Association of childbirth experience with long-term psychological outcomes: a prospective cohort study.

BACKGROUND: There has been limited research on the lasting impact of giving birth on both mothers and infants. This study aimed to investigate women's memories of their childbirth experience 4 months and 4 years after giving birth. Additionally, it aimed to examine how the childbirth experience is linked to women's mental health, sexual satisfaction, exclusive breastfeeding, and the type of subsequent birth. METHODS: In this prospective cohort study, a total of 580 women giving birth in Tabriz hospitals in 2018 were followed up for 4 years. The data were collected using a childbirth experience questionnaire, a mental health inventory, and a sexual satisfaction scale for women, and were analyzed by a Pearson correlation test, an independent samples t-test, and a general linear model. RESULTS: The total scores of the childbirth experience in two short-term (4 months) and long-term (4 years) time points following the birth had a significant and strong correlation with each other (r = .51; p < .001). After adjusting for the effects of socio-demographic and obstetric characteristics, sexual satisfaction had significant relationships with childbirth experience (p < .001) and postpartum complications (p < .001). In addition, mental health had significant relationships with childbirth experience (p < .001), postpartum complications (p < .001), and low income (p = .004). CONCLUSIONS: Even 4 years after giving birth, women have a clear recall of their childbirth experience. This experience has a significant association with long-term outcomes such as sexual satisfaction, mental health, exclusive breastfeeding, and subsequent birth type.

Childbearing is a significant event in a mother's life. Women often remember the births of their babies distinctly, even after many years. However, some mothers do not perceive this life event as a positive one. Factors affecting this perception are multidimensional and may include demographic variables and obstetric events (e.g., immediate postpartum complications like hemorrhage), which contribute to negative childbirth experiences. It's important to note that women who feel unsupported or lack control during labour and childbirth are more likely to have negative birth experiences. Although a birth experience is influenced by various factors, this can have serious consequences, such as mental health problems, disrupted mother-infant bonding, and reluctance to have subsequent pregnancies or initiate or continue breastfeeding. Therefore, this study mainly aimed to investigate women's recollection of their childbirth experience at 4 months and 4 years after giving birth, as well as examine the correlation of childbirth experience with women's mental health, sexual satisfaction, exclusive breastfeeding, inclination to have children, and the type of next birth 4 years after the childbirth.

Consumption of probiotic yogurt and vitamin D-fortified yogurt increases fasting level of GLP-1 in obese adults undergoing low-calorie diet: A double-blind randomized controlled trial.

Energy restriction and manipulation of macronutrient composition of the diet are the main approaches that are used by people who aim to lose weight. When such strategies are employed, appetite and endocrine regulators of satiety, such as gut peptides, all are deeply affected. The gut microbiota-brain axis controls energy homeostasis in humans by affecting central satiety and gut peptides. The purpose of this study was to evaluate if the synergistic effect of probiotics and vitamin D in yogurt matrix can modulate this effect. In the double-blind, randomized, placebo-controlled trial, 140 obese adults were randomly allocated into four groups: 1) regular yogurt plus low-calorie diet; 2) PY plus low-calorie diet; 3) vitamin D-fortified yogurt plus low-calorie diet, and 4) probiotic and vitamin D co-fortified yogurt plus low-calorie diet. All groups were encouraged to increase their physical activity. Glucagon-like peptide-1 (GLP-1), peptide Tyrosin-Tysrosin (PYY), ghrelin, anthropometric variables, insulin, fasting blood sugar (FBS), insulin resistance/sensitivity, 1,25(OH)2 D3, dietary intake, and physical activity were measured before and after 10 weeks. The difference between groups for GLP-1 after 10 weeks was significant after adjusting for baseline GLP-1 and protein intake as confounders. PY showed the largest effect size (ES) on GLP-1 (p = 14.2) and FBS (p = 14) compared with others. Pairwise comparison of yogurts effect sizes on GLP-1 showed a significant difference in group 1 vs. group 2 (p = .001), group 1 vs. group 3 (p = .003), and group 1 vs. group 4 (p = .048). Vitamin D-fortified yogurt had the largest effect size on the serum level of vitamin D and it showed a significant difference with RY (p = .018) and PY (p = .002). Consumption of vitamin D-fortified yogurt and PY could be regarded as a promising approach during calorie restriction.

Prevalence of peripheral artery disease in patients with infectious diabetic foot ulcer in Imam Reza Hospital in Kermanshah during 2019-2020.

BACKGROUND: Diabetes mellitus (DM) is one of the main public health troubles diabetic foot ulcer (DFU) is one of the most important and relatively common causes of hospitalization. This study investigates the prevalence of peripheral artery disease (PAD) in Imam Reza Hospital of Kermanshah during 2017-2018. MATERIALS AND METHODS: This study is descriptive-analytical. The study population was 196 cases with infectious DFUs admitted to Imam Reza Hospital of Kermanshah during 2019-2020. The presence or absence of PAD was assessed in these cases. The collected data were analyzed by SPSS software (version 18.0). RESULTS: Among 196 patients studied, 120 (61.22%) patients had PAD. The prevalence of PAD was higher in men than in women and it was more common in Type 2 DM patients than in Type 1 DM patients. The majority of ulcers were located on the nonplantar surface of the foot. Moreover, the prevalence of PAD had a significant relationship by increasing the duration of diabetes (P = 0.041), history of amputation (P = 0.002), history of diabetic foot (P = 0.006), and peripheral neuropathy (P = 0.005). CONCLUSION: A considerable number of diabetic patients with DFU had PAD. This necessitates more intense interventions to manage PAD as a strong risk factor for DFU in diabetics. Neurovascular assessment of diabetic patients and early diagnosis of PAD may be appropriate interventions to prevent development of DFUs. We recommend trial studies to find out the best methods to address early detection of PAD in diabetics.

Phytotherapeutic management of polycystic ovary syndrome: role of aerial parts of wood betony (Stachys lavandulifolia).

Pharmacological treatments of polycystic ovary syndrome (PCOS) have side effects. We compared the efficacy and safety of the aerial parts of wood botany (AWB) with those of Medroxyprogesterone acetate (MPA) in the management of abnormal uterine bleeding (AUB) due to PCOS. We conducted a randomized clinical trial of 66 women aged 15-45 years, with AUB. Participants were randomly assigned to either cyclical 10-mg BD MPA for three cycles or 5 g ABW TDS for three months. Clinical symptoms and paraclinical parameters were recorded before and 3 months after initiation of the treatment. Comparisons were made using generalized linear models. Age-adjusted prevalence rate of different patterns of AUB, decreased from 2.7 (95%CIs: 0.6-48.0) to 1.1 (95%CIs: 0.1-18.3) for patients taking MPA, and from 2.5 (95% CIs: 0.2-40.2) to 0.7 (95%CIs: 0.0-12.1). Decrease in prevalence rate was similar across two arms of the study (P value = 0.248). Adverse effects were observed less frequently (24.2%) among participants on MPA than among those on AWB (45.5%). The multivariate-adjusted odds for developing adverse reaction of MPA was 0.40 (95%CIs: 0.14-1.19, P value = 0.099) time odds of AWB. In conclusion, AWB may be used as an alternative for MPA in the treatment of AUB caused by PCOS.

Diagnostic value of chemical shift artifact in distinguishing benign lymphadenopathy.

PURPOSE: Today, distinguishing metastatic lymph nodes from secondary benign inflammatory ones via using non-invasive methods is increasingly favorable. In this study, the diagnostic value of chemical shift artifact (CSA) in magnetic resonance imaging (MRI) was evaluated to distinguish benign lymphadenopathy. SUBJECTS AND METHODS: A prospective intraindividual internal review board-approved study was carried out on 15 men and 15 women having lymphadenopathic lesions in different locations of the body who underwent contrast-enhanced dynamic MR imaging at 1.5 T. Then, the imaging findings were compared with pathology reports, using the statistics analyses. RESULTS: Due to the findings of the CSA existence in MRI, a total of 56.7% of the studied lesions (17 of 30) were identified as benign lesions and the rest were malignant, whereas the pathology reports distinguished twelve malignant and eighteen benign cases. Furthermore, the CSA findings comparing the pathology reports indicated that CSA, with confidence of 79.5%, has a significant diagnostic value to differentiate benign lesions from malignant ones. CONCLUSION: Our study demonstrated that CSA in MR imaging has a suitable diagnostic potential nearing readiness for clinical trials. Furthermore, CSA seems to be a feasible tool to differentiate benign lymph nodes from malignant ones; however, further studies including larger numbers of patients are required to confirm our results.

Predicting pressure ulcer risk: comparing the predictive validity of 4 scales.

OBJECTIVE: To compare the predictive validity of 4 pressure ulcer risk assessment tools. METHODS: Prospective clinical design in which 230 subjects free of pressure ulceration on admission were assessed using the Braden, Gosnell, Norton, and Waterlow scales within 48 hours of admission. Subjects' skin condition was assessed once every 24 hours for a minimum of 14 days to identify any skin breakdown. RESULTS: Based on Youden's index, the Gosnell Scale had better predictive validity in identifying patients at risk for pressure ulcer development (J = 68%). The other scales did not predict individuals at risk with high accuracy, despite having high sensitivity and specificity. CONCLUSION: Numerous pressure ulcer risk assessment tools have been developed, but sufficient evidence for using one tool over another does not exist. In this study, the Gosnell Scale was found to be more appropriate for application in patients with neurologic and orthopedic conditions. CLINICAL RELEVANCE: Being able to predict which patients are at risk for pressure ulcers can assist practitioners in tailoring care to prevent unnecessary complications and suffering, as well as reduce costs.