Practice of Iranian adolescent girls regarding puberty and menstrual hygiene and its predictors, 2013

Adolescence is a unique period in life cycle. During this period, adolescents face with many behavioural challenges. This study aimed to determine adolescent girls' practice regarding puberty and menstrual hygiene, as well as its relationship with socio-demographic characteristics. This cross-sectional study was conducted on 1017 female students who were studying at second and third grade of secondary schools in Tabriz, 2013. Samples were selected randomly. Questionnaires used in the study were the practice and socio-demographic questionnaires. General linear model was used to determine predictors of practice. Mean [SD] of practice score in adolescent girls was 64.2 [12.1] from attainable score of 0-100. More than half of students [56.7%] had moderate practice. According to adjusted general liner model, variables of being in second class, having a father with elementary education or illiterate, living in undesirable economic status, having peer groups and friends as main source of information, having insufficient information about puberty had negative relationships with practice score. While, there was a positive relationship between age at menarche and practice score [P<0.05]. The findings show that the practice of adolescents about puberty and menstrual hygiene is moderate. Thus, it is necessary to educate the girls about puberty and menstrual hygiene to enable them to have a healthy reproductive life in future

Effect of Hypericum perforatum L. compared with metronidazole in bacterial vaginosis: A double-blind randomized trial

Objective: To compare effect of Hypericum perforatum (H. perforatum) vaginal gel with metronidazole on bacterial vaginosis (BV) in terms of initial response to treatment and preventing recurrence (primary outcomes) and also patient complaints (secondary outcomes). Methods: In this double-blind, double dummy trial, married women aged 18-49 with BV were randomized into two groups and administered 5 g of 3% H. perforatum and placebo of metronidazole (n=82), or 5 g of 0.75% metronidazole and placebo of H. perforatum (n=80) vaginally for 5 d. Amsel criteria were used for diagnosis and assessing cure and recurrence of BV. The comparisons was done using Chi-square, Fisher's exact and logistic regression. Results: At 10-12 d, cure rate was 82% in the H. perforatum and 85% in metronidazole group (risk ratio 0.9, 95% confidence interval 0.6 to 1.3). Among the cured women, recurrence rate was 9% in the H. perforatum and 13% in the metronidazole group at the 30-35 d visit (risk ratio 0.8, 95% confidence interval 0.4 to 1.3). There was no statistically significant difference between the groups regarding any patient complaints, except itching which was less in H. perforatum group (5% vs. 16%, P=0.018 at the first and 13% vs. 43%, P < 0.001 at the second follow-up). No significant adverse event was reported at any groups. Conclusions: H. perforatum could be a good option for treatment of BV. However, further studies are needed for its public use.

Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial / 中西医结合学报

<p><b>BACKGROUND</b>Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area.</p><p><b>OBJECTIVE</b>The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>In this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratified block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d.</p><p><b>MAIN OUTCOME MEASURES</b>Perineal pain and wound healing were assessed using visual analogue scale (0-10) and Redness, Edema, Ecchymosis, Discharge, Approximation scale (0-15), respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors.</p><p><b>RESULTS</b>Follow-up rate was 100% up to the 8 h time point in both groups, and 86% (62 of 72) in the cinnamon group and 85% (61 of 72) in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was significantly lower than that in the placebo group at (4±1) h (adjusted difference: -0.6, 95% confidence interval: -1.0 to -0.2) and (8±1) h (-0.9, -1.4 to -0.3) after intervention, and on the 10-11th day after delivery (-1.4, -2.0 to -0.7). Also the cinnamon group showed significantly more improvement than the control group in healing score at (8±1) h (-0.2, -0.4 to -0.04) and the 10-11th day after delivery (-1.6, -2.0 to -1.1).</p><p><b>CONCLUSION</b>Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.</p>

Facilitators and inhibitors of health promoting behaviors: the experience of Iranian women of reproductive age

There is scant information on the facilitators and inhibitors of health promoting behaviors among reproductive aged Iranian women. This study aims to explore the experience of factors influencing health promoting behaviors among Iranian women of reproductive age from a qualitative perspective. This study was performed in Tehran in 2011, over about 8 months. Qualitative methods, specifically in depth interviews, were used to gather data on 15 women of reproductive age. Data continued to be collected until introduction of new information ceased. The interviews were recorded, transcribed verbatim, and analyzed by conventional content analysis. The reported factors were categorized into four main groups and 12 subgroups: [1] personal barriers [lack of time, school or work duties, lack of preparation or motivation, physical disability]; [2] socio environmental barriers [family responsibilities, environmental pressures, high costs and financial pressures]; [3] personal facilitators [personal interest and motivation, experience of disease]; and [4] socio environmental facilitators [family and social support networks, encouraging and motivating environment, media, and public education]. In these women's experience, factors influencing health promoting behaviors were either facilitators or inhibitors; most were inhibitors. The findings of this study show that, in addition to personal factors, the pursuit of health promoting behaviors is affected by socio environmental factors. These results will be useful in designing interventions and plans for women's health promotion that focus on the improvement of their environment and the modification of social factors

Effect of cervical wiping with sterile cotton on the quality of pap-smear

There are conflicting reports about the effect of wiping cervix with cotton on Pap-smear results. Therefore, we aimed to do a research about this subject. 234 eligible women attended to have Pap-smear at an educational hospital in Rasht, Iran, from July to September 2011, were allocated by block randomization into two groups. In the intervention group, we cleaned cervix with a sterile cotton rotating 360 degrees and obtained samples using spatula for exocervix and cytobrush for endocervix. This method was performed without cleaning the cervix on the control group. Data collection, vulvovaginal examination, laboratory assay were done by investigators masked to the group allocation. Participants were also blind. The data were analyzed using logistic regression in SPSS-13. Rate of sufficient endocervical cell of the slides in the intervention group was significantly higher than in the control group [70.3% vs. 57.8%, p=0.03]. In the intervention group 42.4% of the slides were satisfactory and 57.6% had limited quality for interpretation. These figures in the control group were 37.1% and 62.9%, respectively. This difference was not statistically significant. Also, there was no significant difference between the groups on rate of slides with inadequacy of squamous cells and obscuring 75% or more of the slides with inflammatory exudate or blood [p>0.05]. There were no significant differences between the groups on some quality indicators of the smears. However, frequency of smears with sufficient endocervical cells was higher in the group with cervical wipping. Therefore, it is recommended to clean cervix before obtaining the smears

Prevalence of water pipe use and its correlates in Iranian women of reproductive age in Tehran: a population-based study

The objective of this study was to determine the prevalence of water pipe smoking and its associated sociodemographic factors among Iranian women of reproductive age in Tehran. This was a population-based cross-sectional study of 1,359 Iranian women aged 15-49 years. The multistage random cluster technique was used to obtain the sample. Questionnaire-based interviews with questions relating to water pipe smoking and sociodemographic variables were used to collect the data. The multivariate logistic regression model was used to analyze the relationships between the dependent variable [water pipe smoking] and the independent variables [sociodemographic characteristics]. The prevalence of water pipe smoking was 6.3% among Iranian women. Water pipe smoking was more likely in the age range of 15-24 years [odds ratio [OR] = 4.8, 95% confidence interval [95% CI] = 2.7-8.6] compared to the age range of 35 years or older, in women with a university education [OR = 1.9, 95% CI = 1.3-3.0] compared to women with a high-school diploma or lower, and in women with an average crowding index score [OR = 4.7, 95% CI = 2.1-10.6] compared to women living in small families. The findings of this study show that Iranian women with a university education and the younger age group [15-24 years] were at most risk of water pipe smoking. The findings of this study about associated factors may contribute to the development of efficient health promotion programmes for the prevention and cessation of water pipe smoking

Knowledge, attitudes and practice about Pap smear among women reffering to a public hospital

The Pap smear is a reliable, inexpensive and effective screening test for cervical cancer; the second most common cancer among women worldwide. We aimed to determine women's knowledge, attitudes and practice towards Pap smear and barriers for the screening in a public hospital. This study, was carried out on 350 outpatient married women reffering for a visit at the clinics of the Alzahra educational hospital, Rasht- Iran, 2011. A questionnaire including demographic characteristics [24 questions], knowledge [14 questions], attitudes [11 statments] and practice [10 questions] towards Pap smear was completed by interview with the women. The data were analyzed using SPSS ver.13. Mean age of participants was 32 [SD 12] years. Of the respondents, only 44.3% were aware of the Pap smear and 27.1% had had it at least once in their life. The most common reason for having the test was physicians' or other health workers' advise and for not having the test was no recommendation by health providers and lack of knowledge about Pap smear. Embarrassing, fear of the test result or economic problems mentioned by only 12 [4.2%] as the main barrier. Mean [+/- SD] knowledge score of the women who had heard about the Pap smear was 59.4 [24.3] and attitudes score of all participants was 48.5 [11.6] from possible range score of 0-100. Women with a history of Pap smear had had higher awareness and attitudes score. The knowledge and practice of the women was inadequate and need to be promoted. Considering the main reason mentioned by the participants for not having the test, all health providers should educate and encourage women to do regular Pap smear

Comparison of continuation rates and reasons of discontinuation for cyclofem and depot -medroxyprogesterone acetate in rural areas of east Azerbaijan province, Iran

In this study continuation rate and reasons for discontinuation of Depot-medroxyprogestrone acetate [DMPA]and Cyclofem have been compared. A retrospective cohort study was conducted with 422 women [202 Cyclofemand 220 DMPA users]who had started using the methods 12-24 months before the study in East Azerbaijan health houses. Data were collected by reviewing the records and interview with the clients and analysed using Kaplan-Meier and Cox Regression. The 3, 6, 9, 12 months continuation rate were 56%, 37%, 30%, 27% respectively for Cyclofem versus 75%, 59.5%, 48%, 42.5% for DMPA. Menstrual changes were reported significantly more by the DMPA users than the Cyclofem users [85% vs. 73%, P=0.008] as the main reason for the discontinuation, the difference mainly reflected of amenorrhea [50% vs. 23%, P=0.003]. None of DMPA users and 11% of Cyclofem users claimed frequency of visits and lack of method supplies as their main discontinuation reason. Discontinuation rate was high for the both methods but it was higher for Cyclofem. The common side effects mentioned as the main reasons for discontinuation of the both methods are not health threatening. Therefore, health care providers may help to improve their continuation rate by appropriate consultation