Objective To study the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin (Hb) ‡13.2 g/dl.Design A randomised, double-blind, placebo-controlled trial.Setting Routine health services.Population Seven hundred and twenty-seven pregnant women with Hb ‡13.2 g/dl in the early stage of the second trimester.Methods Each woman took one tablet of 50 mg of ferrous sulphate daily in the case group (n = 370) or placebo in the control group (n = 357) throughout pregnancy.Main outcome measures Pregnancy outcome.Results While there were no significant differences in demographic and obstetric characteristics between the two groups before any intervention, small-for- Conclusions Our finding proves that routine iron supplementation in nonanaemic women is not rational and may be harmful.Keywords Iron supplementation, nonanaemic women, pregnancy outcome.Please cite this paper as: Ziaei S, Norrozi M, Faghihzadeh S, Jafarbegloo E. A randomised placebo-controlled trial to determine the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin ‡ 13.2 g/dl. BJOG 2007;114:684-688.

Later admission in labor increases the rate of spontaneous vaginal delivery in low risk nulliparous women.

Background: Hot flashes affect as many as 75% of menopausal women. Estrogen reliably reduces the severity of hot flashes and remain the single most effective treatment. Today, however, more and more women are seeking alternatives. Instead of hormonal therapy, women are turning to vitamins, and other over-the-counter products for relief from hot flashes. This study was undertaken to assess the effect of vitamin E on hot flashes. Method: A placebo double blind-controlled trial was conducted. After 1 week baseline period, the enrolled patients (n = 51) received placebo (identical in appearance to vitamin E softgel) daily for 4 weeks, followed by 1 week wash out and 400 IU vitamin E (softgel cap) daily for the next 4 weeks. Diary was used to measure hot flashes before and at the end of the study. Result: There were statistical significant differences in hot flashes severity score (2.37 ± 0.74, 1.80 ± 0.87) and their daily frequency (5.00 ± 3.34, 3.19 ± 2.74) after the treatments between the placebo and vitamin E therapies (p < 0.0001). Conclusion: Based on our trial, vitamin E is recommended for the treatment of hot flashes.

BackgroundAccurate and timely diagnosis of endometriosis is associated with confusion. Clinical manifestations, imaging techniques, biomarkers and surgical techniques are used as diagnostic approaches. This paper reviews current evidence on clinical manifestation in order to help practitioners and perhaps improve women’s health.MethodsA review of the literature on clinical diagnosis of pelvic endometriosis that appeared in the English language biomedical journals was performed using PubMed, Science Direct and Google Scholar. The search strategy included the combination of key words ‘endometriosis’ and ‘diagnosis’ or ‘clinical diagnosis’ in the titles or abstracts of articles. The search included all papers published during the year 2000 to 2014. Then, the findings were classified in order to summarize the evidence.ResultsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, in all 51 papers were found relevant and included in this review. In general we found three categories of diagnostic approaches for clinical manifestation including: i) diagnosis via symptoms obtained from history taking, ii) diagnosis via signs obtained from physical examination and iii) diagnosis via risk factors obtained from history taking.ConclusionDiagnosis of endometriosis is a matter of concern. Since the disease is associated with diverse clinical symptoms and signs, deeper and more comprehensive consideration according to patient’s history and clinical findings is recommended for early and more accurate detection in order to prioritize women for further investigation and contribute to its early management.

BackgroundThe prevalence of endometriosis is considerable but its diagnosis is a dilemma. The aim of this study was to explore the perception and experiences of endometriosis patients and physicians about occurrence and diagnosis of endometriosis.MethodsA qualitative research using content analysis was used to obtain data from purposely selected endometriosis patients (12 participants) and gynecologists (6 participants) from January to September 2013 in Tehran. Data were coded and analyzed using a thematic approach.ResultsSeven themes emerged: 1) pain localization, 2) Severity of pain and struggle for pain relief, 3) Feeling inability to play the role of femininity, 4) Reducing physical health, 5) Disruption of social life, 6) Looking for a reliable diagnostic indicator, 7) Uncertainty of physical examination. The results highlighted that patients with the disease can experience different feelings that interfere with their wellbeing and their lives, and sometimes could be disabling.ConclusionPatients and physicians are looking for a certain, noninvasive and inexpensive diagnostic method. This study helps to promote clinical diagnostic view and knowledge development about description of endometriosis diagnosis to decrease diagnostic delay and mismanagement.