregnancy after ICSI were compared between groups. Results: In 120 included couples, 59 men (49.2%) had DFIs ≤ 15% and 61 (50.8%) cases had DFIs >15%. In the group with higher DF