[Evaluating the effect of oral bromelain [pineapple] on episiotomy wound healing in primiparus women]

Episiotomy is the most common perineal incision in midwifery to facilitate the expulsion of the fetus. Perineal damages cause disability in many normal daily activities. The purpose of this study was to determine the effect of bromelain on episiotomy wound healing in primiparus women. In this double-blind clinical trial study, 82 primiparus women referred to Ahvaz Amiralmomenin hospital were randomly assigned to receive bromelain [100 mg] and placebo. The initial dose of bromelain was administered 2 hours after delivery. Tablets were given three times a day for six days. Wound healing was measured by REEDA scale on 3[th], 7[th] and 14[th] day after delivery. Data were analyzed using independent T-test, Chi-square and Mann-Whitney tests. The average scores of wound healing in bromelain group were significantly lower than placebo group on 3[th], 7[th] and 14[th] day after delivery [P=0.001]. There was a significant difference in total wound healing between the two groups on 14[th] day after delivery [P=0.001]. Bromelain has a significant effect on better and faster healing of episiotomy wound. Hence, it can be used to accelerate episiotomy wound healing

Educational needs in premarital counseling: viewpoints of couples referring to health care centers in Mashhad

In recent years, premarital programs are considered important in order to promote the quality of married life. This study was performed to determine the educational needs in premarital stages from the viewpoints of married couples referring to health care centers of Mashhad. This descriptive cross-sectional study was performed on 223 couples [n = 446] referring to health centers in Mashhad during the years 2006-2007. The data gathering tool was a questionnaire containing 2 forms. The first form included 8 demographic questions and 4 questions related to samples' viewpoints about the way of holding sessions. The second form included 47 questions on 7 areas including fertility, family planning, congenital diseases, prevalent cancer prevention, sexual relationships, relationship with spouse and family, and Islamic and legal issues and 2 open questions were dedicated to other viewpoints of couples. Descriptive statistics and t-test were used for analyzing the data. The need to education in all areas was higher than average in both groups. Comparing the scores in 7 areas showed no significant difference between males and females. The most important need in both groups was concerning the relationship with spouse and family [3.97 +/- 0.067 in females and 3.95 +/- 0.077 in males]. Couples have a tendency for more education in the field of relationship with spouse and family, and are willing to increase the number of educational sessions to 3 or 4. Males and females had felt the need for providing educational programs in the mentioned priorities

[ comparison of the acupressure and pyridoxine effect on severity of both nausea and vomiting in primigravida women]

Gastric disorders especially nausea and vomiting are the most common complaint during pregnancy. Previous studies have shown that nearly 20% of pregnant women visited physician for these problems. The aim of this study was to compare the effect of acupressure and Vit. B6 [pyridoxine] on reduction of nausea and vomiting in primigravida women. In a clinical trial study, 100 women with gestational age of 10-16 weeks and single fetus were randomly selected from primigravida women who referred to antenatal care centers of Ahvaz for nausea and vomiting. Then they were allocated to acupressure [n=50] or pyridoxine group [n=50]. Treatment with acupressure or pyridoxine was carried out for four days. In acupressure group sea band was placed on the neiguan [p6] point of hand and in pyridoxine group, each patient had 40 mg of Vit. B6 every day. Severity of nausea and vomiting was recorded by each subjects. Data was analyzed by Chi-square, Manwithney, Wilcoxon and t-tests. Our results showed that nausea score and frequency of vomiting were decreased significantly by both treatments [p<0.001]. Also acupressure was significantly more effective in reduction of vomiting frequency [p<0.001]. The severity of nausea was not different in two groups. Our results showed that acupressure was more effective than Vitamin. B6 in treatment of pregnancy vomiting. Regarding the fact that sea band is cheap, comfortable, available and easily use, it is recommended to reduce vomiting in pregnancy

[corelation between engagement time of fetal head in early active phase and delivery outcome in primigravida women]

Engagement that is the passage of fetus head through the pelvic inlet is one of the main stages of delivery. There is a controversy about the engagement time in different resources. The main objective of this descriptive study is to determine a possible correlation between engagement time of fetal head and delivery outcome in primiparous women.This descriptive study carried out on 471 primiparous women. The inclusion criteria were minimum height 145cm, documented term gestation 37-42 weeks, vertex presentation, single fetus, spontaneous onset of labor, cervical dilatation 4cm or less and lack of any complications. At the onset of active labor, 386 women had unengaged and 85 of them had an engaged fetal head. The data were analyzed by using t and X[2] tests.Our results significantly showed that unengagement of fetal head conferred a longer active phase as well as a longer second stage of labor [p=0.001]. Furthermore, an increased need for oxytocin was observed in women with an unengaged fetal presentation [p=0.04], but the delivery method of labors, length of third stage of labor, first and fifth minute Apgar score in two groups showed no significant differences. This study showed that unengaged fetal head in early active phase although increases the duration of delivery but it does not increase delivery complications [cesarean section rate, fetal distress and low Apgar score]