Is there an association between platelet and blood inflammatory indices and the risk of gestational diabetes mellitus?

OBJECTIVE: Gestational diabetes mellitus (GDM) is the most prevalent medical complication in pregnancy. Early diagnosis of GDM can influence maternal/neonatal outcomes. To assess the association between platelet and blood inflammatory indices and the risk of GDM occurrence using the complete blood count (CBC) test. We also aimed to determine the sensitivity of each parameter for an early screening of this disorder during pregnancy.METHODS: This case-control study included 2 groups of 110 pregnant women with and without GDM. The women in each group were compared after the routine screening for GDM and after the CBC test at 24–28 weeks' gestation after being matched according to the inclusion criteria. Data were analyzed using SPSS version 16 and Medcalc version 14.8.1 software.RESULTS: There were statistically significant intergroup differences in white blood cell (WBC) count, platelet count, mean platelet volume (MPV), plateletcrit (PCT), MPV to platelet ratio, platelet to lymphocyte ratio, and Rh values. The values of lymphocyte count, neutrophil count, neutrophil to lymphocyte ratio, and blood group were not significantly different between groups. The logistic regression analysis showed the predictive values of WBC, platelet, MPV, and PCT in GDM. According to the receiver operating characteristic curve for all 3 variables, the level below the PCT chart was more than that of the others.CONCLUSION: Increasing platelet and inflammatory indices on the CBC test in the second trimester of pregnancy seemed to be associated with the probability of GDM occurrence.

Effects of aromatherapy with Rosa damascena on nulliparous women's pain and anxiety of labor during first stage of labor / 中西医结合学报

<p><b>BACKGROUND</b>Reducing labor pain and anxiety is one of the most important goals of maternity care.</p><p><b>OBJECTIVE</b>This study aimed to assess the effects of aromatherapy with Rosa damascena on pain and anxiety in the first stage of labor among nulliparous women.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>This was a randomized clinical trial of 110 nulliparous women. The eligible participants were randomly assigned to two groups of aromatherapy and control in an Iranian maternity hospital. The participants received 0.08 mL of Rosa damascena essence in the aromatherapy group and 0.08 mL of normal saline in the control group, every 30 min. Pain was measured 3 times, once each at three stages of cervical dilation (4-5, 6-7, and 8-10 cm). Anxiety was measured twice, once each at two stages of cervical dilation (4-7 and 8-10 cm). The tools for data collection were the Spielberger anxiety questionnaire, numerical pain rating scale, demographic and obstetric questionnaire, and an observational checklist. Data analyses included the t-test, Mann-Whitney U test and Chi-square test.</p><p><b>MAIN OUTCOME MEASURES</b>Severity of labor pain and severity of anxiety were used as primary outcome measures. Labor and delivery characteristics (including number of contractions, duration of contractions in second stage, Bishop score, augmentation by oxytocin, Apgar score, and mode of delivery), demographic characteristics, and fertility information were used as secondary outcome measures.</p><p><b>RESULTS</b>Pain severity in the group receiving aromatherapy with R. damascena was significantly lower than in the control group after treatment at each pain assessment (cervical dilation of 4-5, 6-7, and 8-10 cm; P < 0.05). Anxiety levels were also significantly lower in the treatment group than in the control group after treatment at each time of measurement (cervical dilation of 4-7 and 8-10 cm; P < 0.05).</p><p><b>CONCLUSION</b>Aromatherapy with R. damascena reduced the severity of pain and anxiety in the first stage of labor. Aromatherapy with R. damascena is a convenient and effective method for pain and anxiety reduction during the first stage of labor.</p><p><b>TRIAL REGISTRATION</b>Iranian Registry of Clinical Trial: IRCT201306258801N3.</p>

Prediction of adequate prenatal care utilization based on the extended parallel process model

Background: Pregnancy complications are one of the major public health concerns. One of the main causes of preventable complications is the absence of or inadequate provision of prenatal care. The present study was conducted to investigate whether Extended Parallel Process Model's constructs can predict the utilization of prenatal care services

Methods: The present longitudinal prospective study was conducted on 192 pregnant women selected through the multi-stage sampling of health facilities in Qeshm, Hormozgan province, from April to June 2015. Participants were followed up from the first half of pregnancy until their childbirth to assess adequate or inadequate/non-utilization of prenatal care services. Data were collected using the structured Risk Behavior Diagnosis Scale. The analysis of the data was carried out in SPSS-22 using one-way ANOVA, linear regression and logistic regression analysis. The level of significance was set at 0.05

Results: Totally, 178 pregnant women with a mean age of 25.31+/-5.42 completed the study. Perceived self-efficacy [OR=25.23; P<0.001] and perceived susceptibility [OR=0.048; P<0.001] were two predictors of the intention to utilize prenatal care. Husband's occupation in the labor market [OR=0.43; P=0.02], unwanted pregnancy [OR=0.352; P<0.001], and the need to care for the minors or elderly at home [OR=0.35; P=0.045] were associated with lower odds of receiving prenatal care

Conclusion: The model showed that when perceived efficacy of the prenatal care services overcame the perceived threat, the likelihood of prenatal care usage will increase. This study identified some modifiable factors associated with prenatal care usage by women, providing key targets for appropriate clinical interventions

[Comparison of energy-restricted high protein [HP] with standard-protein [SP] diets in women with polycystic ovary syndrome]

Some researchers administer a diet with a higher ratio of protein to carbohydrates [HP] in patients with polycystic ovary syndrome [PCOS], but there is a limited number of dietary interventions compared the effects of an HP diet with a standard protein [SP] diet. Therefore, the aim of this review was to compare the effects of energy-restricted HP diets with those of iso-calorically prescribed SP diets on anthropometric, metabolic, hormonal, and reproductive outcomes in women with PCOS. Searches for English-language studies published between 2000 and 2014 were conducted using PubMed, Science Direct, and Scopus databases to identify all randomized controlled trials that compared HP diet with SP diet. There was no difference in anthropometric outcomes between two different diets. There was no difference in reproductive outcomes between the two dietary treatments. Weight loss decreased testosterone, free testosterone, or FAI [Free Androgen Index] and increased SHBG, independent of prescribed diet. There was no difference in metabolic outcomes between the two dietary treatments. A standard-protein weight-loss diet reduced HDL- cholesterol, while no changes occurred for a high protein weight-loss diet. The high-protein diet reduced total cholesterol to HDL-C ratio. Weight loss, independent of diet composition, decreased fasting insulin, insulin resistance and Improvements in lipid profiles. High protein diet caused subtle and inconsistent changes in metabolic variables, and weight loss results in clinical benefit, regardless of diet composition, in women with PCOS

Psychological predictors of intention to deliver vaginally through the extended parallel process model: a mixed-method approach in pregnant iranian women

Despite the fact that cesarean delivery does not offer significant health benefits for either mother or newborn, there has been a noticeable upward trend in elective cesarean births in Iran, over the last two decades. This study aims to examine whether knowledge, perception of health threats, efficacy, and personal beliefs act as psychological predictors towards the intention of women to have a normal vaginal delivery. The mixed-method approach was used as quantitative and qualitative design. Simultaneously, 290 pregnant women who visited prenatal clinics participated in the study. Quantitative and qualitative data were collected using a structured questionnaire based on Witte's Extended Parallel Process Model, and four focus groups, respectively. Women perceived lower personal risk but higher levels of efficacy. Perceived self-efficacy, severity, and response efficacy emerged as significant predictors of intention to experience vaginal birth. The participants' insufficient knowledge and misconceptions about birth methods were prevalent. Major themes were identified and divided into negative and positive beliefs about vaginal birth. This educational model is useful for understanding women's intention to undergo a vaginal birth, especially when it is combined with a qualitative approach. Maternal care providers should acknowledge their clients' beliefs and intended childbirth methods prior to offering medical intervention.

Attitude of pregnant women, midwives, obstetricians and anesthesiologists toward mode of delivery: a qualitative study

To investigate the attitudes toward mode of delivery of pregnant women, midwives, obstetricians and anesthesiologists who participate in childbirth in Shahrood, Iran. This was a qualitative research with tri-angulations data collection strategy. The study sample was consisted of primiparous and multiparous women, midwives, obstetricians and anesthesiologists. A total of 18 women who seek prenatal care from Fatemiyeh obstetrics clinics during pregnancy, were asked to participate in 3 focus group discussions. 8 midwives in labour ward and clinic were interviewed individually. All of physicians were participate in study by Delphi method for data collection purpose. All interviews and discussions were tape recorded. The main themes were categorized into two main categories: [causes of intention to cesarean] and [causes of intention to vaginal delivery]. The main reason for intention to use cesarean was fear of pain due to vaginal delivery and the main reason for intention to use vaginal birth was fear of post cesarean pain and its morbidity. Other reasons that raise the cesarean section rate in Shahrood included, fear of legal complaints after vaginal birth complications fear of sexual disorders after vaginal birth, existing conflicts between midwives duties and obstetricians and negative attitudes. The results clearly show that although most of women and health providers do not consider cesarean section as the first option for delivery, but some essential obstacles remain as major reasons for increasing cesarean rate

Clinico-mycological profiles of dermatophytosis in Gorgan, North of Iran

Dermatophytes are a group of closely related fungi that invade keratinized tissues [skin, hair and nails] of humans and animals and produce infections called dermatophytosis. Our objective was to determine causative agents of dermatophytosis in Gorgan, North of Iran. Data was based on collecting specimens from 1108 patients clinically suspected to have fungal infection during five years from 2003 through 2007. Specimens were collected from hair, nail and skin and were investigated by direct examination and cultured in Sabouraud dextrose agar. Fungal colonies were identified by macroscopic and microscopic examination and supplementary tests. 351 samples out of 1108 were positive for dermatophytes and 277 ones had positive cultures. Epidemophyton floccosum was the most frequent species [70.4%] followed by Trichophyton rubrum [14.5%] and Microsporum audouinii [7.2%]. Regarding the location of the lesions, groin and nails were the most frequent sites that developed dermatophytosis in the majority of the patients. Dermatophytosis is probably still one of the most infectious diseases in Iran. The anthropophilic [E.fluoccosum] and zoophilic [T. rubrum] species were the most common causes of dermatophyte of tinea in Gorgan, north of Iran. The frequency of tinea was higher in females and tinea cruris showed a remarkably increasing rate and can be an important public health issue in Gorgan