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This study was a randomized double - blind controlled clinical trial to investigate the effect of nitroglycerine ointment on primary dysmenorrhea and its side effects among the students resident of selected dormitory of Tehran university of medical sciences in 1999.The investigated units consisted of 112 students suffering from primary dysmenorrhea grade 2 and 3.The samples were randomly assigned into two equal groups : control Group (56 students )and experimental group (56 students )as well.The severity of pain and side effects were evaluated once before and five times after applying the ointment. Then ,a comparison was made to assess the effect of drug and placebo on two groups according to severity of pain and side effects.The results showed that severity of pain in case group was significantly lower than control group during 30 minutes and one, two and four hours after applying the ointment, (in all cases p=o.oo)Moreover , 15 -30 minutes after applying the ointment, it was effective in relieving pain and it reached its highest degree when two hours passed, then the effectiveness of the ointment in relieving pain was reduced , but it continued to be effective within four hours after applying as well. Furthermore, the findings revealed that 5 mg of Nitroglycerine 1% was effective in relieving primary dysmenorrhea, however, it was accompanied with following side effects in two groups: headache 21.4% in case group VS 1.8% in control group (p=0.00), dizziness 21.4%in case group VS 1.8% in control group (p=0.00), hotflashing 35.7% in case group vs 1.8% in control group (p=0.00), arrhythmia 10.8% in case group VS 0% in control group (p= C.05), a significant falling in systolic and diastolic blood pressure (p=0.05) and a significant increasing in heart beat. (p=0.05).

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Menopause is a physiological change for women, which occurs between 40-59 years of age and has a great impact on their life quality and its patterns. This is a descriptive and analytic research, which was carried out to assess the impact of menopause and some socio-demographic and medical variables on quality of life and its patterns in Tehran in 2001. Samples were taken at random from 210 healthy women aged between 40 to 60 years and in four groups: pre-menopausal, about menopausal, menopausal and post-menopausal women with duration of less than or more than 5 years. The data was collected via a special questionnaire through interview. Analysis of data has been done by using SPSS Statistical tests 2, Bonferroni and LSD. The findings show that quality of life and its patterns were related to the menopausal stage with the highest percentage related to pre-menopausal women and the lowest to post-menopausal with a duration of 5 five years (p<0/0001). The results of the study were affected by different factors such as menopausal signs, marital situation and the age of the samples but there was no relationship with duration of the menopause, job, education, financial situation of the women, the age of the woman's first menstruation, and the number of children staying with the family. According to the findings, it is suggested that the health program designers and decision makers develop special plans to enhance women's quality of life and patterns, especially women who are about menopausal age (the first five years).

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Introduction: Anually, 585000 women die from complications of pregnancy and childbirth in the world. Using postpartum contraceptive methods helps to prevent repeated pregnancies.

Materials and Methods: This research is a descriptive and analytic cross-sectional study that has been performed among women who refered to health centers of Kermanshah city in 2002 to evaluate contraceptive use during two years postpartum and attitude toward it. In this study, some of health centers of Kermanshah city had been selected with cluster sampling and then 260 married women in fertility ages attending these health centers who had delivered during previous two years were selected, using stratified random sampling. Data collecting was performed by interview using a questionnaire that was consisted of 5 parts the data were analyzed using 2 and Fisher exact test, student T-test, Pearson and Logistic regression. Standard deviation (Sd) was reported for mean values.

Results: The findings of this research indicated that 50.4% of women had a positive attitude toward using contraceptive methods during two years postpartum and 79.2% were using some contraceptive method. Husband education (p=0.036), having sexual activity (p=0.001), the time that has been elapsed from the last delivery (p=0.001), number of pregnancies (p=0.013), tendency to have more children (p=0.037), attitude toward contraceptive use (p=0.001), the type of breast feeding (exclusive or partial) (p=0.001), and quality of menstural cycles (p=0.001) were in relation to use of contraceptive methods during two years postpartum.

Conclusion: According to these findings, attitudes and believes, breast feeding status and quality of menstural cycles play an essential role in postpartum contraception. Therefore, key steps to better family planning services at this time include effective counseling and starting training programs.

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Introduction: A balanced and proper diet is an essential factor in maintaining individual’s health. The improvement of feeding in different age groups, especially children, is considered a significant step in primary health care.

Materials and Methods: This research is a descriptive and analytic study. A sample of 225 mothers whose babies were between 0-24 months and who were referred to selected centers were chosen, using random sampling. The tool was a questionnaire. To analyze the data, the descriptive statistical, frequency distribution charts, the mean and central tendency as well as inferential statistics (2 test and Pearson correlation) were applied.   

Results: The findings of the research showed that there is a meaningful relation between variables of age, occupation, the method of the last delivery, inclination of mother to the breast feeding, age of fetus at the time of birth, hospitalization of the neonate, the time of first breast feeding after the childbirth, the quality of baby’s nutrition while he is hospitalized, the quality of the baby’s first nutrition, the time of starting aid-feeding, using the aid-milk and using the pacifier by the baby with the duration of breast feeding. Such a relationship was also found between husband’s idea about the breast feeding, examination of the breast during the pregnancy, teaching the advantages of the breast feeding and its correct method during the pregnancy, the place of the last childbirth, teaching the importance and the correct method of breast feeding after the childbirth, an encouraging and supporting husband concerning breast feeding, presence of the mother and the baby in a same-room after the childbirth, manner of arranging the intervals and times of the breast feeding, breast feeding during the night, renewed pregnancy and the duration of breast feeding in each session with the duration of breast feeding.

Conclusion: According to the findings of the research, different factors affect duration of the breast feeding. Necessity of the midwife’s attempt to instruct mothers during pregnancy and after childbirth was affirmed. The necessity of instruction of the medical groups about breast feeding is also made clear more than before.

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Introduction: Obesity is a problem to individual’s health and determintion of its causative factors is essential for prevention of obesity and maintenance of health.
Materials and Methods: This research is a case-control analytic study (prospective) which has been conducted in kindergartens and pre-elementary schools affiliated to health organization in Qazvin city. After a preliminary study on twenty 5-6 year-old children, 35 obese (case) and 70 normal (control) children were chosen. The kindergartens and pre-elementary schools were selected based on random cluster case-picking method. The tools were a questionnaire, tape meter and spring scale. The obesity was defined as a weight/ height ratio more that two standard deviation above average for sex. The statistical tests were 2, t test and Mann-Whitney test.
Results: The findings showed that the individual characteristics of the child, except weight birth and playing hours, were congruous in case and control groups. Also there was no significant difference between milk-feeding patterns in case and control groups, 77.1% and 85.7% dominant feeding on mother's milk, 20% and 8.6% feeding on formula and 2.9% and 5.7% feeding jointly on mothers milk and formula, respectively. In case of length of each feeding pattern group, no meaningful difference in two groups was found. Therefore all the survey hypotheses were rejected.
Conclusion: According to the research findings, no meaningful relationship between feeding patterns in infancy and obesity in 5-6 year-old children was found and hence probably other factors are playing a role in predisposing to obesity. It is recommended that more extensive researches being carried out in this field.

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Introduction: Pregnancy is a natural phenomena and basis of birth but can induce various dangers to mother and fetus. Since mother is the central part of family, maternal mortality would be an irreparable damage to the community. On average 10100 live births and 12 maternal mortalities occur in Kurdestan province each year the maternal mortality rate is therefore 118/100000 live births which in comparison to similar figure in whole country (37/100000 live births) is three times higher.

Materials and Methods: This research is an analytic case-control study. Cases and controls were matched for place of residence and age at gestation. Cases (n=55) were chosen by census and controls (n=220) were chosen by random sampling. The tool used to collect data was questionnaire, validity and reliability of which was tested by content validity and test-retest method. The statistical testing used in this study were Chi square and odds ratio. Data were analyzed by SPSS .11 software.

Results: Most of maternal mortalities had occurred in women 18-35 years of age, illiterate and living in rural areas. Marivan had the highest maternal mortality compared to other surveyed cities (29.1%). Prenatal care (OR= 22.7), parturition agent (OR= 9.85), use of one of the method of family planning (OR= 2.5) and parturition method (OR= 2.3) had meaningful relationship with maternal mortality.

Conclusion: According to findings of this research, it is possible to decrease the maternal mortality by improving prenatal care and family planning and preventing parturition by uneducated midwives and avoiding unnecessary cesarian sections.

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Background & Aim: Labor pain is one of the most intensive type of pain and regarding its control still is a problem in many countries. The aim of this study is to investigate the effect of transcendental meditation on pain and length of active phase of labor in primiparous women.

Methods & Materials: This study configured as a semi-experimental clinical trial work. Samples was selected by convenient sampling method and contained as 90 primiparous women’s (45 case and 45 control) whom refer to clinic and delivery room in Fatemieh Hospital of Hamadan. Samples were divided into two random group and accomplished to experience and observation transcendental meditation method used for training pregnant woman within third trimester of pregnancy (28th-30th week) and performed by them for two time a day during 10 to 15 minutes. The case and control groups were matched according their age, education and occupation case and control group were confined to bed when they were in the beginning of active phase (3-4 cm of dilatation). Collecting of data, questionnaire information of biophysical and other equipment for recording biophysical developments and other McGill instrument was used to record severity of pain. Reliability and validity instrument in the prior researches have been test. The length of active phase was measured over maternal and recorded.

Results: The results of this study showed that there is significant differences in the level of pain at the beginning of first, second and third hour of active phase of labor in case and control group (p<0.001). Also, the length of active phase of labor showed significant difference between case and control group (p<0.001). Although, the body temperature and systolic blood pressure in two group showed no significant differences but there was meaningful differences in diastolic blood pressure (p<0.029), however this differences was in normal range. Regard to rate of breathing significant differences has been shown in case and control group (p<0.006).

Conclusion: Transcendental meditation in participated samples over this research among the mothers agony experience group has less pain within all active phase hours.

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Background & Aim: Working conditions in some professions particularly among health care providers result in exposure to various stressors in daily work life that can affect mental health status. Regarding specific conditions that midwives encountered in their workplace, this study investigates mental health status among midwives working in Tehran&aposs public hospitals and its related factors.

Methods & Materials: In this cross-sectional study all midwives working in Tehran&aposs public hospitals who had inclusion criteria (n=370) were studied. Data were gathered using GHQ-12 questionnaire and then were analyzed using chi-square statistical test.

Results: The results showed that 35.1% of subjects had not good mental health. Midwives&apos mental health was significantly related to their educational level (P<0.001), economic statue (P=0.04), marriage status (P<0.001) and shift work (P=0.02).

Conclusion: Regarding high prevalence of poor mental health status among midwives, it is recommended to investigate related occupational factors in order to improve working conditions of midwives working in hospitals.

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Background & Aim: Menopause is an important event in women&aposs lives. By increasing life expectancy, women spend about one-third of their lives in menopausal stage. Lack of knowledge about self-care and unhealthy life style in menopause women result in many of serious damages in this period. This study is to determine the effect of educating self care strategies on knowledge and practice of menopausal women.

Methods & Materials: This is a semi-experimental study. A total of 81 women were selected using convenience sampling method. All women completed an 11-item questionnaire covering demographic information, medical history, lifestyle and current symptoms and their severity. The women completed pre- and post-intervention (at the baseline and 6 weeks later) questionnaire which assessed knowledge and beliefs about menopause and a number of health-related behaviors. The intervention included giving information and group discussion about menopause, stress management, health behaviors (smoking, exercise, diet) and treatment choices.

Results: The results indicated that at the baseline, 22.2% had poor knowledge, 64.2% had average and 13.6% had good knowledge. Following the educational intervention, none of the respondents had poor knowledge. 27.5% were at average and 72.5% were at good level of knowledge.

Conclusion: According to the findings, education had strong effect on promoting the respondents&apos knowledge about self-care strategies. We believe the stronger efforts are needed to promote good health-related behaviors for these women.

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Background & Aim: Postpartum depression is a severe and pervasive sadness with labile mood that affect 8-15% women after delivery. It can negatively impress mother-infant bonding. There are a lot of factors which make women vulnerable to postpartum depression so that controlling them can prevent from the postpartum depression incidence. Several researches have shown an association between serum cholesterol reduction and depression. The aim of present study is to determine relation between postpartum depression with total serum cholesterol changes before and after child birth in Lahijanian women in years 2006-2007.

Methods & Materials: This research sought a descriptive-analytical design. Samples consisted of healthy Primigravidia women (101 persons) with normal labor, normal delivery at term, married, and a medium to high socio-educational level, without history of a depressive disorder, and metabolic disorders or hyperlipidemia. The excluded were the women with maternal or fetal complication before delivery, having problem with accepting infant gender, fetal death and being depressed during pregnancy. All women were visited in two stages: 3 weeks before the expected delivery and also 6 weeks after delivery. On both visits the Beck depression inventory and serum cholesterol registration questionnaire were completed. Data were collected using a questionnaire which had three sections: demographic characteristics, the Beck depression inventory and laboratory tests. Data were analysed using descriptive and inferential statistics (Spearman correlation coefficient and t-test) by SPSS computer software.

Results: Findings indicated that serum cholesterol declined considerably in the postpartum period, also it was shown that there was a significant correlation between reduced serum cholesterol and postpartum depression (r=-0.331, P<0.001).

Conclusion: Serum cholesterol reduction has a relation with postpartum depression.

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Background & Aim: Pregnancy and post-partum period are accompanied by important changes in women&aposs quality of life. Patient counseling is an effective way to improve quality of life. This study aimed to assess the effect of telephone counseling on the quality of life among women with a normal vaginal delivery in Razi hospital in Marand.
Methods & Materials: In this randomized clinical trial, 260 women were recruited to the study. The participants who had met the inclusion criteria were randomly allocated in two intervention and control groups. The intervention group (n=130) received telephone counseling twice at the first week for 20 minutes and then once a week from the 2^nd week to the 6^th week. Moreover, we had provided a 24-hour hotline for women. The control group (n=130) received the routine care. Data were gathered using a demographic sheet, a postpartum problem&aposs checklist, and the SF-36 quality of life questionnaire. Data were analyzed using SPSS-13.
Results: The results showed no significant differences in physical and mental quality of life in the first day of post-partum between two groups. The women&aposs quality of life in both physical and mental dimension were significantly higher in the intervention group in the 42^nd day after childbirth (P<0.001).
Conclusion: Telephone counseling by midwives could help to improve women&aposs quality of life in post-partum period. More studies are recommended.

 

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Background & Aim: Infants are very sensitive and special attention is needed to take care of their physical and mental health. Some studies showed that massage by parents can improve infants&apos sleep quality. The aim of this study was to compare the effect of massage with sunflower oil or sesame oil on infants&apos crying and sleep times.

Methods & Materials: This triple-blinded clinical trial was conducted on 120 infants who were 10-15 days old, full-term, single, exclusively breastfed and with no history of hospitalization. The infants were assigned randomly into three groups of sunflower oil massage, sesame oil massage and massage with no oils. Mothers administered 15 minutes of massage to their infants twice per day (morning and afternoon) for 28 days. Times of crying and sleep were measured by a parents&apos information form at baseline, and at the end of the first, second, third, and fourth weeks of the study. Data were analyzed using the repeated measures ANOVA.

Result: Within four weeks of following, decreasing pattern of infants crying time was not significant (P=0.18) however, the mean of crying time between the three groups was significant (P=0.007). The interaction effect of crying time and groups was not significant (P=0.18). Increasing pattern of infant sleep time was statistically significant in the fourth weeks of the following (P<0.001) however, the mean of sleep time between three groups was not significant (P<0.56). The interaction effect of sleeping time and groups was not significant (P<0.10).

Conclusion: Since there were not statistical significant differences between the infants&apos crying and sleep times between the three groups, and despite the fact that increasing pattern of infants sleep time is a normal pattern, it is not possible to have a proper conclusion.

 

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Background & Aim: Hypothermia is a main side effect during surgery in which blood pressure, heart rate, intra cranial pressure, oxygen consumption, pain and discomfort increase. The rate of cesarean section in Iran is three times more than global standard. This study aimed to investigate effect of pre-warmed intravenous fluid therapy on prevention of shivering after general anesthesia in cesarean section.

Methods & Materials: A total of 62 women undergoing general anesthesia for elective cesarean section were randomly allocated into two intervention and control groups. In the intervention group, patients received pre-warmed serum (37°C) and in the control group, patients received serum at room temperature (25.5°C). The postoperative shivering and some homodynamic parameters of the participants were assessed in recovery room.

Results: The mean of body temperature in the intervention and control groups were 35.9°C±0.48 and 35.42°C±0.6, respectively (P<0.05). The incidence of post operative shivering in the intervention and control groups were 13% and 35%, respectively (P<0.05).

Conclusion: Infusion of pre-warmed serum (37°C) would prevent postoperative shivering and could improve nursing care for women underwent general anesthesia in cesarean section.

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Background & Aim: The physiologic childbirth program in Iran is an emerging program that needs to be evaluated like any other program to improve its quality and process. Evidence suggests that the implementation of the physiologic childbirth program faces some challenges. The present research aimed to explore the challenges of the physiologic childbirth program from the perspective of service providers.
Methods & Materials: This qualitative research was carried out through a content analysis method in two mother-friendly hospitals of Ahwaz and Mashhad in 2016-2017. Data were collected through semi-structured interviews with 17 physiologic childbirth service providers. The content analysis method of Elo and Kyngas was used for qualitative data analysis.
Results: Data analysis led to five main categories: low motivation of midwives in performing physiologic childbirth; barriers related to manpower; medical interventions in physiologic childbirth; challenges from the environment and facilities; and educational barriers.
Conclusion: Different challenges in interaction with each other create a complex environment in which the implementation of physiologic childbirth program becomes more difficult. Therefore, policymakers, authorities, doctors, midwives and mothers need to work in a coordinated way to resolve the mentioned challenge.
 

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Background & Aim: Sexual function is an important part of the health of women, and the satisfaction of basic psychological needs is among the variables related to sexual dysfunction. The self-determination theory is one of the most important motivational theories, which considers one’s internal motive the main cause of behavior, and also views three psychological needs (autonomy, relatedness, and competence) as the basis of human behavior. This study was to determine the effect of sexual consulting based on the self-determination theory on women’s sexual function.
Methods & Materials: This clinical trial was conducted on 104 married women aged 18 to 49 years referred to Mashhad health centers in two groups of intervention and control in 2019. The intervention group received five sessions of two-hour group counseling based on the constructs of self-determination theory, with intervals of one week. The data was collected using the sexual performance questionnaire and the constructs of self-determination theory (basic psychological needs) before and after the intervention. Data was analyzed using the SPSS software version 16 through independent t-test, paired t-test, Mann-Whitney and Wilcoxon tests.
Results: There was no statistically significant difference between the two groups in the average score of sexual function before the intervention. However, after the intervention, the difference in the average score of sexual function between before and after the intervention was 2.76±3.02 for the intervention group and -0.25±0.73 for the control group, which showed a significant increase in the sexual function score of the intervention group compared to the control (P<0.001). Moreover, after the intervention between the intervention and control groups, a statistically significant difference was observed in the average scores of autonomy, competence and relatedness (P<0.001).
Conclusion: Providing group sexual counseling based on the self-determination theory can satisfy the basic needs relating to sexuality and improve women's sexual performance.
Clinical trial registry: IRCT20180726040602N1