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The objective of this study is to determine the incidence of microbial contamination on medical students’ white coats, the way they handle and clean their white coats and their perception towards contamination. For this purpose, cross sectional survey of the bacterial contamination of white coats in a medical college has been carried out in 3 different locations; Royal College of Medicine, Perak, University of Kuala Lumpur and a private college attached to Ipoh General Hospital. It was found that the incidence of Staphylococus aureus, was 32% on short-sleeved and 54% on long-sleeved white coats. Bacillus species was the second most common type of bacteria found. Male collars and female pockets had higher microbial contaminations (p=0.01, 0.03 respectively). Clinical students’ white coats were significantly less contaminated than non-clinical students (p=0.001) although they tend to wear it for a longer period (5.75 ± 2.19 h vs. 2.32 ± 0.81 h) (p=0.001). Clinical students owned more short-sleeved coats (p=0.001) and washed their coats more often (p=0.01) than non-clinical ones. More than eighty one percent of clinical students wear their white coats in the college the majority of whom were females (p=0.005). Perception of clinical and non-clinical students towards white coat contamination was similar. Medical students’ white coats are contaminated with bacteria and they are potentially source of cross infection. Student’s way of handling and washing white coats should be corrected by issuing and following standard guidelines. Students should be bared from wearing white coats in non-clinical areas. Washing hands and using plastic aprons is highly recommended before examining wounds.

Polycystic ovary syndrome (PCOS) is a common endocrinopathy with symptoms such as obesity, insulin resistance and hyperandrogenemia. PCOS might be the result of a genetic disorder. Genetic discrepancy in the production of leptin, a product of the obesity gene, may lead to various endocrinopathies such as PCOS. The objective of this study was first, to ascertain the incidence of PCOS, using the gold standard; second, to ascertain the genetic property of leptin; and third, to evaluate the association between leptin concentration and PCOS. A total of 154 Tehran-resident female-female twins were studied. They included 48 pairs of monozygotic (MZ) and 29 pairs of dyzygotic (DZ) twins, aged 15-45 years. Clinical, ultrasound and biochemical findings were used to diagnose PCOS. The incidence of PCOS using biochemical and clinical features was 16.2%. The correlation coefficient between serum leptin levels of MZ twins was higher than that of the DZ twins. The serum level of leptin was similar between subjects with or without PCOS, irrespective of their zygosity. It was concluded that the incidence of PCOS is high among twins, and that leptin is likely to be genetically determined, although the effect of environmental factors cannot be denied. This study did not find any association between the diagnosis of PCOS and leptin level. However, the link between the two may lie with other entities such as eating disorders and/or obesity. [ABSTRACT FROM AUTHOR]

Background and Methodology: The ovarian cycles of females living and interacting together may synchronise due to pheromones released from axillary secretary glands, the highest concentration of which is produced in the mid-follicular phase, prior to ovulation. The objective of this study was to find evidence for menstrual synchrony in a group of female students living together and to obtain a correlation between the ability to smell the putative pheromone, 5alpha-androst-16-en-3alpha-ol (3alpha-androstenol), found in apocrine secretions and menstrual synchrony. This cross-sectional study involved 88 students who completed a standard questionnaire and whose sense of smell was measured using ten varying thresholds. The menstrual history, friendship scale and menstrual hygiene score was determined for the participants.Results: A total of 59.1% of the subjects studied were found to have menstrual synchrony. There was no significant association between menstrual synchrony and smelling threshold. However, a significant correlation was found between menstrual synchrony and personal hygiene score (p<0.01).Conclusions: The phenomenon of menstrual synchrony may be related to various factors. The results failed to demonstrate any significant difference between synchronised and non-synchronised subjects in detecting the steroid by sense of smell. However, the odours associated with menstrual blood or vaginal discharge might have an affect on menstrual synchrony. [ABSTRACT FROM AUTHOR]

A combined dynamical and statistical model for fission was employed in our calculation. There is no doubt that a Langevin description plus a Monte Carlo treatment of the evaporation processes provide the most adequate dynamical description. In this paper, we would consider a strongly shaped dependent friction force and we use the numerical method rather than the analytical one. The objective of this article is to calculate the time dependent fission widths of the 224Th nucleus. The fission widths were calculated with both chaos-weighted wall friction (CWWF) and wall friction (WF) dissipations. The calculations are repeated for 100000 trajectories. The result was compared to the others' work. We use nuclear elongation coordinate with time and it is necessary to repeat the small steps many times to improve the accuracy. [ABSTRACT FROM AUTHOR]

Background: Childbirth constitutes a significant milestone in a woman's life, influencing both her physical and mental well-being as well as her relationship with the child. Employing a birth plan (BP) can contribute positively to obstetric outcomes, enhancing the overall birthing experience for women. BPs are not universally embraced in many countries, and there is limited research on women's experiences with BP in Iran. This study seeks to explore and understand the perspectives of women who have utilized a BP during their delivery., Methods: This qualitative study included 14 women who had BP and experienced delivery. Data was collected through in-depth, semi-structured individual interviews. The sample selection followed a purposive approach, and data analysis utilized content analysis with a conventional approach facilitated by MAXQDA software version 2020., Results: The examination of pertinent data concerning women's experiences identified five key themes: preparation, participation, support, emotional well-being, and unmet expectations., Conclusions: This study's findings indicate that BPs enhance the overall birthing experience, suggesting their potential utility in improving the quality of obstetric care. Nevertheless, additional studies are essential to validate these results on a broader scale and facilitate the nationwide implementation of BPs., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness, safety, and side effects associated with the usage of different treatments for unscheduled vaginal bleeding in premenopausal women using progestin-only pills., (Copyright © 2024 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)

Background: Contraceptive methods are well-established in their ability to prevent pregnancy and increase individual agency in childbearing. Evidence suggests that contraceptives can also be used to treat adverse conditions associated with menstruation, including abnormal and prolonged uterine bleeding, heavy menstrual bleeding, painful menstruation, endometriosis, uterine fibroids, and premenstrual dysphoric disorders.This review investigates the effects of contraceptive techniques such as contraceptive pills, and long-acting reversible contraceptives (e.g. intrauterine devices, implants) on menstrual morbidity., Methods: Over ten databases with no geographical boundaries were searched from inception until October 2023. Study designs were one of the following types to be included: parallel or cluster randomised controlled trials, controlled clinical trials, controlled before and after studies, interrupted time series studies, cohort or longitudinal analyses, regression discontinuity designs, and case-control studies. Ten team members screened the papers in pairs with a Kappa score of more than 7, and Covidence was used. Conflicts were resolved by discussion, and the full papers were divided among the reviewers to extract the data from eligible studies., Results: Hormonal contraceptives are considered a well-tolerated, non-invasive, and clinically effective treatment for abnormal and prolonged uterine bleeding, heavy menstrual bleeding, painful menstruation, endometriosis, uterine fibroids, and premenstrual dysphoric disorders. Our studies investigating quality of life or well-being in women with heavy menstrual bleeding, endometriosis, or uterine fibroids have found improvements in all dimensions assessed., Conclusions: Hormonal contraceptives significantly reduce pain, symptom severity, and abnormal bleeding patterns associated with women who suffer from heavy menstrual bleeding, endometriosis, and uterine fibroids.

Background: The World Health Organization recognizes childbirth preparation as an essential component of antenatal care, as it plays a crucial role in reducing maternal mortality and improving women's childbirth experience. Countries worldwide have implemented various interventions to assist women in preparing for childbirth, based on their own resources. This study was conducted with the aim of exploring the perspectives of pregnant and postpartum women on childbirth preparation and the facilitating and inhibiting factors, in Tabriz, Iran., Methods: This qualitative study was conducted with 25 participants, selected purposively among pregnant women in weeks 37 to 40 of gestation and postpartum women within 10 days to 6 weeks after childbirth. Data collection was done through semi-structured, in-depth individual interviews using an interview guide. The data was analyzed using content analysis method with conventional approach., Results: The perspectives of pregnant and postpartum women regarding childbirth preparation revealed that factors such as maternal health during pregnancy, having an antenatal care plan, improving health literacy, and developing a birth plan were identified as crucial elements for effective childbirth preparation. Additionally, mental and emotional preparation, support, financial planning, participation in preparation classes, and awareness of childbirth methods were recognized as facilitators. On the other hand, insufficient mental and emotional preparedness, inadequate support, weak antenatal care, information deficiencies, insufficient physical activity, and a lack of a birth plan were identified as barriers., Conclusion: The findings highlight the multifaceted nature of childbirth preparedness, necessitating the involvement of families, the healthcare system, and the entire community. Utilizing the study results in strategic planning for pre-pregnancy, during pregnancy, and inter-pregnancy care can enhance childbirth preparedness and contribute to achieving Iran's population rejuvenation policy goals., (© 2024. The Author(s).)

Background: There are few reliable Iranian-induced abortion data. The aim of this paper was to investigate the prevalence and socioeconomic characteristics of women and men who report having had or been a partner in an abortion., Materials and Methods: A cross-sectional survey of women and men aged 15-49 years referred to the health center that randomly selected from 110 health center that was used., Results: Data from 1520 women and men surveys were analyzed. One in 10 women and one in 12 men had experienced or been a partner in an abortion. In adjusted analyses, women and men in the 34-49 age group [adjusted odds ratio (AOR) 0.62, 95% (CI) 0.41, 0.96], the importance of religion in fertility (AOR = 0.42; 95% CI 0.26, 0.67), dissatisfied general health (AOR = 0.52; 95% CI 0.32, 0.87), and history of unwanted pregnancy for twice (AOR = 2.32; 95% CI 1.43, 3.77) and history of unwanted pregnancy for three-time or more (AOR = 2.69; 95% CI 1.59, 5.49) were associated with significantly increased odds of abortion. Haven't heard of medication abortion, that is, abortion with tablets (AOR = 0.43; 95% CI 0.29, 0.67) was associated with significantly reduced odds of abortion., Conclusions: The findings contribute to scarce information about abortion in Iranian. Due to the high prevalence of abortion and the country's population growth policy, Iranian women need a full range of sexual and reproductive health services, including contraceptive counseling and accessible abortion care., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Background: Contraceptive use is the principal method by which women avoid unintended pregnancy. An unintended pregnancy can induce long-term distress related to the medical, emotional, and social consequences of carrying that pregnancy to term., Objectives: This review investigates the effects of modern contraception techniques such as birth control pills, long-acting reversible contraceptives (e.g., intrauterine devices, implants), and condoms on mental health status., Methods: We searched multiple databases from inception until February 2022, with no geographical boundaries. RCTs underwent a quality assessment using the GRADE approach while the quality of observational studies was assessed using the Downs and Black scoring system. Data were analyzed through meta-analysis and relative risk and mean difference were calculated and forest plots were created for each outcome when two or more data points were eligible for analysis., Main Results: The total number of included studies was 43. In women without previous mental disorders, both RCTs (3 studies, SMD 0.18, 95% CI [0.02, 0.34], high quality of evidence) and cohort studies (RR 1.04 95% CI [1.03, 1.04]) detected a slight increase in the risk of depression development. In women with previous mental disorders, both RCTs (9 studies, SMD - 0.15, 95% CI [-0.30, -0.00], high quality of evidence) and cohort studies (SMD - 0.26, 95% CI [-0.37, -0.15]) detected slight protective effects of depression development. It was also noticed that HC demonstrated protective effects for anxiety in both groups (SMD - 0.20, 95% CI [-0.40, -0.01])., Conclusions: Among women with pre-existing mental disorders who use hormonal contraceptives, we reported protective association with decreased depressive symptoms. However, the study also draws attention to some potential negative effects, including an increase in the risk of depression and antidepressant use among contraceptive users, a risk that is higher among women who use the hormonal IUD, implant, or patch/ring methods. Providers should select contraceptive methods taking individual aspects into account to maximize benefits and minimize risks., (© 2024. The Author(s).)

Background and Aim: The relationship between psychological factors and treatment outcomes with assisted reproductive technology has sparked considerable debate. This study aims to investigate the emotional risk factors in couples seeking infertility treatment using assisted reproductive technology in Sari, Iran, from 2020 to 2022., Materials and Methods: This research is a cross-sectional study and emotional risk factors and other related factors were examined using the Persian version of the SCREENIVF demographic, social, and clinical status questionnaire, social, and clinical status questionnaire before using Assisted reproductive technology in 460 infertile couples selected from infertility treatment centers in Sari City, Iran. The samples were randomly selected using a table of random numbers. Data analysis was performed using SPSS version 22 software., Results: The mean age of the male and female participants were 31.70 ± 5.71 and 35.22 ± 5.48, respectively. The results regarding emotional risk factors and other related factors revealed that the variables of remarriage (P = 0.048) and exposure of spouse to emotional risk factors (P = 0.001), history of depression disorder (P = 0.007), and history of anxiety disorder (P = 0.009) were significantly correlated with the exposure of women to emotional risk factors. Furthermore, men's exposure to emotional risk factors was significantly correlated with primary education (P = 0.026) and diploma (P = 0.043) levels, age (P = 0.006), and wife's exposure to emotional risk factors (P = 0.001)., Conclusion: By identifying infertile couples who are at risk of emotional risk factors, healthcare professionals can provide appropriate support and interventions to mitigate the emotional challenges associated with infertility. This proactive approach can significantly enhance couples undergoing infertility treatment's well-being and mental health., (© 2024. The Author(s).)

Polycystic ovary syndrome is one of the commonest and complex endocrine disorders in females of reproductive age. Attention to self-care behaviors such as health-promoting behaviors can improve physiological and psychological conditions in women with PCOS. This study aimed to determine the efficacy of Social Network-Based Motivational Interviewing on health-promoting behaviors and quality of life of infertile women with polycystic ovary syndrome. In this randomized controlled trial, 60 infertile women with polycystic ovary syndrome were randomly selected and assigned to the interventio (n = 30) or a control group (n = 30). Participants in the control group received routine care. Those in the intervention group received five motivational group sessions in WhatsApp, which were conducted in five groups of six participants each. The data related to health-promoting behaviors and quality of life were collected through an online questionnaire. Both groups were followed up immediately and 2 months after the intervention. Data collected in the two stages were analyzed using the paired-samples t-test, Chi-square, and repeated measures analysis. No significant difference was observed between the two groups before the intervention means health-promoting behaviors and quality of life scores (p>0.05). Immediately and two months after the intervention, the mean scores of health-promoting behaviors and their domains increased in the intervention group. This increase is statistically compared to the first test, and the scores obtained by the control group in the second (p< 0.001, ES = 1.5) and the third test (p< 0.001, ES= 1.3) were significant. The score of the quality of life variable increase was not statistically significant compared to the first test and also to the scores obtained by the control group. However According to the Generalized estimating equations (GEE) test, the changes in quality of life score between the two groups in the three stages of measurement are statistically significant. WhatsApp support increases the health-promoting self-care behaviors rate and has favorable effects on follow-up.Trial registration: Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/48089 ). Registered August 11 2020., (© 2024. The Author(s).)

Background: The danger of sexual activities among adolescents is worrisome worldwide. This study aimed to delineate total contraception knowledge of university students and the prevalence of contraceptive use, in addition to the association between sex education in school and the students' contraception knowledge., Materials and Methods: A school-based cross-sectional study was carried out., Results: The mean total level of contraceptive knowledge was 16.53 ± 2.38, which ranged from 5 to 18. In response to which method was the most suitable for the youngsters, 36.3% responded pills, 49.2% condoms, 6.3% injection, 0.7% withdrawal, 0.5% periodic abstinence, and 5.9% other. Adjusted to sociodemographic characteristics and other confounders, students with a history of sex education in school tended to have a higher level of contraceptive knowledge than those without [AOR: 1.06; 95% CI: 0.15, 2.64]. Moreover, adjusted to the characteristics of one-night stands, students with a high level of contraceptive knowledge agreed that one-night stands were OK compared with those without the knowledge [AOR: 0.65; 95% CI: 0.16, 1.13]., Conclusion: Although the total contraceptive knowledge was satisfactory, more attention should be paid to male students' education. Modern and long-term effective contraceptive methods had better be included in the training program., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Background: According to the World Health Organization (WHO), intrapartum care is considered a platform for providing respectful, personalized, and women-centered services to women. This study aims to investigate the intrapartum care model proposed by WHO., Methods: This convergent parallel mixed-methods study will be carried out in qualitative and quantitative phases. In the quantitative phase (a quasi-experimental study), 108 pregnant women admitted to the maternity ward will be randomized to intervention (receiving intrapartum care based on the WHO model) and control group (receiving routine hospital care) before the beginning of the active stage of labor (cervix dilatation equal to 5 cm) and Wijma's delivery fear scale (DFS) will be completed for them and again at 7-8 cm dilatation. The participants of both groups will be followed up for 6 weeks after labor and then they will be invited to a relatively quiet place to complete the Childbirth Experience Questionnaire (CEQ 2.0), the Edinburgh Postpartum Depression Scale (EPDS), the Post-Traumatic Stress Disorder (PTSD) Symptom Scale (PSS-I), the Pregnancy and Childbirth Questionnaire (PCQ), exclusive breastfeeding and a checklist on willingness to give birth to another child. The qualitative phase will employ content analysis to explain mothers' views about the effects of this model especially subjective components of this model on their labor process after 4-6 weeks. The two phase's results will be discussed in combination., Discussion: The implementation of such care models is expected to prevent mental disorders caused by negative experiences of childbirth, and also, prevent uncontrolled increases in cesarean sections., Clinical Trial Registration: https://fa.irct.ir/user/trial/68313/view, identifier (IRCT20120718010324N69)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Abdolalipour, Abbasalizadeh, Mohammad-Alizadeh-Charandabi, Abbasalizadeh, Jahanfar and Mirghafourvand.)

Background: Histological chorioamnionitis (HCA) is a histologic response to intra-uterine inflammation that is usually confirmed by pathology examination after pre-term delivery and characterized by acute granulocyte infiltration into the fetal-maternal or fetal tissues. This study aimed to compare the HCA in pre-term delivery with and without pre-term rupture of membrane for assessment of its role on early neonatal outcomes and fetal heart rate patterns., Materials and Methods: This case-control study was conducted on placenta, chorionamnion, and cord of 100 cases with and without pre-term rupture of membrane between 28 0/7 and 36 6/7 weeks delivered between March 2018 and February 2021. The kind of delivery, gestational age, neonatal intensive care unit admission, a 5 min Apgar score <7, and fetal heart rate patterns in two groups with and without HCA were assessed., Results: The odds ratio (OR) for HCA was adjusted for fetal heart rate patterns, gestational age, and delivery mode (vaginal delivery or cesarean section). Vaginal delivery, gestational age, neonatal intensive care unit admission, and a 5 min Apgar score <7 were associated with HCA [OR: 2.4, 95% confidence interval (CI): 1.2-9.5, P < 0.05; OR: 0.8, 95% CI: 0.5-1.1, P < 0.05; OR: 1.1, 95% CI: 0.6-2.1, P < 0.05; and OR: 0.9, 95% CI: 0.7-1.3, P < 0.05), respectively. However, there were no specific fetal heart rate patterns associated with HCA., Conclusion: Placental histology examination in pre-term infants with low Apgar scores may be useful to investigate the association between neonatal complications in pre-term delivery and asymptomatic chorioamnionitis., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Advanced Biomedical Research.)

Background: Menstruation is a natural occurrence that women experience during their reproductive years and may encounter many years throughout their lifespan. Many adolescent females lack accurate knowledge about menstruation, so they may face issues from receiving incorrect information from unreliable sources. Our study aimed to investigate the practices and beliefs surrounding menstruation among Iranian adolescent females., Methods: This qualitative study was conducted using conventional content analysis. A purposeful sampling method was used to select 18 adolescent females from secondary and high schools located in the three regions of Neyshabur City-Iran. Data were collected through in-depth, semi-structured interviews., Results: Three main themes were extracted, consisting of lifestyle and related beliefs, lake of support, and awareness and information., Conclusions: misconceptions and wrong behaviors during menstruation indicate that the lake of knowledge an traditional factors influence adolescent girls' health. The study provides the basis for intervention planning in this regard and different levels (individual, intrapersonal, health systems, and community)., (© 2024. The Author(s).)

Background: In 2018, the World Health Organization published a set of recommendations for further emphasis on the quality of intrapartum care to improve the childbirth experience. This study aimed to determine the effects of the WHO intrapartum care model on the childbirth experience, fear of childbirth, the quality of intrapartum care (primary outcomes), as well as post-traumatic stress disorder symptoms, postpartum depression, the duration of childbirth stages, the frequency of vaginal childbirth, Apgar score less than 7, desire for subsequent childbearing, and exclusive breastfeeding in the 4 to 6 weeks postpartum period (secondary outcomes)., Methods: This study was a randomized controlled trial involving 108 pregnant women admitted to the maternity units of Al-Zahra and Taleghani hospitals in Tabriz-Iran. Participants were allocated to either the intervention group, which received care according to the ' 'intrapartum care model, or the control group, which received the' 'hospital's routine care, using the blocked randomization method. A Partograph chart was drawn for each participant during pregnancy. A delivery fear scale was completed by all participants both before the beginning of the active phase (pre-intervention) and during 7 to 8 cm dilation (post-intervention). Participants in both groups were followed up for 4 to 6 weeks after childbirth and were asked to complete questionnaires on childbirth experience, postpartum depression, and post-traumatic stress disorder symptoms, as well as the pregnancy and childbirth questionnaire and checklists on the desire to have children again and exclusive breastfeeding. The data were analyzed using independent T and Mann-Whitney U tests and analysis of covariance ANCOVA with adjustments for the parity variable and the baseline scores or childbirth fear., Results: The average score for the childbirth experience total was notably higher in the intervention group (Adjusted Mean Difference (AMD) (95% Confidence Interval (CI)): 7.0 (0.6 to 0.8), p < 0.001). Similarly, the intrapartum care quality score exhibited a significant increase in the intervention group (AMD (95% CI): 7.0 (4.0 to 10), p < 0.001). Furthermore, the post-intervention fear of childbirth score demonstrated a substantial decrease in the intervention group (AMD (95% CI): -16.0 (-22.0 to -10.0), p < 0.001). No statistically significant differences were observed between the two groups in terms of mean scores for depression, PTSD symptoms, duration of childbirth stages, frequency of vaginal childbirth, Apgar score less than 7, and exclusive breastfeeding in the 4 to 6 weeks postpartum (p > 0.05)., Conclusion: The intrapartum care model endorsed by the World Health Organization (WHO) has demonstrated effectiveness in enhancing childbirth experiences and increasing maternal satisfaction with the quality of obstetric care. Additionally, it contributes to the reduction of fear associated with labor and childbirth. Future research endeavors should explore strategies to prioritize and integrate respectful, high-quality care during labor and childbirth alongside clinical measures., (© 2024. The Author(s).)

Objective: Spirulina ( arthrospira platensis ) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of high-dose Spirulina platensis for SARS-CoV-2 infection., Study Design: We conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome., Results: Within seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial., Conclusion: High-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19., Clinical Trial Registration: https://irct.ir/trial/54375, Iranian Registry of Clinical Trials number (IRCT20210216050373N1)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Aghasadeghi, Zaheri Birgani, Jamalimoghadamsiyahkali, Hosamirudsari, Moradi, Jafari-Sabet, Sadigh, Rahimi, Tavakoli, Hamidi-Fard, Bahramali, Parmoon, Arjmand Hashjin, Mirzajani, Kouhkheil, Roshangaran, Khalaf, Khademi Nadoushan, Gholamiyan Yousef Abad, Shahryarpour, Izadi, Zendedel, Jahanfar, Dadras, SeyedAlinaghi and Hackett.)

Background: Quarantine during COVID-19 disease may be associated with psychological distress and other behavioral problems. This study aimed to investigate depression, anxiety, and stress in self-quarantined pregnant women at home for 14 days during the coronavirus disease outbreak in Iran., Materials and Methods: A cross-sectional web survey was carried out on 874 pregnant women in all governmental health centers of two cities in Iran using the census method in 2020-21. Survey data were collected with the Depression, Anxiety, and Stress Scale-21. Data were analyzed using descriptive statistics and analytical tests (Chi-square, Pearson's correlation coefficient, and logistic regression) at significance level less than 0.05., Results: Approximately 40.04% (N = 350) of the participants were classified as a self-quarantine group. The mean (SD) of the stress score was higher for the quarantine group compared to nonquarantine (8.12 (4.95) vs. 5.96 (4.51)) (F 2,874 = 25.180, p < 0.001). But there was no significant difference in the depression and anxiety scores between the quarantine group compared to nonquarantine, respectively. Additionally, the adjusted odds ratio for stress score was associated with an unwanted pregnancy (1.993, 95% CI: 1.108-3.587; p = 0.021), younger age (1.707, 95% CI: 1.082-2.692; p = 0.022) and uninsured coverage (2.240, 95% CI: 1.320-3.801; p = 0.003), and complete quarantine (2.027, 95% CI: 1.548-2.654; p < 0.001)., Conclusions: Self-quarantine during the COVID-19 pandemic has been related to high-stress levels, specifically, among women of younger age, uninsured, and unwanted pregnancies. Thus, quarantined pregnant women will need more mental health support and medical supplies., Competing Interests: Nothing to declare., (Copyright: © 2024 Iranian Journal of Nursing and Midwifery Research.)

Background: The midwifery continuity of care model is one of the care models that have not been evaluated well in some countries including Iran. We aimed to assess the effect of a program based on this model on the clinical competence of midwifery students and delivery outcomes in Ahvaz, Iran., Methods: This sequential embedded mixed-methods study will include a quantitative and a qualitative phase. In the first stage, based on the Iranian midwifery curriculum and review of seminal midwifery texts, a questionnaire will be developed to assess midwifery students' clinical competence. Then, in the second stage, the quantitative phase (randomized clinical trial) will be conducted to see the effect of continuity of care provided by students on maternal and neonatal outcomes. In the third stage, a qualitative study (conventional content analysis) will be carried out to investigate the students' and mothers' perception of continuity of care. Finally, the results of the quantitative and qualitative phases will be integrated., Discussion: According to the nature of the study, the findings of this research can be effectively used in providing conventional midwifery services in public centers and in midwifery education., Trial Registration: This study was approved by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1401.460). Also, the study protocol was registered in the Iranian Registry for Randomized Controlled Trials (IRCT20221227056938N1)., (© 2024. The Author(s).)

Background: Perceived care quality and patient satisfaction have been important care quality indicators in recent decades, and healthcare professionals have been influential on women's childbirth experience. This study investigated the measurement properties of the Persian version of the Pregnancy and Childbirth Questionnaire (PCQ), designed to measure mothers' satisfaction with the quality of healthcare services provided during pregnancy and childbirth., Methods: This is a cross-sectional methodological study. Instrument translation, face validity, content validity, structural validity, and reliability evaluation were performed to determine the measurement properties of the PCQ's Persian version. A backward-forward approach was employed for the translation process. Impact scores were selected based on the items' importance to measure face validity. Content validity index (CVI) and content validity ratio (CVR) were calculated to measure content validity, and exploratory and confirmatory factor analyses were used to measure structural validity. The cluster random sampling method was used, resulting in a sample of 250 eligible women referred to the health centers of Tabriz, Iran, who were 4 to 6 weeks after giving birth. Cronbach's alpha coefficient and Intraclass Correlation Coefficient (ICC) using a test-retest approach were used to determine the questionnaire's reliability., Results: The impact scores of all items were above 1.5, which indicates a suitable face validity. The content validity was also favorable (CVR = 0.95, CVI = 0.90). Exploratory factor analysis on 25 items led to the removal of item 2 due to a factor loading of less than 0.3 and the extraction of three factors explaining 65.07% of the variances. The results of the sample adequacy size were significant (< 0.001, and Kaiser-Meyer-Olkin = 0.886). The model's validity was confirmed based on the confirmatory factor analysis fit indicators (i.e., RMSEA = 0.08, SRMR = 0.09, TLI = 0.91, CFI = 0.93, x 2 /df = 4.65). The tool's reliability was also confirmed (Cronbach's alpha = 0.88, and ICC (95% CI) = 0.93 (0.88 to 0.95))., Conclusion: The validity and reliability of the PCQ's Persian version were suitable to measure the extent to which Iranian women are satisfied with the quality of prenatal and intrapartum care., (© 2024. The Author(s).)

Background: Disease-discordant twins are excellent subjects for matched case-control studies as they allow for the control of confounding factors such as age, gender, genetic background, and intrauterine and early environment factors. Study design: A cross-sectional study., Methods: Past medical history documentation and physical examination were conducted for all participants. Fasting venous blood samples were taken to measure fasting blood glucose (FBG) and lipid levels. The ACE model, a structural equation model, was used to assess heritability., Results: This study included 710 twin pairs (210 monozygotic and 500 dizygotic) ranging in age from 2 to 52 years (mean age: 11.67±10.71 years). The study was conducted using participants from the Isfahan Twin Registry (ITR) in 2017. Results showed that in early childhood (2-6 years), height, weight, and body mass index (BMI) were influenced by shared environmental factors (76%, 75%, and 73%, respectively). In late childhood (7-12 years), hip circumference, waist circumference (WC), and low-density lipoprotein (LDL) cholesterol were found to be highly heritable (90%, 76%, and 64%, respectively). In adolescents, height (94%), neck circumference (85%), LDL-cholesterol (81%), WC (70%), triglycerides (69%), weight (68%), and BMI (65%) were all found to be highly or moderately heritable. In adult twins, arm circumference (97%), weight (86%), BMI (82%), and neck circumference (81%) were highly heritable., Conclusion: This study demonstrates that both genetic and environmental factors play a role in influencing individuals at different stages of their lives. Notably, while certain traits such as obesity have a high heritability during childhood, their heritability tends to decrease as individuals transition into adulthood., (© 2024 The Author(s); Published by Hamadan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: Despite conflicting findings in the current literature regarding the correlation between contraceptives and maternal health consequences, statistical analyses indicate that family planning may decrease the occurrence of such outcomes. Consequently, it is crucial to assess the capability of family planning to mitigate adverse maternal health outcomes., Objectives: This review investigates the effects of modern contraceptive use on maternal health., Search Methods: This systematic review is registered on Prospero (CRD42022332783). We searched numerous databases with an upper date limit of February 2022 and no geographical boundaries., Selection Criteria: We included observational studies, including cross-sectional, cohort, case-control studies, and non-RCT with a comparison group. We excluded systematic reviews, scoping reviews, narrative reviews, and meta-analyses from the body of this review., Main Results: The review included nineteen studies, with five studies reporting a reduction in maternal mortality linked to increased access to family planning resources and contraceptive use. Another three studies examined the impact of contraception on the risk of preeclampsia and our analysis found that preeclampsia risk was lower by approximately 6% among contraceptive users (95% CI 0.82-1.13) compared to non-users. Two studies assessed the effect of hormonal contraceptives on postpartum glucose tolerance and found that low-androgen contraception was associated with a reduced risk of gestational diabetes (OR 0.84, 95% CI 0.58-1.22), while DMPA injection was possibly linked to a higher risk of falling glucose status postpartum (OR 1.42, 95% CI 0.85-2.36). Two studies evaluated high-risk pregnancies and births in contraceptive users versus non-users, with the risk ratio being 30% lower among contraceptive users of any form (95% CI 0.61, 0.80). None of these results were statistically significant except the latter. In terms of adverse maternal health outcomes, certain contraceptives were found to be associated with ectopic pregnancy and pregnancy-related venous thromboembolism through additional analysis., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Jahanfar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: This study aimed to examine the experiences of transgender women who work in the sex industry regarding their access to health care facilities for sexual health. Transgender women sex workers are recognised worldwide as a high-risk group for HIV and sexually transmitted infections (STIs)., Methods: In Iran, between January and May 2022, we employed a snowball sampling technique to recruit a diverse group of 22 transgender women sex workers aged 19-42 years. Semi-structured interviews were conducted with these participants to provide insights into their experiences with accessing sexual health care., Results: The data was analysed using thematic analysis, revealing four overarching themes: experiences of violence, contextual barriers to health, socioeconomic challenges and HIV/STI risk practices, and 11 sub-themes. The results demonstrate that many participants experienced difficulties in accessing sexual health services due to violence, discrimination, financial difficulties and lack of awareness about STIs., Conclusion: Sex workers face extraordinarily challenging occupational risks, including sexual and physical abuse, mental health issues, and HIV and STIs. Targeted public intervention programs and research for this group are urgently needed. Outreach programs engaging with underserved transgender women sex workers have the potential to enhance access to healthcare services, and contribute to the reduction of HIV transmission rates.

Background and Objectives: Unintended pregnancy is considered one of the critical indicators of community health as being a risk factor in unsanitary abortions, miscarriage, and insufficient prenatal care. This study aimed to determine the frequency of unintended pregnancy and the related factors in married women., Materials and Methods: The study was conducted on 1013 married women aged 15-49 who were referred to health centers in the South of Tehran. To analyze the data, single and multiple logistic regressions were used., Results: About 50% of participants had already experienced at least one unintended pregnancy. Analysis showed the following predictive factors for unintended pregnancy: being within the age range of 26 to 40 (AOR, 95% CI = 1.91; 1.25-2.90), being over 40 years of age (AOR, 95% CI = 1.96; 1.04-3.71), spouse education level of high-school or lower (AOR, 95% CI = 1.64; 1.11-2.42), first marriage age range of 21 to 30 years (AOR, 95% CI = 0.64; 0.47-0.88), use of the DMPA method as contraception (AOR, 95% CI = 3.42; 1.16-10.06), history of tubectomy (AOR, 95% CI = 4.45; 1.99-10) and history of vasectomy (AOR, 95% CI = 4.61; 1.18-17.98)., Conclusions: Training and distribution of free contraceptive methods would be much more effective and less expensive than paying for costly illegal induction of abortion and unwarranted complications due to abortion., Implications: Vulnerable women who are referred to health centers to receive health services should be trained in contraceptive methods and be informed of the probability of unintended pregnancy with each contraceptive method and the consequences of self-induced abortion., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

The availability and accessibility of sexual and reproductive health (SRH) services for transgender individuals are crucial. This population is deprived of health care due to rejection, stigma, gender-based discrimination, confidentiality, and violence. This review attempts to provide readers with an account of the fundamental problems that the transgender population faces regarding experiences of SRH. This meta-synthesis review applied the Social-Ecological Model (SEM) to address trans individuals' SRH factors. The databases were searched using "SRH" and "transgender" keywords. Fifty studies were finally selected. All studies were qualitative, including 36 semi-structured/ in-depth interviews, two focus group studies, and 12 interviews and focus group studies. The Social-Ecological Model application illustrates the impact of individual, interpersonal, institutional, and social factors on the condition of SRH among transgender individuals. This meta-synthesis reinforces multiple levels of factors that influence the SRH of transgender individuals. These include limited information, lack of awareness, low socioeconomic status, stigma and discrimination, and social deprivation. Interventions are urgently needed to provide better sexual and reproductive well-being for transgender individuals., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aimed to investigate the fertility knowledge and its related factors in married men and women in Zanjan, Iran. In this cross-sectional study, 1200 individuals (including 600 women aged 18-49 years and 600 men aged 18-59 years) referred to urban and rural health centres in Zanjan, were recruited through cluster sampling from June to September 2020. The Cardiff Fertility Knowledge Scale was used to assess fertility knowledge. Data were analysed by descriptive statistical methods such as mean and standard deviation and analytical statistics, including independent sample t-test, ANOVA test, Pearson Correlation and Linear Regression were used. The average correct scores of fertility knowledge were 49.7%, 53.3%, and 51.55% for men, women, and in total, respectively. The multiple linear regression model showed that fertility knowledge was significantly related to being female, being from a higher economic status, having desire to have children in the future, and having desire to increase fertility knowledge (all p  < 0.05). Fertility knowledge among the Iranian reproductive-age men and women was modest. The findings suggested that interventions to increase fertility knowledge are essential, especially interventions targeting men and lower socioeconomic groups.

Background and Aims: Despite the fact that public health measures such as social isolation can help control the coronavirus disease 2019 (Covid-19) pandemic, these procedures may contribute to elevated levels of stress and escalate various forms of violence against women. The current study aimed to estimate the prevalence of domestic violence and identify factors associated with domestic violence during the Covid-19 lockdown among married women attending healthcare centers in Iran., Methods: This cross-sectional study, conducted between 2020 and 2021, focused on a sample of 5317 married women who sought healthcare services within urban centers across five major cities in Iran. Sampling was done through a multistage cluster method. The Revised Conflict Tactics Scales (CTS2) were used to assess levels of violence. The collected data was analyzed using descriptive and inferential statistics, including independent sample t -test, Chi-square, and multiple logistic regression) with the SPSS software version 22., Results: During the Covid-19 lockdown, psychological violence was reported by 66.7% of women (95% confidence interval [CI], 65.44%-67.98%), physical violence by 44.8% (95% CI, 43.43%-46.10%), sexual violence by 28.8% (95% CI, 27.60%-30.03%), and injury by 24.5% (95% CI, 23.39%-25.70%). The multiple logistic regression showed several significant factors associated with domestic violence. These included low levels of social support ( p  < 0.001), shorter duration of marriage ( p  < 0.001), unemployment of both women ( p  < 0.007) and their spouses ( p  < 0.001), poor economic status ( p  < 0.001), as well as substance abuse by the husband, including alcohol ( p  < 0.001) and drug abuse ( p  < 0.01), and smoking ( p  < 0.01)., Conclusion: The findings highlighted the magnitude of domestic violence against women during the Covid-19 lockdown. It is crucial to implement comprehensive strategies that encompass preventive and responsive measures to address domestic violence not only during lockdowns but also in the post-lockdown period., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)