ObjectivesThe aim of the present study was to evaluate the prevalence of polycystic ovary syndrome (PCOS), its phenotypical and cardio-metabolic features in a community sample of the Iranian population in comparison to healthy eumenorrheic, non-hirsute women without polycystic ovaries. The second aim was to assess the cardio-metabolic characteristics of women who suffered from one criteria of PCOS compared to those healthy eumenorrheic, non-hirsute women.MethodsIn this cross-sectional population-based study, a total of 1,960 eligible women, aged (18–45 years) were recruited from the Tehran-Lipid and Glucose-Study participants and were classified as the three groups of (i) women with PCOS by the Rotterdam criteria, (ii) non-PCOS women with one criteria of PCOS and (iii) healthy eumenorrheic, non-hirsute women without polycystic ovaries morphology (PCOM) as the control group. Further PCOS women were extended to four phenotypes of hyperandrogenism, oligo-anovulation, polycystic ovaries (phenotype A), hyperandrogenism, oligo/anovulation (phenotype B), hyperandrogenism, polycystic ovaries (phenotype C) and oligo-anovulation, polycystic ovaries (phenotype D). Cardio-metabolic profiles and the prevalence of comorbidities of metabolic syndrome (MetS) and lipid abnormalities were compared among these groups linear, and the median regression models adjusted for age and body mass index.ResultsThe prevalence of PCOS according to the diagnostic criteria of the NIH, Rotterdam and AE-PCOS Society were 13.6, 19.4, and 17.8, respectively. Among those who met the Rotterdam criteria, 23.9, 46.3, 21.6, and 8.2% had phenotypes A, B, C, and D, respectively. Among the remaining 1,580 women who did not fulfil the PCOS criteria, 108 (6.8%) suffered from only oligo/anovulation, 332 (21%) only hyperandrogenism/hyperandrogenemia, 159 (16.2%) only PCOM in ultrasound and 981 (62%) were healthy eumenorrheic, non-hirsute women without PCOM. The study revealed that some adiposity indices and lipid abnormalities in PCOS phenotypes with hyperandrogenism (A, B, and C) were worse than in healthy women. By contrast, women with phenotype D did not differ from the healthy ones in terms of adiposity and lipid abnormalities. However, the respective values for other cardio-metabolic profiles and MetS rates in different phenotypes of PCOS were similar to the healthy women. Only the prevalence of MetS in phenotype A was significantly higher than in the healthy women. There were no statistically significant differences between participants with one criteria of PCOS and healthy counterparts in terms of most adiposity indexes, cardio-metabolic factors, and comorbidity of MetS and its components. However, women with hyperandrogenism had a significantly higher level of the waist to height ratio (WHtR) and hypertriglyceridemia than their healthy counterparts.ConclusionPCOS, mainly classical phenotypes A and B, are common among Iranian women of reproductive age. Women with PCOS who had androgen excess exhibited the worst lipid profile, and those who had full three criteria of the syndrome exhibited the higher rate of MetS. However, women with only ovulatory dysfunction and only PCOM had similar cardio-metabolic characteristics, compared to healthy subjects. These data suggest that routine screening for metabolic disturbances may be needed in the prevention of cardio-metabolic disorders in patients with more serious phenotypes of PCOS.

Objectives-The accurate, rapid diagnosis of stress urinary incontinence (SUI) in women can profoundly improve their sexual and psychosocial life. In this study, the diagnostic power of SUI was assessed by transperineal ultrasound.Methods-In this hospital-based case-control study, married women who were referred to the gynecologic and ultrasound wards with negative urinalysis and culture results were enrolled by random sampling. Patients with positive cough signs based on the urodynamic testing data were considered cases, whereas control women showed no cough symptoms and were recruited from the same ward.Results-There was a significant difference (P < .001) in bladder neck descent (mean AE SD, 10.89 AE 5.51 versus 7.08 AE 2.60 mm, respectively; P = .0001) and the retrovesical (β) angle with the Valsalva maneuver (144.22 AE 19.63 versus 111.81 AE 24.47 ; P < .001) between the case and control groups. Also, the β angle without the Valsalva maneuver was higher in the case group (112.35 AE 23.10 ) than the control group (120.17 AE 25.16 ; P = .001). There was no case of a urinary leak, urethral diverticulitis, a bladder stone or mass, and cystourethrocele in the patients of each group. The results of multivariate logistic regression with a backward method showed that bladder neck descent (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.09-1.40), the β angles with and without the Valsalva maneuver (OR, 1.1; 95% CI, 1.06-1.13; and OR, 1.04; 95% CI, 1.01-1.06) were the predictors of SUI. A β angle higher than 127 with the Valsalva maneuver, with an area under the curve of 0.89 (95% CI, 0.75-0.96), could very well predict the SUI response. This finding shows that it can be very well used to distinguish between normal and non-normal responses, with 89% sensitivity and 79% specificity.Conclusions-The β angle with the Valsalva maneuver could very well predict the SUI response. Key Words-diagnosis; female urogenital diseases; retrovesical angle; stress urinary incontinence; transperineal ultrasound S tress urinary incontinence (SUI) is one of the crucial pelvic floor disorders, affecting many women around the world. 1 This disease occurs with an incidence rate ranging from 10% to 30% in different ethnicities/races. 2 Stress urinary incontinence is defined as unintended urine leakage by coughing, sneezing, lifting, or laughing, which can rigorously impair the patient's quality of life 3 and negatively affect her social and sexual life. Women with this problem will avoid social gatherings and lose

Objective: Surfactant administration has an essential role in the treatment of neonatal respiratory distress syndrome (RDS). This is coupled with the capability of a lung sonography scoring system (LUS scoring) in assessing neonatal lungs with RDS, makes evaluating the role of such a scoring system important in deciding to use surfactant therapy. Materials and Methods: This cross-sectional study was conducted on neonates with RDS, at a gestational age of more than 30 weeks. Using a high-frequency ultrasound transducer, neonates’ results were assessed by a radiologist, and then LUS scoring was determined in both groups, with and without the need for surfactant therapy. Results: The mean LUS scoring in the two groups was 9.08 ± 3.09 and 4.12 ± 2.56, respectively, which indicated a significant difference. The LUS scoring had a higher ability to predict the need for surfactant treatment, based on a receiver operating curve analysis. The best diagnostic cutoff point, for LUS scoring in predicting the need for surfactant treatment, was 6 in neonates 30–32 weeks and 7 in neonates 32–34 weeks. The use of LUS scoring had a sensitivity of 85.1%, 84% and a specificity of 87.2%, 88%, respectively. Conclusion: The LUS scoring may be used to help in the predicted need for surfactant therapy, in neonates with RDS.

Arteriovenous fistula (AVF) between the external carotid artery and external jugular vein is extremely rare, with only few cases reported in the literature so far. Most of these AVFs have been either iatrogenic or secondary to previous trauma.Herein, we report a 42-year-old woman with congenital AVF between the external carotid artery and external jugular vein, presenting with palpitation and dyspnea. The patient was suffering from mitral and tricuspid regurgitation. On physical examination, a thrill on the left side of the neck and an audible bruit over the left mandibular angle were detected.The possibility of abnormal AVF was considered and it was confirmed on contrast-enhanced computed tomography (CT), inferring that this modality is not only fast and non-invasive, but also accurate in detecting vascular abnormalities.

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