����JFIFXX�����    $.' ",#(7),01444'9=82<.342  2!!22222222222222222222222222222222222222222222222222����"��4�� ���,�PG"Z_�4�˷����kjز�Z�,F+��_z�,�© �����zh6�٨�ic�fu���#ډb���_�N�?��wQ���5-�~�I���8����TK<5o�Iv-�����k�_U_�����~b�M��d����Ӝ�U�Hh��?]��E�w��Q���k�{��_}qFW7HTՑ��Y��F�?_�'ϔ��_�Ջt��=||I ��6�έ"�����D���/[�k�9���Y�8ds|\���Ҿp6�Ҵ���]��.����6�z<�v��@]�i%��$j��~�g��J>��no����pM[me�i$[����s�o�ᘨ�˸ nɜG-�ĨU�ycP�3.DB�li�;��hj���x7Z^�N�h������N3u{�:j�x�힞��#M&��jL P@_���� P��&��o8������9�����@Sz6�t7#O�ߋ �s}Yf�T���lmr����Z)'N��k�۞p����w\�Tȯ?�8`�O��i{wﭹW�[�r�� ��Q4F�׊���3m&L�=��h3����z~��#�\�l :�F,j@�� ʱ�wQT����8�"kJO���6�֚l����}���R�>ډK���]��y����&����p�}b��;N�1�m�r$�|��7�>e�@B�TM*-iH��g�D�)� E�m�|�ؘbҗ�a��Ҿ����t4���o���G��*oCN�rP���Q��@z,|?W[0�����:�n,jWiE��W��$~/�hp\��?��{(�0���+�Y8rΟ�+����>S-S����VN;�}�s?.����� w�9��˟<���Mq4�Wv'��{)0�1mB��V����W[�����8�/<� �%���wT^�5���b��)iM� pg�N�&ݝ��VO~�q���u���9� ����!��J27����$O-���! �:�%H��� ـ����y�ΠM=t{!S�� oK8������t<����è:a������[�����ա�H���~��w��Qz`�po�^ ����Q��n� �,uu�C�$ ^���,������8�#��:�6��e�|~���!�3�3.�\0��q��o�4`.|� ����y�Q�`~;�d�ׯ,��O�Zw�������`73�v�܋�<���Ȏ�� ـ4k��5�K�a�u�=9Yd��$>x�A�&�� j0� ���vF��� Y�|�y��� ~�6�@c��1vOp�Ig����4��l�OD���L����� R���c���j�_�uX6��3?nk��Wy�f;^*B� ��@�~a�`��Eu������+���6�L��.ü>��}y���}_�O�6�͐�:�YrG�X��kG�����l^w���~㒶sy��Iu�!� W ��X��N�7BV��O��!X�2����wvG�R�f�T#�����t�/?���%8�^�W�aT��G�cL�M���I��(J����1~�8�?aT ���]����AS�E��(��*E}� 2��#I/�׍qz��^t�̔���b�Yz4x���t�){ OH��+(E��A&�N�������XT��o��"�XC��'���)}�J�z�p� ��~5�}�^����+�6����w��c��Q�|Lp�d�H��}�(�.|����k��c4^�"�����Z?ȕ ��a<�L�!039C� �Eu�C�F�Ew�ç ;�n?�*o���B�8�bʝ���'#Rqf���M}7����]����s2tcS{�\icTx;�\��7K���P���ʇ Z O-��~��c>"��?�������P��E��O�8��@�8��G��Q�g�a�Վ���󁶠�䧘��_%#r�>�1�z�a��eb��qcPѵ��n���#L��� =��׀t� L�7�`��V���A{�C:�g���e@�w1 Xp3�c3�ġ����p��M"'-�@n4���fG��B3�DJ�8[Jo�ߐ���gK)ƛ��$���� ���8�3�����+���� �����6�ʻ���� ���S�kI�*KZlT _`���?��K����QK�d����B`�s}�>���`��*�>��,*@J�d�oF*����弝��O}�k��s��]��y�ߘ��c1G�V���<=�7��7����6�q�PT��tXԀ�!9*4�4Tހ3XΛex�46���Y��D ����� �BdemDa����\�_l,��G�/���֌7���Y�](�xTt^%�GE�����4�}bT���ڹ�����;Y)���B�Q��u��>J/J �⮶.�XԄ��j�ݳ�+E��d ��r�5�_D�1 ��o�� �B�x�΢�#���<��W�����8���R6�@g�M�.��� dr�D��>(otU��@x=��~v���2� ӣ�d�oBd��3�eO�6�㣷�����ݜ6��6Y��Qz`��S��{���\P�~z m5{J/L��1������<�e�ͅPu�b�]�ϔ���'������f�b� Zpw��c`"��i���BD@:)ִ�:�]��hv�E�w���T�l��P���"Ju�}��وV J��G6��. J/�Qgl߭�e�����@�z�Zev2u�)]կ�����7x���s�M�-<ɯ�c��r�v�����@��$�ޮ}lk���a���'����>x��O\�ZFu>�����ck#��&:��`�$�ai�>2Δ����l���oF[h��lE�ܺ�Πk:)���`�� $[6�����9�����kOw�\|���8}������ބ:��񶐕��I�A1/�=�2[�,�!��.}gN#�u����b��� ~��݊��}34q����d�E��Lc��$��"�[q�U�硬g^��%B �z���r�pJ�ru%v\h1Y�ne`ǥ:g���pQM~�^�Xi� ��`S�:V29.�P���V�?B�k�� AEvw%�_�9C�Q����wKekPؠ�\�;Io d�{ ߞo�c1eP����\� `����E=���@K<�Y���eڼ�J���w����{av�F�'�M�@/J��+9p���|]�����Iw &`��8���&M�hg��[�{��Xj��%��Ӓ�$��(����ʹN���<>�I���RY���K2�NPlL�ɀ)��&e����B+ь����( � �JTx���_?EZ� }@ 6�U���뙢ط�z��dWI�n` D����噥�[��uV��"�G&Ú����2g�}&m��?ċ�"����Om#��������� ��{�ON��"S�X��Ne��ysQ���@Fn��Vg���dX�~nj�]J�<�K]:��FW��b�������62�=��5f����JKw��bf�X�55��~J �%^����:�-�QIE��P��v�nZum� z � ~ə ���� ���ة����;�f��\v���g�8�1��f24;�V���ǔ�)����9���1\��c��v�/'Ƞ�w�������$�4�R-��t���� e�6�/�ġ �̕Ecy�J���u�B���<�W�ַ~�w[B1L۲�-JS΂�{���΃������A��20�c#��@ 0!1@AP"#2Q`$3V�%45a6�FRUq��� ����^7ׅ,$n�������+��F�`��2X'��0vM��p�L=������5��8������u�p~���.�`r�����\���O��,ư�0oS ��_�M�����l���4�kv\JSd���x���SW�<��Ae�IX����������$I���w�:S���y���›R��9�Q[���,�5�;�@]�%���u�@ *ro�lbI �� ��+���%m:�͇ZV�����u�̉����θau<�fc�.����{�4Ա� �Q����*�Sm��8\ujqs]{kN���)qO�y�_*dJ�b�7���yQqI&9�ԌK!�M}�R�;������S�T���1���i[U�ɵz�]��U)V�S6���3$K{�ߊ<�(� E]Զ[ǼENg�����'�\?#)Dkf��J���o��v���'�%ƞ�&K�u�!��b�35LX�Ϸ��63$K�a�;�9>,R��W��3�3� d�JeTYE.Mϧ��-�o�j3+y��y^�c�������VO�9NV\nd�1 ��!͕_)a�v;����թ�M�lWR1��)El��P;��yوÏ�u 3�k�5Pr6<�⒲l�!˞*��u־�n�!�l:����UNW ��%��Chx8vL'��X�@��*��)���̮��ˍ��� ���D-M�+J�U�kvK����+�x8��cY������?�Ԡ��~3mo��|�u@[XeY�C�\Kp�x8�oC�C�&����N�~3-H���� ��MX�s�u<`���~"WL��$8ξ��3���a�)|:@�m�\���^�`�@ҷ)�5p+��6���p�%i)P M���ngc�����#0Aruz���RL+xSS?���ʮ}()#�t��mˇ!��0}}y����<�e� �-ή�Ԩ��X������ MF���ԙ~l L.3���}�V뽺�v�����멬��Nl�)�2����^�Iq��a��M��qG��T�����c3#������3U�Ǎ���}��לS�|qa��ڃ�+���-��2�f����/��bz��ڐ�� �ݼ[2�ç����k�X�2�* �Z�d���J�G����M*9W���s{��w���T��x��y,�in�O�v��]���n����P�$�JB@=4�OTI�n��e�22a\����q�d���%�$��(���:���: /*�K[PR�fr\nڙdN���F�n�$�4�[�� U�zƶ����� �mʋ���,�ao�u 3�z� �x��Kn����\[��VFmbE;�_U��&V�Gg�]L�۪&#n%�$ɯ�dG���D�TI=�%+AB�Ru#��b4�1�»x�cs�YzڙJG��f��Il��d�eF'T� iA��T���uC�$����Y��H?����[!G`}���ͪ� �纤Hv\������j�Ex�K���!���OiƸ�Yj�+u-<���'q����uN�*�r\��+�]���<�wOZ.fp�ێ��,-*)V?j-kÊ#�`�r��dV����(�ݽBk�����G�ƛk�QmUڗe��Z���f}|����8�8��a���i��3'J�����~G_�^���d�8w������ R�`(�~�.��u���l�s+g�bv���W���lGc}��u���afE~1�Ue������Z�0�8�=e�� f@/�jqEKQQ�J��oN��J���W5~M>$6�Lt�;$ʳ{���^��6�{����v6���ķܰg�V�cnn �~z�x�«�,2�u�?cE+Ș�H؎�%�Za�)���X>uW�Tz�Nyo����s���FQƤ��$��*�&�LLXL)�1�" L��eO��ɟ�9=���:t��Z���c��Ž���Y?�ӭV�wv�~,Y��r�ۗ�|�y��GaF�����C�����.�+� ���v1���fήJ�����]�S��T��B��n5sW}y�$��~z�'�c ��8 ��� ,! �p��VN�S��N�N�q��y8z˱�A��4��*��'������2n<�s���^ǧ˭P�Jޮɏ�U�G�L�J�*#��<�V��t7�8����TĜ>��i}K%,���)[��z�21z ?�N�i�n1?T�I�R#��m-�����������������1����lA�`��fT5+��ܐ�c�q՝��ʐ��,���3�f2U�եmab��#ŠdQ�y>\��)�SLY����w#��.���ʑ�f��� ,"+�w�~�N�'�c�O�3F�������N<���)j��&��,-� �љ���֊�_�zS���TǦ����w�>��?�������n��U仆�V���e�����0���$�C�d���rP �m�׈e�Xm�Vu� �L��.�bֹ��� �[Դaզ���*��\y�8�Է:�Ez\�0�Kq�C b��̘��cө���Q��=0Y��s�N��S.���3.���O�o:���#���v7�[#߫ ��5�܎�L���Er4���9n��COWlG�^��0k�%<���ZB���aB_���������'=��{i�v�l�$�uC���mƎҝ{�c㱼�y]���W�i ��ߧc��m�H� m�"�"�����;Y�ߝ�Z�Ǔ�����:S#��|}�y�,/k�Ld� TA�(�AI$+I3��;Y*���Z��}|��ӧO��d�v��..#:n��f>�>���ȶI�TX��� 8��y����"d�R�|�)0���=���n4��6ⲑ�+��r<�O�܂~zh�z����7ܓ�HH�Ga롏���nCo�>������a ���~]���R���̲c?�6(�q�;5%� |�uj�~z8R=X��I�V=�|{v�Gj\gc��q����z�؋%M�ߍ����1y��#��@f^���^�>N�����#x#۹��6�Y~�?�dfPO��{��P�4��V��u1E1J �*|���%���JN��`eWu�zk M6���q t[�� ��g�G���v��WIG��u_ft����5�j�"�Y�:T��ɐ���*�;� e5���4����q$C��2d�}���� _S�L#m�Yp��O�.�C�;��c����Hi#֩%+) �Ӎ��ƲV���SYź��g |���tj��3�8���r|���V��1#;.SQ�A[���S������#���`n�+���$��$I �P\[�@�s��(�ED�z���P��])8�G#��0B��[ى��X�II�q<��9�~[Z멜�Z�⊔IWU&A>�P~�#��dp<�?����7���c��'~���5 ��+$���lx@�M�dm��n<=e�dyX��?{�|Aef ,|n3�<~z�ƃ�uۧ�����P��Y,�ӥQ�*g�#먙R�\���;T��i,��[9Qi歉����c>]9�� ��"�c��P�� �Md?٥��If�ت�u��k��/����F��9�c*9��Ǎ:�ØF���z�n*�@|I�ށ9����N3{'��[�'ͬ�Ҳ4��#}��!�V� Fu��,�,mTIk���v C�7v���B�6k�T9��1�*l� '~��ƞF��lU��'�M ����][ΩũJ_�{�i�I�n��$���L�� j��O�dx�����kza۪��#�E��Cl����x˘�o�����V���ɞ�ljr��)�/,�߬h�L��#��^��L�ф�,íMƁe�̩�NB�L�����iL����q�}��(��q��6IçJ$�W�E$��:������=#����(�K�B����zђ <��K(�N�۫K�w��^O{!����)�H���>x�������lx�?>Պ�+�>�W���,Ly!_�D���Ō�l���Q�!�[ �S����J��1��Ɛ�Y}��b,+�Lo�x�ɓ)����=�y�oh�@�꥟/��I��ѭ=��P�y9��� �ۍYӘ�e+�p�Jnϱ?V\SO%�(�t� ���=?MR�[Ș�����d�/ ��n�l��B�7j� ��!�;ӥ�/�[-���A�>�dN�sLj ��,ɪv��=1c�.SQ�O3�U���ƀ�ܽ�E����������̻��9G�ϷD�7(�}��Ävӌ\�y�_0[w ���<΍>����a_��[0+�L��F.�޺��f�>oN�T����q;���y\��bՃ��y�jH�<|q-eɏ�_?_9+P���Hp$�����[ux�K w�Mw��N�ی'$Y2�=��q���KB��P��~������Yul:�[<����F1�2�O���5=d����]Y�sw:���Ϯ���E��j,_Q��X��z`H1,#II ��d�wr��P˂@�ZJV����y$�\y�{}��^~���[:N����ߌ�U�������O��d�����ؾe��${p>G��3c���Ė�lʌ�� ת��[��`ϱ�-W����dg�I��ig2��� ��}s ��ؤ(%#sS@���~���3�X�nRG�~\jc3�v��ӍL��M[JB�T��s3}��j�Nʖ��W����;7��ç?=X�F=-�=����q�ߚ���#���='�c��7���ڑW�I(O+=:uxq�������������e2�zi+�kuG�R��������0�&e�n���iT^J����~\jy���p'dtG��s����O��3����9* �b#Ɋ�� p������[Bws�T�>d4�ۧs���nv�n���U���_�~,�v����ƜJ1��s�� �QIz��)�(lv8M���U=�;����56��G���s#�K���MP�=��LvyGd��}�VwWBF�'�à �?MH�U�g2�� ����!�p�7Q��j��ڴ����=��j�u��� Jn�A s���uM������e��Ɔ�Ҕ�!)'��8Ϣ�ٔ��ޝ(��Vp���צ֖d=�IC�J�Ǡ{q������kԭ�߸���i��@K����u�|�p=..�*+����x�����z[Aqġ#s2a�Ɗ���RR�)*HRsi�~�a &f��M��P����-K�L@��Z��Xy�'x�{}��Zm+���:�)�) IJ�-i�u���� ���ܒH��'�L(7�y�GӜq���� j��� 6ߌg1�g�o���,kر���tY�?W,���p���e���f�OQS��!K�۟cҒA�|ս�j�>��=⬒��˧L[�� �߿2JaB~R��u�:��Q�] �0H~���]�7��Ƽ�I���(}��cq '�ήET���q�?f�ab���ӥvr� �)o��-Q��_'����ᴎo��K������;��V���o��%���~OK ����*��b�f:���-ťIR��`B�5!RB@���ï�� �u �̯e\�_U�_������� g�ES��3�������QT��a����x����U<~�c?�*�#]�MW,[8O�a�x��]�1bC|踤�P��lw5V%�)�{t�<��d��5���0i�XSU��m:��Z�┵�i�"��1�^B�-��P�hJ��&)O��*�D��c�W��vM��)����}���P��ܗ-q����\mmζZ-l@�}��a��E�6��F�@��&Sg@���ݚ�M����� ȹ 4����#p�\H����dYDo�H���"��\��..R�B�H�z_�/5˘����6��KhJR��P�mƶi�m���3�,#c�co��q�a)*Pt����R�m�k�7x�D�E�\Y�閣_X�<���~�)���c[[�BP����6�Yq���S��0����%_����;��Àv�~�| VS؇ ��'O0��F0��\���U�-�d@�����7�SJ*z��3n��y��P����O���������m�~�P�3|Y��ʉr#�C�<�G~�.,! ���bqx���h~0=��!ǫ�jy����l�O,�[B��~��|9��ٱ����Xly�#�i�B��g%�S��������tˋ���e���ې��\[d�t)��.+u�|1 ������#�~Oj����hS�%��i.�~X���I�H�m��0n���c�1uE�q��cF�RF�o���7� �O�ꮧ� ���ۛ{��ʛi5�rw?׌#Qn�TW��~?y$��m\�\o����%W� ?=>S�N@�� �Ʈ���R����N�)�r"C�:��:����� �����#��qb��Y�. �6[��2K����2u�Ǧ�HYR��Q�MV��� �G�$��Q+.>�����nNH��q�^��� ����q��mM��V��D�+�-�#*�U�̒ ���p욳��u:�������IB���m���PV@O���r[b= �� ��1U�E��_Nm�yKbN�O���U�}�the�`�|6֮P>�\2�P�V���I�D�i�P�O;�9�r�mAHG�W�S]��J*�_�G��+kP�2����Ka�Z���H�'K�x�W�MZ%�O�YD�Rc+o��?�q��Ghm��d�S�oh�\�D�|:W������UA�Qc yT�q������~^�H��/��#p�CZ���T�I�1�ӏT����4��"�ČZ�����}��`w�#�*,ʹ�� ��0�i��課�Om�*�da��^gJ݅{���l�e9uF#T�ֲ��̲�ٞC"�q���ߍ ոޑ�o#�XZTp����@ o�8��(jd��xw�]�,f���`~�|,s��^����f�1���t��|��m�򸄭/ctr��5s��7�9Q�4�H1꠲BB@l9@���C�����+�wp�xu�£Yc�9��?`@#�o�mH�s2��)�=��2�.�l����jg�9$�Y�S�%*L������R�Y������7Z���,*=�䷘$�������arm�o�ϰ���UW.|�r�uf����IGw�t����Zwo��~5 ��YյhO+=8fF�)�W�7�L9lM�̘·Y���֘YLf�큹�pRF���99.A �"wz��=E\Z���'a� 2��Ǚ�#;�'}�G���*��l��^"q��+2FQ� hj��kŦ��${���ޮ-�T�٭cf�|�3#~�RJ����t��$b�(R��(����r���dx� >U b�&9,>���%E\� Ά�e�$��'�q't��*�א���ެ�b��-|d���SB�O�O��$�R+�H�)�܎�K��1m`;�J�2�Y~9��O�g8=vqD`K[�F)k�[���1m޼c��n���]s�k�z$@��)!I �x՝"v��9=�ZA=`Ɠi �:�E��)`7��vI��}d�YI�_ �o�:ob���o ���3Q��&D&�2=�� �Ά��;>�h����y.*ⅥS������Ӭ�+q&����j|UƧ����}���J0��WW< ۋS�)jQR�j���Ư��rN)�Gű�4Ѷ(�S)Ǣ�8��i��W52���No˓� ۍ%�5brOn�L�;�n��\G����=�^U�dI���8$�&���h��'���+�(������cȁ߫k�l��S^���cƗjԌE�ꭔ��gF���Ȓ��@���}O���*;e�v�WV���YJ\�]X'5��ղ�k�F��b 6R�o՜m��i N�i����>J����?��lPm�U��}>_Z&�KK��q�r��I�D�Չ~�q�3fL�:S�e>���E���-G���{L�6p�e,8��������QI��h��a�Xa��U�A'���ʂ���s�+טIjP�-��y�8ۈZ?J$��W�P� ��R�s�]��|�l(�ԓ��sƊi��o(��S0��Y� 8�T97.�����WiL��c�~�dxc�E|�2!�X�K�Ƙਫ਼�$((�6�~|d9u+�qd�^3�89��Y�6L�.I�����?���iI�q���9�)O/뚅����O���X��X�V��ZF[�یgQ�L��K1���RҖr@v�#��X�l��F���Нy�S�8�7�kF!A��sM���^rkp�jP�DyS$N���q��nxҍ!U�f�!eh�i�2�m���`�Y�I�9r�6� �TF���C}/�y�^���Η���5d�'��9A-��J��>{�_l+�`��A���[�'��յ�ϛ#w:݅�%��X�}�&�PSt�Q�"�-��\縵�/����$Ɨh�Xb�*�y��BS����;W�ջ_mc�����vt?2}1�;qS�d�d~u:2k5�2�R�~�z+|HE!)�Ǟl��7`��0�<�,�2*���Hl-��x�^����'_TV�gZA�'j� ^�2Ϊ��N7t�����?w�� �x1��f��Iz�C-Ȗ��K�^q�;���-W�DvT�7��8�Z�������� hK�(P:��Q- �8�n�Z���܃e貾�<�1�YT<�,�����"�6{/ �?�͟��|1�:�#g��W�>$����d��J��d�B��=��jf[��%rE^��il:��B���x���Sּ�1հ��,�=��*�7 fcG��#q� �eh?��2�7�����,�!7x��6�n�LC�4x��},Geǝ�tC.��vS �F�43��zz\��;QYC,6����~;RYS/6���|2���5���v��T��i����������mlv��������&� �nRh^ejR�LG�f���? �ۉҬܦƩ��|��Ȱ����>3����!v��i�ʯ�>�v��オ�X3e���_1z�Kȗ\<������!�8���V��]��?b�k41�Re��T�q��mz��TiOʦ�Z��Xq���L������q"+���2ۨ��8}�&N7XU7Ap�d�X��~�׿��&4e�o�F��� �H����O���č�c�� 懴�6���͉��+)��v;j��ݷ�� �UV�� i��� j���Y9GdÒJ1��詞�����V?h��l����l�cGs�ځ�������y�Ac�����\V3�? �� ܙg�>qH�S,�E�W�[�㺨�uch�⍸�O�}���a��>�q�6�n6����N6�q������N ! 1AQaq�0@����"2BRb�#Pr���3C`��Scst���$4D���%Td�� ?���N����a��3��m���C���w��������xA�m�q�m���m������$����4n淿t'��C"w��zU=D�\R+w�p+Y�T�&�պ@��ƃ��3ޯ?�Aﶂ��aŘ���@-�����Q�=���9D��ռ�ѻ@��M�V��P��܅�G5�f�Y<�u=,EC)�<�Fy'�"�&�չ�X~f��l�KԆV��?�� �W�N����=(� �;���{�r����ٌ�Y���h{�١������jW����P���Tc�����X�K�r��}���w�R��%��?���E��m�� �Y�q|����\lEE4���r���}�lsI�Y������f�$�=�d�yO����p�����yBj8jU�o�/�S��?�U��*������ˍ�0������u�q�m [�?f����a�� )Q�>����6#������� ?����0UQ����,IX���(6ڵ[�DI�MNލ�c&���υ�j\��X�R|,4��� j������T�hA�e��^���d���b<����n�� �즇�=!���3�^�`j�h�ȓr��jẕ�c�,ٞX����-����a�ﶔ���#�$��]w�O��Ӫ�1y%��L�Y<�wg#�ǝ�̗`�x�xa�t�w��»1���o7o5��>�m뭛C���Uƃߜ}�C���y1Xνm�F8�jI���]����H���ۺиE@I�i;r�8ӭ����V�F�Շ| ��&?�3|x�B�MuS�Ge�=Ӕ�#BE5G�����Y!z��_e��q�р/W>|-�Ci߇�t�1ޯќd�R3�u��g�=0 5��[?�#͏��q�cf���H��{ ?u�=?�?ǯ���}Z��z���hmΔ�BFTW�����<�q�(v� ��!��z���iW]*�J�V�z��gX֧A�q�&��/w���u�gYӘa���; �i=����g:��?2�dž6�ى�k�4�>�Pxs����}������G�9��3 ���)gG�R<>r h�$��'nc�h�P��Bj��J�ҧH� -��N1���N��?��~��}-q!=��_2hc�M��l�vY%UE�@|�v����M2�.Y[|y�"Eï��K�ZF,�ɯ?,q�?v�M 80jx�"�;�9vk�����+ ֧�� �ȺU��?�%�vcV��mA�6��Qg^M����A}�3�nl� QRN�l8�kkn�'�����(��M�7m9و�q���%ޟ���*h$Zk"��$�9��: �?U8�Sl��,,|ɒ��xH(ѷ����Gn�/Q�4�P��G�%��Ա8�N��!� �&�7�;���eKM7�4��9R/%����l�c>�x;������>��C�:�����t��h?aKX�bhe�ᜋ^�$�Iհ �hr7%F$�E��Fd���t��5���+�(M6�t����Ü�UU|zW�=a�Ts�Tg������dqP�Q����b'�m���1{|Y����X�N��b �P~��F^F:����k6�"�j!�� �I�r�`��1&�-$�Bevk:y���#yw��I0��x��=D�4��tU���P�ZH��ڠ底taP��6����b>�xa����Q�#� WeF��ŮNj�p�J* mQ�N����*I�-*�ȩ�F�g�3 �5��V�ʊ�ɮ�a��5F���O@{���NX��?����H�]3��1�Ri_u��������ѕ�� ����0��� F��~��:60�p�͈�S��qX#a�5>���`�o&+�<2�D����: �������ڝ�$�nP���*)�N�|y�Ej�F�5ټ�e���ihy�Z �>���k�bH�a�v��h�-#���!�Po=@k̆IEN��@��}Ll?j�O������߭�ʞ���Q|A07x���wt!xf���I2?Z��<ץ�T���cU�j��]��陎Ltl �}5�ϓ��$�,��O�mˊ�;�@O��jE��j(�ا,��LX���LO���Ц�90�O �.����a��nA���7������j4 ��W��_ٓ���zW�jcB������y՗+EM�)d���N�g6�y1_x��p�$Lv:��9�"z��p���ʙ$��^��JԼ*�ϭ����o���=x�Lj�6�J��u82�A�H�3$�ٕ@�=Vv�]�'�qEz�;I˼��)��=��ɯ���x �/�W(V���p�����$ �m�������u�����񶤑Oqˎ�T����r��㠚x�sr�GC��byp�G��1ߠ�w e�8�$⿄����/�M{*}��W�]˷.�CK\�ުx���/$�WPw���r� |i���&�}�{�X� �>��$-��l���?-z���g����lΆ���(F���h�vS*���b���߲ڡn,|)mrH[���a�3�ר�[1��3o_�U�3�TC�$��(�=�)0�kgP���� ��u�^=��4 �WYCҸ:��vQ�ר�X�à��tk�m,�t*��^�,�}D*� �"(�I��9R����>`�`��[~Q]�#af��i6l��8���6�:,s�s�N6�j"�A4���IuQ��6E,�GnH��zS�HO�uk�5$�I�4��ؤ�Q9�@��C����wp�BGv[]�u�Ov���0I4���\��y�����Q�Ѹ��~>Z��8�T��a��q�ޣ;z��a���/��S��I:�ܫ_�|������>=Z����8:�S��U�I�J��"IY���8%b8���H��:�QO�6�;7�I�S��J��ҌAά3��>c���E+&jf$eC+�z�;��V����� �r���ʺ������my�e���aQ�f&��6�ND��.:��NT�vm�<- u���ǝ\MvZY�N�NT��-A�>jr!S��n�O 1�3�Ns�%�3D@���`������ܟ 1�^c<���� �a�ɽ�̲�Xë#�w�|y�cW�=�9I*H8�p�^(4���՗�k��arOcW�tO�\�ƍR��8����'�K���I�Q�����?5�>[�}��yU�ײ -h��=��% q�ThG�2�)���"ו3]�!kB��*p�FDl�A���,�eEi�H�f�Ps�����5�H:�Փ~�H�0Dت�D�I����h�F3�������c��2���E��9�H��5�zԑ�ʚ�i�X�=:m�xg�hd(�v����׊�9iS��O��d@0ڽ���:�p�5�h-��t�&���X�q�ӕ,��ie�|���7A�2���O%P��E��htj��Y1��w�Ѓ!����  ���� ࢽ��My�7�\�a�@�ţ�J �4�Ȼ�F�@o�̒?4�wx��)��]�P��~�����u�����5�����7X ��9��^ܩ�U;Iꭆ 5 �������eK2�7(�{|��Y׎ �V��\"���Z�1� Z�����}��(�Ǝ"�1S���_�vE30>���p;� ΝD��%x�W�?W?v����o�^V�i�d��r[��/&>�~`�9Wh��y�;���R��� ;;ɮT��?����r$�g1�K����A��C��c��K��l:�'��3 c�ﳯ*"t8�~l��)���m��+U,z��`(�>yJ�?����h>��]��v��ЍG*�{`��;y]��I�T� ;c��NU�fo¾h���/$���|NS���1�S�"�H��V���T���4��uhǜ�]�v;���5�͠x��'C\�SBpl���h}�N����� A�Bx���%��ޭ�l��/����T��w�ʽ]D�=����K���ž�r㻠l4�S�O?=�k �M:� ��c�C�a�#ha���)�ѐxc�s���gP�iG��{+���x���Q���I= �� z��ԫ+ �8"�k�ñ�j=|����c ��y��CF��/��*9ж�h{ �?4�o� ��k�m�Q�N�x��;�Y��4膚�a�w?�6�>e]�����Q�r�:����g�,i"�����ԩA�*M�<�G��b�if��l^M��5� �Ҩ�{����6J��ZJ�����P�*�����Y���ݛu�_4�9�I8�7���������,^ToR���m4�H��?�N�S�ѕw��/S��甍�@�9H�S�T��t�ƻ���ʒU��*{Xs�@����f�����֒Li�K{H�w^���������Ϥm�tq���s� ���ք��f:��o~s��g�r��ט� �S�ѱC�e]�x���a��) ���(b-$(�j>�7q�B?ӕ�F��hV25r[7 Y� }L�R��}����*sg+��x�r�2�U=�*'WS��ZDW]�WǞ�<��叓���{�$�9Ou4��y�90-�1�'*D`�c�^o?(�9��u���ݐ��'PI&� f�Jݮ�������:wS����jfP1F:X �H�9dԯ���˝[�_54 �}*;@�ܨ�� ð�yn�T���?�ןd�#���4rG�ͨ��H�1�|-#���Mr�S3��G�3�����)�.᧏3v�z֑��r����$G"�`j �1t��x0<Ɔ�Wh6�y�6��,œ�Ga��gA����y��b��)��h�D��ß�_�m��ü �gG;��e�v��ݝ�nQ� ��C����-�*��o���y�a��M��I�>�<���]obD��"�:���G�A��-\%LT�8���c�)��+y76���o�Q�#*{�(F�⽕�y����=���rW�\p���۩�c���A���^e6��K������ʐ�cVf5$�'->���ՉN"���F�"�UQ@�f��Gb~��#�&�M=��8�ט�JNu9��D��[̤�s�o�~������ G��9T�tW^g5y$b��Y'��س�Ǵ�=��U-2 #�MC�t(�i� �lj�@Q 5�̣i�*�O����s�x�K�f��}\��M{E�V�{�υ��Ƈ�����);�H����I��fe�Lȣr�2��>��W�I�Ȃ6������i��k�� �5�YOxȺ����>��Y�f5'��|��H+��98pj�n�.O�y�������jY��~��i�w'������l�;�s�2��Y��:'lg�ꥴ)o#'Sa�a�K��Z� �m��}�`169�n���"���x��I ��*+� }F<��cГ���F�P�������ֹ*�PqX�x۩��,� ��N�� �4<-����%����:��7����W���u�`����� $�?�I��&����o��o��`v�>��P��"��l���4��5'�Z�gE���8���?��[�X�7(��.Q�-��*���ތL@̲����v��.5���[��=�t\+�CNܛ��,g�SQnH����}*F�G16���&:�t��4ُ"A��̣��$�b �|����#rs��a�����T�� ]�<�j��BS�('$�ɻ� �wP;�/�n��?�ݜ��x�F��yUn�~mL*-�������Xf�wd^�a�}��f�,=t�׵i�.2/wpN�Ep8�OР���•��R�FJ� 55TZ��T �ɭ�<��]��/�0�r�@�f��V��V����Nz�G��^���7hZi����k��3�,kN�e|�vg�1{9]_i��X5y7� 8e]�U����'�-2,���e"����]ot�I��Y_��n�(JҼ��1�O ]bXc���Nu�No��pS���Q_���_�?i�~�x h5d'�(qw52] ��'ޤ�q��o1�R!���`ywy�A4u���h<קy���\[~�4�\ X�Wt/� 6�����n�F�a8��f���z �3$�t(���q��q�x��^�XWeN'p<-v�!�{�(>ӽDP7��ո0�y)�e$ٕv�Ih'Q�EA�m*�H��RI��=:��� ���4牢) �%_iN�ݧ�l]� �Nt���G��H�L��� ɱ�g<���1V�,�J~�ٹ�"K��Q�� 9�HS�9�?@��k����r�;we݁�]I�!{ �@�G�[�"��`���J:�n]�{�cA�E����V��ʆ���#��U9�6����j�#Y�m\��q�e4h�B�7��C�������d<�?J����1g:ٳ���=Y���D�p�ц� ׈ǔ��1�]26؜oS�'��9�V�FVu�P�h�9�xc�oq�X��p�o�5��Ա5$�9W�V(�[Ak�aY錎qf;�'�[�|���b�6�Ck��)��#a#a˙��8���=äh�4��2��C��4tm^ �n'c���]GQ$[Wҿ��i���vN�{Fu ��1�gx��1┷���N�m��{j-,��x�� Ūm�ЧS�[�s���Gna���䑴�� x�p 8<������97�Q���ϴ�v�aϚG��Rt�Һ׈�f^\r��WH�JU�7Z���y)�vg=����n��4�_)y��D'y�6�]�c�5̪�\� �PF�k����&�c;��cq�$~T�7j ���nç]�<�g ":�to�t}�159�<�/�8������m�b�K#g'I'.W�����6��I/��>v��\�MN��g���m�A�yQL�4u�Lj�j9��#44�t��l^�}L����n��R��!��t��±]��r��h6ٍ>�yҏ�N��fU�� ���� Fm@�8}�/u��jb9������he:A�y�ծw��GpΧh�5����l}�3p468��)U��d��c����;Us/�֔�YX�1�O2��uq�s��`hwg�r~�{ R��mhN��؎*q 42�*th��>�#���E����#��Hv�O����q�}�����6�e��\�,Wk�#���X��b>��p}�դ��3���T5��†��6��[��@�P�y*n��|'f�֧>�lư΂�̺����SU�'*�q�p�_S�����M�� '��c�6�����m�� ySʨ;M��r���Ƌ�m�Kxo,���Gm�P��A�G�:��i��w�9�}M(�^�V��$ǒ�ѽ�9���|���� �a����J�SQ�a���r�B;����}���ٻ֢�2�%U���c�#�g���N�a�ݕ�'�v�[�OY'��3L�3�;,p�]@�S��{ls��X�'���c�jw�k'a�.��}�}&�� �dP�*�bK=ɍ!����;3n�gΊU�ߴmt�'*{,=SzfD� A��ko~�G�aoq�_mi}#�m�������P�Xhύ����mxǍ�΂���巿zf��Q���c���|kc�����?���W��Y�$���_Lv����l߶��c���`?����l�j�ݲˏ!V��6����U�Ђ(A���4y)H���p�Z_�x��>���e��R��$�/�`^'3qˏ�-&Q�=?��CFVR �D�fV�9��{�8g�������n�h�(P"��6�[�D���< E�����~0<@�`�G�6����Hг�cc�� �c�K.5��D��d�B���`?�XQ��2��ٿyqo&+�1^� DW�0�ꊩ���G�#��Q�nL3��c���������/��x ��1�1[y�x�პCW��C�c�UĨ80�m�e�4.{�m��u���I=��f�����0QRls9���f���������9���~f�����Ǩ��a�"@�8���ȁ�Q����#c�ic������G��$���G���r/$W�(��W���V�"��m�7�[m�A�m����bo��D� j����۳� l���^�k�h׽����� ��#� iXn�v��eT�k�a�^Y�4�BN��ĕ��0 !01@Q"2AaPq3BR������?���@4�Q�����T3,���㺠�W�[=JK�Ϟ���2�r^7��vc�:�9 �E�ߴ�w�S#d���Ix��u��:��Hp��9E!�� V 2;73|F��9Y���*ʬ�F��D����u&���y؟��^EA��A��(ɩ���^��GV:ݜDy�`��Jr29ܾ�㝉��[���E;Fzx��YG��U�e�Y�C���� ����v-tx����I�sם�Ę�q��Eb�+P\ :>�i�C'�;�����k|z�رn�y]�#ǿb��Q��������w�����(�r|ӹs��[�D��2v-%��@;�8<a���[\o[ϧw��I!��*0�krs)�[�J9^��ʜ��p1)� "��/_>��o��<1����A�E�y^�C��`�x1'ܣn�p��s`l���fQ��):�l����b>�Me�jH^?�kl3(�z:���1ŠK&?Q�~�{�ٺ�h�y���/�[��V�|6��}�KbX����mn[-��7�5q�94�������dm���c^���h� X��5��<�eޘ>G���-�}�دB�ޟ� ��|�rt�M��V+�]�c?�-#ڛ��^ǂ}���Lkr���O��u�>�-D�ry� D?:ޞ�U��ǜ�7�V��?瓮�"�#���r��չģVR;�n���/_� ؉v�ݶe5d�b9��/O��009�G���5n�W����JpA�*�r9�>�1��.[t���s�F���nQ� V 77R�]�ɫ8����_0<՜�IF�u(v��4��F�k�3��E)��N:��yڮe��P�`�1}�$WS��J�SQ�N�j�ٺ��޵�#l���ј(�5=��5�lǏmoW�v-�1����v,W�mn��߀$x�<����v�j(����c]��@#��1������Ǔ���o'��u+����;G�#�޸��v-lη��/(`i⣍Pm^���ԯ̾9Z��F��������n��1��� ��]�[��)�'������:�֪�W��FC����� �B9،!?���]��V��A�Վ�M��b�w��G F>_DȬ0¤�#�QR�[V��kz���m�w�"��9ZG�7'[��=�Q����j8R?�zf�\a�=��O�U����*oB�A�|G���2�54 �p��.w7� �� ��&������ξxGHp� B%��$g�����t�Џ򤵍z���HN�u�Я�-�'4��0��;_��3 !01"@AQa2Pq#3BR������?��ʩca��en��^��8���<�u#��m*08r��y�N"�<�Ѳ0��@\�p��� �����Kv�D��J8�Fҽ� �f�Y��-m�ybX�NP����}�!*8t(�OqѢ��Q�wW�K��ZD��Δ^e��!� ��B�K��p~�����e*l}z#9ң�k���q#�Ft�o��S�R����-�w�!�S���Ӥß|M�l޶V��!eˈ�8Y���c�ЮM2��tk���� ������J�fS����Ö*i/2�����n]�k�\���|4yX�8��U�P.���Ы[���l��@"�t�<������5�lF���vU�����W��W��;�b�cД^6[#7@vU�xgZv��F�6��Q,K�v��� �+Ъ��n��Ǣ��Ft���8��0��c�@�!�Zq s�v�t�;#](B��-�nῃ~���3g������5�J�%���O������n�kB�ĺ�.r��+���#�N$?�q�/�s�6��p��a����a��J/��M�8��6�ܰ"�*������ɗud"\w���aT(����[��F��U՛����RT�b���n�*��6���O��SJ�.�ij<�v�MT��R\c��5l�sZB>F��<7�;EA��{��E���Ö��1U/�#��d1�a�n.1ě����0�ʾR�h��|�R��Ao�3�m3 ��%�� ���28Q� ��y��φ���H�To�7�lW>����#i`�q���c����a��� �m,B�-j����݋�'mR1Ήt�>��V��p���s�0IbI�C.���1R�ea�����]H�6����������4B>��o��](��$B���m�����a�!=��?�B� K�Ǿ+�Ծ"�n���K��*��+��[T#�{E�J�S����Q�����s�5�:�U�\wĐ�f�3����܆&�)����I���Ԇw��E T�lrTf6Q|R�h:��[K�� �z��c֧�G�C��%\��_�a�84��HcO�bi��ؖV��7H �)*ģK~Xhչ0��4?�0��� �E<���}3���#���u�?�� ��|g�S�6ꊤ�|�I#Hڛ� �ա��w�X��9��7���Ŀ%�SL��y6č��|�F�a 8���b��$�sק�h���b9RAu7�˨p�Č�_\*w��묦��F ����4D~�f����|(�"m���NK��i�S�>�$d7SlA��/�²����SL��|6N�}���S�˯���g��]6��; �#�.��<���q'Q�1|KQ$�����񛩶"�$r�b:���N8�w@��8$�� �AjfG|~�9F ���Y��ʺ��Bwؒ������M:I岎�G��`s�YV5����6��A �b:�W���G�q%l�����F��H���7�������Fsv7��k�� 403WebShell
403Webshell
Server IP : 172.67.215.126  /  Your IP : 172.69.130.107
Web Server : Apache/2.4.52 (Ubuntu)
System : Linux ip-172-31-19-221 6.8.0-1029-aws #31~22.04.1-Ubuntu SMP Thu Apr 24 21:16:18 UTC 2025 x86_64
User : www-data ( 33)
PHP Version : 8.1.28
Disable Function : NONE
MySQL : OFF  |  cURL : ON  |  WGET : ON  |  Perl : ON  |  Python : OFF  |  Sudo : ON  |  Pkexec : ON
Directory :  /efsdata/scitechnol.com/httpdocs/submission/uploads/

Upload File :
current_dir [ Writeable ] document_root [ Writeable ]

 

Command :


[ Back ]     

Current File : /efsdata/scitechnol.com/httpdocs/submission/uploads/0-0-Manuscript-2014-07-13.doc
��ࡱ�>��	xz����w�������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������[�	��0��bjbj����	.�ΐΐ-.���������������������������&�G6}}}}XXX&&&&&&&$e(�+R2&Q�XXXXX2&��}}��&@@@X��}�}&@X&@@@}������d����:�@�%�&0�&@Y+�XY+@@(Y+�h"�XX@XXXXX2&2&@XXX�&XXXX��������������������������������������������������������������������Y+XXXXXXXXX�	�:	Title: sleep quality in women with endometriosis
Authors:
Fatemeh Davari Tanha, Associate professor of OBS&GYN,Department of endocrinology and reproductive medicine,Women�s hospital, Tehran university of medical sciences, Tehran University of Medical Sciences, Tehran, Iran
Fariba Askari, department of midwifery, Gonabad university of medical sciences, Gonabad ,Iran
Mina Akrami, Women�s hospital, Tehran university of medical sciences, Tehran University of Medical Sciences, Tehran, Iran
Mona Mohseni, Women�s hospital, Tehran university of medical sciences, Tehran University of Medical Sciences, Tehran, Iran
Mahsa Ghajarzadeh, Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
Corresponding author: 
Mahsa Ghajarzadeh Brain and Spinal Injury Research Center (BASIR), Tehran
University of Medical Sciences, Tehran, Iran
e-mail: m.ghajarzadeh@gmail.com
Cell:989121726995
Tel: 982166581560

Address: Imam Hospital, Tehran ,Iran




Abstract:
Endometriosis is a gynecological disorder characterize as the implantation of endometrial tissue outside the uterine cavity. Psychological symptoms such as anxiety, bipolar disorder, depressive symptom and impaired quality of life are common in these women. Sleep quality had not been considered in these women as it should be. The goal of this study was to evaluate sleep quality in women with endometriosis.
In this cross-sectional study 61 married women with laparoscopically diagnosed endometriosis asked to fill valid and reliable Pittsburg Sleep Questionnaire (PSQI) questionnaire. Mean age and mean education level were 31.4�6.7 years and 11.7�3.1 years. Dysmenorrhea followed by dyspareunia were the most common symptoms (68.8% and 40.3%). Mean PSQI score was 6.1�3.4, twenty eight (45.9%) had PSQI score equal or less than 5  and 33 (54.1%) had PSQI score more than 5 (poor sleep). Mean PSQI was significantly different between cases with and without dysmenorrhea and dyspareunia. Sleep quality should be considered in women with endometriosis.





















Introduction:
Endometriosis is a gynecological disorder characterize as the implantation of endometrial tissue outside the uterine cavity. The prevalence of endometriosis has been reported to be between 6 to 10% in the general female population and higher (5% to 50%) in infertile women (1,2).Clinical symptoms of enoometriosis in affected women could range from asymptomatic to different disabling symptoms such as abnormal menstrual bleeding, dysmenorrhea and dyspareunia (DD),chronic pelvic pain, and painful defecation (3,4). Psychological symptoms such as anxiety, bipolar disorder, depressive symptom and impaired quality of life (5-7).
Although there are some studies evaluating psychological problems in women with endometriosis, sleep quality evaluation is not regarded as well in these women. The goal of this study was to evaluate sleep quality in women with endometriosis.
Materials and Methods:
In this cross-sectional study 61 married women with laparoscopically diagnosed endometriosis (who referred to outpatient clinic of gynecology in Women�s hospital between March 2013 and September 2013 were enrolled. Cases with psychological problems and women who were under treatment for depression.
A structured questionnaire applied to collect information about age, BMI(Body Mass Index), history of infertility, family history of endometriosis, surgery history, clinical symptoms and age at the first menstruation.
We  collected information about age, BMI(Body Mass Index), history of infertility, family history of endometriosis, surgery history, clinical symptoms and age at the first menstruation.
Pittsburg Sleep Questionnaire (PSQI), a self-administrative instrument, consists of 9 questions generating seven-component scores (sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction). Each component score ranged from 0 to 3 (0, not in the past month; 1, less than once per week; 2, once or twice per week; and 3, three or more times per week). A valid and reliable Persian Version of this test was applied for assessing the quality of sleep in current survey. The total score ranges from 0 to 21 while higher scores indicates poorer sleep quality; A total score e" 5 indicates a  poor  sleeper. Valid and reliable Persian version administered (8).
Data was analyzed using SPSS version 18 and presented as Mean� SD. The Mann Whiteny U test applied for continuous as well as the Pearson X2 test with Fisher�s exact test were used for categorical variables assessment. 
P-value < 0.05 was considered statistically significant.
Results:
Sixty one women with endometriosis enrolled in this study. Mean age and mean education level were 31.4�6.7 years and 11.7�3.1 years. Mean age at the first menstruation was 12.7�2 years and mean BMI was 25.4�5.1 kg/m2. Seven women were single (11.4%)( and others were married. Mean years of married life was 16.4�7.4 year. Positive family history of endometriosis reported in 8 (13.1%) and 31 (50.8%) had previous surgery. Only fourteen cases had only one clinical symptom and dysmenorrhea followed by dyspareunia were the most common symptoms (68.8% and 40.3%). Pelvic pain and pain during defecation had been reported by 21 ( 34.4%) and 13 (21.3%).
Mean PSQI score was 6.1�3.4, twenty eight (45.9%) had PSQI score equal or less than 5  and 33 (54.1%) had PSQI score more than 5 (poor sleep).
Mean age, BMI, education level and age at the first menstruation were not significantly different between patients with and without poor sleep (table 1).
Tabl 1 : mean age, BMI, Education level and age at the first menstruation in patients with and without poor sleep. 
PSQId"5PSQI>5P valueAge 31.2�6.231.5�7.20.8BMI24.8�5.328.5�50.4Education level12.2�3.111.3�3.20.2Age at the first menstruation12.8�1.912.6�2.10.6 
Mean PSQI score was significantly different between patients with and without dyspareunia (table 2).
Table 2: mean PSQI in patients with and without dyspareunia
With dyspareunia
N=25Without dyspareunia
N=36P valuePSQI score 7.5�45.1�2.60.01
Mean PSQI score was significantly different between patients with and without dysmenorrhea (Table 3).

Table 3: mean PSQI in patients with and without dysmenorrhea.
With dysmenorrhea
N=42Without dysmenorrhea
N=219P valuePSQI score 6.8�3.64.6�2.20.008
Mean PSQI score was not significantly different between patients with and without pelvic pain (table 4).
Table 4: mean PSQI in patients with and without pelvic pain
With pelvic pain
N=21Without pelvic pain 
N=40P valuePSQI score 7.3�2.45.5�3.70.05
Mean PSQI score was not significantly different between patients with and without pain during defecation (table 5).
Table 5: mean PSQI in patients with and without pain during defecation.
With pain during defecation
N=13Without pain during defecation
N=48P valuePSQI score 8�4.75.6�2.80.1
Discussion:
The results of this study showed that near 50% of enrolled patients had poor sleep and mean PSQI score differed significantly between women with and without dyspareunia and dyspareunia symptoms. Pain is the most common clinical presentation of women with endometriosis while dysmenorrheal is the most frequent presentation followed by dyspareunia and pelvic pain (3). As our results showed, dysmenorrheal was the most presenting symptoms in our patients.
Near 40% of women who enrolled in this study had dyspareunia. Dyspareunia had been considered to be related with negative attitude toward sexuality, anxiety, and avoidance of intercourse (4). 
Endometriosis is a leading cause of infertily which sequentially psychological stress, low self-esteem , depression and decreased quality of life (7).
Until now, sleep quality had not been considered precisely in women with endometriosis. In this study we found that poor sleep could be present in near 40% of cases and patients with dysmenorrheal and dyspareunia mean PSQI score is higher than cases without these symptoms which could show that clinical symptoms I women with endometriosis could affect quality of sleep. We found no statistically significant difference between age, education level, BMI and age at the first menstruation in cases with and without poor sleep.
To our knowledge this is the first study evaluating sleep quality I women with endometriosis. This study had some limitations. First, it was a single center study. Second, the sample size was limited. So large studies with multi centric should be performed.
Conclusion: sleep quality should be considered in women with endometriosis.













References:
1. Kennedy S, Bergqvist A, Chapron C, D�Hooghe T, Dunselman G, Saridogan E, et al. ESHRE guideline on the diagnosis and
management of endometriosis. Hum Reprod. 2005;20(10):2698�704.
2. Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364
(9447):789�99

3. Bulletti C, Coccia ME, Battistoni S, Borini A.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed/20574791" Endometriosis and infertility. J Assist Reprod Genet. 2010 Aug;27(8):441-7

4. Ferrero S, Esposito F, Abbamonte LH, Anserini P, Remorgida V, Ragni N. Quality of sex life in women with endometriosis and deep dyspareunia.
 HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed/15749483" \o "Fertility and sterility." Fertil Steril. 2005 Mar;83(3):573-9.

5.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Low%20WY%5BAuthor%5D&cauthor=true&cauthor_uid=8463987" Low WY,  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Edelmann%20RJ%5BAuthor%5D&cauthor=true&cauthor_uid=8463987" Edelmann RJ,  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Sutton%20C%5BAuthor%5D&cauthor=true&cauthor_uid=8463987" Sutton C. A psychological profile of endometriosis patients in comparison to patients with pelvic pain of other origins.
 HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed/8463987" \o "Journal of psychosomatic research." J Psychosom Res. 1993;37(2):111-6.
6.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Kumar%20V%5BAuthor%5D&cauthor=true&cauthor_uid=22082788" Kumar V,  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Khan%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22082788" Khan M,  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Vilos%20GA%5BAuthor%5D&cauthor=true&cauthor_uid=22082788" Vilos GA,  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Sharma%20V%5BAuthor%5D&cauthor=true&cauthor_uid=22082788" Sharma V. Revisiting the association between endometriosis and bipolar disorder.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed/22082788" \o "Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obst�trique et gyn�cologie du Canada : JOGC." J Obstet Gynaecol Can. 2011 Nov;33(11):1141-5.

7.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Sepulcri%20Rde%20P%5BAuthor%5D&cauthor=true&cauthor_uid=19010584" Sepulcri Rde P,  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=do%20Amaral%20VF%5BAuthor%5D&cauthor=true&cauthor_uid=19010584" do Amaral VF. Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed/19010584" \o "European journal of obstetrics, gynecology, and reproductive biology." Eur J Obstet Gynecol Reprod Biol. 2009 Jan;142(1):53-6

8. HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=%22Farrahi%20Moghaddam%20J%22%5BAuthor%5D"Farrahi Moghaddam J, HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=%22Nakhaee%20N%22%5BAuthor%5D"Nakhaee N, 1:NP�	!	o	}	�	�	�	1
d
e
x
�
�
�������������p��p��p�����_N h�\>5�CJOJQJ\�^JaJ h�7�5�CJOJQJ\�^JaJ)hsh�7�B*CJOJQJ^JaJph#  hsh�7�CJOJQJ^JaJ&hsh�7�5�CJOJQJ\�^JaJ hsh�R�CJOJQJ^JaJ)hsh�R�B*CJOJQJ^JaJph# /hsh�R�5�B*CJOJQJ\�^JaJph# h�7�&h�4h�7�5�CJOJQJ\�^JaJ1:	p	�	e
�
�
6c����������u
�����������������������dhgd�1?dhgd#�d��7$8$H$gd�7�d�gd�7�d��7$8$H$gd�7�gd�R�gd�7����)<WX�"
#
t
u
�
�
�
�
�
&'�������´��ᒄ��vcSB hX;,hX;,CJOJQJ^JaJh�M�CJOJQJ^J_H)aJ$ha3lh�M�CJOJQJ^J_H)aJh[Q�CJOJQJ^JaJh�]CJOJQJ^JaJ hsh�]CJOJQJ^JaJ hHhHCJOJQJ^JaJhHCJOJQJ^JaJh�-GCJOJQJ^JaJ h�-Gh�-GCJOJQJ^JaJh�\>CJOJQJ^JaJ hsh�\>CJOJQJ^JaJ'`aopqr~�����U��������Ϳ�������{m_N_N_= h�-�h�-�CJOJQJ^JaJ hsh�Y�CJOJQJ^JaJh�Y�CJOJQJ^JaJh�O�CJOJQJ^JaJ h�0�h�O�CJOJQJ^JaJ h�O�h�O�CJOJQJ^JaJ hsh�~3CJOJQJ^JaJ h�~3h�~3CJOJQJ^JaJh�~3CJOJQJ^JaJ h�.�hX;,CJOJQJ^JaJ hX;,5�CJOJQJ\�^JaJ hPLhX;,CJOJQJ^JaJ�����
-.EFj}����Ⱥ���pbpbTC5hnKCJOJQJ^JaJ hsh�=CJOJQJ^JaJh�yCJOJQJ^JaJh�}CJOJQJ^JaJ hsh�}CJOJQJ^JaJ&h�e>h�q5�CJOJQJ\�^JaJ&h�e>h�e>5�CJOJQJ\�^JaJ h�-G5�CJOJQJ\�^JaJh�-GCJOJQJ^JaJhHCJOJQJ^JaJh�O�CJOJQJ^JaJh�-�CJOJQJ^JaJh�1?CJOJQJ^JaJ�������	

����������������������������d��7$8$H$gd$U!d�gd�<,���3������̺���wiXJ9+hA2�CJOJQJ^JaJ hshA2�CJOJQJ^JaJht�CJOJQJ^JaJ hsht�CJOJQJ^JaJh�<�CJOJQJ^JaJh��CJOJQJ^JaJh�X�CJOJPJQJ^JaJ$hsh�X�CJOJPJQJ^JaJ#h�X�B*CJOJQJ^JaJph#h�'#B*CJOJQJ^JaJph)hsh�'#B*CJOJQJ^JaJph hsh�'#CJOJQJ^JaJhwKCJOJQJ^JaJ
.7HZ���������D���Ⱥ����tfRA3Ah;Y�CJOJQJ^JaJ hsh$U!CJOJQJ^JaJ&hsh$U!5�CJOJQJ\�^JaJh9^�CJOJQJ^JaJh�;�CJOJQJ^JaJh\]�CJOJQJ^JaJh!�CJOJQJ^JaJh�r�CJOJQJ^JaJhloCJOJQJ^JaJh�c�CJOJQJ^JaJhf0DCJOJQJ^JaJh)`4CJOJQJ^JaJh�<,CJOJQJ^JaJhv�CJOJQJ^JaJDJS\afqrw{������YZ�mp9>?�����������������´�����taN$h�V(h#r�CJOJQJ^J_H)aJ$ha3lh#r�CJOJQJ^J_H)aJhEs�CJOJQJ^JaJh�T�CJOJQJ^JaJ ha3lhEs�CJOJQJ^JaJ$ha3lhEs�CJOJQJ^J_H)aJh�>VCJOJQJ^JaJ hshD0CJOJQJ^JaJhD0CJOJQJ^JaJ hsh$U!CJOJQJ^JaJh$U!CJOJQJ^JaJ���Z?S\�u��  , ���������������d�$Ifgd��d�gd�Qd�gd�z�d�gd	l<d�gdoNd��7$8$H$gd#r�d��7$8$H$gd�p:d�gdWp�d�gd�<,d��7$8$H$gd$U!d��7$8$H$gd;Y������S[\���������ﻧ���q`O>- h�.�hw*`CJOJQJ^JaJ h�.�h�@�CJOJQJ^JaJ hPL5�CJOJQJ\�^JaJ hPLhw*`CJOJQJ^JaJ hPLh1
�CJOJQJ^JaJ h#r�5�CJOJQJ\�^JaJ&h&�h&�5�CJOJQJ\�^JaJ&ha3lh#r�6�CJOJQJ]�^JaJ ha3lh#r�CJOJQJ^JaJ#h�V(h#r�CJH*OJQJ^JaJ h�V(hCCJOJQJ^JaJ h�V(h#r�CJOJQJ^JaJ�345o�����8EP\|���������~pbTCTCT5Th�7�CJOJQJ^JaJ hsh0)�CJOJQJ^JaJh0)�CJOJQJ^JaJh}*CCJOJQJ^JaJhC[|CJOJQJ^JaJh�lCJOJQJ^JaJha�CJOJQJ^JaJh�
1CJOJQJ^JaJh�N'CJOJQJ^JaJht�CJOJQJ^JaJh!CJOJQJ^JaJ#h�Oh�OCJH*OJQJ^JaJh�OCJOJQJ^JaJh�}%CJOJQJ^JaJ���������&'-:<\fstu����Ⱥ���qqcUG9h�z�CJOJQJ^JaJhX�CJOJQJ^JaJh	l<CJOJQJ^JaJh�{CJOJQJ^JaJh�meCJOJQJ^JaJh|n�CJOJQJ^JaJh�V1CJOJQJ^JaJ h�0�h�0�CJOJQJ^JaJh�{-CJOJQJ^JaJhpuCJOJQJ^JaJhM(CJOJQJ^JaJh0)�CJOJQJ^JaJh�CJOJQJ^JaJhoNCJOJQJ^JaJ��
'6<X�     * . 6 8 H J Z \ b f l n ~ � � � � � � � � � ������ȷȷȦ��������s�s�s���s�s�s���b� h��h�.VCJOJQJ^JaJ h��h:�CJOJQJ^JaJ h��h
CJOJQJ^JaJ h��hLSCJOJQJ^JaJ h��h�H~CJOJQJ^JaJ h��h�QCJOJQJ^JaJh�QCJOJQJ^JaJh"V�CJOJQJ^JaJhVRCJOJQJ^JaJh<7CJOJQJ^JaJ&, . 8 J \ d ^RRRRd�$Ifgd���kd$$If�l��\���H��$Z	Z	Z	Z	
t��0�6���������������������4�4�
la�yt��d f n � � � ^RRRRd�$Ifgd���kd�$$If�l��\���H��$Z	Z	Z	Z	
t��0�6���������������������4�4�
la�yt��� � � � � � ^RRRRd�$Ifgd���kd*$$If�l��\���H��$Z	Z	Z	Z	
t��0�6���������������������4�4�
la�yt��� � � � �  !"!2!4!D!F!L!P!R!T!""""?"J"K"�����޼޼��ޮ��~pbTCT h
[Gh �CJOJQJ^JaJh �CJOJQJ^JaJh|U�CJOJQJ^JaJhjg?CJOJQJ^JaJh"V�CJOJQJ^JaJ h�-�h"V�CJOJQJ^JaJ h�0�h�^�CJOJQJ^JaJh�z�CJOJQJ^JaJ h��h�>�CJOJQJ^JaJ h��h
CJOJQJ^JaJ h��h�H~CJOJQJ^JaJ h��h�.VCJOJQJ^JaJ� � "!4!F!N!^RRRRd�$Ifgd���kd�$$If�l��\���H��$Z	Z	Z	Z	
t��0�6���������������������4�4�
la�yt��N!P!T!"K"L"]"^VNF::d�$IfgdP�d�gd �d�gd"V�d�gd�z��kdT$$If�l��\���H��$Z	Z	Z	Z	
t��0�6���������������������4�4�
la�yt��K"L"]"`"a"b"j"u"v"y"z"{"�"�"�"�"�"�"�"�"�"�"�"�"�"�"�"��ʹ�ۨ�ʹ���۔��쨹�o��^M h�-�hNwCJOJQJ^JaJ h"V�5�CJOJQJ\�^JaJ hP�hCCJOJQJ^JaJ&hP�hqz5�CJOJQJ\�^JaJ&hP�h
[G5�CJOJQJ\�^JaJ hP�h
[GCJOJQJ^JaJ hP�hqzCJOJQJ^JaJ hP�h�3:CJOJQJ^JaJ hP�h"V�CJOJQJ^JaJ&hP�h"V�5�CJOJQJ\�^JaJ]"b"v"{"�"�"�"�"�"�"����R�����kd�$$If�l��\����$�
�
Z	
t��0�6���������������������4�4�
la�P�ytP�d�$IfgdP�	�"�"�"##J#K#^VNNF:d�$IfgdP�d�gd�[�d�gdNwd�gd"V��kd�$$If�l��\����$�
�
Z	
t��0�6���������������������4�4�
la�P�ytP��"�"
##;#H#J#K#O#\#_#`#a#i#v#y#z#{#|#�#�#�#�#�#�#�#�#�#�#�#�#�#�����ȴ�򣒁�򣁒����p_�������Qh��CJOJQJ^JaJ hoo�hNwCJOJQJ^JaJ hoo�h/mCJOJQJ^JaJ hP�h�@oCJOJQJ^JaJ hP�h/mCJOJQJ^JaJ hP�hNwCJOJQJ^JaJ&hP�hNw5�CJOJQJ\�^JaJh �CJOJQJ^JaJh&�CJOJQJ^JaJhNwCJOJQJ^JaJh�)XCJOJQJ^JaJK#]#b#w#}#�#�#�#�#�#�����R����kdq$$If�l��\����$�
�
Z	
t��0�6���������������������4�4�
la�P�ytP�d�$IfgdP�	�#�#�#�#$O$P$�RJB:�d�gd�[�d�gd%t�d�gd�<,�kd5$$If�l��\����$�
�
Z	
t��0�6���������������������4�4�
la�P�ytP�d�$IfgdP��#�#$$	$$O$P$d$e$}$$�$�$�$�$�$�$�$�$�$�$�$�$�$�$�$�����~�~���m�m�m�m�\��Nh9W�CJOJQJ^JaJ hP�h�CJOJQJ^JaJ hP�h�aCJOJQJ^JaJ hP�h�F�CJOJQJ^JaJ hP�h.�CJOJQJ^JaJ&hP�h.�5�CJOJQJ\�^JaJh�[�CJOJQJ^JaJh%t�CJOJQJ^JaJh�%CJOJQJ^JaJ h�-�h%t�CJOJQJ^JaJ h�-�h�%CJOJQJ^JaJP$a$f${$�$�$�$�$�$�$�����R����kd�$$If�l��\����$�
�
Z	
t��0�6���������������������4�4�
la�P�ytP�d�$IfgdP�	�$�$�$�$ %h%i%�%�RJBB��d�gdAS�d�gd�<,�kd�$$If�l��\����$�
�
Z	
t��0�6���������������������4�4�
la�P�ytP�d�$IfgdP��$�$%%% %T%U%g%h%i%n%�%�%�%�%�%�%�%�%�%�%�%�%������ᦒ�p�_�p�_���N� hP�hb.CJOJQJ^JaJ hP�hk�CJOJQJ^JaJ hP�hD2CJOJQJ^JaJ hP�h�@�CJOJQJ^JaJ&hP�h�@�5�CJOJQJ\�^JaJh9W�CJOJQJ^JaJ h�-�hAS�CJOJQJ^JaJh�T�CJOJQJ^JaJh��CJOJQJ^JaJhAS�CJOJQJ^JaJ h�-�h��CJOJQJ^JaJ�%�%�%�%�%�%�%�%�%�%����R�����kd�$$If�l��\����$�
�
Z	
t��0�6���������������������4�4�
la�P�ytP�d�$IfgdP�	�%�%�%�%�%�%�%�%�%�%t&�&�&�&O'R'�����޹���udS>))h	�h�wB*CJOJQJ^JaJph)h	�h�7�B*CJOJQJ^JaJph h	�h�7�CJOJQJ^JaJ h	�h�g�CJOJQJ^JaJ h	�h�H{CJOJQJ^JaJ h	�h+	)CJOJQJ^JaJ&hyh+	)5�CJOJQJ\�^JaJhAS�CJOJQJ^JaJ&hP�h�@�5�CJOJQJ\�^JaJ hP�h�(CJOJQJ^JaJ hP�h�@�CJOJQJ^JaJ hP�h�Y�CJOJQJ^JaJ�%�%�%�%�'k()^VNFF>d�gd="/d�gd	�d�gd+	)d�gdAS��kdE$$If�l��\����$�
�
Z	
t��0�6���������������������4�4�
la�P�ytP�R'j'�'�'�'�'(U(V(d(f(j(k(�(�(�()�)���ٷ�����y�hWIW;h@�CJOJQJ^JaJh="/CJOJQJ^JaJ h="/h="/CJOJQJ^JaJ h="/h&jTCJOJQJ^JaJh{>�CJOJQJ^JaJh	�CJOJQJ^JaJ h	�h	�CJOJQJ^JaJ h	�h�~�CJOJQJ^JaJ h	�h�|�CJOJQJ^JaJ h	�h+	)CJOJQJ^JaJ h	�h�O�CJOJQJ^JaJ)h	�h�&�B*CJOJQJ^JaJph�)�)�)�)t*++9+,,^,_,`,a,b,k,t-���ŷ򩛍�|kZL>- h>�h��CJOJQJ^JaJhx�CJOJQJ^JaJh+	)CJOJQJ^JaJ h	�h	�CJOJQJ^JaJ h="/h="/CJOJQJ^JaJ hP�h�+GCJOJQJ^JaJh�/NCJOJQJ^JaJh�aCJOJQJ^JaJhO!3CJOJQJ^JaJh	M�CJOJQJ^JaJhE�CJOJQJ^JaJ hsh%&�CJOJQJ^JaJh%&�CJOJQJ^JaJh�V(CJOJQJ^JaJ)+,^,_,`,a,b,c,d,e,f,g,h,i,j,k,w,�,.-e-s-���������������������d��7$8$H$gd��gd��d�gd�<,d��7$8$H$gd	�d��7$8$H$gd�s�d�gd�ad�gd	M�s-t--...�.=/>/ 1�1�4�4�6�6�����������v
-DM�
����gd�r�
-DM�
����gd�$
-DM�
����gdU[�
-DM�
����gdU[�d�-DM�
����gd�\�
-DM�
����gd�\�d�-DM�
����gd��
-DM�
����gd��
-DM�
����gd��d��7$8$H$gd��t-�-�-�-�-�-...-...w.x.�.�.//%/&/</=/>/A/�����������o�o�oaSA#h�K0h�\�5�B*CJ\�aJph�h�\�CJOJQJ^JaJh��CJOJQJ^JaJ h�jh��CJOJQJ^JaJ)jh�jh��CJOJQJU^JaJ'h>�h��0J5�B*CJ\�aJph�#h>�h��5�B*CJ\�aJph� h>�h��CJOJQJ^JaJh>�h��0JCJaJh>�h��0JCJaJjh>�h��CJUaJh>�h��CJaJA/B/�/�/�/�/�/�/(0)040507080�0�0�0�0�0�0�0�0 1!1�1�1�1�1�1�1�1�1�12���������������������׮������{jUj)jh�K0h�/2CJOJQJU^JaJ h�K0h�/2CJOJQJ^JaJ h�K0hfUCJOJQJ^JaJ h�K0h�\�CJOJQJ^JaJ h�\�h�\�CJOJQJ^JaJ)jh�\�h�\�CJOJQJU^JaJ'h�K0h�\�0J5�B*CJ\�aJph�#h�K0h�\�5�B*CJ\�aJph�,jh�K0h�\�5�B*CJU\�aJph�!222 2"2#2�2�2�2�2�2�23	33333�3�3�3�3�3�3�3�3�3�3�3�4�4�4�4�4�4�4�4�4.5/5����������������������ȵȵȠȠȠȒ�{l{ljh��h�r�CJUaJh��h�r�CJaJh�r�CJOJQJaJhU[�CJOJQJ^JaJ)jh�K0hU[�CJOJQJU^JaJ$h�K0hU[�0JCJOJQJ^JaJ h�K0hU[�CJOJQJ^JaJ h�K0h�/2CJOJQJ^JaJ)jh�K0h�/2CJOJQJU^JaJ'/5=5>5@5A5�5�5�5�5�5�5�56666�6�6�6�6�6�6�6�6;7<7O7���������ɼ����������q\q\C0h��h�w�0J>*B*CJOJQJ^JaJph�)jh��h�w�CJOJQJU^JaJ h��h�w�CJOJQJ^JaJ h��h�r�CJOJQJ^JaJh��h�$B*CJaJph/J�jh��h�$CJUaJh��h�$CJaJh��h�$0JCJaJh��h�$0JCJaJh��h�r�CJaJjh��h�r�CJUaJh��h�r�B*CJaJph/J�O7P7R7S7�7�7�7�7�7�7�R�S�]�^�v�����������������������٭ٜ�~m\ h��h��CJOJQJ^JaJ h>�h�\�CJOJQJ^JaJh�\�h�\�CJOJQJaJh�\�hfUCJOJQJaJ h��h�/2CJOJQJ^JaJ h��hDr@CJOJQJ^JaJU0h��h�w�0J>*B*CJOJQJ^JaJph� h��h�w�CJOJQJ^JaJ)jh��h�w�CJOJQJU^JaJHYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sheibani%20V%22%5BAuthor%5D"Sheibani V, Garrusi B, Amirkafi A.Reliability and validity of the Persian version
of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath.2011; 16:79-82





�6������������������d�gd�<,d�-DM�
����gd��
-DM�
����gd�\�d�-DM�
����gd�\�
-DM�
����gd�/2gd�w�d��7$8$H$gdDr@,1�h��/ ��=!��"��#��$��%��������$$If�!vh5�Z	5�Z	5�Z	5�Z	#vZ	:V�l
t��0�65�Z	yt���$$If�!vh5�Z	5�Z	5�Z	5�Z	#vZ	:V�l
t��0�65�Z	yt���$$If�!vh5�Z	5�Z	5�Z	5�Z	#vZ	:V�l
t��0�65�Z	yt���$$If�!vh5�Z	5�Z	5�Z	5�Z	#vZ	:V�l
t��0�65�Z	yt���$$If�!vh5�Z	5�Z	5�Z	5�Z	#vZ	:V�l
t��0�65�Z	yt���$$If�P�!vh5�5��
5��
5�Z	#v#v�
#v�
#vZ	:V�l
t��0�65�5��
5��
5�Z	a�P�ytP��$$If�P�!vh5�5��
5��
5�Z	#v#v�
#v�
#vZ	:V�l
t��0�65�5��
5��
5�Z	a�P�ytP��$$If�P�!vh5�5��
5��
5�Z	#v#v�
#v�
#vZ	:V�l
t��0�65�5��
5��
5�Z	a�P�ytP��$$If�P�!vh5�5��
5��
5�Z	#v#v�
#v�
#vZ	:V�l
t��0�65�5��
5��
5�Z	a�P�ytP��$$If�P�!vh5�5��
5��
5�Z	#v#v�
#v�
#vZ	:V�l
t��0�65�5��
5��
5�Z	a�P�ytP��$$If�P�!vh5�5��
5��
5�Z	#v#v�
#v�
#vZ	:V�l
t��0�65�5��
5��
5�Z	a�P�ytP��$$If�P�!vh5�5��
5��
5�Z	#v#v�
#v�
#vZ	:V�l
t��0�65�5��
5��
5�Z	a�P�ytP��$$If�P�!vh5�5��
5��
5�Z	#v#v�
#v�
#vZ	:V�l
t��0�65�5��
5��
5�Z	a�P�ytP�j���������666666666vvvvvvvvv666666>666666666666666666666666666�6666666666�666666666666hH66666666666666666666666666666666666666666666666666666666666666666�62���� 0@P`p������2(�� 0@P`p������ 0@P`p������ 0@P`p������ 0@P`p������ 0@P`p������ 0@P`p��8X�V~ OJQJ^J_HmH	nH	sH	tH	J`�JNormald��CJ_HaJmH	sH	tH	h@h���	Heading 1d����x@&'5�B*CJ!KH$OJQJ\�^JaJ!phDA`�D
Default Paragraph FontRi@�R0Table Normal�4�
l4�a�(k �(
0No List\���\���Heading 1 Char'5B*CJ!KH$OJQJ\^JaJ!ph �O� ��jrnlF�OF��title1d��CJOJQJ^JaJ*�O�!*�\�	highlight4U@�14�w�0	Hyperlink	>*ph�j��Cj�H~�
Table Grid7:V�0PK!����[Content_Types].xml���j�0E����ж�r�(��΢Iw},��-j��4	��w�P�-t#bΙ{U�����T�U^h�d}㨫��)��*1P�'��	�^��W��0)��T�9<�l�#��$yi}��;�~@��(��H����u�*Dנz��/0�ǰ��$��X��3aZ����,�D0j~�3߶�b��~i>���3�\`�?�/�[���G��\�!�-�Rk.�s�Ի�..���a濭?��PK!�֧�6_rels/.rels���j�0���}Q��%v/��C/�}�(h"���O�
����=������ ����C?�h�v=��Ʌ��%[xp��{۵_�Pѣ<�1�H�0���O�R�Bd���JE�4b$��q_����6L�R�7`������0̞O��,�En7�Li�b��/�S���e��е�����PK!ky���theme/theme/themeManager.xml�M
� @�}�w��7c�(Eb�ˮ��C�AǠҟ����7��՛K
Y,�
�e�.���|,���H�,l����xɴ��I�sQ}#Ր���� ֵ+�!�,�^�$j=�GW��)�E�+&
8���PK!����Ptheme/theme/theme1.xml�YOo�6��w toc'vu�ر�-M�n�i���P�@�I}��úa��m�a[�إ�4�:lЯ�GR��X^�6؊�>$�������!)O�^�r�C$�y@�����/�yH*��񄴽)�޵��߻��UDb�`}"�qۋ�Jח���X^�)I`n�E���p)���li�V[]�1M<������O�P��6r�=���z�gb�Ig��u��S�eb��O������R�D۫����qu	�g��Z����o~ٺlAp�lx�pT0���+[}`j���zA��V�2�F���i�@�q�v�֬5\|��ʜ̭N��le�X�ds���jcs���7���f����
��W��+�Ն�7����`���g�Ș��J���j|��h(�K��D-����
dX��iJ�؇(��x$(��:��;�˹!�I_�T��S1�����?E��?�����?ZBΪm���U/������?�~����xY���'���y5�g&΋/����ɋ�>���G�M�Ge���D�����3Vq%'#q�����$�8��K�����)f�w9:ĵ��
x}r�x����w���r�:\TZaG�*�y8I�j�bR��c|XŻ�ǿ�I
u3KG�nD1�NIB�s���
��R��u���K>V�.EL+M2�#'�f��i~�V��vl�{u8��z��H�
�*���:�(W�☕
~��J�T�e\O*�tHG��HY��}KN�P�*ݾ˦���TѼ�9/#��A7�qZ��$*c?���qU��n��w�N��%��O��i�4=3ڗP��
����1�P�m\\9���������Mؓ�2a�D�]�;Yt�\��[x����]�}Wr��|�]��g-���
eW�
�)6-r��CS�j��
i�d	�DЇA�ΜIqbJ#x�꺃6k���#��A�Sh��&ʌt(Q�%��p%m��&]�caSl=�X�����\P�1�Mh�9�M��V�dDA��aV�B��[݈fJ�íP|8�քA�V^��f
�H��n���-��"�d>�z��n��NJ�	�ة�>�b���&����2��v����Kyϼ��D:����,AGm��\nz��i�Ù��.uχYC�6�OMf��3o�r��$��5�����NH�T[XF64�T,ќ���M0�E)`#�5�XY�`�פ;��%�1�U�٥m;���R>QD����D�cp�U�'��&LE�/p���m���%]�����8fi��r�S4�d7y\�`�J�n���ί�I�R��3U�~7+���׸#��m�q�BiD���������i*�L6�9�m�Y&���i���HE��=(K&�N!V�.K�e�LD�ĕ�{D	����vEꦚde��NƟ��e�(�MN9ߜR�6����&3(��a���/D��U�z�<�{ˊ�Y��ȳ����V���)�9�Z[��4^n��5���!J��?��Q�3�eBo�C����M����m<�.�vp�����IY�f���Z�Y_p�[�=al-�Y�}Nc͙���ŋ4vfa��vl����'S��A�8�|�*u�{��-�ߟ0%M0�7%����<���ҍ���PK!
ѐ��'theme/theme/_rels/themeManager.xml.rels��M
�0���wooӺ�&݈Э���5
6?$Q��
�,.�a��i����c2�1h�:�q��m��@RN��;d�`��o7�g�K(M&$R(.1�r'J��ЊT���8��V�"��AȻ�H�u}��|�$�b{��P����8�g/]�QAsم(����#��L�[������PK-!����[Content_Types].xmlPK-!�֧�6+_rels/.relsPK-!ky���theme/theme/themeManager.xmlPK-!����P�theme/theme/theme1.xmlPK-!
ѐ��'�	theme/theme/_rels/themeManager.xml.relsPK]�
<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<a:clrMap xmlns:a="http://schemas.openxmlformats.org/drawingml/2006/main" bg1="lt1" tx1="dk1" bg2="lt2" tx2="dk2" accent1="accent1" accent2="accent2" accent3="accent3" accent4="accent4" accent5="accent5" accent6="accent6" hlink="hlink" folHlink="folHlink"/>-.������'��D����� K"�"�#�$�%R'�)t-A/2/5O7�� "#$&'()-0369;=>ABCDE��, d � � N!]"�"K#�#P$�$�%�%)s-�6��!%*+,./124578:<?@G*#d#�#B$�$�$�$1%8%;%�%�%�%)&2&�&''-'�'�'�'(((�(�(�())Z)**;*�*�*�*9+F+�+$,F,a,�,�,�,(-2-5-�-�--.X��X��X��X��X��X��X��X��X��X��X��X��X��X��X���X���X����8�@�����������0�(	�
��B
�S����	?�:ABHINgy��:Abiu{��ejkv������q}������H	U	�	�	�	�	����8DQ\|�������w���������_jlwOZ	""""!")"-"6":"C"�"�"�"�"�"##
### #&#�#�#�#�#�#�#�#�#�#�#�#�#5$@$�$�$�$�$�%�%''�(�(	****�*�*�*�*=+C+%,(,+,1,2,9,:,@,�,�,�,�,)-0-�-�-�-�-�-�-�-�-/.bk��ci����q�!q�

�
�
��TV��:@.kOW]!�!s"}"�"�"�"�"�"�"�"�"�#�#�#�#�$�$�$4&5&�&'')Y)'***I+�+P,T,�-�-/.33333333333333333333333333333333333:eeW��
<<fs,./.=�>�DbOe!�q�<�.�Cp5$_�N�(xh#~{l3\F�
�B�Y{l3�pM�d�g{�� 0Z4$�,�b�4E"�.�7�$$�;�k�N�(+�pj?�(D''j�vS*
�0E"�xht�2�gCb�4�vS*.�7�?\8�7o �O�;;w4}QA�;�]rc�q�<��B�}3>Fe^��B�,��gC�lhxhs$+F�c�k{
�Ioj<O{
�Io �O�W�Ws$+Fxh�B�Y�O�[xh�R�Y!xh�X�Yoj<O� 0Zze�q�O�[�pM�?\{�G�\�>��%^w�zFe^j?�(xh\P&`�.�]rc�xDbOe�d�g�%^�lh\P&`D''j�~zk
�0�;�k�X�Y�c�kQA�;p>nn�f�pxhHI|n�Cp8�7�f�p�$$+�p�;;�y�pp>nnze�q�x4$w�zHI|nw4}#~�~G�\��� LSP!y�f>�/mpuHIF	
�(�l
b.��]�w�CoN�Q�$�!$U!8_!	I"�'#}%�%�}%�'�N'M(�V(mp(+	)�w*X;,�<,�{-bc.="/M/D0�K0�
1�V1�/2D2O!3�~3)`4�P6<7�3:�p:�#<	l<�=�=�>�\>�e>�1?jg?Dr@}*Cf0D#G�+G�-G
[G(XHnKwKPL8%N�/N�O�<P�LRVR�DT&jTfU�.V�>V�)XlY�2Zw*`H8`�a�a�,b�me�hlo�@oq�qNw�x8Yx�y�yyqz�{�H{C[|�}�|}�H~�4��r��M��X�t��-��7�\]��T��O�v�S	����z�k�E�|U�Df�A2��g�|n��\��S��]��@��m��s��@�X��F���-�0)�;Y��c�%&�>��y�[Q�AS���1
�	M��Y��w�.��^��f��~�	��)� m�:��f�x�Wp�&��.��>��;�@��<��7�U[���{>�9^�oo���#��3��R�t�a�I�Es��y���#r��T��>�%t��M�#�!��0��;��X��)��7��Y� ��O�P�9W�JU��O�"V�E(��[��|��@��&����~�-./.�@�H�L��6--.p@pp4@p pD@p@��Unknown������������G��* ��Times New Roman5��Symbol3.��* ��Arialk ��MyriadPro-SemiCnArial Unicode MS7.���{ @�CalibriA���� B�Cambria Math"q���hte'�ue'��I'�S�I'S!�������20..2�q���HX	�$P�����������������������e>2!xx���Aria TM
ma.ghajarzade����Oh��+'��0t��������	
0<
HT\dl�Aria TMNormal.dotmma.ghajarzade3Microsoft Office Word@F�#@�+���@Z�O����I'����՜.��+,��D��՜.��+,��4�hp��������
���sazgar.comS.Title( 8@_PID_HLINKS�A�
f{/0Ghttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Sheibani%20V%22%5BAuthor%5DK-Fhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Nakhaee%20N%22%5BAuthor%5D*Rhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Farrahi%20Moghaddam%20J%22%5BAuthor%5D+9',http://www.ncbi.nlm.nih.gov/pubmed/190105847$ghttp://www.ncbi.nlm.nih.gov/pubmed?term=do%20Amaral%20VF%5BAuthor%5D&cauthor=true&cauthor_uid=19010584+!ihttp://www.ncbi.nlm.nih.gov/pubmed?term=Sepulcri%20Rde%20P%5BAuthor%5D&cauthor=true&cauthor_uid=19010584+8,http://www.ncbi.nlm.nih.gov/pubmed/22082788eahttp://www.ncbi.nlm.nih.gov/pubmed?term=Sharma%20V%5BAuthor%5D&cauthor=true&cauthor_uid=22082788L(ahttp://www.ncbi.nlm.nih.gov/pubmed?term=Vilos%20GA%5BAuthor%5D&cauthor=true&cauthor_uid=22082788o_http://www.ncbi.nlm.nih.gov/pubmed?term=Khan%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22082788Wt`http://www.ncbi.nlm.nih.gov/pubmed?term=Kumar%20V%5BAuthor%5D&cauthor=true&cauthor_uid=22082788)0+http://www.ncbi.nlm.nih.gov/pubmed/84639872^`http://www.ncbi.nlm.nih.gov/pubmed?term=Sutton%20C%5BAuthor%5D&cauthor=true&cauthor_uid=8463987:	chttp://www.ncbi.nlm.nih.gov/pubmed?term=Edelmann%20RJ%5BAuthor%5D&cauthor=true&cauthor_uid=8463987c^http://www.ncbi.nlm.nih.gov/pubmed?term=Low%20WY%5BAuthor%5D&cauthor=true&cauthor_uid=8463987#7,http://www.ncbi.nlm.nih.gov/pubmed/15749483&:,http://www.ncbi.nlm.nih.gov/pubmed/20574791	

 !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGH����JKLMNOP����RSTUVWXYZ[\]^_`abcdef����hijklmn����pqrstuv��������y����������������������������Root Entry��������	�F��	d���{�Data
������������I1Table����QY+WordDocument����.�SummaryInformation(������������gDocumentSummaryInformation8��������oCompObj������������y������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������
����	�F'Microsoft Office Word 97-2003 Document
MSWordDocWord.Document.8�9�q

Youez - 2016 - github.com/yon3zu
LinuXploit