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Background: Endometriosis is one of the most frequent illnesses and is connected with substantial problems, such as pain and reduced social function. Objective: This study aimed to examine the association between painful endometriosis symptoms and women's quality of life. Methods: This research included 169 endometriosis patients. Data was collected using sociodemographic, ENDO PAIN- 4D, and EHP-30 questionnaires. To examine the relationships between pain symptoms and quality of life, the Pearson correlation test was performed. Also, the general linear model with controlling the probable confounding variables was used for multivariate analysis. Results: The mean (SD) of the overall ENDOPAIN 4D and the overall EHP 30 scores were 66.0 (61.0), and 35.9 (22.4), respectively. In terms of quality of life, the emotional domain had the greatest 42.0 (20.3), and the pain domain had the lowest mean score 7.2 (4.5). The total score of EHP 30 and ENDOPAIN 4D had a substantial positive connection (r = 0.55 and p > 0.001). With an increasing ENDOPAIN 4D score, the quality-of-life score increased (B = 0.2; CI: 95 %: 0.1 to 0.2). Explaining that in the EHP-30 scale, the quality of life worsens as the score increases. Conclusion: This study found that the more intense the painful symptoms of endometriosis, the poorer the quality of life. Thus, it is vital to lessen the painful symptoms and practice self-care to enhance these patients' quality of life.

Background Urinary incontinence has a significant impact on the psychosocial well-being of postmenopausal women. This study aimed to determine the relationship between urinary incontinence with sexual function and quality of life. Method It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021–2022. Data were collected using questionnaires of socio-demographic and obstetrics characteristics, female sexual function index (FSFI), Menopause-Specific Quality of Life (MENQOL), and Urinary Incontinence Diagnosis (UIDQ). Independent sample t-test and general linear model (GLM) were used to compare the quality of life and sexual function score between the two groups of women with and without stress, urgency, and mixed urinary incontinence. Results Independent sample t-test showed a significant difference in the quality of life and sexual function between women with and without stress, urgency, and mixed urinary incontinence ( p < 0.05). Based on the GLM with adjusting the socio-demographic and obstetrics characteristics, women without stress incontinence reported a lower mean score of MENQOL (B = − 23.38; 95% CI = −30.1 to −16.6; p < 0.001) and a higher mean score of sexual function (B = 4.5; 95% CI = 2.1–7.0; p < 0.001) compared to women with stress incontinence; a lower MENQOL score and a higher sexual function score indicate better condition. However, there was no significant relationship between urgency and mixed incontinence with quality of life and sexual function ( p > 0.05). Conclusion As urinary incontinence remarkably affects sexual function and quality of life of postmenopausal women, health care providers should consider better solutions for this issue in their work program.

Endometriosis is one of the leading gynecological disorders in reproductive ages. About two-thirds of women with endometriosis experience chronic pelvic pain. There are different methods for the assessment of pain in endometriosis. One of these questionnaires is endometriosis painful symptoms-4 dimensions (ENDOPAIN-4D) questionnaire, which has not been validated in Iran. Therefore, we decided to conduct a study to determine the psychometric properties of this questionnaire. In this study, we randomly selected 169 women with endometriosis from two educational-medical centres of Al-Zahra and Taleghani in Tabriz, Iran, in 2020. We evaluated the validity of ENDOPAIN-4D in terms of face, content, and structure (through exploratory and confirmatory factor analyses). We used internal consistency assessment and test-retest reliability to determine the questionnaire reliability. In this study, the CVI and CVR for the ENDOPAIN-4D instrument were obtained as 0.99 and 0.98, respectively. In the exploratory factor analysis, we extracted a four-factor structure, and the confirmatory factor analysis gave a good fit for the extracted model. We obtained Cronbach's alpha coefficient as 0.96 and the intra-class correlation coefficient (ICC) (at 95% confidence interval) as 0.94 (0.85 to 0.98). The Persian version of ENDOPAIN-4D has acceptable content validity, construct validity and reliability for the evaluation of pelvic pain and gynaecology in Iranian women with endometriosis.Impact Statement

Electrical stimulation (ES) has been shown to improve some of impairments after spinal cord injury (SCI), but the underlying mechanisms remain unclear. The Wnt signaling pathways and the endocannabinoid system appear to be modulated in response to SCI. This study aimed to investigate the effect of ES therapy on the activity of canonical/noncanonical Wnt signaling pathways, brain-derived neurotrophic factor (BDNF), and fatty-acid amide hydrolase (FAAH), which regulate endocannabinoids levels. Forty male Wistar rats were randomly divided into four groups: (a) Sham, (b) laminectomy + epidural subthreshold ES, (c) SCI, and (d) SCI + epidural subthreshold ES. A moderate contusion SCI was performed at the thoracic level (T10). Epidural subthreshold ES was delivered to upper the level of T10 segment every day (1 hr/rat) for 2 weeks. Then, animals were killed and immunoblotting was used to assess spinal cord parameters. Results revealed that ES intervention for 14 days could significantly increase wingless-type3 (Wnt3), Wnt7, β-catenin, Nestin, and cyclin D1 levels, as well as phosphorylation of glycogen synthase kinase 3β and Jun N-terminal kinase. Additionally, SCI reduced BDNF and FAAH levels, and ES increased BDNF and FAAH levels in the injury site. We propose that ES therapy may improve some of impairments after SCI through Wnt signaling pathways. Outcomes also suggest that BDNF and FAAH are important players in the beneficial impacts of ES therapy. However, the precise mechanism of BDNF, FAAH, and Wnt signaling pathways on SCI requires further investigation.

Background Giving a healthy birth plays a vital role in a person’s personality development, but giving unhealthy birth and abortion can increase the risk of a range of mental disorders and psychological harms including reduced well-being and quality of life. Psychological interventions can reduce the problems of individuals, so the present study was conducted to evaluate the effect of counseling with hope therapy on psychological well-being (primary outcome) and quality of life (secondary outcome) of women with an experience of abortion. Method This randomized controlled trial was conducted in Alzahra and Taleghani educational and medical centers in Tabriz, Iran, on 52 women aged 16 years and above whose pregnancies led to abortion in 2020–21. Participants were assigned to intervention and control groups using random blocking method. The intervention group received counseling with hope therapy approach in 8 sessions of 45 min twice a week. The psychological well-being and WHO Quality of Life (WHOQOL) questionnaires were completed before the intervention and immediately and 4 weeks after the intervention. Independent t-test and repeated measures ANOVA were used to compare the outcomes in two groups. Results After the intervention based on the repeated measures ANOVA test and by adjusting the baseline score, the mean total score of psychological well-being in the counseling group was significantly higher than that in the control group (adjusted mean difference (AMD): 76.76; 95% confidence interval (95% CI): 63.81 to 89.70; P P P Conclusion Using hope therapy can improve the psychological well-being and quality of life of women after abortion. However, further clinical trials are required before making a definitive conclusion. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N60. Date of registration: 17 Dec 2020. Date of first registration: 20 Dec 2020.

Background: The crisis of COVID-19 disease causes stress in the whole population, including pregnant women, and because pregnancy is a potentially stressful event, it can lead to complications in both mother and fetus. Considering the importance of prevention in controlling of this infection, the present study was conducted to determine the status of self-care performance of pregnant women in the prevention of COVID-19 disease and its relationship with perceived stress during the epidemic period of this disease.Method: This cross-sectional study was performed on 228 pregnant women who referred to Tabriz-Iran health centers for prenatal care by cluster sampling. Data collection tools included questionnaires of demographic-social characteristics, self-care performance and perceived stress. Spearman correlation test was used to examine the correlation between self-care performance and perceived stress in bivariate analysis and in multivariate analysis, multivariate linear regression with control of demographic-social and obstetric characteristics as possible confounders, was used.Results: The median (25-75 percentiles) self-care performance score of participants was 0.71 (0.65-0.76) from the achievable range of 20-80, and the mean (±SD) perceived stress score of them was 25.5 (± 5.6) from the achievable range of 0-56. The Spearman’s rank correlation test results showed a significant inverse correlation between perceived stress and self-care performance scores. According to multivariate linear regression test, the variables of self-care performance, education, spouse's education and number of family members were the predictors of perceived stress in pregnant women during COVID-19 epidemic. Conclusion: According to the results of the present study, the self-care performance of pregnant women in the prevention of COVID-19 disease was good and their stress was moderate. There was a significant inverse correlation between self-care performance and perceived stress, which could indicate the high value and importance of the fetus for the mother and strict adherence to health protocols to prevent COVID-19, which also leads to calming and reduced perceived stress.

Background: Pregnancy is a critical stage of a woman’s life. Considering the dramatic increase of the need for social support during pregnancy, the present study aimed to determine the level of social support for pregnant women and its relationship with neonatal anthropometric indices and postnatal depression in pregnant women who referred to health centers of Tabriz, Iran in 2013.Methods: In this study, 450 women were selected using cluster sampling. We assessed socio-demographic characteristics and social support status (using interpersonal support evaluation list) ISEL)) at 26-36 weeks of pregnancy. Neonatal height and weight were measured immediately after birth. Maternal depression was assessed six weeks after delivery using the Edinburgh postnatal depression scale (EPDS). Pearson’s correlation was used for determining the relation between the social support score with anthropometric indices and depression score. Results: The mean (standard deviation) score of social support was 69.6 (14.6) out of 90. Overall, 12% of the pregnant women had poor social support (score less than 45). Increasing social support score was correlated with decreasing depression score (P

Objectives: The present study aimed at determining the relationship between sleep quality and overweight and obesity in women of reproductive age referred to health centers and bases in Yazd in 2014-2015. Materials and Methods: A total of 450 women of reproductive age with a body mass index (BMI) of >18.5 were participated in this study and divided into 3 equal groups (n = 150) of normal weight, overweight, and obese. Instruments used in this study were the Pittsburgh Sleep Quality Index (PSQI) and a socio-demographic questionnaire. Data from the questionnaires were completed by the participants and analyzed using statistical methods. Results: In this study, 66% of normal weight women of reproductive age had an acceptable sleep quality, while 77% of overweight and 93% of obese women of reproductive age had poor sleep quality, respectively. The results of this study showed that a significant correlation existed between BMI of normal weight women of reproductive age and the components of sleep quality (P = 0.001). An inverse significant relationship was also found between BMI of overweight women of reproductive age and the components of sleep quality (P < 0.05) and finally, an inverse significant relationship was also found between BMI of obese women of reproductive age and the components of sleep quality (P < 0.05). A significant relationship also existed between socio-demographic and components of sleep quality (P < 0.05). It seems that among the components of sleep quality, the effect of sleep disorder, impaired daily functioning, and consumption of hypnotic drugs was higher than sleep duration and good sleep in overweight and obesity. Conclusion: The results of this study revealed that women of reproductive age with overweight and obesity have poor sleep quality. Among components of sleep quality, sleep disorder, impaired daily functioning, and consumption of hypnotic drugs have the most important role in reducing sleep quality. It seems that change in lifestyle can improve sleep quality and thus can reduce BMI

Background: Selenium (Se) and Electrical stimulation (ES) play an important role in maintaining the integrity of various body functions after spinal cord injury (SCI). Objectives: This study aimed to investigate the effect of Se and ES on the sperm parameters and the repair of the damaged spinal cord in a rat model. Methods: A total of 50 male Wistar rats were randomly divided into five groups (n = 10 per each group, including control, sham, SCI, Se, and ES. After SCI in the T10 space, the BBB and Von Frey test were used to evaluate the motor and sensory functions. Six weeks after the treatment, the assessment of sperm parameters was done. Results: The treatment with Se, compared to the SCI group, significantly increased the sperm concentration (38.66 ± 14.81 vs. 18.50 ± 7.02, P 0.05). A significant increase was observed in the BBB locomotor Score and Von Frey test in the SE and ES groups compared to the SCI group and between the Se and ES groups. However, no significant difference was observed between the Se and ES groups in the Von Frey test. Conclusions: The effect of Selenium on sperm parameters and motor function was superior than that of the Electrical stimulation, but the effective effect on repairing the sensory function was the same.

Objectives: The aim of this study was exploring sleep hygiene and its related factors among the elderly in Tabriz, Iran. This study was conducted on 100 elderly men and women over the age of 60 in Tabriz, Iran. Materials and Methods: This was a cross-sectional study which conducted on 100 men and women over 60 years old who were selected among four active retirement centers in Tabriz, Iran in 2010. A questionnaire consisting of four sections was used for data collection. Data was gathered on socio-demographic, personal, environmental and nutritionalpharmaceutical factors of sleep hygiene. Overall sleep hygiene was considered to be as optimal if the score of three domains was between 119 and 177, moderate with score 60118 and unfavorable with score 0-59. Descriptive statistics and chi-square tests were used to analyze the data. Results: Most participants (74%) claimed that they wake up frequently during the night. Sleep hygiene in 16% of the participants was optimal and in 84% was moderate. Regarding personal, environmental and nutritionalpharmaceutical factors, sleep hygiene in 18%, 16% and 54% of the samples was optimal respectively. There was a significant relationship between gender, marital status, number of household, the amount of revenue, marital life satisfaction with sleep hygiene in the elderly (p

Non-stress test (NST) is known as one of the most common assessments for evaluation of fetus well being. Since the prevalence of its false positive results is high and majority of fetuses with non-reactive results are not at risk, it is important to find out effective approaches to identify such results to avoid unnecessary interventions. So this survey was conducted with the aim of comparing the effects of acoustic stimulation with feeding mothers stimulation on non-reactive NST results. This study preformed on 104 healthy pregnant women with non-reactive NST results and gestational ages between 32 and 42 weeks in Tabriz Alzahra hospital. Subjects were divided into two groups for acoustic stimulation and feeding mother stimulation. Half an hour later NST repeated for participants of each group in the same environmental condition and again the results evaluated. According to our findings, 75 % of subjects with non-reactive NST results changed to reactive after acoustic stimulation group. However, 80 % of participants with non-reactive NST results changed into reactive after feeding stimulation. No significant differences found while comparing test results. Both stimulating approaches were effective in the identification of false positive NSTs and might be useful in preventing the unnecessary interventions.

Background: Episiotomy, a common surgical practice in midwifery, is accompanied with high levels of pain and discomfort for mothers. The importance of medicinal herbs and traditional medicine in wound healing cannot be neglected. Objectives: Considering the positive effects and easy accessibility of Equisetum arvense, this study examined the effectiveness of topical application of Equisetum arvense ointment in wound healing, reduction of inflammation and pain relief after episiotomy in nulliparous mothers. Patients and Methods: This double-blind clinical trial was performed on 108 postpartum nulliparous mothers (54 women in horsetail group and 54 women in placebo group) in Alzahra Educational-Medical Center (Tabriz, Iran). About 5 ± 1 and 10 ± 1 days after the childbirth, the primary outcomes of episiotomy, i.e. wound healing and pain intensity, were assessed based on redness, edema, ecchymosis, discharge and approximation of the edges (REEDA) scale and a visual analogue scale (VAS), respectively. The secondary outcomes evaluated in the current research were the number of used painkillers and the adverse events during the 10-day period of the study. Data was analyzed using independent t and Mann-Whitney U tests. Results: The case and control groups had no significant differences in for the mean wound healing score (5.0 ± 1.6 vs. 4.1 ± 1.6) and mean pain intensity (5.7 ± 2.4 vs. 5.3 ± 2.2) at baseline. During both follow-up sessions (5 ± 1 and 10 ± 1days after delivery), the mean scores were significantly lower in the case group than the control group. The adjusted pain score difference (MD) after 5 ± 1 and 10 ± 1 days was -2.3 (95% CI: -3.2 to -1.3) and 3.8 (95% CI: -4.7 to -3.0), respectively. The mean numbers of acetaminophen pills used in the control and case groups during the 10-day period of the study were 6.8 ± 4.4 and 11.6 ± 7.1, respectively (P < 0.001). Conclusions: According to our findings, 3% Equisetum arvense ointment promoted wound healing and relieved pain during the 10-day period after episiotomy. Since this study was the first to assess the effects of Equisetum arvense ointment on wound healing and pain intensity following episiotomy in humans, further research is warranted to fully clarify the beneficial effects of prepared ointment.

Purpose: The Non stress test (NST) is one of the significant diagnostic fetal wellbeing tests. The purpose of this study is to assess diagnostic value of NST during latent phase of labor by considering maternal and neonatal outcomes. Subjects: This case control study was performed on 450 healthy pregnant women with gestational ages between 38-42 weeks in AL-Zahra teaching hospital in Tabriz, Iran. All participants underwent NST after being admitted to labor during their latent phase of delivery. Participants were divided into two groups including the study group which included 150 participants with non-reactive NST results whereas 300 subjects with reactive NST results assigned in the control group. Subjects in both groups were hospitalized for pregnancy termination because of the delivery time. In order to find out the importance of routine performance of NST during delivery, the relationship between NST results and maternal and fetal outcomes was evaluated. Several criteria including type of delivery, meconium defecation, descent arrest, bradycardia, Apgar score, and still birth were compared between two groups. Results: Findings of this study showed that descent arrest occurred in 2.7% of the subjects in the study group, whereas it occurred in 4.7% of the participants in the control group (p=0.44). Bradycardia found in 28% of the participants in study group and 3.3% of the control group (p

Objective. This study aimed to determine the effect of educational program on Breastfeeding self-efficacy and duration of exclusive breastfeeding in pregnant women in Ahvaz, Iran. Methods. This randomized controlled trial was conducted on 120 nulliparous pregnant women who tended to breastfeed. The primary self-efficacy scores of samples were measured using Faux and Dennis breastfeeding self-efficacy questionnaire. Women were randomly recruited into two intervention and control groups. Educational program (two training sessions, each lasted two hours) with two days interval was performed for intervention group. One month after delivery, self-efficacy scores were determined. Six months after child birth, duration of exclusive breastfeeding was assessed. Data were analyzed by means of descriptive and inferential statistics. Findings. The breastfeeding self-efficacy in the intervention group increased significantly compared to the control group one month after delivery (123.6 versus 101.7, P<0.001). The duration of exclusive breastfeeding was significantly higher in the intervention group (5.03 mo versus 2.7 mo, P<0.001). Also, there was a significant relationship between breastfeeding self-efficacy and duration of exclusive breastfeeding (P<0.001). Conclusion. The educational program could increase the self-efficacy and exclusive breastfeeding duration of mothers. These results can draw the attention of authorities to the importance of educational programs for mothers regarding the exclusive breastfeeding.

Background: Dysmenorrhea is one of the most common types of cyclic pain that affects 50% of women and girls in their menstrual ages. Because of the side-effects and contraindications of chemical medicines, using herbs has been investigated in treating dysmenorrhea. Objectives: The aim of this study was to determine the effect of Rosa damascena extract on primary dysmenorrhea among the students of Kowsar dormitory in Tabriz University of Medical Sciences. Materials and Methods: This study was performed in Iran on 92 single 18-24 year old students with BMI :19-25 and obtaining pain intensity score of 5-8 in Visual Analogue Scale that were randomly classified and included in two groups of 46 persons. The participants received two capsules of Mefenamic Acid and Rosa damascena with the similar physical properties in two consecutive cycles per 6 hours for 3 days in a cross-over form. The data were collected through the questionnaire of demographic characteristics and check-list of visual analogue scale. Descriptive statistics and repeated measurement test and independent samples t test by using SPSS (13/win) were used in order to determine and compare the effects of two drugs on dysmenorrheal pain intensity of the groups. Results: There was a significant difference between the average of pain intensity at different hours of measurement in each group after the end of first cycle and second cycle (P < 0.001). There was no significant difference between the average of pain intensity in two groups in the first cycle (P = 0.35) and second cycle (P = 0.22). Conclusions: In this study¸ Rosa damascena and Mefenamic acid had similar effects on pain intensity of primary dysmenorrhea . With further studies, Rosa damascena which has no chemical side effects¸ can be suggested for treating primary dysmenorrhea.

Introduction: Infertility is considered a traumatic stressor for infertile couples, and it becomes a psychosocial crisis for that person. Considering the importance of fertility and based on the cultural and social aspects of it in Iran, the present study aimed to determine mental health and its individual and social predictors in infertile women referring to the infertility center of Al-Zahra hospital in Tabriz, Iran, during 2012-2013. Methods: This was a descriptive-correlational study on 345 infertile women referring to Al-Zahra hospital in Tabriz, Iran, via convenient sampling. Data was gathered by the perceived social support questionnaire and mental health questionnaire. To determine the relationship between social support and personal and social characteristics, and mental health, multivariate linear regression was used. Data were analyzed using SPSS software. Results: The mean (SD) total score of mental health of women was 29.70 (11.50), the score ranged from 0 to 84. The best condition was below the depression scale, and the worst condition was below the social dysfunction scale. Social support from the family was also a predictor of the mental health of infertile women. Conclusion: The findings of this study showed that infertile women, in terms of mental health and its subscales, have unfavorable conditions. Moreover, social support from the family is an important factor influencing mental health. Therefore, strengthening the social support of the family to improve the mental health of infertile women seems necessary., Journal of Caring Sciences; EISSN 2251-9920

BACKGROUND: Clinical learning environment (CLE) is an important factor in clinical education of nursing students. The CLE of nursing students has been less studied in Iran. Therefore, the aim of present study was to investigate the viewpoints of nursing students in Tabriz nursing faculty regarding CLE. METHODS: In this descriptive study, 133 nursing students participated. For data collection the CLE inventory was used that assesses six aspects including personalization, cooperation, task orientation, innovation, satisfaction with clinical education, and satisfaction with clinical instructors. The score ranged from 46 to 184 and scores below 115 were considered as a negative. RESULTS: The average score of viewpoint regarding CLE was 108.4 (12.7) and 93.2% of students had a negative viewpoint about CLE. CONCLUSIONS: Educational authorities should have special attention to the quality of CLE of nursing students.