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Introduction: Pregnant women and their fetuses are considered as high-risk groups during the COVID-19 pandemic. The aim of this study was to identify the risk factors of adverse pregnancy outcomes among women with COVID-19. Methods: This case-control study was conducted among pregnant women who delivered live infants at least 60 days before data collection in Hormozgan Province, south of Iran, 2021. The case and control groups included women with and without the history of COVID-19, respectively. A 47-item checklist including demographic information of the mothers, maternal current and past medical history, maternal and fetal prenatal and post-natal outcomes; and other COVID-19 related outcomes was used. The logistic regression analysis was used for data analysis. Results: A total of 1337 women (668 in case and 669 in control groups) participated in this study. The mean (SD) gestational age in the case and control groups were 32.83 (84.64) and 23.75 (6.93) weeks respectively. Maternal age and the incidence of abortion, obesity, and multiple pregnancies was higher in the COVID-19 group compared with the control group. The most common COVID-19 symptoms were myalgia (24.8%), cough (19.3%), fever (17.5%) and olfactory disorder (14.3%). The preventive factors against COVID-19 adverse pregnancy outcomes were low and normal body mass index, influenza vaccination history, and multivitamin consumption, while the risk factors were multiple pregnancies, abortion and preterm labor. Conclusion: This study showed that pregnant women were to COVID-19. The identified risk factors for COVID-19 adverse pregnancy outcomes can be used to prioritized pregnant women in receiving COVID-19 related health services. [ABSTRACT FROM AUTHOR]

Background Coronavirus disease 2019 (COVID-19) has become a global health issue with various effects on the physical and mental state of the societies. The aim of this study was to identify the demographic characteristics and mental health condition of Tehran Municipality employees during the COVID-19 pandemic. Methods This cross-sectional study was performed on Tehran Municipality employees in 2020–2021. Participants were selected using stratified random sampling and were divided into COVID-19 and uninfected groups. Demographic characteristics, COVID-19 risk behaviors, General Health Questionnaire-28 (GHQ-28), and Well- Being Social Inventory were filled for all participants. Results A total of 510 participants (363 uninfected participants and 147 participants with COVID-19) were evaluated. The prevalence of female gender was significantly higher in COVID-19 group compared to uninfected group (p<0.001). There was a significant difference between groups in terms of education level (p<0.001), prevalence of excess weight (p<0.001), and working sector (p<0.001). The uninfected group mainly had low contact with clients (p<0.001) and few underlying diseases (p=0.004) compared to the COVID-19 group. The mean GHQ-28 and WellBeing Social Inventory were significantly higher in the uninfected group compared to the COVID-19 group (p=0.002 and p<0.001, respectively). The prevalence of no and low contact level was significantly higher in the high infection cluster compared to moderate and low infection clusters (p=0.024). Conclusions The findings of this study indicated that all workers should be educated about the significance of social distancing and follow the recommendations regardless of their level of contact with clients. [ABSTRACT FROM AUTHOR]

Background: Breast cancer screening can reduce mortality and improve the quality of life in affected women. The present study aimed to determine the predictive factors of breast cancer screening in Iranian women based on the health belief model (HBM). Methods: This review was conducted by searching electronic databases of Google Scholar; electronic databases, including Scopus, PubMed/MEDLINE, Cochrane Library, Web of Science, ProQuest, Embase, and Google scholar Magiran; and SID with the English keywords of "breast cancer," "mammography," "health belief model," and "breast self-exam" and the equivalent Persian keywords. The results were evaluated based on the health belief model (HBM) constructs. Articles were evaluated for quality and the findings were extracted and reviewed. Results: A total of 8 relevant articles were selected for review. Women's awareness of breast cancer screening methods was moderate in two studies and poor in two other studies. Among the constructs of HBM, knowledge, perceived susceptibility, perceived severity, perceived benefits, and action plan were poor in the majority of the studies, while perceived barriers, cues to action, and self-efficacy were mainly good. Conclusion: Considering the observed weakness of many HBM constructs, it is recommended that special attention be given to all HBM constructs in implementing HBM-based education programs. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) not only has put populations at risk for mental and sexual health risks. This systematic review and meta-analysis was performed on published articles reporting female sexual function before and during COVID-19 pandemic in PubMed, Web of Science, Scopus, Google Scholar, Magiran and SID databases till August 2021. From the initial 3198 articles, 8 articles were included in the review. Meta-analysis showed no significant difference in total FSFI score and its domains during the COVID-19 pandemic and the pre-pandemic period. Further studies should separately evaluate the effect of lockdown on female sexual function. [ABSTRACT FROM AUTHOR]

Objective: The coronavirus 2019 (COVID -19) pandemic had great psychological impact on COVID-19 patients and their families. Relatives of the deceased COVID-19 patients are at risk for complicated grief. Healthcare providers (HCPs) should be able to identify complicated grief cases. The aim of this study was to assess HCP knowledge regarding complicated grief during the COVID-19 pandemic. Method: This cross-sectional study was conducted using an online researcher-made questionnaire. The questionnaire was designed and validated before being used in this study. The questionnaire included demographic questions as well as knowledge about complicated grief and its symptoms, risk factors and management. The link to the questionnaire website was sent to HCP governmental and private sectors. Data was analyzed using the ordinal regression model by the SPSS 16 software. Results: A total of 887 HCPs (69% female and 31% male) participated in this study. Majority of the participants (594, 70%) had fair overall knowledge about complicated grief while 206 (23.2%) participants had poor knowledge. Poor knowledge level about risk factors for complicated grief was observed in 44.3% of the participants. Fair or poor knowledge about prevention and management of complicate grief was observed in 39.2% of participants. Knowledge about complicated grief had a significant positive relationship with female gender (OR: 1.55; 95% CI: 1.15-2.08) and higher education level (OR: 1.86; 95% CI: 1.37-2.54). Conclusion: Knowledge of HCPs about complicated grief was low. There is need for HCP knowledge improvement regarding complicated grief by appropriate education. [ABSTRACT FROM AUTHOR]

The aim of this mixed method systematic review was to assess maternal satisfaction with normal vaginal delivery and its influencing factors in Iranian population. All quantitative and qualitative studies about the factors related to women's satisfaction with normal vaginal delivery were searched. Data extraction was performed using the data extraction form adapted from the Cochrane Collaboration guidelines. The quality of all studies was assessed by two researchers independently using the risk assessment checklist by Cochrane Collaboration. Studies that were conducted on pregnant women older than 18 years old who were in the first post-partum year and assessed satisfaction were included in this review. The current study revealed that the level of satisfaction about normal vaginal delivery was moderate in Iranian women. Fear of pain, vaginal delivery complication and sexual dysfunction were the most common factors that affected satisfaction about vaginal delivery. [ABSTRACT FROM AUTHOR]

Aim: Sex differences in COVID-19 outcomes might be explained from a sex hormones (SexHs) perspective. Materials & methods: PubMed, Scopus, Web of Science, EMBASE and Google Scholar were searched up to March 2021. Results: Based on the literature review, the crosstalk between SexHs (estrogens, progesterone and testosterone), their receptors (estrogen α and β, androgen, and progesterone) and the immune system shaped the sex-related differences in immune responses against COVID-19. Differential production of SexHs over the lifespan (during pregnancy, reproductive years, menopause and andropause) and over different seasons may result in disparities in body response toward COVID-19. Moreover, SexHs-specific differences might affect vaccine efficacy and response to treatment. Conclusion: The roles of SexHs need to be considered in vaccine development and even treatment of COVID-19. Female and male sex hormones (SexHs) play a pivotal role in the body's defense against viral infections. SexHs and their binding molecules are among the main possible indicators of sex disparities in COVID-19 severity and response to treatment. Changes in the levels of SexHs from the childbearing age to menopause and pregnancy in females, and the aging process in males affect the immune function. This article sheds light on how physiologic hormonal differences in different sexes and in different stages of life affect COVID-19 severity. As a consequence the role of SexHs should be considered in vaccine development and treatment of COVID-19, especially for patients who suffer from hormone-related medical conditions in different stages of life. [ABSTRACT FROM AUTHOR]

Saffron and its active ingredients were found effective in the management of pain due to neurological and inflammatory causes. Therefore, this study was conducted to evaluate the effect of saffron on anxiety, fatigue and pain during labor progress. In this review study, articles in Persian and English language indexed in reputable databases, including Irandoc, Iranmedx, SID, Google scholar, Magiran, Scopus, web of science and PubMed were searched Articles that met the inclusion criteria were analyzed qualitatively. Out of 34040 studies, 6 articles were included. The mean score of anxiety and fatigue, active phase length score of the first and second stages of delivery were lower in the saffron consumer group compared to pharmacotherapy group. Saffron can increase cervical ripening in term pregnancies. Saffron had abortive effects. Saffron can be used as a facilitator of labour and a natural analgesic for labor pains. [ABSTRACT FROM AUTHOR]

Background: The Coronavirus Disease 2019 (COVID-19) outbreak has put a great burden on global health and healthcare systems. There is controversy regarding the possibility of vertical transmission of COVID-19. This proposed systematic review will be done to assess the possibility of vertical transmission of COVID-19 based on currently published literature. Methods: In this study, all published observational studies, including cross-sectional, cohort, and case-control studies, as well as case reports and case series, in peer-reviewed journals in any language until the end of July 2020 will be assessed. Editorials, commentaries, and letters to editors will be excluded from the review. Searching will be conducted using international bibliographic databases, including PubMed, Embase, and Web of Science based on Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. The search strategy will be improved and finalized based on the results of the primary search. Data extraction of the included articles will be performed by two researchers using the Zotero and review manager (revMan) software. The heterogeneity of the articles will be assessed using DerSimonian & Laird Q test and I² statistic. The pooled estimated prevalence of vertical transmission of COVID-19 will be performed using the Metaprop command. Publication bias will be assessed using Begg’s rank correlation and the Egger weighted regression methods Results: Based on the reviewers comments the results section was deleted because this manuscript was a systematic review protocol. Conclusion: The findings of this study will help practitioners and health care providers in decision-making for the care and management of COVID-19-infected pregnant women. [ABSTRACT FROM AUTHOR]

Childbirth is one of the most important influencing factors for sexual function. Therefore, this study was conducted with the aim of comparing sexual function in primiparous and multiparous women. This cross-sectional analytical study was performed using systematic random sampling on 420 women in the postpartum period who referred to Bandar Abbas health Centres in 2018. The data were collected using an interview method which consisted of a Female Sexual Function Index questionnaire and a demographic questionnaire. The data analysis was performed using the SPSS Version 23 software. The results showed that sexual dysfunction was lower in multiparous women compared to primiparous women (p = .006). Low sexual activity in primiparous women can be due to less privacy and more time and energy loss. Several factors including housing situation, monthly income, episiotomy incision, and the education level of the couple were influential in the sexual function of the primiparous women (p < .05). Sexual function differs between primiparous and multiparous women in postpartum period and the number of deliveries can affect sexual performance.IMPACT STATEMENTWhat is already known on this subject? Sexual function in humans is affected by a complexity of interactions. Childbirth is among the most one of the important factors that influences sexual function. Pregnancy and childbirth affect all organs of the female body, especially the genital tract, and the resulting changes may cause problems in sexual intercourse. Negative childbirth experiences from previous deliveries can affect sexual performance.What do the results of this study add? Regarding the high prevalence of sexual problems during the postpartum period and the direct impact of this on spousal relationship, and also given the controversial data on the relationship between parity and sexual dysfunction, the present study was conducted to compare postpartum sexual function between primiparous and multiparous women.What are the implications of these findings for clinical practice and/or further research? The sexual and emotional intimacy of couples may be affected due to the changes in women's sexual function as the result of physiological and anatomical changes during pregnancy and postpartum. Therefore, to improve the quality of sexual relations, screening and counselling for sexual disorders should not be limited to pregnancy and postpartum periods, but should also be included in pre-pregnancy counselling centres. [ABSTRACT FROM AUTHOR]

Objective: The aim of this overview was to evaluate the effectiveness of phytoestrogens on vaginal health and dyspareunia in peri- and post-menopausal women.Material and Methods: Three databases including MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials were from inception to August 2017.Result: Two systematic reviews and 11 RCTs were included in the overview. According to the findings, isoflavones increased the maturation value and attenuated the vaginal atrophy in the post-menopausal women. Topical isoflavones had beneficial effects on the vaginal atrophy. Similar efficacy was found in Pueraria mirifica and conjugated estrogen cream on dryness ( p = 0.277), soreness ( p = 0.124) and irritation ( p = 0.469), as well as discharge ( p = 0.225) and dyspareunia ( p = 0.089). However, the conjugated estrogen cream was more effective compared to Pueraria mirifica ( p > 0.005) regarding maturation index improvement. Comparison of fennel 5% vaginal cream and placebo gel showed significant difference in superficial cells ( p < 0.01), parabasal cells ( p < 0.01) and intermediate cells ( p < 0.01), whereas no difference was found between the oral fennel and placebo in terms of superficial, parabasal and intermediate cells as well as Maturation value. Administration of 80 mg red clover oil had a significant effect on superficial ( p < 0.005), intermediate ( p < 0.005) and parabasal and vaginal dryness ( p < 0.005) compared to the placebo. Flaxseed had also a trivial effect on maturation value. Genistein had a more prominent effect on the genital score. The severity of dyspareunia decreased by 27%.Conclusion: Phytoestrogens have various effects based on administration route and type on the vaginal atrophy. [ABSTRACT FROM AUTHOR]

Objectives: The present mini review aimed to summarize the existing knowledge regarding the beneficial and adverse effects of raloxifene in menopausal women. Methods: This study is a review of relevant publications about the effects of raloxifene on sleep disorder, depression, venous thromboembolism, the plasma concentration of lipoprotein, breast cancer, and cognitive function among menopausal women. Results: Raloxifene showed no significant effect on depression and sleep disorder. Verbal memory improved with administration of 60 mg/day of raloxifene while a mild cognitive impairment risk reduction by 33% was observed with administration of 120 mg/day of raloxifene. Raloxifene was associated with a 50% decrease in the need for prolapse surgery. The result of a meta-analysis showed a significant decline in the plasma concentration of lipoprotein in the raloxifene group compared to placebo (standardized mean difference, -0.43; 10 trials). A network meta-analysis showed that raloxifene significantly decreased the risk of breast cancer (relative risk, 0.572; 95% confidence interval, 0.327-0.881; P = 0.01). In terms of adverse effects of raloxifene, the odds ratio (OR) was observed to be 1.54 (P = 0.006), indicating 54% increase in the risk of deep vein thrombosis (DVT) while the OR for pulmonary embolism (PE) was 1.05, suggesting a 91% increase in the risk of PE alone (P = 0.03). Conclusions: Raloxifene had no significant effect on depression and sleep disorder but decreased the concentration of lipoprotein. Raloxifene administration was associated with an increased risk of DVT and PE and a decreased risk of breast cancer and pelvic organ prolapse in postmenopausal women. [ABSTRACT FROM AUTHOR]

Objective: Polycystic ovarian syndrome (PCOS) is a common condition amongst women of reproductive age that can result in increased mortality and morbidity in women due to increased risk of diabetes mellitus and cardiovascular diseases. The aim of this systematic review was to assess the effectiveness of common treatments of PCOS on the predictors of diabetes in non-diabetic PCOS women. Materials and methods: An extensive search was performed on the publications in three medical databases including pubmed, scopus and google scholar from 1995 till 2017. The articles were screened based on their quality and included in this systematic review. A total of 25 articles including cohort, randomised controlled trial, review and meta-analysis were included in the review. Results: This systematic review revealed that the effect of lifestyle modification might be low in PCOS subjects due to high drop-out rate while the benefits of this intervention including weight and fat reduction may not be achieved by medical interventions. Metformin treatment may result in improvements in insulin sensitivity while its weight reduction effect is still not documented in PCOS subjects. Thiazolidendiones might be tolerated by the PCOS subjects and may result in similar effects as metformin but this effect should be documented by further studies. Conclusion: Combination of lifestyle modification with metformin or thiazolidinedions might improve the outcome of the prevention strategies. On the other hand this study revealed a different response to treatments in non-obese compared with obese PCOS subjects. [ABSTRACT FROM AUTHOR]

Background: In order to provide a better healthcare education to the society, health care students should have an acceptable electronic health (E-Health) literacy. Objective: The aim of this study was to assess the level of E-Health literacy of Medicine and Health Sciences university students in Mashhad, Iran. Methods: This cross-sectional study was performed on 192 students of Mashhad University of Medical Sciences using a validated Persian translate of the E-Health literacy scale (P-EHEALS) questionnaire in 2016. Demographic data including age, monthly income, level of education, preference of website for obtaining health related information and minutes of Internet use per day were obtained from the subjects. Independent-samples t-test and analysis of variance (ANOVA) were used for comparison between groups, and Pearson correlation coefficient and linear regression were used to assess the correlation between study parameters and EHEALS score using SPSS version 21. Results: A total of 192 (67.2% female and 32.8% male) subjects with mean age of 24.71±5.30 years participated in the study. Mean P-EHEALS score of the subjects was 28.21±6.95. There was a significant difference in P-EHEALS score between genders (p<0.001), department (p=0.001), education level (p<0.001) and health status (p=0.003) as well as monthly income (p=0.03), website preference categories (p=0.02). Male students were significantly more likely to gain higher P-EHEALS scores. Conclusion: The level of E-Health literacy was low in Medical and Health Sciences university students in Mashhad. More studies are needed to assess the contributors to E-Health literacy. [ABSTRACT FROM AUTHOR]