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        Misoprostol complications in second-trimester termination of pregnancy among women with a history of more than one cesarean section

        ( Marzieh Jamali ),( Mahmood Bakhtiyari ),( Fatemeh Arab ),( Masoumeh Mirzamoradi ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.3

        Objective This study aims to investigate the complications due to misoprostol administration for second-trimester termination of pregnancy among women with history of 2 or more cesarean scarring. Methods The cohort of this retrospective study included 678 subjects who required second-trimester pregnancy termination, from 2013 to 2015 and treated with vaginal misoprostol of 100 to 400 μg. The subjects were divided into 3 groups based on their history of cesarean sections: without a history of cesarean section, with a history of one cesarean section, and with a history of more than one cesarean section and uterine scaring. Results The results showed that the success rate of misoprostol administration for pregnancy termination was 95.72%. The rate of bleeding as a complication was significantly higher in subjects with a history of more than one cesarean section than in other participants (risk ratio [RR], 2.24; 95% confidence interval [CI], 1.11-4.0). The incidence of uterine rupture was higher in the group with a history of more than one cesarean section than in other groups. However, no significant difference was observed between the groups (RR, 1.44; 95% CI, 0.27-7.6). There was a significant relationship between the need for other auxiliary treatments in the pregnancy termination and the history of uterine scarring (RR, 3.3; 95% CI, 1.23-9.1). Conclusion The present study showed that pregnancy termination using smaller divided dose of misoprostol in patients with previous history of cesarean scarring may be associated with lower incidence of uterine rupture.

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        Income-related inequality in completed suicide across the provinces of Iran

        Mohammad Hassan Kazemi-Galougahi,Asieh Mansouri,Samaneh Akbarpour,Mahmood Bakhtiyari,Majid Sartipi,Rahmatollah Moradzadeh 한국역학회 2018 Epidemiology and Health Vol.40 No.-

        OBJECTIVES: The aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran. METHODS: This ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran. RESULTS: The Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06). CONCLUSIONS: This study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.

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        A novel radiofrequency modulation therapy versus routine physiotherapy modalities in treatment of myofascial pelvic pain syndrome: a pilot randomized trial

        ( Elaheh Miri Ashtiani ),( Nasim Shokouhi ),( Mona Mohseni ),( Nafiseh Saedi ),( Ali Asghar Haeri-mehrizi ),( Mahmood Bakhtiyari ) 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.3

        Objective The current study aimed to compare the effectiveness of novel radiofrequency modulation (RM) therapy with a tailored physiotherapy course for patients with chronic pelvic pain (CPP) of myofascial origin, also known as myofascial pelvic pain syndrome (MPPS). Methods We enrolled 46 patients with myofascial CPP to compare the effectiveness of a 10-session routine physiotherapy course versus a 6-session RM with an integrated device (HIGGS) in alleviating MPPS morbidity and pelvic floor muscle (PFM) rehabilitation. The primary outcome was reduction in pelvic pain after the final session and in the follow-up period 3 months after the final intervention session. Results The 6-session therapy in the RM group and the manual, biofeedback, and transcutaneous electrical nerve stimulation therapies in the physiotherapy group were similarly effective in reducing pain and improving PFM endurance after the final intervention session in each group, whereas perineometer readings and PFM strength were associated with greater improvements in the physiotherapy group. Conclusion The results of this study demonstrated comparable effectiveness of RM in the management of MPPS and improvement of PFM function compared to routine physiotherapy programs with fewer sessions of therapy.

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