The effect of iron supplementation on menstrual bleeding volume and hemoglobin level during menstrual bleeding : A randomized clinical trial.

BACKGROUND: Many women around the world avoid taking iron supplements during their menstrual bleeding, thinking that menstrual bleeding will increase after taking these supplements. Due to the lack of relevant scientific evidence in this regard, this study was performed to determine the effect of iron supplementation on menstrual blood volume and hemoglobin level during menstrual bleeding. MATERIALS AND METHODS: In this three-blind randomized clinical trial, 160 non-anemic female students of Rafsanjan University of Medical Sciences were selected through a public call and then they were randomly assigned to two intervention and control groups. The intervention group was given a ferrous sulfate tablet containsing 50 mg of elemental iron daily in the first four days of bleeding for three consecutive menstrual cycles, and the control group received a placebo simultaneously. Before and after the intervention, the level of hemoglobin was measured and the Higham chart was completed in each menstrual cycle by the participants of the two groups. The obtained data were analyzed using the SPSS software version 21 and Chi-square, independent t-test, paired t-test, analysis of variance with repeated measures, and nonparametric tests. RESULTS: Before performing the intervention, the mean Higham score and hemoglobin level of the two groups were not statistically significant (P = 0.307, P = 0.670). The mean Higham score after each intervention was not statistically significant between the two groups over time or when considering the interaction of the time group (P = 0.77, P = 0.916). The hemoglobin level of these two groups did not change significantly after the intervention compared with that before the intervention (P = 0.444). CONCLUSION: Compared with a placebo, taking iron supplements containing 50 mg of elemental iron during the first four days of menstrual bleeding in non-anemic women did not change the volume of menstrual bleeding and hemoglobin level.

Effect of misoprostol with and without evening primrose (Oenothera biennis) on induction of missed abortion.

Objective: To determine whether addition of evening primrose to a misoprostol-based abortion regimen can increase the success of abortion. Materials and Methods: In this randomized clinical trial., 148 women referring to Niknafas Hospital in Rafsanajn with diagnosis of missed abortion were randomly allocated into two 74-subject groups. The intervention group used 2000 mg vaginal evening primrose capsules the night before the hospitalization, while the control group did not receive any medication. Both groups received an initial dose of 800 µg of vaginal misoprostol after admission and the next dose was given three hours later if necessary. Results: The two groups had significant differences in terms of full abortion, consistency and dilatation of cervix, duration between the first dose of misoprostol until the ejection of fetus, the misoprostol dose administered, and the level of vaginal bleeding during the hospitalization. They had no significant differences regarding curettage, duration of hospitalization, or side effects. The mean pain score had no significant difference between the two groups, though the score was lower in the intervention group (p>0.05). Conclusion: Administration of vaginal evening primrose before vaginal misoprostol was found to be more effective compared to misoprostol alone in missed abortion.

Relation between sexual function, perceived social support, and adherence to treatment with infertility factor in women: A cross-sectional study.

Background: In some societies, childbearing is a part of women's identity and infertile women are under a great amount of pressure from others. Objective: This study aims to evaluate the relationship between infertility factors and sexual functioning, perceived social support, and adherence to treatment in infertile women. Materials and Methods: In this cross-sectional study, 230 infertile women who referred to the infertility center of Shahrekord, Iran in 2022 were enrolled. Data were collected using demographic characteristics checklist, female sexual function index, multidimensional scale of perceived social support, and general adherence scale. Results: No significant relation was observed between the infertility factor and the mean score of sexual function, the mean score of perceived social support, and the mean score of adherence to treatment (p > 0.05). Among the aspects of sexual functioning, only the mean score of lubrication in the group of male factors was significantly higher than the common factors for men and women (p = 0.07). A linear positive relation was observed between sexual functioning (r = 0.189), perceived social support (r = 0.200), and adherence to treatment (r = 0.146) in infertile women. Conclusion: By providing proper training and counseling to infertile couples, we can improve their social support and sexual function so that they can complete their infertility treatment as a result.

Knowledge and experience of midwives and gynecologists about manual rotation of persistent occiput posterior position.

BACKGROUND: management of persistent occiput posterior position has always been controversial. Manual rotation by a delivery operator can reduce instrumental delivery and cesarean section. AIM: This study aims to determine the knowledge and experience of midwives and gynecologists about manual rotation of persistent occiput posterior position. METHODS: This descriptive cross-sectional study was performed in 2022. The questionnaire link was sent to 300 participating midwives and gynecologists via WhatsApp Messenger. Two hundred sixty-two participants completed the questionnaire. Data analysis was performed using SPSS22 statistical software and descriptive statistics. RESULTS: 189 people (73.3%) had limited information about this technique, and 240 (93%) had never performed it. If this technique is recognized as a safe intervention and is included in the national protocol, 239 people (92.6%) want to learn, and 212 (82.2%) are willing to do it. CONCLUSION: According to the results, the knowledge and skills of midwives and gynecologists need to be trained and improved for manual rotation of persistent occiput posterior position.

The Effect of Palm Pollen Extract on Sexual Disorders in Postmenopausal Women: A Randomized Clinical Trial.

Background: Considering the numerous nutritional and estrogenic compounds of palm pollen and their effect on sexual function, this study was performed to investigate the effect of palm pollen extract on sexual disorders in postmenopausal women. Methods: In this three-blind clinical trial, 110 postmenopausal women from December 2019 to December 2020 from Rafsanjan comprehensive health service centers were randomly assigned to two groups, using a lottery method. The intervention group received 300 mg capsule of palm pollen extract, and the control group received placebo for 4 weeks. Sexual disorders were assessed with a 6-item female sexual function index before, at the end of the intervention, and 4 weeks after the end of the intervention. Independent t-test, Chi-square and repeated measures ANOVA were used to analyze the data through SPSS software version 21. The statistically significant level was considered P value less than 0.05. Results: The mean scores of sexual disorders before the intervention in the intervention and control groups were 15.36±5.01 and 14.13±4.67 (P=0.68); at the end of the intervention, they were 15.18±4.50 and 14.22±3.91 (P=0.43) and 4 weeks after the end of the intervention we obtained 15.7±4.77 and 14.44±3.78, respectively (P=0.90). Conclusions: According to the results, daily consumption of 300 mg of date pollen extract had no effect on improving sexual disorders in postmenopausal women. Further studies in this field are suggested.Trial Registration Number: IRCT20160308026971N1.

Comparison of pregnancy outcome during pandemic of COVID-19 and non-pandemic situations, Yazd, Iran, in 2019-2020.

This study aimed to compare the pregnancy outcomes during pandemic and non-pandemic COVID-19 in women referred to health service centres in Yazd. This descriptive study was performed based on the information obtained from all pregnant women referred to comprehensive health service centres in Yazd city using census method, between March 21 2019 and December 21 2019 and between March 20 2020 and December 20 2020. The pregnant mothers' information, including their pregnancy outcome, and maternal and neonatal complications, was extracted from the electronic health information system of Yazd city. The obtained data were analysed by Chi-Square test. No significant difference was found between non-pandemic and pandemic COVID-19 situations in most variables. As well, maternal and neonatal death were equally observed in both non-pandemic and pandemic COVID-19 situations. Wanted pregnancy, post term birth, multiple pregnancy and caesarean section rates were found to be higher in pandemic than non-pandemic COVID-19 (p<.001). Reported abortion, screening for foetal anueploidy in the first and second trimesters as well as the number of episodes of prenatal care during COVID-19 pandemic were significantly lower than those of non-pandemic period (p<.001). The outcome of pregnancy during the pandemic was not significantly different from that of non-pandemic situation.Impact StatementWhat is already known on this subject? Studies already showed COVID-19 in pregnancy alter the maternal and neonatal outcomes in different degrees compared with pregnant individuals without COVID-19. However, it is not clear that pregnancy outcome dose alter during pandemic of COVID-19 compared to non-pandemic situations in general population?What do the results of this study add? The results of this study revealed that the outcome of pregnancy during pandemic was not significantly different from that of non-pandemic situation.What are the implications of these findings for clinical practice and/or further research? According to results of this study, we can ensure pregnant women in the situation of pandemic COVID-19 that they are not in greater risk. We suggest future research should be done for comparison of pregnancy outcome in the situation of delta variant pandemic with non-pandemic COVID-19.

The role of health beliefs and health literacy in women's health promoting behaviours based on the health belief model: a descriptive study.

BACKGROUND: Health literacy and health beliefs are factors that can effectively contribute to adoption of preventive behaviors among women. The present study was done to explore the role of health beliefs and health literacy in women's health promoting behaviors based on the health belief model (HBM). METHODS: The descriptive study was conducted in 2020 on 431 female students of Rafsanjan University of Medical Sciences (RUMS) who had been selected through stratified sampling. Data collection tool was a questionnaire which covered eight demographic information, 41 health literacy questions and 50 researcher-developed questions of health belief based on HBM constructs. Data were collected electronically and SPSS version 20 and independent t-test, one-way ANOVA, Pearson correlation coefficient and Multiple Linear Regression were used for data analysis at a significance level less than 0.05. RESULTS: The preventive behaviors were adopted by 75.57% of the population and the total health literacy score was found to be 52.71 out of 100. According to the Multiple regression analysis, self-efficacy (ß = 0.414, p = 0.001) and cues to action (ß = 0.299, p = 0.001) were found to be the first and second robust predictors of behavior, respectively. Health literacy, self-efficacy, cues to action and perceived susceptibility constructs predicted 52.1% of preventive behaviors. CONCLUSION: It is recommended that researchers design, implement and evaluate interventions based on behavioral change theories, especially the self-efficacy theory, in order to promote women's health.

The effect of walking during late pregnancy on the outcomes of labor and delivery: A randomized clinical trial.

BACKGROUND: Exercising during pregnancy has various benefits for the mother and the fetus, but there are controversial results about its effect on labor and delivery. Therefore, the present study was conducted to evaluate the effect of walking during late pregnancy on the outcomes of labor and delivery. MATERIALS AND METHODS: The present randomized clinical trial was conducted on 102 pregnant women who were referred to the comprehensive health service centers of Rafsanjan and were selected using convenient sampling method and randomly were allocated into two groups from August 2018 to February 2019. The intervention group performed walking from the 34th week of pregnancy until the time of delivery 4 times per week, each time for 40 min. The control group just received the routine prenatal care. Information about the outcomes of delivery were gathered from the participants' medical files in the hospital and were analyzed using SPSS software version 22 and Chi-square and independent t-tests. RESULTS: The results indicated that the Bishop score of the intervention group was significantly higher than the control group (P < 0.05). Furthermore, regarding the duration of the third phase of delivery, spontaneous labor, induced labor, cesarean section , and instrumental delivery, a statistically significant difference was observed between the intervention and the control groups (P < 0.05). There was no statistically significant difference between both the groups regarding the duration of the first and the second stages of delivery and Apgar score at 1st and 5th min (P > 0.05). CONCLUSIONS: Walking during late pregnancy could improve Bishop score, increase spontaneous onset of labor, and decrease induction, cesarean, and instrumental delivery without having any adverse effect on the neonate's Apgar score.

The effect of ketamine on preventing postpartum depression.

Postpartum depression is a common disabling psychosocial disorder that could have adverse effects on the life of the mother, infant, and family. The present study was conducted to evaluate the effect of ketamine on preventing postpartum depression in women undergoing caesarian sections considering the relatively known positive effect of ketamine on major depression. The present double-blind, randomized clinical trial was conducted on 134 women undergoing scheduled caesarian sections. Participants were randomly allocated into two groups of control and intervention. To induce anesthesia, 1-2 mg/kg of body weight of Nesdonal and 0.5 mg/kg of body weight of ketamine were used in the intervention group, while only 3-5 mg/kg of body weight Nesdonal was administered in the control group. Data were gathered using the Edinburgh Postnatal Depression Scale (EPDS) in three stages: before the caesarian section and two and four weeks after the caesarian section. Data were analyzed using variance analysis with repeated measures and the Chi-square test. Results of the present study showed that the mean (± standard deviation) of the depression score in the intervention and control groups were 13.78±3.87 and 13.79±4.78(p = 0.98) before the caesarian section, 11.82±3.41 and 14.34±4.29 (p < 0.001) two weeks after and 10.84±3.48 and 13.09±3.79 (p = 0.001) four weeks after the caesarian section, respectively. Using ketamine in the induction of general anesthesia could be effective in preventing postpartum depression. However, further studies are required to strengthen these findings.

The effect of aromatherapy with lavender essential oil on the working memory of women with multiple sclerosis.

Working memory, one of the cognitive components, may be impaired in patients with multiple sclerosis. Accordingly, this study aims to determine the effects of aromatherapy with lavender essential oil on the working memory of women with multiple sclerosis (MS). In this clinical trial, 60 women with multiple sclerosis were selected using the sampling method from patients referred to the MS Clinic of Rafsanjan. Based on the inclusion and exclusion criteria, the participants were randomly divided into intervention and placebo groups. In addition, the working memory test developed by Daneman and Carpenter was used to evaluate the participants' working memory before the intervention and the day after the last intervention. The collected data were analyzed using SPSS Statistics version 18.0. According to intragroup comparison results and based on the paired t-test, the mean score of the working memory before the intervention in the intervention group was 82.77±6.87, which increased to 87.64±5.57 after the intervention (P<0.001). The average working memory score of the placebo group was 80.30±11.09 and 82.09±11.31 before and after the intervention, respectively, which did not have a statistically significant difference (P=0.154). Based on findings from the independent t-test, the mean scores of working memory had a statistically significant difference between the intervention and placebo groups after the intervention (P=0.02). According to the results from this study, aromatherapy with lavender essential oil improved working memory in women with multiple sclerosis.

The outcomes of peer-led diabetes education in comparison to education delivered by health professionals in Iranian patients.

Education is an important aspect of care for diabetic patients. This study aimed to compare the effect of education by health care provider and peer on self-care behaviors among Iranian patients with diabetes. In this clinical randomized control trial, we enrolled 120 patients with type 2 diabetes who were referred to the Diabetes Clinic at a university medical center hospital in an urban area of Iran. Participants were randomly allocated into three groups. Patients in care provider group (CPG) received additional education provided by a nurse, other than routine education in a Diabetes Clinic. Patients in peer education group (PEG) received education given by a peer. Patients in control group (CG) received the routine education in accordance with the usual procedures at the Diabetes Clinic. Data collected at baseline and 12 weeks (3 months) were demographic variables and diabetes self-care activities. Self-care behaviors post intervention differed significantly by group; PEG patients demonstrated the greatest improvement. CG patients' self-care behaviors did not change significantly and were significantly lower than scores by CPG and PEG patients. In line with the World Health Organization recommendations, future studies are warranted to confirm the effectiveness of peer-led education among diabetic patients in the Iranian culture.

Usefulness of 360 degree evaluation in evaluating nursing students in Iran.

PURPOSE: This study aimed to evaluate the clinical nursing students using 360 degree evaluation. METHODS: In this descriptive cross-sectional study that conducted between September 2014 and February 2015, 28 students who were selected by census from those who were passing the last semester of the Nursing BSc program in Rafsanjan University of Medical Sciences. Data collection tools included demographic questionnaire and students' evaluation questionnaire, to evaluate "professional behavior" and "clinical skills" in pediatric ward. Every student got evaluated from clinical instructor, students, peers, clinical nurses, and children's mothers' point of view. Data analysis was done with descriptive and analytic statistics test including Pearson coefficient using SPSS version 18.0. RESULTS: The evaluation mean scores were as following: students, 89.74±6.17; peers, 94.12±6.87; children's mothers, 92.87±6.21; clinical instructor, 84.01±8.81; and the nurses, 94.87±6.35. The results showed a significant correlation between evaluation scores of peers, clinical instructor and self-evaluation (Pearson coefficient, p<0.001), but the correlation between the nurses' evaluation score and that of the clinical instructor was not significant (Pearson coefficient, p=0.052). CONCLUSION: 360 Degree evaluation can provide additional useful information on student performance and evaluation of different perspectives of care. The use of this method is recommended for clinical evaluation of nursing students.

Positive changes after breast cancer: A qualitative study.

INTRODUCTION: Traumatic events such as breast cancer along with negative effects on patients also have positive effects. These cases have been studied less in Iran. Therefore, this study was conducted with the aim of explanation of positive changes after breast cancer by using a qualitative approach. MATERIALS AND METHODS: This qualitative study was conducted in 2012 in one of the specialized centers for cancer affiliated to Isfahan University of Medical Sciences. In this study, it was interviewed with 19 women with breast cancer about positive changes after cancer by using individual, open and deep methods. The interviews were analyzed with conventional content analysis method. RESULTS: The titles of the three major categories were included as behavioral changes to maintain and promote health (acquisition of health information and adopting promoting health behaviors), spiritual development (attention to the God and sense of meaning in life, revising the values and priorities, strengthening moral and behavioral traits) and personal growth and flourish (feeling empowerment, confidence and efforts to achieve the goals and desires). These three categories have led to emerge themes in this study as the "Awakening after cancer." CONCLUSIONS: The results of this study indicated positive changes after breast cancer. Considering such changes while providing care and consulting to patients with breast cancer in addition to facilitate and accelerate positive changes will be prompted to provide care and proper and influential consulting to promote patient health.

Empowerment needs of women with breast cancer: a qualitative study.

BACKGROUND: Due to the increasing number of women suffering from breast cancer worldwide, promoting the empowerment of these patients is an important factor affecting their survival. OBJECTIVES: Few studies have investigated the empowerment needs of the breast cancer women, especially in Iran. Therefore, this study was performed to explain the empowerment needs of women with breast cancer in Iran. PATIENTS AND METHODS: In this qualitative study, 19 women with breast cancer were interviewed regarding their empowerment needs using the individual open-ended and, in-depth interviews and then the qualitative data were analyzed through content analysis. RESULTS: Three main categories of empowerment needs from the participants' perspectives were as follows: 1- information: the initial empowerment plans (timely and comprehensive information, coordination and continuity of information, easy and full-time access to information), 2- beliefs: the approval of the empowerment plans for execution (actuality, trust and hope and new beliefs), and 3- skills: efficient execution of the empowerment plans (communication skills, expression the needs, emotions, questions and use of the internet). CONCLUSIONS: It seems that promoting the empowerment of women with breast cancer is essential. Factors found in this study and also in similar studies, in which empowerment needs are explained in-depth through the experiences of the patients, should be considered and used in the treatment, educational and counseling programs to promote the empowerment of women with breast cancer.