---

The present research is a descriptive - analytic study about the rate of use, reasons of use or refusal of Hormone Replacement Therapy in menopausal women referred to gynecology clinics in selected hospitals of Tehran University of Medical Sciences in the year 2001. Samples of research included 400 women age between 40-65 years which selected on accidental basis and collected means was questionnaire which contain demographic characteristics (age, job and education), receiving information, information source, the reasons for use or refusal of Hormon Replacement Therapy. Research findings showed that 8.75% of menopausal women used Hormone Replacement Therapy. Their reasons are as follow: 28.57% due to physician recommendation. 26.37% due to improvement of hot flash. 23.08% for prevention of osteoporosis 16.48% due to hysterectomy. 3.3% due to prevention of cardiovascular diseases. 2.2% because of improvement of sexual activities. The reasons for non-useres are as follows: 46.96% having no information about such a method, 16.4% thinking about menopuae as a natural phenomenon and no need for treatment, 10.53% not-suffering from menopausal effects, 7.08% medical recommendation, 5.6% fear of hazardous effect leading to cancer. In the present research, there is no significant relationship between age, job and the method of Hormone Replacement Therapy but have significant relationship between education rate and receiving information about the method of use.

---

The present study is a descriptive one made for the purpose of quality assessment of family planning counseling in health and treatment centers affiliated to Tehran University of Medical Sciences in year 2000. 410 client of the Family Planning Social Services who had attended 25 health and treatment centers affiliated to Tehran University of Medical Sciences were participated in this research study. A checklist was completed through the observation of family planning counseling sessions. The finding and results of this study showed that personnel&aposs behaviour and the quality of family planning counseling for the majority of samples in the first section have been suitable. In the section of the history taking from clients helping them to select suitable method and to determine next appointment, data for the majority of samples in this study have been in an average level. In the section of need understanding of clients introductory methods providing information the audiovisual training equipments used during family planning counseling, explanation of way of utilizing the selected method, and finally the environment for family planning counseling have not been suitable for majority of the samples. The findings of this study can be beneficial for public health planning in order to improve the quality of the family planning services.

---

Pregnancy and delivery are special events in women’s and their family’s life. Although pregnancy is a natural phenomenon and not a disease, sometimes it can be associated with several dangers to the mother and her fetus. Maternal death is a global finding and its five most important causes are bleeding, infection, hypertension, prolonged labor and abortion in unsanitary condition. Early diagnosis of abnormal labor progression and prevention of prolonged labor can reduce the risk of postpartum bleeding and infection. The chart of labor called “Partograph” has been introduced and applied since 1970 to help diagnosis of the abnormal labor and cephalopelvic disproportion. Partograph is an early alerting system which can prevent probable difficulties in different stages of labor through recording of all of the observations and examinations on one chart, so that mother can be referred as soon as possible to higher levels of health services.

---

Background & Objective: According to Iranian national statistics, every year 400 to 500 thousand unwanted pregnancies occur in Iran. The emergency contraceptive methods are easily accessible and affordable for the women of this region. Regarding the important role of health care providers in representing these methods, this study is to determine the knowledge and attitudes of these staff toward required contraceptive methods.

Methods & Materials: In this semi-experimental study, 216 health personnel working in south of Tehran health centers were randomly selected. Two 30- minute educational sessions were presented to the staff. The methods of education included face to face, and group discussion. At the end of each session a pamphlet was given to the staff. Data were gathered using a questionnaire before and 2-6 weeks after the education. Statistical analysis was carried out using statistical package for social sciences (SPSS).

Results: The results showed that there were significant statistical differences between the knowledge and attitudes (P<0.001) of personnel about the emergency contraceptive methods before and after education. There was no significant relationship between demographic characteristics and attitudes of personnel. There was a significant relationship between sex (P<0.001), educational level (P<0.003), educational major (P<0.001), with knowledge after intervention.

Conclusion: Knowledge and attitudes toward emergency contraceptive methods increased significantly after education. This finding reveals the importance of continuous education for health care staff such as midwives and physicians to facilitate successful guidance of their patients towards effective family planning.

---

Background & Objective: Osteoporosis is a metabolic disease which results from gradual destruction of bone mass. Prevention of osteoporosis should be started from childhood by getting adequate calcium and doing weight-bearing exercises. Participating of mothers in health education interventions is likely to promote longer-lasting health behaviors in their daughters. The aim of this study was to investigate the effect of simultaneous education of mothers and daughters on osteoporosis preventive behavior among high school female students.

Methods & Materials: In this interventional study, 400 female students were randomly selected via a two-phased sampling method. At first stage, four schools were selected randomly. At the second stage, 400 students were divided randomly into two groups. Their osteoporosis preventive behaviors were measured using a two-sectioned questionnaire: demographic section, and osteoporosis preventive behaviors assessment section. The first group participated in the educational programs with their mothers and the other group participated without their mothers. The educational program had two sessions, each one lasted 45 minutes. The second stage of the study was performed three months later. Data analysis was carried out using t-test and chi squared test.

Results: Results showed that in both groups, osteoporosis preventive behaviors scores increased significantly after intervention. It was higher in case group (P<0.001). Eating behavior was significantly different in two groups (P=0.003).

Conclusion: Results showed that simultaneous educational program for mothers and daughters promotes eating behavior in the girls.

---

Background & Objective: High rates of cesarean delivery have worried health policy makers. One of the main reasons for cesarean section in Iran is cesarean election. Health Belief Model (HBM) is one of the most powerful models used in health education programs. The objective of this study was to determine the effect of education designed based on HBM on choosing delivery mode among pregnant women.

Methods & Materials: In this experimental study, 128 nulliparous women were recruited from Shahrood health care centers and private gynecologists' offices. Samples were randomly allocated into two equal groups. Women in the experimental group participated in two 40-minutes educational classes which were designed based on HBM. Data were gathered both before and after the classes, and then were analyzed using SPSS.     

Results: The results indicated that there were no significant differences between two groups in demographic characteristics, infertility history, disease history, perceived susceptibility, and perceived benefits and barriers. After the intervention, significant differences were found between perceived  susceptibility (P<0.001), perceived severity (P<0.001), perceived barriers (P=0.004), with practice (choosing the delivery mode) (P<0.001).

Conclusion: The results showed that using HBM in program designing was effective in the pregnant women's decision-making toward delivery mode.

---

Background & Aim: Childbearing is a potentially traumatic event in the lives of women and can lead to post traumatic stress disorder in some women. This study aimed to determine the prevalence and predisposing factors of post traumatic stress disorder after childbearing in women in Bushehr.

Methods & Materials: In this cross-sectional study, 400 women who attended the medical centers 6-8 weeks after delivery were recruited to the study. Participants with traumatic delivery were included in the study. They completed the posttraumatic symptoms scale-I (PSS-I), and predisposing factors questionnaire. Data were analyzed in two groups of women with the PTSD and without PTSD using Chi-square and Fisher&aposs exact test with P=0.05.

Results: The results of this study showed that 54.4% of women had experienced a traumatic delivery and one-third of the women were affected to PTSD after childbearing. There were significant differences between obstetrical factors including complications of pregnancy, wanted pregnancy, post-partum complications, interval of the last two pregnancies less than two years neonatal factors including type of feeding, issues of child care, birth weight and psychological factors including stressful life events, and maternity social support with the PTSD (P<0.05). Income had statistically significant association with the PTSD (P<0.05).

Conclusion: Some of obstetrical, neonatal and psychological factors are associated with occurrence of the PTSD after delivery

---

Background & Aim: The Non Stress Test (NST) is a main assessment tool for fetal wellbeing however, it has a high rate of false-positive results. External stimulation with halogen light has been recommended to aid in provoking fetal response, decreasing false-positive results and promoting the test. This study aimed to assess the effect of halogen light stimulation on nonreactive pattern of NST.

Methods & Materials: From 850 women who underwent NSTs, 50 women with singleton and cephalic fetuses who had nonreactive NSTs were allocated to receive halogen light stimulation through a halogen light source of 1,000,000 candle power. The light was applied to the lower abdomen above symphysis pubis over fetal head for 10 seconds. Results were compared to BPP scores as a backup test. We used mean± SD, chi-square Test and Fisher&aposs Exact Test. The >α0.05 was considered as significant level.

Results: Following stimulation, 68% of nonreactive results changed to reactive patterns. In half of the cases, first acceleration occurred in less than two minutes. Almost 90% of fetuses had reactive pattern within nine minutes.

Conclusion: Halogen light stimulation decreased the incidence of non reactive tests and testing time. Halogen light stimulation is safe and efficient in fetal well being assessment.

---

Background & Aim: Most of the psychological turmoil of marital conflicts is related to sexual dissatisfaction. Sexual satisfaction is influenced by physical and mental illnesses. Pelvic floor muscle relaxation is a major health problem in which prolapsed pelvic floor muscles causes paralysis, pelvic organs&apos prolpases, pelvic organs&apos dysfunction, dyspareunia, and back pain. The aim of this study was to assess the effect of pelvic floor muscle exercise on sexual satisfaction in primiparous women.

Methods & Materials: This clinical trial was conducted among 100 primiparous women selected through cluster randomized sampling from five clinics of Tehran University of Medical Sciences. Samples were randomly divided into two equal groups. The intervention group received pelvic floor exercises (Kegel) for 16 weeks. The control group did not receive any intervention. Data were collected using the Linda Berg questionnaire before the intervention and 16 weeks after the intervention in both groups. Data were analyzed using descriptive statistics and chi-square, t-test in the SPSS v.18.

Results: After 16 weeks, significant differences were reported in the levels of sexual satisfaction in the intervention and control groups (P<0.001).

Conclusion: The Kegel exercises are easy and non-expensive methods that should be offered by health professionals to increase sexual satisfaction in women after childbirth.

---

Background & Aim: Pregnancy can conflict with sexual function that can be affected by physical and psychological changes during pregnancy. The aim of this study was to compare sexual functions between nulliparous and multiparous pregnant women referred to health centers in Eastern district of Guilan.

Methods & Materials: This cross-sectional study was carried out in Guilan during 2009-2010. We used convenient sampling method to select 554 pregnant women. Data were gathered using a questionnaire including demographic characteristics, sexual function and fear of harm to fetus. The SPSS-16 was used to analyze the data by the Mann-Whitney U and Generalized linear models. The level of significance was set at 5%.

Results: There was no significant difference between nulliparous and multiparous pregnant women regarding sexual function in the first and second trimesters of pregnancy (P=0.353, P=0.251). There were significant differences between nulliparous and multiparous pregnant women regarding sexual desire (P=0.002), arousal (P=0.01), orgasm (P=0.01), pain (P=0.02) and sexual function total score (P=0.016). There was significant difference between nulliparous and multiparous pregnant women regarding sexual function (P=0.008).

Conclusion: Sexual counseling and rehabilitation programs should be compiled as part of the comprehensive care of prenatal care especially for multiparous pregnant women.

---

  Background & Aim: Hysterectomy is the second most common major surgery among women of reproductive age. Studies have suggested that women do not usually receive adequate information regarding hysterectomy before the surgery. Depression is a common psychiatric condition diagnosed after hysterectomy. The aim of this study was to assess the impact of pre-hysterectomy counseling on depression among women.

  Methods & Materials : In this clinical trial, 100 women who had undergone hysterectomy for non-malignant conditionswere selected from two hospitals (women’s’ hospital and Imam Khomeini hospital) and completed the informed consent forms. Participants were randomly divided into two intervention and control groups. In the intervention group, we implemented the supportive counseling within two sessions. Depression was assessed 1-2 weeks before the surgery and two monthsafter the surgery. Data were gathered using the 30-item SAMA questionnaire (modified BECK questionnaire in Iran)for depression and a demographic questionnaire. The two groups were assessed using the Wilcoxon rank-sum test, Mann Whitney U test and paired-t test. Data were analyzed in the SPSS-14.0. The p-value less than 0.05 was considered significant forall tests.

  Results: Mann Whitney U test showed no significant difference between the control and intervention groups in the mean score of depression (p<0.001). In the intervention group, the mean score of depression was 44.46 ± 6.7 at baseline and 20.86 ± 5.9 after the intervention.

  Conclusion : Pre-hysterectomy counseling should be provided for women in order to reduce negative psychological consequences.