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مقدمه: زایمان زودرس، یک حادثه جدی در دوران بارداری است، اما شیوع آن با توجه به جمعیت های مختلف و وضعیت اقتصادی و اجتماعی افراد در جوامع مختلف، متفاوت می باشد. اختلالات روانی مانند استرس، اضطراب و افسردگی با تحریکات هورمونی می تواند باعث افزایش زایمان زودرس شوند، لذا مطالعه حاضر با هدف تعیین ارتباط زایمان زودرس با درصد اضطراب، استرس و افسردگی حین بارداری انجام شد. روش‌کار: این مطالعه کوهورت آینده نگر در سال 1389 بر روی 300 زن باردار مراجعه کننده به مراکز بهداشتی درمانی شهری شهرستان دورود انجام شد. در مطالعه حاضر وقوع زایمان زودرس در دو گروه مواجهه و غیر مواجهه با استرس، اضطراب و افسردگی مورد بررسی قرار گرفت. نمونه گیری به صورت طبقه بندی شده انجام شد. با استفاده از ابزار اندازه گیری Dass21، نمره اضطراب، استرس و افسردگی زنان باردار تعیین و نمرات به 5 دسته طبقه بندی شد. ابزار مطالعه شامل فرم انتخاب واحد پژوهش، مقیاس DASS21 و فرم مصاحبه مشخصات واحدهای پژوهش بود. تجزیه و تحلیل داده ها با استفاده از نرم افزار آماری SPSS (نسخه 13) و آزمون کای دو، شاخص خطر نسبی و رگرسیون لوجستیک انجام شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد. یافته‌ها: دو گروه از نظر وقوع زایمان زودرس تفاوت آماری معنی داری داشتند (0001/0>p). خطر وقوع زایمان زودرس در کسانی که دارای اضطراب، استرس و افسردگی بودند، 797/3 برابر افراد طبیعی بود (797/3=OR). عوامل مؤثر بر زایمان زودرس در گروه دارای اضطراب، استرس و افسردگی (0001/0>p) شامل تعداد دفعات شستشو لباس روزانه با دست (001/0=p)، تعداد دفعات پختن غذا روزانه (0001/0>p)، گروه سنی مادر (022/0=p)، طبقه اجتماعی اقتصادی (23/0=p) و تعداد بارداری (003/0=p) بود. نتیجه‌گیری: وقوع زایمان زودرس در زنان بارداری که مواجهه با استرس، اضطراب و افسردگی دارند، بیشتر است.

مقدمه: دیس‌منوره یا قاعدگی دردناک اختلال شایعی است که حداقل نیمی از زنان در طول دوره باروری خود آن را تجربه می‌کنند. از روش‌های کاهنده سطح پروستاگلاندین‌ها می‌توان در درمان دیس‌منوره استفاده کرد. یکی از این روش‌ها به‌کارگیری آیودی آزاد کننده لونورژسترل با نام تجاری میرنا است. این مطالعه با هدف بررسی فراوانی دیس‌منوره در مصرف‌کنندگان آیودی مسی در مقایسه با آیودی میرنا صورت گرفت. روش کار: این کارآزمایی بالینی دوسوکور روی 160 زن 20-35 ساله ، متقاضی استفاده از آیودی مراجعه‌کننده به مرکز بهداشتی درمانی شهید آیت در سال 86-1385 انجام شد. نمونه‌ها با روش تصادفی سازی به دو گروه 80 نفره گروه A (جایگذاری آی یودی میرنا) و گروه B (جایگذاری آی یودی مسی A-380) استفاده می کردند، تقسیم شدند. دو گروه در بدو ورود به مطالعه و ماه‌های 1، 3 و 6 بعد از جایگذاری آی یودی پیگیری شدند و پرسش‌نامه‌های طراحی شده در مورد هر کدام از آنها تکمیل شد. داده ها با آزمون مجذور کای، آزمون تی مستقل و آنالیز واریانس با اندازه‌گیری مکرر به‌کمک SPSS (نسخه 5/11) تحلیل شد. یافته ها: با وجود این‌که شش ماه پس از جایگذاری آیودی دیس‌منوره به طور معناداری در هر دو گروه در مقایسه با ماه اول کاهش یافته بود (001/0 >p)، دیس‌منوره در گروه A به طور معناداری زودتر و سریع‌تر از گروه B کاهش یافت (003/0 > p). نتیجه گیری: در موارد عدم پاسخ بیماران به درمان‌های دیس‌منوره می‌توان به‌صورت انتخابی از میرنا علاوه بر روش ضد بارداری به عنوان روشی موثر در درمان دیس‌منوره در خانم های جوان استفاده کرد.

Background and Aim: Considering the quality of prenatal care services, indentification of the avoidable and inevitable maternal factors and proper promotion of the knowledge and skills of health care service providers is vital for providing suitable preventive and interventional services with the aim of ensuring a successful pregnancy and proper management in the health care system. This study was conducted to compare the adverse pregnancy outcomes among women with or without a history of Covid-19 in the pregnancy and postpartum stages covered by the Babol University of Medical Sciences, Babol, Iran. Materials and Methods: This was a descriptive-analytical cross-sectional study including 4124 women, either pregnant or after a recent childbirth (with or without Covid-19) between 20.2.2020 and 29.3.2022, registered in the Sib electronic system (hereinafter Sib) of Babol University of Medical Sciences, Babol, Iran. Using a checklist developed and validated by an expert panel data were collected on the prevalence of maternal and neonatal outcomes in mothers with or without a history of Covid-19 and compared. The data collected were analyzed with SPSS 24 using descriptive tests such as chi-square and Fisher's exact test and STATA version 22, and the adverse outcomes with high frequencies following Covid-19 were determined. Results: Analysis of the data showed the following to be the most common outcomes among mothers with a history of Covid-19: 1. obstetric complications and maternal disorders/diseases (hypertension, type-2 diabetes mellitus, at least one case of bleeding during pregnancy, premature/delayed birth and premature rupture of the amniotic sac, n= 457, 27.8%); 2. medical and surgical problems (unhealthy pregnancy weight gain and thromboembolic events, n=206, 12.5%). In addition, there was a statistically significant difference between the two groups of pregnant mothers with and without a Covid-19 infection as regards medical and surgical problems (P=0.001) and obstetric complications and maternal diseases (p=0.002). As regards the adverse neonatal outcomes in pregnant mothers with and without a history of Covid-19, there was a statistically significant difference between the two groups in terms of Apgar score at minutes 1 and 5 (p≥0.001) and exclusive breastfeeding (P=0.001) and the presence of Covid-19 symptoms in the baby (p<0.001). Conclusion: Based on the findings of this study it seems that Covid-19 infection during pregnancy is associated with a higher risk of some of the undesirable maternal and neonatal outcomes. Therefore, it is essential to plan and implement programs for health education, creation of a sound attitude towards better management, enhancement of the skills and capabilities of the health-care providers and, finally, promotion of the knowledge of service recipients. [ABSTRACT FROM AUTHOR]

Background: Normal vaginal delivery causes sexual dysfunction as well as urinary and fecal incontinence, which can threaten a person's quality of life. It is believed that pelvic floor muscle strength is the most important factor in improving sexual satisfaction and function and urinary control. Therefore, This study aimed to investigate the role of physiotherapy and pelvic floor exercises in reducing sexual dysfunction and incontinence in primiparous women. Methods: This study was performed as a prospective randomized clinical trial on primiparous women who were referred to Al-Zahra and Shahid Beheshti educational hospitals in Isfahan between march 2019-Mars 2020. In this study, after obtaining ethics approval from the Medical Ethics Committee of Isfahan University of Medical Sciences, patients were divided into control (n=57) and intervention (n=57) groups. In the control group, no intervention was performed and only routine postpartum recommendations (multivitamin tablets and 500 mg calcium tablets once daily for two months) were prescribed. For the intervention group the pelvic floor physiotherapy was performed Sexual function and urinary and fecal incontinence were assessed in both groups at 8 and 16 weeks postpartum by completing two questionnaires. Results: In two groups of intervention and control; Mean maternal age, body mass index, and birth weight were not significant (P>0.05) In the intervention group, at the 8th and 16th weeks after delivery, the mean score of total sexual function, and the total score of female urinary and fecal incontinence was a significant difference. (P<0.05). Compared between the groups, the mean sexual function and pelvic floor irritation at 16 weeks postpartum were significantly different between the two groups. Physiotherapy and pelvic floor exercise intervention reduce pelvic floor irritation and improve sexual function. Conclusion: it seems that simultaneous performance of physiotherapy (biofeedback) and pelvic floor exercises by strengthening the strength of the pelvic floor muscles increases sexual function as well as a relative improvement of pelvic floor irritation in the postpartum period. [ABSTRACT FROM AUTHOR]

Background: The pandemic of Covid-19 is spreading around the world. Extensive research is needed to focus on identifying the underlying causes of the disease. This study aimed to investigate the clinical and etiological symptoms of the Covid-19. Methods: This descriptive-analytical study, conducted on 510 infected patients in the infectious disease clinic of Imam Khomeini Hospital in Tehran from March 2019 to June 2020 for A period of Four months during the first wave of Covid-19 pandemic. The method of selecting patients was continuous and was divided into two groups of 179 inpatients and 331 outpatients based on lung scan and clinical symptoms. Demographic information, clinical signs, and risk factors were collected through a questionnaire and the data were statistically analyzed. Results: Symptoms such as fever, chills and cough were reported in the majority of patients in both groups, to such an extent that they were present in 176 (52%) of outpatients and in 101 (59%) of inpatients. The mean hemoglobin measured in hospitalized patients was lower, P=0.001). Vitamin D3 supplementation was reported in 30% of outpatients and in 16.5% of hospitalized patients (P=0.001). This means that vitamin D3 consumption is higher in the outpatient group. The results showed that Chronic diseases such as hypertension was 4.9 times more likely (OR=4.9, 95% CI2. 433-10.25, P=0.0001) and anemia with 22 times more likely (OR=22.905, 95% CI9. 355-56.083, P=0.000) to be effective in the severity of the disease. It seems Vitamin D3 intake has a supportive effect on reducing the severity of the disease and decreases the risk of the disease getting worse. Conclusion: Fever, chills and cough were important symptoms in identifying infected patients with Covid-19. According to the results of the present study and the findings of other studies, the supportive effect of vitamin D3 in reducing the severity of infectious diseases should be considered. Clinical trials with appropriate sample size are recommended to investigate the functional role of this vitamin in Reducing the severity of viral diseases of the respiratory tract. [ABSTRACT FROM AUTHOR]

Asthma is an inflammatory and chronic disease that affects about 300 million people globally. The disease is more common in developed countries. The increase in the prevalence of asthma is not only due to genetic factors, but also to many environmental factors related to urbanization and type of nutrition. It has been reported that obesity is an independent risk factor for asthma and obese children are at higher risk of asthma. The researchers found that many of the common phenotypes of obesity and asthma are due to genetic effects and some genetic component is common to asthma and obesity. Genetic data suggest that there are areas of genetic overlap between the obesity and asthma genes. These children experience more severe asthma and have a poor treatment outcome. On the other hand, there is an association between vitamin D deficiency in the earlier stages of life and incidence of asthma in the following years. Interestingly, obesity is a common risk factor for both asthma and vitamin D deficiency. Therefore, study on the interaction of asthma, obesity, and vitamin D deficiency may play an important role in unraveling the intricate nature of asthma. Prevalence of Pediatric asthma in 6-7 and 13-14 years-old children has been reported more than 10% in Iran. In this review we aimed to assess the latest findings about pediatric asthma and its association with obesity and vitamin D in Iran and the other countries. In addition, the results of a pilot study that has examined the frequency of overweight and obesity, as well as vitamin D deficiency in children with asthma in Tehran, are briefly presented. Enrolling a national study on obesity and vitamin D levels in children with asthma, can provide excellent information on the effects of obesity and vitamin D deficiency on asthma in Iranian children. Also the results could provide a basis for ecological studies to measure correlation between pediatric asthma and Sunlight and food and cultural habits in different parts of the country. Also, it is recommended that for a better understanding of the subject, experimental studies examine the effect of vitamin D supplementation and vitamin D-rich diets on the prevention and treatment of pediatric asthma in different age groups as well as different ethnicities of Iran. [ABSTRACT FROM AUTHOR]

Fertility style is of great importance to human population growth rates. Identifying the different factors on fertility can influence the adoption of population policies on controlling population growth. The purpose of this review study was determination of demographic and clinical factors role on fertility patterns in Iran. A systematic search was conducted in Persian and English documents including, Cochrane Library, PubMed, Thomson Reuters, SID and Medical Library (MedLib), Magiran, Google Scholar and Science Direct (from 1991 to 2017). All types of full articles (observational or interventional) were reviewed. Keywords for search included fertility; prognostic factors; factor, demographic; determinant, fertility. By reviewing the abstracts of articles, 107 articles were selected, but overall, 31 eligible articles were included in the study. The results showed that, the marriage age, mother's education and employment are of the most important determinants of factors in fertility, also the age difference between couples, maternal and fetal complications in previous pregnancies, the number of previous children and their gender were reported as factors affecting the fertility style. It seems that the age of men and women at the time of marriage, the level of education of women and being employed are of the most important factors affecting fertility. There is also an imbalance in childbearing in different stratum of society; so that women's employment and higher education are important obstacles to childbearing. [ABSTRACT FROM AUTHOR]

Background: Menopause is a critical and sensitive period and has a common symptom of vasomotor signs, psychologic changes and sleep disorders. With regarding the citalopram complications and effects of Iranian herbs, the aim of this study was to compared the therapeutic effect of the combination of area part of Melissa officinalis and fennel fruits extract with Nigella sativa powder with citalopram on menopausal symptoms of post-menopausal women. Methods: This randomized clinical trial was conducted in Islamic Azad University of Pharmaceutical Sciences, Tehran, Iran, from April 2015 to October 2017. 56 postmenopausal women referred to the clinics of Gorgan health centers with the age between 45 and 65 years, natural menopause confirmed by amenorrhea for at least 12 months, discomfort a hot flash were randomized to two treatment groups. Group 1 (28 patients) received 1000 mg (Melissa officinalis extract, Nigella saliva powder, and fennel fruits) and Group 2 (19 subjects) received 20 mg citalopram in an eight-week course of treatment (1 per day for each group). The frequency of the variables in the Menopause-Specific Quality of Life Questionnaire (MENQOL) was compared in the two groups before and post intervention. The questionnaire included of twenty-nine questions in four domains of vasomotor, psycho-social, physical and sexual symptoms. Results: The mean age in the herbal treatment group was 47.78±5.5 years and in the citalopram group was 46.4±4.9 years, and t-test did not show this difference in two groups (P=0.362). There was no significant difference in the improvement of menopausal symptoms compared to the citalopram group in the combined product group, but the feeling of anger and fatigue in the citalopram group was greater after treatment (P=0.03). Conclusion: The present study showed that the combination of Nigella Sativa, Melissa officinalis extract, and fennel fruits generally do not reduce menopausal symptoms in postmenopausal women, and it's just the feeling of anger and fatigue has been better than the citalopram group. [ABSTRACT FROM AUTHOR]

Background: To reduce cesarean section rate, we need complex interventions to modify related behavior. We aimed to identify the effectiveness of a community-based intervention on prenatal care status, delivery and decline of cesarean section rate. Methods: A quasi-experimental study was carried out on mothers residing in Khak Sefid and Javadiyeh in Tehran from January 2011 to September 2014. Study population was 274 mothers; attending in health centers for first vaccination of their neonates. Mothers' demographic data were recorded in some questionnaires. One year interventions including; consultation, distribution of educational package and training courses (for mothers, fathers and their families, educational programs for midwives, obstetricians and gynecologist, residents, medical students), accomplishment of 10 steps babyfriendly principles and provision adequate personnel in labor-delivery room were implemented in community, hospitals and health centers. After intervention, 250 mothers who were attending in health centers for vaccination of 2 months aged neonates were assessed and their data were recorded in the same questionnaires. The effectiveness of intervention on cesarean section rate and cesarean tendency in before and after intervention groups were compared. P< 0.05 was considered as level of significance. Results: Of 274 mothers in "before intervention" group 193 (70.44%) and of 250 mothers in "after intervention", 169 subjects (67.6%) had cesarean section. Although a significant decline was seen in cesarean tendency in "after intervention" group (P= 0.034), no significant difference was seen between 2 groups' cesarean section rates (P= 0.48). In "after intervention" group episiotomy, induction of labor rate and maternal morbidity were significantly lower than "before intervention" group (P= 0.0001, 0.0001, 0.01). Although no significant difference was seen between two groups neonatal birth weight (P= 0.69), a significant difference was seen between two groups' gestational age (P= 0.007). Conclusion: After intervention, in spite of no decline in cesarean section rate, NVD tendency and morbidity rate were raised and improved respectively. It seems that cesarean section rate was influenced by other important factors. [ABSTRACT FROM AUTHOR]