An Evaluation of Acupressure on the Sanyinjiao (SP6) and Hugo (LI4) Points on the Pain Severity and Length of Labor: A Systematic Review and Meta-analysis Study

Background:

In this study, the effects of SP6 and LI4 acupressure on the pain severity and length of labor are examined.

Materials and Methods:

This systematic review and meta-analysis study was performed on articles published in 2004–2015. The articles, published in the English and Farsi languages, related to the effects of acupressure on the SP6 and LI4 points on the length and pain severity of labor. Data were collected by searching medical databases, including PubMed, ISI, MagIran, Google Scholar, Iran Medex, SID, Irandoc, and EMBASE, for relevant material.

Results:

Women who received SP6 acupressure experienced less pain immediately after the intervention [−0.56, 95% confidence interval (CI): −0.77, −0.36] than women in the touch group and exhibited decrease in the length of labor (−0.99, 95% CI: −1.39, −0.39), the active phase (0.95, 95% CI: −1.30, −0.61), and the second stage of labor (−0.39, 95% CI: −0.74, −0.03). Women who received LI4 acupressure experienced less pain immediately after the intervention (−0.94, 95%, CI: −1.36, −0.53) than women in the touch group and exhibited shorter active phase (−0.91, 95%, CI: −1.18, −0.63) and second stage of labor (−0.55, 95%, CI: −0.95, −0.15) lengths.

Conclusions:

The use of SP6 and LI4 acupressure shows promise as a method for managing the length and pain severity of labor, but further study is required to establish its effectiveness along with other pharmacological and nonpharmacological methods.

The Effect of Sevoflurane Plus Propofol on Pain and Complications after Laminectomy: A Randomized Double Blind Clinical Trial

INTRODUCTION

Pain is one of the most important reasons for the patients concern after surgery. The perfect sedative should have properties like rapid onset, least pain and adverse effects.

AIM

To assess the effect of sevoflurane plus propofol on postoperative pain, haemodynamic stability and complication after lumbar disc surgery.

MATERIALS AND METHODS

This was a randomized double- blind clinical trial. A total of 75 patients scheduled for elective lumbar disc surgery with simple random sampling design received sevoflurane (n=25, induced with Thiopentone and maintained with sevoflurane), propofol (n=25, induced and maintained with propofol) and sevoflurane plus propofol (n=25, induced with propofol and maintained with sevoflurane). Visual Analog Scale (VAS) was used to determine the intensity of postoperative pain. Complications after surgery and haemodynamic changes during surgery were recorded.

RESULTS

The mean pain intensity and morphine consumption in the sevoflurane plus propofol group was lower compared to the propofol and sevoflurane groups at different intervals (p<0.001). The prevalence of shivering, nausea and vomiting in the sevoflurane plus propofol group was 24%, 28%, 28% respectively vs sevoflurane group 32%, 60%, 48% respectively and propofol group 32%, 16%, 12% respectively with p-value > 0.05, <0.001, <0.05 respectively. The mean blood pressure and heart rate were significantly lower in the sevoflurane plus propofol group compared to the propofol and sevoflurane groups (p<0.001).

CONCLUSION

According to the effect on pain and complications after lumbar disc surgery sevoflurane plus propofol can be regarded as safe and alternative drug in general anaesthesia for these patients.

Effect of Ketofol on Pain and Complication after Caesarean Delivery under Spinal Anaesthesia: A Randomized Double-blind Clinical Trial

INTRODUCTION

Pain is the key concern of women after caesarean delivery that may interfere with breastfeeding.

AIM

The aim of this study was to assess effect of ketofol (ketamine/propofol combination) on pain and complication after caesarean delivery under spinal anaesthesia.

MATERIALS AND METHODS

In this randomized double-blind clinical trial, 92 parturient scheduled for elective caesarean delivery under spinal anaesthesia were included. The simple random sampling method was used to place subjects in four groups of ketamine (0.25 mg/kg), propofol (0.25 mg/kg), ketofol (25 mg ketamine plus 25 mg propofol) and placebo (saline). The drugs were administered intravenously immediately after clamping the umbilical cord. Visual Analog Scale (VAS) was used to determine the intensity of pain. Complications after surgery including shivering, nausea and vomiting as well as onset of breastfeeding were recorded.

RESULTS

The mean score of pain, morphine consumption and time of breastfeeding in the ketofol group were significantly lower than other groups at various intervals (p<0.05, p<0.001). The frequencies of shivering, nausea, vomiting, retention and pruritus in the ketofol group were significantly lower than other groups (p<0.001, p<0.05).

CONCLUSION

The effective role of ketofol on reducing pain and complication after caesarean delivery indicated that it can be considered as a safe and alternative drug in these patients.

Association between Hyperglycaemia with Neurological Outcomes Following Severe Head Trauma

INTRODUCTION

Head Trauma (HT) is a major cause of death, disability and important public health problem. HT is also the main cause of hyperglycaemia that can increase mortality.

AIM

The aim of this study was to assess the correlation between hyperglycaemia with neurological outcomes following severe Traumatic Brain Injury (TBI).

MATERIALS AND METHODS

This is a descriptive and correlation study that was carried out at the Imam Khomeini Hospital affiliated with Ilam University of Medical Sciences, Ilam, IR, during March 2014-March 2015 on patients with severe TBI. Data were collected from the patient records on mortality, Intensive Care Unit (ICU) length of stay, hospital length of stay, admission GCS score, Injury Severity Score (ISS), mechanical ventilation, Ventilation Associated Pneumonia (VAP) and Acute Respiratory Distress Syndrome (ARDS). Random Blood Sugar (RBS) level on admission was recorded. Patients with diabetes mellitus (to minimize the overlap between acute stress hyperglycaemia and diabetic hyperglycaemia) were excluded.

RESULTS

About 34(40%) of patients were admitted with hyperglycaemia (RBS ≥ 200 mg/dl) over the study period. The mortality rate, length of ICU stay, hospital stay, ISS and VAP & ARDS in patients with RBS levels ≥ 200 mg was significantly higher than patients with RBS levels below ≤ 200mg (p<0.05, p<0.001). A significant correlation was found between RBS with GCS arrival, length of ICU stay, length of hospital stay, ISS, mechanical ventilation and VAP & ARDS (p<0.05, p< 0.001). RBS is a predicate factor for ISS (p <0.05, OR : 1.36), GCS (p <0.001, OR : 1.69), mechanical ventilation (p< 0.05, OR : 1.27), VAP & ARDS (p <0.001, OR : 1.68), length of ICU stay (p <0.001, OR : 1.87) and length of hospital stay (p <0.05, OR : 1.24).

CONCLUSION

Hyperglycaemia after severe TBI (RBS ≥ 200) is associated with poor outcome. It can be a predictive factor for mortality rate, ICU stay, GCS arrival, VAP & RDS, hospital stay and ISS. Management of hyperglycaemia with insulin protocol in cases with value >200mg/dl, is critical in improving the outcome of patients with TBI.

The Effect of Gabapentin Plus Celecoxib on Pain and Associated Complications After Laminectomy

INTRODUCTION

Prevention and treatment of postoperative pain is a major challenge in postoperative care and well-being of the surgical patient. The multimodal analgesic method has been recommended as an alternative treatment for the management of postoperative pain.

AIM

To assess the comparative effect of gabapentin versus gabapentin plus celecoxib on pain and associated complications after laminectomy.

MATERIALS AND METHODS

In this randomized double- blind clinical trial, 114 patients scheduled for elective laminectomy received gabapentin (n=38, 900 mg daily), gabapentin plus celecoxib (n=38, 200 mg celecoxib plus 300mg gabapentin twice a day), and placebo (n=38, capsule containing starch). Visual Analog Scale (VAS) was used to determine the severity of pain. Complications after surgery, anxiety scores before surgery and patient's satisfaction 24 hour after surgery were recorded.

RESULTS

The mean pain sevenity score and morphine consumption in the gabapentin plus celecoxib group were less compared to the placebo and gabapentin group respectively at various intervals (p < 0.001). The mean anxiety score, shivering, nausea, vomiting and pruritus in the gabapentin group were significantly lower compared to the placebo and gabapentin plus celecoxib groups respectively (p < 0.001, p < 0.05). The frequencies of drowsiness (42.1%) in the gabapentin group were significantly high compared to the placebo and gabapentin plus celecoxib group respectively (p <0.001, p< 0.05). In the gabapentin plus celecoxib group patient satisfaction was significantly higher compared to the placebo and gabapentin group (p< 0.05).

CONCLUSION

Combination of 300 mg gabapentin plus 200 mg celecoxib twice a day is a good alternative in multimodal analgesia, effective in pain control with lesser side effects seen with gabapentin alone.

Comparing Gabapentin and Celecoxib in Pain Management and Complications After Laminectomy: A Randomized Double-Blind Clinical Trial

BACKGROUND

Complications and postoperative pain are major care problems that can affect the quality of health care plan.

OBJECTIVES

According to the use of multimodal therapy the current study aimed to compare the efficacy of gabapentin and celecoxib in pain management and complications after laminectomy at Ilam University of Medical Sciences, Ilam, Iran, in 2015.

PATIENTS AND METHODS

In this randomized double-blind clinical trial, 114 patients scheduled for elective laminectomy with simple random sampling design received gabapentin (n = 38, 900 mg/day), celecoxib (n = 38, 600 mg/day) and placebo (n = 38, capsule contain starch). Visual analog scale (VAS) was used to determine the intensity of pain. Complications after surgery, anxiety scores before surgery and patient's satisfaction 24 hours after the surgery were recorded.

RESULTS

The mean pain intensity in the gabapentin group was lower compared to those of the placebo and celecoxib groups respectively at different time durations (P < 0.001). The means of morphine consumption were 11.9 mg, 22.8 mg and 30.1 mg in the gabapentin, celecoxib and placebo groups, respectively (P < 0.001). The prevalence of shivering, nausea, vomiting and pruritus were 10.5%, 12.8%, 10.3% and 18.4% in the gabapentin group vs 31.5%, 29.8%, 32.4% and 28.9% in the celecoxib group and 42.1%, 44.7%, 39.5% and 44.7% in the placebo group (P < 0.001). The mean anxiety score in the gabapentin group was 2.4 vs those of the celecoxib group 3 and placebo group 3.6 (P < 0.001). The frequencies of drowsiness were 42.1%, 13.2% and 5.3% in the gabapentin, celecoxib and placebo groups, respectively (P < 0.001). In the gabapentin group, patient satisfaction was significantly higher compared to those of the placebo and celecoxib groups (P < 0.05).

CONCLUSIONS

According to the effect of gabapentin on pain management, complications after laminectomy and increased patients satisfaction, it can be regarded as an alter native in multimodal analgesia.

Outcome and Predicting Factor Following Severe Traumatic Brain Injury: A Retrospective Cross-Sectional Study

INTRODUCTION

Severe traumatic brain injury (TBI) is a major and challenging problem in critical care medicine.

AIM

To assess the outcome and predicting factor following severe TBI.

MATERIALS AND METHODS

This is a retrospective and cross-sectional study. Data were collected from two sections; one section consisting of a questionnaire answered by the patients and other section from the patient records. The instruments used included the Glasgow Outcome Scale (GOS), SF-36 and the Hospital Anxiety and Depression Scale (HAD).

RESULTS

The mortality rate of the patients was 46.2%. The quality of life (QOL) of the patients in most dimension were impaired and (58%) of patients had unfavourable QOL. About (37.5%) of patients with anxiety and (27.5%) had a depression. A significant correlation was found between age, GCS arrival, length of ICU stay, mechanical ventilation, VAP & ARDS and pupil reactivity with QOL, GOS, HAD-A and HAD-D (p<0.05, p< 0.001). GCS arrival a predicate factor for QOL and GOS (p <0.001, OR: 1.75, 1.94 respectively); length of ICU stay a predicate factor for QOL and GOS (p <0.05, OR : 1.11, 1.28 respectively); mechanical ventilation a predicate factor for GOS (p <0.001, OR : 1.78); ventilation associated pneumonia (VAP) & acute respiratory distress syndrome (ARDS) and pupil reactivity a predicate factor for GOS (p <0.05, OR : 1.36; p<0.001, OR: 1.94 respectively). The GCS arrival and ICU stay a predicate factor for HAD-A (p<0.05, OR: 1.73, 1.38 respectively).

CONCLUSION

With respect to results advanced in pre hospital, medical and surgical care for the decrease in mortality rates of Head trauma (HT), the use of trauma triage tools and strict enforcement of traffic rules are necessary.

Claudication Due to Sciatic Nerve Palsy Following Nicolau Syndrome: A Case Report

Nicolau syndrome is a rare drug reaction due to intramuscular injection administration that can lead to limb loss or even death. A 3.8-year-old Iranian boy received an intramuscular injection of Benzathine Penicillin. Immediately after injection the child developed lower limb pain and livedoid discolouration and was referred to our department. The patient was diagnosed to develop Nicolau syndrome and fasciotomy carried out due to compartment syndrome. Pharmacologic therapy with Heparin, Cefazolin and Methylprednisolone was initiated. On 18(th) day, he was discharged, although he was not able to move. Finally, after 6 months of care at home, physiotherapy and Electromyography (EMG) at regular intervals, the child was gradually able to move and his claudication improved.

A 7-Years Retrospective Study of Gastrointestinal Cancers Incidence in the Western Iran

INTRODUCTION

In Iran, cancer is the third reason of the death and every year 500,000 new cases were detected, and 14% of all death is related to cancer. The most common system that is affected by cancer (after the skin) is gastrointestinal (GI) system. The purpose of the study is evaluation of the 7 years incidence (2002-2008) of the GI cancers in Ilam province in the west of Iran.

MATERIALS AND METHODS

In this retrospective cross-sectional study, total 307 record health related to the patients affected by the gastro-intestinal system cancer were evaluated after referring to the pathologic centers of the Ilam province and neighboring provinces. Patient's data were recorded from their file based on the standard questionnaire.

RESULT

The mean age ± standard deviation of participants was 63.8+1.5. More than half of participants study was men (58.3%). The prevalence of the esophagus, stomach, small intestine and colorectal cancers was significantly higher in the men than the women (unlike liver cancer) (p<0.001). The most common site of GI cancer were esophagus (38.1%) and stomach (34.2%) but small intestine was allocated the least prevalence (1%) to itself. The most common pathology type of cancer was adenocarcinoma in the GI system (68.1%).

CONCLUSION

According to the high prevalence of the GI cancer and also the ascending incidence of the patient with disease in the Ilam province, special measures should be considered for the reduction of the life and property load resulted from this disease. People by introduction of the warning signs of the gastrointestinal system cancer should be screened for GI cancer.

The Effect of Whole Body Massage on the Process and Physiological Outcome of Trauma ICU Patients: A Double-Blind Randomized Clinical Trial

BACKGROUND AND AIM

Hospitalization of traumatic patients in the Intensive Care Unit (ICU) and their critical condition can cause haemodynamic instabilities and deterioration in the level of consciousness. The study aimed to investigate the effect of whole body massage on the vital signs, Glasgow Coma Scale (GCS) scores and arterial blood gases (ABG) in trauma ICU patients.

MATERIALS AND METHODS

In a randomized, double-blind trial, 108 trauma ICU patients received whole body massage {experimental group (n=54)}, or routine care {control group (n=54)}. The patients vital signs; systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), pulse rate (PR), Temperature (T), GCS score and ABG parameters were measured by a nurse at the same time in both groups before the intervention and 1 hour and 3 hours after the intervention with a checklist. The patient in experimental group received full body massage in 45 minute by a family member.

RESULTS

According to the findings, significant differences were observed between experimental and control groups in SBP 1 hour and 3 hours after intervention (p< 0.001), DBP, RR and PR 1 hour after intervention (p<0.001) and GCS 1 hour and 3 hours after intervention (p<0.05). Of ABG parameters, significant differences were observed between experimental and control groups in O2 saturation (p<0.001), PH (p<0.001) and pO2 (p<0.05). No significant differences between experimental and control groups in Temperature, pCO2 and HCO3 (p>0.05).

CONCLUSION

With respect to this study, massage therapy is a safe and effective treatment in intensive care units to reduce patient's physical and psychological problems. Therefore the use of massage therapy is recommended to clinical practice as a routine method.

The effect of cinnamon on menstrual bleeding and systemic symptoms with primary dysmenorrhea

Background:

Primary dysmenorrhea with interferes in daily activities can have adverse effects on quality of life of women.

Objectives:

Regarding the use of herbal medicine, the aim of this study was to assess the effect of cinnamon on primary dysmenorrhea in a sample of Iranian female college students from Ilam University of Medical Sciences (west of Iran) during 2013-2014.

Patients and Methods:

In a randomized double-blind trial, 76 female student received placebo (n = 38, capsules containing starch, three times a day (TDS)) or cinnamon (n = 38, capsules containing 420 mg cinnamon, TDS) in 24 hours. Visual analogue scale (VAS) was used to determine the severity of pain and nausea. Vomiting and menstrual bleeding were assessed by counting the number of saturated pads. The parameters were recorded in the group during the first 72 hours of the cycle.

Results:

The mean amount of menstrual bleeding in the cinnamon group was significantly lower than the placebo group (P < 0.05 and P < 0.001, respectively). The mean pain severity score in the cinnamon group was less than the placebo group at various intervals (4.1 ± 0.5 vs. 6.1 ± 0.4 at 24 hours, 3.2 ± 0.6 vs. 6.1 ± 0.4 at 48 hours, and 1.8 ± 0.4 vs. 4.0 ± 0.3 at 72 hours, respectively) (P < 0.001). The mean severity of nausea and the frequencies of vomiting significantly decreased in the cinnamon group compared with the placebo group at various intervals (P < 0.001, P < 0.05).

Conclusions:

Regarding the significant effect of cinnamon on reduction of pain, menstrual bleeding, nausea and vomiting with primary dysmenorrhea without side effects, it can be regarded as a safe and effective treatment for dysmenorrhea in young women.

Comparative effect of cinnamon and Ibuprofen for treatment of primary dysmenorrhea: a randomized double-blind clinical trial

BACKGROUND AND AIMS

Primary dysmenorrheal has a negative impact on women's quality of life. The purpose of this study was to compare the effect of Cinnamon and Ibuprofen for treatment of primary dysmenorrheal in a sample of Iranian female college students from Ilam University of Medical Sciences (western Iran).

MATERIALS AND METHODS

In a randomized, double-blind trial, out of 114, control group received placebo (empty capsules contain starch, TDS, n= 38) a test group received Ibuprofen (capsule containing 400mg Ibuprofen, TDS, n=38), or another test group received Cinnamon (capsule containing 420 mg Cinnamon, TDS, n= 38) in 24 h. To determine severity of pain, we used the VAS scale. Pain intensity and duration of pain were monitored in the group during first 72 h of cycle.

RESULTS

The mean pain severity score and mean duration of pain in Ibuprofen and Cinnamon were less than placebo group respectively (p< 0.001). Of 4 hours after the intervention there were no statistically significant differences between the Cinnamon and placebo group (p> 0.05). Of eight hours after the intervention, the mean pain severity in the cinnamon group was significantly lower than placebo group (p< 0.001). At various time intervals the mean pain severity in the Ibuprofen group were significantly less than Cinnamon and placebo groups (p< 0.001).

CONCLUSION

Cinnamon compared with placebo significantly reduced the severity and duration of pain during menstruation, but this effect was lower compared with Ibuprofen. Cinnamon can be regarded as a safe and effective treatment for primary dysmenorrhea. More researches are recommended to study the efficacy of Cinnamon on reducing menstrual bleeding.

Association of body weight and female sexual dysfunction: a case control study

Background:

Obesity is rapidly increasing worldwide with negative effects on women’s health, psychosocial factors and quality of life. Female sexual dysfunction (FSD) is a major public health problem that is worrying for many women physically, emotionally and socially.

Objectives:

The purpose of this study was to investigate the association of body weight with FSD and sexual satisfaction, in Ilam, western Iran, in 2010 to 2011.

Patients and Methods:

This was a case-control study on 120 women aged 18–50 years [64 with FSD (case), 64 without FSD (control)] married, from Ilam-IR, who were interviewed as per the Iranian version of Female Sexual Function Index (FSFI). Body mass index (BMI) and waist-to-hip ratio (WHR) were recorded by researchers. The subjects were randomly selected from primary health centers.

Results:

FSFI score was significantly lower in overweight women (P < 0.05). FSFI strongly correlated with body mass index (BMI) (r = -0.68, P < 0.001) and waist-to-hip ratio (r = -0.29, P < 0.05) in women with FSD. Of sexual function parameters, there was a strong and inverse correlation between BMI and arousal (r = -0.71, P < 0.001), lubrication (r = -0.61, P < 0.001), orgasm (r = -0.52, P < 0.001) and satisfaction (r = -0.54, P < 0.001), while pain (r = -0.12, P > 0.05) and desire (r = -0.17, P > 0.05) did not correlate with BMI. There was an association between BMI and extreme satisfaction (r = -0.28, P < 0.05). Extreme physical pleasure (r = -0.19, P > 0.05) and extreme emotional satisfaction (r = -0.16, P > 0.05) were not correlated with BMI.

Conclusions:

Overweight and obesity negative affect sexuality in women with sexual dysfunction. A systematic evaluation of sexual function to disclose a cause and effect relationship between obesity and FSD is suggested.

Associated factors with male infertility: a case control study

OBJECTIVE

Sperm analysis is an important step to evaluate and diagnose male's infertility. The present study aimed to determine associated factors with males' infertility by using semen analysis.

MATERIALS AND METHODS

In this study 96 men were evaluated who attended to the infertility clinics of Ilam province, western Iran between May 2010 to May 2011. Semen analysis was done using the Weili Dynamic Sperm Analysis software adapted to the WHO classification. Based on movement and speed characters, sperms were classified to either A, B, C or D classes. Participants were stratified into two groups that called "Oligospermia (OS)" with sperm counts of less than 20 million in mL (n=48) and "Non-Oligospermia (NOS)" with values more than determined cutoff point (n=48).

RESULTS

The Mean age ±SD for OS and NOS group were 29.9 ±5.1 y and 31.17 ±5.24 y, respectively (p>0.05). Overall, 62.5% of OS and 31.2% of NOS were clinically infertile (OR=3.6, CI, 1.5-8.5, p=0.01). A significant difference was found between job and live ratio(A+B+C) in NOS group (F=2.8, p<0.05).

CONCLUSION

Prevalence of infertility was higher in the OS men compared to the NOS group. The main risk factors in the OS group were History of Varicocele surgery and residence site of patients that are totally similar to the NOS men. Further case-control studies and clinical trials are recommended to recognize infertility causes in men.

Using VARK Approach for Assessing Preferred Learning Styles of First Year Medical Sciences Students: A Survey from Iran

BACKGROUND

Preferred learning styles of learners are different, which depend on tastes, mentality preparedness, as well as physical condition, in terms of sensory modalities. Identifying and employing appropriate learning styles could play an important role in selecting teaching styles, which can improve education ultimately.

AIM

The present study aimed to assess the diversity of learning styles amongst medical students of a medical sciences university which was located west of Iran, in 2010.

METHODS

A cross-sectional study which employed VARK learning style's questionnaire was done on 141 first year medical sciences students at Ilam University of Medical Sciences in 2010. Data was collected with use of VARK questionnaire. The validity of the questionnaire was assessed on basis of experts' views and its reliability was calculated by using Cronbach's alpha coefficients (α=0.86). Data were analysed by using SPSS software and Chi-square test.

RESULTS

Overall, 41.6% of the samples preferred to use a single learning style (Uni-modal). Of these, 17.7% preferred the Aural style, 17% preferred Reading and Writing, 6.4% preferred Kinesthetic style and 0.7% preferred Visual styles. Among the rest of the 82 students who preferred more than one style (multimodal), 17% chose two modes (bimodal), 13.5% chose three modes (tri-modal), and 27.6% chose four modes (quad-modal). There was a significant difference between educational levels and majors on one hand and choice of quad modal of VARK styles on the other hand (p=0.008). A significant association was also found between participants' genders and selection of visual and reading/writing styles (p=0.03).

CONCLUSION

The preferred learning styles of medical students in the present study were aural and reading/writing. It is suggested that all medical students must be tested to determine their desired learning styles by using VARK questionnaire, also to choose appropriate teaching methods and to improve educational goals.

Female sexual dysfunction: prevalence and risk factors

BACKGROUND AND AIM

Sexual dysfunction adversely affects quality of life, self esteem and interpersonal relationships and it may often be responsible for psychopathological disturbances. The purpose of this study was to explore the prevalence and associated risk factors for Female Sexual Dysfunction (FSD) in women with Kurdish culture from western Iran .

MATERIAL AND METHODS

This was a cross-sectional descriptive survey which included 400 women aged 18-50 years old, married, from Ilam-IR, who were interviewed as per the Iranian version of Female Sexual Function Index (FSFI). The subjects were randomly selected from 4 primary health centres.

RESULTS

According to the findings, 185 (46.2%) women reported FSD. Prevalence of FSD increased with age, from 22% in women aged <20 years to 75.7% in women aged 40-50 years. FSD was detected as a desire problem in 45.3% of women, an arousal problem in 37.5%, a lubrication problem in 41.2%, an orgasm problem in 42.0%, a satisfaction problem in 44.5% and a pain problem in 42.5%. The educational level was inversely correlated with the risk of FSD (OR: 1.54 ,95% CI: 1.09-2.13). Patients with FSD were significantly more likely to be older than 40 years (OR: 2.23, 95% CI: 1.12-2.68), who had sexual intercourse fewer than 3 times a week (OR:1.85, 95% CI: 1.23-1.99), who had been married for 10 years or more (OR:1.76, 95% CI: 1.04-1.97), who had 3 children or more (OR: 1.48, 95% CI: 0.97-1.24), who had husbands aged 40 years or more (OR: 2.11, 95% CI: 1.35-2.37) and who were unemployed (OR: 1.34, 95% CI: 1.06-1.63). No significant differences were detected in smoking history, residences and contraception methods used (p>0.05).

CONCLUSION

FSD needs to be recognized as a significant public health problem in Kurd women. Further research, particularly studies on awareness and competency of physicians in the management of FSD, is required.