[Sexual dysfunction and predisposing factors in women with multiple sclerosis]

Objective [s]: Sexual dysfunction [SD] in patients with multiple sclerosis [MS] is common, but often overlooked. The purpose of this study was to determine prevalence of sexual dysfunction and its predisposing factors in women with multiple sclerosis

Method: This was a cross sectional study. Participants were recruited from two MS clinics in Tehran. Sexual function and disability status were quantified by the Female Sexual Function Index-FSFI and Expanded Disability Status Scale [EDSS] respectively. Clinical characteristics and the extent of physical disability were examined by a neurologist. Data were analyzed by univariate and multivariate logistic regression

Results: In all 226 MS patients were studied. The mean age of participants was 35.77 years [SD = 8.07]. Sexual dysfunction were diagnosed in 125[55/3%] of participants. The most common sexual problem in women was arousal dysfunction [44/2%] and the lowest frequency of the dysfunction was sexual pain [12/8%]. Results obtained from multiple logistic regression analysis showed that MS patients with sexual dysfunction had lower educational status [Odds ratio=1.95 CI 95%= 1.957-0.998], insufficiency low [Odds ratio=3.94 CI 95%= 1.614-90619], more than 3 children [Odds ratio=4.659 CI 95%= 1.517-14.314] and Secondary Progressive MS-[SPMS] [Odds ratio=3.034 CI 95%= 1.447-6.362]

Conclusion: Awareness of sexual problems and related factors for the management and treatment of women with MS is necessary. It is suggested that sexual rehabilitation programs compiled as part of the comprehensive care of patients with MS

[Development of "intention to use oral contraception" questionnaire based on theory of planned behavior in women using withdrawal method]

Need assessment for promotion reproductive health is important subject and development a questionnaire is essential. Thus the aim of this study was development of questionnaire of intention to use of oral contraception in withdrawal users based on construct of Theory of Planned Behavior [TPB]. In-depth interviews were conducted to elicit the salient beliefs relevant to oral contraception among withdrawal users. Then a cross-sectional study carried out in Tehran, Iran for validate of questionnaire. Participants recruited from attending five family planning clinics of public health services in the Eastern district of Tehran, Iran. Validity and reliability was evaluated using concurrent, content validity and Cronbach's alpha and test- retest respectively. Factor structure of the questionnaire was extracted by exploratory factor analysis [EFA]. Confirmatory factor analysis [CFA] conducted to assess how well the EFA extracted model fits observed data. The SPSS version 16 and Lisrel programs were used to analyze the data. Reliability and validity were confirmed. The principal component analysis revealed a three-factor structure for the questionnaire including attitude, subjective norm and perceive behavior control that explained 50.4 percent of the total of variance. In general, the findings suggest that questionnaire of intention to use of oral contraception in withdrawal users based on Theory of Planned Behavior is a reliable and valid measure

[Comparison of sexual function between nulliparous with multiparous pregnant women]

Pregnancy can conflict with sexual function that can be affected by physical and psychological changes during pregnancy. The aim of this study was to compare sexual functions between nulliparous and multiparous pregnant women referred to health centers in Eastern district of Guilan. This cross-sectional study was carried out in Guilan during 2009-2010. We used convenient sampling method to select 554 pregnant women. Data were gathered using a questionnaire including demographic characteristics, sexual function and fear of harm to fetus. The SPSS-16 was used to analyze the data by the Mann-Whitney U and Generalized linear models. The level of significance was set at 5%. There was no significant difference between nulliparous and multiparous pregnant women regarding sexual function in the first and second trimesters of pregnancy [P=0.353, P=0.251]. There were significant differences between nulliparous and multiparous pregnant women regarding sexual desire [P=0.002], arousal [P=0.01], orgasm [P=0.01], pain [P=0.02] and sexual function total score [P=0.016]. There was significant difference between nulliparous and multiparous pregnant women regarding sexual function [P=0.008]. Sexual counseling and rehabilitation programs should be compiled as part of the comprehensive care of prenatal care especially for multiparous pregnant women

[Effect of Quran citation during third trimester of pregnancy on severity of labor pain in primiparas women: a clinical trial]

Objective [s]: To investigate the effects of Quran reading during third trimester on severity of labor pain in primiparas women

Methods: This was a randomized clinical trial. A sample of primiparas women attending a prenatal care centre in hospital, entered into the study. They were randomly allocated into two groups: the experimental group [n=41] included women who they were reading Quran from third trimester of pregnancy to normal spontaneous delivery [at least 30 times] whereas the control group [n=46] received routine care only. Severity of pain were determined by visual analogue scale in three cervical dilatation of 3-5, 5-8, 8-10 centimeter and second stage

Results: In all 87 women took part in this study. There were not differing between two groups in baseline characteristics. There were significant differences in severity of pain score between two groups in cervical dilatation of 3-5, 5-8, 8-10 centimeter [P=0.001, P=0.003, P=0.023 respectively] but there was no significance difference in severity of pain score in second stage [P=0.368]

Conclusion: This study provides evidence for the use of Quran reading is an acceptable and non- medical strategy for reducing the pain during labor at the first stage of delivery

[Women's perceptions of modern contraception methods: a quantitative study]

Objective[s]: Withdrawal contraception accompanied with high unwanted and morbidity .the aim of this study to gain of the knowledge, perceptions and experiences of using contraceptive methods withdrawal users to design effective effective intervention for them

Methods: In the first stage qualitative methods used to elicit questionnaire with 50 women .In the second stage cross-sectional study was performed 300 women attending to the health care centers in west Tehran were selected randomly. In the both of them women were not intended to become pregnant and use withdrawal contraception .data analyzed by using descriptive statistical tests

Results: They had used modern contraceptive methods before withdrawal in 70.7 percent .The mean withdrawal usage was 60.5 4.9 and modern contraceptive was 2.3 2.9 years. The most common source of information on modern contraceptive was health care providers and informal sources. The women are familiar with emergency contraception in 34 percent. Unwanted pregnancy related to withdrawal contraception was 33/7 percent. The most common beliefs related to oral pills nervousness [79.3%] obesity [26.7%] infertility [79.3%], IUD infection [34%] pregnancy [22.7%], spontaneous movement [21%] condom, pregnancy [73.7%] and three monthly injection, pregnancy [33.3%]

Conclusion: It was important that planners will be design family planning packages should contain programs to correct the wrong beliefs. Side effects of modern contraception should be as soon as possible recognizing. They counselors must be guided them .Positive attitude related to withdrawal contraception suggests that family planning programs disseminated essential information among this groups

[ implication of health belief model in planning educational programmes for preventing HIV/AIDS among university students]

To plan an educational program to prevent HIV/AIDS among university students based on Health Belief Model [HBM]. This descriptive cross-sectional study was conducted in Tehran University in academic year of 2004-2005. The instrument used was a questionnaire including demographic information, knowledge questions, health belief model constructs [perceived severity, perceived susceptibility, perceived benefits and barriers] and attitude towards HIV/AIDS patients, high risk behaviors questionnaire and intention to take HIV test. The participants were selected through stratified and systematic methods. Data were analyzed performing Chi-square test, Pearson correlation and one was ANOVA. In all 664 students participated in the study. The mean age was 18.74 +/- 8/1. according to self report,%4.1 were smoker,%2.9 used substance drugs,%1.5 suffered from sexual transmitted disease and HIV/AIDS.%26.4 believed that their knowledge is insufficient.%71.1 believed in having low risk of being infected. Almost all of the participants were highly aware of HIV/AIDS. The results also indicated that there was a significant relationship between the participants' knowledge and their perceived severity and susceptibility and benefits in term of willing to take the test. Lack of HIV voluntary counseling and testing center and feat of the test results were the main barriers of HIV test. The findings suggest that we need to educate and raise the people consciousness about the perceived benefits of HIV test, the way of giving the test results, and the contact details and services for voluntary counseling and testing centers