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09 ± 7.33. Having adjusted the confounder variables' effect by logistic regression multivariate analysis; the odd ratio for HSDD has been analyzed. The findings suggested that the odd ratio for HSDD in those not satisfied or slightly feeling fulfilled with their BI has been OR 4.2 (95% CI 1.98-9.05) and OR 3.9 (95% CI 2.29-6.65), respectively, times more than the ones highly satisfied with their body image. Conclusion The present study results indicate that being dissatisfied with BI is a determinant factor of HSDD that is more probable in the people with negative image of their body structure and feeling lack of bodily appeal. Thus it is imperative to pay attention to this factor when analyzing HSDD.Objective The purpose of this study was comparison of association of three main first trimester screening factors with pregnancy outcomes among Iranian pregnant women. Materials and methods This prospective study was done during 2017-2019 years in Qazvin, Iran. To do so, a total of 1500pregnant women in first trimester were enrolled. At the first step, Nuchal translucency (NT) was measured in 11-13 ± 5 week, then the serum pregnancy-associated plasma protein A (PAPP-A) and free-β-human chorionic gonadotropin (free-β-HCG) were measured in 12-14 weeks of gestation. Pregnant women were followed up until the end of pregnancy for the complications of pregnancy such as intra-uterine growth retardation (IUGR), intrauterine death (IUFD), different types of fetal loss and preterm labor. Results The results showed that low levels of serum biomarkers had more association with pregnancy complications in comparison to high levels of them. Significant association of IUGR (P = 0.001), IUFD (P = 0.032) and pre-term labor (P = 0.002) was shown in women with low serum levels of PAPP-A in comparison to low serum levels of free-β-hCG. Significant high frequency of different types of fetal loss (IUFD, Abortion, Elective termination) was shown in fetuses with N ≥ 3 in comparison to low levels of serum biomarkers (P = 0.001). Conclusion This study highlighted the importance of accurately interpreting the results of the first trimester of pregnancy screening which should be considered by primatologists for subsequent pregnancy care.Objective Endometriosis is a chronic, painful disease that can be disabling. There is a scarcity of research on the clinical management and outcomes of endometriosis in American Indian (AI) women. The aim of this study was to determine whether there are discrepancies between AI and White women in symptoms at presentation, initial diagnosis methods, clinical management, and long-term outcomes of endometriosis, in a rural state. Materials and methods This retrospective study described and compared the clinical management and long-term outcomes of AI and White women diagnosed with endometriosis. All statistical tests were two-tailed with p-value less then .05 considered to be significant. Results 110 women diagnosed with endometriosis were included in the study, with 50% (n = 55) AI and 50% (n = 55) White. White women were more likely to have private insurance (80% vs. buy CTPI-2 42%; p less then 0.001). AI women were more likely than White women to report abdominal pain at diagnosis (20.3% vs. 9%; p = 0.010), and be diagnosed with mild endometriosis symptoms at the initial visit, (44.4% vs. 10%; p = 0.051). White women were more likely to report a reduction or cessation of pain compared to AI women (63.3% vs. 34%; p = 0.004). Conclusion We found the majority of women continue to report pain long after endometriosis diagnosis. AI women were less likely to report a reduction or cessation of pain. Future research should investigate why pain is more persistent in AI women.Objective The aim of this study was to evaluate the safety and efficacy of fractional CO2 laser for treatment of vulvovaginal atrophy. Materials and methods In this clinical trial study, we evaluated the laser effect on vulvovaginal atrophy in 47 women aged 43-80 years. Each woman was treated with fractional CO2 laser, SmartXide2V2LR, DEKA, Monalisa Touch, vaginal 360o probe and cosmetic probe. The severity of vulvovaginal atrophy symptoms was evaluated before first session of laser and every 4 weeks after laser treatment until 12 weeks. Adverse effects including pain and itching were assessed at all visits. The statistical analysis was performed using SPSS version 23. Results The response to laser therapy for vaginal dryness was significantly (p less then 0.001) improved. Also, the response to laser therapy for each symptom include dyspareunia, vaginal discharge, itching and urge urinary incontinence was statistically significant (p less then 0.001) based on visual analogue scale (VAS). Conclusion It seems vaginal fractional CO2 laser can be applied as an effective and safe treatment method in genitourinary syndrome of menopause (GSM). It is necessary to conduct studies with long-term follow-up.Objective Abortion related procedures contribute to a significant economic burden because it resulted in prolonged hospital stays for patients. We aimed to gather available evidence on the economic burden of abortion and post-abortion complication treatment cares worldwide. Materials and methods PubMed, Web of Science, Scopus, and Embase databases were searched through November 2019. Two researchers independently conducted the quality assessment and data extraction process. The latest web-based tool adjusted the estimates of costs expressed in one specific currency and price year into a specific target currency (the year 2016 $US). Results Totally, 2082 records were retrieved and 32 studies were deemed eligible for qualitative synthesis. The mean total costs per patient with abortion or post-abortion care ranged from $23 to $564. The annual costs ranged from 189,000 $US to 134 million $US. Conclusion Abortion and post-abortion care impose a substantial economic burden on society. Understanding the burdensome of abortion or pregnancy termination among policymakers provides vital information and enables informed decisions to be made to establish health care priorities and allocating scarce resources.
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