Are Iranian obese women candidate for bariatric surgery different cognitively, emotionally and behaviorally from their normal weight counterparts?

OBJECTIVE: The purpose of the present study was to examine the cognitive, emotional and behavioral differences between obese and normal weight women. METHODS: The participants consisted of 60 obese women (BMI ≥ 35, Mean age 35.83) who were candidates for bariatric surgery and 60 normal weight women (BMI ≤ 24.90, Mean age 33.38) who were selected through convenient sampling method. The two groups were matched with respect to age and education. Measures included the Young Schema Questionnaire-Short Form, Difficulties in Emotion Regulation Scale (DERS) and the Binge Eating Scale. Independent sample t test and Mann-Whitney U tests were conducted to compare the two groups' scores on early maladaptive schemas, DER and binge eating. RESULTS: Results indicated that obese women candidate for bariatric surgery scored significantly higher on emotional deprivation, mistrust, failure, dependency, enmeshment, self-sacrifice, especially abandonment, social isolation, vulnerability, self-control and subjugation schemas, but not on shame, entitlement, emotional inhibition and unrelenting standards. Obese women also displayed higher scores on three subscales of DERS, i.e., goal, impulse and strategies. BE scores were significantly higher in obese women than normal weight ones. CONCLUSION: The findings showed that obese women candidates for bariatric surgery suffered from more cognitive, emotional and behavioral vulnerability compared to women with normal weight. Addressing these vulnerabilities among obese women could improve outcomes of weight loss surgeries and cognitive behavioral interventions so that weight regain is minimized and better outcomes are achieved.

Effects of simvastatin in prevention of pain recurrences after surgery for endometriosis.

BACKGROUND: To compare efficacy of simvastatin with GnRHa (Decapeptyl 3.75 mg) on endometriosis-related pains following surgery for endometriosis. MATERIAL/METHODS: Sixty women with pelvic endometriosis, after laparoscopic diagnosis and conservative laparoscopic surgery, were treated with either simvastatin (n=30) for 16 weeks or Decapeptyl (n=30) every 4 weeks for 4 doses. RESULTS: Using VAS, the score of dyspareunia, dysmenorrhea, and pelvic pain 6 months after laparoscopic surgery declined significantly in both groups (p=0.001), but the difference between results of the 2 groups was not significant (p>0.05). CONCLUSIONS: Both treatment modalities showed comparable effectiveness in the treatment of pains related to endometriosis.

Effectiveness of continuing medical education considering participant's idea in Iran University.

OBJECTIVE: To examine the satisfaction and perception of participants with the current CME programme in Iran and eventually to re-design the programme accordingly. METHODS: In this descriptive cross-sectional study the attitude of participants in 28 CME programmes of Iran University, Iran, implemented between 2007 and 2009 were evaluated. A questionnaire was prepared (reliability coefficient of Cronbach's alpha = 0.97) consisting of seven main questions (Likert scale) related to attitude of participants about the quality of programme's content, lecturer teaching skills and participant's learning and satisfaction; three open questions about weaknesses and strengths of the programmes and their recommendations about it; gender, type and duration of different programme. Our participants (physicians, nurses, midwives, health care providers, dentists, clinical laboratorists and nutritionist) completed the questionnaire at the end of their CME programmes. RESULTS: According to total score of the questions > or = 28, only 47.7% believed that the CME programme was effective. Workshops were more effective than seminar sessions (61.5% vs 30.1%, p < 0.001). Total score of participant's attitude was significantly higher in male in comparison with female (24.6 +/- 0.48 vs 22.9 +/- 0.54, p = 0.02) and also significantly higher for workshops than seminars (28.2 +/- 0.21 vs 24.3 +/- 0.31, p < 0.001). Effective programmes (total score > or = 28) had significantly lower duration (18.1 +/- 0.39 vs 19.1 +/- 0.34 hours, p = 0.044). CONCLUSION: While short course workshops are preferred in our community, effective, dynamic, and interactive educational methods in CME programme should be considered in this area as well.

Incidental adrenocortical oncocytoma.

A 66-year-old man with a history of hypertension and poor compliance with therapeutic regimens for the past 10 years presented with right renal colic. Sonographic evaluation of the kidneys revealed an incidental left renal upper pole mass. There were no palpitations, headache, weakness or fatigue, and the physical examination was unremarkable. Further evaluation including laboratory tests, abdominal computed tomography scan and magnetic resonance imaging revealed a non-functioning left adrenal mass with no malignant characteristic. Laparascopic left adrenalectomy and subsequent pathologic examination demonstrated a 8×6.5×4 cm oncocytoma. Follow-up of the patient for 1 year has revealed no complication or recurrence. Adrenocortical oncocytoma is an exceptionally rare tumour, mainly non-functional and benign, that should be considered in the differential diagnosis of adrenal "incidentalomas".

Primary mediastinal myelolipoma.

Myelolipoma is a rare mesenchymal tumor composed of an admixture of fat and bone marrow-derived hematopoietic cells. It is typically an adrenal lesion, and mediastinal location is extremely unusual. We describe a 56-year-old man with nonspecific symptoms of cough and dyspnea and no underlying disease whose chest computed tomography showed a huge (25 x 15 cm) mediastinal tumor containing calcification. Surgical removal and subsequent pathologic examination of the tumor revealed myelolipoma. Primary myelolipoma should be considered in the differential diagnosis of large posterior mediastinal tumors containing calcification.