Quality of life questionnaire for women with gestational diabetes mellitus (GDMQ-36): development and psychometric properties.

BACKGROUND: Gestational diabetes mellitus carries serious risks to mother and fetus and causes social, mental, and psychological consequences which can affect mothers' quality of life. Accordingly, this study aims to develop and assess the psychometric properties of quality of life questionnaire for women with gestational diabetes mellitus. METHODS: A methodological study of sequential exploratory mixed method was developed and implemented. It included qualitative (development of a quality of life questionnaire for mothers with GDM) and quantitative (assessment of psychometric prosperities of quality of life questionnaire for mothers with GDM) phases. RESULTS: Based on the findings of the qualitative phase and literature review, the primary questionnaire was prepared with 142 items. The outcome of face validity and content validity assessment was a 67-item questionnaire. S-CVI and S-CVR turned out to be 0.92 and 0.68, respectively. The results of exploratory factor analysis yielded an instrument with 36 items in five domains including concerns about high-risk pregnancy, perceived constraints, disease complications, medication and treatment, and support. Five factors explained 46.68% of the total variance of the questionnaire. The results indicated a moderate and significant correlation between the questionnaire of "Diabetes Clients Quality Of Life" and the researcher-made questionnaire (r = 0.63). Cronbach's alpha coefficient for the entire scale was 0.93 and the intra-class correlation coefficient was 0.95. CONCLUSION: Quality of life questionnaire for mothers with GDM is a valid and reliable tool capable of measuring the quality of life of women with GDM.

Corrigendum to "Comparison between Fluconazole with Oral Protexin Combination and Fluconazole in the Treatment of Vulvovaginal Candidiasis".

[This corrects the article DOI: 10.5402/2012/375806.].

The impact of a sexual enhancement program on the sexual function of postmenopausal women.

OBJECTIVES: To examine the effects of sex education on sexual function in postmenopausal women. METHODS: A randomized clinical trial was carried on 104 postmenopausal women, aged 40-60 years, residing in the cities of Chalus and Nowshahr, Iran. Their sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. The participants were randomly assigned to two groups: (1) intervention, in which the subjects received a sexual enhancement program with weekly follow-ups; and (2) controls, who received general educational material on postmenopause. Both groups were re-assessed after 12 weeks using the FSFI questionnaire. RESULTS: There were no significant differences between the two groups in terms of demographic and socioeconomic characteristics, or their total scores of FSFI, in the initial stage of the study. After implementation of the sexual enhancement program, however, the total scores of sexual function, as well as the scores in the arousal and pain domains, were significantly higher in the intervention group, compared to the control group (24.41 vs. 22.70, 3.35 vs. 2.73, and 4.50 vs. 3.98, respectively). CONCLUSION: Sexual function of postmenopausal women can be improved by a sexual enhancement program.

Correlation between Kind of Delivery and Posttraumatic Stress Disorder.

BACKGROUND: Posttraumatic stress disorder (PTSD) is a very common mental condition and a unique anxiety disorder. AIM: The present study tried to examine the correlation between kind of delivery and PTSD. SUBJECTS AND METHODS: This prospective study evaluated 240 Iranian female residents of Tehran, Iran, during the third trimester of their pregnancy and 6-8 weeks after labor. Data were collected using the customized screening form, the Symptom Checklist-90, PTSD Symptom Scale (PSS), and Social Support Questionnaire. The collected data were then analyzed with SPSS software. RESULTS: According to the participants' responses to the subscales of the PSS, reexperiencing, avoidance, and hyperarousal symptoms were present in 100, 25, and 77 participants, respectively. Moreover, 15 individuals manifested all three groups of symptoms. Therefore, the prevalence of PTSD in the studied population was 6.2%. The logistic regression analysis revealed PTSD to be 0.06 times more prevalent in women with poor social support after delivery than in those enjoying a desirable level of support (P < 0.01; odds ratio = 0.06). Based onChisquare test results, there was no significant correlation between the kind of delivery and the incidence of PTSD after delivery (P = 0.48). CONCLUSION: Since PTSD was more common after cesarean sections (than after vaginal deliveries), health policymakers need to develop efficient strategies to promote vaginal delivery.

Daily intake of vitamin D- or calcium-vitamin D-fortified Persian yogurt drink (doogh) attenuates diabetes-induced oxidative stress: evidence for antioxidative properties of vitamin D.

BACKGROUND: Both poor vitamin D status and oxidative stress (OS) have been independently associated with late diabetic complications, including cardiovascular disease (CVD). The present study aimed to examine the effect of daily intake of vitamin D alone or in combination with calcium as a fortified Persian yogurt drink (doogh) on OS over 12 weeks. METHODS: Ninety patients with type 2 diabetes aged 30-50 years from both sexes were randomly allocated to one of the three groups to receive two 250-mL bottles of doogh a day, which was either plain (PD; containing 150 mg per 250 mL of calcium and no detectable vitamin D), vitamin D-fortified (DD; containing 150 mg of calcium + 500 IU vitamin D per 250 mL) or calcium-vitamin D-fortified (CDD; 250 mg od calcium + 500 IU vitamin D per 250 mL). RESULTS: Although mean (SD) serum concentrations of protein carbonyl significantly decreased in both DD and CDD groups [-2.07 (4.39) nm, P = 0.015 and -4.4 (7.64) nm, P = 0.003, respectively], the change in PD group was not significant [-0.54 (6.96) nm, P = 0.674]. A similar pattern was observed for cardiac myeloperoxidase [PD: -19.4 (75.9) µg L(-1) , P = 0.173; DD: -21.8 (54.2) µg L(-1) , P = 0.035, CDD: -48.5 (76.9) µg L(-1) , P = 0.002]. Superoxide dismutase increased significantly only in DD and CDD [56.9 (74.0) U L(-1) , P < 0.001 and 51.6 (119.9) U L(-1) , P = 0.025, respectively]. Changes of serum advanced glycation end-products showed a significant between-group difference among PD, DD and CDD [239.4 (388.4) U L(-1) , -58.1 (147.6) U L(-1) and -143.7 (475.9) U L(-1)  × 10(3) , respectively, P = 0.003], which remained significant after controlling for changes of fasting serum glucose (P = 0.013) and glycated haemoglobin (P = 0.015). CONCLUSIONS: The findings of the present study demonstrated an OS attenuating effect of vitamin D. However, extra calcium did not convey additional benefit.

The challenges of female adolescents' health needs.

Due to adolescents' future crucial roles, their health needs should be included in the national health system policy. In this cross-sectional study 2010 female adolescents were recruited from randomly selected schools in Iran. To obtain their health needs, the participants completed a self-administrated questionnaire. It was revealed that emotional needs were the most important health needs of adolescents. Furthermore, there was a meaningful relationship between health needs' score with the adolescents' age and their mothers' education level. Finally, the mean score of health needs was significantly higher in urban adolescents. Therefore, it is suggested that adolescents' emotional health needs to be paid attention; otherwise irrecoverable serious problems may occur in the next generation's health.

Comparison between Fluconazole with Oral Protexin Combination and Fluconazole in the Treatment of Vulvovaginal Candidiasis.

Background. According to the limited studies reporting new treatments for vulvovaginal candidiasis, this study was designed to compare the combination of fluconazole and oral protexin with fluconazole in the treatment of vulvovaginal candidiasis. Methods. A double-blind clinical trial was conducted, involving 90 women who were referred to the gynecology clinic. Vulvovaginal candidiasis was diagnosed with itching, cheesy vaginal discharge, and any one of the following: dysuria, pH < 4.5, dyspareunia, vulvar erythema, or vulvar edema and if branched hyphae and Candida buds were visible after addition of KOH 10% in the culture and the result of cultivation in Sabouraud's dextrose agar medium was positive. Patients were randomly classified into two groups Absence of discharge, itching, and negative culture results 5-7 days after completion of treatment indicated treatment success. Data in this study were analyzed using the SPSS version 17.0 software. Results. The combinations, fluconazole-oral protexin and fluconazole-placebo, were equally effective in reduction of complaints and symptoms, but fluconazole-oral protexin combination elicited a better therapeutic response (χ(2) = 6.7, P = 0.01). [corrected] In addition, fluconazole-oral protexin combination treatment demonstrated better recovery time (t = -2.04, P = 0.04). Conclusion. This study demonstrated that complementary treatment with probiotic Lactobacillus increased the efficacy of fluconazole in treatment of vulvovaginal candidiasis. Further research is recommended.

Correlation between anthropometric indices at birth and developmental delay in children aged 4-60 months in Isfahan, Iran.

BACKGROUND: Advances in medical knowledge and treatment modalities have resulted in an increased survival rate for high-risk infants. This increased number of survivors enables study of the future development of these children. Other than infection and trauma, developmental and behavioral problems are the most common medical problems among such children. This study sought correlations between anthropometric indices at birth and developmental delay in children aged 4-60 months who visited health service centers affiliated with the Isfahan University of Medical Sciences in 2010. METHODS: In this descriptive, correlational study, 401 children aged 4-60 months and visiting health service centers were selected using a multistage method. Anthropometric indices at birth were collected from their health care records, and developmental status was measured using the Ages and Stages Questionnaire, the validity (0.84) and reliability (0.94) of which were obtained from a previous study. RESULTS: The mean age of the children in the normal group was 17.33 ± 13.18 months and that in the developmental delay group was 29.92 ± 19.19 months. Most children in the normal group were female (56%) and in the developmental delay group were male (55.2%). No correlation was found between height and head circumference at birth and developmental delay. However, the birth weight of children with developmental delay was four times lower than that of children with normal development (P = 0.004, odds ratio 4). CONCLUSION: Birth weight and male gender were factors that strongly correlated with developmental delay in this study.

Socially-deviant middle eastern women at a great risk of poor reproductive health.

BACKGROUND: It is important to examine scale and scope of the reproductive health among socially-vulnerable women. The study was aimed at testing the hypothesis that as compared to general population, reproductive health is poorer among socially-vulnerable women. METHODS: We enrolled 100 cases and 203 controls conducted from January 2010 to January 2011. Cases were socially-vulnerable women seeking care from Tehran's Center for Improving Social Health of Socially-Damaged Women (Specific Center for Socially-Vulnerable Women). Controls were women referring to health centers of Tehran. RESULTS: Mean age of cases and controls were 34.1 years and 33.8 years, respectively. Unwanted pregnancy was reported by 62.9% of cases and 33% of controls. Among socially-vulnerable women, 50.6% of abortions were reported to happen during the period in which they were using drugs. Among cases, 45.7% reported to give birth to low birth weight newborns and for controls was 11.7%. Among cases with low birth weight child, 64.9% used drug during pregnancy. Birth control was reported by 81.5% of cases and 92.8% controls. The most common method of contraception was condom among both cases (66%) and controls (31.2%). At least one screening test for cervical cancer was reported by 82.8% of controls and for 47% of cases. Mean age at first sexual intercourse was 15.7 years among cases and 20.9 years among controls. Mean Sexual Performance Scale score was lower among cases (22.3) than controls (25.9) and sexual dysfunction was more prevalent among cases (80.6%) than controls (59.1%). CONCLUSION: A high prevalence of reproductive health disorders was documented among socially-damaged women as compared to the women from general population.

The effect of reflexology on pain intensity and duration of labor on primiparas.

BACKGROUND: Reflexology is an ancient, mild and non-invasive technique, used widely as one of the non-pharmacological methods for pain relief. The aim of this research was to determine the effect of reflexology on pain intensity as well as to determine the duration of labor in primiparas. METHODS: In 2008, a randomized clinical trial study was conducted randomly enrolling 120 parturient women with low risk pregnancy into three groups in Shahid Akbarabadi Hospital, Tehran, Iran. The first group received 40 minutes of reflexology at the beginning of active phase (4-5 cm cervical dilatation). Emotional support was offered for the second group in the same stage of pregnancy and with the same duration. The third group received only routine care during labor. Pain severity was evaluated with visual analogue scale (0 to 10 cm). In all groups, pregnant women were asked to evaluate the severity of pain experienced before and after intervention and also at cervical dilatations of 6-7 cm and 8-10 cm respectively. Data were collected through the numerical pain scale. RESULTS: Pain intensity at all the three stages of cervical dilatation was significantly lower in the reflexology group. During the 4-5 cm dilatation stage, women in the supported group reported less severe pain compared to those receiving routine care, but no significant differences at the later stages of labor. This indicates that reflexology could decrease the duration of first, second and third stages of labor. CONCLUSION: Our findings showed that reflexology can be useful to decrease the pain intensity as well as duration of labor.