Genital self-image and sexual function in Iranian women from pregnancy to postpartum: a cohort study.

BACKGROUND: Genital self-image is among the factors affecting women's sexual function. AIM: The present study aimed to determine changes in the genital self-image and its relationship with women's sexual function in the third trimester of pregnancy and postpartum. METHODS: The participants of this prospective cohort study included 301 eligible pregnant women chosen through stratified random sampling with proportional allocation from comprehensive health centers in Gorgan, Iran. The Persian version of the 7-item Female Genital Self-Image Scale, the 6-item Female Sexual Function Index, and Depression Anxiety and Stress Scale 21 were filled in a self-report manner on 2 occasions: (1) 30 to 37 weeks of pregnancy and (2) 12 to 16 weeks (± 2 weeks) postpartum. Finally, the data were analyzed using SPSS 24 software. OUTCOMES: Outcomes included Female Genital Self-Image Scale and Female Sexual Function Index changes from pregnancy to postpartum according to the childbirth mode. RESULTS: The mean age of participants was 29.66 ± 5.27 years. These values for the genital self-image scores of women during pregnancy (19.18 ± 3.25) and postpartum (19.43 ± 3.57) were not significantly different (P = .30). Also, this difference was not statistically significant regarding the mode of delivery in 2 groups of women with vaginal birth (P = .62) and cesarean section (P = .14). The mean Female Sexual Function Index scores during pregnancy (15.15 ± 6.73) and postpartum (17.52 ± 6.46) were significantly different (P = .001). In addition, this difference was significant in women with vaginal birth (P = .004) and cesarean section (P = .001). CLINICAL IMPLICATIONS: Clinicians should inform women/couples about changes in female sexual function and address genital self-image as a factor involved in female sexual function during pregnancy and postpartum.Strengths and Limitations: Because the participants of this study were women in the third trimester of pregnancy, the obtained results may not be generalized to pregnant women in the first and second trimesters of pregnancy or even to different postpartum periods (ie, midterm and long term). CONCLUSION: The results showed that the female genital self-image is not significantly different during pregnancy and postpartum, or with the mode of delivery. However, the female sexual function score in postpartum is higher than in pregnancy, regardless of the mode of delivery.

Comparing the self-awareness and problem-solving skills training on sexual desire of newly married women: A field trial study.

BACKGROUND: Sexual desire of women is one of the most important factors affecting marital and sexual satisfaction. Regarding the association of life skills level with sexual dissatisfaction and sexual desire, the present study aims to compare the effect of self-awareness and problem-solving skills training on the sexual desire of newly married women. MATERIALS AND METHODS: This was an experimental field trial study conducted since October 2019 to September 2020. The participants included 105 married women with a history of up to 5 years of cohabitation assigned randomly to either of the two intervention or control groups. The data collection tools include a demographic form, Hulbert index of sexual desire (HISD), and ENRICH couple scale that were completed by the participants before (T1), immediately (T2), and one month after the intervention (T3). The first intervention group received self-awareness skills training, whereas the second one received problem-solving skills training (four sessions of 90 min) weekly. On the other hand, the control group received no training. Statistical analyses were performed using SPSS 16 software and descriptive-analytical statistical tests including one-way ANOVA, Kruskal-Wallis, Bonferroni test, tests of within-subjects effects, and analysis test with repeated measures. P value < 0.05 was considered significant. RESULTS: The effect of time (statistic test: 51.24, P-value < 0.001) and the interaction effects of Time and Group on sexual desire (statistic test: 2.87, P-value: 0.03) were statistically significant. The mean score of sexual desire both in interventions and control groups showed statistically significant improvement. The mean score of sexual desire in the self-awareness group was 44.31 ± 9.08 (T1), 51.34 ± 10.92 (T2), and 59.48 ± 13.76 (T3) (P < 0.001); in the problem-solving group was 48.74 ± 10.21 (T1), 52.08 ± 10.59 (T2), and 57.40 ± 12.40 (T3) (P < 0.001); and in the control group was 47.74 ± 11.60 (T1), 50.08 ± 10.04 (T2), and 54.94 ± 12.15 (T3) (P = 0.02). CONCLUSION: The present study showed the effectiveness of both self-awareness and problem-solving skills training on newly married women's sexual desire. Moreover, this study showed simply participating in a study related to sexual desire as a control group could be effective on women's sexual desire.

Preferred mode of delivery association with the body image and genital image in pregnant women - a cross-sectional study.

BACKGROUND: Pregnant women experience several changes in their appearance, body shape and body image. In some studies, there has been a relationship between these changes and the type of delivery. This study aimed to investigate the relationship of the prenatal body image and genital image with the mode of delivery preferred by pregnant women in Gorgan in 2020. METHODS: In this cross-sectional study, 334 pregnant women were selected by stratified sampling. The Prenatal Body Image Questionnaire (PBIQ), Female Genital Self-Image Scale (FGSIS), pregnant women's preferences for mode of delivery questionnaire (PPMDQ) and DASS-21 were completed on line. The data was analyzed using Spearman test and linear regression. RESULTS: The average score of PBIQ, FGSIS, and PPMDQ was 68.24 (standard deviation = 17.71), 19.25 (standard deviation = 3.3), and 63.12 (standard deviation = 3.3) respectively. Vaginal delivery as a preferred mode of delivery was inversely correlated with dissatisfaction with body image (r=-0.32, P < 0.001), and directly correlated with satisfaction with the genital image (r = 0.19, P < 0.001). There was a significant inverse correlation between prenatal body image dissatisfaction and genital image satisfaction (r=-0.32, P < 0.001). While FGSIS score could not predict PPMDQ, PBIQ score could. CONCLUSIONS: Satisfaction with the prenatal body image or genital image is associated with the choice of vaginal delivery. These results can be the basis for prenatal care and childbirth counselling.

The Comparison of the Effects of Training Self-awareness and Problem-solving Skills on Marital Satisfaction of Married Women: A Randomized Controlled Trial.

Background: One of the most important causes of marital dissatisfaction is the lack of life skills. This study aimed to compare the effects of training self-awareness and problem-solving skills on marital satisfaction of married women. Methods: This study was a randomized field trial conducted in Gorgan since October 2019 to September 2020. A total of 105 married women were allocated to one of two interventions or a control group based on triplex block randomization. Data collection tools were the Persian version of the self-awareness questionnaire, problem-solving questionnaire and Four ENRICH Couple Scales. The participants completed the questionnaires before (T1), immediately (T2), and one month after the intervention completion (T3). The first intervention group received self-awareness skills training and the second received problem-solving skills training one session per week for four weeks. The control group did not receive any training. Data were analyzed using One-way ANOVA, Kruskal-Wallis, Chi-square, Fishers exact test, exact test, repeated measure ANOVA, and Bonferroni test, using SPSS 16. A P value <0.05 was considered significant. Results: The mean score of ENRICH Scales in the three groups, immediately and one month after the intervention, were not statistically significant (P>0.05). However, in the problem-solving group, the scale of marital satisfaction was significantly different at T2 and T3 (31.40±4.55, 33±5.21, P=0.008). In the self-awareness training group at T1 and T3, the mean of the conflict resolution scale (32.60±63.28, 33.94±5.74, P=0.03) was significantly different. Conclusion: The results showed that problem-solving skills training was more effective in increasing the score of marital satisfaction compared to self-awareness skills training.Trial Registration Number: IRCT20190721044290N1.

Recurrent viral RNA positivity and candidiasis findings in hospitalized patients with COVID-19.

Background: The aim of this study was to evaluate reinfection and fungal infections among 785 patients with COVID-19 disease admitted to Baqiyatallah Hospital in Northeastern Iran after the onset of the COVID-19 epidemic. Materials & Methods: In this descriptive-analytic study (20 February-21 July 2020), reinfection and fungal infections among 785 patients were investigated using epidemiological questionnaire, clinical trials, Real-time PCR and CT scan (chest computed tomography) from the hospital HIS (hospital's information system) and collected samples. Results: Reinfection and one oral candidiasis were diagnosed in one 68-year-old man and one 47-year-old man 63 and 42 days after the initial infection, respectively. Conclusion: The research results showed that exposure to COVID-19 may not establish long-term protective immunity to all patients.

Diagnostic Significance of Serum Fatty Acid Synthase in Patients with Pancreatic Cancer.

BACKGROUND Pancreatic cancer is considered as the most deadly tumor among gastrointestinal cancers because of its poor prognosis. The frequently deregulated pathway in the cancer cell is associated with an increased expression of various genes, including the synthesis of fatty acids. We aimed to evaluate the level of serum fatty acid synthase (FASN) as a diagnostic marker for early diagnosis of pancreatic cancer. METHODS Serum FASN levels were measured by ELISA in 92 patients with pancreatic adenocarcinomas and in 92 healthy controls. Logistic regression analysis was used to identify independent predictors of certain diagnostic categories. RESULTS Serum FASN levels were significantly higher in patients with pancreatic cancer than in healthy controls (1.35 [0.98-2.3] ng/mL vs 1.04 [0.19-1.34] ng/mL, p < 0.001) and in smokers compared to non-smokers (1.41 [0.79-2.52] ng/mL vs 1.07 [0.21-1.74] ng/mL, p < 0.001). FASN levels and smoking were associated with increased risk of PC (1.54 [1.1- 2.14] ng/mL, p = 0.011 and 5.69 [2.68-12.09] ng/mL, p < 0.001, respectively). CONCLUSION Elevated serum FASN levels in patients with pancreatic cancer indicate the need for the production of large numbers of lipids for the survival and proliferation of human cancer cells and the diagnostic value of FASN as a new diagnostic biomarker.

Efficacy and safety of rituximab therapy in patients with systemic sclerosis disease (SSc): systematic review and meta-analysis.

The clinical benefits of rituximab in systemic sclerosis (SSc) are still contentious. The present meta-analysis aimed to systematically assess rituximab's safety and efficacy profile in SSc patients. A systematic online query was performed in PubMed, Scopus, Web of Science, and Embase. The studies on the application of rituximab for patients with SSc were reviewed comprehensively for over two years. In terms of efficacy profile, mRSS, MS, LVEF, sPAP, FVC, DLCO, TLC, FEV, DAS, severity activity, HAQ-DI and SF36 were assessed for organ involvement and quality of life. The level of biological and immunological markers was also evaluated in SSc patients treated with RTX. In total, 24 studies met the criteria. Although they did not have a high quality, they were free from heterogeneity and publication bias. The pooled results revealed a long-term improvement in mRSS and MS. HAQ-DI was improved to 0.78 after 12 months, and DAS was significantly reduced to 0.33, 0.23, and 0.24 following 6, 12, and 24 months of treatment, respectively (p = 0.00 for both parameters). The rest of the parameters remained stable over time in patients with SSc. The pooled analysis of these patients demonstrated that the induction of death, cancer, infection, and infusion were 9, 5, 18 and 10%, respectively. Based on the pooled results of this meta-analysis, rituximab improves skin score and disease indices and stabilizes organ involvement in SSc patients. Rituximab seems to possess reasonable safety, similar to previous data from other autoimmune diseases.

Antifungal Activity of ZnO Nanoparticles and Nystatin and Downregulation of SAP1-3 Genes Expression in Fluconazole-Resistant Candida albicans Isolates from Vulvovaginal Candidiasis.

PURPOSE: Antifungal resistance and virulence properties of Candida albicans (C. albicans) are growing health problems worldwide. The present study aims to investigate the effect of Zinc Oxide (ZnO) nanoparticles and Nystatin on SAP1-3 genes expression in C. albicans isolates of females with Vulvovaginal Candidiasis (VVC) isolated from Sayad Shirazi Obstetrics and Gynecology Hospital in Northeastern Iran during 2017-2018. PATIENTS AND METHODS: In this descriptive-analytic study, vaginal samples were collected from 280 VVC women. 196 (70%) of C. albicans isolates were identified by phenotypic and ITS genotypic methods. Susceptibility to Fluconazole C. albicans isolates was determined by the disk diffusion method. Detection of ERG11 gene was done by RT-PCR technique. RESULTS: It was revealed that PCR amplified the ERG11 gene in all of the Fluconazole-resistant isolates. Real-time PCR was used to survey the effects of 3±1.7µg/mL concentrations of ZnO nanoparticles and Nystatin on expression of SAP1-3 genes before and after treatment. 186 (95%) susceptible C. albicans and 10 (5%) Fluconazole-resistant C. albicans isolates from VVC were exposed to sub-minimum inhibitory concentrations (Sub-MIC) of ZnO-np (range=0.02-12 µg/mL). Sub-MIC concentration was used for each strain, which reduced the expression of SAP1-3 genes to 1.8 MIC in the vaginal swabs. The observed reduction in gene expression was significant for both ZnO nanoparticles and Nystatin (P=0.01 and P=0.07, respectively). CONCLUSION: ZnO as antifungal agent can well reduce the growth and gene expression of SAP1-3 in the pathogenesis of VVC.

Pulmonary Function Testing in Cement Transport Workers at Incheh Borun Border, Northeast of Iran.

BACKGROUND: The aim of this study was to evaluate respiratory problems via pulmonary function testing in cement transport workers at Incheh Borun border in northeast of Iran in 2016. METHODS: The study was conducted on 358 male workers. All subjects were evaluated for respiratory symptoms via pulmonary function testing and completion of the American Thoracic Society questionnaire. RESULTS: Mean age of workers was 34.8±12.87 yr (age range 16-79 yr). Mean duration of employment was 6.1±4.36 yr. Most workers (75.4%) were illiterate or had elementary education. In addition, 56 (15.6%) subjects were smokers. Only three individuals (0.3%) had obstructive pattern. There was a significant relationship between age of workers and frequency of respiratory problems (P<0.05). CONCLUSION: It is necessary to educate the workers about the health and safety regulations and use of personal protective equipment in workplace. In addition, periodic evaluation of respiratory function could help protect workers from developing occupational diseases.

The epidemiology of cutaneous leishmaniasis in Golestan Province, Iran: A cross-sectional study of 8-years.

BACKGROUND: Leishmaniasis occurs with an incidence of 0.5-1.5 million new cases annually, and is also endemic in 88 countries across the world. AIM: Presently, we aimed to investigate the status of Cutaneous Leishmaniasis (CL) in Golestan Province in North of Iran. METHODS: A retrospective survey was conducted on existed data of 6873 patients with CL who attended to Health Centers in Golestan Province during 2010 to 2017 years. Data were collected using patient sheets and online registry form of CL. Descriptive statistical methods such as mean and standard deviation, and Chi-square test were employed to report and analyze results. p-Value <0.05 was considered significant. RESULTS: CL cases were more common in men 3885 (56.7%) than women 2965 (43.3%) (p = 0.001). The most and least cases was reported in 2017 and 2104 as 18 and 3 CL cases, accordingly. CL was mainly happen in the November (3816 cases), December (2832 cases) months. Presently, CL gradually increases in the last three years from 2014 to 2017 years. CONCLUSION: Decrease of exposurement, improve the nutrition and child's immunity can be more beneficial.

Comparison Effect of Tranexamic Acid (TA) and Tranexamic Acid Combined with Vitamin C (TXC) on Drainage Volume and Atrial Fibrillation Arrhythmia in Patients Undergoing Cardiac Bypass Surgery: Randomized Clinical Trial.

BACKGROUND: Tranexamic acid and vitamin C are potent antifibrinolytic and oxidative stress agents that reduce blood loss and transfusion blood in cardiopulmonary bypass (CPB). OBJECTIVES: The aim of this study was to evaluate the efficacy of tranexamic acid (TA) and tranexamic acid combined with vitamin C (TXC) on drainage volume (blood loss) and atrial fibrillation (AF) in patients undergoing cardiac bypass surgery in Gorgan, Shafa hospital, Iran. METHODS: This study is a double-blind randomized clinical trial. A sample size of 120 candidates of cardiac bypass surgery were included in this prospective study. Patients were randomly assigned to treatments in two groups. In both groups, 50 mg/kg tranexamic acid was administered intravenously directly before sternotomy: group A (N = 58) patients received tranexamic acid (TA) only and group B (N = 62) tranexamic acid with vitamin C (TXC) half an hour before surgery and 2 g vitamin C with 100 mL 0.9% saline were injected. Subsequently, during 4 days after surgery, 1000 mg of vitamin C and 100 cc 0.9% saline was infused every day. Intraoperative and postoperative blood loss (volume of blood in the drain) and atrial fibrillation complications were recorded for 24 hours after the operation. RESULTS: The patients who received vitamin C had less bleeding during operation and in the early hours post-operation. Patients in (TA) group had mean drainage of 34.41 milliliter more than patients in (TXC) group (P < 0.001). Chi-square test showed that arrhythmia (AF) condition was the same in the two groups during 14 times of study (four times during operation and ten times up to 24 hours after the operation), and AF arrhythmia in the two groups was less than 5%. CONCLUSIONS: In this study tranexamic acid with vitamin C have a positive effect on the amount of drainage (blood loss) and there was no significant difference in the incidence of AF between two groups.

Comparison of the Effect of Dexamethasone and Tranexamic Acid, Separately or in Combination on Post-Rhinoplasty Edema and Ecchymosis.

BACKGROUND: Dexamethasone and tranexamic acid are used to decrease post-rhinoplasty periorbital edema and ecchymosis. We compared the impact of each medication separately or in combination in this regard. METHODS: A prospective, randomized triple-blinded study was undertaken on 60 patients who underwent primary open rhinoplasty. They were divided into four groups: Group D (n = 15) received 8 mg dexamethasone, group T (n = 15) received 10 mg/kg tranexamic acid, group DT (n = 15) received both 8 mg dexamethasone and 10 mg/kg tranexamic acid, and group P (n = 15) received neither medication and served as the placebo control group. The medications were given intravenously (IV) 1 h before and three doses every 8 h postoperatively. Digital photographs were taken on the first, third and seventh postoperative days. One expert examiner blinded to the study evaluated the periorbital edema and ecchymosis on a scale of 0-4. Periorbital edema and ecchymosis were examined in all groups. RESULTS: In group D, group T and group DT, periorbital edema and ecchymosis ratings were significantly lower compared with the control group (p < 0.01). No statistically significant difference was seen in preventing or decreasing both periorbital edema and ecchymosis among group D, group T and group DT. CONCLUSION: Tranexamic acid and dexamethasone, separately or in combination, had similar effects in reducing periorbital edema and ecchymosis in open rhinoplasty. Combined application did not show a significantly higher beneficial effect in this regard. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .