Paternal postnatal depression: prevalence and the associated demographic and maternal reproductive factors among Iranian fathers.

BACKGROUND: Paternal postnatal depression (PPND) is a critical mental health issue that may harm family members' health and relationships. The Edinburgh Postpartum Depression Scale (EPDS) is the most common self-reported questionnaire for postnatal depression screening among mothers and fathers worldwide. However, identifying fathers with postnatal depression and determining the related factors have been neglected in some countries. AIMS: The present study aimed to determine the prevalence of PPND and then to identify its predictive demographic and reproductive factors. Two cut-off points (10 and 12) for the EPDS were used to detect PPND. METHODS: This cross-sectional study was conducted on 400 eligible fathers selected via multistage sampling. Data were collected using a demographic checklist and the EPDS. RESULTS: None of the participants had previously been screened for PPND. The mean age of the participants was 35.53 ± 5.47 years, and most of them were self-employed and had university degrees. The prevalence of PPND was 24.5% and 16.3% using the EPDS cut-off scores 10 and 12, respectively. An unwanted pregnancy and an abortion history were the predictors of PPND at both EPDS cut-off scores, with gravidity and the number of abortions also being associated with PPND at the cut-off score of 10. CONCLUSION: In line with the related literature, our results revealed a fairly high prevalence of PPND and its related factors. This indicates the need for a screening program for fathers during the postnatal period to detect and adequately manage PPND and prevent its adverse effects.

The relationship between sex steroids (E2, progesterone, and AMH) levels and severity and fatality of COVID-19: A systematic review.

Sex steroids are powerful modulators of the immune system and they may affect the immune response and inflammatory consequences of COVID-19. This systematic review aims to explore the impact of sex steroids on COVID-19 mortality and complications. We looked up the keywords of the study in Scopus, PubMed, and Web of Science. All related original articles published in English, as of October 16, 2021, were reviewed to be included in our research. Concerns regarding the effect of sex hormones on COVID-19, eight full texts have been identified for the conclusion. In these studies, the relationship between estradiol and COVID-19 mortality has been mentioned. The most significant findings were the higher COVID-19 mortality rate in men, compared to women; also, in menopausal women compared to younger women and who received estradiol. In two studies, oral contraceptive pills had a protective effect on the morbidity of SARS-CoV-2 infection. In a randomized controlled trial, subcutaneous injection of progesterone in hospitalized men significantly reduced their symptoms and need for oxygen therapy. Hormone replacement therapy was positively associated with reducing COVID-19 symptoms. Although the results were insufficient for a conclusion, this study represents estrogen as an appropriate pharmacological method for preventing and diminishing the inflammation related to COVID-19 disease. However, future prospective studies and clinical trials are needed to clarify and approve this protective effect.

Comparison between the Efficacy of Nigella sativa-Honey and Clotrimazole on Vulvovaginal Candidiasis: A Randomized Clinical Trial.

Materials and Methods: This triple-blind, randomized controlled trial was conducted on eighty-four 18 to 49-year-old nonpregnant women from August 2019 to February 2020. The subjects were randomly divided into two groups after confirming the diagnosis of VVC infection through fungal culture. Clinical signs and symptoms and lab tests were recorded at baseline and 6-10 days after treatment. The treatment time for each group was seven nights. Results: There were no significant differences in clinical and laboratory evaluations between the two groups at the beginning of the study (P > 0.05). After treatment, secretion, redness, itching, and fungal culture improved in the two groups (P < 0.001), while pruritus (p = 0.013) and secretion (p = 0.025) in the control group significantly improved. In this trial, no patients showed drug-specific side effects. Conclusion: The results of this study show that the N. sativa-honey significantly improves the symptoms of VVC; thus, the application of N. sativa-honey can be considered as a complementary therapy in the treatment of VVC. This trial is registered with IRCT20190711044176N1.

Knowledge and performance of the Iranian general population in the use of masks during the 2019 coronavirus.

BACKGROUND: The use of personal protective equipment (especially face masks) has increased in different communities amid the COVID-19 pandemic. Therefore, the present study aimed to assess knowledge and performance of Iranian general population in wearing face masks. MATERIALS AND METHODS: The present study is a cross-sectional study conducted using a valid and reliable questionnaire on 1843 eligible individuals. The questionnaires were shared by Link (www.porsall.com) in groups and social networks. Data were analyzed using SPSS (Version 24.0, SPSS Inc., Chicago, IL). RESULTS: The mean age of the participants was 42.84 years (standard deviation: 16.84). The majority had inadequate and low knowledge of masks (69.2%), nearly 30% had moderate (30.1%), and few had adequate and high knowledge of masks. The individuals' knowledge on when to wear a mask was also assessed and the results showed poor and low in 42.2%, 46.9% moderate and high performance in 10.7%. The participants' performance on how to properly wear a mask was also assessed and 12% showed poor, 69.3% showed moderate, and 18.7% showed high performance. Safe removal of masks was also assessed, and the results showed 52% low and poor, 27.6% moderate, and 20.3% high performance. A significant and direct correlation was found between the overall score knowledge and performance regarding use of masks (P < 0.001). CONCLUSION: The results showed poor to moderate knowledge and performance of majority of Iranian general population regarding the masks. Therefore, further effective training courses and action plans are needed in Iran given the importance of masks for the prevention of COVID-19, especially in public places. Educational package about how to use the mask and its benefits, through the media and health centers is recommended.

Relationship between paternal postnatal depression and its predictors factors among Iranian fathers

ABSTRACT Background: Paternal postnatal depression (PPND) is widely overlooked despite being the most common mental health disorder among fathers in the postpartum period, and it affects all aspects of family life, particularly the relationship with the spouse and children. Objective: To determine the predictor factors of PPND. Methods: A descriptive-analytical study was performed on 400 fathers of children aged six weeks to one-year referring to the healthcare centers. Data were collected using a demographic characteristics form and the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed using SPSS software version 22. Results: The mean EPDS score was 6/54± 4.3, the mean age of the studied fathers was 35 ± 5.4, and 57.7% had experienced more than one pregnancy with their spouses. There was a significant relationship (P>0.05) between the education level and the EPDS score. According to linear regression, the most influential factors on EPDS score included satisfaction with life and general health, as well as an unwanted pregnancy amongst maternal fertility characteristics. Conclusion: Determining the predictor/related factors with paternal postnatal depression helped us to identify at-risk fathers promptly, to manage earlier, and to prevent the adverse effects of PPND on family health and relationship.

'Does HPV affect my fertility?' Reproductive concerns of HPV-positive women: a qualitative study.

BACKGROUND: Reproductive health changes can occur following infection with Human papillomavirus. HPV is the most prevalent sexually transmitted infection causing a variety of clinical manifestations ranging from warts to cancer. This study aimed to explore the reproductive concerns of women infected with HPV. METHODS: In this qualitative study, we used the conventional content analysis approach, with the aid of MAXQDA.10 software, to analyze data extracted from the face-to-face semi-structured interviews with 20 Iranian HPV-positive women (sampled by maximum variation purposive sampling). The accuracy of this research was ensured according to the four criteria proposed by Guba and Lincoln. RESULTS: Exploring participants' reproductive concerns, three main categories were identified from the interviews including concerns about fertility potential, pregnancy and non-pregnancy reproductive issues. HPV-positive women concerned about reduced female/ male fertility due to HPV, the impact of the HPV on the fetal health, adverse pregnancy outcomes such as miscarriage and preterm delivery, and mother-to-child transmission of HPV during breastfeeding. HPV-positive women with abnormal cytology results were anxious that becoming pregnant or taking hormonal contraception might worsen their abnormalities. Most married women were reluctant to use a condom. Participants requested further information about the potential reproductive risks of the HPV vaccine. They also wanted to know about the safety of HPV vaccine during pregnancy and breastfeeding. CONCLUSIONS: HPV-positive women had some reproductive concerns that should be considered in the designing of educational-consulting interventions. Women need to be better understood and informed about the impact of HPV on their reproductive health. Health care providers may lack knowledge about these specific areas, and they could benefit from additional up-to-date information to address women's reproductive concerns.

Iranian women's psychological responses to positive HPV test result: a qualitative study.

BACKGROUND: Human papillomavirus testing as an established screenings test allow for the early detection and treatment of cervical cancer. Testing positive for HPV may have adverse consequences for women. This study aimed to explore the psychological impacts of testing positive for HPV on women in a developing country with a distinct cultural and religious background. METHODS: Qualitative face-to-face semi-structured interviews were conducted with 40 Iranian women who received a positive high-risk HPV result. Content analysis approach was used to data analysis through MAXQDA10. RESULTS: Three main categories were emerged: initial confrontation; STD-related psychological burden; and rebuilding health. Initial reactions to positive HPV results were shock, unrealistic fear, confusion, distress, and financial concerns. Stigma was manifested in form of self-blame, fear of HPV-disclosure, negative body image, being stigmatized by healthcare providers, and receiving health care anonymously. Refusal to use insurance services showed how evident and powerful the stigma was. Most women reported lifestyles and sexual behaviors modifications to help their immune system to clear HPV; indicating that the screening can work as a valuable opportunity to improve women's physical and sexual health. Regular follow-up, safe sex and a focus on spirituality enable women infected with HPV to take control of the situation. Worrying about other HPV-linked cancers (oropharynx and anal) and fears of partner infection indicated that women consider HPV to be more than just a cause of cervical cancer. CONCLUSIONS: The findings implied to the HPV-positive women's need to support and factual information. Designing and implementing interventions that mitigate the psychological effect of positive HPV test results can highlight the potential benefits of screening for women's health.

Understanding HPV-positive women's needs and experiences in relation to patient-provider communication issues: a qualitative study.

BACKGROUND: HPV testing has been integrated in cervical cancer screening program. Patient-providers relationship is extremely important to improve cervical cancer screening outcomes. This qualitative study aims to understand HPV-positive women's needs and preferences about HCPs and patient-provider communication based on their experiences of accessing primary and specialized care. METHODS: We conducted 40 semi-structured interviews with HPV-positive women. Recorded interviews transcribed and analyzed using conventional content analysis approach. RESULTS: The analysis of the data led to the extraction of three main categories, including: provider's communication and counseling skills, commitment to professional principles, and knowledgeable and competent provider. Women needed understandable discussion about HPV, emotional support and acceptance, receiving HPV-related guidance and advice, and some considerations during clinical appointments. Women needed HCPs to treat them respectfully, gently and with non-judgmental attitude. "Precancerous" and "high-risk" words and watching colposcopy monitor during procedure had made women anxious. Weak referral system and limited interactions among gynecologists and other HCPs highlighted by participants. CONCLUSION: The results of this study, based on the experiences and perceptions of HPV women receiving health care, contain messages and practical tips to healthcare providers at the primary and specialized levels of care to facilitate patient-provider communication around HPV. Providers need to approach the discussion of HPV with sensitivity and take individual needs and preferences into account to improve the HPV-positive women's healthcare experience.

Effect of counseling on sexual function and behavior in postmenopausal women and their spouses: a randomized, controlled trial (RCT) study.

Sexual dysfunction is present the most important problem among menopausal women and thus counseling may have a major role for improving menopausal sexual state in this population. We aimed to assess effects of counseling on sexual function of menopause women and their spouses. An interventional trial study was performed on 120 consecutive Iranian couples (menopause women and their spouses) who were resident in Hamadan, Iran in 2015. The subjects were randomly assigned to receive counseling service (n = 60) or did not receive this service (n = 60). Couples were asked to complete a standardized validated questionnaire assessing sexual function and behaviors. The frequency of sexual intercourse was considerably increased following first and second counseling sessions compared with the time before counseling in former group, while sexually state was remained unchanged in those who not received these counseling. Furthermore, dyspareunia in interventional women with counseling was significantly reduced after the first and second counseling, whereas this complaint was not significantly removed in the control group within the study period. Also, unsuccessful intercourse was significantly decreased in men who received counseling sessions, while this parameter was remained unchanged in other men. In addition, talking with the partner about sexually and Satisfaction degree of wife's love was significantly improved in both men and women in interventional groups compared with the control groups. Active and structured counseling effectively improve sexual functions and behaviors in menopausal women and their spouses.