The Effectiveness of Herbal Medicines on Cyclic Mastalgia: A Systematic Review on Meta-analysis / A eficácia dos medicamentos fitoterápicos na mastalgia cíclica: Uma revisão sistemática em metanálise

Abstract Objective Different drugs are used to treat mastalgia, such as danazol and bromocriptine, and both are associated with side effects, due to which most of women and healthcare providers are interested in herbal medicines. Therefore we aim to study the effectiveness of phytoestrogens on the severity of cyclic mastalgia. Methods To carry out the present study, English electronic resources such as the Cochrane Library, ISI Web of Science, Scopus, and PubMed were used systematically and with no time limitation up to February 10, 2020. Results In total, 20 studies were included in the present meta-analysis. The results of the meta-analysis showed that herbal medicines versus the control group (standard mean difference [SMD] = - 0.585; 95% confidence interval [CI]: - 0.728-- 0.44; heterogeneity; p = 0.02; I2 = 42%), herbal medicines versus the B group (SMD = - 0.59; 95%CI: - 0.75-- 0.44; heterogeneity; p = 0.03; I2 = 42%), and its subgroups, such as phytoestrogen (SMD = - 0.691; 95%CI: - 0.82-- 0.55; heterogeneity; p = 0.669; I2 = 0%), Vitex-agnus-castus (SMD = - 0.642; 95%CI: - 0.84-- 0.44; p < 0.001; p = 203; I2 = 32%), flaxseed (SMD = - 0.63; 95%CI: - 0.901-- 0.367; p = 0.871; I2 = 0%), and evening primrose (SMD= - 0.485; 95%CI:- 0.84-- 0.12; p = 0.008; heterogeneity; p = 0.06; I2 = 56%] may have effective and helpful effects on improving cyclic breast mastalgia. Also, chamomile, isoflavone, cinnamon, and nigella sativa significantly reduced mastalgia symptoms. Conclusion Herbal medicines and their subgroups may have effective and helpful effects on improving cyclic breast mastalgia. The findings of our meta-analysis must be done cautiously because low methodological quality in some evaluated studies of this systematic review.

Resumo Objetivo Diferentes drogas são utilizadas para tratar a mastalgia, como danazol e bromocriptina, e ambas estão associadas a efeitos colaterais, devido aos quais a maioria das mulheres e dos profissionais de saúde está interessada em medicamentos fitoterápicos. Portanto, nosso objetivo no presente estudo é estudar a eficácia dos fitoestrogênios na gravidade da mastalgia cíclica. Métodos Para a realização do presente estudo, foram utilizados recursos eletrônicos em inglês como a Cochrane Library, ISI Web of Science, Scopus e PubMed, de forma sistemática e sem limitação de tempo até 10 de fevereiro de 2020. Resultados No total, 20 estudos foram incluídos na presente metanálise. Os resultados da metanálise mostraram que fitoterápicos versus grupo controle (SMD = - 0,585; intervalo de confiança (IC) 95%: - 0,728-- 0,44; heterogeneidade; p = 0,02; I2 = 42%), fitoterápicos versus grupo B (SMD = - 0,59; IC95%: - 0,75-- 0,44; heterogeneidade; p = 0,03; I2 = 42%) e seus subgrupos, como fitoestrogênios (SMD = - 0,691; IC95%: - 0,82-- 0,55; heterogeneidade; p = 0,669; I2 = 0%), Vitex-agnus-castus (SMD = - 0,642; IC95%: - 0,84-- 0,44; p < 0,001; p = 203; I2 = 32%), linhaça (SMD = - 0,63; IC95%: - 0,901-- 0,367; p = 0,871; I2 = 0%) e prímula (SMD = - 0,485; IC95%: - 0,84-- 0,12; p = 0,008; heterogeneidade; p = 0,06; I2 = 56%) podem ter efeitos eficazes e úteis na melhora da mastalgia cíclica da mama. Além disso, camomila, isoflavona, canela e Nigella sativa reduziram significativamente a mastalgia. Conclusão Os medicamentos fitoterápicos e seus subgrupos podem ter efeitos eficazes e úteis na melhora da mastalgia mamária cíclica. Os achados do presente estudo devem ser explantados com atenção devido ao pequeno número de estudos existentes sobre o tema, a maioria dos quais com um tamanho de amostra pequeno.

Overview of the Effect of Complementary Medicine on Treating or Mitigating the Risk of Endometriosis / Visão geral do efeito da medicina complementar no tratamento ou mitigação do risco de endometriose

Abstract Objective Endometriosis is a hormone-dependent chronic inflammatory disease with symptoms such as pelvic pain, which affect the physical, emotional, and social health of women in reproductive age. The current overview article aims to explore the effect of complementary medicine on the treatment or in mitigating the risk of endometriosis. Methods This is an overview article done in Iran. Two separate researchers systematically searched 3 databases (Medline, Scopus, and Cochrane Central Register Trials) until September 2020. The methodological quality of each study was assessed using the assessment of multiple systematic reviews (AMSTAR) tool. Results The results of two reviews suggested that physical activity, tobacco smoking, diet, coffee and caffeine intake had no effect on mitigating the risk of endometriosis or improving its treatment, but acupuncture successfully reduced pain and related marker (serum CA-125) levels. Conclusion As endometriosis is an annoying disease with many complications and is hard to diagnose and treat, related studies in complementary medicine can help patients with endometriosis. Based on the relevant literature review, among the complementary medicine available for the treatment or to mitigate the risk of endometriosis, only acupuncture seems to alleviate the pain of endometriosis.

Resumo Objetivo A endometriose é uma doença inflamatória crônica hormono-dependente com sintomas como dores pélvicas, que afetam a saúde física, emocional e social de mulheres em idade reprodutiva. O presente artigo de visão geral tem como objetivo explorar o efeito da medicina complementar no tratamento ou na mitigação do risco de endometriose. Métodos Trata-se de um artigo de visão geral feito no Irã. Dois pesquisadores separados pesquisaram sistematicamente 3 bancos de dados (Medline, Scopus e Cochrane Central Register Trials) até setembro de 2020. A qualidade metodológica de cada estudo foi avaliada usando a ferramenta avaliação da qualidade dos relatos de revisão sistemática (AMSTAR, na sigla em inglês). Resultados Os resultados de duas revisões sugeriram que atividade física, tabagismo, dieta, consumo de café e cafeína não tiveram efeito na redução do risco de endometriose ou na melhoria do tratamento, mas a acupuntura reduziu com sucesso a dor e os níveis de marcadores relacionados (CA-125 sérico). Conclusão Como a endometriose é uma doença incômoda, com muitas complicações e de difícil diagnóstico e tratamento, estudos relacionados em medicina complementar podem ajudar pacientes com endometriose. Com base na revisão da literatura relevante, entre os medicamentos complementares disponíveis para o tratamento ou risco de endometriose, apenas a acupuntura parece aliviar a dor da endometriose.

Barriers to Puberty Talk between Mothers and Daughters: A Qualitative Study

Abstract Objective The aim of the present study is to explain the barriers to puberty talk between mothers and daughters. Methods In the present study, the conventional content analysis method was used. The present study was conducted from September 2018 to August 2019 in Iran. The study population consisted of mothers and adolescent girls. The data was collected using purposeful sampling method. The sample consisted of 4 mothers and 6 girls that were interviewed using semistructured interviews. Data collection continued until data saturation was achieved. Data analysis was conducted as described by Graneheimet al. using NVivo 11 software. Results In the present study, after exploring the views of the participants about barriers to puberty talk between mothers and daughters, one dominant theme emerged. Puberty talk is seen as an "inappropriate talk with a girl." There were several subthemes, including "lack of mother's awareness regarding the school role, the busy schedule of the mother, and the adoption of alternatives to mother's talk with girls". Conclusions Different sociocultural factors affect puberty talk between mothers and adolescent girls. It is important thatmothers and policymakers take these barriers intoaccount.

The effect of dialectic behavioral counseling on depression, anxiety, and postpartum hematocrit levelprotocolo 20210073553284 prefeitura

Abstract Objective Childbirth is a biological, psychological, and sociological event that can be a positive or negative experience, and, without support, this period may be potentially damaging. Parturition may distort maternal emotions and lead to short- or long-term disorders such as postpartum depression and anxiety. The present research aims to study the effects of dialectic behavioral therapy-based counseling on depression, anxiety symptoms, and postpartum hematocrit level. Methods The current research is a clinical trial study, and the sample was selected using parturients who were referred to the Health General Center with a diagnosis of postpartum depression and anxiety. The sample size consisted of 116 subjects who agreed to participate in the study. The patients in intervention group underwent group dialectic behavioral counseling (10 sessions/one session per week) and the control group did not receive any type of intervention. The patients were assessed in the first and last sessions as well as 2 months after the end of the sessions, using the Beck depression scale and Spielberg anxiety scale as well as the results of hematocrit tests. Data were analyzed using the IBMSPSS Statistics for Windows, Version 21.0 (IBMCorp., Armonk, NY, USA) Results The results implied the effectiveness of dialectic behavioral therapy on reduction of the depression score, anxiety symptoms (p-value ≤ 0.0001), and hematocrit level (p-value=0.04). The participants' depression, anxiety, and hematocrit levels decreased in the experiment group compared to the control group, and this decrease has remained until the 2-month follow-up. Conclusion It seems that dialectic behavioral counseling reduces the levels of postpartum depression, anxiety, and hematocrits.

The effectiveness of psycho-educational and cognitive-behavioral counseling on female sexual dysfunction

Abstract Introduction Sexual function is a multidimensional phenomenon that is affected by many biological and psychological factors. Cognitive-behavioral sex therapies are among themost common nonpharmacological approaches to psychosexual problems. The purpose of the present study was to investigate the effectiveness of psychoeducational and cognitive-behavioral counseling on female sexual dysfunction. Methods The present study was a clinical trial with intervention and control groups. The study population consisted of women referring to the general clinic of a governmental hospital in Iran. After completing the demographic questionnaire and Female Sexual Function Index (FSFI), those who obtained the cutoff score ≤ 28 were contacted and invited to participate in the study. Convenience sampling method was used and 35 subjects were randomly allocated for each group. Eight counseling sessions were held for the intervention group (two/week/1.5 hour). Post-test was taken from both groups after 1 month, and the results were statistically analyzed by PASW Statistics for Windows, Version 18 (SPSS Inc., Chicago, IL, USA). Results The total mean scores of FSFI and the subscales of sexual desire, arousal, orgasm, and satisfaction were significantly higher in the intervention group than in the control group after the intervention. In addition, postintervention pain mean scores in the intervention group were significantly lower than in the control group (p < 0.05). Conclusion The results of the present study indicate that psychoeducational cognitive- behavioral counseling is effective in improving female sexual function. It is recommended to compare the effects of psychoeducational cognitive-behavioral counseling on sexual dysfunctions of couples and with a larger sample size in future research.